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.

Loading...
Contact info

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

Table of content: 2015 volume:11 issue:1

Article
Residual cardiovascular risk in diabetes and obesity: Targeting lipid abnormalities other than LDL cholesterol

Loading...
Loading...
Abstract

Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions. Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk. Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD) as the chief modifiable contributor to residual cardiovascular risk, especially in conditions associated with insulin-resistant, and call to improve awareness and clinical management. The probable benefit of residual CVD risk reduction suggests a role for treatment of persistently high TG concentration even in statin – treated patients, with TG lowering agents including fibrates, niacin, omega polyunsaturated fatty acids, and other non statin treatment. Therapeutic lifestyle changes including; medically assisted weight loss, physical activity, and dietary changes, as well as improvement of glycemic control should be an adjunct to lipid-lowering pharmacological therapies. Therapy should be concomitantly assessed for treatment tolerance and adequacy with focused laboratory evaluations and patient follow-up. Therapy should be boosted to attain goals according to risk level, and that even more intensive therapy might be warranted in patients with CVD history.


Article
Vancomycin resistance among methicillin resistant Saphylococcus Aureus isolates from general hospitals

Loading...
Loading...
Abstract

Background: Multidrug resistant methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community acquired infections. The glycopeptides vancomycin has been proposed as the drug of choice for treating such infections; this lead to the emergence of vancomycin intermediate sensitive S. aureus (VISA) and vancomycin resistant S.aureus (VRSA). Objectives: To identify the vancomycin resistance both phenotypically and genotypically among MRSA isolates from different hospitals and to determine the sensitivity of these isolates to different antimicrobial agents. Methods: A total of 204 S. aureus isolates were obtained randomly from various clinical specimens including (wound swab, burn swab, ear swab, urine, sputum, blood and other body fluids) from different inpatient and outpatient who were attending different hospitals in Baghdad. The susceptibility pattern of the S. aureus isolates to different antibiotics was determined by disk diffusion method and vancomycin minimum inhibitory concentration (MIC) for MRSA isolates were determined using broth dilution method following clinical laboratory standard institution (CLSI) guidelines. Van A gene was amplified by PCR using standard primers. Results: All VRSA isolates were MRSA. Twelve VRSA isolates were positive for van A gene, while the remaining ten isolates were negative. All VRSA had a vancomycin MIC of 16μg/ml or more. In the present study, VRSA showed resistance to a wide range of antimicrobial agents (ampicillin, cephalothin, cefoxitin, erythromycin, gentamicin, oxacillin, penicillin, rifampin, tetracycline and trimethoprim). Conclusions: There were high incidences of resistance to the commonly used antibiotics among VRSA isolates compared to VISA and VSSA. Further molecular studies such as PCR technique to identify genes rather than van A (e.g. van HAX analogue) might be suitable to predict VRSA lacking the van A gene.

Keywords

Staphylococcus aureus --- MRSA --- VRSA --- VISA --- van A gene.


Article
Knowledge, attitude and practice regarding measles vaccine campaign among medical and engineering students: Baghdad, 2011

Loading...
Loading...
Abstract

Background: The strategy for eliminating measles from Iraq includes conducting mass immunization campaign against measles, within the framework of the national strategic plan for the elimination of this disease. Awareness about this campaign is fundamental for their success. Objective: The study aims at finding out the knowledge, attitudes and practices regarding vaccination against measles among two groups of students in two different colleges ( medical and engineering) .To report uptake of Measles vaccine and reasons for declining the vaccine among medical and non-medical students in the campaign Method: Across sectional study has been conducted at Al-Kindy College of Medicine/ Baghdad University and University of Technology for the period from first of December 2011 till fifteenth of April 2012. A convenience sample of 180 students of the first and second stage including (81 male, 99 female) students from Al- Kindy College of Medicine and 180 students (87 male, 93female) from University of Technology department of Mechanical Engineering. All students were given a questionnaire to assess their knowledge of the campaign and the vaccine. Results: Overall 55.8 % of medical and engineering students accepted the vaccine with higher uptake among males than females ( 58.9 % and 53.1% respectively). Almost 44.2 % of students who did not accept the vaccine gave their reason as having little information about the vaccine and said that the vaccine is ineffective. Conclusion: In spite of awareness of the effect of measles campaign among students of the Medical College in Baghdad University and University of Technology but the measles campaign in university students may have been more successful with better use of health education messages.


