Table of content

Al-Kindy College Medical Journal

مجلة كلية الطب الكندي

ISSN: 18109543
Publisher: Baghdad University
Faculty: Al-Kindy Medicine
Language: English

This journal is Open Access

About

Al-Kindy College Medical Journal ((Al-Kindy Col.Med.J)), a periodic peer reviewed scientific journal published biannually by Al-Kindy College of Medicine –University of Baghdad. specialised
in research of medical and related subject ISNN 1810-9543
The articles and research studies published in the journal are carefully selected and reviewed by a high standard advisory board from doctors who are most seniors and experts in their medical fields according to the subjects submitted to the journal.
Al-Kindy Col.Med.J is well recognized by Baghdad ,Mustansiriya and Nahrain universities for promotion of their teaching staff.
Three hundred articles ,research papers, case reports and studies have been published ourn medical journal since 2003 till now and the journal has been distributed to all medical collages of Iraq and most counties in the Middle East.

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Contact info

Mobile: +964 7803546157
web site: www.kmc.edu.iq
E-mail: journal@kmc.uobaghdad.edu.iq
info@kmc.uobaghdad.edu.iq

Table of content: 2009 volume:5 issue:1

Article
Lipid Profile and Antihypertensive Drugs

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Abstract

Background: Hypertension and dyslipidemia are cardiovascular risk factors that commonly coexist . Objective : To evaluate the effects of ß - blocker (Atenolol) , ACE inhibitor (Captopril) calcium Channel blocker (Nefidipin ) and diuretics on serum lipid profiles . Method: Thirty untreated hypertensive and 147 hypertensive patient treated with these antihypertensive drugs, attending different public health clinics in Basrah pronivce were enrolled in this study . Serum lipid profile were determined enzymaticaly using kits from BioMerieux, France . Result : The study has revealed that ß-blocker do not significantly affect total cholesterol ( TC ) and LDL- cholesterol , but increase significantly triglyceride (TG) and VLDL – cholesterol and decrease HDL – cholesterol. Diuretics causes a significant elevation of TG with generally no significant changes in TC , LDL – cholesterol , VLDL – cholesterol and HDL-cholesterol. ACE inhibitor and calcium channel blockers appears to have no significant effect on plasma lipids . Conclusion :It may important to measure blood lipid levels to identify pre-existing hyperlipidemia before starting the antihypertensive therapy and to select antihypertensive agent that will not influence the lipid profile or interfere with the therapy of hyperlipidemia


Article
Serum Zinc in Iraqi Acute Leukemic Patients

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Abstract

Background: Leukemia is a group of malignant disorders associated with increased numbers of blood white blood cells. Acute leukemia occurs at all ages. Because zinc influences many body systems and functions, zinc is an essential nutrient for tissue growth, cellular division, protein synthesis DNA and RNA replication it also ought to play a critical role in the growth of tumor. In this study, serum zinc was estimated in leukemic patients and compared with healthy subjects. Methods: The subjects in the present study were; fourty-four depressed patients aged (14-48 year), thirty-one apparently healthy subjects were selected as control group. Their sex and age were comparable to that of patients. Determination of serum zinc was carried out using flame atomic absorption spectrophotometer. Results: The results showed a significant decrease in serum zinc at (p<0.05) in leukemic patients as compared with healthy control. Conclusion: The decrease in serum concentration of zinc in leukemia can be explained by means of the changes in immunity system and the need for zinc to synthesize nucleic acid and tumor cell division in this disorder in addition to other possible mechanisms.

