Journal of the Faculty of Medicine Baghdad

Background: tuberculosis is an endemic disease in Yemen. Abdominal Tuberculosis (AT) is the most common extra pulmonary manifestation of the disease.The clinical picture can be non specific.Laparoscopy is the most accurate diagnostic method but has its limitation depending on presentation. The aim of this study was to present the common clinical manifestation and the
different type of Abdominal TB,the surgical procedure used,the morbidity and
mortality of the disease.
Patient and Methods: This is a prospective study of 48 patients with Abdominal TB who were
admitted to Kuwait University hospital in Sana'a-Yemen between Jan 2002-Dec
2004.fourteen patients (29%) were treated medically with Anti TB drugs.Thirty
four patients (71%) required surgical Intervention for diagnosis and treatment.
Results : Thirty two patients (67%) were female ,16 patients ( 33%) were male with a ratio of 2:1 .Fifty percent of patients were in age group 20-40.The most common symptom was Anorexia (94%) abdominal pain (92%) fever (90%).The most common signs were Abdominal mass ,ascitis and abdominal tenderness.Smeares and culture of ascitis fluid were negative for A.F.B. . Out of the 34 patients who required surgical treatment ;17 patients (50%) had Tuberculous peritonitis,32% had tuberculosis of intestine, and 17%had tubeculous mesenteric lymphadenitis.Complication rate was 50%,and mortality was 9%.
Conclusions: Diagnosis of Abdominal TB should be suspected in patients of abdominal pain with vague clinical presentation coming from endemic areas.not all patients present with ascitis and whene ascitis is present smears and culture are usually negative for A.F.B. Laparoscopy has its limitation Surgery should be avoided unless complication occur and should be conservative.Tube drains can be used with no fear of TB Sinus.

Summary:
Background:
In modem laryngological practice laryngovideostroscopic examination is an important
step for correct diagnosis of vocal cord lesions.
Aims:
To asses the role of laryngovideostroboscopy as a clinical tool in evaluation of hoarse
patients.
Patients and Methods:
Stroboscopic examinations were carried out on 43 patients presented with hoarseness at
the ENT department at Al- Kadhimya Teaching Hospital during the period from “January
2006 to October 2006".
Results:
Stroboscopic examination contributed significant diagnostic information, it changed
the diagnosis made by nonstroboscopic means in 8 cases (19%), this resulted in avoidance
of surgery in 4 cases and 4 cases referred to surgery instead of medical therapy.
Conclusion:
Laryngovideostroboscopy is a useful clinical tool in modem laryngoloical practice so as
to alter the diagnosis and management plan which may result in avoidance of unnecessary
surgical and /or medical-therapies.

Background:
Percutaneous Balloon Pulmonary Valvuloplasty (BPV) is now the treatment of
choice for pulmonary valve stenosis (PS) Patients and Methods. It is a retrospective
study involving 40 consecutive patients with moderate to severe PS underwent
BPV in Ibn Albitar Hospital for Cardiac Surgery from Sept. 2003 to Sept. 2004 ,
were medical records , Electrocardiograms ( ECG ) , Echo Doppler studies , and
Catheterization data were reviewed carefully.
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200
Results:
Mean pressure gradient across pulmonary valve (PV) was reduced from 112 +/-
46 mmHg before intervention to 49 It/- 34.7 after intervention.
Procedure failure occurred in one patient (2.5 %), four patients (10%)
developed mild to moderate pulmonary regurgitation , no mortality was detected .
Conclusion:
BPV is effective and safe procedure for patients with valvular PS.

