Journal of the Faculty of Medicine Baghdad

Summary
Background: The removal of an impacted foreign body in the esophagus is still a common practice in the Thoracic Department of the Medical City Hospital .The objective of this study is to cast a light on this rather a common phenomenon in our country , its risks and its management.
Patients and Methods: This is a retrospective study of 120 patients with foreign bodies in the esophagus managed successfully in our department during five years period 1998 – 2002 inclusive .The study included 65 males and 55 females . Their ages range between I year and 75 years. The most common age group was less than 10 years , which constitutes about 30% of our patients .Varieties of foreign bodies were encountered ,their ways of presentation , clinical findings and radiological appearances will be prescribe .
Results: Successful removal of the foreign bodies was done in most of the cases .In 4patients esophageal dilatation was done for an area of stricture on which the foreign body was impacted. Surgery was necessary in two patients for the removal of foreign bodies which were impossible to be removed endoscopically .
Conclusion: Rigid esophagoscopy under general anesthesia is the procedure of choice for foreign body removal and nearly all the cases could be considered preventable.
Key words: Foreign body (FB), Esophagoscopy

Summary:

Background: management modalities for liver metastasis from primary breast cancer are evolving steadily but systemic chemotherapy remains the mainstay of treatment.
Patients and methods: 30 patients with breast carcinoma and liver metastasis managed at (Baghdad teaching hospital) during the period from Jan. 2005 to Jan. 2007.
Results: 16 patients showed response to chemotherapy. 20% complete response was found and 33% showed partial response 57% went into progressive disease. The duration of response lasted for less than six months in 4 patients and more than six months in two patients.
Conclusion: chemotherapy remains the mainstay of treatment of liver metastasis but new modalities of treatment add much for chemotherapy if used in combination.
Key words: breast cancer, liver metastasis, chemotherapy

Summary:
Background: Dobutamine stress echocardiography (DSE) is a well established non invasive test for the diagnosis and risk stratification of patients with coronary artery disease. Aim of the study was to conduct a pilot study in order to establish the basis for the future routine practice of DSE in our center (Ibn Al-Bitar Hospital for Cardiac Surgery).
Patients and Methods: Fifty consecutive patients who were referred from the outpatient of our center, from August 2007 to July 2008, were included. The age range was 39 – 70 years with an average of 57.18 years. Fifty-eight percent were males. Patients were enrolled in the study in accordance with the American Heart Association/ American College of Cardiology guidelines, including mainly those who are unable to exercise due to an orthopedic problem (26%) or limited functional capacity (30%). Some Patients with resting electrocardiographic changes (20%) and non diagnostic exercise test (14%) were also included as well as five patients (10%) for the assessment of myocardial viability. The baseline echocardiogram was normal in 44 % of cases. Others had resting wall motion abnormalities due to previous myocardial infarction (50%) or left bundle branch block (6%). Dobutamine was given by a syringe or an infusion pump at incremental doses (every three minutes) of 5,10,20,30, and finally 40 µg/kg/min. Atropine was needed at peak test in 36% of cases to increase the proportion of patients who reach the target heart rate.
Results: The test was positive in 5 patients (10%); negative in 34(68%), non diagnostic in 2(4%), aborted due to intolerable symptoms in 3(6%) and stopped due to arrhythmias in 3(6%) patients. Side effects included chest tightness and irritability in 40%, headache in 12%, nausea and vomiting in 10%, and postural hypotension in 4%. Infrequent ventricular/atrial ectopics occurred in 13%, supraventricular tachycardia in one patient, and complex multiple ventricular ectopics in 3 patients; no incidence of sustained ventricular tachycardia or ventricular fibrillation occurred. There was no incidence of myocardial infarction or death.
Conclusions: DSE is a safe and practical test provided it is used according to the recommended protocols. A special unit for DSE in our centre is recommended.
Keywords: Dobutamine, echocardiography, imagining stress test

