Table of content

Mustansiriya Medical Journal

مجلة المستنصرية الطبية

ISSN: 20701128 22274081
Publisher: Al-Mustansyriah University
Faculty: Medicine
Language: English

This journal is Open Access

About

Mustansiriya Medical Journal MMJ, a semi-annual peer-reviewed journal, is the official Journal of the College of Medicine, Al-Mustansiriya University. The journal was first published during the academic year 2001 - 2002 as the "Journal of Basic Medical Sciences" . Later on, an in order to expand the scope of publication and attract more scientific articles, the editorial board decided in late 2007 to switch the name from “ The Journal of Basic Medical Sciences” to “Mustansiriya Medical Journal”, the official Journal of the Faculty of Medicine at the University of Mustansiriya. The first issue with this new name was published in May 2008.

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Contact info

Iraq, Baghdad, College of Medicine, Al-Mustansiriya University, P.o.Box: 14132
Tel: 5413485
Fax: 5410584
email: mmj.mcom@yahoo.com

Table of content: 2011 volume:10 issue:1

Article
Admission plasma glucose level among non-diabetic patients sustaining acute coronary syndrome

Authors: Hussein S. Sakhi
Pages: 1-7
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Abstract

Background Stress hyperglycemia occurs in 5−30% of patients with apoplexy, myocardial infarction, sepsis, trauma and other critical illnesses, and it correlates with poor outcome. Aims: assessment of the prevalence of admission hyperglycemia among acute coronary syndrome patients and its impact on the outcome. Patients and methods Observational case control study had recruited 80 non-diabetic adults’ patients (43 males, 37 females) who were randomly selected after admission to the CCU/department of medicine/ Al-Yarmouk Teaching Hospital in the period from March to October 2009 because of acute coronary syndrome. Detailed history and physical examination were done, body mass index, waist-hip-ratio were recorded, venous blood sample were taken from patients to measure plasma glucose level and HbA1c; ECG and echocardiogram were done to all patients included in the study. Results 80 patients (43 males, 37 females) completed the study, their age groups ranging from 37-76 years, 3 patients were excluded from the study (2 male, 1 female) when they found to have high HbA1c ( ≥6.5%). 16 patients (20.6% of total no.) (7 male, 9 female) with a mean age of (62.19±7.17) were found to have casual admission (stress) hyperglycemic, a p value <0.05. Hyperglycemia is more likely associated with a female gender, advancing age, higher BMI, android pattern of body fat distribution, and higher killip classes (III, IV). Conclusions Casual admission (stress) hyperglycemia is not uncommon among non- diabetic adults admitted for acute coronary syndrome. Poorer outcome in patients with ACS is more likely among those with higher glycemic level, especially with advancing age, female gender and increased total body fat.


Article
A study of the correlation between the histopathological grading and size of breast cancer with the axillary lymph node involvement

Authors: Maitham M. Al-khateeb
Pages: 15-21
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Abstract

Background breast cancer In Iraq is the commonest tumor affecting females accounting for more than 18% in 2007 of registered female cancers with increase incidence in young women. Aims The study aims to outline the correlation between histopathological grading of breast cancer cells with the ipsilateral A.L.N involvement in relation to the size of cancer. Patients & methods A continuous prospective study where by almost all mastectomized patient for breast cancer in Al- Yarmouk Teaching Hospital were included from January 2008 to January 2011, revision to all histopathological reports in the histopathological department was done , tables were made and the P value was calculated. Results Breast cancer cases represent 28.1% of breast surgery in this Hospital during the period of study. The commonest age group was the 5th decade 36.9% followed by the 4th decade 23%. Urban cases more than rural area cases, (I.D.C) 81.5% and (I.L.C) 18.5%. Regarding The histological grading grade II came first 70.8% grade III 20% and grade (I) 9.2%, A.L.N involvement 100% in grade (III), 65.2% In grade (II) and 33.3% in grade I. Breast cancer size 2-5 cm represent 63% of The cases, tumor size more than 5 cm represent 30% and those with size less than 2 cm 6.3%. Conclusions Breast cancer cases represent 28.1% of total breast surgical disease for the same period of time done in this hospital and this is an important percent which reflect the need for increased emphasis on early detection by clinical and mammographic method or U/S study.


