Table of content

Medical Journal of Babylon

مجلة بابل الطبية

ISSN: 1812156X 23126760
Publisher: Babylon University
Faculty: Medicine
Language: English

This journal is Open Access

About

Medical Journal of Babylon (MJB) is a quarterly medical journal concerned with clinical and basic medical researches. MJB follows the Publication Ethics Statements suggested by Committee on Publication Ethics (COPE) and International Committee of Medical Journal Editors (ICMJE).

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العنوان البريدي: العراق-محافظة بابل- الحلة –ص ب 473 جامعة بابل –كلية الطب – مجلة بابل الطبية
عنوان البريد الالكتروني medjbabylon2004@gmail.com

Table of content: 2018 volume:15 issue:1

Article
Isolation and Diagnosis of Phenolic Compounds in Pomegranate Peel and Their Use in Inhibition of Intestinal Pathogenic Bacteria Isolated from Human Intestine and Stomach
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Background: Pomegranate (Punica granatum L.) has gained commercial importance in food and health industries due to increasing scientific evidence linking its consumption to better health outcomes. Objective: This study aimed to detect the active substances (phenols, tannins, flavonoids, alkaloids, and saponins) in the pomegranate peel and their effectiveness against bacteria isolated from intestine and stomach which included Salmonella and Escherichia coli, which are responsible for most gastrointestinal diseases. Materials and Methods: The experiment was designed randomly and was statistically analyzed using the least significant difference at P < 0.05. The plant extracts were obtained by alcoholic extraction using Soxholet. The compounds were diagnosed qualitatively and quantitatively using reference methods. Results: The results showed that peels contained high concentration compounds of alkaloid, tannic acid, and saponins. A 15% alcohol extract gave a high inhibition rate compared to the water extract and alcohol at a rate of 40 mm corresponds to 19 mm in the chloroform extract and 20 mm in the water extract at the concentration of 15%. A 15% concentration of alcoholic extract with antacid ampicillin and chlorophyll was compared with high efficacy compared to effective anti-ampicillin.


Article
Diagnosis of the Problems Which Facing the Researchers during Studying In vitro Lead Toxicity

Authors: Sabah Hussain Enayah
Pages: 5-11
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Background: Lead (Pb) is one of the most difficult metals to investigate in laboratory experiments because it is very easily precipitates or forms complex ions. Many experiments were conducted with Pb and observed unique chemical properties of this metal. Objective: The present investigation was designed to evaluate the cytotoxicity of Pb exposer on pheochromocytoma (PC12) cells in different condition and media to admit the difficulties facing the researchers in bioavailability of Pb in media and prevent precipitation formation. Materials and Methods: Pb from 0.01 to 100 μM had been used on PC12 cells cultured and treated in different conditions for 6, 12, 24, and 48 h. Resazurin assay was used to assess the cell viability. Result: As numerous studies have demonstrated a possible mechanism for Pb‑induced neurotoxicity using in vitro model, the current study is the first study which explained the complexity of Pb participations in media that facing the authors and what the reason for that and how we can solve this problem to make pb more bioavailable in the media. Conclusion: Use of phosphate buffer in experiments with Pb is not acceptable because all Pb can be precipitated. However, it could be possible to use the standard media, but for the time of treatment with Pb phosphates must be removed from the media.


Article
The Impact of Electrolytes in Pathogenesis of Simple Febrile Convulsions

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Febrile convulsion is one of the most common seizure disturbances in children with an approximate rate of 2%–5%, febrile seizures (FSs) occur between the age of 6 and 60 months with a 38°C or higher temperature, and they do not result from central nervous system infection or any metabolic imbalance, and these seizures occur when a history of prior FSs is absent. In this study, 150 children whose ages ranged between 6 and 60 months were divided into three groups: Group A included 50 children with febrile convulsions, Group B included 50 children having fever without convulsion, and Group C included 50 healthy children with nonfebrile convulsions. In the present study, the serum sodium and potassium were significantly lower in cases of febrile convulsion than the control groups, whereas no significant changes were shown in the levels of ionic calcium in the cases of febrile convulsion when compared with the control groups. These findings revealed that there is a correlation between differences of serum sodium and potassium in simple febrile convulsion.


