Table of content

Diyala Journal of Medicine

مجلة ديالى الطبية

ISSN: 97642219
Publisher: Diyala University
Faculty: Medicine
Language: English

This journal is Open Access

About

A scientific, medical journal published by medical college , diyala university at 2010
No. of issues per year(2)
No. of papers per issue(15-20)
No. of issue published (3) issue

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Contact info

djm.diyala@yahoo.com

Table of content: 2013 volume:5 issue:2

Article
Association Between Size of Adenoid and Otitis Media with Effusion Among a Sample of Primary School Age Children in Erbil City

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Abstract

Background: The pharyngeal tonsil (adenoid) constitutes the upper portion of the Waldeyer’s ring and it is situated at the top of the nasopharynx, next to the auditory tube and choana. Hypertrophy of the adenoids and eustachian tube dysfunction are often considered to be causal factors for otitis medial with effusion. There are many methods used to measure the size of adenoid such as lateral soft tissue X-ray of nasopharynx. Objectives: This study aimed to evaluate the grades of adenoidal hypertrophy among schools age children with otitis media and to find of an association between size of adenoid and occurrence of otitis media with effusion. Subjects and Methods: In this cross sectional study, 17 primary schools were visited; all pupils from the first to the sixth year of elementary study were examined in the period from mid October 2009 to mid May 2010. A total of 1,035 pupils were interviewed and those with positive findings that suggest otitis media with effusion were referred to the otolaryngology outpatient department to confirm diagnosis using further investigations such as tympanometry; and a pure tone audiometry was also used to assess the hearing threshold. Adenoid size was measured by adenoid/nasopharyngeal ratio on cervical lateral views of simple X-rays. Results: Otitis media with effusion was found in 48 (4.6%) of the studied children. The most common type of tympanometry results seen among the children with otitis media was type B. Grade 3+ adenoid hypertrophy was mainly seen among patients having unilateral and bilateral otits media with effusion, accounting for 16% and 37% of all cases of otits media with effusion accordingly. Type B tympanogram was significantly associated with positive history of oral breathing in the studied children (p value < 0.05). Conclusions: The study concluded that adenoid hypertrophy was associated with otits media with effusion in school age children. The proportion of otitis media with effusion increases with the severity of nasopharyngeal obstruction by adenoid hypertrophy.

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Article
Biofilms Formation on Contact Lenses: Clinical and Bacteriological Study
الغشاء الحيوي المتكون على العدسات اللاصقة: دراسة سريرية وبكتيريولوجية

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Background: Biofilms can be defined as communities of microorganisms attached to a surface to prevent themselves from the environmental effects and cause infections. A study on microbial contamination associated with contact lenses wearers was carried out on women in Ramadi city, some of them were asymptomatic and others were complaining of redness, tearing and itching. Objectives: 1-Isolation and identification of microbial infection associated with contact lens wearers by examination of the storage case solution 2-Studying of different factors that have effect on microbial infections among contact lenses wearers such as (age, wearing type, symptoms) 3-Performance of biofilm assay on the new contact lenses, Microtitre plate (MTP) and comparison with used contact lenses and the ability of biofilm formation among different isolates from storage case solution. Material and Methods Collection of the samples Eighty samples of solution were collected from women of different Sources who Contact lenses: Five used and two new contact lenses as well as Microtiter plate (MTP) were used as samples to observe biofilm formation in this study. Sample from twenty new storage solution bottles were used as a control sample Isolation and identification of microorganisms: Macroscopical examination, Culture and Biochemical tests., Microscopic examination were done. Biofilm assay: according to Yukinobu, el al., 2006. Results: The study was done during the period from April 2008 to Jan. 30th 2009. Samples were collected from (80) women distributed as follows: (housewife, pupil, student, staff and others). Their ages were ranging from 13 – 36 years. The most common age of contamination was found to be ranged between 19-24 years which accumulated for (55%) of all Eye' redness is found to be the most common symptom (26.25%)) complained by the sampled women of this study. Isolates of Pseudomonas aeruginosa, Staph. aureus, Staph. epidermidis, Liesteria and Klebsiella were obtained from the storage solutions of contact lenses. According to the optical density showed by Microtitre plate (MTP) Reader, Pseudomonas aeruginosa was the most common bacterial type associated with biofilm formation for the considered samples. Conclusion: Pseudomonas aeruginosa was the most common bacterial type associated with Biofilm formations. توطئة: الغشاء الحيوي هو ألتصاق الأحياء المجهرية على السطوح وذلك لحماية نفسها من التأثيرات البيئية والدراسة شملت النساء المستخدمات للعدسات اللاصقة في الرمادي بعضها لم تظهر عليها الأعراض وقد ظهر على بعضهن أعراض كأحمرار العين وتدميع العين مع الحكة. الغرض (الهدف) من الدراسة : 1- عزل وتشخيص الأصابات الميكروبية من مستخدمات العدسات الاصقة وفحص محلول حفظ العدسات اللاصقة, 2- دراسة العوامل المؤثرة كالعمر ونوعية الأستخدام والأعراض 3- دراسة الغشاء الحيوي المتكون على العدسات الجديده والمستعملة وعلى أوعية التخفيف الدقيق. المواد وطرق العمل جمع النماذج : تم جمع ثمانون عينة من مصادر مختلفة من محلول حفظ العدسات خمسة عدسات جديدة وعدسات مستعملة عدد أثنان وكذلك استخدمت أوعية التخفيف الدقيق لمشاهدة تكوين الغشاء الحيوي نموذج السيطرة: عشرون نموذج من قناني محلول حفظ العدسات تم أستخدامها كنموج سيطرة عزل الأحياء المجهرية وفحصها وزرعها وعمل الفحوصات للكيمياء الحيوية لها الغشاء الحيوي حسب Yukinobu et al,2006 النتائج: خلال الفترة من نيسان 2008 ولغاية كانون الأول 2009 جمعت عينات من ثمانون امرأة كربات بيوت وطالبات تتراوح أعمارهن بين 13-36 سنة التلوث كان محصور بين عمر 19-24 سنة. أحمرار العين كانت نسبته26.25%. تم عزل انواع من البكتريا كالزوائف الزنجارية و المكورات العنقودية الذهبية والمكورات العنقودية الجلدية والكلبسيللا واللستيريا من سائل حفظ العدسات اللاصقة. الأستنتاجات: الزوائف الزنجارية هي من أكثر انواع البكتريا شيوعا لتكوين الأصابة أو التلوث للغشاء الحيوي والمتكون على العدسات الاصقة


