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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Practical approach to train and assess professional behaviour of medical students

Ghanim Y. M. Alsheikh

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 86-91
DOI: 10.33762/mjbu.2021.169992

The gradual decline of doctor-patient communication skills and professional attitudes and behaviour have steadily been observed in all countries across the globe. This deterioration has resulted in repeated and renewed demands to make medical schools more aligned to the necessity to train professional behaviours in undergraduate medical study. Medical educators have been criticised for not effectively training and rigorously assessing these skills. Training of behaviour has been abstracted in teaching of ethics and communication skills which in most of the cases is based on theoretical “preaching” lectures and use of book/guide and in some cases, training using supervised role-playing sessions at the best of options. Although good communication skills are essential for an optimal doctor-patient relationship and certainly contribute to improved health outcomes, still other aspects of behaviour are not covered. Furthermore, while the need for training on professional behaviour is specified as a requirement in the adopted graduate outcomes, formal training in these skills has been fragmentary and not clearly addressed in curriculum documents of the medical colleges in Iraq. A practical approach is here proposed to support medical colleges to bridge this gap. The methods of design, construction and use of standardised checklists for training medical students and assessing their acquisition of behavioural (affective) skills is described

A 5 year retrospective analysis of pharmacovigilance study, completeness and quality of suspected adverse drug reaction forms at adverse drug reaction monitoring center Port Blair.

Priyanka Hotha; C. Dinesh M. Naidu; Nimisha Elezebeth Zachariah

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 92-103
DOI: 10.33762/mjbu.2021.130470.1077

In India, Adverse Drug Reaction (ADRs) related morbidity and mortality is one of the leading health problem. ADRs result in diminished quality of life, prolonged hospital stay, morbidity and mortality. The present study was planned to scrutinise suspected ADRs forms and evaluate completeness with quality assessment of ADR reports at AMC Port Blair. The study was a 5 year retrospective observational study. The collected data was evaluated based on patients’ demographic, adverse drug reaction and drug characteristics with completeness and quality of reactions. A total of 877 ADRs from 715 offending drugs in 671 patients were reported. In India, 9.5% hospital admissions were because of ADRs. 52% female experienced ADRs which was more than male. The occurrence of ADRs in adult patients was high. Antibiotics (39%) was most commonly prescribed class of drug followed by NSAID (10.9%). Majority of ADRs (45%) were observed in the skin followed by musculoskeletal system (12.7%). In our study, 60.2% of patients recovered in the outcome parameters. 83.6% of drugs withdrew for management of ADRs. Rechallenge was made only in 12.3% patients, 71.6% of patients had non-serious reactions and 71.7% ADRs were probable. We received the highest completeness score in 2020 which was 0.98. ADRs remain as a challenge in modern healthcare. The health system should promote spontaneous reporting of ADRs. The proper documentation and periodic reporting to ADR monitoring centres (AMC) reduce the incidence of new ADRs and maintain the public confidence toward safe use of drugs. This good quality reporting increases the potential for signal generation.

Association between Taq1 rs: 731236 SNP of VDR gene and risk factor among Sudanese patients with breast cancer

Amira S. Khalafalla; Abuagla Dafalla; Yousif Abdelhameed Mohammed; Adam D. Abakar; Mergani Adil; GadAllah osman Modawe

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 104-110
DOI: 10.33762/mjbu.2021.130830.1082

Abstract:
Background: Breast cancer is the most frequent cancer in women globally as well asSudan, it has risen to become the second commonest cause of death in women.Vitamin D receptor (VDR) is a ligand-dependent transcription factor. Vitamin D-ligandedVDR, has anti-proliferative properties in a variety of tumor types by inducing cell cycle arrest, senescence, differentiation, and death. The role of VDR TaqI polymorphism is currently unknown. However, studies suggest that these polymorphisms may affect messenger RNA (mRNA) stability.
Methods and patients: This case control 198 participants, (97) breast cancer patients and another 101control group. Data was collectedby a questionnaire. 2 ml of venous blood was collected and stored at -20 till DNA extraction. Phenol chloroform method was used for DNA extraction. VDR TaqI was examined and genotyped using CTPP-PCR after designing of suitable primers and PCR condition. Then data was analyzed statistically using the SPSS program (version 21) and the SNPS tats online tool.
Results: The three genotypes reported in this study for TaqI SNP (CC, TC, and TT) were evenly distributed throughout cases and controls, so according to this findings there is no statistically significant association of this SNP with breast cancer risk (p. value 0.650) (OR(95%CI) 1.39 (0.64-3.00), 1.00 (0.54-1.87), 1.00).
Conclusions: This study found no association of TaqI polymorphism and breast cancer risk factors

