Print ISSN: 0253-0759

Online ISSN: 2413-4414

Volume 26, Issue 1

Volume 26, Issue 1, Winter and Spring 2008, Page 1-67


MELASMA IN BASRAH: A CLINICAL AND EPIDEMIOLOGICAL STUDY

Khalil I. Al-Hamdi; Hassan J. Hasony; Hadi L. Jareh

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 1-5
DOI: 10.33762/mjbu.2008.48322

ABSTRACT
A total of 392 individuals were enrolled in the study divided into two main groups (196 melasma cases and 196
control group). Melasma prevalence and diagnosis were done by screening different groups of population on
clinical basis with the aids of Wood's light examination (by the same dermatologist). The study was carried
out at the departments of microbiology and dermatology in Basrah medical college during the period from
October 2003 to the end of March 2005. The study showed that melasma was more prevalent in age intervals of
21-30 years and 31-40 years presented in 45.7% and 38.2% respectively. The prevalence of melasma among
dermatological clinic attendants was 0.57% while the prevalence among pregnant women, female teachers and
male outdoor workers were presented in 37.9%, 17.5% and 14.2% respectively. Melasma was more frequent
among brown skin patients (75.5%) compared to white (18.3%) and black (6.1%) colored skin (P<0.01). Also
non-seborrhoeic skin patients was more affected (63.2%) than seborrhoeic skin (37.6%) patients (P<0.01).
However, sun exposure for 4-6 hours daily was the leading aggravating factor (59.7%) of the total melasma
cases although drugs and cosmetics (18.4%) and emotional factor (40.3%) had significant (P<0.01) effect on
prevalence of melasma in the community.

LOCALLY MADE CHITOSAN COVALENTLY LINKED TO INDOMETHACIN: A NOVEL APPROACH TO FORMULATE SUSTAINED RELEASE INDOMETHACIN CAPSULE IN BASRAH

Akhlas F. Thajeel; Jawad H. Ahmed

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 6-14
DOI: 10.33762/mjbu.2008.48324

ABSTRACT
The sustained release capsules are pharmaceutical dosage form used for the treatment of chronic rather than acute
diseases and are useful because of its convenience and less side effects. This work describes an attempt to formulate
indomethacin sustained release capsule using indomethacin covalently linked to chitosan. Chitosan was prepared by
alkaline -N-deacetylation of chitin, which was isolated from the shells of local shrimps. The yield of chitosan was
found to be 80%. This polymer was found to be white crystal, odorless and the IR spectroscopy of it was similar to a
standard reference. Chitosan has been covalently linked to indomethacin and the ratio of drug to polymer was found
to be 5:1. The chemical interaction between the drug and the polymer was proved by IR studies. In vitro release at
different pH were performed and the release of indomethacin in the prepared sustained release capsule were tested
and compared with conventional indomethacin capsule INDOMIN-25mg, and a commercial sustained release capsule
INDO-75-SR. The release of indomethacin in our product was completed within 12 hours, while the conventional
INDOMIN capsule and commercial INDO-75-SR capsule released within 2.5 and 5 hours respectively. In conclusion a
cheap, locally made chitosan can be used in formulation of sustained release capsules by covalently linked to drugs
containing carboxyl group (like indomethacin) or can be modified to have a carboxyl group.

EVALUATION OF PNEUMATIC LITHOCLAST EFFICACY IN TREATMENT OF URETERIC STONES

Murtadha M. S. Majeed; Abdulla Y. Al-Timary; Majid A. Mohammed

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 15-18
DOI: 10.33762/mjbu.2008.48326

ABSTRACT
To evaluate the use of ureteroscopic pneumatic lithotripsy in the treatment of ureteral stones and to present our
clinical experience in the endoscopic management of ureteral calculi. From February 2005 to January 2007, 60
consecutive patients underwent ureteroscopic pneumatic lithotripsy of ureteral stones. Twenty five patients were
females and 35 patients were males with male to female ratio of 1.4: 1. The age range was from 17- 52 years. Thirty
six patients had radiolucent stones while 24 patients had radio-opaque stones. Of the 14 patients with upper ureteric
stones, the stone free rate for the radio-opaque stones were 50% and for the radiolucent were 75%. Of the 16 patients
with midureteric stones, the stone free rate for the radio-opaque stones were 75% and for the radiolucent ureteral
calculi was 62.5%. Thirty patients had lower uretric stones; the stone free rate for the radio-opaque stones were 60%
and for the radiolucent stones were 85%. The overall stone free rate for ureteral calculi was 71.66%. We conclude
that ureleroscopic pneumatic lithotripsy found to be safe, and cost effective mean of clearing ureteric calculi at all
levels. It is tolerated well by the patients with short hospital stay.

