Table of content

Basrah Journal of Surgery

مجلة البصرة الجراحية

ISSN: 16833589
Publisher: Basrah University
Faculty: Medicine
Language: English

This journal is Open Access

About

Basrah Journal of Surgery


Editor-in- chief

Prof. Thamer A. Hamdan, FRCS
Prof. Salam N. Asfar, MSc

Information Administrator

Dr. Jasim M. Salman, MB,ChB, DA, FICMS

Associate Editors

Dr. Hashim S. Khayat, FRCS

Prof. Mazin H. Al-Hawaz, CABS, FRCS

Prof. Zeki A. Al-Faddagh, CABS, FRCS

Prof. Issam Merdan CABS, FICMS

Assist. Prof. Ali A. Alshawi, FFDRCSI, FDSRCS

Assist. Prof. Mazin Abdulsattar, CABS

Dr. Zuhair Al-Barazanchi, MSc, PhD



National Advisory Board



Prof. Ahmad M Al-Abbasi, FRCS

Prof. Abdulla M. Jawad, PhD

Dr. Hasan K. Muhamed, FRCS

Assist. Prof. Tahir A Hawrami, DS, CABS

Assist. Prof. Farhad K. Sulayvani, CABS

Prof. Hassan J Hasony, MPhil, PhD

Prof. Nadhim K. Mahdi, PhD



International Advisory Board











Dr. Majeed H Alwan, FRCS, New Zealand

Dr. Luay P Susan, MD, Cleveland, Ohio, USA

Prof. Stewart L Weinstein, MD, USA, Former president AAOS

Dr. Robert W Buchoiz, MD, USA, Former President AAOS

Dr. Cody Bünger, MD, USA, President SICOT

Dr. Scott A Hoffinger, MD, Oakland, CA, USA

Dr. Sebastian Gitter, Dr.med. Biberach, Germany

Dr. Alec Benjamin, FRCS, UK

Prof. W Al-Ma’ani, MD, Jordan

Prof. K Fathie, MD, FACS, USA

Prof. Hikmat Jamil, MD, PhD, USA

Prof. Wajdy L Haillo, MD, PhD, USA

Mr. David Gallaway, PhD, FRCS

Dr. Rick Wilkerson, MD, USA

Dr. Sabri Shukur, FDSRS, USA

Prof. Gary Selnow, USA

Dr. John Howe, USA

Dr. Karim A Shaikley, MD, USA

Dr. John Chalmers, FRCS, UK

Dr. J Frazer, MD, USA

Dr. M Zayer, MD, Sweden

Dr. S Al-Bodur, MD, Jordan




Administrative Secretary

Ms. Elham Altoma
Ms. Salima J Sa’ad
Instructions to Authors

Basrah Journal of Surgery publishes original articles, review articles, leading articles and case reports; all manuscripts are submitted to editorial review. Authors are requested to send two copies of their articles and other editorial material to:

The Editor
Basrah Journal of Surgery, Dept. of Surgery, College of Medicine, University of Basrah. IRAQ.
salamasfar@yahoo.com
OR basjsurg95@yahoo.com
An article is reviewed for publication on the understanding that the work it reports has not been submitted simultaneously to another journal, has not been accepted for publication by another journal, has not been accepted for publication by another journal nor has it been already published. Any such attempt, when detected, will result in automatic rejection and may prejudice acceptance of future contributions. The articles and their illustrations become property of the journal. The editorial board does not necessarily agree with views expressed by the authors.
A covering letter must accompany all submissions and must be signed by all authors. The first named author is responsible for ensuring that all authors have seen and approved the manuscript and are fully conversant with its contents.
Authors should consult “uniform requirements for manuscripts submitted to biomedical journals” produced by the international committee of medical Journal Editors and published in the British Medical Journal, 6 February 1988, 401-5. Only manuscripts, which comply with this, the Vancouver style, will be considered. The text of the articles is usually divided into sections with the headings, Summary (abstract), Introduc-tion, Methods, Results and Discussion. Long articles may need subheadings within some sections to clarify its content. Two good quality plain paper copies of all written and tubular material should be submitted. The manuscript must be typed double-spaced with a minimum of 3cm margins on A4 paper (210 × 297 mm) in the following order:
1. Title page with name of the author(s). The appointment of each author at the time of performance of the work reported should be mentioned; if an author has since moved then his new address is to be added as footnote. Authors names should be mentioned up to six, if there are more authors then the first three are mentioned followed by “et al.”.
2. Summary should be concise, complete in itself and outline the aim, results and conclusions of the paper. Randomized controlled trials should be identified.
3. The text of all articles should be short and to the point.
4. References should be numbered according to their sequence in the text and not alphabetically. They should be written down in compliance with Vancouver style; i.e.
A) Journal: Ferguson AJ, Mazier WP, Ganchrow MI, Friend WG. The closed technique of haemorrhoidectomy. Surgery 1971; 70: 480.
B) Book: Golgberg SM, Nivato-vongs S, Rothenberger DA, Colon, Rectum and Anus. In: Schwartz SI, Shire GT, Spencer FC, eds. Principles of surgery. 4th ed. Singapore: MacGraw Hill; 1984.
5. Tables should be separately typed each on one sheet and must have a Roman identifying number and a short descriptive title.
6. Illustrations should be submitted in duplicate. Photographs must be of the highest professional quality. Original line drawings may be sent instead of photographs. Never write on the front or back of drawing or photographs.
7. Pagination, all pages should be numbered in the sequence, title page, summary, text, acknowledgment, references, tables and legends for illustrations.
8. Abbreviations should be limited in the text. Terms, which are mentioned frequently, may be abbreviated, and clearly defined on first use.
9. Statistical analysis should include a clear description of which methods were used for which analysis. Results of statistical tests should be reported by stating the value of the test statistic, the number of degrees of freedom and the P value. For example, t=1.34, 16 d.f., p=0.2. There should also be an indication whether the results were statistically significant or not.
10. It is preferable to provide the manuscript on a compact disc using MS Word 2003 version.




Checklist for authors
1-Covering letter.
2-Two copies of the article.
3-Writing style according to the Vancouver style.
4-Tables, graphs and legends for the photos each on separate sheet of paper.
5-A copy of the article on a compact disc.


Announcement
The editorial board would like to inform our readers that the journal has been included in the Index Medicus for the WHO Eastern Mediterranean Region (IMEMR) starting from the March, 1999 issue (Vol.5, No.1). This issue as well as all forthcoming issues of the journal will appear in WHO/EMRO web site on the Internet at the address http://www.who.sci.eg The journal was also included in the collection of the National Library of Medicine, Bethesda, Maryland starting from the same issue (i.e. Vol.5, No. 1) as we were informed by the National Institutions of Health in their letter dated February 2, 2000.

Website: http://basjsurge.com email: basjsurg95@yahoo.com

Mobile: 009647801061850 Editor 009647801018133 Information Administrator

مجلة البصرة الجراحية 2015

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Contact info

Website: http://sites.google.com/site/basjsurg email:basjsurg95@yahoo.com, elhamaltoma74@gmail.com
Mobile: 009647801061850 Editor 009647801002992 Editorial Consultant
009647801537124 Secretary

The Editor: Basrah Journal of Surgery, Dept. of Surgery, College of Medicine, University of Basrah. IRAQ.
salamasfar@yahoo.com, OR basjsurg95@yahoo.com

Table of content: 2009 volume:15 issue:2

Article
1-DO WE NEED CONTINUOUS MEDICAL EDUCATION?

Authors: THAMER A HAMDAN
Pages: 1-2
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Abstract

Editorial

Keywords


Article
2-MEDICAL ERRORS AND RESPONSIBILITY OF THE PHYSICIAN

Authors: Thamer A Hamdan
Pages: 3-9
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Abstract

LEADING ARTICLE The physician is an active member of the society. He interacts with it, influences and takes care of it. His duty is not only to cure patients, but also to take the necessary procedures to reduce errors and to lessen the harm resulting from these errors on the health of the patient. Such faults and errors may seem travail, but they are serious however tiny they are because they are related to the divine and precious life of the human being.