Article
The Role of Immunization Status and Vitamin A in Outbreak of Measles Among Patients Admitted in Al-Yarmouk Teaching Hospital October 2010-April 2011
أهمية الحالة المناعية وفيتامين أ في وبائية الحصبة للمرضى الراقدين في مستشفى اليرموك التعليمي (تشرين أول 2010-نيسان 2011)

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Abstract

Background: Measles is a highly contagious viral illness; it is endemic in Iraq and worldwide developing countries. Measles is carrying many complications with morbidity and mortality. Aims of the study: To determine the role of previous immunization agonist measles and the use of the vitamin A to decrease the mortality and morbidity of disease. Patients & Methods: A cross-sectional study was conducted at Al-Yarmouk Teaching Hospital included 632 patients (318 males at age 15-42 years & 314 females at age 17-42 years) whose admitted to hospital for the period between October 2010 to April 2011. Diagnosis was according to the clinical manifestation and confirmed by ELISA for detected antibody (IgM & IgG). Results: The study shows the role of immunization against measles. It is very important to control out break and decrease mortality and morbidity of the disease, therefor must be re immunization against measles in booster dose in the 18th & 30th years old, and in premarital program in Iraq to decrease the outbreak in pregnants women's to decrease mortality and morbidity among mothers and babies. The use of vitamin A in treatment of measles patient to decrease mortality and morbidity of disease, and must be supplement to child and scholar in outbreak season of disease. المقدمة: الحصبة هي مرض فيروسي شديد العدوى، بل هو متوطن في العراق والبلدان النامية في جميع أنحاء العالم. الحصبة يحمل الكثير من التعقيدات مع معدلات الاعتلال والوفيات. الهدف من الدراسة: لتحديد دور السابقة الحصبة ناهض التحصين واستخدام فيتامين (أ) لخفض معدلات الوفيات والمراضة من الأمراض. طريقة العمل: دراسة مقطعية لوبائية الحصبة للمرضى الراقدين في مستشفى اليرموك للفترة (تشرين أول 2010 ولغاية نيسان 2011) . الدراسة شملت 632 مريض (314 ذكر و 318 أنثى) للأعمار مختلفة من سن 15 سنة ولغاية 42 سنة. جميع هولاء المرضى شخصوا اعتمادا على التاريخ المرضي والإعراض السريرية والفحوصات المختبرية التأكيدية اعتمادا على فحص المسضادات المناعية نوع IgM و IgG لفيروس الحصبة المؤكدة بفحص الاليزا. واستقصت الدراسة التاريخ المرضي المتابعة السريرية والمضاعفات للمرضى النتائج: لوحظ إن اللقاح ضد الحصبة يقلل من إعراض المرض ومضاعفاته ويقلل نسبة الوفيات . وان التاريخ المناعي للمرضى الملقحين أو غير مكتملي اللقاح هم بحاجة إلى جرعة تقوية بعد فترة عشر سنوات. كما اظهرت الدراسة إن استخدام فيتامين أ يقلل من الإعراض والمضاعفات والوفيات ويسارع بشفاء المرضى في وقت أسرع من دون استخدامه لذا نوصي بإعطاء جرعات مناسبة منه للملامسين من الطلبة وإفراد العائلة وكذلك إعطاء جرعة تقوية لقاحي في سن 18-22 سنة , لتقليل وبائية الحصبة ومضاعفاتها.

