About Journal

Al-Anbar Medical Journal (AMJ) is an international peer-reviewed journal published biannually by the College of Medicine, University of Anbar. The Journal provides a suitable media of communication for biomedical researchers all over the world. The Journal welcomes original articles, review articles, case reports, images in clinical practice, and short communications in all fields relevant to medicine. The Journal is open access for both researchers and readers.
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Journal Information

Publisher: University of Anbar

Email:  amj@uoanbar.edu.iq

Editor-in-chief: Prof. Dr. Raid M. Al-Ani

Managing Editor: ِAss. Prof. Dr. Aamr Fakree AL-Ubaide

Print ISSN: 2706-6207

Online ISSN: 2664-3154

Types and Clinical Profile of Unilateral Sinonasal Masses

Ammar H. Khammas; Husam S. Hameed; Firas J. Alobaidy

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 1-4
DOI: 10.33091/amj.2022.174522

Background: Unilateral mass in the sinonasal region is a common problem facing the otolaryngologist in daily clinical practice. There are various benign and malignant conditions originating in this area with different clinical features depending on their nature and extent.
Objectives: To evaluate the types and clinical profile of unilateral sinonasal masses.
Materials and methods: This study includes 60 patients who attended the outpatient clinic at Alyarmook Teaching Hospital, Baghdad, Iraq, between January 2017 and April 2018. A thourough history from each patient was taken. Moreover, the clinical examination was done according to standard clinical practice. The imaging results of the nose and paranasal sinuses were documented. Then biopsy was taken from the mass at the operating room under local or general anesthesia if indicated. The specimen was sent for histopathological examination and the results were documented on the data collection sheet. The patients were divided into two groups: non-neoplastic and neoplastic according to the histopathological results.
Results: Out of 60 patients, there were 36 (60%) males. The age of our cases was ranged from 6 to 79 years with a mean age of 34.20 ± 18.126 years. Non-neoplastic causes were (n=38, 63.3%) more than the neoplastic group, and the majority of them were unilateral simple polyp (n=23, 38.3%). Inverted papilloma was the most common benign tumor (n=8, 13.3%), while, squamous cell carcinoma was the commonest malignant neoplasm (n=2, 3.3%). Non-neoplastic causes were more in both sexes. The most affected age group was 20-49 years (n=31, 51.7%). The non-neoplastic causes were mostly seen in the age group 20-49 years (n=22, 36.7%). There was no statistically significant difference between the age and gender and the causes of unilateral sinonasal lesions (P-value > 0.05). Nasal obstruction, nasal discharge, and hyposmia were more in non-neoplastic than neoplastic group. While epistaxis and facial pain were found to be higher in the neoplastic group.
Conclusion: Non-neoplastic masses outnumber neoplastic ones. Among non-neoplastic lesions, inflammatory polyps were the most common. Benign neoplasms outnumber the malignant neoplasms with inverted papilloma and squamous cell carcinoma were the most common respectively.

Modes of Transmission of Brucellosis in Anbar Governorate, Iraq

Hani Y. Danhash; Rafi Khaleel Al_Ani; Maher S. Khaleel

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 5-9
DOI: 10.33091/amj.2022.174523

Background: Brucellosis is a common and endemic disease in the Anbar governorate. Besides,
the Brucella microorganism has different ways of transmission.
Objectives: The study aimed to determine the ways of transmission of Brucella organisms to
human beings in the Al-Anbar governorate.
Materials and methods: A retrospective study was carried out on patients visiting the two main
Ramadi Teaching Hospitals in Ramadi city, Iraq for the diagnosis and treatment of Brucellosis.
Patients with blood-culture-positive brucellae were enrolled in the study. The study included
the period between February 2002 and March 2005. Data were collected and recorded regarding
age, gender, and residence. The possible ways of acquiring the disease were recorded too. These
included ingestion of possibly contaminated foods, butchering of animals, meat cutting, keeping
animals in homes or nearby their livings, cleaning animal places, caring for, milking of them, aiding
in their delivery and if they wear gloves, blowing in the mouth of delivered fetuses, their work, and
possible laboratory worker exposure.
Results: A total of 312 patients with brucellosis were enrolled in the study. The disease appears
to be more common in rural areas (P-value
<0.001). More cases were females in all age groups,
and it was more common in the age group 31-40 years. The main mode of transmission is direct
or indirect contact with infected domestic animals (P-value
<0.001). Lab workers and ingestion
of raw milk and unsafe milk products were the least recorded expected risk for infection. Three
risky behaviors for acquiring brucellosis were also recognized in this study: milking animals, aiding
domestic animals in delivery, and blowing in the mouth of delivered fetuses to promote breathing
of the newly delivered animals.
Conclusion: Direct or indirect animal contact was the main way of Brucella transmission in the
Al-Anbar governorate

