The Medical Journal of Basrah University

Abstract

ABSTRACT
Objective: To investigate the relationship of Cryptosporidium and immunological parameters among children with malignant diseases.
Methods: Stool samples were collected from 101 children with malignant disease and 107 apparently healthy children. Direct smear method and then formalin-ether sedimentation method were done for all stool samples to identify intestinal parasites. Fecal smears were prepared from the sediment and stained by the modified Ziehl-Neelsen method for the recovery of acid-fast oocysts of Cryptosporidium. Phagocytic activity, complement C3 and C4 estimation, immunoglobulin levels and CD3, CD4, CD8, CD19 marking and phenotyping were carried out for 30 patients with acute lymphocytic leukemia (ALL) and 20 control group.
Results: ALL was the major type (47.52%) of malignant cases in the studied subjects. The other type ranged from 0.99% to 10.9%. Out of the 101 patients, 50(49.5%) were found to be positive for intestinal parasites compared to 13(12.15%) of the control group (P<0.01). Cryptosporidium oocysts were found to be excreted by 10(9.0%) patients and 1(0.93%) of the control group (P<0.01). The phagocytic activity, levels of IgM, IgA, IgG and CD3, CD4 cell numbers were lower in patients than in control group while higher in case of C3, C4, CD8 and CD19.
Conclusion: Children with malignancy are immunocompromised. Therefore, Cryptosporidium and other intestinal parasites must be considered in the differential diagnosis in this risky group in order to reduce the suffering often faced by those children.

Abstract

ABSTRACT
A cross sectional study to assess Blood Lead Levels (BLLs) among children in Basrah was carried out during July
2005. The study included children 1-6 years old attending three selected primary health care centres located at
different socioeconomic areas in Basrah (representing both rural and urban communities). Two of the health
centres are located in the city centre, one in a relatively high socioeconomic area (Al-Razi health centre) & the
second in low socioeconomic area (Al-Seef health centre). The third health centre included in the study is located in
Abul-Khasib district. The questionnaire method was used in collecting information regarding socioeconomic factors
that may be related to environmental exposure to lead, and a blood sample was taken from each child to measure the
blood lead level. The BLLs among children in this study ranged between 1 and 65 μg/dL (mean ± SD, 11.59 ± 9.1
μg/dL). Overall, 40.4% of children had elevated blood lead levels ≥10 mg/dL). The mean BLL was significantly higher
for children who live in rural or in urban low socioeconomic area than that for children living in urban high
socioeconomic area. Age above 2 years was significantly associated with elevated BLLs.

Abstract

ABSTRACT
A prospective study was carried out to determine the predictors of outcome in neonates with sepsis admitted to
neonatal care unit at Basrah Maternity and Children Hospital over six months (from the first of November 2004 till
the end of April 2005). One-hundred twenty neonates were studied, sepsis was confirmed by clinical and laboratory
measures. Seventy four (61.7%) neonates were males and 46 (38.3%) were females. Thirty three (27.5%) were
preterm and 87 (72.5%) were full term. Sixty seven (55.8%) neonates were still alive during period of
hospitalization and discharged home, while fifty three (44.2%) neonates died. Early onset sepsis was detected in
35(29.2%) neonates while late onset sepsis was detected in 85(70.8%) neonates, however, the mortality rate was
higher in early onset sepsis (62.9%) compared to late onset sepsis (36.5%). The mean body weight was significantly
lower in neonates who died (1.97±0.67), compared to those who survived (2.79±0.6). A significantly higher
mortality rates were among premature neonates (69.7%), and those with intrauterine growth retardation (70.8%).
In addition, the death rate was higher in neonates with maternal history of prolonged rupture of membrane ≥24
hours (61.5%) compared to (39.4%) in neonates with maternal history of rupture membrane of < 24 hours before
labor. The clinical signs that predict high mortality were sclermic skin (94.2%), signs of dehydration (82.8%) and
prolonged capillary refilling time (68%). Highest mortality was associated with positive blood culture for
Pseudomonas aeruginosa and Staphylococcus aureus, where all neonates died (100%), followed by klebsiella spp.
and Escherichia coli (71.1%) and (48.5%) respectively in comparison with neonates who have positive blood
culture for Proteus and Enterobacter aeruginosa where only 7.9% and 11.1% of neonates died respectively. A
statistically significant higher mortality was reported in neonates having thrombocytopenia, neutropenia and Creactive
protein ≥10 mg / dl. Regression analysis of different neonatal and maternal variables, hematological and
microbiological tests, revealed that body weight, gestational age, thrombocytopenia, neutropenia, positive blood
culture for klebsiella spp., prolonged capillary refilling time, sclerma and signs of dehydration are predictive factors
of the outcome of death in neonatal sepsis.

