Table of content

Iraqi Academic Scientific Journal

المجلة العراقية للاختصاصات الطبية

ISSN: 16088360
Publisher: The Iraqi Borad for Medical Specialization
Faculty:
Language: English

This journal is Open Access

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E-mail:IPMJ2000@yahoo.com

Table of content: 2006 volume:5 issue:3

Article
Conservative Surgery for Ampullary and Periampullary Carcinoma

Authors: Zuhair Raouf Al-Bahrani
Pages: 246-253
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ABSTRACT: BACKGROUND: The objective of this study is to present the results of transduodenal resection of ampullary & periampullary carcinoma and compare it with that of by-pass surgery. METHODS: Out of (64) patients, (35) were subjected to transduodenal resection and (29) to by-pass procedures during the period 1972-2003 at the Medical City Hospital and Al-Mustansiria Private Hospital, Baghdad. RESULTS: (39) Patients were males and (25) were females. Age ranged from (19-80) peak (60-69) years. Fluctuating jaundice, cholangitis and weight loss are main symptoms. Mortality was one case in both procedures. Histopathology were (29) well, (26) moderately and (9) poorly differentiated adenocarcinoma. Chemotherapy was given to (17) of the resection group and (13) patients of the by-pass group. The 2 and 5--year survival after by-pass alone was 44% and 8% compared to 68.6% and 31.4% in the resection group respectively. The size of the tumour, its grade and adjuvant chemotherapy had influence on the prognosis. CONCLUSION: Ampullary or periampullary carcinoma can be dealt with by transduodenal resection as a curative or palliative with results comparable to more radical procedures such as Whipple’s procedure.


Article
Adrenal Disorders, Presentations and Ways of Investigations

Authors: Safa M Al- Obaidi
Pages: 254-259
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ABSTRACT: BACKGROUND: Adrenal disorders in surgical practice are presented either as hyperfunctional disorders or non functional disorders (incidentalomas). Functionally, medullary tumors (pheochromocytoma) result in excess secretion of catecholamines(1), on the other hand, functioning adrenocortical tumors could secrete excess of cortisol (Cushing syndrome), aldosterone (Conn's syndrome) or sex hormones (virilizing syndromes).(2) . Aim of our study was to identify the most common types of adrenal tumors, its presentation and outlining the best diagnostic work up and to show our experiences in dealing with adrenal disorders in Iraq. METHODS: This is a prospective study of 20 cases diagnosed as having adrenal disorders, admitted and evaluated in Baghdad Teaching Hospital-Medical City from January 2002 to December 2004. The collected data including; age, gender, presentations, methods of investigations and histopathological records. RESULTS: Their assessment revealed that adrenal disorders were most commonly encountered in the (30-39) years age group (9/20, 45%). The mean age was 40 years with a female preponderance and female: male ratio of 2: 1. Obesity was noted in (7/20, 35%). Headache was manifested in (5/20, 25%), palpitation in (4/20, 20%) and uncontrolled hypertension in (4/20, 20%). Plasma cortisol was elevated and its diurnal rhythm was lost in (8/20, 40%), 24-urinary VMA was elevated in (6/20, 30%). 24-urniary 17-ketosteroid was elevated in (1/20, 5%). The most commonly encountered clinical type of adrenal disorders was hypercortisonism in the form of Cushing disease and syndrome (8/20, 40%). CONCLUSION: Adrenal disorders mostly affect young age group patients with a female preponderance. Functioning adrenal disorders have presented earlier than non functioning ones owing to the symptoms they had caused. U/S, CT scan, MRI and IVP are very important in visualization, localization, assessment of distant metastases and finally discrimination of benign from malignant disorders.


