Showing papers in "Zanco Journal of Medical Sciences in 2017"
TL;DR: Obesity is frequently found in rheumatoid arthritis patients, and it is associated with higher disease activity, but not with the latex positivity in these patients.
Abstract: Background and objective: The prevalence of obesity is rising across the world and it is regarded as a major health concern which is thought to be associated with a number of chronic illnesses including rheumatoid arthritis. This study aimed to find out the prevalence of obesity in patients with rheumatoid arthritis and to apprehend the association of obesity with disease activity and latex positivity.
Methods: One hundred twenty patients with rheumatoid arthritis who were regularly visiting Rizgary Teaching Hospital in Erbil were included in a cross-sectional study using specially designed mixed questionnaire. Body mass index and waist circumferences were measured, and their association with disease activity score 28 (DAS28) and clinical disease activity index (CDAI) were estimated. Furthermore, we evaluated their association with positive latex test.
Results: There was increased frequency of obesity in rheumatoid arthritis patients, and there was a positive association between body mass index and waist circumference with disease activity measured by DAS28 and CDAI (P <0.001). There was no significant association between obesity and latex positivity which has been assessed separately for males and females (P = 0.898 and 0.086, respectively).
Conclusion: Obesity is frequently found in rheumatoid arthritis patients. It is associated with higher disease activity, but not with the latex positivity in these patients.
6 citations
TL;DR: Ascorbic acid decreased the severity of the induced CTX oral mucositis by a significant increase in epithelial thickness, significant decrease in damage score, andsignificant increase in PCNA immune expression at day four and eight respectively (P <0.05).
Abstract: * Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq. Introduction Oral mucositis is currently considered to be the most severe complication of anticancer therapy, affecting 40‐80% of patients undergoing chemo-therapy and almost all those undergoing radiotherapy of the head and neck. It may result in dose reduction or discontinuation of chemotherapy or unplanned treatment interruption. It is characterized by erythematous, erosive, and ulcerative lesions in the oral cavity, causing difficulty in eating and drinking. In addition, mucositis can have a significant economic impact because of increased hospitalization, and the requirement of parenteral nutrition. Cyclophosphamide (CTX) is a nitrogen mustard compound which is directly targeting on the nucleic acid contents that is the deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) and interferes with DNA replication and RNA transcription. CTX, administered either alone or in conjunction with other drugs, has proved Background and objective: Oral mucositis is currently considered to be the most severe complication of anticancer therapy such as cyclophosphamide (CTX). Ascorbic acid is a well-known antioxidant, which can protect the body from damage caused by free radicals that can be generated during normal metabolism as well as through exposure to toxins and carcinogens. This study aimed to evaluate the effectiveness of ascorbic acid as a treatment for CTX induced oral mucositis. Methods: Forty Wister-albino rats, age about 6-8 weeks and weighing 150-200 g were used. The rats were randomly divided by simple random allocation into two groups (20 animals each). The control group was intraperitoneally injected with physiological saline and the animals were grouped randomly into two groups: Saline/Water treated group which were daily received intraperitoneal injection of distilled water, while the Saline/ Ascorbic acid treated group received a daily intraperitoneal injection of ascorbic acid (12mg/kg/day). For the induction of mucositis, a single dose (300 mg/kg) of CTX was administered intraperitoneally to each animal in the study group, and the animals were grouped randomly into two groups: CTX /Water treated group which was daily received intraperitoneal injection of distilled water, while the CTX /Ascorbic acid treated group were daily received intraperitoneal injection of 12 mg/kg /day of ascorbic acid. The animals were sacrificed at day four and eight (five animals each) and the tongue was dissected from the jaw for histological and immunohistochemical analysis. Results: Ascorbic acid decreased the severity of the induced CTX oral mucositis by a significant increase in epithelial thickness, significant decrease in damage score, and significant increase in PCNA immune expression at day four and eight respectively (P <0.05). Conclusion: CTX chemotherapy has a deleterious effect on the oral mucosa leading to marked morphometric and microscopic changes. Ascorbic acid can protect the oral mucosa from CTX-induced cytotoxicity, and attenuate or decrease the associated injury.
5 citations
TL;DR: Energy drinks consumption is found to be highly prevalent in adolescents and young adults in Erbil city, which calls for review and regulating the sale of these drinks including adolescents' education, raising community’s awareness, banning selling it in public places and increasing taxes.
Abstract: Background and objective: Energy drinks have become increasingly prevalent among young adults and adolescents in recent years, particularly young students and athletes who see the consumption of energy drinks as an easy and quick way to boost academic and athletic performance. This study was conducted to determine the prevalence of consumption of energy drinks in a sample of adolescent and adults in Erbil city as well as perceived benefits and its health hazards.
Methods: A convenience sample of 600 individuals from different sectors and social groups of Erbil city was selected. Data was obtained through direct interview. The data was managed through SPSS program version 18, using appropriate statistical tests.
Results: The prevalence of energy drinks consumption among the study population was 42.7%, especially adolescents and young adults (those ≤ 25 years) and was more common among males than females (55.7% and 29.8%, respectively). The main reasons for its consumption were related to getting energy and improving the mood and performance (66.0% and 30.4%, respectively). 62.7% of participants think that it is harmful and could have adverse effects such as heartbeat irregularity and blood pressure swinging, addiction, and osteoporosis (46.2%, 33.7% and 13.2%, respectively). Televisions were the major source of advertisement (71.45). A significant statistical association had been found between the age, gender and educational status of the participants and consuming energy drinks (P = 0.001, 0.001 and 0.002, respectively).
Conclusion: Energy drinks consumption found to be highly prevalent in adolescents and young adults in Erbil city, which calls for review and regulating the sale of these drinks including adolescents' education, raising community’s awareness, banning selling it in public places and increasing taxes.
5 citations
TL;DR: In vitro antibacterial and antibiofilm activity of Ammi majus seed extracts against six isolated Gram-positive bacteria revealed highest antibacterial activity against Streptococcus species and strongest antibio Film activity on Staphylococcus Species.
Abstract: Background and objective: Ammi majus belongs to family Apiaceae is an important plant used in a different country traditionally for treatment bacterial infection. This study aimed to investigate in vitro antibacterial and antibiofilm activity of Ammi majus seed extracts against six isolated Gram-positive bacteria.
