About Journal

The Medical Journal of Basrah University (MJBU) is an open access scientific journal published biannually by the College of Medicine, University of Basrah, Iraq, since 1977. It’s based on a double-blind peer-reviewing system to maintain a high quality of publication proceed by plagiarism check to ensure the originality of submitted manuscripts. The Medical Journal of Basrah University (MJBU) published review articles, original articles and case reports, under the license of Creative Commons Attribution 4.0 international (CC-BY). It had been indexed in Iraqi Academic Scientific...
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Improving outcomes of medical colleges: A proposed Institutional Governance and Communication Protocol (IGCP)

Ghanim Y. M. Alsheikh

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 1-6
DOI: 10.33762/mjbu.2020.126983.1009

Governance and communication represent the foundations for effective impact on the level of institutional performance in higher education colleges, including medical schools. Governance encompasses the frameworks of structures, relationships, and processes ongoing in the college. It is recognized that medical schools in Iraq lack the adoption of a clear mechanism in this field. This article aims to present a proposed protocol for the development of governance and institutional communication in Iraqi medical colleges whose components have been formulated according to the needs of these colleges. The proposal reviews the components, benefits, and foundations of governance according to a number of targeted values, thus presenting a proposed framework for the components of an institutional system for governance and communication. This proposal allows ample discussions among college stakeholders which leads to revision and implementation to fill the gap towards achieving effective and efficient governance that enables the achievement of college goals. The framework addresses number of elements including at least: neutrality in the work and decisions of councils and their strategic and operational roles, the absence of a strategy for senior management, institutional and individual periodic planning, standard operation procedures, job description, key performance indicators, human resource management policies and documentation concepts, and in the forefront of them digital documentation and communication via the Internet and databases.

Epidemiological Features of COVID-19 Epidemic in Basrah-Southern Iraq-First Report

Omran S Habib; Abbas K AlKanan; ِAlaa H Abed; Nihad Q Mohammed

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 7-18
DOI: 10.33762/mjbu.2020.126943.1008

Epidemiological Features of COVID-19 Epidemic in Basrah-Southern Iraq-First Report
Abstract
Background: COVID- 19 expanded from an outbreak in China to a devastating pandemic across the world. .
Objective: To describe the epidemiology of COVID-19 in Basrah Province-Southern Iraq
Methods: Data were obtained from the Department of Public Health in Basrah and the daily communique of the Ministry of Health. Data on population were obtained from the Ministry of Planning. For all provinces the total number of cases and their fate in terms of being under treatment, cured or died was obtained. For cases in Basrah, data on age, sex, residence, fate, travel history and presence of co-morbidity for 152 cases.
Results: In Basrah, The mean age was 46 years (Median 45 years) and the range was 13-98 years. No difference in the risk of COVID-19 was related to sex. Geographical variation was inconclusive The time trend of the epidemic is modest in both new daily cases and in cumulative numbers. At one point in time (April 10) the incidence rate was 56.28 per million , which was at intermediate level among other provinces.
The total cases used for Iraq was 1279. The highest numbers were reported in Baghdad, Najaf, Erbil, Basrah and Sulaymaniyah.The lowest incidence rate was in Salah Al-Din (0.61 per million) and the highest was in Najaf (170.16 per million). The case fatality ratio for closed cases and for all cases was variable among provinces.
Conclusion: COVID-19 in Basrah and Iraq is modest until today the 10th of April 2020.

The dynamics of COVID-19 epidemic in Basrah province-Second report

Omran Habib; Haider Jassim; Wael Jasimy Al-Shihaby; Mustafa AR Mohamed

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 19-28
DOI: 10.33762/mjbu.2020.127210.1019

Abstract
Background: COVID-19 pandemic still expanding across the world and continuing at modest pattern In Basrah.
Objective: To further elaborate on COVID-19 epidemic in Basrah province and document the changing dynamic of the disease.
Methods: two sources were used for obtaining data in this study. The first is an excel sheet containing information on 736 cases covering age, gender, residence, travel history, comorbidity and fate, which is obtained from The Department of Public Health in Basrah. The second is the daily numbers of new cases (also 736) obtained from the daily communiqué of the Ministry of Health. Statistical Package for Social Sciences (SPSS-version 20) and Excel programmes were used for statistical analysis.
Results: The mean age was 35.5±18.9 (for males=35.6+19.0 and for females=35.5±18.8), the median was 34 years (males =34 and females =33). The incidence rate was higher in older age groups, females and three districts (Basrah city, Al-Hartha and Al-Mdaina). The case fatality was within the international figures and significantly predicted by older age, travel history and presence of co-morbidity. The epidemic curve is moderate, fluctuant and does not help yet in predicting an exit from the epidemic.
Conclusion: The epidemic of COVID-19 in Basrah is moderate, cluster in transmission and changing in time but is unpredictable.
Key words: COVID-19, Case fatality ratio, incidence rate

Vitamin D Status in Children with Recurrent Wheeze

Sawsan Habib; Ghufran Salman

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 29-36
DOI: 10.33762/mjbu.2020.127089.1014

