Table of content

Zanco Journal of Medical Sciences

مجلة زانكو للعلوم الطبية

ISSN: 19955588/19955596
Publisher: Hawler Medical Univeristy
Faculty:
Language: English

This journal is Open Access

About

Zanco Journal of Medical Sciences (Zanco J Med Sci) is the scientific journal of Hawler Medical University. Zanco J Med Sci is a peer-reviewed, open access journal. Zanco J Med Sci aims to publish peer-reviewed and original scientific research of Iraqi, regional and international interest. Submissions of manuscripts in the clinical and basic medical sciences come within the scope of its publication. Original articles, review articles, case reports, brief communications, insights, and letters to the editor are all considered.

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+964 66 264 8226 direct line
+964 66 227 3384, Ext: 449
Email: zanco.journal@hmu.edu.krd

Table of content: 2010 volume:14 issue:1

Article
Predictive Factors For Conversion Of Laparoscopic Cholecystectomy To Open Procedure
العوامل التنبؤية لتحويل استئصال المرارة بالمنظار إلى طريقة الفتح

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Abstract

Background and Objectives: Laparoscopic cholecystectomy is the gold stander surgery for gallbladder diseases, especially symptomatic gall stone disease. to identify the factors that causes the conversion of planed laparoscopic cholecystectomy to an open procedure. Identifying these predictive factors will predict the conversion rate and eventually will help the surgeon, the patient and the hospital in planning the surgery. Methods: Retrospective study. Between October 2003 and December 2004 hundred and fifty patients with symptomatic gallstone underwent laparoscopic cholecystectomy in Department of Surgery, Sulaimaniyah Teaching Hospital Results: ages of the patients were between 11-70 years with a mean of 40, female to male were 5/1, and in 47% the symptoms were present for more than two years. Conversion incidence was 8.7. Conclusions: The predictive factors for conversion in our study accordingly were duration of the symptoms, abnormal intra-abdominal findings, concurrent illnesses, and intra-operative complications


Article
Relationship Between Hemoglobin Level and Feeding Pattern in Apparently Healthy Children Below Two Years
العلاقة بين مستوى الهيموغلوبين ونمط التغذية لدى الأطفال الأصحاء على ما يبدو دون عامين

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Abstract

Background and Objectives: Anemia is still one of the most common problems in the world even in developed countries, but its evaluation is still underestimated especially in developing countries like our, so it needs further planning, screening and management. This study was done in 12 primary health care centers PHCC in Erbil city – Kurdistan re-gion/Iraq during period fro 1st Feb - 31st Jul 2008. The main objectives were to determine the hemoglobin value in our children , to estimate the prevalence of anemia and correlating it with feeding pattern . Methods: This prospective study was conducted in 500 apparently healthy children col-lected randomly, visiting the vaccination centers routinely during 5 months period. Feeding. pattern were studied in relation to hemoglobin (Hb) level only. Results: From total 500 children conducted in this study, the mean Hb. of them was 10.4 g/dl. Those with normal Hb were 196 (39.2%), while 304 (60.4%) of them were anemic. Those with mild anemia were 145 (29.0%) and 159 (31.8%) of them had moderate anemia. The sex had no effect on Hb level. The anemia was lesser in children below one year Children on breast feeding had lower percent of anemia (51.9%),those on exclusive breast feeding only 6 (33.4%) while those on adult milk (74.9%) of them were anemic. Conclusions: There was a high prevalence of anemia among the investigated children and less common in children with breast feedin.


Article
Women's satisfaction about MCH care services provided to pregnants attend antenatal care units in Erbil city
رضا النساء عن خدمات رعاية صحة الأم والطفل المقدمة للحوامل يحضرن وحدات الرعاية السابقة للولادة في مدينة أربيل

Authors: Jwan Muhammad Sabir
Pages: 16-21
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Abstract