Effect of Preoperative Alpha-Blocker in Ureteroscopy for Ureteral Stones: A Case-Control Study

Asaad I Othman; Nabeel M Al-Hamamy

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 10-14
DOI: 10.33091/amj.2021.174524

Background: Urothethiasis is the most common urinary tract disease with a global prevalence
rate of 2-20%. Alfa-blocker has a relaxation effect on the smooth muscles of the ureter making the
removal of ureteric stone easier during the ureteroscopic procedure.
Objectives: To evaluate the effect of preoperative -adrenoreceptor antagonists therapy (tamsulosin) in the treatment of ureteral stone using a ureteroscope regarding operative time, access to
the ureter, and the complication rate.
Materials and methods: A prospective case-control study was conducted at Al-Jamhory
Teaching Hospital, Mosul, Iraq. During the period from June 2019 to August 2020. Subjectts with
ureteral stones (7-15 mm) scheduled for ureteroscopic intervention were enrolled in the study. The
patients were classified into two groups, the first group was received a pre-operative alpha-blocker
(tamsulosin 0.4 mg capsule per day for 7 days), and the second group (Control) did not receive
further medication. The operative time, uretric access, and intra- and postoperative complications
were registered for both groups.
Results: There was a matching between the two groups regarding the age, gender, and side, size,
and location of the ureteric stones. There was a statistically significant difference between the two
groups regarding the operative time (23.2
± 4.569 minute in the treated group vs. 25.48 ± 4.904
minute in the control group) (P-value = 0.009). Besides, the ureteroscopic operation was easier
(P-value = 0.031) in treated group (n = 51 easy case, 85%) than the control group (n=41, 68.33%
easy case). The intraoperative and postoperative complications were mucosal injury, perforation,
bleeding, pain, hematuria, and fever. The total number of complicated cases was 14 (23.33%) in
the treated group and 25 (41.66%) in the control group, and there was a significant difference
between the two groups (P-value = 0.032).
Conclusion: The study revealed that the preoperative alpha-blocker tamsulosin was improved the
outcome of ureteroscopy (shorter operative time, easier access to the ureter, and low complication
rate).

The Effect of Sweet-tasting Foods Addiction on Appetite-related Hormones among Obese Adolescents

Nour Shakir Rezaieg

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 15-20
DOI: 10.33091/amj.2021.174525

Background: Food ingestion and energy spending are organized through a complicated neurological system that involves both hypothalamic centers and peripheral satiety regulation
(gastrointestinal and pancreatic hormones).
Objectives: To assess the effects of sugar addiction on appetite-related hormones and metabolic
hormones.
Materials and methods: The study was done in two main hospitals in Anbar governorate, Iraq
from April 2020 to November 2020. Concentration of fasting blood glucose (FBG), insulin, hormone
insulin resistance (HOMA-IR), leptin, ghrelin, lipid profile, TSH, T3, and T4 were measured in the
54 obese adolescents and were compared with 54 normal-weight adolescents.
Results: There was a significant increase in the concentrations of FBG, insulin, HOMA-IR, leptin,
total cholesterol (TC), triacylglycerol (TAG), low-density lipoprotein cholesterol (LDL-C), and
TSH in obese adolescents as compared to normal-weight adolescents (P-value
<0.05). While there
was a significant (P
< 0.05) decreased in the concentrations of ghrelin, high-density lipoprotein
cholesterol (HDL-C), T3, and T4 in obese adolescents compared with normal-weight adolescents.
The results also showed that there is a significant positive correlation between the concentration
of leptin and each of BMI, FBG, insulin, and HOMA-IR, while there was a significant negative
association between leptin level with HDL-C and ghrelin.
Conclusion: Sweet-tasting meals are a major source of stimulation, which leads to overeating and
thus leads to obesity

Value of Shear Wave Elastography in Discriminating Category IV Breast Lesions According to Breast Imaging-Reporting and Data System

Mohammed Abd Kadhim; Noor Yousif Abed

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 21-26
DOI: 10.33091/amj.2021.174526

Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificity
in the diagnosis of breast lesions.
Objectives: To evaluate the value of SWE to discriminate benign from malignant Breast
Imaging-Reporting and Data System (BI-RADS) IV breast lesions.
Materials and methods: A cross sectional analytic study was done in the Radiology Department,
Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year
(February 2020 to January 2021). The study included 42 female patients with suspicious breast
lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for
all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or
true cut biopsy or excisional biopsy.
Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign
breast lesions. There was a statistically significant association between the quality of SWE and
histopathological diagnosis as the proportion of malignant breast lesions was significantly higher
among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with
malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions
(133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean
SWV
> 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity,
and 73.8% accuracy.
Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast
lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off
value in SWE is 83 KPa for E-mean.

