Table of content

Iraqi Academic Scientific Journal

المجلة العراقية للاختصاصات الطبية

ISSN: 16088360
Publisher: The Iraqi Borad for Medical Specialization
Faculty:
Language: English

This journal is Open Access

About

publisher Every Three Months 2000

Loading...
Contact info

Mobil:07903960529
E-mail:IPMJ2000@yahoo.com

Table of content: 2008 volume:7 issue:1

Article
"Kohl" Use for Infants

Authors: Luay Abdulla Muhiddin AL-Nouri
Pages: 1-5
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Kohl is still being used for the eyes of infants. The habit is of concern to paediatritians because of the serious toxic effects. OBJECTIVES: 1.To determine how frequent kohl was being used for infants eyes, the reasons for its use and the method of application. 2. To estimate the blood and urine level of lead in infants, and in kohl samples from the local market. 3. To document kohl induced encephalopathy. METHODS: Mothers of 150 children under a year of age were interviewed and samples of 40 infants' blood and urine were analyzed for their lead content. RESULTS: Kohl was used for 47% of infants. Forty percent of town mothers and 57% of rural mothers were applying it to their infants eyes. Fifty percent of illiterate mothers and 33% of college graduates were applying it. The habit started in the neonatal period: 40% of which on the third day after birth. The reasons for the use were: cosmetic 54%, improving vision 41% and prevention of eye infection 4%. The mean blood and urine levels of lead were higher among kohl user, but it did not reach statistical significance. The lead contents of kohl samples varied from 0.4% to 54%. In two infants encephalitis was present, the most likely cause was kohl use. CONCLUSION: Kohl use is common during infancy. Its lead content could be high. I t was usually applied to the conjunctival side of the eyelid where a higher chance of absorption into the blood stream was expected. Kohl use for infants could lead to encephalopathy. Active means should be adopted to educate mothers about the hazards of kohl use for infants, and possibly banning the sales of lead containing kohl.

Keywords

Kohl --- lead --- encephalopathy.


Article
Some Anthropometric Measurements of Normal Full Term Neoborns at Birth

Authors: Kholod Dhaher Habib Alshemeri
Pages: 6-11
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: All health personnel working in child health care should be familiar with normal patterns of growth, so that they can recognize any deviations from the normal range and try to deal with the underlying disorders which could be nutritional, socio economic or infectious diseases. OBJECTIVES: I undertook this study to find some anthropometric measurements like length, weight and occipitofrontal circumference of normal healthy Iraqi neonates at birth which can be used in future to draw an Iraqi growth chart. METHODS: The Study carried out from 1st of May 2005 to30th of April 2006 at Fatema AL-Zahra Teaching Hospital. The study was performed on 1001 live born neonates with gestational age (37-42 week) were all born in Fatema AL-Zahra teaching hospital in Baghdad. Babies of mothers with risk factors (gestational hypertension, gestational diabetes mellitus, cigarette smoking and multiple gestation ,number of party more than 5,mother age less than 17 years, or more than 35 years, mother body weight less than 45kilogram(kg) or more than 90 kg, mother height less than 150 centimeter(cm)), premature, and malformed babies were all excluded. The study was performed by measuring the length, weight and (&) occipitofrontal circumference (OFC ) of these babies. RESULTS: The Results showed that the mean length at birth(male & female) was 50.888 (+/- 1.1004) cm ,(male ; female was51 cm(+/- 1.055) ; 50.72 cm (+/_0.953)). The mean OFC(male & female) was 34.678(+/- 1.189) cm ( male ;female ,34.719(+/- 1.1305) cm ; 34.621(+/-1.074)cm ) .The mean birth weight (male & female) was 3.291 (+/-0.346)kg (male ; female was 3.30(+/-0.356) kg ; 3.28(+/-0.336)kg ). CONCLUSION: The study concluded that the mean length at birth(male & female) was 50.888 (+/- 1.1004) , The mean OFC(male & female) was 34.678(+/-1.189) cm . .The mean birth weight (male & female) was 3.291(+/-0.346) kg.


