Background and objective: The purpose of this study was to examine the effectiveness of Tranexamic acid administered in the third stage of labor to reduce vaginal blood loss and prevent postpartum hemorrhage in women with high-risk factors for postpartum Hemorrhage. Methods: A double-blind randomized placebo-controlled trial with two parallel groups was conducted in women scheduled to undergo vaginal delivery at the Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq. The women were randomly assigned to receive tranexamic acid (97 women) or placebo (99 women) immediately after fetal delivery in the third stage of labor. The vaginal blood loss and the time from fetal to placental delivery were measured. Results: The mean blood loss in the placebo group (Group 1) was 354.5 gram, which was considerably greater than the mean blood loss in the tranexamic group (Group 2), which was 284.4 gram. The incidence of postpartum hemorrhage (blood loss of ≥500 ml.) and (blood loss of ≥250 ml.) was significantly higher in G1 than G2. The length of the third stage of labor lasted 10.28 minutes in G1, which was longer than in G2, which lasted 7.82 minutes. Oxytocin was given to both groups as an active management of the third stage of labor. Conclusion: In this single-center study, women with risk factors for postpartum hemorrhage who received tranexamic acid had lower postpartum blood loss and a shorter time for placental delivery than those women who received placebo. Larger multicenter randomized clinical trials are needed to generalize these findings.
{"title":"Tranexamic acid for the prevention of postpartum hemorrhage and decreasing blood loss after vaginal delivery in high-risky parturient: A double-blind randomized controlled trial","authors":"C. Hasan, S. Alalaf, S. Khoshnaw","doi":"10.15218/zjms.2022.024","DOIUrl":"https://doi.org/10.15218/zjms.2022.024","url":null,"abstract":"Background and objective: The purpose of this study was to examine the effectiveness of Tranexamic acid administered in the third stage of labor to reduce vaginal blood loss and prevent postpartum hemorrhage in women with high-risk factors for postpartum Hemorrhage. Methods: A double-blind randomized placebo-controlled trial with two parallel groups was conducted in women scheduled to undergo vaginal delivery at the Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq. The women were randomly assigned to receive tranexamic acid (97 women) or placebo (99 women) immediately after fetal delivery in the third stage of labor. The vaginal blood loss and the time from fetal to placental delivery were measured. Results: The mean blood loss in the placebo group (Group 1) was 354.5 gram, which was considerably greater than the mean blood loss in the tranexamic group (Group 2), which was 284.4 gram. The incidence of postpartum hemorrhage (blood loss of ≥500 ml.) and (blood loss of ≥250 ml.) was significantly higher in G1 than G2. The length of the third stage of labor lasted 10.28 minutes in G1, which was longer than in G2, which lasted 7.82 minutes. Oxytocin was given to both groups as an active management of the third stage of labor. Conclusion: In this single-center study, women with risk factors for postpartum hemorrhage who received tranexamic acid had lower postpartum blood loss and a shorter time for placental delivery than those women who received placebo. Larger multicenter randomized clinical trials are needed to generalize these findings.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44433041","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}
Background and objective: Thyroid surgery has traditionally been done on an inpatient basis. With the advent of minimal access techniques. This study aimed to assess the outcome of short-stay total thyroidectomy in comparison with a longer stay in terms of postoperative complications. Methods: This was an observational comparative study which was carried out at the surgical units of Erbil of Rizgary Teaching Hospital and private hospitals in Erbil city. The data were collected in the period between January 2017 and March 2021. Data of 192 patients’ records who underwent thyroidectomy were collected. Results: In this study, 33 (17.1%) patients were males while 159 (82.8%) were females. Out of 192 patients, 137 underwent sutureless technique while 55 of them underwent sutured way of hemostasis. Majority of patients 173 (90.1%) were discharged before 23 hours, while 19 (9.9%) were discharged after 23 hours. Significantly, higher percentage of males (24.2%) stayed more than 23 hours in the hospital compared with 6.9% of females (P = 0.006). The majority of indications with goiter, Graves’ disease, toxic nodule and solitary stayed between 12-23 hours while half of those with cancer stayed more than 23 hours (P = 0.023). Conclusion: Short-stay thyroid surgery is a feasible and safe procedure when combined with sutureless technique: this returns to overall less postoperative complications; day-case and short-stay procedures account for an expanding area of modern-day surgery.
