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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Accreditation of the Iraqi Medical Colleges: The last warning

Ghanim Alsheikh; Omar Mustafa

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 1-7
DOI: 10.33762/mjbu.2022.176729

By 2024, all international medical graduates (IMGs) intending to apply for certification or gain verification of their primary medical qualification (PMQ) by the Educational Commission for Foreign Medical Graduates (ECFMG) will require that their medical school has been appropriately accredited. The World Federation for Medical Education (WFME) Recognition Program is the only one accepted by the ECFMG for the recognition of medical school accrediting agencies. This applies to anyone intending to work or study in the United States, United Kingdom and an increasing number of countries adopting such approach. The process of accreditation of Iraqi medical colleges started in 2007 but to date there is no internationally recognized body in Iraq to accredit those colleges. This means by the 2024, graduates from Iraqi medical colleges may not be able to work and study in many parts of the world. Urgent action is required as we detailed in this article. ministry of higher education, universities, medical colleges need to collaborate with the National Council to get it recognized by the WFME and save the future of thousands of doctors who will graduate in the forthcoming years starting with 2024 and on.

Psychological profile of breast cancer patients-sample from al-Resafa / Baghdad

Sahar Al-Shatari; Mahir Suhail; Iman A. Mohammed; Iman Chaloob

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 8-19
DOI: 10.33762/mjbu.2022.132513.1093

Background: Among cancer patients; the Prevalence of psychiatric disorders is approximately 50% and most of the disorders are related to the occurrence of cancer and cancer treatment.
Objectives: to estimate psychological problems and conditions in breast-cancer married patients, in al-Resafa side of Baghdad, and its relation with their demographic features and some habits.
Method & patients: A cross-sectional study was conducted from 1st June 2018 till 1st January 2019; data were collected from patients attending breast tumor center at Baghdad teaching hospital, radiotherapy & nuclear medicine hospital, and 10 breast-tumor-centers at 10 hospitals in Al-Resafa / Baghdad city.
Results: in this study 182 married women with breast cancer, higher percentage 56(30.8%) aged (50-60) year, housewife 153(84.1%), complete intermediate school 36(19.8%), diagnosed in second-stage 113(62.1%), non-smoker 124(68.1%) and always practicing exercise 121(66.5%). The psychological problems; sleep-disturbance 66(33.5%), stress 60(33%), loss-of-appetite 56(30.8), outrage-without-causes 27(14.8%), crying-without-causes 22(12.1%), loss-of-hope 15(8.2%), marital-problems 14(7.7%), loss-of-interest 13(7.1%), suicide-attempt 8(4.4%), and losing-interest-to-their-children 7(3.8%). But most of them had good overall psychological condition 149(81.9%).
Conclusion: 182 married women with breast cancer aged 49.42 ±11.213, complete/intermediate school, diagnosed in second-stage, non-smoker, and always practicing exercise. Psychological conditions were one-third of them have sleep disturbance, stress, loss-of-appetite, one-sixth of them had outrage-without-causes, and crying-without-causes, less than ten percent had a loss-of-hope, marital problems, loss-of-interest, suicide-attempt, and losing-interest-to their children. The overall psychological condition is good in the majority of them with statistically significant with smoking only

Thyroid function abnormalities in hepatitis C positive patients in a single center in Basrah

Amar Alaa Hussein; Alaa Mousa

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 20-29
DOI: 10.33762/mjbu.2022.132265.1092

Background: Hepatitis c virus (HCV) is global health problem it has many extrahepatic manifestations including hematologic, lymphoproliferative, endocrine, and renal diseases. The most common and important endocrine disorder are thyroid abnormalities.
The aim of this study: Is to investigate the correlation between HCV infection and thyroid function abnormalities and the factors that may affect it.
Patients and methods: This were a case-control study with 51 patients (27 males) were HCV positive who were attending Faiha Gastroenterology and Hepatology center and 49 HCV negative persons (34 males) from health workers and patients’ relatives represent control group. They were sent for thyroid function test in form of Thyroid stimulating hormone (TSH), free tetraiodothyronine (FT4), total triiodothyronine (T3), anti-thyroid peroxidase antibody, thyroglobulin, and anti-thyroglobulin.
Results: thyroid function abnormalities were found in eighteen patients (35.3%) of HCV positive group ,and nine (18.4%)in control group but the difference was not significant (p = 0.057), also there was no difference in thyroid antibodies prevalence between the two groups (p ˃ 0.05).The distribution of thyroid abnormalities in HCV patients was as follows: Four patients (7.8%) have hypothyroidism, Four (7.8%) have subclinical hypothyroidism, and Ten (19.7%) have weird thyroid function, while in control group: Four (8.2%) have subclinical hypothyroidism, Five(10.2%) have weird thyroid function and none have hyperthyroidism in both groups. Abnormal thyroid function was more in women with age group 30-40 years and was statistically significant.
Conclusion: Thyroid abnormalities are more in HCV positive patients where hypothyroidism is the most frequent, they are more in women, and more in 30-40 years old.
With the majority of hypothyroidism has autoimmune origin.