Article
Cleft Palate Repair without Fracture of the Pterygoid Hamulus

Authors: Harith A Al Ani
Pages: 260-264
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ABSTRACT: BACKGROUND: Cleft palate repair should be done with minimal tension across the suture line in order to avoid the development of palatal fistula. Fracture of the pterygoid hamulus is routinely done by many surgeons during cleft palate surgery to facilitate soft tissue approximation. OBJECTIVE: To demonstrate the actual need for fracturing the pterygoid hamulus in palatoplasty. PATIENTS AND METHODS: Seventy-one cleft palate patients were studied, their ages ranged between 16 months and 14 years .In all of them surgical repair was done by Veau-Wardill- Kilner operation without fracturing of the pterygoid hamulus .Dissection of the mucoperiosteal flaps from the underlying muscles was done to overcome the tension and the clefts were closed in layers . The patients were observed for the ease of the closure during surgery and the development of fistulas postoperatively. RESULTS: Closure can be obtained with minimal tension without fracturing the pterygoid hamulus even in wide clefts if the flaps are properly released from the underlying muscular attachment. Postoperatively three cases developed postoperative bleeding and 2 cases had palatal fistulas. CONCLUSION: Fracturing of the pterygoid hamulus is not indicated in repair of narrow to moderate clefts. In wide clefts successful closure can be obtained without fracturing if adequate release of the flaps from the muscles is done, otherwise fracturing might be justifiable to reduce the tension across the suture line.


Article
Immunological Effect of Polysaccharide Extracted from Pseudomonas aeruginosa against Leishmania donovani in mice

Authors: Hasna H. Jumah
Pages: 265-278
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ABSTRACT: BACKGROUND: Visceral leishmaniasis is a serious disease with high pathoogenicity. It was noticed that Polysaccharide extracted from Pseudomonas aeruginosa had the ability to induce both cellular & humoral immunity response against bacteria, fungi & parasites. OBJECTIVE: The aim of this study was to know the immunological effects of polysaccharide extracted from Pseudomonas aeruginosa before & after the infection of BALB/c mice with Leishmania donovani in trial to provide a method for prevention of the disease in human. METHODS: 174 male BALB/c mice were divided into control & experimental groups with each group consisting of six animals. The experimental groups injected intraperitoneally (i.p) with 0.2 ml phosphate buffer saline (PBS) containing 1×108 parasite. Cerdain groups were injected intraperitoneally by polysaccharide (PS) at doses of 100, 150, 250 μg on day 3, 6, and daily for 6 days before infection with Leishmania donovani. These animals were sacrified after 8 weeks. Other groups were injected intraperitoneally with polysaccharides on day 7 post infection at the doses of 100, 150, 250, μg, 6 animals were sacrified after 2, 4, 6, 8 weeks. Total & differential count of leukocytes, measurement of spleen & liver weight and index, measurement of cellular immune response, histopathological changes liver and spleen were carried out. RESULTS: This study showed an increase in the total count of leukocyte accompanied by an increase in lymphocyte with decrease in monocyte percent in mice treated with polysaccharide before and after infection with Leishmania donovani which were statistically significant. Reduction in liver & spleen weights & their index in all treated groups was noticed before & after infection. The cellular immune response represented by delayed hypersensitivity has been enhanced in the mice treated with polysaccharide before &after infection. In treated groups, histopathological studies of mice showed hepatocyte hypertrophy, infiltration of the inflammatory cells in liver before & after infection. In spleen showed an increase in lymphocytes & monocytes in red pulp, while the infected mice (non treated) showed a necrotic foci, loss of architecture of both liver & spleen & obvious granulomatous inflammation in liver. CONCLUSION: Polysaccharidde extracted from Pseudomonas aeruginosa induced immunological activity by activation of cell mediated responses, stimulated an increase in WBC count & lymphocytes with minor histoptholgical changes in liver and spleen.