Awareness of Gout and Hyperuricemia in a Sample of the Adult Population in Iraq

Shaimaa K. Jubair; Sami S. Shihab; Naqaa A. Mousa

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 27-32
DOI: 10.33091/amj.2022.174527

Background: Gout is the most common type of inflammatory arthritis in men and postmenopausal
women. The incidence and prevalence of hyperuricemia and gout were increased all over the world
even among developed countries.
Materials and methods: A cross-sectional study was conducted at the Rheumatology Unit of
Baghdad Teaching Hospital in Medical City, Baghdad, Iraq from October 2020 to April 2021. A
total of 247 subjects were included in the study. Data were collected using a pre-constructed data
collection sheet by face-to-face individual interviews. The sheet includes demographic characteristics, gout-related questions regarding the etiology, suspected predisposing agents, complications,
diagnostic methods, food-related, clinical manifestations among studied cases, and attitudes of the
gout patients among the study sample.
Results: Of 247 subjects, there were 67.2% (n = 166) males, 27.9 (n = 69) from the age group
40-49 years, 36.4% (n = 90) from Baghdad city, 25.5% (n = 63) university graduates, 19.9% with
good income, 70.5 (174) employed, 221 (89.5%) married, 85% (n = 210) non-smokers, and 8.9%
(n = 22) with family history of gout. Overall, 59 (23.9%) of the participants had a high level of
awareness whereas low awareness levels accounted for 41.3% (n = 102). The awareness level showed
a statistically significant association with education level, occupation, economic status, smoking
habit, family history of gout, and patients with gout (P-value
< 0.05).
Conclusion: There was a high proportion (41.3%) of the participants with a low level of awareness
about gout and hyperuricemia. The awareness level among the participants was related to the
education level, occupation, economic status, smoking habit, family history of gout, and patients
with gout.

Impact of COVID-19 Pandemic on Antenatal Healthcare in Al-Ramadi city, Iraq

Haifa G. Al-Ani

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 33-36
DOI: 10.33091/amj.2022.174528

Background:Antenatal care (ANC) is a form of preventive medicine, pregnancy-specific, and
general health advice effectively given in the antenatal period. ANC is conducted by healthcare
personnel on pregnant women at regular intervals to protect and improve maternal and neonatal
health.
Objectives: The study aimed to know if the COVID-19 pandemic affects the coverage rate of
ANC visits of pregnant women.
Materials and methods: This is a retrospective cross-sectional study conducted at Al-Andalus
Primary Healthcare Center which is located in the center of Al-Ramadi city, Iraq. We reviewed the
records of all ANC first, second, and total visits of the months February, May, and October during
the years 2019, 2020, and 2021.
Results: The study showed the coverage rate of ANC visits was statistically significantly declined
with the restrictions imposed in response to the COVID-19 pandemic. At the end of 2021, there
are some elevation in the coverage rate of ANC visits. .
Conclusion: The study concluded that the lockdown period in the pandemic state due to
COVID-19 led to a significant decline in the coverage rate of ANC visits.

A Comparison of Patients’ Satisfaction after Functional and Camouflage Orthodontic Treatments in cl II Malocclusion

Luay Ali Zaidan; Nisreen M. Saleh

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 37-42
DOI: 10.33091/amj.2022.174529

Background: Functional and camouflage orthodontic treatments in cl II malocclusions are
different treatment methods that are usually used in orthodontic practice. A comparison of
patients’ satisfaction with these two treatment groups is an important tool for the evaluation of
treatment outcomes.
Objectives: We aimed to compare patients’ satisfaction with orthodontic treatment subjectively
(according to the opinion of patients) between functional and camouflage orthodontic treatments
in patients with class II malocclusion.
Materials and methods: The sample of the study was formed from individuals whose treatments
were finished between February 2017 and July 2020 at the Department of Orthodontics, Faculty
of Dentistry at Suleyman Demirel University, Turkey. A satisfaction questionnaire was used to
evaluate the satisfaction of the patients with the treatment process at the end of their treatment.
The subjects of the study were selected from 2 genders and a total of 146 cases of average age 11-22
years. The research material consists of a satisfaction questionnaire that was given at the time of
treatment end.
Results: The general satisfaction questionnaire score was found to be higher in the patients
who received functional orthodontic treatment (P-value = 0.011). In the subgroups, the total
questionnaire scores among the treatment subgroups were found to be quite similar.
Conclusion: In our study, the satisfaction level of the quality of life questionnaire was found
to be high, while in response to more specific questions on satisfaction, some departments of the
questionnaire found less satisfaction or dissatisfaction in patients.

