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Article
Maternal and Neonatal Outcomes in Diabetic and Non-Diabetic Women with Macrosomic Births
تضخم الجسم عند حدیثي الولادة:حصیلة الأم وحدیث الولادة في أمھات مصابات بالسكر وغیر مصابات بالسكر

Author: Tala Anwar Al-Awqati
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 1 Pages: 15-18
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Macrosomia is generally defined as birth weight of least 4000 g. Macrosomia increases the frequency of obstetric complications such as shoulder dystocia, perineal laceration or cesarean section and the risk of brachial plexus palsy, asphyxia and cerebral hemorrhage in newborn. Objective: The aim of this retrospective study is to examine the maternal and neonatal outcomes of macrosomic babies at Al -Yarmok Teaching Hospital, and to compare the outcomes in infants of diabetic and non-diabetic mothersPatients and methods: At Al-Yarmouk Teaching Hospital, gynecology and obstetric department, in cooperation with special care baby unit (SCBU) a retrospective analysis was conducted in a one-year period (from November 2009 to November 2010). The study group was all live born, singleton neonates with a birth weight of equal or more than 4000 g. The information was taken from the medical records of the mother and the infant The data analysis was performed with Medcalc statistical software. Statistical significance was set at p<0.05. The outcomes were compared between the diabetic and non-diabetic groups using Fisher exact test.Results: During the study period, there were 8254 deliveries. Macrosomic infants were 165, representing 2%. The mean birth weight (standard deviation) of all macrosomic infants was 4363g (325g.) Of the165 macrosomic infants, 112(67.9%) born to non-diabetic mothers, while 53(32.1%) born to diabetic mothers. Seventy two infants of the total group (43.6%) were above 4500g, fifty three of them in the non-diabetic mothers(47.3% of the this group) . The diabetic mothers were significantly older than non- diabetic mothers (p<0.03). The mean gestational age at delivery(standard deviation) were 39.58weeks(SD0.87), 39.58weeks(SD 1.11) in the non-diabetic and diabetic mothers respectively, however, the difference was statistically not significant (p>0.58).Seventy percent of the non-diabetic group delivered by caesarean section, and 80% of the diabetic group delivered by caesarean section (p>0.14). After vaginal deliveries, there were four cases of vaginal tear, all of them seen in the non-diabetic mothers. Episiotomy was significantly higher in non-diabetic group (p=0.028). Hypoglycemia was significantly higher in the non-diabetic mothers (p=0.02), while the duration of hospitalization more than three days was significantly higher in the infant of diabetic mothers (p=0.05). Respiratory distress was seen in about quarter of the infants of diabetic mothers, in spite of 15% only of non-diabetic mothers had this complication, but this difference was not significant when evaluated by t-test(p=0.19). Birth trauma including shoulder dystocia, Bells palsy and fracture clavicle were seen in 4 infants, 2 in each group. The heavier infants were delivered by caesarean section more than those below4500g. Conclusion: Macrosomic infants represent a risk group for adverse neonatal outcome and maternal morbidities, regardless the diabetic status of the mother. In studied group, the hypoglycemia was higher in the infant of non-diabetic mothers than those of diabetic mothers. Our macrosomic infants tend to be heavier than what found in the literatures.

