The Medical Journal of Tikrit University
This journal is dedicated to the Medical College of Tikrit University, providing a platform for researchers to publish their work. It allows scholars to share their findings, enabling others to benefit from reviewing and building upon published research.
The efficacy, safety and tolerance of azithromycin pulse therapy in papulopustular acne in Iraqi patients
Objective: to assess efficacy, safety, and tolerance of azithromycin in acne.Methods: open-label non- comparative therapeutic study of 500 mg of azithromycin thrice weekly for 8 weeks in treatment of moderate-sever papulopustular facial acne in Iraqi patients. Patients were examined by two dermatologists and a full count of lesions, we used special grading system of papulopustular acne .The lesions were counted at the beginning of the treatment (baseline, day 1) and at weeks (2,4,8). The difference between the number of lesions at baseline and in subsequent visits was used to evaluate the efficacy of therapy. A difference equal to or greater than 50 % was considered "good-excellent", 20 – 50% "moderate," and < 20 % "poor".No topical therapy was associated. All patients were also evaluated at 2 months, post-treatment follow-up visit. 74 patients were enrolled (11-27 years) with moderate-sever papulopustular acne. (72%) had excellent response, (12%) moderate response, (16%) poor response. The pustular inflammatory acne responded more dramatically, while the comedonal lesions more resistant. No serious side effects were noticed. After the 8 week, patients advised to stop azithromycin and followed up for 2 months. Conclusions: azithromycin pulse therapy is safe, effective and tolerable antibiotic for mild-moderate inflammatory acne with very few side effects.
Significance of Lipid Profiles and Glycemic Control in Children with Diabetes Mellitus in Baqubah City
Background: Diabetes mellitus (DM) is associated with a high risk of cardiovascular disease.to evaluate the relationship between long diabetic control ,the HbA1c and lipid profile parameters owning diabetic children and that with healthy ones Method :Forty seven patients with DM were evaluated by history and data about each patient included age, gender, family history of Diabetes, member of the family with DM and time were diagnosed as Diabetes Miletus. Result was revised for HbA1c and Lipid profile (total cholesterol, triglycerides, HDL-C and LDL-C) was performed. Fifty healthy children were included as control for both lipid profile and HbA1c. Results :From47 patients with DM (15, 31.9%) were males and (32, 68.1%) were females. The mean ± SD for age of patients with diabetes mellitus was (9.49 ± 3.804) year. Dyslipidemia and elevated HbA1c were significantly more frequent among DM children and adolescents compared to control subjects. Cholesterol, HDL, LDL and HbA1c P - value (P=0.003), (P=0.001), (P=0.036) and (P=0.000) respectively.Triglycerides it was statistically non-significant P - value (P=0.135). Conclusion :Diabetic children with poor control are at higher risk of developing dyslipidemia.
Diabetes mellitus, Dyslipidemia, HbA1c, cholesterol
Assessment of primary health care services from attendant's point of view in Tikrit city.
Primary health care focused on health care services including health promotion .illness and injury prevention .diagnosis and treatment of these illness and injury. To Assess the accessibility of primary health care services in Tikrit city, estimate the attendants satisfaction toward health services delivered by PHHC and To identify the gaps that affected the fluency of services. Descriptive study was carried from 1st March to 30th May 2010.three primary health care centers in Tikrit city were included in the study , enrolled 283 attendants of these centers were interviewed by researchers ,data were collected through special design questionnaire form. Most of attendants were children which account about 37% and less likely women were account 35% while 82% from urban. The causes for seeking medical care from primary health care centers were 32% for vaccination ,25% for antenatal care and 35% ,8% for medical care and investigation respectively, 86% of attendants were visit the centers previously and but 66% faced difficulties to reach the centers and only 33% founded the centers accessible farther more 85% they needed vehicles to reach the centers. Regarding the average time consumed by attendants as followings 3 + 1.2 min for waiting to tackle the ticket and 10 + 1.5min average time waiting on doctor room .89% of attendants said that the physicians listening to them while 18% said that physicians did not examine them. The attendants were summarized their opinion as followings 12% very good services while 1% were said the services very poor quality that was because of shortage in the staff ,and crowding of attendants at beginning of working hours. The present study conclude that most of attendants were facing difficulties in reaching the PHCCs and the services delivered by PH Cs were subjected to some obstacles like accessibility of these centers and crowding at beginning of working day.
Primary health care services, patients satisfaction
Management of Imperforate anus in children a study of 20 cases
A prospective study of twenty cases of imperforate anus in children in salahaldeen government from January 2008 to January 2010 .A twenty cases managed 8 patients (40%) of them female and 12pateints(60%) are males the male patient 9(45%) of them have a high type imperforate anus and 3(15%) of the male have low type imperforate anus. the females 8(40%) patients present with anovestibular fistula .all females and all male with high type imperforate anus a protective colostomy done for them .three cases(15%) was low type imperfoate anus treated by anoplasty in the neonatal age group .all females8(40%) patients treated by cutback technique and all male with high type treated by posterior sagital anorectoplasty. closure colostomy done in 8 to 12 weeks of definitive surgery. Two (10%) patients was down syndrome and three (15%) patients have congenital heart diseases.