Abstract

ABSTRACT
Objective: to evaluate the effect of lovastatin and simvastatin on liver function tests in a number of hyperlipidaemic
patients.
Design: case control study.
Setting: the study was conducted in Al-Salam Hospital in Mosul during the period from July 2003 to July 2004.
Participants: forty-two patients taking lovastatin and fifty-three patients taking simvastatin. Another fifty,
apparently healthy subjects, were also involved as a control group.
Intervention: ALT, AST and ALP activities and bilirubin concentrations of patients on lovastatin, simvastatin and
control group were compared.
Main outcome measures: measurement of serum of ALT, AST and ALP activities and serum bilirubin concentration
in lovastatin, simvastatin and control groups.
Results: results of the study revealed a minor elevation of ALT, AST and ALP activities and bilirubin concentrations
above the upper normal limit values in a number of participants taking lovastatin or simvastatin therapy. A
significant elevation of ALT, AST and bilirubin in the lovastatin group compared with the control group and a
significant elevation of ALT and bilirubin in the simvastatin group when also compared with the control group were
found. Stratification of the patients according to age, duration of treatment and dose, revealed a good correlation
between some of the hepatic parameters and the age, duration of treatment and dose, though some of these elevations
were not statistically significant.
Conclusion: therapy with lovastatin or simvastatin is associated with a mild effect on the liver and the effect is related
to the variables of age, duration of therapy and dose. Periodic monitoring of biochemical hepatic parameters during
therapy with lovastatin and simvastatin may be of value to observe any serious elevation of these parameters.

Abstract

ABSTRACT
Objective: to verify the occurrence of congenital neural tube anomalies among the newborns of pregnant women who
had experienced exposure to tobacco smoke.
Design: A cross sectional study of pregnant women at delivery considering their newborns as a gestational cohort.
Methods: A systematic random sample of 2300 pregnant women who attended for labour at Maternity and Children
hospital in Najaf city were interviewed for history of tobacco smoke exposure during the period 2002-2004. The
sample was subdivided into exposed and unexposed women to tobacco smoke. The newborns were clinically examined
by a pediatrician for presence of any congenital anomalies especially neural tube defects.
Results: The over all newly delivered newborns with congenital anomalies were 3.4% among smoker mothers, and
1.9% among nonsmokers (including small defects). The most frequent neural tube defects among smoker mothers
were anencephaly (1.8%) and spina bifida (1.2%), versus 0.7% and 0.6% respectively among non smokers or
unexposed women (P<0.05). There was some increase in the risk of such defects among exposed women to tobacco
smoke who did not take folic acid in relation to unexposed in spite of no statistically significant difference. Also there
was no significant difference in the distribution of neural tube defects between those women who live in urban or
rural areas or between different age groups.
Conclusion: Smoking is a risk factor for neural tube defects.

Abstract

ABSTRACT
A cross-sectional comparative study was carried out to study the prevalence of occupational allergic disorders among
flour mill workers. In this study the flour mill workers from three major flour mill industries in Basrah (study group)
were compared to non exposed group from diary products and pepsi cola industries (comparative group). The results
showed that the prevalence of work-related allergic conditions as reported by workers and diagnosed by one of the
investigators was significantly higher among the study group than that in the comparison group.

ABSTRACT
Investigations have been carried out on the effect of maternal protein free diet on the placenta of laboratory mice of
Balb/C strain. The thickness of placental barrier was measured. Placental weight, fetal weight, fetal numbers were
also calculated and histological study was also done. Animal husbandry and the day of conception were arranged.
Pregnant mice were dissected at days (12th, 14th, and 18th) of gestation. Thirty placentas from mice on protein free
diet and fifteen placentas from mice on control diet, were taken, stained by haematoxylin and eosin and examined
under light microscope with screen. The following results are subsequently obtained:
1. Reduction in fetal number and weight of mice after protein malnutrition, in comparison to their
control at the same stage of gestation.
2. Reduction in placental weight of mice after protein malnutrition, in comparison to their control
at the same stage of gestation.
3. Reduction in the thickness of trophoblastic layers of placental barrier in mice after protein
malnutrition, which are measured by using light microscope with screen and scientific ruler.
4. Morphological changes showed thin placental barrier, with basophilic cytoplasm and
degenerated nuclei. Areas of degeneration infiltrated with phagocytic cells with increase in the
number and size of blood vessels were seen.
These changes may affect the placental function, which may be the main cause of decrease in fetal weight (intra
uterine growth retardation), placental weight and fetal number.

