Vol 15, No 2 (2011)

Background and objectives: Echinococcus granulosus exists as a complex of different strains that differ in a wide variety of criteria that impact on the epidemiology, immunology, pathology and control of hydatid disease. This study was undertaken to investigate both humoral and cellular immune responses that are developed against hydatid cysts in Erbil.

Methods: Thirty patients (9 males and 21 female) with surgically confirmed cystic echinococcosis and 10 apparently healthy individuals were included in this study. IgG ELISA was performed to asses humoral immune responses. CD4/ CD8 ratio, eosinophil count and lymphocyte transformation response were done to asses the cellular immune responses. The level of IFN-γ and TNF-α was also assayed.

Results: The sensitivity of ELISA to detect anti-hydatid antibodies was shown to be 83.33%. CD4 / CD8 ratio was significantly (P< 0.001) decreased in patients with cystic echinococcosis as compared to normal control group, while eosinophil count (P< 0.001), lymphocyte transformation response (P< 0.001) and IFN-γ level (P< 0.01) were significantly increased. In contrast the level of TNFα was non- significantly changed in echinococcosis patients.

Conclusion: The current study showed that the local strain of Echinococcus granulosus induces both cellular and humoral immune responses, and the number of peripheral blood CD8 T cells was significantly increased in cystic echinococcosis patients. However, hyporesponsivness to hydatid specific antigens has not been induced.

Background and Objectives: Toxic injury occurs in the liver more often than other organ, this can be attributed to the fact that virtually all ingested substances that are absorbed are first presented to the liver & that the liver is responsible for the metabolism and elimination of many substances. Carbon tetrachloride (CCl4) is very well known to cause hepatotoxicity that may be associated with impaired calcium and trace element homeostasis. This study was designed to evaluate the protective effect of benfotiamine against CCl4-induced disturbances in calcium, iron, copper and zinc homeostasis in liver tissue of rats.

Methods: Liver tissue homogenate from normal controls, CCl4-treated and benfotiamine (70 mg/kg) pre-treated before induction of hepatic damage with CCl4 in rats were obtained, and processed for estimation of levels of free forms of calcium, iron, copper and zinc using atomic absorption spectrophotometry.

Results: Analysis of data revealed significant elevation in calcium, iron and copper levels in hepatic tissue due to exposure to CCl4 compared to controls, while zinc levels not significantly affected. Pretreatment with benfotiamine results in significant decrease in calcium, iron and copper levels compared to non-treated group, while zinc levels found to be significantly elevated.

Conclusions: Benfotiamine has a protective effect against CCl4-induced hepatic tissue damage which may be, in part, attributed to restoration of calcium and other trace elements homeostasis.

Background and objectives: Schizophrenia is the heartland of psychiatry and the core of its clinical practice. The onsets of schizophrenia characteristically occur between the ages of 15 and 45. There are minor sex differences in age of onset. Schizophrenia is over presented among people of lower social class. The relationship of birth order to schizophrenia has been controversial.

Methods: Eighty six schizophrenic patients who were admitted to psychiatric unit of Basra General Hospital, who met DSM-1V criteria for schizophrenia were included in this study. The data was obtained by personal interview from the patients and their accompanied relatives, after taking their consent, according to the following: age, sex, marital status, social class, season of birth and birth order.

Results: This study shows high male to female ratio. Two third of the patients were single and in younger age group. The study also shows high percentage of schizophrenic patients in upper and middle social class. The season of birth of schizophrenic patients were in spring and there is no much difference between first and last born.

Conclusion: There is certain factor, the young, single, season of birth … etc have special risk in developing schizophrenia and these should provide basis for further studies.

Background and objectives:There is controversy as to which instrumentation and/or obturation techniques to choose for the treatment of the internal resorption defects. This in vitro study compared the instrumentation and obturation quality of simulated internal resorption cavities (IRC) with 3 different techniques.

