Medical students, especially in their early years of study, always ask a question: why do we study biostatistics? We are going to be doctors, not statisticians. On the other hand, graduated doctors feel day by day that they are in need of better understanding of statistics, not only as researchers, but as readers of medical literature. This gap in knowledge is partly attributed to the curricula of some medical colleges since biostatics was not emphasized upon previously. With the introduction of “evidence based medicine” as a cornerstone for patient’s management, more importance was given to biostatistics, study designs and research methodology. Guidelines of evidence based medicine mainly depend on the results of Meta analysis which is based on evidences extracted from a number of randomized controlled trials. It provides the most powerful evidence which aids doctors in decision making process on the best management options for their patients. In spite of the mentioned advances in the statistical and methodological procedures, many researchers think that the ‘p’ value is the only method that shows whether or not there is significant difference between the study groups, and hence building inferences accordingly. In order to assure the validity of a study, readers must also be able to exclude role of chance, bias, and confounding variables. Bias and confounding variables are methodological issues which researchers must put in mind prior to conducting the study. It is highly recommended to write a detailed protocol as well as considering these issues. Once bias occurred, is difficult to be dealt with in the stage of analysis hence it would be advisable to eliminate or minimize it at earlier stages. The introduction of statistical packages could partly reduce the effects of confounders during study analysis. Most of articles submitted to our journal contain the probability of chance (the p value). In my observation, some of the researchers mention that ‘p’ is less or more than 0.05 or 0.01 without mentioning the actual value of ‘p’. A ‘p’ value of 0.051 and of 0.9 are considered not significant (more than 0.05), but it is evident that the first one could become significant (less than 0.05) by simply increasing the sample size as it is close to the significance level. The size of the ‘p’ value is a function of both the strength of the association and the sample size. The ‘p’ value should not be considered as a fast method for establishing the role of chance, but as a guide to the likelihood that chance could be an explanation of the findings. No ‘p’ value albeit being small, could exclude chance findings completely. The output of some statistical packages present the ‘p’ value as 0.000. In fact it is not zero, and should be written as < 0.001 when presented to the journal. A related but more informative measure used to evaluate the role of chance is the confidence interval (CI) which is defined as “the range within which the true value or the population value is likely to lie, with certain degree of assurance”. The CI provides information about the level of significance and the sample size of the study. The larger the sample size, the narrower the C.I. Thus the P value and C.I together provide the best information about the role of chance. Nearly all the researches are conducted on samples (not the whole population) aimed at generalizing the results obtained from studying the sample to the population from which the sample was drawn from. It is worth mentioning that the sample size is an important determinant of the power of the study to detect significant differences between the study groups if these differences truly exist. Bigger sample size gives more power to the study. In conclusion, biostatistics has a paramount role in medical researches when performed in a sound and scientific manner.
Background and objective: Pre-eclampsia and eclampsia are claimed to be associated with disturbances in lipid profile. The purpose of this study was to determine any significant association between pre-eclampsia/eclampsia with lipid profile disturbances.
Conclusion: Pre-eclampsia and eclampsia are associated with dyslipidemia. This association may be significant in understanding the pathologic processes of preeclampsia and may help in developing strategies for prevention or early diagnosis of the disorder.
Keywords: Pre-eclampsia, cholesterol, triglycerides, low density lipoprotein (LDL)
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Background and objective: Myristica fragrans is an aromatic green tree usually growing to around 5-13 meters high, and their seeds (nutmegs) is firm broadly ovoid. The objectives of the study were to find the concentration of nutmeg oil that has maximum antibacterial action against Staphylococcus aureus and to evaluate the healing potential of this concentration on a chemically induced oral ulceration in the rabbit’s cheek mucosa.
Methods: Different concentrations of nutmeg oil were prepared and their antibacterial activity against Staphylococcus aureus was determined by disk diffusion method. The chemically induced oral ulcerations in rabbit’s cheek mucosa were achieved by ethanol, and then these ulcerations were irrigated with 0.5ml (5%) of nutmeg oil twice daily. Biopsies were taken after four and eight days of the experiment, processed and stained by hematoxylin and eosin.
