Home | Journal Issues | vol.60,No.1,2018



  • Article title : Laparoscopic colorectal surgery in Baghdad teaching hospital A review of 12 patients
    Description :

    Ahmed S. Ahmed*       CABS, FACS, EBS (SO)
    Background: colonic resections by laparoscopy are being performed with increasing frequency worldwide.
    Objective: The aim of this study is to evaluate our experience in the laparoscopic management of colorectal disease and to compare our results with other institutes.
    Patients and Methods: This is a prospective study conducted during the period from 1st of January 2017 till the 15th of November 2017, 12 patients underwent laparoscopic colectomy in in Baghdad Teaching Hospital and followed up for 30 days postoperatively.
    Results: 12 patients were included in this study, 83.3% of them were male, majority of patients (41.7%) were between 60 – 69 years, most of the patients (33.3%) have a body mass index of 23 -25, 83.3% of operations took 240 – 360 minutes and malignant diseases was the most common indication for surgery with (58.3%), while Abdominoperineal Resection was the most common indication for laparoscopic intervention (25%). Half of the patients discharged from hospital in 96-120 hours postoperatively, furthermore in majority of cases (66.7%) bowel sounds return to normal in 48-72 hours postoperatively. Conversion to open procedure occurred in 16.7% of patients, while complications occurred in 16.7% of patients.
    Conclusion: Although laparoscopic colorectal surgery is a not popular in our institute, our results are promising.
    Keywords: Laparoscopic, colorectal, conversion to open.


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  • Article title : Conversion of sleeve Gastrectomy to Roux-en-Y Gastric bypass for weight loss failure
    Description :

    Mohammed Q. AbdulJabbar * MRCS CABS DGS
    Ramiz S. Mukhtar ** FRCS
    Mustafa A. Abbas*** CABS, FACS
    Background: Obesity is a global health issue. Laparoscopic sleeve gastrectomy has progressively become the most popular procedure among the surgical community as a definitive bariatric operation. The increasing number of surgeries performed will be likely be followed by increasing reports of patients experiencing weight loss failure.
    Objectives: To determine the effectiveness of conversion from laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass in cases with weight loss failure.
    Patient &methods: retrospective review of patients who had operated with laparoscopic sleeve gastrectomy from October 2009 to January 2016 at saint Raphael hospital, 21 patients included in this study had insufficient weight loss after Sleeve Gastrectomy and converted to Roux-en-Y gastric bypass.
    Results: fifteen patients (71.4%) had LSG as their single bariatric operation before conversion to roux en Y gastric bypass, 2 patients (9.5%) had Intra gastric ballon and 4 (19.1%) patients had laparoscopic adjustable gastric band before to their sleeve gastrectomy. Fourteen patients (66.6%) were female and 7 (33.4%) were males, At 6, 12, 18 months after bypass ,mean BMI was 37.2 (32.7-44.3),32.5(28.7-39.1) and 30.2 kg/m2 (24.3-37.9 kg/m2) respectively , reflecting a %EWL (percentage weight loss) at 18 month of 61.7%.
    Conclusion: insufficient weight loss after Sleeve Gastrectomy can be safely and effectively treated by conversion to Roux-en-Y gastric bypass to control weight loss failure or weight regain.
    Keywords: weight loss failure, weight regain, failed Sleeve Gastrectomy.


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  • Article title : The incidence and risk factors of hypocalcaemia after thyroid surgery
    Description :

    Aws B. Abed* FICS
    Mohannad K. Al Bermani* FICS
    Waleed A. Salman* FICS
    Background: Hypocalcaemia is a well-recognized complication of thyroid surgery. It is most often transient event that occurs after extensive thyroid resection that may require calcium and/or vitamin D supplements to alleviate or prevent the symptoms.
    Objective: of this study is to determine the incidence of hypocalcaemia after thyroid surgery and find out the risk factors involved regarding the patient age, gender, and muscular built, clinical diagnosis, extent of surgery, ligation of the inferior thyroid artery, pathology report and the experience of the surgeon.
    Patients and methods: This prospective study was carried out on 100 patients who underwent thyroid surgery for various thyroid diseases at the surgical department of Baghdad teaching hospital in the period between November 2009 to November 2013.Serial serum calcium measurements were recorded as well as details of the operation, patient age and gender, ligation of the inferior thyroid artery or not, pathological report and experience of the operator. Hypocalcaemia was considered transient if it was resolved within 6 months and permanent if it persisted after 6 months and the patient was maintained on supplementation therapy of calcium and vitamin D.
    Results: We found that the incidence of post-thyroidectomy hypocalcaemia was 30 % and in the majority of the cases (24%) was transient, while it was permanent in only (6%) of cases and had occurred mainly after total thyroidectomy and in cases with ligation of the inferior thyroid artery.
    Conclusions: We concluded that post thyroidectomy hypocalcaemia is a relatively common complication, but it is transient in the majority of the patients. Its incidence is related to the extent of the surgery and can be reduced by the use of the correct surgical procedures.
    Keywords: hypocalcaemia, post thyroidectomy, total thyroidectomy, subtotal thyroidectomy.