Evaluation of serum cholesterol and triglycerides level in normal and low birth weight neonates
Normal birth weight neonates are those who delivered with a birth weight of 2500 g up to 2600 g, while the low birth weight neonates are those who delivered with a birth weight of less than 2500 g. The Aim of this study is to evaluate the serum levels of cholesterol and triglycerides in apparently healthy normal birth weight neonates and low birth weight neonates. In a cases control study conducted in Iraq, the serum levels of cholesterol and triglycerides were tested during the period from the first of March 2006 to the last of July 2009. The study had been done on 200 neonates; they were divided into 2 groups, and these includes 100 apparently healthy normal birth weight mature neonates (NBW) and 100 apparently healthy low birth weight premature neonates (LBW). Each group was assessed for both physical characteristics and send for serum cholestrol and triglyceride level. The results revealed that: The mean serum cholesterol level in LBW (1.78 mmol/L) was significantly lower than that in NBW neonates (2.2 mmol/L). The mean serum triglyceride level in LBW (0.52 g/L) was significantly lower than that in NBW neonates (0.62 g/L). Conclusion: Serum cholesterol and triglycerides are significantly decreased in LBW neonates compared to the apparently healthy NBW neonates.
Reliability of tuberculosis rapid test in diagnosis of pulmonary tuberculosis in Al-Hawija district.
Tuberculosis (TB) is common in Iraqg, early diagnosis, especially for active pulmonary cases, allows to start therapy of the disease rapidly. Pulmonary tuberculosis is usually diagnosed by presence of clinical features, direct sputum smears examination for acid fast bacillus (AFB), and chest X ray (CXR). Advances in serological assays for fuberculosis have made serology an attractive surveillance method, tuberculosis rapid test is one of these new methods. This employed to detect antibodies specific for mycobacterial antigens in the serum of suspected TB patients. The aim of this study is o evaluate the reliability of tuberculosis rapid test in diagnosis of pulmonary TB patients in Al-Hawija district. A fifty patients were studied between August 2010 and February 2011, who were then classified into two groups; a group of pulmonary tuberculosis (n = 30) and a group of non-tuberculous pulmonary infection (control group) (n = 20). Direct sputum smears examination for AFB, CXR, and tuberculosis rapid test were performed to all patients. The mean age of pulmonary TB group was 37.3+16.4 years and 17(57%) patients of them were men, while the mean age of the control group was 36+16.2 years and 11(55%) patients of them were men. Direct sputum microscopic examinations for AFB were positive in 9 (30%) patients of pulmonary TB group, while none of the control group was sputum smear positive. The results of the tuberculosis rapid test revealed that 21(70%) of pulmonary TB group and 3(15%) of control group were positive. The sensitivity, specificity, positive predictive value and negative predictive value of tuberculosis rapid test were 70%, 85%, 87.5% and 40% respectively, which also compared to sputum smears results. Conclusion: It was concluded that tuberculosis rapid test in comparison to sputum smears examination, it can be used as a rapid diagnostic test of pulmonary TB along with traditional diagnostic tests in endemic areas.
The knowledge of Tikrit university female students about breast self examination
Breast cancer is the leading cause of cancer mortality in women worldwide. The prognosis of breast cancer depend on the early detection of the disease, and the best mean for early detection of breast lump is breast self examination. To assess the knowledge of Tikrit university female students about breast self examination also to estimate rate of practice of breast self examination and to identify the student knowledge about breast tumour. This study cross-sectional study carried out from the beginning of March to the end of April 2010 enrolled 158 Tikrit university female students.Multistage sampling technique was chosen ,Data collected by using interviewer administered questionnaire for were filled by the members of the study group from different colleges; Medicine, Dentistry, Pharmacy, Engineering, Science, Computers and mathematics, Arts, Veterinary medicine, Agriculture, Breeding and Law colleges using questionnaire that included general information about the age, residence, socioeconomic state. Knowledge was weighting by using score; 4&5 considered as good information, 2&3 considered as middle information and less than 2 considered as bad information. The study revealed about the source of information that 43 (32%) of them from TV,21 (15%) from meeting and lectures and22 (16%) from books and journals. The knowledge about the steps of breast examination, only 32 (24%) of females was having a good information, 48 (35%) middle information and 56 (41%) bad information also when the students asked about the most appropriate time for examination, the answers were:96 (70%) just after . Although 136 (86%) of students hear about BSE; only 24 (18%) examined their breast and 112 (82%) did not and the cause that prevent females from examination of breast was Lack of knowledge in 27 (24%) ,Worry to find lump in 14 (13%), Forgetfulness in 51 (45%) and No time in 20 (18%).It was also found that 147 (93%) know about breast lump and 11 (7%) do not know about breast lump. The majority of study sample heard about BSE before, the majority of the study sample had unqualified knowledge related to BSE. The main source of information was TV, and the least sources were internet and relative but the majority of the study samples do not practice BSE.
Assessment of patient documentation and registration in emergency department in Tikrit Teaching Hospital.
