Pub Date : 2021-12-01DOI: 10.33899/mmed.2021.131088.1106
Sura Alnuaimy, L. Al-Allaf, Z. Al-Omar
Background: Among the frequent daily challenges in the practice of gynecology are abnormal uterine bleeding (AUB) beside the distinction of fundamental endometrial lesions that stand behind it .Ki67 is among the excellent markers as the higher proliferation rate is one of the features of cancer cells. Aim: This study aims to clarify the expression of Ki67 in the endometrium of women suffering from abnormal uterine bleeding in Nineveh Province and to correlate its expression with the histological picture. Subjects, Materials, and Methods: This is a case series study that was enrolled analysis of data (retrospectively and prospectively) of 51 females who were presented with history of abnormal uterine bleeding and they were underwent an elective D&C and or hysterectomy after admission in several Hospitals, in Nineveh Province, Northern Iraq from 1 st January, 2020 to 30 th December, 2020. The selected paraffin blocks (n-=51) were cut into 3-4 micrometers thick sections and mounted on poly-L-lysine glass slides for immunohistochemical staining with using of positive and negative control sections at Unit of Immunohistochemistry in Vin Hospital -Duhok-North of Iraq. Staining was performe using the optimized protocol recommended by the International Ki67 in Breast Cancer Working Group together with Dako Autostainer according to manufacturer instructions. Results: This work revealed that 23(45%) out of 51 cases were aged >50 years. The highest mean of percentage of Ki67expression was in sections of proliferative endometrium. In fact, sections of 3/7 of cases which were exhibited a percentage of Ki67 expression from 76% to 100% aged >50 years, while sections of 3/7 of cases of menopause women showed percentage of Ki67 expression from 26% to 75 %. Further, 12 cases out of 17 showed an intensity of staining score of 2 were aged ˂50 years, while 3 out of 5 cases (which revealed an intensity of 3 ) were aged < 50 years. Five cases out of 17 which showed an intensity of staining score of 2 were aged >50 years, while 2 out of 5 cases which exhibited an intensity score of 3 were aged > 50 years. The current study showed that 11/16 cases of benign conditions presented with percentage of Ki67 expression of less than 25%,while 14/15 cases of endometrial hyperplasia presented with Ki67 expression of <25%. In contrary, 8 cases out of 20 of cases of endometrial adenocarcinoma showed Ki67 expression of >25%. Further, the intensity of Ki67 immunostaining of more than 2 was shown in 4 cases of endometrial adenocarcinoma. Regarding cases of endometrial hyperplasia, the current work revealed that 7 cases (46%) out of 15 cases were aged more than 50 years. About 4 cases (26%) of them are of atypical type with no significant differences between the percentage and intensity of Ki67 expression in cases of endometrial hyperplasia. In fact, 15 cases (75%) of endometrial adenocarcinoma were aged more than 50 years. Four (20%) of them were of grade 3, while six cases (30%) of the
背景:在日常妇科实践中,子宫异常出血(AUB)是常见的挑战之一,而其背后的根本子宫内膜病变的区别。ki67是优秀的标志物之一,因为癌细胞的高增殖率是其特征之一。目的:本研究旨在阐明Ki67在尼尼微省子宫异常出血妇女子宫内膜中的表达,并探讨其表达与子宫异常出血的组织学关系。研究对象、材料和方法:本研究是一项病例系列研究,回顾性和前瞻性分析了伊拉克北部尼尼微省2020年1月1日至12月30日期间51名有异常子宫出血史的女性,她们在入院后接受了选择性D&C和/或子宫切除术。选择的石蜡块(n-=51)切成3-4微米厚的切片,装在聚l -赖氨酸玻片上,使用伊拉克北部杜霍克Vin医院免疫组化部的阳性和阴性对照切片进行免疫组化染色。根据制造商说明,使用国际Ki67乳腺癌工作组推荐的优化方案和Dako Autostainer进行染色。结果:51例患者中23例(45%)年龄在50 ~ 50岁之间。ki67的平均表达百分比最高的是增殖子宫内膜切片。事实上,3/7的病例切片显示Ki67的表达百分比从76%到100%,年龄在50岁左右,而3/7的绝经期妇女切片显示Ki67的表达百分比从26%到75%。此外,17例中有12例显示染色强度评分为2,年龄小于50岁,而5例中有3例(显示强度为3)年龄小于50岁。17例染色强度评分为2分的5例年龄为> ~ 50岁,5例染色强度评分为3分的2例年龄为> ~ 50岁。本研究显示,11/16的良性病变Ki67表达率低于25%,14/15的子宫内膜增生Ki67表达率为25%。此外,在4例子宫内膜腺癌中,Ki67免疫染色强度大于2。关于子宫内膜增生的病例,目前的研究显示,15例中有7例(46%)年龄在50岁以上。其中约4例(26%)为不典型型,Ki67在子宫内膜增生中的表达比例和表达强度无显著差异。事实上,15例(75%)子宫内膜腺癌患者年龄超过50岁。3级4例(20%),2级6例(30%)。根据子宫内膜腺癌分级,5例1级(分化程度高)子宫内膜腺癌切片中2例Ki67表达率大于15%,10例2级(中度分化)子宫内膜腺癌切片中5例Ki67表达率大于15%。最后,5例3级(低分化)子宫内膜腺癌中有3例Ki67表达率超过15%。16例中约有5例Ki67表达量大于25%。20例子宫内膜腺癌中有8例Ki67表达量大于25%。结论:通过对女性AUB切片中Ki67的免疫组化表达分析,发现Ki67与患者年龄有关。Ki67的表达与不良肿瘤特征之间存在显著关联。Ki67在增殖期和子宫内膜增生期的表达差异有统计学意义,在子宫内膜增生期的表达差异有统计学意义。Sura Atallah Mahmoud Al-Nuaimy Ann Coll Med Mosul December 2021 Vol. 43 no . 177和子宫内膜癌。Ki67可作为子宫内膜癌的诊断和预后工具。
