Pub Date : 2021-09-26DOI: 10.32007/jfacmedbagdad.6331846
Taiceer A. Turkan, J. R. Al-Rawi
Abstract Background: Hair loss is a common skin condition. Hair is not a vital organ but losing it has a worse effect on the psychological state of the patient and may interrupt his daily social activities. Telogen effluvium founded to be the commonest noninflammatory cause to diffuse hair loss. Since nutritional disturbances are one of the triggering factors for it. It might be useful in the management of TE Due to the limited number of studies& little information is available on this subject possible role of vitamin D or its deficiency should be studied further. Aim of the study: to determine the association between Telogen effluvium and vitamin D level. Materials and methods: This is a case-control study performed in a period between December 2018 until June 2020; in Baghdad dermatology center at medical city. One hundred women who were seeking treatment for diffuse hair shedding and who hadn’t received treatment or supplements yet and One hundred fifty control subjects are chosen from patients who were referred to the dermatology clinic for the treatment of nevi and who are not pregnant or lactating, had no systemic or local scalp diseases are included in the study. Full History, physical examination performed for all cases including looking for cutaneous diseases, supplements & drug intake. Serum Vitamin D3 is measured using (Ichroma (TM), Boditech Med Inc., Korea). Result: A total of 250 females were included in this study, 100 of them got telogen effluvium & 150 were patients who attend dermatology clinic seeking treatments for nevi or skin tag (control group) .The mean age of cases was (22.59 ±4.837 year) that wasn’t significantly different from mean age of control group (23.647±6.022 years) (p-value =0.127). The mean level of Vitamin D was significantly lower than that of control group (11.16±4.49) Vs (18.98±10.65), P value <0.001. Vitamin D mean level in acute phase was significantly higher than that of chronic phase pts. (11.68±4.77 & 9.93 ±3.55 respectively), p value=0.04. Mean vit. D among symptomatic patients. (9.7 ± 3.5) was significantly lower than that among asymptomatic pts. (13±4.19) (p=0.001).No significant association were noticed between job & residence of the patients of both groups, (P-value =0.283 & 0.069 respectively (. Conclusion: Age mean difference was not significant among cases and controls. Deficiency in vitamin D may assume a possible leading cause of telogen effluvium among women with hair loss. Cases were significantly associated with low level of Vitamin D3 than controls.Low level of vitamin D was dominant among housewives, urban women, and among symptomatic patients with acute duration.
{"title":"Vitamin D level and telogen hair loss: A Case control study","authors":"Taiceer A. Turkan, J. R. Al-Rawi","doi":"10.32007/jfacmedbagdad.6331846","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6331846","url":null,"abstract":"Abstract \u0000 \u0000Background: Hair loss is a common skin condition. Hair is not a vital organ but losing it has a worse effect on the psychological state of the patient and may interrupt his daily social activities. Telogen effluvium founded to be the commonest noninflammatory cause to diffuse hair loss. Since nutritional disturbances are one of the triggering factors for it. It might be useful in the management of TE Due to the limited number of studies& little information is available on this subject possible role of vitamin D or its deficiency should be studied further. \u0000Aim of the study: to determine the association between Telogen effluvium and vitamin D level. \u0000Materials and methods: This is a case-control study performed in a period between December 2018 until June 2020; in Baghdad dermatology center at medical city. One hundred women who were seeking treatment for diffuse hair shedding and who hadn’t received treatment or supplements yet and One hundred fifty control subjects are chosen from patients who were referred to the dermatology clinic for the treatment of nevi and who are not pregnant or lactating, had no systemic or local scalp diseases are included in the study. Full History, physical examination performed for all cases including looking for