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Article
UNUSUAL PRESENTATION OF A COMMON DISEASE

Authors: Mazin A Abdullah --- Noori H Jasim --- Furat Shani
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2006 Volume: 12 Issue: 2 Pages: 100-105
Publisher: Basrah University جامعة البصرة

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Abstract

UNUSUAL PRESENTATION OF A COMMON DISEASEMazin A Abdullah*, Noori H Jasim#, Furat Shani@*CABS, Lecturer, Dept of Surgery, College of Medicine, University of Basrah. #FICMS, Lecturer, Dept of Surgery, College of Medicine, University of Basrah, @CABS, Lecturer, Dept of Surgery, College of Medicine, University of BasrahAbstractThis study aimed to describe the clinical features of acute rupture of hydatid cyst in the peritoneum. We retrospectively studied 7 patients who underwent explorative laparotomy between January 2002 and October 2005, and in whom exploration confirmed the rupture of hydatid cyst in the peritoneum. Rupture was secondary to trauma in 2 patients, and occurred spontaneously in 5 patients.All patients presented with acute peritonitis, and anaphylactic shock developed in 4 patients. One patient died postoperatively. Ultrasonogrophic diagnosis was made in 3 patients. Surgical treatment consisted of the treatment of peritonitis, the ruptured hydatid cyst and evacuation of the free intraperitoneal hydatid fluid. All patients kept on albendazole. Acute rupture of hydatid cyst in the peritoneum should be considered when evaluating acute abdomen in endemic areas.

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Article
EVALUATION OF THE ESTROGEN AND PROGESTRON RECPTORS IN FEMALE BREAST CANCER IN RESPECT TO AGE, GRADE AND STAGE

Authors: Noori H Jasim --- Mazin Al-Hawaz --- Thaer Jasim Chasib
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2013 Volume: 19 Issue: 2 Pages: 9-18
Publisher: Basrah University جامعة البصرة

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Abstract

Thaer Jasim Chasib*, Mazin Al-Hawaz@ & Noori H Jasim#*MBChB Arab Board Candidate, Basrah General Hospital. @MBChB, CABS, FRCS. #MBChB, FICMS, PhD, Department of Surgery, College of Medicine, Basrah, IRAQ.Abstract Breast Cancer is a disease characterized by its tremendous heterogenicity in its course and treatment that demand the physicians and patients. It is the commonest type of malignancy among Iraqi women. Hormone receptors study in breast cancer is mandatory because it determine the prognosis and the course of treatment and has a wide acceptance in the management of breast cancer. this study aimed to evaluate the relation of estrogen and progesterone receptors positive (+ve) or negative (–ve) in respect to the age, grade and stage. A sixty seven female patients diagnosed as a breast cancer were undergone a surgery in term of mastectomy and axillary dissection and specimens were sent to a histopathology and receptor detection studies. All specimens were processed by same procedure of tissue preparations which include formalin fixation, paraffin embedded, receptor detection methods (Immuno-histochemistry and enzyme immuno assay studies). Most of affected cases in this study are equal or less than 47 years (37 cases representing 55.22%. Mean age group in this study was 47 year. The tumor mainly in Grade II (42 cases 62.68%) and mainly in stage IIA and IIIA (20 cases 29.86% for each one). Estrogen (ER) receptor expression represents higher positivity (49 cases 73.13%), while for progesterone (PR) receptor expression (45 cases 67.16%) representing more than two third of cases. The ER, PR expression in relation to the age was statistically significant (P value is 0.01). While, the ER and PR receptor expression in relation to the grade and stage was not significant (P values are 0.8, 0.5 respectively). In conclusion, breast cancer is a disease of early age group with moderately advanced stage and grade and about two thirds of patients have a positive estrogen and progesterone receptor expression which was more in older than in younger patients.


Article
EARLY DIAGNOSIS AND PROMPT SURGICAL EXCISION WITH COMPLETE DIVERTING COLOSTOMY: IMPROVE THE OUTCOME IN PATIENTS WITH FOURNIER’S GANGRENE.

Authors: Jasim D Saud --- Noori H Jasim --- Majid A Mohammed
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2006 Volume: 12 Issue: 1 Pages: 82-86
Publisher: Basrah University جامعة البصرة

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Abstract

Fournier’s gangrene is uncommon acute fulminating cellulitis of scrotum, perineum and groin which develops suddenly and often without any apparent causes. The aim of this study is to elucidate the effectiveness of early and extensive surgical excision with primarily performed complete diverting colostomy in outcome of patients. Fourteen patients with Fournier’s gangrene were included from January 2000 to October 2005 at Basrah General Hospital. History and examination has been taken. Treatment was in form of giving triple antibiotics. Early wide extensive excision of necrotic skin with complete diverting colostomy at the same occasion has been done in all patients. There were all male patients, their ages ranged between 4-75 years old, the average is 50 years. Determining the possible underlying cause finding that five patients has no obvious cause , three had perianal abscesses , determining the extent of disease , finding that in ten patients sloughing of tissue involved perineum , scrotum plus groin and or penis mortality were two out of fourteen patients ( 14%). Fournier’s gangrene is a rapidly progressive, fulminate infection. With institution of aggressive treatment, including early Surgical intervention, formation of completely diverting colostomy in first operation, haemo- dynamic support if needed, intensive care monitoring and broad spectrum antibiotic coverage, the disease has a greatly reduced mortality.


