Study on prevalence of and influencing factors of mild cognitive impairment among elderly people in communities of Nanning / 中华疾病控制杂志

Objective To investigate the prevalence and influencing factors of mild cognitive impairment (MCI) among elderly people in communities of Nanning, so as to provide scientific basis for the formulation of MCI early intervention measures. Methods A total of sample of 3 000 elderly people aged 60 or above living in Nanning area were sampled out using the method of cluster random sampling from three communities in Nanning. The Beijing version of the montreal cognitive assessment (MOCA-BJ) was administered by face to face interview. Results 833 MCI patients were detected. The standardized prevalence rate of MCI was 27.27% by the age composition of the population in Nanning in 2010. Single factor analysis showed that there were significant differences(all P<0.05)in the prevalence of MCI in different groups by age, education, occupation, exercise time, sleep time, number of reading, community activities and housework. Multivariate analysis showed that old age, primary education level, occupation of farmer/migrant worker and enterprise personnel/worker were the risk factors of MCI, adequate sleep time, moderate exercise time and reading times were the protective factors of MCI (all P<0.05). Conclusions The prevalence rate of MCI is high among the elderly in Nanning. The elderly with advanced age, primary school education, occupation as farmer/peasant-worker and enterprise personnel/workerare at high risk of developing MCI. Effective measures should be taken as soon as possible to prevent the occurrence and development of MCI.

Phalangeal Osteosarcoma Mistaken for Tuberculosis: A Case Report

We report a 21-year old female patient who presented with an 18-month history of a swelling in the distal phalanx of her right little finger. Although the history, clinical features and MRI were suggestive of a benign tumour or a tuberculous lesion, the histo-pathological examination of the swelling was reported as a conventional osteosarcoma. Osteosarcoma of the hand is very rare. This article highlights the possibility of a seemingly benign lesion seen in a routine clinic could well turn out to be malignant, and the need to maintain a high index of suspicion

Mass gathering in Aqaba, Jordan, during Eid Al Adha, 2010

During the 5-day Eid Al Adha holiday, Aqaba is the site of one of the largest mass gatherings in Jordan. Public health concerns during this holiday included: food- and waterborne diseases, drowning, injuries by marine creatures, road traffic crashes, and pressure on emergency departments at hospitals. This cross-sectional study was carried out in Aqaba during the period 16-20 November 2010 and aimed to identify and prioritize the major public health risks and to overview the preparedness plans of the Health Directorate during previous Eid events in Aqaba. All related stakeholders participated in the study. An exploratory visit to Aqaba was made and an introductory workshop was conducted for participants. Relevant data were collected and compared with the figures for the week prior to the event. No food poisoning outbreaks were reported during the event. There was a 23% increase in emergency department attendance, a 33% increase in hospital admissions, and road traffic crashes increased by more than 300%. More males were affected than females

value of urine cytology in the diagnosis of bladder cancer Cytopathological correlation

To identify the value of urine cytology in the diagnosis of bladder cancer by comparing cytologic and histologic findings. This study was conducted from January to December 2012 at the Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. The laboratory database was retrospectively reviewed for all patients with a histopathological diagnosis of urothelial carcinoma [UC] between January 2007 and December 2011. Histopathological diagnosis was considered the gold standard, and urine cytology findings were correlated with the results of bladder biopsy. Biopsies with low- and high-grade lesions were considered positive. All data were analyzed using the Statistical Package for Social Sciences. We reviewed the results of 191 patients. Urine cytology results were positive for malignancy in 70 cases [36.6%] and negative in 19 [9.9%]. One hundred and two cases [53.4%] were considered suspicious for malignancy. Histopathological examination revealed that there were 82 cases [42.9%] of low-grade UC, and 64 cases [33.5%] of high-grade UC. Seven cases [3.7%] were positive for malignancies other than UC. For urine cytology, the overall sensitivity was 94.1%, and 26.3% specificity. The sensitivity of urine cytology for low-grade was 18.3%, and 51.3% for high-grade UC. The specificity for both grades was 26.3%. This study shows that sensitivity of urine cytology is higher in high-grade UC than in low-grade UC. The high sensitivity of urine cytology confirms that it is still a valuable tool in bladder cancer diagnosis

Oral Health Related Quality Of Life And Periodontal Status Of A Selected Malaysian Adult Population: A Pilot Study

