Journal of the Faculty of Medicine Baghdad

Background:
Inflammation has been shown to play a role in atherosclerosis and acute coronary
syndromes. An elevated total WBC count has been associated with increased cardiovascular
risk, but which leukocyte subtypes carry this risk. is uncertain. This study was designed to
determine the effect of WBC count and other inflammatory markers on severity and
outcome of patients with UA/NSTEMI.
Patients and Methods:
Seventy (70) patients with UA / NSTEMI admitted to CCU at the Iraqi Center for Heart
Diseases were subjected to thorough history and physical examination and WBC indices to
find their relation to clinical severity and outcome for both in-hospital and/month after
discharge. The results were compared with other thirty (30) patients with chronic stable
angina and thirty (30) healthy persons as two control groups.
Fac Med Baghdad
2007; Vol.49, No.4
Received Sept. 2006
Accepted Oct .2007
Results:
High total baseline total WBC was more prevalent in patient with UA/NSTEMI than in
those with stable angina and normal persons (94.1%, 5.9%. and 0%) respectively. High
baseline neutrophil was found only in those with UA./NSTEMI (100%, 0%, and 0%). High
baseline Neutrophil/lymphocyte (N/L ratio) and Positive CRP were more prevalent in
patients with UA/NSTEMI than in other two groups (92.3%. 7.7%. 0%) and (98.5%, 1 .5%.
0%) respectively.
Higher total baseline WBC count was significantly found in more severe Braunwald\'s
class of those with UA/NSTEMI 6.3%. 31.3%. and 50.5% for patients with class I, II, III
respectively. The same was true for baseline high neutrophil count (6.7%. 33.3% to 60%),
high Baseline N/L ratio (7.7%, 15%. and 21.6%).
Patient in the UA/NSTEMI group with higher baseline WBC count had higher risk for
death as compared to those of low and intermediate WBC count (0.00%. 0.00%. and
100.00%). The same was true for those with higher baseline neutrophil count (0.00%.
1.90%, 20.00%) and those with higher baseline N/L ratio (0.00%. 25.000%. 75.000%)
respectively.
Conclusions:
Total baseline WBC and differential count is simple, cheap and widely available
bedside test that predicted the severity of CAD and one month survival.

Background:
Acute leukemias are clonal neoplastic proliferations of immature cells of the
hemopoietic system. They are divided into acute myeloid leukemia (AML), acute
lymphoblastic leukemia (ALL) and acute undifferentiated leukemia (AUL). LDH has been
suggested as a possible non-specific tumor marker for many years, and total serum LDH is
frequently elevated in neoplastic diseases. The aims of the study are to evaluate the
significance of increased serum LDH levels in patients with acute leukemia and to
determine the importance of serum LDH level in the follow up and assessment of treatment
responses.
Patients, Materials and Methods:
This study was conducted at Baghdad Teaching Hospital in Medical City during the
period of October 2003 till October 2004. It included 108 patients with acute leukemias.
The patient groups were compared with 21 apparently healthy control subjects. All patients
had full medical history, complete physical examination, and routine investigations and
other specific investigations e.g. BM aspiration and biopsy. Serum lactate dehydrogenase
LDH level was estimated in all patients serially during diagnosis and after chemotherapy as
well as in control subjects.
Results:
Total serum LDH levels were significantly higher among patients with acute leukemias
compared to that of the controls. Comparing the three types of leukemic patients, no
significant difference was observed in total serum LDH levels between AML, ALL and
AUL patients. Regarding treatment, levels of total serum LDH were significantly decreased
in both remitter and non-remitter patients with acute leukemia with no significant difference
between them.
Conclusion:
Although total serum LDH is higher in all acute leukemic patients, it is hardly
discriminator between subsets of acute leukemia and is of little value in the prognosis and
prediction of treatment response and outcome.