Article
Chronic Renal Failure in Children Admitted to Children Welfare Teaching Hospital

Authors: Nariman Fahmi Ahmed
Pages: 12-17
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Chroic renal failure (CRF) is a devastating medical, psychological, social and economic problem for patients and their families. AIM OF THE STUDY: The aim of the present study was to determine the etiology, clinical presentations and highlight treatment modalities used for patients with CRF admitted to children welfare teaching hospital. PATIENTS' AND METHODS: A Retrospective study of all children with CRF admitted to children welfare teaching hospital during the period from 1stof jan.2002 to 1st of jan.2007 were included in the study .CRF was defined as having glomerular filtration rate less than 80m1 /min/1.73m2. RESULTS: The study group included 50 patients with CRF below 17 years of age,29(58%) males and 21(42%) females. Male: female ratio 1.38:1 Their age ranged between (1m -17 year).Twenty (40%) patients were above 10 years of age. In this study the mean glomerular Filtration rate was (29.5 + 18.5m1 /min/1.73m2). Congenital abnormalities were the major cause of CRF, it was found in 18 patients (36%), followed by hereditary conditions in 14 (28%) patients and glomerular diseases in 13 (26%) patients. The most common presenting symptom was anemia. It was found in 16(32%) patients followed by hypertension in 12 patients (24%) and failure to thrive in 12(24%) patients. Twenty-one patients (42%) received peritoneal dialysis, four (8%) received hemodialysis. Renal transplant was done to 3 patients (6%). CONCLUSION: Congenital abnormalities was to the most common cause of CRF in our patients. Establishing registry system that provide detailed information concerning the incidence, causes, and overall outcomes of mild to severe renal functional impairment acquired during developmental age can clarify further the natural history of the disease and the factors that influence its course.


Article
Prevalence of Fibromyalgia in Iraqi People with Joint Hypermobility Syndrome

Authors: Khudhir Zghayer Mayouf Al-Bidri
Pages: 18-21
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Joint hypermobility occur when large or small joints in the body are able to extend beyond their normal physiological limits. Fibromyalgia is characterized by chronic diffuse pain. Both conditions are shared with various soft tissue problems and this draw the attention of a lot of researchers and clinicians to look for possible relations between them. OBJECTIVE: To detect the correlation between firbomyalgia in Iraqi people with joint mobility. METHODS: One hundred Iraqi individuals with joint hypermobility syndrome according to the Beighton Score were studied and compared with another hundred normal mobile individuals matched for age and sex serving as control group. Full history was taken and complete clinical examination was done for all individuals in both groups. The American College of Rheumatology 1990 Criteria for fibromyalgia were applied for all individuals in both groups. They were quationed about presence of chronic widespread pain, sleep disturbance, mood change and fatigue. Detection of at least 11 of 18 tender points by digital palpation at specific soft tissue sites was needed for diagnosis of FMS. RESULTS: There was statistically significant increase frequency of fibromyalgia among individuals with hypermobile joints compared to normal mobile people. The frequency was 22% in the individuals with hypermobile joints versus 11% in the individuals with normal mobile joints, which was reported mainly in females between the age 30-59 years. CONCLUSION: The results showed significant relationship between fibromyalgia and joint mobility.


Article
The Role of Anticardiolipin and Anti-B2 Glycoprotein Antibodies in Clinical Complication of Lupus Nephritis

Authors: Nawar Abass Abud Noor
Pages: 22-25
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Although there was confliction regarding the association of raised anticardiolipin antibodies (ACL) level with renal disease in systemic lupus erythematosus (SLE), the role of B2glycoprotein as a cofactor for ACL binding is established.The presence of ACL &anti-B2GPІ may be directly involved in pathogenesis of antiphospholipid antibodies associated symptoms like recurrent fetal loss, thrombocytopenia and thrombosis. AIM OF STUDY: To study the possible association between some auto antibodies with the most common clinical complication of disease. PATIENTS AND METHODS: The study was conducted on 25 patients with lupus nephritis, attended the renal clinic in specialized surgical hospital/ medical city /Baghdad, 25 lupus patients without nephritis and 25 healthy controls. Enzyme linked immunsorbant assay was used for detection for ACL, anti-B2GP. RESULT: Although there was no significant difference in mean concentrations of ACL and anti- B2GP between lupus nephritis and without nephritis (P>0.05), lupus nephritis patients were more likely positive for ACL. Positivity of 100% For ACL & anti- B2GPwere detected in thrombotic complication, in fetal loss complication patients more likely to be positive for ACL (75%), anti- B2GP (50%), in thrombocytopenia positivity of ACL &anti-B2GP (75%). CONCLUSION: There was no association between anti-B2GP and renal disease and presence of both ACL &anti- B2GP carry higher risk for thrombosis and recurrent fetal loss.