Article
Histopathological effect of energy drinks (Red Bull) on Brain, Liver, Kidney, and Heart in Rabbits

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Background: Red bull has been known as a healthy drink within many populations. The chemical composition of energy drinks can produce multiple adverse effects, including serious behavioral effects. Objective: To study the effect of energy drinks (Red Bull) on brain, liver, kidney, and heart in rabbits. Methods: thirty males albino rabbits were used, animals divided into 3 groups (A, B, and C), each group contain 10 rabbits. Group A treated with high dose of red bull (10 cc), Group B treated with low dose (5 cc), and Group C is control group. Results: The results showed that control group had no any pathological changes while both Groups A and B showed many pathological changes, Group A showed renal vascular congestion, hemorrhage of interstitial tissue, focal atrophy, and degeneration of lining epithelium of proximal and distal convoluted tubules, while Group B showed renal vascular congestion, glomerular capillary congestion, hemorrhage of interstitial tissue with swelling of lining epithelium of proximal and distal convoluted tubules that appeared as pale cytoplasm with star-shaped lumen, and swelling of glomeruli; this reveals that there is dose–response relationship between treated groups with low and high dose of red bull. Conclusion: Energy drinks have dose–response relationship with adverse effect; it has become apparent that the consumption of these energy drinks will seriously harm the body.

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Article
The Role of Autonomic Neuropathy in Predicting Ovarian Hyperstimulation Syndrome

Authors: Zahid Mohammed A. Kadhim
Pages: 21-24
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Background: Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovarian stimulation during the assisted reproductive technique. Objective: This study was aimed to elucidate the effect of autonomic neuropathy on the occurrence of OHSS during assisted reproductive techniques. Materials and Methods: One hundred subfertile women underwent ovarian stimulation. The ovarian response was diagnosed by hormone concentrations and vaginal ultrasound. Autonomic function tests were done for all patients using Ewing’s protocol. Results: Twenty-eight percent of subfertile women involved in this study had autonomic neuropathy. Out of 100 infertile women undergoing ovarian stimulation, only 5 (5%) had been developed OHSS, all of them had autonomic neuropathy (P < 0.05). The sensitivity and specificity of the autonomic neuropathy for the occurrence of OHSS was 100% and 58% which was insignificant (P > 0.05). The best cutoff score associated with OHSS was ≥1.5 which detected from receiver operating characteristic curve. The odds ratio for the absence of OHSS in patients without neuropathy was 9.891, which was significant as compared with the patients with neuropathy (P < 0.05). Conclusion: The study concludes that ovarian stimulation may cause autonomic function disturbance which can predict OHSS.


Article
A 5‑year Study of Re‑laparotomies, Planned and Unplanned, in Al‑Hillah Teaching General Hospital

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Objective: The aim of this study was to evaluate the incidence of re laparotomies (RLs) among laparotomies performed within 5-year period, the indications, and the main factors affecting the mortality rate. Materials and Methods: This retrospective study was conducted by evaluating file records of patients undergoing RL following abdominal surgery (2012–2016). The patients including, age, sex, type of the first surgical procedure, the cause of the re-exploration, the time interval between the index operation and the RL and the performed procedures, and the outcome were recorded. Results: Fifty-nine patients were included in the study, 83% were male. The mean age was 34.66 years. The mean duration between first operation and RL was 11.55 days. About 83.05% patients underwent RLs in the early period. The incidence of RLs was 1.62%. The indication for RLs was abdominal sepsis 23.72%, followed by intestinal obstruction 20.33% and missed injury 16.94%. The rate of RL among patients sustaining trauma was 37.28%, males 90.9%. Conclusion: We concluded that the incidence of RL is consistent with the literatures. The most :common indication was sepsis. Early intervention is the most important factor that can reduce the mortality when re-exploration is required.


Article
New Animal Model of Induced Acute Hepatic Injury by Acetaminophen and Vitamin D3 Protective Effect

Authors: Malath Azeez Al‑Saady
Pages: 28-31
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Background: Drug-induced liver injury is of great interest especially drugs that broadly used like acetaminophen. Objective: To assess new model of acetaminophen-induced acute hepatic injury and Vitamin D3 effectiveness. Materials and Methods: Eighteen male rabbits allocated into three groups six rabbits for each. Group 1 receives acetaminophen to induce acute hepatic injury and Group 2 receive single injection of Vitamin D3 before induction of hepatic injury, and group 3 was control. After 24 h from three-spaced injection of acetaminophen sample of blood taken to measure serum level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, and albumin. Results: Successful model of acetaminophen-induced hepatic injury achieved by significant elevation (P ≤ 0.05) of ALT and AST of Group 1 and 2 compared with control. No significance variation observed (P ≥ 0.05) between treatment Group 1 and 2 in liver function enzymes level. Conclusion: A new easy model of acetaminophen-induced acute hepatic injury effectively obtained. Although no statistical signifi cant Vitamin D3 lower the levels of ALT and AST.