Keywords

leukemia --- zinc --- inflammation


Article
Glucose Tolerance in Pregnant Women Inflictedwith Candida Albicans

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Background: Many previous studies were concerned with the relationship between gestational diabetes and the development of vaginal candidiasis in pregnant women. In this study, our aim is directed to uncover glucose tolerance status in non-diabetic pregnant women inflicted with candida albicans. Methods: Thirty-four pregnant women with vaginal condidiasis (as demonstrated by microscopy) were enrolled in this study. The patients were nearly similar in their anthropometric and demographic criteria with those of the healthy pregnant women (control group, forty –two women). Fasting plasma sugar and glucose tolerance test were alone for all patients and control group. Results: fasting plasma sugar was significantly higher in the candidiasis-positive pregnant women in comparison to those of candidiasis-negative subjects (5.09 mmol/L vs. 4.71, p <0.02). Plasma glucose level after 30 minutes of performing oral glucose tolerance test was also significant (8.47mmol/Lvs. 7.84, P <0.04). The same trend of significance was noticed after 60 minutes and 120 minutes of performing the corresponding test. The results were (8.13 mmol/L vs. 7.10, P <0.02) and (6.90mmol/L vs. 6.15, P<0.05) respectively. Conclusion: the results reveal an impaired oral glucose tolerance test in pregnant women with candida albicans


Article
Oral Tumors; Clinicopathological Study amongPatients Attending ENT Clinic in Baghdad

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Background: Oral tumors are one of the most challenging tumors regarding their good prognosis in early diagnosis and very difficult control in advancing stages. Objectives: To study the prevalence, types and clinical presentation of oral tumors in comparison to other oral lesions among patients attending ENT clinic. Al-Kindy Col Med J 2008 Vol.5(1) 1 1 Original Article Methods: This study included 534 patients with different oral complains attending ENT clinics in AI-Yarmouk Teaching Hospital, and AI-Kindy Teaching Hospital - Baghdad, in the period from 1st jan1999 till 31th des 2006 (8 years interval). Results: The results of this study showed that the prevalence of malignant lesions was 13.5% (72 out of 534); the males constitute 59.7 % of them. Premalignant lesions constitute only 3.9% (21 out of 534) of patients; the males constitute 66.7 % of them. Benign lesions in 8.6% (46 out of 534); the males constitute 69.6 % of them. Other lesions constitute 74% (395 out of 534); the males constitute 65.8 % of them. Squamous cell carcinoma is the most common malignant tumor (found in 71% of malignant lesions). Conclusions: Most patients are males and the most common manifestation is sore throat. The most common sign of presentation is swelling and the most common histological type of malignant tumors is squamous cell carcinoma (71%). These patients usually attend ENT clinic seeking for simple therapy, we see that it’s the job of the otolaryngologist to diagnose those patients early which has a major influence on prognosis. Key words:

Keywords

Oral --- tumors --- ENT clinic.


Article
Psychiatric Squele of Sodium Valproate VersusCarbamazipine in Patients with Primary Generalized Epilepsy

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Background: psychiatric and behavioral side effects are common in patients with epilepsy and it may represent an intrinsic feature of the disease itself or a side effect of the antiepileptic use. Our aim in the present study is to assess the psychiatric side effects of Sodium Valproate and Carbamazipine .as these drugs are the most commonly used antiepileptic drugs in Iraq. Methods: 80 patients with primary generalized epilepsy on Carbamazipine and 50 patients on Sodium Valproate were enrolled in the present study; all the patients were assessed for any psychological disturbances using semi-structural interview based on the tenth edition of the international classification of the diseases(ICD 10) adopted by WHO. Results: thirty percent of patients taking Sodium Valproate and (9%) of patients taking Carbamazipine were found to have depression while (16%) of patients taking Sodium Valproate and (20%) of patients taking Carbamazipine were found to have anxiety. There were no reported psychosis, suicidal attempts, cognitive deficit and mania in both groups of patients in the present study. Discussion: Carbamazipine is associated with lower rates of psychological side effects than Sodium Valproate; this result may be related to mood stabilization effects of Carbamazipine. Conclusion: Carbamazipine is preferred to Sodium Valproate when the efficacy of both drugs is comparable.


