Background and objectives: Hematuria can be an indicator of serious urinary tract disease. Bladder cancer is most commonly presented with painless hematuria. The aim of this study was to evaluate the incidence of bladder cancer among patients presented with hematuria.
Methods: This prospective study evaluated 562 patients over 30 years old who complained from hematuria. These patients underwent urinalysis and cytological, hematological, radiological, endoscopical and histopathological evaluations in order to identify different etiological causes of hematuria. The incidence of bladder cancer among these patients was calculated and the patients' characteristics were evaluated.
Results: The incidence of urological malignancies was found in 54 (9.6%) patients, from which 42 patients had bladder cancer (7.8%). Among these 42 patients with bladder cancer; 33 (78.6%) were males and 9 (21.4%) were females; 33 (78.6%) patients presented with gross, painless and intermittent hematuria. The highest incidence rate was among the age group 50-69 years.
Conclusions: Presence of blood in the urine should be considered a serious symptom that requires a full urologic evaluation of the entire urinary tract until significant pathology, including urothelial cancer, is excluded.
Background and Objectives: Sweat test is the only available method to diagnose cystic fibrosis in Iraq. Many cases of recurrent chest infections was misdiagnosed as cystic fibrosis and sent for sweat test. The Aim of the study is to analyze the results of sweat test and to correlate those results to different clinical presentations in children suspected to have cystic fibrosis and to set criteria for referral so that to avoid misuse of the test as it is limited.
Methods: Over one year period from 1st of March 2001 till 1st of March 2002, (87) patients with different symptoms were referred for sweat test with the suspicion of cystic fibrosis. All cases were studied and analyzed regarding full history and any associated symptoms, family history and physical examination. The results of the sweat test were evaluated and correlated to the symptoms.
Results: There were 55 males & 32 females with ratio of 1.7:1. Mean age of patients was 4.7 years. Repeated chest infection were the most common cause for referral (90%) and chronic diarrhea (20.6%).Twelve out of 87 cases(13.8%) referred had positive sweat test. The test was positive in 4 cases (7%) when children presented with recurrent chest infections alone while it was positive in all cases 7 (100%) when recurrent chest infections was accompanied by chronic diarrhea and clubbing. Equivocal results were found in 11 cases (19%) of the recurrent chest problems alone and in one case (14.3%) of failure to thrive and chronic liver disease.
Conclusion: Sweat test was significantly positive in patients with recurrent chest infection accompanied by persistent diarrhea and finger clubbing. It is recommended not to refer every case with recurrent respiratory infection especially those who are not associated with other symptoms but to follow up them closely.
Background and objectives: Cytokines are peptides involved in regulation of both cellular and humoral immune response. The purpose of this study was to evaluate the variations in response to different bacterial species in the palatine tonsils of patients with recurrent bacterial tonsillitis and to determine whether the local inflammation and mucosal immunity function independently from the systemic response.
Methods: The levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and interferon-� (IFN-�) were determined in the serum and tonsillar tissue supernatant with enzyme-linked immunosorbent assay (ELIAS) in group of 30 children with recurrent bacterial tonsillitis (10 children harbored S.aureus in their tonsils, 10 children harbored S.pyogenes in their tonsils, and 10 children harbored mixed bacteria in their tonsils) and 8 normal control subject.
Results: Normal concentration of IL-6 and IFN-� was observed in the peripheral blood with significant increase in IL-10 in comparison with control group, while mucosal IL-6, IL-10, and IFN-� concentration was highly increased. S.pyogenes in the recurrent tonsillitis (RT) patient was more effective in inducing IL-10 and IFN-� in compare to those harbors S.aureus in their tonsils. While RT-TE harbors mixed bacteria in their tonsils show a significant decrease in local mucosal IFN-� in compare to those harbors S.pyogenes or S.aureus in their tonsils.
Conclusion: Normal concentration of cytokine was observed in peripheral blood, with significant increase in mucosal IL-6, IL-10, and IFN-� concentration. S.pyogenes in the tonsils of RT-patient was more effective in inducing IL-10 and IFN-� in compare to those harbors S.aureus in their tonsils. While RT-TE harbors mixed bacteria in their tonsils show a significant decrease in mucosal IFN-� in compare to those harbors S.pyogenes or S.aureus in their tonsils.
Key words: Recurrent tonsillitis, S.aureus, S.pyogenes, IL-6, IL-10, IFN- �.
Background and Objectives: Sialic acids (SAs) are acetylated derivatives of neuraminic acid. They are attached to non reducing residues of the carbohydrate chains of glycoproteins and glycolipids. An elevation in the serum total sialic acid (TSA) concentration and serum total sialic acid to total protein (TP), TSA/TP has been observed in a number of pathological conditions and cancers type. The aim of the present study was to determine the serum TSA level and TSA/ TP in patients with breast masses and to evaluate if these biochemical parameters are sensitive and specific biomarkers of breast masses.