    Pages: 9-13.

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  • Article title : Colostomy Closure in Pediatric Age Group: Analysis Of Out Come in Single Center Experience.
    Description :

    Hassan K, Qatia* FRCS, FICMS
    Background: Closure colostomy is a common procedure in the pediatric surgical practice, considered a major one because it involves anastomosis of the large bowel, and requires strict bowel preparation and prophylactic antibiotics. It’s the last event in the management of some pediatric surgical conditions, as Hirschsprung’s disease and anorectal malformations.
    Objectives: To evaluate the complications of colostomy closure in pediatric patients.
    Patients and methods: A total of 106 patients underwent colostomy closure were enrolled in this prospective study conducted in Welfare Teaching Hospital in Medical City Complex, from October 2015 to January 2017, were reviewed looking for complications following closure colostomy. Data was collected including age, gender, indication of colostomy, type and location of colostomy, presence of stoma complication, and presence of associated anomalies. Details of colostomy closure, including pre-operative, intra-operative and post-operative variables were recorded.
    Results: Of 106 patients included, there were 38(35.8%) females and 68(64.2%) males, with an average age of 2.4 year. Indications for colostomy were Hirschsprung’s disease 58(54.7%) and anorectal malformations 48(45.3%). Site of colostomy was transverse colon 54(50.9%), and sigmoid colon 52(49.1%). The type of colostomy was divided 8(7.5%) and loop 98(92.5%). Forty eight patients (45.3%) developed complications; the most common being wound infection 30 (28.3%), followed by fecal fistula 6 (5.7%), wound dehiscence 4 (3.8%), adhesive intestinal obstrution 4 (3.8%) and incisional hernia 4 (3.8%).
    Conclusion: Closure colostomy is a high morbidity procedure. With morbidity rate of 45.3%, the highest complications were wound infection.
    Key words: Hirschsprung’s disease (HD), Anorectal malformation (AM).


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  • Article title : Chronic Subdural Hematoma A Prospective Study
    Description :

    Ali K. AL-Shalchy* FICMS, MRCS, FRCS
    Wameedh Q. Abdul-hussein** FICMS, CABNS
    Saif S. AL-Musawy** FICMS
    Background: Chronic subdural hematoma is a blood collection in the subdural space for more than 3 weeks from the onset of the bleeding. It is more likely to develop in infancy and after the age of 60 years. The incidence of subdural hematoma is 1- 2 per 100,000 people per year.
    Objective: To delineate the most common feature aspects of SDH like: age, predisposing factors, symptoms and signs and different types of management of the disease.
    Patients and Methods: A prospective study of 40 patients from the period January 2012 - January 2014, and conducted in Gazi Al-Hariri Hospital of Surgical Specialties, disregarding the age, complaining of chronic subdural hematoma as proved by CT scan. It includes the predisposing factors, the symptoms and signs, the location of hematoma, mode of treatment, complications and the outcome.
    Results: In this study the highest incidence of CSDH was above 50 year and the second age group was below 1 year. It was more common in males than females and they were unilateral more than bilateral, as shown by C.T scan which was the most reliable method for diagnosis and assessment.
    Conclusions: The most suitable treatment was burr hole in the older age group but craniotomy with membranectomy were still performed. In patients below 1 year, subdural peritoneal shunt found to be the method of choice. This study shows that the most common complications are the recurrence and infection. Outcome depends mainly on the early recognition and treatment.
    Keywords: Chronic subdural hematoma, traumatic brain injury, Burr hole aspiration.