Article
The effect of Ginseng and Nigella sativa on the psychomotor performance: Randomized clinical trial

Authors: Ali Kadhum Chelab
Pages: 22-27
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Abstract

Background Ginseng and nigella sativa produced different central effects separately but the combined effects not studied previously. Aims This study aimed to shows the separated and combined effects of Ginseng and Nigella sativa on the psychomotor performance. Subjects and method 20 healthy volunteers (15 males + 5 females) enrolled in this study, they were medical college students, and their ages were 20 – 21 year with mean of 20.2±0.41. Each volunteer do the psychomotor performance before and after each selected agents. Results The result showed ginseng produce significant improvement in all parameters of psychomotor performances, while the nigella improves only the choice reaction time and produces insignificant changes on other parameters. The combined action of ginseng and nigella produced significant improvement in all psychomotor performances parameters. Conclusions From these results, we can conclude, that combined effect of ginseng and nigella sativa produced significant effects more than ginseng alone and removed the inhibitory action of nigella sativa, also nigella sativa modulate the stimulatory action of ginseng, regarding the choice reaction time which reflect the cognitive function improvement.

Keywords

CRT --- CFFT --- Cognition


Article
Effect of N-acetylcysteine on wound healing in burned patients

Authors: Faruk H. Al-Jawad
Pages: 28-31
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Abstract

Background The magnitude of free radical generation and their disposal mechanisms are known to be altered in burn; and there is some kind of correlation exists between altered free radical cascades and delay wound healing. Aims Exploration of the variable effect of N-acetylcysteine on Wound Healing in Burned Patients. Methods 60 burned patients with different ages of both sexes and varying burn percentage were involved in this study. Patients allocated into 2 groups: A, B each group include 30 patients. Groups: B treated with antioxidant N-acetylcysteine, compared with group A which is treated according to hospital policy without antioxidant; also 30 healthy subjects (group C) were involved in the study as control group for comparison.To each group, serum malondialdehyde and serum glutathione levels, microbiological examination, healing time and mortality rate were measured depending on standard methods. Results Administration of N-acetylcysteine to burned patients produce significant reduction in the wound healing time and improvement in mortality rate, compared to group A, where no antioxidant was given. Conclusions This study clearly showed the beneficial effect of N-acetylcysteine in the treatment of burned patients represented by shortening of healing time, in addition to reduction in hospitalization period; it is recommended to add antioxidant to the treatment list of burned patients.


Article
A clinical study of the hepatopulmonary syndrome in Iraqi patients with chronic liver disease

Authors: Ziad M. Jureidini
Pages: 32-38
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Abstract

Objective To evaluate the frequency, clinical, and laboratory features of HPS and to determine their usefulness in its diagnosis in Iraqi patients with liver disease. Patients and Methods Fifty-two patients with chronic liver disease were evaluated for the presence of HPS using pulse oximetry, arterial blood gas analysis (ABG), and transthoracic contrast-enhanced echocardiography (CEE). Patients with SaO2 of ≤92% and/or a decrease in SaO2 of ≥4% after change from supine to upright position; were further tested with ABG and CEE. Patients who had a PaO2 of ≤70 mmHg together with positive CEE were considered to have HPS. Results Of 52 patients studied, 13 (26.9%) were in Child-Pugh class A, 16 (30.7%) in class B, and 23 (42.3%) in class C. Four patients (7.6%) proved to have HPS; one was in Child-Pugh class B and the other three were in class C (p=0.3574). Among the clinical features assessed as predictors of HPS, dyspnea (p = 0.0027), cyanosis (p < 0.0001), and finger clubbing (p = 0.0514) reached statistical significance. Neither upper GI endoscopy nor biochemical liver tests were statistically different between patients with and without HPS. Conclusions HPS is not rare. Dyspnea is a useful marker for its presence in the appropriate clinical setting. Platypnea, cyanosis, and finger clubbing are much less sensitive but more specific features of the syndrome. No particular pattern of biochemical liver tests is useful in predicting the presence or absence of HPS. There was a trend for HPS to occur in patients with more advanced liver disease.


