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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A study on job satisfaction of family physicians in Basrah

Rana Ali; Omran Habib

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 51-58
DOI: 10.33762/mjbu.2019.163348

Background: Job satisfaction is a reflection of interaction of the physicians and all the components of the surrounding environments. A high level of satisfaction is desirable and may contribute to better workers performance.Objectives: To explore the degree of satisfaction of family physicians in Basrah with their jobs. Methods: A cross-sectional study targeting all family physicians who were working in Basrah at the time of the study (2018) was carried out. A total of 67 out of 74 physicians were successfully interviewed according to a special questionnaire form that was prepared in the light of selected readings and guided by the researchers view on areas of interest. The data collection phase lasted for four months (April-August 2018). Results: A good proportion (43.3%) of family physicians in Basrah were posted in places other than family medicine practice. The majority were young, females, and reasonably lived close to their work sites. Family physicians were very satisfied with the supervisors (95.5%), colleagues (97.0%) and clients (86.6%). They were also satisfied with their competence in handling their daily tasks and fairly satisfied with their postgraduate training and in-services training. They were very unsatisfied with their income, their work conditions in terms of amenities and staffing, with respect to specialty under two thirds (61.2%) expressed their satisfaction with their status as family physicians but 38.8% were not satisfied and this was reflected on their desire to quit to other specialty (55.2%). A big problem is the perception that the specialty is not respected by the public (85.1%), not respected by other clinical specialties (95.5%), not supported by mass media (95.5%), and the specialty is not optimally utilized (79.1%). However, 67.2% reported that the specialty improved care delivery at primary health care centres. Conclusions: Mostly family physicians were happy with competence required to handle tasks. Except for the overall work environment, participants denied to have adequate amenities. Most positive points were related to humanities. Most of negative points were related to income, recognition and amenities. They expressed negative views on all aspects of salary valuation and most of them wanted to change specialty.

Impacts of bariatric surgery on type 2 diabetes mellitus

Mohamed Yassin; Issam merdan; Falih algazgooz

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 59-67
DOI: 10.33762/mjbu.2019.163355

Objective: To determine the beneficial effect of bariatric surgery on the treatment of type 2 diabetes mellitus in obese patients.Patients and methods: This prospective study was conducted in Al-Sader teaching hospital and Al-Musawi privet hospital from August 2013 to August 2017 on 332 patients with body mass index between 35-55, their age was range from 30-60 years, and they were 185 (55.7%) females and 147 (44.3%) males. All patients in this study were diabetic type 2 with different stages of the disease, types of medications, C peptide levels, HbA1c and BMI. They were subjected to three different bariatric procedures; laparoscopic sleeve gastrectomy (LSG), mini gastric bypass (MGB), and laparoscopic Roux-en-Y gastric bypass (LRYGB), they were followed for a period of 1-4 years regarding their glycemic control, HbA1c, type and number of medications.Results: Three hundred and thirty two patients were included in this study, 111 patients (33.5%) had MGB, 88 patients (26.5%) had LRYGB, 133 patients (40%) had LSG according to the following selection criteria; duration and severity of DM, C peptide, other comorbidities and the patients preference Resolution of DM was achieved in 100 patient (90%) of MGB, 77 patient (87%) of LRYGB and 75 patient (57%) of LSG while other patients had no improvement. Conclusion: Bariatric surgery for obese diabetic patients resulted in complete resolution in most patients, improvement of diabetes in some and overall improvement in the quality of life in all patients.

Assessment of vitamins D and B12 after laparoscopic sleeve gastrectomy

Rula Abdual-Hafed; Issam Merdan; Abdul Kareem Alebadi

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 68-73
DOI: 10.33762/mjbu.2019.163356

Background: Obesity is a big health problem due to its related diseases, so laparoscopic sleeve gastrectomy is one of the bariatric surgeries which have a role in the weight reduction, but it affects the micronutrients concentrations including vitamins D and B12.Aims: To assess concentrations of vitamins D and B12 prior to laparoscopic sleeve gastrectomy and post-surgery in first, third, sixth and twelve months after the surgery by taking blood samples in this scheduled follow up visits.Patients and Methods: This study was carried out in department of surgery at Al-Sadr Teaching Hospital in Basrah, Iraq from June 2016 to June 2017.It include 82 patients from both gender and from different age groups. Detection of Vitamins D and B12 deficiency pre and postoperative periods, in every follow up visits were by taking a samples of blood and statistical calculation of vitamins values.Results: There were no significant differences related to the age groups but there were a significant reduction of both vitamins in relation to sex and time (pre and postoperatively). The deficiency of vitamin D before surgery mean (35.18) which decreased then increased reaching (37.46) in the end of first year post surgery which was a significant P value 0.045, while the deficiency of vitamin B12 prior to surgery which was 51.90 then after surgery decreased then increased reaching 51.58 by the end of first year post surgery which was non-significant P-value 0.490 (P value < 0.05 significant).Conclusions: This study determined the presence of deficiencies of both vitamins D and B12 before and after laparoscopic sleeve gastrectomy during first year post surgery, so it is recommended for giving vitamin D prior to surgery, while vitamin B12 was not given.