Background it has been shown that low serum 25-hydroxyvitamin D concentration was associated with a higher risk of upper and lower respiratory infections in children
Aim to evaluate vitamin D concentration and selected biochemical markers in infants and children with recurrent wheeze.
Methods a case-control study has been carried out to measure serum vitamin D concentration; on 33 patients with recurrent wheeze, their ages ranged from 4-60 months; over the period from the1stof March 2014 to the end of June 2014.
Forty-two age and sex matched healthy children were selected as control group. List of investigation was measured by spectrophotometer as serum calcium, phosphorus, alkaline phosphatase and 25-OH vitamin.
Result
Frequency of breast feeding in the first two years of life was low in wheezy children and significantly shorter duration of breast feeding less than 4 months in wheezy children than control group, P value 0.01.
Vitamin D concentration was significantly low in children with recurrent wheeze than the control group; (21.69 ng/ml, 39.36 ng/ml) respectively with p-value 0.000
The severity of vitamin D deficiency was significant in children with recurrent wheeze, severe deficiency of vitamin D There is no significant relation observed between mean Vitamin D concentration and selected variables of infants and children with wheeze (p value >0.05)
Conclusion vitamin D supplementation may be considered in infants and children with recurrent wheeze.

FACTORS INFLUENCING COMPLIANCE WITH IMMUNIZATION REGIMEN AMONG MOTHERS IN BASRAH, IRAQ

Jhood Abdul Samad Molan

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 37-46
DOI: 10.33762/mjbu.2020.126642.1002

ABSTRACT
Introduction: Immunization is a proven tool for controlling and eliminating the life-threatening infectious diseases among children. In most developed countries, immunization programs have had dramatic success in reducing morbidity and mortality rate significantly. Although the children received immunization free of charge, the immunization status in developing countries did not achieve the immunization targets of the WHO. The factors and barriers that influence the immunization program include child demographic factors, family factors and other factors.
Purpose: It was to evaluate immunization completeness among children younger than 2 years, demographic characteristics and familial data associated with immunization rates and the reasons of immunization incompleteness as reported by the mothers attending PHC centers in Basrah.
Methods: A cross-sectional study was conducted in four PHC centers in Basrah during a period of February to April 2019; two hundred twenty five mothers with children aged below 2 years were interviewed.
Results: About one third of children were incompletely immunized. The study found significant association of immunization completeness with child’s age (p<0.05). Other demographic factors (child’s gender, birth weight, mother’s education, occupation and family income) were insignificantly associated with immunization completeness (p>0.05). The most reported reasons for incomplete immunization were: remoteness of PHC centers and transportation problems, fear, negligence and forgetfulness, vaccine unavailability and child’s illness.
Conclusion: Incomplete immunization was observed in (29.8%) of the children, which represent an alarming percentage.
Keywords: Immunization; Compliance; Basrah; Child and Maternal Factors

The Effect of Folate Status on Methotrexate Serum Level and Response in Children with Acute Lymphoblastic Leukemia

Dhuha Emad Omran; Nabeel Ali; Jenan Ghalib

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 47-57
DOI: 10.33762/mjbu.2020.126734.1006

Background: Children in our area are more prone to folate deficiency due to many reasons including leukemia. The folate status of patients especially prior to therapy could influence methotreaxate therapeutic effect or toxicity
Patients and Methods: A total of 34 children newly diagnosed with acute lymphoblastic leukemia, and 25 normal healthy children were included as a control group. Parameters measured include; Serum folate, Serum methotrexate, blood parameters, liver function tests, blood urea and serum creatinine that were measured before initiation of chemotherapy, during treatment and following completion.
Result: Newly diagnosed ALL children have low folate level at the time of diagnosis (5.26 ± 3.82 ng/ml, mean±sd) which is significantly lower than control group (11.16 ± 5.20 ng/ml, mean±sd) (p value ˂ 0.0001). Leukemic children that have low folate is 20 with a serum level (3.12 ± 1 ng/ml, mean±sd), normal folate level is found in only 14 leukemic children and their level (8.83 ± 4.14 ng/ml, mean±sd). Low WBC and platelets count was detected following the first methotrexate dose which returns back to normal afterward. Folate serum level of all leukemic children at end of all doses is significantly elevated (14.58 ± 5.3 ng/ml, mean±sd) (p value ˂ 0.0001).
Conclusion: Serum folate level is low in a considerable number of newly diagnosed ALL children before the initiation of treatment protocol, this lead to more hematological toxicity following the first methotrexate dose. It is recommended that serum folate should be measured and deficiency corrected prior to cytotoxic therapy to reduce toxicity.

