Table of content

Al-Kindy College Medical Journal

مجلة كلية الطب الكندي

ISSN: 18109543
Publisher: Baghdad University
Faculty: Al-Kindy Medicine
Language: English

This journal is Open Access

About

Al-Kindy College Medical Journal ((Al-Kindy Col.Med.J)), a periodic peer reviewed scientific journal published biannually by Al-Kindy College of Medicine –University of Baghdad. specialised
in research of medical and related subject ISNN 1810-9543
The articles and research studies published in the journal are carefully selected and reviewed by a high standard advisory board from doctors who are most seniors and experts in their medical fields according to the subjects submitted to the journal.
Al-Kindy Col.Med.J is well recognized by Baghdad ,Mustansiriya and Nahrain universities for promotion of their teaching staff.
Three hundred articles ,research papers, case reports and studies have been published ourn medical journal since 2003 till now and the journal has been distributed to all medical collages of Iraq and most counties in the Middle East.

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Mobile: +964 7803546157
web site: www.kmc.edu.iq
E-mail: journal@kmc.uobaghdad.edu.iq
info@kmc.uobaghdad.edu.iq

Table of content: 2007 volume:4 issue:1

Article
Urine Cytology in Patients withLong Standing Dialysis

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Abstract

Background: Dialysis is in common use to treat patients with end stage renal failure .However longstanding dialysis harboring some cellular changes in various body fluids. This study was conducted in order to detect these changes in urine.
Objective: The study was conducted to detect cellular changes in urine of patients with longstanding dialysis.
Method: Fifty-three urine samples were examined cytologically obtained from patients with longstanding dialysis during 6 months period. Freshly voided midstream urine samples were taken . Samples were centrifuged and 2 to 3 drops of sediments were smeared on 2 glass slides and fixed in 95% ethyl alcohol then stained with Hand E stain to be evaluated.
Results: Gross physical examination of all urine samples were neither purulent nor hemorrhagic .Microscopically there was increased exfoliation of urothelial cells except in 9 cases. No significant cytological atypia were seen in all urine samples. Excessive exfoliation in the absence of significant inflammation, hemorrhage and cytological atypia compared with control group.
Conclusion: The study revealed that some cytological changes do occur in the urothelial cells of patients with longstanding dialysis. These changes need further attention and study to disclose their causes.
Key words: Urine cytology, dialysis.

Keywords

Urine cytology --- dialysis


Article
5 Years Experience in IntracapsularFemoral Neck Fracture Management

Authors: Ali H Khudair
Pages: 5-10
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Abstract

Background: Displaced intracapsular fracture of the femoral neck remain a challenging issue despite the advancement in the ways of treatment .The purpose of this study is to assess the results of different methods of treatment in different age groups.
Methods: This study was conducted over a period from (1998-2004) on 26 patients, with ages of 5 – 85 years with intracapsular fracture of the femoral neck due to different insults in Tikrit teaching hospital. Open reduction and internal fixation was done to those patients of<60 years of age, while uncemented Austin-Moore hemiarthroplasty was conducted in patients of >60 years old. Patients were followed for 6-12 months for any complication.
Results: The main age group among the patients were those >60 years [13 (50%)]. The main cause of fracture was fall from standing position in 19 (73%), were treated by uncemented Austin-Moore prostheses. The main complications were hip and knee pain [8(30.7%) and5 (19.2%)] respectively.
Non-union (11.5%) and avascular necrosis (11.5%) was the commonest complications in young patients, and were treated by internal fixation especially if the time of surgery was delayed over 24 hours.
Conclusion: The reduction and internal fixation will continue to be used as the primary treatment of displaced intracapsular fracture in many younger patients because the benefits of preservation of the normal hip joint which should be done urgently within the first 24 hours. However, if this method of treatment is unsuccessful and requires revision, the risk of early complications is higher and hip function is poor. When hemiarthroplasty is the treatment of choice cemented fixation is preferable.
Key words: intracapsular, fracture, femoral neck


Article
Trace Elements in Serum and Seminal Plasma and Their Relationship to Infertility in Iraqi Males

Authors: Basil Y Salah --- Zina A Marrow --- Nahla M Tawfiq
Pages: 11-14
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Abstract