Measuring the level of patient's satisfaction for those attending primary health centers versus family medicine centers in Basrah governorate

Riyadh Al Hilfi; Rajaa A Mahmoud; Nihad Q Al Hamadi

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 74-80
DOI: 10.33762/mjbu.2019.163357

Background: Patient satisfaction is defined as the total judgments made by the recipient of a healthcare as to whether -or not- their expectations have been met. It is an important measure of healthcare quality as it offers information on the provider’s success to meet the clients’ expectations.The Study Objectives: The study aimed at measuring patient's satisfaction in primary health centers of Basrah governorate with a comparison between primary health centers that follow family medicine strategy versus general primary health centers.Methodology: It's a cross sectional study involved patients attended primary health care centers in Basrah governorate during June 2016.Standard check lists and questionnaires from Iraqi Ministry of Health were used to measure five main indicators of patient satisfaction including: appearance, credibility, responsiveness, security and empathy with a four likert scale to measure the satisfaction of patient. A total sample included 456 patients. Results: The lowest Cronbach's coefficient alpha value was found by the study to be in the "general appearance" dimension which included the general infrastructural appearance of the health facility with appropriate waiting areas for the attendees, cleanliness and lighting of the facility in addition to the general look and appearance of the health workers and service providers. While “assurance” dimensions shows the highest percentage of satisfaction. In addition, no significant difference was revealed for the chosen satisfactory dimensions between the health care centers providing family-medicine services compared to those with no family-medicine ones.Conclusions: The study remarks important weaknesses in some of the patient satisfactory dimensions including general appearance, responsiveness, apathy and assurance. However, it provides an evidence of having no significant difference for the chosen satisfactory dimensions between the health care centers providing family-medicine services compared to those with no family-medicine ones.

Dietary habits and nutritional knowledge among high health institute students in Basrah

Jhood AS Molan

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 81-90
DOI: 10.33762/mjbu.2019.163358

Introduction: Nutrition is vital for the maintenance of health and prevention of disease. The burden of nutrition-related chronic diseases (such as CVD, cancer, diabetes and osteoporosis) and obesity is increasing rapidly world-wide. Nutritional knowledge may play a pivotal role in the adoption of healthier food habits but it must be noted that knowledge on its own cannot bring about the desired changes due to the complex nature of food behavior.OBJECTIVE: It was to assess dietary habits and nutritional knowledge of the high health institute female students in Basrah and the relationship between nutritional knowledge and socio-demographic factors.Methods: Seventy eight female students of the high health institute were administered a special questionnaire form regarding their dietary habits and nutritional knowledge.Results: The majority of the students 82.1% were in the age group < 24 years old. The mean body mass index (BMI) was (23.56 kg/m²) however twenty three students were classified as overweight. Academic study was the main source of information for 56.4% of the students. The mean survey scores were 70.78% for dietary habits and 73.32% for nutritional knowledge. No statistical significant association was found between dietary habits and nutritional knowledge. A significant association was found between the students’ BMI and their nutritional knowledge level (p<0.05). The level of knowledge consistently decreased with the increase in BMI. Much like habits and knowledge, none of the other association between other variables (age, place of residence, paternal education level) showed any statistical significance.Conclusions: Important point observed in the present study was that though the students had good level of nutritional knowledge and dietary habits, the association between them was not statistically significant. It may be suggested that the adequate nutritional knowledge observed may not have translated into the appropriate dietary habits in the students

The effect of Lactobacillus plantarum on expression of biofilm genes of Streptococcus mutans isolated from dental caries

Zahra Saeed; Basil Abbas; Rasha Othman

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 91-99
DOI: 10.33762/mjbu.2019.163359