Article
The impact of advancing age on total serum IgE in asthmatic patient

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The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of groups A and B. The linear regression analysis exhibited significant correlations for IgE (r=-0.65, P<0.001) with ages in asthmatic patients but not in healthy individuals.تم تصمیم الدراسة الحالیة لتقییم تاثیرالتقدم بالسن على مستوى ا لكلوبین المناعي في المرضى المصابین بالربو. لتحقیق ھذاالغرض, تم دراسة 90 مصابا بالربو ( IgE) و 30 شخصا صحیحا استعملوا بوصفھم مجموعة سیطرة . تم تقسیم ا لمرضى الى, 9) تتراوح اعمارھم من 20 الى 30 سنة ) A 4 مجامیع تضمنت مجموعة 13 ) تتراوح اعمارھم اكبر من 30 الى 40 سنة ومجموعة ) B وتألفت مجموعة (45) D 23 ) تتراوح اعمارھم اكبر من 40 الى 50 سنة وتكونت مجموعة )C في IgE اعمارھم اكثر من 50 سنة . دلت النتائج على زیادة معنویة في مستوى بین تحلیل الارتباط .B و A عند مقارنتھا مع مثیلاتھا في مجموعتي D مجموعة (r= -0.65, P<0.001) IgE الخطي علاقات ارتباطیة معنویة بین مستوى واعمار مرضى الربو لكن لیس لدى الشخاص الأصحاء.

Keywords


Article
Isolation, Identification, and Antimicrobial Susceptibility of Uropathogenic Morganella Morganii

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Background: Morganella morganii is one of the important nosocomial pathogens that may cause urinary tract infection and bacteremia. Methods: The above bacterium was identified from 250 bacterial strains which were isolated from 220 urine samples of patients with urinary tract infection. Antimicrobial susceptibility, by using disk diffusion method, of isolates was tested against some antibiotics. Results: Two M. moganii strains were isolated from female catheterized urinary tract patients, and identified by conventional biochemical tests and API20E system at the first time in Iraq. Both of them produced urease and hemolysin. Antimicrobial susceptibility test showed that these strains are resistant to, amoxicillin-clavulanate, cephalothin, gentamycin, tetracycline, trimethoprim-sulfamethaxzole, penicillin, and piperacillin, while they are sensitive to amikacin, ciprofloxacin, and norfloxacin. Conclusions: M. moganii one of opportunistic uropathogens, especially in catheterized patients. It has produced many virulence factors and exhibited multidrug resistance.


Article
Obesity, Glycemic and Hormonal Criteria Of Polycystic Ovary Syndrome

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Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women, at reproductive age. PCOS is a chronic hyperandrogenic state that has many significant short-term and long-term implications for patients such as oligomenorrhea, amenorrhea, infertility, diabetes mellitus, cardiovascular disease, increased risk of endometrial cancer, and hirsutism. Objectives: To evaluate the obesity and glycemic criteria among women with polycystic ovary syndrome. Method: A case control designed study was carried out at the National Diabetes Center (NDC) / Al-Mustansiryia University; on 50 participants formed the PCOS group and 50 healthy control participants. Data collected about age, age at menarche and BMI. Also, blood samples examined for FPG and 2-h OGTT test carried out for all the participants. Moreover hormonal assessment for the LH, FSH and total testosterone were done for all participants. Results : PCOS group women age and age at menarche were 27.62 ± 5.74 and 12.0 ± 1.06 years; vs. the control group were 25.42 ± 4.94 and 11.64 ± 0.69 years respectively. All PCOS group were experienced signs and symptoms of ovarian dysfunction, and infertility while the control group did not experience any of such evidences. BMI showed significant difference between study groups (t-test (P < 0.05)); 98% of the PCOS group was obese vs. 58% of the control group. The waist/hip ratio showed insignificant difference (t-test (P > 0.05). Fasting plasma glucose (FPG) showed insignificant difference between the study groups (t-test (P >0.05); about 18% of the PCOS group was prediabetic (Impaired Fasting Glucose, IFG) (100-125mg/dl) and 6% was diabetic (>126mg/dl) whereas the entire control group was normoglycemic. The OGTT showed significant difference between the study groups (t-test (P < 0.05)); about 22% of the PCOS group was prediabetic (Impaired Glucose Tolerance, IGT) (140-199mg/dl) and 6% was diabetic (>200mg/dl) whereas the entire control group was normoglycemic. PCOS group showed highly significant elevation in the LH level vs. the control group by about four folds (t-test (P < 0.05)). Also, FSH showed similar elevation by about two folds among the PCOS group vs. the control group (t-test (P < 0.05)). Moreover the LH/FSH ratio was elevated by about two folds among the PCOS group vs. the control group (t-test (P < 0.05)). Total serum testosterone of the PCOS group showed significant raise vs. the control group (t-test (P < 0.05)). Whole the PCOS group had A total testosterone level >60 ng/dL and in contrary the entire control group didn't show any elevation >60ng/dl. Conclusion: obesity of android (central) type was frequent and prevalent among PCOS women. About 20-28% of PCOS women was prediabetic or diabetic due to insulin resistance and decreased insulin sensitivity. Hormonal assay of LH, FSH, LH/FSH ratio and total testosterone were all significantly elevated by two folds or more among the PCOS women. It is not essential that a woman who had polycystic ovaries by ultrasound to have PCOS.