Dermatological Manifestations of Patients with COVID 19: A Cross-sectional study

Iqbal G. Farhood; Ali T. AbdulHasan; Salam F. Lafta; Afraa Mamoori; Fatima Al-Hasani

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 43-47
DOI: 10.33091/amj.2022.174530

Background: A Global pandemic Coronavirus disease-19 (COVID-19) caused by the severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). It was isolated in December 2019 in Wuhan
(China). Skin manifestations of COVID-19 disease are overlooked in the clinical approach to those
suspected of this virus focusing on the pulmonary findings.
Objectives: This study aimed to describe the dermatological manifestations of COVID-19 in Iraqi
patients.
Materials and methods: A cross-sectional study was carried out at general hospitals, primary
care centers, and private clinics in three Iraqi cities Baghdad, Babil, and Karbala. The study
covered the period from October 2020 to February 2021. Data regarding the demographic and
clinical characteristics of each participant were registered. A thorough physical examination by a
dermatologist was conducted for every subject. The data were entered and analyzed using SPSS
version 25.
Results: One hundred COVID-19 patients with cutaneous manifestations were enrolled in this
study. There were 59 females. Their ages ranged from 19-62 years. Most of the patients were from
the age group
40 years (68). Just above half of the participants were non-healthcare workers.
The highest blood group of the patients was A (45) and the least AB (11). Half of the subjects
were presented within the first 7 days from the onset of the disease. Fifty-one cases were with mild
disease form. In 54 patients, dermatological manifestations have appeared in the active stage of
the disease. Hair loss was the commonest manifestation (30), all of them in the age group
40
years, and the majority of the cases (26) was affecting the female. While the least manifestation
was acrocyanosis in 2 patients, both of them were male and from the age group
> 40 years. There
were highly statistically significant differences between the skin manifestations and the age and
gender (P-value = 0.000). 
Conclusion: Most of the patients were from the age group 40 years and female. Hair loss was
the commonest skin abnormality due to COVID-19. The majority of cutaneous manifestations
were started in the active phase of the infection. The age and gender determined the type of
dermatological manifestations.

Hydatid Cyst Pleural and Pericardial Effusions as a Complication of Postoperative Hydatid Cyst Resection from the Liver: A Case Report

Haitham Noaman; Khalil Sarhan Khalaf

Al- Anbar Medical Journal, 2022, Volume 18, Issue 1, Pages 48-50
DOI: 10.33091/amj.2022.174531

Hydatid cyst is a zoonotic endemic disease in Iraq. It carries considerable complications either
related to the disease itself or following its surgical removal. Pleural and pericardial effusion is
a rare postoperative complication of hydatid cyst removal. A 65year-old Iraqi female patient
complained of right-sided chest heaviness and palpitation one month following surgical removal of
2 large hydatid cysts. There were no other associated symptoms. Physical examination revealed
the possibility of pleural and pericardial effusions (poor air entry and stony dullness of the right
posterior part of lower zone, difficulty to palpate the apex beat, increase heart dullness, and no
pericardial rub). The diagnosis was confirmed by chest X-ray and echocardiogram. She received
Albendazole tablet 400 mg twice daily for 6 weeks with a good response. The Early presumption
of the disease in an endemic area with a good dose and appropriate course of Albendazole tablets
treatment can give very good results. To our best knowledge, this is the first case in the world
who presented with hydatid cyst pleural and pericardial effusions and responded completely to the
Albendazole tablets.