Background and objective Quality of antenatal care services and client satisfaction are interrelated concepts. Measuring quality of care conceptualized in such a broad manner represents a true challenge Studies have revealed positive correlations between patient satisfaction and health care utilization. The present study aimed to determine the level of satisfaction for pregnant women in Erbil society for provision of services and health care utilization . Method Cross sectional study was carried out on 300 pregnant women attending (MCH) maternal &child health unit of three primary health care center (PHC) in Erbil city ( nazdar bamerni, mala-afandi, azadi) from 1st of march 2008 to the 5th of September 2008. The variables included were socio-economic state, age ,occupation ,address, educational state, religion ,satisfaction with overall care provider, drug provision, tetanus vaccine , waiting time ,and health education regarding family planning and breast feeding programs . Result about two third of the sample at age group 21-30 year, majority of women 76% was housewives, 43.3% with primary school education, most of them 77.7% from moderate socioeconomic status,89.7% satisfied with care services available, 91.4% were satisfied with adequate medicine supply,88.7% satisfied with tetanus vaccine supply , 84% of the sample satisfied with waiting time in less than one hour, while access of session in female health education talking about important family planning and birth spacing method were19.4%, and information of benefit breast feeding 42.3%. Conclusion: The study revealed that majority of women satisfy with health care services but Erbil need to improve in the program of health education regarding family Planning and benefits of breast feeding.


Article
Spectrum of Acute Complications of Measles in Erbil City
طيف مضاعفات الحصبة الحادة في مدينة أربيل

Authors: Kawes Omer Hamad
Pages: 22-27
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Abstract

Background and Objectives: Measles is an infectious viral disease which is highly communicable and a notifiable disease, it is encountered as a cause of morbidity and mortality. The objective of this study was to find out the most encountered acute complications of measles and relation of these complications to the age of children and vaccination status. Patients and methods: This is a prospective study done in Raparin pediatric teaching hospital, Erbil city, in the period of December 2008 to May 2009. Sixty eight cases of measles admitted with variable complications were studied. History was taken, complete examination and follow up in the hospital for variable complications was done. Results: The mean age was 23.28 ±18.91 months, 42 cases (61.8%) of the admitted children were two years or less. Male children were 35(51.5%) cases and female 33 (48.5%) cases. Most of affected cases were unvaccinated for measles 58 cases (85.3%), history of contact in the family was observed in 33 cases (48.5 %) while10 cases (14.7%) has contact history in the pediatric hospital and 25 cases (36.8%) didn’t show any clear contact history. The most common complications were diarrhea 45 cases (66.2%), pneumonia and vomiting 36 cases (52.9%) for each and febrile convulsions 5 cases (7.4%) and encephalitis 2 cases (2.9%). Conclusions: Children who were infected and developed complications were less than two years of age , most of them were not vaccinated and they were from rural areas.

Keywords

Measles --- Vaccination


Article
Estimation of Interleukin-8 Level in Diarrheic Children Infected with Rotavirus
تقدير مستوى الانترلوكين -8 لدى الأطفال المصابين بالإسهال المصابون بفيروس الروتا

Authors: Rukia M. Al-Barzinji
Pages: 28-34
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Abstract

Background and Objective: Rotavirus is the most important cause of severe diarrhea in children worldwide. We have investigated that certain cytokines especially interleukin- 8 (IL-8) as a chemokine, may play an important role in the pathogenesis of and the protection against rotavirus disease in children. The purpose of this study was to reveal the association between IL-8 and child diarrhea with rotavirus. Methods: Stool samples were collected from 150 children under 5 years of age who developed diarrhea and 45 from non-diarrheic children of equivalent age. All samples were detected for rotavirus and serum IL-8 level. The study was undertaken from May to December of 2006. Enzyme linked immunosorbant assay (ELISA) was applied for detection rotavirus and IL-8. Results: Among the children, female patients with breast feeding were less infected with rotavirus compared to males with artificial and mixed feeding. The IL-8 concentration was highly significantly between the study groups (P< 0.01). Regarding the gender, serum IL-8 level was significantly higher in males than females (P<0.05). However, no significance prevalence in IL-8 level was recorded between gender in healthy control group (P>0.05). Conclusions: Rotavirus infection induces the expression of chemokines as IL-8. These data support the hypothesis that chemokine secretion may play a role in the initiation and modulation of the immune response to rotavirus infection.

