Issue 1


Prevalence of Rickets and Certain Associated Risk Factors Among Children Under Five Years of Age Attending the Outpatient Clinic of Maternity and Children Teaching Hospital in Ramadi City

Fakhri Jamil Al-Dalla Ali

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 1-13

Objective: this study is an attempt to search for prevalence, risk factors and diagnostic criteria of rickets among children under 5 years of age, attending the outpatient clinic of Maternity and Children Hospital in Ramadi city.Subject and Methods: Four hundred children under 5 years of age, attending the outpatient clinic of Maternity and Children Hospital in Ramadi city over a period of 2 months(1st of December 2001 to the end of January 2002), were selected randomly and studied for the prevalence of rickets and certain associated risk factors. Diagnosis of rickets was based on clinical, biochemical and radiological findings of active disease. One hundred twenty six children matched for age and sex who had no evidence of rickets, were used as control.Results: The prevalence of rickets for children attending the outpatient clinic was 10.5% and its 95% confidence interval was 7.8 -13.8%. The majority of cases (97.6%) were within the age range from 3-24 months. The exclusive breast feeding, small houses, apartments and urban areas were found as a significant risk factors for developing rickets ( p< 0.001, p=0.04, p=0.01 and p=0.02 respectively). Widening of the wrist at all age groups was detected in 69% of rachitic subjects. The mean of serum alkaline phosphatase significantly increased while the mean of serum calcium and phosphorus significantly declined by increasing radiological severity of rickets ( p <0.001).Conclusion: vitamin D deficiency rickets still represents an important health problem in our area. It is mostly seen in children under the age of 2 years. The exclusively breast fed infants or those living in apartments or small houses in urban areas are more prone to develop rickets. Widening of the wrist seems to be a good clinical sign for the diagnosis of rickets, and serum alkaline phosphatase appears as the best available indicator for the diagnosis of rickets and its severity.Key words: Rickets. Under 5 years. Ramadi. Iraq.

Indications and Types of Thoracic Incisions in Al-Ramadi City

Saad Mikhlif Mhaidi

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 14-24

Background:Thoracotomy incision was done in Ramadi City and it is not uncommon surgical procedure.Objectives: Descriptive study for the indications for thoracotomy and the type of surgical incision .Materials &Methods:A descriptive study was carried out on 130 consecutive patients who underwent thoracotomy for a time period between June 2007-June 2010 the whole work was done in Ramadi Teaching Hospital and Private hospital.Results:-The age of incidence was ranged from one day to seventy six years old. Male to female ratio was equal.Thoracotomy indications in childhood age group were commonly due to congenital malformation (Tracheo-esophageal fistula, diaphragmatic hernia and cong. Lobar emphysema).In adulthood :-Hydatid cysts of the lung, mixed H.C of the right lung and right liver lobe or H.C of the posterior segment of the liver had higher percentage of indications in addition to early stages of bronchogenic tumors if those cases detected early and they are fit for surgery .Regarding the type of thoracotomy incision, postero-lateral thoracotomy at the fifth intercostal space without rib resection was the most popular type of incision. Median sternotomy was used for cardiac injury and thymectomy procedures.Thoracotomy can be used in some cases of the H.C liver and (mixed H.C right lung and posterior segment of the right lobe of the liver)without the need for thoraco-abdominal incision.Conclusions &Recommendations:Thoracotomy is not uncommon procedure in Al-Ramadi Teaching Hospital it is regularly done for both emergency and elective indications.1-There are many types of thoracotomy incisions and the classical postero-lateral thoracotomy is the most common type. the procedure can be indicated in cases of emergency and elective manner, thoracic and extra-thoracic conditions. 2-Congenital malformations of the esophagus(T.E.F),diaphragmatic hernia and lobar emphysema are major indications of thoracotomy in childhood.3-Hydatid cysts of the lungs, posterior liver and right lung or hydatid cyst of the posterior liver are common indications of thoracotomy in adult age group.4-old age group can tolerate the procedure and good results can be obtained if careful patient selection and preparation.Key words : Thoracotomy, Incisions ,Saad , Al-Anbar, Iraq .

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.

