Volume 13, Issue 1, Winter and Spring 2016


Molecular and Bacteriological Detection of Multi-drug resistant and Metallo- β -Lactamase Producer Acinetobacter baumannii in Ramadi City, West of Iraq

Mushtak T. S. Al- Ouqaili; doun Jal; oot; Ahmed Sa; Amin Suleiman Badawy

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 1-13

Background: One leading factor responsible for resistance in Acinetobacter baumannii, is the production of carbapenamases like metallo-β-lactamases (MBLs), which hydrolyze a variety of β-lactams including penicillin, cephalosporins and carbapenems. This study aims to evaluate phenotypic method against genotypic, PCR as gold standard test among carbapenem resistant A. baumannii for identifying MBL producers.
Patients and Methods: One hundred and eighty-eight of 213 patients were culture positive (88.26%). Forty-four Acinetobacter baumannii clinical isolates were chosen for this study. Phenotypic expression of MBL was detected by IPM-EDTA-disk synergy test and presence of blaIMP-1 and blaIMP was detected by PCR for all metallo- β -lactamase producing Acinetobacter baumannii.
Results: Forty-one (93.2%) isolates of Acinetobacter baumannii (out of 44 isolates) were found to be MBL producers by IPM-EDTA-disk synergy test. Thirty-five (80%) Acinetobacter baumannii of 44 presumptive MBL producer isolates (with isolates were negative for MBL producer in phenotypic method used as control) were positive for bla IMP-1 gene by PCR, while twelve (27.3%) Acinetobacter baumannii out of 44 presumptive MBL producer isolates (with isolates were negative for MBL producer in phenotypic method used as control) were positive for blaIMP gene by PCR. The coexistence of blaIMP-1 with blaIMP genes in present study 25% (11/44) of cases.
Conclusion: Most isolates of Acinetobacter baumannii were found to be metallo beta-lactamase (MBL) producers using IPM-EDTA-disk synergy test. Further, isolates of A. baumannii have been produced MBL gene (bla IMP-1). It seems to be the major mechanism of resistance among Iraqi nosocomial isolates of A. baumannii.

Hepatitis B Surface Antigen Prevalence Among Screened Populations and Certain risk Groups in AL-Anbar Governorate, West of Iraq

Yasin. H. Majeed

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 14-19

Background:- Hepatitis B virus (HBV) infection is a worldwide problem, two billion people have been infected with hepatitis B virus (HBV), 360 million have chronic infection and 600,000 die each year from HBV related liver disease or hepatocellular carcinoma (HCC).
Aim of the study: This study aims to determine the prevalence of the HB virus in AL-Anbar Governorate among screened groups.
Patients and methods:-This is a retrospective study conducted and achieved in Al-Anbar Central Laboratory during the period from January to December 2012. Requestionary sheet include age, sex and residency were recorded. The sera from study group individuals were submitted for screening by preliminary screening test, dipstick immunoassay which depends on immune-chromatography for detection of hepatitis B virus. After that all hepatitis B positive sera were examined for the presence of Hepatitis B surface antigen (HBsAg) by enzyme linked immunosorbent assay (ELISA). 1-Blood donors 2-Routine screened populations which include [before marriage, vaccination, endoscopical and dental procedure]. And 3- Among certain risk groups which include pregnant women, midwife, health worker and contacts [persons who in contact with positive HBsAg].
Results:- The prevalence of HBsAg among blood donor was 1.25% and among certain risk groups include pregnant women was 0.46%, health worker was 0.28%, non-urgent operation was 0.63%, midwife 0.64%, contacts were 0.97%. While the prevalence among routine screened populations were 12.39%.
Conclusion: - The prevalence of hepatitis B surface Ag is high among routine screened population and low among certain high risk groups. Although there is discrepancy between these two groups HBV screening is highly recommended.

