bluuebunny/crossref_metadata_2025 huggingface dataset:
NASAL CARRIERS OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA), INFECTION SAFETY AND HAND HYGIENE AMONG HEALTH WORKERS IN SULAIMANI CITY
Authors: Fathi Narmeen , Mohammed Mohammed
Published: July 2017

Background

Staphylococcus aureus, a well known constant human pathogen that also exploit human as carrier to new hosts when inhabiting area like nose and skin. Over years strains had emerged with ability to resist the effect of several antimicrobial agents. The ability to resist the methicillin caused by different genetic backgrounds was one of the problems in the fight against these organisms.

Objectives

This study was aimed to isolate and identify Methicillin resistant Staphylococcus aureus (MRSA) inhabiting the nose of health workers in the main hospitals in Sulaimani city and to identify the susceptibility of these strains to several antimicrobial agents, also to inquire about daily infection safety and hand hygiene practice of the health workers.

Methods

To those who agreed to participate in the study, questionnaires were documented. Nasal swabs were obtained and isolation of Staphylococci was done on selective media, then S. aureus was confirmed and subjected to antimicrobial susceptibility using disk diffusion method.

Results

The participants were grouped in to nine occupational groups. Gloves were always used by 30.5% of the participants, not used in 18.8% and the other 50.6% were selective in using gloves. Hand cleansing with antiseptic were practiced in 31.7% while face mask were used by 18.4%. Hand washing during work in health facility were not practiced in 58.6%, 1-10 times hand washing was reported in 20.4%, 11-20 times hand washing in 10.8% and more than twenty time washing in 10%. Forty five out of 249 nasal swabs yielded S. aureus making the carrier rate of 18% while methicillin-resistant S. aureus rate was 5.6% among the participants.

Conclusion

Hand hygiene practice and infection safety were suboptimal in our health facilities. Nasal carrier of S. aureus was 18% in health workers while MRSA strains were isolated in 5.6% of the health workers. Prompt measure for hand hygiene must be implemented urgently to control transmission of S. aureus and to limit development of antimicrobial resistance.
ACUTE SCROTUM
Authors: Rasheed Aso
Published: July 2017

Background

Acute scrotum is regarded as an emergency urological problem, it is a name given to a condition that affect the viability and health of the testis. Although the acute scrotum is defined as acute scrotal swelling with or without pain, most patients present with pain as their primary complaint. Since there are different conditions which could lead to acute scrotum, early diagnosis and management of acute scrotum will greatly protect the testis future. Acute scrotum may be due to simple condition like minor trauma with heamatoma of the scrotal sac and intact testis or a serious condition like testicular torsion. Torsion must be considered in any patient with testicular pain and swelling. It account for about 0.5% of total emergency visits. It should be differentiated from epididymitis, orchitis, trauma, testicular segmental infarction. All together they account for 85% -90% of all cases of acute testicular pain, as their symptoms overlaps.

Objective

To identify those patients who have acute testis pain due to testicular torsion whom they need urgent operation and to differentiate them from non operative patients. Furthermore to find out the number of patients presented with each pathology during this period and their outcome.

Patients and Methods

Seventy patients with sudden pain, swelling with or without history of trauma were admitted to Sulaimani Teaching Hospital for diagnosis and treatment. The analysis was made for the etiology, age, disease location, time of occurrence, time of arrivals, diagnosis, treatment were recorded.

Results

Fifty three had infection, 9 patients had torsion of testis, and 4 patients had torsion of testis appendix, 11 patients had trauma and 3 patients had testicular abscess.

Conclusion

Proper history, physical examination and color Doppler ultrasound with early interventions directly affect the prognosis.
BENZHEXOL (ARTANE) ABUSE IN AN IRAQI FEDERAL PRISON IN KURDISTAN REGION
Authors: Mohammad Amin Nazar , Hamid Danial
Published: July 2017

Background

Artane is an anticholinergic drug which is prescribed by doctors to patients throughout the world. It is also abused by psychotic patients and nonpsychotic young people. This problem was highlighted in the Middle East recently. Prisons in Iraq were among the places where the abuse was obvious.

Objectives

This study was carried out to determine the prevalence of Artane abuse among the prison inmates, finding the demographic data about Artane abuser inmates and to find sources of Artane supplies to prison inmates

Methods

Among inmates of one of the prisons in Kurdistan Region, 508 were interviewed for addiction on various substances (in the period from 15th of January 2007 to 1st of October 2007).

Results

The research found 146 (28.7%) of the 508 Interviewed to be dependent on substances. Artane was found to be the main drug that was abused by inmates. They were mostly young, single and were addicted on other substances with Artane.

Conclusion

Artane abuse is a problem in Iraq and Kurdistan Region that needs to be addressed by the medical, legal and social authorities in the region. Prisons are among the places that need to be looked at for this abuse.
MANAGEMENT OF ATROPHIC-EROSIVE GINGIVAL LICHEN PLANUS WITH TOPICAL AND SYSTEMIC CORTICOSTEROID THERAPY, A CASE REPORT
Authors: Gaphor Shanaz , Abdullah Mustafa
Published: July 2017

The gingiva is a target of autoimmune diseases and about 10% of patients with oral lichen planus have the disease confined to the gingiva, clinically named desquamative gingivitis. The purpose of this paper is to describe 59 year-old female with atrophic-erosive gingival lichen planus that was presented to the Department of Oral Diagnosis, School of Dentistry at Sulaimani University service for evaluation of persistent pain, associated soreness and burning of her gingiva for 3-4 years, which were localized for anterior maxillary region. The histopathological examination confirmed the diagnosis of atrophic-erosive oral lichen planus. The treatment prescribed for the patient was topical and systemic corticosteroid (prednisolone). Substantial improvement was observed in the gingival lesion with reduction in erythema in some regions and complete resolution of pain. The results presented allow the authors to consider the association between local and systemic corticosteroid as a potential therapy for atrophic-erosive gingival lichen planus.
CORONAL SEALING ABILITY OF COPALITE VARNISH WITH DIFFERENT INTERMEDIATE RESTORATIONS AS AN INTRA-ORIFICE BARRIER IN ENDODONTICALLY TREATED TEETH. A COMPARATIVE IN-VITRO STUDY
Authors: Faraj Bestoon , Mohammed Hawzhen , Mohammed Kali
Published: July 2017

Background

Coronal restorations having an effect on the outcome of root canal treatment.