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Article
PCR in Comparison with Culture Methods for The Diagnosis of Candida albicans Responsible for Candidemia in Leukemic Patients
طريقة تفاعل البلمرة المتسلسل في تشخيص تعطن الدم بداء المبيضات البيضاء بالمقارنة مع طريقة الزرع لتشخيص فطر المبيضات البيضاء

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Background: Currently, candidemia infections represent an increasing cause of morbidity and mortality in seriously ill hospitalized patients. Because the accurate diagnosis of candidiasis remains difficult, fast and reliable assay for characterization of fungal pathogens is critical for the early initiation of adequate antifungal therapy and/or for introduction of preventive measures. Objective: To detect candidemia in leukemic patients by molecular methods in comparing with golden standard method(culture method). Materials and methods: A total of 60 leukemic patients were included in this study. Clinical type and other demographic data were recorded. Blood samples were taken from each patient, culture; germ tube formation and carbohydrate fermentation were done for each sample. DNA extraction and polymerase chain reaction (PCR) were used for detection of Candida albicansin cultured bottles. This study was conducted on leukemic patients admitted to four different hospitals in Baghdad city from September 2010 to March 2011. Sixty patients suffering from acute lymphoid (ALL) and myeloid (AML) leukemia were included in this study. The age of patients were ranging between 3-46 years old. Twenty five apparently healthy individuals were enrolled in this study as control group. Three milliliters of blood were collected from each patient; 1.5 ml was inoculated in 20 ml Brain heart infusion broth (Cruikshank. 1975). The rest of blood (1.5ml) was stored in -20ᴼC for further analysis. Blood cultures were incubated at 37°C for 10 days, and examined daily for growth. DNA purification kit was purchased from QIAGENE®Company. This method was used for the purification of genomic DNA from fresh or frozen samples of 1 ml overnight yeast cultures by using the GentraPuregene Yeast/Bact. Kit. PCR was performed to detect Candida albicans species through the amplification of specific gene (αINT1) Results: Only one positive culture result out of 60 samples was obtained for Candida sp., (1.7%). PCR results showed that there were only three out of sixty were positive for C. albicans (5%). In this study we obtained only one positive sample according to culture, while three samples only gave positive results according to PCR method. These results suggest that molecular analysis of candidemia is more sensitive and less time consuming than culture and other conventional methods. Conclusions: From this study, we concluded the following: 1. The rate of candidemia was 1.7% among leukemic patients, according to culture results. 2. Only 5% of blood cultures was positive according to PCR. 3. PCR results showed 100% sensitivity and 96.6% specificity and it is rapid, easy, reliable and also applicable in clinical laboratory for identification of medically important حالياً الإصاباتَ بداء المبيضات منتشرةوبنسب متزايدةبالاخص للمرضى الراقدين في المستشفيات. ولأن التشخيصَ الدقيقَ لداءفطرالمبيّضاتِ يَبْقىصعبَ ,لذلك يتطلب اجراء فحوصات سريعة وموثوقة لمعرفة الأسباب المرضية الفطريةِ لغرض العلاج المبكر او لغرض الوقاية. لقد تم شمل 60 مريضا بسرطان الدم في هذه الدراسةِ. اخذت عينات دم مِنْ كُلّ مريض، وتم زراعته بوسط Sabourauds agar الفطري،وتم اختبار تشكيل الإنبوبِ الفطري وإختمارِ الكربوهيدراتِ. تم أستخلاص الحامض النووي الرايبي منقوص الاوكسجين وتفاعل البلمرةالمتسلسل (PCR) لفطر المبيضيات البيضاء. أظهرت النتائج بأنّ هنالك عينةِ دمّ وحيدةِ إيجابيةَ للزرع الفطري. وبواسطة عينات اخذت من القناني المزروعة، كان هنالك 3 عيناتَ ايجابية لأستخلاص الحامض النووي الرايبي منقوص الاوكسجين وتفاعل البلمرةالمتسلسل (PCR) لفطرِالمبيّضات البيضاء. وكانت الطريقة الاخيرة(PCR) هي الاكثر حساسية لكشف داء المبيضيات في الدم . نقترح استخدام طريقة البلمرة في تشخيص مرض اللوكيميا او اي مرض داخلي تسسببه هذه الفطريات بدل طريقة الزرع الكلاسيكبة كونها غير دقيقة نتيجة حدوث التلوث بالجراثيم الاخرى عند زرع عينة الدم كما انها تستهلك موادا كثيرة لان كل عينة يجب ان يعاد زرعها يوميا ولمدة شهر كامل الى ان يتم الحصول على النتيجة النهائية.