Methods: The reliability of serum TSA level and TSA / TP as biomarkers in breast masses was evaluated in (30) apparently healthy females and (30) female patients (10 with breast benign masses and 20 with breast cancer). Serum TSA was measured calorimetrically by thiobarbituric acid method of Warren, whereas TP was estimated according to the method of B.L. Oser.
Results: The mean�SE concentrations of serum TSA were (54.7�2.1, 61�6.5 and 122�4.1 mg/dl) in normal subjects, patients with benign breast masses and breast cancer respectively, and the mean�S.E of serum TSA/ TP were (9�0.3, 10.5�1 and 19.5�0.6 mg/gm) in normal subjects, patients with benign breast masses and breast cancer respectively. Data analysis indicated a non significant increase in serum TSA value and TSA/ TP in patients with breast benign masses and a significant increase(P<0.01) in patients with breast cancer compared with normal subjects.
Conclusion: The results obtained in this study indicate that serum TSA value and TSA/ TP measurements appeared to be of a value in the detection of benign breast masses and cancer.
KEY WORDS: Benign breast masses, Breast cancer, TSA, TSA/ TP.
Background and Objectives: Varicocele constitutes the most common surgical correctable cause of male sub-fertility. This prospective study evaluates the effect of surgical treatment of varicocele on the sperm quantity and motility in infertile persons, and compares the results with other similar studies.
Methods: The study was carried out through obtaining complete history and conducting physical examination for the study populations. Seminal fluid analysis was carried out to the study population and changes in sperm quantity and quality were taken as parameters of improvement.
Results: Left side varicolcele (90%) at grade 2 severity (44.2%) was predominant among the studied population. The most common age of presentation was 20-25 years (42.8%). Aِll the patients had abnormal seminal fluid either in quantity or activity. The study showed that after 3 months of surgical correction of varicocele, sperm quantity had significantly increased in 45 cases (64.2%) and sperm activity had increased in 55 cases (78.5%).
Conclusion: Although, there is lack of a definable and consistent end-point for assessing the efficacy of varicocelectomy, this study supports the utility of varicocelectomy in its favourable effect on sperm quantity and activity.
Key words: Varicocele, Varicocelectomy, Seminal Fluid Analysis.
Background and objectives: Palatine tonsils are mucosa associated lymphoid tissue. Immunohistological study for all palatine tonsils compartment was evaluated. The objective of the study was to determine the histological modification or damage induced by immune responses or the mucosal pathogen occurring at mucosal level in the palatine tonsils harbors different bacteria including S.aureus, S.pyogenes or mixed bacteria.
Methods: Fifteen human palatine tonsils were examined. Swab was taken from core of tonsils for bacteriological investigation then all specimens were fixed in 10% formal saline and treated according to routine techniques of light microscopy. Slices 5�m thickness were stained with hematoxylin and eosin.
Results: Thickness of epithelium surface shows significant differences between the test groups. While no significant deference in lymphocyte and plasma cell infiltrating to surface epithelium were observed among these group. S.pyogenes shows a significant decrease in filtration of polymorphnuclear neutrophils (PMN). No significant differences in APCs were seen among the three groups within the follicle and extra follicular area while plasma cell increased significantly in tonsils harbors S.aureus. In the patient with RT harbor S.pyogenes the germinal centers had ill-defined borders and the number of follicles was significantly decreased. In contrast, tonsils of patients with RT harbor S.aureus and mixed bacteria had well defined germinal center borders and distinct morphological zones with germinal centers.
Conclusion: Palatine tonsils harbors S.pyogenes secrete hallmark of enzymes and toxins which have irritative effect on cellular organization, thickness of epithelium surface, necrosis of tissue, and atrophied to mild hypertrophy tonsils with less number of follicle which had germinal center with ill-defined border. On the other hand, tonsils harbors S.aureus show enhanced in numerical density of plasma cells in epithelium and exrafollicular area, Migration of PMN cell and PMN in tonsillar surface secretion with increased number of follicle, defined germinal center borders, distinct morphological zones and frequently hypertrophied tonsils.
Key words: Recurrent tonsillitis, Palatine-histology, S.aureus, S.pyogenes, Mucosal protection.
Background and objectives: Male factors are responsible for a considerable proportion of infertility whether independently or in association with other female factors. This study was to evaluate the prevalence of etiological factors of infertility among males attending Erbil in-vitro fertilization (IVF) center.
Methods: 1999 males attended IVF Center from Jan 2004 to Jan 2008 Complaint of infertility, was included in this study. Full history, physical examination and necessary investigations were carried out to these patients.
Results: Of the 1999 male patients, 925 (46.27%) patients had normal evaluation, 1074 (53.7%) patients were diagnosed with different etiological factors associated with infertility. Out of these 1074 patients, 290 (27%) patients were diagnosed with clinical varicocele. 160 (14.8%) patients had normal exam and biopsy, but semen parameter revealed azoospermia or severe oligospermia (<10million/ml) indicating obstructive causes. Another 223 (20%) patients had testicular failure and 80 (7.4%) patients had pyospermia. Idiopathic defect of sperm parameter was responsible for 130 (12%) infertility cases as no cause could be identified.
