The goal of current study is to compare visual inspection method of the cervix by using acetic acid sensitivity, specificity, positive and negative predictive values with Pap smear test values. This cross sectional study was obtained in Sulaimani city Kurdistan region at Maternity Teaching Hospital throughout the period (first September 2012) to (first February 2001). This study include 115 samples were reproductive women and premenopausal  between ages 20-50 years old with symptomatic women ( vaginal discharge, dyspareunia, post coital bleeding , intermenestrual bleeding ) and prepared patients for a Pap smear test done for them. The cervix was painted with 5% concentration of acetic fluid for visual inspection method and monitored for aceto-white wounds and biopsies were taken from suspected areas. After that, the samples in 95% concentration of the ethyl alcohol were fixed. The results shows that, 114 samples among all other samples were appropriate  for analyzing, statistical data analyzed by Epi Info software program and Chi-squared test used to find significance between variables with considering P-value less or lower than 0.05 as significant level. The result indicate that sensitivity rate was 16% for visual inspection method, specificity 71%, positive predictive value 3.13% and negative predictive value 93.9% to detect pre-cancerous lesion of the cervix. In conclusion, cervix visual inspection method for cancer had a low rate sensitivity compare with pap smear with a non-significant relationship between the two methods and Pap smear needed to conform visual inspection for cervical cancer.

Preeclampsia is a multisystem disorder characterized by gestational hypertension after the 20th week of gestation with proteinuria, is common and dangerous adverse event of pregnancy. Several studies reported relationship between uric acid concentrations and severity of disease in pregnant women. The objective of this study was to explore the relation between serum uric acid level and perinatal outcomes. A case–control study conducted in Sulaimani Maternity Teaching Hospital from January 2014 to July 2014. Included 100 pregnant women in third trimester with signs and symptoms of labour, who had no comorbid diseases. Grouped to 30 control without hypertension, 30 with pregnancy induced hypertension (PIH) and 40 with severe preeclampsia based on clinical and laboratory evaluation. SPSS v21 was used for obtain mean, standard deviation, frequency and percentage. One way ANOVA test used to obtain P value with consider <0.05 significant value. Results show serum uric acid mean and standard deviation (±SD) for control, PIH and severe preeclampsia groups were (5.83 ± 9.544), (4.35 ± 1.372) and (7.59 ± 0.508) respectively. The positive and significant (˂ 0.001) correlation coefficient was found between high serum uric acid level and oligohydramnios, low birth weight and low Apgar score. The highest level of serum uric acid was recorded in preeclampsia group and the lowest level was in PIH group. Significant and adverse perinatal outcomes relation were noted in the patients with high serum uric acid (>7 mg/dl); decreased amniotic fluid index (AFI), caused low birth weight and low Apgar score. In   conclusion that severity of illness in pregnant preeclampsia cases can be estimated by serum uric acid level and high serum uric acid indicate high risk cases. Maternal serum uric acid is a useful index for estimate fetal health status and predict neonate outcomes.

The present study was designed to investigate the probable hypoglycemic, antioxidant, anti-inflammatory, immuno-modulatory as well as anti-apoptotic protective capacities of bone marrow derived mesenchymal stem cells (BM-MSCs) in comparison with the standard insulin treatment in diabetic rats. Methods: Animals were divided into four groups; control group, STZdiabetic group (D), D+Insulin group and D+BM-MSCs group; and the study continued for four consecutive weeks. Results: Insulin as well as BM-MSCs administration significantly improved the hyperglycemic status resulting from diabetes induction; as evidenced by lowered blood glucose, HbA1c and AGEs levels, while enhanced serum insulin, C-peptide and HO-1 levels, compared to the diabetic group. Regarding oxidative stress and antioxidants, both insulin or BM-MSCs injection significantly attenuate the oxidative stress status resulting from diabetes induction, as evidenced by downregulating MDA, ROS and XO levels, accompanied by up-regulating the antioxidants' markers content as GSH, SOD, CAT, GST, TAC and HO-1 in different body tissues (Pancreas, Liver, Kidney and Heart) compared to the diabetic group. Also, treatment of diabetic rats with insulin or BM-MSCs significantly ameliorated the inflammatory disorders as indicated via markedly decreased serum inflammatory markers; such as CRP, TNF-α, TGF-β and CD 95; compared to the untreated diabetic rats. In addition, insulin or BM-MSCs therapy was found to suppress pancreatic auto-immunity resulting in an obvious pancreatic cells apoptosis arrest in diabetic rats; which was confirmed by declined pancreatic CD4 + , CD8 + , annexin V, P53 and caspase-3 levels accompanied by Bcl-2 level elevation; compared to the diabetic group. Comparing both treatments together, most of the measured parameters were reverted back to near normal levels after BM-MSCs treatment confirming its anti-diabetic potency, in addition to their tissue protective and regenerative capabilities.

Background: A standard obstetric analgesic should have a good analgesic effect without reducing the intensity of uterine contraction. The present study aimed to evaluate and compare the efficacy of intramuscular tramadol and pethidine on labor pain and duration. Material and Methods: A total of 170 multigravida women in active labor were randomly assigned to two identical groups, so that 85 pregnant women received pethidine (50mg/2ml) and 85 pregnant women received tramadol (100mg/2ml) intramuscularly. Results: The labor duration in the tramadol group was shorter than in the pethidine group. In 1st stage of labor, 64.7% of the participants in the tramadol group received the drug for 120±30 minutes, while 67.1% in the pethidine group received the drug for 180±30 minutes. In the 2nd stage, 44.7% of the participants in the tramadol group received the drug for 15±5 minutes, while 51.8% in the pethidine group received the drug for 25±5 minutes. The Visual Analog Scale (VAS) was used before, and 1 and 3 hours after drug administration. The pethidine group obtained a lower VAS mean score compared to those in the tramadol group at 1 hour after drug administration (4 vs 6; P≤.001). Moreover, there was a significant higher level of vomiting and dizziness among women in the pethidine group (29.4% vs 1.2%; P≤.001). Conclusion: Tramadol appears to lead to a shorter labor duration and cause lower maternal side-effects, although its analgesic efficacy was not as much as pethidine.

Background  Excessive gestational weight gain and gestational diabetes mellitus (GDM) significantly increase morbidity and mortality for both the mother and the fetus.  Objectives  To assess maternal weight gain at 28 weeks of gestation in women developing GDM compared with pregnant women without GDM. Patients and Methods This study is a case-control study of weight gain in pregnant women at 28 weeks of gestation. Data analysis of weight gain was obtained in 225 pregnant women (75 cases of GDM and 150 pregnant women without GDM-controls). Results Two hundred twenty-five women (GDM group of 75 women and 150 control pregnant women) were evaluated. Demographics characteristics of both groups (case-controls) were compatible. There was a significant difference between mean weight gain among GDM groups (17.36 ±2.89) in comparison to mean weight gain in controls groups (15.67± 2.34) giving a P-value =0.001. Furthermore, we subdivided the rate of weight gain into three categories: pregnant women who gained weight 0-10kg, 10-20, and above 20kg. There was a significant difference according to these categories, 25.3% of women with GDM had an increase of weight of more than 20 kg while only 7.3% of women without GDM increased their weight more than 20kg making P-value=0.001. Conclusion Weight gain is higher in women diagnosed with GDM at 28 weeks of gestation in comparison to women without GDM.