Bacterial contamination associated with mobile phones used by students at Basrah Medical College, Basrah, Iraq

Nidham Mohammed Jamalludeen

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 58-66
DOI: 10.33762/mjbu.2020.127020.1011

Bacterial contamination associated with mobile phones used by students at Basrah Medical College, Basrah, Iraq

ABSTRACT:
Background: Cell phones are increasingly becoming an important vector for pathogens, especially when they are combined with unhealthy behaviors that speed up the spread of nosocomial infections.
Objectives: This study was conducted to investigate microbial contamination of mobile phones belonging to students of Basrah Medical College, located in the southern region of Iraq.
Methods: Samples were collected aseptically with sterile swabs moistened with sterile normal saline solution over a period of four weeks. One hundred mobile devices were included in this study. The wet swab was rolled over the exposed surfaces of the mobile phones.
Results: Of 100 swabs samples, 137 isolates were identified. Of these, Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa were the most frequently identified microorganisms, in addition to other important pathogens.
Conclusion: This study showed that mobile phones are potential carriers for the spread of many pathogens, and a measure of cleanliness must be introduced to prevent the possibility of cross contamination. It was also revealed that bacteria colonized mobile phones of medical students and the contaminated mobile phones are able to transport microbes that may be able to produce serious disease.

Key words: Basrah, Medical students, Mobile phone, Staphylococcus spp.

Tachycardia-induced cardiomyopathy, a diagnosis forgotten in the real world: Review of case series.

Amar Alhamdi

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 67-79
DOI: 10.33762/mjbu.2020.165391

Background: Left ventricular dysfunction induced by long-standing recurrent tachyarrhythmias, known as tachycardia-induced cardiomyopathy, is a reversible type of dilated cardiomyopathy and heart failure characterized by left ventricular failure that is usually recoverable once the tachyarrhythmia is well controlled by stabilizing the sinus rhythm or by heart rate control.
Patients and methods: Twenty four patients with heart failure due to dilated cardiomyopathy and tachyarrhythmia were included. The arrhythmia and heart failure were both treated accordingly. The New York Heart Association’sfunctional class, left ventricular ejection fraction assessment and chest X-ray were done periodically to assess improvement.
Results:  Stabilization of the sinus rhythm was achieved in all patients. The NYHA class improved remarkably, from class III-IV to class I in all patients. The left ventricular ejection fraction rose remarkably from 20-30% to 45-57%. The cardiac size remarkably improved radiologically. The symptoms of recurrent long-standing palpitation preceding the symptoms of dyspnea in heart failure are the first implication that arrhythmia is inducing the heart failure this was noticed in 20 patients.
Conclusion: Tachycardia-induced cardiomyopathy is a reversible cause of heart failure. Controlling the arrhythmia recovers normal LV function.

Perioperative Events of Laparoscopic Cholecystectomy in Patients with Hemoglobinopathies

Rafid Mohammed; Habeeb F Al-Ibadi; Ali G Redha

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 80-88
DOI: 10.33762/mjbu.2020.165440

Background: Hemoglobinopathies are common genetic disorders affecting the synthesis of one of the globin chains of hemoglobin molecule. Laparoscopic cholecystectomy is the standard procedure for treatment of patients with normal hemoglobin and symptomatic gall stones, but doubt is still to date regarding safety of this procedure in patients with hemoglobinopathy.
Aims:1. To assess the safety of laparoscopic cholecystectomy for hemoglobinopathic patients, 2. To describe the perioperative events that might happen before, during or after this procedure.
Patients and Methods: This is a record-based comparative study conducted over a period of seven years, involved 62 hemoglobinopathic patients and 148 patients with normal hemoglobin variant. All underwent laparoscopic cholecystectomy and comparison done regarding perioperative events.
Results: The overall complication rate was 56.5% in hemoglobinopathic patients and 21.6% in the other group and the difference was statistically significant (P- value ˂0.001). Vaso-occlusive crisis occurred in 9 patients (14.5%), respiratory complications (atelectasis and bronchitis) in (9.7%), acute chest syndrome in (4.8%) and hemolysis in (4.8%).
Conclusions: 1. Laparoscopic cholecystectomy is safe in well prepared hemoglobinopathic patients but it is associated with significantly higher rate of disease related complications, namely acute chest syndrome, hemolysis and vaso-occlusive crises.2- Hemoglobinopathic patients require special pre, intra and post-operative care which should be offered by the surgeon, the physician and the anesthetist

Knowledge and practice of adults attending primary health care centers regarding major coronary heart disease risk factors in Basrah city

Jhood Abdul Samad Molan; Narjis Ajeel

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 89-99
DOI: 10.33762/mjbu.2020.165441

Introduction: Cardiovascular diseases (CVDs) are common in the general population, affecting the majority of adults past the age of 60 years. The prevalence of coronary heart disease (CHD) is approximately one-third to one-half that of total CVD. Knowledge of CHD risk factors has been identified as a prerequisite for changes in behavior and is often targeted by prevention programs.
Objective: The study aimed to study the knowledge of risk factors and the practice of CHD related behaviors among individuals > 18 years of age attending PHC centers in Basrah city center and to find out the sociodemographic factors that affect such knowledge and practice.
Methods: The study involved 423 male and female aged 18 years and above, attending 6 primary health care centers in Basrah city. Data were collected through direct interview of the participants by the investigators, using a special questionnaire form prepared for the purpose of the study.
Results: The results of the study showed that 77.3% of the participants had good level of knowledge (know at least 7 risk factors).  The most common knowledgeable risk factors by the participants were stress, smoking, fatty diet and obesity in descending order. Older age groups, high educated persons, governmental employees and participants with history of coronary heart disease related illness were more likely to have higher knowledge score. Practicing diet modification and regular exercise were prevalent in 23.5% and 12.8% of the participants respectively.
Conclusions: The knowledge level of risk factors for CHD in selected PHC centers in Basrah seems to be good, however, the practice of CHD preventive behaviors was quite poor, this necessitates the need for public health education programs.