Methods: The antibacterial activity of seed extracts were screened by disk diffusion and agar overlay bioautography method and their activities were further determined by minimum inhibitory and minimum bactericidal concentration. Biofilm formation was evaluated by the microtiter plate crystal violet assay. The quantity of bound bacteria was determined by measuring absorbance at (OD630 nm) using microtiter plate reader.
Results: Ethanol 80% and ethyl acetate extracts showed variable activity against all isolated bacteria while petroleum ether extract revealed resistance against studied bacteria. Streptococcus mitis showed more pronounced sensitivity against both extracts by disk diffusion (12 mm and 10 mm) and bioautography method with minimum inhibitory concentration 7.8125 mg/ml of ethanol 80% and 15.625 mg/ml for ethyl acetate extracts. Ethanol 80% and ethyl acetate extract significantly reduced biofilm formation as compared to control, showed antibiofilm activity at 0.4883-62.5 mg/ml and exhibited strongest antibiofim activity against Staphylococcus aureus.
Conclusion: Ammi majus seed extracts revealed highest antibacterial activity against Streptococcus species and strongest antibiofilm activity on Staphylococcus species.
5 citations
TL;DR: Histopathological examination of the products of conception is an important method in detecting undiagnosed molar pregnancy that needs special follow-up and further management in cases of first-trimester miscarriage.
Abstract: Background and objective: Miscarriage represents a common problem that occurs in the first trimester of pregnancy. There is no general agreement on the value of submitting tissues from uterine evacuation in cases of miscarriage for histopathological examination. This study aimed to evaluate the role of histopathological examination in cases of first-trimester miscarriage.
Methods: This is a descriptive study was carried out over a period of 14 months, from January 2015 to March 2016, at Erbil Maternity Hospital. A total of 375 biopsies from patients admitted to maternity hospital with the diagnosis of the first trimester miscarriage and cases of spontaneous miscarriage were included in this study. The clinical data including age, parity, gestational age, clinical diagnosis, the method of evacuation, and other relevant information were collected and submitted for histopathological examination.
Results: Incomplete miscarriage was the commonest type of miscarriage and constituted 65.3% of the studied group and surgical evacuation was the most common method of termination. The histopathology reports confirmed the pregnancy in all patients and revealed retained product of normal pregnancy in 315 (86.6%) cases, partial mole in 15 (4%) patients, complete hydatidiform mole in one (0.2%) case, decidual reaction in 21 (5.6%) cases and no product of conception in 13 (3.4%) cases.
Conclusion: Histopathological examination of the products of conception is an important method in detecting undiagnosed molar pregnancy that needs special follow-up and further management.
5 citations
TL;DR: Within the limits of this study, dental implant emergence into healthymaxillary sinus is considered a safe and successful procedure.
Abstract: Background and objective: Perforation of the maxillary sinus by a dental implant isan issue of concern by many dental implant clinicians. This study aimed to assess thesuccess rate and consequences of dental implants emerging into the maxillary sinus.Methods: The maxillary sinus was intentionally perforated for dental implant placementin 35 patients with reduced posterior maxillary bone height (4 mm or more). A total of 70implants engaged bicortically and emerged into the sinus. Nineteen female and 16 malepatients were involved in the study. The patients were followed up for sinus complicationsand dental implant success.Results: From the total, only two implants were failed; one during gingival formerplacement and the other after loading by one year. No patient presented with sinusitisclinically and radiographically. Three patients developed epistaxis just on the day ofsurgery and became well after on.Conclusion: Within the limits of this study, dental implant emergence into healthymaxillary sinus is considered a safe and successful procedure.
4 citations
TL;DR: Direct fine needle aspiration smears and cell blocks complement each other, and the results indicate that both are needed in the diagnostic work-up of patients with a primary malignant lung mass.
Abstract: Background and objective: Fine needle aspiration cytology with cell block preparation is widely used for preoperative confirmation of solitary lung mass and classification of the histologic types. This study aimed to highlight the importance of cell-block preparation in the diagnosis of primary malignant lung lesion by comparing cytomorphological preservation on paired cell block and conventional fine needle aspiration samples.
Methods: During January 2012 to October 2015, a total of 100 cases with solitary lung mass were included, either visited Rizgary Teaching Hospital or Walfare private hospital. All the patients had undergone fine needle aspiration and cell block preparation under a CT-guide.
Results: The samples were evaluated by the fine needle aspirations and cell blocks preparations from primary lung lesion under a CT-guide. 74% were male, and the majority of them were in the sixth and seventh decade. Squamous cell carcinoma was the most common histologic type consisting 42% of the studied cases, followed by adenocarconima (31%), small cell carcinoma (19%) and the remaining 8% were large cell carcinomas. In the assessment of agreement of cellularity between the two methods of sample preparation, cell block served better than fine needle aspiration (P = 0.715). However, this difference was statistically non-significant. A significant relation was found for morphology which was preserved in fine needle aspiration samples better than that in cell block samples (P <0.05). In contrast, all cell block samples displayed a statistically highly significant architectural preservation compared to fine needle aspiration samples (P <0.001). The sensitivity and specificity of the present study were 98.46%, 99.2% respectively.
Conclusion: Direct fine needle aspiration smears and cell blocks complement each other, and our results indicate that both are needed in the diagnostic work-up of patients with a primary malignant lung mass.
4 citations
TL;DR: Dental implants may have a chance to osseointegrate even in the lack of primary stability, clinically and radiographically, according to a study evaluating the fate of dental implants placed without primary stability.
Abstract: Background and objective: Primary implant stability is considered necessary forachieving and maintaining osseointegration. This experimental study aimed to evaluate theoutcome of implants without primary stability, clinically and radiographically.Methods: Two adult sheep (3-4 years of age), 70 kg in weight, were included in the study.After sedation and local anesthesia, the lateral side of the basal bone of mandible isexposed by a single long incision. The implant bed performed in the inferior border of thebasal bone of mandible drilling to 5 mm in diameter and 10 mm in length. Five implantswere inserted into the basal bone of mandible for each side (right and left), but the sizes ofinserted implant was 3.8 mm in diameter and 10 mm in length, after 4 months the 2 sheepwere sacrificed and the universal torque ratchet was used to measure the stability of theimplant by a counter torque 30 N/cm test. Cone Beam Tomography (CBCT) was used toevaluate the implants radiographically.Results: Nineteen (from 20) implants successfully tolerated a 30 N/cm countertorque testcomprising (95%). Only one implant failed to osseointegrate (5%). During the healingperiod, no any adverse clinical signs reported.Conclusion: Dental implants may have a chance to osseointegrate even in the lack ofprimary stability.
