Vol 16, No 1 (2012)

Background and objectives: This study way conducted in order to investigate the magnitude of the women suicide attempted by burning in Sulaimani and to ascertain the factors related to female suicide, including sociocultural factors and ways to solve this problem.

Methods: The present study is a prospective study of self inflicted burns by women treated at the burn unit of Sulaimani teaching hospital and Emergency hospital over five years   period from 1st January 2003 to 31st December 2007.

Results: Out of the total number of 760 admissions to burn unit over the period, 386(50.2%) patients were positively identified as having attempted suicide by burning. Of them 345(46.6%) patients were females and 41 were males. The Suicide attempted was more common in the marriages women 258(74.7%) and women with low educational level168 (48.7%). The most common causes of suicide were arrogant husband (60) (17.4%) and forced marriage (58) (16.8%).

Conclusion: Burning by kerosene is a common, traditional, and dramatic way of attempting suicide by women in Sulaimani. We suggest that Kurdish women organizations or other related authorities have to start programs for communications with women to rescue those in desperate situations, and suicide prevention programs in Kurdistan to prevent suicide as well as to evaluate prevention programs to identify evidence-based practices that are culturally appropriate and affordable within severe resource constrains.

Background and objectives: The established methods to demonstrate the neuroprotective efficacy of drugs still use in vivo animal tests. The objective of the present study, therefore, was to develop in vitro screening systems based on digitized fluorescent imaging of individual neurons from neuronal cell cultures as a practical model for assessment of neuroprotectors during excitotoxicity.

Methods: Cortical cells from embryonic mice were cultivated on glass coverslips Cells were loaded with the fluorescence dye rhodamine-123. The coverslips were mounted in a temperature controlled flow-through chamber. The superfusion chamber was mounted on an inverted microscope. The emission light after excitation of the dye was measured with an intensified CCD camera, accordingly the changes in the mitochondrial membrane potential were monitored.

Results: Neurotoxic concentrations of glutamic acid induced a rapid and irreversible damage to mitochondrial membrane potential. The non-competitive NMDA-receptor antagonist MK-801 (dizocilpine) preserved neuronal viability. The loss of rhodamine-123 fluorescence highly correlated with the ongoing neuronal cell death and was shown to be a suitable parameter to determine the neuroprotective action of pharmaceutical compounds.

Conclusion: Loss of the mitochondrial membrane potential can be used as dynamic markers of cellular injury in vitro. Presumably, the in vivo animal experiments are required and cannot be avoided completely. However, the described approach can at least enlighten the preliminary neuroprotective effect of drugs or their critical concentrations directly on the neuronal level and by that way avoid a large number of animal tests.

Background and objectives: It is controversial whether the onset of myocardial infarction occurs randomly or is precipitated by identifiable stimuli. The aim of this study is to emphasise the relationship of exercise, rest and bed related onset ST-segment elevation myocardial infarction with subsequent in-hospital complications.

Methods: The study has been done perspectively having collecting data from those patients whom had been admitted from 1^st of November 2008 till 1^st of June 2009 to the Coronary Care Unit (CCU) in Hawler Teaching Hospital in Erbil city. The study had included one hundred twenty one patients (84 men, 37 women) whom they exhibited a newly developed ST-segment elevation myocardial infarction (STEMI) over the chronological age ranged from (35-86), mean age (56.76±11.12). Transthoracic echocardiography had been employed over 88 recently admitted patients whose in-hospital complications were precisely being clarified and recorded. The onset of pain of acute myocardial infarction whether during exercise, rest or during sleep (bed) has been verified and studied.

Results: Patients whose symptoms of STEMI began at rest, or bed had higher incidence of early acute mitral regurgitation (26, 59.1%), (13,65%) respectively versus exercise related STEMI onset(8,33.3%)p value=0.04.

Conclusion: Early echocardiographic examination is recommended especially to patients having had physical body rest in order to detect early bed-related onset STEMI and to diagnose complications like acute mitral regurgitation.

Background and objectives: Acute respiratory tract infection is a leading cause of childhood morbidity & mortality in developing countries .respiratory distress with wheezing in infants is quite common & presents substantial diagnostic problems. The aim is to determine the clinical characteristics of wheezy chest in children below 2 years of age in Raparin pediatric hospital in Hawler Governorate

Methods: a prospective study conducted between 1^st of January till 1^st of June 2007 in Raparin hospital , three hundreds children of 1-24 months old admitted with respiratory distress & acute wheezing were recruited & 62 children with no respiratory distress were also studied as control cases. Chest x-ray, total & differential WBC counts were undertaken for all of them.

Results: of the 300 cases, 191 were due to bronchiolitis. thier age were between 1-6 months (47.23 %), male was the most common gender affected (67.67%).Fever with temperature above 37.7 Cᵒ indicate pneumonia (68.9%) more likely rather than other 2 diseases (asthma ,bronchiloitis). One hundred percent of cases of asthma had history of previous attack of wheeze & +ve family history of atopy.Among bronchopneumonia patients, 77% had opacity in chest x-ray (CXR) while 39.9% of bronchiolitis cases had normal CXR. In 84.8 % of cases with bronchiolitis WBC count were normal with only 4.2% had lymphocytosis, while 11.5% of bronchopneumonia patients had leukocytosis with 24.6% of these cases had neutrophilia.