Background and Objective:
There are many treatment modalities in managing complete rectal prolapse (CRP)
current study present simple technique of cauterization plication operation in the treatment
of complete rectal prolapse.
Methods:
The study include 30 patients present with CRP their mean age (74.3 ± 4.6), 19 females
and 11 males. With the patient under- general anesthesia in litliotomy position the
proolapsed rectum pulled outside the anal canal, the mucosa was cauterized, the muscle
layer was plicated by 2/0 dixon suture. Posterior levtorplasty were done in 10 adult patients
when it is indicated.
Results:
The postoperative follow up was 12-24 months. Six had postoperative mucosal
prolapse and two had recurrence 5 months after operation. Fecal impaction, stricture and
fistula formation were not encountered.
Conclusion:
The cauterization - plication operation is a simple and easy operation fix the treatment
of CKP. It gave satisfactory results with minimal complications.

Introduction:
Neonatal Respiratory distress syndrome (RDS) remains one of the major cause's neonatal
morbidity and mortality despite advances in perinatal care especially in developed
countries.
Objectives:
The aims of this study were to find out me risk factors of mothers and newborns (NB)
which increase the incidence, morbidity, and mortality of RDS.
Patients & Methods:
A prospective descriptive cross-sectional study was conducted on 100 live NR infants
born at neonatal care units in Baghdad hospital & private nursing home (medical city
complex) / Baghdad in the period from the first of March to the end of June 2006. They
were presented with RDS, which was diagnosed clinically and radio-graphically. The study
includes preterm and mil term N8 with all birth weights.
Results:
In tins study, there was an increase in the incidence of RDS in preterm NBs 3.5 times
more than in mil term, and 2.0 times more in small for gestational age (SGA) than in
appropriate for gestational age (AGA). It was found that the risk of death from RDS with air
leak was 11 times more than those without air leak, and from RDS with pneumonia 4.0
times more than those without pneumonia.
The risk of death among NB delivered by elective Caesarian section (C/S) was 2.4 times
more than those born by emergency C/S. and 5.1 times more in NB of diabetic mothers than
those without diabetes.
Conclusions:
We conclude that prematurity and SGA are risk factors for the development of RDS, and
air leak and pneumonia are most important complications that increase the risk of death
from RDS. So we recommend a proper and regular antenatal care and. management of high
risk pregnancies to avoid premature delivery and SGA, and proper respiratory care of NB to
decrease the complications of RDS especially air leak and pneumonia to decrease the risk of
death.

Objective:
To assess the subjective rating of quality of life of college students in
University Of Science And Technology in Jordan as a sample of healthy educated
young population through applying the WHOQOL-BREF instrument as a field trial
in Jordan and to compare the finding with similar previous study.
Methods
Three hundreds forms of Arabic version of the self-reporting questionnaire
WHOQOL-BREF were distributed to students of third class attending the lecture
halls in three colleges (college of Engineering, college of science, college of
medicine) in the university campus in AL Ramtha–Jordan from the first of March
to first of may 2007., with respect to university regulations,interested participants
were only included in the study.
Results
The rate of response was 100%, the majority of the sample were of single
healthy Jordanian nationals of comparable age and sex distribution. About 68.6
%of the students described their quality of life as good or very good while 3o%as
acceptable, or fair, the remaining 1.3% reported bad or very bad.
Fac Med Baghdad
2007; Vol.49, No.4
Received July 2006
Accepted Jun.2007
Regarding the mean scores distribution of the four domains there were no
significant statistical differences between the demographic variables and type of
academic discipline. This study findings showed a higher scoring than the previous
one done In Iraq.
Conclusion
The overall psychological profile of college students in Jordan assessed by the
WHOQOL-BREF is good manifested through their satisfaction with their life
quality ,no important association with given variables was found ,The study
revealed better reporting than the Iraqi study reflecting the cultural differences and
environmental effects.
The investigator recommends re application of the same instrument on other
population sample.