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  • Article title : Forced vital capacity (FVC), peaked expiratory flow rate (PEFR), are additional parameters in the assessment of the reversibility test.
    Description :

    Mustafa N.Abd Ali *          CABM, FICMS
    Ahmed H. Jasim**             FICMS
    Abdulrasool N. Nassr***  CABM, FICMS
    Monqith A. Kadhim****   FICMS
    Background: Spirometry is important test performed in patients expect to have air way obstruction, assessment of intense reaction to inhalers (the trial of reversibility of air way blockade) is a normally utilized technique in clinical and academic studies. The consequences of this test are utilized to take choices on treatment, consideration, exclusion from diagnosis and other research thinks about, and for analytic marking [asthma versus chronic obstructive air way disease (COPD)]. Usually, the (FEV1) or (FVC) standards before and after giving of the bronchodilator are compared and the adjustment is processed to distinguish variations from the norm in lung volumes and air flow.
    Objective: The aim of this study was to investigate the effectiveness of FVC and PEFR as further constraints to evaluate bronchodilator reaction in asthmatic peoples with severe or moderate airflow blockade.
    Patients and methods: This study is cross sectional studyperformed in Baghdad teaching hospital where one hundred patient were enrolled in this study patients were detected with asthma and confirm airway blockade according to (GINA) guidelines.The pulmonary function for all members were investigated with a convenient spirometer (spiro-lab3 Spirometer) as stated by those measures from claiming American thoracic particular social order,The mean and standard deviation results of predicted% values pulmonary function test were also used for comparisons were measured by t-test. A p-value of ≤ 0.05 considered to be significant statistically.
    Results: The post bronchodilator (post –BD) results of FVC, PEFR are greater than pre- bronchodilator where are statistically significant P value = 0.00. the amount of the changes of FVC post (BD) was more than 400ml from pre (BD) and the amount of the changes of PEFR post (BD) more than 1000ml from the pre (BD) both were p value = 0.00.
    Conclusion: The asthmatic patients with moderate and severe airway obstruction, we observed that FVC and PEFR is a valuable important limit to FEV1 to evaluate reversibility reaction
    Key word: forced vital capacity(FVC), peaked expiratory flow rate (PEFR), spirometry and forced expiratory volume in 1st second (FEV1).

    Pages: 24-27.

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  • Article title : Comparison between dexmedetomidine and propofol as sedatives for critically ill patients in intensive care units
    Description :

    Sabah N. AL-Saad* FICMS, CABA&IC
    Haitham A. Sahib AI-Jaafari ** FICMS, CABA&IC
    Background: Regarding using of sedation in the intensive care unit (ICU) should allow the patient to be more comfortable, calm, cooperative,and at the same time easily arousable without delay niether weaning nor prolonged mechanical ventilation.
    Objective: The aim of my study is to compare the effect of dexmeditomidine Versus propofol for sedation and hemodynamic stability in critically ill patient.
    Patient and method: A randomized study of 44 patients admitted to ICU; 22 of them received dexmedetomidine and the other 22 patients received propofol for sedation.The level of consciousness, blood pressure, heart rate, respiratory rate and requirement for adjuvants to reach the target level of sedation were monitored for the first 12 hours.
    Result: By applying Null hypothesis it was found that dexmedetomidine was significantly effective when compared with propofol for sedation with p-value less than 0.001, while it was not significantly effective when compared with propofol plus adjuvant with p-value> 0.05.
    Conclusion: Dexmedetomidine is effective as a sole sedative agent with haemodynamic stability without the need to add any adjuvant to it, while propofol cause hypotension and bradycardia if used alone to reach our target level of sedation, but can be used with adjuvant to reach our target of sedation and haemodynamic stability.
    Keywords: Dexmedetomidine, Propofol, Sedation, ICU.

    Pages: 28-31.