Keywords

MEDICAL --- ERRORS --- RESPONSIBILITY --- PHYSICIAN


Article
NUTRITION IN GASTROINTESTINAL SURGICAL PATIENTS

Authors: Majeed H Alwan
Pages: 10-15
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Abstract

Despite important advances in surgical care and minimized surgical trauma, postoperative complications are still of great concern. Nutritional depletion has been demonstrated to be a major determinant in the development of postoperative complications. Nutritional status of gastrointestinal surgical patients is an important issue, which need to be attended in particularly during the perioperative period. Fears of postoperative ileus and the integrity of the newly constructed anastomosis have led to the adoption of starvation with administration of intravenous fluids until the return of normal bowel sounds and passage of flatus. However, it has been shown that early postoperative enteral feeding is both beneficial and well-tolerated. Meta-analysis has shown that enteral feeding compared with parenteral nutrition is associated with fewer complications, reduced costs and a shorter hospital stay. Therefore it should be the preferred option whenever possible. Evidence to support preoperative nutrition is limited, but malnourished individuals fed for 7-10 days preoperatively may have improved surgical outcome. Prolong preoperative starvation is not essential, and the administration of preoperative carbohydrates is safe without the fear of increasing the risk of aspiration. Initially nutritional support was aimed at meeting the energy needs and providing proteins and other essential micronutrients, while now it is more directed at modulation of the immune functions, the so called immunonutrition. Multimodal strategies including minimal invasive surgery, adequate postoperative analgesia, nutritional care, and enforced mobilization resulted in reduction in postoperative complications and length of hospital stay.


Article
OPEN ABDOMEN, WHAT IS NEW IN ITS SURGICAL MANAGEMENT?

Authors: Ghassan AA Nasir
Pages: 16-19
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Abstract

Open abdomen is a concept that the abdomen is left open after laparotomy especially when it was done as emergency for traumatic abdomen or reopens the abdomen when signs of increase intra-abdominal pressure (IAP) causing abdominal compartment syndrome (ACS). This open abdomen must be covered temporarily till the signs of abdominal compartment syndrome (ACS) disappears and intra-abdominal pressure (IAP) returns normal, then reclose the abdomen by one of definitive procedure. It was found that Vacuum-assisted wound closure (VAWC) is the best temporary procedure to close the abdomen to get early or late fascial closure as the best definitive closure of open abdomen. Also It was found that the classification of open abdomen is so helpful in choosing the procedure for temporary and definitive closure, this classification is new thing and dependable.

Keywords

ABDOMEN --- SURGICAL


Article
IS IT SAFE NOT TO LIGATE THE INFERIOR THYROID ARTERY DURING SUBTOTAL THYROIDECTOMY?

Authors: Ahmed D Chiad --- Mazin H Al-Hawaz
Pages: 20-33
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Abstract

Thyroid surgeries are common operations with an extremely low mortality. It is associated with specific morbidities which are dramatically decreased due to the rapid progression in operative techniques which helped to make the thyroid surgery less feared and better understood than it once was. Inferior thyroid artery is one of the vital structures that require special attention during operative technique in order to avoid troublesome and in most cases a preventable complications. We conducted this study to assess the: Prevalence and significance of post-operative hypoparathyroidism following thyroid surgery, with or without inferior thyroid artery ligation. Incidence of recurrent laryngeal nerve injury with or without inferior thyroid artery ligation. Intraoperative and post operative bleeding with or without inferior thyroid artery ligation. A prospective observational study was done from June 2005 to June 2008, at Basrah General Hospital. One hundred and eight patients underwent subtotal thyroidectomy. Majority of them (90) patients were females. Patients were placed in two groups, Group I had inferior thyroid artery ligation whereas in Group II, inferior thyroid artery was not ligated. Analysis of data reveals that (50%) of patients in group I had hypocalcemia, (16.1%) recurrent laryngeal nerve injury and (4.83%) hematoma, whereas in group II (47.82%) had hypocalcemia, (8.7%) recurrent laryngeal nerve injury and (2.17%) hematoma. Statistically, there is no significant difference regarding post-operative hypocalcaemia, recurrent laryngeal nerve injury and hematoma formation between truncal ligation and nonligation of inferior thyroid arteries.~ �C