Background: Men with azoospermia require testicular and epididymal sperm
aspiration for intracytoplasmic sperm injection. Women over 37 years of age demonstrate
an increase number of immature oocytes after induction of ovulation.
The development of a technique for in vitro maturation (IVM) and fertilization (IVF) of
the oocytes using testicular, epididymal and vassal sperm (TS, ES, VS, respectively) will be
of therapeutic value for the treatment of azoospermic patients.
Objectives: The goal of the study was to develop an animal model for the treatment of
infertile couples with obstructive azoospermia and immature oocytes.
Materials and Methods: Canine ovaries and testes were collected from a local animal
clinic. Immature oocytes were retrieved from the ovaries and cultured in modified tissue
culture medium (MTCM). The mature oocytes were in vitro fertilized by TS, ES, and VS.
The normality of the fertilized oocytes was studied.
Results: Sperm motility index was significantly higher (P<0.01) in sperm retrieved
from the vas deference compared to ES and TS. The concentration of the sperm was
significantly higher (P<0.05) in the testes compared to epididymis and vas deference while
VS and ES normal morphology were significantly (p<0.01) better than TS. Viable oocyte
percentage was significantly higher (P Significant higher IVF was reported in VS compared to other groups (P < 0.05) and the SPI
was significantly higher after 96 versus 72 hours duration (P Conclusion: IVM of the oocytes in MTCM for 72 and 96 h resulted in a significant
increase in IVM rate compared to 48,120, and 144 h durations. In vitro viable mature
oocytes showed higher IVF rates when fertilized with VS compared to ES and TS. The
results showed that canine oocytes are good model for azoospermic patients.

Background and Objectives:
Poisoning is an important cause of childhood and adolescence hospital emergency
presentations and admissions and a major health problem in this population sector. The
present study was designed to describe the epidemiology and pattern of poisoning in
addition to its case fatality rate.
Methods:
A total of 1450 pediatric cases with poisoning admitted to the Central Teaching
Hospital of Pediatrics, Baghdad, during the 10 years study period extending from the 1st of
January 1993 to 31st of December 2002, were analyzed.
Results:
The peak age for poisoning cases in the present study was 1-4 years, constituting about
three quarters of total pediatric admissions with poisoning. Males were more frequent than
females in the present work, and this gender bias was more evident in younger ages and less
evident in teenagers. Non-medicinal substances were responsible for the major part (three-
quarters) of poisoning cases, especially petroleum products and pesticides. The overall case-
fatality rate was 2.6%. The risk of death was higher in the more vulnerable age groups
(infants and neonates). It was also higher in males and in cases with poisoning by other
noxious substances eaten as food, followed by metals (mainly lead), systemic antibiotics
and pesticides. However out of a total of 37 deaths attributed to poisoning that occurred
during the present study period of 10 years, non-medicinal substances (especially petroleum
products, pesticides and metals) were responsible for three-quarters of these deaths.
Conclusion:
Children under 5 years of age are the most-vulnerable group for poisoning incidents. In
addition Petroleum products, insecticides and lead metal were responsible for the highest
proportion of poisoning admission and fatality necessitating special steps directed towards
the prevention of these problems.

Background:
Bronchiolitis is the first episode of wheezing associated with low-grade fever, rhinitis,
tachypnea, and increase respiratory effort in a previously healthy infant during the winter
months. It is the most common disease of the lower respiratory tract.
Methods:
This is a case control study carried out on one hundred infants with a mean age of 3.9
months ± 2.2 months admitted to Children Welfare Teaching Hospital in Medical City –
Baghdad with acute bronchiolitis during the period from 1st
January 2006 to 1st
April 2006.
epidemiological risk factors, clinical presentations, chest X-ray findings, treatment,
complications and outcome were analyzed. Another one hundred infants (age and sex
matched) were seen in the outpatient clinical in the same period and for health problems
other than bronchiolitis were taken as a control group. Chi square test was used and a
P<0.05 was considered significant.
Results:
It was found that 64% of patients were males and 36% were females M/F: 1.9/1, 80%
were <6 months and 20% were >6 months of age. Most cases (87%) were admitted on
January and February. Bronchiolitis was uncommon and less severe in neonatal period.
There was a significant association between urban residence and acute bronchiolitis. There
was no significant association between each of family history of atopy, parental smoking,
pets at home and crowding index > 30 with bronchiolitis. Fever >38.1C was significantly
more common in infants with bronchiolitis > 6 months of age than those less than 6 months.
Conclusions:
The mean clinical scores of severity, the mean duration of hospitalization and Chest X-
ray findings were higher in: male sex, age <6 months, infants who were on exclusive breast
feeding. Corticosteroids did not reduce the duration of hospitalization in children with acute
bronchiolitis.