Article
Magnetic resonance imaging findings of knee injury

Loading...
Loading...
Abstract

Background: Since its introduction to musculoskeletal imaging in the early 1980, magnetic resonance imaging (MRI) has revolutionized diagnostic imaging of the knee. It is therefore become the examination of choice in the evaluation of internal joint structures of the knee like menisci, cruciate ligaments, and articular cartilage. Objectives: to describe the MRI finding in various knee injuries. Patients and methods: A cross sectional study was done on 130 patients with history of knee injury in MRI unit at institute of radiology and al-Shaheed Ghazi Al-Hariri Hospital in medical city complex - Baghdad, from October 2011 to February 2013 includes 103 men, 27 women; the mean age was 33.86 years. MR imaging studies of the knee performed using a 1.5 T MR system. The sequences included coronal and sagittal PD, sagittal T2 FSE, fat suppressed T2 FSE, STIR axial and coronal. Knee MR studies were obtained to evaluate ligament, menisci, articular surface and bone pathologies of knee injuries. Results: MR images were normal in 15 patients; it was positive for meniscal tears in 59 patients and maximum involvement was in the medial meniscus and the posterior horn. These tears were classified into grade 1 (28.8%), grade 2 (11.5%), grade 3 (53.9%) and grade 4 (5.8%). Ligament tears were seen in 70 patients. Secondary signs associated with ligament tears were also assessed. Conclusions: MRI is an accurate, non-invasive technique for examination of the soft tissues and osseous structures of the knee. It has great capability in diagnosing meniscal tears and classifying them into grades and types, which would avoid unnecessary arthroscopic examination. It is a very good modality to diagnose complete tears of the anterior cruciate ligament (ACL).maging, meniscus.


Article
Weight loss program outcome of obese attending AL-Kindy obesity research and therapy unit

Loading...
Loading...
Abstract

Background: overweight and obesity are the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese. Numerous studies show that weight loss, even if only 5-10%, significantly improves dyslipidemia, hypertension, diabetes mellitus, risk for osteoarthritis and its symptoms and risk for selected cancers. Objectives: is to evaluate the effect of diet and exercise program on anthropometric and biochemical status of adult obese patients. Methods: descriptive study. 124 adult obese patients attending Al Kindy obesity research and therapy unit during December 2012 were included. Measurement of Wt, height Ht and WC performed and BMI was calculated. Laboratory test analysis, on the fasting state, was performed for plasma glucose, uric acid, Ch, Tg, and HDL, and LDL and VLDL levels were estimated. Patients were advised about decreasing their weight by decreasing calories intake by about 500 calories daily with increasing physical activity to one hour of medium tension aerobic exercise for 3 months then reexamined. Results: eighteen point five percents are males and 81.5% are females with mean age of 37.3 years, weight was reduced by 3 kilograms and waist by 6.6 cm and BMI by 1.9 Kg/m2 within 3 months. Age groups, 30-39 and 40-49 years showed better response (3.5-4 kg Wt loss), while males lost 2.6 kg and female lost 3.8 kg within 3 months. With reduction of total cholesterol by 17.3 mg/dl and reduction of total triglycerides by 24 mg/dl and reduction of LDL by 5 mg/dl and of VLDL by 4.3 mg/dl and increment of HDL by 1.8 mg/dl. Mean fasting plasma glucose fell by 6.3 mg/dl and the uric acid level by 0.13 mg/dl. Conclusions: mean weight loss of this program was modest and middle age group responded to weight loss program better than young significantly, old and males respond less than females but insignificantly. In addition weight loss significantly resulted in correction of lipoproteins, blood glucose, and urate levels.