Conclusion: Male infertility in Erbil appears to be most commonly associated with varicocele, a significant number of the infertility cases can be attributed to treatable conditions like varicocele and pyospermia.
Key words: Infertility, Male, In-vitro fertilization, Varicocele.
Background and objective: As far as the toxoplasmosis was regarded as a cause of abortion & congenital malformation of newly born babies that is why the seroprevalence of Toxoplasma gondii antibodies was determined in (189) women suffering from spontaneous abortions in Erbil (Maternity teaching hospital) from January 2000 to December 2001.
Methods: The seriological tests used for the diagnosis of Toxoplasmosis include Latex agglutination Test (LAT) and enzyme linked immunosorbent assay (ELISA) .
Results: Out of 189 women with spontaneous abortions, 124 cases (66%) were seropositive for Toxoplasmosis by the LAT. Patients with 2 or 3 abortion had the highest prevalence of seropositivity (54%,15%) respectively. The highest percentage of positive results were seen in patients in the age groups (21-30), (31-40) & less than (20) years at (56.5%), (22.6%, 12.9%) respectively. Women in rural areas had a higher percentage of seropositive result than urban areas. With ELISA, among positive LAT, (60.3%) positive for IgG and (45.5%) positive for IgM titers were seen.
Conclusion: To confirm that toxoplasmosis may be one of the causative factors of abortion in Erbil among women especially in rural area after excluding other causes of abortions like chromosomal abnormality & other biological agents.
Key words: Abortion, Toxoplasmosis, immunological tests.
Background and objectives : To deterimine dmft and DMFT for children aged (1-12) years old and to investigate their attendance for seeking dental treatment into pedodontic clinic in the college of dentistry.
Methods: 1079 case sheets had been checked which represent the total number of children attending the pedodontic dental clinic department during the academic year of 2006-2007. WHO methodology was used to assess the individual tooth status.
Results: High dmft and DMFT scores (5,94 , 1,42) had been found. The main cause of the patients� visits was for the relief of pain and the most frequent treatment given was extraction and more than � of cases visited the clinic just one time to get rid of this pain and discomfort.
Conclusion: More efforts required to draw attention of parents and children to preserve their primary teeth and look for preventive measures offered in pedodontic clinic like fluoride application and oral hygiene improvement for getting best dental results.
Key words: dmft , DMFt , Dental treatment need and demand.
Background and objectives: The saliva can contribute to strengthening the tooth by supplying the components known to help build strong hydroxyapatite structure. The flow rate and pH of saliva are also recognized to be critical factors that affect the dental caries. The aim of the study was to correlate unstimulated salivary flow rate and pH to dental caries experience of (6 � 11) years old children.
Methods: This study was carried out on (120) healthy children, 6 � 11 years old, their teeth were examined for caries experience, the unstimulated salivary flow rate, and pH were measured immediately after saliva collection.
Results: The total mean of decayed, missing, and filling surfaces of permanent teeth (DMFS) was (1.52), while the total mean of decayed, missing, and filling of permanent teeth (DMFT) was (1.22). The total mean of decayed, missing, and filling surfaces of deciduous teeth (dmfs) was (5.44), while the total mean of decayed, missing, and filling of deciduous teeth (dmft) was (3.79). The females showed higher scores than males. The total mean values were (0.53) ml/ min for flow rate and (6.85) for pH, and the males showed higher values than females. Highly significant relation was found between the flow rate with DMFS and DMFT, non significant relation with dmfs, and significant relation with dmft. Highly significant relation found between the pH with DMFS, significant relation with DMFT, and highly significant relation with dmfs and dmft.
Conclusion: The females showed higher scores of decayed, missing and filling surfaces and teeth than males. While the males showed higher values of salivary flow rate and pH than females.
Key words: Caries experience, salivary pH, salivary flow rate.
Background and objectives: The aim of this study was to compare post operative pain and swelling after surgical removal of impacted third molars, using three closure techniques.
Methods: Ninety patients with impacted lower third molars were randomly divided into three groups of thirty each (from March 2007 to September 2007). Panoramic radiographs were taken to assess the depths and angulations of third molars, and the relation to inferior dental canal. In Group 1, the wound was completely closed. In Group 2, a 5-6 mm wedge of mucoperiosteum distal to mandibular second molar was removed for drainage. In Group 3, a polythene tube drain inserted through the buccal muco periosteal flap of mandibular second molar for drainage. Pain and swelling were evaluated for 7 days after surgery with the visual analog scale (VAS scale).
Results: The statistical analysis (analysis of variance for repeated measures, P<0:05) showed no significant difference between the three groups with regard to pain (P=0.183) except for day 7, in which a significant difference was reported (P=0.019), between Group I and Group II. Swelling was not significantly different between the three groups (P=0.056).
Conclusion: We concluded that different closure techniques have no significant effect on postoperative pain and swelling.
Key words: pain and swelling, lower third molar closure techniques.