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  • Article title : Factors associated with nonalcoholic fatty liver disease grades detected by ultrasound at a screening center in Klang Valley, Malaysia.
    Description :

    Abdul Sattar A. Khammas* MSc
    Safwan S. Mohammed* CABR
    Hasyma Abu Hassan** PhD
    Hayati k. Shahar*** PhD
    Ramlah M. Ibrahim**** MSc
    Nurul N. Mohamad Nasir**** MSc
    Sarah Q. M. Salih***** MSc
    Rozi Mahmud****** PhD
    Background: Non-alcoholic fatty liver disease (NAFLD) is a very common liver disease in the world, particularly in Western and developed countries. It is rapidly growing in the Asia- Pacific region.
    Objectives: This study was designed to determine the association between risk factors and non-alcoholic fatty liver disease grades among Malaysian adults.
    Patients and Methods: A cross-sectional observational study design was prospectively carried out in this study. Consecutive 628 respondents who attended for a medical checkup at urban health center had been recruited for the study. All respondents had physical examination, blood tests, clinical assessments and abdominal ultrasound. A structured self-administered questionnaire has been also used in this study in this survey.
    Results: From total of 628 “health screened” subjects, 235 subjects (37.4%) were diagnosed to have non-alcoholic fatty liver disease. Female gender and Chinese race were predominant in our study population. Of those with NAFLD, more than half subjects (63.4) had a moderate grade of non-alcoholic fatty liver disease. The mean age of the study population was 54.54 ±6.69 years. Differences of mean body mass index (BMI) and waist to hip ratio (WHR) were found to be significant among non-alcoholic fatty liver disease grades (P< 0.001). Similarly, mean triglycerides (TG) and high-densiy lipoprotein-cholesterol (HDL-C) levels had significant differences among non-alcoholic fatty liver disease grades (P< 0.001 and P= 0.016, respectively).
    Conclusion: non-alcoholic fatty liver disease is common among urban Malaysian adult population. Anthropometric measurements were a closely correlated with non-alcoholic fatty liver disease grades.
    Key words: Non-alcoholic fatty liver disease, NAFLD grades, sonography, urban population.

    Pages: 32-37.

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  • Article title : The Timing of Elective Caesarean Deliveries and Early Neonatal Respiratory Morbidity in Term Neonates
    Description :

    Asmaa G.Tahir* MBChB
    Manal B. Baythoon* CABP
    Yasir I. AL Saddi* FIBMS, DCH
    Background: Respiratory distress is one of interesting presentation of elective caesarean delivery, the presence of labor before elective caesarean delivery decrease the risk of Respiratory distress. adverse respiratory problem in neonate delivered before 39 weeks of gestation are increased.
    Objective: To evaluate the association between gestational age at delivery and neonatal respiratory outcomes after elective caesarean delivery between 37 and 41completed weeks.
    Patients and Methods: Descriptive study with prospectively collected data from Baghdad teaching hospital/Medical city at neonatal care unit. All infants of gestational age from 37 to 41 completed weeks, with uncomplicated pregnancy, of which 1407 were born by elective caesarean delivery compared to 1304, delivered by spontaneous vaginal delivery between 1st of September 2015 and 31st of January 2016. The neonates delivered by elective caesarean delivery were stratified into five groups according to the gestational age.
    Result: There were 1407 neonates delivered by elective caesarean delivery compared with 1304 by spontaneous vaginal delivary of overall 118 neonates were admitted to the Neonatal care unit with Respiratory distress and receiving oxygen therapy or assisted ventilation. Early neonatal Respiratory distress risk was significantly higher in neonate delivered by elective caesarean delivery the rate of Respiratory distress increased with earlier gestational age for both group. The hospitalization days, also decreased with increased gestational age.
    Conclusion: Term neonates delivered by elective caesarean section are at increased risk for developing Respiratory distress compared vaginal delivery. The neonatal Respiratory distress decreased if elective caesarean delivery performed after 39 gestational weeks
    Keywords: RD (Respiratory distress), ECS (elective caesarean delivery), TTN (transient tachypnea of the newborn), GA (gestational age), O2 (oxygen therapy), SVD (spontaneous vaginal delivary), NCU(Neonatal care unit).