Conclusion: It can be concluded from this study that bronchiolitis, bronchopneumonia & asthma can be differentiated up to reasonable extent on the basis of clinical features supported by simple available investigations..

Background and objectives: The objective of this study was to explore the optimal combination of agents with their doses used along with cisplatin for the protection of hepatotoxicity.

Methods: This experiment was carried out on a patients suffering from different solid types of tumor divided into two groups: cisplatin group receiving cisplatin in a dose of 90 mg/ m² body surface area(BSA) and the therapy group receiving cisplatin in a dose of 90 mg/m² BSA and bismuth subcitrate (200mg/day) with vitamin E (400mg/day). Ten healthy subjects were taken as a control group.Total serum bilirubin (TSB), serum glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT) and alkaline phosphatase (ALP) were tested for the assessments of liver function.

Results: The level of TSB, GPT, GOT and ALP in healthy subjects did not changed significantly with respect to baseline value along the entire period of the study ; while cisplatin group showed a sustain and significant elevation in TSB, GPT, GOT and ALP level in comparison with baseline along the entire period of the study, P<0.05. Meanwhile, the hepatotoxic effect of cisplatin was shown to be slightly but however significantly decreased in patients received bismuth-vitamin E therapy (P<0.05) along the entire period of the study.

Conclusion: Bismuth and vitamin E combination play a beneficial role for prevention of cisplatin hepatotoxicity. The potentiated actions for prevention of cisplatin hepatotoxicity could be achieved via combined use of these agents.

Background and objectives: L-fucose is a methyl pentose similar to L-galactose, except for the loss of the alcohol group on carbon No.6. It is found in human serum bound to proteins by covalent bonding and it is a member of a large group of compounds known as glycoproteins Glycoproteins determine and steer up the vital functions of plasma membranes, e.g. cell-cell recognition, growth control, information uptake mediated via hormones or toxins and the attachment of antibodies. The aim of the current study is to measure the serum concentrations of these parameters on both the healthy individuals and the myocardial infarction patients.

Methods: The existing study has been initiated and implemented in earnest over the period commenced from February 2009 to October 2010 materialised on 100 healthy volunteer individuals countered to 110 (newly diagnosed myocardial infarction) patients. Serum total fucose and protein bound fucose were measured by UV/VIS spectrophotometery.

Results: The mean concentrations of serum fucose and protein bound fucose were significantly being higher on my ocardial infarction patients versus those of the control individuals.

Conclusion: in order to envisage the negative impact on the heart muscle can be judged by the increase in serum level of fucose and the subsequent protein bound fucose on the myocardial infarction patients, thus, they can be labelled as the biomarkered for the myocardial infarction.

Background and objectives: Skin diseases in developing world have stimulated a lot of interest over the years because they are potentially preventable and controllable and because skin diseases also serve as an index of community development. The present study was designed to determine the burden of the skin diseases in rural areas of Erbil governorate.

Methods: The study is a community based conducted in one of the rural areas of Erbil study, house to house survey method was applied and all the households were examined after explaining for them the process. Data regarding socio-demographic variables were collected from each family by a specially designed questionnaire. All the household members were clinically examined and the dermatological findings were recorded.

Results: The study population composed of 542 persons, 262 (48.33%) male and 280 (51.67%) female with male to female ratio 0.94:1. The overall prevalence of skin diseases was 36.3%, 164 (30.2%) of them affected with one disease, and 33 (6.1%) affected with two diseases. Infectious dermatoses have the highest prevalence rate (20.1%), followed by eczematous skin diseases (10.2%). The overall prevalence of skin diseases was higher among females than males; the prevalence of skin diseases was increasing with rising crowding index.

Conclusion: The study concluded that the prevalence of skin diseases in rural areas of Erbil governorate is one of the great public health problems that have a significant burden on the population. So, increased public and professional awareness of dermatological care might decrease the size of these disorders and its burden in the community.

Background and objectives: Polycystic ovary syndrome (PCOS) is one of the most   common endocrine disorders in women of fertile age, affecting 5-10% of the female population. The aim of the present study is to evaluate the endocrine and metabolic effects of metformin in patients with polycystic ovary syndrome in Kirkuk city.

Methods: Eighty female with polycystic ovary syndrome (PCOS), were classified in to two groups, the first group ,who received Clomifene citrate and Metformin hydrochloride included 45 patients and the second group , who received Clomifene citrate only (control group) included 35 patients. All study patients, were diagnosed as polycystic ovary syndrome and they were on treatment at least two months before blood sample collection. Laboratory assessment that obtained included serum, free testosterone, leptin and insulin glucose and lipid profile.

Results: No significant differences in median of, serum insulin, insulin resistance or serum leptin between study groups were observed. The median free serum testosterone was significantly lower (23 pg/ml) in those treated with metformin compared to those on ordinary treatment (50 pg/ml). Fasting serum glucose, HDL – cholesterol and total cholesterol were significantly higher in group without metformin (116.2 , 41.3 , 161.8   mg/dL respectively) compaired to group with metformin (101.5, 34.3 , 138.8   mg/dL   respectively). The remaining biomarkers (serum   LDL-cholesterol, serum VLDL-cholesterol and triglyceride) showed no statistically significant differences between two groups.

