The Medical Journal of Basrah University

Backgrounds: Osteoarthritis (OA)is a prevalent disorder characterized by focal loss of articular cartilage in weight-bearing synovial
joints and associated with significant pain and functional impairment. Sleep disturbances are common symptoms in adults and are
related to numerous chronic conditions like osteoarthritis.
Aim of the study: To discover the relationship between knee osteoarthritis with sleep disturbances
Materials and methods: Cross-sectional study, including 102 with knee osteoarthritis consulted outpatient clinic in Al-Sader
Teaching Hospital / in Al-Basrah during the period from September 2023 to December 2023 assessed for the presence of sleep
disturbance. Knee osteoarthritis pain was assessed by the VAS scale and the radiological grade of OA was recorded. A sleep scale
from the Medical Outcome Study (MOS) was used to assess sleep disturbances in patients with knee osteoarthritis over the past 4
weeks.
Results: Out of the 102 patients with knee osteoarthritis, 73.5 % were female and 72.5% of them were married. The mean age was
(53.9 ± 11.4) years and the majority 73.5% of the participants were homemakers. Most of the participants had high BMI values
(31.05 ± 5.7) kg/m2 with increased waist circumference (103.4 ±14.9) cm. About 75% of participants were in grade 2 and 3
osteoarthritis and about 94% of the patients complained of moderate to severe pain when assessed using Visual Analog Score
Analysis (VAS). There is a significant association between knee osteoarthritis grades and the MOS sleep scale on one hand and pain
score assessed by the visual analogue scale on the other hand. Conclusion Sleep disturbances become more prevalent with an increase
in the grades of knee osteoarthritis and are associated with worse pain scores.

Background: Foot ulcers represent a major problem for diabetic patients and the managing doctors as well. Patients
may need a major or minor lower limb amputation due to severe gangrene. Diabetic foot is regarded as the major
cause of lower limb amputation in the world. The study aimed to identify the effects of high Wagner’s grade,
poor glycemic control, and anemia as risk factors for amputation in diabetic foot patients.
Materials and methods: A cross-sectional study was undertaken on 65 patients with diabetic foot ulcers at Al-Sader
Teaching Hospital in Basrah. Ulcer grading was determined using Wagner’s classification system. The surgical
outcome of the patients was studied in correlation with Hb level, HbA1C level, and Wagner’s grade to
demonstrate the effect of these three variables on the outcome.
Results: Of the 65 studied patients, 28(43.1%) required debridement, 32(49.2 %) had amputations and 5 (7.7%)
patients had disarticulations. Thirty-eight patients (58.5%) had HbA1C levels of 8 and above, and 26 of them
(68.4%) ended with amputation or disarticulation. Hemoglobin levels below 10 gm/dl were reported in 36 patients
(55.4%), and 22 of them (61.1%) ended with amputation or disarticulation. There are Forty-five patients (69.2%
of all) presented with Wagner 3,4, and 5 ulcers, and 31 (68.9%) of them ended with amputation or disarticulation,
this indicates a statistically significant association between the high Wagner’s grade and the need for major limb
amputation.
Conclusion: the study showed that low hemoglobin level, poor blood sugar control, and high Wagner’s grade are
all predictors of poor outcomes and an increased risk of amputation in our studied patients.

Background: Genes and hormones play an important and complicated role in differentiating the gonads to the testis or ovary. Primary
or secondary amenorrhea is either absence or unexpected early end of menstruation. Hormonal, physiological, environmental and genetic
reasons are all involved in developing such a disorder. Diagnosis is very important to provide the required treatment and one of the
powerful diagnostic goals is Karyotyping.
Aim of study: So, the study aimed to identify the chromosomal abnormalities through karyotyping and how frequent each is.
Methods: Samples of 174 patients who were referred to AlBayan Private Laboratory in Basrah City from 2018 to 2022
Results: A total of 174 patients were diagnosed with PA and the results showed that out of 174 patients, 57(30%) were diagnosed with
chromosomal abnormalities using cytogenetics. Karyotype analysis showed that 46, XY represented more than 50% of the genetic
abnormalities, followed by 27% and 3% due to 45, X or 46, X, i(Xq) respectively. However, all the rest abnormalities displayed the
same percentage, 1% of the total number of PA patients. Our study showed that a significant number of cases with primary amenorrhoea
harbor chromosomal abnormalities, which are significant in gonadal dysgenesis.
Conclusion: So genetic counselling, routine chromosomal study, hormonal assessment, and radiological evaluation are important for
proper management, also the hormonal replacement for Turner Syndrome patients, and screening for malignancy in patients with sex
reversal are important