Keywords

Rotavirus --- Diarrhea --- Children


Article
Retrospective Comparison of Weight Gain between Olanzapine- and Risperidone-Treated Patients
مقارنة بأثر رجعي لزيادة الوزن بين المرضى الذين عولجوا أولانزابين وريسبيريدون

Authors: Twana Abdulrahman Rahim
Pages: 35-41
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Abstract

Background and Objectives: Weight gain as a side effect of the second generation antipsychotics have been increasingly noted during therapy; however no studies addressed such a valid clinical concern in Iraq till now. The objective of this study was to determine the weight changes among patients treated with either Olanzap-ine or Risperidone. Methods: A retrospective study was performed by reviewing the charts of 80 patients who have been treated with Olanzapine monotherapy (60 patients) or Risperidone monotherapy (20 patients) through the period of April 2008 to April 2009, compar-ing the baseline weight in kilograms with after one month of therapy weight. Results: Among the 60 patients treated with Olanzapine, 42 (70%) gained weight, 70.37% of males and 69.69% of females treated with Olanzapine gained weight. Among the 20 patients treated with Risperidone, 12 (60%) gained weight, 50% of males and 75% of females treated with Risperidone gained weight. Those treated with Olanzapine, gained 3.96 kg after 30 days of treatment, while the amount of gain was 2.25 kg among those treated with Risperidone after the same period. Olanzapine-treated group gained about 6.21% of their baseline weight which was significantly higher than that of Risperidone-treated group who gained about 2.89% of their baseline weight (P value of 0.03). Females gained more amount of weight than males in both group. Conclusions: Both second generation antipsychotics, Olanzapine and Risperidone, are associated with weight gain. However, Olanzapine appears to have a greater potential in inducing weight gain. Both genders affected nearly equally, though females were victims of more amount of weight gain.


Article
The effect of treating generalized anxiety disorder on psychoactive substance abuse and dependency in Erbil city
تأثير علاج اضطراب القلق العام على تعاطي المخدرات النفسي والاعتماد عليها في مدينة أربيل

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Abstract

Background & objectives: Generalized anxiety disorder is a common psychiatric disorder; it may act as a risk factor for psychoactive substance abuse and dependency development. The objectives are to assess the degree of abuse and dependency in generalized anxiety disorder patients, and the effect of treating the disorder on substances abuse and dependency. Methods: 120 patients with generalized anxiety disorder, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), were studied from January 2007 to June 2008 for the presence of psychoactive substance abuse and dependency according to DSM-IV. All cases were managed for six months by the tricyclic antidepressant imipramine (35-75mg/day), with counseling to decrease anxiety by reassurance and anxiety management including relaxation training, in addition to supporting and encouraging the patients with abuse to stop the used psychoactive substances by a tapering schedule over weeks. Results: Substance abuse were presents in 32.5% of patients (tobacco 17.5%, benzodiazepines 13.3%, and alcohol 1.7%), this rate decreased to 13.3% (tobacco 11.7%, benzodiazepines 0.8%, and alcohol 0.8%) six months after starting treatment. The decrease in benzodiazepines abuse and dependency was greater than that in tobacco or alcohol. Conclusion: Generalized anxiety disorder appears to encourage abuse on psychoactive substances. Treating the disorder decreases abuse and using imipramine appears to have a good therapeutic effect on generalized anxiety disorder with low risk for abuse.


Article
Applications of Geographical Information System (GIS) in Planning of Health Services in Erbil City, Kurdistan Region
تطبيقات نظام المعلومات الجغرافية (GIS) في تخطيط الخدمات الصحية في مدينة أربيل، إقليم كوردستان

Authors: Sherzad Ali Ismail --- Yousif Jafar Khidr
Pages: 47-54
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Background and objectives: Geographic Information System (GIS) is a system for solving complex planning and management problems. GIS provides an excellent means of visualizing and spatial analyzing health data. The aim of this study was to highlight the valuable uses of GIS in planning of health services in Erbil city. Methods; This is a cross-sectional study, conducted in Erbil city during the period between (1/2/2009-1/5/2009). Data on number of health centers and hospitals, health manpower and health services of 2008 were collected & analyzed spatially and presented in appropriate maps, figures and tables. Health services data was linked to the population data for computing health indicators like doctor- population ratio and nurse -population ratio. Bed occupancy rate (BOR) and average patients stay for all hospitals of year 2008 is calculated and analyzed spatially. Results: Total number of health centers(HCs) which provide all types of health services to the community were (15), (12) of them have one or more of these health services. There are (13) quarters without health centers. Most of physicians (80.6%) & assistant physicians (Medical assistants) (79%) are working in hospitals, while only (19.4%) of physicians & (21%) of medical assistant are working in HC. The highest number of doctor-population ratio was in (Shahid Najdee Haidar) HC (14588) while the lowest was in (Mala Afandi) HC (1635). Maximum bed occupancy rate was in (Hawler teaching) hospital (66.7%), while the minimum was in (Amal) Hospital (11%). Conclusions: GIS is a promising tool for evaluating health facility distribution and planning of equitable distribution health services in Erbil city.


