د.قاسم محمد هاشم الغالبي

Background: There are many illnesses having their base in the early periods of life, one of them are the alterations that occurs in the system and the function of the blood vessels which eventually will lead to atherosclerosis and arterial hypertension. Objective: In this research, we established the effects of tobacco smoke on blood pressure of elementary school children in al-Najaf governorate, Al-manathera town. Methods: A case control study we evaluated the blood pressure for 336 males (144 were exposed and 192 not exposed to cigarette smoking) and for 345 females (149 were exposed and 196 non exposed to cigarette smoking) from September 2016 to February 2017. A questioner was given to the pupils, after recording the weight and height, to be finished d by the parents. After full exam we removed children with acute and chronic diseases and those taking drugs, we calculated and correlate blood pressure in the exposed and non-exposed grouping. Informations were analyzed by applying independent t test by SPSS version 21. Values are revealed as mean ± SD. Results: The mean diastolic and systolic blood pressure of the exposed groups were greater than those of not-exposed groups (108.06 (4.65), 64.88 (3.79), 106.01 (4.17), 63.25 (3.37), respectively, CI: 0.95, P<0.01). Conclusion: Our study indicates that elementary school children who were exposed to passive tobacco smoking have higher systolic and diastolic blood pressures when matches to children who were not exposed.

Background: Jaundice is most frequent situations requiring medical attention in neonate (involvev 60% full-term infants and 80% preterm infants in the 1st week after birth). Neonatal jaundice is the most frequent cause for hospital admission in the first 2 weeks of life. Light therapy is one of ordinary approach to treat hyperbilirubinemi. Phototherapy plays a signifying part in treatment and prevention of hyperbilirubinemia. However, this treatment form may lead to development of some complications such as induction of hypocalcemia. Objective: The goal of research is to estimate the outcome of light therapy on serum calcium in neoborne with hyperbilirubinemia who undergo phtotherapy and to find the relation between effect of phototherapy on serum calcium and gender, mode of delivery and type of feeding. Methods: Across sectional study was conducted at neonatal care unit at AlZahraa teaching hospital from January 2017 to December 2017. This study was conducted on 62 neonates (37 male and 25 female) with neonatal hyperbilirubinemia admmited in newborn nursery of either gender managed by phototherapy entered in this study, calcium level evaluated before and 48 hours after light therapy for all neonate under phototherapy and the tow values were compared. Results: There was statistically important decline of serum calcium and bilirubin after phototherapy as compared with serum calcium and bilirubin levels before phototherapy in this study (P<0.001). Four neonates evolved hypocalcemia (sr.Ca<8 mg/dl) no one had symptoms. There was no expressive corporation between decline serum calcium level and gender, mode of delivery and type of feeding. Conclusion: There is significant decrease in serum calcium after light therapy but risk of hypocalcemia is low in healthy babies. No expressive corporation founds between decline in serum calcium and gender, mode of delivery and type of feeding.

Background: Meningitis is one of dangerous disease in children and the differentiation between acute bacterial and non- bacterial meningitis (particularly viral meningitis) is so important because they differ in their prognosis and treatment. CSF culture and gram stain is ideal for diagnosis but it is coasty and time consuming,so looking for biological markers like CSF-CRP to simplify the accuracy of initial diagnosis of acute meningitis. Objective: To find out the significance of CSF-CRP in patients with bacterial meningitis. Methods: Cross sectional study performed in Babylon teaching hospital on 45 clinically suspected meningitis patients were evaluated for Serum CBC, CRP, Lumbar puncture and CSF examination. Immediately after hospital admission, lumbar puncture and Cerebrospinal Fluid (CSF) examination (bacteriological, cytological and chemical) were done for all patients. Results: CSF-CRP level was remarkably increased in bacterial meningitis (mean 6.59 ± 5.81 mg/l) in comparison with non-bacterial meningitis (mean 1.14 ± 2.36 mg/l), (p<0.001). There are positive relations with WBC and CRP in non-bacterial and bacterial meningitis but this correlation become greatly significant with bacterial meningitis positive groups. Conclusion: This study shows that CSF-CRP can be used for early diagnosis of bacterial meningitis and may be a helpful association in differentiation bacterial and non-bacterial meningitis with CBC and serum CR

