The Medical Journal of Basrah University

Abstract

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ABSTRACT
Background: The composition of honey and its therapeutic benefits depend partly on the type of the trees from
which bees extract their nutrients. It is, therefore, expected that honey produced at various seasons or at different
locations might have different properties.
Objective: To investigate the glycemic response to three types of locally produced natural honey in comparison to
dextrose and table sugar.
Design: A cross-over study on healthy volunteers
Settings: College of Medicine, University of Basrah
Methods: Five apparently healthy volunteers, 3 males and 2 females, took part in the study. Each volunteer received,
the three types of honey (Seeba, Sarraji and Nahr-Khooz, one of them spring-type and other two are autumn-type),
dextrose, and sugar (75g in 200 ml distilled water) in a cross-over design. Blood glucose level was measured before
ingestion and 30 minutes, 1 hour, 1.5 hours and 2 hours after ingestion.
Results: The three types of honey raised the blood glucose level 30 minutes after ingestion by a range of 31-39% with
respect to pre-ingestion level. There was no statistically significant differences between the three types, although,
"Sarraji" type-an autumn-type, tended to result in a lower and "Seeba" honey-a spring type-in a higher blood
glucose levels. Generally, the effect of honey on blood glucose was more gentler, on a per gram basis, than dextrose or
table sugar, representing 61.8% of the level reached after dextrose or sugar load. Honey glycemic effect is also shortlived;
occurring mainly in the first hour after ingestion.
Conclusion: Different types of natural honey did not seem to differ significantly in their effect on blood glucose.
Their effect in raising the blood glucose is milder and shorter than that caused by same amount of dextrose or table
sugar. Studying the effect of smaller doses of honey in diabetic patients is recommended.

ABSTRACT
This is a cross sectional record based study aimed at studying the incidence and trend of caesarian section in Basrah
Maternity and Child Hospital during the period extending from 1997-2003. In addition a sample of 150 women who
were delivered by caesarean section in the same hospital over the period extending from the 1st of June to the 15th of
September 2004 were also included to study the indication for Caesarean section. The results of the study showed that,
the overall incidence rate of caesarean section over the period 1997-2003 was 15.25%. The annual incidence of
caesarean section in the 7 years period showed a steady increase from 10.8% to 21.3%. The commonest indication for
elective caesarean section was previous two scars (33%), while for emergency cases abnormal presentation and lie
was the commonest indication (27%).

Abstract

ABSTRACT
A prospective study was done during the period from October 2005 to July 2006 at the Departments of Microbiology
and dermatology, Basrah University Medical College, and aimed on the evaluation of the effectiveness of topical
antimicrobial agents on the plaque type psoriasis clinically and bacteriologically, before and after drug therapy and to
compare it with that of the non-involved skin of psoriatic patients and healthy controls. Bacteriological examination
was carried out on 500 skin swabs taken from psoriatic plaques before and after treatment for 3 weeks with topical
fusidic acid (2% concentration, IHP, Denmark) or tetracycline (3%, SDI) pre-and post-application and from
uninvolved skin of psoriatic patients and from matched healthy controls. In addition to the responses to either fusidic
acid or tetracycline, topical applications were assessed clinically by psoriasis severity index (PSI). Plaque psoriasis
showed a significant clinical responses (P<0.001) to topical antimicrobial agents (changes in PSI score). Guttate
psoriasis had no such responses. On the other hand, psoriasis plaques harboured a higher density (104-105 CFU/ ml)
of microbial population compared to the non-involved skin of psoriatic patients (Not exceeds 102 CFU/ml). Microbial
density was reduced significantly (P<0.01) by 3 weeks after topical fusidic acid and tetracycline application (from >
105 to <102 CFU/ml). Staphylococcus epidermidis (a species of coagulase-negative staphylococci) was
significantly the most prevalent bacteria (P<0.001) on the psoriatic plaques.
In conclusion, topical fusidic acid (2%) and tetracycline (3%) are effective in the treatment of mild to moderate
plaque psoriasis but not in the treatment of guttate psoriasis. Staphylococcus epdermidis may play a role in the
pathogenesis of plaque psoriasis. Further detailed study is suggested to clarify this role.