Article
Childhood Asthma in Relation to Some Predisposing Factors

Authors: Masarra Shakir Saeed
Pages: 279-284
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ABSTRACT: BACKGROUND: Asthma is the most prevalent chronic condition among children . Both environmental and hereditary factors are important in the pathogenesis of asthma . OBJECTIVE: To determine the severity of asthma among the asthmatic patients and its association with some allergens . METHODS: A cross sectional hospital based study ; involved 120 patients suffering from asthma during the period from Feb.- Aug 2003. A questionnaire was designed for the purpose as well as clinical examination and serological study to asses the level of IgE against selected allergens . RESULTS: The study revealed that 53% of the patients were males . The most age group affected was (2-5) y ; 57(47.5%) of cases . The mild type of asthma is the predominant type; About 39 (32%) of the patients suffering from mild intermittent asthma(MIA) and 53(44%) from mild persistent type . The main age group affected by MIA was (2-5)y ;17(43%) patients. Patients with MIA were more sensitive to H1 allergens 12(40%) and least sensitive to F1 (3%). For moderate persistent asthmatic patients , they were more sensitive to H2 8(34.7%) , then H1 6(26%). Patients from all age groups were sensitive mainly to H1 ; (2-5)y: 18(36%) , for (>5-10)y : 10(38.5%) , for (>10-15)y : 7(33%). There was a significant relation between the mild type of asthma and the family history of asthma , atopy , drug and food allergy . The most important aggravating factor for the age group 2-5y was dust ; 17( 31%), while among the age group (5-10)y was exercise , 10 (31%). Among the age group (10-15) y both dust and exercise were important factors 8 (29.6%) for each . Exposure to dust was a significant aggravating factor for MIA 13(38.2%). CONCLUSION: Since the majority of patients suffering from mild type of asthma we recommend health education to the parents and patients towards home management of asthma and avoidance of the allergens which exacerbate the acute attacks


Article
Human Leukocyte Antigen-DP in Acute Nonlymphocytic and Acute Lymphoblastic Leukemia

Authors: Majid Sakhi Jabir
Pages: 285-288
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ABSTRACT: BACKGRAOUND: Acute leukemias are characterized by the elonogenic proliferation of hematopoietic progenitor cells arrested in maturation .Clinical manifestations are related to the infiltration of the bone marrow and other tissues by the leukemic blasts. METHODS: Peripheral blood mononuclear cell (PBMC) from leukemic patients (29)(ANLL),(36)(ALL) and from normal donors(55)were typed for Human leukocyte antigen-DP specificities using microlymphocytotoxicity assay. RESULTS: Results showed frequencies of (DPw) alleles in (ANLL) patients were not significantly different from controls ,exept that in DPw1 was absent .In contrast ,in ALL,frequencies of DPw2 and DPw5 were significantly increased (p< 0.05,relative risk (RR)= 1.95 and p<0.01,RR=4.27,respectively . CONCLUSION: These results ,demonstrate both positive and negative associations between major histocompatibility complex (MHC) gene products which are in only very weak linkage with the rest of HLA ,and (ALL,ANLL) patients.The HLD-DP region could thus contain long sought –after genes influencing susceptibility and resistance to leukemogenesis.

Keywords

ANLL --- ALL --- HLA --- DP-Antigen.


Article
The Significance of Lipid Abnormalities in Children with Insulin-Dependant Diabetes Mellitus

Authors: Salem Rahma
Pages: 289-294
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ABSTRACT: BACKGROUND: To evaluate serum lipids in children with type 1 diabetes mellitus and its relation to glycemic control, in comparison with sex and age matched non-diabetic children. METHODS: Fasting blood glucose, glycosylated haemoglobin (HbA1c) and lipid profile were estimated in 45 children (20 males and 25 females) with type 1 diabetes attending diabetic clinic at Sulaymani children hospital from the period of November 2005 till Jully 2006. Fifty health children (23 males and 27 females) admitted to the same hospital with acute illnesses like respiratory tract infections were randomly selected as controls. RESULTS: Mean total cholesterol, triglycerides, LDL-C, VLDL-C, and LDL-C/HDL-C ratio were significantly higher in diabetic children compared to the control. However, there was no significant difference in the levels of HDL-C in both groups .In addition to that, diabetic patients with poor control have a significantly higher levels of blood glucose, total cholesterol, triglycerides, LDL-C and LDL-C/HDL-C ratio as compared to those with good control. A significant correlation between most lipid variables and HbA1c was observed in diabetic patients. CONCLUSION: Children with type 1 diabetes should be screened for serum lipids as significant lipid abnormalities are related to glycemic control. Both can be improved with dietary guidelines and insulin therapy.