Article
The Impact of Osteoporosis in Patients with Ankylosing Spondylitis and Its Relationship to Physical Activity

Authors: Abdulkareem Shehab Diab
Pages: 32-38
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Background: Osteoporosis (OP) is a major fracture risk in ankylosing spondylitis (AS), and there are few qualitative reports on bone mass in AS. Objective: The aim of this study was to correlate the bone mineral density (BMD) with disease activity and physical activity (PA) in AS. Materials and Methods: Sixty-two participants who met the criteria for diagnosis of AS (28 males and 34 females) were recruited from Al-Yarmouk Teaching Hospital Baghdad, Iraq. The study was conducted at baseline and after 6 months of exercises. European healthrelated quality of life was used to reflect physical function. The erythrocyte sedimentation rate and C-reactive protein were used to evaluate AS disease as markers for disease activity. The study measured BMD at two events, before and after performing the relevant exercise. Results: Results found that 9.6% of patients reported fractures. Low bone mass in the AS patients were 17 (27%) in number. Osteopenic patients were 9 (14%) in number, while osteoporotic patients were 8 (13%) in number. An association (P = 0.05) between BMD and PA was noticed in AS participants. There was a weak (P ˂ 0.055) significant association of higher European health-related quality of life scores with lower spinal and hip BMD. No association of AS disease activity with BMD was found, although bone loss in AS is common in persistent active disease; regular PA seems to be a positive factor for improving bone quantity and prevent fracture. Programmed exercise promotes healthy bone. The severity of AS in Iraq is less than the other countries. Conclusion: PA in AS patients has a positive effect on bone status. This implies that AS disease-related loss in BMD is preventable by the relevant exercise program. This information is important, as it can be utilized while designing preventive and treatment plans for AS patients.


Article
A Comparison between the Effect of Shisha and Cigarette Smoking on Serum Lipid Profile of Males in Nasiriyah City

Pages: 39-42
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Objective: This study aimed to recognize the harm of shisha smoking compared to cigarettes smoking by measuring serum lipid profile in males in AL-Nasiriya city and association lipid profile change with increase of smoking per day. Materials and Methods: This study was conducted between June to December (2015) in Nasiriya city in Iraq ,all samples were randomly selected. Spectrophotometer was used for biochemical analysis for each group of lipid profile. The subjects were divided into three groups, cigarette smokers (n = 35), shisha smokers (n = 20) and non-smokers groups (n = 20). Age ranged between (30 – 60) years and mean of duration smoking was (13.4±1.3) years. Results: Results showed that the increased levels of total cholesterol (TC), triglyceride (TG), very low density lipoprotein (VLDL) and low density lipoprotein (LDL) were significant in all groups of smokers as compared to non-smokers. Conclusion: The study concludes that the danger of shisha impact on human health may be similar or even worse than cigarette smoking.


Article
Effect of Midazolam on Bupivacaine Action in Intrathecal Anesthesia

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Background: Subarachnoid anesthesia is regarded as one of the famous neuroaxial block procedures available nowadays. Neuraxial anesthesia offers many benefits over general anesthesia. Objective: This study is designed to compare the effect of adding 1 and 2 mg midazolam to hyperbaric bupivacaine on duration of sensory and motor block and intraoperative hemodynamic changes for the cesarian section under subarachnoid anesthesia. Methods: Ninety patients with the American Society of Anesthesiology Classifications I/II (range: 18–40 years) were randomly allocated into three groups and were underwent spinal anesthesia for Cesarean Section in Duhok Maternity Hospital, Iraq. Group A (n = 30) received intrathecal of bupivacaine 12.5 mg + 0.4 ml of normal saline, Group B (n = 30) intrathecal of bupivacaine 12.5 mg + 1 mg midazolam, and Group C (n = 30) intrathecal of bupivacaine 12.5 mg + 2 mg midazolam. The study groups were comparable in age and hemodynamic status changes prior and intra-intervention commencement. Results: The analgesic duration of those patients in Groups C and B were significantly longer, 183.33 and 181.00 min compared to 138.00 min in Group A for motor block (P < 0.0001) and 212.00, 210.00, and 142.00 min, respectively, for sensory block (P < 0.0001) with no any substantial difference in hemodynamic status changes. Conclusion: The longer duration of analgesic was found using midazolam adjuvant with bupivacaine compared to free adjuvant group in women underwent spinal anesthesia.