Background: glutathione peroxidase, catalase, and superoxide dismutase enzymes are the main antioxidants that serve as the body's
first line of defence against oxidative stress.
The aim of the study: To examine 5-selenocyanatouracil anti-inflammatory and antioxidant properties.
Materials and methods: Four groups of rats were employed; the control group received distilled water the paracetamol group
received 500 mg/kg body weight of paracetamol, the paracetamol & 5-Selenocyanatouracil groups received 50 mg/kg of 5-
selenocyanatouracil after 30 minutes of paracetamol, and the second paracetamol & 5-Selenocyanatouracil group received 100 mg/kg
of 5-selenocyanatouracil after 30 minutes of paracetamol administration.
Results: The findings demonstrated that 5-selenocyanatouracil considerably (p<0.05) raised levels of superoxide dismutase and
glutathione reductase while notably lowering levels of Malondialdehyde and Interleukin-6.
Conclusion: The findings showed that the prepared 5-selenocyanatouracil compound had antioxidant and anti-inflammatory activity.

Schistosomiasis is widespread in Egypt and portions of Iraq where rice crops are grown. Urinary schistosomiasis spreads across different
regions of the world, including Iraq. High infection rates have been documented in Iraq since the 1930s, it presents a serious risk to the
country's health. The infection rates in the provinces of Maysan, Basra, and Thi-qar were 84%, 80%, and 80%, respectively. For the last
several years Iraq has been free from the incidences of schistosomiasis Some reports mentioned that Iraq has applied a Schistosomiasis
control and elimination program resulting in reduced prevalence of the disease. In 2003 and 2010, schistosomiasis was still not eliminated,
with prevalence rates at 0. 1%). According to the information received in this paper, the mountainous regions of the country are risk-free.
Some Cases of Schistosomiasis have been documented throughout the whole river systems of the Euphrates and Tigris (up to Samarra in
the north), as well as their tributaries, irrigation canals, marshlands, and urban areas. There are isolated cases in the Nineveh Governorate's
Telkef area and the Al Qa'im (Al-Anbar Governorate). Some studies mentioned that the national control programs ensured that Iraq was
schistosomiasis-free in 2020. Research has found a correlation between schistosomiasis-associated infections and bladder cancer the
studies concluded that schistosomiasis-associated bladder cancer still is a problem in Iraq as well as other endemic countries.

Introduction: Sodium Risedronate (SR) is a member of bisphosphonate drugs used for osteoporosis treatment. Albeit its well-known
efficacy, SR suffers from low oral absorption (only 0.63%) and many adverse effects.
The aim of the study: formulate and characterize oil-in-water microemulsion systems for the oral delivery of SR.
Methods: Sunflower oil was used for the oil phase. Next, the solubility of SR in different surfactants and co-surfactants was detected.
Three different ratios of (Tween 80/glycerin) microemulsions were studied: (2/1), (1/1), and (1/2). Regarding SR microemulsions, three
different formulations: (2/1), (1/1), and (1/2) (Tween 80/glycerin) were characterized for their: transparency, conductivity, light
transmission, refractive index, droplet size, dissolution tests, and intensive stability studies.
Results: As Tween 80 and glycerin were the best surfactant/co-surfactant mixture, the higher surfactant ratio (Tween 80) had the largest
microemulsion region in pseudo-ternary diagrams and a new detected phase (gels). SR microemulsions were transparent liquids of the
o/w type. (2/1) formulation had the smallest droplet size (8nm) with good stability results across three diverse protocols. Followed by
the (1/1) formulation (10.89 nm), though this formulation showed an overloading problem (0.4% SR) in stability tests. (1/2) formulation
(19.21 nm) had the highest loading capacity (0.6% SR).
Conclusion: The outstanding stability of the (2/1) (0.1% SR) formulation as a highly stable finished drug form or a potential step for
further formulation development, along with the notable drug loading capacity of the (1/2) (0.6% SR) formulation, emphasize the
significance of further studies to validate their efficacy and potentials.