4 citations
TL;DR: Fasting during Ramadan was found to be an independent risk factor for stroke, and specifically ischemic stroke, in Erbil, where the summer is too hot and the daytime (fasting hours) is long.
Abstract: Background and objective: Cerebrovascular diseases are attacks of sudden neurological deficits (motor, sensory or cerebellar). There are a lot of risk factors for stroke like age, diabetes, hypertension, smoking, hyperlipidemia, cardiac diseases and others. This study aimed to show if there is increasing rate of cerebrovascular events during Ramadan in relation to fasting in our city during the summer season.
Methods: This case-control study was carried out in Rizgary Teaching Hospital, Erbil- Iraq from 1st of August to 30th of August 2011. Patients were included in this study if they were middle aged and elderly patients having clinical and radiological features of stroke, another group of in-patients was selected as a control group. Chi square test and logistic regression analyses were used to show the association between stroke and fasting.
Results: A sample of 60 patients and 60 control cases were included in this study. Fasting was significant risk factor for stroke in our studied sample, 66.7% of the cases were fasting compared with 40% of the control group (P = 0.03). Hyperlipidemia and history of ischemic heart disease found also to be associated with stroke (P = 0.017 and 0.011, respectively). Logistic regression analysis showed that only fasting and hypercholesterolemia were independent risks factors in causing stroke in our studied sample.
Conclusion: In Erbil, where the summer is too hot and the daytime (fasting hours) is long, fasting during Ramadan was found to be an independent risk factor for stroke, and specifically ischemic stroke.
4 citations
TL;DR: The relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population was studied.
Abstract: Background and objective: Extraction of an impacted mandibular third lower molar tooth is one of the common surgical procedures that may lead to the damage of inferior alveolar nerve due to roots proximity to the mandibular canal. This study aimed to know the relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population.
Methods: A sample of 366 digital panoramic radiographs of patients with impacted mandibular third molar was studied. Panoramic radiographic signs images were evaluated for the presence of root contact with the superior border of the mandibular canal, darkening of the roots apex, deflected roots, narrow root, superimposition of the canal, interruption of the white line, diversion of the inferior alveolar canal, and narrowing of the inferior alveolar canal. The depths of impaction, relation with ramus, and type of angulation were also studied.
Results: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the gender (P = 0.001) and age (P <0.001) were seen. A significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the depth of impaction (P <0.001), relation with the ramus (P =0.004), and angulation of impaction were also seen (P <0.001).
Conclusion: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with gender, age, depth of impaction, relation with the ramus, and angulation of impaction were seen.
3 citations
TL;DR: Significant inverse correlations were found between Doppler indices of fetal middle cerebral and umbilical arteries, and Gestational age, while the correlation with maternal uterine artery index was not significant with advancing gestational age.
Abstract: Background and objective: Intrauterine growth retardation remains the most frequent cause of perinatal morbidity and mortality. Doppler ultrasound has become an indispensable tool in evaluating pregnancies at risk, on the basis of the vascular resistance to blood flow. This study aimed to evaluate non-invasively the fetoplacental and uteroplacental circulations in clinically confirmed high-risk pregnancies, using Doppler parameters of some vessels to apply clinical interventions which could result in reduced prenatal morbidity and mortality and help to decide the type of delivery.
Methods: This cross-sectional study was conducted in Duhok city from June 2014 to January 2015. The study involved 100 pregnant women between 26–42 weeks of gestation with known last menstrual period and a definite clinical high-risk for intrauterine growth retardation. Various Doppler indices were performed including the resistive index, pulsatility indices of both umbilical and middle cerebral arteries, and the resistive index of the uterine artery to predict fetal health, correlated with physical and clinical outcomes, taking into consideration the variability in Doppler measurements of gestational age. Data have been described and then analyzed statistically for their correlation with gestational age.
Results: Umbilical artery and fetal middle cerebral artery Doppler indices are correlated inversely with gestational age. Although the uterine artery has a major role in Doppler examination of high-risk pregnancies, there is only a weak correlation between maternal uterine artery Doppler index and gestational age in late pregnancy. Doppler measurement of three arteries was more conclusive and show more sensitivity than one arterial Doppler measurement in the third trimester.
Conclusion: Significant inverse correlations were found between Doppler indices of fetal middle cerebral and umbilical arteries, and gestational age, while the correlation with maternal uterine artery index was not significant with advancing gestational age.
TL;DR: The effect of Helicobacter pylori infection in gastroesophageal reflux disease patients was significant regarding endoscopic finding while inversely related to symptoms severity, and the eradication of infection did not cause improvement in symptom severity i.e. triple therapy not advised in the course of treatment.
Abstract: Background and objective: The Helicobacter pylori infections role in etiology of peptic ulcer is well known, but its role in gastroesophageal reflux disease is one of the important issues which has to be confirmed. We tried to find out the effect of Helicobacter pylori infection on gastroesophageal reflux disease.
Methods: The current study was done on 100 patients with gastroesophageal reflux disease from January 1st to June 30th, 2014 in Rizgary Teaching Hospital, Erbil city. The diagnosis was made by history, clinical examination, and endoscopy. Helicobacter pylori infection was confirmed by gastric biopsy and histopathological examination. We tried to find out the effects of Helicobacter pylori infection in gastroesophageal reflux disease patients and its eradication on their symptoms. The data was analyzed with the statistical package for the social sciences (version 18).
Results: The mean age ± SD of participants was 37.13 ± 12.5 (17-75 years). The prevalence of Helicobacter pylori infection was 75%. The endoscopy showed that 50 out of 75 patients had erosive esophagitis and 25 out of 75 patients had normal appearance known as non-erosive esophagitis. The study showed no significance of its eradication on symptoms of gastroesophageal reflux disease.