Background:
To assess the feasibility and early results of non-surgical transcatheter closure of atrial
septal detect (ASD) using the Ampiatzer septal Occluder (ASO).
Patients and Methods:
From June 2003 to June 2005, i75 patients with ASD secundum, age range 3- 65 years,
female to male ratio of 3:2. were evaluated for transcatheter closure using ASO at Ibn Al-
Bitar Hospital for Cardiac Surgery. Transthoracic echocardiography was performed in al
patients using standard suhxyphoid, apical, parasternal and suprasternal views. In all
patients, the procedure was done under general anesthesia.
Results:
Based on transesophageal echocardiography (TEE) Findings, 60 patients (33.7%) did
not meet the criteria for transcatheter closure (40 females and 20 males). One hundred
Fifteen patients were found to have ASDs suitable for device closure. The device was
successfully deployed in allpatients except 11 of them (104/115) (90.4%).
Fac Med Baghdad
2008 ; Vol.50 ,
No.1
Received June 2007
In 11 cases with failure of ASO deployment, 6 patients had small floppy inferior rims
which were not able to hold the device after the Minnesota wegeal maneuver. One adult
patient with a large ASD secundum and second degree AV block developed complete heart
block during the procedure before the deployment of the occluder. One of them dislodged
into the left atrium (LA) immediately after deployment because of a very small inferior rim
and the other one dislodged into the LA because of descrewing of the cable after multiple
manipulations. Both of them were referred for surgery. An other one of the 11 patients had
developed a thrombus in the LA during the procedure because of delay in giving heparin
after placing the guide wire in the left upper pulmonary vein. In the last patient, the
procedure was abandoned and the occluder recaptured into the sheath before release from
the cable because the TEE showed that the LA disc encroached on the mitral valve causing
mitral stenosis.
Conclusion:
The transcatheter closure of secundum ASD is safe, efficacious with a very low rate of
early and Sate complications. It is becoming an increasingly popular alternative to surgical
closure.

Summary:
Background :
To study the incidence of premature uterine contraction (PUC) with bacterial
vaginosis (BV) in Ramadi city and to correlate the incidence of (PUC) with severity
(grades of BV).
Patients and Methods:
A prospective study was performed involving 250 women who consecutively
attended Gynecological ward in Maternity and Child Hospital. 150 women were
control groups (without uterine contraction), and 100 women were regarded as
patients group (with uterine contraction) at 28-34 weeks of gestation. BV was
diagnosed on the basis of four diagnostic criteria; vaginal pH>4.7, homogenous
vaginal discharge, a positive Whiff test, and the presence of clue cells.
Results:
A total of 250 high vaginal specimens, BV were diagnosed in 74% of cases
with PUC (patient group); the incidence was 8% in grade I (GI), 29% in GII, and
37% in GIII. BV was 10% of cases without uterine contraction (control group).
Conclusions:
There was statistically significant correlation between BV and PUC up to 74%.
The incidence and severity of PUC increased with increasing the severity of BV.
The patients who used more IUCD (intrauterine contraceptive device), higher
reproductive ability, used vaginal douching, and have history of PID (pelvic
inflammatory disease) are more liable to have BV and more liable to have PUC.

Summary:
Background:
Trichomonas vaginalis is a pear shaped parasite, with a short undulating
membrane, lined with a flagellum and four anterior flagella. It is one of the most
common organisms causing infection in the female genital tract, which is normally
limited to vulva, vagina and cervix. It doesn't usually extend to the uterus. The
mucosal surface may be tender, inflamed and covered with a frothy yellow or
cream colored discharge.
Aim:
To evaluate the infection rate of Trichomonas vaginalis among females
complaining of vaginal discharge with or without pruritis vulvae, and to isolate the
parasite by different laboratory methods, such as wet mount method, culture on
special media and staining by special stains e.g. Leischman's stain, Giemsa's stain
and Papanicolaou's stain.
Fac Med Baghdad
2008; Vol.50,
No.1
Received Feb. 2007
Accepted Setp.2007
Methods:
The study was conducted in the period from November 1992 to August 1993 on
480 female patients presented with vaginal discharge with or without prurits vulvae
attended the Gynecological and Antenatal Outpatient Clinics in Medical City in
Baghdad, compared to 50 females complaining of gynecological problems other
than infection attended the same clinic.
Investigations carried out during this work include:
Wet mount examination ,Culture on artificial media ,Examination of fixed stained
smears with: Gram’s stain , Leishman's stain ,Giemsa's stain, Papanicolaou's
stained smear.
Results:
Among 480 females presented with vaginal discharge with or without pruritis
vulvae, an infection rate of (19.16%) was reported. Females subjected to this study
were classified into different groups, non-diabetics, diabetics, workers in hospital
and control group, giving an infection rates of (20.5%), (2.5%), (33.33%) and (8%)
respectively. Evaluation of the rate of infection among different age groups
revealed that the highest infection rate was in the ages of greatest sexual activities
from (14-39) years old. The signs of Trichomonas vaginalis infection were those of
vulvar, vaginal and cervical erythemae. The presenting symptoms were those of
discharge, discharge & itching, discharge & dysuria, itching, discharge & itching &
dysuria. However (12.5%) of the patients were asymptomatic. The discharge was of
different characters and the patients presented in different stages of the disease.
Conclusion:
Trichomonas vaginalis is a common cause of vaginits , most frequently seen at
the ages of greatest sexual activity where the patient usually presents with vaginal
discharge of different character which may or may not be associated with itching.
It has been noticed that clinical judgement alone is unsatisfactory for the
diagnosis of trichomoniasis and it must be aided by laboratory examination.

