Issue 1

Species differences in methotrexate-induced hepatotoxicity and nephrotoxicity: Rabbits resist methotrexate nephrotoxicity

Jawad H. Ahmed

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 1-14
DOI: 10.33762/mjbu.2016.111176

Background: Animal models are important tools for studying drug-induced toxicity. Species differences in drug-induced nephrotoxicity or hepatotoxicity was frequently reported, however, clear evidence of species differences in nephrotoxicity or hepatotoxicity induced by methotrexate (MTX) is not available.
Aim: The present study was designed to investigate nephrotoxicity or hepatotoxicity of MTX in mice and rabbits.
Methodology: twelve rabbits and 16 mice were used for the study. Each species of animals was divided into 2 groups; control and MTX treatedgroups. The control groups were treated with normal saline intra-peritoneum (IP), MTX was given IP in a dose of 20 mg/kg/weekly for 38 days for the rabbits and at a dose of 10mg/kg/ weekly for 23 days for mice. Serum levels of liver enzymes, urea, creatinine, Malondialdehyde (MDA) and MDA in liver homogenate were estimated for the rabbits. In mice, glutathione (GSH) and MDA were estimated in liver and kidney homogenates. Histopathological examination of the kidney and liver was done for the 2 species.
Results: In the rabbits, MTX resulted in a significant increase in liver enzymes, and in MDA levels of serum, liver and kidney homogenates, while the levels of urea and creatinine were not affected. Histopathological changes suggestive of liver damage were seen, while the kidneys appeared normal on histopathological examination. In the mice, MTX resulted in a significant increase in MDA in the liver homogenates with a small and insignificant reduction in GSH. In mice kidney homogenates, MTX had not affected MDA, while GSH was significantly reduced. Histopathological examination in mice showed significant damage in both liver and kidney.
Conclusion: MTX produced hepatotoxicity in rabbits and mice but nephrotoxicity occurred in mice only. This suggests that rabbits might be resistant to MTX induced nephrotoxicity

Paraffin embedded marrow clot sections as an adjuvant procedure in the diagnosis of bone marrow diseases.

Jasim M. A. Al-Diab

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 15-19
DOI: 10.33762/mjbu.2016.111183

Objectives: This study was conducted to evaluate the role of histopathological examination of paraffin embedded marrow clot sections in the diagnosis of different neoplastic and non-neoplastic marrow diseases, and whether these sections can replace the need for performing bone marrow trephine biopsy.
Methods: Patients included in the study are those with clinical manifestations of hematological disorders who were subjected to peripheral blood examination, marrow aspirate cytology with complimentary bone marrow trephine and marrow clot biopsy. Along with marrow aspiration, the blood left behind after preparing marrow smears, was used to prepare paraffin embedded histological clot sections. The results for 114 patients were analyzed simultaneously for their concordance to highlight the usefulness of marrow clot sections in the diagnosis of different diseases affecting the bone marrow. Immunohistochemical stains were used whenever indicated to obtain additional diagnostic information.
Results: Marrow clot sections were diagnostic and concordant with the complete blood count, marrow aspirates and trephines in 63% of the cases. While trephines were unconvincing in another 15.7% of the cases, the clot sections were diagnostic. In 1.7% of the cases, the clot sections and trephines were diagnostic while marrow aspirates were inconclusive, thus in 81% of the cases, marrow clot sections provided the diagnosis and replacing the need for performing trephine biopsy. However, trephine biopsy is still considered necessary in 19 % of the cases in whom the clot sections are of poor quality and unconvincing
Conclusion: In most of the cases clot sections can replace the need for trephine biopsy, but trephine biopsy is still required in other cases. The clot sections are useful as an adjuvant procedure to increase the diagnostic yield in marrow studies. Because it is difficult to expect which patients will be diagnosed by clot sections and which will need trephine biopsy, it is advisable to perform both trephine and clot biopsy together with the marrow aspirates.