Objectives

The aim of this study was to evaluate and compare sealing ability of three cement base materials with and without cavity varnish in the orifice of root canal systems after root-canal treatment.

Methods

The palatal root of extracted human maxillary first molar teeth were selected, after preparation and obturation three millimeters of coronal gutta-percha were removed from the coronal aspect of the root canal and divided randomly into six groups (6 roots each). Root canal orifices were restored with conventional glass ionomer cement, zinc polycarboxylate cement and zinc phosphate cement bases with and without cavity varnish. All the specimens were thermocycled for 100 cycles at 7°C – 55°C for 60 sec in each bath. They were immersed in the 1% methylene blue solution for 7 days, and then sectioned into longitudinal sections. The extent of dye penetration was measured using stereomicroscope. Data were analyzed statistically.

Results

All the materials leaked at the interface of restorative material-dentin wall. Glass ionomer cement with varnish sealed significantly better than the other groups.

Conclusion

Placement of a suitable intra-orifice barrier, like conventional glass ionomer cement with a layer of copalite cavity varnish over it, may help minimize coronal microleakage in endodontically treated teeth.
EFFECT OF ACYCLOVIR ON EMBRYO IMPLANTATION IN MICE
Authors: Mustafa Snoor , Naoum Kameel
Published: July 2017

Background

Acyclovir is the antiviral drug used for treatment of herpes simplex and varcilla zoster viral infections and its adverse effects are not well studied on the embryo implantation.

Objectives

This study was conducted to determine the effect of Acyclovir on the process of implantation in mice of Swiss Webster Albino type and to detect whether there is any effect of Acyclovir on implantation of embryo in mice.

Materials and Methods

Adult female Swiss Webster albino mice were used in this study, aged 8-10 weeks and of 20-25gms body weight. The study was conducted from October 2009 through January 2010. A group of 24 mature female mice were included in this study and they were divided into two groups: Group 1(experimental group), included 12 mice injected with a single daily dose of 50 mg/kg b.wt. of Acyclovir subcutaneously on day 1-5 of gestation at 10:00 a.m; Group 2 included 12 mice injected D.W subcutaneously and considered as a control group. All animals were sacrificed on day 7 at noon and the uteri of all mice were examined for presence of implantation sites.

Results

In this study, out of 12 pregnant females, only two embryos were implanted from only one mouse (8.33%), the remaining 11 (91.67%) showed no sign of implantation at day7 postcoitus. The mean implant in the experimental group was 0.16±0.75, whereas in the control group a total of 84 embryos from 12 pregnant females were implanted and the mean implant was 7±1.41. Statistically, the result was highly significant since the p-value was < 0.01.

Conclusion

Exposure to Acyclovir at early days of pregnancy resulted in inhibition of embryo implantation.
ANTIMULLERIAN HORMONE SERUM CONCENTRATIONS IN NORMOOVULATORY AND ANOVULATORY WOMEN OF REPRODUCTIVE AGE
Authors: Jawad Ariana , Ali Mahabad
Published: July 2017

Background

Anti-Mullerian hormone (AMH), produced by growing pre-antral and early antral ovarian follicles, has been shown to be a useful marker for ovarian ageing. Serum AMH concentrations are elevated during reproductive life in anovulatory women, especially in those patients exhibiting polycystic ovaries (PCO) and have been implicated in the pathogenesis of polycystic ovary syndrome (PCOS).

Objectives

The aim of our study is to compare the AMH concentrations in anovulatory women with normoovulatory women of similar age.

Patients and Methods

The study included 70 anovulatory normogonadotrophic women (50 cases with PCOS and 20 cases with Non-PCOS anovulatory women) and 30 cases control group (normal ovulatory women). PCOS patients was diagnosed according to the Rotterdam definition, Serum AMH was measured with a second-generation immunoassay in both groups.

Results

Mean AMH level in anovulatory group was 2.22 ng/ml (0.6-4.10) and for control group was 6.11 (0.10- 19.00), there was significant difference in AMH, LH and testosterone level between patients and control group, difference also significant in AMH level between PCOS and non-PCOS subgroup. There was negative correlation between age of the women and AMH level both in control and patient group.

Conclusion

Serum AMH concentrations are elevated in anovulatory, especially in those patients exhibiting PCOS.
EFFICACY AND SAFETY OF DEFERASIROX THERAPY ON β-THALASSEMIA MAJOR PATIENTS IN BABYLON THALASSEMIA CENTER
Authors: Al-Wataify Ahmed
Published: July 2017

Background

Chronic iron overload from frequent blood transfusion leads to significant morbidity and mortality. Iron chelation therapy is an important part of management of those patients. Deferasirox is once daily oral iron chelator that is now widely used for treatment of transfusion hemosiderosis and represents a significant advance in treatment.

Objectives

The aim of this study is to assess the efficacy and safety of deferasirox therapy in a group of patients with β- thalassemia major.