Patient information, medical history, clinical outcomes and demographic information, can be registered in different ways in registration programs. Emergency department records are important source of injury surveillance data. The bedside registration, combined with a new electronic medical record system, helps to expedite patient care in the emergency department. To identify the registration and documentation performance in emergency unit in Tikrit teaching hospital and to estimate the gap in the file system registration. This is a cross-sectional study performed by collecting and analysis of data registered on files of cases admitted to the emergency unit in Tikrit Teaching Hospital over one month period extended from 1-31 January 2011 (including demographical data, examination, lab Investigation, discharging notes and doctor notes) of (2660) records these information was divided into items weighing by using scales designed according the data registered in the records. Current study revealed that most of the demographic information were not fully written as 1560 (58.65%) files did not meet the standards of documentation while patients history there were 1500(56.4%) files with partially written general history. (52.6%), (60.2%) not written information systematic and background history respectively. The study founded that examination notes there were a high percentage of incomplete documentation of vital signs, general assessment and systematic examination which represented ( 70.7% ) (65.41% ) and (59.4% ) respectively. The sources of referral showed (51.9%) were walk-in patients which is the most common source. Most of files contain discharging note, (40.6 %) were discharged home, and (39.1%) discharged on their responsibility. There were (68.42%) files contained the notes of the house officer. Registration of files does not meet the international standards, as files are packed in nylon sacs and stored in the unit of statistics. Concerning the registration book of accidents; it is found that not all items of trauma (international classification) were recorded. This study concludes that patients’ files in emergency department were not fully documented, also there is no standardized program of registration of patient files and no computerized data for this unit.
Pharmacoepidemiological study of prescription pattern of analgesics,antipyretics, and nonsteroidal anti-inflammatory drugs at Tikrit teaching hospital, Iraq, Tikrit.
A cross sectional study of outpatient prescriptions kept by the pharmacy department at Tikrit teaching Hospital during the period 7th December 2009 until 7th December 2010 ,To examine the outpatients’ prescribing pattern of doctors to analgesics, antipyretics, and nonsteroidal anti-inflammatory drugs (NSAIDs) . The type and number of drugs prescribed, patient’s diagnoses and age, and the prescribing physician were analyzed. The study sample included 1898 prescriptions, (1040%) of them containing to analgesics, antipyretics, and non steroidal anti-inflammatory drugs (NSAIDs) .There was no significant seasonal variation in the pattern of prescription. The most commonly prescribed agent was paracetamol (63.9%), followed in decreasing frequency by ibuprofen, diclofenac, and aspirin. In few of the prescriptions combination of analgesics, antipyretics, and NSAIDs were used. infection in 40%, and musculoskeletal disorders in 17.7% of all treated cases. The rest were a variety of problems for some of which, the drugs were used inappropriately. Aspirin was used exclusively in adults for cardio- protection, while paracetamol was used mainly as analgesic-antipyretic over all age groups.
Causes of Measles Outbreak in Al-Sader city-Baghdad/Iraq
Background: measles is a highly contagious viral disease causes high mortality and morbidity in pediatrics. It is a preventable disease (by vaccination). So vaccination is a major issue in preventing the disease and its spread. The study conducted in this research work aims to allocate the causes of new epidemic of measles in Al-Sader city and its prevention if a future attack may occur. Patients and methods: A case-control study done on patients attend Al-Imam Ali hospital from 1st of march to 31st of may. Data collected from patients who diagnosed clinically as measles (318 patients) and from patients attend the same hospital for other medical problems (3280 patients). Results: Measles diagnosed clinically in 318 patients. 73.6% of them (their ages 5 years and younger), 13.8% were vaccinated and 22.9% were from low socioeconomic class. 97.1% were in close contact with measles cases; 48.7% were admitted to the hospital. Unfortunately one baby died (age was 9 months). Conclusion: vaccination programs should be more effective, age of first measles vaccine should be re-evaluated. While public education about vaccination and diseases control should be taught via various media channels.
Epidemiology of urinary incontinence of women in Tikrit city
A cross sectional study was conducted To find out prevalence rate of urine incontinence (U Dina sample of women (n=91) in the age group (50 — 65) years in Tikrit city (Al Arbaan area, Al Zohor area, Al Metdar area) .The study will also investigate the relationship between UI (stress and urge) and the following variables: age of the woman and her parity, diabetes mellitus, urinary tract infection (UTI),body mass index (BMI), medications (diuretics), menopause, past history of hysterectomy, and poor mobility. Approximately one third of respondents had urinary incontinence; (23.1%) had stress UL, (26.4%) had urge UI, and 18.1% had the mixed type. | Prevalence rate of UI was( 56.3%) for women suffering from UTI and (50%) for those who use diuretics. Approximately (54%) of women who need help to go around inside the house were complaining of UL High prevalence rates were also observed if parity was 5 - 6 (43.5%), women at menopause (39.7%), obese women (39.3%), and in diabetic women (35%). and in women with past history of hysterectomy (28.6%).
Echocardiographic assessment of aortic wall elasticity in apparently healthy individuals: the association with age and serum total cholesterol.