Effect of Perineural Dextrose Injection on Myofascial Pain Syndrome

Sinan Ismail Khalil

Al- Anbar Medical Journal, In Press
DOI: 10.33091/amj.2022.174963

Background: Myofascial pain syndrome (MFPS) is defined as the motor, sensory, and autonomic signs resulting from trigger points (TrPs).
Objectives: To assess the effectiveness of the perineural injection in patients with MFPS.
Materials and methods: The study was conducted at AL Ramadi Teaching Hospital, Department of Rheumatology, Ramadi City, Iraq. The study period was from June 2019 to January 2021. A retrospective review of 100 patients with prospectively collected clinical and radiologic data was performed to evaluate the effectiveness of perineural injection on MFPS. A 3 ml of 5% dextrose solution was managed sub-cutaneous straight at the labeled chronic constrictive injury and tender spots rounding the knee. The VAS and WOMAC were calculated for each participant at the time of the presentation and 1, 3, and 6 months following treatment.
Results: The mean age of the patients was 60.93 ± 6.17 years (25-70 years). Three-quarters (75/100) of the cases were female. Seventy subjects were from the age group 40 years, while the remaining 30 cases were from the age group < 40 years. Fifty-five cases were with right-sided involvement. Successful results were achieved in 90% of the participants. There were no statistically significant differences between the effective and not effective groups regarding the age, gender, and the involved side (P-value > 0.05). There was a reduction in the mean VAS (8.47 ± 0.77) of pain and WOMAC (78.99 ± 5.69) score at the time of presentation to 1.87 ± 1.32 for the VAS and 17.84 ± 4.66 WOMAC at 6-months post-injection period. No complications were reported in all patients apart from mild pain at the injection site.
Conclusion: Perineural dextrose injection was successful in 90% of the patients with MFPS. This modality results in a sharp reduction of both VAS and WOMAC scores from the time of the presentation to 6-months post- reatment. We recommend using this modality because it is easy, effective, and safe.

The Prevalence of Lower Limb Amputations in Al-Ramadi City

Dr.Ayyoub A. Al-Dolaymi

Al- Anbar Medical Journal, 2008, Volume 6, Issue 1, Pages 71-75

AbstractAim: The study aims at determining the prevalence and causes of lower limb amputations in Al-Ramadi General Hospital.Methods: The medical data and records of all patients with lower limb amputation who were treated in Al-Ramadi General Hospital from January 2003 to January 2008 were reviewed. Age, sex, cause and level of amputation were taken in to consideration.Results: we record a total number of 221 patients were studied among them 125 male (56%) and 96 female (44%). The mean age was 44 years. Trans-femoral amputation was the commonest leading level of amputation 29%, followed by toe amputation 26%. Diabetes Mellitus DM (42%) was the most common cause of amputation followed by trauma (41%).Conclusions: Diabetes Mellitus is the main cause of lower limb amputation in Al-Ramadi city. Good control of blood sugar and education programs are important to minimize the complication of this disease. Proper identification of the high risk patients and follow-up programs should reduce the occurrence of the amputationRecommendations: It is recommended to develop of high specialized centers for treatment and follow-up of diabetic patients.Keywords: amputation, trauma, prevalence, diabetes.

Residual Alveolar Ridge Atrophy In Anbar Province

Suhair W. Aboud; Halah F. Ahmed; Tahrir N. N. Aldelaimi

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 25-29

Background: Alveolar ridge atrophy represent a serious dental problem to maxillofacial surgeon, prosthodontist and general dental practitioner. Objectives & Aims: To evaluate the cases of residual alveolar ridge atrophy in Anbar Province.Materials & Methods: A total of 275 edentulous patients were examined in this clinical study in College of Dentistry, Anbar University, Kalk & Baat classification was used to classify the patient casts according to the degree of resorption into three classes.Results: About (65. 4%) has no previous dentures, the mean ridge height was greater in male than in female, 36. 8% had high CL 1, and 14. 4% had extensive CL2 resorption. Conclusion: It has been found that the residual alveolar bone resorption was attributed to multiplicity of correlated factors such a sex, age, general health & metabolic activity.Key words:Ridge atrophy, alveolar ridge, edentulous patients, mandible, bone resorption.

