bluuebunny/crossref_metadata_2025 huggingface dataset:
Some maternal and neonatal factors affecting early and late neonatal sepsis
Authors: Wannas Abd Abdulaziz
Published: January 2024

Abstract

Background:

Neonatal sepsis categorized as early and late onset. Early neonatal sepsis (ENS)  in the first 7 days of life with 85% occurs in the first 24 hours of life. Late neonatal sepsis  (LNS )occurs after the first week of life and is acquired from care giving environment.

Aims of study:

To explain the effect of some maternal and neonatal factors on early and late neonatal sepsis, like premature rupture of membranes, midwife interference and prematurity. With change in blood investigations, like effect of antibiotics on the results of blood cultures.

Methods:

We prepared a questionnaire about the name ,age in days, gender with perinatal and maternal history and take blood samples for CBC and differential, blood culture, CRP and ESR to explain the effect of neonatal sepsis on the blood investigation results and identify the specific pathogen causing neonatal sepsis by blood culture.

Results:

We found that the neonate is more susceptible to ENS in comparison to LNS. Also we found that the blood culture result highly affecting by antibiotics used before culture. The mortality rate is more in ENS in comparison to late type.

There was no significant difference in gender, maternal fever and antenatal care, between ENS and LNS groups. Prematurity was higher in ENS group compared to LNS group (44.7%, vs. 29%) respectively; and the difference was significant (p = 0.042). Mode of delivery showed no effect in ENS group (NVD = C/S = 50%); while it seems to be more effective in LNS group as (74.2% vs 25.8%) of patients are C/S, (p = 0.003).Only (13.2%) of ENS subjects were home delivery , while (25.8%) of LNS subjects were home delivery, (p = 0.048). Midwife interference was more effective in LNS subjects than ENS subjects, (35.5%, vs. 18.4%) respectively, (p = 0.019).Premature rupture of membrane was significantly more frequent in ENS subjects than LNS subjects (31.6% vs. 16.1%) respectively, (p = 0.028).Death was more frequent in ENS subjects than LNS subjects; (18.4%, vs. 3.2%) respectively .

Conclusion and Recommendation:

We found that  the premature neonate more susceptible for neonatal sepsis than full term with premature rapture of membrane more frequently affecting ENS in comparison to late type. we found also that the C-reactive protien and platelets count had high sensitivity to the diagnosis of neonatal sepsis.We recommend antenatal care especially in the third trimester and use of antibiotic prophylaxis if there is a history of leaking liquor and avoid prematurity because premature neonates are more prone to early neonatal sepsis. Antibiotics should be avoided before blood culture aspiration to avoid false negative results.
Effects of the prednisolone and hydrocortisone on the body weight of the pregnant rats and their embryo in the different stages of pregnancy
Authors: Dhahir latif Al-Hussainy Ahmed , Kareem Khalaf Taif
Published: January 2024

The aim of the study was to investigate the effects of prednisolone and hydrocortisone on the body weight of the pregnant rats and their embryos after treatment with the drugs during pregnancy.Materials and Methods: Thirty six adult female pregnant rats were randomly divided into three groups: Grop-1: control group C. (n = 12) received Distilled water 1 ml /kg b.w./day/intramuscularly for 14 days. Group-2: first treatment T1. (n=12) treated with prednisolone 4mg/kg b.w/day/intramuscularly for 14 days . Group-3: second treatment T2.(n=12) treated with hydrocortisone 40mg/kg b.w/day/ intramuscularly for 14 days.The body weight of the pregnant rats and their embryo detected at the day 15th and 20th of the gestation (developmental stage of rat embryo=E). At the detected period for taking the body weight of the pregnant rats and six animals from each group were sacrificed and taken the body weight of embryo with and without placenta.Results: the results showed that prednisolone decrease the body weight of the pregnant rats and its embryo more than hydrocortisone, and may cause absorption for percentage of embryo.Conclusion: prednisolone and hydrocortisone causes low body weight in the pregnant rats and its embryo when used for 14 days intramuscularly.
Incidence Rate of Musculoskeletal Congenital Anomalies of Neonates in Muthanna Province From 1/1/2008 to 1/1/2009
Authors: Taha Hassan Al-Azzawi Ali
Published: January 2024

The aim of this study is to know the incidence rate of musculoskeletal congenital anomalies in Muthanna province at the period of 1/1/2008 to 1/1/2009 . The study compromised ( 218 ) live birth neonates ( 1 day â€“ 1 year ) of musculoskeletal congenital anomalies at Hussein Teaching and obstetric and pediatric teaching hospitals . The overall incidence of various types of musculoskeletal congenital anomalies was ( 0.7 %) ( 7 per 1000) , and this is high incidence in comparison with the other countries .The fertility rate was ( 47 % ) and this is a good rate .The study showed high incidence of musculoskeletal congenital anomalies in Samawa city than Rumaitha and Khidher cities . The study revealed ( 35 ) cases due to chicken pox and German Rubella , ( 28 ) cases due to toxoplasmosis , ( 25 ) cases due to diabetes mellitus , ( 2 ) cases associated with the epilepsy and ( 2 ) cases due to thyroid diseases . The mothers were interviewed regarding the age , family history , consanguinity , parity , maturity of fetus , history of maternal disease , history of exposure to ionizing radiation or chemical agent and use of folic acid . The neonate was examined and sent for some investigations ( e.g. radiograph , ultrasound , computerized tomographic scan and some lab. Investigations ) .
Pathological Study of Cutaneous Leishmaniasis in Al-Diwaniya province
Authors: A. Dawood Khairy , F.  Al-Jeboori Al-muâ€™tasimbellah
Published: January 2024

