Volume 5, Issue 1, Spring 2009, Page 1-223

Five years experience in inguinal hernia repair using local anesthesia

Adel Mosa Al; Rekabi; Adel Shaker Al Tamimi

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 1-7

Background : Groin hernia is a common pathologic entity, and its incidence is high in adults older than 65. Further, geriatric patients who are candidates for herniorrhaphy often have concomitant diseases that increase the surgical risk. Cardiovascular, pulmonary, and urinary complications can occur after hernioplasty, especially if the procedure is performed under general or spinal anesthesia. Conversely, patients who receive local anesthesia do not generally have serious intra- or postoperative complications.Objectives: the study is designed to assess several parameters that might support the benefit or the adverse from using local anesthesia during repair of inguinal hernia. Methods : during the period from February 2002 to October 2007, one hundred thirty six patients with inguinal hernia attending Baghdad and Al Diwaniya teaching hospitals were managed by surgical repair utilizing local anesthesia. Most patients were managed by hernioplasty using Lichtenstien repair or suture less method , few patients were managed by herniorraphy using Darn repair , in all patients local anesthetic were used initially for inguinal field block. The choice of local anesthesia was limited to patients who are partially or totally unfit for general anesthesia. Results : In our study 64.7%of patients have excellent intra operative pain control while 3% were converted to other mode of anesthesia , regarding post operative pain control 93.8% of those in whom bupivacain was used they need only simple oral analgesics as compared to 89.3%of patients in whom Lidocain was used , they require an injectable analgesics including narcotic one. Regarding the best approach to repair inguinal hernia it is found that suture less method is the most appropriate when local anesthesia is selected . Regarding technical difficulties occasionally arise during reduction of the contents and improper retraction during surgery .The rate of conversion to other mode of anesthesia was 11.8 %. Limitations of using local anesthesia are large irreducible hernia and when there are signs and symptoms of strangulation. Conclusion : local anesthesia is effective method in inguinal hernia repair , especially when bupivacaine is used.The advantage of using prosthetic materials for repair is to add simplicity and quickness for the operation while using local anesthetic drugs .Aim of the study : To evaluate the feasibility and safety and effectiveness of local anesthesia during inguinal hernia repair .

The relationship between acute myocardial infarction and mood disorders

Karem N. Hussain; Mazin Z Alshibani

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 8-17

Acute myocardial infarction (AMI) acts as an important risk factor for occurrence of depression, which affectS long term morbidity and mortality considering baseline health state in patients with AMI.To estimate frequency of depression among patients within first 3 weeks after occurrence of AMI and to evaluate the effect of different demographic factors, biochemical changes, type and site of M.I on its frequency. This is a cross sectional study that enrolled 116 patients with AMI who had been admitted to coronary care unite (CCU) at Al-Diwaniya Teaching Hospital during the period between 1st of July 2007-31st of October 2008. Only 80 patients were followed up the Diagnosis of depression was done according to criteria of structural clinical interview for diagnostic and statistical manual of mental disorder-4- revision (SCID-DSM-4-R).This study revealed that 22.5% of patients had post-AMI depression. The females constitute 88.89% of depressed group, ،ف 65year old age were 44.44%, patients with hypertension and hyperlipidemia were 66.67%, diabetic patients were 27.78% and patients had positive history of MI were 33.33%. Patients with ejection fraction (E.F) < 35%, renal failure or insufficiency, chronic obstructive pulmonary disease (COPD) and anterior MI were 22.22%. Patients with non ST elevation myocardial infarction (NSTEMI), peak creatine phosphokinase (CPK) ،ف500 u/l and current smoker constitute 66.67%, 55.56% and 16.67% respectively.This study proves that depression after AMI was more common in females and less common in diabetic patients, current smokers and patients with COPD.

Abiochemical evaluation of lenses on cataract patients

Suhayr E.Alqaysi

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 18-23

A study of (46) patients, suffering from cataract disease was done in the Ophthalmology Department of Al-Jamhori Teaching Hospital, Babylon Governorate for the period from May - August 2008. Their ages FROM ranged from (30 -79) years old.(13) suffering from diabetes, (10) hypertension, (11) diabetes with hypertension, and (12) suffering from cataract only used as a control group.This study included measuring some biochemical parameters (total protein, albumin, cholesterol, and triacylglycerides), in lens homogenates.The results revealed highly significant increase in the total protein concentrations, while albumin concentration decreased significantly, on diabetes cataract and no changes in cholesterol and triacylglycerides concentration happened when compared with control groups.