Article
6-THE ROLE OF CONVENTIONAL ULTRASOUND IN THE ASSESSMENT OF THYROID NODULES IN AL-SULAIMANYIA TERRITORY$

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Abstract

A palpable thyroid nodule is a common clinical problem; the ultrasonography (US) and fine needle aspiration biopsy (FNA) are its main diagnostic tools. This article aimed to study the reliability and advantages of ultrasound as a diagnostic aid in predicting malignancy in thyroid nodules and to reduce the number of unnecessary surgery. Two hundreds and thirty three patients were examined by ultrasound, and then fine needle aspiration cytology under ultrasound guidance (US-FNAC) was done for 210 of them. From those 210 patients we obtained the histopathological proof of 58 patients who underwent surgery. We calculated the sensitivity, specificity and accuracy of US-FNAC. There are certain sonographic criteria that suggest malignancy these include microcalcification, irregular margins, and hypoechogenicity of the nodule. The sensitivity, specificity, and accuracy of US-FNAC were 80%, 96%, and 94% respectively. Although ultrasound can not reliably distinguish benign from malignant nodules, but it can identify suspected nodules based on certain sono-graphic criteria.


Article
7-CAN CYSTIC ARTERY CAUTERIZATION BE SAFELY PRACTICED IN LAPAROSCOPIC CHOLECYSTECTOMY?

Authors: Falih M Ali --- Safwan A Tahasam --- Adnan Y Al-Adab
Pages: 45-48
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Abstract

This study aimed to evaluate the safety and efficacy of cystic artery cauterization in laparoscopic cholecystectomy (Lap.Chole.) and to outline possible complications and limitations that might arise from adoption of such approach. Cauterization of the cystic artery was adopted as the principal mean of securing the cystic artery in the course of standard lap.chole. The technique was applied on 46 cases of laparoscopic cholecystectomy. Patients with adhesions in the triangle of Calot and/or very short cystic arteries were excluded from the study. All patients were followed up for 2-3 weeks. We didn't get any serious complication in form of: major bile duct injury, right hepatic artery injury, post operative hematoma. Mean operative time was 35 minutes. Out of the 46 patients who had cystic artery cauterization we had the following complications: one patient developed intra-operative bleeding from the cystic artery in the course of its skeletonization which was controlled by prompt clipping, another patient developed rather severe bleeding from a torn cystic artery and we converted him to open cholecystectomy. Forty one patients were females (age range 18-48 years) and 5 were males (age range 33-49 years). Complications occurred exclusively in females. Apart from conversion due to other causes, the incidence rate of conversion due to bleeding from cystic artery during clipping and cauterization was 1.5%, 2% respectively.


Article
8-AURICULAR RECONSTRUCTION BY COSTAL CARTILAGE GRAFT IN BASRAH PROVENCE

Authors: JABIR R HAMEED
Pages: 49-55
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Abstract

Auricular reconstruction represents a meticulous reconstructive and aesthetic problem to the plastic surgeon. One of the greatest challenges in facial plastic surgery is total ear reconstruction. The ability to reconstruct a fully satisfactory complete external ear has for centuries been an elusive goal. The most promising field of advances with the hope of eventually clinical utility lies in the realm of bioengineering with cultured cartilage. To date, no perfect material has been found to substitute for the sharply elastic cartilage normally present in ear, the matter of total auricular reconstruction remain very complex, Prosthetic restoration is not favored by most but does remain available option for many patients. Tissue engineers have waited to create a precise three dimensional auricular reconstruction neocartilage. Ten patients were operated upon for auricular reconstruction in Basrah Alsader Teaching Hospital. The operation had 2 stages: First stage, creation and implantation of framework cartilage graft, which harvested from the 6th ,7th & 8th ribs. The second stage, was detachment of the constructed auricles ear lobe transposition and post auricular sulcus was defined by separating the constructed auricle from the head covering the under surface with a thick split thickness skin graft. The success rate was 90% with good and satisfactory result except in one case; there was infection with loss of the cartilage.

