Thi-Qar Medical Journal

Background and objectives:metabolic syndrome is a common disorder associated
with increased risk of cardiovascular diseases and diabetes , its prevalence in Iraq is not well
estimated , many studies relate the relation of this syndrome to coronary artery disease due to
the clustering of the cardiovascular risk factors in this syndrome , for this reason we tried in our
study to evaluate the relationship between this syndrome and ischemic heart disease
documented by coronay angiography , furthermore we planned in our study to classify and
determine the severity of different coronary lesion in this syndrome.
Patients and methods: in this study we enrolled 146 patients with lschemic heart disease, 76
of them having the criteria of metabolic syndrome and 70 patients with IHD and no metabolic
syndrome were taken as controls between February 2010 to February 2011- angiography was
done for all the patients, and the different types of coronary lesions and their complexity
scores analyzed and reported according to the American heart association criteria and syntax
scoring system.
Results &Conclusion:
The mean syntax score was significantly higher among patients with this syndrome and
also, complex coronay lesions in from of, ostial, bifucational and multi vessels disease were
significantly higher in this group wether they are diabetics or not in comparison to the control
group.

SUMMARY : Serum malondialdehyde (MDA), as an index of lipid peroxidation, and
the serum enzymes creatinin kinase (CK) , lactate dehydrogenase ( LDH ), were
evaluated in a group of 32 patients with acute myocardial infarction (AMI) , 12 with
angina pectoris (AP), and 88 healthy subjects as a control group . MDA values were
within the normal range in those with angina pectoris patients, while in those with
acute myocardial infarction patients a significant increase in serum MDA was
observed in the days following the acute event, reaching a peak level in 6-8 days
later, a significant relation was found between the integrated concentration-time
MDA curve and the integrated serum enzymes activity curves reached during the
nine days after the acute event. The "in vivo" relevance of the increased serum MDA
in the post-infarct period is unknown at the present, but as lipid peroxides are
known to harm cellular structures and to inhibit prostacyclin synthesis.

Objective : To present the advantages of native arteriovenous fistula creation in
comparison with graft AVF creation in patients with chronic renal failure and on
regular hemo – dialysis or those with impending end stage renal disease and that
searching for a suitable superficial vein for this purpose is mandatory.
Patients : This is a prospective study of 50 patients for whom an arteriovenous fistula
was created in the upper limb under local anaesthesia over a period of about one
year ( from 1st of January 2013 till 1st of December 2013 ).
Methods : The case sheets of relevant patients for whom an AVF was created were
reviewed to collect information like patient's sex, age, site of AVF, type of
anastomosis, etc…
Results: AVF creation was offered for different age groups and for both sexes. Side to
side anastomosis was carried out for most patients and the preferred site was the
cubital fossa between the brachial artery and a nearby superfial vein. The time of first
cannulation after AVF creation was variable depending on several factors. Different
complications but no mortality had been recorded perioperatively.
Conclusions:Native AVF creation is always preferred over graft AVF and every effort
was made to search for a suitable superficial vein for the purpose of AVF creation.
The elbow region was a suitable option for elderly patients and those with
comorbidities despite the fact that the more distal location of AVF is associated with
less complications. Side to side anastomosis for AVF creation was the procedure of
choice and the non dominant upper limb is prefere if possible.

A total of 552 samples of vaginal discharge were collected from women that
visited the Maternity and Pediatrics hospital in Basrah Province .Microscopic
examination of vaginal discharge revealed that 4.1 % of these women were infected
with Trichomoniasis .
In present diagnostic study, two technique were used to diagnosed the same sample
for the first time in Iraq , these include microscopic examination ( wet preparation )
and Polymerase chain reaction (PCR) .PCR technique was the highest sensitivity (
100 % ) which diagnosed three samples were considered negative in the other
diagnostic technique and microscopic recorded sensitivity 88.4 % .In the same time
diagnosis by vaginal discharge were found to be highly percent ( 100 % ) than the
urine (1.9%) .