The relationship between BCG scar size and socioeconomic status on the severity and mortality of COVID-19 patients, “as indicators of the immunity”

Jawd K. Albazoony

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 30-35
DOI: 10.33762/mjbu.2023.128935.1050

Background: The severity and mortality by COVID-19 vary among countries. This may be related to the underlying immunity. Response to the vaccine effect is immunologically related to several factors like vaccination, infestation with parasites and nutrition. Socioeconomic status is an important factor in health problems.
Objectives: The purpose of the study is to understand the effect of the BCG scar size and the socioeconomic status as indicators of underlying immunity on the severity and mortality of COVID-19 patients.
Method: A comparative study of PCR-confirmed COVID-19 patients were done in Basrah, Teaching Hospital. The patients were divided into two groups: Severe and mild to moderate cases. All confirmed cases during April and May 2020 in Basrah Teaching Hospital were included. The BCG scar size and socioeconomic status were studied and related to the severity and mortality of COVID-19 cases.
Results: Patients who had small BCG scar size and high socioeconomic status were significantly associated with higher severity and mortality due to COVID-19 infection.
Conclusion: BCG scar size and socioeconomic class can be used as good indicators for immune response against infection and the extent of their severity and mortality.

The Extra-Pulmonary Manifestations and Complications of COVID-19: An Observational Study from Basrah - Southern Iraq

Hassan Ala Farid; Ali Raheem Hashim; Alaa Abdullah Fadhil

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 36-50
DOI: 10.33762/mjbu.2022.133373.1098

Background: The coronavirus was first recognised in December 2019 in Wuhan, China as an outbreak of an unidentified health storm. Although the main presenting complaints are respiratory complaints, many patients are presented with multisystem and extrapulmonary manifestations.
Objective: This study aims to assess the extrapulmonary manifestations of COVID-19.
Methods: A cross-sectional observation study was conducted in Basrah teaching hospital, which is a specialised and tertiary centre for COVID-19 management, for a 5-month duration and involving 507 patients with confirmed COVID-19 infection.
Results and Conclusions: The extrapulmonary manifestation was reported in 347 patients (68%), and the clinical manifestations analysis of the enrolled patients showed that most of the neurological manifestations were headaches. Myocardial infarction is the most common cardiovascular manifestation. Moreover, gastrointestinal manifestations showed that nausea and vomiting, followed by abdominal pain and diarrhea, are frequently reported symptoms. Additionally, stroke, new atrial fibrillation, conjunctivitis, macular skin rash, urticaria, acute kidney injury, fatigue, joint pain, deep venous thrombosis, diabetic ketoacidosis, and hyperglycemia were observed also at lower percentages.

The impact of understanding the difference in response of TNFa and CXCL13 in patients with rheumatoid arthritis and ankylosing spondylitis concerning treatment strategy of both diseases

saif ali jabbar salman aljubran; Nabeel Abduljaleel Ali; Jawad Hasan Ahmed; saad wahid

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 51-60
DOI: 10.33762/mjbu.2022.133389.1099

Introduction: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic inflammatory conditions that damage joints and impair patient’s physical fitness. Despite sharing many drugs in their treatment guidelines, they have many differences in their pathogenicity. It is generally understood that a mismatch between pro-and anti-inflammatory cytokine activity promotes autoimmune and chronic inflammation. However, it is still unclear how cytokines are arranged within such complex signaling pathways, and hence which cytokine would be the better target for the evolution of treatments.
Methods: This cross-sectional study included 71 patients, 45 with RA, and 26 with AS. According to the type of the treatments, RA patients were divided into three groups (1,2,3), and AS patients were divided into 2 groups (4,5) Data collection was made by clinical examination and specially designed questionnaire form. Five to seven milliliters of blood were collected, centrifuged and the serum was stored at -24 C till the time of assay. Serum TNFa, CXCL13, and ICAM1 were determined by the ELISA. CRP is measured by the photometric method, and ESR by the Wintrobe method. Data were analyzed statistically utilizing the SPSS program (version 26).
Results: Eighty-two percent of patients with RA were females, and (18%) were males, their mean age was (51.84 ± 10.74) years and their mean weight was (73.28 ± 13.17) Kg. Regarding AS, (4%) of the patients were females and (96%) were males, with a mean age was (41.88 ± 10.95) years and mean weight was (78.67 + 13.4) Kg. Serum inflammatory parameters except ICAM1 were significantly higher in patients with RA than in those with AS, regardless of the treatment type.
Conclusion: TNFa is significantly correlated with DAS-CRP, ASDAS in patients with RA and AS but its level is significantly higher in patients with RA. Serum CXCL13 correlates with disease activity in patients with RA and could be used as a target for the evolution of new treatments while it has a minor role in patients with AS.