Patients and Methods

A prospective study of 160 patients with β-thalassemia major for one year duration in Babylon thalassemia center, whose age ranged from 2—15 years with mean age of 6.7 ± 2.3years, have their serum ferritin level ranged from 1000—4000 ng/ml. The initial usage of Deferasirox dose depended on serum ferritin level ranged from 20 - 40 mg/kg/day, the patients classified into 2 groups based on serum ferritin either higher or lower than 3000ng/ml (137 patients with level of < 3000ng/ml, 18 patients >3000ng/ml and only 5 patients stopped treatment due to poor Compliance), the initial dose for first group is ≥20-<30mg/kg/day and the dose adjustment was performed in steps of 5-10 mg/kg/day every 3 months based on serum ferritin and safety marker of the drug, while the initial dose for the second group is 40mg/kg/day.

Results

The median base serum ferritin level was 2836.456±1244 ng/ml decreased to 2000.56±531.1 ng/ml after 12 months of deferasirox therapy (p value<.001). The optimum dose in reducing serum ferritin in the first group is ≥30-<40mg/kg/day in 65.69%. While, for the second group is 40mg/kg/day in 62.5% and 23 patients discontinued treatment. The commonest adverse effect is gastro-intestinal upset in 38.7%.

Conclusion

Deferasirox is effective and tolerable chelation in treatment of β-thalassemia major with iron overload.
TYPES OF ORGANISMS CAUSING URINARY TRACT INFECTION AND THEIR ANTIBIOTIC SENSITIVITY PATTERN IN SULAIMANI TEACHING HOSPITAL
Authors: Hassan Karwan , Ameen Ismaeel , Ramzi Zhian
Published: July 2017

Background

Urinary tract infection (UTI) is amongst the most common bacterial infections that prompt patients to seek medical advice. Approximately 10% of human populations get urinary tract infection at some stage of their live.

Objectives

The study was carried out to determine the types of micro-organisms causing UTI and their sensitivity to antibiotics in Sulaimani Teaching Hospital.

Methods

Records of patients admitted in Sulaimani Teaching Hospital, who had complicated UTI, were studied for a period of five years, from 1st December 2006 to 1st December 2010. All study subjects who had positive records of urine sample cultures inoculated on MacConkey and blood agar media were included in the study. The isolated bacteria were identified using biochemical tests. Disk diffusion susceptibility test was used to determine susceptibility of bacterial agents to antibiotics.

Results

A total of 2055 urine samples were found to be positive. The main isolated organism was Escherichia coli (E coli) 67.69%, followed by Pseudomonus aeruginosa 11.24%, then Proteus Species 7.15%, Gram negative bacilli 4.53%, Staphylococcus aureus 4.23%, Klebsiella species 3.55% and lastly Salmonella species represented 1.61%.

Conclusion

The commonest microorganism for UTI in this study was E. coli, followed by Pseudomonas, Proteus. Resistance of organisms to antibiotics is high probably due to misuse and overuse of antibiotics.
THE EFFICACY OF INTRANASAL CORTICOSTEROID THERAPY ON THE ADENOID HYPERTROPHY
Authors: Aziz Muaid , Abdulla Sarwar
Published: July 2017

Background

Adenoid hypertrophy is associated with high morbidity rate in children. Although surgical treatment is indicated in severe cases, however there are evidences that some medical treatments are effective in improving symptoms and signs of patients with adenoid hypertrophy.

Objectives

To evaluate the effect of intranasal corticosteroid in improving the symptoms and signs that caused by adenoid hypertrophy.

Patients and Methods

One hundred and thirteen patients with symptoms and signs of adenoid hypertrophy were included in this study with an age range from 3-12 years, using intranasal corticosteroid (Betamethasone 0.1% nasal drops) for of 8 weeks were evaluated pre and post treatment depending on clinical presentation and lateral neck radiography.

Results

Clinical features of adenoid hypertrophy significantly less frequent after using intranasal corticosteroid. P value <0.05 was significant for nasal obstruction, snoring, mouth breathing, sleep disturbance, nasal discharge and postnasal drip while not significant >0.05 % for hyponasal speech. The radiographic findings revealed that adenoid size after treatment with intranasal corticosteroid drop was significantly decreased and airway diameter was significantly more than before treatment.

Conclusion

According to our study, intranasal Betamethasone improved the symptoms and sings of adenoid hypertrophy and can be considered an alternative effective non-surgical treatment for mild and moderate adenoid hypertrophy and some symptomatic relieve of severe adenoid hypertrophy.
THE EFFICACY OF TWO DIFFERENT COMPOSITE LINERS IN PREVENTING MICROLEAKAGE IN DEEP CLASS II GLASS-CERAMIC MICROHYBRITE COMPOSITE RESTORATION ; (IN VITRO STUDY)
Authors: A. Rahman Miwan , Faris Tavga
Published: July 2017

Background

Potential liner materials include resin modified glass ionomer (RMGI) and flowable liners have been suggested by some studies to inhibit the occlusal and gingival microleakage in Class II composite restorations, which may act as a flexible intermediate layer, relieving the stresses of polymerization shrinkage and subsequently decreasing the microleakage.

Objectives

The purpose of this study is to determine the microleakage prevention effect of two different liners (Resin- modified glass ionomer and Flowable composite liner) on the occlusal and gingival cavosurface margin of deep class II cavity restorations using glass-ceramic microhybrid composite.