Analysis of p53 codon 72 polymorphism and HPV 5,8 E6 oncoprotein expression in Basal cell carcinoma in Basrah

Wasan AA. Sayhood; Hassan J. Hasony; Khalil I. AL-Hamdi

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 20-26
DOI: 10.33762/mjbu.2016.111184

Background: Two polymorphic forms of the p53 gene that codes either for Arginine or proline at codon 72 were identified, However, this individual might have one of the three genotypes: Arginine/Arginine, Proline/Proline or Arginine /Proline. Previous studies suggested that Arginine form of the p53 codon 72 polymorphism is a risk factor for HPV associated with cervical cancer and has been explored as a possible risk factor for the development of skin cancer in general. This study was aimed to clarify the association of this polymorphism in relation to beta Human Papilloma virus (HPV) 5,8 E6 oncoprotein expression in basal cell carcinoma in Basra, Iraq.
Patients & Methods: Blood samples and tissue biopsy from 29 histologically confirmed BCC cases and 31 normal controls were analyzed using polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) method to determine the genotype of p53 codon 72 and conventional PCR for HPV 5 and 8 E6 oncoprotein expression in BCC biopsies.
Results: the frequency of Arg/Arg, Pro/Pro or Arg/Pro were 10.3%, 24.1% and 65.5% respectively among patients group and 6.5%, 58.1% and 35.5% among the control group. This result showed a significant increase in the frequency of p53-72 Arginine/Proline heterozygous among BCC cases as compared with controls according to the dominant genetic model (P value =0.007, the Odds ratio = 4.3, 95% CI = (1.4340-13.2059). There was negative expression of HPV 5 and 8 E6 oncoprotein in all the biopsies tested.
Conclusion: These finding indicates that the heterozygosity of the p53 codon 72 could be an immunogentic risk factors in the development of BCC, but there was no association detected with HPV5,8 E6 oncoprotein from the examined cases.

Evaluation of Straight needle threading technique by using a silk suture as a frontalis sling for the management of sever blepharoptosis

Amer Salman Al mansory

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 27-34
DOI: 10.33762/mjbu.2016.111185

Aim: To evaluate the use of Straight needle threading technique to perform frontalis sling by silk suture material as a surgical correction of severe blepharoptosis cases.
Settings and Design: a prospective study was performed on patients who underwent 3-0 silk frontalis suspension using a Straight needle threading technique with an average of 8 months follow up period. Baker’s criteria for satisfactory results was used in which the correction of > = 1 mm from the normal side (or corrected side in bilateral ptosis).
Patients and Methods: An eighty seven eyes in 67 patients were done, 25 eyes were operated on under local anaesthesia and 62 eyes under GA, 20 cases bilateral and 47 cases unilateral, 55.2% males (37 cases) and 44.8% females (30cases). The average age was 12 years (range 2-70 years).
Statistical analysis was done by using the frequency values analysed by the program Statistical package for social sciences (SPSS) version 20 to analyse the results.
Results: it was satisfactory in 76.4%, unsatisfactory in 23.6%, overcorrection 3.5%, under correction 15.3%, Entropion 0%, Lagophthalmus 4.8%, exposure keratitis 0%.
Conclusion: the use of silk suture by straight needle threading technique is fast, easy, and low cost method to correct a complex problem like sever ptosis with a comparable aesthetic and functional results to other non- autologous materials, with good safety profile.

Role of the private health sector in detection of cases of tuberculosis in Missan Governorate

Yaseen Obaid Yaseen

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 35-41
DOI: 10.33762/mjbu.2016.111186