Article
Neonatal Infection in the Neonatal Unit at Baghdad Teaching Hospital, Iraq

Authors: Batool A. Al-Shawii
Pages: 295-297
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ABSTRACT: BACKGROUND: In Iraq, the true magnitude of the neonatal infection among newborns receiving care is not known as health system was badly eroded in the last two decades. This work was carried out to find factors associated with neonatal infection among newborns receiving care in intensive unit. METHODS: The records of a total of 723 neonates admitted to the neonatal intensive unit at Baghdad teaching hospital during the period Nov. 2003 to Oct. 2004 were reviewed. Information regarded birth weight, gestational age, medical history of the mothers, bacterial infections and management procedures were collected. RESULTS: Out of the total neonates, 9.3% had bacterial infection. Low birth weight, prematurity and prolonged rupture of membrane were factors significantly associated with bacterial infection (p = 0.001, 0.002 and 0.03, respectively). Oxygen therapy, invasive procedures, and the nasogastric tube (p = 0.01) were significantly associated with infection. S. aureus, enterbacter and E. coli were the commonest pathogens. CONCLUSION: The study provides useful information for future surveillance in association with preventive program as there were several factors associated with neonatal infection which could be prevented.


Article
Causes of Delay in Age Appropriate Vaccination

Authors: Kholod Dhaher Al- Shemari
Pages: 298-301
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ABSTRACT: BACKGROUND: The child vaccination status is influenced by factors such as the child’s health status , economic status ,parental health attitudes and family characteristics . The effects of these risk factors including the child’s age , poverty status , geographic location , race , ethnicity and education level of parents . We undertook this study to estimate the risk factors of children who had delay in age appropriate vaccination . METHODS : 200 children with history of delay in their age appropriate vaccination were examined in their last visit to vaccination department in Fatema Al-Zahra teaching hospital . their mothers had been inquired about the real causes of delayed vaccination . RESULTS : Child sickness , poverty , large family size , low parental education level , terroristic explosion , one parent family , vaccine contamination rumor ,and displaced families , were significantly related causes of increased child vaccination delay . CONCLUSION : the study had concluded that large family size formed 30.5% of the demographic factors that influenced vaccination status of children .


Article
The Role of Inter Leukin- 10 in Infectious Mononucleosis Like Syndrome

Authors: Jabbar, R. Z.
Pages: 302-307
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ABSTRACT: BACKGROUND: Infectious mononucleosis is caused by the ubiquitous Epstein-Barr virus .It is a common condition usually adolescents and young adults. Most cases are mild to moderate in severity with full recovery taking place over several weeks. More sever cases and unusual complications occasionally occur. AIMS OF THE STUDY: Determining the role of theTh1and Th2 in infectious mononucleosis –like syndrome by measuring IL-10. METHODS: Enzyme immunoassay for Quantitative Determination of human Interleukin-10 in serum. RESULTS: of cytokines showed a significant increase in IL-10 in patients with EBV infection (122.3±34.97)pg/ml. In non EBV infection the level of IL-10 was also increase (74.24±18.84)pg/ml when compared with the healthy control (2.2±0.86) pg/ml. There was high significant difference between them (p<0.001). CONCLUSION: High levels of IL-10 may be referred to a TH1/TH2 response in infectious mononucleosis like- syndrome in comparison with healthy control group.


Article
Seasonal Fluctuation in the Incidence of Duodenal Ulcer

Authors: Karim Shalan Al-Araji
Pages: 308-311
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ABSTRACT : BACKGROUND : The aim of this study is to investigate and explain the distribution of patients with symptomatic duodenal ulcer " DU " along the months and seasons of the year and to show whether there is a seasonal fluctuation or not . PATIENTS AND METHOD : The reports of all endoscopically proved DU patients residing in Babylon , Iraq during five years period starting from January 1998 to December 2003. The results were plotted on curves month by month and season by season and then the data were analysed to show their distribution along the seasons of the year and whether there is fluctuation or not. RESULTS : Out of 4006 patients endoscoped , 1846 showed DU in a form of : ulcer , deformity , and stenosis . The highest incidence of DU was observed during winter 607 (32.88%) patients and spring 537 (29.08%) patients , progressively diminishing throughout summer 380 (20.58 ) patients and Autumn 322 ( 17.44% ) patients. CONCLUSION: There is a highly statistical significance " P <0.01 " of seasonal variation in the activity of duodenal ulcer with maximum incidence during Winter and Spring and lower during summer and Autumn .