The microorganism and underlying urological anomalies causing the urinary tract infection in the children attended the pediatric surgery clinic at the maternity and children teaching hospital al-qadisiya iraq

Manal Mohammed Kadhim; Mohammed J. Aboud

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 24-36

Urinary tract infections (UTI) are among the most common infections in children. UTI related morbidity remains high despite the use of numerous effective antibacterial agents . The sample of this study was conducted in the pediatric surgery unit at the Maternity and Children Teaching Hospital , Al-Diwaniya ( Iraq) and from the 1st of August 2005 to the end of July 2008. All the patients presenting with UTI to the outpatient clinic or to the surgical ward were investigated prospectively . The aim of this study was to determine how many patients had underlying urological abnormalities, the specific type of abnormality, and the microorganism causing the UTI in the patients with or without urological anomalies.There were 78 (70.9%) girls and 32 (29%) boys , 19 (17.2%) were between 0-1 year, 68 (61.8%) were at an age between 1-5 years, and 23 (20.9%) were more than 5 years of age. Forty seven (42.7%) of these patients had abnormal urological findings. Of 78 girls, 31 (39.7%) had urological abnormalities.
Sixteen children had VUR as an only abnormality. The distribution of abnormalities showed some changes by age and sex. Bacteriuria (>105 bacteria per milliliter of urine) was found in 44 (40%) of patients. The most common bacterial agent of urinary infections was E. coli (61.3%) of total isolates in both sexes , it was the most common pathogen among all patients (those with urological abnormalities and those without). There was no difference in the distribution of microorganisms in patients with and without urological anomalies. The diagnosis of UTI in young children is important as it is a marker for urinary tract abnormalities. A child with a suspected UTI should have a urine culture and colony count performed in order to identify organisms for confirmation of diagnosis and recommend prompt treatment to reduce UTI related morbidity and mortality in children.

Risk factors survey of low birth weight neonates

Zaher Ganem; Shaker K. Gatea; Jasim M.AL.Marzoki

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 37-44

Background: Neonatal mortality rate is one of the main health problems which affected by prenatal status and perinatal conditions. LBW is one of the main causes of neonatal and infantile mortality. Approximately every ten seconds, an infant from a developing country dies from a disease or infection that can be attributed to low birth weight, so this study was done to evaluate the risk factors of LBW in neonate.
Method: A descriptive cross sectional study was done on 1023 neonates, born in Babylon Maternity and Children Teaching Hospital from September 2007 to April 2008 .Neonatal data such as birth weight, gender, gestational age, and maternal data including maternal age, birth interval, history of abortion, antenatal care, parity, level of education, systemic disease, genitourinary infection, smoking, type of delivery, socioeconomic state, residence and maternal weight and height, were reported in this study.
Results: The study reveals that, 14% of neonates were LBW, were female/male ratio 1:0.6. The lower (maternal weight and height, gestational age, economic state and level of education) were associated with more LBW neonates. Also rural residence, irregular antenatal care, GUT infection, C/S delivery or having underling systemic diseases were at risk to get LBW neonates, while maternal age, birth interval and history of abortion found no effect on birth weight.
Conclusions: the results revealed a correlation between LBW in neonates with gestational age, maternal weight and height, and systemic diseases of the mothers. Also there was a correlation with the gender of baby, residence, level of education, socioeconomic state, GUT infection, parity and type of delivery.