Article
Immune Profile in Aborted Iraqi Women with Toxoplasmosis

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Background: Toxoplasmosis is one of the most important causes for abortion in women. The immune responses have a role in the outcome of such infection in gestated women. Aim: The current study was designed to investigate the immune profile in aborted Iraqi women with toxoplasmosis. Materials and Methods: Fifty-five aborted women and 29 healthy control women were enrolled in this study. Enzyme-linked immunosorbent assays were used to estimate serum levels to each of interleukin-1 alpha (IL-1α), granulocyte-monocyte colony-stimulating factor, IL-8, IL-4 IL-10, IL-12, interferon gamma (INF-ɣ), and IL-6. Single-radial-immunodiffusion assay was used to estimate serum levels of C3, C4, and total immunoglobulin gamma. Results: Serum levels of IL-8 showed significant elevation, while IL-6 and INF-ɣ showed significant dropping in infected women compared to control. Other immune factors showed nonsignificant differences between the two groups of the present study. Conclusion: Disturbance of immune response associated with toxoplasmosis may explain the success of parasite in escaping from discrimination and elimination by the immune system then supporting its survival and replication.


Article
Essential Oils of Rosemary as Antimicrobial Agent against Three Types of Bacteria

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Background: Interest in Rosemary has increased due to the importance of being wide antimicrobial, anti-inflammatory, and antioxidant. Objective: This study aimed to evaluate the biological affectivities of essential oils (EOs) of rosemary against three types of bacteria. Materials and Methods: Chemical analyses were conducted using gas chromatography technique on the volatile oils of rosemary, which were extracted by Clevenger. Results: The major contents of these oils were camphor (22.35%), camphene (1.85%), β-pinene (3.75%), sabinene (10.25%), limonene (7.64%), linalool (11.58%), and myrcene (2.14%). The biological affectivities of these oils were examined on three types of bacteria: Bacillus cereus, Escherichia coli, and Pseudomonas. The results proved that the EOs of rosemary were influential against bacteria and gave minimum inhibitory concentration (MIC). The MIC values were 37 μg/ml for E. coli, 69 μg/ml for Pseudomonas, and 20 μg/ml for B. cereus. Results found that Pseudomonas was less sensitive for these oils. Conclusion: The EOs of Rosemary can be used in the pharmaceutical industry for the production of new synthetic agents in the treatment of bacterial disease caused by these three types of bacteria.


Article
Prevalence and Possible Attributes of Decreased Visual Acuity among Primary Schoolchildren in Kufa City, Al‑Najaf Governorate

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Background: Visual impairment in children is a severe worldwide public problem. It can be detrimental to child's ability to learn. In Iraq, the size of this problem among primary school children is not well defined. Objectives: to determine the prevalence of visual impairment among primary school children in Kufa city, Al Najaf Governorate and to identify some factors associated with decreased visual acuity in the sample. Subjects and Methods: A cross sectional study was performed during the period of 1st of March to the 15th of April, 2017; the studied sample was 630 primary school children aged 6 to 15 years of both genders from fourteen governmental schools, both students and schools were randomly selected. Data were collected by using questionnaire designed especially for this study. Measurement of each pupil’s vision was done by using standard Snellen E chart. Those with visual acuity(VA<6/6) was regarded as visually impaired. The Statistical Package for Social Science, SPSS, (version 20) program was used for data entry and analysis. Results: From the total participants, there were 533(84.6%) students with normal VA(VA=6/6), 97(15.4%) students with decreased VA(VA<6/6). It was found that majority 81/97 (84.5%) of children with decreased VA were under the age of 10 years with a high significant statistical difference (X2=28.028, P = 0.0001). Statistical analysis showed a significant association of decreased vision with female gender (X2=4.429, P = 0.0353), rural residency (X2=6.446, P = 0.01), low socioeconomic status (X2=7.128, P = 0.028), and positive family history of wearing spectacles(X2=7.414, P = 0.006), the highest rate of decreased visual acuity was shown in the students of second grade( 24.7%), however, the grade was not statistically significant (X2=7.128, P = 0.265). The overall prevalence of low vision (VA≤6/18) in the studied sample was 5.4% (34/630), statistically, there is a significant correlation between poor vision and female gender (P = 0.031), however, there is no significant association of poor vision with residency (P = 0.373), socioeconomic status (P = 0.431), and family history of using spectacles (P = 0.146). Conclusions: The prevalence of decreased visual acuity among primary school children in Kufa city was 15.4%., reduced vision is significantly higher in younger age group(≤10 years old), female gender, rural residency, lower socioeconomic status, and in those of positive family history of wearing spectacles. Female gender is significantly associated with low vision.