Materials and Methods

Class II cavities were made on both mesial and distal proximal sides of twenty three extracted permanent molars (n= 45 cavities); the gingival margins were placed (1 mm) apical to the cemento enamel junction, and they were randomly assigned to three groups (n=15 cavities). All the cavities were filled with microhybrid resin composite using centripetal placement technique. In group A, no liner was used under the composite, in group B, RMGI liner was used and in group C, flowable liner was used. The specimens were kept in distilled water for 1 week and then they were thermocycled. In order to evaluate the marginal microleakage, the teeth surfaces were isolated with nail varnish then immersed in a 2% methylene blue dye for 24 hours. The specimens were then carefully sectioned mesially/distally at the center and were studied under a stereomicroscope. Then scoring was done.

Results

The results of this study show that in all of the groups the microleakage at the gingival margin was more than at the occlusal margin; in group A (p < 0.01), and in group B and C (p > 0.05). At the occlusal margin, group A showed higher microleakage than group B (p < 0.01), and group C (p > 0.05). At the gingival margin, group A also showed higher microleakage than group B and C (p < 0.01). At the occlusal and gingival margins, group B showed less microleakage than group C (p > 0.05).

Conclusion

The microleakage at the gingival margin was higher than at the occlusal margin in deep class II microhybrid resin composite restorations. More microleakage was seen in the group in which no liner was used. Therefore, it is imperative to use liner under microhybrid composite in deep class II cavity restorations. Resin Modified glass ionomer liner has the ability to reduce occlusal and gingival microleakage more than flowable liner but statistically the difference was not significant. None of the tested liners were able to prevent occlusal and gingival microleakage completely.
ENTERIC FEVER IN SULAIMANI PEDIATRIC TEACHING HOSPITAL: RISK FACTORS, PRESENTATION, AND DRUG SUSCEPTIBILITY
Authors: Mohammed Mohammed , Omer Sherko , Rashid Bakir , Hamawandi Adnan
Published: July 2017

Background

Enteric fever is a severe systemic illness characterized by fever and abdominal pain that is caused by dissemination of typhoid Salmonella serovar, Typhi and Paratyphi. These organisms have no known hosts other than humans. Most commonly, foodborne or waterborne transmission occurs as a result of faecal contamination by ill or asymptomatic chronic carriers.

Objectives

The aim of this study was to determine the risk factors, clinical features in paediatric enteric fever infections along with the antimicrobial susceptibility pattern of the causative agents.

Patients and methods

This is a prospective-hospital based study, done in Sulaimani Paediatric Teaching Hospital. During the study period 250 cases suspected to have typhoid fever were admitted over a period of 3 month from 1st May-1st Augusts 2008; 95 cases with positive blood culture for typhoid were studied for clinical presentation, risk factors and drug susceptibility of isolates in comparison with a control group. Salmonella strains were identified based on their biochemical properties and antimicrobial susceptibility was determined with Kirby- Bauer disk diffusion method.

Results

Out of 250 clinically suspected cases of enteric fever, only 95 (38%) were culture positive for Salmonella. The antimicrobial susceptibility of isolate showed that more than 97% of the isolates were resistant to chloramphenicol, ampicillin and co-trimoxazole. Significant risk factors were eating food outside home (P=0.001, OR, 10.788; 95%, CI: 4.292 -27.112), low socioeconomic status (P=0.017, OR 0.437, 95%, CI: 0.229 -0.832), and household contact (P=0.001, OR=15.864, 95% CI: 6.648 -37.854).

Conclusion

Enteric fever remains one of the endemic febrile illnesses among paediatric age in our community and mainly caused by multi drug resistant Salmonella sereovar Typhi. The most common symptoms indicating infection were fever, headache, vomiting and abdominal pain. Risk factors were eating food outside home, low socioeconomic status and household contact with index cases.
PERINATAL OUTCOME OF BREECH PRESENTATION AT THE MATERNITY TEACHING HOSPITAL IN ERBIL CITY
Authors: Abdulla Shilan , Al-Hadithi Tariq
Published: July 2017

Background and Objectives

Increased perinatal mortality and morbidity with breech presentation is recognized. The objective of this study was to determine the perinatal outcome of breech presentation in Erbil Maternity Teaching Hospital.

Patients and Methods

This is a case-control study, conducted from the 1st of April 2010 to the 1st of April 2011. The sample size was 238 singleton breech deliveries (cases) and compared with 238 singleton cephalic deliveries. Main outcome measures were neonatal mortality and morbidity including admission to NICU and 5 minutes APGAR scores.

Results

A signi cantly higher overall perinatal mortality was documented among breech than cephalic deliveries 7.5% versus 2.5%. Low birth weight was signi cantly (P=0.001) higher among breech than cephalic deliveries. Five minutes APGAR score and neonatal intensive care unit admissions were signi cantly higher among breech than cephalic babies(P=0.026 and 0.001 respectively).

Conclusion

Breech babies had signi cantly higher overall perinatal mortality and a lower APGAR score at  ve minutes and admitted more frequently to NICU than cephalic babies.
THE CORRELATION BETWEEN INTERFERON-Α AND INTERLEUKIN-6 WITH SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY
Authors: Tofiq Dana , Mirza Raouf , Hussain Ali , Mohammed Zaid
Published: July 2017

Background 

Systemic lupus erythematosus is a chronic autoimmune disease affecting many organ systems with diverse clinical manifestations in association with autoantibodies to components of the cell nucleus. Cytokines, like interferon-α and interleukin-6, are important components of immune response regulation and their imbalance play an important role in the pathogenesis of the disease.

Objectives

To compare the serum levels of interferon-α and interleukin-6 in systemic lupus erythematosus patients and the apparently healthy subjects, and to  find out the correlation between the serum levels of the two cytokines and the disease activity according to systemic lupus erythematosus disease activity index.