Background:
Angiogenic potential m most tumors; characterized by VEGF and vascular bed density
around tumor islands, is believed to be an important marker in predicting tumor growth,
recurrence and metastasis.
Materials and Methods:
The study included 50 cases of ameloblastomas. From each case 4 μm sections were
stained IHC with antivascular endothelial growth factor antibody- and endothelial lined
vessels anti CD34 antibody to evaluate their expression and intensity in relation to their
Fac Med Baghdad clinicopathological features.
2008 ; Vol.50 ,
No.
Results:
Generally, VEGF was significantly highly expressed with strong intensity in outer cell
layer of tumor islands, and the newly formed blood vessels were significantly
predominantly rounded and small in size in comparison to dental folicale and papilla of
tooth germ. Young aged patients (≤ 20yrs) had highest mean MvD around tumor islands
(35.9). Regarding WHO classification; follicular, plexiform and lining cells in UAB had
higher expression then acanthomatous and types, but 67% of those in plexiform were of
moderate intensity. There was no significant differences in mean MvD in all histological
solid subtypes, and characterized by round and small vessels. Except those in plexiform,
they were elongated and medium. UAB had significant lower microvessel count around
lining tumor cells (but not around mural growth) and more percentage of elongated medium
sized vessels than follicular but less than plexiform. There was significant correlation
between VEGF expression and the shape of microvessels. Considering different
morphological cellular pattern, basal cells showed the highest VEGF positivity and intensity
(87.5).
1
Received Sept. 2006
Conclusions:
The present study indicate the usefulness of the VEGF expression and MvD in
explaining the aggressive, locally invasive biological behavior of ameloblastoma. The high
angiogenic potential is enhancing tumor cell survival and the increase in the production of
new blood vessels formation is facilitating tumor growth, and by time will enhance the
proliferation potential of the incompletely removed surviving tumor islands, so increasing
the chance of ameloblastoma recurrence.

Background:
Progesterone hormone is important in the preparation for and in maintaining of pregnancy
through different mechanisms but mainly by shifting the balance from Th1 to Th2 mediated
immunity to avoid rejection of the fetus; in this study we tried to find out whether there is a
relation between the level of the expression of progesterone and its stimulant HCG hormone and
recurrent pregnancy loss (RPL).
Patients and Methods:
Immunohistochemistry technique was performed to detect and determine the expression of
progesterone and HCG hormones using paraffin embedded sections of curate samples obtained
from 40 women, who where divided into three groups: 24 women with RPL, 10 women with
abortion for the first time, and 6 women with induced abortion.
Fac Med Baghdad
200
Results:
The levels of the expression of both progesterone and HCG hormones were found to be
significantly down-regulated in the first group as compared with the second group (p=0.00), and
the third group (p=0.00), with a highly significant positive correlation between these two
parameters (r=0.866, p<0.01).
Conclusion:
Low expression of progesterone in women with RPL could raise the possibility of
underlying immuno-endocrine pathology responsible for this recurrent loss due to the important
role of progesterone as an immunosuppressive hormone help in maintaining pregnancy.