External Apical Root Resorption after Orthodontic Treatment in Ramadi City

Zena Hekmat AL-Taee

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 20-28

Background:- External Apical Root resorption is one of the most common and undesirable sequel of orthodontic treatment .
Objective:-The purpose of the present study was to research and identify factors related to root resorption during orthodontic treatment in Ramadi city.
Patients and Methods: This study consisted of 172 patients who had completed orthodontic treatments and taken the pre- and post-treatment panoramic radiographs. The length of tooth was measured. A NOVA and t test was performed to compare the mean amount of root resorption between right and left side, male and female, between extraction and non-extraction cases, open bite ,deep bite and normal bite and class I ,class II &class III. The correlation coefficients were measured between the amount of root resorption and the beginning age of the orthodontic treatment, and the duration of treatment.
Results: In this study the maxillary central incisors were the most resorbed teeth, there is no significant different between male and female, left and right side. There was a significant different between extraction and non-extraction therapy, open bite, normal bite and deep bite and class I,II and III treatment. this study showed that treatment duration and the age of the patient was not related to the degree of resorption .
Conclusion :-The radiographic follow up for the assessment of root resorption of all patients undergoing orthodontic therapy .These findings show that orthodontic treatment should be carefully performed to the tooth, moved a greater distances during treatment.

Outcome of Implantable Collamer Lens (ICL) Implantation in Patients with High Myopia in Iraq

Thakir M. Mohsin

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 29-36

Aim: To study the visual outcome and the possible complications following implantable collamer lenses implantation (ICL) in patients with high myopia.
Methods: Thirty eyes of 15 patients(8 males and 7 females) with myopia ranging from -9 to -19 Diopters underwent the procedure of implantable collamer lens implantation between February 2010 and July 2010 in Ramadi city, Iraq . The mean age was 26.7 ± 5.58 years. Detailed ophthalmological examination was carried out for all patients including preoperative visual acuity (uncorrected and the best spectacle corrected visual acuity), slitlamp examination, fundus examination, intraocular pressure measurement, corneal topography, anterior chamber depth, Pachymetry and horizontal corneal diameter (white to white distance).
Results: The uncorrected visual acuity of 6/18 or better was achieved in 90% (27 eyes) after six months from the ICL implantation. This study showed that the preoperative best spectacle corrected visual acuity (BSCVA) was 6/6 in 40% (12 eyes), 6/9 in 33% (10 eyes), 6/12 in 10% (3 eyes), 6/18 in 10% (3 eyes) and 6/24 in 6.6% (2 eyes). Postoperatively, we found that the uncorrected visual acuity (UCVA) was 6/6 in 36% (11 eyes), 6/9 in 36% (11 eyes), 6/12 in 10% (3 eyes), 6/18 in 10% (3 eyes), and 6/24 in 6.6% (2 eyes). Intraocular pressure was measured at each postoperative visit i.e. the first postoperative day, the third postoperative day, the seventh postoperative day, after one month, after two months, after three months and after six months. The mean intraocular pressure was 19.93 ±4.83 mmHg, 15.50 ±1.85 mmHg, 15.07 ±1.51 mmHg, 14.63 ±1.73 mmHg, 14.57 ±1.77 mmHg, 14.23 ±1.74 mmHg, 14.13 ±1.55 mm Hg, respectively.
Conclusion: Implantable collamer lenses implantation is a reliable solution for patients with high myopia . The procedure showed predictable results and it is safe with no serious complications. However, longer period of follow up is needed.

The Effect of Β3-Adrenoceptor Agonist (Brl37344) on Carbachol and Efs–Evoked Contractions of Isolated Ovine Detrusor Muscle Strip