Article
Non-Metastatic Breast Cancer : Clinical Presentation and Patterns of Surgical Treatment

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Background : Breast cancer is the most common cancer of women. When breast cancer is detected and treated early, the chances for survival are better. Surgery is the most important treatment for non-metastatic breast cancer. Al-Kindy Col Med J 2008 Vol.5(1) 40 Original Article Objectives : The aim of this study is to review different clinical presentation and to evaluate types of surgical procedures and complications in treatment of non-metastatic breast cancer. Method : During the period from Jun 1998 to May 2005, 93 patients with non-metastatic breast cancer were diagnosed and treated surgically in 2 hospitals in Baghdad ( Hammad Shihab military hospital and Al-Kindy teaching hospital). Results : Women constituted ( 98.93% ), while men constituted (1.07%), with male to female ratio of (0.01:1). The peak incidence of non-metastatic breast cancer (25.8%) was at age group 51-60 years, while (60.2 % ) of cases happened in women over 50 years of age. The right breast was the most common side affected, and the upper outer quadrant of the breast was the most common location affected by cancer. Painless lump (91.4%) was the most common symptom, and the hard lump was the most common sign (100%). The highest frequency of cases was diagnosed in stage II followed by stage III, and invasive ductal cancer was the most common histopathologic type. (87.1 %) of patients underwent modified radical mastectomy, while (12.9%) underwent breast-conservation surgery. Breast-conservation surgery carried higher incidence of recurrent disease than modified radical mastectomy (33.3% vs.13.6%). Conclusion : The majority of patients with non-metastatic breast cancer were over 50 years of age, and the preponderance were diagnosed in stage II. Modified radical mastectomy may be preferable method for treatment as it carries a lower rate of local or distant recurrence than conventional breast-conservation surgery procedures. Key words: Non-metastatic breast cancer,


Article
The Effect of Continuous Darkness and Continuous Light on the Reactivity of Smooth Muscles to Drugs in the Rat Vas Deferens

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Background: The vasoconstricting agents: nor-adrenaline and 5- hydroxytryptamine (5-HT) have a stimulant action on smooth muscle contractility of the rat vas deferens. Objective: This study aimed to investigate the effect of exposure to continuous darkness and continuous light on the contractility of the vasa deferntia smooth muscles from rats to applied nor-adrenaline and 5-HT. Method: Male albino wistar rats were divided into 3 experimental groups. Group 1: Control animals, were exposed to the ordinary photoperiod each day. Group 2: Rats were kept in a dark room. Group 3: In a room under a bright artificial light. All animals were killed after 4 weeks. Results: Vasa deferentia preparations from continuous dark group of rats exhibited a reduced reactivity with a significant lower maximal response to 5-HT than those from control rats. The maximal response in the control vasa deferentia preparations were nearly doubled compared with that of the continuous dark preparation where as they responded to exogenous nor-adrenaline with no significant difference from those of continuous dark animals. Vasa deferentia of continuous light animals responded with decreased reactivity and a smaller maximal response to both vasoconstrictors compared with that of control animals. Conclusion: It is concluded that changes in the rhythm of the photoperiod have considerable effects on the reactivity of the vasa deferentia smooth muscle from rats to applied nor-adrenaline and 5-HT.