Evaluation of Serum Sialic Acid and Protein Associated Sialic Acid In Premature Low Birth Weight Neonates

Hazim H. Edan; Salam S.Ahmed; Ahmed H. Al-Anee

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 30-42

Objective: In a pioneer study conducted in Iraq, the serum levels of sialic acid and protein associated sialic acid were tested to evaluate their level in premature low birth weight (LBW) neonates The study was conducted in Tikrit Teaching Hospital during the period from the 1st of February 2006 till the 1st of July 2007. Material & Methods: The study had been done on 300 neonates; they were divided into 4 groups, and these includes 100 apparently healthy normal birth weight mature neonates (NBW), 100 apparently healthy low birth weight premature neonates (LBW), 50 low birth weight premature neonates with birth asphyxia (LBW+BA), and 50 low birth weight premature neonates with respiratory distress syndrome (LBW+RDS). The following biochemical parameters were measured in sera of the studied neonates and the control groups which included: total sialic acid (TSA) and protein associated sialic acid (PASA).Results: Revealed that: there is a significant statistical difference between the NBW and the LBW neonates regarding the birth weight and the gestational age while there is no significant difference concerning the age of the newborns. Also there is a significant statistical difference between the LBW neonates and the LBW+BA and LBW+RDS neonates regarding the gestational age, age, and birth weight. The mean serum level of TSA is lower in the LBW in comparison with the NBW. It is also found that the mean value is significantly higher in LBW+BA and LBW+RDS in comparison with LBW and NBW neonates. It is also evident that the mean serum value in LBW+BA is significantly higher than that in LBW+RDS. Serum TSA levels are correlated strongly and positively with serum PASA levels in LBW neonates and LBW+BA and in LBW+RDS . In conclusion; the mean serum sialic acid and protein associated sialic acid level was found to be significantly higher in LBW+BA and LBW+RDS in comparison with premature LBW and NBW neonates.

Diabetic Control and the Occurrence of Oral Candidiasis

Qais A. Adi; Widad F. Jabber

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 43-49

Background:Being diabetic in itself may not place a person at increased risk of fungal infection, unless diabetic control is very poor, as evidenced by glycosylated hemoglobin (HbA1c) concentration of more than 12%.Aim of Study:Assessment of the value of HbA1c to predict the prevalence of oral yeast infection in diabetic patients in multiple variable analysis including age, sex, smoking and dental histories.Methods:Occurrence of fungal infection in 51 diabetics was analyzed statistically in relation to different variables including age, sex, smoking, denture wearing and diabetic control.Results: The prevalence of oral yeast infection in our population was 49%. HbA1c above 12% was strongly associated with oral yeast infection (odd ratio= 13) (p<0.001), risk of oral candidiasis among diabetics wearing dentures was significantly higher than among dentate diabetics (odd ratio=4.78). After controlling for the effect of denture wearing, HbA1c> 12% remained highly predictive of oral yeast infection, particularly among diabetics without dentures. Key words:Diabetes mellitus, fasting blood sugar, urinary glucose concentration, glycosylated hemoglobin, oral candidiasis.

Evaluation of IL-2, IL-8, IL-10 expression in trophoplastic tissue of women with spontaneous miscarriage infected by Toxoplasma gondii

Nidhal Abdul Mohaimen; Ahmed Majid

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 50-58

Background: For normal pregnancy to be established, a Th2 type immune response must be induced by the maternal immune system at the maternal-fetal interface .The induction of a strong type 1 cytokine response at the fetal maternal interface may result in rejection of the fetus. Thus, such response could contribute to spontaneous abortion during acute toxoplasmosis in pregnant women.Aim:To investigate the level of IL-10, IL-2 and IL-8 proteins expression within trophoplastic tissue in patients complaining spontaneous miscarriage, and they were T.gondii positive.Materials and Methods: A total of fifty women, aged between (16 − 42) years, were involved in this study. Enzyme Linked Immunosorbent Assay test was used for the detection of specific IgM( using serum samples) and immunohistochemistry( using . trophoblastic tissue ) method was used for the detection of antigen in trophoplastic tissue as diagnostic methods for T.gondii and evaluation of IL-10, IL-2, IL-8 proteins .Samples were classified into three groups: Group A- patients with spontaneous miscarriage and Toxoplasma gondii positive ( n= 20 women) , with a mean age of (23.8± 1.631);Group B- patients with spontaneous miscarriage and Toxoplasma gondii negative( n= 20 women), with a mean age of (25.5± 1.60);Group C- Control group ,women with induced abortion for medical causes( n=10 women), with a mean age of (26.4± 1.628). Results: The highest percent of IL-2(65.25±1.599)% was within group(A) then lower than this(63.50±2.335)% was within group (B) and the lowest percent (11.60±1.522)% was within the control group. While the highest percent of IL-10 (70.60±2.272) % was within the induced abortion group, and the lowest was found within (A) and (B) groups (20.80±1.268) %and (22.25±1.859) % respectively, The highest percent of IL-8 (55.80±3.427)% was within group (A) , lower than this(43.65±3.224)% was within group (B) and the lowest percent(14.40±1.327)% was within the control group,Conclusions: These results highlighted the possible protective role of IL-10 during successful pregnancies, and that IL-2 increased in expression in cases of spontaneous miscarriage .Key words:trophoplastic tissue, Spontaneous miscarriage, Toxoplasma gondii, IL-2, IL-8, IL-10.