Results: The concentration 100% of nutmeg oil and the dimethyl sulfoxide; which was used as diluents for preparing different concentrations of nutmeg oil, showed no inhibition zone for Staphylococcus aureus. The concentration (5%) showed maximum inhibitory zone (16.8mm) for the micro-organism which was parallel to the effects of amoxicillin (positive control), both with highly significant action (P<0.05). The histopathological pictures showed a delay in the healing process of oral ulcers in rabbits treated by this concentration.
Conclusion: The concentration of nutmeg oil (5%) has a good antibacterial action against Staphylococcus aureus, but it causes a delay in the healing process of oral ulcerations.
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Background and objective: Diabetes mellitus is associated with many complications such as cardiovascular disease, even in the presence of intensive glycemic control. Homocystein takes part in the development of atherosclerosis and vascular injury and it is suggested to contribute in atherosclerotic process of diabetes mellitus. C-peptide recently used to diagnose diabetes.The present study was designed to evaluate serum levels of Homocysteine, C-peptide levels and lipid profile in diabetic patients.
Methods: This study includes 75 diabetic patients (35 type 1 and 40 type 2) and 30 controls. After 12 hours fasting, serum homocystiene, C-peptide, lipid profile, HbA1c and blood glucose were measured for patients and controls.
Results: The results showed that homocysteine level in type 1 and type 2 diabetic patients significantly increased as compared with controls. And the C-peptide level in type 1 diabetic patient was very low, while in type 2 diabetic patients and in controls was normal. The results also showed that the lipid profiles (except HDL) were increased in diabetic patients.
Conclusion: Serum homocysteine (Hcy) level and lipid profile (except HDL) are significantly elevated in diabetic patients. The C-peptide level in type 1 diabetic patient was very low, while in type 2 and controls was normal.
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Background and objective: The purpose of this study was to evaluate the effect of duration of finishing and polishing procedures on the surface roughness of two different types of composite resins.
Methods: Forty samples of 6 mm in diameter and 2 mm in depth were prepared, 2 types of composite resins were used (nanocomposite and hybrid composite resin). Twenty samples of each type of material were prepared and divided into two main groups and then each main group subdivided randomly into two subgroups of 10 samples for each subgroup (one). Ten samples of each material were submitted to finishing by using a finishing kit. The available finishing kits used in this study containing discs, cups and points that were used with a slow-speed hand piece in a dry field and with a light intermittent pressure for about 15 seconds. While the other 10 samples of each material were finished for about 30 second; then the analysis of the surface roughness was carried out, three readings were made on each surface using a stylus tip and the extension of each reading was 2 mm stroke.
Results: There was non significant difference between the groups that were finished and polished for 15 second and the other groups that were finished and polished for 30 second for the two different types of composite resin.
Conclusion: Increasing duration of finishing and polishing has no effect on the surface roughness of The two different types of composite resin.
Keywords: Nano composite, Hybrid composite, Finishing bur, Duration.
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Background and objective: Cryotherapy with liquid nitrogen is a widely used method for treatment of common warts by dermatologists. Traditionally, when treating warts, liquid nitrogen is applied at intervals of 3 weeks. This study was designed to compare the efficacy, and time to clearance of 2-week and 3-week interval cryotherapy of patients attending the department of dermatology and venereology at Rizgary Teaching Hospital in Erbil City.
Methods: In This comparative study 80 immunocompetant patients, age range 10-55 years with common warts on the hands and/or feet were enrolled from November 2008 through May 2009. Patients were randomized to receive cryotherapy at interval of either 2 or 3 weeks. All patients allocated to have liquid nitrogen applied with a cryo-spray technique. Cure rates were evaluated in both groups after 3 months and after 6 treatments.
Results: 72 patients completed the study. The mean times for clearance of all warts in both groups were 9 weeks in every 2-week treatment group and 14 weeks in every 3-week treatment group. The mean numbers of treatment sessions required to achieve clearance were similar in each group (4.5 and 4.7 treatment sessions) for 2- and 3- week interval groups respectively. Cure rates at 3 months were 64% in the 2-week interval treatment group and 45% in the 3-week group. After 6 treatment sessions cure rates were similar for both groups; 65% and 60% for 2- and 3- week interval groups respectively. Morbidity was slightly greater in the 2-week interval treatment group.
Conclusion: Cryotherapy of common warts is effective and the percentage of cure is related to the number of treatments received, and independent from the period between treatments.
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Background and objective: Healthy school environment is one of the main determinants of students’ health in order to maximize the benefit from the educational programs. This study was aimed to assess the primary school environment in Erbil city.