Background: TIDM is known to be polygenic disease that appears from the interaction
of mutation in multiple genes including HLA. The autoimmune mediated destruction of
pancreatic β-cells is reflected by the presence of autoantibodies against prominent
antigens in the pancreatic β-cells.
Objective: This study was designed to investigate the role of HLA-class I and class II
antigens in the etiology of type 1 diabetes mellitus (T1DM) and also assessment of
glutamic acid decarboxylase (GAD65) autoantibodies in the patients at the onset of the
disease.
Patients & Methods: Sixty T1DM patients who were newly onset of the disease
(diagnosed less than five months) were selected. Eighty apparently healthy control
subjects, matched with age, sex and ethnic backgrounds underwent the HLA-typing by
lymphocytotoxicity assay. Finally 50 healthy individuals were selected randomly to
undergo serological assessment of GAD65 autoantibodies using IRMA method.
Results & Conclusion: At HLA-class I region, T1DM patients showed a significant
increased frequency of antigen A9 (40.0 vs.18.75%) and B8 (28.33 vs.8.75%) as
compared to control subject. At HLA-class II region, DR3 and DR4 were significantly
increased in patients (53.33 vs.26.25% and 50.0 vs. 12.5% respectively) as compared to
controls. In addition to that, T1DM was significantly associated with DQ2 (33.33 vs.15%)
and DQ3 (40.0 vs. 20%) antigens as compared to controls, suggesting that these
haplotypes had a role in disease susceptibility, while the frequency of DR2 and DQ1
antigens were significantly lowered in patients compared to controls (6.66 vs. 25% and
6.66 vs. 22.5% respectively). These molecules might had protective effect.
Anti-GAD65 autoantibodies were present in 50% of T1DM children especially in
older ages and in females more than males. High proportion of GADA was found in the
patients carrying HLA-DR3/DR4 heterozygous. In conclusion, susceptibility to T1DM is
genetically controlled.

Background:
Angiogenesis plays a crucial role in tumorigensis; several reports have described a
significant increase in microvessel density (MVD) in colorectal carcinogenesis There are
several methods to measure the angiogenesis in neoplasms, but immunohitochemistry seems
to be the mainstay of all. This method enable us to measure the tumor microvessel densities
highlighted by using antibodies directed against endothelial cell markers like CD31,CD34
or others; then assessment of MVD by manual count of the number of microvessels in what
appears to be the most vascular area of the tumor(called the hot spot) using a protocol
described by Weidner et al.Automated cellular imaging system is used to analyze
immunohistochemically stained slides .studies have shown that the device offers accurate
precision and reproducibility of immunostained slide analysis exceeding that possible with
manual evaluation which was the prevalent method .
Aims of the study: To assess the angiogenesis in normal, adenomatous (benign) and malignant colorectal
tissues using CD34 and the microvessels will be measured both manually by hot spot
method as the MVD and by the use of computerized image analysis system as fraction area
,we correlate between microvessels density and fraction area with various
clinicopathological parameters in colorectal cancer (CRC), and to a compare between the
results which obtained from both methods.
Methods:
Paraffin embedded archival materials from 50 cases including three normal resection
(non tumoruos) margins, 12 benign colonic lesions and 35 colonic adenocarcinoma were
used . 5mm section were cut and they were stained by anti CD34 antibody Angiogenesis
was measured as MVD by two methods : manually by light microscope and by a computer
image analysis system (as fraction area). Then the MVD and fraction area were correlated
with different clinicopathological parameters.
Results :
This study demonstrate that there is a statistical difference in MVD and fraction area in
both hot spot method and CIAS respectively between benign and malignant tumors . P value
< 0.05 in hot spot method and less than 0.001 in CIAS and there was highly significant
correlation between MVD and fraction area with the grade . There was significant increase
in MVD and fraction area from well differentiated to moderately differentiated and to
poorly differentiated .There was no significant correlation between MVD and lymph node
involvement by hot spot method but CIAS proved a significant correlation between
fraction area and lymph node involvement.Both methods (hot spot and CIAS) proved no
significant correlation with age , sex , size of the tumor , site of the tumor , stage of the
tumor and the number of lymph node involverment .

