The Medical Journal of Basrah University

Background: Aspirin is commonly used as antithrombotic agent to prevent primary and secondary cardiovascular
events. A proportion of aspirin-treated patients was found to be resistant to its antithrombotic effect. This proportion
varies widely in different studies ranging from 0 to 60% of aspirin treated patients.
Aim: To determine the prevalence of aspirin resistance among patients with stable ischemic heart disease through
measurement of 11-dehydrothromboxane B2 in urine.
Methods: The level of 11-dehydroTXB2 in urine was measured by ELISA method using commercial kits (Wuhan
company, China). Fifty three patients with stable ischemic heart disease (IHD) on 100 mg aspirin daily for not less
than one month (recruited from the Teaching Hospital Consultation Clinics and 50 apparently healthy volunteers
were involved in this study). Urine samples were taken in the morning from patients and volunteers and freezed until
analysis for 11-dehydroTXB2 and urinary creatinine. Blood samples were used for measurement of different blood
indices, lipid profile and glucose level. Absolute values of 11-dehydroTXB2 in pg/ml of urine and normalized values in
pg/mg creatinine were used for analysis. Two cutoff points reported in the literature to be associated with increased
incidence of clinical events were used to determine the prevalence of aspirin resistance.
Results: The level of 11-dehydroTXB2 in urine of normal subjects was 60.26±66.3 pg/mg creatinine, ranging from
11 to 379 pg/mg creatinine, while the level in patients with stable IHD on aspirin treatment 100mg orally, was 63.34
± 61.27 pg/mg creatinine, ranging from 5 to 316 pg/mg creatinine. There was no statistically significant difference
between males and females in the two groups. Associated diseases such as diabetes and hypertension, cholesterol level
and different blood indices do not seem to be associated with altered levels of 11-dehydroTXB2. The prevalence of
aspirin resistance in the present study was ranging from 1.8% to 7.5% for patients with stable ischemic heart disease.
Conclusion: the prevalence of aspirin resistance was ranging from 1.8% to 7.5% in patients with stable IHD. The
level of 11-dehydroTXB2 in urine of apparently healthy subjects and patients with stable IHD on aspirin treatment
100mg orally was similar

Background: At the present time, a national strategy is adopted in Iraq by the Iraqi Cancer Board to control cancer.
The strategy consists of six approaches to deal with the problem of cancer in Iraq. One of these approaches is to
establish a population based cancer registration. Among the important sources of data for such registry are hospital
based cancer registries.
Objective: To evaluate the cancer registry in Basrah General Hospital over a 4-year period (2005-2008) and to study
the pattern of cancer cases admitted to the same hospital during the same period.
Patients & methods: A descriptive retrospective record based study involving all diagnosed cancer cases admitted to
Basrah General Hospital over a four-year period (2005-2008) was carried out. Cancer cases were identified by
examining inpatients records that are available in each of the studied wards. Further the information related to each
cancer case derived from the inpatients records and compared with data recorded and compiled by the cancer
registration unit in Basrah General Hospital. This was performed to assess the reliability and adequacy of hospital
cancer registry as an important source of data about cancer cases diagnosed or admitted to the hospital.
Results: The total admitted cancer cases identified during 2005-2008 were 1207. Male cancer cases represented
61.4% of the total cases, while females represented 38.6%. The most frequent age group among males was 65-74
years compared to a younger age group for females (45-54 years). Majority of patients were inhabitants of Basrah
governorate (70.8%).The total admitted cancer cases during 2005, 27006, 2007 and 2008 were 263, 288, 353 and 303
respectively. The most frequent type of admitted cancer cases to Basrah General Hospital was urinary bladder cancer
forming 43.8% of total admitted cases. It ranked as the first male cancer accounting for 53.9% of total males' cases.
Breast cancer ranked as second type of cancer (11.9%), it was the first female cancer representing 28.1% of total
females' cancer. The effort of the hospital registration unit to register cancer cases was very limited with a very low
coverage for all sorts of cancer during 2005-2008.
Conclusion: while interesting information on cancer pattern has been derived from Basrah General Hospital data,
they are still incomplete and may represent a selective and biased sample of the patient population