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  • Article title : Seroprevalence of Hepatitis Bs antigen among pregnant women visiting primary health care centers in Baghdad Al-Jadeda sector in Baghdad.
    Description :

    Shayma S. Ali* FICMS/FM
    Ban A. Ridha Salman** FICMS/FM
    Background: Hepatitis B is a potentially life-threatening liver infection which is caused by the hepatitis B virus. Universal testing of hepatitis B virus of pregnant women already occurs in many parts of the world, but still suboptimal in resource-limited settings.
    Objectives: To find the seroprevalence of hepatitis B s antigen in pregnant women visiting primary health care centers in Baghdad Al-Jadeda health sector that belongs to Baghdad Al-Rusafa health directorate and to determine the effect of some social and obstetrical factors in the infected women.
    Patients and Methods: A retrospective cross-sectional study carried on 6975 records of pregnant women visited primary health care centers from 1st of January 2016 to 30th of June 2017, whose blood samples were tested at the time of visits for hepatitis B s antigen in the reference laboratory and confirmation tests were established in the central public health laboratory in Baghdad for positive cases and included in their records. The effect of certain sociodemographic and obstetrical factors was also assessed in the study.
    Results: Of total number of 6975 pregnant women records, hepatitis B s antigen was positive for 11, two were excluded to avoid duplication of data and the final number of infected pregnant women was 9 with prevalence rate of 0.13%. No important findings from their antenatal records regarding effect of certain sociodemographic and obstetrical factors were found except that husband of the majority of cases (55.6%) were HBs Ag negative and no information available about rest of the cases (44.4%).
    Conclusion: There was a low prevalence of hepatitis B among studied pregnant women. We also concluded that source of infection to these women was mainly parenteral rather than sexual.
    Keywords: hepatitis B virus, hepatitis B s antigen, pregnant women.

    Pages: 43-46.

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  • Article title : Effect of Combined Oral Contraception on Coagulation Profiles in Women Attending Fertility Control Clinic In Baqubah City- Iraq
    Description :

    Sawsan T. Salman* FICMS, CABOG
    Areej A. Hussein* PhD
    Raakad K. Saadi** FICMS
    Background: Use of oral contraception has been associated with an increased abnormalities of lipid and carbohydrate metabolism as well as hemostatic variables at baseline (increased plasma levels of factor VII, factor X, fibrinogen and of D-dimers).
    Objectives: To evaluate the effect of oral contraceptive pills (combined pills) on coagulation tests,prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen level.
    Patients and methods: This is a descriptive cross sectional study which was conducted in fertility control clinic in Al-Batool Teaching Hospital for Maternity and Children in Baqubah city, during the period from December 2015 to October 2016. Eighty eight women were enrolled in this study according to inclusion criteria, 63 women were use contraceptive pills(study group) and other 25 females not taken these pills (control group), prothrombin time, activated partial thromboplastin time and fibrinogen level measured by using the coagulometer instrument.
    Results: The mean age was 29.89 and 30.89 years for all participants (subject and control) it was (range 20-45). The results of cases revealed that PT= 12.89 seconds, APTT= 30.45 seconds, and fibrinogen level= 2.18 g/l while the results of control group revealed that PT= 11.92 seconds, APTT= 29.85 seconds and fibrinogen level= 2.24 g/l. Overall no significant variations were noticed in these parameters with P value > 0.05 also no significant changes were noticed between age groups, duration of oral contraceptives and some clinical parameters.
    Conclusion: Effect of combined oral contraceptives use on prothrombin time, activated partial thromboplastin time and fibrinogen levels are minor compared with control group.
    Key word: Oral contraception, estrogen,progestagens, thrombosis, blood coagulation.


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  • Article title : Epidemiology of Skin Diseases among Displaced People in Diyala Province
    Description :

    Naseer K. Alwan* MBChB
    Shahab A. Shakir** FIBMS
    Hayder H. Waheeb* FIBMS
    Background: Diyala have many internally displaced persons as a consequence of the armed conflict. Those peoples experience serious health problems related to their displacement, including skin disorders.
    Objective: To determine the prevalence of skin diseases and the use of health care among displaced patients in Diyala.
    Methods: A case-series study conducted on 246 displaced patients from May to November 2017, who attended Baqubah teaching hospital in Diyala. All patients were diagnosed by dermatologists depending on clinical findings.
    Results: A total of 246 displaced patient from all age groups mean±SD (21.9±18.59) years, range 1-64) consulate the clinic, of them (29.3%) male and (70.7%) female with male to female ratio (1:2.4). Infectious skin diseases have the highest rate (65.9%), followed by dermatitis (18.4%), acne (5.7%), alopecia (5.3%), and Papulosquamous diseases (4.8%). Parasitic skin infestations (31.7%) and viral infection (24.4%) were the commonest noted infections. Significant associations present between previous consultation and economic status, and between prevalence of skin infections and low economic status. Significant associations between skin diseases and rising crowding index.
    Conclusion: Infectious skin diseases are common among displaced patients, significantly higher among low economic status. Skin diseases significantly associated with rising crowding index.
    Keywords: Skin diseases, internally displaced persons, crowding index.