Yousif Shabaan Dawood; Majid A. K. Lafi

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 37-46

Background: The concept of using β3-agonists in the treatment of overactive bladder with less side effects than the currently used anticholinergics, has been introduced recently.
Objectives: The aim of this paper to report the presence of β3-AR in the ovine detrusor muscle.
Methods: Appropriate sets of experiments using isolated ovine detrusor strips preparation. Cumulative effects of selected β-AR agonists including BRL37344 (BRL) were obtained on carbachol in presence and absence of propranolol and the β3-antagonist SR59230A, and EFS contracted strips.
Results: All agonists tested produced concentration-dependent relaxation, the rank order of their relaxing potency in the ovine detrusor muscle was isoprenaline (ISO)>BRL> dobutamine > salbutamol. Both ISO and BRL significantly suppressed 5Hz EFS contraction at a concentration had no significant effect on 40Hz EFS contraction.
Conclusion: It is concluded that β3-ARs are present abundantly in the ovine detrusor and the activation of which by the β-AR agonists suppresses the non-voiding detrusor contraction

Fuchs Uveitis Syndrome Clinical Features, Visual Outcome after Cataract Surgery and Complications

Younis I. Kalaph

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 47-56

Background : Fuchs uveitis is a chronic non-granulomatous specific uveitis entity. It is a common ocular disorder in Iraq and in different parts of the world. The aims of this research are to study the clinical features, complications and determining the visual outcome after cataract surgery.
Patients and Methods: (76) patients with Fuchs uveitis presented to Ramadi Teaching Hospital were prospectively studied ,there were (40) males and (36) females aged between (16) years and (60) years.
Clinical assessment including thorough slit lamp examination, visual acuity, intraocular pressure measurement and fundus examination was done for all patients and cataract surgery was done when indicated.
Results: Results showed that the clinical features of our patients are similar to the classical features of the condition, low incidence of glaucoma (3.9% )only and cataract surgery is safe with very good visual outcome in (77.63%) of patients.
Conclusion : FUS patients have clinical features similar to the classical features of the condition with low incidence of glaucoma . Cataract surgery is safe with very good visual outcome.

The Effect of the P2X1 Receptor Antagonist MRS2159 on ATP- and EFS-Evoked Contractions of Isolated Ovine Detrusor Muscle Str

Mohammed H. Mahdi; Majid A. K. Lafi

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 57-73

Background: Overactive bladder (OAB) is a storage symptom complex often associated with detrusor over activity (DO). Antimuscarinic drugs still the mainstay treatment for OAB but the adverse effects limit their effectiveness, hence, alternatives are needed. Recently, β3 agonists have been introduced in clinical use for the treatment of OAB. At present, experimental search focusing on the potential use of P2X1 antagonist in DO.
Objectives: This study aims to investigate the possible existence of P2X1 purinoceptors and their interplay with β-Adrenoceptors in the ovine detrusor smooth muscle (DSM), and to examine the interaction of selected purinoceptors agonists and antagonists on models of voiding and non-voiding detrusor contractions.
Methods: In vitro experiments were performed on ovine detrusor muscle preparations in an organ bath containing Krebs solution. The contractile response of intact and denuded ovine DSM strips evoked by either 500µM adenosine 5’-triphosphate (ATP) or 10µM α,β-methylene ATP (α,β-meATP) or EFS was measured before and after the addition of 100µM MRS2159 (MRS) and 10µM isoprenaline (ISO) separately.
Results: ATP (500µM) and α,β-meATP (10 µM) effectively contracted the isolated ovine DSM producing a response consisting of two phases an initial transient rapid phasic contraction and a later slowly developing tonic contraction. MRS inhibited the phasic contractions evoked by 500µM ATP and 10Hz EFS in intact and denuded tissues, but it is completely abolished the contractions evoked by 10µM α,β-meATP. The cumulative administration of 50µM α,β-meATP abolished the phasic and tonic contractions evoked by ATP.
Conclusions: The contractile activity evoked by 10Hz EFS in the ovine DSM is largely mediated by the activation of P2X1 purinoceptors which are present abundantly in the ovine DSM and there is an intracellular inter talk between P2X1 purinoceptors and β-AR in the ovine DSM.