الخلاصة: تضخم الجسم یعرف بأنه الوزن الولادي أكثر من ٤٠٠٠ غ ا رم. وهذا یؤدي الى زیادة التعقیداتالولادیة أمثال تعسر ولادة الكتف، تمزق المنطقة العجانیة، زیادة نسبة العملیات القیصریة ونسبةشلل الظفیرة الخیشومیة، الاختناق والنزف داخل الدماغ.الهدف من الد ا رسة: الد ا رسة الاسترجاعیة هدفها هو فحص حصیلة الأم وحدیث الولادة بعد ولادة طفلضخم الجسم في مستشفى الیرموك التعلیمي ومقارنة حدیثي الولادة في أمهات مصابات بالسكروأمهات غیر مصابات بالسكر.الطریقة:- في مستشفى الیرموك التعلیمي وبالتعاون بین قسم النسائیة والتولید مع قسم رعایة حدیثيالولادة، قمنا بد ا رسة استرجاعیة خلال سنة حیث تم الرجوع إلى سجلات المرضى الذین هم أكثرمن ٤٠٠٠ غ ا رم كوزن ولادي وتم تحلیل النماذج باستعمال ب رنامج مدكالك وتم استعمال فحصفشر.النتائج : - خلال فترة الد ا رسة كان هنالك ٨٢٤٥ ولادة، منهم ١٦٥ حدیث ولادة ذات حجم متضخم٦٧.٩ %) ولدوا من أم غیر مصابة ) ٣٢٥ غ ا رم، ١١٢ ± ویمثلون ٢% معدل الوزن كان ٤٣٦٣٣٢ %) ولدوا من ام مصابة بالسكر، كان معدل عمر الأمهات المصابات ) بالسكر، بینما ٥٣بالسكر أعلى من الغیر مصابات بالسكري. ٦٨ % من الأمهات الغیر مصابات بالسكر تمتالولادة عن طریق عملیة قیصیریة في حین كانت هذة النسبة ٧٩.٣ % في الأمهات المصاباتبالسكري. كانت هنالك أربع حالات تمزق عجانیة. نسبة هبوط السكر كانت أعلى في المجموعةغیر المصابة بالسكر وبدرجة ذات قیمة إحصائیة. حالات الإصابة المیكانیكیة وتشمل تعسر ولادةالكتف،شلل الظفیرة الخیشومیة، شلل العصب السابع المؤقت وكسر عظم الترقوة كانت موجودة فيأربعة حالات اثنان في كل مجموعة.الاستنتاج :- حدیثو الولادة المصابون بتضخم الجسم یمثلون مجموعة قابلة لنتائج خطیرة من حیث الأموالرضیع وبغض النظر كون الأم مصابة بالسكر أو غیر مصابة.


Article
Evaluation of Risk Factors For Acute Periprosthetic Infection Post Total Knee Replacement Iraqi Patients

Authors: Mahmood Shihab --- Hazim A. Aljumily --- Belal Salman --- Anmar Hamid
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 549-555
Publisher: Babylon University جامعة بابل

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Abstract

Periprosthetic joint infection (PJI) is one of the most challenging complications after total joint arthroplasty,with an incidence of 1% to 4% after primary TKA. This complication poses challenges on many aspects, one ofwhich is the difficulty in reaching a diagnosis.Although variation exists, the majority of them rely on the results of joint aspiration or deep tissue culture;serologic tests, namely erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); and theappearance of the joint during surgery (with regard to presence of purulence); presence or absenceof a sinus tract; and the result of histologic analysis of tissue obtained during surgery (frozen section).Taken together, these findings suggest incorporating synovial WBC and PMN% results into a set of diagnosticcriteria may improve the strength of those criteria for diagnosing PJI.The Objective is To evaluate the risk factors for peri-prosthetic infection post total knee replacement for Iraqipatients.This prospective study consists of 264 patients (51 males and 213 females) ages ranged from 49-75 years(mean 62 years) had been performed unilateral primary total knee replacement between January 2012 toSeptember 2013 in the Nursing Home Hospital arthroplasty Department, in Baghdad, that are divided into threegroups according to the primary pathology, Group I are 207 patients had primary osteoarthritis, GroupII are 42 patients had rheumatoid arthritis, and Group III are 15 post-traumatic arthritis.264 patients with 51 (19.3 %) males and 213 (80.6 %) females’ patients had primary OA 207 case (74.8%),Rheumatoid arthritis 42 case (15.9%) and posttraumatic 15 cases (5.6%). These patients were allocated into 3groups according to their primary pathology:In Group I, 182 patients (non-diabetic), 4 patients had deep infection, whereas 3 of 25 diabetic patients developeddeep infection. In Group II, 34 non diabetic patients, and 8 diabetic patients one and 2 patients had deep infectionrespectively. Group III, 12 non-diabetic and 3 diabetic patients had one patient each with documented deep woundinfection. As a total number of documented acute deep infections during 6 weeks of TKR is 12 cases (4.5%).We conclude that: Diabetic patients are more risk in early postoperative infection than non-diabetic patients.Rheumatoid arthritis adds more incidence of infection to diabetic patients in the TKR. posttraumatic arthritispatients considered as a risk for early postoperative deep infection.