{"title":"Short-stay sutureless total thyroidectomy","authors":"Sabat Abdulhamid, A. Al Dabbagh","doi":"10.15218/zjms.2022.025","DOIUrl":"https://doi.org/10.15218/zjms.2022.025","url":null,"abstract":"Background and objective: Thyroid surgery has traditionally been done on an inpatient basis. With the advent of minimal access techniques. This study aimed to assess the outcome of short-stay total thyroidectomy in comparison with a longer stay in terms of postoperative complications. Methods: This was an observational comparative study which was carried out at the surgical units of Erbil of Rizgary Teaching Hospital and private hospitals in Erbil city. The data were collected in the period between January 2017 and March 2021. Data of 192 patients’ records who underwent thyroidectomy were collected. Results: In this study, 33 (17.1%) patients were males while 159 (82.8%) were females. Out of 192 patients, 137 underwent sutureless technique while 55 of them underwent sutured way of hemostasis. Majority of patients 173 (90.1%) were discharged before 23 hours, while 19 (9.9%) were discharged after 23 hours. Significantly, higher percentage of males (24.2%) stayed more than 23 hours in the hospital compared with 6.9% of females (P = 0.006). The majority of indications with goiter, Graves’ disease, toxic nodule and solitary stayed between 12-23 hours while half of those with cancer stayed more than 23 hours (P = 0.023). Conclusion: Short-stay thyroid surgery is a feasible and safe procedure when combined with sutureless technique: this returns to overall less postoperative complications; day-case and short-stay procedures account for an expanding area of modern-day surgery.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45657259","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}
Background and objective: The traditional herbs Beta vulgaris and Corchorus olitorius are cultivated in Iraq and recorded in the Kurdish ethnobotany for various health problems including expectorant, laxative, diuretic, and anti-inflammatory and to relieve fever and pain. This study aimed to assess and compare the different biological properties of methanolic leaf extracts of Beta vulgaris and Corchorus olitorius cultivated in Iraq and recognize various classes of phytoconstituents present in each one. Methods: The bioactive entities in the crude methanolic leaves extracts of Beta vulgaris and Corchorus olitorius were subjected to phytochemical evaluations. The antioxidant and anti-inflammatory activities were evaluated with the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and egg albumin denaturation assays, respectively. The leaf extracts were tested for antibacterial properties using the agar well diffusion and broth microdilution methods. Results: The crude methanolic extracts of Beta vulgaris and Corchorus olitorius showed the presence of carbohydrates, alkaloids, cardioactive glycosides, coumarins, flavonoids, phenols, tannins, terpenoids, and steroids. The Beta vulgaris displayed higher gallic acid content 417.90±0.52 mg/gm of the extract compared to 79.85±0.99 mg/gm for Corchorus olitorius with (P <0.001).The antioxidant activity of Beta vulgaris leaves extract was significantly higher with (P = 0.035) in reference to ascorbic acid. Among the selected bacterial species, Klebsiella pneumoniae revealed pronounced sensitivity towards the methanolic extracts of both plants. The Corchorus olitorius leaves extract showed higher antibacterial activity than Beta vulgaris. Beta vulgaris presented greater anti-inflammatory activity at 1000 μg/mL with inhibition of 93.0% compared to 83.2% using acetylsalicylic acid as positive control. Conclusion: The methanolic leaf extracts of Beta vulgaris and Corchorus olitorius possess antibacterial, antioxidant, and anti-inflammatory potentials.