Article
Clinical Presentation and Follow-up of Eighteen Patients with Thrombotic Thrombocytopenic Purpura
عرض سريري ومتابعة ثمانية عشر مريضا يعانون من فرفرية نقص الصفيحات الخثاري

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Background and Objectives: Major advances achieved during the past 30years in under-standing the pathophysiology of Thrombotic Thrombocytopenic Purpura (TTP). More recently treatment outcomes were revolutionized by the introduction of plasma exchange. In this study a descriptive analysis of clinical presentation and treatment outcomes with a modified Plasma Exchangee protocol (PE) is presented. Methods: During the period from November 2004 to July 2006, eighteen patients with acute episode of TTP were enrolled. After clinical and Laboratory evaluation, patients were assigned to receive modified “low volume plasma exchange “, and their response was monitored for a mean of 64 weeks. Results: The classical Pentad of TTP was only documented in 27% cases. Of patients enrolled, one died before starting PE, while of the remaining 17 put on PE Complete remission (CR) was achieved in 70% with a mean follow up of 64 weeks. Four patients died during the first few days of starting PE. Of patients who achieved CR none had a relapse. Conclusions: The classical “pentad” of TTP is present in small proportion of patients at presentation. Our results with the modified “low volume exchange ” may suggest that even small volume of plasma exchange can be life saving .


Article
Prevalence of Osteoarthritis of Weight Bearing Joints in Relation to Body Weight in Both Genders
انتشار هشاشة العظام من المفاصل الحاملة للوزن فيما يتعلق بوزن الجسم في كلا الجنسين

Authors: Niaz J. AL-Barzinjy
Pages: 61-66
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Background and Objective: Obesity is an important and increasing public health problem, being a risk factor for overall mortality and major chronic disease. To determine relationship between different measures of body mass index and incidence of hip and knee osteoarthritis in male and female. Methods: Comparison of prevalence of primary osteoarthritis of knee and hip. Between age and sex matched control from out patient clinic of Erbil and Rizgary teaching hospital over period of eleven months starting on Jan 2007.this constituted one hundred and eighty five subjects of normal body `mass index. And one hundred and sixty subjects with high body mass index. Subjects fulfilling our inclusion criteria under went clinical evaluation and radiology of their knee and hip joints, we assessed by chi-squared test, differences in frequency of osteoarthritis between those with normal body mass index and those with high body mass index and between male and female. Results: Obesity was a stronger predictor of osteoarthritis of knee joint with no sex and age difference. In the prevalence of osteoarthritis of hip joint. No link between obesity and hip osteoarthritis was found in this study.

Keywords

Obesity --- Osteoarthritis


Article
Pattern of mandibular third molar impaction in patients attended the Hawler College of Dentistry: a retrospective radiographic study
نمط الانحشار المولي الفك السفلي لدى المرضى الذين حضروا كلية هولير لطب الأسنان: دراسة إشعاعية بأثر رجعي

Authors: Omed I. Shihab --- Katayon N. Kurchid
Pages: 67-70
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Back grounds and objectives: The aim of this study was to assess radiographically the angulations and depth of impacted mandibular third molars. Method: In a retrospective study 163 impacted mandibular third molars of 100 patients were examined on orthopantomograms (OPT) in the College of Dentistry/ Hawler Medical University during 2008. From these orthopantomograms the angulations (mesioangular, distoangular, vertical, and horizontal) and the depth (types A, B, and C) of the impacted mandibular third molars were recorded. The frequencies of unilateral and bilateral impaction were also recorded. Results: The average age of the patients was 26.5 + 5 ranging from 20-40 years with a median of 25 years. Fifty eight (58%) of the cases were female and 42 (42%) were male. The frequency of mesioangular, distoangular, vertical and horizontal impactions were 73 (44.8%), 37 (22.6%), 28 (17.2%), and 25(15.4%) successively. The depths of the impactions were 45 (27.6%) depth A, 74 (45.4%) depth B, and 44 (27%) depth C.The frequency of unilateral impaction was 26 (26%) and that of bilateral impaction was 74 (74%). Conclusion: Impacted mandibular third molars are more common in female. Mesioangular impaction is more common followed by distoangular. Depth B most common and most of the patients have bilateral impaction.