THE EFFECT OF BROMOCRIPTINE ON C-REACTIVE PROTEIN IN WOMEN WITH HYPERPROLACTINEMIC AMENORRHEA

Isam Hamo Mahmood

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 19-23
DOI: 10.33762/mjbu.2008.48346

ABSTRACT
C-reactive protein has become the subject of avid interest in recent years. Increased concentrations of C-reactive
protein (CRP) became widely accepted as a risk factor of many inflammatory diseases including atherosclerosis,
ischemic vascular diseases, type 2 diabetes mellitus, hypertension and colon cancer. Data evaluating the
concentration of CRP in hyperprolactinemic condition and the effect of bromocriptine on CRP concentration are not
available. Thus the present study was designed to measure the concentration of CRP in a number of women with
hyperprolactinemic amenorrhea and to evaluate the effect of bromocriptine on CRP concentration. The study tackled
sixty women, who had amenorrhea for at least three months and serum prolactin concentration at least twice the
upper limit of normal values. Bromocriptine is administered in a daily dose of 2 (2.5 mg) tablets. Serum prolactin and
serum CRP were assessed before and after bromocriptine administration, using commercial kits. Mean CRP
concentration of the control group was 1.38±1.85 mg/L which is statistically lower than value of 6.35±4.62 mg/L of
the patients before bromocripine therapy (P<0.001). A significant drop of CRP (from a mean of 6.35±4.62 mg/L to a
mean of 2.73±3.14 mg/L) was obtained after treatment with bromocriptine (P<0.001). The correlation between
serum prolactin level and serum CRP level before and after bromocriptine administration was not statistically
significant: r= 0.24, P>0.05 and r = 0.12, P>0.2, respectively. The present study showed that women with
hyperprolactinemic amenorrhea is associated with increased level of CRP and therapy with bromocriptine
significantly reduced CRP, suggesting a possible anti-inflammatory action of bromocriptine in addition to prolactin
lowering effects.

LAPAROSCOPIC SURGICAL APPROACH FOR ECTOPIC PREGNANCY

Ghada S. Al-Sakkal; Emil N. Azzo; Khalida M. Ameen

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 24-27
DOI: 10.33762/mjbu.2008.48347

ABSTRACT
The objective of our study is evaluation of therapeutic laparoscopy in the treatment of ectopic pregnancy. This is a
prospective study carried out for the period from October 2000 till June 2004, in the department of obstetric and
Gynaecology in Azadi General Hospital in Kirkuk city, north of Iraq. Surgical Laparoscopic approach was performed
for 40 women with the provisional diagnosis of ectopic pregnancy. The duration of the operation ranged between 20-
70 minutes. Salpingostomy was carried out for 22 patients (55%), 7 patients (17.5%) had salpingectomy, one patient
(2.5%) had fimbrial expression, 3 patients (7.5%) had wedge resection of ovarian ectopic, one patient (2.5%) had
segmental resection, two patients (5%) had complete tubal abortion with no active bleeding, and 4 patients (10%)
were converted to laparotomy. Most of the involved patients had no major intraoperative or postoperative
complications with shorter hospital stay. Subsequent intrauterine pregnancy rate was 80%. No recurrent ectopic was
elected in this series. In conclusion, inspite of the limited number of patients, the obtained results proved the
usefulness of operative laparoscopy in the treatment of ectopic pregnancy with maximum safety and efficiency. The
follow up of patients showed improvement in future fertility. More work is needed to confirm our results.

MICROSPORIDIOSIS IN MALIGNANCY AFFECTED PATIENTS IN MOSUL, IRAQ

Abdul-Salam M. Al-Mukhtar; Nawfal Y. Al-Dabbagh; Nihad S. Al-Sherrefat

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 28-31
DOI: 10.33762/mjbu.2008.48352

ABSTRACT
Over nine months period, the incidence of microsporidiosis in patients receiving treatment for malignancy was
investigated. A total of 53 patients (27 males and 26 females) were involved in this study. All patients had stool
analysis for microsporidium spp. stools from 53 control groups (30 males and 32 females) have also been
investigated. Microsporidium spp. spores were detected in stools of 5 males and 3 females among patients treated
with anti-cancer therapy. Three patients particularly affected with leukemia showed positive results. It was concluded
that advanced stages of malignancy affected patients who received anti-cancer therapy are at risk from infection with
this pathogen, while working physicians showed little awareness concerning this opportunistic infection.