In the present study, 42 patients were observed, as cutaneous leishmaniasis, from 1 September 2012 until the end of August 2013. They divided to 25 (595. %) males and 17 (40.5%) females, and the diagnosis was depend on clinical examination, pathological lesions and parasitic isolation. Lesions were classified depending on number, so the patients who have multiple lesions were (64.3%), while (35.7%) have single lesion, the number of lesions per patient ranged from one to 12 lesions. Most of the lesions were located on face (40.5%), but some lesions were on the face & hand   (21.4%), while few were found in hand and back (2.4%).  Histopathologicaly, the cutaneous lesions were observed; keratinized layer and epidermal cells were necrosed or not present over the ulcer, Skin biopsies were taken, fixed with formalin, sectioned, and stained with hematoxyline and eosin stain (H & E stain). Microscopic examination, showed accumulation of amastigote, inflammatory cells such as neutrophils and lymphocytes with macrophages engulf amastigotes. Eleven samples of aspirated blood were collected by fine needle, for making direct Giemsa-stained smears before the cultivation, 72.7% of the cases were positive to the presence of leishmania tropica. There are three culture media were used in this study, biphasic medium, NNN medium, and lockâ€™s solution; 63.4% of cases were positive in NNN medium, and 72.7 % were positive in both of biphasic media and Lockâ€™s solution.
Musculoskeletal biopsy (Bone and soft tissue lesions) referred by orthopedic unit in Al-Diwaniyiah teaching hospital
Authors: Jawad Kadhim Al-Shaibany Raad , Wali Ali Thair
Published: January 2024

Objectives. To study the frequency and type of bone and soft tissue lesions referred by orthopedic unit in Al-Deewaniyiah teaching Hospital.

Patients materials and methods. The surgical pathology reports of 86 patients presented with bony and soft tissue lesions were studied. Those records belong to the period extending from January 2014 through December 2014. Histopathologic features were reviewed and classification was made.

Results. Lesions referred by orthopedic unit represented about 5% out of all surgical biopsies received by the surgical pathology unit of Al-Deewaniyah teaching hospital. Bony lesions represented 25.5% of lesions while soft tissue lesions represented 74.5% of lesions. There was apparent association between type of lesion and age of the patients. There was no significant association between type of lesion and gender of patients.

Conclusion. Bony and soft tissue lesions represent a minor fraction of surgical specimens examined by surgical pathology unit and most of these lesions are benign
Assessment of C3 and C4 component of complement system in aborted women infected with Toxoplasma gondii
Authors: Fadhil al kalaby Rana , A. Sultan Baqur , N. AL-Fatlawi Sabah
Published: January 2024

Background: The complement system consists of more than 30 proteins that are either present as soluble proteins in the blood or present as membrane-associated proteins. Inappropriate complement activation and complement deficiencies are the underlying cause of the pathophysiology of many diseases.Methods: A case-control study was conducted to asses role of complement system during toxoplasmosis in Najaf province. Thirty five sera of infected women with toxoplasmosis by investigation antibody against toxoplasmosis for IgG and IgM by ELISA technique were tested to determine the levels of C3 and C4 by using single radial immunodiffusion technique and compared with the ten of control sera of non infected subjects and non-aborted.Results: The high C3 in significant differences(P<0.05) and C4 with no significant differences(P>0.05) levels were found in aborted toxo-positive women in compared with control. Likewise, it was found that association between concentration of C3,C4 and number of abortion.Conclusion: complement were play role in immune response of pregnant women especially against toxoplasmosis that cause abortion to these women.
The Impact of Toll-Like Receptor 2 Genetic Variations on Susceptibility to Tuberculosis
Authors: Jabbar Altamimi Bushra , Muhsin Ali Zahra
Published: January 2024

Background: Tuberculosis is a disease of worldwide distribution. This disease is known to caused by Mycobacterium tuberculosis, however several environmental and genetic factors can affect the occurrence and progression of the disease. Toll-like receptor 2 (TLR2) has a particular importance in immune response against this bacteria.Aims: This study aimed to investigate the association of two single nuclotide polymorphisms(SNPs) in TLR2 gene which are Arg677Trp and Arg753Gln with the incidence of TB in Iraqi patients.Subject and Methods: A case-control study was conducted which involved 55 patients with confirmed pulmonary TB and other age-matched unrelated 30 healthy individuals as control group. Blood samples were obtained from each subject and DNA was extracted. The gene of TLR2 was amplified with polymerase chain reaction (PCR) using specific sets of primers. Genotyping was achieved by direct sequencing.Results: Only the SNPArg753Gln appeared in two genotypes which were GG and AG in both TB patients and control groups. In TB patients, these genotypes account for 44 (85.45%) and 11 (14.55%) respectively, compared with 29 (96.7%) and 1 (3.3%) respectively in control group with significant difference (OR =7.251 95% CI=1.008-59.211, P = 0.035). The SNP Arg677Trp had only one genotype which was CC.Conclusion: The allele A of the SNP Arg753Gln could be considered as a risk factor for TB among Iraqi patients.
Subcostal TAP block as analgesic for open cholecystectomy
Authors: A. Al-Khafaji Raad
Published: January 2024

