نقدم حالة من الحمل التوأم ثنائي الكيس ثنائي الجنين حيث يكون احد الاجنة طبيعيًا مع المشيمة الطبيعية ، ويكون الجنين الآخر طبيعيًا مع المشيمة العنقودية الجزئية.

كانت المريضة تبلغ من العمر 31 عامًا عندما قدمت إلى المستشفى المركزي الخاص ، وكان عمر الحمل 22 أسبوعًا و 5 أيام مع إجراء التلقيح الاصطناعي (بعد 10 سنوات من العقم) كانت المريضة تعاني من تقلصات الرحم و نزف مهبلي منذ 8 أسابيع من الحمل.

تم إجراء جميع التح

Background: The neonatal deaths account for two-third of all deaths in the first year of life, and 40% of under-five mortality. Extreme prematurity, respiratory distress syndrome , neonatal infections , and congenital malformations are among the common causes of neonatal deaths.
Methods: We retrospectively studied 668 neonates who died over 5 years period from first of Jan. 2000 to the end of Dec. 2004 in neonatal care unit of children Welfare Teaching Hospital-medical city, by obtaining data from reviewing their medical records and death certificates.
Results: The death rate in neonates admitted to SCBU (special Care baby Unit) during the period of study was (10.7%), male constituted 432 (64.7%) and female

Case Report: Common bile duct perforation has been reported in adults after invasive procedures, spontaneous common bile duct perforation is a rare entity as a cute abdomen in adults. A few cases due to choledocholithiasis have been reported as a cause of spontaneous perforation. We report an adult patient who presented with acute abdomen after spontaneous common bile duct perforation due to unknown etiology who was treated successfully.

خلفية: التسرطن القولون والمستقيم الإنسان هي عملية معقدة، عملية متعددة الخطوات وmultigenetic. مصفوفة الفلزي-2 و 2-انزيمات الأكسدة الحلقية هي انزيم رئيسي في تدهور المواد خارج الخلية، وأعرب أكثر من ظهائر في عدة مثل غدية القولون والمستقيم.

الأهداف: تم تصميم هذه الدراسة للكشف عن التعبير عن مصفوفة الفلزي-2 و 2-انزيمات الأكسدة الحلقية في المرضى الذين يعانون من سرطان القولون والمستقيم والعلاق

الخلفية :- دراسة نخاع العظم لازالت هي النقطه الاساسيه التي تعكس فعالية ونشاط نظام بناء الخلايا الدمويه, الامراض الدمويه وبعض الامراض العامه في جسم الانسان.

ان من الصعب اعطاء التشخيص النهائي لامراض الخلل النخاعي المتشعب لحد الان بسبب تشابه المؤشرات والخواص الطبيه بالاضافه الى النسيجيه مثل تليف نخاع العظم والذي يعتبر مهما لانه يؤثر بشكل من الاشكال على نشاط نخاع العظم.

Background: Rheumatoid arthritis (RA) is a chronic and debilitating autoimmune disease characterized by chronic inflammation with subsequent cartilage and bone destruction. Cytokines are  key mediators of inflammation and can be found in abundance both in the joint and blood of patients. This study was designed to evaluate the role of pro- and anti-inflammatory cytokines in pathogenesis of RA, as well as study the correlation among these cytokines.
Patients and methods: Forty patients with RA and thirty age-matched healthy controls were included in this study. Serum cytokines were measured by enzyme-linked immunosorbent assay.
Results: The serum levels of pro-inflammatory cytokines (IL-1α, IL-2, IL-6, IL-8

Back ground: Anaemia is one of commonest health problems in antenatal care units of developing countries and contributes significantly to increased maternal and fetal morbidity and mortality.
Patients and methods: During the period from 1st of July 2007 to the end of October 2007, hundred anaemic pregnant women attending the gynaecology and obstetrics department in Al- Yarmook teaching hospital in Baghdad and 20 apparently healthy pregnant women,aged between 17 - 46 years as a control were included in this study. Anaemic women included in this study fulfilled the criteria of haemoglobin concentration of less than 110 g/L in first trimester and 105g/L in the second and third trimesters, no history of acute

Background: Patient evaluation of the healthcare provided by his/her family doctor is a multidimensional concept, its main component being the doctor-patient interaction.
Materials and Methods: a total of 200 client chosen by systematic random sampling were successfully interviewed immediately after having the contact with the family physician in the family medicine center.
Results: The present study showed that the majority of the clients were young age, most of them were female, completed secondary education and the majorities were unemployed. This study determined the client general satisfaction the services provided by the physician the overall satisfaction was high (98%), the most significant stat