Background: Environmental chemicals are thought to adversely affect human reproductive function.
Objective : To estimate the concentration of cadmium(Cd) , lead ( Pb ) and Zinc ( Zn ) in serum and seminal plasma among infertile men .
Methods: A sample of 70 infertile men was investigated. The relationship of trace elements concentration in serum and seminal plasma was studied in relation to sperm density, motility and sperm count.
Results: Except for Zinc the concentration of (Pb) and (Cd) were generally higher in serum than in seminal plasma. The mean concentration of (Zn) in seminal plasma was more than 25 times higher than in serum There were no statistical significant differences observed in the serum and seminal plasma levels of trace elements among the normospermic , oligospermic and azoospermic.
Conclusion: It seems that no significant relationship between these trace elements and the clinical classification of the infertile men was noted. Without considering environmental conditions of life and work, way of nutrition smoking and other possible factors, this study does not present great value.
Key words: Trace elements, infertility, seminal plasma


Article
Electro Cardiographic Features of PtientsWith Tetralogy of Fallot

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Abstract

Background: For many decades, the ECG was the workhorse of non-invasive cardiac test and today although other techniques provide more details about the structural anomalies in congenital heart diseases, ECG is likely to be part of clinical evaluation of patients with such diseases because it is inexpensive, easy to perform and in certain situations may be both sensitive and specific.
Objective: this study carried out to identify the pattern of ECG study in patients with TOF.
Methods: this is a retrospective study of 200 patients with TOF, referred to Ibn Al-Bitar cardiac center from April 1993 to May 1999. The diagnosis of TOF established by echocrdiographic, catheterization and angiographic study. For each patient, the ECG tracing had been analyzed for rhythm, p-wave, P-R interval, QRS axis, duration and T-wave in V1 and any chamber enlargement.
Results: The ECG analysis revealed that all patients had sinus rhythm, normal P-R interval and normal p-wave duration and amplitude, and normal QRS duration. All studied patients had one criteria of RVH and 95% of them had two or more of such criteria.
Conclusion: we found that in the absence of RVH criteria, the diagnosis of TOF is unlikely and the present of northwest axis should indicate canal type VSD.
Key words: ECG, TOF, congenital heart disease

Keywords

ECG --- TOF --- congenital heart disease


Article
Bacterial Infections Associated withCutaneous Leishmaniasis

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Background:Oriental sore occurs mostly in the mediteranian region , North Africa ,and the Middle East . Rodents are the main reservoir for the parasite . The wet type caused by L. major is rural and the dry type caused by L. tropica is urban and humans are presumably the only reservoir. Sand fly vectors are involved in all forms.
Objectives: This study aimed to show the most important bacterial infections concomitant with cutaneous leishmaniasis .
Methods; The study was performed on 75 patients (ages 1-50 years ) from both sexes were attending Skin Diseases Department of Ramadi General Hospital during the period extended from January to June 2000. These patients were clinically diagnosed as patients with cutaneous leishmaniasis. Skin specimens were taken for bacteriological and parasitological investigations .The same thing was done for specimens from 25 intact individuals resembling the test group as negative controls.
Results: Children showed more lesions with Positive cutaneous leishmaniasis, adult females, showed more l lesions than adult males. Children showed more bacterial isolates than adults, from both positive and negative l lesions. Staphylococcal and Streptococcal isolates took the first rank of isolation in all age groups and both sexes. E. coli and fecal Streptococci were isolated from children only.
Conclusion: Bacterial invasion for the skin lesion with cutaneous leishmaniasis complicates the lesion and leads to misdiagnosis, in addition to the delay of healing of the lesion via bacterial end-products. There is a need for accurate diagnostic techniques like polymerase chain reaction (PCR) for both bacterial and parasitic agents, suitable effective antimicrobial therapy, in addition to the antileishmanial agents. Good sanitation of the lesion and community education to prevent infections.
Keywords: Bacteria and Leishmania, Bacterial skin infection, L concomitant infections.