Article
Correlation between magnetic resonance imaging and intra-operative findings in disc herniation at lumbo-sacral region

Loading...
Loading...
Abstract

Background: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration. Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniation Methods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were operated on, all of the cases required excision of disc through posterior approach in knee elbow position. The time between MRI taken and surgery was two weeks, from which the data were taken in a questioner forma which include name , age ,gender , occupation , chief complaint , duration, MRI findings and intra operative finding , from June 2011 to October 2013 at Al- Kindy teaching hospital . Results: In our study 75 patients were diagnosed by clinical examination and MRI finding to have disc herniation at lumbar region . The female more than male ( 36 females , 12 males) and the ratio was 5-1, the accuracy of MRI against intra operative finding in deciding the provisional diagnosis as disc herniation was 68% .The commonest site was L4-5 disc herniation 43 patients (57.3 % ) , and L5-S1 prolapse is the next common disc herniation level 27 patient (36 % ) , L3-L4 disc herniation was two cases (2.7 %) and L4-L5 ,L5-S1 disc herniation was 3 cases (4% ). Conclusion: The most common level was L4-5 followed by L5S1.The MRI is more accurate in diagnosis of the lumbo-sacral disc herniation and its level in single one is more than multiple levels. Keywords: Disc herniation, MRI, Surgery, posterior approach Al


Article
Serum anti-Mullerian hormone level as a marker of polycystic ovarian syndrome in Iraqi women

Pages: 28-31
Loading...
Loading...
Abstract

Background: Polycystic ovarian syndrome is one of the common gynaecological diseases encountered nowadays in the gynaecological clinic. Many criteria and diagnostic test had been evolved to be used with different classifications methods. Objectives: The present study aimed to measure the anti-mullerian hormone levels in serum of the women with Polycystic Ovary Syndrome and to test the possibility that if it can be used as a marker for diagnosis of polycystic ovary syndrome patients. Methods: A cross sectional study that had been conducted at Kamal AL-Samaraee Hospital, AL-Suwayrah Hospital and Al-Elwiya Maternity Teaching Hospital during the period from July, 1st, 2013 – Jan. 1st, 2014. Where forty women with Polycystic ovarian syndrome (with mean body mass index of 33.25±6.79kg/m2) were enrolled in the study group and being compared to apparently health women as a control group that were matched for age and their (mean body mass index was 27.63±3.51kg/m2). Clinical history, biochemical and hormonal analysis were determined for both groups. Results: The mean serum of anti-mullerian hormone showed statically significant difference (P = 0.0001) in poly-Cystic ovarian syndrome patients compare to the control group and when this hormone compared with other hormones that use for predicting the occurrence of PCOS as (LH , FSH , testosterone, prolactin and insulin), anti mullarian hormone showed the highest sensitivity and specificity as 82.10 % and 100 % respectively, with a cut off value of (>7.9) in Iraqi women. Conclusions: Anti - mullerian hormone could be the best marker in comparison with other hormones used for the diagnosis of PCOS. Keywords: Polycystic ovarian syndrome, anti-mullerian hormone, luteinizing hormone, follicular stimulating hormone.

Keywords


Article
Estimation of vitamin E level and its relation to lipid profile in patients with type II Diabetes Mellitus