Aim: To assess the oral health related quality of life(OHQoL) of a selected population of Malaysian adults andto compare the OHQoL by periodontal status. Material& Methods: This cross-sectional study comprises aconvenient sampling of fifty subjects from the PrimaryCare Unit, Faculty of Dentistry, University of Malaya.OHQoL was assessed using the Malaysian versionof Oral Health Impact Profile-14 (OHIP-14). Basicperiodontal examination (BPE) was performed on allsubjects to determine their periodontal status. Descriptivestatistics and bivariate analysis were performed. Results:Psychological discomfort, physical pain and psychologicaldisability domains were the most affected dimensions inthis population. Subjects with income levels >RM2,500had higher impacts on their OHQoL as compared to thosefrom other income levels (p0.05). Conclusion:Subjects with high income levels had high impacts ontheir OHQoL. Those with periodontitis experiencedhigher impacts on their OHQoL as compared to those whohad a healthy periodontium or gingivitis and affected awide range of domains of quality of life.

study on angiotensin converting enzyme gene insertion/deletion polymorphism and serum cortisol among a sample of egyptian patients with major depression disorder

Angiotensin-converting enzyme [ACE] is assumed to influence the activity of the hypothalamic-pituitary-adrenocortical [HPA] system, which shows hyperactivity in the majority of patients with major depression. The ACE gene, known to be associated with cardiovascular disorders, which in turn are accompanied with an increased susceptibility for depression, is therefore a promising candidate gene for effective disorders. However, the results are conflicting, with no reported studies on Egyptian depressed patients. This study aimed to assess ACE insertion / deletion [I/D] gene polymorphism among Egyptian depressed patients in order to clarify HPA system dysregulation, and to determine its possible association with severity of depression. This case/control study was conducted on 42 adult depressed patients, and 37 healthy controls were screened to detect genetic associations with unipolar major depression. Determination of ACE genotypes was performed for all subjects by real time PCR. Total serum cortisol levels were measured by ELISA. The frequencies of the DD, ID and II genotypes were 26.2%, 45.2%,and 28.2%, respectively among the cases, and 17.49%, 25.2%, and 56.41%3 respectively among the controls. Significant differences in ACE gefiotype distribution were observed between cases and controls [p - 0.0384]. Serum cortisol in patients show the highest value in the ID polymorphism while II polymorphism shows the lowest value of a.m. cortisol. Data illustrated a significant association of ID polymorphism with the more severity of illness. Our findings support that ACE gene I/D polymorphism and high D allele frequency are associated with depression, also hypercortisolimia is significantly higher in individuals with major depression compared to control among Egyptian adults. ACE gene polymorphism might provide a common link between developing depressive episode and dysfunctional HPA-axis

Histopathological pattern of ovarian neoplasms and their age distribution in the western region of Saudi Arabia

To identify the different histopathological types of ovarian neoplasms and their age distribution. This is a retrospective study were ovarian neoplasms received by the Pathology Department of King Abdulaziz University, Jeddah, Saudi Arabia between January 1995 and December 2010 were reviewed and their frequencies in different age groups were calculated. Out of 618 ovarian specimens studied, 382 [61.8%] were ovarian neoplasms while 38.2% were non-neoplastic functional cysts. Benign neoplasms [n=278; 72.8%] were more common than borderline [n=20; 5.2%] and malignant ones [n=84; 22%] in all age groups. Surface epithelial neoplasms were the most common [61%] followed by germ cell [28%], gender cord stromal [7.6%] and metastatic tumors [3.4%]. The most common benign neoplasm was serous cystadenoma [44.6%] and the most common malignant was serous cystadenocarcinoma [33.3%]. The most common ovarian neoplasm below the age of 20 years was surface epithelial tumors [n=24] followed by germ cell tumor [16 cases]. Benign neoplasms [n=213] were more common than malignant ones [n=42] in the age group from 20-51 years. Malignant ovarian neoplasms [35 out of the 71] were more common than benign [34 cases] in the age above 52. Benign ovarian neoplasms are more common than malignant ones. The most common benign ovarian neoplasm is serous cystadenoma and the commonest malignant neoplasm is serous cystadenocarcinoma. The prevalence of malignant ovarian neoplasms increases with increasing age

Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding

Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies. The present study aims to identify the pattern of histopathological diagnoses encountered in women of various age groups presenting with abnormal uterine bleeding. A retrospective age specific comparative analysis. Department of Pathology. Two thousand two hundred ninety-five endometrial samples from women presenting with abnormal uterine bleeding from January 1995 to June 2008 were retrieved and analyzed. The commonest histopathological diagnosis was secretory endometrium 571 [24.9%], followed by proliferative endometrium 498 [21.7%], endometrial polyp 227 [9.9%], disordered proliferative endometrium 200 [8.7%], simple cystic hyperplasia 160 [7%], chronic endometritis 134 [5.8%], inactive endometrium 126 [5.5%], atrophic endometrium 70 [3.1%], uterine malignancies 41 [1.8%], complex hyperplasia without atypia 33 [1.4%] and finally complex hyperplasia with atypia 15 [0.7%]. Two hundred twenty [9.6%] revealed no endometrial tissue and were considered insufficient for diagnosis. Uterine malignancies and complex hyperplasia with atypia were more common in the age group of 52 years and older, 3.3% and 1.2% respectively. The present study revealed that secretory and proliferative endometrium are the most common endometrial histopathological patterns identified in endometrial samples obtained for abnormal uterine bleeding in our region

Open renal approach: comparative analysis of sub-costal incision versus trans-costal incision with excision of 12[th] rib

To compare the outcome of sub-costal incision with trans-costal incision and 12[th] rib resection in the surgical approach for benign renal disease. It is a prospective, analytical, comparative study using randomized controlled trial [RCT], conducted at Fatima hospital-Baqai medical university [Karachi], from June 2005 to December 2008. In total 54 patients were enrolled in the study, who either underwent pyelolithotomy or nephrectomy via sub-costal [group A: 27 patients] or trans-costal incision [group B: 27 patients]. Incision time, duration of operation, postoperative pain, duration of hospital stay, and peroperative and postoperative complications were noted. Incision time and duration of operation were longer in group B patients [p-value 0.002 and 0.029 respectively]; pain perception was also markedly high in this group [p=0.001]. Total period to stay in hospital was marginally higher in group B [p=0.212]. Peroperative and postoperative complications were also slightly higher in group B patients [p-value 0.064 and 0.838 respectively]. Sub-costal renal approach provides adequate exposure, is quick, safe and less painful

Histopathological pattern of thyroid lesions in western region of Saudi Arabia

Partial or complete thyroidectomies are frequently encountered by the practicing pathologist and the possibility of neoplastic disease is of major concern in patients with thyroid nodules. Pathological evaluation of those specimens ranged from non-neoplasticlesion to highly aggressive malignancy. This study aimed to document the frequency of different patterns of thyroid diseases as presented to pathology departments at King Abdul-Aziz University Hospital [KAUH] and King Faisal Specialty Hospital and Research centre [KFSHRC] within the last twelve years. All specimens presented to pathology departments at KAUH [1997-2008] and KFSHRC [2000-2008] as thyroidectomies [partial or complete] were retrospectively reviewed and categorized according to their histological appearance. The total number of the studied cases was 845 cases. The age of the patients ranged between 9 and 93 years. One hundred seventy eight were males and 667 were female [male to female ratio; 1:3.7]. The reviewed cases were classically categorized into two main groups; Non-neoplastic [494; 58.5%] and Neoplastic [351; 41.5%]. The non-neoplastic group includes: Multinodular Goiter [311 cases; 36.8%], hashimoto/chronic lymphocytic thyroiditis [64 cases; 7.6%], single hyperplastic nodule [51 cases; 6%], Grave's disease [8 cases; 0.9%], miscellaneous [58 cases; 6.9%]. The neoplastic group includes benign category represented by "Adenomas" and includes 94 cases [11% of all cases, and 26.8% of neoplastic cases] and the malignant category includes 256 cases, representing 30.3% of all studied cases and 73% of the neoplastic category. Two hundred and nine cases [81.6% of malignant] were papillary carcinoma. Thyroid lesions are more common in Saudi female. The majority of the thyroid nodules in Saudi are non-neoplastic. Papillary carcinoma is the commonest type of thyroid cancer in Saudi society. Thyroid neoplasm is rare in Saudi children

Massive ascites as the primary clinical presentation in a postmenopausal woman with malignant ovarian steroid cell tumor, NOS [18 month follow up]