Risk Factors and Neonatal Outcome among Preterm Birth at Basrah Central Hospitals

Ali F. Al-Assadi; Dhamia S. Al- Haroon; Alaa Al-Rubaye; Baidaa A. Abdul-Rahman

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 87-96
DOI: 10.33762/mjbu.2018.159467

Background: Preterm birth (PTB) is a major clinical problem associated with perinatal mortality and morbidity. The aim of the present study is to identify risk factors associated with preterm birth and neonatal outcome in Basrah, Iraq.
Material and Method: A prospective observational study was conducted over a period of one year from May 2014 to May 2015. About 1145 cases of preterm deliveries were studied in the three main central hospitals in Basra city (Basrah Maternity and Child Hospital, Al-Mwany Hospital and Al-Basrah Hospital). The probable risk factors and the neonatal outcome were recorded and analyzed.
Results: Incidence of preterm birth was 2.42%. Presence of factors like multiparty 73.6%, prior miscarriage 41.3%, inter pregnancy interval of < 1 year 39.1%, urinary tract infection 28.4%, cervical incompetence 12.1%, prior preterm birth 12.1%, multiple pregnancies 11.6%, poor socio-economic state were the most frequent risk factor associated with preterm birth. Perinatal death among preterm birth in the study group was 34.7%, antepartum haemorrhage and congenital abnormalities were the common causes of stillbirth, whereas respiratory distress syndrome was the common cause of early neonatal deaths. Neonatal death rate was 84.3% in babies with birth weight less than 1000 grams.
Conclusion: The commonest predisposing factors were multiparous, smoker and co smoker, previous miscarriage, inter-pregnancy interval less than one year, infection, and maternal age.
.

Facts about type 2 diabetes mellitus and its control in Misan Governorate. Single-center experience

Yaseen O. Yaseen; Jabbar J. Atyia

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 81-86
DOI: 10.33762/mjbu.2018.159463

Background: Diabetes mellitus is a metabolic disease that can affect every system of the body particularly if it is not controlled for long period of time. Complications of diabetes can be halted or prevented by good metabolic control. Measures that are considered in the treatment of diabetes mellitus include; healthy diet, physical activity, blood sugar monitoring, compliance with drugs, and hygienic habits.
Aim of the study: The aim of present study is to shed light on the outcome of treatment and control of type2 diabetes mellitus (T2DM) among patients in Misan governorate.
Patients and methods: In this study, records of 336 patients with T2DM, followed up for one year, were reviewed. HbA1c levels at the first visit and every three months later on for one year were used to reflect glycemic control. Other parameters taken into consideration were; age, gender sex, duration of diabetes, and the type of treatment.
Results: It was found that only (24.1%) of patients, had reasonably good glycemic control, as reflected by HbA1c levels less than 7% with significantly more men than women. Better glycemic control was recognized among patients with disease duration from 6-10 years as compared to those with disease duration below 5 years or above 10 years.
Conclusion: Control of T2DM in our study is not so different from that in some other studies in other regions; also gender seems to have an impact on glycemic control, it was found that glycemic control was significantly better among men than women (P-value > 0.05).
17.3%)

Effect of Azithromycin in Treatment of Cutaneous Leishmaniasis

Dindar S Qurtas

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 97-102
DOI: 10.33762/mjbu.2018.159464

Introduction: Leishmaniasis is a vector born protozoal infection. Cutaneous leishmaniasis outbreak occurred during 2014 in Erbil governorate, Kurdistan-Iraq. First choice of its treatment is pentavalent antimony. Other options of treatment are available. Azithromycin is used as trial to be effective but human studies are lacking.
Patients and Methods: Prospective randomized open labeled interventional study conducted on 63 patients. The sample divided in to two groups. Group A received only intra-lesional sodium stibogluconate and the group B received combination therapy of intra-lesional sodium stibogluconate and azithromycin 500 mg orally. Follow up done for lesions’ healing at 6th week and at the end of 8th week of therapy.
Results: Nodular lesions were dominant morphology among the Lesions (71.5%). Lesions mostly were ulcerated (59%). Mean duration of lesions were 3 ± 1.1 and 2.4 ± 1.8 weeks in patients of group A and B respectively. At 6th week in patients of group A, there were 13(41.9%) patients with complete healing of the lesions, while in group B it was found in 23(71.8%) patients. At the end of 8th week group A patients showed complete healing in 21(67.7%) patients while in patients of group B complete healing found in 27(84.3%).
Conclusions: Results of this study concludes that combination therapy of azithromycin and intra-lesional sodium stibogluconate provides more therapeutic effect if compared with the effect of intra-lesional sodium stibogluconate alone.
.

