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

About

publisher Every Three Months 2000

Loading...
Contact info

Mobil:07903960529
E-mail:IPMJ2000@yahoo.com

Table of content: 2009 volume:8 issue:1

Article
Renal Involvement in 25 Patients with Systemic Sclerosis

Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Renal involvement is considered a poor prognostic factor and not frequently a cause of death in patients with scleroderma. Renal involvement can be divided into scleroderma renal crisis and non-renal crisis abnormalities. OBJECTIVE: To evaluate the frequency of renal involvement in 25 Iraqi patients with systemic sclerosis (SSc). METHODS: Twenty five patients with SSc (21 female and 4 male) were included in a case-controlled study. All patients fulfilled the American College of Rheumatology criteria for SSc. All patients were of diffuse type. Other types of SSc were excluded. All patients underwent measurement of blood pressure and investigations had been done for them which included: hemoglobin (Hb), white blood cell (WBC) count, platelet count, erythrocyte sedimentation rate (ESR), blood urea (BU), serum creatinine (SCr), general urine examination (GUE), and rheumatoid factor (RF). Same investigations were done for 25 healthy person (considered as control group). RESULT: All patients (100%) had Raynaud’s phenomenon, 23 patients (29%) had dysphagia, 21 patients (84%) had arthralgia, 10 patients (40%) had telangiectasia and 2 patients (8%) had subcutaneous calcification. Three patients (12%) had moderate hypertension. Fourteen patients (56%) had anemia, 2 patients (8%) had leukocytosis, 6 patients (24%) had elevated ESR, 1 patient (4%) had elevated BU, 1 patient (4%) had albuminuria and 4 patients (16%) had positive RF. Platelet count and SCr were normal in all patients. Only 1 patient (4%) had renal involvement in form of combination of azotemia, albuminuria and hypertension. CONCLUSION: Renal involvement in systemic sclerosis among Iraqi patients is rare.

Keywords

renal --- iraqi --- systemic sclerosis.


Article
Beneficial Effect of Isotretinoin Gel As AdjunctiveTreatment to Oral Azithromycin in the Management of Facial Acne Vulgaris.

Authors: Sabeeh A. Al-Mashhadani
Pages: 7-10
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Acne is a multifactorial disease with multiple pathogenic factors, hence combination therapies are needed. Combination therapies using agents with complementary mechanisms of action increasingly are recognized as an effective strategy for treating acne. OBJECTIVE: The rationale of utilizing topical retinoids with azithromycin in treating facial acne vulgaris will be highlighted, particularly in relation to improvement. METHODS: A randomized, clinical trial was carried out at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital between April 2007 and August 2008. A total of 48 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and azithromycin plus isotretinoin gel, both groups received Azithromycin for two months. Azithromycin 250 mg was prescribed every day for one month and every other day for the following month. Patients in second group were instructed to apply Isotretinoin gel 0.05% once daily over a 3 months treatment period. The clinical assessment was done by counting the number of inflammatory lesions in three occasions: baseline, two months and three months. RESULT: After two months, both groups showed a statistically significant difference from the baseline in reducing inflammatory lesions and improving acne. Adding topical isotretinoin gel produced a higher percentage of reduction in their lesional counts, but differences between the two groups were not statistically significant. After three months, regression in the percentage of reduction of the lesional count from 57.7% to 32.4% in the first group. While in the second group the reduction was maintain in 69.8%. CONCLUSION: Adding topical 0.05 per cent isotretinoin gel to oral azithromycin enhances and maintains the rate of improvement of facial acne vulgaris.


Article
Perniosis: Clinical and Epidemiological Study in Iraqi Patients

Authors: Adil A. Al-Nuaimy
Pages: 11-13
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Perniosis(chilblains) is a common skin problem. This condition results from abnormal reaction to cold which is usually seen during the cold months of year. OBJECTIVE: The aim of the present study is to shed a light on different clinical and epidemiological aspects of perniosis in Iraq. METHODS: A total of 40 patients with perniosis were seen between January to march 2008 in the department of dermatology and venereology of Baghdad Teaching Hospital. A detailed history was taken from each patient regarding age, sex, occupation, duration of attack, family history, smoking, drug history, medical history, relieving and aggrevating factors and previous treatment modality. Full examination was done to each patient to assess the distribution and extent and morphology of the lesions and to see if there other skin diseases. Biopsies was done for 6 patients for histopathological study. RESULTS: A total of 40 patients were assessed. Their ages ranged from 5-60 years with a mean age of 22 SD± 6.2, 31 females and 9 males (3.5:1). Main sites of involvemnt were; toes 39% , fingers 22% ,heals 10% and nose 2.5% . Main types of lesions were ; erythematous cyanotic swellings 82% , vesicular lesions 23% ,ulcerations 10% and erythema multiforme like lesions 15%. Family history was positive in 22.5% of patients. CONCLUSION: Perniosis occur mainly in females between 10-20 years . Most common sites of involvement are toes and fingers . genetic susceptibility is an important factor in the development of the disease. Majority of patients are healthy without any medical or dermatological diseases .Majority are non smokers and did not have any history of drug intake.