Summary:
Background: Adenoidal hypertrophy is generally considered a common condition of childhood .When obstructive symptoms or recurrent otitis media (suppurative or non suppurative) occurs, adenoidectomy is generally indicated.A wide range of bacteria could be isolated from the surface and core tissue of the removed adenoid tissue.
Patients and Methods: A prospective study carried out in the ENT Department of AL-DIWANIYAH Teaching Hospital between October 2007 and September 2008.Involved 73 patients between 3 and 7 years, they were 31 male and 42 female .All patients underwent adenoidectomy .Surface and core swabs was taken from all specimens and submitted to bacteriological study.
Results: Pathogens were detected in (83.56%) of core specimens versus (46.57%) in surface swab cultures. β -hemolytic streptococcus was the most commonly grown organism in the core of the adenoid and/or surface culture. Resistance was shown to the commonly used antibiotics by most of the isolated pathogens.
Conclusion: β -hemolytic streptococcus is the most common isolated organism in patients with adenoidal hypertrophy followed by Staphylococcus aureus, Streptococcus pneumonia then Haemophilus influenzae. Most of the isolated strains show resistance to the commonly used antibiotics.
Keywords: Adenoid disease, Bacteriology, Adenoid surface swab, Adenoid core swab.

Summary:
Background: Shunt operations are performed for different reasons mainly hydrocephalus congenital or acquired. It’s associated with certain morbidity and mortality.
Patients and method: A prospective study from Jan 2004 to Jan 2006, 226 patients under went shunt operation in the specialized surgical hospital in Baghdad. The patients were divided into two groups according to the way of applying the upper end catheter. In group A49 patients where posterior parietal approach was used, and group (B) 174 where parietal or temproprietal approach was used.
Results and discussions: different complications were recorded, but the most frequent was upper end obstruction by choroids plexus or by debris.
In group (A) only one patient 2% while in group (B) 27 patients 15.5% this wide difference in incidence of this complication, clears the significance of posterior parietal approach as a method of choice in applying ventricular catheter.
Other complications were recorded as infection, lower end obstruction of others. A low rate of mortality recorded and discussed thoroughly.
Conclusion: Choosing the post parietal type with prophylactic antibiotics carries the best results.
Key words: Hydrocephalus, shunt post parietal.

Summary:
Background: Gliomas are brain tumours of supporting tissue of the brain. The management of low grade glioma is still a great debate ranges from just follow up to extensive surgery followed by DXT, with or without chemothery.
Patients and Methods: 282 patients taken from neuro-surgical hospital between 1980-1990, divided to 3 groups with different modality of management & follow up for 15 years.
Results: the five years survival and symptomatic improvement was higher in the group managed by extensive surgery and DXT with or without cytoxic drugs followed by group managed by biopsy and DXT with or without cytoxic.
Conclusion: management of low grade glioma symptoms & out come (survival) is best by extensive surgery & DXT with or with out cytotoxic, followed by biopsy & DXT with or without cytotoxic drugs.
Keywords: glioma, DXT, cytotoxic drugs.