Background: The aortic elastic properties are relevant at several sites of cardiovascular. Increased arterial stiffness is an independent risk factor and predictor of cardiovascular mortality and an early predictor of coronary risk useful in screening. Therefore the evaluation of arterial stiffness may be important for clinical diagnosis and intervention in cardiovascular disease. Aim: The purpose of this study was to show the effect of age and total serum cholesterol on the percent wall thickness change, after adjusting for stroke volume. Methodology: A cross-sectional study using two-dimensional and Doppler of blood flow of aortic root echocardiography was preformed for a random sample of 60 apparently healthy males with an age ranging between 17 and 75 year. Aortic wall elasticity was assessed by percent wall thickness change. Results: Using multivariate modelling it was shown that age, serum cholesterol and stroke volume were a statistically significant independent predictors of Aortic wall elasticity (assessed by percent wall thickness change), after adjusting for blood pressure and BMI. Age and serum total cholesterol had an average ROC area of round 0.7 when used to predict high rigidity of Aortic artery. An age of 68 years and above was 95% specific in detecting rigid artic artery with low sensitivity 30%. A serum total cholesterol of 199 mg/di and above was associated with sensitivity of 50% and specificity of 85% in detecting rigid aortic artery. Conclusion: Being in the sixth decade of life and having a serum cholesterol of >200 mg/dl will predict a rigid aorta with a reasonably high specificity. Measurements of aortic artery elasticity using Echocardiography is simple and may contribute to cardiovascular risk assessment.
Echocardiography, stroke volume, aortic stiffness.
Maternal mortality, descriptive study in ninava city
More than 500,000 women died from complications related to pregnancy or childbirth in 2000 in developing countries, but 99% of those maternal deaths were preventable . The aim of this paper was to analysis MMR in Nineveh city in the year 2007. Data concerning maternal deaths collected from the reports issued by Committee of Confidential Inquiry for Maternal Deaths were analyzed regarding the maternal age ,parity , direct and indirect causes of deaths , rate of deaths in side and out side hospital, level of care available at delivery, distance women need to arrive to health facilities, mode of transport. 43 maternal deaths among 95526 deliveries during the study period . MMR was estimated to be 45/100000 live births. The age range was between 20-42years there were 22(84.8%) cases >30,rnost of them(44.9% ) were grand multiparous (parity >5). ). Direct causes of maternal deaths were accounting 36cases(83.7%) of deaths, indirect causes were present in four cases ( 9.3%). Unknown causes found in three cases. The leading direct causes of maternal deaths were hemorrhage twenty four cases (55.8%) ,Hypertension nine (20.5%) ,pulmonary embolism three (6.9%). 21/24(75%) died from hemorrhage out side hospital after home births and three cases (6.9%) from ante partum haemorrhage in side hospital . The level of care available at delivery was estimated, 40% attended by traditional birth attendants(TBA), 33% by lady health visitors, 10% by doctors and to 17% no level of care was available. The distance women needed to arrive to the hospital was between 10 and 100 KM. Majority of the cases (sixteen )transported by private car. Hypertension complicated pregnancy is the second direct cause of death . Nine cases (20.6%) died from hypertension complication .Six cases (66.6%) in side health institute from cerebrrevascualr accident ,pulmonary oedema ,coagulation failure. Three cases(33.6%) out side health institute before delivery from eclamptic fits. The present study conclude that, although registrations of maternal deaths is improved in our locality, still the direct avoidable causes of maternal deaths ( haemorrhage , hypertension, pulmonary embolism ) are the major causes of deaths. Also, the present study recommend that, strong policies to reduces these causes were needed in term of activation of basic emergency obstetrics care. There must strategies to reduce avoidable causes by: First, by ensuring availability of health professionals trained and experienced in obstetric complications may significantly reduced maternal mortality. Second by, traditional birth attendant should be trained not to cause complications, rather recognize complications and not to manage complications on their own and should be motivated to make referrals. Third by, existing health services should be improved and emergency obstetrical care should be available to all women round the clock. Equipping the existing basic health units and rural health centres with Basic emergency obstetric care (BEOC) includes: injectable antibiotics, anticonvulsants and oxytocics Misoprostole , 0 negative blood products. And the fourth by, repeated and closely spaced pregnancies should be discouraged and contraceptive prevalence needs to be increased in culturally conservative areas.
CCEMD confidential inquiry of maternal deaths, MMR Maternal mortality ratio. TBA traditional birth attendance .SBA skilled birth attendance. BEOC, Basic emergency obstetric care
Prevalence of Musculoskeletal Symptoms among Visual Display Terminal Users
Background: Musculoskeletal pains are the main health problems reported by computer workers. There has been an increased frequency of ergonomic injuries and illness in the computer workstation. The increase in Visual Display Terminal (VDT) use has been associated with an increased prevalence of disorders in the neck, upper extremities and lower back of the body. Furthermore, poor workstation design has been associated with an increased risk of developing these symptoms. Aims: To estimate the prevalence of musculoskeletal disorders among visual display terminal (VDT) users. Method: A cross-sectional study was conducted over a two month period during the summer of 2010 in Baquba. One hundred twenty VDT workers are selected randomly comprising 60 male and 60 female. Questionnaire was performed among these VDT workers for study period to measure the prevalence during the previous 12 months of musculoskeletal disorders. The survey was carried out on the effect of work with VDTs on musculoskeletal disorders in workers in the computer workstation. Results: The result of this study was that the neck, shoulder and lower back problem are the main problems among VDT workers. Both male and female VDT workers also suffered pain in neck, shoulder, low back, forearm, wrist, elbow and the different parts of the upper extremities. This study revealed that the female VDT workers suffer more discomfort feeling than male VDT workers. Prolonged period of work in an awkward posture mainly lead to discomfort feeling among the VDT workers. The 12 month prevalence of musculoskeletal complaints in various body parts were: neck (30.0%), back (28.3%), shoulder (18.3%), wrist (8.3%), forearm (6.6%) elbow (5.8%) and (2,5%) fingers. It was found that there was a gradual increase in musculoskeletal complaints as the number of hours spent for working on computers daily increased. Conclusions: It is concluded that; The VDT workers suffered pain mainly in neck, upper extremities and lower back of the body. As the duration of job increased, the risk for musculoskeletal symptoms significantly increased. Recommendation: More consideration should be paid to the ergonomics of workstations, the placing of the mouse, the postures of the upper extremities and the handling of the mouse.