Article
In vitro antimicrobial activity of Miswak extracts against some oral pathogenic isolates
في النشاط المضاد للميكروبات في المستخلصات المسواك ضد بعض العزلات المسببة للأمراض عن طريق الفم

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Background and objectives: Siwak, Miswak, or Arak (Salvadora persica ) belongs to Salvadoraceae and is considered as the most widely used twigs since early times by Babylonians some 7000 years ago, it was later used throughout the Greek and Roman empires, and has also been used by ancient Egyptians and Muslims. The aim of this study was to determine the antibacterial activities of different extracts of Siwak on the growth of different oral isolates of Streptococcus mutans, Staphylococcus aerus and Candida albicans. Method: Experiments were conducted in the laboratories of the College of Science, University of Salahaddin and College of Dentistry, Hawler Medical University for a period from Jun. 2008 to Feb. 2009, to determine the effects of different Siwak (Salvadora persica) extracts at concentrations of 500, 1000, 5000 and 10000 µg/ ml on the growth of different oral isolates of Streptococcus mutans, Staphylococcus aureus, and Candida albicans. Results: The results showed that all Siwak extracts (especially Siwak aqueous extract) were effective against Streptococcus mutans. and Staphylococcus aureus. The strongest antibacterial activity was observed using the concentrations of 10000 µg/ ml. While Siwak extracts were ineffective against Candida albicans. Conclusion: Siwak extracts had significant antibacterial effect against Streptococcus mutans. and Staphylococcus aureus, and ineffective against Candida albicans.


Article
A new insight in the role of serum albumin and albumin binding capacity for cobalt and copper in ischemic heart disease
رؤية جديدة لدور قدرة الزلال في المصل والزلال في مصل الكوبالت والنحاس في أمراض القلب الإقفارية

Authors: Sanaa G. Hama AL- Mandalawi
Pages: 79-84
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Background and Objectives: In the presence of ischemia, albumin, undergoes changes resulting in the formation of ischemia modified albumin .Increased serum concentration of ischemia modified albumin that was measured by albumin cobalt binding assay have been found in patients with myocardial ischemia. The purpose of this study was to investigate the relationship between serum albumin concentration and ischemia modified albumin concentration. Methods: Eighteen patients with stable angina and fifteen who didn’t have any evidence of coronary artery disease , were taken as control subjects, both groups underwent treadimall exercise stress test ,about 15 minuets after treadimall test blood samples were drawn from all the subjects, brought to laboratory to measure the serum ischemia modified albumin concentration and serum albumin concentration. Results: The study showed a significant difference in ischemia modified albumin between study groups, while no significant difference in serum albumin between both groups. There is a largest Receiver Operating Characteristics(ROC) area for ratio of serum albumin cobalt binding to serum albumin than serum albumin cobalt binding capacity alone.There is a weak positive linear correlation for both cupper and cobalt binding capacity among control subject ,where there is a weak negative linear correlation for both markers among cases with ischemic heart disease (IHD). Conclusion: The quantification of the role of serum albumin in combination with albumin cobalt binding capacity is expected to differentiate between ischemic heart disease patient and normal subject to larger extent.


Article
Epidemio-clinical study of Herpes Zoster in Erbil City
دراسة وبائية سريرية لمرض الهربس في مدينة أربيل

Authors: Khalis Bilal Mohammed Ali
Pages: 85-90
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Background and objectives: Herpes zoster is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. This study highlightes the epidemiological and clinical pattern of the disease in Erbil city. Methods: A descriptive study conducted on patients with herpes zoster throughout July 2004 to July 2008, a specially designed questionnaire was prepared for this purpose obtaining age, sex, dermatome distribution, the presenting symptoms and date of infection. Results: Out of 525 patients, 323 (61.5%) were male and 202 (38.5%) were female, with male to female ratio 1.59:1. The age of the patients ranged from 3-85 years, with (Mean ± SD = 43.12 ± 20.16). The highest percentage was among 40-49 years of age (17.14%), the frequency was increasing with progress of age, both sides of the body were affected equally, thoracic dermatomes (41.14%) were more affected than the other dermatomes. The pain was the commonest prodromal and presenting symptom, and the vesicles were the commonest type of skin lesions. No seasonal variation was noticed in the frequency of the disease. Conclusion: The study concluded that epidemiological and clinical pattern of the disease in Erbil city is more or less similar to that found in other populations.

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