The aims of the study are to determine the rate and spectrum of mental disorders among offenders referral to
psychiatric evaluation and find out the relation between mental disorder and the nature of the offence. This is
cross sectional study that enrolled 120 referrals to the Forensic Psychiatric Committee (FPC) in Al-Rashad
Mental Hospital during the period from April 2012 – January 2013. The referrals were interviewed according to
a semi-structured interview questionnaire (SSIQ) based on DSM-IV-TR and the diagnosis was compared with
that given by the FPC and the cases was included in the study when it was agreed by both the SSIQ and the FPC.
This study revealed that illiterate and those with low level of education rated the highest 82.5% were mentally
ill. Interfamilial violent assaults were the commonest offences among males while murder, sex crimes and
wandering were the commonest among females. Schizophrenia was commonest diagnosis among males and
schizophrenia, mental retardation among females. Most of referrals had previous history of referral 83% with
intrafamilial violence was the commonest offence and schizophrenia was the commonest
offence and schizophrenia was the commonest diagnosis.Most of the offenders who were referred for
psychiatric evaluation were found to bementally ill and the most frequent mental illness was schizophrenia.
Most of referral cases were due to violent assaults committed by male schizophrenic and other psychotic.

Objective: To compare the effectiveness of rectally used misoprostol in the active management of third
stage of labor with intramuscular oxytocin.
Methods: A comparative prospective study was performed at 2 hospitals in Basrah, 200 pregnant
women in active labor were enrolled. Women were randomized to receive rectal misoprostol 600µg or
intramuscular oxytocin 10 IU with delivery of the anterior shoulder. The primary outcome measures
were the incidence of postpartum hemorrhage or change in Hb. concentration before delivery and
12hour after delivery. Secondary outcomes included the need for additional uterotonic agents, sever
post partum hemorrhage ,blood transfusion , and medication side effects.
Results: The percentage of PPH was 5% in the misoprostol group and 6% in oxytocin group (p >0.05).
There were no significant difference among the groups in the drop of Hb. conc. (p>0.05). Secondary
outcome measures including severe PPH and the duration of the 3rd stage of labor and medication side
effects were similar in both groups.
Conclusion: Rectal misoprostol 600µg is as effective as 10 IU intramuscular oxytocin in minimizing
blood loss in the 3rd stage of labor. This confirms the utility of misoprostol as a safe and effective
uterotonic drug for use in some areas where other pharmacologic agent may be less feasible.

This present study, reflect the incidence of crystalluria among children (4-10)
years old, in which the extent of crystalluria were more in patients who were
suffered from G.I.T. infections 65(56.52%), more than those patients who were
suffered from R.T.I. and were treated by co-trimoxazole. Also this study showing as,
that the patients who were treated by only co-trimoxazole, were highly exposed to
crystalluria 88(76.52%), more than those patients who were treated by both co
trimoxazole and I.V. fluid 27(23.43%). Also we found that crystalluria were
developed more in female patients 74(64.34%), than male patients 41(35.62%).

Supracondylar humeral fracture represents the commonest pediatric elbow fracture. It
mostly occurs below the age of 10 years after simple fall on outstretched hand or on the
elbow. The factors that contribute to its high frequency include weakness of the
supracondylar area and the relative ligamentous laxity in children as well as the more
liability to fall in this age group. It is a source of relatively high morbidity rate. Possible
complications include neurovascular injury, compartment syndrome, joint stiffness and
deformity. In this study we to assessed multiple epidemiologic factors including the
crude number of cases over the period of time of the study, the fracture type according
to displacement and rate of each possible complication. We also followed cases
prospectively documenting the modality of treatment offered, the healing time, the way
of dealing with complications and their prognosis. The output results of the study help
in standardizing the orthopaedic handling of this fracture in our locality. This includes
the proper assessment of the size of the problem and its complications and the best way
of dealing with it.

