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A peer reviewed scientific Journal published by the College of Medicine, University of Basrah First issue was published at 1977 Numbers of issues per year 2 Approximate number of articles/ issue are 15
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Journal Information

Publisher: University of Basrah

Email:  mjbu_iraq@yahoo.com

Editor-in-chief: Professor Dr. Khalil I. Al-Hamdi

Print ISSN: 0253-0759

Online ISSN: 2413-4414

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

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.
.

Self-reported hand contact dermatitis among female hairdressers in Basrah

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
.

Xanthomatous meningioma; a rare histological variant

The Medical Journal of Basrah University, Volume 36, Issue 2, Pages 66-70
DOI: 10.33762/mjbu.2018.159462

Introduction: Meningiomas are tumors of the central nervous system originating from the meningothelial tissues, the arachnoid cap cells of the cranium and spinal cord. According to the WHO classification system, grade 1 meningiomas are of nine subtypes. Xanthomatous meningioma is a rare histological variant of meningioma belong to the subtype "Metaplastic meningioma". The Meningioma with a predominantly xanthomatous cellular changes with lipid-laden vacuolated cytoplasm is classified as ‘’xanthomatous meningioma’’
Case report: A 61 year old patient presented with headache, disorientation and hemiparesis. Magnetic resonance imaging (MRI) shows large right parietal enhancing dural based convexity meningioma. The tumor resected enblock and the histological examination revealed features of classical meningioma with predominant areas of xanthomatous changes. Immunostaining for epithelial membrane antigen and vimentin wase positive in both xanthomatous foamy cells and meningothelial areas. GFAP was negative. CD 68 was positive in few scattered cells in the xanthomatous areas. Ki-67 index was 1% in the highly cellular area. The final histopathological diagnosis was xanthomatous meningioma, WHO grade I.
Conclusion: Xanthomatous meningioma is a rare variant of meningioma belongs to the subtype metaplastic meningioma. We present the case because it is an extremely rare worldwide.
.

Assessment of dipping status of systemic blood pressure by 24 hour Ambulatory Blood Pressure Monitoring (ABPM) in patients with features of optic nerve head (disc) changes of Optic Neuropathy

The Medical Journal of Basrah University, Volume 36, Issue 2, Pages 71-80
DOI: 10.33762/mjbu.2018.159466

Background: Optic neuropathy is a spectrum of disease of different etiology, and especially when associated with systemic disease like hypertension, where there is effect on auto regulation mechanism of the ocular perfusion.
Aim: To see the blood pressure behavior and dipping status by 24 hour Ambulatory Blood Pressure Monitoring among patients who were diagnosed to have features of secondary optic neuropathy whether they were hypertensive or not.
Methods: Ninety-four patients were included in a cross sectional study, and using specific exclusion criteria, 38 patients were having changes of optic neuropathy as diagnosed by optical coherence tomography, with 56 other patients as a control group. All were examined and investigated, and subjected to 24 hour Ambulatory Blood Pressure Monitoring test using specific device (CONTEC ™ - AUTOMATIC BP MONITER - MODEL: ABPM50) and the data from the device were displayed to the computer for measurement and analysis. The dipping status was calculated manually using a specific formula. The data, then fed to SPSS software version 20 for statistical analysis.
Results: There was no statistical significance for age, sex, BMI and other risk factors like hypertension, diabetes mellitus and dyslipidemia. Reverse or blunted response was common among hypertensive patients in both studied groups, but the P-value not significant.
Conclusion: This study showed that there was no specific BP dipping pattern by ABPM in the studied patients with optic neuropathy in our locality.
.

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

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

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.
.

Effect of Azithromycin in Treatment of Cutaneous Leishmaniasis

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.
.