Effect of Nigella Sativa L. seeds on ovaries function in adult Rats treated with Lead Acetate

M. A. ASSI; J.K.Arak; M.A.Assi

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 59-70

Background: There is an increasing interest toward medicinal plants and their active ingredients in the last years. Aims of the Study: This study aimed to show the effect of Nagela sativa L. seeds on the functions of ovaries in adult rats treated with lead acetate.Materials and Methods : Thirty adult female rats were randomly divided into three groups and treated orally as following for 8 weeks . Rats in the first group were received one ml of distilled water as control group . Rats in the second group were received lead acetate ( 10 mg / kg ) as test 1 group. While rats in the third group received 100 mg/kg seeds of Nigella sativa with 10 mg /kg lead acetate as test group-2. Fasting blood specimens were collected to poll serum 2,4,and 8 weeks for the measurement of LH, FSHAnd estrogen hormone.Results: The results revealed significant (P<0.05) increase in ovarian weight to body weight ratio, FSH, numbers and diameters of graffian follicles in two treated groups (T1andT2)compared with control group. Exposure of animals to lead acetate (T1) reflects a significant (P<0.05) increase in LH hormones with a significant decrease in estrogen compared with control group. Treatment of animals with Nigella Sativa pulse lead acetate caused significant (P<0.05) decrease in serum LH hormone compared with T1 group but the concentration of estrogen was significantly (P<0.05) increase.Ovaries histological studies of (T1 group) indicated an increase in diameters of graffian follicles and vaculation of granulosa cells, while the ovary of the animals in (T2 group) showed decrease in number and diameter of graffian follicles in comparison with normal structure of these follicles. On conclusion it seems likely that dosage of rats with (10 mg/kg B.W) of lead acetate caused a significant redaction on ovarian function and the treatment of animals with (100 mg/kg B.W) of Nigella sativa caused a significant enhancement of its reproductive function.Keywords : Nigella sativa , ovarian hormones, lead acetate, medicinal plants.

The Use of Surgical Burs in Autotransplant of Ectopic Impacted Maxillary Canine

Mohammed Hilal Hussein

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 71-77

Background: Canine auto-transplantation is a surgical procedure applied in cases of ankylosed or severely displaced impacted canines that cannot be resolved orthodontically. This study was conducted to describe the transplantation method associated with orthodontic treatment.Materials and Methods: This study was carried out on 21 healthy subjects (age range from 18- 24), who were suffering from ectopic impacted maxillary canines, surgical burs were used to drill the alveolar bone of them. The study was conducted from October 2006 to February 2009 in Oral Surgery Clinic of Dentistry College/ Anbar University and private clinic. Results: Results showed that the use of both methods of drilling resulted in similar healing and period required for stability of transplanted canines. Conclusion: The use of classical surgical burs or burs of implant surgical kit are helpful in creating socket for autotransplanted maxillary canines.Key words: Surgical burs, autotransplant of maxillary canine

UVEITIC GLAUCOMA PATIENTSThe Prevalence and Review of the Condition

Younis Ismail

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 78-86

Background: uveitic glaucoma is one of the common and serious complications of intraocular inflammation. The purpose of this study was to determine the prevalence of uveitic glaucoma and review its presentation , causes, mechanisms, and its visual effects. Patients and Methods: (76) patients with uveitis presented to Ramadi teaching hospital were included in this study ,there were only(14) who had developed secondary glaucoma : (9) males and (5) females.A full history and thorough ocular examination was done for each patient. Results: Results showed that the prevalence of uveitic glaucoma was (18.42%) of uveitic patients and it affected males more than females of young age group(21-40) years old. The most common presentation is unilateral (78.5%). The most common cause is Behcet's disease (53.7%) , then followed by idiopathic and Fuch's uveites (14.2%) ,and then by other less frequent causes. Pupillary block was found to be the most common mechanism (42.8%) and severe vision loss affected (50%) of the patients. Conclusion: Uveitic glaucoma is a common complication of uveitis. The most common causes of uveitic glaucoma is Behcet's disease and the main mechanism is by pupillary block . It appears that early diagnosis and early proper management of uveitis is an important factor for preventing it and reducing its complications.Key Words : Glaucoma ,Uveitis , Ocular disorders.