Epidimiology of giardiasis in sulaimaniya and chamchamal with its effect on some biochemical parameters and pcv

Fatema M. Ali; Lazem H. K. Al-taie

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 45-53

The present study aimed to detect the percentage of infection with Giardia lamblia in different ages and sexes in Sulaimaniya and Chamchamal, and showing the effects of Giardiasis on some biochemical par0meters and PCV% which related to the public health in society.The prevalence of Giardiasis and its relationship to age, and sex was studied randomly in 1200 out patients in two different areas, Sulaimani city( urban )andChamchamal (semirural) during period from April to June 2007. Stool samples were examined microscopically by direct general stool examination (GSE).40 blood samples were collected from patients whom found infected with G. lambila for estimation of PCV ,TSP, Alb, Glo, A/G, S.Chol. S.TG, and S. Cal. The results showed that the higher rate of infection was recorded in Chamchamal as semirural. Age factor had effect on the prevalence of infection; the rate in children (55%) was higher significantly than in adults(45%).The percentage of infection was higher in females than in males.Infected children suffered from reduction in PCV,S.chol. and S. Cal.and A/G ratio which attributed to elevation of Glob, infected adults suffered from reduction in S.Chol., S. TG., S.Cal., and Glob, which cause the elevation of A/G. It can be concluded from the present study that Giardiasis was higher in semi rural area than urban, children than adults, and in females than males. PCV and serum Calcium were the most affected by the Giardiasis.

Dose the shape of epiglottis have a role in the globus pharynges

Husam Majeed Hameed

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 54-62

Back ground: globus pharyngeus is a sensation of a lump or tightness in the throat, it accounts for about 4% of otolaryngological referrals.
A wide variety of explanations have been done; gastroesophageal reflux or esophageal dysmotility are the most popular organic explanations.
Objective: To evaluate the incidence and the role of the curled epiglottic tip touching and indenting the tongue base in patients with globus pharyngeus.
Patients and method:Two group were selected; group A (40 patients) selected according to selection criteria from a number of patients diagnosed as globus pharyngeus patients , a flexible nasopharyngoscopy was done searching for the incidence of an epiglottic tip touching and indenting the base of the tongue, for instillation of a few drops10% xylocain done and the disappearance of the globus sensation was reevaluated again. Group B (40 patients) selected randomly from patients examined for non-globus complaint, and again searching for the incidence of an epiglottic tip touching and indenting the base of the tongue where studied.
Results and Discussion: Group A:In 65% (26 patients), the epiglottis touching and indenting the tongue base, 88.5 % (23 patients) out of these 26 patients showed positive response to local anesthesia; so globus sensation temporarily disappeared. (P value < 0.01) was highly significant, and this might mean: pressure effect of curled epiglottic tipwhich had been temporarily eliminated. Group B: only 7.5%
(3 patients) had an epiglottic tip touching and indenting the tongue base, while 37 patients had the epiglottis not touching the tongue base in both resting and the protrusion position . ( p- value >o.1 ) was not significant ; so this might mean that the curled epiglottic tip touching the tongue base is not a common finding in people or patients other than patients with globus pharyngeus .
Conclusion: A curled epiglottic tip indenting the tongue base may be a cause of the globus sensation when there is no other pathology found.

A comparative study to find the effect of hypertension on physical parameters for intra cerebral hemorrhage buy using spiral CT- scan technique

Mayadah Hassen Rhaf

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 63-70

CT offers high diagnostic capability. The project is related to the intra cerebral hemorrhage which means bleeding that occurs directly into the brain parenchyma. Hypertension high blood pressure (140 / 90 mmhg or higher) is the most important risk factor for all types of stroke; including cerebral infarction, irrespective of sex, race, or nationality.
The aim of this research is to study the effect of hypertension to the physical parameters for patients with intra cerebral hemorrhage (ICH). The study enrolled 24 subjects without any problem (10 males and 14 females) with a mean age of( 61.25 ± 6.4285) years with age between 41-72 years, and 20 subjects with hypertension (12 males and 8 females) with a mean age of (59.45 ± 10.44)years with age between 40-75 years. Many physical parameters have been measured (Lateral ventricle diameter, length, area, volume, cerebral radius, Head circumference, Left and right dilatation ratio). The results show that the physical parameters measurements with age have directly proportional except the radius and diameters which is inversely proportional with subject , s age in two study grops. The mean value in left side of all physical parameters measurements is larger than right side exept the lateral ventrical volum and area. Gender with all physical parameters measurements has weakly relation.Clear physical parametres measurements changes are with age period (70-75)