Keywords

Candidemia --- PCR --- Candida albicans.


Article
Serum Cytokine Levels in Patients with Chronic Atopic Dermatitis: a Useful Clinical Marker for Disease Activity

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Abstract

Objective: To measure the serum level of IL4, IL10 and IFN-gamma of Atopic patients before and after treatment with tacrolimus ointment or topical steroid by using enzyme linked immunosorbant assay (ELISA) to evaluate the disease activity. Methods: IL4, IL10 and IFN-gamma concentrations in the serum were measured by enzyme-linked immunosorbent assay in fifty atopic dermatitis patients were giving two types of treatment and 43/50 were re-analyzed after one month of treatment with tacrolimus or topical and systemic steroids. The severity of atopic dermatitis was graded on the criteria of Hanifin and Rajika. The disease activity was assessed by each patient on a visual analogue scale (VAS). Results: Higher serum IFN-γ, IL-10 and IL-4 concentrations were found in AD patients sera at the time of diagnosis and correlated with disease activity before and after treatment. Serum IFN-γ, IL-10 and IL-4 concentrations also correlated with VAS scores for itching, skin condition; overall skin symptoms and total VAS score. Serum IFN-γ concentration could be a good indicator to define the degree of the general activity in chronic AD patients, also IFN-γ can play a role in the immuno-pathogenesis of AD, and furthermore may be used in the diagnosis and follow up of the disease in addition to other parameters. Conclusion: The sera of patients group revealed a statistically significant increase in the concentration of IFN-gamma, IL-4 and IL-10 before treatment when compared with that of the same patients after treatment with topical tacrolimus-steroid and also there were no statistically significant differences between two treatments.


Article
Effect of Inhibitors β-Lactamase on Recovery Effectiveness of Some β-Lactam Antibioticis Against Pseudomonas Aeruginosa
تأثير مثبطات البيتالاكتاميز على استرجاع فعالية بعض مضادات البيتالاكتام ضد الزوائف الزنجارية

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Thirty-four samples with position Pseudomonas aeruginosa cultures isolated from bourns, wounds urinary tract infection and Otities media were collected from Baquba General Hospital during September-December 2010. The sensitivily of these isolates were tested against (16) antibiotics. The results showed that the highest resistances were for Amoxicillin ,Ampicillin , CO-Trimoxazole and Nitroforautoin with 100% , while the lowest resistance was for Ofloxacin with 3% .The results of minimum inhibitory concentration (M.I.C) toward eleven antibiotics showed different range among isolates , some were able to resist high concentration of Ampicillin and Amoxicillin reach to 1024µg/ml , while others were inhibited by 2µg/ml of Ciprofloxacin . The isolates showed low sensitivity for combination Ampicillin-Sulbactam with 0%, while it shwed high sensitivity toward combination of Piperacillin-Tazobactam and Ceftazidime-Clavulanic acid 91.17, 100% respectively. The results of plasmid content was studied indicate that all isolates contain single large plasmid band, while the study of plasmid curing appear the plasmid loss at concentration 512 µg/ml of acridin orange.نشطت 34 عزلة من الزوائف الزنجارية المعزولة من إصابات الجروح والحروق والتهابات المجاري لبولية والتهابات الاذن الوسطى من مستشفيات مدينة بعقوبة / العراق . درست حساسية جميع العزلات تجاه 16 مضادا حيويا وأظهرت النتائج ان أعلى مقاومة كانت ضد Amoxicillin و Ampicillin و CO-Trimoxazole وNitroforautoin بنسبة 100%, بينما اقل مقاومة كانت اتجاه Ofloxacin بنسبة 3% .بينت نتائج تقدير التركيز المثبط الأدنى لأحد عشر مضادا حيويا ضد بكتريا الزوائف الزنجارية بان هناك اختلافا بين العزلات إذ كانت أعلى مقاومة لمضادي Ampicillin و Amoxicillin بتركيز 1024 مكغم / مل وادنى مقاومة لمضاد Ciprofloxacin بتركيز 2 مكغم / مل . أظهرت العزلات أدنى حساسية ضد توليفة Ampicillin – Sulbactam بنسبة 0 % وحساسية عالية ضد توليفة Piperacillin – Tazobactam و Ceftazidime – Clavulanic acid بنسبة 91.17 و 100% على التوالي . أشارت نتائج النسق البلازميدي احتواء جميع العزلات على بلازميد واحد كبير الحجم بينما أظهرت نتائج التحييد البلازميدي بان العزلات فقدت بلازميداتها عند تركيز 512 مكغم / مل من الاكردين البرتقالي .


