bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTRAVENOUS LINE COLONIZATION IN PATIENTS RECEIVING CYTOTOXIC DRUGS
Authors: Hama Rahim Hero , Omer Sherko 
Published: August 2017

Background
Hospital acquired infections are infections that develop during the hospital stay; they mainly include urinary tract, respiratory tract or blood stream infections.
Objectives
To investigate microbial colonization of intravenous cannula of cancers patients receiving cytotoxic drugs.
Materials and Methods
Colonization of intravenous cannulas was investigated by cultivation of the device surface and lumen on different culture media under aerobic incubation. The isolates were identified based on cultural, morphological and biochemical activities. The susceptibility of the isolates to antimicrobial drugs was investigated using Bauer-Kirby disk diffusion method and the bacterial isolates were further investigated for their ability to form biofilm.
Results
From 200 cultivated intravenous cannulas, microbial colonization was detected among 26% and 11% of intravenous cannulas from cancer and non-cancer patients respectively; Out of 37 isolates, 34 (91.9 %) were Gram-positive bacteria, 2 (5.4 %) Gram-negative bacteria and one (2.7 %) was a Candida species. The main bacterial isolates were bacteria belonging to different coagulase negative staphylococci species such as Staphylococcus epidermidis, S. hominis and others. Few faecal organisms were isolated including a single isolate of each Klebsiella pneumoniae and Escherichia coli. All bacterial isolates were able to form biofilm and most showed to have biofilm-related icaA and icaD genes.
Conclusion
We detected microbial colonization of intravenous cannulas in 18.5% of all cultivated devices. We observed more colonization in cancer patients (26%) in comparison to the control group (11%). Most of the isolates were species of CoNS that were able to form biofilm.
EARLY OUTCOME OF TOT SURGERY FOR URINARY INCONTINENCE IN SULAIMANI TEACHING HOSPITAL
Authors: Bajalan Diar , Hassan Mohammed , Sami Ali , Abdulwahab Ahmed , Ameen Ismaeel 
Published: August 2017

Background
Female urinary incontinence is a major health issue affecting about 30% of adult women and majority of them is stress type. Transobturator tape (TOT) technique is relatively safe and associated with minimum complication rate.
Objectives
To identify the safety, success rate and efficacy of TOT procedures performed for female patients with stress urinary incontinence.
Patients and Methods
A prospective study included thirty patients with history of urinary incontinence (22 patients with stress type and 8 patients with mixed type UI). They underwent TOT procedure in Sulaimani teaching hospital under general or spinal anesthesia; they were collected over a year from June 2014 to June 2015, all of them referred from urological clinic with history of stress or mixed urinary incontinence. The response of TOT surgery was assessed in both subjective and objective ways, using the ICIQ-UI short form and both cough stress test and Q-tip test (before and after surgery), 20 of them had urodynamic study before surgery to confirm the diagnosis, follow up done at one week, three months and six months postoperatively.
Results
A total of 30 females with mean age (48.8±9.51) years, Mean number of deliveries for studied females was (4.9±2) deliveries. Main type of urinary incontinence among studied females was stress urinary incontinence (73, 3%); followed by mixed urinary incontinence (26, 7%), all of them were from Sulaimani city and its peripheries. In this study; we found that the success rate is 80% (considering both objective and subjective outcome) which is comparative to similar studies. The early complications were mainly perineal (groin) and upper thigh pain, while the late complications were the development of de novo detrusor over activity, there were no vaginal or urethral erosions.
Conclusion
Transobturator tape (TOT) is an efficient and safe way of managing stress urinary incontinence with high success rate and short hospitalization with minimum and simple early complications.
COMPARISON OF POST OPERATIVE CORNEAL ASTIGMATISM BETWEEN SMALL INCISION CATARACT SURGERY (SICS) AND EXTRA CAPSULAR CATARACT EXTRACTION (ECCE)
Authors: Hama Salih Bakhtiar , Mardan Roza 
Published: August 2017