We conclude that metformin treatment has beneficial effects on serum, free testosterone cholesterol and glucose in obese women with PCOS.

Background and objectives: Postpartum depression is a global, life-threatening disorder which affects particular mothers in their post-natal periods. It’s regarded to be one of the major disabling conditions of motherhood. We aimed to study the rate of, as well as assessing a group of psycho-obstetrical risk factors behind postpartum depression.
Methods: 98 newly gave-birth mothers were recruited with mean age of 27.07 year between the periods of November 2009 to February 2010. Edinburg Post-natal Depression Scale was adopted by authors for the assessment of postpartum depression. Comparisons on groups of demographic, obstetrical, and psychological data were done between both positive and negative mothers for the disorder.
Results: 39.8% of mothers were diagnosed as postpartum depression. For which, no particular demographic factors were significantly predictive for. Depressed mothers were of significant higher mean number of gestation with p value of 0.0472. However, no other obstetrical factors revealed back statistical significant differences. Past history of depres-sive disorders, whether post-natal or not, was significant predictor for current postpartum depression with p value of 0.02 for history of previous postpartum depression, and p value of 0.042 for non postpartum depressive disorders.
Conclusion: Postpartum depression is highly prevalent in our society. History of depres-sive disorders is a strong predictor for future postpartum disorder. However, there were no clear correlation between postpartum depression and other demographic and obstetrical data apart from the mean number of gestation.

Background and objectives: Breast cancer has specific challenges for women. This study was carried out to identify the frequency of depression and anxiety in women with breast cancer..
Methods: A hospital based case-control study was carried out in Erbil city from August, 15th to November, 1st 2010. The convenient sample included 100 cases of diagnosed breast cancer for the last three years attending Maternity and Nanakali hospitals and two hundred age-matched (± 5 years) non-cancer women attending the Maternity hospital for gynaecological conditions were taken as a control group.
Results: The mean ± SD ages of cases and controls were 45.51 ± 8.87.4 and 44.57 ± 8.59 years, respectively (P=0.378). The proportion of depression among cases (69%) was higher than that among controls (17.5%) (P<0.001), and the proportion of anxiety among cases (56%) was higher than that among controls (16%) (P<0.001). Multiple logistic re-gression analysis of risk factors for depression revealed that breast cancer (OR=10.531), owned home (OR=0.463), and years of formal education (OR=0.917) have a statistically significant association with depression. While breast cancer (OR=8.735) and parity (OR=1.167) have a statistically significant association with anxiety and borderline anxiety.
Conclusion: Increased levels of depression and anxiety after a diagnosis of breast cancer highlight the need for dedicated psychiatric service provision.

Background and objectives: The urinary tract infection (UTI) occurs in any part of the urinary system. Researches on bacterial adhesions were carried out due to the role of blood group types or the influence of numerous kinds of foods. This study is an attempt to investigate the role of these two factors.

Methods: This work was conducted through; first; investigating the ABO-Rh group distribution of 103 patients with UTI, and second; detecting the optimal pH of the media that might facilitates the attachment of Escherichia coli (E. coli) to the lining mucosa layer.

Results: 58.4% of females UTIs patients were between 10- 30 years, and 53.9% of males were more than 51 years. The distribution of blood groups in female UITs patients was as follows;18.2% A⁺,22.1% B⁺, 7.8% AB⁺,44.2% O⁺, 3.9% A^- , 2.6% O^-, respectively: and non with B^- and AB^-, while in male UITs patients was as follows;46.2% A⁺, 11.5% AB⁺, 38.5% O⁺, 3.8% O^- respectively, and non with B⁺, A^-, B^-, and AB^-. The pH of urine in UTIs female patients was less than 7 and saliva pH was 7, whereas both in males were less than 7. Some acid-yielding and alkaline-yielding foods prevented the growth of E. coli. Neutral foods did not.

Conclusions: Patients who are owners of A and O blood groups are more prone to infection at age 10-30 for females and males who are over 51 years. Read phonetically Dictionary - View detailed dictionary. The pH of both urine and saliva in males and females were neutral and slightly acidic. Some acid and alkaline yielding foods prevented the growth of bacteria.

Objective: To present a case of bilateral ovarian fibromas associated with Meigs syndrome.
Design: Descriptive case study
Setting: Soran private hospital & Medya diagnostic centre in Erbil.
Patient: A 49-year-old woman presented with bilateral ovarian masses, ascitis and hydrothorax.
Intervention: Surgical removal of both ovaries with 15 cm left ovarian mass & 5.5 right ovarian mass with total abdominal hysterectomy.
Results: Histopathological examination revealed bilateral ovarian fibromas with foci of calcification
Conclusion: The clinician should be aware about rare benign syndromes, like Meigs, which may mimic malignancy when ovarian masses associated with ascitis and mislead the diagnosis and management plan.