Article
Influence of Mobile Phone Electromagnetic Field Exposures on Pseudomonas Aeruginosa and Staphylococcus Aureusinvitro

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Background: Mechanism underlying the lethal effect of microwave radiation on microorganisms are yet to be discovered. Some researchers hypothesized that electromagnetic waves can increase the target temperature and destroy life. Objectives: The aim of this study was to determine the impact of cell phone radiation on bacteria that cause otitis media. Materials and Methods: Two bacterial isolates were selected from cases of inflammation of the middle ear(otitis media). Pseudomonas aeruginosa and Staphylococcus aureus, isolates were exposed to electromagnetic waves emitted from mobile. After the incubation period, the absorbance was measured to determine the degree of turbidity by using spectrophotometer on the wavelength 400nm. Results: It was found that is no effect of mobile radiation up to six minutes of exposure to both bacterial Species, but influence began after the six minutes and increased influence directly proportional to the time. Effective dose 50 of Staphylococcus aureus was 11.5 minutes while for Pseudomonas aeruginosa was 14.2 minutes. Conclusions: The radiofrequency of cell phone effects on the bacteria depend on the following factors: the exposure time to mobile radiation, water content and increasing temperature, breaking protein molecule.


Article
Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions
والبروجستيرون في حالات الإجهاض المعتاد CA125, HCG باستخدام التنبؤ بنتيجة الحمل

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Background: - Although CA125 is a valuable tumor marker of ovarian carcinoma but it may be have a value to assess the risk of miscarriage at the early stages of pregnancy for woman with history of recurrent pregnancy loss either alone or in combination with other biochemical marker. Objective: To predict pregnancy outcome by studying the level of serum β HCG, progesterone and CA125 at different gestational age in the first trimester for predicting pregnancy loss. Patient and Methods: This study was conducted in Al-Batool Teaching Hospital (in the center of Diyala governorate by studying the patient records as a prospective trail in period from Jan. 2010 to Jan. 2011. The study carried out on 90 pregnant women with a history of recurrent pregnancy loss in there first trimester of pregnancy divided in 3 groups (30 women with no history of abortion as control group, 30 women with history of recurrent pregnancy loss, 30 women who failed to complete their pregnancy in the first trimester during the study. Serial maternal B-HCG, progesterone and CA125 were determined. Results: Serum B-HCG showed a sensitivity of 97%, a specificity of 53%, a PPV(positive predictive value) of 56% and a NPV(negative predictive value) of 97%. Serum progesterone showed a sensitivity of 27%, a specificity of 79%, a PPV of 38% and a NPV of 69%, while serum CA125 showed a sensitivity of 8%, a specificity of 60%, a PPV of 10% and a NPV of 70%. Conclusion: the value of CA125 in recurrent abortions is still unclear and cannot be recommended on routine basis. On the other hand, β-HCG is 97% sensitive with a 53% NPV as a single serum measurement for the prediction of pregnancy outcome. الخلفية: - على الرغم من أن CA125 هو علامة قيمه لكشف سرطان المبيض ولكن قد يكون لها قيمة لتقييم مخاطر الإجهاض في المراحل الأولى من الحمل في امرأة مع تاريخ فقدان الحمل المتكرر إما وحدها أو بالاشتراك مع علامة حيوية كيميائية اخرى الهدف: توقع نتيجة الحمل من خلال دراسة مستوى مصل البروجسترون، HCG و CA125 في مراحل الحمل المختلفة في الأشهر الثلاثة الأولى لتنبؤ فقدان الحمل . العينات وطرق العمل: أجريت هذه الدراسة في مستشفى البتول التعليمي (في وسط محافظة ديالى) من خلال دراسة سجلات المرضى كدراسة مستقبليه في الفترة من يناير 2010 - يناير 2011 الدراسة التي أجريت على 90 امرأة حامل لديها تاريخ فقدان الحمل المتكرر في الأشهر الثلاثة الأولى من الحمل حيث قسمت الحوامل الى 3 مجموعات (30من النساء اللواتي ليس لهن اجهاض سابق استخدمت كمجموعة ضابطة، 30 امرأة مع تاريخ فقدان الحمل المتكرر ، 30 امرأة فشلت في إكمال الحمل في الأشهر الثلاثة بشكل متسلسل. B-HCG والبروجسترون وCA125 وتم قياس الأولى خلال فترة الدراسة. النتائج: اظهرت النتائج بان حساسية B-HCG 97% والخصوصية 53% PPV (القيمة التنبؤية الايجابية) 56% وNPV (القيمة التنبؤية السلبية ) 97%. وايضا اظهرت النتائج بان حاسية البروجستون 27% والخصوصية 79% وPPV 38% MPV 69%. بينما حساسية CA125 8% والخصوصية 60% و PPV 10% وMPV 70% . الاستنتاج :ان قيمة CA125 في حالات الاجهاض المتكررة لا تزال غير واضحة ولا نستطيع اعتمادها كاساس روتيني. من الناحية الاخرى حساسية B-HCG 97% و MPV 53% يمكن استخدامهم كقياس مستقل للتنبؤ بنتيجة الحمل.