Article
Left Ventricular Function in Early Stages of Ischemia

Authors: Nadiya Younis Mohammed
Pages: 26-29
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Ischemic heart diseases are common diseases that influence the heart performance via the changes occurring in cardiac muscles resulting from the disease. These changes can affect the left ventricular wall, septum thickness and an eventual effect on the cardiac performance. AIM OF THE STUDY: The merit of this work is to investigate the effects of left ventricular function on patients who suffer from early ischemic heart. METHODS: Twenty five patients complaining from chest pain and diagnosed as angina were subjected to our investigation, they were free from other cardiac diseases and have no previous heart attack their average age was (52.85±12.69 years old). Eighteen normal individuals (control) with average age (48.33±12.55 years old) are chosen and are free from any disease. M-mode, 2- dimensional parasternal long axis view was used in the measurements of LV interdiameter, septum and posterior wall thicknesses. Doppler echocardiography tracing of four chamber apical view was obtained to indicate the ejection time and mitral flow velocities at early diastole E and at atrial contraction (end of diastole) A. RESULTS: The effect of early IHD was found on the interventricular septum (decreased by 44.18%), posterior left ventricular wall (decreased by 47.62%), fractional shortening (decreased by 28.93%), and ejection fraction (decreased by 20.05%). There was no significant change observed on the A/E ratio but a significant change was seen on E wave only. CONCLUSION: In early of IHD, ejection fraction and percentage changes of wall thickness indicate cardiac performance. In addition reduced early mitral flow velocity is more frequent than the change in early to late mitral flow velocity ratio.


Article
Medico-legal and Serological Study of the Role of C- Reactive Protein and Anticholesterol Auto-antibodies in the Diagnosis of Ischemic Heart Disease

Authors: Nabeel Ghazi Hashim
Pages: 30-39
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: No previous Iraqi study was done on the role of C - reactive protein (CRP) and anticholesterol autoantibodies (ACHA) in the diagnosis of ischemic heart disease (IHD) especially from the medico-legal point of view. AIMS OF THE STUDY: To determine the role of CRP and ACHA in the diagnosis of IHD particularly myocardial infarction (MI) with special attention to the medico- legal aspect. METHODS: Forty four lived patients from Al- Kadhimiya hospital and 20 cadavers in medico-legal institute of Baghdad were included in this study, in addition to 18 apparently healthy persons and 3 cadavers as controls. A number of risk factors were studied such as age, sex, smoking, and others. CRP and ACHA detected and estimated in the sera of the lived and dead patients. Histopathological examination was done on cardiac tissue specimens taken from the cadavers. RESULTS: Patients with anterior MI have higher CRP values than in patients with other types of MI. ACHA of IgM type was higher in controls than in lived and patients, while that of IgG was higher in lived patients as compared with dead patients and controls. CONCLUSION: Elderly males are affected more by MI. CRP is elevated in acute coronary syndrome. ACHA are present in healthy individuals, but high in CAD.