Article
Iron Status in Patients with Chronic Renal Failure on Haemodialysis

Authors: Safa Ez-Aldeen Al-Mukhtar
Pages: 318-324
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ABSTRACT: BACKGROUND: Anaemia is common in renal failure. Serum iron (SI), and the percentage of transferrin saturation (TSAT) reflect the amount of iron immediately available for haemoglobin (Hb) synthesis. Serum ferritin level reflects total body iron stores. Adequate iron stores are essential for achieving maximum benefit from recombinant human erythropoietin (Epo). A low level of either of these indices may indicate the need for supplement iron to support erythropoiesis. METHODS: Seventy Patients with end stage renal disease (ESRD) on regular haemodialysis (HD) were included in this study from three dialysis centers in Baghdad: We have collected data on, serum iron, total iron binding capacity (TIBC), TSAT, Serum ferritin, and blood film, was done. Fifty subjects were included in the control group. RESULTS: A44 patients (62.9%) were receiving regular parenteral Iron Dextran with Epo, and 26 patients (37.1%) were receiving irregular oral or intramuscular iron Dextran with Epo. According to the serum ferritin, 41 patients (58.6%) involved have serum ferritin level >300ng/ml, of them; the TSAT was > 20% in 27 patients while TSAT ≤ 20% in 14 patients in this group, and Hb was > 11 g/dl in 11 patients where as ≤ 11 g/dl in 30 patients in this group. Serum ferritin in 29 patients (41.4%) was ≤ 300 ng/ml, of them, the TSAT was ≤ 20% in 26 patients and > 20% in three patients only, the Hb level was ≤ 11 g/dl in all patients in this group. There was significant correlation with anaemia. (Hb ≤ 11 g/dl) and low serum ferritin (P<0.005), patients with TSAT ≤ 20%, all were anaemic (Hb≤11 g/dl) and there was a significant association between these two markers (P<0.005). In patients receiving regular parenteral iron and Epo (44 patients) (62.9%), the TSAT was > 20% in 21 patients (30%), while those who taking no or irregular iron therapy with Epo (26 patients) (37.1%), the STAT was >20% in 9 (12.9%) the difference was not statically significant. CONCLUSION: The serum ferritin in our study group was higher than that reported in other studies. Serum ferritin of ≤ 300 ng/ml, and TSAT of≤ 20% in our study group was significantly correlated with anaemia. Serum ferritin of ≤ 300 ng/ml and a TSAT of≤ 20% were significantly associated.


Article
The Awareness about NIDs Program in a Rural Area of Al-Nahrawan District of Baghdad

Authors: Essam J AL-Zwaini
Pages: 325-329
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ABSTRACT: BACKGROUND: A cross sectional study was conducted to explore the awareness of the local population of AL-Nahrawan district about National Immunization days (NIDs) and their major sources of information about the campaign. METHODS: A total of 476 households, selected randomly during the first NIDs round of the year 2000, were screened using pretested questionnaires. The questionnaires include questions about various aspects of NIDs campaign. RESULTS: There were 61.8% females, 70% aged between 20-39 years and about 79% were either illiterate or can just read and write. The study reveal that 88.2% of the respondents were aware of the NIDs but only 10.5% knew the date of the next NIDs and less than half of the respondents (43.3%) were understood the purpose of the program. Tow aspects of the NIDs ( whether a previously immunized child is involved in NIDs and whether involved children should be vaccinated again in the next NIDs were understood by the majority of the respondents 92.2% and 78.2% respectively). Among the various media used to increase awareness of population about NIDs, the television was the most popular. CONCLUSION: The general awareness about NIDs program in AL-Nahrawan district is acceptable which probably reflect the successfulness of the program in Iraq. Some points about the program need to be verified and reinforced.