Loading...
Loading...
Abstract

Background: Type 2 diabetes mellitus (T2DM) is considered a global disease as it affects over 150 million people worldwide, a number that is supposed to be doubled by 2025. High glucose levels, in vitro, appear to raise the extent of LDL oxidation, and glycated LDL is more prone to oxidative modification. Objective: To investigate the relationship between serum level of vitamin E and lipid profile in patients with type II DM. Methods: This study involved 28 patients suffering from type II DM diagnosed 1-4 years ago and with age ranged from 17 -60 years old, with different residence around Basra ; In addition to 56 apparently healthy persons matched in age and sex to the patients as a control group. The medical histories were taken and General examinations were done to them with measurement of their height and weight. Four milliliters of venous blood was drawn from each patient and control to measure TG, TC, VLDL, HDL, LDL, HbA1C and Vitamin E and the results were used to assess the presence of any association between Vit E levels and lipid profile. Results: The mean levels for patients and controls of TG were (157.1± 24.9 and 119.8 ± 29.0) mg/dl, of TC were (204.0 ± 43.2 and 168.0 ± 31.5) mg/dl, of VLDL was (31.5 ± 5.0 and 24.2 ± 5.9) mg/dl, of LDL was (129.6 ± 42.8 and 97.6 ± 30.8) mg/dl, of HDL was (42.9 ± 10.2 ± 46.0 ± 9.0) Mg /dl, of HbA1C were (9.4 ± 3.0 and 5.0 ± 0.7) % and of vitamin E were (3.7 ± 1.3 and 6.8 ± 2.0) mg/dl, respectively. There was a significant difference between all the above measured parameters, except of HDL, between cases and controls. Also there was a significant association between DM type II and low level of vitamin E. there was a significant negative correlations between vitamin E and TG, TC, LDL, VLDL but not HDL, even after adjustment for age, sex and BMI. Conclusion: Diabetes mellitus type II has a significant effect on vitamin E which is an important guard against dyslipidemias, one the major causes of diabetes vascular complications.


Article
Organizational and behavioral determinants of health information system performance in Iraq

Loading...
Loading...
Abstract

Background: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools, Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq. Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health information system performance. Results: The overall mean confidence for Health information system tasks was 69.41%, while for tasks competence, it was 37.1% and that of motivation level was 43.4%. The total score of promoting a culture of information was 63.96% with department provide reward for a good work revealed a total percent of 56.83%. Conclusion: It can be concluded that overall mean confidence for Health information system tasks is generally high compared to a low competency level for Health information system tasks, with a negative motivation feeling among respondents. Keywords: Health information system, organizational and behavioral determinant, OBAT tool, culture of information.


Article
Extrapituitary prolactin –1149 G/T promoter polymorphism in some rheumatoid arthritis patients

Authors: Adnan F. AL-Azzawie MSc biology*
Pages: 40-44
Loading...
Loading...
Abstract

Background: Prolactin is a hormone, as well as a cytokine which is synthesized and secreted from the anterior pituitary gland and various extra pituitary sites including immune cells under control of a superdistal promoter that contains a single nucleotide polymorphism -1149 G/T. Rheumatoid Arthritis has been associated with increased serum prolactin levels. Objectives: To investigate the association of the extra pituitary -1149 G/T promoter polymorphism among Iraqi rheumatoid arthritis patients and prolactin levels. Methods: We tested 73 patients with rheumatoid arthritis and 40 healthy individuals. The DNA samples were genotyped using the Polymerase Chain Reaction-Restriction fragment Length Polymorphism method and the levels of prolactin serum were measured using Enzyme linked immunosorbent assay. Results: The parameters rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate and serum prolactin concentrations of rheumatoid arthritis patients were significantly increased compared with healthy controls. The frequency of T allele and TT genotype was highest in control group compared with their frequency in rheumatoid arthritis patients, vice versa the G allele and GG genotype. There is significant differences in prolactin levels in rheumatoid arthritis patients compared with healthy controls according to PRL-1149 G/T polymorphism. In rheumatoid arthritis patients, carriers of the GG, GT genotypes had higher prolactin levels in comparison to TT genotype but did not show any significant difference. Conclusions: There is a possible association between prolactin levels and rheumatoid arthritis. We found correlation between rheumatoid arthritis and prolactin -1149 G/T polymorphism. The prolactin -1149 G allele is a genetic marker for increased rheumatoid arthritis susceptibility in Iraqi population. In addition, influence of prolactin -1149 G/T polymorphism on prolactin levels.