Abstract

ABSTRACT
Change in lifestyle increased the prevalence of obesity, which is associated with high serum leptin (SL) concentration
and insulin resistance (IR). IR may be present, many years before the appearance of diabetes mellitus. The aim is to
investigate the relationship between SL and IR in non-diabetic young female. Eighty students (aged 18-30 years)
were recruited in this cross-sectional study. Fasting SL, serum insulin, blood glucose, HDL, LDL, total cholesterol,
and triglycerides were measured in addition to anthropometric measurements and blood pressure. IR, Body Mass
Index (BMI), Waist-hip ratio (WHR) and Waist-height ratio (WHtR) were calculated. The mean BMI was 26.7±6.0
kg/m2, mean fasting SL was 30.1 ± 15.4 mg/ml and serum HDL-cholesterol was 59.2 ± 12.2 mg/dl. BMI correlated
directly with fasting SL (P<0.01), fasting insulin (P<0.01) and IR (P<0.01). IR was best predicted by Fasting SL
(value± SE: 0.343±0.007, P<0.01) with which it had a strong positive correlation (P<0.01). There was a positive
correlation between fasting SL and WHtR (P<0.01) but not with WHR. In addition IR correlated positively with
systolic and diastolic blood pressure (r = 0.292, P<0.01 and r = 0.298, P< 0.01 respectively). There is a significant
association between fasting SL and IR in non-diabetic young females that depends on body fatness and its
parameters. Early preventive measures and treatment of those with IR could prevent progression to DM.

Abstract

ABSTRACT
Objectives: The aim of this work was to determine the five years survival of patients with breast cancer attending the
Oncology Center of Basrah between October 1999 and December 2001.
Methods: Three hundred eight patients attending the Oncology Center for registration and treatment during the years
1999- 2001 were studied and the status of each whether alive or dead was ascertained after one year and five years.
Result: Among 308 patients, 5 were males, 68.16% were in advanced stage (i.e. stage 2-4) and 5 years survival was
(25.24 %).
Conclusion: Five years survival of breast cancer in Basrah is low. This needs the adoption of wide scale screening
program to help early detection and to review the care and modalities of treatment to improve the outcome.

Abstract

ABSTRACT
One hundred and eighty asymptomatic workers in the steel industry of Basrah whose duration of employment ranges
from 5-15 year were randomly selected and examined at Al Sader teaching hospital during the period (2000-2002).
Workers was assessed clinically and the function of their respiratory system were studied by measuring FEV1 (Forced
Expiratory Volume in the first second) and FVC (Forced Vital Capacity). The results showed that the majority of the
examined workers 45.55% had restrictive pulmonary defect, 20% had obstructive pulmonary defect while 7.22% had
combined obstructive and restrictive defects.

Abstract

ABSTRACT
Background: Racial variation in the clinical presentation of rheumatoid arthritis (RA) and its response to treatment
is well known. Ethnicity and associated socioeconomic factors make it necessary to study the effectiveness of the antirheumatic
drugs such as sulfasalazine (SSZ) in our RA patients, and to what extent it interacts with the nonsteroidal
anti-inflammatory drug (NSAID); diclofenac.
Objective: To investigate the efficacy and toxicity of sulfasalazine alone or in combination with diclofenac in the
treatment of moderate to severe RA.
Methods: A three month-randomized clinical trial was conducted on patients with moderate to severe RA: Group I:
received SSZ (500 mg orally twice daily), and Group II: received SSZ plus diclofenac sodium 100mg SR tablets once
daily. Evaluation involved: pain, morning stiffness, joint function, patients and physician global assessment,
radiological assessment, ACR criteria, laboratory findings and drug adverse effects.
Results: Only 17 patients out of 20, managed to complete the 12 week treatment course. Oral SSZ (500mg twice
daily for 3 months) resulted in a statistically significant clinical improvement after 12 weeks of treatment. The
average percent improvement in six clinical parameters was 21.1%. The 20% improvement using ACR criteria
involved 11% of patients. The improvement occurred especially in the number of swollen joints and in joint pain. The
overall improvement that occurred two weeks after treatment with SSZ continued at the same level over the 12 week
treatment period. No statistically significant changes were detected in the laboratory parameters measured including
ESR. No radiological progression was found 12 weeks after treatment in joint space narrowing and joint erosion. SSZ
reduced symptoms reported by patients before treatment by 57.4%. Diclofenac as a sustained release formulation
administered concomitantly with SSZ did not change the improvement caused by SSZ as measured by the six clinical
parameters (23% versus 23.4%). However, the ACR20 increased from 11% to 25%. No effect on laboratory
measurements was found. Diclofenac in combination with SSZ reduced the symptoms reported by patients by 70.6%
compared with 57.4% by SSZ alone.
Conclusion: SSZ treatment for 12 weeks caused mild to moderate improvement in all measured clinical parameters,
especially in the number of swollen joints and in joint pain. Diclofenac as a sustained release formulation, given with
SSZ, did not change the improvement caused by SSZ as measured by six clinical parameters, although it increased
the ACR20 of SSZ from 11% to 25%.