Conclusion: The effect of Helicobacter pylori infection in gastroesophageal reflux disease patients was significant regarding endoscopic finding while inversely related to symptoms severity. The eradication of infection did not cause improvement in symptom severity i.e. triple therapy not advised in the course of treatment.
TL;DR: The ability of A. clavatus to undergo sexual reproduction is highly significant in understanding the biology and evolution of the species and will facilitate research into the genetic basis of pathogenicity and fungicide resistance.
Abstract: Background and objective: Aspergillus clavatus is an opportunistic human pathogen causing invasive aspergillosis. It is an economically important species because it can grow on rotting fruit (apples) and stored food products and able to produce a variety of mycotoxins. It has only been known to reproduce mitotically. This study aimed to discover the sexual reproduction in A. clavatus.
Methods: Identifying mating-type (MAT1-1 or MAT1-2) using PCR of 20 worldwide clinical and environmental isolates, crossing isolates on oatmeal agar in darkness with plate sealing, Recombination in ascospore offspring was demonstrated using molecular markers.
Results: There were similar ratios of the two mating types (45% MAT1-1 n = 9, 55% MAT1-2 n = 11). A. clavatus possesses a functional sexual cycle with mature cleistothecia fawn to brown/yellow in color, containing heat-resistant ascospores, produced after four weeks incubation at 25˚C and 28˚C on Nescofilm- sealed oatmeal agar plates. The cleistothecia contain hyaline ascospores that have two equatorial ridges. Recombination, leading to increased genotypic variation demonstrated in the ascospore offspring using molecular markers.
Conclusion: The ability of A. clavatus to undergo sexual reproduction is highly significant in understanding the biology and evolution of the species. The presence of a sexual cycle provides an invaluable tool for classical genetic analysis and will facilitate research into the genetic basis of pathogenicity and fungicide resistance.
TL;DR: In this article, the value of p53 protein immunoexpression in the diagnosis of hydatidiform molar pregnancy and the differential diagnosis of its subtypes (complete and partial) from abortions was assessed.
Abstract: Background and objective: Trophoblastic diseases constitute a spectrum of tumors and tumor- like conditions characterized by proliferation of pregnancy associated trophoblastic tissue of progressive malignant potential. This study aimed to assess the value of p53 protein immunoexpression in the diagnosis of hydatidiform molar pregnancy and the differential diagnosis of its subtypes (complete and partial) from abortions.
Methods: A cross-sectional study of tissue sections from 68 formalin-fixed, paraffin- embedded specimens of products of conception, including 1st trimester abortion (n=15), partial hydatidiform mole PHM (n=24), complete hydatidiform CHM (n=24) and full term placenta (n=5), all were examined at the Histopathology Department of Maternity Teaching Hospital in Erbil, Iraq during the period of Jan.2013-Jun.2013. Immunohistochemistry was performed using p53 antibody and the standard streptavidin-biotin immunoperoxidase method. The labeling index (number of positive nuclei/total number of nuclei) for villous cytotrophoblasts, syncytiotrophoblasts and stromal cells were evaluated separately. Statistical analysis was carried out by one way ANOVA and Fisher’s exact tests, statistical significance was determined at P ≤0.05.
Results: All villous trophoblastic lesions showed higher p53 immunoexpression in all villous components especially cytotrophoblasts, being the highest in complete hydatidiform mole (>50%) and partial hydatidiform mole (>20%). A statistically significant difference was found in immunoexpressins of p53 that was useful in separating abortion from complete hydatidiformmole, P <0.001, and partial hydatidiform mole, P <0.0002. It was also useful in separating between the complete hydatidiform mole and partial hydatidiform mole (P <0.001).
Conclusion: p53 immunoexpression was valuable in differentiation between molar and non molar pregnancies and between subtypes of molar pregnancies.
TL;DR: The study concluded that most of the cancer patients have depression symptoms, and there was no significant association between the level of depression and the socio-demographic characteristics of the patients and the medical status as well.
Abstract: Background and objective: Depressive symptoms are present in several psychiatric disorders, the ones most commonly seen in patients with cancer, especially more common in those who are at the end of life. This study aimed to assess the severity of depression and association between socio-demographic data with the severity of depression among Cancer Patients in Nanakaly Hospital, Erbil City.
Methods: A cross-sectional study was conducted on 100 cancer patients of both genders in Nanakaly Hospital, Erbil city, Iraq, from February 22nd, 2016 to April 27th, 2016. A questionnaire was designed for the study; it contained two parts. Part one consisted of socio-demographic characteristics such as age, gender, level of education, occupation, marital status, economic status, religion and residential area of the patients. Part two consisted of Beck depression rating inventory. Data were collected through interviews with patients. Frequency, percentages and Chi-square tests were used for interpretation of data.
Results: The mean age (±SD) was 49.54 (±16.66) years. Each of males and females represented 50% of the sample. Most of the participants were married (75%), illiterate (35%), Muslims (94%), housewives (38%), had somehow sufficient income (40%) and from rural areas (84%). Majority of the studied sample (79%) suffered from moderate depression level, while only (21%) of them suffered from severe depression. There was no significant association between the level of depression and the socio-demographic characteristics of the patients and the medical status as well.
Conclusion: The study concluded that most of the cancer patients have depression symptoms.
TL;DR: Chamomile extract at a dose of (100 mg/ kg) one time daily for sixteen days cannot be used for the treatment of oral mucositis and shows a significant increase in histological damage scores, decrease in the ki-67 immune expression and increase in caspase -3 epithelial immune expression.
Abstract: Background and objective: Chamomile has been used as an herbal medication sinceancient times and is still popular until today. This study aimed to investigate the potentialanticytotoxic effect of chamomile extract on the lingual mucosa of rabbits treated with5-fluorouracil (5-FU).Methods: Thirty six rabbits were used in the study. For induction of tongue mucositis forthe study group, 5-FU at a dose of (4 mg/kg) was administered intraperitoneally one timedaily for five successive days. The control animals were intraperitoneally injected bynormal saline one time daily for five successive days. The rats in each group wererandomly divided into two groups: Distilled water and chamomile extract treated groups(9 animals each). A volume of distilled water equal to chamomile extract was given bygavage tube, while the other group was gavaged with chamomile extract at a dose of (100mg/ kg) one time daily. The treatment with distilled water or the chamomile extract wascontinued for sixteen days and then the animals were sacrificed, and the tongues wereexcised for histopathological and immunohistochemical analysis.Results: The 5-FU/water treated group showed a significant increase in histologicaldamage scores, decrease in the ki-67and increase in caspase -3 epithelial immuneexpression (P <0.05) in comparison with saline/water treated group. The 5-FU/chamomiletreated group showed a significant increase in damage score, significant decrease in ki-67immune expression and significant increase in caspase-3 immune expression (P <0.05) incomparison with 5-FU/water treated group.Conclusion: Chamomile extract at a dose of (100 mg/ kg) one time daily for sixteen dayscannot be used for the treatment of oral mucositis. It causes damage to the tissue,decreases proliferation, and increases apoptosis.