Summary:
Background: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –brachial pressure index (ABI) is a non invasive test proved to be sensitive and specific in detecting and assessing the severity of peripheral arterial disease.
Patients and Methods: One hundred fifty patients (150) were enrolled in this study, from January - June 2007; all were referred to the Iraqi Centre for Heart Diseases (I.C.H.D.) for further evaluation, with request for further assessment of CAD or lower extremity peripheral arterial disease.
Clinical data and physical examination were performed; ABI was calculated by measurement of systolic pressure on both ankles over both dorsalis pedis and posterior tibial arteries and on both arms over the brachial arteries by using a Doppler stethoscope. The Ankle –Brachial Pressure Index (ABI) calculation was made by taking the lowest value for the ankle pressure and the highest value for the brachial pressure. The normal value for the ABI range from (1-1.4), a cutoff value of < 0.90 was used to identify low ABI. All patients underwent diagnostic coronary angiography and quantitative coronary angiography (QCA) was used to identify the lesion length and severity of stenosis. The severity of CAD was quantified by GENSINI score, the number of diseased vessels and the number of significant lesions.
Results: The mean Ankle-Brachial Pressure index (ABI) for the sample was 0.908±0.31 (range 0-1.53), the mean GENSINI score was 44.02±40 (range 0-148), GENSINI score was zero in 30 (20%) patients, 40 (26%) were having no diseased vessel, 41(27%) having single, and 43 (28.7%) double and 26 (17%) triple vessel disease. ABI was inversely related to the extent of CAD assessed by GENSINI (p-value 0.015), number of diseased vessels (p-value 0.009), and number of significant lesions (p-value 0.021). ABI < 0.9 was recorded in 51 patients (34%) and a low ABI was an independent factor for a higher GENSINI scores (p-value 0.043) and a higher number of diseased vessels (p-value 0.0001). Patients who were referred with PAD were found to have significantly lower ABI than the rest of the sample (p=0.0001), and a coexisted CAD was detected in 15 out of 20 (75%) patients.
Conclusions: ABI was a useful bedside clinical test that predicts the severity of the CAD in patients who are already suffering from or suspected to have ischemic heart disease.
Keywords: IHD, Ankle-Brachial Pressure index, GENSINI score

Summary:
Background: Disinfection of denture and soft denture liners became among the priorities for cross contamination control as well as patient's health. All the trials aimed to have maximum infection control with minimal adverse changes in the materials properties.
Materials and methods: Discs of 30x2mm were made from Coe Super Soft and Coe Soft denture liners. Every 5 specimens were immersed separately and daily in CHX, Sodium hypochlorite and chlorine dioxide, control group specimens were immersed in the distilled water. Hardness property of the experimental and control groups was evaluated by using Shore A durometer after 1, 7, 30 days.
Results: Statistical analysis indicated non significant differences when the control group was compared with every disinfectant solution regarding tested periods, while ANOVA test showed significant differences among tested solutions after every testing period. Further LSD attributed these differences to the chlorine dioxide since it is the only solution that decreases hardness value after immersion.
Conclusion: Either of the tested solutions can be used safely regarding hardness property, although CHX and Sodium hypochlorite are more recommended since their effects on the hardness property was relatively same in comparison to the control.
Keywords: CHX, Sodium hypochlorite, Chlorine dioxide, hardness, soft denture liners.

Summary:
Background: diagnostic yield of flexible bronchoscope is limited by its inability to guide biopsy instruments directly to the lesion. The diagnostic success rate is dependent on the size and location of the lesion.
Patient and methods: A cross-sectional study to evaluate the diagnostic yield of flexible fiberoptic bronchoscope (F.F.B) in patients with solitary lung lesion (S.L.L.) on chest X-ray. Twenty one patient with S.L.L. on chest X-ray, size of lesions range between 2-6 cm, using F.F.B. for diagnosis. The samples obtained by F.F.B. from the site of the lesion sent for cytological and histological study & AFB.
Result: definitive diagnosis was established by F.F.B in 7 patients from 21 patients with S.L.L. The diagnostic yield of F.F.B. decreases as the S.L.L. decrease in size.
Conclusions: there is a limitation in diagnostic yield of F.F.B. in diagnosis of small S.L.L., we should look for other methods to enhance the diagnostic yield of F.F.B. in this situation.
Keyword: Flexible fiberopticbronchoscope (F.F.B) Solitary lung lesion (S.L.L).