A clinical and mycological study of superficial mycosis was conducted on 23 cases (7
males and 16 females) , and collected from patients (5-50) years old. Direct
microscopy by KOH (potassium hydroxide) mount and culture was undertaken to
isolate the fungal pathogen in each case. Non-dermatophyte molds were isolated
from 18 cases (78.26%) and 21 isolates were identified from these cases ; 10 isolates
Candida albicans (47.61%), 5 isolates Rhizopus stolonifer (23.8%), 2 isolates
Penicillium sp. and 2 isolates Aspergillus nidulans (9.5%) respectively, 1 isolate
Alternaria alternata and1 isolate Fusarium sp. (4.7%) respectively . Alcoholic &
aqueous extracts of the punica granatum (Pomegranate) peels were prepared. The
anti-fungal activity of the extracts was evaluated on isolated fungi by means of the
agar-well diffusion assay. The Minimum inhibitory concentrations were 10-300
mg/ml against isolated fungi. Their was little difference between the activities of
alcoholic extract & aqueous extract. These results suggest the Pomegranate Peels
extract which contains active constituents as a promising anti-fungal agent.

Background: Yeasts of the genus Malassezia are known to be members of the skin
micro flora of human and other warm-blooded vertebrates. Seborrheic dermatitis is
a common inflammatory dermatoses that may affect infants, adolescents, and adults
of all ethnicities and races, Malassezia spp. have been found in both healthy skin and
at sites affected with seborrheic dermatitis.
Aims: To identify of Malassezia spp. are suspected to be involved in the
development of seborrheic dermatitis and normal subject.
Materials and Methods: Thirty one patients with seborrheic dermatitis were
included in this study, who attended Al-Kadhumyia teaching hospital / Dermatology
department, from the 30th of October 2010 to the 1st of April 2011. Twenty five (25)
were males and six (6) were females, with the mean age of 36.29 ± 4.65 years
(ranging between 3 months to 70 years old). The diagnosis was established by
clinical examination done by consultant Dermatologist. Control included 48
apparently healthy individuals were randomly selected from entities, primary and
secondary schools in Al-Mashtale city (25 males and 23 females) with a mean age of
15.68±15.68 years (ranging between 1-70 years old). Both groups were investigated
for Malassezia spp., cultivation and identification of Malassezia spp. included
Sabouraud َs dextrose agar with and without olive oil.
Results: Malassezia obtusa and M. pachydermatis had a high percentage overall
Malassezia spp. with seborrheic dermatitis patients (12.90%). According to gender,
males had higher infection rate than females. Seborrheic dermatitis patients with
age group of (31-40) years had a high percentage among others (25.80%). Oily
skinned patients revealed seborrheic dermatitis.
Conclusions: from these findings, it was suggested that M. obtusa and M.
pachydermatis reported a high percentage overall Malassezia spp. with seborrheic
dermatitis patients.

A total of 224 medical students were rolled in a prospective study to compare the effect
of formaldehyde in embalmed and plastinated cadavers on medical students. The study
was conducted in Basrah medical college at 2009-2010 . Questionaire were used to
study the effect of exposure of medical students to formaldehyde at department of
anatomy. The results indicate the effect of formaldehyde used in embalmed cadavers is
more than in plastinated cadavers. 66.38% of the students used embalmed cadavers
and 8.99% of the students used plastinated cadavers developed eye symptoms like (
itching ,burning ,lacrimation ) , 14.69% of the students used embalmed cadavers and
12.77 % of the students use plastinated cadavers developed nose symptoms like
(irritation ,running nose ,sneezing ) 31.14% % of the students used embalmed cadavers
and 7.36% the students use plastinated cadavers develop respiratory tract symptoms
(sore throat ,cough ) ,15% of the students used embalmed cadavers and 5.72% of the students used plastinated cadavers developed skin symptoms
(itching ,dryness )
,33.9% % of the students used embalmed cadavers and 8.99% of the student used
plastinated cadavers developed central nervous system symptoms ( headache
,nausea ,vomiting ) .