Steroid cell tumors, not otherwise specified [NOS] are rare, usually benign, ovarian sex Cord stromal tumors of the ovary presenting with virulization in middle age women [Average age: 43]. Rarely, these tumors occur in postmenopausal women and, even More rarely, show a malignant clinical behavior. Although excess androgen secretion with Virulization is usually the primary presenting symptoms, rarely patients with this tumour may Present primarily with ascites. A case of a 65-year-old woman with malignant steroid cell Tumor who primarily presented with [sudden onset of] massive ascites is reported. Aspects of presentation, pathologic findings and management are presented

Sterilization - an update

Sterilization refers to any process that effectively kills or eliminates transmissible agents [such as fungi, bacteria, viruses, spore forms etc.] from a surface, equipment, article of food or medication, or biological culture medium. Sterilization is the first and most important step in any dental procedure. There are different methods to sterilize the instruments but autoclaving is the recommended method, because almost all non-disposable dental items including UV light tip, plastic items, hand pieces, scalers, towels and even cotton rolls can easily be sterilized. This method is the easiest and cost effective. There are different models with printers; these printouts are very helpful for record keeping and in medico-legal cases. Different types of autoclaves e.g. type N, S and B are available in different designs. Dentists working in remote areas in non-industrialized countries may not be familiar with different types of autoclaves. This article describes various methods of sterilizations with advantages and drawbacks

Non insulinoma pancreatogenous hypoglycemia syndrome in a Saudi male

Nesidioblastosis is focal or diffuse islet hyperplasia leading to hyperinsulinism with subsequent hypoglycemia in the absence of insulinoma, usually described in neonates and infancy. We described the first adult case of nesidioblastosis in Saudi Arabia and the Gulf region. The diagnosis and treatment of the condition can be very difficult and challenging. Despite the fact that our patient responded initially to surgical treatment, his hypoglycemic symptoms occasionally recurred and needed adjunctive medical treatment. Although initially thought to affect only infants and children, cases of nesidioblastosis can affect adults and pose a diagnostic and therapeutic challenge to the clinicians

Pattern of abnormal Pap smears in developing countries: a report from a large referral hospital in Saudi Arabia using the revised 2001 Bethesda system

Reports describing the frequency and pattern of abnormal Pap smears in developing countries using the revised Bethesda system for Pap smear are few. We studied the pattern of cervical intraepithelial le- sions and carcinoma detected in Pap smears of Saudi females in the western region of Saudi Arabia using the revised system. All cervical Pap smears reported in the Department of Pathology of King Abdulaziz Medical City, Jeddah, from 1 January 1998 to 31 August 2005 were reclassified according to the revised system with age ranges identified. Of 5590 sufficient smears, 261 [5%] were identified as abnormal and were further classified as atypical squamous cells of undetermined significance [ASC-US] [103 cases, 40%], atypical squamous cells of high grade [6 cases, 2%], low-grade squamous intraepithelial lesions [LSIL] [56 cases, 22%], high-grade squamous intraepithelial lesions [HSIL] [31 cases, 12%], glandular cell abnormalities [30 cases, 11%] and invasive squa-mous cell carcinoma [21 cases, 9%]. The ASC-US/SIL ratio was 1.9%. Invasive adenocarcinoma accounted for 14 cases [4%] with a similar age range as invasive squamous cell carcinoma. Although this study showed a lower incidence and a wider age range of cervical epithelial cell abnormalities than others published internationally, the results emphasize the need for a well-organized cervical screening program supplemented by larger national studies on the pattern of cervical abnormalities in this country. The information provided in this study will encourage use of the Pap smear as a screening method for cervical cancer in developing countries