cutaneous diseases, supplements & drug intake. Serum Vitamin D3 is measured using (Ichroma (TM), Boditech Med Inc., Korea). \u0000Result: A total of 250 females were included in this study, 100 of them got telogen effluvium & 150 were patients who attend dermatology clinic seeking treatments for nevi or skin tag (control group) .The mean age of cases was (22.59 ±4.837 year) that wasn’t significantly different from mean age of control group (23.647±6.022 years) (p-value =0.127). The mean level of Vitamin D was significantly lower than that of control group (11.16±4.49) Vs (18.98±10.65), P value <0.001. Vitamin D mean level in acute phase was significantly higher than that of chronic phase pts. (11.68±4.77 & 9.93 ±3.55 respectively), p value=0.04. Mean vit. D among symptomatic patients. (9.7 ± 3.5) was significantly lower than that among asymptomatic pts. (13±4.19) (p=0.001).No significant association were noticed between job & residence of the patients of both groups, (P-value =0.283 & 0.069 respectively (. \u0000Conclusion: Age mean difference was not significant among cases and controls. Deficiency in vitamin D may assume a possible leading cause of telogen effluvium among women with hair loss. Cases were significantly associated with low level of Vitamin D3 than controls.Low level of vitamin D was dominant among housewives, urban women, and among symptomatic patients with acute duration.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46522037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-13DOI: 10.32007/jfacmedbagdad.6321833
B. Razzaq, T. Hassan
Abstract Background: Scabies is a skin infestation by the Sarcoptes scabiei mite. Scabies is transmitted through close personal contact. Settings like hospitals, prisons and childcare centers are at greater risk of outbreaks. Both male and female may be infected with scabies in any age groups. It is common in tropical climate countries poor people who live in rural areas and among displaced patients. It rises significantly among low economic status because skin diseases are significantly associated with a higher crowding index. Objectives: To estimate the prevalence of scabies in Al- Daseem region and identify factors associated with an increased risk of scabies among patients. Methodology: A retrospective cross sectional study was carried out about scabies outbreak in Al- Daseem area which located at Al-Rusafa side in Baghdad during 2019. Basic data were obtained from records of communicable disease section/public health director / Al-Rusafa health directorate. All registered cases during 2019 were included in the study, and then data computerized and analyzed using SPSS version 23 using frequency tables for the selected variables under study. Participants represented by students of Ali Al Wardi School (the only school in Al Daseem area) and from people live in this area (20% of them selected randomly). Data included socio-demographic information (age, sex, family member, and treatment). The diagnosis of scabies was based on their typical history of (itching that worsens at night, the distribution of lesions, and a history of contact with other family member infected with scabies). Results: A total of 11363 participants information were obtained from database, 6473were male and 4873 were female. There were 746 (6.6% of total) participants infected with scabies of them, there were 457 (7%) male patients and 289 (5.9%) female patients. There was significant association between scabies and gender of patients, P=0.018. According to the age groups of patients, there were 161 (6.4%) patients 6 years old, 337 (8.8%) patients within (7-12 years) age group, 82 (6.7%) patients within (13-19 years) age group, and there were 166 (4.3%) patients 20 years old. There was a significant difference between scabies and age group, p<0.001. Of the total patients, there were 622 (85%) patients had another family member infected with scabies. There was a significant association between patients and having another family member infected with it, P<0.001. Conclusion: prevalence of scabies in Al-Daseem region was (6.6%). Scabies was dominant among male, age group of (7-12 years), and having other family member infected with scabies. Key words: Scabies, Al-Desame, outbreak, mite, school.