Methods:Ninety extracted human roots were used and sectioned transversely 5 mm from the apex and hemi-circular cavities were prepared in both sections. The sections were glued back together using superglue and embedded in plaster mold, thus obtaining root canals with cavities simulating internal resorption. The samples were randomly divided into 3 groups of 30 roots and instrumented by pro-taper rotary files, hybrid technique, or step-back technique, then each group subdivided into three subgroups of 10 roots and obturated with cold lateral condensation, warm vertical compaction, or injectable thermo-plasticized technique. After obturation, the samples were radio-graphed in Bucco-lingual and Mesio-distal view. After that, the plaster molds were removed, and the samples were then sectioned at the previous level and the quality of the obturation of the IRC were viewed under stereomicroscope.

Results: There was highly significant difference between pro-taper rotary files compared with hybrid and step-back techniques. The results of obturation techniques radiographically and by stereomicroscope showed that there was highly significant difference in between injectable thermo-plasticized compared with other two techniques.

Conclusion:The pro-taper rotary files and injectable thermo-plasticized technique gave the best results for treatment of simulated internal resorption cavities (IRC).

Background and objectives: Hyperlipidemia is characterized by increased concentrations of lipids including triglycerides, total cholesterol, low density lipoproteins, very low density lipoproteins in the blood and some times decreased high density lipoproteins .

Many drugs have been used for treatment of this disorder. The present study was designed to estimate the effects of simvastatin on lipid profile, atherogenic index, transaminases, creatinine, uric acid and alkaline phosphatase.

Methods: This study covered 70 subjects, they were divided into two groups, the first group included 45 hyperlipidaemic patients which were treated with 20mg simvastatin and second group included 25 normal subjects. After 12 hours fasting, serum lipid profile, transaminases; alkaline phosphatase, uric acid and creatinine were measured for the patients in 3 intervals before treatment, after 8 weeks and 16 weeks of treatment, and one time for normal subjects.

Results: : After therapy, simvastatin showed a significant reduction in serum (TC, TG, LDL, VLDL and atherogenic index) and also, significant rise in HDL noticed, by performing a comparison between the group before treatment, and groups after treatment.Serum ALT, AST and ALP were significantly increased but were still within normal levels.Insignificant effect was observed from serum creatinine, uric acid and also body mass index by performing a comparison between group before treatment and groups after treatment.

Conclusions:Simvastatin was effective in controlling lipid profile and atherogenic index, with no significant abnormality in liver functions.

Background and objectives: Male Infertility is often caused by problems with sperm production or motility. Zinc in human semen seems to play an important role in the physiology of spermatozoa .This study was designed to demonstrate the relationships between concentrations of zinc and testosterone in serum and seminal plasma and sperm quality among infertile men.

Methods: One hundred four infertile males, aged (19-44) years, were selected from Infertile Clinic-Azadi Teaching Hospital- Kirkuk Province. Forty known fertile males were selected as normospermic control group. Semen samples were analyzed according to WHO criteria. Serum and seminal plasma zinc concentrations were estimated by atomic absorption technique. Serum testosterone was measured by MiniVIDAS apparatus.

Results: The mean value of serum testosterone was significantly lower in infertile males (4.87±0.15 ng/ml) as compared to control group (6.41±0.16 ng/ml); (P< 0.01), significant correlations were observed between serum testosterone with seminal plasma zinc level in oligospermic subjects (r=0.44) and with serum zinc level in azoospermic subjects (r=0.37), (P< 0.01); (P< 0.05) respectively. Serum and seminal plasma zinc levels were lower in infertile men (7.75±0.18 µmol/L); (0.83±0.02 mmol/L) when compared with normospermic control group (14.09±0.27 µmol/L); (1.41±0.01 mmol/L) respectively (p<0.01),

Conclusion: Zinc may contribute to fertility through its positive effect on spermatogenesis. Also there was significant decrease in serum and seminal plasma zinc levels in oligospermic and azoospermic infertile males with significantly low androgen. It indicates that the zinc may have a role for steroidogenesis.