Self-reported hand contact dermatitis among female hairdressers in Basrah

Wasan H. Ghani; Asaad Q Al-Yassen

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 60-65
DOI: 10.33762/mjbu.2018.159465

Background: Occupational skin diseases are common and deserve medical attention. Hairdressers are special risky group for skin diseases.
Objective: To determine the prevalence of self-reported hand contact dermatitis among female hairdressers in Basrah city.
Methods: Sixty one salons in Basrah city center were chosen randomly by using the systematic random sampling technique from a name’s list of registered salons in Basrah General Health Directorate. A convenient sample of female hairdressers was chosen from these salons.
A special questionnaire form prepared for the purpose of the study was used for collection of data from female hairdressers who agreed to participate in the study by direct interview.
Results: A total of 80 female hairdressers were included in the study. Their age ranged between 19 and 65 years old with a median age of 32.5 years. The prevalence of self- reported hand contact dermatitis or eczema among female hairdressers was 31.3%. It was significantly associated with the age and nationality of female hairdressers (P-value = 0.021 and 0.035 respectively). Furthermore, there was significant association between self- reported hand contact dermatitis and personal history of atopy (P-value < 0.001) and family history of atopy. (P-value=0.031).
Conclusions: The self- reported hand contact dermatitis is fairly common and associated significantly with age of female hairdressers, nationality, personal and family history of atopy. We recommend to enhance occupational health measures for the hairdressers with special alteration in the preventive aspects
.

Assessment of the documentation completeness level of the medical records in Basrah General Hospital

Riyadh A. Al Hilfi; Rajaa A. Mahmoud; Nihad . Q Al-Hamadi; Atared Majeed; Shabeeb A. Saihoud

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 50-59
DOI: 10.33762/mjbu.2018.159461

Background: Medical records documentation is an important legal and professional requirement for all health professionals. They include information which describes all aspects of patient's care. But, despite the importance of medical records to support better quality service provided at the health facilities, incomplete documentation is very common all over the world.
Objective of the study: to assess the documentation completeness level of the medical records in the different inpatient wards of Basrah General Hospital.
Methodology: The study was a descriptive cross-sectional one. Medical records of 268 inpatients from Basrah General Hospital during June 2016 were included from four departments of the hospital (medicine, surgery, pediatrics and obstetrics and gynecology). A standard Iraqi Ministry of Health inpatient medical record with a two-level scoring system for assessing the level of documentation completeness were used in the study.
Results: the overall documentation level for the medical records included in the study was generally poor in 78% of the records. Surgical department was found to be the worse in documenting patient's notes related to medical history, while Gynecology and Obstetrics department was found to be the worst in documenting the medical examination assessment and the physician's notes related to the patient's state and details of any improvement / deterioration of his/her condition.
Conclusions and recommendations: The present study confirmed obvious incompleteness of documenting medical data for inpatient records in Basrah General Hospital especially in the general surgery, internal medicine and Gynecology and Obstetrics words. This is specifically found for the Physician notes (patient’s state and details of any improvement/deterioration of the condition) and the Clinical pharmaceutical sheet. A hospital based quality improvement project to improve the medical record documentation completion is highly recommended to be implemented by the Quality Assurance Unit of Basrah Directorate of Health.
.

Epidemiological Features of COVID-19 Epidemic in Basrah-Southern Iraq-First Report

Omran S Habib; Abbas K AlKanan; ِAlaa H Abed; Nihad Q Mohammed

The Medical Journal of Basrah University, 2020, Volume 38, Issue 1, Pages 7-18
DOI: 10.33762/mjbu.2020.126943.1008

Epidemiological Features of COVID-19 Epidemic in Basrah-Southern Iraq-First Report
Abstract
Background: COVID- 19 expanded from an outbreak in China to a devastating pandemic across the world. .
Objective: To describe the epidemiology of COVID-19 in Basrah Province-Southern Iraq
Methods: Data were obtained from the Department of Public Health in Basrah and the daily communique of the Ministry of Health. Data on population were obtained from the Ministry of Planning. For all provinces the total number of cases and their fate in terms of being under treatment, cured or died was obtained. For cases in Basrah, data on age, sex, residence, fate, travel history and presence of co-morbidity for 152 cases.
Results: In Basrah, The mean age was 46 years (Median 45 years) and the range was 13-98 years. No difference in the risk of COVID-19 was related to sex. Geographical variation was inconclusive The time trend of the epidemic is modest in both new daily cases and in cumulative numbers. At one point in time (April 10) the incidence rate was 56.28 per million , which was at intermediate level among other provinces.
The total cases used for Iraq was 1279. The highest numbers were reported in Baghdad, Najaf, Erbil, Basrah and Sulaymaniyah.The lowest incidence rate was in Salah Al-Din (0.61 per million) and the highest was in Najaf (170.16 per million). The case fatality ratio for closed cases and for all cases was variable among provinces.
Conclusion: COVID-19 in Basrah and Iraq is modest until today the 10th of April 2020.