{"title":"The Phytochemical assay, and in vitro assessment of the antioxidant, antibacterial, and anti-inflammatory properties of Beta vulgaris L. (Amaranthaceae), and Corchorus olitorius L. (Malvaceae) crude leaf extracts","authors":"Aveen N. Adham","doi":"10.15218/zjms.2022.028","DOIUrl":"https://doi.org/10.15218/zjms.2022.028","url":null,"abstract":"Background and objective: The traditional herbs Beta vulgaris and Corchorus olitorius are cultivated in Iraq and recorded in the Kurdish ethnobotany for various health problems including expectorant, laxative, diuretic, and anti-inflammatory and to relieve fever and pain. This study aimed to assess and compare the different biological properties of methanolic leaf extracts of Beta vulgaris and Corchorus olitorius cultivated in Iraq and recognize various classes of phytoconstituents present in each one. Methods: The bioactive entities in the crude methanolic leaves extracts of Beta vulgaris and Corchorus olitorius were subjected to phytochemical evaluations. The antioxidant and anti-inflammatory activities were evaluated with the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and egg albumin denaturation assays, respectively. The leaf extracts were tested for antibacterial properties using the agar well diffusion and broth microdilution methods. Results: The crude methanolic extracts of Beta vulgaris and Corchorus olitorius showed the presence of carbohydrates, alkaloids, cardioactive glycosides, coumarins, flavonoids, phenols, tannins, terpenoids, and steroids. The Beta vulgaris displayed higher gallic acid content 417.90±0.52 mg/gm of the extract compared to 79.85±0.99 mg/gm for Corchorus olitorius with (P <0.001).The antioxidant activity of Beta vulgaris leaves extract was significantly higher with (P = 0.035) in reference to ascorbic acid. Among the selected bacterial species, Klebsiella pneumoniae revealed pronounced sensitivity towards the methanolic extracts of both plants. The Corchorus olitorius leaves extract showed higher antibacterial activity than Beta vulgaris. Beta vulgaris presented greater anti-inflammatory activity at 1000 μg/mL with inhibition of 93.0% compared to 83.2% using acetylsalicylic acid as positive control. Conclusion: The methanolic leaf extracts of Beta vulgaris and Corchorus olitorius possess antibacterial, antioxidant, and anti-inflammatory potentials.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44878617","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}
Background and objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease-19 (COVID-19). The effects of COVID-19 on the thyroid axis remain uncertain. This study aimed to determine the occurrence of thyroid dysfunction, as previously demonstrated for SARS-CoV-1 infection, and to analyze electrolytes (sodium, potassium, and chloride) to determine the severity of the disease. Methods: Blood samples were taken from patients who were admitted to Erbil hospitals from July to October 2021. Infection was detected by polymerase chain reaction (PCR). The 306 cases were labeled as moderate or severe. The samples were assessed for doing C-reactive protein (CRP), as a marker of systemic inflammation, thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4), and (sodium, potassium, and chloride) electrolytes. Results: Patients comprised of 157 (51.3%) males and 149 (48.7%) females. The result revealed that 274 (89.5%), 278 (90.8%), 292 (95.4%) of patients had normal TSH, T3, T4 level respectively, 22 (7.2%), 23 (7.5%), 9 (2.9%) of patients had low TSH, T3, T4 level respectively, and 10 (3.3%), 5 (1.6%), 5 (1.6%), had high TSH, T3, T4 level respectively. There was no significant difference between moderate and severe cases in alterations of TSH, T3, T4 level. There was a significant difference between moderate and severe cases in sodium, potassium, and chloride electrolyte abnormality. Conclusion: The occurrence of thyroid dysfunction in moderate and severe cases. The severity of the COVID-19 infection is associated with abnormalities in sodium, calcium, and chloride electrolytes.