Abstract

ABSTRACT
Risk factors for ischemic heart disease in 421 middle aged and elderly patients attending three hospitals in Basrah
were studied. Metabolic syndrome defined as the presence of three or more of these risk factors were studied too.
Obesity, hypertension, smoking, diabetes and dyslipidemia were present in 46%, 42%, 40%, 30% and 30% of patients
respectively. Most of these factors were uncontrolled. 161(38%) of patients had no detectable risk factor. Metabolic
syndrome was present in 118(28%) of the studied patients.

Abstract

ABSTRACT
Active smokers are exposed to reactive free radicals that are present in cigarette smoke. Oxygen free radicals,
including superoxide, hydroxyl radicals, peroxyl radical hydrogen peroxide and singlet oxygen, are highly reactive
species that can cause a wide spectrum of cell damage including enzyme inactivation, lipid peroxidation, protein and
lipoprotein oxidation, and DNA damage. Free radicals are believed to be involved in the pathogenesis of
cardiovascular diseases and cancer. The purpose of the present study was to measure the total antioxidant status
(TAS) in active cigarette smoking individuals in Mosul city. Twenty active smokers and twenty nonsmokers
participated1in the study. Blood sample was taken from each individual and the TAS had been measured in the sera
using the Cayman chemical antioxidant assay kit (USA). The results obtained from the study revealed a significant
(P<0.001) reduction of the TAS in the smoker’s group as compared with the non-smoker’s group. In conclusion,
smokers possess low TAS than non smokers which may be due to the presence of high amounts of free radicals in
cigarette smoke that generate an oxidative stress in the smoker’s body that may cause exhaustion of antioxidants of
the body.

Abstract

ABSTRACT
A retrospective study was conducted on 376 patients with history of prolonged fever who were admitted
in Al-Nassiriya Pediatric Hospital during the year 2002; their clinical features were highly suggestive of
Kala-azar. Bone marrow examination was done for 200 cases and the results were positive in 168 cases
(84%). Serological tests were not available to confirm cases diagnosed on clinical bases and those with
bone marrow negative results, for that reason the last two groups had been excluded from the study. It
was found that the majority of cases (94.64%) were below the age of 3 years, 51.8% were males and 48.2%
were females. A high percentage of cases 85% were from rural areas and only 15% were from city center.
The number of cases recorded during the year 2002 was much greater than that recorded during the
years 1989, and 1990. The study had elucidated one of the important health problems among children in
Thi-Qar governorate. The importance of preventive measures was stressed.

Abstract

ABSTRACT
This study aimed at determining the burden of cancer as a cause of death in Basrah over three selected years; namely
1989, 1997 and 2005. All death registries in Basrah city, Districts and sub districts were used as sources of
information for data compiling. Every death recorded in the three years was checked for cause of death and all cases
for which any type of cancer written as the cause of death were identified. Data related to age, sex, place of residence,
type of cancer, place where death was certified and year of death were obtained. In addition, the numbers of total
deaths due to all causes in each year were also recorded. The results indicate a total of 297 deaths in 1989, 499 deaths
in 1997 and 649 deaths in 2005 could be attributed to cancer. Regarding sex distribution of deaths, slightly more
deaths occurred in males (53.8%) than in females (46.2%) with significant rise of cancer in females in 2005. Cancer
as a cause of death represents about 5% of all deaths with some degree of increase in 1997 and 2005 as compared to
1989, but no major change in the cancer specific death rates among different years. Geographically, the distribution
shows significant but not substantial variation with years. The mean age of dead persons was similar in the three
years. The leading cancer deaths were those of lung, urinary bladder, blood, breast, lymphomas and CNS. The overall
risk of death is not much different in different years except for a slight increase in 1997 and 2005 in comparison to
1989. Most cancers show stable or slightly fluctuating level of risk of death with time. Slight rise in the risk of death
may be noticed in cancers of CNS, blood (leukemia), Bones, lymphomas and Colon-rectum. The researchers suggest
that the stable level of mortality could reflect some improvement in treatment based on early diagnosis of many
cancers. A study covering at least ten years is highly recommended to establish more sound time trend in cancer
mortality.