Thalassemia is commonest hereditary anemia, Iraq is among countries with highest prevalence of major thalassemia, thalassemia patients have poor growth and delayed maturation mainly due to iron overload but zinc deficiency also has been suggested as a contributing factor

Abstract: Background: Beta thalassemia major is a common clinical problem we are facing it in our country, present transfusion protocols have increased the life expectancy of patient with beta thalassemia major, but iron overload is a major clinical complication of the treatment. Aim of the Study: This study is to determine the prevalence of diabetes mellitus and association of some factors with impaired glucose tolerance test in transfusion dependent beta thalassemia major. Patients and Methods: A case control study was done on a randomized group of patient with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in AL–Zahraa Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf, during a period from 15 of January 2016 to 1st of May 2016. According to inclusion and exclusion criteria, a total number of 50 thalassemic patients included in this study all of them on blood transfusion as part of their treatment. And 50 patient control are healthy children chosen from visits to schools, with same age. Consent was obtained from the patients’ first-degree relatives (mother or father) these patients were also informed that the results of the study would be provided to them as free useful laboratory tests. The patients were diagnosed with beta thalassemia major as recorded in their files( by Hemoglobin electrophoresis). The patients name, age, gender, time of first blood transfusion ,number of blood transfusion , time of starting of chelation treatment, period of chelation therapy, history of previous splenectomy ,hepatitis state, and family history of diabetes mellitus was taken and relevant systemic examination was done. Patient suffering from any acute illness, liver disease and previously diagnosed case of diabetes mellitus, were excluded, we define impaired Oral glucose tolerance according to World Health Organization. Results: There was Statistically significant association of Diabetes and glucose intolerance in thalasemic children ( p- value<0.001), and significant association with higher age ( p-value<0.001) and with low Hemoglobin (p-value<0.001 ) with prevalence of Diabetes and glucose intolerance in thalassemic children. Conclusion: The study showed increasing incidence of Diabetes mellitus and glucose intolerance in thalassemia children and this probability increases with low Hemoglobin and higher age.

Abstract Background: Skeletal changes and bone complications in patients with beta thalassemia major are common and risky. We aim in this study to early detection of low bone density in children with thalassemia major thus overcome any asymptomatic skeletal changes and pathological fractures. The methods : this study is a cross sectional conducted in the center of hereditary blood disorders in alzahra teaching hospital for the period between 1st of October 2011 to end of November 2012. Fifty, randomly selected (selecting one patients every five of them) beta thalassemia major patients from a total of ( 685 patients) registered in the centre were evaluated for bone marrow densitometry ( BMD). Patients were classified according to their ages in 3 main groups , group A ( 2 – 5 yr) , group B ( 6 – 10 yr) and group C ( 11 – 15 yr ) . Dual energy x-ray absorptiometry ( DEXA) was performed in lumbar regions of those patients . The Z-scores were measured from bone density values according to age and gender. The Z score less than -2.5 was taken as cut off value for osteoporosis, and between -1 and -2.5 as osteopenia. Biochemical and hormonal parameters were recorded and analyzed . Results : The patient age mean was ( 15 ± 5.5 years ) and BMD mean of spine was ( - 2.6500 +/- 0.9 ). Mean Hb. Was ( 9.01g/dl) . All groups of patients with high serum Ferritin level , and (10 %) with hypocalcemia , (26%) had hypophosphatemia , (38 % ) with high alkaline phosphates enzyme level. BMD was low in all patients of groups C ( 100% ) , (77.78 %) of group B and (52.63 %) of group A ( p = 0.048 ) , there is a significant relation between high levels of serum ferritin and BMD ( p = 0.0046 ) While there is no significant relation between S.Ca , S.Ph. , S.ALP level and BMD . Conclusion: present study show that patient of beta thalassemia major may show evidence of low BMD even in younger age group , and those with no clear clinical presentation of bone disease .

نظرا لوجود محاضرات متزامنه لهذا اليوم الخميس 9/3 في انعاش الطفل تقرر تاجيل المحاضرة الى يوم الاثنين 13/3 شاكرين لكم ذلك

يوم الاحد 3/10 عطلة رسميه بمناسبة يوم الدولة العراقية تؤجل مادة الفحص والتدريب العملي الى يوم اخر يحدد في موعد لاحق