Abstract

ABSTRACT
This is a comparative study, carried out to involve 160 individuals; 80 individuals with work-related allergic
symptoms who were grain industry workers with direct contact to the grain dust, and 80 individuals (control group)
were taken from Basrah General Hospital, not suffering from allergic disorders. The first group was divided into two
subgroups, including 47 workers in high exposure places to grain dust and 33 workers in low exposure places. ELISA
test was performed using locally prepared albumin/globulin extract to detect wheat specific IgE. The results showed
that 70% of individuals with work-related allergic symptoms had allergy in comparison to nil among control group.
The study also showed that the highest rate of positive ELISA result was observed in 80.8 % of individuals with workrelated
allergic symptoms working in highly exposed places to grain dust, compared to only 54.5 % among those
working in low exposed places. The study revealed a highly significant association between specific allergy and years
of service. The presence of respiratory symptoms was higher among workers in highly exposed places, followed by
skin and conjunctival symptoms.

Abstract

ABSTRACT
Background: Human milk is the ideal and uniquely superior food for infant for first year of life. Some
sociodemographic factor correlate most strongly with the prevalence and duration of breast feeding.
Objectives: To determine the prevalence of breast feeding and factors influencing the feeding practices in a study
population in Thi-Qar governorate.
Design: Cross-sectional study.
Methods: in three hospitals in Thi-qar governorate, the mother of infants in the primary health care units of these
hospitals, had been randomly selected and interviewed with a questionnaire which included information about the
age, sex and mode of feeding for the infants, and the sociodemographic status of the mothers. The sociodemographic
variables included, urban / rural residence, educational level, occupation or employment, family income, place and
type of delivery and contraceptive use.
Results: the prevalence of breast feeding was 90%, and bottle feeding prevalence was 10%; the mean time of weaning
was 11 months. Factor that were significantly associated with duration of breast feeding were maternal age, level of
education, area of residence, occupation, family income, place and type of delivery and contraceptive use. The most
common reasons for refusing to breast feed were in adequately secreted milk and the mother employment outside the
home.
Conclusions: the prevalence of women nursing breast feeding was higher than the estimated national data the
prevalence of the bottle-feeding was higher in women who needed to work out of their homes and in those with
higher educational level

Abstract

ABSTRACT
The results reported in this paper are part of a comprehensive cross-sectional study carried out in Basrah
governorate-Southern Iraq to quantify specific aspects of fertility. The study covered 2670 ever married women aged
15-60 years. The studied women were interviewed regarding demographic characteristics and detailed history of their
pregnancy experience. The results showed that the crude birth rate was 36.4 per 1000 population, the general fertility
rate was 139.3 per 1000 women, the average number of pregnancies per woman was 4.3 and the average number of
live births was 3.4 per woman. About 37.9% of women had at least one lost pregnancy (abortion or still birth) and
pregnancy wastage accounted for 14.1% of all reported pregnancies. The total fertility rate was 6.4 per woman and
showed some degree of decline over the last two decades. About 70% (R2=0.70)of fertility variation among women
could be explained by variables related to envisaged ideal family size, duration of use of family planning methods,
pregnancy wastage, number of women siblings, duration of couple separation, education of woman father, education
of woman and education of husband.

Abstract

ABSTRACT
Objectives: A prospective study was carried out to study the outcome of patients with visceral leishmaniasis and to
determine factors associated with poor outcome.
Methods: The study included 132 in-patient children who were admitted to Basrah Maternity and Children Hospital
and Basrah General Hospital during one year(from the first of November 2004 till the end of October 2005), with
visceral leishmaniasis confirmed by bone marrow examination and direct agglutination test.
Nutritional assessment was done for each patient. All patients with confirmed visceral leishmaniasis were sent for
complete blood count. The final diagnosis and the outcome of the patients with visceral leishmaniasis were recorded
also.
Results: Among 132 sero-positive cases, 78 (59.0%) cases were males, and 54(40.9%) were females. The age of
patients ranged between 2 months to 12 years.
Sixty five (49.2%) of the cases were improved, 31.8% were discharged on the family responsibility, and 15 cases died.
The commonest cause of death was bleeding in 6 cases (40%), followed by hepatic failure in 4 (26.6%), other causes
of death were bronchopneumonia, renal and heart failure.
Nutritional status and duration of illness were significant determinants of the outcome of visceral leishmaniasis
patients. A significantly higher number of malnourished patients didn’t improve compared to well nourished patients,
and a significantly higher percent of patients who presented late have died compared to those who presented earlier
especially in the first 2 weeks of illness, P<0.05. By using multivariate regression analysis, six variables; low
hemoglobin value, low platelet count, male sex, young age, high Direct Agglutination Test titer and malnutrition
were found to be significant predictors of death and relapse.
Conclusion: Male sex, anemia, thrombocytopenia, high DAT titer and malnutrition are poor prognostic factors in
addition late presentation.