Background
Cataract surgery is the most common type of surgery done by ophthalmologists. There are many methods of performing cataract surgery. Each of them has its own advantages and complications. Here we want to find the outcome of both the manual small incision cataract surgery and the conventional extracapsular cataract extraction surgery.
Objectives
To find the degree of postoperative corneal astigmatism in both manual small incision cataract surgery and the extracapsular cataract extraction surgery and compare these outcomes in both techniques.
Patients and Methods
We performed an experimental study conducted from January 2016 to June 2016 in Shahid Dr.Aso hospital ophthalmology department and Best Vision private hospital, Sulemani Province/Kurdistan Region of Iraq. One hundred cases were enrolled in the study, 50 cases underwent manual small incision cataract surgery and the other 50 underwent extracapsular cataract extraction surgery. All patients had their history taken, preoperative evaluation by (Slit-lamp examination, intraocular pressure measurement, indirect ophthalmoscopy for fundus examination, intraocular lens measurement, B-scan). Postoperatively; after 2 months, all cases in both groups were re-evaluated by the same measures of the preoperative examination.
Results
The mean postoperative uncorrected visual acuity in the manual small incision cataract surgery and extracapsular cataract extraction group was 6/9 and 6/12, respectively. The mean postoperative corneal astigmatism was 1.27+0.94 in manual small incision cataract surgery compared to 2.59+1.65 in the extracapsular cataract extraction surgery.
Conclusion
Both manual small incision and extracapsular cataract extraction techniques are safe and effective for visual rehabilitation of cataract patients. However, manual small incision cataract surgery gives better uncorrected visual acuity and less induced corneal astigmatism at 8 weeks postoperatively.
ACCURACY OF TRANSPERINEAL ULTRASOUND RELATIVE TO MAGNETIC RESONANCE IMAGING IN EVALUATION OF PERIANAL FISTULAS
Authors: Fateh Salah 
Published: August 2017

Background
Ano-rectal fistula is a chronic inflammation of perianal tissues affecting 1/10.000 individuals. Traditionally, treatment is surgical with the possibility of recurrence reaching up to a quarter of cases, therefore preoperative appropriate evaluations and imaging are necessary to decrease recurrence rate.
Objectives
Determining accuracy of transperineal ultrasound relative to magnetic resonance imaging in evaluation of perianal fistulas.
Methods
A prospective study was conducted on 51 patients with clinically diagnosed perianal fistula. Transperineal ultrasound (TPUS) and magnetic resonance imaging (MRI) were done for all patients. The following variables were recorded by each of the tests and the results were compared one to one: Firstly the number of the tracts, their relation to the anal sphincters. Secndly the number of internal openings, their sites and distances from the anal verge. Thirdly any associated findings, including perianal abscess, extension (branching) or local inflammatory phlegmons. Descriptive statistics were used. P-values ≤ 0.05 were considered statistically significant.
Results
Relative to the MRI, the accuracy of TPUS in detection of fistula tract was 96%. Finding of at least one relation of the tract to the anal sphincter was 86.7%, detection of internal opening was 82%, and localization of the internal opening was 82% with comparable result in measuring their distance from the anal verge (P value = 0.15). Lastly the overall accuracy of TPUS to find at least one associated finding was 92%. Among detected associated findings, TPUS was able to accurately classify them with no significant difference between TPUS and MRI (P-Value > 0.05). Three superficial fistula tracts were detected by TPUS and proved by surgical operation while they were undetectable by MRI.
Conclusion
TPUS is an accurate imaging investigation in the evaluation of perianal fistula and its results was comparable to those of MRI in preoperative assessment of perianal fistula diseases.
ENDOTRACHEAL INTUBATION WITH SEVOFLURANE IN SURGICAL PEDIATRIC PATIENTS: INCREMENTAL VERSUS HIGH CONCENTRATION INHALATION INDUCTION
Authors: Boujan Amir , Hassan Dara 
Published: August 2017