Clomiphene citrate in the management of oligoasthenospermia

Ameer Kadhum Daher

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 71-78

Background: Although clomiphene citrate (clomid) is, anti-estrogen, typically used for women with fertility problems, there have been a variety studies as to the use of clomiphene citrate in treating male subfertility.
Objective: To evaluate the role of clomid in treating male with oligoasthenospermia.
Methods: A prospective clinical study of 40 men with preliminary diagnosis of oligoasthenospermia according to WHO protocols in Wassit Government Iraq from July 2007 through July 2008.Clomid 50 mg oral daily dose was given for 4 months. The changes in sperm counts, the percentage of active sperms, pregnancy rate and side effects were recorded and analyzed.
Results: The mean sperm count before treatment was 11millions per ml, while the mean percentages of sperm motility were 15%. After treatment the mean sperm count increased to 35 millions per ml (3 times) and the mean percentage of motile sperm to 30 % (2 times).8 patients (20%) reported their wives became pregnant.4 patients (10%) failed to respond.

Conclusions and recommendations:
In patients with normogonadotrophic oligoasthenospermia, clomiphene citrate improves sperm counts and motility and probably increase pregnancy rate.This can possibly convert the choice of treatment from IVF/ICSI to less costly IUI.Also it may save some women from being treated for a problem of male infertility.However, controlled trails with larger number of patients are needed to confirm the findings of this study.

Orthostatic hypotension and dizziness among insulin dependent diabetic patients

Hudda Jabbar Dibby

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 79-88

This study was carried out on 90 patient with insulin dependent for at least 10 year those attending the diabetic clinic and internal medicine consultation unit in Al-Diwamiya Teaching hospital and some popular clinic in Al-Diwaniya city and a 120 age and sex match control subject from patients relatives and medical staff.
The blood pressure was measured in supine and standing position for each subject, orthostatic hypotension was defined as a decline in systolic blood pressure of 20mmHg or more one minute after standing, postural dizziness was any feeling of dizziness, light headedness, or faintness that occurred while standing.
The prevalence of orthostatic hypotension and postural dizziness was higher in patient with diabetes than in control subject from the 90 diabetic patient a 27 develop orthostatic hypotension while only 16 subject develop orthostatic hypotension from the 120 non diabetic control subjects.
Those patients with diabetes and had orthostatic hypotension were older and with high fasting glucose level and higher supine systolic blood pressure and lower standing systolic blood pressure than those without orthostatic hypotension.
Postural dizziness among the diabetics patient were higher than its prevalence among non diabetic subject, and there was no significant difference between those who had orthostatic with postural dizziness and postural dizziness without orthostatic hypotension in both diabetic and non diabetic control subject.

Prevalence of hepatitis C viral infection among multi-transfused thalassemic patients

Rahman Karim Mohsin; Abass M. Al-shebani; alan Hadi AL-Zamili

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 89-99

A prospective study was conducted on 325 patients (187 males and 138 females) with B –thalassemia major &sickle- thalassemia - who were attending the thalassemia center at Maternity and Children Teaching Hospital in Al-Diwaniya , from the period of September 2007 till April 2008. Their ages ranged from 1-20 years.
They were studied for Anti HCV sero positivity among patients with B- thalassemia major &Sickle- thalassemia (12 patients (4.01%) and 1 patient (3.84%) respectively).
Anti HCV sero positivity was significantly higher among patient's ages from (5-15 years) and also sero positivity was more among males. Statistically, there were significant differences among both sexes.
The study has revealed also that anti HCV sero positivity was directly related to the frequency of blood transfusion. Also they were studied for HCV antibodies. 13 patients (4 %) were found to have antibodies in comparison to zero among the 325 children of the control group.The risk of exposure to HCV was higher than HBsAG and HIV among the same patients.