Health Characteristics of Infertile Women and Their Socio- Demographic Correlates In Al-Anbar Provinc

Mahasin A. Altaha; ya Abdulhadi Al-Rawi

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 74-84

Background: Infertility is a global public health concern affecting approximately a tenth of couples worldwide. The incidence of infertility in a population has important demographic and social associations and implications. Many studies have focused on the medical aspects of infertility but have rarely examined the socio-demographic determinants and correlates.
Objectives: The aim of this study was to explore and analyze reproductive, demographic and social correlates of infertility among a sample of infertile women attending the infertility center in AlAnbar Province.
Patients and methods: A case control study conducted in the infertility center at Al-Ramadi Maternity and Children Teaching Hospital during the period of September 2013 to August 2014. The study consisted of 150 cases of primary and secondary infertile, and 301 healthy fertile women. A structured questionnaire, including various reproductive and socio-demographic variables, was developed and designed for the purpose of the study. Bivariate analyses included estimation of odds ratio (OR), and 95% confidence interval (CI) for odds ratio were performed.
Results: There were significant associations between female infertility and being from rural areas, low education, unemployment, age at marriage > 25 years, second marriage for a woman; and being a second or third wife. Infertile women were strongly significantly different from their fertile counterparts in having low income, bad quality of life, not satisfied with their daily activities, feeling of much life stress, having poor and irrational nutrition, bad relationship with their husbands; and not contented with sexual intimacy. Body mass index > 30 was found to increase the risk of infertility about 15 times, while smoking did not have a significant relation with infertility. All women with primary and secondary infertility felt that their condition affected their social life negatively.
Conclusion: Female infertility is associated with various demographic and social correlates leading to bad quality of life and much stress. Thus, couples' education and sympathetic marital counseling should be an essential component of any program of infertility management.

Diabetes Mellitus Risk Factors and Awareness among patients with Type II Diabetes Mellitus Disease in Al-Noaman General Hospital in Baghdad City - 2014