Article
Behavioral Disturbances among School Childrenin Baghdad Province

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Background: Mental health of children has recently been receiving increased attention in many parts of the world. However, such attention has been lacking in developing countries, particularly in the form of systematic research Aim: The study aimed to find out the frequency of behavior disorders in a sample of primary school children and the different social and demographic factors that might be related to this disorder. Methods: The study is a cross-sectional one that included 918 primary school pupils in both urban and rural areas of Baghdad. Rutter's questionnaire teacher's version was used to assess the pupils, and the demographic data was obtained by special questionnaire sent to the parents to be completed. Results: The rate of behavior disorder was found to be 49%, in both rural and urban areas, males had higher prevalence rate than females. The disturbed pupils had higher scholastic failure and their parents of lower educational level and came from highly crowded houses, they had higher rate of disrupted family by either death of one of the parents or their father is married to more than one wife. Conclusion: There is high rate of behavior disturbances in school aged children in Baghdad, associated with low socioeconomic status, bereaved children and having fathers married to more than one wife. The study shows that these children have low scholastic achievement.


Article
Carotid Intima-Media Thickness in Rheumatoid Arthritis Detected by Doppler Ultrasound

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Background: The excess mortality associated with rheumatoid arthritis is largely due to cardiovascular disease. Rheumatoid arthritis is of primary importance in atherogenesis. The intima-media thickness of extracranial carotid arteries is a measurable index of the presence of atherosclerosis. Objective: To assess carotid intima-media thickness in rheumatoid arthritis by Doppler ultrasound. Methods: Fifty two Iraqi patients with rheumatoid arthritis were studied and compared with another fifty two, healthy individuals matched for age and sex as a control group. Full history was taken and complete clinical examination was done for all individuals in both groups. Rheumatoid arthritis diagnosis was based on The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Carotid intima-media thickness was measured by Doppler ultrasound. Results: There was a significant increase in the frequency of increased carotid intima-media thickness among individuals with rheumatoid arthritis (44.2%) compared to healthy control group (3.8%) (P=0.000001). Conclusion: Increased carotid intima-media thickness occurs in high frequency in rheumatoid arthritis.


Article
The Use of Myocardial Performance Index (Mpi)in Assessment of Heart Function

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Background: Ejection fraction have been used frequently for assessment of the left ventricular function, but can be associated with errors in which myocardial performance index have been used as another parameter to measure the left ventricular function. Objective: selecting another echocardiography parameter for the assessment of myocardial in function instead of the ejection fraction. Methods: 160 patients referred to the echocardiogram unit from the period december 2007 to august 2008 requesting assessment of left ventricular function. After clinical examination, routine blood tests; chest x-ray and electrocardiographic recording have been completed. All patients informed to come for this unit after the first visit monthly for three successive months. For the purpose of comparison (30) thirty volunteers admitted to this study as control having same age range. The (160) patients were categorized into two groups. Group (A) includes (70) patients with ischemic heart disease with complications like pulmonary oedema, myocardial infarction, recent admission to coronary care unit because of recurrent severs chest pain. Group (B) includes (90) patients with ischemic heart disease without any of the above complications. Myocardial performance index is done by using the four chambers view and pulse wave and curser along the mitral inflow of the blood jet. Results: Assessment of left ventricular function by using the myocardial performance index in group A was more significant than using the ejection fraction in comparison to the control group (P value 0.02, 0.03 respectively) the same was found in group B in comparison to control group (P value 0.01; 0.05 respectively). Conclusion The myocardial performance index (MPI) in the control groups was 0.44-0.36 MS indicating that its range is very narrow in the control group, The (MPI) in the two groups of patients was high in comparisons with control group.