Article
Analgesia in labor: Evaluating clinical trial comparing between Entonox versus parenteral pethidine during the first stage of labor

Authors: Ali H. Muslih
Pages: 39-42
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Abstract

Background An adequate analgesia during labor is important to minimize the deleterious effects of sever labor pain on maternal and fetal condition and also on the progress of labor. Aim To compare the clinical effectiveness of inhalational analgesia by using Entonox versus systemic analgesia by using I.V pethidine for pain relief in the first stage of labor. Patients and methods 48 multiparous women were selected in the first stage of labor, were randomly allocated into 2 groups, group A had received I.V pethidine and group B had received Entonox. Total pain score measurement was done by using the parameters of Mc Gill pain questionnaire which include pain rating index (PRI) and present pain intensity (PPI). Results A comparison between group A&B done, the difference in PPI between pethidine & Entonox was showing a statistical significance P<0.001. The difference in PRI between pethidine &Entonox was carrying no statistical significance. Conclusions Inhalational analgesia by using Entonox in a proper intermittent technique is more effective than systemic analgesia by using parenteral pethidine for reducing present pain intensity in the 1st stage of labor.

Keywords

Pethidine --- Entonox --- Labor pain --- PPI --- PRI


Article
Carriage rate of streptococcus species on gum of apparently healthy population in health and Medical Technology College

Authors: Nazar S. Mohammed
Pages: 43-46
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Abstract

Background Gum specimens were collected from the labial vestibule of mouth using swabs and sterile cotton were submitted to standard microbiological technique for the isolation and characterization of bacterial isolate. Aims To estimate the carriage rate of streptococcus spp. On gum of healthy population. Patients and Methods This study was conducted in the College of Health and Medical Technology and Teaching Laboratories of Medical City for the period from 1st September 2010 15th April /2011. A total of 757 participants were included .They were chosen randomly form staff and students of Health and Medical Technical College. Results 69% of normal healthy individuals were carrier for Streptococcus spp. In the labial vestibule rate between male and female participants (64% vs 5%), (P<0.05), there was significant difference in the gum carriage of streptococcus Mutans rate were 17% between male and female participants (16% vs 1%), (P<0.05). However, the age group between (18-20 years) showed higher carriage of Streptococcus salivarius. The study also found that there was significant difference between the age group (18-20) which showed higher carriage of Streptococcus mutans rate compared to other age groups. On the other hand, slightly higher carriage rate was established among rural compared to urban population (341 % vs 416%), (P>0.05). In addition, smoker participants (only male) had higher significant carriage rate in comparison with non –smokers (62.3% vs 37.7%), (P>0.05). Conclusions Considerable proportion of healthy population carries Streptococcus species (spp.) In their labial vestibule.


Article
Antimicrobial susceptibility patterns against Escherichia coli and prevalence of extended–spectrum β-lactamases

Authors: Shrooq R. Kadhim
Pages: 47-50
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Abstract

Background There is rapid increase in bacterial resistance to antibiotics resulted in increased morbidity and mortality among patients in hospitals. Aims Monitoring of antibiotic resistance to provide data for antibiotic therapy and resistance control prescription programs. Materials and Methods Sixty seven clinical samples were collected from urine, stool, pus, wound of the patients and operating theater from some of Baghdad hospitals in 2010. Sixty two isolates of Escherichia coli were detected by bacteriological and biochemical tests, these isolates were submitted to hemolysis test and antibiotic susceptibility to 10 kinds of antibiotic disks on Mueller Hinton agar by disk diffusion method. The detection of β-lactamase production was also done and Extended-spectrum beta-lactamase (ESBL) for all the isolates. Results Hemolysis test was positive for two isolates. All the isolates of E. coli were resistant to ampicillin and cephalothin (100%) and high resistance was observed to cephalixin (95.1%), tobramycin (90.3%), doxycycline (82.2%) and nalidixic acid (70.9%). Both ciprofloxacin and nitrofurantoin was (67.7%). Low resistance was noticed to amikacin (11.2%) and trimethoprime (8.1%). β-lactamase test was positive for 57 isolates (91.9%), while three isolates (4.8%) showed positive result for extended-spectrum beta-lactamase. Conclusions Isolates of E.coli showed high resistance to ampicillin,cephalothin and cephalixin. Low resistance was revealed to amikacin and trimethoprime .Most of the isolates were positive for β-lactamase test (91.9%) and (4.8%) of the isolates were positive for extended-spectrum beta-lactamase.

Table of content: volume:10 issue:1