Article
Effect of Maternal Hypertension on Neonatal Outcome in Diyala Province, Iraq

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Abstract

Background: Maternal hypertension and preeclampsia are a multisystem, highly variable disorder unique to pregnancy and a leading cause of maternal and fetal/neonatal morbidity and mortality. Given the progressive nature of the disorder, delivery is often necessary to minimize maternal morbidity and mortality; obstetricians must balance the need for achieving in utero fetal maturation with the maternal and fetal risks of continuing pregnancy. Objectives: To evaluate the maternal burden and neonatal outcomes of infants delivered to mothers with preeclampsia, to review the outcomes of late-preterm infants, and potential strategies to optimize fetal outcomes in pregnancies complicated by preeclampsia. Materials and Methods: A cohort prospective study done in Albatool Maternity Teaching Hospital from October 2011 to April 2012 for 55 mothers coming for antenatal follow up how hypertension and preeclampsia had been followed till delivery with their delivered neonates looking for the maternal hypertension, medication, liver function, complete blood picture, complications of preeclampsia and neonatal condition at birth, weight, respiratory function, feeding, complete blood picture and liver function, small for gestational age (SGA), respiratory distress syndrome (RDS), and neonatal death (NND) . Results: Infants of women with preeclampsia were more likely to be SGA 27(49% ) and have RDS 6 (10.1%); Frequency of preterm delivery at <37 weeks' gestation rose greatly with increasing severity of maternal hypertension 16 (29%). Fetal distress was seen in 12 cases (21.8%) with meconium staining of liquor in 8 cases 14.5% ,33 neonates (60%) required admission for many reasons. Mothers with hypertension have high risk of ante partum hemorrhage 40(72%), 17 delivered normally (30%) while 38 delivered by caesarean section (70%). Conclusion: Compared with neonates delivered prematurely because of other etiologies, neonates born to preeclamptic mothers were more likely to be SGA and have less RDS, but had a decrease in mortality. This may be a reflection of the differences in the underlying pathophysiology behind indicated preterm birth due to preeclampsia.


Article
Prevalence of Undernutrition in Children Admitted to Pediatrics Hospital at Diyala Province
نسبة وجود سوء التغذية عند الأطفال الراقدين في مستشفى الأطفال في محافظة ديالى