The role of epidural neostigmine in postoperative analgesia

Basim Hrez Al-Sudani

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 100-108

A prospective randomized study was performed for 60 adult male patients presented for external fixation of tibial fractures under general anaesthesia in Al-Diwaniya Teaching Hospital.All subjects according to American Society of Anaesthesiologist (ASA) classification were grade 1,between 20 – 35 of age. Before induction of general anaesthesia,an epidural catheter was inserted.At the end of surgery and recovery ,subjects were allocated into four groups (15 patients in each group):
Group 1 ( n=15 ) received 4 ml of epidural saline with 4 ml of 0.75% lidocaine (control group).
Group 2 ( n=15 ) received 4 ug|kg epidural neostigmine diluted with normal saline to a total 4 ml volume with 4 ml of 0.75% lidocaine.
Group 3 ( n=15 ) received 7 ug|kg epidural neostigmine diluted with normal saline to a total 4 ml volume with 4 ml of 0.75% lidocaine.
Group 4 ( n=15 ) received 10 ug|kg epidural neostigmine diluted with normal saline to a total 4 ml volume with 4 ml of 0.75% lidocaine.
All patients were assessed for 24 hours postoperatively for hemodynamic recording (heart rate and mean arterial blood pressure monitoring) at fixed intervals (3,6,9,12,24 hr) .For postoperative pain relief , diclofenac suppository was administered in increments of 50 mg on patient demand.The time from the end of surgery to first request, and the number of times diclofenac was requested in the first 24 hours after surgery , were recorded.Degree of sedation and number of postoperative nausea and vomiting were assessed.The aim of this study is to show the impact of addition of epidural neostigmine in three different doses with lidocaine or the use of epidural lidocaine alone on the postoperative analgesia following external fixation of tibial fractures.The result showed that the mean arterial blood pressure (MAP) and heart rate(HR) during the postoperative period showed significant decrease in the four groups compared to the baseline reading. However , the reduction was within 20% of the baseline and thus clinically acceptable and harmless.The postoperative analgesic duration(expressed as the time of first rescue analgesic supplementation of diclofenac suppository given ) , was significantly longer in group 4 in comparison with other groups. The number of times diclofenac was requested during the first 24 hours after surgery were significantly lower in group 4 in comparison with other groups. Also there was no significant difference between the four groups as regarding postoperative nausea and vomiting. As regarding sedation , Group 4 has a significantly higher sedation score than the other groups in the first three hours postoperatively.Thus , it is concluded that postoperative epidural neostigmine in dose of 10 ug/kg, can provide a good postoperative analgesia , without side effect , when added to lidocaine and produces a longer duration of analgesia than lidocaine alone.

Determination of heavy elements levels in blood of children with anemia living at Al- Najaf City

Hussein Al-Shahin; Mustafa A. Al-Kadium; Maha A. Al-Shamri; Rasha S. Nima

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 109-119

This study aimed to determine Fe ,Pb , Mn ,Se, Cu ,and Zn levels in the blood of children with anemia , living at Al- Najaf City ,as indicators of environmental pollution in this city. Sixty five children (mean age 7.8 ±0.5) including 34 girls , 28 boys having anemia and the ages matched healthy children 29 girls and 28 boys ,were studied .We observed iron deficiency anemia (IDA) in 35 child (16 girls ,19 boys) ,and only anemia (OA) in 30 child (15 girls ,15 boys). It was found that significant difference of Hb, PCV ,MCV (P<0.01) , and ferritin(P<0.001) values in IDA patients (both girls and boys)were found, when compared with healthy children. The results show that there are significantly higher levels of Pb , Mn , and Zn ,in the serum of children in (IDA) group( both girls and boys) in comparison with their control groups . While Se , and Cu levels were significantly lower in (OA) and(IDA) groups , girls and boys, as related to their control groups. In conclusion ,children with iron deficient anemia are more sensitive to the pollutants and more at risk as compared to healthy children . Their bloods are considered as an index of biologically active metals in the body, reflecting direct interaction of atmospheric pollution of a population.

Hemolytic uremic syndrome complications and treatment

Samar Sahib Abbas

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 120-126

uremic syndrome admitted during a period of eight years (1991-1998) to Al-Mansour pediatric teaching hospital in Baghdad.It is found that gastrointestinal tract complications was the commonest (32.7%) followed by central nervous system complications (20%) while hypertension was present only in (14.5%) of patients thirty three percent of patients died. Central nervous system complications were statistically significant risk factor for death . these result comes with the result of taper – D et al (11) study except that the number of death was only (8%) which is low figure in comparison with this study.