Article
Parental Perception of Fever in Children

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Abstract

Back ground : Fever is a common medical problem in children. parents have been shown unrealistic fears of harmful effects of fever in their children. Resulting in inappropriate management of fever in their children.
Objective: the objective of this study was to survey parents about their knowledge andattitude concerning fever in their children.
Methods : The study involved random selection of parents who brought their febrile children to emergency department or out-patient clinics of five teaching and non teaching hospitals in Baghdad from first of October to end of December 2002.
Parents of 400 febrile children were interviewed using a standard questionnaire to obtain sociodemographic information and current knowledge of fever.
Results: Approximately 69% of the respondents were female, 68% their age was in the range of 21-35 years. Seventy seven percent of parents had two or more children. More than 70% of parents demonstrated a poor understanding of definition of fever , maximum temperature of untreated fever and threshold temperature requiring antipyretics . Twenty sevev percent of parents considered temperature less than 38.0 co to be fever, another 27% did not know, the definition of fever, 61% felt that temperature of less than 40,0 co could be dangerous to a child, and 27% could not define high fever. Another 28% believed that if left untreated, temperature could rise to 42.0 co or higher, but 39% could not provide an answer, and about 60% did not know the minimum temperature for administering antipyretics. And 60% did not know the minimum temperature for bathing , or sponging.
Approximately 93% of parents demonstrated fear of consequent body damage from fever , including convulsion ,brain damage ,coma, blindness and even death.
Conclusion: parental misconception about fever reflects the lack of active health education. Health professionals have apparently not done enough to educate parents on this common medical problem and it,s consequences.
Key Words: fever , hyperthermia, hyperpyrexia.


Article
Arthrogrypotic Club Foot

Authors: Abdullah Y Al-Mihyawi
Pages: 33-39
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Background: Arthrogryposis Multiplex congenita is a rare disorder, characterized by multiple joint deformities i.e. multiple congenital contractures, with shapelessly cylindrical limbs and absent skin creases.
Club foot can be the only obvious deformity of this widespread disorder.
Objective: To assess the most frequent recurrent deformity after extensive soft-tissue release operations for arthrogrypotic club foot and its appropriate treatment regarding combined tendon transfer and bony operations.
Methods: A retrospective study of 14 patients with arthrogrypotic club foot (28 feet), had been operated on by multiple soft tissue and bony operations and followed in a period between January (1993) till February (1999).
Both clinical assessment including goniometer use to measure the recurrent deformity, and radiological assessment, was used in this study.
Results: In this series, 4 patients (7 feet) had recurrent deformity, 3 patients
(5 feet) out of these 4 had recurrent forefoot adduction, 2 of them had bilateral affection. The 4th patient had bilateral recurrent varus heel.
Conclusion: The main problem in arthrogrypotic club foot is the liability for recurrence. The most frequent recurrent deformity was forefoot adduction. Combined tendon transfer and bony operations can correct the deformity once performed at the same cession forefoot adduction. All required 2nd operation, in the 1st 3 patient combined Evan’s (calcaneocuboid wedge-excision) and tibialis anterior transfer operations were performed. Talectomy was performed on one foot in the 4th patient, combined with capsulectomy of the calcaneocuboid joint, while triple arthrodesis don on the other foot.
Key words: arthrogrypotic club foot, recurrent forefoot adduction, tibialis ant. Transfer


Article
Microbiological Study of Male’sUrethral Discharge

Authors: Waleed I A AL – Obadi
Pages: 40-42
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Objective: To evaluate male patients complaining of urethritis clinically according to the isolated organisms.
Method: A total of 100 male patients attending to of Dermatological and Venereal private clinics for the period April 2003 to November 2003 were included in the study. Urethral swab was obtained from each male for culture and direct immunofluorescence examination was done. Demographic data was obtained, also.
Results: N. gonorrhoea was the predominate cause of infection in 22%. A peak of infection was reported in the second decade of age. Highest rate reported among single males. A significant association was noticed between profuse discharge and infection with gonorrhoea.
Conclusion: This study demonstrated that peak of infection in the second decade of age and among singles. A broad range of causative agents was reported.
Key words: Gonorrhoea, urethral discharge, non gonococcal urethral discharge


Article
Iron Deficiency Anemia: The Utility of Upper GastrointestinalEndoscopy and Histopathology

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Background: occult blood loss must be considered as a possible cause in every case of iron deficiency anemia.
Objective: to evaluate upper gastrointestinal endoscopy in finding a potential cause for iron deficiency anemia among children in Al-Anbar governorate.
Methods: Twenty five children aged 2-14 years, referred to the gastroenterology unit in Al-Ramadi General Hospital for upper gastrointestinal endoscopy had iron deficiency anemia. Fiberoptic endoscopy was used under general anesthesia and endoscopic tissue biopsies were taken from 22 patients for histopathological examination.
Results: The main presenting signs and symptoms were pallor, abdominal pain, and stunting. The upper gastrointestinal endoscopy showed thinning of duodenal folds & serrated mucosa in 8 (32%), duodenal ulcer in 3 (12%), esophageal varices in 1 (4%), nodular gastritis in 1 (4%), and reflux esophagitis in1 (4%), with a yield rate of 56%.
While tissue biopsies revealed histopathological findings suggestive of celiac disease in 12 (48%), Giardia lamblia in 2 (8%), Helicobacter pylori gastritis in 1 (4%), and esophagitis in 1 (4%). There was a significant association between the endoscopic finding of thinning of duodenal folds and serrated mucosa and the histopathological finding suggestive of celiac disease, P<0.05.
Conclusion: Iron deficiency anemia in children 2-14 years of age warrants upper gastrointestinal endoscopy to find potentially treatable causes for the iron deficiency anemia.
Key words: Children; Iron deficiency anemia; Upper gastrointestinal Endoscopy.