Bacterial vaginosis and Candida albicans vaginitis among women in Ramadi City

Huda R. S. AL-Alwani

Al- Anbar Medical Journal, 2008, Volume 6, Issue 1, Pages 13-18

AbstractPatients and methods: A prospective study was performed involving 65 women who consecutively attended Gynecological ward in Maternity and Child Hospital in Ramadi for complaints of genital malodour and/or abnormal vaginal discharge. Bacterial vaginosis was diagnosed in 30 women on the basis of four diagnostic criteria: vaginal pH> 4.7, homogenous vaginal discharge, a positive amine test and presence clue cells. This diagnosis was further strengthened by microscopy of wet preparation and stained smears and culture of vaginal discharge under aerobic, facultative anaerobic, and anaerobic cultural condition. Results: A total of 65 high vaginal specimens, bacterial vaginosis was diagnosed in 30 (46.2%) women, vulvovaginal yeast fungi infection in 12 (18.5%) women, other aetiology in 16 (24.6%) and in Seven (10.8%) women showing sterile vaginal discharge. The sensitivity for in vitro bacterial vaginosis detecting criteria was > 90% with the exception of homogenous discharge (73.3%) and their specificity was > 90% except vaginal pH > 4.5 (56%). Gardenerella vaginalis 27 (90%) was the predominant bacteria isolated in women suffering from bacterial vaginosis followed by Staphylococcus epidermidis (63.3%) and Streptococcus faecalis 13 (43.3%). Candida albicans 11 (91.6%) was the major cause of vulvovaginal yeast fungi infections followed by Saccharomyces cerevisiae 1 (8.3%). Conclusions: The four diagnostic criteria for bacterial vaginosis supported by gram staining and facultative anaerobic culture should be introduce into laboratory routine procedures to differentiate symptomatic carrier (true infection) caused largely by Gardenerella vaginalis from asymptomatic carrier (colonization).Also, there was a strong association between diagnosis of bacterial vaginosis and the occurrence of Gardenerella vaginalis. Further, there was no difference between women with or without bacterial vaginosis in regards to contraceptive methods used (except for use of an intrauterine device). Further more, Diabetes mellitus, hygienic condition were the most predominant risk factors associated with highly frequently fungal isolates, Candida albicans.

Effect of Tramadol on Ovine Ureteral Smooth Muscle Contractility: an in vitro Experimental Study

Atheer K. Zgair; Majid A. K. Lafi; Jamal A. Noman

Al- Anbar Medical Journal, 2013, Volume 11, Issue 1, Pages 11-16

Background: Tramadol was recently suggested to be an effective and relatively safe pharmacological treatment for pain and hyperalgesia in urinary colic from calculosis. It can apparently represent a valid therapeutic approach to this medical problem, especially in cases where conventional therapy cannot be applied. However, up to our knowledge, the in vitro effect of tramadol on ureteral smooth muscle contractility has not been investigated.
Objectives: The aim of this study is to investigate the effect of tramadol on the ovine spontaneous ureteral activity and attempt to determine its pharmacological basis.
Methods: In vitro experiments were performed on ureteral ring preparations in an organ bath. Contractions per minute (frequency) were calculated. The effect of tramadol, was obtained on its own and in the presence of naloxone, chlorpheniramine, phenoxybenzamine, atropine, or diclofenac; while, the effects of histamine, phenylephrine and acetylcholine (ACh) were recorded on their own and in the presence of their respective antagonists.
Results: Tramadol (50M) significantly enhanced the spontaneous rhythmic motility (1.21 ± 0.25 to 3.3 ± 0.54). Further, naloxone (2M), chlorpheniramine (M), atropine (M), or diclofenac (10M) failed to inhibit the excitatory effect of tramadol. However, phenoxybenzamine (1M) appreciably attenuated the excitatory effect of tramadol.
Conclusions: Tramadol produces substantial excitatory-ureteral activity by a mechanism that is still to be clarified and apparently not dependent on activation of opioid receptors, H1-receptors, muscarinic-receptors, or prostanoid synthesis and partly dependent on aminergic mechanisms

Non-Hodgkin's Lymphoma: a Preliminary Morphometric Study

Aiad Abdullah Abdulrazak

Al- Anbar Medical Journal, 2013, Volume 11, Issue 1, Pages 62-68

Background: Assessment of nuclear morphology is crucial for the diagnosis of non-Hodgkin's lymphoma. However, it is often hampered by subjectivity and inter-obsever variation.
Objectives: This work is aimed at studying the usefulness of nuclear morphometry as an objective approach to the diagnosis of non-Hodgkin's lymphoma.
Material and Methods: Hematoxylin-Eosin stained sections from twenty-eight cases of non-Hodgkin's lymphoma was evaluated for nuclear size, area and perimeter by semi-automated image analysis system.
Results: The parameters related to nuclear morphology (nuclear size, area, & perimeter) of neoplastic lymphocytes were significantly higher in large cell lymphoma as compared to small cell, intermediate cell & Burkitt's lymphoma but, not for mixed cell lymphoma. This finding was further substantiated when calculating the overlap index.
Conclusion: This study supports the assumption that nuclear morphometry offers a more objective and reproducible diagnostic method for subcategorizing lymphoid tumors than is currently possible by conventional histopathological techniques