Clinical presentation and electrocardiographic features of Brugada syndrome in Iraq

AMAR Talib AL-HAMDI

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 111-119
DOI: 10.33762/mjbu.2021.130674.1080

Background: Brugada syndrome is a clinical entity composed of twelve leads electrocardiographic changes of coved or saddle shaped ST-segment elevation in V1 and V2 with serious ventricular arrhythmias which may cause sudden cardiac death.
Objectives: The objectives of this study is to highlight the clinical presentation and the types of ECG changes of Brugada syndrome cases seen in Iraq and to orient physicians about this fatal condition.
Patients and Methods: Patients presented with symptoms of palpitation, dizzy attacks or syncope and diagnosed as Brugada syndrome were included in this case series study. The diagnosis of Brugada syndrome based mainly on the typical coved or saddle shaped or variant ST-Segment elevation in electrocardiographic leads V1, V2.
Results: Eighteen patients were included in this case series study. All are males. Age ranged from 15-45 Y. The presenting symptoms were palpitation in 12 patients, syncope in 8, dizzy spells and pre syncope in 14 and chest pain seen in 2. The arrhythmic events were clinically documented in 10. Monomorphic VT seen in 4, VF in 2, atrial fibrillation in 2 and atrial flutter in 2. Induced VF by EP study seen in 2. Type I Brugada ECG pattern was seen in 6 patients, type II in 4 and three of type III. Five showed a variant type of the syndrome. Family history of sudden cardiac death was seen in 8 patients while in 10 it was negative. ICD was implanted in 6 patients. In 12 patients (67%) the diagnosis of Brugada syndrome was missed during the provisional medical contacts.
Conclusion: Brugada syndrome is not uncommon in Iraq but needs a high diagnostic suspicion through appreciating the symptomologies and electrocardiographic features of this fatal syndrome to plan management to prevent sudden cardiac death.
Key words: Brugada syndrome, Iraq

Ready to-Use Supplementary Food in the Outpatient Management of Children with Acute Malnutrition in Basrah

Nedhal S Kudhayer; Sawsan Habib

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 120-127
DOI: 10.33762/mjbu.2021.130966.1085

Summary
Background Ready-to-use supplementary foods are high-energy, lipid-based provide energy, protein, fat, vitamins and minerals to treat acute malnutrition in children aged 6 -59 months.
Aim To evaluate the effect of ready-to-use supplement foods on the outpatient management of children with acute malnutrition.
Methods A prospective appropriate study was carried out on children with acute malnutrition who were referred to the nutritional rehabilitation center at Basra Teaching Hospital; were received ready-to- use supplementary foods at a quantity sufficient to meet their nutrient requirements for full catch- up growth and followed at two subsequent visits
Results Moderate wasting and underweight recorded in (66.7 %) and severe wasting in (33.33%) of the patients. Mean weight gain at the first and second follow-up visit was (5.78 ±2.43) and (6.52 ±2.75) g/kg/day respectively. There was a significant improvement in the weight for height Z score at the first and second follow-up visits after the administration of ready-to-use supplementary foods (P value < 0.05). Approximately 32% of the children aged 12-18-month experienced moderate weight gain. Bottle feeding with complementary feeding was reported in 24.19% of the children with moderate weight gain, and 9.52% and 34.68% of the children of illiterate parents and unemployed fathers respectively, showed moderate weight gain. Children belong to families with low income group accounted for 37.09% of those with moderate weight gain. Family income was the only variable that depend on the weight gain results (P value < 0.05). Conclusion: Ready-to-use supplementary food is significantly effective for outpatient management of acute malnutrition.
Key words: Acute Malnutrition, Ready-to-Use Supplementary Food, Outpatients

low birth weight risk factors in Basra city

Zainab hussain Almussa

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 128-138
DOI: 10.33762/mjbu.2021.129962.1070