THE INTERACTION BETWEEN NIGELLA SATIVA FIXED OIL AND RANITIDINE ON

Jawad H. Ahmed; Ahmed H. Naema; Nabeel A. Ali

The Medical Journal of Basrah University, 2012, Volume 30, Issue 1, Pages 19-25
DOI: 10.33762/mjbu.2012.64010

Background: The use of herbal preparations has increased dramatically, making drug interactions with these
preparations a major health concern, especially as herbal medications are usually not subjected to the same
regulations as prescription drugs
Aim: as a potential drug-herb interaction is possible, this study was designed to investigate the interaction between
Nigella sativa (NS) and ranitidine (R) on absolute ethanol induced gastric mucosal damage in rabbit
Materials and Methods: Five groups of rabbits (6 each) were used. Acute gastric ulcerations were induced by ethanol
through a stomach tube. The oil of NS was given orally, ranitidine by (IM), combination of NS+R or normal saline
were given 1 hour before ethanol. Ulcer index, serum and stomach tissue MDA, gastric volume and pH, and
histopathology were evaluated.
Results: Monotherapy of NSoil or R reduced the mean ulcer index from 91.7±19.4mm in the control group to
43.3±8.7 and 22.5±9.4mm for NS and R treatment respectively. There were significant reductions in serum and
stomach tissue MDA and in gastric secretion. When NS and R were given in combination the anti-ulcer effect of both
disappeared. This was associated with increased MDA levels in stomach tissue, but not serum. The pH of stomach
content was also changed toward ethanol treated values.
Conclusion: These findings document the gastro-protective potential of NS against ethanol-induced gastric ulcer.
There was a significant NS-R interaction manifested as failure of the combination to inhibit ulcers formation. Until
further wider studies are available to confirm such interaction, the simultaneous use of Nigella sativa and ranitidine
should be discouraged.

Assessment of the documentation completeness level of the medical records in Basrah General Hospital

Riyadh A. Al Hilfi; Rajaa A. Mahmoud; Nihad . Q Al-Hamadi; Atared Majeed; Shabeeb A. Saihoud

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 50-59
DOI: 10.33762/mjbu.2018.159461

Background: Medical records documentation is an important legal and professional requirement for all health professionals. They include information which describes all aspects of patient's care. But, despite the importance of medical records to support better quality service provided at the health facilities, incomplete documentation is very common all over the world.
Objective of the study: to assess the documentation completeness level of the medical records in the different inpatient wards of Basrah General Hospital.
Methodology: The study was a descriptive cross-sectional one. Medical records of 268 inpatients from Basrah General Hospital during June 2016 were included from four departments of the hospital (medicine, surgery, pediatrics and obstetrics and gynecology). A standard Iraqi Ministry of Health inpatient medical record with a two-level scoring system for assessing the level of documentation completeness were used in the study.
Results: the overall documentation level for the medical records included in the study was generally poor in 78% of the records. Surgical department was found to be the worse in documenting patient's notes related to medical history, while Gynecology and Obstetrics department was found to be the worst in documenting the medical examination assessment and the physician's notes related to the patient's state and details of any improvement / deterioration of his/her condition.
Conclusions and recommendations: The present study confirmed obvious incompleteness of documenting medical data for inpatient records in Basrah General Hospital especially in the general surgery, internal medicine and Gynecology and Obstetrics words. This is specifically found for the Physician notes (patient’s state and details of any improvement/deterioration of the condition) and the Clinical pharmaceutical sheet. A hospital based quality improvement project to improve the medical record documentation completion is highly recommended to be implemented by the Quality Assurance Unit of Basrah Directorate of Health.
.

Self-reported hand contact dermatitis among female hairdressers in Basrah

Wasan H. Ghani; Asaad Q Al-Yassen

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 60-65
DOI: 10.33762/mjbu.2018.159465

Background: Occupational skin diseases are common and deserve medical attention. Hairdressers are special risky group for skin diseases.
Objective: To determine the prevalence of self-reported hand contact dermatitis among female hairdressers in Basrah city.
Methods: Sixty one salons in Basrah city center were chosen randomly by using the systematic random sampling technique from a name’s list of registered salons in Basrah General Health Directorate. A convenient sample of female hairdressers was chosen from these salons.
A special questionnaire form prepared for the purpose of the study was used for collection of data from female hairdressers who agreed to participate in the study by direct interview.
Results: A total of 80 female hairdressers were included in the study. Their age ranged between 19 and 65 years old with a median age of 32.5 years. The prevalence of self- reported hand contact dermatitis or eczema among female hairdressers was 31.3%. It was significantly associated with the age and nationality of female hairdressers (P-value = 0.021 and 0.035 respectively). Furthermore, there was significant association between self- reported hand contact dermatitis and personal history of atopy (P-value < 0.001) and family history of atopy. (P-value=0.031).
Conclusions: The self- reported hand contact dermatitis is fairly common and associated significantly with age of female hairdressers, nationality, personal and family history of atopy. We recommend to enhance occupational health measures for the hairdressers with special alteration in the preventive aspects
.