Non-Hodgkin's Lymphoma: a Preliminary Morphometric Study

Aiad Abdullah Abdulrazak

Al- Anbar Medical Journal, 2013, Volume 11, Issue 1, Pages 62-68

Background: Assessment of nuclear morphology is crucial for the diagnosis of non-Hodgkin's lymphoma. However, it is often hampered by subjectivity and inter-obsever variation.
Objectives: This work is aimed at studying the usefulness of nuclear morphometry as an objective approach to the diagnosis of non-Hodgkin's lymphoma.
Material and Methods: Hematoxylin-Eosin stained sections from twenty-eight cases of non-Hodgkin's lymphoma was evaluated for nuclear size, area and perimeter by semi-automated image analysis system.
Results: The parameters related to nuclear morphology (nuclear size, area, & perimeter) of neoplastic lymphocytes were significantly higher in large cell lymphoma as compared to small cell, intermediate cell & Burkitt's lymphoma but, not for mixed cell lymphoma. This finding was further substantiated when calculating the overlap index.
Conclusion: This study supports the assumption that nuclear morphometry offers a more objective and reproducible diagnostic method for subcategorizing lymphoid tumors than is currently possible by conventional histopathological techniques

Detection of Human Rhinovirus Antigen (RhV-Ag) and Total IgE in Serum Samples from Common Cold Patients

Noor N. Al-Hayani; Israa H. Saadoon; Mushtak T. Salih

Al- Anbar Medical Journal, 2017, Volume 14, Issue 1, Pages 15-23

Background: Human rhinovirus infections account for approximately 50% of common colds and up to 80% or more of all infections during respiratory epidemic outbreaks. Rhinovirus infections are considered as a major trigger of asthma exacerbations. Almost all children have experienced at least one rhinovirus infection by the age of two years. An enzyme linked immunosorbent assay (ELISA) can detect rhinovirus specific antibodies in both sera and nasal secretions of patients with a rhinovirus infection. An enzyme linked immunosorbent assay was shown to be more sensitive and reliable than the traditional neutralization test.
Patients and Methods: A cross sectional study was carried out in Al- Ramadi city from the first of December, 2012 to the end of April 2013. The number of patients recruited in this study who having a common cold was 150. All of them were tested for the RhV-Ag and IgE tests. An interview was carried out with these patients using questionnaire prepared by the investigators and it's include the following: name, age, residency and occupation …etc.
Results: Out of 150 patients, RhV-Ag was found in 104 (69.33%) as detected by the technique of Enzyme Linked Immunosorbent assay. The simple linear correlation coefficient between RhV-Ag and IgE readings was calculated and found to be significant (r=0.242, p<0.05). The two-sample t-test was used in order to compare means RhV-Ag and IgE between adults and children of the considered sample, the t-test revealed that means RhV-Ag and IgE of the children were significantly lower than that of the adults.
Conclusion: Means of RhV-Ag and IgE were compared with respect to age groups (adults and children), in both comparisons adults found to have significantly higher means than children. IgE and RhV-Ag were found to be significantly linearly correlated.

The role of campylobacter species in diarrhea among children under five years of age in Ramadi city ,west of Iraq .

Saleem O. Al-Mawla; Fakhri J Al-Dalla Ali; Mohammad M.Al-Ani

Al- Anbar Medical Journal, 2008, Volume 6, Issue 1, Pages 76-87

Objective: The main objectives of the present study were to identify the incidence of Campylobacter species and their antibiotic susceptibility and risk factors among children with diarrhea under five years of age admitted to maternity and children hospital in Ramadi city.Materials and methods: Two hundred eighty children under five years of age admitted to maternity and children hospital in Ramadi city for management of diarrhea over a period of one year from (1st of October 2005 to 30th of September 2006), were studied for identification of Campylobacter species as a cause of diarrhea. Each child was studied for the followings: age, sex, residency, source of water supply, associated symptoms, type of feeding and family history of chicken breeding.Specific cultures of stool specimens for Campylobacter were done for all patients and also for ordinary bacterial agents. Isolates were identified and the percentage of the causative agents were discussed .Results: Campylobacter species as a causative agent of acute diarrhea in Ramadi city was found to be 8.92%.The incidence of Campylobacter species among other bacterial causes of diarrhea was 21.2%. Ciprofloxacin , nalidixic acid and clindamycin demonstrated high level of susceptibility (96%, 92% and 96% respectively), while the remaining antibiotics showed either moderate susceptibility or resistance.Conclusion: Campylobacter species is an imprtant cause for diarrhea among children under five years of age admitted to maternity and children hospital in Ramadi city. Bottle feeding and chicken breeding are important risk factors for getting Campylobacter infection. Ciprofloxacin, nalidixic acid and clindamycin are the most effective treatment for Campylobacter species, and recommended as drugs of choice.Keywords: campylobacter , diarrhea ,under five ,Ramadi.