Methods: A cross-sectional study was conducted in 50 primary schools in Erbil city out of 242 schools through the academic year 2010-2011. Data were collected using a questionnaire constructed by the researchers which included general information, area around the school, school environment, class-room and school canteen.
Results: Most of the primary schools were located near the main street, nearly all (98%) the streets leading to the schools were paved. In contrast, thirty one (62%) schools had been exposed to a pollution source, mainly noise (54.84%) and garbage (45.16%) pollution. The majority of the schools had standard school fencing, school yard, and garbage container, and only 8 (16%) of them had available/standard school ground. The study showed that nearly half of the schools had appropriate classrooms, lighting, and majority of them had adequate desks, appropriate blackboards and clean classrooms, while ventilation and age appropriate desks were partially available. The amount of chlorine in water was not tested. There is lack of materials in the first aid kits. Canteens were available, but not standard and the working staff did not have the health certificate.
Conclusion: School environment in Erbil city is not optimum.
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Background and objective: Exposure evidence to welding fume aerosols demonstrates that particulate air pollutants can cause both pulmonary and airway inflammation. However, few data show that particulates pollutants can induce systemic inflammatory responses in animals. The aim of this study was to test whether exposure to welding fume by inhalation of its fine and ultra fine particles and different compositions of the electrical welding processes would produce physiological disorders for the blood parameters of exposed rat’s animal.
Methods: We conducted the study using hematology coulter counter to analyze whole blood samples of rats after exposure to welding fumes. We investigated the effect of wielding fume exposure on some hematological parameters such as the red blood corpuscles (RBCs), white blood cells (WBCs) and platelet parameters. Fourteen male albino rats were randomly assigned to control or wielding fume inhalation.
Results: Significant decrease were observed after four weeks of wielding fume inhalation in the hemoglobin (Hb) concentration, RBCs count, hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red distribution width (RDW), mean corpuscular hemoglobin concentration (MCHC), Platelete counts (PLTs) and platelete large cell ratio ( P-LCR ).On the other hand, platelet distribution width (PDW).
Conclusion: We conclude that inhalation of wielding fume for a long time influence the progression of anemia and inflammation suggesting that welding fume profoundly affects whole-blood profiles.
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Background and objective: Prevention of bacterial adhesion is an attractive target for the development of new therapies in the prevention of bacterial infection. The aim of this study is to investigate the effects of pomegranate peel extract, vitamin C, combination of pomegranate peel extract and vitamin C & gemifloxacin on adhesion of E.coli to uroepithelial cells.
Methods: Uroepithelial cells were incubated with E. coli ATCC 25922 bacteria previously exposed to either the aqueous extract of pomegranate peel (AEPP), vitamin C, combination of both or gemifloxacin and the adherence was assessed by light microscopy.
Results: AEPP showed good antibacterial activity with minimum inhibitory concentration MIC of 25μg/ml and 10 mmol/ml for vitamin C and upon combination, the MIC was10µg/ml &5mmol/ml for AEPP & vitamin C respectively whereas for gemifloxacin was 0.03μg/ml. In vitro and in vivo adhesion of E.coli to uroepithelial cells were significantly inhibited by AEPP, vitamin C alone and in combination and by gemifloxacin.
Conclusion: AEPP showed good antibacterial activity, inhibited E.coli adhesion to uroepithelial cells and were potentiated by vitamin C.
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Background and objective: To evaluate p53 and p21 proteins over expression in gliomas and their relation to some clinico-pathological parameters.
Methods: From September 2009 to July 2010, a formalin fixed, paraffin embedded blocks of 60 gliomas cases were collected in addition to 44 astrocytomas, 5 oligodendrogliomas, 2 oligoastrocytomas, and 9 ependymomas. These cases were evaluated by immunohistochemistry using streptavidin-biotin method.
Results: Overall, 53% of gliomas were positive for p53; these cases formed 66% of astrocytomas, 20% of oligodendrogliomas and 100% of oligoastrocytomas. In contrast to astrocytomas, all ependymoma cases were negative for p53 protein. There was a significant association of p53 expression with patient’s age and tumor site. On the other hand, p21 expression was positive in 25% of gliomas; they comprised 23% of astrocytomas, 40% of oligodendrogliomas, 50% of oligoastrocytomas and 22% of ependymomas. Both p53 and p21 expressions seemed to be raising from low to high grades astrocytoma but they did not reach level of significance.