DECIDUOUS TEETH AND BLOOD LEAD LEVELS IN CHILDREN OF BASRAH CITY

Jawad K. Mehdi

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 32-36
DOI: 10.33762/mjbu.2008.48354

ABSTRACT
To determine lead exposure among in children of Basrah a total of 100 deciduous whole teeth were collected from 100
children. Teeth and blood were analyzed for lead concentrations using atomic absorption spectrophotometry and
ALAD activity by colorimeter. Children were between 5 and 15 years old (56 males and 44 females). The study period
extended from January 2005 till the end of May 2006. Laboratory investigations included measuring teeth and blood
lead levels and ALAD activity, A questionnaire was used to gather information on each person, such as age, sex, place
where the person lives, the mean blood lead level (BLL), deciduous teeth lead level (DLL) and aminolevulinic acid
dehydrotase (ALAD) were 11.42±2.7μg /dl, 7.6±3.93 μg/g and 202±19.74 U/ml RBC respectively. BLL, DLL ALAD
activity was significantly different according to the age, sex and urban areas. There was a significant correlation
(P<0.01) between all parameters (age, BLL and DLL and ALAD) which is included in this study. In conclusion, the
levels of lead in deciduous teeth and blood serves as a dosimeter for lead exposure which originates from different
sources, also there were high correlation between BLL and DLL and ALAD.

LIFESTYLE DETERMINANTS OF HIGH- DENSITY LIPOPROTEIN CHOLESTEROL (HDL-C) IN YOUNG ADULTS

Jasim N. Al-Asadi; Omran S. Habib; Lamia M Al-Naama

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 37-41
DOI: 10.33762/mjbu.2008.48356

ABSTRACT
High-density lipoprotein cholesterol is a potent predictor of coronary heart disease. Genetic as well as environmental
factors including lifestyle factors play a role as determinants of its level in the blood. To examine the effects of certain
lifestyle factors on serum level of high density lipoprotein cholesterol in young adult people. Three-hundred thirtyeight
young adult subjects of both sexes aged 20-44 years asymptomatic for cardiovascular diseases were interviewed
according to special questionnaire including information on lifestyle habits. Physical examination was done, height,
body weight, and blood pressure measurements were performed. Blood analysis to determine the blood level of high
density lipoprotein cholesterol was done after 12 hours fasting. Smoking and obesity were the most significant risk
factors associated with a decreased level of high density lipoprotein cholesterol. The level of HDL-C was 50.9±12.1
mg/dl in smokers compared with 58.3±12.8 mg/dl in non-smokers. Its level was 49.8±9.8 mg/dl in obese individuals
compared to 58.4±12.8mg/dl in normal body weight subjects. Physical activity was not significantly associated with
low level of HDL-C by univariate analysis, but it was found to be significantly associated with its level by the multiple
regression analysis. High-density lipoprotein cholesterol level was a function of many factors, some of them were
lifestyle related such as smoking, physical activity, and obesity. Therefore, efforts to encourage more physical
activity, quitting smoking, consuming low fat diet, and keeping ideal body weight are recommended.

SCREENING FOR GESTATIONAL DIABETES BY 50 GRAMS GLUCOSE CHALLENGE TEST

Safaa; George Hussein; Narjis A. H Ajeel

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 42-48
DOI: 10.33762/mjbu.2008.48358

ABSTRACT
This cross sectional study was an attempt to estimate the prevalence of gestational diabetes among pregnant women
in Basrah (using the 50 gm glucose challenge test) and to identify the high risk groups. The study involved 304
pregnant women who were attending the antenatal care clinics of two primary health care centres during a threemonth
period. All pregnant women included in the study were interviewed, blood samples were drawn, and urine
samples were checked for the presence of sugar. The results showed that the prevalence of glucose intolerance was
4.3% according to 50 grams glucose challenge test. Also the results showed that the main risk factors, which were
significantly and independently associated with impaired glucose tolerance, were history of habitual miscarriage,
history of neonatal death and family history of diabetes mellitus. Urine test for sugar as a screening test for
gestational diabetes was found to be neither sensitive nor specific in comparison with 50 grams oral glucose test. It
was recommended that pregnant women should be screened for gestational diabetes by the 50 grams glucose
challenge test and the screening can be done at least for high risk women.