prevalence; musculoskeletal symptoms; workstations; VDT.
Big Perineal lipomas with imperforate anus
Newborn male patient presented at alkhansaa teaching hospital with signs of neonatal intestinal obstruction secondary to big perineal lipoma and anorectal malformation, a colostomy performed .After 4 months the size of lipoma get bigger, a decision for excising lipoma with posterior sagittal ano-recteoplasty was performed .Regular dilatation for the internal anal sphinector and closure of colostomy was done ,follow up for 5 years shows normal bowel function with total continence t although it has been said that perineal lipoma with anorectal malformation may compromise bowel function ,we conclude that the line of management is the same as simple anorectal malformation and the outcome is promising if excision of lipoma done early in life.
The effect of gender on range of motion (ROM) for knee joint
This study was distinguished there is a difference between male and female knee range of motion (ROM). Participants were grouped according to injured and non-injured knees within their gender mostly from ages 15-25 years. A goniometer is used to measure range of motion (in degree) of knee joint. The measurements in this study included the comparison of knee ROM in male injured, male non-injured, females injured, and female non-injured participants.. This results showed that injured females have a more decreased motion of flexion while injured males had a more decreased motion of extension , that compared to a normal ROM of flexion of 140° and an extension of 0°. The results showed non-injured females to have an average flexion of 122.7100° and injured females to have an average flexion of 116.0000 and an average extension 2.1200°, The non-injured males to have an average flexion of 125.4500° and the injured males of our study had a flexion average of 126.5550° and average extension of 2.0730°. The difference between non-injured females and injured females was 6.71° of flexion and the difference between non-injured males and injured males was 1.105° of flexion. When comparing injured. males to injured females there was a difference of 10.555° of flexion and 0.047° of extension. These results suggest that injured females have a more decreased flexion while injured males have a more decreased extension.
Review on the management of chronic traumatic coccydynia
The purpose of this study is to evaluate the conservative treatment of chronic traumatic coccydynia by intrarectal manipulation of the coccyx and massage of the coccygeal Muscles. Case series study was done in the department of Neurosurgery, Ibn-Sina teaching hospital in Mosul, from March 2000-August 2006. Sixty five patients (sixty females, five males) with chronic traumatic coccydynia treated by intra rectal manipulation of the coccyx and massage of the coccygeal muscles. Those with failure of this method treated by coccydectomy. Sixty five patients underwent intra rectal manipulation of the coccyx. Sixty patients responded to conservative treatment. Five patients underwent coccydectomy, three of them did well the remaining two did not respond even to surgical treatment. Conservative treatment for chronic traumatic coccydynia is the treatment of choice. Surgical treatment is required only to those patients with failure of conservative treatment.
Management of abdominal Non-Hodgkin's lymphoma in children in Mosel
A Case series study include 34 child with abdominal NHL treated in AL~ Khanssa teaching hospital in Mosel between January 2001 and J anuary 2010 . 34 children with abdominal NHL treated, complete history and full examination done, with investigations which include hematological and radiological study. Fine needle aspiration cytology from the abdominal mass done in some patient. For those patients underwent laparatomy, a uniform policy was made to resect the tumor if possible or to debulk the tumor irrespective to the diseases spread, and if this was not possible to perform only a biopsy .The resected specimen sent for histopathology. All patients send for chemotherapy. The total number was 34 patients, 25 male, 9 female. Male to female ratio is 2.8 / 1. Age ranges between 2 and 14 years, in eight patients FNA cytology done, The total number was 34 patients, 25 male, 9 female. Male to Six out of 34 presented with acute abdomen three patients had intestinal obstruction. One patient present with multiple abdominal mass. Twenty-eight patients presented with palpable abdominal mass or masses without acute symptoms. Burkett’s lymphomas are the most common type of abdominal NHL makes 30 patients (90%), Lymphoblastic lymphoma (LBL) three patients (8%), and Large cell lymphoma (LCL) one patient (2%).