Conclusions:
Assessment of tumor vascularity by counting the microvessels using anti CD34
antibody is useful in quantifying angiogenesis in colorectal adenocarcinoma . Intratumoral
microvessels count (by manual and computerized method) is important in the assessment of
the biological behavior of CRC. Microvessel count is higher in malignant tumors than
benign tumors and it is correlated with the tumor grade and higher MVD is associated with
lymph node metastasis . Statistically no significant correlation was found between MVD
and age, sex of the patients, tumor size, site, stage, histological type and number of lymph
node metastasis . The use of CIAS for assessment of angiogenesis is reliable, reproducible
and more precise than the manual method.

Background: - Genetic Factors have a major role in the development of bladder
cancer.
Objectives: - This study was carried out to shed a light on the possible association of
HLA class II antigens and BC patients and to correlate this finding with the family
history.
Patients and Methodes :- Lymphocytotxicity assay had been used to assess HLA-
typing of 65 BC patients and 50 healthy controls.
Results:- comparison between BC patients and healthy controls showed several
antigens deviations in their frequencies. HLA-DR1, HLA-DQ1 and HLA-DQ3 antigens
were observed with increased frequencies in patients group with significant differences
(P=0.000, 0.000 and 0.017 respectively). Moreover there was decrease frequency of
HLA-DR7 in patients group (P=0.010). Stastical analysis showed non significant
correlation of the specific HLA –Ags with family history.
Conclusions: - This finding demonstrated that HLA-DR1, DR7, DQ1 and DQ3 might
play a role in BC susceptibility.
• Department of clinical biochemistry. Collage of Medicine Al-Mustansyriah
University
• Department of Microbiology. Collage of Medicine. Baghdad University
• Ministry of Health.

Background:
B -Natriuretic peptide is a neurohormone normally synthesized in ventricular heart
muscle and known to be released in situations when left ventricular wall stress increases, it
has a variety of physiological functions on its own, that are thought to be compensatory.
Objective:
The aim of this study was to apply B-natriuretic peptide (BNP) as a biomarker and to
correlate its levels with the severity of heart failure using certain selected parameters as
indicators of cardiac function.
Patients and Methods
Forty Six (46) patients with provisional diagnosis of heart failure were chosen for this
work, thirty six (36) males and ten (10) Females, their age ranged between 33 and 80 Years.
All underwent complete physical examination and ECG tracing together with
ECHO/DOPPLER examination for heart failure.
Eleven (11) healthy Subjects were chosen as control group for purpose of comparison.
The patients were divided into groups, according to Age , Gender, BMI, whether they
had the following selected associated diseases: (IHD, hypertension, and diabetes mellitus),
smoking habit, Drugs intake, cardiac chambers dilatation including (LV in systole and
diastole, RV, and LA), EF%, FS%, degree of diastolic impairment, LV Segmental wall
motion abnormalities.
Five ml (5ml) specimen of venous blood were aspirated from each patient, and also the
control group for estimation of BNP level, using ELIZA
technique.
Results
There was a significant difference in mean serum BNP levels between cases of
congestive heart failure and control group. Considering the subject as a positive for heart
failure if his BNP level was ≥ 375pmol/l, at this cutoff value there will be a sensitivity of
80.4% and specificity of 100%. Also the study showed highest values of mean BNP in those
patients having restrictive pattern of diastolic dysfunction.
Conclusion:
BNP was used as a biomarker for the first time in Iraq to diagnose congestive heart
failure. The role of BNP as a guide to determine the severity of heart failure and the efficacy
of treatment was promising, so BNP fulfill most of the criteria in patients with suspected
heart failure.
At this point it was found that the mean of the right ventricular dimensions were
significantly higher in the group with highest BNP quartile compared to lowest quartile
BNP group, probably reflecting more severe form of impaired cardiac function and heart
failure, a finding which has not been mentioned in any earlier studies in the same field.