TL;DR: Serum high density lipoproteins significantly reduced while other parameters of lipid profiles significantly increased in comparisons to control while the correlation between dyslipidemia and disease activity was found to be highly associated with active rheumatoid arthritis.
Abstract: Background and objective: This study aimed to measure the prevalence of dyslipidemia in patients with rheumatoid arthritis compared with healthy control people and find out the correlation between dyslipidemia and disease activity.
Methods: A prospective case-control was done. A total of 100 female patients with rheumatoid arthritis were included in the study. This study was conducted at the Rheumatology Out-patient Clinic in Rizgary Teaching Hospital, Erbil City over seven months from April 2013 to October 2013. Patients who fulfilling the 1987 revised American College of Rheumatology and 2010 American College of Rheumatology/European League against rheumatism classification criteria for rheumatoid arthritis and 100 healthy female age-matched controls with the mean age for both groups being 45. Fasting lipid profiles of cases and controls were estimated after an overnight fasting of 12 hours. Association between lipid profile and disease activity using disease activity score DAS 28, inflammatory markers (CRP and ESR) was also determined.
Results: Rheumatoid arthritis patients showed a higher prevalence of associated dyslipidemia (47%) in comparison to control (5%), P = 0.004. There was a significant reduction in serum high density lipoproteins (P = 0.04), with significant elevation of serum total cholesterol, triglyceride, low density lipoprotein and very low density lipoprotein (P = 0.001, 0.004, 0.04 and 0.05, respectively) in comparison to controls. There was a significant relation between disease activity score 28 and serum high density lipoproteins (P <0.001) and there was a significant relation between ESR and triglyceride (P = 0.05).
Conclusion: is frequent among the patients with rheumatoid arthritis and highly associated with active rheumatoid arthritis. Serum high density lipoproteins significantly reduced while other parameters of lipid profiles significantly increased in comparisons to control.
TL;DR: Users of anabolic-androgenic steroids have sperm with abnormal shape, especially tapered head, and low concentration of sperm with sluggish motility attributing to infertility.
Abstract: Background and objective: Anabolic androgenic steroids are synthetic compounds based on the structure of testosterone, and are used to treat various conditions such as reproductive system dysfunction. High doses of anabolic androgenic steroids and exercise influence the hypothalamic pituitary gonadal axis, which can, in turn, affect testicular apoptosis. This study aimed to investigate the influence of anabolic androgenic steroids on semen parameters in bodybuilders (heavy exercise) in Erbil city.
Methods: Semen specimens and serum were collected from 150 which divided into three groups; each consists of 50 men. The control group (A) didn't practice exercise so didn't receive nandrolone. The exercise group (B) who practice daily without taking nandrolone. The exercise and treated group (C) who practice exercise and had been using nandrolone (200 mg- wk-1, intramuscularly) for at least three months. Smear prepared by methyline blue stain and assessment of semen volume, sperm morphology, sperm concentration ,motility were carried out .Serum levels of follicle-stimulating hormone, luteinizing hormone, and testosterone were also carried out.
Results: There was no difference in the semen volume within three groups. Sperm concentration and the percentage of sperm motility in the group C was significantly lower (P <0.001) than that in the other groups. A significantly increased percentage of sperm with the tapered head was found in the group C. Our results also demonstrated a significant decrease in testosterone and follicle-stimulating hormone in the group C compared to group A and B.
Conclusion: Users of anabolic-androgenic steroids have sperm with abnormal shape, especially tapered head, and low concentration of sperm with sluggish motility attributing to infertility.
TL;DR: The level of independency in the different daily living activities was relatively high, which might be attributed to having a younger age group of elderly in the geriatric homes, and dependency was significantly associated with the sex, education level, employment status and smoking status of the participants.
Abstract: Background and objective: Maintaining the ability to perform basic self-care activities bythe older adults is fundamental to maintaining their independence and quality of life. Thisstudy aimed to assess the level of functional dependency of the residents of geriatrichomes in Erbil and Sulaymaniyah cities.Methods: This cross-sectional study involved 94 older adults living in geriatric homesin Erbil and Sulaymaniyah cities. Data was collected on the socio-demographiccharacteristics, clinical characteristics, social issues and daily recreation activities of theparticipants using a questionnaire. Nine essential activities of daily living were assessedthrough a three-point Likert scale of independent, requires assistance and dependent.Results: The mean and standard deviation age of the participants was 71.88 ± 8.94 years(range 60-81 years). Around half (43.6%) of the participants had at least one dependentactivity. The level of dependency was highest in shopping, climbing stairs and bathingactivities. Dependency of activities of daily living was significantly (P <0.001) higher infemales than males; in illiterate and those read and write than primary school graduatesand secondary school and higher level graduates; in those self-employed before enteringgeriatric home than retired and unemployed; and in ex-smokers and non-smokers thansmokers.Conclusion: The level of independency in the different daily living activities was relativelyhigh, which might be attributed to having a younger age group of elderly in thegeriatric homes. Dependency was significantly associated with the sex, education level,employment status and smoking status of the participants.
TL;DR: Salivary calcium and alkaline phosphatase level have a major role in causing nursing caries in children, and salivary inorganic phosphorus level showed a negative correlation with caries activity (dmfs).
Abstract: Background and objective: Nursing caries is a complex and severe form of tooth decay that affects a child’s teeth and leads to severe pain, teeth loss, and psychological problems. This type of decay is caused by primary factors (host, cariogenic bacteria, fermentable carbohydrate and the time) and other secondary factors. Besides, the dental caries influence by the role of saliva as a defense system. These defense systems include clearance, buffering, antimicrobial agents, and calcium and phosphate delivery for remineralization. This study aimed to find out the relationship between calcium, inorganic phosphorus and alkaline phosphatase of unstimulated saliva in children with nursing caries.