LOW-LYING PLACENTA IN BASRA: FETOMATERNAL OUTCOME

Fouad Hamad AL-Dahhan

The Medical Journal of Basrah University, 2006, Volume 24, Issue 1, Pages 13-18
DOI: 10.33762/mjbu.2006.46410

ABSTRACT
Objective: To study the maternal and foetal complications of low-lying placenta at the main referral
hospital in Basrah.
Methods: This is a case control study of 598 pregnant women attended the ultrasound department at
Basra Maternity & Child Hospital, from December 1998 to June 2000; 182 cases with low-lying placenta
and 416 control.
Results: When the low-lying placenta compared with the control group, there is a significant increase in
the incidence of obstetrical & neonatal complications. These include abortion, preterm labour, abnormal
lie, and presentation, caesarean section, postpartum haemorrhage and caesarean hysterectomy.
Neonatal complications include preterm babies, babies with low birth weight and Apgar score. Perinatal
deaths mainly caused by Respiratory Distress Syndrome constitute 6.9%. Type I & II praevia carries a
lower risk of antenatal, postnatal, & foetal complications than type III & IV. There was no maternal
death among the study group.
Conclusion: Low lying placenta, especially major degree, have a high incidence of obstetrical
complications, the most important of which are preterm labour and massive ante-partum and
postpartum haemorrhage. There is increased incidence of neonatal complications, mainly prematurity,
small for gestational age and perinatal deaths. There was no relation noted between placenta praevia
and congenital anomalies of the newborns.

VALIDITY OF CHEST X-RAY IN ESTIMATION OF CARDIAC SIZE IN COMPARISON TO ECHOCARDIOGRAPHY

Mazin Abd-Hazaa; Sadik Sharif; Adel Abdul-Hassan Kadhum

The Medical Journal of Basrah University, 2007, Volume 25, Issue 2, Pages 48-51
DOI: 10.33762/mjbu.2007.48266

ABSTRACT
This is a cross-sectional study carried out to study the validity of the cardiothoracic ratio as a predictor of cardiac
enlargement. The study involved 150 patients attending Alsader Teaching Hospital for various cardiac symptoms.
The cardiothoracic ratio (CTR) was measured for 150 posterior anterior (PA) view chest x-ray. Left Ventricular
Internal Dimension in systole (LVIDs) and Left Ventricular Internal Dimension in diastole (LVIDd) were measured
by 2D echocardiography (through the parasternal axis) in patients who have a PA view chest x-ray within the same
week. The study showed that the ability of chest x-ray (by measuring CTR) to measure cardiac size in patient with
cardiomegaly in comparison to echocardiography (by measuring LVIDd) is high (sensitivity 85.71%), while the
ability of chest x-ray to exclude cardiomegaly in comparison to echocardiography is low (specificity 13.79%).
Furthermore, the ability of chest x-ray to detect (sensitivity) or exclude (specificity) cardiomegaly in comparison to
echocardiography (by measuring LVIDs) was 90.47% and 17.24% respectively. The study found significant
correlation between CTR and LVIDd (using Pearson correlation), and there was no significant correlation between
CTR and Body mass index (BMI). The study recommended that because it is easy and cheap to measure the CTR by
the chest x-ray for any patient in the emergency department, it can be regarded as a preliminary measure to the size
of the heart, but echocardiographic measurements remained the most accurate.

Assessment of the documentation completeness level of the medical records in Basrah General Hospital

Riyadh A. Al Hilfi; Rajaa A. Mahmoud; Nihad . Q Al-Hamadi; Atared Majeed; Shabeeb A. Saihoud

The Medical Journal of Basrah University, 2018, Volume 36, Issue 2, Pages 50-59
DOI: 10.33762/mjbu.2018.159461

Background: Medical records documentation is an important legal and professional requirement for all health professionals. They include information which describes all aspects of patient's care. But, despite the importance of medical records to support better quality service provided at the health facilities, incomplete documentation is very common all over the world.
Objective of the study: to assess the documentation completeness level of the medical records in the different inpatient wards of Basrah General Hospital.
Methodology: The study was a descriptive cross-sectional one. Medical records of 268 inpatients from Basrah General Hospital during June 2016 were included from four departments of the hospital (medicine, surgery, pediatrics and obstetrics and gynecology). A standard Iraqi Ministry of Health inpatient medical record with a two-level scoring system for assessing the level of documentation completeness were used in the study.
Results: the overall documentation level for the medical records included in the study was generally poor in 78% of the records. Surgical department was found to be the worse in documenting patient's notes related to medical history, while Gynecology and Obstetrics department was found to be the worst in documenting the medical examination assessment and the physician's notes related to the patient's state and details of any improvement / deterioration of his/her condition.
Conclusions and recommendations: The present study confirmed obvious incompleteness of documenting medical data for inpatient records in Basrah General Hospital especially in the general surgery, internal medicine and Gynecology and Obstetrics words. This is specifically found for the Physician notes (patient’s state and details of any improvement/deterioration of the condition) and the Clinical pharmaceutical sheet. A hospital based quality improvement project to improve the medical record documentation completion is highly recommended to be implemented by the Quality Assurance Unit of Basrah Directorate of Health.
.