Background and Objectives: Since 1950s, phototherapy had been the treatment of choice for neonatal jaundice. Continuous phototherapy was the pattern used for many years; however intermittent phototherapy was also used with conflicting and controversial results. This work aim is to assess intermittent phototherapy for the treatment of neonatal jaundice in comparison with continuous phototherapy.

Methods: In a prospective clinical study all newborns with neonatal jaundice admitted to neonatology department of Raperin hospital in Erbil, between August 2009 and February 2010, for phototherapy were included in the study. The patients were randomly divided into 2 groups. In the control group continuous phototherapy defined as two hours on and half an hour off was used while in the study group intermittent phototherapy defined as one hour on and one hour off was used. Mean total serum bilirubin level in both continuous and intermittent phototherapy groups were compared after each12, 24, 36, 48, and 72 hours of commencing phototherapy. The effect of biodemographic characteristics (gender, gestational age, birth weight, age in hours, and bilirubin levels at admission) were also studied.

Results: There was no any significant difference between the two groups regarding mean total serum bilirubin measured at every 12 hours. There was no any significant difference between the 2 groups regarding biodemographic characteristics (p> 0.05).

Conclusion: Intermittent phototherapy is as effective as continuous one in the treatment of indirect hyperbilirubinemia in full term infants and in the absence of hemolytic causes.

Background and objectives: Urinary tract infections are amongst the most common infections, Hospital-acquired urinary tract infection increases not only morbidity and mortality but also hospital costs. The objectives of this study were to determine bacteria responsible for hospital-acquired urinary tract infection, their antibiotic sensitivities and to describe the risk factors of the infection.

Methods: All urine samples fulfilling the criteria for significant bacteriuria were included in the study. Isolation and identification of bacteria was performed by standard method and susceptibility testing was determined by disk diffusion method.

Results: Out of 290 patients, 133 (45.86%) have acquired hospital-acquired urinary tract infection. Older age, hospitalization and catheterization were risk factors of the infection. Escherichia coli (51.70%) and Klebsiella pneumoniae (16.33%) represented the most common isolates. The most bacteria isolates were sensitive to ciprofloxacin, rifampin and trimethoprim + sulphamethoxazole.

Conclusions: To prevent hospital-acquired urinary tract infections, important factors must be taken into consideration, for example: avoid unnecessary urethral catheterization, choose narrow spectrum antibiotics according to antibiotic sensitivities, and investigate regularly the causative bacteria and their susceptibility patterns

Background and objectives: Over the last 35 years electrical nerve stimulation has been employed increasingly in the treatment of chronic pain. This study was carried out to compare the analgesic effect that produced by applying a fixed frequency (50 Hz) high intensity tolerably painful transcutaneous electrical nerve stimulation (TENS) with the conventional low intensity TENS.

Methods:

Thirty six patients (26 Females and 10 males with age 18 – 54 years) were selected from patients consulting a private psychiatric clinic in Erbil city from March 2009 to march 2010. They had chronic pain in head and neck for more than 2 years. The cases were allocated randomly into two groups; group A treated by the conventional TENS of high frequency 100 Hz with low intensity current, by applying the electrical electrodes on the nucheal region (back of neck) for 20 minutes once daily for six days, and once weekly for one month then follow up the patients after 3 months, while in group B; the same procedure was applied but with fixed frequency 50 Hz and high intensity current adjusted to a tolerably painful level. The pain measured by verbal scale ranged from 0 to 4.  

Results: Patients who received high intensity TENS; 94% of them got immediate pain relief and 17% got long lasting pain relief more than three months, while with the conventional TENS only 33% got immediate pain relief and no one got long lasting pain relief.

Conclusion: The tolerably painful high intensity TENS gives better analgesic effect than the conventional TENS, and in some patients it may leads to long lasting analgesic effect(this may be attributed to the pan stimulation involving a variety of afferent fibers; Aa/β, Ad & C).