Article
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia

Loading...
Loading...
Abstract

Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements. Objective: our study was designed to determine the effectiveness of local infiltration of 0.5% of bupivacaine before closure of surgical wounds in controlling postoperative pain and improve patient’s outcome after total hip and knee replacement surgeries in first 24hrs postoperative period. Methods: Twenty patients from class I (healthy patients) and class II (patients mild systemic diseases) of ASA (American society of anesthetists) undergoing elective orthopaedic surgeries were randomly assigned in two groups and (both of them have general anesthesia); Group A (10patients) received local infiltration of 0.5% bupivacaine before closure of surgical wounds and group B (10 patients) received local infiltration of 0.9% of normal saline. We use uniform technique of anesthesia in both at rest and on passive mobilization by nurses and residents groups. Visual analogue pain scale scores were assessed blinded to analgesic treatment and we check the needs for analgesic drugs post-operative in both groups. Results: Group A showed a significant reduction in postoperative pain at rest and on mobilization after infiltration of 0.5% bupivacaine with short hospital stay and only 3 patients need for post-operative analgesia ,while all patients in group B require at least single dose of analgesia like pethidine or non-steroidal anti-inflammatory drugs. Conclusion: The use of 0.5% Bupivacaine by wound infiltration is effective for post-operative pain relief, as it reduces the requirements for additional post-operative analgesia after total hip and knee replacements.


Article
The prevalence and antimicrobial resistance of Pseudomonas species in patients with chronic suppurative otitis media

Authors: Zaid I. AL-Ataar M.B.Ch.B, M.Sc*
Pages: 49-52
Loading...
Loading...
Abstract

Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world. Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance.. Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were males, 209 (52%) case were females. Swabs for aural discharge were taken from those patients. Discharge is cultured by inoculating it into blood, Mac Conkey agar, chocolate agars and Sabouraud agar (for fungi).If the isolate shows to be Pseudomonas isolate growth then another culture of the isolate is performed on Muller Hinton Agar. Then the antibiotic susceptibility and resistance of Pseudomonas isolate is assessed by (Kirby-Bauer Method) Results: 196 (48%) case were males, 209 (52%) case were females with a male to female ratio 1:1. One hundred fifteen (73%) cases were infected with Pseudomonas species (PS). The sensitivity of the Pseudomonas isolates to the following antibiotics was Amikacin 91.7%, Imipenem 89.7%, Ceftazidime 81.8%, Ciprofloxacin 73.7%, Garamycin 72.9%, Tobramycin 67.7%, Ticarcillin 66.7%,Cefoperazone 42.9% Conclusion: Pseudomonas species is the commonest microorganism in cases of CSOM. Microbiological identifications and antibiotic resistance determination of pathogens isolated from the middle ear in patients with CSOM not responding to empirical antibiotic treatment gives possibility of the choice of an effective antibiotic and its proper dosage. Cefoperazone , a relatively new antibiotic that is used in Iraq to combat pseudomonal infections has proven to be poorly effective compared with other previously used antibiotics.


Article
Epidemiological characteristics of acute symptomatic hepatitis A in Al Alwyia pediatric teaching hospital during 2013

Loading...
Loading...
Abstract

ABSTRACT Background: Concerns about hepatitis A infections is increasing worldwide specially after improving economic and sanitary conditions in many countries making older age groups who escape infection on early life vulnerable to infection. Objectives: The objectives were to estimate the frequency of hepatitis A among children consulting Al Alwyia pediatric Teaching Hospital during the year 2013 and to study some demographic characteristics of the disease. Methods: This cross - sectional hospital -based study was conducted during 2013-2014 and include pediatric patients (43525 patients) who consult Al Alwyia pediatric hospital during that time. The outcome is total IgM antibodies to hepatitis A virus detected using Enzyme Linked Fluorescent Assay (ELFA) the test is performed on 380 clinically suspected cases. The age distribution of the susceptible population is estimated using a simple catalytic model. Results: The age groups (1-4 and 5-–9) constitute 43.6% and 42 % of sero-positive cases respectively with a P value of 0.001. The incidence is more among males (56%). Incidence is more during June and July 40 %and 15.6% respectively with a p value of 0.001. 1.2% needed causality or ward admissions. Conclusions: High incidence in school age group might indicate the transition to older age groups and vaccinations should be considered at near future.