Keywords

AURICULAR --- GRAFT --- RECONSTRUCTION


Article
9-EMERGENCY PERIPARTUM HYSTERECTOMY: EXPERIENCE AT BASRAH MATERNITY AND CHILDREN HOSPITAL

Authors: Haifa Al-Shaheen
Pages: 56-63
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Abstract

To estimate the incidence, indications, risk factors and complications associated with emergency peripartum hysterectomy, we analyzed retrospectively all cases of emergency peripartum hysterectomy performed at Basrah Maternity and Children from 1st of January 2005 to 31st of December 2007. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment less than 24 hours after delivery. There were 20 emergency peripartum hysterectomy among 51,121 deliveries for a rate of 0.3/1000. Fifteen women (75%) were delivered by caesarean delivery. Eighteen women were multiparous and 2 were primiparous. Most frequent indications were placenta accrete (60%), 9 with praevia and 3 with out praevia), followed by uterine atony in (20%), uterine rupture in (10%), extended cervical tear in (5%), and retroperitoneal haematoma in 5%. Placenta accreta was the most common indication in multiparous women (66.6%, 12 of 18) while uterine atony was the most common in primiparous. Eleven out of 12 (91.7%) women with placenta accrete had a previous caesarean delivery. Three (25%) had a previous one caesarean section and 8 (66.6%) women had .2 previous caesarean section. Fourteen (70%) of hysterectomies were subtotal. Intraopeartive complications were (15%) and Postoperative febrile morbidity was (60%).We concluded that placenta accreta has become the most common indication for emergency peripartum hysterectomy. The number of caesarean deliveries increased the risk of placenta accreta proportionally.


Article
10-NON RADIO OPAQUE FOREIGN BODIES IN ORTHOPAEDIC PRACTICE

Authors: Jasim Hasan Amarah
Pages: 64-68
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Abstract

Orthopaedic surgeons often remove foreign bodies from the extremities. If the foreign body is radio-opaque, it can be located using conventional radiographs or fluoroscopy. However if the foreign body is a radiolucent object, it may not be detected by radiograph leading to serious complications. The aim of this paper is to discuss the role of US in detection of non radioopaque foreign body in addition to the presentation and nature of the foreign body. Twenty patients with penetrating injuries to the extremities were treated from January- December 2008 at Samawa General Hospital. They were 11 male and 9 female, their ages ranged between 4 to 50 years (average 22.7). All patients were evaluated by detailed history, clinical examination, radiography and US which were done at the department of radiology in Samawa General Hospital. The lower limb was affected in 14 cases (70%) while the upper limb in 6 cases (30%). presenting symptoms were; pain (16 cases) followed by swelling (3 cases), limping and discharging sinus (one case). No foreign bodies were detected by radiography in this study. On the other hand, US detect and localize foreign body in each case. Fifteen patients had history of failed previous interventions for removing foreign bodies. In conclusion, Non radio-opaque foreign bodies are common in children and adults most often presenting as penetrating injury to the extremities. Failure to remove it may lead to serious complications and malpractice lawsuits. US has emerged as the study of choice for detection of radiolucent foreign bodies.


