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Muthanna Medical Journal

مجلة المثنى الطبية

ISSN: 2226146x
Publisher: Al-Muthanna University
Faculty:
Language: English

This journal is Open Access

About

Muthanna Medical Journal (MMJ) is the official journal of Muthanna Medical College, a semiannual peer-reviewed online and print journal. The MMJ allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional/subject-based repository.
The Journal follows the ICMJE's Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals.

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Postal Mail
Muthanna Medical School
Samawah
Tel: 0782542-5669
Email: yousif_ghaly@yahoo.com

Table of content: 2016 volume:3 issue:1

Article
Facts about chronic tonsillitis: a pathological study

Authors: Raid M. S. AL-Ani
Pages: 1-5
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Abstract

Although tonsillectomy was the commonest procedure performed by otolaryngologists, there is no consensus among them to send the excised tonsils for histopathological study. The objective of this study is to determine the unique histopathological features of chronically infected tonsils and to evaluate the necessity for routine histopathological examination of excised tonsillar tissues. This prospective study was conducted in Al-Ramadi Teaching Hospital/ENT Department and Pathology and Forensic Medicine Department in Anbar Medical College, Iraq. Hundred adult patients with chronic tonsillitis were subjected to histopathological examination during the period from 1 January 2012 to 31 December 2012. The histopathological results showed features of chronicity in form of hyperplasia 200(100%), fibrosis 144(72%), surface ulceration 112(56%), crypt abscess 80(40%), bacterial colonies 48(24%), focal suppuration 16(8%) and focal necrosis 8(4%). No malignant or granulomatous changes were found in the examined tissues. In conclusion, there is a strong correlation between the clinical and pathological findings of patient with chronic tonsillitis. Granulomatous or malignant lesions were not recorded. This study support previous studies which reported that routine histopathological examination of the removed tonsils is not recommended unless suspicious findings like weight loss, history of cancer, neck mass, asymmetry of the tonsils and fungating or ulcerative tonsillar mass.


Article
Effect of treatment with subcutaneous epinephrine versus nebulized salbutamol on O2 saturation and rate of admission in patients with bronchiolitis

Pages: 5-9
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Abstract

Despite wide spread use of epinephrine β2-agonists in infants with bronchiolitis since the late 1950s, the efficacy of these drugs remains unproven. The objective of the study is to determine the effective treatment with subcutaneous (s.c) epinephrine versus nebulized salbutamol on O2 saturation and rate of admission to hospital in patients (age 2 years or less) with bronchiolitis. Single dose of epinephrine (0.01 mg/kg) has been used across various age groups of 2 years or less (maximum dose used was 0.15 mg) and no complications were reported suggesting that the dose is safe; however the maximum safe dose cannot be interpreted from this study. The response to sc epinephrine in patients younger than 12 months was significantly better than in older patients, suggesting a useful role of s.c epinephrine in bronchiolitis in this age. The s.c epinephrine relieves clinical manifestations of respiratory distress (wheezing, chest retractions, flaring of alanasi, cyanosis) and improves parameters of respiratory distress (oxygen saturation, respiratory rate) in infants treated for acute bronchiolitis with maximal effectiveness at 30-60 minute. For s.c epinephrine, every patient had his own disposable syringe; while for nebulized salbutamol, all patients share the same nebulizer. So that, s.c epinephrine may decrease the likelihood of transmission of infection between the patients. The s.c epinephrine reduces the admission rate (13%), compared to nebulized salbutamol (24%). The observation that peak action of s.c epinephrine occurs 30-60 minutes after administration suggests the need for caution in repetitive administration during this period.


Article
Epidemiology of the poisoning in children admitted to emergency unit at Al-Diwaniah teaching hospital of pediatrics

Pages: 10-16
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Abstract

Poisoning in any medical centre is considered as one of the most common medical emergencies in children. Acute poisoning in children constitute about less than three percent of all pediatric emergency admissions. The aim of study; to evaluate acute poisoning in children below 15 year old admitted to emergency unit. Hydrocarbons were the most common poisonous substances leading to hospitalization; we had the highest frequency of admissions in winter. Further, the highest number of poisonous cases was in January and December 79 case and lowest rate 23 case was observed in October; there is an increasing trend in proportion of kerosene poisoning from December to February. The rate of suicidal attempt is very low in our study only 6 cases this result is contrary to other two studies, these are common in adolescent also related to the nature of social environment and learning in each area. In our society accidental kerosene poisoning, which the most common cause of the intoxicated patient admitted to the emergency unit, occur when the patient try to do procedure to prepare kerosene heater stove or for light (lantern). Only very few cases is related to suicidal attack in our study, We recommend to remove all the poisoning agent as soon as possible from the areas easily reach by the child (removal of poisonous plants and removal of fuel sources like kerosene). Poison control centre to triage poisonings, prepare service accurate and timely advice to health personnel and caregiver should be available in each governorate.