Purpose: To determine the types of peripheral retinal degenerations in highly myopic Iraqi patients
Design: cross sectional study
Participants: Two hundred patients with high myopia attending the outpatient clinic of ophthalmologic department
in Alkadhimyia teaching hospital in Baghdad and AL-Sadr teaching hospital in Basrah from the period of July 2008
to march 2010.
Methods: Each patient was examined thoroughly starting with visual acuity and refraction to determine the degree
of myopia followed by anterior segment examination to exclude media opacity and inflammatory eye diseases then
the pupil was dilated and the vitreous with the peripheral retina were examined by the indirect ophthalmoscope and
then by the three mirror.
Results: One hundred twenty two (61%) patients were found to have posterior vitreous detachment. The peripheral
retina showed the following types of retinal changes and degenerations: 66(33%) patients had pigment clumps,
54(27%) patients had paving stone degeneration, 24(12%) patients had snow flakes degenerations, 20(10%) patients
had lattice degeneration, 10(5%) patients had peripheral cystoids degeneration, 6(3%) patients had white without
pressure degeneration and only 20(10%) patients had normal peripheral retina.
Conclusions: high myopia is a pathological condition that predisposes the patient to peripheral retinal
degenerations. Most of the patients in the study group had a benign type of degeneration while a minority had a more
serious type of degeneration. Three mirror examinations is important in high myopia to detect these degenerations
and to prevent eventual complications.

Background: The use of herbal preparations has increased dramatically, making drug interactions with these
preparations a major health concern, especially as herbal medications are usually not subjected to the same
regulations as prescription drugs
Aim: as a potential drug-herb interaction is possible, this study was designed to investigate the interaction between
Nigella sativa (NS) and ranitidine (R) on absolute ethanol induced gastric mucosal damage in rabbit
Materials and Methods: Five groups of rabbits (6 each) were used. Acute gastric ulcerations were induced by ethanol
through a stomach tube. The oil of NS was given orally, ranitidine by (IM), combination of NS+R or normal saline
were given 1 hour before ethanol. Ulcer index, serum and stomach tissue MDA, gastric volume and pH, and
histopathology were evaluated.
Results: Monotherapy of NSoil or R reduced the mean ulcer index from 91.7±19.4mm in the control group to
43.3±8.7 and 22.5±9.4mm for NS and R treatment respectively. There were significant reductions in serum and
stomach tissue MDA and in gastric secretion. When NS and R were given in combination the anti-ulcer effect of both
disappeared. This was associated with increased MDA levels in stomach tissue, but not serum. The pH of stomach
content was also changed toward ethanol treated values.
Conclusion: These findings document the gastro-protective potential of NS against ethanol-induced gastric ulcer.
There was a significant NS-R interaction manifested as failure of the combination to inhibit ulcers formation. Until
further wider studies are available to confirm such interaction, the simultaneous use of Nigella sativa and ranitidine
should be discouraged.

The Objectives: safety of blood products is one of the major issues in the area of transfusion medicine. In previous
study we found that hepatitis B virus was epidemic in some of Basrah medical institutions to assess the prevalence of
anti-HBc and anti-HBs antibodies in serum samples of healthy blood donors negative for both HBsAg and anti-HCV
in the Central Blood Bank, Basrah-Iraq.
Results: 204 serum samples negative for both HBsAg and anti-HCV collected from healthy blood donors were
tested for the presence of HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc by using rapid chromatographic
immunoassay. Of the 204 samples tested, 13 (6.37%) of the HBsAg negative blood samples were found to be
positive for anti-HBc. 3(1.47%) out of 13 anti-HBc positive were found positive for anti-HBs.
Conclusion: detection of anti-HBc and anti-HBs antibodies were more important than other markers in detection
of latent Hepatitis B virus infection.