Summary:
Background: depressed mood and anxiety are common symptoms in hospitalized cancer patients .it is often presumed that anxiety and depression affect the occurrence and experience of physical symptoms . the researcher was aimed to assess the level of depression among cancer patients and the chemotherapy side effects and to find out the significant difference between depression level regarding these side effects.
Patients and methods: A descriptive analytical study was conducted on a purposive sample of 50 cancer patients from both sexes who were admitted to Radiation and Neuclur Medicine Hospital in Baghdad for the purpose of giving chemotherapy for the period from April 4th to June 20th , 2008. A structured interview using the Self Care Diary (SCD) of Nail et al (1991) and Hospital Anxiety and Depression Scale (HADS) was implemented for data collection.
Results: It was found that cancer patient has a significant level of depression and the relationship between depression and presence of chemotherapy side effects in hospitalized cancer patients is not significant.
Conclusions: there is no relationship between depression and chemotherapy side effects but it may be due to the disease it self.
Key words: depression, chemotherapy, side effects.

Summary:

This article aims to cast a shadow over the history of mental health education and training in Iraq and a projection of Islamic scientific heritage in Baghdad during the seventh century. It also discloses the foundation of first teaching and training centers in psychiatry focusing on the marked contribution of the pioneer psychiatrists. Introduction. Up to our knowledge there is no elaborate published literature focusing on historical role of Iraq in mental health education and training and its current reality apart from scares data about mental health in Mediterranean region as a whole. In this article, we try calling the attention to the outstanding contribution of Iraq in mental health and medical education in general which appeared to be established during the golden era of Abbasid Caliphs in Baghdad during the seventh century. After several decades of scientific and cultural deterioration associated with Ottomans colonization , Baghdad intellectuals started to build the first medical school in Iraq at the end of twentieth century , teaching mental illnesses as part of the curriculum took place and continue to progress through establishing the national training programs .

Summary:
Background: Molecular DNA hybridization has confirmed more than 120 different human papilloma virus (HPV) genotypes. A small group of them have high- risk oncogenic potential. Many studies have described an association of such high risk-HPV genotypes with a variety of oral lesions including squamous cell carcinoma, leukoplakia, and lichen planus. .
Materials and Methods: A total number of 42 tissue specimens, representing 27 patients with oral lichen planus and 15 apparently-healthy oral tissues, were included in this study. The molecular methods for HPV detection and genotyping were performed by in situ hybridization(ISH) using cocktailed- and specific high- risk HPV DNA probes, respectively.
Results:The overall percentage of HPV in the total group of patients with oral lichen planus (OLP) was 33.3 %. Negative HPV DNA- ISH reactions were detected in all tissues of the control group. The overall genotyping results revealed HPV 16- DNA in all HPV- positive oral lichen planus tissues , while none of these OLP tissues showed ISH reactions for HPV 18-DNA or HPV 31/33-DNA.
Conclusions: The significant incidence of such high oncogenic HPV genotype in those patients with oral precancerous lesions could have a relevant importance along its pathogenesis and the multi-steps oral carcinogenesis , HPV-16-associated oral lichen planus that has mostly previliged the site of cheek mucosa represents a herald indicator for spread of such sexually important transmitted infection among Iraqi general population.
Key Words: Oral lichen planus; Human Papilloma Virus; In Situ Hybridization

Summary:

Background: Toxoplasma gondii infection in humans is widespread through out the world, approximately half a billion humans have antibody to T. gondii.
Patients and Methods: Blood samples were collected from (186) persons, of different sexes and ages. Tow differ serological tests , ELISA and LAT for qualitative determination of T. gondii antibody titer in serum samples.
Results: Out of the 186 human sera, the seropositivity for T. gondii IgG anti-body by ELISA 70 (37.63 %) and 108 (58.06 %) by LAT. The prevalence of toxoplasmosis was highest in age groups 35-44 (48.5%) and 45-54 ( 52.o%) in human, in comparism with other age groups.
Conclusion: Statistical results show no significant differences between both tests (ELISA &LAT) at (P ≥ 0.05).The prevalence of toxoplasmosis was increased proportionally with the age of individuals, while gender has no effect on the prevalent rate.
Keywords: Toxoplasma gondii; seroprevalence;ELISA;LAT; Sulaimani