Conclusion: The results of the present study suggest that p53 overexpression is common in gliomas and p21 expression is less common. There was a trend of both marker expressions increasing with higher grades.
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Background and objective: Doppler ultrasound technique has been proposed as a noninvasive means of quantifying diastolic and systolic cardiac function by measuring flow propagation into the left ventricle and ejection blood to the body. The relationship between Doppler-derived parameters and underlying fluid dynamics is still unclear.
Methods: The purpose of this study is to deduce effective physical parameters used in measuring the change in the geometrical shapes of the aortic valve leaflets during the vortex formation. These parameters are defined as the “Blockage factor, Strouhal number and Formation number”. One hundred fifty subjects were selected; The B-factor was correlated with Strouhal number and Formation number for 100 normal aortic valve subjects, and 50 abnormal subjects divided equally into regurgitate (25), and stenotic aortic valve (25), other physical parameters are also calculated. Doppler Echocardiography technique as a noninvasive technique that provides unique hemodynamic information which can not be achieved by any other means.
Results: The accuracy of the results depends, however, on meticulous technique and an understanding of Doppler principles and flow dynamics. This technique recommended through scientific literature. It has been found that the mean values and standard deviation of (ST-No) and (F-No) for normal aortic valve are (l.55 ± 0.55) and (10.12 ± 3.16), regurgitate (2.823± 0.992) and (5.722± 1.68), and for stenotic aortic valve subjects are (0.939± 0.14) and (l5.82± 2.20) respectively.
Conclusion: The results show that (St-No) of normal aortic valve is larger than that for stenotic, which may indicate that the inertial effects of normal valve are larger than those of stenotic valve. This because pressure energy is expanded to overcome inertia rather than converted solely to kinetic energy. The results obtained showed significant elevation of (ST-No) with aortic valve dimensions, and the improvement in efficiency decreases with increasing Strouhal number. A significant elevated (F-No) has been also noted to be increased with aortic valve area. The study of the Formation number and Strouhal number' is important to determine the severity of the stenotic and regurgitate aortic valve and gives a good parameters that can be used in medical diagnosis.
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Background and objective: Thalassemias constitute a form of anemia that has clear problems in relation to oral health. The purpose of this study to determine whether beta thalassemic disease is associated with increased risk of gingival disease.
Methods: In this case control study, 50 transfusion dependent thalassemic patients aged 12 to 24 years compared with 50 healthy control subjects matching in age and sex. At beginning both beta thalassemic patients and healthy control subjects were receiving scaling and polishing with good oral hygiene instruction and using the same tooth paste and tooth brush in order to obtain zero score at base line. Then, the all subjects were followed up for six month at one week (base line), one month, three months and six months interval. Gingival health status was assessed through these six months by application of Silness and Loe plaque index (PI), Ramfjord calculus index (Cal I) and Loe and Silness Gingival index (GI). Data were analyzed by using chi square, fisher's exact test, student t-test and paired t-test.
Results: At base line, results showed that plaque index and gingival index were higher among beta thalassemic patients than healthy control subjects with no statistical significance difference. Regarding the calculus index, there was no calculus in both groups at base line. After six month follow up (one, three and six month interval) results showed that plaque index, calculus index and gingival index were higher among beta thalassemic patients than healthy control group with statistically significant difference (P<0.05).
Conclusion: Patients with beta thalassemic major showed significant difference in their gingival health status and therefore a special oral hygiene care program needed for this target group.
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Background and objective: Facial appearance is fundamental for communication and interaction with the environment. Attractiveness nowadays reported increasing interest and attention among different ethnicities and varying education level groups. Aim: To study the perception of facial profile attractiveness among Iraqi Orthodontists and Maxillofacial surgeons (as concerned dental professionals) compared to Iraqi lay-individuals.
Methods: Digital facial profile images were taken for a young male and female, altered in 2 degrees of prognathism and retrognathism in 4, 8 mm for each jaw, and combinations, collecting 12 images each, which were “E-mailed”to a sample of 80 Iraqis (from the pool of Baghdad society): 40 dental professionals (20 orthodontists, 20 maxillofacial surgeons), and 40 lay individuals, with equally distributed genders. Ratting was carried out for 24 images, scoring each on a numerical scale of 1-10 as the least to the most attractive profile.