Methods

A cross-sectional analytic study conducted on 37 systemic lupus erythematosus patients. The patients were investigated for the serum level of the two cytokines, and the results were compared with those of 31 apparently healthy subjects. Then, the disease activity was measured in the patients according to systemic lupus erythematosus disease activity index and arranged into groups of different disease activity, and their corresponding cytokine levels were compared.

Results

The serum levels of interferon-α and interleukin-6, in systemic lupus erythematosus patients were signi cantly higher than those of the healthy subjects (37.26 ± 27.58 IU/ml), (18.09 ± 21.02 pg/ml) respectively in the patients, and (13.29 ± 23.63 IU/ml), (7.10 ± 19.80 pg/ml) respectively in the healthy subjects, with p-values of (< 0.001) and (0.031) respectively. Eight (21.6%) of systemic lupus erythematosus patients had inactive disease, 9 (24.3%) had mild to moderately active disease, and 20 (54.1%) had highly active disease. There were a signi cant positive correlation between the serum levels of interleukin-6 and systemic lupus erythematosus disease activity, with p-value of (0.016), while there were no signi cant correlation between the serum levels of interferon-α and disease activity, with p-value of (0.734).

Conclusions

The serum levels of both cytokines in systemic lupus erythematosus patients are signi cantly higher than their levels in the serum of healthy subjects, and interleukin-6 is significantly correlated with the systemic lupus erythematosus disease activity.
MAST CELLS AND APOPTOTIC BODIES IN SEBORRHEIC KERATOSIS: A COMPARATIVE STUDY BETWEEN UVB INDUCED SEBORRHEIC KERATOSIS IN MICE AND SPORADIC CASES IN HUMANS
Authors: Salmo Nabil , Saeed Azad , Hassan Snur , Khudeir Hasanaein
Published: July 2017

Background 

Exposure to ultraviolet type B (UVB) radiation induces a number of pathologic changes in skin, including erythema, edema, epidermal hyperplasia, sunburn cell formation, immune suppression and eventually leads to cancer development.

Objective

To elucidate the differences in histological appearances of mast cells and apoptotic bodies between the two species (mice and human) among hyperkeratotic and acanthotic types of seborrheic keratosis (SK).

Materials and Methods

Thirty paraffin blocks were used in this study;  fifteen histologically con rmed acanthotic and hyperkeratotic SK cases in human (9 acanthotic and 6 hyperkeratotic) and  fifteen blocks from both types acanthotic and hyperkeratotic SK cases in mice induced by UVB light (9 acanthotic and 6 hyperkeratotic).

Results

Our results revealed that there was a signi cant correlation between mast cells and apoptotic bodies for both groups according to Pearson Correlation test. In human cases mast cells counting ranged between 2-10 with a mean number of 5.2/1HPF, while the total number of apoptotic bodies ranged from 1-4 with a mean number of 2.6/10HPF. When compared to mice cases, the number of mast cells were increased with a range of 12-23 and with a mean number of 19.067/1HPF, while apoptotic bodies were decreased with a range of 3-20/10HPF and with a mean number of 9.4/10HPF.

Conclusion

Dermal mast cells in ltration were remarkably increased in mice skin specimens which were exposed to UVB. The number of apoptotic bodies in UVB induced cases were more than in human sporadic cases.
IDENTIFICATION OF GLANDULAR DIFFERENTIATION IN APPENDICEAL CARCINOID TUMOR- A STUDY IN SULAIMANIA CITY
Authors: Abdullah Asmaa , Yasseen Hadeel , Khudier Hassanain , Ibrahim Ali
Published: July 2017

Background

Carcinoid tumor of appendix is the most common appendiceal tumor. Both the classical and mixed carcinoid tumor could be identified using the routine H&E stain. Using additional stains such as Periodic Schiff stain, Alcian blue and cytokeratin 20 (CK20) stain have been used to detect these appendiceal mixed (glandular) carcinoid tumors.

Objective

To identify glandular differentiation and mucin production in appendiceal carcinoid tumors by using special stains and immunohistochemistry.

Patients and Methods

This retrospective case-control study was carried out in research laboratory of Pathology Department/School of Medicine. All pathological reports of patients with appendiceal carcinoid tumor were collected from the laboratory of pathology-Sulaimani Teaching Hospital over the period of six years (from the 1st of January 2006 to the 31st of December 2011), patient’s age, sex and histopathological diagnosis were documented. Fifteen cases (out of 10533 appendectomies) were divided into 2 groups: classical (insular) and mixed (insular with mucinous differentiation). Formalin-fixed, paraffin-embedded, 4- micrometer- thick sections were immunostained with CK20 using HIER-LSAB method. All cases were stained with Alcian blue stain for acidic mucin detection, and PAS stain for neutral mucin detection within the carcinoid tumor. Then the results of H&E stain, immunostain for epithelial differentiation and the special stains for mucin production were evaluated together and compared with similar studies.

Results

The carcinoid tumor is more common in females with a peak age range of 21-30 years, mean incidence 0.14% for fifteen cases of carcinoid tumors. Carcinoid tumor in patients above 50 years is usually mixed type. PAS and Alcian blue stains are of no statistically significant correlation with glandular differentiation, while CK20 has statistically significant correlation with glandular differentiation but staining intensity is variable.

Conclusion

H&E is the main method for the identification of glandular differentiation of carcinoid tumor, however CK20 has important value to assist the diagnosis, while mucin stains have limited value in the identification of glandular differentiation of carcinoid tumor.
MATERNAL AND NEONATAL OUTCOME OF TERM PREGNANCIES PRESENTED WITH REDUCED FETAL MOVEMENT
Authors: Kellow Sundus , Adnan Hala
Published: July 2017

Background 

Maternal perception of fetal movements is the most common method to assess fetal wellbeing in most communities nowadays. It is regarded as unstructured screening on which most pregnant women depend.Significant reduction or sudden alteration in fetal movement is a potentially important sign of impending fetal death. Studies of fetal physiology using ultrasound have demonstrated an association between reduced fetal movement and poor perinatal outcome.