Keywords

Poisoning --- Causes --- Hospital outcome --- Aldiwaniah --- Iraq


Article
Erythrocyte sedimentation rate in patients with positive sputum for AFB and negative HIV serological test

Authors: Ahmad Hasan Raheem
Pages: 17-23
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Abstract

The goals of this study are detection of the prevalence of ESR elevation in patients whosuffering from pulmonary tuberculosis with positive sputum for acid fast bacilli and negative serological test for HIV, and showingthe effect of normal ESR ondiagnosis of active pulmonary tuberculosis. 37 patients of pulmonary TB with sputum positive for AFB and negative serological test for HIV, were involved in this retrospective study over145 days,at major TB center of Al-Hillacity, Iraq.The Westergren method used for detection of ESR for all patients. Of the total 37 patients involved in this study 21(57%) were males and 16(43%) were females. The ages of the male patients ranged from 21-82 years, and the females from 23-75 years in addition to one girl with age of 5-year. 22(59.5%) patients cigarette smoker and 15(40.5%) non smoker. 3 patients (8.1%) with ESR less than 20mm/hr, 13 patients (35.1%) with ESR 20-40mm/hr,12 patients (32.4%) with ESR 41-60mm/hr and 9 patients (24.3%) more than 60 mm/hr. According to dependent normal range in this study 7(19 %) patientswith normal ESR. 19% of patients involved in this study have normal ESR, so the pulmonary TB should be expected in any patient with suggestive clinical features even when the ESR is normal specially in an endemic area as in Iraq, and it is clear from result above that the smoking is important risk factor for pulmonary TB.

Keywords

ESR --- Tuberculosis --- Acid Fast Bacilli --- Sputum --- HIV


Article
MicroRNA-92gene expression in epithelial ovarian cancer using a novel Real-Time Polymerase change reaction

Authors: Shoroq Mohammed AL-Temimi
Pages: 23-33
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Abstract

MiR–92 is one of six miRs encoded by the miR-17-92 cluster and its one of the best-characterized oncogenic miR clusters. A role for miR-92 in the pathogenesis of human cancers has been implicated by the high incidence of amplification in multiple neoplasm. The objective of this study is to estimation the miR-92 gene expression levels in both fresh tissues and serum ofsame ovarian cancer patients by using stem-loop follow by Taq-Man Real Time PCR (RT-PCR) technique and correlate the miR-92 gene expression with stages and lymph node involvement of ovarian cancer patients. Stem-Loop RT-PCR was performed to identify the level of miR-92 gene expression in both fresh tissues and serum of same ovarian cancer patients. The expression levels of miR-92 relative to mRNA of GAPDH were determined by using the livak method. Mean fold change of miR-92 was statistical significantly higher in ovarian cancer from precancerous tissues. Mean fold change of serum miR-92 gene expression was higher statistical significantly difference from healthy control , mean fold change of miR-92 in advance stage( III,IV) was higher statistical significantly difference from that early stage (I,II) and mean fold change of miR‑92 in patient with positive lymph node was higher statistical significantly difference from that of negative lymph node .There was no significant associationbetween gene expression of miR-92 and age of patients. Together we concluded that the over-expression of miR-92 were observed in serum patients with epithelial ovarian cancer compared with healthy controls, and miR-92 gene expression levels increased with lymph node involvement and advance stage of epithelial ovarian cancer.


Article
Arthroscopic debridement and lavage of knee joint osteoarthrosis

Authors: Zuhair Gheni Abd Ali
Pages: 34-37
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Abstract

Recent advances in instrumentation and the growing understanding of the pathophysiology of osteoarthrosis of the knee joint have led to increase the use of arthroscopy for the management of degenerative arthritis of the knee, during this study 50-patient perform to them arthroscopic debridement and lavage from October 2010- April 2014, 30 male patients and 20 female patientin multicenter in Baghdad and Al Najaf cities, patient age range from 40-60 year, all with single knee joinst eoarthrosis, our procedure include debridement and lavage of the hypertrophied synovium and osteophyte and subchondral penetration, in most patient short term symptomatic relieve can be achieved with the arthroscopic debridement and lavage of the osteoarthritic knee joint, the greater symptomatic relieve and more persistent pain relieve can be achieved in patient who have acutonsent of pain, mechanical disturbance from cartilage or meniscal fragment, normal knee joint axis, and minimal radiographic evidence of degenerative osteoarthrosis.


Article
Bacteriological study for some aerobic bacteria contaminated the post–operative wounds

Authors: Shaimaa M.S. Zain Ulabdeen
Pages: 38-42
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Abstract

This study include isolation and diagnoses of some aerobic bacteria contaminated the post–operative wounds from infected wounds,100 samples were collected from surgery units of teaching hospital, and Al-Samawah general hospital during September 2014 to February 2015, then the samples cultured on various media (Blood agar, MacConkey agar,chrom agar). Our results showed that from 100 samples included, 73(73%) had growth and 27(27%) had no growth. Further, the present data reported that S. aureusas the commonest isolate at percentage (23.2%),followed by Staphylococcus epidermidis (20.6%), Escherichia coli (12.3%), Pseudomonas aeruginosa, Proteus mirabil, Klebsiellapneumoniae (8.2%), Enterococcus faecalis (6.8%),Citrobactersp (2.7%) and Klebsiella oxytoca, Serratiamarcescens, Acinetobactersp at percentage (1.4%). Fomites should be regarded as a possible source of since bacteria from them can be carried from the hands of theatre personnel to the patient.