Correlation of glycosylated haemoglobin (HbA1c) levels with subclinical atherosclerosis in patients with type 2 diabetes mellitus

The Medical Journal of Basrah University, Volume 36, Issue 2, Pages 103-114
DOI: 10.33762/mjbu.2018.159468

Background: The most common cause of mortality in people with diabetes is cardiovascular disease. The relation between glycosylated hemoglobin (HbA1c), a marker of glycemic control, and the development of subclinical atherosclerosis is debated. An acceptable indicator of subclinical atherosclerosis is the use of ultrasound to measure carotid intima-media thickness (CIMT).
Objective: To conduct a cross-sectional study exploring the correlation between HbA1c and subclinical atherosclerosis as reflected by the carotid intima-media thickness in patients with type 2 diabetes that had no history of an atherosclerotic cardiovascular disease (ischemic heart disease or cerebrovascular accident).
Methods: A total of 71, type 2 diabetic patients participated in this study. Demographic, anthropometric and laboratory measures of the participants were collected. CIMT values were measured by using a high-resolution ultrasound. Increased CIMT values were accepted as >0.9 mm. Participants were categorized into two groups according to CIMT values: a normal CIMT value of ≤ 0.9 mm group, and a high CIMT value of > 0.9 mm group. HbA1c and other collected variables were compared between normal and increased CIMT groups. Furthermore, subgroup analysis was carried out for patients with poor glycemic control (HbA1c>9%).
Results: The mean CIMT was 1.048 ± 0.14 mm, and approximately 79% of the included population had increased CIMT (> 0.9 mm). 49% of participants were poorly controlled (HbA1c > 9%) and 92% of those with poor glycaemic control had increased CIMT.
Correlation analysis of data belonging to participants with poor glycaemic control (HbA1c > 9%) showed a significant correlation between HbA1c levels and CIMT, with a correlation coefficient of 0.409 (P = 0.015). In addition, a significant correlation was found in our initial analysis between CIMT and age, with a value of 0.359 (P = 0.002).
Conclusion: This study revealed that HbA1c levels in patients with poor glycemic control are positively correlated with increased CIMT measures, which is an indicator of subclinical atherosclerosis (SCA). Moreover, increased age is found to be a predictor factor for the development of SCA and, consequently, adverse macrovascular outcomes in patients with T2D.
( (T2D.

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

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.
.

Self-reported hand contact dermatitis among female hairdressers in Basrah

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
.

Effect of Azithromycin in Treatment of Cutaneous Leishmaniasis

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.
.

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

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

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.
.

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.‎

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.

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.

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.

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.

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.

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.

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.

Infant feeding pattern and hospitalization due to infection

Habib Najm Abdulla; ad Kadhum Hassan; Mea

The Medical Journal of Basrah University, Volume 30, Issue 2, Pages 75-84
DOI: 10.33762/mjbu.2012.75740

Objectives: This case-control study was carried out to evaluate the effects of infant feeding pattern on hospital
admission due to infection. Patients and Methods: The study has included 498 infants (320 males and 178 females)
who attended primary health centers for routine check up and vaccination, and 250 infants admitted to Basrah
Maternity and children Hospital (164 males and 86 females), from the first of March 2008 till the end of June 2008,
their ages ranged from 1–12 months. Selected socio-demographic variables were evaluated in addition to child birth
variables, feeding pattern, cause of admission, duration of hospitalization and outcome. Results: The study revealed
a significantly higher percentage of admissions due to diarrhea and respiratory tract infection among infants peon
bottle feeding (23.8%, 15.6%) and partial breast feeding (16.4%, 11.6%), compared to those on exclusive (2% and
1.2%) and predominant breast feeding (11.2% and 10%), P value <0.001 and <0.01 respectively. The effects of
feeding pattern on the outcome have shown that there is a significant increase in the mortality among bottle fed
infants (4.8%) while none of admitted patients on exclusive breastfeeding died, P value <0.01. In addition, there is a
significant association between feeding pattern and duration of hospitalization (P value<0.05), history of previous
hospitalization (P value <0.05), mother age (P value<0.05), mother education (P value <0.001), and mother and
father employment, (P value <0.001 and 0.05 respectively). Conclusions: Feeding pattern among admitted cases
with infections is significantly associated with formula feeding and partial breast feeding compared to exclusive and
predominant breast feeding.

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