Misoprostol for termination of first trimester missed abortion

Maha Assim AL- Azzawy

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 121-141

Background: misoprostol is prostaglandin E1 analogue that can be given by oral, sublingual, vaginal or rectal route. It is cheap and can be stored at room temperature and because of its utero-tonic action, it become an important drug in obstetric and gynecological practice.
Objectives: to evaluate the effectiveness of intravaginal followed by oral misoprostol tablets for medical termination of missed abortion between 8 – 13 weeks.
Methods : a prospective study of (60) women with diagnosed missed abortion admitted to AL- Zahraa General hospital – Wassit Governorate Iraq from July 2006 through July 2007 . 800 micrograms (4 tablets) of misoprostol inserted in the posterior fornix of the vagina after moisture with normal saline followed by oral 400 micrograms (2 tablets) 6 hours later. Another 400 micrograms were given orally 6 hours from the last dose for those patients whodid not respond to the previous two doses.
Results: (48) patients (80%) had complete expulsion . (21) Patients (35%) after the vaginal dose. (15) Patients (25%) respond after the first oral dose and (12) patients (20%) after the second oral dose. (6) Patients (10%) had incomplete abortion; the remainder (6) patients (10%) failed to respond within 24 hours of starting treatment and require surgical evacuation. The mean time for expulsion was 10 hours.
Conclusion: first trimester missed abortion medical termination by misoprostol is effective, save and a practical Methods .

Evaluation of humoral immunity against measles virus in Al-Najaf Governorate /Iraq

Anwar J.M.Sarah; adi; Mohammed A.K.Al-Sa; Mohammad A.Muhsin

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 142-149

This study was conducted to evaluate the anti-measles IgG antibody (AMAb) titers of measles vaccinated and non vaccinated normal individuals in Al-Najaf Governorate. "ELISA" test was applied to test 375 collected sera samples during April to November 2006. Individuals included with age range (1-30) years; 335 of them were vaccinated, and 40 non vaccinated (control group).Age, sex, residency and history of measles vaccination were recorded for each individual. The results revealed; that the highest IgG titer (234.82) had been seen in age group (A, age rang 1-6 year) and the titer was decreasing with increasing of age and reaching to the lowest IgG titer (6.6087) in age group (E, age range 25-30 year). The residency and sex of individuals was showed no significant differences(p >0.01) in AMAb IgG titers.

Solid renal masses: use of spiral Computed tomography for Differentiation between benign and malignant lesions

Emad H.Mahmood; Kassim A. Hadi Taj-Aldean

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 150-162

objective: To determine whether CT images on the basis of their morphologic features and enhancement patterns. could help accurately distinguish benign renal masses from malignant .
patients and Methods : Between April 2006 and February 2009, 80 consecutive patients (age range, 1–65 years; 50 male, 30 female) suspected to have renal mass by physical examination ,underwent ultrasound examination to evaluate the mass ,whether cystic or solid. Only patients with solid renal mass documented with US were included in the study then preoperative renal CT. All CT studies evaluated the mass about the pattern and degree of enhancement, lesion contour, presence of neovascularity, and calcifications .
Results: Of the 80 renal masses (median size, 3.4 cm; range, 1.1–20.0 cm) included in this study, 30 (37 %) were benign and 50 (63 %) were malignant. of benign 14 (47%)patients have abscess and 16(54 %) have angiomyolipoma , while malignant tumor classified as clear cell renal cell carcinomas (RCCs) 28 (56 %) , papillary lesions 16 (32 %) and 6 (12 %) Wilm's tumors. abscess most commonly classified as hypodense with peripheral enhancement while Clear cell RCC most commonly manifested with a mixed enhancement pattern of both hypervascular soft-tissue components and low-attenuation areas that corresponded to necrotic or cystic changes ,whereas the homogeneous and peripheral enhancing patterns were more predictive of less aggressive papillary . Clear cell RCCs tended to be hypervascular and angiomyolipomas tended to enhance moderately, and papillary lesions were mostly hypovascular.
Conclusion: Certain imaging features and the degree of enhancement may be helpful in differentiation of renal masses .