Article
Heart Rate and Blood Pressure Responses to Exercise Testing in Relation to Age in Healthy Men

Authors: Affan Ezzat Hassan
Pages: 14-20
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: There are many circulatory changes that occur during exercise including the stimulatory effects on the circulation by the mass sympathetic discharge, the increased arterial pressure and cardiac output. OBJECTIVE: To investigate the effect of aging process on the heart rate and blood pressure responses during exercise in normal Iraqi male subjects. METHODS: The subjects involved in the study were normal healthy people, their total number was 80 persons all of them were males. They were grouped into three age groups; 20 ≤ 29 years, 30 ≤ 39 years and 40 ≤ 50 years. Each subject performed the exercise on motor driven treadmill device. Testing was conducted at The Medical City Teaching Hospital-Treadmill and Echo unit. Blood pressure was measured indirectly by auscultation. The heart rate was determined by ECG. RESULT: There was a significant differences in heart rate after the exercise between the three age groups, a significant differences in systolic blood pressure after the exercise between group2 and group3 was also noted, a non significant decrease in diastolic blood pressure among the three age groups and there was a significant increase in mean blood pressure between group2 and group3. CONCLUSION: There was a negative linear correlation between heart rate after the exercise and increasing age, while a positive linear correlation between systolic blood pressure and increasing age was found and there was a positive linear correlation between age and the mean blood pressure after the exercise.

Keywords

age --- exercise --- heart rate --- blood pressure.


Article
Deep Vein Thrombosis in Iraqi Spinal Cord Injured Patients

Authors: Talal Abdulsamad
Pages: 21-26
Loading...
Loading...
Abstract

ABSTRACT: BACK GROUND: Spinal cord problems is an important complication of spinal cord injury. Deep vein thrombosis is a critical sequel & need early diagnosis and management. OBJECTIVE: To determine the frequency and time of occurrence of deep vein thrombosis (DVT) in Iraqi Spinal Cord Injured patients, and a possible etiologic relationship between DVT and Spinal Cord Injuries (SCI) types. METHODS: One hundred nine Iraqi patients with spinal cord injury admitted at Ibn_Alkuff SCI Hospital from the 1st of January till 30th of June 2006 were studied, full history was taken and complete clinical examination was done for all patients. DVT was diagnosed by physical examination and confirmed by Doppler ultrasound. Special scales and scores were included in this study to assess spinal cord injury impairment (American spinal injury association scale/score and Modified Ashworth spasticity scale). RESULT: A total sample of 109 Iraqi patients were included in this descriptive cross sectional study, 100 males (91.7%) and 9 females (8.3%), the age of patients ranged from 11 to 65 years (mean 33.8 years), the disease duration ranged from 1 to 240 months (mean 20.5 months). Eleven patients (10.1%) were having DVT (were male patients).Our study showed statistically significant association between the presence of deep vein thrombosis and neurological level of spinal cord injury, flaccidity and ASIA scale (A and B). (p=0.011, p=0.017 and p=0.006 respectively) Our results showed no statistical significant association between age, gender, duration of spinal cord injury and causes of spinal cord injury in determining the presence of DVT. (p=0.71, p=0.36, p=0.68 and p=0.34 respectively) CONCLUSION: DVT is more likely to develop in Iraqi spinal cord injured patients who have a lumbar neurological level of injury or who have flaccid paralysis. Also SCI patients with ASIA scale A and B are more liable to develop DVT. These groups of patients needs close observation and monitoring.