Objectives

To observe the outcome of pregnancies presented with reduced fetal movement (RFM ) at term regarding intra-partum complications, time and mode of delivery and neonatal outcome.

Methods

A prospective case –control study. The data collected at Sulaimania Maternity Teaching Hospital throughout the period from the 1st of September 2012 to the 1st of March 2013. One-hundred low risk pregnant ladies at term were included in the study; fifty of them with reduced fetal movements and the other fifty with good fetal movement. After taking full history and examination including fetal heart rate and manual non stress test(MNST), they were sent to ultrasound (US) examination for amniotic fluid index and Umbilical artery Doppler velocimetery. Then they were followed up until delivery when intrapartum complications, mode of delivery and neonatal outcome were recorded and tabulated for comparison between the two groups.

Results

Regarding the mode of delivery, although the rate of C/S for fetal distress was more among the cases (45.8%) than control (29.4%) it didn’t reach significant statistical difference. The number of stillbirth were just 2 babies in the case group. There were significant neonatal complications as birth asphyxia 24% with meconium

aspiration syndrome 16%, seizures 10% and early neonatal death 6% in the studied (case) group.

Conclusion

Reduced fetal movement is an important symptom that should be taken seriously and manage accordingly, to reduce perinatal morbidity and mortality. Each maternity hospital should have a protocol to deal with every pregnant presents with reduced fetal movement.
RARE ISOLATED PARTIAL ANOMALOUS PULMONARY VENOUS RETURN TO CORONARY SINUS
Authors: Salih Aso , Alsaedy Talal
Published: July 2017

Background 

A 6-years-old female was referred to our clinic for evaluation of symptomatic tachypnea, exertional dyspnea and previous echo finding of unexplained right side heart enlargement. An isolated anomalous pulmonary venous return of both right pulmonary veins to the coronary sinus vein was diagnosed after echocardiographic and CT angiogram evaluation. Adequate choice of surgical approach was done.
THE IMPLICATION OF RHEUMATOID ARTHRITIS ON BLOOD PRESSURE CONTROL
Authors: Amin Asso , Merza Raof , Muhammed Kosar , Omer Bahra
Published: July 2017

Background

Rheumatoid Arthritis associates with excessive morbidity and mortality from cardiovascular events. Hypertension is considered as a major risk factor for development of cardiovascular disease. Insufficient control of blood pressure appears to be more in Rheumatoid arthritis. However, factors influence the control of blood pressure in rheumatoid arthritis is understudied.

Objectives

To determine the control of blood pressure in rheumatoid arthritis versus non rheumatoid arthritis hypertensive subjects by using ambulatory blood pressure measurement and to identify the factors associated with insufficient control of blood pressure in Rheumatoid arthritis patients.

Patients and Methods

This is a case control study performed on seventy eight patients, 40 Rheumatoid arthritis hypertensive patient and 38 non-Rheumatoid arthritis hypertensive candidates between September 2012 and March 2013. Participants were between 45 and 85 years. An ambulatory blood pressure measurement was carried out for

all patients and an abnormal blood pressure was defined as systolic of more than 140 mm Hg and or diastolic of more than 90mm Hg.

Results

Blood pressure control is significantly lower in rheumatoid arthritis hypertensive patients compared to hypertensive non Rheumatoid arthritis control subjects (p-value 0.034). Furthermore, steroid users had more insufficient control of blood pressure compared to non users (p-value 0.028).There was significant association

between methotrexate use and better control of hypertension (p-value 0.008).

Conclusion

The present study concludes that blood pressure control is lower in rheumatoid arthritis patients compared with non rheumatoid arthritis subjects; this may be of importance in the context of the increased cardiovascular morbidity and mortality. Those with co morbidity may require closer monitoring and treatment strategies.
NECESSARY INCISION IN UPPER ABDOMINAL SURGERY FEASIBILITY AND OUTCOME
Authors: Abdulkarem Kalander , Faraj Faruk , Abdullah Khalid
Published: July 2017

Background

Minilaparotomy could offer the patient a less invasive surgical approach when compared to the standardlaparotomy; it fulfills the criteria of a minimally invasive surgery involving a very small abdominal incision. The natural progression of minimal invasive surgeries is to perform the same large-scale technical operation with minimal or no evidence of scaring. Between laparotomy and laparoscopy another possible alternative is mini-laparotomy, which serves as an interesting option due to the size and benefit of the small incisions.

Objective

The Aim of our study was to assess the feasibility of performing a major upper abdominal operation through a small incision less than 6 cm in length and recording the outcomes of the procedures.

Methods

This is a prospective study carried out in Sulaymaniyah teaching hospital from October 2010 to October 2012. The study includes thirty-one patients for whom various upper abdominal surgeries were performed.The operations were categorized in to four main groups; (Upper Gastrointestinal, Hepatobiliary, Spleen and combined surgical procedures). Data were collected regarding demographic aspects of each patient. After the procedures the patients were monitored for any local complications related to the incision. Shortly before discharge wound inspection was preformed, information regarding length of incision, duration of hospital stay and wound related complications were recorded.

Results

Of the thirty-one patients, 51.6 % were male and 48.4 % female, the age ranged from 6 months to 85 years, with a mean age of 38.47. The mean incision length was 4.30 cm, ranging from 2 -9 cm, with a mean hospital stay of 42.58 hours (1.77 days). There were no local complications related to the incision noted during the period of observation.