Hepatitis C virus in thalassemia patients in TIKRIT
A cross-sectional study performed on 50 patients(60% were females and 40% were males) with thalassemia major who attend thalassemia clinic at Tikrit teaching hospital for regular blood transfusions to determine the frequency of HCV infection and studying the effects of that infection on liver function and its relation to blood transfusions and iron status. Demographic data were obtained from patients files with results of antibody testing for HCV and samples of blood were sent for serum iron level and liver enzymes. Out of 50 thalassemia patients, 10% of them had positive anti-HCV antibody, their age range 17.34 years. Eighty percent of seronegative and 66% of seropositive patients were received blood transfusion at a rate more than 100 times. It was shown that 60% of patients with positive anti-HCV had abnormal liver function tests although this not significant statistically as compared with those of negative results for HCV. Patients with positive HCV and elevated iron level constitute about 80%, and 88% for those with sronegative results and high serum iron. As well as 72% of total patients had both elevated both the iron level and liver enzymes. It has been concluded that the risk of infection with HCV was significantly increased with older age groups and with the frequency of transfusions.
Role of FNA in the initial management of a wide range of pathological conditions: 3-years experience in a teaching hospital
OBJECTIVE: The aim of this study is to determine the utility and accuracy of fine needle aspiration (FNA) cytology in the diagnosis of a wide range of pathological conditions, to increase the awareness about this test to those who are unfamiliar with it and to compare the results with that of others. METHODS: All patients with palpable lesions and azospermia attending to the hospital during the period 2009 through to 2011 were included in this study. The patients were interrogated and a complete history and physical examination was conducted. The procedure is performed in an outpatient setting without any image guidance. The aspirated smears were stained and examined and the specimens were assigned to one of four different diagnoses: unsatisfactory/inadequate, negative for malignancy, atypical/suspicious, and positive for malignancy. The cases were followed up and if surgical excision done, the results were compared to that of FNA and the reliability and accuracy of FNA were evaluated for all cases. RESULTS: A total of 566 FNAs were performed 162 male and 404 female were 11 inadequate smears ( 1.94%) with an overall adequacy rate of 98.06%. Most of the insufficiency was seen-in-thyroid cases. Two hundred seventy three (273) FNAs were thyroid aspirate, 127 breast, 98 lymph node, and 24 had salivary gland enlargement. In addition there were five (5) patients had soft tissue lesions. Thirty nine (39) patients underwent testicular FNA for assessment of infertility. Only 273 (51.8%) had subsequent surgical biopsy. Comparison of FNA with subsequent biopsy results showed an accuracy rate of 95.23%. Overall false positive results were seen in only5 cases (1.8%) most of which are thyroid cases, while false negative results were reported in only 8 cases (2.93%) and breast cases were the most common. The total sensitivity of FNA procedure was 89.47%% and specificity 97.46%, with the predictive value for positive diagnosis 93.15 % and for negative diagnosis 96%. CONCLUSION: FNA is a reliable safe and efficient tool that can yields a definitive diagnosis in a wide range of inflammatory, benign and malignant lesions. The results of this study are similar to those found in previous regional and international studies. Its use for routine diagnosis must be encouraged particularly in underdeveloped countries.
Fine needle aspiration cytology, mass, infertility.
Hepatitis B In Patients With Thalassemia Major In Tikrit Teaching Hospital
Thalassemia is hereditary disease which have a significant risk of contracting of blood — born infections like hepatitis and HIV through the regular episodes of blood transfusions. This study was conducted to evaluate patients with thalassemia and to find out the percentage of hepatitis B infected patients. It was a cross sectional study done in Tikrit Teaching Hospital involved all thalassemia patients , (50) patients. The percentage of hepatitis B among these patients was (10%). Among the seropositive patients, males and females comprised (10%) for each. Patients from urban area were (9.1%) , while those from rural areas were (11.8%). The percentage of non-vaccinated patients with seropositive hepatitis B was (14.3%) compared to the non-vaccinated (6.9%). It was found that when the blood transfusion amount increases the risk of acquiring hepatitis also increases. There were (18.2%) of patients with abnormal liver function test had seropositivity for hepatitis B, and (3.6%) of the same group had normal function test. It was revealed that (16.7%) of the seropositive patients had undergone splenectomy. It is concluded that hepatitis is still a risk among thalassemic patients attending thalassemia center in Tikrit Teaching: Hospital: Therefore it is recommended to ensure a good vaccination for all patients and a regular screening about this infection and to conduct a broader study involving many centers across the country.
Monthly and seasonal variations of acute upper gastrointestinal bleeding in Mosul
Previous studies have reported seasonal variations in the incidence of acute upper gastrointestinal bleeding especially so for peptic ulcer. There is no study focusing on this issue in our locality. The study aimed to assess whether monthly and seasonal climatic changes during the year have an influence on the incidence of bleeding from duodenal ulcer (DU) and erosive gastroduodenitis (EGD); both of which are major causes of bleeding in this region. This case-series study involved (416) patients presented with acute upper astrointestinal bleeding at Al-Salam General Hospital in Mosul during the period from 1 April 2001 to 31 March 2011. All patients were subjected to endoscopic examination and causes of bleeding, and date of examination were documented. Monthly and seasonal evaluation of bleeding incidents were made and correlated with the major causes of bleeding. The main causes of bleeding were (EGD) and (DU) making 41.11% and 30.53% respectively. Duodenal ulcer bleeding showed significant monthly (p=0.035) and seasonal (p=0.005) fluctuations, peaked in November, during autumn, and the trough was in July and August during summer (P=0.0004). Bleeding due to (EGD) showed neither significant monthly (p=0.117) nor seasonal (p=0.711) variations. In this study (DU) bleeding showed clear seasonal fluctuation which is not detected in bleeding due to (EGD).