Open Cholecystectomy, is associated with high pain score post op.TAP block provides effective post op analgesiaAimThe aim is to evaluate the effectiveness of US guided subcostal TAP block for post op pain in open cholecystectomyPatients were divided into two groups. Thirty patients received subcostal TAP block after commencing GA. Another thirty patients did not receive the block.Post operative pain was recorded in both groups , so as any possible complications like nausea and vomiting .We found that subcostal TAP block is effective , simple , and reliable as analgesia in open cholecystectomy post operativelyPatients and MethodsA total of 60 patients undergoing emergency and elective cholecystectomy were allocated into two groups : U/S guided subcostal TAP block , the A group , and the non TAP block group , the B group. All patients received same general anaesthesia drugs and technique.The A group received subcostal TAP block 5 minutes before starting surgery , a total of 20 ml , 10 ml 1% lidocaine and 10 ml 0,25% bupivacaine Rescue post op analgesia was in the form of I.V tramal and diclofenac.Pain score was recorded post op , using VAS ( Visual Analogue Score ).

ResultsGroup A ( 30 patients ) , received subcostal TAP block 5 minutes prior to starting surgery , and Group B ( 30 patients ) did not received TAP block. Post op pain score recorded in both groups , and showed pain score 0-2 in group A , and 6-8 in group B which received rescue analgesiaConclusionSubcostal TAP block is effective analgesic technique with opioid â€“sparing effect in open cholecystectomy post operatively
Intracapsular fracture of the neck femur in age group between 20-50 years ,the result of Internal fixation with cannulated screws
Authors: Mahdi Saleh Iskandar
Published: January 2024

Background:Femoral neck fracture represent important subject because it has many complications and followed by morbidity , prospective study was done on (20) patient, The treatment options of femoral neck fracture are many ,we choose treatment with cannulated screws and evaluatethe result of it regarding the union rate and occurrence of the complications.Patients and Methods:This study was performed on 20 patients with femoral neck fractures in period between September 2009 and September 2010 in orthopedic department in the Hospital for Specialized Surgeries in medical city/ Baghdad ,we did preoperative assessment to them and including radiological examination ,laboratory investigations to identify medical diseases and treat them ,classify patient according garden classification and Treated by reduction of displaced fractures and capsulatomy and then fixation with three cannulated secrewResults:Twenty patients with femoral neck fractures 7 females 35%, and 13 males 65%, 12 patients were left-sided 60%, 8 patients were right-sided 40%.11 patients were with undisplaced femoral neck fractures (55%), 9 patients with displaced femoral neck fractures (45%). The age of the patients was ranging from 20 â€“ 50year ,The result of our study was indicated that union rate of 85% , and 25% of vascular necrosis.Conclusions:the cannulated hip screws is a good method of fixation regarding union rate and low complication rate , the result of treatment is influenced mainly by the fracture displacement and quality of reduction and time of surgery.
Etiology of lacrimal sac infections
Authors: Majied Hamied Furkaan
Published: January 2024

Background:The lacrimal sac infection common problem exposing the eyeball and the orbit into the risk of contaminations and the subsequent; orbital cellulitis, conjunctivitis, and even keratitis so it is an indirect sight threatening disorder and should be studied promptly.Patient and methodsAt Al-Diwaniya Teaching hospital, at the outpatient clinic of ophthalmology; after clinical diagnosis of dacryocystitis, a sixty tow samples of lacrimal sac contents were studied microbiologically (12 bilateral and 38 unilateral) .From June 2010 to June 2013.Results and conclusions:78%(39) of cases were with positive results, while the remainder were negative. No fungal infection recommended. The most common pathogen is the Staph species, and the most effective antibiotic is the Chloramphenicol, which is available and non coasty drug could be used as a first line therapy.
Role of Cataract Surgery in IOP Lowering
Authors: Furkaan.M. Hameed Furkaan
Published: January 2024

Background:Glaucoma is a neurodegenerative disease of the optic nerve, which can be pathologically explained either by direct ischemia by the intra ocular pressure or by direct pressure on the optic nerve fibers as they pass through the lamina cribrosa.Glaucoma and cataract are frequently encountered in the same patient, there prevalence increasing with age.Aim of the study:Determine the effect of cataract surgery on level of intraocular pressure.Patients and methods:A prospective comparative study started since October 2012 until July 2015 eighty patients included of four groups 20 normal, 20 with pseudo exfoliation syndrome, 20 with pseudo exfoliation glaucoma, and 20 with primary open angle glaucoma (both types of glaucomas are controlled). Six readings IOP by Goldman applanation tonometry each included eye; one preoperative (phacoemulsification), one post operative 1 week, one month, three months, six month, and one year post operative.Results:All of the four included groups get lower intraocular pressure levels after cataract surgery
Phylogenetic Analysis of MERSCoV in Human and Camels in Iraq
Authors: F. Al salihi Saba , A. Alrodhan Mohsen
Published: January 2024