Article
Evaluation of Serum Interleukin-6 Levels inCorrelation to the Severity of Acute Appendicitis

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Background: Acute appendicitis is a common surgical problem that is associated with an acute-phase reaction. Previous studies have shown that cytokines and acute-phase proteins are activated and may serve as indicators for appendicitis. Objective: The aim of this study was to evaluate of serum levels of interleukin-6 (IL-6) in correlation to the severity to acute appendicitis. Methods: This is a prospective study from December 2008 to March 2009 of patients who had appendectomy in Department of Surgery, Al-Kindy Teaching Hospital - Baghdad/Iraq. Serum for estimating levels of interleukin-6 (IL-6) was taken pre-operatively. Depending on the macroscopic evidence during the operation and the histopathological examination of the specimens, the patients were separated into 3 groups, group one with negative appendectomy (normal appendix), group two with non-complicated acute appendicitis (catarrhal, suppurative), and group three with complicated acute appendicitis (perforated, gangrenous). The histopathological results were correlated with IL-6 values statistically. Results: A total number of 50 patients were included in this study, 28 male (56%) and 22 female (44%). The mean age was 23 year (ranged from 7 to 50). On histological examination, there were 7 patients (14%) in group one, 29 patients (58%) in group two, and 14 patients (28%) in group three. Serum IL-6 values gave true negative results in 6%, true positive results in 82%, false negative results in 4%, and false positive results in 8%. We determined, therefore, in the present study the sensitivity, specificity, and accuracy of serum IL-6 were calculated as 95.34%, 42.85%, and 88% respectively. Conclusion: Laboratory results should be considered to be integrated within the clinical assessment. If used critically, IL-6 can provide surgeons with complementary information in discerning the necessity for urgent operation.


Article
Incidence of Injuries to Major Blood Vessels in the Lower Limb

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Background: Blood vessels injury is one of the most common causes of medical emergencies that admitted to hospitals and at the same time it regarded as one of the most important causes of death. They may represent less than 15% of all injuries; they deserve special attention because of their severe complications. Objective: The aim of the present study is to assess anatomically the injures of major arteries and veins in the lower limb with their management. Methods: The present study extended from April 2006 to February 2007, in which 65 patients with lower limb vascular injury were examined in Emergency Department and Forensic Medicine Department of Tikrit Teaching Hospital in Salah-Aldin governorate. Diagnosis was made by clinical diagnosis alone, or in combination with angiography. Some surgical interferences as vascular repair was carried out, but if not possible the interposition graft was used by great saphenous vein for vascular reconstruction. Results: The total cases were 65 patients (49 males and 16 females), ranging from 16 years to 67 years with a mean age of 41.5±6.4 years. Penetrating trauma was the main cause of injury for 52 patients. Seventeen cases had bilateral limbs vascular injuries. Arterial injuries were most common in the femoral arteries, followed by the tibial and finally the popliteal arteries. Vascular repair were performed in 16 cases, while in 11 cases great saphenous vein interposition graft were done. There were 17 cases associated with venous injury, of which 11 cases had surgical vascular repair, and 6 had vein graft interposition. There were concomitant femur fractures in 2 cases, fibula fractured in 3, tibia fractured in 1 and the foot bones fractured in 3. Conclusion: Lower limb vascular injured patient should be transferred to vascular surgery centers as soon as possible. After first aid management, anticoagulant treatment may be started post operatively to prevent the propagation of the thrombosis. Early fasciotomy is done if there is any suspicion of occurrence of compartment syndrome.