Enhancement of enteric bacterial growth in culture media supplemented with cyclamate and aspartame

Bushra J. Al-Timim

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 163-167

This study aimed to show the effect of sweeteners Sodium cyclamate and aspartame on culture media and its role in the enhancement of the growth of some clinical isolates of Escherichia coli, Klebsiella pneumoniae and Enterobacter. Results showed that Klebsiella pneumoniae isolates were unable to grow in low concentration of aspartame (0.9, 1.8 mg/ml) but they showed well growth at relatively high concentrations of this compound. Results also showed that Enterobacter spp was the best growers (109 cells/ml) at high concentration of aspartame (9.0 mg/ml) P> 0.05 . Sodium cyclamate enhanced the growth of E.coli, Klebsiella pneumoniae ,and Enterobacter spp. at different concentrations P< 0.001. Escherichia coli showed heavy growth and was the best growers (109-1010 cells/ml) at different concentrations of Sodium cyclamate.

TAUS versus TVUS in detection early pregnancy complication

Amjaad Majeed Hameed

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 168-176

Background:Using TVUS(transvaginal ultrasound ) visualization of pelvic organ is limited due to attenuation of ultrasound beam by intervening anterior abdominal wall and pelvic fat while TVUS (high frequency transducers 5-7MHz) now day regard important revolution in diagnosis of early pregnancy and their complications ,because it facilitate high resolution image of target organ uterus , adenaxa and cul de sac.
Aim of study:To evaluate TVUS in detection of early pregnancy complication and compare transvaginal approach with TAUS .
Patient and Methods :Sixty four patients were included in this study all of them have positive pregnancy test with signs and symptoms of early pregnancy complication .All of those patient examine by TAUS than by TVUS .with good explanation of the procedure to the patients .
Results:From sixty four patients a twenty five patients has normal intrauterine pregnancy all of them are diagnosed by TVUS while only 12 diagnosed by TAUS.Five patients have blighted ova all of them are diagnosed by TVUS and only 2 diagnosed by TAUS. All of 6 patient with subchronic hematoma are diagnosed by TVUS only 4 diagnosed by TAUS .
Three cases were diagnosed as ectopic pregnancy and all of them are diagnosed by TVUS only 1 diagnosed by TAUS . Two patient that diagnosed only by TVUS had intact gestational sac in the adenaxa with positive heart pulsation in fetal pole.Incomplete abortion diagnosed in 8 patient all of them diagnosed by TVUS , only 3 diagnosed by TAUS Fourteen patients has missed abortion only 8 of them are diagnosed by TAUS .
Conclusion and Recommendation:TVUS is more sensitive and more accurate in diagnoses of normal early pregnancy and in detection of early pregnancy complication.Many patient refused TVUS. So good explanation of the procedure to the patient is important.

Penetrating colorectal injuries

Fadel Habeeb Taher

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 177-184

Background:The treatment of colorectal injury has fluctuated over the past 100 years ,colostomy was the only option available currently a new approach through primary repair of colorectal injuries .
Aims:to ascertain the efficiency of primary colonic repair in comparison with colostomy in colorectal injuries .
Patients and Methods :A prospective study was conducted in Al-Yarmouk Teaching Hospital on 86 patients with colorectal injuries who have undergone laparotomy from Jan 2005 to Jan 2006
Twenty two patient were selected forad primary repair and 64 patients selected colostomy depending on Flints' grade which display severity of colonic injury .
Results : male to female ratio was 4:1 and peak age was 20-40 years 22 patients were treated by primary repair this including simple repair of perforation primary repair in 15 patients (17,44%)and resection and anastomosis in 7 patients (8.14%)while colostomy group included 23 patients were treated by primary repair with proximal colostomy ,37 patients were treated by exteriorization of the injured part,and 4 patients only underwent Hartmanns' colostomy.
Conclusions :primary repair of colorectal injuries is safe ,effective and much better than colostomy in term of morbidity, ,mortality and stay in hospital.

Detection of Anti-rubella Virus IgM and IgG in Aborative Pregnant Women in Al-Qadisiya Governorate

SAIF J. Yasir; Yuniss A. Al-Khfaji; afar K. Nama

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 185-195

The present study aimed to detect the levels of IgM and IgG immunoglobulins in their sera. The study included a collection of venous blood samples from three hundred women underwent abortion ranging in age from (15-35) years from Al-Qadisiya governorate.
Enzyme- Elinked immunosorbant assay (ELISA), was used to determine the immunological response against rubella virus in our the samples. ELISA test reflected a new infections which was (8 %) positive. Anti-rubella IgG antibodies ELISA test revealed (70%) positive result.

