The Medical Journal of Basrah University

Abstract

ABSTRACT
Forty-four patients who had rheumatoid arthritis were evaluated clinically and by laboratory tests. Twenty-two
patients received zinc sulphate capsule (50 mg/day) plus standard treatment, while twenty-two patients received
placebo and standard treatment. All th1e patients were evaluated one month later. Those who received zinc therapy
revealed significant improvement in both clinical and laboratory tests, in comparison with those who received placebo
therapy.

Abstract

ABSTRACT
Diabetic nephropathy is the most important cause of increased morbidity and premature mortality in patients with type 1
diabetes mellitus. Detection of microalbuminuria helps to carry out early interventions to halt the progression of early stages of
diabetic nephropathy to advanced renal disease. In this study the albumin: creatinine ratio was estimated in 70 children and
adolescents with type 1 diabetes mellitus and 74 non-diabetic subjects attending Basrah Maternity and Children Hospital over
one-year period (from the first of June 2001 till the end of May 2002), their ages ranged from 16 month-18 year. Albumin:
creatinine ratio on early morning urine samples, HbA1C, blood pressure measurements and growth measures were recorded.
Microalbuminuria (albumin: creatinine ratio 30-300mg/g) was present in 41.42% of patients with type 1 diabetes mellitus, while
macroalbuminuria (albumin: creatinine ratio > 300mg/g) was detected in one patient (1.42%). Factors associated with a raised
albumin: creatinine ratio compared with normoalbuminuric patients (albumin: creatinine ratio < 30 mg/g) with type 1 diabetes
mellitus include longer duration of diabetes mellitus (P-value < 0.01), poor glycemic control reflected by raised HbA1C (P-value
<0.001), and older age of diabetic patients (P-value <0.05). Microalbuminuria was not associated with body mass index, gender
and systolic and diastolic blood pressure. These results stress the need for routine monitoring of diabetic patients for
microalbuminuria and the importance of improved glycemic control in these patients.

Abstract

ABSTRACT
The study was conducted on 210 patients of both sexes suffering from Type 2 Diabetes Mellitus to investigate the effected of diet or
hypoglycemic agents therapy on fasting blood sugar (FBS) and glycosylated haemoglobin (HbA1c). Seventy-two of the patients
treated by diet only and 138 by hypoglycemic agents. Another 95 adult individuals taken from the same population who were
apparently healthy and not suffering from diabetes mellitus were used as controls. A statistical higher values of FBS
(178.13±70.84 mg/dl for diet and 219.08±73.02 mg/dl for hypoglyecemic group) and HbA1c (8.35±2.07% for diet and 9.57±1.83
% for hypoglycemic group) were found among the diabetic patients in comparison with the control group (FBS=99.73±9.04
mg/dl, HbA1c=5.64±0.71%).Comparison between FBS and HbA1c of the diet and those of the hypoglycemic groups showed a
highly significant differences (P<0.0001 for both). A strong correlation was found between FBS and HbA1c of the patients treated
with diet or hypoglycemic agents (r=0.85 and 0.78, respectively, P<0.0001). The study concluded that, diabetes mellitus is a
progressive disease which is difficult to control even by continuous use of diet or hypoglycemic therapy, and measurement of
HbA1c can be used to assess the glycemic state and to confirms FBS measurements.

Abstract

ABSTRACT
A seroepidemiological study was carried out in Basrah from October 2003 to October 2004. The study aimed on
determination of the prevalence of rubella IgG antibody among children under 15 years of age and females at
childbearing age, rates of vaccination and provide information on immunity gap in certain age groups post
vaccination and to estimate the duration of vaccine induced immunity and the rate of overtime loss of rubella
antibody post vaccination. A total of 1309 blood samples were collected beside 80 pairs of blood samples from children
and 77 samples from females at childbearing age. Specimens were collected from primary health care centers and
primary schools. An Enzyme-linked Immunosorbent Assay (ELISA) was used for detection of rubella IgG antibody.
The overall vaccination coverage was 78.9% leaving 21.1% unvaccinated. There were a variation in vaccination
coverage in different age groups, 66.9% among 2-5 years old children, 85% of 6-8 years old and 83.2% of 10-14 years
old. The prevalence of rubella antibody and vaccination coverage in rural areas (37.6%) is significantly (P<0.05)
lower than in urban areas (62.3%) among children received 2 doses of MMR. There is a significant decline in the
levels of rubella antibody overtime post vaccination and losses of protective levels of antibody was quite evident by 3-4
years after the primary doses of rubella vaccine which stress the need for booster doses. The prevalence of rubella IgG
antibody among females at childbearing age was 68.8% leaving 27.2% of those female were susceptible to rubella
with increased risk of congenital rubella syndrome (CRS) if these females catch the infection during early pregnancy.