Background: Acute gastroenteritis continues to be a significant cause of morbidity and mortality
worldwide. Rotavirus causes more than 130 million episodes of severe diarrhea in children less than five years
throughout the world and is considered as main problem in many countries. Few data are available about
gastroenteritis attributable to rotavirus in Jordan.
Objectives: The primary purpose of this study is to determine epidemiological, clinical and laboratory characteristics
of hospitalized cases attributable to rotavirus gastroenteritis in children less than five years old in selected hospitals
during the period May 2007-April 2008 to provide Ministry of Health with evidence upon which to base its futuristic
decision in regard to development of more suitable preventive measures. This study will improve the existing diarrhea
surveillance system in MoH, facilitate and support the decision of introducing rotavirus vaccine in national
immunization programme.
Methods: Descriptive Cross-sectional study was performed on the hospitalized children less than five years old with
acute gastroenteritis in three selected hospitals in three governorates (north, middle and south regions) with
population about 45.3% of Jordan population for the period May 2007 to April 2008. Standard case definition was
adopted. Analysis was performed using SPSS and Epi Info statistical packages.
Results: 377 cases were enrolled with 171 positive for rotavirus. Results showed that Incidence rate of rotavirus
disease is 5.2/ 10000 children less than five years old per year; male: female ratio is 1.8:1 with largest proportion of
cases among children 6-11 months old. Southern region has the highest incidence rate. Vomiting is an outstanding
symptom for rotavirus cases (P< 0.01) in addition to diarrhea and fever which require admission to hospital for fluid
replacement. Majority of rotavirus cases were with some dehydration (30%). Mean stay duration is 3 days.
Predominant genotypes are G1P8.G2P4 and G9P untypeable.
Conclusions: Although mortality of gastroenteritis is no longer a problem in Jordan due to accessibility to health
services, morbidity is still high and rotavirus is a relevant cause for gastroenteritis in children less than five years old;
which require hospitalization most of the time (45.4% of admitted gastroenteritis).

Background: Low birthweight (less than 2500 gm) is a reliable indicator in monitoring and evaluating the success
of maternal and child health programs. Low birthweight neonates are at greater risk of having disability and diseases
such as cerebral palsy, visual problems, learning disabilities and respiratory problems.
Objectives: To assess the risk factors affecting the delivery of low birthweight neonates at the Maternity Hospitals in
Basrah City.
Methods: This study was a hospital-based case-control study by collecting and investigating the data by direct
interview, antenatal care record, and medical records, during the period from 1st November 2010 to the 29th April
2011. A total of 510 live births neonates were studied, 255 low birthweight neonates (50%) compared with 255
normal birthweight neonates (50%).The data were collected by direct interview with the mothers, medical records
and some anthropometric measurements taken from both mother (prepartum) and her neonate after birth, by using
specially designed questionnaire form for this purpose.
Results: The results showed that the overall mean birthweight/gm and standard deviation were (1998.6±313.0) for
the Low birthweight group. Highly significant risk factors identified in this study, which include type of delivery,
weight of mothers prepartum less than 60 kilograms with height less than 150 cm and mother with history of preterm
delivery, complications during pregnancy such as pregnancy-induced hypertension, pre-eclampsia, urinary tract
infection, premature rupture of membrane and hemorrhage, stressful life events and decrease of hemoglobin level
with P-value <0.0001. While significant risk factors identified with p-value <0.05 included multiparity and placenta
previa. Other factors that didn’t show significant association include age of mother, education, occupation, with pvalue
> 0.05.
Conclusions and recommendations: This study suggests that low birthweight could be the result of preterm or
intrauterine growth retardation. Factors amenable to intervention, such as birth interval, maternal nutrition,
maternal weight and smoking habits, appeared to have a role in low birthweight. Extended community-based studies,
preferable on national basis, are recommended to evaluate the actual picture of the problem of Low birthweight in
Iraq.