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Abstract

Background: Nutritional support is an essential aspect of the clinical management of children admitted to hospital. The mean length of hospital stay of most children is only a few days, but can be considerably longer in some children with chronic diseases or underlying problems. During their brief stay, attention is mostly focused on the primary medical problem with a little attention given to the child’s nutritional status. Really we don’t know how much the nutritional problems are prevalent in the hospitalized children in the province & in overall country, so the purpose of this review is to describe the current prevalence of undernutrition in hospitalized children in order to bring an attention & care to that problem. Patient & method: This is a prospective study, it was done at al- Batool teaching hospital for maternity & children from 1st of September 2011 to 1st of March 2012. All the patients from >1 month to 5 yr had been included; Weight for age & sex was measured for those patients & compared to the international values published by World Health Organization (WHO). Prevalence of underweight malnutrition was calculated & showed, in addition to other characters of the sample. Results: The total number of the registered children was 410, the number of underweight children was 108 (26.3 %), so the prevalence of underweight was 26.3 %. The malnourished children were 59 (55 %) male & 49 (45 %) female, while most of them (105 (79 %)) were below 2 year of life. Those malnourished children were classified according to the type of malnutrition into: acute malnutrition (wasting) and chronic malnutrition (stunting), while according to other classification for malnutrition, the sample was divided into two groups, underweight & marasmus. while both of kwashiorkor & marasmic- kwashiorkor were not present in the study because edema was not detected clinically on data collection. Conclusion: Malnutrition among hospitalized children is worthy of attention, and effective strategies for systematic screening and treatment of malnutrition in pediatrics patients need to be developed and implemented. حالة التغذية عند الأطفال من النقاط الأساسية التي يجب الانتباه إليها وعلاجها عند دخولهم إلى المستشفيات وهذا ما يتم إهماله في كثير من الحالات, حيث يتم التركيز على السبب الرئيسي الذي أدى إلى دخوله المستشفى. نحن لا نعرف مدى وجود هذه المشكلة (أي سوء التغذية) في مستشفيات المحافظة أو في العراق ككل, لذا قمنا بهذه الدراسة لمعرفة نسبة وجود سوء التغذية عند الأطفال الراقدين في المستشفى من اجل التعرف ومراعاة الانتباه إلى ذلك. أقيمت هذه الدراسة في مستشفى البتول ألتعلمي للنسائية والأطفال في محافظة ديالى- العراق للأطفال البالغين 5 سنوات فما دون, خلال 6 أشهر جمع 410 طفل وتمت مقارنتهم مع جداول منظمة الصحة العالمية للتغذية فيما يخص الوزن والطول, وقد وجد إن نسبة سوء التغذية تبلغ 26,3%, منها كان مزمن وأخرى كانت حادة, نستنتج من ذلك إن سوء التغذية للأطفال الراقدين في المستشفى جديرة بالاهتمام مما يتطلب إنشاء نظام متكامل لتشخيص و علاج تلك المشكلة.


Article
Relationship between Increased WBC with Increased Lipid Profile in Blood
العلاقة بين ارتفاع نسبة كريات الدم البيضاء بالدم وزيادة الدهون بالدم

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Abstract

Objective: leucocytes are cells of the immune system involved in defending the body against both infectious disease and foreign materials. When increase or decrease in the number of leukocytes in the blood is often an indicator of disease(the normal level of WBC in blood between 4000 to 11000 cell /ml ), , they make up approximately 1% of blood in a healthy adult.[3] An increasing in the number of leukocytes over the upper limits is called leukocytosis, and the decrease below the lower limit is called leukopenia. Method: This research contained study 64 patients (average age between 20 – 35 years ) suffering from increasing WBC " diagnostic by WBC count test "and perform lipid profile test (Triglyceride , cholesterol , LDL , HDL ) for all patients and shows the changes in lipid profile Results: we found relationship between increasing levels of lipid and increasing WBC disease. These result are (45% cholesterol) (58%Triglyceride)(39% LDL)(22% HDL). That is mean, the increasing of lipid profile were stimulation of immune system to increasing the white blood cell. We conclude than an increasing WBC associated with increasing of lipid profile اشتمل البحث دراسة 64 مريضا تتراوح اعمارهم من 20 - 35 يعانون من زيادة في كريات الدم البيضاء increased WBC مشخصون سابقاً بواسطة فحص حجم كريات الدم المضغوطة ( WBC count) وقد أجرى لهم فحوصات الدهون الكلي lipid profile (Triglyceride , cholesterol , LDL , HDL ) وأظهرت النتائج وجود علاقة بين ارتفاع مستوى تركيز الدهون بالدم وزيادة الـ WBC COUNT على حدٍ سواء , حيث كانت نسبة الزيادة للأشخاص المصابين بالـ increased WBC وارتفاع الدهون كما يلي (45% cholesterol)(58%Triglyceride)(39% LDL)(22% HDL) .


Article
Upper Gastrointestinal Endoscopic Findings of Patients Presnting with Dyspepsia in Diyala Province

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Abstract

Introduction: Endoscopy of upper gastrointestinal tract is a safe and easily carried out procedure of high diagnostic value and also atheraputic value in some cases. Endoscopy is not costly and has aremarkable low incidence of morbidity, Dyspepsia is a non-specific group of symptoms related to the upper GI tract. It is the medical term for indigestion, a symptom that includes epigastric pain, heartburn, distension, nausea or 'an acid feeling' occurring after eating or drinking. The symptom is subjective and frequent. The most common causes of indigestion are gastroesophageal acid reflux and functional dyspepsia. Other cases are a consequence of a more serious organic illness[6]. Objective: To evaluate the common causes of dyspepsia by endoscopic examination. Material and methods: Atotal of(9785) endoscopic examination of upper GI tract were recorded and analyzed during the period between first of January 1998 to end of December 2009. Results: The endoscopic findings of (9785) patients with dyspepsia were studied .out of 9785 patients ,5112 patients(52.24%)were males while 4673(47.76%) were females. The endoscopic findings were normal in (3219)patients(32.89%) The abnormal findings included duodenal lesion in 3793 patients(38.76%) ,gastric lesions in 1492 patients (15.24%) ,esophageal lesions in 1111 patients(11.35%) and others causes in 170 paients(1.73%). Conclusion: The upper gastrointestinal endoscopy has ahigh diagnostic values in the investigations of upper gastrointestinal symptoms