Article
11-HEMOSTASIS WITH SURGICEL FOR TONSILLECTOMY: A PILOT STUDY

Authors: Abdulmohsen E Hussain --- Yaseen H Ali6
Pages: 69-71
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Abstract

This study aimed to evaluate the use of surgicel as the primary hemostasis method in tonsillectomy. It is a cross-sectional prospective study included 211 patients who underwent tonsillectomy alone or with conjugation with adenoidectomy over a period of 4 years in a tertiary centre. The surgeon used cold steel dissection and surgicel as primary Hemostasis technique. There was no post-tonsillectomy hemorrhage in this study, giving a 0% risk of post tonsillectomy bleeding. It is concluded that the use of surgicel is a valid technique to achieve hemostasis in tonsillectomy. Larger number of patients has to be operated on using this technique in order to validate the comparison between our technique and techniques currently used.


Article
12-INFLUENCE OF BODY MASS INDEX ON THE INCIDENCE OF PRETERM LABOUR

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Abstract

Nutritional status of the women has been considered as an important prognostic indicator of pregnancy outcome and risk of preterm birth. Few studies have evaluated the patterns of body mass index in developing regions where malnutrition and poor weight gain as well as maternal obesity have significant influences on the pregnancy outcome. This study aims to show the effect of pregnancy body mass index on the incidence of preterm labour. This is a prospective descriptive study of 200 women attended Basrah Maternity and Child Hospital who were diagnosed with preterm labour were recruited in the study. Patients were classified into categories that were based on their body mass index (BMI) according to the national institute of health guidelines. Rate of spontaneous preterm birth were determined. Women with body mass index <19 kg/m2 had 34.5% of spontaneous preterm labour, with BMI 19-24.9 kg/m2 had 28.5% of spontaneous preterm labour, while those with BMI 25-29.9 kg/m2 had 21% of spontaneous preterm labour, women with BMI 30-34.9 kg/m2 had 14% of spontaneous preterm labour and with BMI >/35kg/m2 had 2%of spontaneous preterm labour. Risk of spontaneous preterm labour tend to progressively decrease with increasing body mass index. Thinner women who have preterm delivery tend to deliver at earlier gestational age than women who were obese 42.3% of non obese women deliver before 30 weeks of gestation compared to 25% of the obese, 44% of non obese deliver at gestational age 30-40 weeks compared to 28.25 of the obese. In conclusion, high body mass index is associated with a lower rate of spontaneous preterm birth.

Keywords

BODY MASS INDEX --- PRETERM --- LABOUR


Article
13-LAPAROSCOPIC LIVER HYDATID ENDOCYSTECTOMY (INITIAL EXPERIENCE OF FOURTEEN CASES)

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Abstract

This study demonstrates the effectiveness and safe outcome of the treatment of hydatid disease by laparoscopic approach in selected cases. This is an experimental prospective study. Fourteen cases of liver hydatid (11 men & 3 women), properly selected were subjected to laparoscopic hydatid endocystectomy in the period from February to September 2004 at the endosurgery Center. Sirte County.����

Keywords

LAPAROSCOPICY --- HYDATID


Article
14-MANUAL PHACOEMULSIFICATION IN BASRAH; THE FIRST SERIES FROM IRAQ

Authors: Sajid Al Assadyd
Pages: 81-87
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Abstract

This prospective study includes 80 eyes of 78 patients with cataract, who had manual phacoemulsification operated upon by the same surgeon at Basrah Hospitals between Feb, 2006 and Jul, 2007. They were 35 males and 43 females, 2 of them (females) have cataract in both eyes. The age of patients range from 35-70 years, 23 eyes of 21 patients (28.7%) at age of between 35-45 years, 20 eyes (25%) at age of between 46-55 years, 27 eyes (33.7%) at age of between 56-65 years, 10 eyes (12.5%) at age . 66 years. The pre-operative visions for those patients were ranged from 6/24 to projection of light (PL), depend on the type and extent of cataract. There was selected with no significant corneal astigmatism in all of these patients. Surgery was done on 21 eyes (26%) with posterior subcapsular cataract, 20 eyes (25%) with nuclear cataract, 30 eyes (38%) with mature cataract and 9 eyes (11%) with hypermature cataract. On the first postoperative day, according to Oxford Cataract Treatment and Evaluation Team Grade (OCTET) classification the observation was: Grade 0 was reported in 46 eyes (58%), Grade I developed in 25 eyes (31%), Grade II developed in 8 eyes (10%), and Grade III developed in 1 eye (1%). On the 7th postoperative day, 54 eyes (67.5%) had Uncorrected Visual Acuity (UCVA) of good outcome, 23 eyes (28.7%) had of borderline. On day 40 postoperative, 75 eyes (93.7%) achieved a best corrected visual acuity (BCVA) of good outcome. The final refractive states in 73 eyes (91.2%) was emmetropic or within (-1) diopteric sphere of the desired refractive target without a significant astigmatism.