Salivary IgA Concentration and Oral Parameters in EarlyOnset Type Ι Diabetic Patient

Lamia Ibrahim Soud

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 87-92

Back ground: Diabetes mellitus is a metabolic disorder of multiple etiology.Effect of disease include long- term damage,dysfunction and failure of various organs in addition to oral complicationObjectives: This study was conducted to evaluate the oral parameters (flow rate, pH, IgA concentration), in addition to the gingival condition (GI) of both study and control groupsPatiants and Methods: The study included 25 children,suffering from type Ι diabetes mellitus (IDDM); their ages range was from (5-13) years,compared with the control group of healthy children matching with age and sexResults : The present study has shown that the individuals with IDDM have significant reduction in salivary flow rate; pH .while GI has higher significance in IDDM individuals in comparison to control group.salivary IgA recorded a higher asignificant concentration among the IDDM children as compared to the healthy childrenConclusion : It is concluded that higher salivary IgA concentration and gingivitis can attribute to their low salivary flow rate, pH in IDDM child.Therefore, special preventive program recommended with special protocol to the management of the IDDM in the communityKey word: Salivary IgA. Diabetic child, flow rate. pH .gingivitis

Identification of Sex Groups In Forensic Medicine According to the Mesiodistal Crown Diameter of Teeth

Ibrahim H. Al-Fahdawi

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 103-109

Background: The identification of sex groups In forensic medicine according to different criteria is of great importance. Objectives: To identify sex groups is the mesiodistal crown diameter of the teeth. Materials and Methods: Two samples (one sample for each sex group) of secondary school students from Ramadi city, Al-Anbar Governorate, Iraq, were considered in this study. Each sample involved 40 students. The age is ranged between 13-19 years old. Results: Statistical t-test was performed to detect any significant difference when comparing means of crown diameter according to sex of the students as well as the side of the tooth for each sex. The result of this test revealed that half the teeth on the maxilla and more than half the teeth on the mandible are significantly different with respect to sex. Moreover, only molar and first premolar teeth on the maxilla are significantly different with respect to the side of the tooth.Key words. Tooth size, Mesiodistal crown diameter, Iraq.

The Interaction of H. pylori and Non-Steroidal Anti-Inflammatory Drugs and Their Effect on Induction of Peptic Ulcer

Essam M. Abdullah

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 110-117

Objective: To study the interaction of non steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection in induction peptic ulcer.Methods: Fifty patients with dyspepsia (28 males and 22 females) attended to Endoscopic Units in Ramadi Teaching Hospital during the period from May 2009- March 2010. Endoscopic was done for them and findings varied from gastritis, peptic ulcer to duodenitis. Biopsy specimens from the antrum and the corpus of the stomach were taken and then were prepared for detection of H. pylori using the rapid urease test and culture. Anti-H. pylori antibody was measured by enzyme-linked immunosorbent assay (ELISA).Results: Out of the fifty patients with dyspepsia, 23 (46%) patients were found to have peptic ulcer. Fifty percent of the patients were NSAIDS users and the other half were NSAIDs non users. Among NSAIDs users, nine patients (36%) had H. pylori infection; while 17(68%) of the NSAIDs non users had H. pylori infection.Conclusion: NSAIDs appeared to be a risk factor for gastric ulcer, further H. pylori infection play a role in decreasing the rate of gastric ulcer among NSAIDs.Key word: NSAIDs, H. pylori, peptic ulcer.

Scanning Electron Microscopic Evaluation of Surface Roughness of Porcelain By using Different Glazing and Polishing Technique

Mahir M. Al-Noime

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 118-122

Background:ceramic material is the most easthitic material used in dentistry because it has many physiacal properties of high compatibility with oral tissue.Methods & Materials:thirty porcelain(ceramic)specimens resembling flat back facing(porcelain buttons)were fabricated. The samples were randomly divided into five groups according to the types of finishing and polishing, each group consist of six specimens.Results:Group I:no glazing and polishing is roughGroup II: applied glaze: smooth and shiny.Group III: polishing porcelain by sand paper disc followed by rubber cups and polishing paste give polished surface.Group IV: polishing by sand paper disc and rubber weel.Group V:polishing by sand paper disc; rubber wheel and polishing paste give satisfactory results with shorter time and cheaper material.conclusion:SEM evaluation found overglazing (applied glaze)produce a better smooth surface.Aim of the study:To get a good and smooth surface of ceramic material as an aesthetic material used in dentistry by using different smoothing and polishing material.

Candy Like Bezoar : as a Rare Cause of Intestinal Obstruction and Perforation in 18 –Months Old GirlCase Report

Salih Hussein Ali

Al- Anbar Medical Journal, 2011, Volume 9, Issue 1, Pages 123-126

Summary:18 old months female child presented to Fallujah Hospital with intestinal obstruction and perforation due to eating a candy like indigestible balls, the child underwent three complicated operations as a result of this mistakeKey words: Bezoars-Intestinal obstruction-Perforation.