Summary:
Back ground: A urinary tract infection is one of the most common diseases occurring from neonate up to geriatric age groups
Patients and Methods: A total of (100) Midstream urine (MSU) samples were collected from patients having signs and symptoms of Lower urinary tract infection. These patients were attending Urology Clinic, Ramadi General Hospital.
Result: Culturing of (100) MSU samples on MacConky and blood agar resulted in (5) types of bacteria which included: Escherichia coli (46%) and it was found the most frequent bacteria causing LUTI. This is followed by Klebsiella pneumonia (23%), Pseudomonas aeruginosa (13%), Proteus mirabilis (10%) and Staphylococcus epidermidis (8%).
Conclusion: Out of the total studied samples, (38%) were males and (62%) were females. It was found that the age of frequent infection was 60 year in male, while in female was 16-35 year.
Key word: MSU, E. coli, LUTI.

Summary:
Background: To study prevalence and method of diagnosis of acute rubella Infection during early pregnancy in Iraq.
Patients and Methods: Clinical signs and symptoms of acute rubella infection were looked for in (170) pregnant women looked before (12) weeks of gestation .Serial rubella specific IgG and IgM serological testing was done in these (170) women before (12) weeks of pregnancy, after (3) weeks, and again at (18-20) weeks of gestation.
Results: Three woman had clinical signs and symptoms of rubella infection from (26) woman were IgM positive at (9) weeks of pregnancy; (94) were IgG +ve but IgM –ve initially and also on repeat sampling after (3) weeks; while (50) women were nonimmune (IgG and IgM negative) in the first trimester, after (3) weeks and again at (18-20) weeks.
Conclusion(S): Acute rubella infection was diagnosed by serial serologic screening in (26) women in early pregnancy.
Key Words: Rubella, pregnancy, bad obstetric history, IgG, IgM.

Summary :
Background: Cytokines have long been implicated in the pathogenesis of autoimmune diabetes in a number of studies, and playing a role in the initiation of β-cell damaging process. The objective of this study is to gain more understanding about the role of cytokines in initiation of T1DM, through assessment of IFN-γ, IL-10 and IL-6 in diabetic patients.
Patients and methods: A total of 60 patients who were newly diagnosed as having T1DM (diagnosed less than five months) were included in the present study. Fifty apparently healthy control subjects were underwent the measurement of serum IFN-γ, IL-10 and IL-6 by ELISA.
Results: Higher serum levels of IFN-γ, IL-10, and Il-6 were observed in the investigated patients ≤10 years (75.60, 104.92, 147.6 pg/ml respectively) compared to controls (42.66, 57.01, 80.4 pg/ml respectively). The statistical analysis revealed a significant difference between patients and controls (P1= 0.005, 0.003, 0.036 respectively). The mean levels of serum IFN-γ, IL-10, and Il-6 were also significantly elevated in >10 years old patients (70.78, 84.22, 171.8 pg/ml respectively) than controls (40.39, 59.50, 81.6 pg/ml respectively), (P1= 0.006, 0.037, 0.04 respectively). A statistically difference of mean IL-10 concentration appears between patients in both age groups (P2= 0.04). No significant differences appear in the mean serum concentrations of IFN-γ, and IL-6 between the two age groups (P2=0.73, 0.07 respectively).
Conclusions: In children with diabetes, a significant elevation of serum levels of IFN-γ, IL-10 and IL-6 were observed.
Key Words: T1DM, IFN-γ, IL-10 and IL-6

Summary:
Background: The role of cytokines in cancer immunity and carcinogenesis in general has been well established, which play an important role in the pathogenesis of many solid cancers.This study aimed to estimate serum levels of IL-2 and IL-4, and to shed light on the correlation of these interleukins with progression of breast cancer.
Patients and Methods: The study included 80 women, it comprised of 45 breast cancer patients, 12 patients with benign breast lesions and 23 apparently healthy controls. ELISA method has been used for estimation the level of IL-2 and IL-4 in serum of three studied groups.
Results: This study showed elevation of IL-4 level in the sera of breast cancer patients with significant differences between breast cancer and controls (p<0.001), this elevation was correlated with progression of the tumor. In addition, the elevation of serum level of IL-4 was found to be inversely related to ER and PR expression (P=<0.05). On the other hand, there was a significant decrease in the median of serum level of IL-2 in patients as compared with control groups.
Conclusions: There was association between elevated serum level of IL-4 and breast cancer and this elevation was correlated with advanced stage of disease. In addition, there was no association between the statistical significant decrease of IL-2 serum level and the advanced stage of breast cancer.
Keywords: Breast cancer, Cytokines, ER