Background
Sevoflurane is a preferred anesthetic agent for induction and maintenance of pediatric anesthesia. Many studies have been undertaken to show the optimal technique of induction with sevoflurane. In this study we compare the optimal time needed for successful tracheal intubation with immediate high concentration sevoflurane and incremental sevoflurane induction in surgical pediatric patients.
Patients and Methods
With the approval of the Research Scientific and Ethic Committee of the School of Medicine at Sulaimani University at 18th of May 2011, and the informed written consent from the parents, we studied 100 patients of ASA (American Society of Anesthesiologists) physical status І and II elective pediatric surgical patients aged 2-7 years, patients admitted to Sulaimani Teaching Hospital at the Otorhinolaryngology, Head and Neck Surgical Department, from the first of June 2011 to the first of September 2011. Sevoflurane has been used for induction in children who were scheduled for elective adenotonsillectomy operations. Patients were randomly divided into two equal groups, group 1 (G1) 50 patients, using incremental induction with sevoflurane (1-8 %) in 100% O2, the vapor concentration is increased by 1% every few breaths, and group 2 (G2) 50 patients, using high concentration of sevoflurane for induction, (8%) in 100% O2 from the beginning of induction. Intubation is done when the pupils are miotic and centered, after establishing a good muscle relaxation with no movements in response to laryngoscopy and tracheal intubation. The time from induction to successful tracheal intubation is recorded.
Results
We have found that the mean time for tracheal tube insertion was shorter in (G2) 208.4 seconds ± 44.5 (SD), than (G1) 265.8 seconds ± 44.4 (SD), and this was statistically significant with a P value of less than 0.001, Vital signs were stable in both groups.
Conclusion
In healthy pediatric patients undergoing mask induction of general anesthesia with sevoflurane, the induction time can be significantly shortened using a high concentration compared with a conventional, incremental induction method.
DOES AN ANTENATAL EDUCATIONAL PROGRAM IMPROVE MATERNAL OUTCOMES AMONG OBESE PREGNANT WOMEN IN THE KURDISTAN REGION OF IRAQ
Authors: Hajimam Aveen , Harris Tina 
Published: August 2017

Background
Maternal obesity is associated with health risks for mother and new-born. Obesity during pregnancy has increased dramatically in Iraqi Kurdistan.
Objectives
The aim for this study is to assess the influence of an educational program on the maternal pregnancy outcomes of obese women attending primary health centres in a large city in the Kurdistan region of Iraq.
Methods
A quasi –experiment was undertaken. 292 pregnant women who attended one of three health centres for their antenatal care prior to 20 weeks gestation were recruited to the study. 99 women were recruited were of normal weight with a BMI of 20-25Kg/m2, (baseline group), 96 women had a BMI ≥ 30 and were randomised to receive normal care (control group) and 97 obese women were allocated to received normal antenatal care and invited to participate in an antenatal education programme (intervention group). Maternal outcomes measured were gestational weight gain during pregnancy, pregnancy induced hypertension, Gestational Diabetes Mellitus and duration of pregnancy.
Results
Obese women were older and were more likely to have had more pregnancies than normal weight women. Regarding maternal outcomes there was no statistically significant difference among the three groups regarding pregnancy induced hypertension, and Gestational age at onset of labour. In relation to gestational diabetes mellitus findings indicated that the prevalence of gestational diabetes mellitus was reduced among those obese women who received the educational programme compared to the control and baseline groups. In addition all obese women (intervention and control groups) had a statistically significant lower weight gain in pregnancy compared to baseline group.
Conclusions
The antenatal education programme made a small difference to maternal outcomes. The prevalence of gestational diabetes was reduced in women who accessed the programme suggesting that gestational diabetescould be decreased by educating women during pregnancy regarding healthy diet and exercise.One factor which may have affected the results of this study was the low attendance rate among women who were randomised to receive the education programme. A higher rate of attendance at education classes may have improved outcomes in others areas.
HISTOPATHOLOGICAL CORRELATION OF LUPUS NEPHRITIS WITH EXTRA-RENAL MANIFESTATION AND LABORATORY FINDINGS
Authors: Mirza Raouf 
Published: August 2017

Background
Lupus nephritis is one of the most serious manifestations of Systemic lupus erythematosis and it is a major cause of morbidity and mortality.
Objectives
To find out the relation between Histopathologyical classes of Lupus nephritis with renal, extra renal clinical manifestation and laboratory data.
Patients and Methods
A cross-sectional study performed on 45 patients with biopsy proven lupus nephritis, which they were collected from April 2012 to April 2013.
Results
The current study shows female predominance 32 (71.1%) compared with 13 (28.9%) male. Class IV 15 (33.3%) was the most common type followed by class III 9 (20.9%). The new onset hypertension was the commonest clinical renal presentation 32 (71.1%) and the musculoskeletal manifestation 37 (82.2%) was the most common extra renal manifestation. The correlation between classes of Lupus nephritis with clinical and laboratory data were significant for hypertension, 24 hrs urinary protein excretion, S. Creatinine, S. Albumin, Anti-Sm and Anti-dsDNA positivity and low complement levels (C3, C4).
Conclusion
Class IV is the commonest class of Lupus nephritis. Female preponderance becomes less pronounce in lupus nephritis compared to prevalence SLE.
COMPARING THE EFFECT OF MIDAZOLAM AND METOCLOPRAMIDE ON PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA
Authors: Ali Gona , Hama Aree 
Published: August 2017