Article
The Effect of Obesity on Serum Leptin and Lipid Profile

Authors: Kismat Mohammad Turki
Pages: 27-32
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Obesity has become a leading health concern; this condition is a chronic, complex, multifactorial disease in which a person's weight is ≥ 20% of the ideal weight for a given height. OBJECTIVE: To measure serum leptin level and lipid profiles levels in Iraqi obese individuals comparing the results with matching non obese subjects. METHODS: The study was carried on 30 individuals divided into two groups: 1. Obese subjects group (n=20). 2. Non-obese subjects group (n=10). For all subjects studied measurements of fasting serum leptin and lipid profile have been done. RESULT: Our study showed that mean serum leptin level was significantly higher in obese than non-obese individuals (P<0.001). In addition serum leptin correlates positively and strongly with body mass index (BMI) ( r=0.765,P<0.01). Serum leptin also correlates positively with both triglyceride (TC)(r =0.394, P<0.05) and low density lipoprotein (LDL) (r=0.366,P<0.05) but correlates negatively with high density lipoprotein (HDL)(r=-0.408,P<0.05). CONCLUSION: circulating leptin levels appear to be one of the best biological markers of obesity and hyperleptinemia is closely associated with several risk factors related to obesity syndrome.

Keywords

obesity --- leptin --- lipid profile.


Article
Acute Renal Failure in Children Below 12 Years Causes, Clinical Presentation and Management

Authors: Bushra Jalil Salih
Pages: 33-39
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Acute renal failure (ARF) is a common condition in hospitalized patients, characterized by a rapid fall in glomerular filtration rate (GFR), carries a high morbidity and mortality, often preventable, so rapid recognition and treatment may prevent irreversible loss of nephrons. OBJECTIVE: To find out the cause of acute renal failure in children and to study the clinical presentation and management modalities and sequel. METHODS: A prospective study done in Central Teaching Hospital for children from January 2006 to December 2006. 120 patients aged 1month- to 12 years who were diagnosed and treated as cases of acute renal failure were collected & analyzed. And the distribution of patients according to (age, sex, type of presentation, laboratory finding, type of management and sequel) were done. RESULTS: From hundred twenty patients, there were 77 male and 43 female with 1.7:1 ratio distributed into 93 infant, 14 preschool and 13 school age group .The main type of presentation was acidosis ,oliguria & dehydration. The main causes were gastroenteritis, sepsis and obstructed uropathy in infancy and preschool children, glomerular disease in school age group. 97 need conservative treatments and 23 need urgent peritoneal dialysis (PD) with mortality rate 5.15%, 30.51% respectively. CONCLUSION: Acute renal failure occurred more in infancy and most of them were prerenal acute renal failure can be handled with conservative treatment; peritoneal dialysis is a good choice for treatment of acute renal failure not resolved by conservative therapy.


Article
Predictors of Hypoxemia in Children with Acute Lower Respiratory Tract Infections

Authors: Muhi K.Al-Janabi
Pages: 40-46
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Acute lower respiratory tract infections (ALRI) are the leading cause of morbidity and mortality among children in developing countries, causing one – third of all deaths in childhood. Pulse oxymetry is a simple technique to determine the oxygen saturations. OBJECTIVE: It is important to accurately identify hypoxemic children by use of clinical signs alone. METHODS: A well matched case control study was performed on 104 children from 2 months to 5 years of age admitted with ALRI to the emergency department of Children Welfare Teaching Hospital -Medical City - Baghdad in the period from 15thMarch -15thJune 2006.Clinical symptoms and signs were recorded .Hypoxemia was defined as oxygen saturation less than 95%.The ability of various clinical symptoms and signs to predict the presence of hypoxemia was evaluated. RESULTS: Fifty (48.1%) children were hypoxemic. The median O2 saturation was 91.2%with a range of 82-94% Physical signs including tachypnea, intercostal and subcostal retractions, supraclavicular recessions, grunting and nasal flaring were statistically significantly associated with hypoxemiUse of combinations e.g. Tachypnea or head nodding ( P. 0.02 , sensitivity 70% , specificity 48%),tachypnea or suprasternal recessions( P.0.05 ,sensitivity 70% ,specificity 44%)only slightly improved the predictive ability. CONCLUSION: None of the clinical features either alone or in combinations have sufficient sensitively and specificity to predict hypoxemia in children with acute lower respiratory tract infections, therefore pulse oxymetry is desirable for identification of hypoxemia.