Article
Antibiotic Susceptibility of Bacteria Isolated from Patients with Diabetes Mellitus and Recurrent Urinary Tract Infections in Babylon Province, Iraq

Authors: Mohammed Hassan Ali Alhamdany
Pages: 63-68
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Background: The emergence of the antibiotic resistance in the treatment of UTIs is a serious health problem, especially in the developing countries where there is high level of ignorance, poverty, and bad hygienic practices, Objective: The aim of this study was to detect the types of bacteria and their antibiotic sensitivity in patients with diabetes mellitus with recurrent urinary tract infections and compare between types of bacteria in patients with the previous admission to hospital from those who are not. Materials and Methods: This cross-sectional study was conducted on eighty patients with diabetes mellitus and recurrent urinary tract infection, those patients who visited the Outpatient Unit in Diabetic and Endocrine Center in Merjan Medical City in Babylon Province. This study was carried out from March 1, 2016 to September 30, 2016. General urine examination was done to the patient with urinary tract infection. Urine samples were sent for culture and sensitivity against different types of antibiotics. Results: Results found that the mean age of the patients was (58.23 ± 14.38) and majority of them (63.7%) were female and (52.5%) of them came from rural area. The main bacteria causing urinary tract infection was Escherichia coli in more than 55% of cases, while the amikacin antibiotic regard as the best antibiotic in the treatment of urinary tract infection in this study with lowest resistance percentage (3.8%). Based on the history of previous admission to the hospital, there was 57.5% with a history of previous admission, and there was statistically significant difference in the types of bacteria between the two groups. Conclusion: There was significant difference in bacterial type between patients who previously had hospital admission and those who had not. E. coli was the main bacteria causing UTI in this study. Amikacin showed the best sensitive drug for bacteria that cause urinary tract infection.


Article
Assessment of the Clinical Features Associated with Premenstrual Tension Syndrome among Kirkuk Technical Institute Students with Possible Preventive Strategies

Authors: Wafa Mahmood Jasim
Pages: 69-73
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Background: Menstruation is regarded as a very critical period in female life and a wide range of symptoms may be occur before the onset of the cycle and later on it starts to remove or absent gradually. Objective: The study aimed to assess the clinical features associated with the pre- menstrual tension syndrome among female students and to participate a suggested preventive strategies. Methods: A descriptive crosssectional study was carried out in Kirkuk Technical Institute during the period from 1st February/ 2015 till the end of May /2015 after receiving the administrative agreement and a verbal consent was taken from each student before establishing the study. The sample was collected randomly and 200 female students were collected from two stages (First and second) and from different scientific departments. A special questionnaire form has been prepared by the investigator included five main dimensions designed for study purpose. Results: Show that most of the study female students were from second stage (75.5%), aged between 18-20 years (82.5%) and majority of them started menarche period between the age 12-14 years (50.0%), with regular menstrual cycle (80.5%). More than two third of female students complaining from clinical features of pre- menstrual tension syndrome (75.6%, 86.1%). Conclusion: Female students from both stages are treated and managed their symptoms before and during the menstruation cycle domestically without the need for doctor consultation.


Article
Comparison between Antitumor Activity of Live‑Attenuated Measles Virus and Cisplatin on Ki‑67 Expression of Colon Cancer Cell Line (SW‑480) In vitro