Article
Gene frequency and haplotype analysis of HLA class I in patients with simple renal cysts

Loading...
Loading...
Abstract

Background: The study of human leukocytes (HLA) alleles, and haplotype frequencies within populations provide an important source of information for anthropological investigation, organ and hematopoietic stem cell transplantation as well as disease association, certain diseases showed association with specific alleles specially those of known or suspected hereditary origin or immunological basis, whether simple renal cyst is congenital or acquired is still unclear and need to be investigated. Objectives: To study the genetic aspect of simple renal cysts by detecting the gene frequency and the haplotype of HLA class I of patients with simple renal cysts, and to find the presence of these cysts in other family members. Method: Thirty patients with simple renal cysts who were attending the outpatient clinic of urosurgery in the medical city were tested for HLA class I antigen using the microlymphocytotoxicity technique, in the period from February to June 2004 compared to 50 unrelated apparently healthy individuals. Gene frequency were calculated using square root formula (g=1-√1-f), full history were taken including the family history. Results: Certain gene frequencies were higher in the patients group than in the controls, yet not reached to a statistical significant level. No haplotype association with simple renal cysts was detected in this study; family history was detected in two patients which were proved by ultrasound examination. Conclusion: Increasing the sample size may contribute to best results regarding gene frequency, haplotype and family study. Key words: Gene frequency, Haplotype, Human Leukocyte Antigens.


Article
Symptoms profile of patients with major depression in Baghdad

Loading...
Loading...
Abstract

:Background: Many studies had stated that there are marked variations in the clinical presentation of depressive states between different cultures. Objectives: The main aim of the study is to identify the symptoms profile of patients with major depressive disorder living in Baghdad. Method: Ninety two patients with major depressive disorder consulting Ibn-Rushd psychiatric teaching hospital were studied thoroughly to identify the frequency of symptoms among them. The fifth edition of the Arabic version of the Mini-International Neuropsychiatric Interview (M.I.N.I) was used to identify the Diagnostic and Statistical Manual – fourth edition (DSM-IV) symptoms. A list of other symptoms, which were found to present variably in depression according to culture, was gathered from previous studies and modified was included to calculate their frequency and to compare them to the DSM-IV symptoms. Results: All the 9 DSM-IV symptoms were more common than all the other symptoms. The DSM-IV symptoms did not differ significantly according to sociodemographic variables. Regarding the other symptoms: “Numbness or crawling sensation”, “sex and libido”and “crying “symptoms were all significantly more common in females than in males; “Sex and libido” symptoms differ significantly according to the marital status and to education; &“Hypochondriasis” was significantly more common in elderly group Patients with major depressive disorder with psychotic features were presented with less auditory hallucinations and more visual hallucinations as compared to studies in western societies. Conclusion: The presentation of depression in patients from Baghdad is not different from patients around the world, and the DSM-IV symptoms are the most common symptoms in patients with major depressive disorder from Baghdad.Background: Many studies had stated that there are marked variations in the clinical presentation of depressive states between different cultures. Objectives: The main aim of the study is to identify the symptoms profile of patients with major depressive disorder living in Baghdad. Method: Ninety two patients with major depressive disorder consulting Ibn-Rushd psychiatric teaching hospital were studied thoroughly to identify the frequency of symptoms among them. The fifth edition of the Arabic version of the Mini-International Neuropsychiatric Interview (M.I.N.I) was used to identify the Diagnostic and Statistical Manual – fourth edition (DSM-IV) symptoms. A list of other symptoms, which were found to present variably in depression according to culture, was gathered from previous studies and modified was included to calculate their frequency and to compare them to the DSM-IV symptoms. Results: All the 9 DSM-IV symptoms were more common than all the other symptoms. The DSM-IV symptoms did not differ significantly according to sociodemographic variables. Regarding the other symptoms: “Numbness or crawling sensation”, “sex and libido”and “crying “symptoms were all significantly more common in females than in males; “Sex and libido” symptoms differ significantly according to the marital status and to education; &“Hypochondriasis” was significantly more common in elderly group Patients with major depressive disorder with psychotic features were presented with less auditory hallucinations and more visual hallucinations as compared to studies in western societies. Conclusion: The presentation of depression in patients from Baghdad is not different from patients around the world, and the DSM-IV symptoms are the most common symptoms in patients with major depressive disorder from Baghdad.