Background: Dental caries and decay caused by Streptococcus mutans. Sucrose, stimulates S. mutans to yield insoluble glucans to form oral biofilm also called dental plaque to start process of caries. The GtfB and LuxS genes of S. mutans are responsible for development and evolution of biofilm. Lactobacillus plantarum as probiotic can affect the biofilm formation of S. mutans.Aim of the study: To evaluate the effect of Lactobacillus plantarum against S. mutans biofilm formation.Results: Growing biofilm in the presence of sucrose was detected using 100 well microtiter plate crystal violet assay and biofilm formation by S. mutans in the presence of Lactobacillus was detected. Gene expression of biofilm forming genes (GtfB and LuxS) was quantified through Real- time PCR. The transcriptional levels of GtfB and LuxS genes were remarkably down regulated 9.43 -and 4.24- fold change, respectively, when treated with lactobacillus plantarum in comparison with the control group.Conclusions: Lactobacillus plantarum as probiotics can be used effectively to reduce the chance of dental caries by decreasing the effects of S. mutans and their gene expression to conserve good oral health

Feto-maternal outcome of preeclampsia in multigravida compared to primigravida women

Methal A Alrubaee; Lekaa Kadim

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 100-105
DOI: 10.33762/mjbu.2019.163360

Background: Pregnancy induced hypertension including pre-eclampsia are global public health concern both in developed & developing countries. They have significant prenatal, neonatal & maternal morbidity & mortality.Objectives: The aim of this prospective comparative study is to identify & compare the maternal & neonatal outcome of pre-eclampsia in between multigravida & primigravida.Patients:- This study had been done over period of one year (1st Sep.2017-31st Aug. 2018) in Basrah Maternity & Child Hospital in which (110) multigravida with pre-eclampsia were compared to (108) primigravida with pre-eclampsia. Both groups were admitted to labor room during same period of study with spontaneous labor or for induction of labor.Results:- Multigravida with pre-eclampsia were found to have significantly more advanced age more than thirty years (58%) as well as higher body mass index with morbidly obese (75%).They also exhibited more severe form of pre-eclampsia (75%) as well as recurrent pre-eclampsia (45%) ,with positive family history of pre-eclampsia(64%) & chronic hypertension (27%). Obstetrical complications in term of ante-partum hemorrhage (29%), post-partum hemorrhage (43%) & preterm delivery (50%) were evident more in multgravida with pre-eclampsia as well as poor neonatal outcome in term of low birth weight, & low Apgar score.Conclusion:- Multigravida with pre-eclampsia had significantly higher rates of severe type with adverse maternal& neonatal outcome in comparison to primigravida with pre-eclampsia

Serum vitamin D level, measured by two methods, in a sample of normal subjects in Basrah

Huda A Yaqoob; Nazar S Haddad; Abdullah M Jawad

The Medical Journal of Basrah University, Volume 37, Issue 2, Pages 106-114
DOI: 10.33762/mjbu.2019.163361

Background: Low vitamin D levels had been reported to be common in normal subjects worldwide. Studies in the Middle East had reported extremely low levels of serum vitamin D, despite high exposure to sunlight. Aim: To estimate vitamin D serum concentration in a sample of apparently healthy subjects from Basrah, by 2 methods (chemiluminescent and fluorescent assays). Methods: The study was carried out on apparently healthy subjects during the period from September 2018 to February 2019. Quantitative determination of the total 25-hydroxy vitamin D in serum was made using chemiluminescent microparticle immunoassay and enzyme-linked fluorescent assay. Other parameters (calcium, phosphorus, alkaline phosphatase, parathyroid hormone, hemoglobin, and erythrocyte sedimentation rate and body mass index) were also measured. Results: The mean level of vitamin D measured by the two methods, was 11.57±6.63 ng/ml and 13.31±6.52 ng/ml by chemiluminescent and fluorescent assays respectively. The prevalence of vitamin D deficiency was high, where more than 80% of the 57 subjects had vitamin D level below 20 ng/ml. If the cut-off point of vitamin D deficiency was taken as 10 ng/ml, around 46% of the subjects were found deficient in both methods. Although the two methods of vitamin D assay were well correlated with each other, fluorescent assay gave, on average, a significantly higher levels compared with the chemiluminescent method. Serum parathyroid hormone, showed a negative correlation with vitamin D serum levels. After excluding children and females, no significant difference was found between adult smokers and non-smokers when vitamin D was measured by both methods.Conclusion: Vitamin D deficiency is common (> 80%) among normal subjects. The enzyme-linked fluorescent assay resulted in higher mean level than chemiluminescent assay. The use of a deficiency cut-off point of 10 ng/ml may be more appropriate.