{"title":"Thyroid function analysis and other biochemical parameters in patients with moderate and severe COVID-19","authors":"D. Ali","doi":"10.15218/zjms.2022.026","DOIUrl":"https://doi.org/10.15218/zjms.2022.026","url":null,"abstract":"Background and objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease-19 (COVID-19). The effects of COVID-19 on the thyroid axis remain uncertain. This study aimed to determine the occurrence of thyroid dysfunction, as previously demonstrated for SARS-CoV-1 infection, and to analyze electrolytes (sodium, potassium, and chloride) to determine the severity of the disease. Methods: Blood samples were taken from patients who were admitted to Erbil hospitals from July to October 2021. Infection was detected by polymerase chain reaction (PCR). The 306 cases were labeled as moderate or severe. The samples were assessed for doing C-reactive protein (CRP), as a marker of systemic inflammation, thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4), and (sodium, potassium, and chloride) electrolytes. Results: Patients comprised of 157 (51.3%) males and 149 (48.7%) females. The result revealed that 274 (89.5%), 278 (90.8%), 292 (95.4%) of patients had normal TSH, T3, T4 level respectively, 22 (7.2%), 23 (7.5%), 9 (2.9%) of patients had low TSH, T3, T4 level respectively, and 10 (3.3%), 5 (1.6%), 5 (1.6%), had high TSH, T3, T4 level respectively. There was no significant difference between moderate and severe cases in alterations of TSH, T3, T4 level. There was a significant difference between moderate and severe cases in sodium, potassium, and chloride electrolyte abnormality. Conclusion: The occurrence of thyroid dysfunction in moderate and severe cases. The severity of the COVID-19 infection is associated with abnormalities in sodium, calcium, and chloride electrolytes.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44768231","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}
N. Al-Tawil, Abdullah Mzury, A. Kheder, Hassan =Al–Sulaivany
Background and objective: Stroke is still one of the major causes of death, and the incidence and mortalities are increasing. The objective of the study is to measure the three months outcome of stroke patients discharged alive from the hospital. Methods: A longitudinal study was carried out in Rizgary Teaching Hospital in Erbil, Iraq during the period from 1st of April, 2018 to the 30th September, 2018 involving 100 patients with ischemic stroke. Results: The mean age (± SD) of patients was 64.15 ± 13.35 years, the age ranging from 26-89 years, and the median was 65 years. More than half (54%) of patients were males. Twenty (20%) patients died within three months after the development of stroke, 4% developed ischemic stroke after three months. Significantly higher rates of death were detected among those with chronic obstructive pulmonary disease (P <0.001) and those with dysphagia (P = 0.002). No significant association was detected between the case fatality rate with age, gender, body mass index, smoking, hypercholesterolemia, ischemic heart disease, angina, congestive heart failure, atrial fibrillation, heart valve dysfunction, strenuous physical activity, treatment for diabetes, treatment for high cholesterol, and HbA1c levels. Conclusion: The case fatality rate was relatively high three months after the development of stroke. It is recommended to strengthen the follow up measures after patients’ discharge from the hospital.
{"title":"Three months outcome of a sample of stroke patients in Erbil city","authors":"N. Al-Tawil, Abdullah Mzury, A. Kheder, Hassan =Al–Sulaivany","doi":"10.15218/zjms.2022.029","DOIUrl":"https://doi.org/10.15218/zjms.2022.029","url":null,"abstract":"Background and objective: Stroke is still one of the major causes of death, and the incidence and mortalities are increasing. The objective of the study is to measure the three months outcome of stroke patients discharged alive from the hospital. Methods: A longitudinal study was carried out in Rizgary Teaching Hospital in Erbil, Iraq during the period from 1st of April, 2018 to the 30th September, 2018 involving 100 patients with ischemic stroke. Results: The mean age (± SD) of patients was 64.15 ± 13.35 years, the age ranging from 26-89 years, and the median was 65 years. More than half (54%) of patients were males. Twenty (20%) patients died within three months after the development of stroke, 4% developed ischemic stroke after three months. Significantly higher rates of death were detected among those with chronic obstructive pulmonary disease (P <0.001) and those with dysphagia (P = 0.002). No significant association was detected between the case fatality rate with age, gender, body mass index, smoking, hypercholesterolemia, ischemic heart disease, angina, congestive heart failure, atrial fibrillation, heart valve dysfunction, strenuous physical activity, treatment for diabetes, treatment for high cholesterol, and HbA1c levels. Conclusion: The case fatality rate was relatively high three months after the development of stroke. It is recommended to strengthen the follow up measures after patients’ discharge from the hospital.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42822386","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}
Background and objective: Retractile testis is relatively common in pediatric population. This study followed up boys with retractile testis to investigate the natural course and the need for hormonal therapy and surgical treatments. Methods: A total of 110 boys aged 1.5-10.1 years (mean: 3.2 years) diagnosed as retractile testes, 67 (60.9%) unilateral and 43 (39.09%) bilateral. The mean follow-up period was 4.9±1.3 years. The diagnosis is confirmed on history and examination and ultrasound was made for measuring the size of the testis. Results: A total of 47 (42.72%) cases received human chorionic gonadotropin (17 bilateral and 30 unilateral). Response occurred in 32 boys (68.1%),12 bilateral and 20 unilateral. Failure of response occurred in 15 boys (31.9%). Fourteen of 110 boys (12.72 %) were referred for orchiopexy, including 1 of 12 (8.3%) of bilateral cases and 2 of 20 (10%) of unilateral cases who responded to human chorionic gonadotropin injection, 2 of 5 bilateral cases (40%) and 1 in 10 unilateral cases (10%) in those did not respond to treatment. In those who did not receive treatment, orchiopexy was performed in 6 of 26 bilateral cases (23.1) and in 2 of 37 unilateral cases (5.4%). Conclusion: Although testicular descent was achieved by short-term hormone therapy, the study revealed that there is no significant statistical difference for the need for orchiopexy between those received and those did not receive human chorionic gonadotropin.