The present study was conducted to evaluate the genetic relationship among Middle East respiratory syndrome coronavirus (MERSCoV) of human and camels origin at the period from October 2015 to February 2016.One hundred samples were collected from camel and 100 from human. Nighty four from nasal swabs and six from oropharyngeal swabs Camel samples secerned by immunochromatographic assay (ICA) for detection of viral antigen. The total percentage of ICA positivity was 28%. Human and camel samples subjected to Revers transcription real time- PCR and carried out by RNA extraction by using specific primers and Taq- Man-Probe for detection of nucleocapsid gene 113 bp. The total positive result in camels were 15% ,there was no significant difference between sex and type of samples, in relation to the age group the results showed that age group more than ten years of camel was the heights percent. With significant difference at P<0.05. According to the months of the year October recorded the highest infection rate with significant difference at p<0.05. the result of RT-qPCR according to the regions of study showed that Al-shinafyah in western borders of Iraq-Saudi was the highest infection rate 35% .On the other hand ,100 human 81 nasal swabs and 19 bronchial lavage samples were collected from pilgrims and non-pilgrims. The total positive result was 5%. The pilgrims recorded the highest infection rate. The results of conventional PCR by using specific primers for detection of Nucleocapsid gene (217 bp) of MERSCoV. The results were confirmative. Three human and 11 camel positive samples were used in further sequencing and phylogenetic analysis by extraction and purification of the PCR products. Our clones sequence submitted in GenBank-NCBI for accession number.The phylogenetic tree construction and analysis results showed that most of Iraqi variants of camel and human were located in clade-B in which Saudi Arabia strains were clustered. One of our clones (MERS-Iq.2Huh) of accession number KX150500.1 was located in clade-A in the same branch of Jordanian strain while bat corona virus, SARS corona and neoromica corona virus was out group clustered in separated branch.
Outcome, Efficacy and Safety of Ureteroscopic Pneumatic Lithotripsy In Management of Lower and Mid Ureteric Calculi
Authors: Ali Ghadhban Mohammed , Hamdan Fahad Ali
Published: January 2024

OBJECTIVE: To determine the efficacy and safety of pneumatic lithotripsy in the treatment of mid and lower ureteric calculi.DESIGN: prospective study.DURATION: From 2014 to 2015SETTING: Department of Urology, AL-Diwaniya teaching Hospital.PATIENTS & METHODS:Over a period of one year,one hundred (100) patients of ureteric stones were treated with pneumatic lithoclast. Twenty five (25) Stones were located in mid ureter, Seventy five (75) stones were located in lower ureter . Success rate was defined as symptom free, no residual stones larger than 2mm. General anesthesia was given to all patients.RESULTS:Over all success rate was 90%. Success rate in middle and lower ureteric stones were 82%, 92% respectively. Completely fragmented stones cleared spontaneously within two weeks in 95% of cases and all patients were free of stones one month after the procedure. In six (6) patients stone was migrated, later on submitted for ESWL and successful. Complications were encountered in 11% of cases and were managed conservatively.Hospital stay was 24 to 48 hours.CONCLUSION:Pneumatic lithotripsy is reliable, highly effective rapid, safe and cost effective treatment modality for ureteric stones with negligible incidence of complications.
Synthesis and Characterization of Copper (II ), Zinc (II ),Cobalt (II) and Nickel (II) complexes Derived from2-Hydroxy-1-naphthaldehyde and DL- glycyl-DL- glycin
Authors: Ahmed Redayan Muayed , Tariq Ibrahim Ziad , E. atyi Ghalib
Published: January 2024

Copper (II ) , Zinc (II ) , Cobalt (II) and Nickel (II ) complexes with the Schiff base derived from 2-Hydroxy-1-naphthaldehyde and DL-glycine -DL-glycine were synthesized.These compounds have been characterized by elemental analysis , conductivity measurement, IR and UV-Vis.The molar conductance measurement indicate that the complexes are 1:1 non-electrolytes. The IR data demonstrate the tetradentate binding of the ligand .The COO- stretching bands in the IR spectra suggest that carboxylate acts as a monodentate group when binding with metal . The bonding sites are the carboxylate oxygen , imino nitrogen , amide nitrogen , and phenolic oxygen.
Changes in the Superior Zygapophyseal Joints in the Lower Thoracic and Upper Lumbar Vertebrae in Babylon Population
Authors: Abd Al-Hussain Al-Shouk Asaad , Hadi Kadhim Zaid
Published: January 2024

Background: The articular processes of the vertebral column play a role in weight transmission as well as in governing the range and direction of movement between two vertebrae. The pattern of changes of orientation of these particular processes from thoracic to lumbar type was seldom mentioned in anatomical textbooks.Objective: to study the pattern of changes of zygapophyseal joints in local citizen in Babylon Province.Methodology: 140 persons (80 female and 60 male) aged 20-66 years (mean 46.84± 14.438) attending to radiology department in Marjan Teaching Hospital, Babylon, Iraq, were participated in this study, they were investigated to be free from any congenital anomaly or pathological change. Using computed tomography with axial sections, the lower four thoracic and upper lumbar vertebrae. The zygapophyseal joints were carefully observed to detect the site of changes in orientation from thoracic to lumbar type.Results:The present study revealed that there were two types of change in the orientation of zygapophyseal joint were observed; gradual and sudden.21.42% of subjects showed gradual changes in orientation of zygapophyseal from thoracic type to lumbar type, with female ratio higher than male. The transition started mainly at T11-L2, some subjects showed transition at T12-L2.While 78.58% of subjects showed sudden changes; mainly at T12-L1, and to a lesser extent at T11-T12.Conclusions:In the group of people who were studied it was clear that the change of the superior zygapophyseal joint from flat, posterolaterally oriented which is thoracic type to curved, posteromedially oriented which is lumbar type is more likely to occur as sudden change rather than the gradual change which observed in about one-fifth of the population.
Usefulness of bleeding Profile in Adenotonsillectomy
Authors: Abd-almer jwad Ali
Published: January 2024