Background
Postoperative nausea and vomiting is one of the most frequent complications of general anesthesia. The overall incidence of postoperative nausea and vomiting is currently estimated to be around 20 to 30% and in certain high-risk patients; this incidence may reach 70% .
Aims
The aim of the study is to compare the antiemetic efficacy of midazolam or metoclopramide in laparoscopic surgery under general anesthesia.
Methods
In this study 120 patients (ASA I–II) whom underwnet laparoscopic cholecystectomy in Sulaimani Teaching Hospital were evaluated as double-blinded randomized study, patients were allocated randomly to one of three main groups: Group 1 (n= 40) received midazolam (0.03 mg/kg) i.v as a premedication, Group 2 (n= 40) received metoclopramide (10 mg) i.v as a premedication and Group 3 (n= 40) received standard premedication. Anesthesia was standardized for all patients, follow up done for them up to 24 hrs. Data were interpreted by Chi-square test and Pearson’s test, using Statistical Package of Social Sciences Software (SPSS).
Results
The incidence of postoperative nausea and vomiting was 20% with midazolam (P < 0.05), 35% with metoclopramide (P >0.05), and 57.5% with none of two drugs.
Conclusion
Midazolam is more effective than metoclopramide in preventing post-operative nausea and vomiting.
THE EFFECT OF ADENOTONSILLECTOMY ON THE QUALITY OF LIFE AMONG CHILDREN TWO TO THIRTEEN YEARS OF AGE
Authors: Zmnako Sherko , Chalabi Yusuf , Said Said , Hama Ameen Huner , Krim Rekawt , Mohammed Mohammed 
Published: August 2017

Background
The tonsils and adenoid enlargement are the most common cause of respiratory tract obstruction in children and cause obstructive sleep apnea and snoring. These children may present with recurrent upper respiratory tract infection with frequent antibiotic uses. Parents may worry about some alteration in children’s behavior and development which are caused by adenotonsillar enlargement.
Objectives
To evaluate the quality of life of children with adenotonsillar enlargement, recurrent and chronic tonsillitis before and after adenotonsillectomy.
Patients and Methods
A prospective observational study done. Data collected from (January 2015 to end of July, 2015). Parents of 118 children who underwent adenotonsillectomy in (ENT, Head and Neck Surgery – Sulaimani Teaching Center) were interviewed before the operation and 6 months after the operation, by using the questionnaire about quality of life, physical problems, sleeping problems, speech and swallowing problems, emotional discomfort, limitation of activities and parents’ concerns; each of them scored from zero to six.
Results
The score obtained by the questionnaire after adenotonsillectomy significantlyreduced as compared to the score obtained before the operation. Symptoms which have the highest scores before the operation are nasal obstruction and snoring. There was a decrease in the number of upper respiratory tract infections after the adenotonsillectomy. There was a significant decrease in the use of antibiotics after adenotonsillectomy.
Conclusion
We conclude that the quality of life of these children improved after adenotonsillectomy, especially the physical problems and sleep problems, the number of upper respiratory tract infections decreased and the decrease in the use of antibiotics, but children who have had symptoms of rhinitis had less improvement in their quality of life compared to the children who didn’t have these symptoms.
Urban–Rural Differences in Suicide in the State of Maryland: The Role of Firearms
Authors: Nestadt Paul S. , Triplett Patrick , Fowler David R. , Mojtabai Ramin 
Published: August 2017