Background: Platelet transfusion is significantly involved in the treatment of oncology patients since the disease process as well as
many therapeutic agents can induce significant thrombocytopenia. Many variables regarding platelet products were studied over the
years to determine the quality of platelet products. The study aimed to assess the quality of platelet-rich plasma platelet concentrate, and
apheresis platelet concentrate that are available for transfusion in oncology centres.
Subjects and Methods: A cross-sectional study was conducted at the main blood bank in Basra, Iraq, the blood bank branch in Basra
Specialized Children’s Hospital, and oncology centres in Basra between May 2023 and September 2023. One hundred fifty apheresis
platelet concentrate units and 150 Platelet-rich plasma platelet concentrate units were assessed for their in vitro quality by assessing the
volume of platelet concentrate units, platelet count per unit, and residual white blood cell per unit. Fifty patients were assessed for their
response to platelet transfusion; half received PRP-PC, and the other half received apheresis platelet concentrate.
Results: Apheresis-PC units met volume and residual WBC criteria (98.08%, 90.38%) better than PRP-PC (61.33%, 5.60%). Final
scoring showed 4.6% PRP and 15.3% apheresis-PC, scoring 3. Patient response analysis revealed increased platelet count after
transfusion, with a higher number of transfused units for PRP-PC (13 ± 5.28 units) vs. apheresis-PC (1 ± 0.28 units). Recovery was >
20% for 80% of apheresis-PC and 56% for PRP-PC.
Conclusion: Apheresis-PC outperformed PRP-PC in meeting quality standards. Apheresis-PC had a higher platelet count and lower
WBC contamination, which makes it a better choice for platelet transfusion to reduce recipient exposure to multiple donors. Recipient
differences in age, weight, blood volume, and type of malignancy didn't affect the transfusion response.

Background: Cardiovascular events can be seen in patients without classical cardiovascular risk factors, spurring the search for novel
risk markers. Biomarkers are quantifiable bodily substances that indicate disease. Biomarkers have been studied concerning
cardiovascular disease (CVD) to better understand their role in CVD development and progression. Biomarkers include Leptin, hs-CRP,
and ceruloplasmin. These biomarkers cannot diagnose cardiovascular disease alone, but they can supplement risk factors and risk
stratification.
Method: This is a case-control study that included 90 coronary artery disease patients proved by coronary angiography. Included 53
males and 37 females, ages ranging from 25–45 years, who attended Al-Sadr Teaching Hospital and Basra Oil Specialized Cardiac
Center, from December 2022 to March 2023. The patient\'s group were divided into a high-risk group and a low-risk group according to
the clinical presentation & numbers of coronary vessel disease. On the other hand, 90 healthy participants matched in their age and sex
to the patient’s group were included in the study. Leptin was measured by an enzyme-linked immunosorbent assay (ELISA) whereas
ceruloplasmin and hs-CRP were assayed by electrochemiluminescence immunoassay (ECLIA) using Cobas e411.
Results: Leptin and hs-CRP levels were significantly higher (p<0.05) while ceruloplasmin was significantly lower (P<0.05) in patients
with coronary artery disease compared to age-matched healthy control subjects. These novel risk markers showed no significant
statistical differences between high & low-risk groups of patients with coronary artery disease
Conclusion: There is a positive relationship between the levels of leptin, hs-CRP & risk of CVD, which might be considered as a novel
risk marker for the presence rather than severity of coronary artery disease

Background: Nonalcoholic fatty liver disease is a common hepatic disorder marked by the accumulation of lipids in the liver,
frequently accompanied by metabolic disturbances, including insulin resistance (IR), a condition where cells become less responsive
to insulin's glucose-lowering effects, important in the evolution and progression of NAFLD.
Objective: To evaluate the degree of IR and β-cell function among patients with NAFLD.
Methods: A case-control study was conducted on 75 patients diagnosed with NAFLD and 81 control subjects. Fasting blood glucose,
glycated haemoglobin and insulin were determined in all participants. In addition, insulin resistance and pancreatic ß- cell function
were estimated by HOMA-IR and HOMA-B equations respectively.
Results: HOMA-IR and HOMA-B were significantly higher among patients with NAFLD (3.59 ± 3.52, 277.57 ± 169.89) than controls
(2.56±1.39, 153.46±106.17) respectively, with the comparative P < 0.05 and P < 0.001. In addition, FBG, HbA1c and insulin were
significantly higher among patients with NAFLD than control subjects, P < 0.01.
Conclusion: The strong association between HOMA-IR and NAFLD imply the role of IR in the pathogenesis of NAFLD. The
significant elevation of HOMA-B among patients with NAFLD reflects the degree of hyperinsulinaemia secondary to IR.