Article
Microalbuminuria, Cardiovascular Morbidity, and Mortality in Diabetic and Non–Diabetic Subjects in Kirkuk City

Author: Aseel Sharaf Abdulla
Journal: Diyala Journal For Pure Science مجلة ديالى للعلوم الصرفة ISSN: 83732222 25189255 Year: 2010 Volume: 6 Issue: 3 Pages: 113-125
Publisher: Diyala University جامعة ديالى

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Abstract

Ischemic heart disease (IHD) which, leading cause of death in industrialized nations. Traditional risk factors for (IHD) such as hypertension, smoking, diabetes, and hyperlipidemia may not be able to predict cardiovascular events accurately in male and female. Early detection and prevention of (IHD), especially among the elderly, remains a major public health issue. The aim of this study was estimate the frequency of microalbuminuria in patients with and without diabetes mellitus (DM), answering the question: 'How relevant for general practice are epidemiological findings that microalbuminuria is a significant risk indicator for the development of cardiovascular syndromes?' and analyze prospectively whether the urinary albumin to creatinine (A/C) ratio can indepenendently predicts ischemia heart disease (IHD) in a population suffering from diabetes mellitus (DM) in Kirkuk city. The study group conducted on (120) patients with (IHD) and (DM) their age ranging between (20-79) years and (100) aged matched health control subjects .The males consisted (52.27%) of the total patients, while females (47.73%). They characterized by sex, age, body mass index (BMI), blood pressure (Bp), fasting blood glucose (FBG), serum albumin and creatinine.An interaction between microalbuminuria and IHD with DM was observed, and presence of microalbuminuria more than doubled predictive effect of the conventional atherosclerotic risk factor for development of IHD. Urinary albumin/creatinine ratio is recommended for microalbuminuria assessment, because it reflects urinary albumin excretion. Muscular mass could affect albumin/creatinine ratio, because urinary creatinine reflects muscular mass. Prevalence showed significant higher in the normal male than female individuals and this attributed to the difference in the lean muscle mass between the two sex and more fragrantly in (BMI) of (24-26) Kg/m2 in male groups than females. The relationship of obesity on microalbuminuria and (IHD) was statistically significant the (P) values was found to be (<0.05) in the both sexes.The prevalence of the patient groups suffering from previous signs of ( IHD) with type (I) diabetes mellitus in the nonhigh (uACR) groups were (23.3%), high (uACR) without microalbuminuria groups were (30%) and high (uACR) with microalbuminuria groups were (46.7%) while in the groups with patient suffering from previous signs of ( IHD) with type (II) diabetes mellitus were (20%),(32.2%) and (47.7%) respectively. The excess of the patient groups suffering from previous signs of (IHD) with type (II) diabetes mellitus prevalence in the high (uACR) groups reflected the combination of dissimilar data between the subgroups with and without microalbuminuria .In comparison to the nonhigh (uACR), the patient groups suffering from previous signs of (IHD) with type (II) diabetes mellitus prevalence was significantly increased (P<0.05) in the high (uACR) subgroup with microalbuminuria but not in the high (uACR) subgroup without microalbuminuria


Article
Insulin resistance and hyperinsulinemia in non-diabetic non-obese benign prostatic hyperplasia patients
مقاومة الانسولين وفرط في غير مرضى السكري غير البدناء حميدة مرضى تضخم البروستاتا

Authors: Nehad Nejris Helal --- Mohammed Mohsin Abdul-Aziz
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2008 Volume: 2 Issue: 142 Pages: 138-142
Publisher: Tikrit University جامعة تكريت

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Abstract

Benign Prostatic Hyperplasia (PBH) is the most common benign tumor in men, and its incidence is age related. Despite intense research efforts in the past five decades to elucidate the underlying etiology of prostatic growth in older men, cause and effect relationships have not been established. Insulin is a growth-stimulating hormone. Previous studies have reported the association between hyperinsulinemia and BPH in patients with metabolic disorders like diabetes. To assess insulin level and insulin resistance in non-diabetic non-obese BPH cases and correlated them with prostate size. 35 symptomatic BPH cases and 30 controls were included in this study. Fasting serum insulin concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Insulin resistance was assessed by homeostatic model assessment (HOMA). Fasting glucose was quantified by glucose oxidase method. PSA was calculated by ELISA. Prostatic size was measured by ultrasonography. Fasting serum insulin and HOMA were significantly higher in BPH cases as compared to controls (P value < 0.01 and < 0.001 respectively). Hyperinsulinemia and accompanying insulin resistance were found to be risk factors of increased prostatic size, (P value < 0.00