Article
Congenital Right Intra-Thoracic Hiatal Hernia

Authors: Waleed Mustafa Hussain
Pages: 40-46
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Congenital right sided intra-thoracic hiatal hernia is an uncommon clinical entity consisting of herniation of a viscous through congenitally abnormal esophageal hiatus into an intra-thoracic location . AIM OF THE STUDY : Is to present the diagnostic challenge and the surgical management of eight cases of this uncommon congenital anomaly admitted during asix years period (2000 – 2005 ) to the medical city teaching complex in Baghdad . Iraq and to compare the study with other international studies. METHODS : Eight patients were studied retrospectively in details as regard the age , sex , clinical manifestations , radiological findings . Details of the operative findings and the surgical outcome . RESULTS : All the patients had right sided intra-thoracic abdominal organ herniation mostly the stomach , all the patients ahad large hiatus , the patients were managed successfully through laparatomy with uneventful postoperative course . CONCLUSION: This uncommon variety of the congenital hiatal hernia presented a diagnostic challenge to the pediatrician , pediatric surgeon and the thoracic surgeon .Laparatomy was the procedure of choice and adding an anti –reflux procedure is highly indicated


Article
The Distally Based Radial Forearm Flap in Reconstruction of Complex Defects of the Hand

Authors: Osam Ahmed Ibraheem Al-Najjar
Pages: 47-53
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: The hand is exposed to various types of trauma, the majority of which involve multiple tissues which needs to be repaired in the most perfect way. The distally based radial forearm flap is one of the commonly used flaps for reconstruction of hand defects. AIM OF THE STUDY: The aim is to test the applicability and the versatility of the distally based radial forearm flap in complex soft tissue reconstruction of the hand. METHODS: Nine patients were treated using distally-based radial forearm flaps. There were seven males and two females, mean age was 21 year. Reconstructed sites involved the thumb, the first web, the palm and dorsum of the hand. Neurofasciocutaneous flap was transferred in one case, adipofascial flap in one case, all the remaining flaps were fasciocutaneous island flaps. RESULTS: All the flaps survived completely. There were two donor sites complications, but no major functional disturbances. No patient had symptoms of cold intolerance or other ischemic changes. CONCLUSION: Distally based radial forearm flap is very useful in hand reconstruction especially when no suitable local flaps can solve the problem and it can permit further surgical procedures to be done underneath when indicated.


Article
Unenhanced CT Scanning in Acute Flank Pain: Value of Secondary Signs of Ureteral Obstruction

Authors: May Khalid Ameen
Pages: 54-59
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: To determine the value of secondary signs of ureteral obstruction on helical unenhanced CT in diagnosing or excluding ureteral stone disease. METHODS: Over a period of 15 months, we prospectively analysed the CT scans of 283 patients with acute flank pain for the presence of ureteral stones & associated signs of ureteral obstruction. 105 patients had no confirmatory imaging studies or surgery & were unable to be contacted for follow up .These were excluded from the study. In the remaining 178 patients confirmatory data were availabe & thus were included in the study. Ureteral stone disease was confirmed to be present in 114 patients & absent in 64 patients. For each patient, we determined the presence or absence of ureteral stone, ureteral or collecting system dilatation, perinephric stranding, &renal parenchymal thickening. We also noted the presence or absence of the (" tissue rim" sign) surrounding ureteral stones & extraurinary calcifications. RESULTS: Hydroureter was the sign with the highest sensitivity (92 %) & highest specificity (92%), While hydroureter had the highest specificity (95 %) & highest PPV (97%). The combination of unilateral hydroureter & unilateral perinephric stranding had both the highest PPV (98 %) & NPV (91 %) compared with any individual sign alone . The tissue rim sign was present in (57 %) of urteral stones & in none of the extraurinary calcifications. CONCLUSION: In patients having acute flank pain with suspected ureteral stone disease imaged with unenhanced CT , secondary signs including hydroureter , hydronephrosis , perinephric fat stranding , & renal parenchymal thickening are very common & provides supportive evidence that an acute obstructive process is present & that the urinary tract is likely responsible for the patients' complaints even when the ureteral stone itself could not be identified on CT .