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, 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.
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Self-reported hand contact dermatitis among female hairdressers in Basrah

Wasan H. Ghani; Asaad Q Al-Yassen

The Medical Journal of Basrah University, 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
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Effect of Azithromycin in Treatment of Cutaneous Leishmaniasis

Dindar S Qurtas

The Medical Journal of Basrah University, 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.
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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, 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%)

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, 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.
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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, 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.

LOW-LYING PLACENTA IN BASRA: FETOMATERNAL OUTCOME

Fouad Hamad AL-Dahhan

The Medical Journal of Basrah University, 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.

Thromboprophylaxis in women with unexplained consecutive recurrent ‎miscarriages

Maysoon Sharief; Teshreen Sabri Ali

The Medical Journal of Basrah University, Volume 32, Issue 1, Pages 37-42
DOI: 10.33762/mjbu.2014.94511

Objective: To compare the effect of low dose aspirin and enoxaparin on pregnancy in women with recurrent ‎miscarriage.‎
Patients& Methods: Randomized controlled trail, conducted in Basrah Maternity and Child Hospital during the period ‎from January 2012 till April 2013. Participants were 221 pregnant women aged 18-41 years with history of at least 2 ‎previous miscarriage without apparent causes. They were divided into 2 groups; the first group included 111 were given ‎enoxaparin and the second group involved 108 which were given aspirin.‎
Results: In both groups (75%) of patients had negative serological test for thrombophilia. Enoxaparin group had higher ‎significant incidence of term delivery (86%) with less incidence of preterm delivery (4.5%) and less early pregnancy ‎loss (8%).‎
No significant differences in obstetrical complication but higher incidence of abdominal delivery in both groups.‎
Higher incidence of postpartum hemorrhage in the enoxaparin group in comparison with aspirin group and no significant ‎systemic adverse effect of enoxaparin were noticed on the first group.‎
Conclusion: Since postpartum hemorrhage is treatable, low molecular weight heparin is safe and effective for treating, ‎preventing thrombosis and achieving successful pregnancy.‎

Hanging as a method of suicide: a retrospective study

Abd Alkareem Q. Mohammed

The Medical Journal of Basrah University, Volume 35, Issue 2, Pages 97-104
DOI: 10.33762/mjbu.2017.134241

Objectives: Hanging is a common cause of death worldwide as well as a method of suicide with a high fatality rate, In this retrospective study, data were obtained from cases of hanging reported to Department of Forensic Medicine at the province of Basrah, Iraq, in order to analyze the characteristics of hanging, to focus on its distribution by gender, age groups, marital status, the place of occurrence of the incident, ligature types used, autopsy findings and manner of death, and to determine the possible causes of hanging fatalities over the period of the study, in addition to various other associated factors with the aim to find out which individuals are more prone to death by hanging and to explore the potential control and preventive measures.
Methodology: Over a period of seven years, from January 2010 to December 2016. data from autopsy reports, together with information from police investigation reports and history obtained from relatives were used in this study.
Results: A total of 184 forensic autopsies were conducted on cases of death due to hanging during the period of the study. The highest proportion of hanging cases was suicidal in nature (86%). Twenty eight percent of the suicidal hanging victims were in their 3rd decade of life, and the incidence rate of hanging among female and male victims was almost equal, female to male ratio was 1.1:1.
Conclusion: Hanging is a common cause of suicide in our society, especially among young individuals. Prevention of death by hanging is not easy since different types of materials can be used as a ligature.

Self-reported hand contact dermatitis among female hairdressers in Basrah

Wasan H. Ghani; Asaad Q Al-Yassen

The Medical Journal of Basrah University, 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
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THE ASSOCIATION OF ACUTE HUMAN PARVOVIRUS B19 INFECTION AND SPONTANEOUS MISCARRIAGE IN BASRAH, IRAQ

SADOON R N; HASSAN J HASONY

The Medical Journal of Basrah University, Volume 29, Issue 1, Pages 19-25
DOI: 10.33762/mjbu.2011.49477