Background: Many drug and non drug approaches are utilized for the treatment of
dyslipidemia; flavonoids, the major constituents of silymarin, have been proved to
positively modify lipoproteins in experimentally – induced dyslipidemia.
Objective: This study was designed to evaluate the effect of silymarin, when used
alone or in combination with other hypolipidemic agents, on the lipid profile in
dyslipidemic patients.
Patients and Methods: Fifty seven patients with dyslipidaemia of various etiologies
are involved in this clinical trial. They are randomized into three groups treated with
either 400mg / day silymarin (gr. A) or 20 mg / day lovastatin (gr. B) or a combination
of 200 mg/day silymarin and 10 mg/day lovastatin (gr. C) for 2 months, only 45
patients complete the study . Serum lipid profile (total cholesterol, triglycerides, LDL-
C, VLDL-C and HDL-C) and liver functions indices (SGOT, SGPT, total bilirubin)
were evaluated each month during the follow up period.
Results: Treatment with silymarin results in a significant decrease in TC, TG, LDL-C
and VLDL-C levels, with a significant elevation in HDL-C levels, without any
significant changes in liver function. Meanwhile, adjunct use of silymarin with
lovastatin widens the scope of lovastatin-hypolipidemic effect, without increasing in
the score of adverse effects, and ameliorating the hepatic damage emerged due to its
use.
Conclusions: The results presented in this study indicated that silymarin can be used
alone in clinical practice for the treatment of dyslipidemia, and when combined with
other hypolipidemic agents like lovastatin, improves therapeutic profile and ameliorate
some of its adverse effects.

Summary:
This is a randomized controlled clinical trial carried out to assess the necessity of the
use of prophylactic antibiotics for clean surgical operations in the surgical wards of Ibn-
Sina teaching hospital during the period from December 2002 to April 2003. A total of 80
patients with clean surgical operations and eligible for the study were randomly allocated
to either treatment or control group (40 patients in each group).
Fac Med Baghdad
2007; Vol.49, No.4
Received July 2006
Accepted Jun.2007
Only 7.5% of patients who were not given antibiotics postoperatively developed wound
infection while none of the control group, without statistical significance (P>0.05).
Neither age nor sex have statistical significant association (P>0.05). All the surgical
wound infections were observed in patients were operated for inguinal hernia.
The study concluded that use of postoperative prophylactic antibiotic is not necessary
for wound healing in case of clean surgical operations except for hernia operations.

Summary:
Background:
Hepatitis C Virus is the main causative agent of hepatitis among blood transfused
patients, in which most chronic cases result in liver carcinoma.
Materials & Methods:
Enzyme-Linked Immunosorbent Assay for HCV, FNF-¬ and IL-12p40 estimation with
Recombinant Immunoblotting Assay (RIBA) as a confirmatory test for HCV, have been
applied for HCV detection in 80 HCV patients' samples in comparison with 30 samples for
apparently healthy control, while viral load has been estimated using Branched-DNA (b-
DNA) technique for 32 randomly selected positive cases for HCV. Liver function test has
been applied for patients' sera in comparison with control.
Results & Conclusions:
This study reveals highly specificity & sensitivity of ELISA technique for HCV
detection which results in 100% positivity by RIBA methods. Moreover, Viral load
estimation shows that (71.9%) of HCV sera samples with viral load >615 IU /ml and only
(28.1%) with viral load <615 IU/ml with highly significant difference between them (P =
0.013). Furthermore, there is a highly significant variations between liver function test in
comparison with control group (P< 0.01), while SGPT is the only parameter which
significantly affected by viral load (P= 0.01 1). Beside that, neither INF-¬ nor IL-12p40
level has been affected by viral loads more or less 6151U /ml. It was concluded that ELISA
technique is still the best accurate reliable method for viral detection and SGPT is a good
marker for highly viral loaded samples.

Background: Autoimmune hepatitis (AIH) is a rare chronic liver disease of unknown
etiology, characterized by hypergammaglobulinemia, characteristic autoantibodies, and a
favorable response to immunosuppressive treatment.
Strong circumstantial evidences denoted that there is quite long list of environmental
factors such as (food additives and drugs), viruses and toxins which play an important
role in precipitating this disease. Brucellosis is endemic in Iraq. It may involve any organ
in the body. Liver is frequently involved. Doxycycline used for treatment occasionally
may lead to hepatotoxicity.
Objective: the aim of the study is To show the relationship between brucellosis , AIH,
and hepatotoxicity of doxycycline .
Methods: the study was performed on 2 Iraqi patients with brucellosis, attending the
teaching hospital for gastroenterology and liver disease in the period between November
2003 and July 2004. Brucella were studied by Rose Bengal test and confirmed by indirect
immuno florescence assay (IIF).
Results: anti-SLA/LP Abs was detected in 2 patients with brucellosis.
Conclusion: brucellosis or doxycycline is a trigger of AIH