Postdate Pregnancy: Maternal & Neonatal Outcome

Methal A. Alrubaee; Wafaa S. Almaliki; Saba A. Almahdi

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 61-67
DOI: 10.33762/mjbu.2022.176735

Background: Postdate pregnancy is pregnancy last longer than estimated date of confinement which is known as due date. Postdate pregnancy can be considered as high-risk factor from the point of increasing maternal & neonatal morbidity & mortality. Aim: to identify whether the pregnancy beyond the expected date of delivery has negative effects on the health of mother & neonate.
Study design: This is a prospective case-control study done from (1st Jan. 2020-1st Jan.2021). It includes (600) pregnant women admitted with spontaneous labor or for induction of labor. They were divided into (350) pregnant women as control with gestational age (37 weeks completed -40 weeks) & (250) pregnant women as cases with gestational age (beyond 40 weeks - 42 weeks completed). Estimation of the gestational age based on the last menstrual period & early first trimester ultrasound.
Results: Those with postdate pregnancy were mainly of young age group (62.4%) & multiparous (55.6%). Induction of labor done in (46.4%). Cesarean section rate was (22.4%) mainly for fetal distress (66%). Postpartum hemorrhage consequent to uterine atony was the main maternal complication (16.4%). The newborns had favorable outcome with Apgar score (i. e ≥7) in (77.6%). They were macrosomic (19.2%). Male gender was the predominant sex (68.4%). Meconium-stained liquor affect (23.2%); (12.4%) had meconium aspiration syndrome & (18.8%) admitted to intensive care unit.
Conclusion: Postdate pregnancy negatively affect both maternal & neonatal health by increasing postpartum hemorrhage & cesarean section rate as well as neonatal macrosomia, meconium staining & aspiration.

Knowledge, attitude and practices regarding COVID-19 outbreak among people in Basrah city

Shams S. Ahmed; Lamis A. Hameed

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 68-80
DOI: 10.33762/mjbu.2022.176736

Background: The World Health Organization (WHO) declared COVID-19 an international public health emergency on January 30th and demanded coordinated action from all countries to contain its rapid spread, and a pandemic on March 11th due to its continued spread across countries and continents. During a pandemic, the information gap can have negative consequences by increasing stress and instability. Furthermore, unfavorable attitudes and practices, as well as other misconceptions and beliefs, can intensify the disaster's devastating effects.
Aims: 1. To determine the knowledge, attitude and practices of people in Basrah about COVID-19 pandemic. 2. To know the main source of peoples, information.
Method: This study is a cross-sectional study conducted on a sample of persons selected throughout the period from 25th April to 1st August 2021. The study involved 402 individuals who attended primary health care centers in Basah city center.
Results: In this study, 25.6% of the participants aged 30-39 years and 34.6% of them had secondary school education, 51.7% were females. Majority of the study sample (71.6%) were married. More than half (62.4%) showed self or family history of COVID-19. Half of the participants in this study had moderate level of knowledge, social media was the source of information for 54.2% of the participants, 67.4% of the participants didn’t know the correct symptoms of COVID-19 disease, and also 82% didn’t know the incubation period, while 90.8% know the mode of transmission. Highest percentage (40.5%) had poor attitude, and 59%had poor practice level.
Conclusions: The highest percentage of the participants had moderate knowledge, poor attitude and poor practices. Social media is the main source of information about COVID-19 among the studied sample.
Recommendation: This study recommends enhancing awareness of people about the importance of control and preventive measures against COVID-19 virus in decreasing the prevalence of the disease.

COVID-19 vaccine hesitancy in Iraq: a growing concern

Abrar I Albadr

The Medical Journal of Basrah University, 2022, Volume 40, Issue 1, Pages 81-90
DOI: 10.33762/mjbu.2022.132850.1095

Background: COVID-19 pandemic has made vaccination more of a necessity than a choice as it continues to spread. The need to combat vaccine hesitancy is more relevant now than ever, given the availability of effective and safe vaccines.
Aims: To assess the acceptance rate of COVID-19 vaccines in Iraq, and to identify the reasons for hesitancy.
Methods: A cross-sectional online survey of 1100 Iraqi citizens was conducted in October 2021. Sociodemographics, willingness to get COVID-19 vaccine and a list of reasons for refusal or hesitancy were collected. These factors were compared across basic demographics.
Results: The acceptance rate for COVID-19 vaccine was 46.1%. Females, older adults and those with higher education had higher acceptance rates for COVID-19 vaccine. The most common concern about the COVID-19 vaccine involved fear about side effects (24.6%).
Conclusion: To achieve effective immunizations, it is vital to develop strategies that encourage vaccinations and ensure optimal coverage.

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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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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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.

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.

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

Jhood Abdul Samad Molan

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

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

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.

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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