Summary:
Background: Human leukocyte antigen (HLA) is the most polymorphic genetic system in man. The genes of this region influence susceptibility to certain diseases.
Patients and methods: Immunofixation test is the method used to asses C4 polymorphism of 100 blood samples of 60 AIH patients and 40 healthy normal controls.
Results: An increased frequency of C4A*Q0 was observed for patients group versus control group with P-value (0.003).
Conclusions: This finding demonstrated that C4A*Q0 might play a role in AIH susceptibility.
Key words: autoimmune hepatitis, HLA, C4A*Q0, Immunofixation test.

Summary:
Background: Many workers have described the prevalence of HBV markers and anti-HCV among selected populations including health care personnel in Iraq. The purpose of this study is to describe the demographic characteristics and risk factors of hepatitis B and C in a sample of Iraqi health care workers (HCWs).
Materials and methods: A total of 1656 HCWs selected from Baghdad city was included in this study. A questionnaire form was filled for each HCW by direct interview. The data requested included demographic characteristics and risk factors of exposure to HBV and HCV. HCWs were screened for the presence of HBsAg, anti-HBs and anti-HCV.
Results: A higher prevalence of HBsAg, anti-HBs and anti-HCV was demonstrated among males (7.8%, 44.7% and 2.13%, respectively) than females (3.3%, 34.8% and 0.99%, respectively). The HBsAg carrier rates were decreasing with advancing age, while anti-HBs and anti-HCV showed an increase with advancing age. A higher rate of HBsAg, anti-HBs and anti-HCV was detected among HCWs from low socioeconomic level than those from high socioeconomic level. Health personnel who had a personal history of hepatitis were more likely to be HBsAg positive than those without such a risk factor and HCWs with personal or family history of hepatitis were more likely to have anti-HBs than those without such risk factors. Health personnel with personal history of hepatitis or blood transfusion had significantly higher prevalence of anti-HCV when compared with those without such risk factors.
Conclusion: This study indicates that non-paranteral route is the major route of transmission of HBV infection, while paranteral route is the major route for transmission of HCV among the health personnel.
Keywords: Health care workers, HBV, HCV, Iraq

Summary:
Background : AgNOR parameters are well known to pathologists as a proliferation marker with advantage over other proliferation markers of being cheaper, simpler and able to assess proliferation speed as well as state , AgNOR stainability was found to be well preserved in smears kept for up to 2 years , studies have shown that AgNOR values can serve as a useful prognostic parameter and a marker for tumour progression in different carcinomas )1) This study was conducted to see the importance of AgNOR staining in the peritoneal fluid cytopathological examination
Patient and Methods: It was a descriptive and prospective study conducted in Department of cytopathology in the medical city and Department of pathology n the medical college of Baghdad University, from September 2003 to June 2007. AgNOR staining was performed on 50 peritoneal fluid specimens having malignant cells and 20 other peritoneal fluid specimens as control cases
Results: AgNOR count, size and dispersion were normal in benign mesothelial cells (the proportion of cells with 1 or 2 AgNOR dots ranged from 32% to 98% with a median of 82% and a mean of 80.7%, S.D. 15.4 the proportion of cells with clusters ranged from 0% to12% with a median of 0% and a mean of 1.3%, S.D. 2.5 ) , higher in the malignant cells(the proportion of cells with 1 or 2 AgNOR dots ranged from 15% to 75% with a median of 30.5% and a mean of 28.9%, S.D. 21.1, the proportion of cells with clusters ranged from 23% to88% with a median of 67.6% and a mean of 56.2%, S.D. 36.7 ). AgNOR counts in the malignant cells were significantly greater as compared with counts of normal mesothelial cells .
Conclusion: Typing of AgNOR count, size and dispersion was found to be an important marker in differentiation between normal mesothelial cells and malignant cells of metastatic adenocarcinoma
Key Words: AgNOR Argyrophilic nucleolus organizer region, Pap stain Papanicolau stain ,no. number ,vs. versus, NOR nucleolar organizing regions, S.D. Standard Deviation