Ban Nadhum Al- Any

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 85-95

Background: Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot Background: Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.
Hyperglycemia , or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels .
Objectives : 1. To assess the trends of risk factors in patients with type (II) Diabetes Miletus.
2. To assess the awareness of patients with type (II) Diabetes Miletus.
3. To assess the Dietary Pattern of patients with type (II) Diabetes Miletus.
Method: A Cross sectional descriptive study with convenience non probability sampling had been carried out during the period between February- June , 2014 that (160 ) available patients in AL-Noaman hospital in Baghdad city were interviewed .
Results: The study showed that most of patients were above 60 years of age with average income , low education & had the disease for more than 5 years . Females formed 62% of those involved patients. For other risk factors half of them were still smokers, 62.5% were with family history of the disease , half of patients had hypertension , quarter of them had heart failure & small part of them had renal failure & ischemic heart disease. For the average mean of blood cholesterol was 259 mg /dl, SD ± 83.55 , (CI 275.38- 242.62) p value < 0.05 while average mean of triglycerides was 212 mg /dl , SD ±29. 31, (CI 217.75- 206.25) p value <0.05& average of body mass index (BMI) was 34.
For knowledge & awareness about the disease half of patients knew it by having frequent hunger , thirst & less by frequent urination , blurred vision & others discovered it accidentally. . For risk factors quarter of them said that it occurred due to family history of the disease , others said that it occurred due to lack of exercise , obesity , diet , heart disease while half of them didn’t know about them & most of them didn’t know about the complications of the disease . - More than half of them said that sugar & sweets should be avoided , others said that should avoid all carbohydrates & oil while half of them said that should avoid pregnancy for diabetic females & the same said that could skip treatment when the level of blood sugar has been controlled . - For checking of blood sugar , 50% said that should be checked weekly & others said should be checked monthly .
-More than half of them had their knowledge from relatives while only small part of them had their knowledge from medical staff & there was significant association between awareness & education that x² = 40 , P value =0.005 . - For dietary pattern the study showed that half of them had good & average intake of red meat & more for chicken while 80% with poor intake of fish . more than half of patients had average intake of full cream milk , full cream cheese while reached to70% with good & average intake of yogurt . for egg half of them had boiled & others had fried eggs daily. For carbohydrate most of them had eaten white bread and the same had eaten rice with oil daily while only 20% had brown bread daily . Half of them had good & average intake of fresh vegetables & more for cooked vegetables . Half of them had average & poor intake of apple & banana while for orange 60% had poor intake. Most of them took of tea with sugar & less for coffee with sugar .
Conclusion: most of patients were with poor awareness about the disease &still has high risk factors and most of medical tips were from relatives with poor application of these tips and didn’t follow a healthy lifestyle & dietary pattern.
effectively use the insulin it produces.
Hyperglycemia , or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels .
Objectives : 1. To assess the trends of risk factors in patients with type (II) Diabetes Miletus.
2. To assess the awareness of patients with type (II) Diabetes Miletus.
3. To assess the Dietary Pattern of patients with type (II) Diabetes Miletus.
Method: A Cross sectional descriptive study with convenience non probability sampling had been carried out during the period between February- June , 2014 that (160 ) available patients in AL-Noaman hospital in Baghdad city were interviewed .
Results: The study showed that most of patients were above 60 years of age with average income , low education & had the disease for more than 5 years . Females formed 62% of those involved patients. For other risk factors half of them were still smokers, 62.5% were with family history of the disease , half of patients had hypertension , quarter of them had heart failure & small part of them had renal failure & ischemic heart disease. For the average mean of blood cholesterol was 259 mg /dl, SD ± 83.55 , (CI 275.38- 242.62) p value < 0.05 while average mean of triglycerides was 212 mg /dl , SD ±29. 31, (CI 217.75- 206.25) p value <0.05& average of body mass index (BMI) was 34.
For knowledge & awareness about the disease half of patients knew it by having frequent hunger , thirst & less by frequent urination , blurred vision & others discovered it accidentally. . For risk factors quarter of them said that it occurred due to family history of the disease , others said that it occurred due to lack of exercise , obesity , diet , heart disease while half of them didn’t know about them & most of them didn’t know about the complications of the disease . - More than half of them said that sugar & sweets should be avoided , others said that should avoid all carbohydrates & oil while half of them said that should avoid pregnancy for diabetic females & the same said that could skip treatment when the level of blood sugar has been controlled . - For checking of blood sugar , 50% said that should be checked weekly & others said should be checked monthly .
-More than half of them had their knowledge from relatives while only small part of them had their knowledge from medical staff & there was significant association between awareness & education that x² = 40 , P value =0.005 . - For dietary pattern the study showed that half of them had good & average intake of red meat & more for chicken while 80% with poor intake of fish . more than half of patients had average intake of full cream milk , full cream cheese while reached to70% with good & average intake of yogurt . for egg half of them had boiled & others had fried eggs daily. For carbohydrate most of them had eaten white bread and the same had eaten rice with oil daily while only 20% had brown bread daily . Half of them had good & average intake of fresh vegetables & more for cooked vegetables . Half of them had average & poor intake of apple & banana while for orange 60% had poor intake. Most of them took of tea with sugar & less for coffee with sugar .
Conclusion: most of patients were with poor awareness about the disease &still has high risk factors and most of medical tips were from relatives with poor application of these tips and didn’t follow a healthy lifestyle & dietary pattern..

