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: 2014 volume:7 issue:1

Article
Conservative Treatment of Shaft Femoral Fracture in Children Between Ages (12-48) Months

Authors: Zohair Mohsen Ahmad
Pages: 1-7
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Abstract

Back ground and Objective: Spica cast is an effective method for treatment of closed femoral shaft fracture in young children. Aim of the study: Study done to compare between early (1-4)days, and delayed spica cast treatment after traction 2-3 weeks as a definitive treatment to see any difference in terms of results and complications, their advantages, 1imitation of acceptable reduction, overgrowth Phenomenon, period of hospitalization and cost. Patients and Methods: This study done in our teaching Hospital, Thirty eight patients closed femoral shaft fracture were included in our study their age range between (12-48) months, Antero posterior and lateral views of the injured femur were taken as well as x-ray of pelvis. In 22 patients, early spica cast was done in the first (1-4) days after admission to the hospital. 16 patients continue on skin traction (2-3) weeks, when the fracture feels sticky and early callus appear on the x-ray one and half a hip spica is done under general anesthesia under guide of x-ray screening. Results: The mean age was 30 months, the sex distribution of the patients was 23males 61%, 15 females 39%. 22 cases, right sided fractures 58%, while left sided fractures in 16 children 42%. The causes of fracture femur in our study were 24cases (63%) for fall on the ground, 8cases (21%) by fall from height and lastly 6 cases (16%) by road traffic accident. The sites of fracture shaft femur in children, according to which third of the femur is affected were20 cases 52%in the middle third,12 cases 31% for the proximal third, and 6cases 17% in the distal third. Initial observation of complications in our patients immediately after removal of the spica in patients treated with early spica were 2 cases for shortening, while patients treated with delayed spica following skin traction only one cases. Regrinding lateral angulations only one cases. Recorded in early type of spica. Conclusions: Fracture shaft femur in children treated by early spica cast or delayed spica cast proved to obtain good results in spite of the presence of some degrees of shortening or angulations'. Which prove to be limited at the end of follow up. In decreasing hospitalization time, thus the parents and the patients will be more obedient.


Article
Histopathological and Histochemical Changes of the Popliteal Artery in Diabetic Patients

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Abstract

Back ground: A lot of previous researches studded the endoneural microangiopathy and small vessels diabetic pathological change, but little studded about the diabetic angiopathy of the larger vessels like popliteal artery and related diabetic risk factors .Accordingly the present work designed to study the structural and histochemical changes of the popliteal artery as one of the medium size vessels. Objective: Evaluation of the histopathological and histochemical measurement, of the popliteal artery in diabetic male and female patients with different duration of the diseases, in comparison with normal non diabetic samples. Patient and methods: Histological sections, taken from amputated legs of 30 diabetic patients (8 females and 22 males) at age of (55-75) years, and 30 cadavers (4 females and 26 males) at age of (25-50) years as control group. Results: Histological sections from the popliteal artery of diabetic patients, showed marked decrease in the diameter of the lumen, reduced thickness of tunica media and adventitia, but increase in the thickness of tunica intimae and basement membrane. The loss of endothelium in some places, cellular infiltrations in tunica media with Periodic Acid Schiff positive particles, and in more advance cases calcifications, and organized thrombus was also detected. The multiple regression analysis, showed significant effect of duration of diabetes on the diameter of the lumen, and thickness of the wall and the tunica intima and media of the popliteal artery.


Article
Isolation of Potential Pathogenic Bacteria from Pregnant Genital Tract and Delivery Room in Erbil Hospital

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Abstract

Background: Numerous studies have shown that hospital surfaces and frequently used medical equipment become contaminated by a variety of pathogenic organisms and then spread infection to others. The hypothesis that environmental microorganism cause human diseases arises from two facts, firstly, our interaction with the inanimate environment is constant and close, secondly environmental objects are usually contaminated often with important human pathogens. Objective: To investigate the hygienic conditions of delivery room and vaginal contamination with pathogenic bacteria of referred pregnant women to the Erbil Maternity Hospitals. Material and Methods: Fourty three vaginal swab were collected from pregnant women who attending to Erbil Maternity Hospital randomly and 13 swab samples from 6 delivery room during the period from January till July 2014. The swabs sticks for bacterial culture were inoculated on MacConkey, Mannitol salt and blood agar plates and incubated at 37°C for 18-24 hrs. Later bacterial isolates were identified by standard microbiological techniques and antibiotic susceptibility tests were done according to Clinical Laboratory Standard Instituted (CLSI) [13]. Bacterial growth had been observed in 47 cultures (83.9%).The most dominants bacteria isolated from birth space were E.coli and Staph. aureus, while from vaginal swab isolate in addition to those genera other bacterial genera were isolated including Klebsiella sp., Proteus sp., Pseudomonas aeroginosa, Staph. albus. The delivery room isolated bacteria showed clear resistance toward the antibiotics Cefexime, Amoxicillin, Methicillin, Clindamycine, Norfloxacin, Amikacin, Trimetheprime,Cefotaxime, Ampicillin and Tobramycin but sisnsitive to Vancomycine, Ciprofloxacin. Conclusion: The finding of established bacterial pathogens from delivery room and showing a high resistance to commonly used antibiotics portends danger for surgical patients. This problem could be controlled to some extent by restriction of purposeless uses of antibiotics and by eliminating contamination in the environment of hospitals by applying strict quality standards concerned with the hygienic manners both of patients and health staff, and the performance of invasive procedures using aseptic technique.