Results: Significant difference in perception facial profile was found between genders (P<0.05) and among the groups with different dental education (P<0.001). General agreement was established in all the sample groups on average facial profile to be the most attractive and on the most retrognathicmandibular profile to be the least attractive.
Keywords: Attractive facial profile, perception of facial profile.
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Background and objective: This study aimed to determine the incidence of various partial edentoulism according to Kennedy’s classification of edentulous arches, modification areas, types of removable partial dentures (RPDs), selection of major connectors for RPDs and patterns of tooth loss in relation to the gender and age.
Methods: The study was conducted in Hawler Medical University, College of Dentistry, Dep. of Prosthodontics, Erbil/Iraq. The data were collected from 963 patients aged 17-80 years of both genders. The survey was based on visual examination for determining the incidence of Kennedy’s classification, modification areas in relation to the age and gender, determining the cause of tooth loss and types of major connectors for RPDs.
Results: Kennedy’s class III in both dental arches was the most dominant pattern at a frequency of 49.84%, with class IV being the least in number. Mandibular RPDs were more common than maxillary RPDs. With an increase in age, there was an increase in the Class I and Class II dental arch and a decrease in Class III and class IV in both arches. Gender had no significant relationship with distributions of RPD classification.The majority of the constructed RPDs were acrylic resin 881(91.49%) and only 82 (8.51%) were metal.
Conclusion: Kennedy’s class III is the most common RPD in both dental arches. Gender had no effect on the prevalence of various Kennedy classes, while age has a significant effect.
Keywords: Edentulism, age, gender.
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Background and objective: Where Hydatid cyst of E. granulosus reaches 1 cm in diameter, its wall will differentiated into a thick outer laminated and thin germinal epithelium from which occasionally, daughter cysts could appear within the Hydatid. Aim: management of the Hydatid cyst is performed surgically by separating the two layers of the cyst keeping the inner layer intact during removal process to prevent the generation of daughter cysts at the same site in the future.
Methods: We conducted the study using hematology coulter counter to analyze whole blood samples of rats after exposure to welding fumes. We investigated the effect of wielding fume exposure on some hematological parameters such as the red blood corpuscles (RBCs), white blood cells (WBCs) and platelet parameters. Fourteen male albino rats were randomly assigned to control or wielding fume inhalation.
Results: Total removal of the cyst was done in thirty cases using neurosurgical microscope to separate the cyst wall. Two patients had multiple intracranial Hydatid cysts. The commonest location was in the parietal lobe (21 cases). Recurrence was seen in two cases as a result of rapture of the cyst during the first surgery, in other two cases secondary infestation was seen after 1st operation 9-12 months.
Conclusion: Infection acquired in early life and symptoms usually appear later. (mebendazole) is used as prophylaxis. Pathologically there is no calcification of all cysts. radiologically pressure effect is not associated with edema. Big size lead to shift of the brain to the opposite side
Keywords: Hydatid cyst, E. granulosus, mebendazole, headache, brain.
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Background and objective: The objectives of the study research were to determine the relationship between clinical and chest X-ray findings of pediatric patients.
Methods: A Prospective clinical study carried out at Raparin hospital in Erbil city, Iraq. A sample of 356 children admitted between Decembers 2004 and June 2005 from emergency ward and inwards in Raparin hospital were collected with age range from 2 months to 10 years with mean age of 19 months. All children had chest radiography on the bases of clinical decision by pediatricians. Descriptive and statistical procedures were used to analyze the data.
Results: All children had signs and symptoms of respiratory infections for instance, fever (87.4%), shortness of breath (99.5 %),cough (98%), tachypnea (73.5%), wheezes (93.3% ), chest retraction (80%), crepitations (82%) and, 42.4% of chest X-rays showed focal infiltrations. Three clinical parameters related to pneumonia diagnosed by chest X-ray these were, chest retraction with sensitivity of 80%, and specificity of 88.29%), tachypnea with sensitivity of 73.5% and specificity of 56.59% fever with sensitivity of 87.42% and specificity of 60.98%.
Conclusion: Tachypnea, chest retraction and fever were found to be highly suggestive of pneumonia, chest x-rays was positive in about 425 of patients with pneumonia.
Keywords: pneumonia, chest-X-ray.
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