Background: Leukemias are the primary cause of cancer-related mortality, AML has the lowest survival rate being one of the more
prevalent leukemias in adults worldwide as well as in Iraq.
Materials and methods: The descriptive, epidemiological study was conducted on 412 newly diagnosed AML patients as a sample
of the Iraqi population enrolled in the Oncology Center in the Medical City of Baghdad province and the Basrah Oncology Center
in Basrah province during 2022. Their mean age was 42.09 ± 22.32 years.
Results: Among 412 patients, a median age of 40.05 was the predominant Iraqi AML which was lower than that of other developed
countries. The disease was more predominant in age categories (≥70) years and (60-69) years with 18.52 % and 16.26% respectively.
The majority of the patients were suffering from pallor (65.29%), fever (49.76%), leukocytosis (43.20%) or cytopenia (27.18%) at
the time of presentation.
Conclusion: The study indicates that the disease is highly prevalent, with a younger median age than in other nations, and the most
prevalent subtype of AML was APL. The clinical and epidemiological features have effects on comprehending incidence and
disease development.

Background: Multiple myeloma (MM) is a malignancy of terminally differentiated clonal plasma cells. Expansion of the malignant
plasma cells throughout the bone marrow (BM) leads to cytopenias, bone resorption and production of monoclonal immunoglobulins
known as M components or paraproteins. BM analysis is an important element in establishing the diagnosis of MM. The study aims
to evaluate the diagnostic yield of bone marrow aspirate and bone marrow biopsy in patients with MM. and to Compare the newly
diagnosed and follow-up cases (regarding the bone marrow examination, hematological and biochemical parameters).
Methods: This is a cross-sectional study conducted from the first of August 2022 to the first of August 2023, and included 32 patients
with MM. The patients were diagnosed at the Basrah Oncology and hematology center. The laboratory parameters and BM
examination were analyzed and correlated. Immunohistochemical staining with CD138 was done for selected cases.
Results: Anemia (Hemoglobin (Hb) < 10 g/dL) was seen in 59.4% of total cases. Hypercalcemia was found in 9.4% of total cases.
Serum creatinine of more than 2 mg/dL was found in 25% of total cases. Monoclonal (M) protein was positive in 84.4% of total
cases. There is a significant difference between the positive results of BMA and BMB.
Conclusions: BMA and BMB complement each other for BM evaluation. The combined use of BMA smears, HE stained BMB
sections and CD138 IHC is beneficial in obtaining the most clinically relevant BM plasma cell percentage.

Background: Nowadays, the use of herbal medicines is very substantial in the treatment of cancer. One of the most common cancers among
women is Cervical cancer. Due to the side effects of some chemical drugs, the use of medicinal plants with minimum side effects and
interference has been considered. Rosemary (R. Official L.), a member of the Lamiaceae family, is known for its antioxidant properties. One
of the main compounds for antioxidant activity is Carnosic acid (CA), a polyphenol with antitumor biological activities.
Method: This study investigated the effect of Carnosic acid at different concentrations (2.5, 5, 10, 15, 20, 25, and 50) mg/ml on a Cervical
cancer cell line (Hela). Cytotoxicity and growth inhibitory power (IC50) were calculated using the MTT test, Prism software. The real-time
PCR method investigated TGF-β1 gene expression on Hela cancer cell lines and cells treated with Carnosic acid. To assess and quantify
oxidative stress and apoptotic behavior, we utilized a plate reader and the appropriate kit to measure catalase activity (CAT) level by detecting
570 nm light absorption.
Results: Cytotoxicity assay (MTT) showed the antitumor activity of the group treated with CA compared to the control group (Hela cells
without treatment). Gene expression analysis based on RT-PCR showed downregulation of the TGF-β gene and catalase activity reduction
in cells treated with Carnosic acid compared to untreated cells.
Conclusion: Carnosic acid has been introduced as a promising formula for treating cervical cancer.