Abstract:
Introduction: Low birth weight is the best indicator of the impact in the health system and the best predictor of mortality and morbidity in the neonatal, post neonatal and childhood periods.
Objectives: This study was planned to study the association between birth weight and selected risk factors in Basrah governorate with special reference to: Socio demographic factors, Present obstetric history, Past obstetric history, History of Ante Natal Care, and Medical history.
Methods: This is hospital- based cross sectional study was conducted on 362 infants delivered and /or admitted to AL-Basrah-Maternity and Children Hospital. The data were collected through direct interview of the mothers using a special questionnaire form designed for the study purpose. The questionnaire included information about the following aspects socio-demographic characteristics and other clinical characteristic. Data were analyzed using the Statistical Package for Social Sciences version 15.
Results: The highest percentage of LBW was found among births for mothers who finished their primary education or less including illiterate, mothers in the age group30- 39 years, employed mothers, history of complications during pregnancy, preterm births, previous history of having LBW infant and short preceding birth interval (≤6 months)
Conclusion The factors which found significantly associated with LBW included: low education level, complication during pregnancy, previous history of LBW, preterm delivery, short preceding birth interval- ,No significant association was found between birth weight and the following factors, parent's age, maternal occupation, gravidity, and bad previous obstetric history, low number of ANC visits.
Keywords : low birth weight , risk factors , Basrah city
Correspondence to, Zainab Hussain Tahir Basrah Health Directorate
Zalmussazyahoocom@gmail.com

The effect of tourniquet on early postoperative quadriceps muscle wasting in ACL arthroscopic surgery

Madhat Mahdi; Hussein A. Al Yusir

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 139-144
DOI: 10.33762/mjbu.2021.131456.1088

Background: The main goals of anterior cruciate ligament (ACL) reconstruction and rehabilitation are to reestablish knee function. Quadriceps weakness is one of the most important complications associated with ACL injury and represents a major rehabilitation challenge. This study is designed to test the early effect of tourniquet on muscle wasting and to differentiate weather it is because muscle disuse or injury.
Methods: Twenty six male patients who submit to arthroscopic ACL reconstruction were randomly assigned to the use of an inflated (group T, n _ 13) or deflated (group NT, n _ 13) tourniquet. Patients with preoperative quadriceps wasting or abnormal electro conductive studies were excluded. The primary measures were thigh girth preoperatively and after two weeks, serum creatinine phosphokinase (CPK) preoperatively and one day postoperatively and electro conductive studies preoperatively and 1 month postoperatively.
Results: Patients' mean age was comparable in both groups. There was a significant difference between T and NT groups in term of thigh girth, CPK and electro conductive studies. Mean thigh girth in T group was 2.6 ± 0.5 while in NT group 1.4 ± 0.5. Mean CPK in T group was 813 ± 149 while in NT group 520 ± 203.
Mean femoral latency was 1.85 ± 0.4 in T group and 1 ± 0 in NT group; mean femoral conduction velocity was 1.77 ± 0.4 in T group and 1 ± 0 in NT group; mean muscle denervation was 1.92 ± 0.3 in T group and 1.54 ± 0.5 in NT group; mean motor unit number estimation was 1.9 ± 0.3 in T group and 1.5 ± 0.5 in NT group.
Conclusion: This comparative study show that tourniquet play a significant role in direct muscle injury proved by measurement of postoperative CPK and thigh girth in T group comparing it with NT group.