CYTOGENETIC AND MOLECULAR ANALYSIS OF PATIENTS WITH AMBIGUOUS GENITALIA

Shatha R.Zaidan; Abdul Hussain Moyet Al-Faisal; Nahia A. Ali

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 49-56
DOI: 10.33762/mjbu.2008.48360

ABSTRACT
Ambiguity is one of the sex determination disorders which are caused by several genetic and hormonal factors.
This study was carried out to determine the association between sex external genitalia and genetic phenotype and
to find the role of SRY in ambiguity. Twenty one patients with ambiguous genitalia were involved in the study.
Blood samples were used for cytogenetic analysis and for DNA extraction for PCR analysis with SRY and SMCX
primers.In this study we examined 21 patients with ambigiuity and we grouped them into two groups according to
their external genitalia. The first group consists of 6 patients with apparently female external genitalia and the
second group consists of 15 patients with apparently female external genitalia plus micropenis. Cytogenetic and
molecular analyses were preformed and the cytogentic analysis revealed that 4 patients of group-1 were with
46,XY karyotype and two with 46,XX karyotype. While 14 patients of group-2 were with 46,XX and one with
mosaic karyotype. PCR analysis of the DNA extracted from patients blood of both groups with SRY and SMCX
primers or with SRY primers alone showed that discordance between PCR and cytogenetic results was detected in
patient no.5 from group-1 and patients no.7 and 8 from group-2 where the PCR positive to SRY while the
karyotype is 46,XX. Discordance was detected between the external genitalia and cytogenetic karyotype of the
patients with ambiguity. Such discordance was confirmed by PCR analysis.

EFFECT OF SODIUM VALPROATE ON SELECTED REPRODUCTIVE HORMONES, LIPID PROFILES AND OVARIAN HISTOLOGY IN FEMALE RATS

Najah R. Al-Mousawi; Azhar M. Al-Terahi; Bassim I. Mohammad; Ekhlas S. Hassan

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 57-64
DOI: 10.33762/mjbu.2008.48362

ABSTRACT
This study was conducted to evaluate the effect of sodium valproate (VPA) on reproductive hormones (folliclestimulating
hormone (FSH), luteinizing hormone (LH) & total testosterone), lipid profiles, total cholesterol (TC),
triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) & very low density lipoprotein
(VLDL), ovarian weight & histology in non epileptic female rats. Twenty-four sexually mature female Sprague-
Dawley rats were included in this study, divided randomly into 3 groups, each one included 8 rats. Blood samples
were collected from one group (8 rats), then dissected before starting the treatment & experimental parameters were
measured. The other 2 groups, group I received distilled water & considered as control group, group II received VPA
for 56 days. After treatment, blood samples were collected from animals then killed for measurement of previously
mentioned parameters. VPA caused significant reduction (P<0.05) in serum FSH & insignificant changes in serum
LH & serum total testosterone. VPA treatment significantly reduced weights of ovaries (P<0.05) but insignificantly
affect lipid profiles. Ovaries of VPA treated rats did not show features of polycystic ovaries & their histology appeared
similar to normal tissue. Numbers of corpus leutum & numbers of follicular cysts did not change significantly in these
ovaries. It was concluded that sodium valproate did not produce changes in reproductive hormones (except FSH),
lipid profiles & ovarian histology which were characteristic of polycystic ovarian syndrome (PCOS) in non epileptic
female rats.

REPAIR OF THE FLEXOR TENDON INJURIES OF THE HAND IN CHILDREN: ANALYSIS OF THE REPAIR TECHNIQUES AND TYPE OF IMMOBILIZATION

Avadis A Muradian

The Medical Journal of Basrah University, Volume 26, Issue 1, Pages 65-67
DOI: 10.33762/mjbu.2008.48363

ABSTRACT
This is a prospective study of flexor tendon repair in 26 children with 35 involved fingers, their age ranged between
1.5 to 15 years (average 7). They were presented for surgery within 3 weeks of the injury. Tendon repair using the 4-
strand core suture technique was performed in 65% of the hands and 2-strand in 35%, and postoperatively 73% of
the patients were immobilized by an above-elbow splint. The average follow up period was 9 months (ranged from 4
to 24). Using the Louisville scoring system, satisfactory results was achieved using 4 strand core suture technique and
immobilization by above-elbow splint in 77% of the patients. The postoperative complications consisted of tendon
ruptures in 15% of the cases mostly in those repaired by 2-strand core sutures with immobilization by below-elbow
splint. So we believe that in children the suture technique and type of immobilization had a great influence on the
final outcome following flexor tendon injuries.