Article
Lower Ureteral Obstruction and Leakage in the FirstMonth Following Renal Transplantation

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Background: Transplantation has revolutionized treatment of end- stage renal disease (ESRD) by proving more cost effective than hemodialysis, with a lower morbidity and improved quality of life.
Objective: To evaluate the development of these complications in the first month postoperatively and correlate their development to the type of donation whether related or unrelated.
Methods: Fifty (50) patients aged (15-62) years, with a mean age (34.46 ± 12.4 SD) years with (ESRD), who underwent renal transplantation from September 2000 to October 2002, were followed-up for one month postoperatively clinically and by assessment of renal function tests, sonographic and Doppler examinations. Ureteral obstruction was considered in those patients who had allograft dysfunction, ultrasonic evidence of peritransplant collection, moderate-severe dilatation of upper urinary tract of transplanted kidney and postoperative ipsilateral or bilateral leg edema. Ureteral leakage was considered in those patients who had persistent drainage of urine with or without allograft dysfunction. Two patients were excluded from the follow-up due to death in the first 24-hour postoperatively.
Results: Six (6) patients (12.5% of cases) developed ureteral obstruction due to peri-ureteral fluid collection. In five patients the collection decreased and upper urinary tract dilatation improved gradually, as shown by ultrasound, on watchful waiting. One patient had surgical evacuation of a large hematoma. Four (4) patients (8.3% of cases) developed ureteral leakage. The leakage stopped in one patient after keeping the urethral catheter for a longer period. Three patients had surgical exploration due to persistent urinary leakage. Redo implantation of allograft ureter was done in two cases.
Development of ureteral complications was compared with the type of donation (related or unrelated). The comparison was not statistically significant.
Conclusions: The development of ureteral complications in not related to the type of donation. Extravesical ureteral anastamosis with the use of a stent is less likely to be associated with postoperative ureteral complications.
Key words: Renal transplantation, Extravesical ureteroneocystostomy


Article
Lung Cancer in a Sample of Iraqi Patients

Authors: Yousif A. Al-Rahim
Pages: 53-59
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Background: Lung cancer is responsible for the most cancer deaths in both men and women throughout the world. Deaths from lung cancer (160,440 in 2004, according to the National Cancer Institute) exceed the number of deaths from four other major cancers combined (breast, colon, pancreatic and prostate).
Objective: To assess the behavior and the approaches of lung cancer in a sample of Iraqi patients.
Methods: This descriptive retrospective study was performed using the records of 390 patients proved to have lung cancer that had attending the Thoracic Surgery Department of Surgical Specialties Hospital-Medical City Baghdad for the period from January, 1st , 2001 to December, 31st ,2002.
Results: The results of this study revealed that 71.8% of the patients were male, with a mean age of 63 years. The majority of the patients (90.2%) were smokers, the number of cases increases with the increase in the duration of smoking or the amount of daily cigarette smoking.
Radiotherapy is the primary management of 75.9% and the surgical choice was in 24.1% of the patients, but the tumors were removed only in 42.5% of operable patients.
Conclusions: Lung cancer is an important and serious public health problem with an increasing in incidence and prevalence in Iraq; cough is the most common clinical finding, found in 98.5% of patients, followed by haemoptysis (64.1%); cigarette smoking is responsible for the at least 90% of its etiology. Sequamous cell carcinoma is the most common type of primary lung cancer in Iraq (42.6%) with prominence in male gender; adenocarcinoma is the second common type with equal distribution in male and female.
Key words: Lung cancer, Bronchogenic carcinoma, Tumor


Article
Diagnostic Approach of Atypical Cells in Effusion Cytology Using Computerized Image Analysis