Article
Immunological Study of Febrile Fever: Serum Sialic Acid, Immunoglobulin Levels (IgA, IgG and IgM), Complement Factors (C3 and C4) in Patients with Typhoid Fever and Brucellosis

Authors: Ghassan Mohammad Sulaiman
Pages: 330-336
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ABSTRACT: BACKGROUND: Typhoid fever and brucellosis are frequent causes of bloodstream infections in many countries. The diagnosis of these infections is challenging because they can have diverse clinical manifestations with symptoms that overlap with a wide spectrum of other diseases. However, neither Widal nor Rose-Bengal agglutination assays are sufficiently sensitive, specific, or practical in areas of endemicity .In this study, it was undertaken to determine the sensitivity and specificity of clinical application of sialic acid in the evaluation of humoral immune response in patients with typhoid fever and brucellosis. Furthermore, the role of sialic acid (SA) was investigated as a possible biological marker and to assist diagnosis of disease. METHODS: Serum samples from 35 patients with typhoid fever, 35 patients with brucellosis, and 60 healthy individuals were tested for immunoglobulin A [IgA], IgG and IgM as well as complement factors C3 and C4 by single radial immunodiffusion assay. Determination of serum sialic acid for control, patients and calibration samples was performed by the resorcinol method. RESULTS: The levels of all three classes of immunoglobulin and complement factors were higher in typhoid and brucellosis patients than in healthy individuals, beside significant increases in the serum levels of SA in patients with typhoid fever and brucellosis. There was no significant difference between serum levels of SA in typhoid and brucellosis patients as compared to the control group of healthy individuals. However, we were not able to observe a clinically meaningful difference with respect to sialic acid levels between these two categories. CONCLUSION: Sialic acid is a general disease marker than a specific marker and the none specificity of increase makes SA determination unsuitable as a specific marker. However it may have a clinical utility, which can be used in conjunction with other test.


Article
Hodgkin’s Lymphoma: An Epidemiological Study in the Iraqi Patients

Authors: Ruqia M. Al-Barzinji
Pages: 337-343
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ABSTRACT: BACKGROUND: This work presents an epidemiological approach used to deal and study Hodgkin’s lymphoma (HL) in the Iraqi patients. METHODS: This study was carried out for 80 newly diagnosed HL patients (32 females and 48 males), compared with 50 Non Hodgkin lymphoma (NHL) patients control and 50 healthy individuals considered as healthy control in period between 1st of Jun 2003, and 30th of November, 2004. Newly diagnosed HL histopathological samples were taken and diagnosed as HL according to the National Cancer Institute Working Formula. All patients were subjected to personal interview using especially designed questionnaire format. RESULTS: In this study the age of HL patients ranged between 10-73 years with a mean age of (29.31 ± 1.73) years. There was slight males predominance among HL patients 48 (60%) than females 32 (40%). The age incidence below (45) years old forming 67 (84%), versus13 (16%) incidence above 45 years. The cervical lymph node enlarged was commonly found (70%) and the main clinical presentation was of A symptom (27%) in HL patients. The highest subtype number was recorded in mixed cellularity (MC) (61%) and stage II (38%). There was no significant association between cigarette smocking and risk of HD (p>0.05). CONCLUSION: Such epidemiological study can be performed at any hospital especially in hospitals were lymphoma cases is increased.