Season, upper gastrointestinal bleeding, duodenal ulcer, Erosive gastroduodenitis
The Duration of Breast-Feeding and Causes of Early Weaning in Tikrit City
This study concerned the practice of breast-feeding and causes of weaning among child bearing women in Tikrit city. The duration of breast-feeding and the number of infants who are breast fed of | different ages varies from country to country. It is believed that the prevalence and duration of breast- feeding are declining in many parts of the world for a variety of social. Economical and cultural reasons as results more frequent infections such as diarrhea and upper respiratory infections. This study revealed that most women weaned their infants during the first 6 months of life (40.6%) | and the percentage decrease as the duration of breast-feeding. Regarding the most causes of early weaning, the results showed that the milk-insufficiency is the most common cause of early weaning (45%) fallowed by the age of infants (22%). Data showed that 67.8% of total mothers were housewives while 32.2% were employed mothers.
Evaluation of Skin Prick Test for Common Aeroallergens in Patients Presented with Bronchial Asthma in Tikrit Teaching Hospital
The prevalence of allergic diseases such as asthma is high in general population and aeroallergens - are the most common allergens that cause air way inflammation. The aim of this study is to identification of the most common aeroallergens by skin prick tests and the risk factors among asthmatic patients. A retrospective study were conducted on130 patients with Bronchial asthma of these patients 68(52 %)were male and 62 (48%)were female . Age of patients was between 7 to75 years with a mean of age: 31.62 yr. The patients were referred to allergic clinic of Tikrit Teaching Hospital and skin prick tests(SPT)response to aeroallergens were studied which shows115(88%) of patients were sensitized , but15(12 %) had negative SPT (unsensitized), among the sensitized patients17(13 %) were monosensitized against one allergen,39 (30%) were sensitized against 2 allergens and 59(45%) sensitized against 3 allergens. In regard to pollen aeroallergens(61%) were considered the most common allergen and among pollen the bermuda (36%) had the highest rate of sensitization. Also this study shows the prevalence of Asthma was higher in a third decade age group while less in sixth decade and according to the occupation, positive SPT were higher in house wives patient(38%) . From this study, it can be concluded that pollens are the main sensitizing aeroallergens among patients with asthma presented at Tikrit Teaching Hospital.
Topographic Localization of Islet Cells of Rat Pancreas
Microscopic studies were performed on the islets of langerhans of the rat. Three types of islet cells were distinct. Alpha cells were differentiated at the margins of the islets, Beta cells were numerous and centrally located. Delta cells were distributed among alpha and beta cells.
Chromosomal abnormality in couple with repeated abortion
objective: A proportion of cases with repeated abortion are caused by chromosomal abnormality in one or both parents. Several studies have been done to determine the role of chromosomal abnormalities in couples with repeated abortion. Subjects and Methods: Cytogenetic study was done for 50 Iraqi couples who presented with repeated abortion at the Medical Center In Mosul Medical College .It was done in a private lab. Celis were studied using lymphocyte culture technique arrested at G- metaphase. Results: We found that the percentage of chromosomal abnormalities was (6%). It was not significantly different from that reported worldwide. The nature of these abnormalities were: first case 46, XX,t(5;3X)(q35;q23-q25), second case. 46XY,add(15)(p12) and the third one 46,XY,del (16)( q21). Conclusion: This study should help physicians working in the region to realize the contribution of chromosomal abnormalities as one of the causes of repeated fetal loss. It should also help in setting priorities of cytogenetic screen individual cases.
Renal function tests in hypertensive patients using atenolol
Hypertension is strongly associated with functional and structural abnormalities that damage the kidneys, and other organs and lead to premature morbidity and death. This research is to study the renal function tests in hypertensive patients using Atenolol and comparing the results with that in newly diagnosed untreated hypertensive patient. In addition comparing these results with that of apparently normal residents living in Mosul as a control. Eighty essential hypertensive patients were included in this study. They were divided into two groups, the first group included 50 patients (called Group A), with ages ranged from 38 - 65 years with a mean of 49.86 + 7.02 years, all were used Atenolol as antihypertensive mono therapy. The second group included 30 patients of newly diagnosed untreated hypertensive patients (called Group B), with ages ranged from 36-57 years with a mean of 44.9 years. A third group was the control group (called Group C), consisted of 30 normotensive subjects with ages ranged from 35-58 years with a mean of 45.9 years. The biochemical investigations carried were the renal function tests including serum; urea, creatinine, creatinine clearance, uric acid, sodium and potassium in addition to urine microalbuminuria. A comparison between the means of serum urea in Group B with Group C showed a | significant increase. In addition, there was a significant increase in serum uric acid in Group B in comparison with Group C. Moreover, MA level was significantly higher in Groups A and B when compared with Group C or when compared with each other. The dose of Atenolol showed a significant increase for MA with increased dose. The duration of treatment also showed a significant increase for MA with increased duration of treatment. In addition, age also causes a significant increase in MA with advanced ages and a decreased Crcl in Group A. The overall analysis of the renal function tests indicate that Atenolol although has a mild undesirable effects on renal functions but it has a negative effect on protein excretion, Moreover, untreated hypertensive patients showed more signs of undesirable effects of kidney function tests than treated patients with Atenolol specially in its effect on MA excretion.