Article
15-EVALUATION OF THE CLINICOPATHOLOGICAL CHARACTERISTICS OF LABIAL MUCOCELE

Authors: Ali Darweesh AL Sarraj --- Riad G Al-Taee
Pages: 88-92
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Abstract

The objective of the present study is to evaluate the clinicopathological characteristics of labial mucocele. Eighteen cases of labial mucocele were studied, a special protocol was designed and clinical & histopathological variables were recorded. Only one mucocele occurred in the upper lip, the rest being in the lower lip. One was bilateral. Of the mucoceles examined, 88% were of the extravasation type and 11% were retention. Of the 16 classified as of the retention type, 12.5% were in the initial stage, 31.25% in the resorption stage and 56.25% in the final stage. It is concluded that diagnosis can be established from clinical details although a histopathological study is necessary to confirm the diagnosis.

Keywords

LABIAL MUCOCELE


Article
16-COMBINED THERAPY IN THE TREATMENT OF LARGE AURICULAR KELOID

Authors: Zuhair F Fathallah
Pages: 93-96
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Abstract

Tendency to heal with an abnormal scar7. The external ear is most prone to unfavorable wound responses such as keloids8. Earlobe keloids are common response to ear piercing, especially in females and darker skin individuals9. Keloids on the ears present several therapeutic challenges. They are common after small skin excisions and other procedures, including drainage of auricular hematomas, repair of other auricular traumas or as secondary keloid formation after prior keloid excision. Several treatment modalities are used for keloid such as surgery alone or surgery combined with other measures with varying success rates. Today there is no agreement about which treatment modality will significantly solve the problem10. This paper report a case of a large bilateral post burn ear keloid on the helical rim which was successfully treated with surgery and intra-lesional injection of 5FU and Triamcinolon.

Keywords

AURICULAR --- KELOID


Article
17-FOREQUARTER AMPUTATION FOR RECURRENT EWING'S SARCOMA OF THE HUMERUS (CASE REPORT)

Authors: Jasim Hasan AmarahACH
Pages: 97-99
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Abstract

A 27 year old male, known case of Ewing's Sarcoma of the right lower third humerus since July 2002, he was treated by combined therapy. After 3 years, he presented with pain, pathological fracture of the upper end of the right humerus and soft tissue mass around the right shoulder. Forequarter Amputation was done to him in October 2005. The presentation and management of this patient is discussed.

Keywords

SARCOMA --- EWING'S


Article
18-ACUTE ERYTHRO-LEUKEMIA (DI GUGLIELMO SYNDROME) IN A YOUNG ADULT IN BASRAH CITY

Authors: Thya Al-Saadiat --- Zuhair Al-Barazanchi.
Pages: 100-103
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Abstract

Introduction Giovanni Di Guglielmo first described erythroleukemia, a leukemia composed of purely erythrocytic precursors in 1926, and the disorder is often still referred to as acute Di Guglielmo syndrome. It is classified as an M6 subtype of acute myelogenous leukemia (AML) in the French- American-British (FAB) classification system based on morphologic and cytochemical criteria1a. Acute erythroleukemia accounts for 3-5% of all de novo AMLs and 20-30% of secondary leukemias. It is very rare in children. The incidence of erythroleukemia increases in people older than 50 years2 Mazzella et al (2000) described 2 peaks, one in the seventh decade of life and a second, smaller peak in the fourth decade of life.

Keywords

LEUKEMIA --- GUGLIELMOH Saeed

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