Background: IL-4 is an antibodies inflammatory cytokine which has an important role in protecting against the inflammatory reactions in most of diseases. Here, we try to highlights the role of this cytokine in chronic Rheumatic heart disease and its correlation with the extent of histopathological abnormalities.
Patients and Methods: Rheumatic mitral valve surgical fragments were taken from a total of 48 Iraqi patients with chronic rheumatic heart disease under mitral valve replacement surgery in Ibn Al- Bitar Hospital for Cardiac Surgery-Iraq-Baghdad. Paraffin embedded mitral valve tissue sections were prepared. IL-4-expressing cells were detected by using immunohistochemical staining technique and

Background: In Ulcerative colitis (UC), the presence of a persistently elevated number of T cells in the inflamed area with respect to the activity of the disease suggesting bad prognosis. This study was done to evaluate cellular immune response in different disease activity patterns and its possible implication in evaluation of disease activity.
Materials and methods: This study included Forty seven archived paraffin-embedded samples of ulcerative colitis; these samples diagnosed and graded for disease activity. Then dual
immunofluorescence staining was used for phenotyping of lymphocytic infiltrate (CD3- CD19) and (CD4-CD8). A total and differential T cell as well as plasma cell count was recorded in thes

Background: The hepatitis G virus( HGV), also called hepatitis GB virus, as a member of the Flaviviridae family distantly related to hepatitis C virus (HCV), Little is known about the frequency of HGV infection, the nature of the illness, or how to prevent it. What is known is that transfused blood containing HGV has caused some cases of hepatitis. They infect humans, but are not known to cause human disease. This virus can be transmitted efficiently by blood transfusion and by other parenteral mechanisms. Transient and long lasting infections with HGV have been documented in man.
Patients and methods: HBs Ag, Anti-HCV IgG and Anti-HGV IgG were detected by Enzyme-Linked Immunosorbent Assay (ELISA).HCV RNA

Background: Several studies were carried out on association of infection with male infertility, which revealed great variations in the prevalence of genital infection in different parts of the world. This work was designed to study the effect of infection on semen parameters in a sample of Iraqi infertile males.
Methods: A sample of 400 infertile male patients attending the High Institute for Embryo Research and Infertility Treatment for laboratory investigations and treatment were selected. This study was carried out during the period Nov. 2002 to April 2003, inclusive. Seminal fluid analysis was performed on samples obtained by masturbation into a glass container after 48 to 72 hours from of abstinence from&

Background: Open access gastroduodenoscopy allows general practitioners to request gastroduodenoscopy without prior referral to a specialist. Endoscopy of the upper gastrointestinal tract in experienced hands has definite advantages over conventional barium-meal examination.
Patients and Methods: A total of 266 patients who were referred directly from general practitioner or a specialist attending for esophagogastroduodenoscopy (EGD) to the Endoscopy Unit At Al-Kindi Teaching Hospital from September- 2008 to Feb-2010 as an open access policy. Six inclusion criteria were used to include patients in our study group , while 136 patients had underwent EGD were referred from outpatient clinics of the hospital

CT scan features of Malignant Meningioma
Objective: Meningioma which is a common benign Brain tumor can be malignant, but the final decision is by biopsy. However CT. Scan features can help to evaluate malignancy of a lesion.

The aim of this retrospective study is to look for the malignant features of a malignant meningioma .
Patients and Methods: This is a retrospective study of 50 malignant meningiomas in the neurosurgical unit in the specialized surgical hospital (previously AL-Shaheed Adnan hospital), for the period from March 1992 to March 2007. We search specially for Malignant features on the CT scan study of the patients.
Results: 94%of the patients had different features of malignant men

Background: laparoscopic cholecystectomy is standard treatment in gallbladder disease. Acute cholecystitis has been relative contraindication of laparoscopic cholecystectomy. With the
accumulation of experience in laparoscopic surgery, laparoscopic cholecystectomy is being gradually applied for the treatment of acute cholecystitis
Objective: to evaluate and compare the outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion, need for special modifications of the operative technique, and hospital stay.
Methods: A prospective study done Between April 2007 and January 2010, in the department of general surgery, medical city teac