Objectives. To assess whether the use of firearms explains rural–urban differences in suicide rates. Methods. We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race. Results. Suicide rates were higher in rural compared with urban counties. However, the higher rural suicide rates were limited to firearm suicides (incident rate ratio [IRR] = 1.66; 95% confidence interval [CI] = 1.20, 2.31). Nonfirearm suicide rates were not significantly higher in rural settings. Furthermore, 89% of firearm suicides occurred in men and the higher rural firearm suicide rate was limited to men (IRR = 1.36; 95% CI = 1.09, 1.69). Women were significantly less likely to complete suicide in rural areas (IRR = 0.63; 95% CI = 0.43, 0.94), regardless of method. Conclusions. Male firearm use drives the increased rate of suicide in rural areas. The opposite associations between urbanicity and suicide in men and women may be driven by the male preference for firearms as a method for committing suicide.
ANALYSIS OF SEA WATER POLLUTION IN COASTAL MARINE DISTRICT TUBAN TO THE QUALITY STANDARDS OF SEA WATER WITH USING STORET METHOD
Authors: Spanton Perdana Ixbal , Saputra Abdul Aziz 
Published: August 2017

<pre><em>The sea water is a component that interacts with the terrestrial environment, where sewage from the land will lead to the sea. Waste containing these pollutants will enter into coastal waters and marine ecosystems. Partially soluble in water, partially sinks to the bottom and was concentrated sediment, and partly into the body tissues of marine organisms. This study was conducted to determine the level of pollution of sea water on the coast in the district of Tuban. This research was conducted in the Coastal Water Tuban, East Java. The main material used in research on Analysis of Water Pollution in Coastal Sea on Tuban. The method used in this research is using storet method and compared to the quality standards of the Environment Decree No. 51 in 2004. Based on the analysis of testing at five sampling point’s seawater around Bodies Tuban, obtained by sea water quality measurement results either in physics, chemistry, and microbiology varied. The level of pollution of sea water around Coastal Tuban obtained by using Storet Method average value of analysis is -4.2 included in class B are lightly blackened, while using values obtained Pollution Index average pollution index of 3.60 is included in the category lightly blackened.</em></pre><p><em> </em></p><pre><strong>Keywords:</strong> <em>Analysis of the pollution level of seawater on the coast in Tuban, Quality Standards of Sea Water, Storet Method.</em></pre><pre><em><br /></em></pre>
A Fully Coupled Model for Hydraulic-Fracture Growth During Multiwell-Fracturing Treatments: Enhancing Fracture Complexity
Authors: Li Sanbai , Zhang Dongxiao 
Published: August 2017

Summary
Multiwell-completion techniques, such as sequential fracturing, zipper fracturing, and simultaneous fracturing, have been proposed to improve fracture complexity and connectivity. Critical geomechanics behind the multiwell-fracturing techniques include pore-pressure propagation, cooling stress, tip-induced shear stress, and reversal of stress anisotropy. To optimize multiwell-fracturing treatments, we numerically investigated fracture growth from the perspective of thermo/hydromechanical (THM) coupling. The coupled geomechanics and fluid-heat-flow model is derived from a mixed finite-element (FE) and finite-volume (FV) method, which is capable of simulating multifracture growth in heterogeneous reservoirs. In this study, both hydraulic-fracture (HF) propagation and natural-fracture (NF) reactivation in opening or shearing patterns were taken into account. Particularly, an elastoplastic fracture constitutive model was adopted to predict permanent enhancement of fracture aperture. The effects of perforation-cluster spacing, well spacing, and the fracturing sequence of multiwell completion upon fracture complexity were studied, where the total hydraulically fractured area was treated as the primary indicator of HF effectiveness. By numerical parametric studies, we determined four findings. First, there is an optimal cluster spacing for maximizing the total fracture area for a stage with a given length. Cluster spacing mainly affects stress distribution during HF, which subsequently affects the path of newly created fracture propagation and crossing behaviors (i.e., crossing, arresting, or offsetting). Second, suitable well spacing should be chosen carefully to avoid the hydraulic interconnection between the tip-to-tip stages, as well as to make use of tip-induced shear stresses. Third, the fracturing sequence for multiwell completion is of critical importance. Among three multiwell-completion schemes (i.e., sequential, zipper, and simultaneous fracturing), the zipper-fracturing technique achieves the best fracturing effectiveness for this case study. Fourth, the effect of stress perturbation on NFs can be quite different, depending on the position relative to the created stimulated reservoir volume (SRV). The coupled model significantly improves our understanding of multiwell-fracturing treatments and then provides us with a means to optimize the multiwell completion, enhancing fracture complexity to effectively improve productivity.