Article
Lactobacillus Acidophilus as Antibiofilm Formed by Staphylococcus Aureus Invitro

Authors: Abeer Yousif Abd-Alkareem
Pages: 24-34
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Abstract

Background: The lactobacilli are well known to have a positive effect on human health. These bacilli, which are formed the largest part of the microbiology natural, that characterized by its ability to inhibit the growth of bacteria through the production of various antimicrobial materials such as bacteriocins and biosurfactant, thus preventing the formation of biofilm by lactobacilli, and Staphylococcus aureus for examples of bacteria that have the ability to produce a biofilm. Objective: To determine biofilm production ability by Staphylococcus aureus isolates and evaluate effectiveness of Lactobacillus acidophilus to elimination of planktonic Staphylococcus aureus and their biofilm producers, in vitro. Methods: This study was carried out for the period December 2012 to April 2013 in Ramadi Teaching Hospital in Ramadi City. Fourty isolates of Staphylococcus aureus were isolated from blood, urine, surgical wounds, and intravascular catheters. All specimens were identified using biochemical tests, and they were tested for biofilm production by using Microtiter-plate method. Also, used to study the ability of Lactobacillus acidophilus supernatant to inhibit biofilm produced by Staphylococcus aureus, and used L. acidophilus supernatant to inhibit planktonic S. aureus (S2,S7,S11,S12,and S19) which are highest biofilm produced , in vitro. Results: Fourty Staphylococcus aureus were biofilm produced and distributed in to 20 (50%), 15 (37.5%), and 5(12.5%), our result showed that inhibitory effect of Lactobacillus acidophilus supernatant on planktonic S. aureus (S2, S7, S11, S12, and S19). Significant differences (P<0.01) were found between pre and post treatment of Staphylococcus aureus biofilm with Lactobacillus acidophilus supernatant. Conclusion: Staphylococcus aureus has high ability to produce biofilm, and the Lactobacillus supernatant eradicated planktonic Staphylococcus aureus and their biofilms remarkably in vitro.


Article
Ischemic Heart Disease Mortality, Morbidity and Risk Factors of Coronary Care Unit Patients

Authors: Ali Hussein Salih
Pages: 35-40
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Abstract

Background: Ischemic heart disease (IHD) is the commonest type of heart disease .It causes more deaths and disability and incurs greater economic costs than any other illness. Gender, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and family history are obvious risk factors. In acute state it may be complicated by life threatening arrhythmia, heart failure, circulatory failure and cerebrovascular accidents. Aims of study: To evaluate the patients with ischemic heart disease admitted to the coronary care unit of Baquba teaching hospital Patients and Methods: A total of 160 cases of patients with various symptoms of ischemic heart disease including chest pain, dyspnea, and palpitation are evaluated in the coronary care unit of Baquba teaching hospital by history taking, physical examination, and Electrocardiogram, echocardiogram, and lab tests with continuous follow up until discharge from the coronary care unit. Results: From total number 97(60.62%) patients were males,58 have myocardial infarction and 39 have angina .The rest of the patients were females 63 (39.38%),41 of them have angina and 22 have myocardial infarction. Male was the highest risk factor followed by hypertension, diabetes mellitus, smoking family history and hyperlipidemia .Arrhythmia is the commonest complication while heart failure, cerebrovascular accident and circulatory failure of lesser frequency .