{"title":"Evaluation of the role of human chorionic gonadotropin therapy in the management of retractile testes in children","authors":"S. Berdawd, Abdulrahman Taha, H. Hadi","doi":"10.15218/zjms.2022.027","DOIUrl":"https://doi.org/10.15218/zjms.2022.027","url":null,"abstract":"Background and objective: Retractile testis is relatively common in pediatric population. This study followed up boys with retractile testis to investigate the natural course and the need for hormonal therapy and surgical treatments. Methods: A total of 110 boys aged 1.5-10.1 years (mean: 3.2 years) diagnosed as retractile testes, 67 (60.9%) unilateral and 43 (39.09%) bilateral. The mean follow-up period was 4.9±1.3 years. The diagnosis is confirmed on history and examination and ultrasound was made for measuring the size of the testis. Results: A total of 47 (42.72%) cases received human chorionic gonadotropin (17 bilateral and 30 unilateral). Response occurred in 32 boys (68.1%),12 bilateral and 20 unilateral. Failure of response occurred in 15 boys (31.9%). Fourteen of 110 boys (12.72 %) were referred for orchiopexy, including 1 of 12 (8.3%) of bilateral cases and 2 of 20 (10%) of unilateral cases who responded to human chorionic gonadotropin injection, 2 of 5 bilateral cases (40%) and 1 in 10 unilateral cases (10%) in those did not respond to treatment. In those who did not receive treatment, orchiopexy was performed in 6 of 26 bilateral cases (23.1) and in 2 of 37 unilateral cases (5.4%). Conclusion: Although testicular descent was achieved by short-term hormone therapy, the study revealed that there is no significant statistical difference for the need for orchiopexy between those received and those did not receive human chorionic gonadotropin.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45381327","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}
Background and objective: Gestational diabetes mellitus is the most common metabolic disorder of pregnancy with increasing prevalence at epidemic rates. This study aimed to determine the prevalence of gestational diabetes mellitus and related risk factors in a sample of pregnant women in Erbil city. Methods: A cross-sectional study was conducted on a convenience sample of 216 pregnant women at primary health care centers in Erbil city, Kurdistan Region, Iraq, from April 2019 to January 2021. The pregnant women were selected independent of having or not having risk factors. Pregnant women were screened for diabetes mellitus using 50 gm glucose challenge test in 24–28th weeks of gestational age. Women with positive glucose challenge test underwent 100 g glucose tolerance test. Results: The 50g glucose challenge test revealed that 54 women (25.0%) were positive for gestational diabetes mellitus. Glucose tolerance test (100 gm) revealed that the prevalence of diabetes among the sample was 11.9%. The association between the different characteristics and risk factors with the diagnosed diabetic status of the study participants showed that there was a significant association with the older age, obesity, higher parity, and history of recurrent miscarriage. Conclusion: Pregnancy is associated with a high prevalence of gestational diabetes mellitus in the current research. Pregnant women, particularly those in advanced maternal age, with pre-pregnancy high body mass index and having a history of recurrent miscarriages, should be investigated for the possibility of the presence of gestational diabetes mellitus.