Antenatal care field survey in the catchment area of Bab Al-Moatham Primary Health Care center, Baghdad

HASSAN hadi ALKAZZAZ; Khelowd Salih salih; rasha farhan; sahar Abdul Hassan Esa alshatari

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 145-155
DOI: 10.33762/mjbu.2022.131231.1086

Antenatal care (ANC) has been defined as care given by skilled individuals with extensive healthcare training to both pregnant women and adolescent girls to ensure the best possible health conditions for both the mother and fetus during gestation (1). The objective of this study is to find the percentage of antenatal care booking, care regularity and antenatal care irregularity. This study is A cross-sectional field survey study with an analytic element conducted from 1st January -1st July 2018 . we choose 10% of all the catchment areas (shown in block numbers) as a two-stage cluster sampling method. Fifteen clusters (one cluster to every 180 families in the block) choosing each cluster consisting of 15 households, totals of 225 households some households had two-three married women of reproductive age (15 -49 years old), so the total final female’s participants were 255. This study was done in Bab Al-Moatham Primary Health Care center for family health approach, and it's revealed most houses 195(76.47%) have one adult woman of reproductive age per house, 106(41.6%) of participant's age between 30-39 years, 77(30.2%) married between 2012- 2007, and 87(34.1%) complete primary school. In concern to women reproductive history, the highest percentage have two pregnancies, two babies, without abortion or stillbirth. Out of 255 studied women, 236 women gate pregnancy for 3 years, 191(80.93%) of them had ANC booking, 148(58.1%) have regular ANC visit, while 43(16.9%) have irregular ANC visiting, and 188(98.43%) of them had ANC card. Abortion represents a major problem for irregularity in consuming ANC services. Improving health services and health promotion are essential steps in reducing abortion which might lead to increase ANC booking.

The Effect of Fasting and Smoking on the severity and mortality of COVID-19 patients in Basrah, Iraq

Jawd K. Albazoony

The Medical Journal of Basrah University, 2021, Volume 39, Issue 2, Pages 156-160
DOI: 10.33762/mjbu.2021.127786.1028

ABSTRACT
Background
Fasting has been shown to have an impact body systems in different manners. The influence of fasting on immune system regulation remains controversial. Immunomodulatory effect of nicotine was suggested recently. Low prevalence of smoking was observed among patients with COVID-19.
Aim
To study fasting as an immune modulator in relation to the severity and mortality of COVID-19 patients, and to determine the effect of smoking on such patients.
Methods
This is a comparative study included all PCR-confirmed COVID-19 patients during April, May and June 2020 in Basrah. The severity of and mortality due to COVID-19 infection were studied in fasting patients in Ramadan as compared with the non-fasting months before and one month later. Current smoking in relation to the severity of infection was also studied.
Results
Significantly less severe cases and lower mortality were detected in patients with COVID-19 who were fasting as compared with non-fasting patients before and after the fasting month. Current smoking is significantly less frequently detected among severe as compared with mild to moderate cases.
Conclusion Fasting could be useful to improve immune response against infection and to reduce severity and mortality in patients with infections. Smoking benefit in preventing and ameliorating of respiratory tract infection needs to be further investigated.

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
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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.
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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, 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%)

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.
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Association between apolipoprotein E polymorphism and lipid profile in patients of myocardial infarction

PRAMOD SUDAM KAMBLE

The Medical Journal of Basrah University, 2020, Volume 38, Issue 2, Pages 8-14
DOI: 10.33762/mjbu.2020.127936.1030

ABSTRACT:
Objective: To determine the effect of apo E polymorphism on lipid profile in patients of myocardial infarction as well as normal healthy controls.
Subjects and Method: Total 100 acute myocardial infarction patients with age and gender matched controls, within age ranging from 25 to 80 years were included. Lipid profile levels of MI patients and controls were estimated by standard methods. DNA’s were extracted by salting out method and Genotypes for Apo-E were determined by Multiplex Amplification Refractory Mutation System PCR.
Results: The total cholesterol, LDL cholesterol, TC/HDL-C ratio, LDL-C/HDL-C ratio level was significantly increased (p<0.01) in E4E4 allele than E3E3 allele. Analysis of variants has significant difference (p<0.01) observed in total cholesterol and LDL cholesterol levels in all apo E alleles of MI patients.
Conclusion: Our results suggestive that the risk of myocardial infarction associated with apo E4E4 alleles which are major risk factor for developing the coronary artery disease.

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.

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.
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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.

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.

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.

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.
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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.

PREDICTORS OF MORTALITY OUTCOME IN NEONATAL SEPSIS

Duha Sabeeh Jumah; Mea'ad Kadhum Hassan

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.

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.

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