Summary:
Background
Sildenafil has been used in the treatment of erectile dysfunction (ED). However it has
the disadvantage of many visual disturbances. The aim of this work is to study the effect
of sildenafil on diabetic patients which might have ocular problems due to diabetes
mellitus.
Materials and Methods:
A total of 30 subjects were enrolled in the study, they were divided into two groups.
The control group consisted of 10 healthy subjects but complaining of ED only and the
other (20 patients) had diabetes mellitus and ED as well.
All subjects had ocular tests done before and after sildenafil intake.
It was obvious that sildenafil changed visual tests from totally normal for controls,
before treatent, to visual abnormality in some of the tests after treatment, such as in colour
sense , diplopia & intra ocular pressure ( IOP ) . Fac Med Baghdad
200 Results:
While certain percentage of diabetic patients had visual disturbances even before
sildenafil intake. The abnormalities were in visual acuity, visual field and, in fundus
appearance.
Post – treatment led to increase the percentage of patients with already existing
ocular problems and extend them to include some other new ones like change in colour
sense , diplopia and increased ( IOP ) .
Conclusions:
Comparing the patient group with the control , pre – treatment tests revealed that
diabetic patients had already pre – existing ocular problems due to diabetes such as in the
visual acuity , visual field which were statistically not significant ( p>0.05). The only
significant (p<0.05) difference was in the fundus appearance.
Post – treatment results indicated more ocular damage in diabetic patients as all tests
were abnormal compared to control subjects. So, although not significant but ocular
complications do exist and might cause unpredictable eye damage to certain percentage of
patients which should be taken into consideration.

Objectives:
The study was planned to show the effect of different medicinal plants extracts on
Cryptosporidium spp.
Materials and Methods:
The experimental study was performed in laboratory mice to show the efficacy of
different medical plants extracts (Achillea fragrantissima, Artemisea herba-alba,
Cardaria draba, Mentha longifolia , Olea europea, Prosopis farcta, Punica
granatum, Teucrium polium and Ziziphus spina-charisti on shedding of
Cryptosporidium spp. oocysts.
Results:
In a study on the effect of medical plant extracts on the shedding of oocysts in
mice, it was found that different medical plants extracts decrease the shedding of
Cryptosporidium oocysts in mice. Using 250 mg / kg B.W., route it was shown
that the efficacy of Prosopis farcta (67.6 %) followed by Artemesia herba alba
(57.7 %), Cardaria draba (35.9 %) and the lowest was Teucrium polium (12.7
"/o) but Mentha longifolia had no effect. It was also shown that the efficacy of
medical plants extracts (500 mg / kg B.W.) was higher than (250 mg / kg B.W.)
in shedding of the parasite oocysts.
In a study of the effect of plant extracts on the development of oocysts of
Cryptosporidium in the macrophage in Rpm medium, it was found that the
efficacy of Punica granatum (75.9%) was highest, followed by Prosopis farcta
(67.1%) and Artimesia herba- alba (55%).
Conclusions:
The medical plant extracts have an effect on Cryptosporidium spp. Infection in
albino mice. The possibility of studying the therapeutic research on
Cryptospridium spp. in RPM medium.

Summary:
Background:
Propolis (bee glue) is a resinous hive product. It consists of exudate from plants
mixed with beeswax and used be bees as glue in general-purpose as sealer and
draught-exclude for beehives. Propolis, used in folk medicine, has attracted
researchers attention to elucidate its therapeutic properties, as antioxidant and
anticancer. Therefore, the study aimed to investigate the role of propolis in
modulating effects of mitomycin C; MMC.
Methods:
Ethanolic solutions of propolis were prepared and administered to albino male mice
(Mus musculus) through three types of experiments. In the first, the propolis was
tested alone, while in the second and third experiments, propolis was given orally
before and after MMC (pre- and post-treatments, respectively). All experiments
were paralleled by negative and positive controls. The investigated parameters were
total count of leucocytes, mitotic index, micronucleus formation and chromosomal
aberrations.
Fac Med Baghdad
200
Results:
In the first experiment, the results indicated that 10 mg/kg/day of propolis enhanced
the parameters investigated, and a significant increase was observed in the total
count of leucocytes and mitotic index. Also, there was no significant difference in
the rate of micronucleus formation and chromosomal aberrations as compared to
negative controls. In the second (pre-treatment) and third (post-treatment)
experiments, a similar picture was drawn. However, the dose 10 mg/kg/day was
more effective in this respect.
Conclusion:
The results indicate that propolis may act upon the immunological system and has
the potential to inhibit the genotoxic effects of MMC. A further study will be
needed to determine the effects of compounds isolated from propolis and evaluate
the synergistic effects on MI and MN.