Article
Trends of Histopathology in Childhood Nephrotic Syndrom

Authors: Taghreed Fadel Mohammed
Pages: 47-55
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Nephrotic syndrome (N.S.) is clinical manifestation of different histopathological subtypes OBJECTIVE: This study was conducted to analyze the trend of histopathological subtypes in idiopathic nephrotic syndrome. METHODS: A prospective study was performed from January 2004 to May 2005, at Central child teaching hospital and Al-karama teaching hospital involving 113 patients aged up to 18 years with nephrotic syndrome. The following parameters were studied (age, gender, initial episode, relapse, predisposing factors, positive family history of nephrotic syndrome, clinical presentation and investigation, treatment and complication). RESULT: One hundred thirteen patients enrolled in this study, 71(63%) were males and 42(37%) were females, male to female ratio was 1.7/1. 23(20.3%) patients were with initial attack of nephrotic syndrome, while 90(79.6%) patients with relapse. Age at onset ranged between 0.7-14 (median 2.3) years. Family history of nephrotic syndrome was found in 8 (7%) patients. Biopsies was done in 74(65%) patients. 36(48.6%) patients showed focal segmental glomerulosclerosis. 17(22.9%) patients showed minimal change disease.10(13.5%) patients showed membranoproleferative glomerulonephritis. Other histopathological sub types were 6(8%) patients with mesangioproleferative glomerulonephritis, 3(4%) patients with global masengial sclerosis, and 2 (2.7%) patients with amyloidosis. CONCLUSION: This trend of histopathologic patterns has profound prognostic significance and has significant implications in the management of childhood nephrotic syndrome. There is shift toward an increasing incidence of focal segmental glomerulosclerosis and to lesser extent, the membranoproleferative glomerulonephritis in Iraqi children presenting with idiopathic nephrotic syndrome. Our finding is in agreement with the recommendation of performing renal biopsies on children with idiopathic nephrotic syndrome who are steroid dependant in addition to those who are steroid resistant particularly before starting cytotoxic medication.


Article
Solid Pediatric Tumors

Authors: Ekhlas Ahmad Ali --- Shuaib H.S. Al Talib,
Pages: 62-72
Loading...
Loading...
Abstract

ABSTRACT: BACK GROUND: Children are not merely little adults, and the diseases they have are not merely variants of adult diseases (1,2). Pediatric neoplasm as a group causes more deaths in children than any other disease (2) .Histologically many of the malignant pediatric tumors are unique, with primitive (embryonal) microscopic appearance and exhibit features of organogenesis specific to the sites of tumor origin, so they are frequently designated as blastomas (1,2) .We managed to collect- 175 - cases of solid pediatric tumors OBJECTIVE: 1-To identify different histopathological types of solid pediatric tumors . 2-To find out their relative frequencies ,sites , age &sex distribution . 3-To compare our results with others. METHODS: This is a Prospective study conducted During a period of one year from July 2003 through August 2004; (175) biopsies of children in Mosul with solid tumors were Collected. The surgical specimens were collected from; Al-Salaam teaching hospital, Al-Zahrawi teaching hospital, Al-khansa teaching hospital and few private laboratories. RESULT: There were 92 cases (52.57%) of benign tumors and 83 cases of malignant tumors (47.4%).The leading malignant tumors were Lymphomas 20 cases (24.09%), followed by CNS tumors 14 cases (16.8%) CONCLUSION: 1-Benign tumors are more frequent than malignant ones, with hemangiomas being the prevailing one. 2-Lymphomas constitute the commonest malignant tumors with predominance of non Hodgkin variety. 3-Among the reported tumors with noticeable rise in relative frequency are CNS tumors and Retinoblastomas. This rise may be due to genuine increase in incidence.


Article
Prevalence of Candida Species and Oral Candidiasis during Menstrual Cycle in a Sample of Women in Baghdad City

Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Menstrual cycle define and reflect the women internal endocrine environment. Ovarian hormones, estrogens and progesterone, are not secreted in constant amounts throughout the cycle. Estrogen and progesterone have been shown to inhibit aspects of both innate and acquired immunity at the systemic or local level furthermore they have been shown to influence on maturation and keratinization of oral mucosa. So there may be possible influence of the menstrual cycle on the adherence of Candida to human oral epithelial cells, and may implicate hormonal factors in the aetiology of oral Candidiasis. OBJECTIVE: The purpose of this study was to estimate the prevalence of Candida albicans and other different Candida species in the oral cavity during different periods of menstrual cycle. METHODS: One hundred and seventy six oral swabs were taken from 44 females’ patients attending dental clinic during the period from May to September2007 with age range 14-49 years old at different periods of menstrual cycle on days 5, 13, 22 and 28, which represent menstrual phase, ovulatory phase, mid-luteal phase and premenstrual phase respectively. Swabs were taken from the tongue for isolation of Candida species. The swabs were inoculated on Sabouraud’s glucose agar incubated at 37º for 72 hours; Candida species were identified by gram stain method, germ tube method and fermentation of sugar set. RESULTS: The prevalence of Candida in the oral cavity at 5th, 13th, 22nd and 28th days of menstrual cycle were 31.8%, 22.7%, 40.9% and 25% respectively. The study shows that the prevalence of Candida in the oral cavity was non-significantly higher at 22nd day of menstrual cycle. CONCLUSION: There was no significant influence of menstrual cycle on the prevalence of Candida in the oral cavity during different periods. The prevalence of Candida albicans was higher during different periods of menstrual cycle in comparison to Candida tropicalis and Candida parapsilosis