摘要背景：疥疮是一种由疥螨引起的皮肤病。疥疮是通过密切的个人接触传播的。医院、监狱和儿童保育中心等场所爆发疫情的风险更大。任何年龄组的男性和女性都可能感染疥疮。在热带气候国家，生活在农村地区的穷人和流离失所的病人中很常见。它在低经济地位人群中显著上升，因为皮肤病与较高的拥挤指数显著相关。目的：评估Al-Daseem地区疥疮的患病率，并确定与患者疥疮风险增加相关的因素。方法：对2019年巴格达Al-Rusafa一侧Al-Daseem地区爆发的疥疮进行了回顾性横断面研究。基本数据来自传染病科/公共卫生主任/鲁萨法卫生局的记录。2019年的所有登记病例都被纳入研究，然后使用SPSS 23版对数据进行计算机化和分析，使用研究中选定变量的频率表。参与者由Ali Al Wardi学校（Al Daseem地区唯一的学校）的学生和居住在该地区的人（其中20%是随机选择的）代表。数据包括社会人口统计信息（年龄、性别、家庭成员和治疗）。疥疮的诊断是基于他们的典型病史（夜间瘙痒恶化、病变分布以及与其他感染疥疮的家庭成员接触史）。结果：共从数据库中获得11363名参与者的信息，其中6473人为男性，4873人为女性。有746名（占总数的6.6%）参与者感染了疥疮，其中457名（7%）男性患者和289名（5.9%）女性患者。疥疮与患者性别有显著相关性，P=0.018。根据患者年龄组，6岁患者161例（6.4%），（7-12岁）年龄组患者337例（8.8%），年龄组患者82例（6.7%），20岁患者166例（4.3%）。疥疮与年龄组比较有显著性差异，p＜0.001。在总患者中，有622名（85%）患者的另一名家庭成员感染了疥疮。患者与另一个家庭成员感染该病毒之间存在显著关联，P＜0.001。结论：Al-Daseem地区疥疮患病率为6.6%，疥疮以男性为主，年龄组为7-12岁，有其他家庭成员感染。关键词：疥疮，艾，暴发，螨虫，学校。
{"title":"Scabies outbreaks during 2019 in Al- Daseem, Al-Rusafa-Baghdad: A retrospective study","authors":"B. Razzaq, T. Hassan","doi":"10.32007/jfacmedbagdad.6321833","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321833","url":null,"abstract":"Abstract \u0000Background: Scabies is a skin infestation by the Sarcoptes scabiei mite. Scabies is transmitted through close personal contact. Settings like hospitals, prisons and childcare centers are at greater risk of outbreaks. Both male and female may be infected with scabies in any age groups. It is common in tropical climate countries poor people who live in rural areas and among displaced patients. It rises significantly among low economic status because skin diseases are significantly associated with a higher crowding index. \u0000Objectives: To estimate the prevalence of scabies in Al- Daseem region and identify factors associated with an increased risk of scabies among patients. \u0000 \u0000Methodology: A retrospective cross sectional study was carried out about scabies outbreak in Al- Daseem area which located at Al-Rusafa side in Baghdad during 2019. Basic data were obtained from records of communicable disease section/public health director / Al-Rusafa health directorate. All registered cases during 2019 were included in the study, and then data computerized and analyzed using SPSS version 23 using frequency tables for the selected variables under study. Participants represented by students of Ali Al Wardi School (the only school in Al Daseem area) and from people live in this area (20% of them selected randomly). Data included socio-demographic information (age, sex, family member, and treatment). The diagnosis of scabies was based on their typical history of (itching that worsens at night, the distribution of lesions, and a history of contact with other family member infected with scabies). \u0000 \u0000Results: A total of 11363 participants information were obtained from database, 6473were male and 4873 were female. There were 746 (6.6% of total) participants infected with scabies of them, there were 457 (7%) male patients and 289 (5.9%) female patients. There was significant association between scabies and gender of patients, P=0.018. \u0000According to the age groups of patients, there were 161 (6.4%) patients 6 years old, 337 (8.8%) patients within (7-12 years) age group, 82 (6.7%) patients within (13-19 years) age group, and there were 166 (4.3%) patients 20 years old. There was a significant difference between scabies and age group, p<0.001. Of the total patients, there were 622 (85%) patients had another family member infected with scabies. There was a significant association between patients and having another family member infected with it, P<0.001. \u0000Conclusion: prevalence of scabies in Al-Daseem region was (6.6%). Scabies was dominant among male, age group of (7-12 years), and having other family member infected with scabies. \u0000 \u0000Key words: Scabies, Al-Desame, outbreak, mite, school.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46613760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-13DOI: 10.32007/jfacmedbagdad.6321822
A. Mirza, A. Taha
Abstract As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onset of thromboses, they were successfully managed by catheter directed thrombolysis (CDT) using tissue plasminogen activator (tPA). Owing to the increased morbidity and mortality of vascular thrombosis, there is a need to identify COVID-19 patients who need prophylaxis and prescribe them the right prophylactic drug (s). The excellent outcome of CDT in these two patients, from Sulaymaniyah/Iraq, supports the use of this treatment modality as a valid, safe and effective option for acute arterial and venous thromboses.