ABSTRACT
A case control study was carried out during October 2008 till September 2009 in Basrah. The study was designed to evaluate the occurrence of acute human parvovirus B19 infection among pregnant women and its association with spontaneous abortion.
A total of 182 blood samples were collected from the outpatient clinic, wards and emergency unit at Basrah Maternity and Children Hospital, 91 from women with spontaneous abortion and 91 from women with normal pregnancy as control matching cases in age and gravidity. Maternal serum was kept frozen at –20ºC until serological investigation by Enzyme-linked immunosorbent assay to detect parvovirus B19 IgM (ELISA-B19-IgM), then the positive cases were investigated to determine the level of interferon-gamma by ELISA kit and acute phase protein C-reactive protein (CRP) by latex agglutination test.
The overall prevalence of parvovirus B19 in study population was 53.8% for cases and 41.8% for control. All B19 positive cases were positive for interferon-gamma in different titers and 77.6% of B19-IgM positive cases were positive to CRP as well. The data indicate that the diagnosis of B19 infection during pregnancy should be considered more often, particularly in complete and missed types of abortion, as missed abortion represents more than 50% of B19 seropositive of spontaneously aborted ladies. Significantly (P<0.05) high percentage of B19 positive cases as well as fetal losses were observed in the second trimester. Also the results showed significant difference in B19 antibodies in relation to gravidity (P<0.05).
The main conclusion that human parvovirus B19 is common with high prevalence rates among pregnant in our region, and cases of complete and missed abortion should be investigated to exclude parvovirus B19 infections.

ACUTE ABDOMINAL SURGICAL EMERGENCY IN ELDERLY PATIENTS (A PROSPECTIVE STUDY)

Ahmed Ziara Al-Hussainy; Mazin Hawaz Al-Hawaz; Mazin Abdulsatar Abdulla

The Medical Journal of Basrah University, Volume 27, Issue 1, Pages 34-41
DOI: 10.33762/mjbu.2009.49036

ABSTRACT
Background: Longer life expectancy has created an increasing demand for surgical care of the elderly. In addition,
abdominal surgical emergencies are potentially serious and life threatening for this age group of patients.
Aim: The aim of this study is to know the type of common surgical abdominal emergencies, mode of treatment,
complications and outcome in elderly patients.
Patients and methods: One hundred patients aged 60 years and above who had been admitted to the surgical
department in Basrah General Hospital were prospectively evaluated according to the demographic features, causes
of abdominal emergencies they presented with, post operative clinical course and outcome.
Results: Out of 100 patients included in the study 60% were males and 40% were females, with an average age of
67.39 years (range from 60-83 years). The causes of acute surgical abdominal emergencies were intestinal
obstruction (55%), hollow viscus perforation (17%), acute cholecystitis (12%), mesenteric vascular occlusion (9%),
and acute appendicitis (7%). Most of the cases of intestinal obstruction were due to adhesion, while perforated DU
was the main cause of hollow viscus perforation. Twenty patients (20%) died in the early post operative period with
mesenteric vascular occlusion being the leading cause of death (35%).
Conclusions: Acute intestinal obstruction and hollow viscus perforation appear to be the main causes of acute
abdominal surgical emergencies. Obstructed hernia which constituted 14% of the causes is generally preventable.
Acute mesenteric ischaemia and bowel obstruction secondary to colonic tumour had a worse prognosis in elderly
patients.

Non High Density Lipoproteins (Non-HDL-C) and the degree of glycemic control of type 2 diabetes mellitus

The Medical Journal of Basrah University, Volume 31, Issue 1, Pages 28-33
DOI: 10.33762/mjbu.2013.81816

Objective: To evaluate the level of non high density lipoprotein among dyslipedemic type 2 diabetic patients and its correlation to the degree of glycemic control according to HbA1c.
Patients and methods: The study was conducted prospectively on 113 patients with type 2 diabetes mellitus. 62 (54.9%) patients were females and 51(45.1%) patients were males. Their ages ranged from 34 to 67 with a mean age 50.37±8.76 years. All consulted endocrine and diabetic center in Al-Mawani General Hospital in Basrah Southern Iraq during the period from April 2010 to February 2012. Fasting blood was taken for each patient and send for sugar, lipid profile and HbA1c. Height, weight were taken to calculate body mass index (BMI). Non-HDL-C were calculated by subtracting HDL-C from total cholesterol.
Result: The level of non-HDL-C was significantly elevated in patients with poorly controlled type 2 DM (P-value <0.01) in spite of absent of increments of their HDL-C levels that shows a mean value of (43.19±12.68) in patients with poorly controlled as compaired to fairly controlled diabetes (40.25±14.18).
Conclusions: Non-high density lipoprotein level can be calculated easily from total cholesterol and high density lipoproteins, it provides an index of atherogenic lipid other than low density lipoprotein and its level below 130 mgdl directly correlated with the glycemic control as measured by HbA1c.