Hysterectomy: a clinicopathologic correlation

To study the most common pathologies identified in hysterectomy specimens and to correlate the findings with the clinical indications. Department of Pathology, King A. Aziz Medical City, Jeddah. All hysterectomy specimens in the period between January 2000 and December 2003 were retrieved and studied for the following variables: the primary clinical indication, the pathological diagnosis, the mode of surgery [abdominal versus vaginal] and the patient age. The total number of hysterectomy specimens received was 179. The patient's age ranged between 23-90 years with an average age of 49 years old. The most common clinical indication for hysterectomy was present and previous malignancies 50 [27.9%] including cases of therapeutic and follow up hysterectomies for gynecologic malignancies followed by uterine leiomyoma 44 [24.5%]. Other clinical indications included dysfunctional uterine bleeding 29 [16.2%], uterine prolapse 15 [8.3%], endometrial polyps 10 [5.5%], adenomyosis 5 [2.7%] and endometrial hyperplasia 6 [3.3%]. Emergency hysterectomy for post partum hemorrhage and placenta accreta 15 [8.3%]. Abdominal hysterectomy was the preferred approach [85.4%] for cases other than uterovaginal prolapse. The vaginal route was used in 13.4% of cases and two cases underwent laparoscopic hysterectomy. The most common pathology identified was leiomyoma 62 [34%], followed by adenomyosis in 33 [18.4%] and endometrial polyp in 24 [13.4%]. Changes consistent with uterovaginal prolapse accounted for 15 [8.3%]. Other less frequent pathologies identified included disordered proliferative endometrium, endometritis and simple hyperplasia, which was present in 12 [6.75]. The pathologic examination confirmed the clinical diagnosis in all cases of leiomyomas, adenomyosis and endometrial polyps. This study confirms previous international published data that benign pathologies are more common in hysterectomy specimens than their malignant counterparts and that the most common pathology identified in hysterectomy specimens is leiomyoma. The clinical and pathological correlation is 100% in cases of leiomyoma, adenomyosis and endometrial polyps

Osteomalacic Myopathy due to celiac disease

Celiac disease is a gluten-sensitive enteropathy characterized by malabsorption resulting from inflammatory injury to the mucosa of the small intestine. It is well known to be associated with a variety of neurological disorders including epilepsy, myopathy, neuropathy and ataxia. The nature of this association is unclear. Although osteomalacia secondary to vitamin D deficiency is a recognized complication of celiac disease, however, severe osteomalacic myopathy as the only presentation of celiac disease is extremely rare. We present 2 interesting cases of osteomalacic myopathy secondary to celiac disease, which were treated successfully with full recovery. An important and unique observation was the brisk reflexes noticed in both patients. The mechanism behind this phenomenon is not well understood. Work-up for celiac disease is warranted in any young patient that presents with myopathy

Frequency of benign and preinvasive breast diseases

The importance of benign proliferative and non-invasive breast lesions as a risk factor preceding the development of invasive mammary carcinoma is well established in the literature. The objective of this study is to estimate the magnitude of benign proliferative diseases as well as mammary intra-epithelial neoplasia in the Western region of the Kingdom of Saudi Arabia [KSA], in order to encourage nationwide breast cancer screening programs for early detection of the high risk proliferative and pre-invasive breast lesions. We reviewed histopathology records [reports and slides of selected cases] of 2129 breast cases including mastectomies and breast biopsies from January 1985 to December 2002 in King Abdul-Aziz University Hospital and King Khalid National Guard Hospital, Jeddah, KSA. All the cases and diagnosis are listed and reclassified using systematized nomenclature of medicine [SNOMED] coding system and then regrouped based on the associated risk factors of developing breast carcinoma. Two thousand one hundred and twenty-nine reports were reviewed and 2343 diagnosis were identified as some cases had more than one diagnosis. The total of benign diagnosis were 1504 after exclusion of malignant diagnosis [558], normal breast tissue, gynecomastia, and non-mammary tissue [281]. All diagnosis [1504] were reclassified based on anatomical prognostic indicators into non-proliferative [1283/1504], proliferative [140/1504], atypical hyperplasia [AH] [8/1504], and carcinoma in situ [CIS] [73/1504]. We compare our findings with the literature and we found that the percentage of benign non-proliferative diagnosis was 85.3% that is higher than the literature 69.7%. Proliferative diseases were 9.3% and atypical hyperplasia was 0.5%, which was lower than the literature 26.2% and 3.6%. On the other hand, CIS diagnosis was 4.9%, which is much higher than the reported literature 1.7%. The study findings could be explained on the basis of higher prevalence of benign breast lesions in our population, or it is related to the number of cases studied, or to the diagnostic criteria followed initially. These findings should encourage us to refine our diagnostic criteria of proliferative diseases, AH and CIS [mammary intraepithelial neoplasia [MIN]]. In addition, we strongly encourage a breast cancer screening program, nationwide

Effect of modifying dialysate calcium concentration on some cardiovascular parameters in haemodialysis [HD] patients

