The Medical Journal of Basrah University

Objectives: This case-control study was carried out to evaluate the effects of infant feeding pattern on hospital
admission due to infection. Patients and Methods: The study has included 498 infants (320 males and 178 females)
who attended primary health centers for routine check up and vaccination, and 250 infants admitted to Basrah
Maternity and children Hospital (164 males and 86 females), from the first of March 2008 till the end of June 2008,
their ages ranged from 1–12 months. Selected socio-demographic variables were evaluated in addition to child birth
variables, feeding pattern, cause of admission, duration of hospitalization and outcome. Results: The study revealed
a significantly higher percentage of admissions due to diarrhea and respiratory tract infection among infants peon
bottle feeding (23.8%, 15.6%) and partial breast feeding (16.4%, 11.6%), compared to those on exclusive (2% and
1.2%) and predominant breast feeding (11.2% and 10%), P value <0.001 and <0.01 respectively. The effects of
feeding pattern on the outcome have shown that there is a significant increase in the mortality among bottle fed
infants (4.8%) while none of admitted patients on exclusive breastfeeding died, P value <0.01. In addition, there is a
significant association between feeding pattern and duration of hospitalization (P value<0.05), history of previous
hospitalization (P value <0.05), mother age (P value<0.05), mother education (P value <0.001), and mother and
father employment, (P value <0.001 and 0.05 respectively). Conclusions: Feeding pattern among admitted cases
with infections is significantly associated with formula feeding and partial breast feeding compared to exclusive and
predominant breast feeding.

Objective: To evaluate the impact of metabolic syndrome in patients with type 2 diabetes in Basrah, Iraq. Design: A prospective clinical study. Setting: Al-Mawani General Hospital, Basrah, Iraq. Method: One hundred-ten patients with type 2 diabetes were included. They were 41 males and 69 females. In addition, 108 control subjects were also included. They were 58 males and 50 females. Measurement of height, weight, waist circumference, blood pressure, fasting blood glucose, triglycerides and high density lipoprotein-cholesterol levels were carried out. The updated US National Cholesterol Education Program Adult Treatment Panel III (Updated NCEP ATP III) definition was used for the diagnosis of the metabolic syndrome. Result: The frequencies of the metabolic syndrome were significantly higher in type 2 diabetes male and female patients (75.6% and 94.2% respectively) compared to male and female controls (8.6% and 8.0% respectively), (P<0.001). The major determinants for the metabolic syndrome in male patients with the metabolic syndrome were, blood pressure (P<0.01), high density lipoprotein-cholesterol (P<0.01) and waist circumference (P<0.05). In female patients with the metabolic syndrome, the major metabolic syndrome determinants were waist circumference, triglycerides and high density lipoprotein-cholesterol (P<0.05). Conclusion: Patients with type 2 diabetes have a considerably high frequency of the metabolic syndrome. Hence, they are at a greater risk of atherosclerotic disease and its adverse clinical consequences.