Summary:
Background: Benign prostatic hyperplasia and prostatic adenocarcinoma are two of the most common pathologic mass lesions. Both are encountered mainly in elderly males. The caspases family is a group of at least 15 known proteases that serve as initiator & effector molecules of the apoptosis pathway. Caspase-3, in particular, is thought to play a pathogenetic role in both prostatic hyperplasia and carcinoma. Finasteride is a medication that has routinely been given to patients with hyperplasia and carcinoma; its prostate size-reducing effect is thought to be mediated through caspases.
Patients and methods: fifty patients with prostatic mass lesions were included in this study (20 with hyperplasia & 30 with adenocarcinoma); all were on finasteride treatment. The carcinoma cases were graded according to Gleason scoring system. All cases were analyzed for procaspase-3 strength of staining.
Results: benign hyperplasia & well-differentiated carcinomas show high expression of procaspase-3, in contrast loss of expression of this marker was noted in moderately & poorly differentiated carcinomas.
Conclusion: there is a strong statistical correlation between caspase-3 expression and the degree of tumor differentiation. This may allow the utilization of this marker as a potential prognostic factor, especially in limited biopsy samples.
Key words: prostatic hyperplasia, prostatic adenocarcinoma, procaspase-3, Gleason grade

Summary:
Background: Cerebral ventricular enlargement has been associated with many neurological disorders. Whether this enlargement is primary or secondary to these pathological conditions remains controversial. To define such enlargement, one must have measurements in normal subjects (controls).
Patients and methods: One hundred-twelve (66 male and 46 females) apparently healthy normal subjects, with age ranging between 10-69 years were subjected to C. T scans as part of routine diagnostic workup for complaint of headache or recent minor motor-vehichle accident The ratio (measured as percent) of the ventricular-cross area of the lateral ventricle The maximum width (MTW) of the third ventricle was also determined. The data collected .was statistically analyzed.
Results: Measurements of VBR ratios and MTV in both males and females of the normal groups revealed no significant difference. No significant difference in VBR ratio and MTW was noticed till the age of 49 years. Significant differences were noticed between 49-69 years of age.
Conclusion: Abnormalities of the cerebral ventricular sizes are more easily identified in the Young than that found in old persons.
Keywords: Computerized tomography scan (CT scan), ventriculo-cerebral ratio (VBR %), maximum cerebral third ventricle width (MTW).

Summary:
Background: The hippocampus is empirically assumed to have different functions, of which the best known are: the representation of self-location in cognitive dimensions, and the storage and retrieval of memory.
Materials and methods: Eleven adult male albino rats were used. Brain specimens were processed into paraffin blocks, sectioned (10 µm thick), and stained using Haematoxylin and Eosin, and Luxol Fast Blue MBS counterstained with Cresyl Violet. Morphometric analysis was done through eyepiece micrometers.
Results: The lamellae of the hippocampus were morphometrically evaluated in context of embryogenesis and nerve fiber content.
Conclusion: This study confirmed the existence of differences in nerve fiber distribution among the subfields of the hippocampus which is attributed to differences in the embryonic development processes and to the selectivity of the different connections.
Keywords: Rat Hippocampus, Lamellar Morphometry.