Background: Bone healing of fractures is still an open field for research due to its biological complexity. Adequately adapted experimental model is essential for understanding the factors
influencing the biological process of bone healing. Rabbits provide a good animal model for bone healing studies; its bone had Haversian system similar to human.
Material and Methods: Six young locally breaded New Zeeland male rabbits were used in this study, the study conducted in animal house in college of medicine at November and December 2009. Surgical fracture (osteotomy) induced operatively in right ulna under general anesthesia by a hand saw. At the end of fifth weeks, the animals' scarified and the specimens taken

Background: foreign bodies Inhalation still a common problem in Iraq, occurring in both lay and professional segments of our society. Their successful removal is based on a collected experience of our thoracic surgical teams.
Patients&Methods: A prospective study of two hundred forty eight patients referred to the department of thoracic surgery of the surgical subspecialties hospital of the medical city teaching complex during the year (2007) due to witnessed or suspicion of foreign body inhalation. Patients were grouped into group 1 with definite history of foreign body inhalation and group 2 with no such history.
Results: In group 1, out of 203(81.85%) patients, about 169(83.25%) patients were pr

Background: Diabetes mellitus is a well known risk factor for acute coronary syndrome but the hypothesis that patients with acute phase hyperglycemia, regardless the previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. This paper aims to estimate the prevalence of admission hyperglycemia, its effect on in-hospital prognosis of diabetic and non-diabetic patients with acute coronary syndrome, and to compare it with 2nd day fasting plasma glucose as a prognostic marker.
Methods: One hundred patients, (59) diabetic and (41) non-diabetic, with documented acute coronary syndrome enrolled in this study over the period of June/ 2009-Jan./2010 from coronary c

Background: Congenital defects in continuity of the intestine are morphologically divided into either stenosis or atresia and constitute one of the most common causes of neonatal intestinal obstruction. 
Patients and methods: This is a prospective study for analyzing (60)neonates with jejunoileal atresia who were managed at Children Welfare Teaching Hospital in Baghdad over a three years peroid extending from 1st January 2004 to 1st January 2007.
Results: Thirty six patients (60%) had jejunal atresia while ileal atresia was in(24) patients(40%).The most common type of jejunoileal atresia was type IIIa (38.3%) of the cases and the second was the type II (25%).The clinical presentation for jejunal atresi

Background: Transitional cell carcinomas (TCC) of the bladder are a major health problem. Recently, some studies link high risk Human papilloma viruses' type 16 and type 18 with bladder carcinoma.
Materials and methods: Fifty formalin fixed, paraffin embedded tissues with TCC of the bladder from Specialized Surgical Hospital in Baghdad were included in this study. In addition, ten
apparently normal bladder autopsies were collected from the Forensic Medicine Institute Archives and used as control group. Tissue blocks were sectioned and sticked on charged slides and used for the detection of HPV-16 and HPV-18.
Results: The expression of HPV-16 and HPV-18 DNA signals in TCC of the bladder tissues in the&nbs

Background: In breast carcinoma, amplification &/or over-expression of HER-2/neu has been associated with a group of unfavorable prognostic factors. The Food & Drug Administration Agency approved Trastuzumab (Herceptin) for the therapy of metastatic breast cancer but only in patients with amplification &/or over-expression of this gene. Because of these advances, evaluation of HER-2/neu status in breast cancer specimens is of vital importance.
Patients and methods: thirty eight females with breast carcinoma were included in this study. All histologic sections were stained routinely with the hematoxylin and eosin stains and
immunohistochemically for HER2/neu. All cancers were graded and subcatego

Background: Many etiological factors have been implicated in the pathogenesis of Asthma like; viruses, bacteria and Chlamydia pneumoniae. This study focuses on the role of Chlamydia
pneumoniae in asthma pathogenesis.
Patients and Methods: The detection of Anti-Chlamydia pneumoniae antibodies IgA, IgM and IgG in patients by ELISA, for 35 patients, 18 asthmatic patients, 12 patients with chest infection with no history of asthma, and 5 apparently healthy as control subjects.
Results: The results showed that 80% and 70% of the patients were negative for anti- Chlamydia pneumonia antibodies IgA and IgM respectively, while significantly (p<0.05) high number (73%) of patients were positive for IgG, of which

Background: The periodic review conducted of acute bacterial meningitis in children younger than 5 years of age in Baghdad to reflect changes in the epidemiological pattern of this infection. 