Introduction: Infectious and inflammatory diseases involving the pharynx, tonsils, and adenoids account for a significant proportion of childhood illnesses and pediatric health care expenditures. Preoperative assessment in patients undergoing adenotonsillectomy is crucial and may reveal problems that could complicate either surgery or the patient’s postoperative course. It is crucial to detect the existence of any coagulation abnormalities. routine evaluation of coagulation parameters before surgery in patients undergoing. adenotonsillectomy is controversial.Aim of study: asseses the need for coagulation profile prior to adenotonsillectomyMethod: This study is prospective, consisted of 321 children complaining of adenotonsillar problem. Age, sex, history, physical examination, hemoglobin (Hb %) and bleeding profile in form of prothrombin time, partial thromboplastin time, international normalized ratio was done for all patients. Patients with risk factor for bleeding, abnormal bleeding profile and further work reveals clotting abnormality were excluded from study.Results: Two patients of normal investigation developed secondary hemorrhage, which is due to infection and treated conservatively. Two of prolonged bleeding profile developed primary bleeding readmitted to theater one of them from adenoid remnant, and one from slip ligature.Discussion: Bleeding problems in surgical patients are not uncommon and may occur for a variety of reasons if a bleeding disorder is suspected, a careful clinical history and examination make important contributions in reaching a diagnosis.in our study we find no significant intraoperative or postoperative bleeding occurs due to prolong bleeding profile so relevance of bleeding profile before adenotonsiilectomy is questionable.Conclusion: The routine preoperative bleeding profile is not recommended in every patient undergo adenotonsillectomy operation unless past medical, family history or physical examination suggest bleeding disorders.
Evaluation of Use Full Thickess and Split Thickness Skin Graft in Management of Congenital Hand Syndactyly
Authors: Miri Saadoon Ahmed
Published: January 2024

Background :Hand syndactyly is the commonest type of congenital hand anomalies and its management is a real challenge to the surgeon and stimulate continous search for newer concepts and methods for restoration of function .Aim of the study :The objective of this study is to evaluate the use of full thickness and split thickness skin graft in reconstruction of congenital hand syndactyly and to compare between complications that occur in using these grafts and identify the proper ways of avoiding these complications.Patients and methods:The study involved 16 patients presented to the department of plastic and reconstructive surgery in the hospital of surgical specialties and Al-Wasity hospital. The patients were evaluated preoperativey by talking full history and examination of the hand systematically ,plain radiographic studies were performed and all patients were adviced to use web elastic splint postoperatively and the patients were followed up by regular visits following surgery.Results :3rd web space was the commonest space involved by syndactyly and hyperpigmentation was the most frequent complication reported when using F.T.G. although it was reported in some cases of S.T.G. Shrinking of skin graft and extension lag were more frequently seen when using S.T.G. while web creeping occur commonly when using F.T.G. Other compications like rotational ,derivation deformaties and morbidity of scar at donor and recipient sites were reported.Conclusion :Using F.T.G. and S.T.G. in reconstruction of syndactyly give acceptable functional results although both types have their own disadvantages.
Efficacy and Safety of a Single Rod – Contraceptive Implant (Implanon)
Authors: Mohsen Al-Khafajee Shiemaa , Hamza Sharif Al-Shibany Yasamin
Published: January 2024

Background : Implanon is a subdermal contraceptive implant involves the delivery of a steroid progestin(68 mg of etonogesterel) from a single rod placed under the skin at the inner side of the non-dominant upper arm and the hormone diffuses out slowly at a stable rate providing contraceptive effectiveness for 3 years. Advantages of Implanon includes long term contraceptive action without requiring the user's or provider's attention , low dose of highly effective contraception without use of estrogen and fertility is readily reversible after the removal of implant.Objectives: to assess contraceptive efficacy , safety and acceptability of Implanon .Materials and methods: the study was conducted in Iraq- Al-Samawa and Al-Diwaniya maternity and pediatrics teaching hospital, family planning clinics and privet clinics from the period of October 2012 – October 2014 that includes 41 sexually active women 18-45 years seeking for contraception with normal menstrual cycles , no history of ischemic heart disease or stroke and no history of breast or genital tract malignancy.Results: contraceptive efficacy of Implanon was 98% over 2 years follow up and the most common adverse experience was abnormal bleeding pattern in 100% of women ,as amenorrhea affects 51.22% , infrequent bleeding 26.82% ,prolonged bleeding 12.20% and metromenorhagia 9.76%.. Discontinuation rate was 2.44% because of menstrual bleeding abnormality. Other adverse experiences after Implanon insertion were weight gain of ? 5kg in7.32% after 2 years follow up , acne in 31.71% , mood changes in 21.95% and headache in 12.20%.Conclusions: Implanon is a safe , highly effective and rapidly reversible new method of contraception and the safety profile is acceptable and not essentially different from progestogens in general.
Frequecy of hypothyroidism In multi-transfused thalassemic patients in AL- Diwanyia Maternity ??children Hospital
Authors: Mohammed hussein Al-shebani Abbas
Published: January 2024

Back ground: hypothyroidism in thalassemic children is not uncommon problem ? and need special attention and frequent patient monitoring.

Objective: to establish the frequency of  hypothyrodism among multitransfused

thalassemic patients depending on clinical and laboratory investigations.