Summary:
Background: several new inflammatory markers have emerged as strong predictors of cardiovascular disease in healthy and non-healthy subjects, one of these markers is hs-CRP, which has been proposed as independent risk factor for cardiovascular disease, and it is positively associated with body weight. Little is known, however, about the utility of hs-CRP and other biomarkers in obese hypertensive Iraqi post menopausal women.The aim of study is to examine the hypothesis that there is a relation between obesity, hypertension and a chronic low-grade inflammatory status (represented by high hs-CRP).
Patients and Methods: A total number of 99 postmenopausal women classified into obese hypertensive group (case) and non obese non hypertensive group(control). For these groups, measurement of zinc, calcium, phosphorus, lipid profile, High sensitivity C–Reactive Protein, body mass index and waist circumference were done.
Results: The (Mean ± SD) of hs-CRP in the cases and controls were (5.74 ± 2.1) mg/land (2.1 ± 0.8) mg/l respectively, (P < 0.001).Calcium, phosphorus, zinc and triglycerides showed no statistical significance between the groups (Pvalue >0,05) while body mass index , waist circumference ,HDL ,LDL ,and total were statistically significant (Pvalue <0,05).
Conclusion: There is an elevated serum level of hs-CRP in hypertensive and obese subjects in comparison with low levels in control group (non obese non hypertensive) which suggest a role of hs-CRP in developing hypertension and obesity.
Keywords: high sensitivity C-Reactive protein, hypertension, obesity, postmenopause.

Summary:
Background: Hydatid disease also known as echinococcosis or hydatidosis , is caused by infection with larva (metacestoide) of tape worms of the genus Echinococcus.
Materials and methods: Twelve Rabbits were immunized with three types of antigens (Hydatid cyst fluid antigen; Protoscoleces antigen and Germinal and Laminated layer antigen) according to a specific immunization program and we used indirect hemagglutination test( IHAT) and Enzyme Linked Immuno Sorbent Assay(ELISA) for detecting the anti-Echinococcus antigens in the serum of these animals.
Results: The highest titter of antibodies were recorded in the Rabbit serum when use the first antigen (Hydatid cyst fluid) by using IHA method (1:64)after the end of immunization program while in ELISA method reached (1:128), The serum level for the rabbit serum that immunization with the second antigen(Protoscoleces) has reached (1:256) by using IHAT and (1:512)when use ELISA, The highest titter of third antigen (Germinal and Laminated layer)has reached (1:128) by using IHAT and (1:256) when we used ELISA method.
Conclusion: The highest antibodies titer could be found when use the Protoscoleces antigen more than Cyst fluid and Germinal and Laminated layer antigen.
Key words: Hydatid cyst, E.granulosus

Summary:
Background: Normospermia might be a major problem to the doctor and the infertile couple because the male seminal sample has an accepted seminal parameters during the routine seminal examination and the female partner will be claimed for the infertility and she will suffered from coasty, painful, time consuming, non indicated investigations and treatments. Our purpose was to measure sperm creatine phosphokinase (CK) activity, which reflects cytoplasmic retention in immature spermatozoa and malondialdehyde in the seminal plasma which is a marker of oxidative stress in normospermic infertile males' seminal samples.
Patient and methods: Nine infertile men with aberrantly normal standard seminal analysis parameters where included in this study and fifteen fertile men samples where used as control. The seminal kinase and seminal malondialdehyde were calculated in addition to the standard seminal analysis.
Results: significant higher levels of creatine kinase and malondialdehyde in the normospermic infertile samples (p=0.0001; p=0.006 respectively) and also significant positive correlation between the seminal creatine kinase and seminal malondialdehyde (p=0.001; r=0.613). These markers did not correlate with the percentage of mid piece abnormalities in the studied samples.
Conclusion: The seminal plasma creatine kinase and seminal malondialdehyde might be accepted methods to differentiate infertile samples from healthy despite the presence of accepted ranges of standard seminal analysis.
Keywords: Normospermia, Oxidative stress, Creatine Kinase.