{"title":"Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq","authors":"A. Mirza, A. Taha","doi":"10.32007/jfacmedbagdad.6321822","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321822","url":null,"abstract":"Abstract \u0000As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onset of thromboses, they were successfully managed by catheter directed thrombolysis (CDT) using tissue plasminogen activator (tPA). Owing to the increased morbidity and mortality of vascular thrombosis, there is a need to identify COVID-19 patients who need prophylaxis and prescribe them the right prophylactic drug (s). The excellent outcome of CDT in these two patients, from Sulaymaniyah/Iraq, supports the use of this treatment modality as a valid, safe and effective option for acute arterial and venous thromboses. \u0000 ","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44201029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-13DOI: 10.32007/jfacmedbagdad.6321832
R. Alsaeed, Afrah M. Jassim, S. Razaq, M. Al-Jadiry
Background: Germ cell tumors are a rare heterogeneous group of cancers with high cure rates in the pediatric age group.Objectives: To study the clinical and pathological features in a group of patients with germ cell tumors and to evaluate their outcomes.Patients and methods: A record review was undertaken on a group of patients with germ cell tumor who were admitted to the Children Welfare Teaching Hospital in Baghdad during the years 2009 - 2015. Information on gender, age, clinical signs, pathological findings, treatment and overall survival rate were reviewed.Results: The patients had a mean age of 4.2 years (ranging from 1 month - 14 years). There were 45 girls and 16 boys. Abdominal pain was the most common presentation in 17 patients followed by a lower back mass in 16 patients. Primary sites included extra gonadal (sacrococcygeal 18, pelvis 5, vagina 4, gluteal 3, intra-cardiac, and one each for the mediastinum, orbit and rectum), and gonadal (18 ovarian and 9 testicular). After a mean period of follow-up of 42 months, the overall survival at 1 year was 59%.Conclusion: The prognosis of children with germ cell tumors is favorable, regardless the site and histopathology.
{"title":"Germ cell tumor: A seven-year experience Children Welfare Teaching Hospital","authors":"R. Alsaeed, Afrah M. Jassim, S. Razaq, M. Al-Jadiry","doi":"10.32007/jfacmedbagdad.6321832","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321832","url":null,"abstract":"Background: Germ cell tumors are a rare heterogeneous group of cancers with high cure rates in the pediatric age group.Objectives: To study the clinical and pathological features in a group of patients with germ cell tumors and to evaluate their outcomes.Patients and methods: A record review was undertaken on a group of patients with germ cell tumor who were admitted to the Children Welfare Teaching Hospital in Baghdad during the years 2009 - 2015. Information on gender, age, clinical signs, pathological findings, treatment and overall survival rate were reviewed.Results: The patients had a mean age of 4.2 years (ranging from 1 month - 14 years). There were 45 girls and 16 boys. Abdominal pain was the most common presentation in 17 patients followed by a lower back mass in 16 patients. Primary sites included extra gonadal (sacrococcygeal 18, pelvis 5, vagina 4, gluteal 3, intra-cardiac, and one each for the mediastinum, orbit and rectum), and gonadal (18 ovarian and 9 testicular). After a mean period of follow-up of 42 months, the overall survival at 1 year was 59%.Conclusion: The prognosis of children with germ cell tumors is favorable, regardless the site and histopathology.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48058974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-13DOI: 10.32007/jfacmedbagdad.6321812
Huda Sabah Al-Jadiri, B. M. Ali, Jawad K. Al-Diwan
In Iraq, child’s health had been deteriorated over three turbulent decades starting from the huge and rapid degradation of the country infrastructure by Iraq –Iran war (1980-1988), Gulf War in 1991, and economic sanction.
{"title":"Geopolitical factors affecting childhood nutrition: Iraqi case","authors":"Huda Sabah Al-Jadiri, B. M. Ali, Jawad K. Al-Diwan","doi":"10.32007/jfacmedbagdad.6321812","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321812","url":null,"abstract":"In Iraq, child’s health had been deteriorated over three turbulent decades starting from the huge and rapid degradation of the country infrastructure by Iraq –Iran war (1980-1988), Gulf War in 1991, and economic sanction.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47658798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-11DOI: 10.32007/JFACMEDBAGDAD.6311776
nebal wael saadi, Q. Fahad
Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Up to 10 % of MS patients have onset in paediatric age group. Although the clinical profile of MS appears similar to that seen in adults, several features may differ and specific issues arise in children. Here, we reported a 12-year old girl who presented with 3-year history of episodes of seizures and facial nerve palsy and finally fatigue and cognitive impairment were noted and interfered with her academic performance. Because of the presumed atypical clinical presentations, the diagnosis was missed then dismissed despite neuroimaging features and CSF immunological findings that were highly suggestive of MS. Later, evolution of the disease by neuroimaging helped confirming the diagnosis and directed toward the delayed therapy.