Methods: The sample included 374 children aged 4-6 years; 324 were the study group (with nursing caries) while 50 were control group (caries-free). The case sheet and questionnaire included the child's feeding habits and oral hygiene. A 1.5-2 ml of saliva was collected from the selected children using spitting technique. The method included dental examination for the recording of the dmft and dmfs indices, and saliva analysis to determine the level of salivary calcium, phosphorus and alkaline phosphatase in control and study groups.
Results: The study group children demonstrated a statistically highly significant (P ≤0.01) higher saliva calcium (5.229 ± 0.963 mg/dl) and alkaline phosphatase concentrations (6.321 ± 1.792 KAU/dl) than the control group (4.968± 0.757mg/dl, 5.384 ± 2.119 KAU/dl), respectively. The same group demonstrated a statistically highly significant (P ≤0.01) lower inorganic phosphorus concentration (10.991 ± 1.376 mg/dl) than the control group (11.961 ± 1.484 mg/dl). The study group showed a lower percentage of breastfeeding (28.4%) in comparison to the control group (42.0%). Concerning mix-feeding, the study group showed the higher percentage (45.4%) in comparison to the control group (32.0%). The bottle-fed found to be equal in both groups, there was a statistically non-significant difference between the study and control group.
Conclusion: Salivary calcium and alkaline phosphatase level have a major role in causing nursing caries in children. On the other hand, salivary inorganic phosphorus level showed a negative correlation with caries activity (dmfs). The type of infant feeding has no effect on the children with nursing caries.
TL;DR: The microwave irradiation of Paladent 20 brand of acrylic resin showed better properties than the Major acrylic resin, and some properties of the specimens cured by the dry heat pressure curing device were better than other curing techniques.
Abstract: Background and objective: Dry pressure curing device is one of the devices used in curing of acrylic resin denture bases. This study aimed to evaluate some properties of acrylic resins, cured by three different techniques.
Methods: Two hundred and fifty two specimens were prepared from two brands of heat curing acrylic resin (Paladent20 and Major). The specimens were cured by three techniques (dry heat pressure curing, conventional curing and microwave irradiation). For each curing technique, seven specimens were prepared and some mechanical and physical properties were tested.
Results: Less residual monomer showed in the dry heat pressure curing of Paladent 20 acrylic resin. The conventional curing of Major acrylic resin has shown the least porosity. The highest bending strength and less water sorption showed by microwave irradiation of Major acrylic resin specimens.
Conclusion: Some properties of the specimens cured by the dry heat pressure curing device were better than other curing techniques. The microwave irradiation has some good properties when compared with other techniques. The Paladent 20 brand of acrylic resin showed better properties than the Major acrylic resin.
TL;DR: A not otherwise specific variant is a common morphological lesion in many glomerular and non-glomerular diseases, and it is just like a junk drawer of multipleglomerular alterations with this common pattern of the lesion.
Abstract: Background and objective: Focal segmental glomerulosclerosis shares overlapping patterns of injury with segmental consolidation and obliteration of glomerular architecture by the accumulation of collagenous extracellular matrix or by increased cellularity or both. This study aimed to investigate the patterns of primary focal segmental glomerulosclerosis in adults in Erbil. The specific objectives of this study included determining the frequency of histological variant of Focal segmental glomerulosclerosis, defining the clinical characteristics of the primary type in general and recognizing the clinical and pathological characteristics for each variant separately.
Methods: A cross-sectional, clinico-pathologic study was conducted for 50 patients attending the Nephrology Department in Erbil Teaching Hospital between March and December 2013. This study included patients of >16 years old with biopsy-proven idiopathic focal segmental glomerulosclerosis.
Results: A total of 50 patients were enrolled into this study. The median age of patients was 33 years, ranged from 18 to 54, 31 (62%) males and 19 (38%) females. The frequency of histopathological variants was 80% not otherwise specific focal segmental glomerulosclerosis, 14% glomerular tip lesion, and 6% cellular type. Nephrotic syndrome and hypertension were the main presenting features (92% and 68%, respectively). The mean percentage of sclerosed glomeruli was 40% and the mean interstitial fibrosis and tubular atrophy was 24%.
Conclusion: A not otherwise specific variant is a common morphological lesion in many glomerular and non-glomerular diseases, and it is just like a junk drawer of multiple glomerular alterations with this common pattern of the lesion.
TL;DR: Investigation of the histopathological events in calculus cholecystitis and the presence of the DNA of Helicobacter spp.
Abstract: Background and objective: The presence of bile-resistant Helicobacter spp. in bile and gallbladder tissues has been proposed as a cause of gallbladder disease. This study aimed to assess the histopathological events in calculus cholecystitis and investigate the presence of the DNA of Helicobacter spp. in the bile.
Methods: Forty patients who underwent cholecystectomy for calculus cholecystitis were evaluated for the presence of Helicobacter spp. by polymerase chain reaction methods and gallbladder tissue was evaluated histopathologically. Gall bladders were fixed in formalin and subjected to histopathological investigation while bile sample was used for the extraction of DNA.
Results: The histopathological findings revealed that twenty-seven (67.5%) samples showed mild chronic inflammation, one (2.5 %) sample with acute inflammation, four (10 %) samples with acute on chronic inflammation, eight (20 %) samples have normal histological findings. The molecular investigation revealed that twenty one (52 %) samples out of the forty showed the presence of genomic DNA after being subjected to DNA extraction and that fourteen (66.7 %) samples out of the twenty one showed amplification bands of 300 bp after PCR amplification indicating the presence of Helicobacter spp. within the samples. But no sample revealed the presence of H. pylori DNA when PCR was applied.
Conclusion: Helicobacter spp. are considered as a determining factor for the development of gall bladder inflammation.
TL;DR: Although the presence of significant higher total oxidative capacity in both study pathologies compared to healthy control, however among metabolic syndrome patients neither hypertension nor diabetes mellitus achieved more dominant to total antioxidant capacity.