Abstract

ABSTRACT
Objective: To assess, oxidative stress (by measuring malondialdehyde "MDA" which reflects lipid peroxidation, and
total antioxidant status "TAS"), and immunoglobulin levels (IgA, IgG, IgM) in patients with Hodgkin's lymphoma
before and one month after starting cytotoxic drugs, in comparison with controls.
Design: Case-control study
Setting: This study was conducted in the Hospital of Nuclear Medicine and Department of Pharmacology, College of
Medicine, University of Mosul.
Patients and Methods: Twenty-three patients with Hodgkin’s lymphoma were included in this study together with 24
apparently healthy subjects taken as a control. Initially for both patients and control, serum MDA, TAS and
immunoglobulin levels (IgA, IgG, IgM) were measured and reported one month from starting specific cytotoxic drugs
for the patient groups and after one month gap period for the control using especial commercial kits from Randox
company (UK), for measuring TAS and immunoglobulin levels, while measurement of MDA was done by laboratory
method.
Results: Before starting cytotoxic regimen, there was a highly significant rise in serum MDA concentration in
patients with Hodgkin's lymphoma in comparison with control. After one month from starting cytotoxic regimen,
there was a highly significant rise in serum MDA concentration and a significant reduction in TAS and serum
immunoglobulin levels. By comparing the period before and after starting cytotoxic regimen in patients with
lymphoma, there was a significant rise in MDA and a significant reduction in TAS and immunoglobulin levels with
the exception of IgM which showed insignificant reduction.
Conclusion: This study revealed a rise in the oxidative stress; to which patients with Hodgkin's lymphoma were liable
to, by the effect of specific cytotoxic regimen. This is reflected by the rise in the serum level of MDA and a reduction
in the TAS after cytotoxic regimen. It also indicated a reduction in immunity of such patients during cytotoxic
regimen as reflected by a reduction in immunoglobulin levels.

Abstract

ABSTRACT
This is a cross-sectional study carried out to study stress and the coping strategies among medical students of the
University of Basrah for the year 2005. The study involved 300 students (50 students from each class) selected
randomly. Special question form was designed for the purpose of the study; it included sociodemograhic criteria, like
age, sex, residence and class, academic factors, delay years and coping strategies. The study found that 44.6% of the
medical students perceived stress, and the highest prevalence was among the first year followed by the third then the
fifth year medical students, with significantly higher rates among females than males, among those originally from
other governorates and among those having delay years. The major reported cause of stress was academic factors and
the current political and security reasons. The response or coping strategies vary between individuals. The study
recommended that consideration should be given to program developers and health decision makers to focus on
significant actions to reduce the academic stress perceived by medical students. Psychological consultations have to be
in each medical school trying to help the students to face their individual stressors in a healthy way and to increase
the emotional and financial support for the students specially those from other governorates.

Abstract

ABSTRACT
Objectives: To study the association between metabolic syndrome components and ischemic heart disease (IHD) in
both sex.
Patients & Methods: A total of 1387of adult in-patients attending three different hospitals were studied. Clinical
examination and specific investigations to clarify the incidence of a central metabolic factor (body mass index BMI,
high serum triglycerides TG and low high density lipoprotein HDL), a glucose factor and a blood pressure factor were
carried out. The presence of metabolic syndrome was defined as the presence of three or more risk factors.
Results: There were significant positive association between IHD defined by resting electrocardiogram (ECG) criteria
and the components of metabolic syndrome including obesity, elevated blood pressure, fasting and post challenge
hyperglycemia, high TG and an inverse significant association with HDL cholesterol. Metabolic syndrome was
present in 48% of studied IHD patients, with clear predominance of females 60%. Hypertension was the commonest
risk factor in both males and females (82%), obesity 57%, diabetes 20%; both more common in females. High
triglycerides present in 35%, while low HDL in 23%. These results support the thesis that the metabolic syndrome
exerts effects through different risk factors by different mechanisms.
Conclusions: the metabolic syndrome is common among ischemic heart disease patients and is related to modifiable
risk factors.