{"title":"Paediatric multiple sclerosis: a case report of missed and dismissed diagnosis","authors":"nebal wael saadi, Q. Fahad","doi":"10.32007/JFACMEDBAGDAD.6311776","DOIUrl":"https://doi.org/10.32007/JFACMEDBAGDAD.6311776","url":null,"abstract":"Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Up to 10 % of MS patients have onset in paediatric age group. Although the clinical profile of MS appears similar to that seen in adults, several features may differ and specific issues arise in children. Here, we reported a 12-year old girl who presented with 3-year history of episodes of seizures and facial nerve palsy and finally fatigue and cognitive impairment were noted and interfered with her academic performance. Because of the presumed atypical clinical presentations, the diagnosis was missed then dismissed despite neuroimaging features and CSF immunological findings that were highly suggestive of MS. Later, evolution of the disease by neuroimaging helped confirming the diagnosis and directed toward the delayed therapy.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46313574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-21DOI: 10.32007/JFACMEDBAGDAD.6241810
A. Taha, S. Saed, A. Mohammed, Jivara Hama Nadr
Background Mitral valve (MV) is one of the most complex structures in human heart with a challenging exposure. Traditionally, MV is approached via left atriotomy (LAA) while superior septal approach (SSA) is an alternative.Objective: is to highlight the merits and demerits of these two approaches in providing access to the MV in term of the aortic cross clamp time (ACCT), quality of exposure, and potential complications in view of the published literature. Patients and Method: Over an 18-month period ending at June 30th, 2019, 56 patients with MV disease ± other cardiac diseases were enrolled in this study. Twenty patients had surgery via LAA (one surgeon) whereas 36 were operated upon via SSA (another surgeon). Standard surgery was done via median sternotomy, cardiopulmonary bypass and hypothermia of 32 0C. Perioperative events were recorded. Results In SSA group (males=25; age ranged 23-74 years; mean=57.4), patients had chest pain and breathlessness for a mean of 3 months (>LAA) besides low ejection fraction (EF) in 44%, atrial fibrillation (AF) in 38.9% and dilated LA in 19.4%. They underwent 25 MV replacements (MVR), 11 MV repairs (0 in LAA), 11 coronary artery bypass grafts (CABGs) (2.6 graft per patient vs. 1.3 in LAA; significant) and 2 aortic valve replacement. Mean ACCT was 81.6 minutes (˂LAA). Postoperatively, 32 patients (88.9%) had a normal or improved EF, 11 of 14 AF patients (78.6%) reverted to sinus rhythm and no hospital death was recorded. Conclusion Besides excellent exposure, the SSA enabled us to perform MVR or repair ± additional interventions within a short time and without a heart block. Hence, our results matched the international literature.