Background and objectives: Otitis media with effusion is collection of fluid behind intact tympanic membrane. Otitis media with effusion usually coexists with the adenoid hypertrophy. The adenoid is a part of Waldeyer's ring; its basic function is thought to be antibody production. The aim is to identify the incidence of otitis media with effusion in children with adenoid hypertrophy.

Methods: A prospective descriptive cohort study had been employed at Rizgari Teaching Hospital/ Erbil from January 2008 to July 2008. Summation of total 120 Child aged 3-12 years old were being conducted in the survey. All patients subjected for history, local physical examination, Information's recorded on a specially designed Questionnaire and proper investigations were done including lateral X ray of post nasal space, and audiological examination.

Results: Among 120 patients age (3-12) years old with adenoid hypertrophy, 44 patients (36.7%) had OME, mean age was 6.5 years. Most common age group was (5-6) years (21) (47%).

Conclusion: Adenoid Hypertrophy (AH) can be relevant in the pathogenesis of otitis media with effusion (OME) due to its anatomic position.

Background and objectives: The protective function of saliva against dental caries achieved through its physico-chemical properties The purpose of this comparative study was to evaluate the relationship between some risk factors such as salivary flow rate, pH, oral hygiene (plaque index), buffering capacity, salivary level of lacto bacilli, streptococcus mutans and candida, with dental caries also aimed to determining which salivary factors correlate significantly to dental caries experience in children and adolescents.

Methods: In this study, salivary factors were measured in resting saliva. Resting saliva was collected to determine flow rate, pH, buffering capacity, microorganism level of lactobacilli, streptococcus mutans and candida of (400) healthy school student, (200) children (6-12) years and (200) adolescents (13-16) years in twenty schools in Erbil city of different socioeconomic status. Their teeth were examined to measure the caries experience using decay, missing, and filled teeth index (DMFT), and oral hygiene (plaque index) level using (Silness and Loe 1964) method.

Results: The mean DMFT in children was (5.35), while the mean DMFT in adolescents was (5.54). The mean oral hygiene in children was scored (1.21), while the mean oral hygiene in adolescents was (1.19). The factors showing significant relation ship to dental caries in children were flow rate, pH, oral hygiene (plaque index), lactobacilli, streptococcus mutans and candida, while the salivary factors showing a significant relation ship to dental caries in adolescent were pH, oral hygiene and count of lactobacilli.

Conclusion:Evidence from the current research support a central role of the salivary flow rate, pH, oral hygiene, count of salivary streptococcus mutans, lactobacilli and candida albicans in the increasing of dental caries in children. While in adolescent there was relation between dental caries and salivary pH, oral hygiene and count of lactobacilli.

Background and objectives: Aims of the present study were to investigate the gingival health status in different age groups of both genders in (300) subjects aged 20–80 years, also to fined the effect of the frequency of tooth brushing and education level on gingival health of adult population in Erbil city.

Methods: The examination was performed using plaque, gingival and calculus indices. The level of education and frequency of tooth brushing were reported.

Results: Demonstrated that ; the total mean for plaque(1.18) ,gingival (0.97) and calculus(0.19) scores were increased with increasing age with significant differences fore plaque (P-value =0.017) and calculus(P-value =0.00) score but with no significant difference for gingival score(P-value =0.31) . Males reported higher means than females for plaque and gingival score while male reported equal means with female for calculus with no significant differences. (P-value =0.41), (P-value =0.16), (P-value =0.82) respectively. The highest mean of plaque (1.68), gingival (1.43) and calculus (0.31) scores were seen related to non brushing group with significant differences between all groups.

(P-value =0.00)

The highest mean of plaque (1.45), gingival, (1.19) and calculus (0.23) scores, were seen related to illiterate level of education with significant differences between all groups.

(P-value =0.00)

Conclusion: Females reported less mean plaque score and more healthy gingiva than males. Gingival, plaque and calculus scores were increasing with age. Most of the of them needs increasing their level of education and oral health education.