Article
A Comprehensive Epidemiological Study of Perthes Disease In Duhok Governorate
دراسة وبائية مستفيضة لمرض بيرث في محافظة دهوك

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Abstract

Objectives: Perthes disease has been recognized as a public health problem in Iraq, in general, and in Duhok governorate, Iraqi Kurdistan region in particular, many aspects of which are not yet clear. This study was conducted to deal with the importance and effect of various variables which might have influence in perthes disease occurrence, Methodology: A cross sectional study design was performed & continued for 4 month and included 170 non-randomized consecutive samples collected from the Early detection of childhood disabilities center (E.D.C.D.C.) Duhok. Patients' registers from the center were used to collect data concerning perthes cases. Results: The results indicated that males mainly suffer (68.8%), (41.2%) of perthes cases occur in winter, left sided affection was more occurring (45.9.1%), patients aged (7-11years) were the highest (42.9%), consanguious parents constitute (55.3%), the mother's age group of (26-35 years) had the highest occurrence (58.2%), illiterate mothers (62.4%) were the highest, illiterate fathers were highest (39.4%), deliveries conducted in hospitals constituted significantly the highest rate (78.2%), the highest rate observed was in families having (1-5) children (51.8%), the group with no other disabled children within the same family was the highest (87.1%), Duhok city showed the highest incidence (38.2%), mothers with blood group O+ve were the highest (44.1%), mother's with normal deliveries were highest & finally patients with no complications were the highest (94.1%). Recommendations: It is recommended that all infants with positive risk factors & with positive family history of perthes must be examined carefully, as well as establishment of perthes screening units in all maternity hospitals in Duhok governorate. يعد مرض بيرث مشكلة صحية في العراق بشكل عام وفي محافظة دهوك (اقليم كردستان العراق) بشكل خاص, ولاتزال الكثير من جوانبه غامضة لحد الان. اجريت هذه الدراسة للتعامل مع اهمية وتاثيرمختلف المتغيرات والتي يمكن ان توثر في حدوث مرض بيرث. واجريت دراسة مقطعية عينية استغرقت 4 اشهر وشملت 170عينة متتالية وغيرعشوائية تم جمعها من مركز الكشف المبكر لعوق الاطفال في مدينة دهوك, وتم الاستعانة بملفات المرضى المتوفرة في المركز المذكور للحصول على المعلومات المطلوبة. اشارت النتائج الى ان نسبة الاصابة بين الذكور هي الاعلى(68.8%), وان اعلى نسبة من الاصابات تحدث في فصل الشتاء (41.2%), وان نسبة المرضى الذين يعانون من الاصابة بالجانب الايسر هي الاعلى ((45.9% وان نسبة فئة المرضى الذين تتراوح اعمارهم بين ) 7-11سنة) كانت الاعلى (42.9%), وان نسبةالاطفال المولودون لابوان تربطهما صلة قرابة تبلغ (55.3%)وان الامهات اللاتي تتراوح فئة اعمارهن بين 26-35)سنة) سجلن اعلى نسبة بلغت (58.2%), وان نسبة الامهات الاميات بلغت ( 62.4%) , وان نسبة الاباء الاميين بلغت (39.4%), وان نسبة الولادات التي حدثت في المستشفيات بلغت (78.2%), وان اعلى نسبة وجدت بين العوائل التي يتراوح عدد افرادها بين (1-5) افراد وبلغت (51.8%), وان نسبة المرضى الذين يخلون من اية اعاقات اخرى بلغت (87.1%), وان مدينة دهوك سجلت اعلى نسبة للاصابات.(38.2%) واخيرا نسبة الامهات من فصيلة الدم O+ve بلغت (44.1% ) وان الولادات الطبيعية كانت الاعلى وان المرضى الذين لا يعانون من اية مضاعفات هي الاعلى وبلغت, (94.1%). اوصت الدراسة بالفحص الطبي الدقيق للاطفال المعرضون للاصابة والذين يحملون تاريخ مرضي عائلي موجب للمرض , وانشاء وحدات لمسح حالات بيرث في كافة مستشفيات الامومة والطفولة في محافظة دهوك.

Table of content: volume:5 issue:2