{"title":"Mitral valve surgery: comparison between superior septal and left atrial approaches","authors":"A. Taha, S. Saed, A. Mohammed, Jivara Hama Nadr","doi":"10.32007/JFACMEDBAGDAD.6241810","DOIUrl":"https://doi.org/10.32007/JFACMEDBAGDAD.6241810","url":null,"abstract":"Background Mitral valve (MV) is one of the most complex structures in human heart with a challenging exposure. Traditionally, MV is approached via left atriotomy (LAA) while superior septal approach (SSA) is an alternative.Objective: is to highlight the merits and demerits of these two approaches in providing access to the MV in term of the aortic cross clamp time (ACCT), quality of exposure, and potential complications in view of the published literature. \u0000Patients and Method: Over an 18-month period ending at June 30th, 2019, 56 patients with MV disease ± other cardiac diseases were enrolled in this study. Twenty patients had surgery via LAA (one surgeon) whereas 36 were operated upon via SSA (another surgeon). Standard surgery was done via median sternotomy, cardiopulmonary bypass and hypothermia of 32 0C. Perioperative events were recorded. \u0000Results In SSA group (males=25; age ranged 23-74 years; mean=57.4), patients had chest pain and breathlessness for a mean of 3 months (>LAA) besides low ejection fraction (EF) in 44%, atrial fibrillation (AF) in 38.9% and dilated LA in 19.4%. They underwent 25 MV replacements (MVR), 11 MV repairs (0 in LAA), 11 coronary artery bypass grafts (CABGs) (2.6 graft per patient vs. 1.3 in LAA; significant) and 2 aortic valve replacement. Mean ACCT was 81.6 minutes (˂LAA). Postoperatively, 32 patients (88.9%) had a normal or improved EF, 11 of 14 AF patients (78.6%) reverted to sinus rhythm and no hospital death was recorded. Conclusion Besides excellent exposure, the SSA enabled us to perform MVR or repair ± additional interventions within a short time and without a heart block. Hence, our results matched the international literature.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47858325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.32007/jfacmedbagdad.6321825
N. Dhahir, A. Noaman
Abstract: Background: The alteration of bowel habits, bleeding per-rectum and anemia were common features in both groups in this study, but in young patients there was a delay of 6 months between the presenting symptoms and the definitive diagnosis because the disease was not suspected and investigated in them. The most common site for the tumors in young patients was the rectum and in patients above the age of 40 years was the Sigmoid. The pathological finding showed that classification of the colorectal tumors in young patients appear moderately to poorly differentiated adenocarcinoma , this indicate a more malignant course of the disease in young patients. This study send a message to all clinicians that the incidence of colorectal cancer is increasing in young patients and therefore we should be alert when dealing with young patients presenting with abdominal pain, bleeding per-rectum and alteration of bowel habit to diagnose the disease at an early stage to undertake curative surgery . Aim of the study: To study the clinical coarse of colorectal cancer in age between (less than 40 to above 40), and the most frequent site and distribution, and the types of surgical intervention. Patients and methods: In the period between January 2012 to March 2013, 35 patients with colorectal cancer were treated at Al-Yarmouk Hospital,10 patients were below the age of 40 years ,( 5 Males and 5 Females ) with age ranging from 22-40 years , 25 patients were above the age of 40 years (12 males and13 females). Results:100% of patients less than 40 years presenting as anemia and 50% bleeding per rectum, while 88% of patients above 40 years with weakness and lethargy.30% of patients less 40years age, and 36% of patients above 40 years consider as an emergency cases, and others as elective cases. Surgical treatment involving 50% of patients less than 40 are right, left hemicolectomy and anterior resection, and in age of above 40 56% by left hemicolectomy. More common stages in young patents are C and B but in old A ,B , C. Recommendations: Researchers recommend periodic screening by a doctor to diagnose the tumor early with the need to develop educational programs on early signs of colorectal cancer.