Abstract: Background and objective: Little is known about the status of redox balance and hypertensive nondiabetic and diabetic nonhypertensive metabolic syndrome patients and its relation to metabolic syndrome components in both pathological conditions. This study aimed to assess the association of redox balance with components of metabolic syndrome in "diabetic and hypertensive, metabolic syndrome" patients to find out which pathology can give a powerful evidence for a possible association with oxidative stress.
Methods: The total oxidative capacity, total antioxidant capacity, lipid profile and fasting serum glucose were measured in serum of 35 healthy subjects, 33 hypertensive nondiabetic and 21 diabetic nonhypertensive, metabolic syndrome patients. The body mass index and waist circumference were also measured. All groups were age and gender matched.
Results: In stratified groups, the highly significant total oxidative capacity, total antioxidant capacity and oxidative stress index were shown in diabetic and hypertensive groups respectively compared with healthy control group, with no significant effect for diabetes on total oxidative capacity and oxidative stress index compared to hypertension condition.
Conclusion: Although the presence of significant higher total oxidative capacity in both study pathologies compared to healthy control, however among metabolic syndrome patients neither hypertension nor diabetes mellitus achieved more dominant to total oxidative capacity.
TL;DR: It has been concluded that the addition of 3% BaSO4 nanoparticles produced an acceptable radio-opaque Acetal resin denture base material, although the addition caused some changes in properties, the modified acetal resin remained as a flexible thermoplastic material.
Abstract: Background and objective: Acetal resin or polyoxymethylene is a flexible thermoplastic radiolucent denture base material. This study aimed to evaluate the addition of barium sulfate BaSO4 nanoparticles on the mechanical and physical properties of acetal resin.
Methods: Forty two specimens were prepared from both non-modified and modified acetal resin. The tested specimens were obtained by melt extrusion into the mold equipment followed by injection molding. The radio-opacity of non-modified and modified evaluated, and then some mechanical and physical properties tested.
Results: The results of radio-opacity test showed that the radiographic density of BaSO4 3% Acetal resin specimens was at the same level of 2mm thickness of the aluminum stepwedge. Non-significant decrease noted in surface roughness, creep in all strain regions, and compressive strength and modulus of elasticity.
Conclusion: It has been concluded that the addition of 3% BaSO4 nanoparticles produced an acceptable radio-opaque Acetal resin denture base material. Although the addition caused some changes in properties, the modified Acetal resin remained as a flexible thermoplastic material.
TL;DR: Disease modifying anti-rheumatic drugs and biological therapies provide no significant efficacy in treatment or prevent the occurrence of ocular manifestations in rheumatoid arthritis patients, dry eye was the most common ocular manifestation, and anti-CCP antibodies are a sensitive marker for ocular manifested.
Abstract: Background and objective: Rheumatoid arthritis is a systemic inflammatory disease. Ocular manifestations involved with rheumatoid arthritis are keratoconjunctivitis sicca, episcleritis, scleritis, anterior and posterior uveitis, dry eyes and ulcerative keratitis. This study aimed to detect the prevalence of ocular manifestations in rheumatoid arthritis patients, find out the relation between the effects of disease modifying anti-rheumatic drugs, biological agents and ocular complications in rheumatoid arthritis patients and explore role of anti-cyclic citrullinated peptide antibodies.
Methods: This is a cross-sectional clinical study of 60 rheumatoid arthritis patients who have attended Rizgary Teaching Hospital in Erbil. A data information about symptoms of ocular manifestations and history of ocular complications before starting disease modifying anti-rheumatic drugs and/or biological agents were taken. Musculoskeletal examination, serum Anti-CCP antibodies test were done. Ocular examination by ophthalmologist was done.
Results: This study was conducted from April to November 2015 and involved 60 patients; 55 females and five males with a mean± SD age of 46 ± 11.46 years. Thirty nine (65%) patients had ocular manifestations of rheumatoid arthritis. The most frequent manifestation was dry eyes 30 (50.0%). There was no relation between severity of the rheumatoid arthritis disease and ocular manifestation (P = 0.529). There was a relationship between the Anti-CCP antibodies titer and presence of ocular manifestations in rheumatoid arthritis patients (P = 0.006). There were no curable effects of the disease modifying anti-rheumatic drugs, biological agents on ocular manifestations in rheumatoid arthritis patients (P = 0.787).
Conclusion: Dry eye was the most common ocular manifestation, anti-CCP antibodies are a sensitive marker for ocular manifestations. Disease modifying anti-rheumatic drugs and biological therapies provide no significant efficacy in treatment or prevent the occurrence of ocular manifestations in rheumatoid arthritis patients.
TL;DR: Assessment of the serum levels of IL1RN in obese subjects taking into consideration its relationship to the cardio-metabolic risk factors in asymptomatic obese subjects concluded that serum IL-1RN levels are significantly increased withy body mass index in over-weight-obese subjects and its increment is not correlated with low-grade of inflammation assessed by measurement of hs-CRP.
Abstract: * Department of Immunology, Hawler Medical University, Erbil, Iraq. Introduction Interleukin-1 is a proinflammatory marker that involved with its congers in the development of metabolism disorders including the obesity. Interleukin 1 receptor antagonist (IL1RN) is an acute-phase protein that blocks the interleukin-1A and 1B receptors and thereby exerting anti-inflammatory effect. It is produced by activated monocytes and tissue macrophages and other cells. The relationship between IL1RN, IL-1beta and metabolic derangement included that the metabolic factors, like glucose or fatty acid, stimulate the expression of the IL-1B and thereby the IL-1B stimulates the expression and secretion of the IL1RN. This substance expressed in white rather than brown adipose tissue and a high serum levels observed in obese subjects. A relationship between IL-1RN polymorphism encoded rs315952 and Ser133Serand obesity was observed in obese hypertensive patients. In one study, Background and objective: Interleukin 1 receptor antagonist (IL1RN) is an acute-phase protein that blocks the interleukin-1A and 1B receptors and thereby exerting an anti-inflammatory effect. Expression and secretion of IL1R are under the influence of the metabolic derangement. This study aimed to assess the serum levels of IL1RN in obese subjects taking into consideration its relationship to the cardio-metabolic risk factors in asymptomatic obese subjects. Methods: This cross-sectional study was conducted in Martyr LaylaQasm Center for Diabetes Mellitus in Erbil, Iraq. A total number of 170 women were recruited and distributed into three groups according to their body mass index (BMI): Group I (normal; ≤ 24.99 kg/m); Group II (overweight; 25-29.99 kg/m) and Group III (obese; ≥30 kg/m). The measurements of cardio-metabolic risk factors including the anthropometric measurements, blood pressure, lipid profiles and the score of cardiovascular events using Framingham Heart Study scoring were determined. Interleukin 1RN and high sensitive C-reactive protein (hs-CRP) were also determined. Results: Overweight (Group II) and Obese (Group III) women had significant high values of cardio-metabolic risk factors. Group III have significant high values of hs-CRP, and IL IL-1RN levels compared with Group I and II. The serum levels of IL-1RN are increased as the body mass index is increased but is not associated with increased risk of the cardiovascular events or a proportional increased of hs-CRP. A significant correlation between serum IL-1RN levels with cardiovascular risk (%) was observed among subjects of Group II. Conclusion: The study concludes that serum IL-1RN levels are significantly increased withy body mass index in over-weight-obese subjects and its increment is not correlated with low-grade of inflammation assessed by measurement of hs-CRP. The clinical significant of determination of IL-1NR to predict cardiovascular events risk is marginal in overweight subjects.