Conclusion

Mini-laparotomy is a feasible approach for upper abdominal surgeries in different age groups as well as different operative procedures.
IMPROVEMENT OF QUALITY OF LIFE AFTER ENDOSCOPIC SINUS SURGERY FOR CHRONIC RHINO-SINUSITIS
Authors: Aziz Muaid
Published: July 2017

Background

Chronic Rhinosinusitis has a great impact on patient`s life quality because of its associated symptoms,were endoscopic sinus surgery widely used as treatment for it , so assessment of symptomatic outcome of this type of surgery on quality of life will be of value for otorhinolaryngology surgeons and for the patient.

Objectives

To assess the effect of endoscopic sinus surgery in improving symptoms and health aspect of quality of life for patients with chronic rhinosinusitis depending on the patient`s satisfaction.

This prospective study conducted on 60 patients suffering from chronic rhinosinusitis, with male predominance (33 Males: 27 Females), were underwent endoscopic sinus surgery. Sino-Nasal Assessment Questionnaire used for data collection preoperatively and six months postoperatively. Data analyzed statistically and compared.

Results

There was highly significant association between the preoperative and postoperative scores(p <0.001), no association found for the outcome with the age(p>0.05) or sex (p>0.05), nasal obstruction was the most relieved symptom and cough was the least.

Conclusion

Endoscopic sinus surgery done for patients with chronic rhinosinusitishas a positive effect on disease-specific Quality of Life after six months follow-up.
EFFECT OF AGE, GENDER, BLOOD GROUP AND SOCIAL STATE ON THE SERO-PREVALENCE OF HELICOBACTER PYLORI INFECTION AMONG ASYMPTOMATIC SUBJECTS IN SULAIMANI
Authors: Ibrahim Hadeel , Al-Dhahir Hawa , Mohammed Mohammed
Published: July 2017

Background

It is known that blood group antigens are related to the development of peptic ulcer and gastric carcinoma. Infections due to H. pylori are most widespread among the developing regions due to poor standard of public health.

Objectives

This study sought to determine the seroprevalence of H. pylori in asymptomatic individual in Sulaimani and to correlate such prevalence with age, gender, blood group and Socioeconomic state.

Methods

This study conducted in Ali Kamal Consultation clinic, Kurdistan Teaching center of Gastroenterology & Hepatology (escorts of patients) and students from University of Sulaimani, from the 1st of January to the 20th of November 2013. Serum samples from 188 apparently healthy subjects were tested for the presence of IgG and IgA antibody to H. pylori by use of ELISA test. ABO blood grouping was also done by hemagglutination test.

Results

Of the 188 subjects, there were 92(48.9%) males and 96 (51.1%) females. The age range was 20 to 49 years. The overall prevalence of H. pylori infection in our study was 68.1%. H. pylori antibodies were positive in 73(79.4%) males and 55(57.3%) females, showing no significant difference P=0.079. The overall seroprevalence was found in 57.1% subjects between 20-29 years of age, 75.8% in subjects between 40-49 years of age showing significant difference P=0.045. Distribution of ABO blood groups in H. pylori positive group were, A=70.2%, B=32.4%, AB=57.1% and O=86.1%, with a statistically significant link for blood group O (p=0.001). H. pylori sero-positivity was higher in low social state 59(93.7%), moderate social state 47(87%) then lowest in high social state 22 (31%), P = 0.032.

Conclusions

This study demonstrated that H. pylori infection can be related to ABO blood group, age and social state. People of blood group O, 40-49 years of age and low social state are more prone to develop this infection.
EFFECT OF WALKING OF THE CHILD INDEPENDENTLY ON THE DEVELOPMENTAL DYSPLASIA OF THE HIP
Authors: Ahmed Jager
Published: July 2017

Background

In developmental dysplasia of the hip a number of pathological changes develop, some of them perhaps reflecting a primary dysplasia of the acetabulum and / or the proximal femur, but most of them are results of adaptation to persistent instability and abnormal joint loading. After weight bearing commences, these changes are intensified. Most children begin to walk independently near their 1st year birthday; some do not walk until 18 month of age. At this age group the classical treatment of a dislocated hip is closed reduction with spica cast then abduction splint. Re-displacement is one of the complications of the treatment of developmental dysplasia of the hip.

Objective

The aim is to assess the effect of independent walking of a child on the future treatment of a missed dislocated hip whether it increases the risk of failure of treatment by re-displacement of the hip or not.

Patients and Methods

This study included those children who had missed dislocation or subluxation of the hip and they were at the expected period of beginning of walking independently (age 12-18 months). They were 87 patients with 131 dislocated or subluxated hips. Patients were divided into five groups: Group 1: still not walking independently, Group 2: walking independently for less than 1 month, Group 3: walking for 1-2 months, Group 4: walking for 2-3 months and Group 5: walking for more than 3 months.

Results

Most of patients in Group 1 had bilateral developmental dysplasia of the hip (DDH) (63.3%) and also in Group 5 (80%), while in Group 2, 3 and 4 the DDH were more common in one side (75%, 71.4% and 72.7% respectively ). From the total number of patients who had been included in this study, 21 hips out of 131 showed signs of re-displacement with an incidence of failure of 16 %. There were 3 hips in Group 1, 1 hip in Group 2, 4 hips in Group 3, 6 hips in Group 4 and 7 hips in Group 5.