Frequency of Intestinal Metaplasia in Dyspeptic Patients in Northern Iraq

Muhammed Tafash; Haitham N. Al-Koubaisi; Arkan A. Al-Esawi

Al- Anbar Medical Journal, 2010, Volume 8, Issue 1, Pages 1-6

Background: Intestinal metaplasia is a paracancerous lesion affecting the gastric mucosa in patients with chronic gastritis. Prevalence of intestinal metaplasia is different from region to another; In Iraq there is no available data (at least by the Ministry of Health ) covering this subject.Objectives: To estimate the frequency of intestinal metaplasia (IM) in dyspeptic patients in Northern Iraq. Also, to assess the age and sex distribution of IM. Further, to assess the presence of Helicobacter pylori organisms in gastric mucosa that got IM.Materials and Methods: A total number of 476 antral gastric biopsies were collected in Al-Sulaymaniyah GIT-Centre and examined histologically to detect intestinal metaplasia and then these biopsies stained by Giemsa to detect H.pylori organisms.Results: The frequency of intestinal metaplasia in the antral gastric mucosa of dyspeptic patients was 8.19 %. More than 90% of patients were above the age of 40 years and there was no significant gender predominance. H.pylori colonization in gastric mucosa is significantly decreased in case of IM. Keywords: Intestinal metaplasia , dyspeptic ,chronic gastritis , Iraq

The Effect of Body Mass Index and Serum Estradiol on Serum Prostatic Specific Antigen in Normal Iraqi Men

Nehad Nejris Helal

Al- Anbar Medical Journal, 2010, Volume 8, Issue 1, Pages 7-13

Background: Prostatic Specific Antigen (PSA) is one of the promising tumor markers of this decade. PSA level correlates positively with age and prostatic volume, and age-adjusted PSA values and the PSA density can be used to more precisely screen for prostatic carcinoma.
Aim of the Study: Is to identify the effect of body mass index and serum estradiol level on serum PSA in normal men in Salahaldin province.
Subjects & Methods: A cross-sectional controlled study was conducted during the body mass index from the 1st of February 2009 to the end of August 2009 in Salahaldin province. 50 males with BMI ≥ 30 [obese group or group (1)] and 50 males with BMI ≥ 18.5 and < 25 [control group or group (2)] were enrolled in this study. Subjects were collected from Tikrit Teaching Hospital. All subjects were within the same age group between 40-50 years of age. Total serum PSA, serum estradiol, body mass index, and prostatic volume measurement were done for every person in the study. A P value of less than 0.05 was considered significant. Analysis was performed by SPSS software, version 17.0 for windows (SPSS, Chicago, Illinois, USA).
Results: The mean age of group (1) was 44 + 2.8 years; while for group (2) was 45.4 + 2 years (P=0.31). Also no significant statistical difference was identified between groups concerning prostatic volume, mean 19.9 + 3.6 ml for group (1) and mean volume was 20.7 + 3.4 ml for group (2) (P=0.48). Mean BMI for group (1) 34.85 + 3.7 kg/m2 (CI 33.8-35.9) was significantly higher than that of group (2), 21.9 + 2.78 kg/m2 (CI 21.4-22.42), P< 0.0001. Mean PSA level for group (2) was significantly higher than that of group (1), 3 + 0.7 ng/ml (CI 2.78-3.2), 2.28 + 0.89 ng/ml (CI 2-2.53) respectively, P< 0.001. Mean estradiol level in group (1) was 91.6 + 20.5 pg/ml (CI 85.8-97.5), whereas it was 57.5 + 22.4 pg/ml (CI 51.1-63.9) for group (2), P< 0.0001. The bivariate correlation showed strong inverse relation between PSA level and BMI (Pearson r=0.635, P<0.01). PSA level had strong inverse relation with estadiol level, (Pearson r=0.705, P<0.001). On applying linear regression model, again inverse relations with strong linear trend between PSA level and both BMI and estradiol level. The increase in BMI and estradiol level was associated with considerable decrease in PSA level.
Conclusions: BMI and serum Estradiol had an inverse relationship with serum PSA level. Further studies with larger number of subjects are crucial to asses the specific biological pathway in relation between PSA and BMI.

Keywords: Prostatic specific antigen, Body mass index.

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