PREDICTORS OF MORTALITY OUTCOME IN NEONATAL SEPSIS

Duha Sabeeh Jumah; ad Kadhum Hassan; Mea

The Medical Journal of Basrah University, 2007, Volume 25, Issue 1, Pages 11-18
DOI: 10.33762/mjbu.2007.48118

ABSTRACT
A prospective study was carried out to determine the predictors of outcome in neonates with sepsis admitted to
neonatal care unit at Basrah Maternity and Children Hospital over six months (from the first of November 2004 till
the end of April 2005). One-hundred twenty neonates were studied, sepsis was confirmed by clinical and laboratory
measures. Seventy four (61.7%) neonates were males and 46 (38.3%) were females. Thirty three (27.5%) were
preterm and 87 (72.5%) were full term. Sixty seven (55.8%) neonates were still alive during period of
hospitalization and discharged home, while fifty three (44.2%) neonates died. Early onset sepsis was detected in
35(29.2%) neonates while late onset sepsis was detected in 85(70.8%) neonates, however, the mortality rate was
higher in early onset sepsis (62.9%) compared to late onset sepsis (36.5%). The mean body weight was significantly
lower in neonates who died (1.97±0.67), compared to those who survived (2.79±0.6). A significantly higher
mortality rates were among premature neonates (69.7%), and those with intrauterine growth retardation (70.8%).
In addition, the death rate was higher in neonates with maternal history of prolonged rupture of membrane ≥24
hours (61.5%) compared to (39.4%) in neonates with maternal history of rupture membrane of < 24 hours before
labor. The clinical signs that predict high mortality were sclermic skin (94.2%), signs of dehydration (82.8%) and
prolonged capillary refilling time (68%). Highest mortality was associated with positive blood culture for
Pseudomonas aeruginosa and Staphylococcus aureus, where all neonates died (100%), followed by klebsiella spp.
and Escherichia coli (71.1%) and (48.5%) respectively in comparison with neonates who have positive blood
culture for Proteus and Enterobacter aeruginosa where only 7.9% and 11.1% of neonates died respectively. A
statistically significant higher mortality was reported in neonates having thrombocytopenia, neutropenia and Creactive
protein ≥10 mg / dl. Regression analysis of different neonatal and maternal variables, hematological and
microbiological tests, revealed that body weight, gestational age, thrombocytopenia, neutropenia, positive blood
culture for klebsiella spp., prolonged capillary refilling time, sclerma and signs of dehydration are predictive factors
of the outcome of death in neonatal sepsis.

KNOWLEDGE, ATTITUDE AND PRACTICE OF FAMILY PLANNING AMONG WOMEN IN BASRAH CITY SOUTH OF IRAQ

Samira M. Ebrahim; Nihad K. Muhammed

The Medical Journal of Basrah University, 2011, Volume 29, Issue 1, Pages 70-76
DOI: 10.33762/mjbu.2011.49488

ABSTRACT
Objectives: to estimate the prevalence of contraceptive use, and investigate the factors associated with knowledge, attitudes and practices of family planning.
Method: A cross sectional, household multi-stage sampling. A sample of 900 currently married non pregnant women aged 15-49 years were selected from 30 household clusters in Basrah city, south of Iraq.
Results: Current prevalence of contraceptive use (any method) among 900 non-pregnant women was 53.7%, use of modern methods was 37% and traditional methods was 16.7%. The use of traditional methods of contraceptives was significantly associated with older age, higher educational level. The main cause for not using contraceptives was health reasons. Husband's objection and cost of contraceptives also had role in non use of contraception methods.
Conclusions: The rate of use of contraceptives was low for both any method and for modern types. The pill was the most popular method of contraceptives and the next more popular method was the withdrawal method. The study reveals good knowledge about family planning.
Recommendations: Establishment of sensitive and modern family planning services through all primary health care services in all districts of Basrah. Increase Community awareness of family planning and the advantages of child spacing through mass media, Coordination between public and private sector to provide adequate family planning services and supplies and Policy-makers and health providers should target men since they are primary decision-makers in the home.

Juvenile gigantomastia, two cases treated by reduction mammoplasty with nipple-areola complex graft

Zuhair F. Fathallah; Jabir R. Hameed

The Medical Journal of Basrah University, 2013, Volume 31, Issue 1, Pages 43-46
DOI: 10.33762/mjbu.2013.90703

Gigantomastia or “Gravidic macromastia” is a rare benign disorder of the breast, in which the breasts undergo a massive hypertrophy and increase in size. It may occur during marked hormonal changes as in puberty or pregnancy or after prolonged intake of certain medicine. The condition is manifested as a massive diffuse enlargement of the breast. It is usually associated with psychological effect on the patient and her family and physical disability due to excessive breast growth. This rare condition is of undetermined aetiology, which may be due to excess hormonal secretion, or hypersensitivity of the target organ to normal hormonal level. Histologically it is a glandular hyperplasia with an increase in connective tissue. This paper reports two case of gigantomastia due to hormonal changes during puberty. Ulceration and haemorrhage of the breasts complicated the picture and is the main cause of coming to surgery. Surgical procedure was subtotal mastectomy and free implantation of the nipple areola complex.

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