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Background: Previous studies declare that Ki-67 protein (Ki-67P) expression was shown to be correlated with cell proliferation and was considered as a prognostic marker for different cancer diseases. Objective: The aim of this study was to investigate the relation between Ki-67 and the cytotoxic effect of MV and cisplatin chemotherapy in inhibition of the proliferation of human colon cancer cell line. Materials and Methods: Colon cancer cell line (SW-480) was cultured in microtiter plates incubated in the presence of different titers of measles virus and different concentrations of cisplatin. The expression titer of Human Ki-67 protein was determined in cell culture supernatant by quantitative ELISA. The optical density (OD) was measured with spectrophotometry at a wavelength of 450 nm. The OD value is proportional to the concentration of human Ki-67P. The concentration of human Ki-67P in samples was calculated by comparing the OD of the samples with the standard curve. Results: The expression of Ki-67P was decreased in relation to the virus titer and concentration of cisplatin in treated cell groups. The results showed significant differences in the level of cellular expression of protein (Ki-67) between the virus-infected cells, cisplatin-treated, and the l untreated control cells group (P ≤ 0.001). The lowest Ki-67P expression was recorded after treatment of SW-480 colon tumor cell with high concentration of measles virus. Conclusion: Both live-attenuated MV (Edmonton strain) and cisplatin could reduce Ki-67P expression in tumor cell line when treated with either one of them. Therefore, they have beneficial effects in reducing the resistance to chemotherapy and radiotherapy.

Keywords

Cisplatin --- Ki‑67 --- measles virus --- SW‑480


Article
Transvaginal Cervical Length and Amniotic Fluid Index: Can it Predict Delivery Latency Following Preterm Premature Rupture of Membrane?

Authors: Amal Muneer Mubarak
Pages: 78-82
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Background: This study was performed to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROMs). Materials and Methods: This was a prospective observational study of TVCL measurements in eighty singleton pregnancies with PPROM between 24–34 weeks. Transvaginal ultrasonography was performed to measure the CL and AFI. Delivery latency was defined as the period from the initial TVCL after PPROM to delivery of the baby, with our primary outcome being delivery within 7 days of TVCL. Sensitivity, specificity, and predictive values were used to test whether the presence of a short TVCL, AFI, or a combination of both affected the risk of delivery within 7 days. Results: The study showed that the validity of CL alone in predicting labor when the cutoff value = 2 cm, the sensitivity = 52.6%, specificity = 69%, positive predictive value (PPV) = 60.6%, negative predictive value (NPV) = 61.7%, and accuracy = 61.25%. The validity of AFI alone when the cutoff value = 5 cm, the sensitivity = 71.1%, specificity = 50%, PPV = 56.3%, NPV = 65.6%, and accuracy = 60%. With a combination of CL and AFI in predicting time of labor after PPROM, the following results were found: sensitivity = 50%, specificity = 92.8%, PPV = 86.4%, NPV = 67.2%, and accuracy = 72.5%. In women with PPROM, we found the ratio of gestational age (GA) ≤30 weeks who labored within 7 days as 44.7% and those labored more than 7 days as 55.3%. Conclusion: Our study showed that there was an increase in PPV when combining AFI and CL in the prediction of time of labor, so women with AFI ≤5 and CL ≤2 had 86.4% risk of delivery within 7 days after PROM. Furthermore, we found that there was no significant association between GA and parity with the prediction time of labor.


Article
LigaSure Hemorrhoidectomy versus Excisional Diathermy Hemorrhoidectomy for All Symptomatic Hemorrhoids

Authors: Ibrahim Falih Noori
Pages: 83-88
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Background: Hemorrhoidectomy by LigaSure electrosurgical unit seems to be very effective treatment and results in better surgical outcomes when compared with the conventional excisional hemorrhoidectomy. Objective: The aim of this study was to compare the feasibility and the surgical outcomes of LigaSure hemorrhoidectomy with that of conventional diathermy excisional hemorrhoidectomy. Materials and Methods: Patients characteristics were comparable in both groups. Ninety six patients with symptomatic mainly grade III and IV piles were randomized for either conventional excisional hemorrhoidectomy (48 patients) or to LigaSure hemorrhoidectomy (48 patients) for the period from April 2014 to July 2016. The surgical outcomes of both procedures including the operative time, intra-operative blood loss, postoperative pain, analgesic requirements, early and late postoperative complications, wound healing, recovery time and return to work, recurrence and patient satisfaction were recorded, compared and evaluated. Results: The mean operative time and amount of intraoperative blood loss were significantly lower in LigaSure hemorrhoidectomy group. Postoperative pain and need for parentral analgesia were comparable in the first 24 -48 hours postoperatively, but they were significantly lower in LigaSure group after the second postoperative day. Faster wound healing and early return to work were obviously noted among patient subjected to LigaSure hemorrhoidectomy. Early postoperative complications were lower in LigaSure group while late complications were comparable in both groups. Lastly, LigaSure group showed high satisfaction rate compared to conventional hexcisional hemorrhoidectomy group. Conclusion: LigaSure hemorrhoidectomy is superior and more advantageous in term of operative time, blood loss, post-operative complications, faster wound healing and return to work. It is simple, feasible and easy to learn.