Clinical Patterns and Major Causes of Male Infertility In Fallujah City

Ziad H. Abd; Qais Abdul-Rahman Thamer; Mahasin A. Altaha

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 96-106

Background: Infertility is one of a major public health problem, affecting 15% of couples who attempt pregnancy; in 50% of them, the male partner is responsible. Both environmental and genetic factors, combined or separated, have been suggested as indefinable causes of infertility. Idiopathic infertility represents 15-20% of all cases.
Aim of the study: To determine the clinical patterns and to review the etiologies of infertility among men in Fallujah city and its periphery.
Patients and method: Between the beginning of January 2006 to the end of December 2010, 1410 infertile men from Fallujah city were enrolled in this study. All patients were evaluated by history and physical examinations to show the testicular size, varicocele of spermatic cord, vas deferens abnormalities and secondary sexual characteristics. Investigations including seminal fluid analysis (after three days abstinence and not >7 days) were done to all patients, and assessed according to WHO criteria, while hormonal study was indicated only to those patients with severe oligospermia.
Results: One thousand eighteen patients (72.2%) had primary infertility while 392 (27.8%) had secondary type. Patients with infertility of less than five years were considered in this study, which accounts 1222 patients only. Of those 1222 patients 878 (71.8%) had primary type and 344 (28.2%) had secondary type of infertility. Sperm count was categorized as ( zero, ˂ five millions , 5-10 million, ˃ 10 – 19 million and ≥ 20 million). For all 1222 patients the distribution was 126 (10.3%), 78 (7.1%), 65 (5.3%), 72 (5.9%) and 872 (71 .4%) respectively. Among those with primary infertility the sperm count distribution was 112 (12.8%) , 71 (8.1%) , 51 (5.8%) , 57 (6.5%) and 587 (66.9%) respectively ,while those with secondary infertility the distribution was 14 (4.1%) , 16 (4.7%) ,14 (4.1%) , 15 (4.4%) and 285 (82.8%) respectively. The sperm motility in 854 (70%) was lower than normal (asthenospermia),among them, those with primary infertility the motility was low in 620 (70.6%) while those with secondary type 234 (68%) had low motility.
Six hundreds thirty eight patients (53.2%) have identifiable causes for their infertility ( history of trauma , inguinal operations ,mumps, smoking ,varicocele ,STD ,chemotherapy , chronic medical illness , radiotherapy ,and renal transplant), while 584 patients ( 47.8% ) have non-identifiable causes of infertility. The mean of their age is 30.79 years ±7.09 SD and their duration of infertility between 1-5 years, with mean of 2.28± 1.23SD. Among those patients with non-identifiable infertility, 410 patients (70.2%) had primary infertility and 174 patients (29.8%) had secondary type.
Conclusion: Non-identifiable infertility is high among infertile men in Fallujah city compared to the results of other neighboring countries and previous Iraqi studies. These results may be in a way or another related to military pollution occurred in Fallujah city during 2004 that herald the need of further investigations

Thymoquinone Protects the Heart Against isoprenaline-induced Myocardial Ischemia in mice: A Histopathological Study

Hakim A. Al-Aani; Marwan S.M. Al-Nimer; Bashar R. Rajab

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 107-113

Background: Thymoquinone (TQ) is the most bioactive volatile oil that extracted from Nigella sativa seeds. It protects the tissue against ischemia-reperfusion injury including skeletal muscle, kidney, testes, liver and brain
Objectives: This study aimed to investigate the cardio-protective effect against isoprenaline-induced myocardial cell necrosis in mice
Materials and methods: Thirty six female albino mice were sub-grouped into six groups, each of six animals to receive intraperitoneal injection of dimethylsufoxide (5%W/v), TQ (10 mg/kg) or isoprenaline (30 mg/kg) as the following: Group I: dimethylsulfoxide, Group II: TQ , Group III: isoprenaline, Group IV: TQ twenty four hours prior to the treatment with isoprenaline, Group V:concomitant injections of isoprenaline and TQ and Group VI: treated with isoprenaline twenty four hours before treatment with TQ. After twenty four hours of treatment, the animals were sacrificed by cervical decapitation, the heart is rapidly removed and the left ventricle fixed in formalin solution (10%) for histopathological processing.
Results: Isoprenaline induced inflammatory cells infiltration around the blood vessels and through the cardiac tissue with focal cardiac cell necrosis. Thymoquinone protects the heart against isoprenaline-induced changes. In Groups IV and V mild inflammatory cell infiltration were observed whereas in Group VI, the histopathological findings included normal cardiac cell texture, attenuation of inflammatory cells infiltration and limited focal necrosis.
Conclusions: Thymoquinone protects the heart against isoprenaline-induced myocardial ischemia before or at the time and even after the cardiac insults that induced by isoprenaline suggesting that different mechanisms involved in cardio-protection