Article
Prevalence of Silent Bacteriuria in Patients with Diabetes Mellitus

Authors: Firas Elias Douri
Pages: 60-64
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Diabetes mellitus and it’s complications continue to carry a major health problem. There is evidence that diabetics are more prone to urinary tract infection. AIM OF THE STUDY: The study was done to assess the prevalence of significant bacteriuria in patients with no urinary symptom. METHODS: Midstream urine samples were collected from 200 diabetic patients. There were 102 females and 98 males and 80 urine samples from non diabetic persons as control were screened for bacteriuria. RESULTS: Out of 200 diabetic urine samples 18 patients [9%] had significant bacteriuria while 2 urine samples [2.5%] of non diabetic samples has significant bacteriuria. Three types of bacteria were isolated from urine samples,Escherchia coli, Staphylococcus, and Proteus and Escherchia coli was the high in number among the other genera. CONCLUSION: Analysis of the results showed significant bacteriuria in diabetic patients compared with non diabetic patients {p value < 0.05}.


Article
Hormonal and Immunological Disturbances in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus

Authors: Numman Hamed. Salih
Pages: 65-70
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Rheumatoid arthritis and systemic lupus erythematosus are multifactorial autoimmune diseases. Some recent reports indicated a hormonal disturbances affected the balance between Th1 and Th2 lymphocyte response. OBJECTIVES: To investigate the immunological and hormonal disturbance in patient with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). METHODS: Serum samples, were collected from patients with RA, SLE and control, then the tests for antinuclear antibodies, anti double strand DNA, anticardiolipin antibodies are done by using Enzyme linked immuno assay (ELISA) method. Also, hormonal studies including estrogen, progesterone and prolactin level are done by using the Radio immunoassay technique (RIA). RESULTS: The results indicated the increasing of ANA, anti ds-DNA, and anticardiolipin antibodies. Also, elevation in the levels of estrogen, progesterone and prolactin in patients with RA and SLE comparing with control. CONCLUSION: Immunological and hormonal disturbances in patients with RA and SLE were documented through through the increasing of ANA, anti dsDNA anticardiolipin antibodies and elevation of the level of estrogen, progesterone, and prolactin.


Article
Hafnia Alvei Urinary Tract Infection

Authors: Jamela Ghadban Auda Al-Grawi
Pages: 71-75
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: The genus Hafnia , a member of the family Enterobacteriaceae, consists of Gram negative bacteria that are occasionally implicated in both intestinal and extraintestinal infections in human. This genus contains only a single species (Hafnia alvei). METHODS: The above bacterium was identified from 250 bacterial strains which were isolated from 220 urine samples of patients with urinary tract infection. RESULTS: One H. alvei strain was isolated from an elderly patient, and identified by conventional biochemical tests and API20E system at the first time in Iraq. Antimicrobial susceptibility test showed that this strain is sensitive to Cefotaxime, Ciprofluxacine, Chloramphenicol, Doxycycline and Trimethoprimsulfamethaxzole, while it is resistant to Penicillin, Oxacillin and Amoxicillin plus clavulanic acid. CONCLUSION: H. alvei an important uropathogen that causing urinary tract infection in elderly and may be in immunocompromised patients.


Article
Status of Zinc and Copper Concentrations in Seminal Plasma of Male Infertility and Their Correlation with Various Sperm Parameters

Authors: Basil Oied Mohammed Saleh
Pages: 76-80
Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Human semen contains high concentrations of zinc (Zn) and copper (Cu) in bound and ionic forms .The presence of abnormal levels of these trace elements may affect spermatogenesis with regard to production , maturation , motility , and fertilizing capacity of the spermatozoa. The aim of this study is to evaluate the levels of Zn and Cu in seminal plasma in different groups of male infertility and to correlate their concentrations with various semen parameters. METHODS: Forty primary infertile male individuals ,who had regular unprotected intercourse for at least one year without conception with their partners ,aged 25-40 years were involved in the present study .After seminal plasma fluid analyses they were grouped as, azoospermic (n=12), oligoasthenozoospermic (n=16) ,and teratozoospermic (n=12) .Twelve fertile males selected from general population and after seminal fluid investigation were taken as normospermic control group .Zinc and Copper concentrations in separated seminal plasma of each infertile male and fertile control subject were determined by atomic absorption spectrophotometer. RESULTS: This study showed significant decrease of seminal plasma Zn mean (+SEM) value in oligoasthenozoospermic infertile males than in fertile male controls (p<0.037) .In azoospermic males, the mean (+SEM) value of seminal plasma Zn levels was decreased (but still beyond the significant level,p=0.08) when compared with that of fertile males. With regard to seminal plasma copper level there was insignificant decrease in its level in azoospermic males and insignificant increase in its concentration in oligoasthenozoospermic and in teratozoospermic males when compared with that of healthy fertile males.In addition, there was a significant decrease in seminal plasma copper concentration in azoospermic males than in oligoasthenozoospermic males (p<0.035).The results also revealed a significant positive correlation between the sperm motility values and the seminal plasma zinc levels in oligoasthenozoospermic group(r=0.68, p<0.022) along with a significant negative correlation between sperm morphology values and zinc seminal plasma levels in teratozoospermic group (r=-0.63,p<0.049). CONCLUSION: On the basis of the findings of this study, it seems that the estimation of seminal plasma levels of zinc and copper may aid in investigation and treatment of infertile males.