Abstract

ABSTRACT
Objective: To assess the relationship between the Doppler umbilical artery flow velocity waveforms (AB ratio) in mild
hypertensive pregnancy and the fetal outcome.
Materials & Methods: This is prospective study which carried out between January 2004 and January 2005. Doppler
examination of the umbilical artery was available for 135 pregnant women within 1 week of delivery. The value of the
last Doppler AB ratio was classified into 3 groups: normal (AB ratio is <95th centile value) high AB ratio (if AB
ratio is >95th but <99th centile value) and extreme AB ratio (if ratio is >99th centile value).
Results: Normal AB ratio was found in 91% of mild hypertensive women and 82% of cases were delivered after 36
weeks with average mean birth weight and good Apgar score (more than 6 at one minute). Abnormal ratio was found
in 5% of mild hypertensive cases with 40% of them was delivered before 36 weeks with significant admission in the
intensive baby care unit.
Conclusion: Doppler study can be used as a good tool for assessment of high risk fetus in mild hypertensive women.

ABSTRACT
A prospective study was carried out to evaluate the frequency of toxoplasmosis in children with glucose-6-
phosphate dehydrogenase deficiency at Basrah General Hospital and Basrah Maternity and Children Hospital for 1
year (from October 2004 - October 2005). One hundred ten children (6 months - 60 months) of age were screened
for both toxoplasmosis antibodies and glucose-6-phosphate dehydrogenase deficiency; fifty (45.5%) children had
glucose-6-phosphate dehydrogenase deficiency, 48% of them had toxoplasmosis. The reminder sixty children
(54.5%) had normal glucose-6-phosphate dehydrogenase activity; among them fifteen (25%) had toxoplasmosis.
From this study it was concluded that acquired toxoplasmosis was significantly higher among children with G6PD
deficiency compared to those of normal G6PD activity.

Abstract

ABSTRACT
This is a cross-sectional study carried out to study the validity of the cardiothoracic ratio as a predictor of cardiac
enlargement. The study involved 150 patients attending Alsader Teaching Hospital for various cardiac symptoms.
The cardiothoracic ratio (CTR) was measured for 150 posterior anterior (PA) view chest x-ray. Left Ventricular
Internal Dimension in systole (LVIDs) and Left Ventricular Internal Dimension in diastole (LVIDd) were measured
by 2D echocardiography (through the parasternal axis) in patients who have a PA view chest x-ray within the same
week. The study showed that the ability of chest x-ray (by measuring CTR) to measure cardiac size in patient with
cardiomegaly in comparison to echocardiography (by measuring LVIDd) is high (sensitivity 85.71%), while the
ability of chest x-ray to exclude cardiomegaly in comparison to echocardiography is low (specificity 13.79%).
Furthermore, the ability of chest x-ray to detect (sensitivity) or exclude (specificity) cardiomegaly in comparison to
echocardiography (by measuring LVIDs) was 90.47% and 17.24% respectively. The study found significant
correlation between CTR and LVIDd (using Pearson correlation), and there was no significant correlation between
CTR and Body mass index (BMI). The study recommended that because it is easy and cheap to measure the CTR by
the chest x-ray for any patient in the emergency department, it can be regarded as a preliminary measure to the size
of the heart, but echocardiographic measurements remained the most accurate.

Abstract

ABSTRACT
To date few studies have been reported from Basrah regarding Gestational Trophoblastic disease GTD. This study
was a clinical observational study done in Basrah at the 4 main obstetric hospitals based on 137 patients with GTD.
The objective was to study the incidence of Hydatidiform Mole gestation and other Gestational trophoblastic diseases
in Basrah and to review the clinical presentation and management of Hydatidiform Mole gestation in Basrah. Clinical
records of patients were reviewed with regards to presentation, investigation, management and outcome. Of 137
patients, there were 132 patients (96%) treated for hydatidiform mole, 3 patients (2%) were treated for
choriocarcinoma, 1(1%) patient had invasive mole and 1(1%) patient had placental site tumor. The incidence of
molar pregnancy and choriocarcinoma was 1.7/1000 deliveries and 0.04/1000 deliveries, respectively. Molar
pregnancy seems to be a common problem in Basrah but sever complications such as pre-clampsia & thyrotoxicosis
were not reported in this study.

Abstract

ABSTRACT
Vitex (known locally as kaf murium) has along history of traditional use in women. The effect of alcoholic extract of
vitex agnus-castus was examined for its effect on some blood parameters in mice (Mus Musculus). Mice in the
treatment groups were injected intraperitoneally with two doses (6 mg and 12 mg / mouse) of vitex extract while the
control group received distilled water daily for two weeks. Blood parameters (RBC, Hb, PCV) showed a significant
decrease with both doses in comparison to the control group (P<0.01), while no significant decrease in (WBC) was
found. Biochemical parameters (total serum protein, total serum cholesterol) showed a significant decrease in the
treatment groups as compared with the control group (P<0.01). In conclusion, vitex agnus-castus alcoholic extract
can have a significant adverse effect on blood. Its cholesterol lowering effect worths investigation in the future.