Objectives: a descriptive study was carried out on term neonates with respiratory distress in the early neonatal period who was admitted to the neonatal care units in Basrah Maternity and Children Hospital to assess the causes, outcome, and neonatal, maternal, labor, and delivery characteristics. Patients and Methods: a total of (167) full term neonates, (103) males and (64) females, their ages range from less than one hour to 7 days who were admitted for respiratory distress (from the first of March to the end of August 2010) were recruited in the study from a total of (2858) cases admitted to the 1st and 2nd neonatal care units during the study period, (1348) of them had respiratory distress. Detailed maternal, perinatal, labor and delivery histories were taken and full clinical examination was performed. Results: the most common presenting signs were chest retractions and tachypnea. Eighty four (50.3%) of cases were delivered by caesarean section. It was found that (78.4%) of cases had a gestational age less than 39 weeks and (80%.8) were less than 24 hours of age. Both are statistically significant with p value <0.00l. One hundred forty six) (87.4%) had a normal body weight (2500 to 4000 gm). Ninety one (54.5%( of cases need hospitalization for 3 days or more. It was found that 39(23.4%) of the mothers were risky regarding their ages (<18 years and >35 years) and (27.5%) of the cases had no antenatal care, 95% of mothers were not employed and had less than 10 years of schooling. It was found that 75 (44.9%) cases were due to Transient tachypnea of the newborn and 50.7% of them were delivered by elective caesarean section followed by birth asphyxia in 22(13.2%) cases; (16) (72.75%) of them were delivered vaginally. Meconium Aspiration syndrome was found in (9.6%) of cases, early sepsis in (8.4%), and pneumonia in (7.8%). Congenital heart diseases was responsible for (7.8%) of cases, while anemia was found in (4.2%) of total cases, pneumothorax in (3%) and Respiratory Distress Syndrome in only (1.2%). The deaths were 15(9%) from 167 cases, the commonest causes were found to be due to birth asphyxia and early sepsis, 13 deaths (12.6%) occurred among males and more deaths among those who were less than 39 weeks gestation (9.16%). The total deaths due to Respiratory Distress in the study period were (35) from a total (174) and (150) from a total of (680) deaths in the 1st and 2nd neonatal care units respectively which constitute one fifth of the total deaths. Conclusions: A wise and correct decision of timing of caesarean section is needed with prevention and management of asphyxia and sepsis in addition to adequate measures and facilities of treatment for hospitalized neonates.

Background: Intrauterine insemination (IUI) is a frequently indicated therapeutic modality in infertility and considered to be of low to moderate complexity before the application of more sophisticated assisted reproductive technologies (ART). It is simple and inexpensive treatment in which processed and concentrated motile sperm are placed directly into uterine cavity. IUI is used together with various controlled ovarian hyperstimulation (COH) protocols for many indications such as male infertility, ovulatory disorders, endometriosis and unexplained infertility.
Aim of study: Is to identify the important prognostic variables contributing to the successful outcome. Patients and methods: A prospective study was carried out at Assisted Conception Unit of Basra Medical College, A total of 203 cycles were analyzed to identify prognostic factors regarding treatment outcome. The variables selected for analysis were female age, duration and etiology of infertility, sperm parameters, number of preovulatory follicles, and number of previous treatment cycles and the method of COH. Results: The overall pregnancy rate per cycle was 9.3% (19/203). Of 19 pregnancies, 68.4% resulted in live birth, 26.3% in spontaneous abortion, and 5.3% were ectopic pregnancy. The multiple pregnancy rate was 15.8 % (3 twin pregnancies). Three significant variables for successful outcome were total motile sperm count (>10x106), the method of ovarian stimulation (use of r-FSH alone being superior to Clomiphen Citrate (CC) with r-FSH and CC alone), and multifollicular response. There was a tendency to a higher pregnancy rate in women <40 years and shorter duration of infertility (< 5 years) but this did not reach a statistical significance. Significant difference was not observed among different etiologies, although lowest pregnancy rate was found in unexplained infertility group. Conclusion: IUI may be an option for a selected group of couples prior to considering more sophisticated and expensive assisted reproductive techniques. High total motile sperm count (>10x106), controlled ovarian hyperstimulation (COH) with r-FSH and multifollicular response are valuable predictors for pregnancy in COH-IUI cycle.