Keywords


Article
Compound fractures of the hand metacarpals and phalanges treated by using mini-external fixator

Loading...
Loading...
Abstract

Background: A review of articles of method in treating compound phalangeal fractures by using mini-external fixator, elaborating the anatomy, mechanics, modalities of treatment, and complications of these types of fractures. Also, it compares between different studies regarding the functional results and final outcome. External fixation of phalangeal fractures is a good method for osteo synthesis in certain situations. The simplicity of the surgical procedure and the minimal disruption of the normal bone architecture also make it appealing. Objectives: Evaluating the functional results of the use of mini-external fixator for the treatment of compound fractures of phalangeal bones of the hand. Method: Our study consists of 15 patients, 12 were male and 3 was female, treated with external fixator for sever open hand fractures at Al-Kindy teaching hospital during the period from June 2011 – June 2013, using 2 K-wires bonded by IV needle cover, or 2 K-wires bonded by bone cement. Results: In comparison between different studies, external fixation offers several advantages. It allows preservation of the bone architecture, union of the fracture, facilitating healing of the disrupted area, and good functional results. External fixation is versatile, adapting to a wide range of clinical situations. This method of fixation provides good stability and adequate control of comminuted fractures, allowing not only anatomic restoration but also early active motion. Conclusion: External fixators are appropriate in cases of open, comminuted, unstable fractures. Other appropriate settings for external fixation include temporal management of fractures and length preservation of a functional digit.


Article
Surgical –Audit on breast cancer risk factors in AL-Russafa district in Baghdad

Loading...
Loading...
Abstract

Background: Breast cancer remains a substantial cause of morbidity and mortality, there is a need for continued efforts to understand the etiology of the disease, maintain screening effort, implement prevention strategies, and develop better treatments. Objective: To analyze the risk factors, improve early detection and prevention of breast cancer in Al-Russafa district- Baghdad, aiming to increase survival rate and improve the quality of life. Methods: A cross sectional audit of 258 breast cancer cases seen at Al-Elwiya maternity teaching hospital from January2009 to December 2011,data collected from patients files were: age, gender , residency, marital status, parity, age at menarche and menopause age at first live birth, hormonal therapy, social habit, previous breast diseases, breast feeding and family history of breast cancer. Results: Two hundred fifty eight female diagnosed with breast cancer, age ranging from 20 to 79 years. Breast cancer was more prevalent in the fourth and fifth decade of life. The distribution was according to residency sectors, 10% were unmarried; fourteen percent nultiparous, the age at menarche was prevalent in 12 and 13 years old. Menopa- ausal age was at the fifth decade and age of patients at first live child at twenties. Forty two % received contraceptive hormonal therapy, 15% had previous breast diseases, 20% with family history of breast cancer, 24% non-breastfeeding and 6% smokers. Conclusion: Risk factors of breast cancer in Baghdad is a perplexing issue and needs a privy analysis as the disease has a para amount importance with increasing incidence in last decade. Knowing the risk factors for breast cancer may help us take preventive measures to reduce the likelihood of developing the disease and develop better treatment. Keywords: Breast cancer, Risk factors, surgical audit.Background: Breast cancer remains a substantial cause of morbidity and mortality, there is a need for continued efforts to understand the etiology of the disease, maintain screening effort, implement prevention strategies, and develop better treatments. Objective: To analyze the risk factors, improve early detection and prevention of breast cancer in Al-Russafa district- Baghdad, aiming to increase survival rate and improve the quality of life. Methods: A cross sectional audit of 258 breast cancer cases seen at Al-Elwiya maternity teaching hospital from January2009 to December 2011,data collected from patients files were: age, gender , residency, marital status, parity, age at menarche and menopause age at first live birth, hormonal therapy, social habit, previous breast diseases, breast feeding and family history of breast cancer. Results: Two hundred fifty eight female diagnosed with breast cancer, age ranging from 20 to 79 years. Breast cancer was more prevalent in the fourth and fifth decade of life. The distribution was according to residency sectors, 10% were unmarried; fourteen percent nultiparous, the age at menarche was prevalent in 12 and 13 years old. Menopa- ausal age was at the fifth decade and age of patients at first live child at twenties. Forty two % received contraceptive hormonal therapy, 15% had previous breast diseases, 20% with family history of breast cancer, 24% non-breastfeeding and 6% smokers. Conclusion: Risk factors of breast cancer in Baghdad is a perplexing issue and needs a privy analysis as the disease has a para amount importance with increasing incidence in last decade. Knowing the risk factors for breast cancer may help us take preventive measures to reduce the likelihood of developing the disease and develop better treatment.