In vitro culture of plasmodium berghei using glucose and reticulocytes enriched blood cells

Khalid Majeed Dakhel

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 196-202

In vitro culture of erythrocytic stages of malarial parasite can prove helpful in understanding the biology of the parasite to locate new targets for drug designing and vaccine development. In the present study an attempt has been made to assess certain in vitro conditions which can provide the amiable environment for continuous growth of rodent malaria parasite, Plasmodium berghei. A total of eight different conditions were studied out of which G type proved to be the most-effective in maintaining long-term in vitro culture of P. berghei. G type contained medium RPMI-1640 supplemented with HEPES, sodium bicarbonate and glucose, normal mouse serum and phenylhydrazine hydrochloride (PHC) - induced reticulocyte rich blood. The viability of the parasite in long-term culture was assessed by i.p. injections of 1 x 105 P. berghei- infected erythrocytes from terminated culture pellets after every 24h till 7 days in normal mice.

Monitoring gonadotropin therapy of anovulatory infertility by ultrasound alone

Sajda Al-Rubaei; Weaam Al Mahfooth

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 203-210

In our study we monitor the gonadotopin therapy by ultrasound because serum oestradiol is not available in Basrah, and we investigate whether pelvic ultrasound alone suffices to control ovarian response to gonadotropin to induce ovulation.
Real time ultrasound scanning of follicular development was performed for 35 patients receiving metrodin during 113 cycle. Twenty pregnancies were obtained resulting in a pregnancy rate of (57.1%); with (16) patients singletons, set of twins 4 (20%), with abortions 6(30%) and about patients 2 (5%) develops mild ovarian hyperstimulation syndrome (OHSS).
So ultrasound alone can be used effectively to control gonadotropin therapy in the majority of cases.

Confirmation of positive acid fast bacilli samples by tuberculosis bacilli culture

Nihad A.M. Al-Rashedi; Adnan A. Al-Hamadani; Orass M.S. Al-Taee

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 211-217

This study attempts to estimate the efficiency of acid fast bacilli(AFB) stain technique to diagnosis tuberculosis in the different samples. This study was performed in general Al-Diawynia hospital and Department of Microbiology, Medicine College, Al-Qadisiha University between October 2005 to October 2008. A total of 1654 clinical samples from 750 patients analyzed for acid-fast staining. These were 605 sputum, 67 bronchial wash, 42 pleural fluids, 4 urine, 7 ascetic fluids and 3 cerebrospinal fluids. The stained smear-positive were (5.3 %) distributed in different samples .Seventy five patients (10 %) were evaluated by Lowenstein-Jensen (LJ) medium culture that it was employed as gold standard for tuberculosis diagnosis, of these 58 were culture-positive specimens. The sensitivity of Ziehl-Neelsen (ZN) stain Methods and LJ culture were (68.9 %) and (95.2 %) respectively. The specificity of ZN stain Methods and LJ culture were (88.2 %) and (45.4 %) respectively. The diagnosis accuracy of ZN stain Methods and LJ culture were (73.3 %) and (73.3 %) respectively. The positive predictive value of ZN stain Methods and LJ culture were (95.2 %) and (68.9 %), while negative predictive value were (45.4 %) and (88.2 %) respectively.

Audiological changes in patients with otitis media with effusion (OME)

Kassim R. Dekhil

Al-Qadisiah Medical Journal, Volume 5, Issue 1, Pages 218-223

Otitis media with effusion (OME) is a common problem especially in children and if not diagnosed early and treated appropriately may lead to serious complications.
Our study was conducted to assess the audiological changes associated with OME regarding the type, intensity and each frequency affected. The study involved 50 patients and the age ranged from 4-15 years old. The average of air conduction thresholds in the submitted cases (conductive deafness) were 31dBHL in the range between (0-50) dBHL. 500Hz is the most frequency affected and the least affected one is 2000Hz. In bone conduction thresholds (sensorineural hearing loss), we found that the frequency 1000Hz is the most affected one, while the frequency 250Hz is the least affected.