Article
The Role of Garlic Extract on the Effect of Organic Pesticides on Murine Liver Cells

Authors: Khalid Hamdan Gathwn
Pages: 344-350
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ABSTRACT: BACK GROUND: Organic phosphorus pesticides are most widely preferred pesticides, and know to have detrimental effect on various living organisms. METHODS: Twenty four male Balb/c mice were used. These were divided into four group (1,2,3,4) . Chlorpyriphos was given orally on alternate days by garage (20mg/kg body weight), aqueous garlic alone was given orally daily by garage (200mg/kg body weight, while garlic extract followed by chlorphriphos was also given. RESULTS: Lipid peroxidation (LPO) was measured in liver homogenate . The extent of LPO was significantly increased in animals treated with pesticide while non-significant result were obtained with garlic extract alone . Pretreatment with garlic followed by pesticide showed similar values. The levels of glutathione and total thiol was significantly decreased in animals treated with pesticide and non- significant with garlic . pretreatment with garlic followed by pesticide showed similar value. The free radical scavenging enzyme like SOD , as well as GSH- dependent enzyme (GPx, GST and GR) show significant decrease in animals treated with pesticide and non-significant with garlic. Pretreatment with garlic followed by pesticide showed similar to that of control. CONCLUSION: Pesticide exposure could be prevented by Co-administration of garlic extract.


Article
A Spectroscopic Study on the Level Of Serum Selenium in Northern Baghdad Subject

Authors: Ahsan.K.Abbas
Pages: 351-352
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ABSTRACT: BACKGROUND: This work is performed to measure the concentration of serum selenium in northern Baghdad subject. Selenium is one of the trace element that plays an important role in physiological functions of human body. MATERIALS AND METHODS: Selenium levels of blood serum were measured using furnace atomic absorption spectrophotometer. RESULTS : The results obtained in this work showed a decrease in selenium level and the reduction is proportional to the duration of age. This can be explained principally due to the type of diet and malabsorption young subject may differ in certain diet intake.

Keywords

selenium --- spectroscopy.


Article
Risk Factors for Febrile Seizures: A Matched Case Control Study

Authors: Essam J AL-Zwaini
Pages: 353-358
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ABSTRACT: BACKGROUND: A matched case control study was conducted over 6 months period from the 1st of November 1999 to 30th of April 2000 at the maternity and children hospital in Ramadi city with the aim of determining the risk factors that might lead to development of febrile seizures. METHODS: One hundred patients with febrile seizures admitted to the causality department, aged 6-60 months were matched with another one hundred child having fever but without seizure with the same age range, attending the same hospital during the same period. RESULTS: The mean age and standard deviation for cases was 25.8±15.19 months and for control was 29.9 ± 18.5 months .sixty four percent has febrile seizure for the first time and 36 %had recurrent febrile seizures. The mean age and standard deviation for the first FSs was 23.54± 12.8 months and for recurrent FSs was 29.83 ± 12.5 months. This was statistically not significant. The majority of the cases were between 12 -24 months with a peak at the age of 18 -19 months. Respiratory infections were not found to be a risk factor for FSs when compared with control. CONCLUSION: Male sex, degree of temperature on admission, presence of family history or epilepsy, developmental delay, anemia and admission to neonatal care unite were found to a significant risk factor for occurrence of febrile seizures. Patients are susceptible to develop another attack of seizure at a lower temperature after their first attack.

Keywords

Febrile --- Risk factors --- Ramadi --- Seizures


Article
Pancreatic Fistula Following Surgery of Primary Pancreatic Hydatid Cyst Causing Pancreatitis

Authors: Ghassan A .A .Nasir
Pages: 359-362
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ABSTRACT: BACKGROUND: Primary pancreatic hydatid cyst is rarely encountered and difficult to differentiate from pancreatic cystic neoplasm. THE AIM: Of this case report is to discus the mode of presentation and best management of this condition. CASE REPORT: A twenty-eight years old male, presented with recurrent upper abdominal pain of three years duration. The pain was radiating to the back and associated with vomiting and low-grade fever. The ultrasound as well as CT scan with oral and I.V. contrast revealed that there was a solid-cystic mass in the tail of the pancreas suggesting of pancreatic cystic tumors. Laparotomy revealed pancreatic hydatid cyst, which was communicating with pancreatic duct. The patient treated by endocystectomy, which was complicated by pancreatic fistula. CONCLUSION: Pancreatic hydatid cyst should be kept in mind in any cystic lesion of pancreas. This disease could be treated by endocystectomy or partial pancreatectomy.

Table of content: volume:5 issue:3