TL;DR: The incidence of injury to the lingual nerve can be minimized by careful clinical evaluation, surgeon’s experience, surgical approach and knowledge about anatomical landmarks during surgical removal of an impacted lower third molar tooth.
Abstract: Background and objective: The close proximity of lingual nerve in relation to the lingual cortical bone of the posterior mandibular third molar is clinically important because lingual nerve may be subjected to trauma during surgical removal of the impacted lower third molar. This prospective study aimed to evaluate the incidence of lingual nerve paresthesia following surgical removal of mandibular third molar in College of Dentistry, Hawler Medical University.
Methods: A total of 116 third molars surgery were carried out under local anesthesia for 116 patients for removal of lower mandibular teeth Using Terence Ward's incision made in all cases, and after that, the buccal flap was reflected, lingual tissues had been retracted during bone removal with a periosteal elevator. The sensory disturbance was evaluated on the 7th postoperative day by standard questioning the patients: “Do you have any unusual feeling in your tongue, lingual gingiva and mucosa of the floor of the mouth?"
Results: One patient experienced sensory disturbance, the lingual nerve paresthesia incidence was 0.9% as a transient sensory disturbance, while no patient of permanent sensory disturbance.
Conclusion: The incidence of injury to the lingual nerve can be minimized by careful clinical evaluation, surgeon’s experience, surgical approach and knowledge about anatomical landmarks during surgical removal of an impacted lower third molar tooth.
TL;DR: C-reactive protein positivity was significantly associated with knee osteoarthritis compared to healthy controls, and body mass index, positive family history of knee osteaarthritis, duration of diseases, and Kellgren and Lawrence grade II, were significant associated with positive C-re reactive protein in knee osteOarthritis.
Abstract: Background and objective: Osteoarthritis is the most common joint disease and a leading cause of disability. Increased circulating levels of C-reactive protein have been associated with prevalent knee osteoarthritis. This study aimed to assess the association between C- reactive protein positivity in patients with knee osteoarthritis in Erbil
Methods: Data from100 participants in this case-control study were enrolled from May 1st to December 1st, 2015 in Rizgary Teaching Hospital in Erbil city. Data were divided into two groups. The cases included 50 patients (17 male and 33 female) with a mean age of 58.9 ±3.8 years and diagnosed with primary knee osteoarthritis of one or both knee joints. Controls included 50 persons (17 male and 33 female) with a mean age of 58.1 ±3.9 years without knee osteoarthritis and matched for age, sex, and body mass index. C-reactive protein qualitatively measured. Patients were radiologically assessed by Kellgren and Lawrence grading scale (grade 0-4).
Results: C-reactive protein was positive in 41 out of 50 (82%) of knee osteoarthritis patients compared to 3 out of 50 (6%) of healthy controls (P = 0.001). C- reactive protein positivity among knee osteoarthritis patients were significantly associated with body mass index, positive family history of knee osteoarthritis, duration of diseases, and Kellgren and Lawrence grade (P 0.05).
Conclusion: C-reactive protein positivity was significantly associated with knee osteoarthritis compared to healthy controls. Furthermore, body mass index, positive family history of knee osteoarthritis, early osteoarthritis, and Kellgren and Lawrence grade II, were significantly associated with positive C-reactive protein in knee osteoarthritis.
TL;DR: It is concluded that the simultaneous measurements of high sensitivity C-reactive protein and procalcitonin as inflammatory biomarkers are not necessary because the correlation was not significant.
Abstract: Background and objective: There is evidence that the procalcitonin levels are usually correlated with the high sensitivity C-reactive protein levels in inflammatory conditions. Therefore, this study aimed to assess the simultaneous changes of the procalcitonin and hs-CRP levels in the diabetic foot syndrome complicated type 1 and 2 diabetes.
Method: This observational study was carried in the Center of Diabetes Mellitus in Erbil, Iraq from 1st January to the 30th September 2015. A total number of 170 participants were enrolled in this study. They grouped into Group I (healthy subjects, n=30), Group II (type 1 diabetes with diabetic foot syndrome, n=70) and Group III (type 2 diabetes with diabetic foot syndrome, n=70). The anthropometric measurements, blood pressure, fasting serum glucose and lipid profile, and the inflammatory markers included high sensitivity C-reactive protein and procalcitonin were determined.
Results: Group III patients had a significant longer duration and score of diabetic foot syndrome, higher anthropometric measurements, higher blood pressure and fasting lipid profile levels compared with Group II. Serum procalcitonin and high sensitivity C-reactive protein levels were significantly higher in diabetic patients compared with Group I subjects. The serum levels of procalcitonin and high sensitivity C-reactive protein of Group III patients (1.11±0.47 ng/ml; 12.48±2.57 mg/L) were significantly higher than corresponding values of Group II patients (0.334±0.094 ng/ml; 5.73±0.89 mg/L). A non-significant correlation between procalcitonin with high sensitivity C-reactive protein in Group II and III was observed.
Conclusion: We conclude that the simultaneous measurements of high sensitivity C-reactive protein and procalcitonin as inflammatory biomarkers are not necessary because the correlation was not significant.