Methods: A cross sectional study of thyroid function ,T3,T4, and TSH, was  carried out in 120 transfusion-dependent thalassemia and sickle cell anemia   patients attended the thalassemic Center in AL-Diwanyia Maternity and  Children.Teaching Hospital .The inclusion criteria were 1(the age more than 5  years and 2)receiving frequent blood transfusions at least 6 times per year in the last three years.

Result: eight patients have hypothyroidism and had a prevalence of (6.66%).     Two patients had low T3 and T4 and elevated TSH with signs and symptoms of hypothyroidism and was already treated with thyroxin ,which consistent with   the diagnosis of primary hypothyroidism , and 6 patients had no signs and symptoms of hypothyroidism with normal T3 and T4 but elevated TSH and this was consistent with the diagnosis of subclinical hypothyroidism . No patient of   these 8 have family history of hypothyroidism . All affected patients are receiving

 blood transfusions more than 20 times since the time of diagnosis and all the effected patients have suboptimal  iron –chelating therapy as reflected by the high  serum ferritin level ( < 1000 ).

Conclusion: patient with transfusion dependent hemoglobinpathy need frequent monitoring of their thyroid function at least once yearly to detect early  hypothyroidism and start early treatment .
Microalbuminuria as a predictors for detection of silent ischemia in patients with type two diabetes mellitus
Authors: Talib Nimnim Ali
Published: January 2024

Background: CHD was still the most widespread leading cause of death in worldwide. Many risk factors can play a role in its pathogenesis; DM, HT, dyslipidemia, obesity smoking and microalbuminuria are common known risk factors. Microalbuminuria is independently considered as a risk factor of CHD in patients with diabetes. Its task as a predictor for CHD has not been well examined, and its predictive implication is uncertain.

Aim of study: The purpose of our study was to determine the using of microalbuminuria as a predictor test for detection of silent ischemia in type II DM.

Patient and methods: Selection of 169 patients with type II DM who had neither old nor recent IHD and they hadn’t chest pain. According to the results of microalbuminuria, we were dividing those patients into two groups, with and without microalbuminuria. Group one consist of 74 patients with microalbuminuria while group two consist of 92 patients without microalbuminuria. Treadmill test (TMT) or holter studies were done for all patients of both groups after taking their agreement.

Results: the result would reveal that diabetic patients with microalbuminuria are at high risk of ischemia than those without microalbuminuria independently to other risk factors. 16 of 74 patients from group one and only three of 95 from group two show positive features of ischemia during exercise test with statistically significant (p value < 0.001).

Conclusion: In diabetic patients, microalbuminuria is associated with high CHD risk, independently to other known risk factors. As such, any patient with diabetes mellitus type two had microalbuminuria should search for latent IHD independently to other risk factors. So detection of microalbuminuria and trating of other risk factors is mandatory for improved outcome of CHD risk.

Recommendation: Closely follow up of diabetic patients with tight glycemic control in order to reduce incidence of microalbuminuria and any patient with microalbuminuria should search for CHD.
The liver injury in patients with B-thalassemia major secondary to iron over load in Thalassemia center of Diwaniyah maternity and children teaching Hospital . A clinical study in Thalassemia center of Diwaniyah maternity and children teaching Hospital
Authors: Sabber Mutlag Suzan
Published: January 2024

Background:liver iron concentration assessed by MRI T2* is the better indicator of total-body iron depositions and should be checked in frequent blood transfused patients. MRI T2* can be detect iron overload before iron toxicity becomes clinically apparent.Aim of study: to prevalence of liver injury among patients with B- thalassemia major secondary to iron over load in Thalassemia center of Diwaniyah maternity and children teaching Hospital.Methods: This a cross – sectional study was carried out on 58 patients (34 males and 24 females ) diagnosed ?-thalassemia major on the base of the blood investigations (peripheral blood counts and hemoglobin electrophoresis), their age range from 9 years to 36 years. The study was conducted in Thalassemia center of Diwaniyah maternity and children teaching hospital in Al- Diwaniyah Governorate, Republic of Iraq. The Data collection was carried out during the period from the 30th of December 2015 to 11th of August 2016. They were studied for prevalence of liver injury among patients with thalassemia major secondary to iron over load. Results: Total numbers of B- thalassemia major patients are 58 patient. The numbers of patients with ages less than 10 years are 3 (5.2%), patients with ages(10-18)years are 39 (67.2%), patients with ages(19-25)years are 12(20.7%). statistically significant correlation was found between liver function test (LFT) abnormality ( ALT, AST) and numbers of blood transfusion per year (P=0.001) and also LFT abnormality ( ALT, AST) and ferritin levels (P=0.01). In our study reported that liver iron concentration was presented normal in 23 patients (39.7%), mild iron concentration in 29 patients (50.0%) and moderate iron concentration in 6 patients (10.3%). There was a significant association between serum ferritin level and the liver iron concentration assess by liver MRI T2* (P=0.002).Conclusion: These results showed that correlation between ferritin, LFT abnormality and liver iron storage detected by MRI T2 in patients with ?-thalassemia major. MRI T2* has become the clinical standard to estimate liver iron overload.
Effectiveness of t-PA in Patients with Acute Myocardial Infarction
Authors: Z Alshibani Mazin
Published: January 2024