Article
Bloody Diarrhoea anl0ng Children under five years of Age in Tikirit Teaching Hospital

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ObjectiveIs to study the causes of bloody diarrhea in in (50)cases (37%) , Shigella spp in (25) cases (18% and children under five years of age and to clarify their relations Campylobacter jejuni Icases only (0.75%) to the type offood and mothers educational level ConciusionBloody diarrehea is common in children under methods Ahospital based study was carried out at tikreet 5years age who were admitted to Tikreet Teaching Hospital teaching Hospital in Tikreet city on 133 children who were in Tikreet city , There is astrong positive relationship admitted to the hospital with bloody diarrehea their ages between the occurrence of bloody diarrehea and the type of range between one month -5years. The period study is from food. Education of the mother plays an important rule for (January200 I-July 2001). the occurrence of bloody diarrehoea, mostly those who Results The pathogens causing bloody diarrhea were were illitrate Entamoeba histolytica in (57) cases (42%) Salmonella spp


Article
Splenic Injuries atAl-Kadhimiya Teaching Hospital

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Background: The spleen is the most common solid organ injured in patients who had sustained abdominal trauma. Such injuries to the spleen represent approximately one quarter of all blunt injuries of the abdominal viscera. Due to its remarkable vasculature and its fragile structure, splenic rupture is the most widespread cause of intra-abdominal hemorrhage. Objective: To assess the magnitude of splenic injury, the management of splenic injury, and to evaluate the postoperative complications. Methods: A prospective study of 57 cases of splenic injury was performed in Al-Kadhimiya Teaching Hospital during the period between the 1st of October 2004 and the 1st of October 2006. Statistical analysis was then performed to identify the causes, management and postoperative complications. Splenic injuries were graded into 5 grades. Results: The highest incidence of splenic injury was recorded in age group s31-40 year. Penetrating injury was much more common than blunt trauma (73.68% versus 26.31%). Fifty patients (87 %) were diagnosed by exploratory laparotomy, ultrasonography in 5 patients (8.77 %), CT scan was positive in 2 patients (3.5 %). Associated injuries were recorded in 41 patients 71.92%. Pulmonary complications were the most frequent complications (18 patients, 31.57 %). Conclusion: Splenic injuries are common surgical problems in Al-Kadhimiya Teaching Hospital. Still there are many difficulties in establishing the diagnosis of the splenic injury with shortage in the new diagnostic modalities especially (CT -Scan, MR1 and even U/S scan) in the emergency situations. In spite of the dangerous post-operative complications of splenectomy, it is still the most commonly performed surgical procedure in cases of splenic injury.

Keywords

Spleen --- Splenic Injury --- Splenectomy --- Repair


Article
Evaluation of Adhesions Induced Intestinal Obstructionfollowing Abdominal Penetrating Missile Injuries

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Objectives: To evaluate the incidence of adhesions induced intestinal obstruction after explorative laparotomy due to bullet/shell injury in Al-Kindi teaching hospital/Baghdad. Results: Thirty-six out of the 76 cases with adhesions induced intestinal obstruction (A.I.I.O.) had history of laparotomy for penetrating missile injury, 26 of them were explored as a method of management of A.I.I.O. with mean age (22 for those explored, ٣٧ for those treated conservatively), 16 of them presented within a year or less from the previous surgery. Methods: Comparative interventional prospective study of cases with adhesions induced intestinal obstruction admitted to the surgical wards in Al-Kindi teaching hospital from the 1st of January 2008 to 31st of December 2008. cases were followed considering the indications of previous laparotomies, the patients age, gender, duration between previous surgery and their presentation with intestinal obstruction Conclusion: Cases required surgical interventions for treatment were mainly those following explorative laparotomy for penetrating missile injury they were mainly of young age Groups.


Article
Abdominal Distention and Acute Urinary Retention secondary toCongenital Distal Vaginal Obstruction in a Newborn Female

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Congenital distal vaginal obstruction is usually asymptomatic in a newborn female. On rare occasions, it may present as an acute emergency with life threatening complications. This paper is reporting the rare condition of two newborn females presenting urgently with abdominal distension and acute urinary retention as a result of congenital distal vaginal Obstruction. The case history and urgent management shall be presented and both conditions shall be discussed.

Table of content: volume:5 issue:1