Article
Relationship between Fetal Gender, Pregnancy and Neonatal outcome among Pregnant Women attending labour ward at Al- Batool Teaching Hospital for Maternity and Children in Diyala Governorate Iraq

Authors: Sawsan Talib Salman
Pages: 41-49
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Abstract

Background: In many societies, adverse outcomes in pregnancy and labour have often be ascribed to male fetal gender, so, In recent years, many investigators try to find any relationship between fetal gender and pregnancy outcome. Objective: To evaluate the role of fetal gender on pregnancy and neonatal outcome. Subjects and methods: A cross sectional study was done at a labour ward in Al-Batool Teaching hospital for maternity and children in Diyala Governorate, Iraq during the period from 1st of August till 31st of October 2013. One hundred one pregnant women were eligible for enrollment in the study according to inclusion criteria. The effect of fetal gender on both maternal and fetal parameters were all recorded. Results: A total of 101 neonate were born, of whom 53 were males and 48 were females, there was no significant differences noticed between male and female regarding to the maternal age and parity. Also the result showed that preterm and post term pregnancies more frequently in male bearing pregnancies than in female bearing pregnancies (4.95%, 0.99% respectively), despite these findings were significant statistically, while fetal gender has no positive correlation to the weeks of gestation. Pregnant women with a male fetus had a higher rate of cesarean section (8.91%) than with female fetuses (4.95%) which is statistically significant but there is no positive correlation between fetal gender and cesarean section, the results of this study find that there is no correlation between neonate gender and birth weight. By studying the correlation between neonate gender and other neonatal parameters like Apgar score <7 at 5 mint, admission to NICU, clear liquor, and Meconium liquor it was proved that there is no correlation between fetal gender and these parameters except there is a positive correlation between male gender and Apgar score <7 at 1 mint. Conclusions: There is a positive correlation between male gender and Apgar score <7 at 1 minute but no correlation found between fetal gender and other maternal or neonatal parameters.


Article
Detection of Serum Hs CRP and C3 Complement Levels Following Immunization with Measles Containing Vaccine in Iraqi Young Adults

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Background: Measles remains a major cause of worldwide childhood mortality, and has been targeted by the WHO for global eradication following the eradication of poliomyelitis. Despite the implementation of mass school catch-up campaigns for measles, an outbreak of measles occurred mostly affecting the adult population. Objectives: To measurement of Highly Sensitive C Reactive Protein (Hs CRP) and C3 Complement levels in adult volunteers after vaccination with live attenuated measles containing vaccine, and to compare the results with that following vaccination. Subjects and methods: A sero-surveys for serum Hs CRP and C3 complement levels was conducted among [190] healthy young adults aged 18-25 years, randomly selected, and to compare after a national campaign with measles containing vaccine. Hs CRP and C3 complement were detected in volunteer’s sera prior to, 1, and 4 weeks after vaccination, measured by Enzyme Linked Immunosorbent Assay and Single Radial Immunodiffusion Assay respectively. Results: There was a significant differences (p ≤ 0.05) in the concentration of serum Hs CRP and C3 complement at week one following vaccination with measles containing vaccine, and returned to normal after four weeks. Conclusions: Raising Highly Sensitive C Reactive Protein and Complement C 3 Levels in the sera of adult volunteers after measles containing virus vaccine administration could play a role in increasing innate immune response against measles virus infection and may explain some mechanisms of immune response associated with measles infection.


Article
Abnormal Urinalysis in Acute Appendicitis

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Background: The correlation between urinalysis and appendicitis is still unclear. Urinalysis can be depended may aid diagnose and compare acute perforated and non-perforated appendicitis. Objective: To determine the correlation between routine urinalysis and simple and perforated appendicitis. Methods: The patients (210) analyzed prospectively with clinically suspected acute appendicitis that underwent urinalysis followed by appendectomy at Baquba Teaching Hospital, during the period from August 2013 to March 2014. Urine test strip analysis was used. Results: Patients with acute appendicitis had a higher percentage of positive urine ketone bodies, higher specific gravity, and lower urine pH than patients with normal appendices. Such and other parameters and such data were much higher in patients with perforated appendix. Conclusion: Routine urinalysis may show differences in findings between simple and perforated appendicitis. Clinically, we believe these urine parameters may aid clinicians in decision making for patients with suspected appendicitis.