Tissue plasminogen activator (t-PA) had improve the treatment of ST elevation myocardial infarction (STEMI). The aims considered assessment the response of patients with STEMI to t-PA (Alteplase) infusion by estimate the frequency of selected parameters. This is study that included 62 patients with STEMI who had been treated with t-PA infusion as a thrombolytic therapy. They had been selected from those who had been admitted to the Coronary Care Unit at Al-Diwaniya Teaching Hospital, Diwaniya city, Iraq during the period between 1st of March 2014 to the 31st of August 2015. Specific selected parameters used to assess effectiveness of t-PA. Parameters including: resolution of ST segment elevation (reduction in the ST elevation ? 50%), relieve of chest pain, occurrence of accelerated idioventricular rhythm (AIVR) and positive response for three parameters (simultaneously), observe within 90 minutes after t-PA infusion. After t-PA infusion, 59.6% of the patients had resolution of ST segment elevation, 56.4% getting relieve of chest pain, AIVR occur in 30.6% and positive response of all parameters in 9.6%. Patients less than 60 years old age constitutes 45.1% of patients who had ST segment resolution, 30.6% of patients who had relieve of chest pain, patients with AIVR in 22.5%, and patients with positive response of all three parameters in 9.6%, (significant p.value). Smokers patients getting ST segment resolution in 41.3% of patients, relieve of chest pain in 38.7%, AIVR in 16.12% and positive response for all selected parameters in 8.06% of patients, (significant p.value). 1.61% of patients with ST segment resolution and 11.29% of patients with relieve of chest pain seen with time to perfusion more than 6 hours. This study indicated that increasing age, obesity, diabetes mellitus (DM), and delay in reaching hospital after onset of ischemic chest pain considered as predictors for poor response to t-PA infusion among patients with STEMI. BMI has no significant consideration but smokers patients had been associated with better response to t-PA.
Molecular profile of scpA and sdaB virulence genes in Streptococcus pyogenes isolated from pharyngitis
Authors: S Hamim Saad , R Hussein Khwam , Younus A Kamel Younus
Published: January 2024

Group A Streptococci (GAS) or Streptococcus pyogenes is an important pathogen which causes a wide-ranging of diseases for human. This study was carried out in Ear Nose Throat (ENT) department in Al–Habboby Teaching Hospital, Thi-Qar province, south of Iraq during the period from October 2015 to April 2016. Two hundred and ten swabs were collected from patients infected with pharyngitis. 152 (72.3 %) showed positive growth with S. pyogenes. GAS isolates were subjected to detect two virulence genes (scpA and sdaB) by conventional PCR technique using specific primer pairs and DNA sequencing analysis. The sequencing of PCR products produced from bacterial DNA showed significant alignments identities (96-99%) to the S. pyogenes which are located in BLAST-NCBI Genbank. The six sequences of Streptococcus pyogenes scpA and sdaB genes determined in this study have been deposited in the GenBank under the accession numbers MF49318-MF497323. Phylogenetic analysis of S. pyogenes based upon the neighbour-joining of partial scpA and sdaB gene sequences showed that these sequences were derived from Streptococcal genes. In addition, S. pyogenes can produce several exotoxins that have the potential to damage the host tissues either directly or through the stimulation of cytokine production.
Utility of CA 15-3 in diagnosis of Breast Cancer Recurrence. An Observational Study.
Authors: R. Al-Bayati Musaab
Published: January 2024

Background : CA 15-3 is the commonest tumor marker for breast cancer. Elevated serum levels of this marker was shown to be a predictor of disease recurrence in patients with localized breast cancer. This study aimed to determine the sensitivity of serum CA 15-3 level in the detection of breast cancer recurrence in relation to the molecular subtype of breast cancer, type of recurrence and the number and sites of distant metastasis.

Methods : Retrospective observational study of patients with localized breast cancer followed until relapse. Serum level of CA 15-3 at first documentation of relapse was compared between patients in respect to the molecular subtype of breast cancer, type of recurrence and the number and sites of metastasis.   

Results : Elevation of CA 15-3 were found in 56% of patients at relapse. Only 6% of patients with locoregional relapse shows elevation of this marker compared with 62% of patients with distant metastasis. Elevation of CA 15-3 were more sensitive for detection of relapse in patients with luminal subtype (62%) than in patients with HER2 enriched (45%) and triple negative (35%) breast cancers. The test was more sensitive in patients with bone (69%), lung (65%) and liver (62%) metastasis than in patients with brain metastasis (25%).    

Conclusions : CA 15-3 is a relatively sensitive marker for detection of breast cancer recurrence. However, this sensitivity may be hampered in patients with isolated locoregional relapses and in patients with HER2 enriched and triple negative breast cancers.
Conversion rate of laparoscopic cholecystectomy in a sample of patients from Al-Diwaniyah teaching hospital
Authors: Raoof Alammar Nahedh
Published: January 2024

Back ground:

 

Laparoscopy became used as a surgical procedure for the removal of gallbladder by Lukichev in

 

1983 and Muhe in 1985. Those procedures gained little attention and popularity till the well acknowledged laparoscopic cholycystectomy which was performed by the French gynecologist Mouret in 1987.

Aims of the study:

 

To evaluate the rate of conversion of laparoscopic cholecystectomy into open surgery and its predisposing factors.

Patients and methods: A total number of 1077 patients undergoing elective laparoscopic cholecystectomy were enrolled in the presents study. The sample was composed of 932 females and 145 males and their age ranged from 9-86 years. The study was conducted in Al-Dewaniyiah teaching hospital from January 2015 through December 2015.