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  • Article title : Hepatitis B virus DNA in Blood Donors Positive of Anti-Hepatitis B Core Antibodies and Negative for Surface Antigen in Hawler Major Blood Bank, Kurdistan Region, Iraq
    Description :

    Rasha N. Hassan* MBChB Ali H. Hussain** MBChB, MSc, PhD (Microbiology)
    Background: Occult Hepatitis B virus infection (OBI) among blood donors is an important medical concern.
    Objectives: This study was done to detect the presence of occult hepatitis B virus infections among blood donors with negative hepatitis B surface antigen and positive total anti-hepatitis B core antibodies in Hawler Major Blood Bank in Hawler city/Kurdistan Region of Iraq.
    Methods: A total number of 12,185 blood donors in Hawler Major Blood Bank were screened for HBsAg and total anti-HBcAb using ELISA technique, and then positive results were retested by confirmatory technique by Chemiluminescence assay. All HBsAg-/HBcAb+ were selected as the study group; HBV DNA was tested among HBsAg-/HBcAb+ by conventional PCR and Real time-PCR. Clinical and demographic data of study group were recorded.
    Results: Among the 12,185 blood donors, HBsAg was positive in 27 (0.22%) donors using Chemiluminescence assay, the frequency of HBs Ag -/ HBc Ab+ was 276 (2.27%), and then the total prevalence of HBV infection in all blood donors was 2.49%. Among the 276 HBs Ag-/HBcAb+, occult hepatitis B virus infection (OBI) was positive in 39.1% (108/276) using conventional PCR and Real time-PCR techniques, while the prevalence among all blood donors (n=12,185) was 0.09%. Testing of HBV-DNA in HBs Ag -/ HBc Ab+ group for OBI was done by qualitative PCR (positive HBV-DNA=102/276) or by quantitative Real time-PCR (positive HBV-DNA=108/276).
    Conclusions: The OBI is frequently detected among blood donors in Hawler city especially those have HBsAg-/HBcAb+, and the total anti-HBcAb is an essential serological marker for screening HBV among blood donors. The risk factors for developing OBI among blood donors should be elucidated.
    Keywords: Blood donors, Occult HBV, Hawler city, Blood Bank.


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  • Article title : Comparison of Three DNA Extraction Methods for Detection Echinococcus granulosus Isolated from Sheep and Cows
    Description :

    Dunya N. Ahmed* BSc
    Salwa S. Muhsin** PhD
    Abudulla L. Chyiad *** MSc
    Background: Hydatosis caused by Echinococcus granulosus dog tap worm is zoonotic infection and economic important and to public health constitutes a major threat in certain regions of Middle East. There is establishment of preventive and control strategy for characterization of E.granulosus in all endemic area which is essential in all molecular studies, to check the DNA of the parasite.
    Objective: Our study aimed to obtain the best from three extractions DNA methods from hydatid cyst protoscolecses isolated from sheep in Al-shawlla abattoir in Baghdad.
    Subjects and Methods: Three methods were used to extract DNA samples (boiling, crushing and commercial) DNA samples were performed with electrophoreses on 1.3% agarose. Regarding DNA for methods were compared by time and facility and cost effectiveness.
    Results: The most method were boiling and crushing DNA extraction because of their easy, quickness besides the commercial kit method which had good bands on gel electrophoresis but had most cost effectiveness and time.
    Conclusion: The most method were boiling and crushing using for DNA extraction
    Keywords: DNA extraction methods, hydatid cysts. Echinococcus granulosus.