Vibrios are gram negative rods bacteria that are all widely distributed in nature
the vibrose are found in marine and surface waters. They are curved aerobic rods
and are motile, possessing a polar flagellum. V.vibrios sero group 01 and related
Vibrios cause cholera cause sepsis or enteritis Vibrio cholerae The epidemiology
of cholera closely parallels the recognition of V.cholerae transmission in water and
the development of sanitary water system (1,2,6,9).
V. C is a comma-shaped, curved rod 2-4 long .It is actively motile by means of
polar flagellu on prolonged cultivation. Vibros may become straight rod that
resemble the gram-negative enteric bacteria (1,2,6,9).
V.C. grow well at 37OC on many kinds of media .including defined media
containing mineral salt sand asparagines as sources of carbon and nitrogen V. C.
produce convex, smooth round colonies that are opaque and granular in transmitted
light V.C. grows well on thiosulfate-citrate yellow colonies . V. are oxidasepositive,
vibrio grow at Avery high Pi-Land are rapidly killed by acid (1,2,3,6).
V.C. and related produce a heat-lebile entero toxin with molecular weight of
about 84,000 consisting of subunits A and B .The genes for V.C. enterotoxin are on
the bacterial chromosome-cholera enterotoxin is antigenincally related to LT of
E-coli and can stimulate the production of neutralizing antibodies .However, the
precise role of antitoxic and antibodies in protection against cholera is not clear.
(3,6)
Its structure was determined with one and two dimensional NMR spectra
(COSY, HMBC, HMQC, HOHAHA on nuclei 1H, 13C and 31P) and was further
confirmed with HPLC (18).

Back ground: Viruses may be involved in the pathogenesis of Type 1 Diabetes
Mellitus (T1DM), either through direct β-cell infection or as triggers of
autoimmunity.
Objective: To investigate the presence of specific anti- viral IgG antibodies for
Coxsackie virus type B (CVB5), Poliovirus, and Adenovirus which proposed to be
involved in the etiology of T1DM.
Subjects & methods: A total of 60 Iraqi T1DM children were included in the
presents study. They were new onset of the disease (diagnosis was from one week up
to five months). For the purpose of comparisons, 50 apparently healthy control
subjects were selected. Serum IgG against Coxsackie virus type B5, Adenovirus type
3, 4, and 7, and Poliovaccin Trivalent were detected quantitatively with an indirect
ELISA.
Results: High proportion of anti-CVB5 IgG (20%)(p<0.05) and anti- Polio IgG
(31.67%) were found in T1DM children compared to controls (8%, 26%
respectively), while anti- Adeno IgG were detected in diabetic patients only
(6.67%)(p<1.0001).

Objectives: Severe head injury is the most devastating neurosurgical condition
and it is only next to cancers as the leading cause of death in developed countries.
Because trace elements (TEs) are involved in most of enzymes that drives the
biochemical reactions, so they are considered as a window to the biochemical
environment of the body in general and in brain in specific.
Aim of the Study: This study measured six TEs (Fe, Zn, Mg, Cu, Mn and Co) in
29 patients with severe head injury (GCS Score 3-9); their ages between 5-50 years.
Collection and estimation performed at both Neurosurgical Hospital (NH) in
Baghdad and Medical Research Center (MRC) of College of Medicine,
Kadhimiyah between January 2004 and August 2004. 17 of healthy Iraqi volunteers
of age- and sex- matched were used as a comparable control group in TEs
measurement.
Results: The analysis showed that serum Cu level has a striking significant
positive correlation with GCS (P<0.01) followed by serum Mg (P<0.01), serum Fe
(P<0.05) with mode of correlation is linear except for that of serum Fe has three
phases of correlation. Serum Mg is the only TE showed statistical significant lower
value in patient group than the control group (P<0.01). Zn is the only TE that is
correlated with the mode of intake, significantly lower among patient on IVF than
those on N/G (P<0.01). Serum zinc correlated in linear relation with serum Mg
(P<0.05), serum Fe with serum Mg (P<0.05).