Haemodynamic instability with symptomatic hypotension remains one of the most important complications occuring during HD [20-30% of dialyses]. Calcium ions play a pivotal role in the contractile process of both vascular smooth muscle cells and cardiac myocytes as well as in the release of catecholamines from the synaptic clefts. It has been suggested that the increased clearance of catecholamines by HD may potentiate intradialytic hypotension and that changes in ionized calcium might play an important role in the cardiovascular response during HD. In the present work, we studied the effect of using different dialysate calcium concentrations on the patient serum ionized calcium levels, serum catecholamine levels, haemodynamic data, and echocardiographic parameters before and after HD. Twenty patients [12 males and 8 females], with CRF under chronic regular HD therapy were studied and ten healthy volunteers, matched in age and gender, served as a control group. Patients were dialysed using the standard [low-calcium, 2.5 mEq/L] dialysate for twelve sessions in four weeks, and were then subjected sequentially to the high-calcium [4 mEq/L] dialysate for another twelve sessions in four more weeks. After four weeks of low-calcium dialysis, serum ionized calcium levels showed mild, though statistically significant reduction compared to the predialysis levels. There was no significant change in plasma levels of catecholamines at the end of the four week period. On the other hand, changing to high-calcium dialysate for further four weeks resulted in a very significantly higher post-dialysis levels of ionized calcium compared to predialysis levels. Morever, there was highly significant increase in postdialysis noradrenaline compared to predialysis levels. Low-calcium dialysis resulted in significant reduction in SBP, DBP and mean BP. Regarding vascular reactivity parameters, there was a statistically significant increase in the mean heart rate [HR] and forearm vascular resistance [FVR], while venous tone [VT] was significantly lower in postdialysis compared to predialysis assessment. On the other hand, using high calcium dialysate resulted in minor changes in SBP, DBP, and MBP that did not reach statistical significance. Positive correlation existed between changes in ionized calcium and plasma noradrenaline levels after high-calcium dialysis. No significant changes has been found in the echocardiographic parameters in the pre and post-dialysis assessments, neither in the low-calcium nor in the high-calcium dialysis periods. In conclusion, our study demonstrated that, even in the haemodynamically stable patients, changes in plasma ionized calcium may have an important effect on the blood pressure response during HD. Using high-calcium dialysate solutions may help improving intradialytic hypotension which is the commonest complication occuring during HD

In vitro effect of different non-steroidal anti-inflammatory drungs on human polymorphonuclear leukocyte activity measured by luminol-dependent chemiluminescence of the whole blood

To define the well-known variability in the effects of non-steroidal anti-inflammatory drugs and to search for predictors of such variability using an in vitro model. Polymorphonuclear leukocyte activity was measured by luminol-dependent chemiluminescence of the whole blood using barium sulphate as a stimulator. Blood was taken from 40 apparently healthy volunteers [22 males and 18 females; their age ranged from 20-50 years]. Drugs [indomethacin 10ug/ml, aspirin 300ug/ml, ibuprofen 25ug/ml or diclofenac 8ug/ml] were added into the blood of each individual in vitro. The chemiluminescence was measured in a photon counting system. There was a marked inter and intra individual variation in the chemiluminescence response to the 4 non-steroidal anti-inflammatory drugs, added in vitro. The variation exhibited a continuous pattern. No statistically significant correlation was found between the in vitro effect of one non-steroidal anti-inflammatory drug and the other 3 drugs, nor between the effect of each drug and factors like age, sex, weight, height, packed cell volume, hemoglobin percentage and white blood cell count. Subjects with hemoglobin-AS type [number = 9] responded mainly by enhancement to indomethacin and diclofenac. When the number of subjects rather than the average net effect was compared according to blood groups, those with blood group A showed chemiluminescence responses towards enhancement with indomethacin and diclofenac and blood group O with aspirin. A consistent pattern of enhancement and inhibition was evident; enhancements and inhibitions by any 2 drugs involve a seemingly constant proportion of subjects. Luminol-dependent chemiluminescence responses of polymorphonuclear leukocyte activity could be a good in vitro model to study the variability in response to non-steroidal anti-inflammatory drugs. Characteristics of each individual are not able to predict the pattern of variability. Abnormal hemoglobin and the type of blood group seem to be an interesting area for research

effect of seasonal variations on the incidence of I.H.D.in Tikrit

To examine the effect of seasonal variations on the incidence of IHD in Tikrit. We performed a retrospective cohort study of 1084 patients aged 45-65 yeas old. Comulative of 2 year admitted to S.G.H. in Tikrit during the years [1988-1990] with IHD. The incidence of I.H.D. was higher in the winter's months [November, December, and January]. In contrast the spring's months [April and May] had a lower incidence of IHD. In summer time [June, July, August, and September] there is higher incidence of IHD than spring but lower than winter time