Article
Lymphangiogenesis Using D2-40 in Oral Squamous Cell and Mucoepidermoid Carcinoma and its Correlation with Clinicopathological parameters

Authors: Mustafa Gh. Taher
Pages: 66-75
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Background: Oral squamous cell carcinoma (OSCC) and Mucoepidermoid carcinoma (MEC) are the most common malignant tumor of the oral cavity and salivary gland respectively, the extent of lymph node (LN) metastasis by lymphangiogenesis is a major determinant for the staging and the prognosis of these malignancies and often guides therapeutic decisions. Objective: To correlate the lymphangiogenesis of OSCC and MEC with their clinicopathological parameters. Material and Methods: Fifteen oral squamous cell carcinoma and eighteen mucoepidermoid carcinoma tissue samples collected during the period from 2008 till 2014. Age, gender, site of tumors and stage were reviewed. Lymphangiogenesis obtained by Immunohistochemical findings using D2-40 immunomarker. Results: All cases of OSCC and MEC exhibited positive immunostaining for lymphangiogenic marker. There is a correlation between OSCC and MEC regarding the age group and site of tumors (P=0.001), while gender, lymphatic vessel density (LVD) and TNM stage have no correlation with OSCC and MEC. Lymphatic vessel density and showed no relation with stage of OSCC and MEC. Conclusion: No statistical correlation was found between LVD which expressed by mean of lymphangiogenesis using D2-40 immunomarker and OSCC MEC stage.


Article
Evaluation of Patients with Thyroid Diseases in Baquba City According to Thyroid Function Tests

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Background: Thyroid gland is the largest endocrine gland which is consists of right and left lobes connected by a narrow isthmus, the weight of this gland is 10-20g in normal adult .The function of thyroid gland is to secret T3, T4 under control of TSH. Thyroid hormones help to regulate the body metabolism. Diseases of thyroid are common affecting 5% of population. The disease either change in thyroid hormones secretion or structural changes such as in goiter with or without abnormal thyroid function. Objective: To determine the common causes of thyroid diseases in Diyala province according to thyroid function tests. Patients and Methods: A total number was 2973 patients presented with thyroid diseases at Baquba teaching hospital laboratory unit and private Ibn-alhaitham laboratory sending from specialized doctors, were included in this study 647 male and 2326 females. Results: A total of 2973 patients were included in this study, 2326 (78.24%) were female, and 647 (21.76%) were males. According to thyroid diseases the results of percent work demonstrated that 2611(87.82%) patients from total patients 2973 were euthyroid (normal thyroid function), 213patients (7.16%) were hypothyroid and 149 patients (5.01%) were hyperthyroid. Statistical analysis revealed significant differences among them. Conclusion: Thyroid disease one of common endocrine diseases after diabetes mellitus, most thyroid diseases is euthyroid then hypothyroid followed by hyperthyroid. Thyroid diseases was more common in female than male.


Article
Breast Feeding and Co-morbidities on Mothers and Infants in Two Main Hospitals of Diyala Province, Baquba, Iraq

Authors: Kareem Assi Obaid
Pages: 80-87
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Background: Breast milk is the only food fully adapted to the physiology of human infants. Optimal breastfeeding is defined as initiating breastfeeding immediately after birth exclusively breastfeeding until 6 months of infant age, and continuing breastfeeding with age-appropriate introduction of complementary foods up to age two or longer. Objective: To investigate the relationship between type of feeding in the first year of infant life, and infant morbidity in the same period of infant's age. It focuses on different diseases that affect many infants in spite it could be preventable by very simple and cheap methods. Method and Material: It is a descriptive study done in Al-Batool teaching hospital and Al-Zahra hospital of Diyala province, during the period from October 2012 to March 2013, 100 cases of infant at one year of age have be included in the study regardless of medical reason of hospital admission, divided into three groups of infants exclusive breast feeding, bottle feeding and mixed type of both bottle and breast feeding. This study is considered as to investigate the relationship between type of feeding in the first year of infant life, and infant and maternal co-morbidities. Results: One hundred cases were included in the study, 51 males infant and 49 females included in the sample, according to feeding type the study revealed that31 breast feeding, 34 bottle feeding, and 35 mixed feeding. The current study demonstrate that 69 delivered by section among them 14 breast feeding, 32 bottle feeding and 22 mixed feeding while 31 delivered by normal vaginal delivery including 15 breast feeding, 9 bottle feeding and 7 mixed feeding only. Regarding post-partum maternal weight loss we found 81 had significant weight loss among them 30 breast feeding, 15 bottle feeding and 16 mixed feeding. According to the study of fetal diseases demonstrated that 68 infant developed diarrhea among them 14 breast feeding,29 bottle feeding and 25 mixed feeding , 47 had urinary tract infection 9 of them breast feeding 20 had bottle feeding, 32 infant had constipation five of them breast feeding , 14 bottle feeding and 13 mixed feeding. Conclusion: The duration of breastfeeding showed a decline with decreasing maternal age, less educated and multiparous mothers who lived in rural communities and belonged to the low socio-economic class were more likely to breastfeed, breastfeeding patterns and practices need to be re-assessed hopping this review will serve as baseline information for any upcoming longitudinal studies on breastfeeding.

Table of content: volume:7 issue:1