Article
Heart block necessitating pacing at Iraqi center for heart diseases, October 2011 – August 2013

Authors: Hassan Abdul Amir AL-Daghir
Pages: 43-48
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Abstract

A cross– sectional study was conducted at Iraqi Center for Heart Disease– Baghdad /Iraq. A 82 cases of heart block during the period from October 2011- August 2013. 43(52.43%) were males while female sex was reported in 39 (47.56%), 40(48.78%) had syncope dizziness, 18(21.95%) impaired performance, and 8(9.75%) presyncope. 3rd degree heart block was reported in 47(57.31%), Sick sinus syndrome in 14(17.07%) mobitz 2 in 11(29.39%), bifascicular in 5(6.09%) and be fascicular with prolonged PR interval in 2(2.43%). Temporary pacing was done in 70 (85.36%). Congenital heart block was reported in only one patient (1.21%), while familial heart block had not been reported. Critical IHD had been seen in 20(24.39%). Acute MI was founded in one case (1.21%) only. Permanent pacemaker had been implanted in 74 (90.24%) of patients. The highest rates of heart block had been shown in elderly patients and mostly of the white race. Sex has no an impact on the incidence of heart block. Dizziness was a common presenting symptom. Most of events were insidious. The majority of our cases of heart block were of 3rd degree type. Ischemic heart diseases precede the event in about a quarter of our cases, also DM and hypertension are commonly preceding the occurrence of heart block. Drugs although rarely encountered as a cause of heart block in our series but should be taken into consideration. Congenital heart block was extremely rare and so also the familial type which had not be encountered in our cases. Temporary pacing as a bridge for permanent pacing was commonly used. Cardiac biomarkers were nearly normal in all our patients. Holter study showed AV block to be more common than Sick sinus syndrome in those cases studied by this test. No need to perform treadmill test in most of our cases. Coronary angiography is required to be performed according to the recommended guidelines and IHD was reported in a quarter of our cases. Acute myocardial infarction was rare as a cause of heart block necessitating a permanent pacing.


Article
Detection the biological activity of aqueous extract of Shamar plant seeds Foeniculum vulgare Mill

Authors: Talib F. Abbas
Pages: 49-55
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Abstract

Unfortunately, many type of chemical drugs approved their unsafely, after period of use, it have been withdrawn from markets. Otherwise, herbal medicine wide spread in using and application, with some modification if it's necessary. Shamar herbs Foeniculum vulgare Mill, is a herbaceous plant of the family Umbillflorae, native to the Mediterranean, have a WHO recommendation, is a main component of many manufactured drugs in pediatrics. It is commonly known as fennel has been in medicine as analgesic, digestive, diuretic, lactigenous, anti-inflammatory, anti­- spasmodic agent. Crude extract for the verification of biological activity was prepared from seeds bought in the markets. The antimicrobial activity was determined by paper disc diffusion test and minimum inhibitory concentration MIC. The tested microorganisms were clinical isolates obtained from bacteriology sector of Al- Samawa hospital for women and children, It had been evaluated its biological activity in 3 different model of microorganism (E. coli, Klepsiella spp. and Pseudomonas spp.). Results of evaluation approved the biological activity of Foeniculum vulgare Mill as bactericide effect. The MIC show quantity and quality effects of fennel on the Microorganism model, The Coliform inhibited by the lower concentrations gradient, Klebsiella spp. had affected by higher doses, while, the Pseudomonas spp. did not show any change for all concentrations gradient. Therefore, shamar ( Fennel) extract had a pharmacological character in treat many GIT, respiratory infection, in addition to its favor effect in nursing and lactation.


Article
Missed intrauterine device with rectal penetration; case report

Authors: Sami M.Al-Rubaye
Pages: 61-69
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Abstract

Intrauterine contraceptive device has been used widely as a method of contraception but it is not without complications and here we report a case of migration into the rectum.


Article
Prenatal diagnosis of thoracic ectopia cordis: a case report

Authors: Maithem I. Sabeh
Pages: 70-73
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Abstract

Twenty years old primigravida lady has visited sonar clinic during the second trimester as a part of routine prenatal care after Shirodkar procedure for cervical weakness. The sonographic study revealed a single active viable fetus, of 15 weeks gestational age, in slight hyperflex position. The placenta was normal and situated posteriorly, with normal amount of amniotic fluid. The fetus had anencephaly associated with heart extrathoracically. Family and maternal history revealed exogamous marriage with uneventful obstetric history. A second sonographic follow-up examination was done at 25 weeks gestational age

Table of content: volume:3 issue:1