The study aimed on the study of pattern of exposure and immunological responses to varicella-zoster virus (VZV) infection. Methods: A seroepidemiological study was carried out on 92 blood samples collected from children in primary health care centers and outpatient clinics of Al-Sader Teaching and Basrah maternity and children hospital during the period from January 2007 till March 2008. Serological responses were investigated by an enzyme-linked immunosorbent assay (ELISA) to detect VZV IgG antibody and cellular responses was detected by Erythrocyte rosette (E-Rosette) formation test. Results: The overall VZV- antibody prevalence was 53.3% for both serologic and cellular responses. The degree and pattern of exposure to VZV cases plays important role in the seroconversion and responses to VZV infections. The greatest responses observed in those with direct contact (household) with chickenpox cases (68.6% and 74.3%) and the direct contact acquired from VZV infected mothers (80% for both serologic and cellular responses). Exposure to typical chickenpox cases confers higher serologic and cellular responses (75% and 94.4% respectively). Cellular responses to VZV infections lasted longer than that for serologic responses. Sever VZV infections confers significantly higher levels of immunity (100%) and the complication post VZV infections (Pneumonia and encephalitis) mostly associated with sever cases at earlier age groups rather than the mild VZV cases. The differences in immune responses to VZV infections between male and females was significant (P<0.05). The rates of exposure to VZV infections in urban areas are significantly higher than in rural areas (P<0.05). There was a significant decline in VZV immunity over time post infections and losses of protective immunity levels were quite evident few years post infection which stress the need for vaccination.

Objective: The aim of this study is to evaluate the oxidant and antioxidant level in cancer patients in Basrah during the period from the first of October 2002 till the end of April of the 2003. Material and methods:A total of 64 patients were investigated, who were admitted to the Basrah General Hospital, Teaching Hospital and Basrah Hospital for Maternity and Pediatric in Basrah City. 125 sex and age- matched persons without malignancy served as controls. They were 64 persons as control for leukemic patients (32 male and 32 female). The parameters measured were glutathione (GSH) level, uric acid, malondialdehyde (MDA) and phagocytic functional activity. The leukemic patients were sub classified into two groups according to their age (30 patients ≤16 years and 16 patients >16 years). Results: The biochemical investigation showed a high significant depletion in GSH levels in leukemic patients (P<0.001). The phagocytic activity was high significantly decreased in all leukemic patients (P<0.001). There was no significant difference between male and female leukemic patients in phagocytic activity. The MDA level was highly significantly increased in 16 years old leukemic patients (P<0.01) and extremely high significant in >16 years old leukemic patients (P<0.001). The investigation of uric acid concentration shows extremely high significant increase in all leukemic patients (P<0.001). Conclusion: cancer patients suffer a high degree of ROS formation causing considerable oxidative stress which associated with decrease glutathione level and significant degree of lipid peroxidation

Background: nausea and vomiting induced by cytotoxic drugs cause a considerable distress to many cancer patients and may reduce food intake and affect patient's com pliance with therapy. It is proposed that cytotoxic drugs evoke serotonin release from enterochromaffin cells in intestinal mucosa and this lead to stimulation of vomiting center in the brain. Objective: To investigate relationship between serotonin levels, liver functions and hematological parameters and various adverse effects of cytotoxic drugs especially nausea and vomiting in cancer patients. Method: This is an observational study in cancer patients receiving cytotoxic drugs in Basrah Oncology Unit extend up to 72 hours after treatment in which we took patients information by a special questionnaire form and blood samples were collected for the estimation of serum serotonin levels by ELISA method and measurement of other laboratory tests including liver enzymes and hematological parameters. Results: A total of 100 cancer patients were included in this study. Nausea occurred in 9%, 31% and 40% patients before, 24 and 72 hours after cytotoxic drugs respectively, while vomiting occurred in 6%, 19% and 50% patients in the same order. The severity and frequency of nausea and vomiting increased significantly at 24 and 72 hours. There was a significant (P<0.001) correlation between serum serotonin levels and platelets count before and after treatment. Serum serotonin levels were positively correlated with both lymphomas and colorectal cancer and negatively correlated with leukemias, also serum serotonin levels was positively correlated with the emetogenic potential of cytotoxic drugs. There was no direct relationship between serum serotonin levels and nausea and vomiting. Conclusions: Cytotoxic drugs induced nausea and vomiting in a considerable number of cancer patients despite all antiemetic drugs at 24 and 72 hours. The level of serotonin was affected by both cancer type and emetogenic potential of cytotoxic drugs and there was no direct relationship between the changes of serotonin and nausea and vomiting.