Association Between Epstein-Barr Virus and Burkitt’s lymphoma in Western Iraq. (A molecular case-control study

Kalid A. Z. AL-Fahdawi; Muthana A.K. AL-Zobae; Arkan O. J Al-esawi

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 114-124

Background: Association of EBV with BL is differ according to the geographical distribution and type of BL with a consistent C-MYC chromosomal translocation.
Objectives: The purpose of this study is to find out the association between Epstein Barr virus & the characteristic C-MYC as well as the age and gender distribution of Burkitt's lymphoma in Western Iraq.
Patients and Methods: In this case-control study we have analyzed paraffin sections from 60 patients with Burkitt’s lymphoma (19 endemic BL, 41sporadic BL). Diagnosis of these cases was depend on clinical and histological as well as immunohistochemical bases. Detection of Epstein-Barr virus (EBV) DNA and C-MYC chromosomal translocation by PCRwere performed, using sets of primers flanking the EBNA-1 and the c-MYC chromosomal translocation.
Results: Endemic BL affected mostly children aged 3–10 years (mean age: 5.6 years), whereas sporadic BL affected mostly adults aged 22–37 years(mean age:29 years). The sex ratio of the BL was 2:1 (41M: 19F).Study showed that 18/19 of endemic BL and 8/41 of sporadic BL were positive for EBV(positive EBNA1 by PCR).C-MYC chromosomal translocation was detected in 18/19 endemic BL and in 40/41sporadic BL.
Conclusions: There was significant association between EBV and endemic BL but no such a relation with sporadic BL. Also there was a strong association between C-MYC translocation in both endemic and sporadic BL. However there was no significant correlation between C-MYC translocation of endemic & sporadic BL and the gender.

Fetomaternal Outcome According to Placental Position in Placenta Previa PP))

Rafal Mustafa Murshed

Al- Anbar Medical Journal, 2016, Volume 13, Issue 1, Pages 125-135

Background: Placenta Previa is a leading cause of hemorrhage and is potentially fatal complication for the mother. In addition, pregnancies complicated by (Placenta previa) are at higher risk for adverse perinatal outcome: IUGR, prematurity and perinatal mortality. These finding may result from pathological implantation of the placenta that interfere with normal placental function and leads to abnormal fetal growth.
Aim of the study: To elucidate whether the location of placenta below uterine incision in caesarean section is important in development of fetomaternal complication in placenta previa patients.
Patients and methods: The study was conducted between 1st of March 2012 and 30th of May 2013 in the department of Obstetrics and Gynecology, Baghdad Teaching Hospital, Medical City Complex, Baghdad, Iraq. The study conducted on 100 patients starting at 32 weeks of gestation on ward being diagnosed as placenta previa by ultra sound scan; the subjects are divided into 2 groups: group (a) placenta is located in anterior wall of lower uterine segment. Group (b) placenta is located in posterior wall of lower uterine segment. The results of the 2 groups were compared to each other regarding fetomaternal complications.
Results: eighty five patients were found to have anterior placenta previa and 15 were posterior. Analysis of data show that antepartum hemorrhage, number of c/s, hysterectomy and placenta accreta, hospital staying (days) were significantly higher in anterior group with p value 0.017,0.006,0.027,0.032,0.008 respectively, while there was no statistically significant difference regarding maternal age, number of abortions, history of curettage, number of curettage, birth weight, apgar score1 and 5, neonatal care admission, blood transfusion, oversewing, visceral injury and maternal death.
Conclusions: anterior previa is more dangerous than posterior previa in view of increasing maternal and neonatal morbidity such as excessive blood loss, massive transfusion, placenta accreta and hysterectomy, as well as perinatal morbidity.