Authors: Zainab A J Al-Obaidi
Pages: 60-62
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Background: Cytology is one of the important diagnostic tests done on effusion fluid. It can detect malignant cells in up to 60% of malignant cases.
The most important benign cell present in these effusions is the mesothelial cell.
Mesothelial atypia can be striking andmay simulate metastatic carcinoma. Many clinical conditions may produce such a reactive atypical cells as in anemia,SLE, liver cirrhosis and many other conditions.
Recently many studies showed the value of computerized image analysis in differentiating atypical cells from malignant adenocarcinoma cells in effusion smears. Other studies support the reliability of the quantitative analysisand morphometric features and proved that they are objective prognostic indices.
Methods: Sixty three cases of pleural and peritoneal smears, previously reported as benign (19) cases, malignant (21) cases or atypical (23) cases, were retrieved from the files. In each of these smears; nuclear area, perimeter, and roundness coefficient of 80-100 cell were determined at x400 magnification by the use of image analysis system.
Statistical analysis was performed using analysis of variance and Tukey's HSD test.
Results: The mean values of nuclear roundness, nuclear perimeter and nuclear area vary between the three groups (benign, atypical and malignant cells) by using analysis of variance (p > 0.01).
The value of nuclear roundness, perimeter and area did not differ significantly between benign and atypical cells (Tukey’s test: p<0.01).
On the other hand, the value of nuclear roundness, perimeter and area showed a significant difference between malignant and atypical cells(Tukey's test: p> 0.01).
Conclusion: In conclusion, our data suggest that cytomorphometry performed on effusion smear cells may provide important information for the differentiation of atypical cells from malignant cells, in which the values of atypical cells are closer to those of benign cells during the examination of pleural and peritoneal smears by the use of image analysis system.
Key words: Effusion cytology, Atypical cells, Cytomorphometry


Article
Ectopic pregnancy, A Prospective Study In Al-Batool Teaching Hospital In Mosul – Iraq

Authors: Ghada Al-Daheen
Pages: 63-69
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Background: Ectopic pregnancy (EP) is the implantation of pregnancy at an extra uterine site. EP accounts for approximately 2 % of reported pregnancy. The largest risk factors are upper genital tract infection due to sexually transmitted diseases (STDs), as well as other risk factors as smoking, the use of intrauterine device, previous tubal or pelvic surgery, history of infertility, and the risk of age and parity. It is difficult to diagnose EP clinically. However diagnostic aids like B-hCG assessment and ultrasound scan has proved to be of great help. The treatment trends for ectopic pregnancy have changed to more conservative procedures like salpingostomy, segmental resection and fimbrial expression.
Methods: From September 2000 to September 2002, a prospective study was conducted to forty patients who were admitted at Al-Batool teaching hospital, as proven or suspected cases of ectopic pregnancy.
Complete assessment of the patients through detailed history and clinical examination was carried out, and accordingly patients were classified into unstable and stable groups.
The investigations has included pregnancy test (PT), ultrasound scan (USS), and laparoscopy.
The operative procedures were either salpingectomy, or conservative surgery in the form of salpingostomy and milking of the tubes.
Histopathological examination confirmed EP in all surgically treated patients.
Results: Forty cases of ectopic pregnancies were collected. 67.5 % were in the age group 26 – 35 year.
Women with higher parity had the highest percent with EP (37.5 %).
Twenty - seven cases (67.5 %) were clinically unstable.
USS was performed for twenty – six (65 %) patients with positive results in all, where twenty – one patients (80.76 %) had an adnexial mass.
Diagnostic laparoscopy was carried out in four cases (10 %) only.
Among the forty cases of EP the findings at laparotomy were as follows:
Tubal abortion was evident in four cases ( 10 % ). Intact ampullary pregnancy in fourteen patients (35 % ), two isthmic gestations (5 %), two ovarian pregnancies ( 5 %) , and one corneal pregnancy( 2.5 %). In seventeen cases (42.5 %) there was ruptured ectopic pregnancy. There was accompanying ovarian cysts in five patients (12.5 %),
The operative procedures included: Salpingectomy in thirty one patients ( 77.5 % ) , salpingostomy in two cases ( 5 % ), milking of the tube in four cases ( 10% ), and conservative removal of the products of conception from the ovarian tissue with adequate haemostasis in the two cases of ovarian pregnancy ( 5 % ).
The route of exploration and management was through opened laparotomy in all. Two cases that were treated through laparoscopy.
Conclusion: Early diagnosis of cases of ectopic pregnancy would reduce the morbidity and even the mortality of ectopic pregnancy. It allows more conservative form of treatment to be applied, and thus giving a better chance for the patient to preserve fertility.
Key word: Ectopic pregnancy, tubal pregnancy, risk factors in ectopic pregnancy