{"title":"Gestational diabetes and its correlation with maternal socio-demographic characteristics","authors":"Nask Jubrael, S. Alalaf, N. Shabila, Salah A. Ali","doi":"10.15218/zjms.2022.021","DOIUrl":"https://doi.org/10.15218/zjms.2022.021","url":null,"abstract":"Background and objective: Gestational diabetes mellitus is the most common metabolic disorder of pregnancy with increasing prevalence at epidemic rates. This study aimed to determine the prevalence of gestational diabetes mellitus and related risk factors in a sample of pregnant women in Erbil city. Methods: A cross-sectional study was conducted on a convenience sample of 216 pregnant women at primary health care centers in Erbil city, Kurdistan Region, Iraq, from April 2019 to January 2021. The pregnant women were selected independent of having or not having risk factors. Pregnant women were screened for diabetes mellitus using 50 gm glucose challenge test in 24–28th weeks of gestational age. Women with positive glucose challenge test underwent 100 g glucose tolerance test. Results: The 50g glucose challenge test revealed that 54 women (25.0%) were positive for gestational diabetes mellitus. Glucose tolerance test (100 gm) revealed that the prevalence of diabetes among the sample was 11.9%. The association between the different characteristics and risk factors with the diagnosed diabetic status of the study participants showed that there was a significant association with the older age, obesity, higher parity, and history of recurrent miscarriage. Conclusion: Pregnancy is associated with a high prevalence of gestational diabetes mellitus in the current research. Pregnant women, particularly those in advanced maternal age, with pre-pregnancy high body mass index and having a history of recurrent miscarriages, should be investigated for the possibility of the presence of gestational diabetes mellitus.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44827889","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}
Background and objective: Vestibular migraine is widely accepted as a unique disease, although its pathophysiology remains uncertain. When the patient is asymptomatic, vestibular migraine is often challenging to diagnose as its many symptoms overlap with other conditions. This study aimed to assess the role of videonystagmography and cervical vestibular evoked myogenic potentials tests in diagnosing vestibular migraine. Methods: This study is a descriptive cross-sectional study conducted on 30 patients clinically diagnosed with vestibular migraine in the Audiology Center in Sulaimani City. The study duration was from December 1st, 2018, to June 30th, 2019. The author interpreted magnetic resonance imaging, videonystagmography, and cervical vestibular evoked myogenic potential results. Results: The patients' mean age was 34.9 years with a high predominance of the female gender. Vertigo was the main complaint of the patients (73.4%) with the recurrent course. A family history of migraine was present in 83.3% of the patients. Only two (6.7%) patients had abnormal findings on the brain magnetic resonance imaging. Videonystagmography examination showed that 40% of the patients had abnormal findings; 20% were abnormal on the left, 16.7% were abnormal on the right, and 3.3% were bilaterally abnormal. The cervical vestibular evoked myogenic potentials test was abnormal for 63.3% of the patients; 43.3% abnormality was on the left side, and 20% was on the right side. Conclusion: The cervical vestibular evoked myogenic potentials and videonystagmography tests are helpful in the diagnosis of vestibular migraine. Keywords: Vestibular migraine; Video nystagmography; Cervical vestibular-evoked myogenic potentials.