Article
Role of Endoscopic Ultrasonography Guided Celiac Plexus Neurolysis in the Management of Pancreatic Cancer Pain

Authors: Rayadh A. Z. Al-Sharifi
Pages: 79-84
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Celiac plexus neurolysis (CPN), a chemical splanchnicectomy of the celiac plexus, is used to treat pain caused by pancreatic cancer. Originally performed by anesthesiologists and radiologists via a posterior approach, recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus neurolysis (CPN) is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior percutaneous approach. OBJECTIVE: To assess the efficacy and safety of EUS guided celiac plexus neurolysis in the management of pain caused by pancreatic cancer. METHODS: This study included (310) patients with painful and inoperable pancreatic cancer were submitted to EUS guided celiac plexus neurolysis (CPN) at a tertiary referral center. The following data were collected: age, gender, tumor location, vascular invasion, adjuvant therapy, and laboratory tests including prothrombin time, and complete blood counts were obtained at baseline (before EUS celiac plexus neurolysis). RESULTS: Of 310 procedures performed, 217(70%) patients develop immediate and complete pain relieves (within 24 hours of procedure) and no need for narcotic analgesia during follows up (12 weeks). Sixty-one (20%) patients had partial response to the procedure (decreasing in the need for narcotic analgesia during follow up). Thirty-two (10%) patients were lost to follow up and no outcome of procedure obtained. CONCLUSION: EUS is more safe, feasible, and more effective than other methods in performing CPN and controls pain caused by unresectable pancreatic cancer.


Article
Psychiatric Disorders in Cardiac Patients

Authors: Basil N. Saeed
Pages: 85-89
Loading...
Loading...
Abstract

ABSTRACT: BACK GROUND: Psychiatric disorders and coronary heart disease are not uncommonly seen together in the same patient especially in association with myocardial infarction these disorders vary from simple anxiety, depression, posttraumatic stress disorder, adjustment disorder. OBJECTIVE: Studying the depressive disorders in the Iraqi cardiac patients and its prevalence after April 2003. and trying to ascertain any mispractice in management of such patients by ignoring the psychiatric cause. METHODS: 260 patients admitted to Baghdad teaching hospital medical departments over the period December 2005- October 2007. Those patients were having cither stable angina unstable angina and myocardial infraction. A uniform questionnaire was used for all patients to find out the prevalence any psychiatric disorders. RESULTS: This study showed the presence of depression during the pre and post cardiac events in 70 cases (27%) anxiety was also a very common problem in about 60 cases (23%), however the percentage of patients whom were had psychiatric disorders after an acute events due to un settled security in the country since 2003 were as follow depression (21% cases 8%) from the total number of cases respectively. CONCLUSION: Psychiatric disorders are becoming a common problem in many Iraqi cardiac patients because of the difficulties of their daily life since 2003 and it represents about 50% of the cases of psychiatrics disorders. This may make it an important issue to use antidepressant drugs in many of those patients


Article
Evaluation of the Sensation of Hearing False Mobile Sounds (Phantom Ring Tone; Ringxiety) in Individuals

Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: The annoying feeling of mistakenly thinking that you can hear your mobile phone ringing. This audio illusion is familiar and unnerving sensation is so widespread and now it has an official name: ringxiety. OBJECTIVE: This study was conducted to determine whether "Ringxiety" is common among Iraqi peoples and its correlation with age, sex, education, mobile type, and mobile using time. METHODS: Two hundred adult persons of either sex with a mean age of 20 ± 3 years were asked to answer a questioner with 14 questions. RESULT: The results of this study revealed that 73% of the individual involved experienced the phenomenon of ringxiety from time to time, in addition to 4% who experienced frequent ringxiety. Significant correlations were found between this sign and using mobile for more than 30 minutes per day and also a significant correlation was found between mobile addicts and ringxiety (P value <0.05). 42% of studied subjects experienced mobile vibration mistakenly feeling, which occurs always with ringxiety but not the reverse. This sign was only correlated with the high mobile using time. No association was found between ringxiety and age, education, type of ring tone, or short messages (SMS) using. CONCLUSION: This study has proved that ringxiety is common among mobile users and could be one of the side effects of radio waves or just a malfunction of the brain due to the life heavy duties. Ringxiety might cause discomfort or loss of concentration during car driving or using dangerous machine

Table of content: volume:8 issue:1