Article
THE VALUE OF SIGNS AND SYMPTOMS IN THE DIAGNOSIS OF SPERMATIC CORD TORSION

Authors: Noori H Jasim --- Adnan O Al Mayyahi --- Salah Aldeen M Al Hakee
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2015 Volume: 21 Issue: 2 Pages: 22-33
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract The aim of this study is to evaluate the most useful clinical signs and symptoms in the diagnosis of spermatic cord torsion, and so decreasing unnecessary surgical exploration and testicular loss rates for these patients. Between August 2013 and November 2014, patients with suspected spermatic cord torsion were included in this study; patient case sheets were prepared; history, examination, imaging, and post-operative results were recorded. The patients then divided into non-torsion and torsion groups, the torsion group further subdivided into salvaged and orchiectomy groups. Data evaluated and correlated with the result of the surgical exploration. Seventy-seven patients were included, 11 (15%) patients without torsion and 66 (85%) with torsion. Of the torsion group 35 (53%) were salvaged while orchiectomy done to the remaining 31 (47%). The patients' age ranged from 1 to 29 years with a mean of 16.22 years with standard deviation of 6 years, and they commonly presented during winter months, the salvageability rate decline with increase duration of symptoms especially after 24 hours. There were a significant difference (p<0.05) between torsion and non-torsion groups in the testis lay, testis orientation, cremasteric reflex, high riding testis, left side, and cord knotting. There were significant difference (p<0.05) between salvaged and orchiectomy groups in duration of symptom, onset of symptom, and in presence of scrotal edema.A univariate analysis showed that the pain was very sensitive but lacks specificity; the duration less than 6 hours, abnormal lay, absent cremasteric reflex, high riding testis, abnormal orientation, presence of cord knot, and presence of nausea and vomiting are highly specific.The multivariate analysis then repeated for combination of nausea and vomiting, high riding testis, abnormal lay, and absence of cremasteric reflex; showed 100% specificity if three and more of these four feature were present. In conclusion, careful history and physical examination can aid diagnosis of testicular torsion, no clinical signs and symptoms were highly specific and sensitive for torsion, and a constellation of clinical feature can aid the diagnosis.

Keywords

SPERMATIC CORD --- TORSION


Article
EVALUATION OF THE P53 GENE EXPRESSION IN BREAST CANCER IN RESPECT TO AGE, GRADE, STAGE AND LYMPH NODES

Authors: Haider Kahdim Abdul-Razaq --- Mazin H Alhawaz --- Noori H Jasim Al-Echrish
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2016 Volume: 22 Issue: 2 Pages: 17-25
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract It is previously reported that cancer prognosis is affected by mutations of P53 gene. However, the prognostic significance of P53 mutated gene detection in breast cancer is a subject demanding numerous investigations in a view of numerous facts such as presence of different tumor subtypes, P53 positivity in early breast cancer, different overall survival and disease free period as well as variability of tumor response to chemotherapeutic agents and presence of primary resistance of tumor among patients whether same or different grade and stage. Hence, it is of interest to detect this mutated gene in our area and evaluate its relation to other prognostic factors in terms of age, stage, histological grade and lymph node status. This study aimed to evaluate the relation of P53 mutated gene expression in female with breast cancer in respect to the other prognostic factors such as age, grade, stage and lymph node status. Fifty female patients diagnosed as a breast cancer, underwent clinical and pathological staging (I,IIA,IIB,IIIA,IIIB,IIIC, and IV), histopathological grading (I,II,III). All patients underwent same surgical operation which was modified radical mastectomy and axillary dissection. All specimens were sent to histopathological study and P53 mutated gene detection study by using immunohistochemistry (IHC). P53 mutated gene was detected by immunohistochemistry in 72% of patients with breast cancer. P53 positivity showed a statistically significant direct proportion to histological grade, stage and lymph node status. In addition, more P53 mutated gene expression was detected in younger patients (age group ≤49 years old) and this probably explaining more advance stage observed in this group in this study. All these data leads to a conclusion that the presence of mutated p53 gene is associated with worse prognosis. This study detected P53 mutated gene by IHC for the first time in our region and showed a statically significant association between status of P53 gene mutations and the other prognostic factors such as age, histological grade, stage and lymph node status and consequently to tumor aggressiveness and thereafter to prognosis.

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