{"title":"Role of videonystagmography and cervical vestibular evoked myogenic potentials in the diagnosis of vestibular migraine","authors":"Z. Mohammed","doi":"10.15218/zjms.2022.016","DOIUrl":"https://doi.org/10.15218/zjms.2022.016","url":null,"abstract":"Background and objective: Vestibular migraine is widely accepted as a unique disease, although its pathophysiology remains uncertain. When the patient is asymptomatic, vestibular migraine is often challenging to diagnose as its many symptoms overlap with other conditions. This study aimed to assess the role of videonystagmography and cervical vestibular evoked myogenic potentials tests in diagnosing vestibular migraine. Methods: This study is a descriptive cross-sectional study conducted on 30 patients clinically diagnosed with vestibular migraine in the Audiology Center in Sulaimani City. The study duration was from December 1st, 2018, to June 30th, 2019. The author interpreted magnetic resonance imaging, videonystagmography, and cervical vestibular evoked myogenic potential results. Results: The patients' mean age was 34.9 years with a high predominance of the female gender. Vertigo was the main complaint of the patients (73.4%) with the recurrent course. A family history of migraine was present in 83.3% of the patients. Only two (6.7%) patients had abnormal findings on the brain magnetic resonance imaging. Videonystagmography examination showed that 40% of the patients had abnormal findings; 20% were abnormal on the left, 16.7% were abnormal on the right, and 3.3% were bilaterally abnormal. The cervical vestibular evoked myogenic potentials test was abnormal for 63.3% of the patients; 43.3% abnormality was on the left side, and 20% was on the right side. Conclusion: The cervical vestibular evoked myogenic potentials and videonystagmography tests are helpful in the diagnosis of vestibular migraine. Keywords: Vestibular migraine; Video nystagmography; Cervical vestibular-evoked myogenic potentials.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49563154","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}
Background and objective: Anterior knee pain is a common reason for consultation due to knee pathology among teenagers and young adults. Knowledge of the radiological appearance of the abnormalities allows a more accurate diagnosis of the cause of the pain. This study aimed to determine the causes of anterior knee pain and assess the role of MRI in evaluating cases of anterior knee pain and achieving accurate diagnosis and grading of some of the most common pathologies. Methods: This cross-sectional study included 115 patients suffering from knee joint pain, referred to the radiology department, Rizgari Teaching Hospital from the rheumatology or orthopedic outpatient clinics, or private clinics between March 2017 and January 2020. Only 34 patients had anterior knee pain. All patients underwent an MRI examination. Results: MRI examination was carried out for 34 knees of 115 patients with anterior knee pain, including 13 males (38.24%) and 21 females (61.76%). The mean age of the patients was 31 years (range 14-52 years). Most of the cases presented clinically with AKP, and four cases presented with a history of pain after trauma. Twelve cases (35.29%) had patella Alta while two cases (5.8%) had patella Baja. Trochlear dysplasia was reported in seven cases (20.58%), and type C was the most common trochlear dysplasia, which was seen in four cases out of seven (57.14%). Patellar maltracking was seen in eightcases(23.52 %), tilt of the patella in 10 cases (29.41%), and a combination of patellar tilt, Alta, and maltracking was seen in eight cases (23.52%). Six cases (17.64%) showed a combination between trochlear dysplasia, patellar tilt, and maltracking. Thirty one patients (91.17%) showed signs of patellofemoral arthrosis, and joint effusion was seen in 30 patients (88.23%). Suprapatellarplica was seen in two cases (5.40%). Conclusion: The most common cause of anterior knee pain is patellofemoral instability, either due to abnormal morphology /or joint geometry or post-traumatic, and it is occasionally caused by a serious underlying systemic disease, including inflammatory conditions and malignancies. MRI offers superior soft tissue contrast resolution and allows a more accurate evaluation of the underlying etiology. Keywords: Knee joint; Pain; MRI; Evaluation.
{"title":"Evaluation of anterior knee pain by MRI in Erbil city, Iraqi Kurdistan Region","authors":"Haveen Azo Mohammad Amien","doi":"10.15218/zjms.2022.017","DOIUrl":"https://doi.org/10.15218/zjms.2022.017","url":null,"abstract":"Background and objective: Anterior knee pain is a common reason for consultation due to knee pathology among teenagers and young adults. Knowledge of the radiological appearance of the abnormalities allows a more accurate diagnosis of the cause of the pain. This study aimed to determine the causes of anterior knee pain and assess the role of MRI in evaluating cases of anterior knee pain and achieving accurate diagnosis and grading of some of the most common pathologies. Methods: This cross-sectional study included 115 patients suffering from knee joint pain, referred to the radiology department, Rizgari Teaching Hospital from the rheumatology or orthopedic outpatient clinics, or private clinics between March 2017 and January 2020. Only 34 