{"title":"A Comparative Study of Colorectal Cancer Based on Patient’s Age","authors":"N. Dhahir, A. Noaman","doi":"10.32007/jfacmedbagdad.6321825","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321825","url":null,"abstract":"Abstract: Background: The alteration of bowel habits, bleeding per-rectum and anemia were common features in both groups in this study, but in young patients there was a delay of 6 months between the presenting symptoms and the definitive diagnosis because the disease was not suspected and investigated in them. The most common site for the tumors in young patients was the rectum and in patients above the age of 40 years was the Sigmoid. The pathological finding showed that classification of the colorectal tumors in young patients appear moderately to poorly differentiated adenocarcinoma , this indicate a more malignant course of the disease in young patients. This study send a message to all clinicians that the incidence of colorectal cancer is increasing in young patients and therefore we should be alert when dealing with young patients presenting with abdominal pain, bleeding per-rectum and alteration of bowel habit to diagnose the disease at an early stage to undertake curative surgery . Aim of the study: To study the clinical coarse of colorectal cancer in age between (less than 40 to above 40), and the most frequent site and distribution, and the types of surgical intervention. Patients and methods: In the period between January 2012 to March 2013, 35 patients with colorectal cancer were treated at Al-Yarmouk Hospital,10 patients were below the age of 40 years ,( 5 Males and 5 Females ) with age ranging from 22-40 years , 25 patients were above the age of 40 years (12 males and13 females). Results:100% of patients less than 40 years presenting as anemia and 50% bleeding per rectum, while 88% of patients above 40 years with weakness and lethargy.30% of patients less 40years age, and 36% of patients above 40 years consider as an emergency cases, and others as elective cases. Surgical treatment involving 50% of patients less than 40 are right, left hemicolectomy and anterior resection, and in age of above 40 56% by left hemicolectomy. More common stages in young patents are C and B but in old A ,B , C. Recommendations: Researchers recommend periodic screening by a doctor to diagnose the tumor early with the need to develop educational programs on early signs of colorectal cancer.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69420076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.32007/jfacmedbagdad.6321824
Osama A. Altaei, Abbass N. Al-Sharifi
Abstract Background: A significant proportion of patients with ischemic heart disease have been associated with peripheral arterial disease, yet it is still underestimated by our health system as many of patients are asymptomatic and this condition remains under diagnosed and therefore undertreated. Objective: To study prevalence of peripheral arterial disease of the lower limbs in patient with acute coronary syndrome and its association with certain risk factors. Method: A cross sectional descriptive study was conducted in the coronary care unit at Al-Yarmouk Teaching Hospital from the 1st of January 2016 to the 1st of November 2016 where hundred and fifty (150) patients enrolled to the coronary care unit with approved acute coronary syndrome, had been evaluated for peripheral arterial disease by assessing Demographic, risk factors and clinical features of the patients, including age groups, gender, hypertension, diabetes mellitus, smoking, dyslipidemia, family history. of coronary artery disease, previous history of cerebrovascular accident, body mass index, leg pain, measurement of ankle brachial index using hand held continuous wave Doppler device. Results: in 150 acute coronary syndrome patients were included male were (70.7%) , peripheral arterial disease was found in 31.2% through measuring ankle brachial index, 51% of those patients were asymptomatic and 29.8% with atypical leg pain and 12.8% with intermittent leg pain and 6.4% had pain at rest. And ankle brachial index in the 150 patients with acute coronary syndrome were 68.8% normal (ankle brachial index =1.4-0.91) and 21.3% (ankle brachial index =0.9-0.71) and 7.3 %( ankle brachial index =0.69-0.41) and 2.6% (ankle brachial index ≤0.40). Factors independently related to peripheral arterial disease were old age (>60 years) which constitutes 51% and p value was 0.013, and smoking which constitutes 46.8% and P value was 0.04, and dyslipidemia which constitutes 74% and P value was 0.03, and finally previous history of cerebrovascular accident which constitutes 21.2% and P value was 0.0018. Conclusion: The prevalence of peripheral arterial disease in patients presenting with acute coronary syndrome is considerable and significant, the majority of patients were asymptomatic, it is associated with increased cardiovascular risk. Factors like aging, hypertension, diabetes mellitus, smoking, previous history of cerebrovascular accident, and dyslipidemia were strong predictors of peripheral arterial disease. Key word: peripheral arterial disease , acute coronary syndrome, hypertension, diabetes mellitus.