Background: Hepatitis C virus (HCV) infection is considered a major health problem worldwide. Despite the availability of an
effective direct-acting antiviral (DAA) therapy; 58 million people still have chronic HCV globally. HCV had 6 major genotypes;
identification of specific genotypes linked to appropriate DAA selection.
Aim of this study: To know the predominant HCV genotype in Nineveh governorate.
Patients and Methods: This is a descriptive cross-sectional study conducted in public health laboratory in Nineveh from March
2022 to February 2023, 107 patients with HCV antibodies were included in this study, they underwent HCV real-time polymerase
chain reaction (RT PCR) and genotyping, all those 107 patients had positive HCV antibody by enzyme-linked immunosorbent assay
(ELISA).
Results: From 107 patients with positive HCV antibodies, only 50 patients (46.7%) had positive HCV PCR, Genotype 4 is the most
common HCV genotype in Nineveh (48 % and genotype 1a (26%) is the second common genotype, half of the current patients were
young and HCV more common in male patients (62%).
Conclusion: The most prevalent HCV genotype in Nineveh governorate is genotype 4 followed by genotype 1a.

Background: Psoriasis is a persistent, non-infectious skin condition that impacts people of all ages and has no sex preference, which
is caused by environmental stressors involving skin cells, immunocytes, and several biological signalling molecules. Recent studies
propose that the underlying mechanisms of psoriasis may involve an elevated production of (ROS) and indicate that individuals with
psoriasis exhibit elevated levels of reactive oxygen species (ROS) in their skin. Protein carbonylation is a widely adopted biomarker
for indicating protein oxidation. The objective of this study was to examine serum protein carbonylation levels as a marker of protein
oxidation in psoriasis patients, evaluating the impact of age, body mass index (BMI), and waist circumference (WC) on these levels.
Methods: Conducted as a case-control investigation, this study enlisted 98 psoriasis patients and 81 healthy individuals, matched in
terms of age and sex as controls. Blood samples, obtained through venipuncture (5 ml), were analyzed for protein carbonyl, random
blood sugar, lipid profile, liver enzymes, and complete blood count (CBC).
Results: The study found a significant difference in the mean value of serum protein carbonyl among patients with psoriasis as
compared to the control group (3.82 ± 2.24 ng/ml vs. 3.28 ± 2.54 ng/ml) respectively (P<0.05).
Conclusion: The study observed a non-significant negative correlation between levels of protein carbonyl and both age and the
duration of psoriasis. Additionally, there was no significant negative correlation found between protein carbonyl levels and waist
circumference, indicating that central obesity may render individuals more susceptible to protein oxidation, even when their BMI is
found within the normal range.107

Background: The phrase "developmental dysplasia of the hip (DDH)" describes a range of hip joint anatomical anomalies in
which there is an improper interaction between the femoral head and the acetabulum. Due to capsular laxity and mechanical
instability, this condition of aberrant growth causes hip dysplasia, subluxation, and sometimes dislocation.
Objectives: To assess nurses' knowledge concerning developmental dysplasia of the hip.
Methods: In Al-Basrah City's hospitals, descriptive cross-sectional research was conducted, to determine the level of knowledge
among nurses about the developmental dysplasia of the hip in Al-Basrah Teaching Hospitals from 30th October 2023 to the 13th
of March 2024. Non-probability (convenience) sample consists of (150) nurses from five Teaching Hospitals (Al-Sader
Teaching Hospital, Al-Basrah Teaching Hospital, Al-Mawani Teaching Hospital, Al-Faihaa Teaching Hospital, and Al-Basrah
Hospital for Gynecology and Pediatric). Following a thorough review of the prior research, the researchers created a selfreported questionnaire. Version 26 of the SPSS program was used for data analysis.
Results: The results of this study show more than half of nurses have good knowledge concerning developmental dysplasia of the
hip (53.4%), less than half of nurses have medium knowledge (46.6%), and none have weak knowledge.
Conclusions: More than half of the nurses have good knowledge regarding developmental dysplasia of the hip