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  • Article title : Health Literacy of Diabetic Patients and its Impact on Disease Outcome
    Description :

    Ahmed A. Abdul-Hasan* MBChB
    Batool A. Gh. Yassin* FICM-CM
    Background: Diabetes is one of commonly and costly chronic health issues and a major cause of morbidity and mortality among other non-communicable diseases. Diabetes patients’ literacy about their diseases is to be addressed as a active factor of the disease outcome.
    Objectives: The objectives of the current study were to determine the overall health literacy level among diabetic patients attending the PHC centers and to test the association between the measured health literacy and their glycemic control.
    Methods: A cross section study was conducted on a sample of randomly selected diabetic patients attending primary health care centers in Baghdad during the period from 15th July 2016 to 15th April 2017. Relevant demographic data were recorded and a specially designed tool was used to measure health literacy among diabetic patients, it consist of 15 question covering all aspects of health literacy (Scores 1 to 5 each question). The presenceof diabeticcomplications were recorded and glycemic control of patients was documented by HbA1c.
    Results: With a total literacy score ranging from 15-75, the mean score of the patients in the current study was (mean = 43.34 ± 11.1 SD), and their recent HBA1c found to be ranging from 6.4 to 13.4 (mean = 10.25 ± 1 SD). A statistically significant association was found between patient literacy score and glycemic control (P<0.001), and the presence of complications (P=0.026).
    Conclusion: The glycemic control of diabetic patients (measured by HBA1c) and the presence of the diabetic complication might be affected by the patient literacy about his disease.
    Keywords. HBA1c, Health literacy Score, Diabetes Mellitus, Iraq.


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  • Article title : Growth of diabetic children in post conflict Baghdad, Iraq
    Description :

    Zena S. Hadi* MBChB, DFM
    Eman A Al-Kaseer** MBChB, FIBMS
    Munib A Al-Zubaidi *** MBChB, FIBMS
    Background: previously type 1 diabetes mellitus (T1DM) was listed among causes of sever growth retardation. Iraq was exposed to wars and conflicts that affect health services which in turn affect the glycemic state of diabetic patients.
    Objective: To report on growth of diabetic children in post conflict Iraq.
    Methods: A total of 100 children with T1DM were included in the study. They were attending the consultancy clinic in Children Welfare Teaching Hospital for the period from 1st of Feb to 30th of May 2017. Weight and height were measured. The growth indices at diagnosis were taken from case file.
    Results: A total of 100 children with T1DM included in this study. Their age was 9.3 ± 3.2 years with a male to female ratio of 1. Peak age of children at diagnosis was < 5 years. Of the total diabetic children in this study, (5%) was stunted, (2%) wasted, and (5%) was underweight. Duration of T1DM was a significant determinant of growth indices (height and weight). No significant differences in growth indices (weight, height and BMI) between males and females with T1DM.
    Conclusion: peak of age at diagnosis was < 5 years, sex ratio was equal and weight and height were almost lower than that supposed to be healthy.
    Keywords: type 1 diabetes mellitus, children, growth.


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  • Article title : Risk Factors and Early Detection of Diabetes Mellitus in Early Rheumatoid Arthritis Women
    Description :

    Mohammad H. Ali * BSc, MSc
    Abeer J. Hassan* BSc, MSc, PhD
    Enas J. Hasan** BSc, MSc

    Background: Patients with rheumatoid arthritis show predominance of metabolic disorder characterized by overweight, central obesity, dyslipidemia and impaired glucose tolerance, specifically, few studies have explain insulin resistance in this disease.
    Objective: The aim of present study is to examine insulin resistance and the risk of developing diabetes mellitus in middle age Iraqi women with early rheumatoid arthritis.
    Patients and methods: This work involved seventy female with early rheumatoid arthritis. Who was attending to the National Diabetic Center (NDC) of Al-Mustansiriya University and 35 healthy subjects as a control group. From all subjects blood sample was drawn in fasting state to measure the biochemical parameters which including plasma glucose level and fasting insulin concentrations. Other measurements (RF and anti-CCP) were made by routine methods. Homeostasis model of assessment insulin resistance (HOMA-IR) by using the formula HOMA model Insulin sensitivity was calculated in RA patients and healthy control.
    Results: Results revealed a highly significant in the level of rheumatoid factor (RF), anti-CCP and fasting insulin, and HOMA-IR when compared patient group with control group. While a significant increase in level of FBG in RA group than control group. Also there was a positive correlation with high significance among, Anti-CCP, and RF with HOMA-IR in rheumatoid arthritis group. Conclusions: This study shows that patient with rheumatoid arthritis have abnormal insulin secretion with high value of IR than group of healthy control and these patients may be at risk of diabetic mellitus.
    Keywords: Rheumatoid arthritis, RF, anti-CCP, insulin resistance.

    Pages: 74-76.

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