{"title":"Prevalence of peripheral arterial disease among patients with acute coronary syndrome, a sample of Iraqi patients in Al-Yarmook Teaching Hospital 2016","authors":"Osama A. Altaei, Abbass N. Al-Sharifi","doi":"10.32007/jfacmedbagdad.6321824","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321824","url":null,"abstract":"Abstract Background: A significant proportion of patients with ischemic heart disease have been associated with peripheral arterial disease, yet it is still underestimated by our health system as many of patients are asymptomatic and this condition remains under diagnosed and therefore undertreated. Objective: To study prevalence of peripheral arterial disease of the lower limbs in patient with acute coronary syndrome and its association with certain risk factors. Method: A cross sectional descriptive study was conducted in the coronary care unit at Al-Yarmouk Teaching Hospital from the 1st of January 2016 to the 1st of November 2016 where hundred and fifty (150) patients enrolled to the coronary care unit with approved acute coronary syndrome, had been evaluated for peripheral arterial disease by assessing Demographic, risk factors and clinical features of the patients, including age groups, gender, hypertension, diabetes mellitus, smoking, dyslipidemia, family history. of coronary artery disease, previous history of cerebrovascular accident, body mass index, leg pain, measurement of ankle brachial index using hand held continuous wave Doppler device. Results: in 150 acute coronary syndrome patients were included male were (70.7%) , peripheral arterial disease was found in 31.2% through measuring ankle brachial index, 51% of those patients were asymptomatic and 29.8% with atypical leg pain and 12.8% with intermittent leg pain and 6.4% had pain at rest. And ankle brachial index in the 150 patients with acute coronary syndrome were 68.8% normal (ankle brachial index =1.4-0.91) and 21.3% (ankle brachial index =0.9-0.71) and 7.3 %( ankle brachial index =0.69-0.41) and 2.6% (ankle brachial index ≤0.40). Factors independently related to peripheral arterial disease were old age (>60 years) which constitutes 51% and p value was 0.013, and smoking which constitutes 46.8% and P value was 0.04, and dyslipidemia which constitutes 74% and P value was 0.03, and finally previous history of cerebrovascular accident which constitutes 21.2% and P value was 0.0018. Conclusion: The prevalence of peripheral arterial disease in patients presenting with acute coronary syndrome is considerable and significant, the majority of patients were asymptomatic, it is associated with increased cardiovascular risk. Factors like aging, hypertension, diabetes mellitus, smoking, previous history of cerebrovascular accident, and dyslipidemia were strong predictors of peripheral arterial disease. Key word: peripheral arterial disease , acute coronary syndrome, hypertension, diabetes mellitus.","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69420071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.32007/jfacmedbagdad.6321849
W. Hussen, A. Mohammed, Akeel Yuser
Abstract Background: Eventration of diaphragm is an abnormal elevation of the diaphragm. Publishing on eventration of diaphragm in Iraq is scarce. Objective: This study was carried out to report on the Iraqi experience on eventration of diaphragm. Methods: A total of 18 patients with eventration diaphragm were included in this study. A review of case records of patients with eventration diaphragm treated in Ibn Al-Nafees Teaching Hospital was done. Review of records took place for the period of March 2012 to Dec. 2017. Results: The age of patients was ranged 5 months to 70 years, giving male to female ratio of 2:1. Dyspnea was dominating presenting symptoms followed by cough. The left hemidiaphragm was the most affected site (83.3%). The cause of eventration of diaphragm was idiopathic in 72.2% of patients. Chest X ray showed the elevation of the affected hemidiaphragm. CT scan demonstrated the thinned-out raised hemidiaphragm. The most common complications were atelectasis, and recurrent chest infection. Hospital stay was ranging 4-14 days. Conclusion: Eventration of diaphragm is not uncommon in Iraq. Presentation, management, and complication are similar to that reported in global centers. Key words: Diaphragm. Eventration. Plication. Surgical repair. Phrenic nerve injury
{"title":"Surgery of Eventration of the Diaphragm","authors":"W. Hussen, A. Mohammed, Akeel Yuser","doi":"10.32007/jfacmedbagdad.6321849","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.6321849","url":null,"abstract":"Abstract Background: Eventration of diaphragm is an abnormal elevation of the diaphragm. Publishing on eventration of diaphragm in Iraq is scarce. Objective: This study was carried out to report on the Iraqi experience on eventration of diaphragm. Methods: A total of 18 patients with eventration diaphragm were included in this study. A review of case records of patients with eventration diaphragm treated in Ibn Al-Nafees Teaching Hospital was done. Review of records took place for the period of March 2012 to Dec. 2017. Results: The age of patients was ranged 5 months to 70 years, giving male to female ratio of 2:1. Dyspnea was dominating presenting symptoms followed by cough. The left hemidiaphragm was the most affected site (83.3%). The cause of eventration of diaphragm was idiopathic in 72.2% of patients. Chest X ray showed the elevation of the affected hemidiaphragm. CT scan demonstrated the thinned-out raised hemidiaphragm. The most common complications were atelectasis, and recurrent chest infection. Hospital stay was ranging 4-14 days. Conclusion: Eventration of diaphragm is not uncommon in Iraq. Presentation, management, and complication are similar to that reported in global centers. Key words: Diaphragm. Eventration. Plication. Surgical repair. Phrenic nerve injury","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69419642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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