Article
The frequency of hypoglycemia in macrosomic neonates in Amarah governorate, Iraq

Loading...
Loading...
Abstract

Background: Neonatal macrosomia is defined as a birth weight of more than 4000 g. Significant maternal and neonatal complications can result from the birth of macrosomic infants like hypoglycemia and birth injuries. Objectives: To determine the frequency of hypoglycemia in neonates with macrosomia in Amarah, Iraq Methods: The study involved 146 macrosomic newborn neonates delivered in 2 maternity hospitals in Amarah, Iraq during a period from June 2011 to June 2014. Results: Hypoglycemia was observed in 16% of neonates affected by macrosomia. Maternal diabetes was the most common cause of fetal macrosomia (28%).Our results were compared with those from other parts of the world. Conclusion Macrosomia is associated with increase rate of neonatal hypoglycemia especially among infants of diabetic mothers.


Article
A study of the effect of smoking on pulmonary function tests in AL - Kindy teaching hospital, Baghdad

Loading...
Loading...
Abstract

ABSTRACT Background: In Iraq smoking is a common habit in both the urban and rural areas. There are many respiratory diseases like chronic bronchitis, bronchial carcinoma and emphysema which are related to chronic tobacco smoking. Objectives: To study the effect of tobacco smoking on the respiratory system, to establish a correlation between chronic tobacco smoking and its effects on the parameters which were studied and to create awareness in tobacco smokers about the effects of tobacco on their health Method: In this study 100 male subjects, 50 chronic smokers and 50 non- smokers were assessed for their pulmonary function tests by using a computerized spirometer. Results: Almost all their respiratory parameters were significantly reduced. In the present study obstructive lung dysfunction was the commonest finding in smoker


Article
Aneurysmal bone cyst of the lateral end of clavicle in a twelfth year old girl Case study

Loading...
Loading...
Abstract

Introduction: An aneurysmal bone cyst are enigmatic lesion of unknown cause and presentation and are difficult to distinguish from other lesions, it is a benign, but expansible tumor like lesion that generally occurs in the long bones. An aneurysmal bone cyst arising from the flat bone like clavicle is rare . Case presentation: We report a 12-year-old girl child with an aneurysmal bone cyst of the lateral third of left clavicle treated with enblock resection. The pathologic findings confirmed the diagnosis of aneurysmal bone cyst. The patient has been followed up for one year with no evidence of recurrence . Conclusion: En bloc resection can be curative and provide good results for this rare type of clavicle tumour.

Table of content: volume:11 issue:1