Serum, urea, creatinine, uric acid, microalbuminuria, sodium, potassium, hypertension, captopril.
Tinea capitis in a dermatology center in the city of TIKRIT
Tinea Capitis is a worldwide problem fungal infection of the scalp, it is epidemic in many African American communities and tinea capitis constitutes an important public health problem because of high prevalence; Tinea capitis usually occurs mostly in children and results in scaling and patchy hair loss; an exception may be a kerion; this is a very inflammatory tinea of the scalp and looks like a boil or abscess. The aim of the study is to clarify the prevalence, clinical forms, risk factors, and prevention of tinea capitis in a dermatology center in the city of Tikrit. One hundred patients with tinea capitis attending Department of Dermatology at Tikrit Teaching were enrolled in this study in the period January 2010 through to January 2011 their age range from one year to thirty one years old and the mean age was 11 years. There were 32 females and 68 males. All patients were diagnosed clinically with laboratory investigations (KOH and culture), and detailed tinea capitis questionnaire was completed for each of them. From 100 patients having tinea capitis, the following clinical types are recognized, ectothirx 26%, kerion 33%, endothirx 30%, and favus 11%. The correlation of tinea capitis and residence were 62% in urban area and 38% in rural area. Direct KOH were positive in 75%, while, the culture was positive in 80%. All risk factor were in high percentage, except associated diseases were only 6 patients positive. The present study concludes that Scalp ringworm can affect people of all ages, but this condition is more likely to affect kids under the age of 10. From our study we conclude that the best way to prevent a tinea capitis is to use common sense. Don't share things with someone outside your family, and don't touch other children who have a rash on their scalp or animals with a rash anywhere. When tinea capitis is diagnosed, it is important that all family members be examined for signs of infection
Tinea capitis, direct KOH, Kerionm Tikrit
Retrospective Evaluation of Skin prick Tests to Various Allergens in Patients with Atopic Dermatitis
Atopic dermatitis is a common disease affecting many people. Avoidance therapy to the aeroallergens is a cost-effective and safe measure to help atopic dermatitis patients. Skin prick test (SPT) is a well-established method to identify the responsible allergens. The aim of this study is to determine most responsible allergens that provoke allergy in patients with atopic dermatitis in sallah Al-deen governorate. A retrospective study were conducted on 111 patients with atopic dermatitis, 65(59%) of them were male and 46(41%) were female . Age of patients was between 8 to 64 years with a mean of age: 32.56+ 9.82 yr. These patients were referred to allergic clinic of Tikrit Teaching Hospital, and skin prick test(SPT) response to allergens was done which shows 100(90%) of the patients had positive SPT, (6%)of these patients were monosensitized against one allergen while others were polysensitized for more than one allergen in which (41%) serisitized against 2 allergens ,(36%) sensitized against 3 allergens and 7% were sensitized against >4 allergenic extracts. In regard to frequencies of main allergen groups, Pollens (51%) ' and Moulds(29%) were considered the most common aeroallergens, among pollen the bermuda (34%) had the highest rate of sensitization while sensitization to food allergens was(9%) . We concluded that pollens and in particular Bermuda were the frequent causative aeroallergens in patients with atopic dermatitis.
Detection of Toxoplasma gondii Antibodies in Persons Referred to Maamon-Dabbagh Health Center for Medical Examination before Marriage, Erbil, North of Iraq
Background and objectives: Toxoplasma gondii is a ubiquitous parasite of warm-blooded animals that causes one of the most commen parasitic infections in humans. Symptomatic disease is usually uncommon and most of the infections are asymptomatic. The infection may be serious if it's transmitted to the fetus during pregnancy. Prophylactic measures, early detection of the infection and treatment can avoid congenital toxoplasmosis and many long term effects. This study was conducted to evaluate the prevalence of Toxoplasma gondii antibodies among healthy persons referred to Maamon-Dabbagh Health Center for premarriage medical exarninations. Methods: A total of 322 serum samples were randomly collected and examined for detection of specific Toxoplasma gondii IgM and/or IgG antibodies by Latex agglutination test (LAT). IgM-ELISA and I1gG-ELISA (using commercial enzyme-linked immunosorbent assay kit) were also performed to increase the accuracy of the diagnosis. Various information about participants was collected via., questionnaires and data were analyzed using SPSS software 11. Results: The overall prevalence was 29.19% (94/322)using LAT. Seropositive rate of recent (IgM) T. gondii infection was 7.76% and latent (IgG) T. gondii infection was 19.88%. A significant increase in T. gondii prevalence with increasing age was confirmed (P< 0.001). No significant relations were observed between anti= T. gondii antibodies and gender, occupation, inhabitants of rural and urban areas. Education level and contact with cats. Conclusions: About 69.57% of women in this study in Erbil City were seronegative. These women are susceptible and are at risk of acquired Toxoplasmosis in their pregnancy period. So health education especially in women who are going to marry and also during pregnancy is necessary to prevent congenital toxoplasmosis.
Toxoplasma gondii, Premarriage, ELISA, Erbil.