Article
Perinatal out come of Breech Presentation in the Presentation in the Pretext Mode of Delivery

Authors: Abdulrazak H. Alnakash
Pages: 70-75
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Objectives: To choose the best mode of delivery for term, frank or complete, breech presentation through studying the perinatal outcome of each mode of delivery decided when managing a group of pregnant ladies presented with breech delivery in our centre.
Methods: One hundred and fifty pregnant ladies presented at term with singleton, frank or complete, breech presentation for delivery in our centre during the period from May 2004 to August 2005.
Mode of delivery, parity, gestational age, maternal age, maternal medical illness, and birth weight where the variables that have been tested in each delivery included in the study to verify their relationship to perinatal outcome.
Results: No significant relationship is found between the occurrence of adverse perinatal outcome and the variables. However, mode of delivery was the major determinant of the perinatal outcome.
of the 150 pregnant ladies, 46 were delivered vaginally, 32 had elective caesarean section, and the remaining 54 pregnant, had undergone an emergency caesarean section because they were presented with labour. Thirteen (8.6 %) babies were adversely affected by the process of delivery, 9 (5%) of them were delivered by vaginal route, 3 (2 %) delivered by emergency caesarean section and one (0.6%) by elective caesarean section.
Conclusion: Elective caesarean section is regarded the safest way of delivery for those with term, frank or complete, breech presentation.
Key Words: Breech, Perinatal outcome, Cesarean Section (CS).


Article
Early Laparoscopic Versus OpenCholecystectomy for Acute Cholecystitis

Authors: Mumtaz K. H. AL-Nasir
Pages: 76-81
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Background: Acute cholecystitis is common surgical problem, which was treated previously by conservative treatment .Later early open has been introduced as an alternative to interval for treatment of acute cholecystitis. Early open was found to be a safe, successful with comparable postoperative complication rate. With the advent of laparoscopy laparoscopic have been used for chronic cholecystitis and became the first line of treatment. New reports have shown that laparoscopic can be used as an alternative to open for surgical treatment of acute cholecystitis.
Objectives: to compare the success, safety of early laparoscopic versus early open as a primary treatment of acute cholecystitis.
Methods: out of 68 patients were treated for clinical acute cholecystitis between January 2002 and February 2004 in the department of surgery, at Al – Kindy teaching hospital. A total of 62 patients underwent early for acute cholecystitis as soon as possible after diagnosis. The preferred preoperative imaging technique was ultrasound. 30 (48.3%) of the operations were attempted laparoscopically, whereas the remaining 32 patients (51.7%) underwent initial open .
Results: The mean operative time for the open cases was 75 minutes versus 60 minutes for the laparoscopic group. There was no perioperative mortality in either group. The incidence of conversion to open was 10% (3 patients). Surgical complications related to laparoscopic and open occurred in 2 (6.6%) and 3 (9.3%) cases, respectively. There was no difference between the open and laparoscopic groups in regard to the major postoperative complications.
Conclusion: The current study shows that early (whether performed by open or laparoscopically) is a safe and effective treatment for acute cholecystitis. Low conversion rates can be maintained with strict guidelines for appropriate patient selection, adequate experience, and proper laparoscopic technique.
Key Words: Acute cholecystitis– Conversion rate – Laparoscopic .


Article
Pyogenic Discitis in Female after Delivery and Pelvic Surgery

Authors: Sadiq A.Al-Mukhtar --- Maad M Shalal
Pages: 82-86
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Background: Pyogenic discitis most frequently occurs after home delivery, hemorridectomy, and dilatation and curettage. Discitis is generally due to blood borne bacterial invasion of the disc from adjacent end-plate via communicating vessels. Infective discitis remains an uncommon, but potentially serious cause for back pain. Delayed diagnosis can occur and a high index of suspicion may occur.
Methods: The study included 30 patients suffering from localized low back pain with limitation of movement. Diagnosis was made by history, physical examination and investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of vaginal delivery, 15% had a history of hemorridectomy and 10% had a history of dilatation and curettage and cesarean section surgery. All patients had elevated E.S.R, Positive C-reactive protein and positive MRI finding.
Conclusion, We must think of Pyogenic discitis in any patient with sever backache, fever, local tenderness, and high ESR.
Key words: Discitis, Pyogenic, Infection

Keywords

Discitis --- Pyogenic --- Infection

Table of content: volume:4 issue:1