Background: Metabolic syndrome (MetS) is clustered risk factors that arise from insulin resistance and is associated
with risk of coronary heart disease, as well as diabetes. American Heart Association (AHA) defined MetSon the basis
of 5 components: fasting blood glucose, blood pressure, triglycerides, HDL-C, and waist circumference. Highsensitivity
CRP (hs-CRP) is a measure of systemic inflammatory conditions and is considered as a risk factor in
diabetes mellitus.
Aim: To investigate the correlation of hs-CRP with the number and type of components of MetS diagnostic criteria in
Iraqi patients and to find out the cutoff point for hs-CRP level that might predict the development of metabolic
syndrome.
Methods: This study involved 78 diabetic patients consulting the outpatient clinic at Al Sadr Teaching Hospital. For
all patients anthropometric measures were obtained and fasting blood samples were taken for determination of blood
glucose, lipid profile and hs-CRP level.
Results: Mets was diagnosed in 48 patients. The level of hs-CRP was found to be significantly increased with
increasing number of components of MetS. The lowest value of (0.07 mg/dl) was found in people with absent
components of metabolic syndrome and the highest level of (4.05 mg/dl) in subjects with 4 components. A significant
positive correlation was observed between hs-CRP and waist circumference, FBG, and triglycerides(r=0.514, 0.531,
0.592 respectively, P<001) and a negative correlation with HDL-cholesterol (r=-0.332, p=0.021). Using the level of
0.65 mg/dl, hs-CRP can predict the development of metabolic syndrome with sensitivity and specificity of 81.3% and
93.3% respectively.
Conclusion: Hs-CRP shows a significant correlation with the number of MetS components and its level correlates
well with waist circumference and other biochemical features of MetS. Hs-CRP can predict the development of MetS
with high sensitivity and specificity.

Objective: To study the association between hypertension and hypothyroidism.
Patients and Methods: Sixty two female patients enrolled in this study were selected from eighty three patients
consulted the Endocrine and Diabetic Center in Al-Mawani General Hospital during the period from January 2009 to
December 2011 and presented with features of hypothyroidism. Each patient was interviewed, examined for body
mass index and blood pressure measurements. Twenty one patients were excluded from the study fasting blood
samples were analyzed to determine FT3, FT4, TSH, prolactin and total cholesterol levels.
Results: The level of systolic and diastolic blood pressure in overt hypothyroidism in comparison to subclinical
hypothyroidism showed a dramatic response to thyroxine replacement. Mean difference (95% CI after treatment with
L-thyroxine for systolic (SBP) (19.78-29.31 mmHg) and (10.98-17.07 mmHg) for diastolic blood pressure (DBP) in
overt hypothyroidism, while the mean difference (95% CI in subclinical form is (2.79-8.49 mmHg) for systolic (SBP)
and (0.1-3.24 mmHg) for diastolic (DBP) blood pressure.
Conclusion: Systolic and diastolic hypertension in hypothyroidism is a common association but the response of
blood pressure to replacement with thyroxine was significant in overt hypothyroidism in comparison to subclinical
hypothyroidism, while only systolic component had responded to replacement therapy in subclinical type.

Objectives: This study was performed to determine the local (tissue) and systemic immune responses in
rats infected with Giardia lamblia.
Materials and methods: Rattus noruigicus rats aged 2 months were inoculated with 103 Giardia lablia cyst.
After 7 and 14 days of infection samples (blood and small intestine) collected from both control and infected rats.
Local immune response was assessed by counting the inflammatory cells in small intestine, mast cell number and
lymph node diameter. Whearas systemic immune response was carried out by measurement of total and differential
WBC count, phagocytic activity of polymphonuclear cells by NBT stain and histamine levels in blood plasma by
ELISA kit.
Results: Results showed an infiltration of inflammatory cells in all parts of small intestine and an increasing in
lymph nodules diameter. Also, there is an infiltration of mast cells. Results of systemic immune response revealed a
high significant differences in total and differential WBC count between two studied groups. Moreover, there was an
increasing in phogocytic activity of polymorphonuclear cells and histamine plasma levels.
Conclusion: Recent data indicated that there is a local and systemic immune response during acute phase of
Giardia lamblia infection in experimental animals.