HUMAN RECOMBINANT ERYTHROPOIETIN IN THE TREATMENT OF ANEMIA OF PATIENTS WITH CHRONIC RENAL FAILURE

Isam Hamo Mahmood; Emadeldin Ibrahim Al-badrani; Najlaa Saadi

The Medical Journal of Basrah University, Volume 27, Issue 1, Pages 7-10
DOI: 10.33762/mjbu.2009.49013

ABSTRACT
Objective: To compare the effect of small doses of recombinant erythropoietin on anemia of patients with chronic
kidney disease who need dialysis and those are not on dialysis.
Design: Case-comparative study.
Setting: Nephrology Department in Al-Salaam Teaching Hospital, Mosul.
Methods: Eighty patients having chronic kidney disease (40 patients needed dialysis and 40 patients needed no
dialysis) participated in the study. Epoetin alfa given s.c. in a dose of 4000 IU, 2 times weekly. Hemoglobin was
measured before drug administration and every 2 weeks and at the end of the trial period (3 months).
Result: A significant increase of hemoglobin level had been obtained after treatment with erythropoietin in both
groups. Comparison between hemoglobin elevation of both groups ( 3.0 g/l for patients without dialysis and 2.9 g/l for
patients with dialysis) revealed a non significant difference (P>0.5).
Conclusion: the present study demonstrated that the administration of epoetin alfa, s.c. in a dose of 4000 IU twice
weekly is effective in the elevation of hemoglobin levels in patients with chronic kidney disease. The effect is
comparable in patients who need dialysis and in patients who need no dialysis, also the effect is similar in both sexes.

Respiratory Distress in Full Term Neonates in the First Week of Life in Basrah Maternity and Children Hospital

Assel Mohammed Wadi; Aida Abdul Kareem

The Medical Journal of Basrah University, Volume 30, Issue 2, Pages 91-98
DOI: 10.33762/mjbu.2012.75797

Objectives: a descriptive study was carried out on term neonates with respiratory distress in the early neonatal period who was admitted to the neonatal care units in Basrah Maternity and Children Hospital to assess the causes, outcome, and neonatal, maternal, labor, and delivery characteristics. Patients and Methods: a total of (167) full term neonates, (103) males and (64) females, their ages range from less than one hour to 7 days who were admitted for respiratory distress (from the first of March to the end of August 2010) were recruited in the study from a total of (2858) cases admitted to the 1st and 2nd neonatal care units during the study period, (1348) of them had respiratory distress. Detailed maternal, perinatal, labor and delivery histories were taken and full clinical examination was performed. Results: the most common presenting signs were chest retractions and tachypnea. Eighty four (50.3%) of cases were delivered by caesarean section. It was found that (78.4%) of cases had a gestational age less than 39 weeks and (80%.8) were less than 24 hours of age. Both are statistically significant with p value <0.00l. One hundred forty six) (87.4%) had a normal body weight (2500 to 4000 gm). Ninety one (54.5%( of cases need hospitalization for 3 days or more. It was found that 39(23.4%) of the mothers were risky regarding their ages (<18 years and >35 years) and (27.5%) of the cases had no antenatal care, 95% of mothers were not employed and had less than 10 years of schooling. It was found that 75 (44.9%) cases were due to Transient tachypnea of the newborn and 50.7% of them were delivered by elective caesarean section followed by birth asphyxia in 22(13.2%) cases; (16) (72.75%) of them were delivered vaginally. Meconium Aspiration syndrome was found in (9.6%) of cases, early sepsis in (8.4%), and pneumonia in (7.8%). Congenital heart diseases was responsible for (7.8%) of cases, while anemia was found in (4.2%) of total cases, pneumothorax in (3%) and Respiratory Distress Syndrome in only (1.2%). The deaths were 15(9%) from 167 cases, the commonest causes were found to be due to birth asphyxia and early sepsis, 13 deaths (12.6%) occurred among males and more deaths among those who were less than 39 weeks gestation (9.16%). The total deaths due to Respiratory Distress in the study period were (35) from a total (174) and (150) from a total of (680) deaths in the 1st and 2nd neonatal care units respectively which constitute one fifth of the total deaths. Conclusions: A wise and correct decision of timing of caesarean section is needed with prevention and management of asphyxia and sepsis in addition to adequate measures and facilities of treatment for hospitalized neonates.

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