Background: As tuberculosis (TB) is still endemic disease in Iraq, efforts in detection, diagnosis, treatment, and prevention are of utmost importance to decrease the prevalence and negative impacts of this disease on people. In this study we aim to find out the extent of contribution of the private health sector in, Missan governorate to the detection of cases of tuberculosis and referring them to the Chest and Respiratory Disease Clinic in Missan for further management. Collaboration between the private and public health sectors is crucial for early detection, treatment, and cure of tuberculosis and consequently decrease in its prevalence and transmission to other people.
Patients and methods: Records of patients managed by the Chest and Respiratory Disease Clinic in Missan, for the period between 2012-2014 were reviewed. The above mentioned clinic deals with all cases any different types of tuberculosis. All cases, and of different types of tuberculosis, were enrolled in the study. Particular concern to the source of referral of these cases was considered. Other parameters such as, type of tuberculosis, whether it is newly or previously diagnosed, and the results of the sputum test for acid-fast bacilli. (AFB) were considered.
Results: 752 patients with tuberculosis were diagnosed and managed by the Chest and Respiratory Disease Clinic in Missan for the period between 2012-2014, considerable number of these patients (44.4%) was detected and referred to the TB Center by the physicians in the private health sector. Private health sector had more contribution to detection of extrapulmonary tuberculosis than the public health centers.
Conclusion: The private health sector in Missan governorate has an important role in detection of cases, mostly newly diagnosed cases, of tuberculosis. So collaboration between governmental health faculties and private health sector is essential for effective detection and management of cases of tuberculosis to decrease its prevalence and negative impacts on the public health.

Diagnosis of Noroviruses in Iraqi children suffering from Gastroenteritis by Enzyme linked assay and conventional PCR

Hala Sameh Arif; Abdulrhman M. Hassan Hadi; Huda Thaher Al-Marsome; Jabbar Salman Hassan

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 42-49
DOI: 10.33762/mjbu.2016.111187

Background: Noroviruses have been reported to be second to rotaviruses in causing severe childhood gastroenteritis, according to nucleotide sequence analysis of the polymerase or capsid regions, norovirus is classified at least into five genogroups GI–GV, each genogroup is further divided into distinct genotypes. GI, GII, and GIV have been found in humans.
Amis: To determine the possible implication of Norovirus in a sample of childhood diarrhea and the efficiency of molecular diagnosis in comparing with ELISA method for the detection of this agent.
Methods: Stool samples were collected from 100 patients suffering from diarrhea there age ranged from (6 weeks – 14 years), the stool samples were divided into three portions. The first portion (0.5 mg) was prepared for wet smear preparation, and the second portion was used directly for RNA extraction and directly converted to cDNA and third portion used for ELISA assay, all stored at-20°C.
Statistical analysis: The statistical analysis of this study was performed using the statistical package for social sciences (SPSS) program version (19) and Microsoft Excel 2010. Categorical data formulated as count and percentage. Chi-square test was used to describe the association of these data. The level of statistical significant difference is below or equal to 0.05.
Results: the study showed that 28 (28%) samples out of 100 samples were positive for G1 Norovirus with a PCR product size of approximated (380) bp and 72 (72%) samples were negative. All samples (n=100) were negative for G2 Norovirus. The highest incidence of the Norovirus cases was in the age group (2-5) years followed by (< 2 years) age group and then (> 5 years) group and there was no statistical significant difference between age and positive Norovirus cases.
Conclusions: Norovirus could be included as one of the most important causes of acute gastroenteritis in Iraq.

Pediatric brainstem abscess: a case-based review

Hassen Hadi Almuhammed

The Medical Journal of Basrah University, 2016, Volume 34, Issue 1, Pages 50-55
DOI: 10.33762/mjbu.2016.111188

Solitary brainstem abscess is uncommon condition with high mortality and morbidity. The diagnosis require high index of suspicion and appropriate imaging. It can be managed by medical treatment alone, stereotactic aspiration of the purulent material, or by surgical drainage along with medical therapy. Here, I present a case of a child with large solitary brainstem abscess involving the pons and the medulla oblongata without systemic infection or systemic predisposing factors. The patient managed by mean of microsurgical drainage and antibiotic therapy. The literatures on brainstem abscess was reviewed and an over view of the literature is presented. This case-based review of brainstem abscess reinforce the conclusion that early diagnosis and proper management with microsurgical drainage and maximal medical therapy may result in a good prognosis.