Patients and Methods: Sixty patients with signs and symptoms suggestive of meningitis who were admitted to Central Teaching Hospital in Baghdad City were included in a prospective study started from the 1st October till the 30th of December 2009. By bacteriological study, biochemical and cytological study in the laboratory, WBCs in the blood with differential count was done to support the diagnosis of bacterial meningitis.
Results: Present study revealed that from (60) patients (6) cases (10.0 %) showed posi

Background: Birth trauma is defined as injury to neonates resulting from mechanical forces (such as compression or traction) during the process of birth. Birth injury is used to denote avoidable and unavoidable mechanical and hypoxic- ischemic injury incurred by neonates during labor and delivery. Maternal, labor and infant factors can predispose to birth traumas. Many types of birth traumas can be found including intra and extra cranial, spinal, peripheral nerves, fractures and visceral.
Patients and methods: A cross sectional study was done on 200 babies (100 babies for the study group and 100 babies for the control group), admitted to special care baby unit of Baghdad Teaching Hospital, during the peri

Background: penetrating foreign body is a common problem but penetration by screw driver is very uncommon
Patient & method: A nine years old boy presented with penetrating screw driver through the medial canthus of the eye.
Result: the foreign body removed under GA with good result.
Conclusion: minimal invasive procedure are preferred when we have penetrating head injury.

Background: intestinal anastomosis is one of the most commonly performed procedures it required to reestablish gastrointestinal continuity after surgical resection, traumatic disruption or bypass procedures. In last decade, advances in intestinal stapling devices have led to an increased frequency of stapled anastomosis. There are varieties of proposed benefit from a stapled technique: better blood supply, reduced tissue manipulation, less edema, uniformity of suture, adequate or perhaps wider lumen at the site of anastomosis, ease and rapidity.
Patient and methods: a prospective study was conducted on 103 patients who suffered from benign and malignant diseases in addition to trauma patients. They were d

Background: The plant (Khat) contains at least 40 types of alkaloids. It has an adrenergic like effect especially on the heart one of these alkaloid is cathedulins group which has molecular height of 600- 1200mm.I/L. it is used frequently mainly at the African horn region (e.g. yemen). This plant alkaloids used by people in form of bands (each band is about 50gm, two bands 100gm and so on).
Patients and methods: Three groups of Patients have been included in this study. Group A: (30) patients with dilated cardiomyopathy, Group B: (50) patients with history of ischemic heart disease with clinical presentation of ischemic cardiomyopathy and Group C: (80) cases (50 cases of ischemic cardiomyopathy, 30 cases

Background: Left ventricular hypertrophy and diastolic dysfunction are considered to be an important risk factor for cardiovascular morbidity and mortality in asymptomatic hypertensive
patients. At the bedside, left ventricular geometric remodeling and diastolic dysfunction in hypertension can not be diagnosed without echocardiography which is a useful adjunct to the medical history, physical examination, ECG, and chest radiography. Hence, it provides an opportunity for good management and prognosis of what appears to be preclinical hypertensive complication. 
Subjects and Methods: 127 subjects with essential hypertension of either sex attending echo unit were subjected to medical history, clinical exa

Background: Knowledge about the clinical problems during the fast of Ramadan is important in order to opens the way to further research aimed at discovering the significance of Ramadan fasting in patients with heart disease.
Patients and Methods: Eighty-six outpatients with heart disease with intention to fast were studied in the month of Ramadan 2010 (1430 H) at the Ibn Al-bitar Hospital. Detailed clinical and biochemical assessments were performed within 3 days before the start of Ramadan and then on the last day of Ramadan.
Results: There were 54 (62.8%) males and 32 (37.2%) females with a mean age of 56.3 years (range, 17-84 ). Forty-six patients (53%) had coronary artery disease, 23 patients (27%)

Background: Diabetes mellitus (DM) is a metabolic and vascular illness associated with two to four times coronary artery disease (CAD) events and mortality which correlate well with fasting, postprandial plasma glucose and HbA1c level. Other factors such as aging, gender, smoking, dyslipidaemia and hypertension also play an important role in diabetic micro- and macro-vascular complications. Type 2 DM is reported now to be CAD equivalent.
Patients and Methods: A cross sectional study of 118 patients including 90 males and 28 females being 63 diabetics and 55 non-diabetics over the period from March-November 2007 in Iraqi center for cardiac diseases who were underwent coronary angiographic study.
Results