Article
A Prospective Study to Assess the Relative Frequencies of Different Urological Dysfunctions in Patients with Multiple Sclerosis

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Background: Multiple sclerosis (MS) is a relatively common autoimmune neurological disease. One of the commonly affected organs in MS is the urinary bladder leading to disturbances in bladder function and control of micturition. Objective: The aim of this study was to evaluate the benefits and convenience of using physiological tests in assessing the bladder function and their efficiency in identifying the exact cause of bladder dysfunction in MS. Materials and Methods: Sixty-three patients (41 females and 22 males) with urinary manifestations associated with MS were selected for the study, in whom 5 urodynamic studies to assess their bladder functioning were performed. All patients visited the Neuromedical Clinic in Basrah General Hospital. Results: Results fond that after applying the UDS, 46 (73.01%) of patients were found to have DO, 14 (22.22%) of patients had detrosal areflexia, and 3 (4.7%) had detrusor sphincter dyssynergia. Conclusion: Urgency, with or without incontinence, and frequency are the most common urological problems that face MS patients; therefore, these complaints should be considered seriously by health-care professionals in addition urodynamic studies can be used as an efficient diagnostic test when MS is diagnosed to determine the exact type of the bladder dysfunction; thus, can plan appropriate treatment.


Article
Early Complications of Diagnostic and Therapeutic Ureteroscopy

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Objective: The aim of this study is to report early complications of diagnostic and therapeutic ureteroscopy and to grade each complication according to modified Clavien classification system (MCCS). Materials and Methods: Through a prospective study conducted from March to September 2017, all patients who underwent diagnostic and therapeutic semirigid ureteroscopy were evaluated. The procedure was performed by different surgeons. The recording data included patient demographics, ureteroscopy site (left, right, or bilateral), aim of ureteroscopy (diagnostic or therapeutic), operative time, additional intervention, stone‑free rate, double J stent placement, and complications which were graded according to the modefied clavien classification system with their management. Results: One hundred and fifty patients were included in the study. The average age was 39.9 years and male‑to‑female ratio 2.3/1. The number of patients who underwent right, left, and bilateral ureteroscopy was 74 (49.3%), 64 (42.3%), and 12 (8%), respectively, so the overall number of ureteroscopy procedures was 162. Diagnostic ureteroscopy was done in 20 (13.3%) patients and therapeutic ureteroscopy in 130 (87.7%). Complications occurred in 37.3% of patients. According to MCCS, Grade I, II, IIIa, IIIb, IVa, IVb, and V complications were detected in 40 (26.6%), 6 (4%), 10 (6.7%), 14 (9.3), 0 (0.0%), 2 (1.3%), and 0 (0.0%) of cases, respectively. Conclusion: Ureteroscopy becomes the prevailing procedure for different ureteral pathologies mainly stones with a good safety and efficacy. It is important to adopt a precise classification system for reporting the complications of ureteroscopy. Most of the complications are of low grade and they are amenable to conservative management. The complications of ureteroscopy will continue to decline as the ureteroscopic technology evolved.


Article
Making Use of High Index of Suspicion in Diagnosing Intra‑abdominal Abscess

Authors: Kadhim Ch. Hasan
Pages: 99-101
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More than 80% of intra-abdominal abscesses occur in the postoperative period and the majority after pancreatico- biliary or colorectal surgery. Over 30% of abscesses are associated with clear evidence of anastomotic leak. There are no reliable signs or symptoms of intra-abdominal abscess. Huge abscesses containing more than 1 L of pus may occur without any significant physical finding. This case report describes a patient with generalized abdomen pain and abdominal distension after 2 weeks of headache and fever. After undergoing laparotomy for dealing with perforated typhoid ulcer of the ileum and 2nd operation for bowel leakage ,the patient health two weeks later was fair, but unexplained tiredness while leukocytosis was the only finding which encouraged 3rd operation during which intraabdominal abscesses were found and Corrugated drain was left. We may conclude that unexplained postoperative leukocytosis indicate hidden sepsis. Placing Intraabdominal corrugated drain may be invaluable in preventing recollection.


Article
Modified Sistrunk Operation of Thyroglossal Cyst–Fistula

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Table of content: volume:15 issue:1