Conclusion

Walking of a child independently is associated with an increased risk of failure of closed reduction in patients having developmental dysplasia of the hip between the age of 12-18 months specially after 2 months from walking.
NON TRAUMATIC GASTROINTESTINAL PERFORATION AS A CAUSE OF ACUTE ABDOMEN
Authors: Saeed Kamal , Abdulqadr Kamal
Published: July 2017

Background

Any part of the GI tract may become perforated, releasing gastric or intestinal contents into the peritoneal space. Causes vary. Symptoms develop suddenly, with severe pain and may be followed by signs of shock. Diagnosis is usually made by the presence of free air in the abdomen on imaging studies. Treatment is with fluid resuscitation, antibiotics, and surgery. Mortality varies with the underlying disorder and the patient’s general health.

Objectives

To study the clinical pattern of various gastrointestinal perforations in Surgical Emergency Department in Sulaimany.

Patients and Methods

This prospective study was done in Sulaimany Teaching Hospital, including all emergency, non-traumatic acute abdomen those were caused by gastrointestinal (GI) perforation from the 1st of February 2011 to the 1st of September 2012. A total of 100 patients were collected. Patient’s data were analyzed by history, examination and various laboratory investigations and radiological studies.

Results

The commonest cause of perforation was peptic ulcer (70%), nineteen cases (19%) were infection, and the remaining (11%) were from other causes. Seventy-two patients (72%) were male and (28%) were female, fifty cases were of age between 15-45 years. Most of the patients presented with pain in the abdomen (93%), eighty febrile, and (7%) had shock. Ninety-eight (98%) cases were surgically treated, of which 60 were recovered uneventfully, thirty-one cases developed complications and 8 died post-operatively.

Conclusion

To manage a case of perforated hollow viscus of any sort, a skilled surgical team which can handle these situations confidently is of prime importance.
THREE HUNDRED SIXTY DEGREE PHOTOTHERAPY VERSUS CONVENTIONAL PHOTOTHERAPY IN NEONATAL INDIRECT HYPERBILIRUBINEMIA
Authors: Mahdy Hind , Alrabaty Abbas , Alsaqy Azhar
Published: July 2017

Background

Phototherapy is the mainstay of treatment of hyperbilirubinemia. The efficacy of phototherapy depended on the light spectrum (wavelength), intensity of and type of the light and surface area of the infant exposed to phototherapy and distance of the light from the baby. A measure of the efficacy of phototherapy is the rate of decline in total serum bilirubin per hour and the dramatic reduction in the number of exchange transfusions being performed.

Objectives

To determine the efficacy of increasing surface area of phototherapy (360◦) compared with conventional single surface fluorescent phototherapy.

Patients and Methods

A prospective study was done for 214 neonates, who were admitted to neonatal care unit at Raprin teaching hospital in a period of 6 months from the first of January till the thirty of July 2013. Neonates were presented with significant indirect hyperbilirubinemia that needed phototherapy, less than two weeks of age were included in this study. According to the level of total serum bilirubin and availability of highly intensive phototherapy the cases were divided in to two groups.

Results

The mean starting TSB in group I was 15.03±2.53 mg/dl while in group II 19.65±3.34 mg/dl and the percentage of decline after 12 hour in group I was 19.17±13.08%, while in group II was 39.37±10.31% , and it was statistically significant (p<0.001). The decline rate after 12 hour ,regarding group I was 0.23 ± 0.21 mg/dl/hr, while in group II was 0.50 ± 0.33 mg/dl/hr which was statistically significant (p<0.001). There was a significant decline in the number of exchange transfusion in 2013 when the highly intensive 360 degree phototherapy started to be used.

Conclusion

Increasing surface area of exposure increase the rate of reducing of the serum bilirubin, and decreases rate of exchange transfusion as well.
EFFECTIVENESS OF CINNARIZINE AND/OR POSTURAL RESTRICTION AS AN ADJUVANT MEASURES ON THE THERAPEUTIC EFFECTS OF CANALITH REPOSITIONING PROCEDURE IN TREATING UNILATERAL PC-BPPV
Authors: Zmnako Sherko
Published: July 2017

Background 

Posterior Canal Benign Paroxysmal Positional Vertigo (PC-BPPV) is by far the most common cause of vertigo, to establish the diagnosis the Dix-Hallpike maneuver (DX) is the definitive part of the physical examination.First-line therapy is organized around Canalith Repositioning Procedure (CRP). Further treatment options include: many otolaryngologists had routinely prescribed post-maneuver postural restriction and/or vestibular suppressants the latter as an adjuvant treatment for this disorder.

Patients and Methods

A prospective double blinded randomized interventional controlled study conducted on 109 patients diagnosed as having canalithiasis unilateral PC-BPPV. Enrolled patients were received CRP as an initial standard treatment then randomly assigned in to four groups of treatments. Two different scales of vertigo symptoms assessment were used before and after the procedure: 1- Dizziness Handicap Inventory (DHI). 2- Vertigo Symptom Scale - Short Form (SF).

Results

DHI 1, SF 1 (1 week post-CRP) and DHI 3, SF 3 (3 months post-CRP) didn’t show significant differences across the groups, P value: 0.487, 0.933, 0.979 and 0.145 respectively (P > 0.05). The mean ranks of DHI 2 and SF 2 (1month post-CRP) in G3 in compare with other groups are lower in both scales. The mean ranks of DHI

2 in Groups 1, 2, 3 and 4 are 59.78, 53.33, 29.39 and 42.1 respectively and in addition these ranks for SF 2 are 53.5, 57.07, 29.95 and 45.48 respectively.

Conclusion

Cinnarizine as adjuvant therapy didn’t enhance the therapeutic effect of CRP. Adjuvant postural restriction enhances the therapeutic effect of CRP by facilitating symptoms resolution within one month (medium term effect).