تضخم البروستاتا الحميد (PBH) هو الورم الأكثر شيوعا حميدة في الرجال، ونسبة حدوثه هو سن ذات الصلة. على الرغم من الجهود البحثية المكثفة في العقود الخمسة الماضية لإلقاء الضوء على المسببات الكامنة وراء نمو البروستاتا في الرجال الأكبر سنا، ولم السبب والنتيجة العلاقات الثابتة. الأنسولين هو هرمون النمو ومحفزة. وذكرت دراسات سابقة العلاقة بين فرط وBPH في المرضى الذين يعانون من اضطرابات التمثيل الغذائي مثل مرض السكري. لتقييم مستوى الأنسولين ومقاومة الأنسولين في غير حالات السكري غير البدناء BPH وترتبط بها مع حجم البروستات. وأدرجت 35 بأعراض BPH الحالات والضوابط 30 في هذه الدراسة. وتم قياس الصوم الأنسولين تركيزات مصل الدم بواسطة انزيم مرتبط المناعي فحص (ELISA). وجرى تقييم مقاومة الانسولين بواسطة تقييم نموذج التماثل الساكن (HOMA). وكان كميا السكر الصائم بواسطة طريقة أوكسيديز الجلوكوز. تم حساب دعم البرامج والإدارة بواسطة ELISA. وقد تم قياس حجم البروستاتا بواسطة الموجات فوق الصوتية. وكانت الانسولين في الدم الصيام وهار أعلى بكثير في حالات تضخم البروستاتا مقارنة مع الضوابط (P قيمة <0.01 و 0.001 <على التوالي). تم العثور على فرط والمرافق مقاومة الانسولين لتكون عوامل الخطر من حجم البروستاتا زيادة، (P قيمة <0.00


Article
Laboratory detection tests of subclinical renal involvement in non diabetic smokers
اختبارات الكشف عن مختبر لمشاركة الكلوي دون السريري لدى المدخنين غير السكري

Authors: Jamal M. Hamed بسام عيسى، لمى محمد، جمال محمد --- Luma M. Tuhala --- Bassam E. Hanna
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2009 Volume: 2 Issue: 152 Pages: 87-94
Publisher: Tikrit University جامعة تكريت

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Abstract

The Study was conducted during the period from March-June 2008 in Mosul city as a case-control study included 60 apparently healthy non-smoker male volunteers as a control group and 60 apparently healthy non diabetic cigarette smoker male volunteers, measuring of serum creatinine and urine Protein/Creatinine (P/C) ratio were done in both groups. Results showed significant elevation (P<0.05) of spot urine P/C ratio in smokers with significant positive correlation with smoking status and no significant differences in age and serum creatinine between two groups, therefore , urine P/C ratio is superior in early detection of subclinical irreversible renal involvement in smokers and it is advisable to introduce it routinely

وقد أجريت هذه الدراسة خلال الفترة من مارس ويونيو 2008 في مدينة الموصل ودراسة الحالات والشواهد وشملت 60 اصحاء غير مدخن متطوعا كمجموعة مراقبة و 60 متطوعا اصحاء سيجارة المدخن السكري غير الذكور، وقياس الكرياتينين و تم القيام به البول البروتين / الكرياتينين (P / C) نسبة في كل من المجموعتين. أظهرت النتائج ارتفاع معنوي (P <0.05) من نسبة بقعة P / C البول لدى المدخنين مع ارتباط إيجابي كبير مع حالة التدخين، وعدم وجود فروق كبيرة في السن وكرياتينين المصل بين مجموعتين، وبالتالي، البول P / C نسبة متفوقة في الكشف المبكر من تورط تحت الإكلينيكي كلوي لا رجعة فيها في المدخنين ويستحسن أن ندخله بشكل روتيني

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