Article
The Carmoisine-Sodium Acetate Acetic acid Formalin Stain- Preservative Technique in Identification of Intestinal Parasites

Loading...
Loading...
Abstract

ABSTRACT: BACKGROUND: Definitive diagnosis of the intestinal parasites requires the demonstration of the organisms or eggs in feces or tissues. Stool specimens should be preserved and stained and microscopically examined. METHODS: • Stool samples were collected from patients complaining gastro-intestinal tract. • Carmoisine red food color powder was dissolved in 2 solutions, sodium acetate acetic acid formalin (C-SAformalin) solution, and 10% formal saline (C-10% formal saline) . • Merthiolate-iodine-formalin (MIformalin) solution was prepared, (control solution). • Eleven stool suspensions were prepared from one stool sample directly after the passage , 5 for each serially diluted solution which mentioned above, and one for MIformalin solution. • The suspensions of 64 positive stool samples were selected to this study and subjected to periodic examination which programmed according to the schedule during one year. RESULTS: • C-10% formal saline was inadequate in preservation of protozoan trophozoites. • The most appropriate concentration of C-SAformalin solution was 2%wet/vol, this solution has the ability to preserve the amoeba organisms( trophozoites and cysts ),Chilomastix mesnili (trophozoite and cyst) ,Giardia lamblia (trophozoite and cyst), helminth eggs and the human elements for one year when suspended in this solution, at the same time it has the ability to stain the parasitic and non parasitic findings which mentioned above very efficiently. • The protozoan trophozoites, protozoan cysts and leucocytes these cells were showed various levels of stain uptake. All C-SAformalin solutions which were stored for periods between one day up to 18 months showed the same preservation and staining capability CONCLUSION: The C-SAformalin solution with 2% wt/vol. concentration has proved to be highly efficient in preservation for one year and staining of the intestinal protozoa (trophozoites and cysts), helminth eggs and humane elements, which may be found in stool specimens.


Article
Spondyloepiphysial Dysplasia

Authors: Dawood Sadik. Al-Obidi
Pages: 96-99
Loading...
Loading...
Abstract

ABSTRACT : BACKGROUND: A 13 years old girl from north of Iraq, presented with gross deformity of her back & difficulty in walking& then progressive difficulty in breathing. A thoracic scoliotic deformity with rib hump obvious on her back, it is a case report of spondyloepiphyseal dysplasis(SED) with primary involvement of the vertebrae & epiphyseal centers all over the body. AIM OF THE STUDY: To present a very rare case of (SED), including the deformities& the complications that can be presented with it. METHOD: Examining & survying a 13 years old Iraqi female from north of Iraq. RESULTS: A thoracic scoliotic deformity was found& became more obvious on bending foreword, also rib hump on the right side.Both hips in fixed flexion deformity & limitation of abduction. DISCUSSION: In SEDT the vertebral bodies are malformed& flattened, 1st described by Nilssone (1924).Wynne-Davies& Gormley(1985) estimated the prevalence to be 1 per 100.000 in a Scottish population.

Table of content: volume:7 issue:1