Results: The occurrence of disease in female patients was significantly higher than that of male patients (P<0.001). The conversion rate of laparoscopic cholycystectomy into open surgery was reported in 13 out of 1077 (1.2%). The conversion was reported only in the following intervals:

30-39 years (0.7%), 40-49 years (1.6%), 50-59 years (3.5%) and 60-69% (0.8%). The rate of conversion was significantly higher in males than females (P<0.001).

Conclusions: Conversion rate is acceptable in view with available data. Risks for conversion included: Male gender, advanced age, dense adhesion, diabetes, CBD injury and Cholecystoduodenal fistula.
The Study of the effect of serum zinc level in the mothers and Neonates on neonatal jaundice in al-diwanyia
Authors: Naji Al-Hajjiah Nasma
Published: January 2024

Background :

Zinc has a role in normal growth and development during pregnancy, childhood, and is needed for the proper sense of taste and smell. Studies on animals, adolescents and low birth weight neonates showed that oral zinc salt intake decreased serum bilirubin level, probably through inhibition of the bilirubin enterohepatic circulation.

Objective :

To study the effect of serum zinc level of the newborn and their mothers on neonatal jaundice.

Patient and methods

A case control study included a total 130, 65 with jaundice and 65 healthy neonates with their mothers. The study was carried out from May to October 2016 at ALhussein hospital for children in Al-Diwanyia city. For all neonates serum zinc, total serum bilirubin, hematocrit, blood group typing and Rhesus were carried out. Serum zinc for the mothers also was measured .

Results :

Serum zinc in jaundiced neonates was significantly lower than non jaundiced neonates (P<0.05). One hundred and nine mothers out of 130 mothers have low serum zinc. In multipara, zinc deficiency was more frequent  in the mothers of both groups and P value (0.69).There was  no significant difference was  in mean serum zinc level when gestational age was taken into consideration (full term versus pre-term) (P>0.05).

Conclusions :

This study showed that serum concentration of zinc in neonates with jaundice was significantly lower than that in healthy control.
Estimation of Hepcidin Level and Its Correlation With Iron State in Pregnant Women
Authors: Mohammed Hussein Ghufran , Yahya Hussein Nibras
Published: January 2024

This study aimed for determination of serum hepcidin level and its association with ?iron ?state in pregnant women with and without anemia. ?This study comprises ?86 pregnant women divided into two groups, the first ?group comprises 49 pregnant women without iron deficiency ?anemia?, the second group comprises 37 pregnant women with iron ?deficiency anemia. ?Blood was drawn from all pregnant women for determination of serum ferritin and hepcidin concentrations. The results establish a significant decrease in serum ferritin ?and hepcidin concentrations in pregnant women with anemia as paralleled with pregnant women without anemia. The outcomes of linear regression analysis demonstrate a significant positive association between serum ferritin ?and hepcidin concentrations in both study groups. In conclusion, measurement of serum hepcidin level is an important parameter for ?evaluation the iron state in pregnant women.
Correlation between TARC and MDC gene expression and respiratory syncytial viruses in children
Authors: S. Alrubaye Wisam
Published: January 2024

Abstract:

Background:  Human respiratory syncytial virus( RSV) is the major etiological agent of respiratory tract illness particularly in children, and it provokes allergic and asthma exacerbation, so, the respiratory tract epithelial cell are stimulated and produce several chemokines such as MDC and TARC that play a major role in asthma attack.

Objective:  To identify human genetic groups of RSV  from children with respiratory tract infection and establish the relationship between RSV and allergy exaggeration through determination of the host gene expression (TARC and MDC) which are  induced by RSV infection.

  Methods: Patients suffering from respiratory tract illness (RTI), from several days to fourteen years old of both sexes were enrolled in this study. A nasopharyngeal swabs  (NP) were taken from patients  and subjected to molecular detection of RSV  and gene expression of TARC and MDC were done for positive samples with RSV.

 Results: Out of 230 children suffering from respiratory tract infection, 8 (8%) and 14 (14%) were detected with RSV type A and B respectively, and all epithelial cells of patients who have infected with RSV express TARC and MDC which are known to have an essential role in  severity and hyper-responsiveness of allergy.

Conclusion: Measurement of host gene expression such as TARC and MDC revealed  increased level  of these genes in  asthmatic patients, in children  infected by RSV. Both genes may play an essential role in severity and hyper-responsiveness of allergy.
Depression in Burn Patients at Al-Diwaniya Teaching Hospital
Authors: Al Hamzawi Ali , Hussein Abed Inas , Miri Saadoon Ahmed
Published: January 2024

Background

Burn injuries affact on physical and mental status of the victum.

 The researchers show different outcome in their articles when they study depression in burned patients.

Aim of the study

 The study aims are : 1. identify the prevalence rate of depression in burn patients. 2.measure  severity of depression .3. study the  socio-demographic variables of those patients.

Methods

A case –control study was condefed  on One hunderd patients at the burn unit of AL- Diwaniya Teaching Hospital from a period of April 2nd  2014 to January 2nd 2015.

the presence of depression was diagnosed by using a semi –structured interview schedule based on ICD-10, diagnostic criteria for depression ,and its severity was rated by Beck depression inventory.  

Results

The result revealed the depression was found in 40% of  burned patients compared with 15% among their matched control group and this result was statistically significant .the rate of depression was higher for females than males,according to the Beck Depression Inventory (BDI),  the majority of  depression patients (60%) were of moderate severity.  

Conclusion

The prevelence of depression was 40(40%) patients . There is a close association between burn related variables and depression

The  study show  the importance of  evaluation and management of depression in burn injured patients