Background: Problem-based learning is becoming increasingly adopted in universities of
higher education throughout the world.
Objective: This study is carried out to evaluate the application of this innovative approach in
teaching in Hadramout University College of Medicine (HUCOM) in Yemen.
Methods: A cross-sectional study was designed to collect data from students through a well
structured questionnaire. Students were classified into two groups: students in preclinical
phase (1-3 levels) and students in clinical phase (4-6 level).
Results: Out of 372 students participated in the study; 19% in the preclinical phase know
about PBL before joining the college while only 16% of students in clinical phase. About 44%
students in preclinical phase and 46% of students in clinical phase used all methods for
explanation of their learning objectives. A higher percentage of students in preclinical phase
(72%) reported that they use library as a source for self-directed learning (SDL) while only
60% of students in clinical phase did.
Conclusion: Increased awareness and satisfaction of students toward PBL over time.

Background:
There are many circulatory changes that occur during exercise in order to supply the
tremendous blood flow required by the muscles during the stimulatory effects on circulation
by the mass sympathetic discharge, the increased arterial pressure and cardiac output. The
metabolic effects and the oxidative stress as a result of the work load on cardiac and skeletal
muscles could also show changes.
Objective:
This study was designed to investigate the effects of aging process on the vascular
response during exercise and also in the oxidative stress according to age.
Subjects and Methods:
Eight healthy Iraqi subjects were enrolled in this study. Divided into three groups
according to age, group I (age range 20-29), group II (age range 30-39), and group III (age
range 40-49). They were asked to exercise according to modified Bruce protocol. Blood
samples were taken from each subject pre and post exercise for biochemical tests. The test
included were creatine kinase, uric acid, malonedialdehyde (MDA) , lipid profile
(triglycerides, cholesterol, high density lipoprotein HDL). Low density lipoprotein LDL was
calculated.
Results:
There is a statistical significance increase in heart rate and systolic blood pressure after
exercise in all groups however diastolic blood pressure showed a decrease. A positive linear
correlation is present. Mean serum levels of uric acid was shown to be elevated after exercise,
meanwhile triglycerides levels decreased significantly in all age groups after exercise and also
cholesterol. LDL on the other hand showed a decrease in the younger age group.
Conclusion:
The results obtained set a normative data for the studied parameters for the age group
included in the study to be used in the future for the detection and differentiation of any
cardiovascular abnormality from age related changes. These data have important clinical
implications if we are to prevent the frailty and morbidity associated with old age.

Background:
Variations in the arterial supply in the human brain are not uncommon. Of particular
interest is that of the hippocampus. Knowledge of the vascular anatomy is a key to the
surgical treatment of pathologies in this region.
Objectives:
The aim of the work is a detailed description of the variations and contribution of the
anterior choroidal artery and the branches of the posterior cerebral artery to the supply of
the hippocampus and comparing the results with previous studies.
Materials and Methods:
Formalin-fixed brains from 15 adult cadavers (30 hemispheres) were examined using a
magnifying lens. The hippocampus is identified, and the arteries that are in the vicinity to
hippocampus were carefully dissected and studied.
Results:
The anterior choroidal artery (AchA), and the lateral posterior choroidal arteries
(LPChAs) were present in 100% of the specimens examined. AChA anastomosed with the
anterior branches of LPChA in 31% of specimens. The hippocampal artery, a brunch of the
posterior cerebral artery, was present in 82.8% of specimen. The anterior and middle
temporal arteries were present in 80% of hemispheres.
Conclusions:
ACA has the most constant origin, course and distribution. It supplied the rstra1 and
middle portions of the hippocampus and in the absence of the hippocampal arterial branches
of the posterior cerebral artery (PCA), AchA supplied the major portion of the
hippocampus.
The branches, mainly from P-2A and P-2P segments, of the PCA supplied the middle and
posterior portions of the hippocampus. Variations in their origin from different segments
were noted. The major branches were: the LPChAs, the hippocampal arteu, the anterior and
middle temporal arteries. The common temporal arterydid not contribute to the arterial
supply of the hippocampus.