patients had anterior knee pain. All patients underwent an MRI examination. Results: MRI examination was carried out for 34 knees of 115 patients with anterior knee pain, including 13 males (38.24%) and 21 females (61.76%). The mean age of the patients was 31 years (range 14-52 years). Most of the cases presented clinically with AKP, and four cases presented with a history of pain after trauma. Twelve cases (35.29%) had patella Alta while two cases (5.8%) had patella Baja. Trochlear dysplasia was reported in seven cases (20.58%), and type C was the most common trochlear dysplasia, which was seen in four cases out of seven (57.14%). Patellar maltracking was seen in eightcases(23.52 %), tilt of the patella in 10 cases (29.41%), and a combination of patellar tilt, Alta, and maltracking was seen in eight cases (23.52%). Six cases (17.64%) showed a combination between trochlear dysplasia, patellar tilt, and maltracking. Thirty one patients (91.17%) showed signs of patellofemoral arthrosis, and joint effusion was seen in 30 patients (88.23%). Suprapatellarplica was seen in two cases (5.40%). Conclusion: The most common cause of anterior knee pain is patellofemoral instability, either due to abnormal morphology /or joint geometry or post-traumatic, and it is occasionally caused by a serious underlying systemic disease, including inflammatory conditions and malignancies. MRI offers superior soft tissue contrast resolution and allows a more accurate evaluation of the underlying etiology. Keywords: Knee joint; Pain; MRI; Evaluation.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45838606","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}
Background and objective: Iron deficiency may impair aerobic performance. This study aimed to assess whether intravenous iron (ferric carboxymaltose) will improve symptoms in patients with heart failure with reduced left ventricular ejection fraction and iron deficiency or not, depending on serum ferritin or transferrin saturation with or without anemia. Methods: We enrolled 100 patients with heart failure with reduced ejection fraction (less than 40%) and iron deficiency (serum ferritin less than 100 ng/ml, or between 100-299 ng/ml but transferrin saturation less than 20%). The patient received an intravenous iron supplement of ferric carboxymaltose (1000-2500mg) until the correction of their iron status. We checked the 6-minute walking test, New York Heart Association functional class, and ejection fraction for each patient at baseline, 12 weeks, and 24 weeks after intervention. Results: Our study showed a significant improvement in the patient's functional status. The 6-minute walking test, New York Heart Association functional class, improved significantly in patients at 12 weeks and continues to improve beyond 24 weeks with or without anemia. The left ventricular ejection fraction in our study was not improved significantly. Conclusion: Treatment with intravenous iron supplement (ferric carboxymaltose) in patients with chronic stable heart failure and iron deficiency, with or without anemia, improves symptoms, functional capacity, and quality of life. Keywords: Iron replacement therapy; Six minute walking test; Heart failure; Ejection fraction; Iron deficiency.
{"title":"Impact of iron replacement therapy on six minutes walking test (functional state) in patients with heart failure with reduced ejection fraction and iron deficiency","authors":"H. Ismael, M. Habeeb","doi":"10.15218/zjms.2022.015","DOIUrl":"https://doi.org/10.15218/zjms.2022.015","url":null,"abstract":"Background and objective: Iron deficiency may impair aerobic performance. This study aimed to assess whether intravenous iron (ferric carboxymaltose) will improve symptoms in patients with heart failure with reduced left ventricular ejection fraction and iron deficiency or not, depending on serum ferritin or transferrin saturation with or without anemia. Methods: We enrolled 100 patients with heart failure with reduced ejection fraction (less than 40%) and iron deficiency (serum ferritin less than 100 ng/ml, or between 100-299 ng/ml but transferrin saturation less than 20%). The patient received an intravenous iron supplement of ferric carboxymaltose (1000-2500mg) until the correction of their iron status. We checked the 6-minute walking test, New York Heart Association functional class, and ejection fraction for each patient at baseline, 12 weeks, and 24 weeks after intervention. Results: Our study showed a significant improvement in the patient's functional status. The 6-minute walking test, New York Heart Association functional class, improved significantly in patients at 12 weeks and continues to improve beyond 24 weeks with or without anemia. The left ventricular ejection fraction in our study was not improved significantly. Conclusion: Treatment with intravenous iron supplement (ferric carboxymaltose) in patients with chronic stable heart failure and iron deficiency, with or without anemia, improves symptoms, functional capacity, and quality of life. Keywords: Iron replacement therapy; Six minute walking test; Heart failure; Ejection fraction; Iron deficiency.","PeriodicalId":53383,"journal":{"name":"Zanco Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48057292","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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