{"title":"Clarification of Ki67 Expression in Association with the Histological Picture of Endometrium in Cases with Abnormal Uterine Bleeding in Nineveh Province","authors":"Sura Alnuaimy, L. Al-Allaf, Z. Al-Omar","doi":"10.33899/mmed.2021.131088.1106","DOIUrl":"https://doi.org/10.33899/mmed.2021.131088.1106","url":null,"abstract":"Background: Among the frequent daily challenges in the practice of gynecology are abnormal uterine bleeding (AUB) beside the distinction of fundamental endometrial lesions that stand behind it .Ki67 is among the excellent markers as the higher proliferation rate is one of the features of cancer cells. Aim: This study aims to clarify the expression of Ki67 in the endometrium of women suffering from abnormal uterine bleeding in Nineveh Province and to correlate its expression with the histological picture. Subjects, Materials, and Methods: This is a case series study that was enrolled analysis of data (retrospectively and prospectively) of 51 females who were presented with history of abnormal uterine bleeding and they were underwent an elective D&C and or hysterectomy after admission in several Hospitals, in Nineveh Province, Northern Iraq from 1 st January, 2020 to 30 th December, 2020. The selected paraffin blocks (n-=51) were cut into 3-4 micrometers thick sections and mounted on poly-L-lysine glass slides for immunohistochemical staining with using of positive and negative control sections at Unit of Immunohistochemistry in Vin Hospital -Duhok-North of Iraq. Staining was performe using the optimized protocol recommended by the International Ki67 in Breast Cancer Working Group together with Dako Autostainer according to manufacturer instructions. Results: This work revealed that 23(45%) out of 51 cases were aged >50 years. The highest mean of percentage of Ki67expression was in sections of proliferative endometrium. In fact, sections of 3/7 of cases which were exhibited a percentage of Ki67 expression from 76% to 100% aged >50 years, while sections of 3/7 of cases of menopause women showed percentage of Ki67 expression from 26% to 75 %. Further, 12 cases out of 17 showed an intensity of staining score of 2 were aged ˂50 years, while 3 out of 5 cases (which revealed an intensity of 3 ) were aged < 50 years. Five cases out of 17 which showed an intensity of staining score of 2 were aged >50 years, while 2 out of 5 cases which exhibited an intensity score of 3 were aged > 50 years. The current study showed that 11/16 cases of benign conditions presented with percentage of Ki67 expression of less than 25%,while 14/15 cases of endometrial hyperplasia presented with Ki67 expression of <25%. In contrary, 8 cases out of 20 of cases of endometrial adenocarcinoma showed Ki67 expression of >25%. Further, the intensity of Ki67 immunostaining of more than 2 was shown in 4 cases of endometrial adenocarcinoma. Regarding cases of endometrial hyperplasia, the current work revealed that 7 cases (46%) out of 15 cases were aged more than 50 years. About 4 cases (26%) of them are of atypical type with no significant differences between the percentage and intensity of Ki67 expression in cases of endometrial hyperplasia. In fact, 15 cases (75%) of endometrial adenocarcinoma were aged more than 50 years. Four (20%) of them were of grade 3, while six cases (30%) of the","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75091096","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 : 2021-12-01DOI: 10.33899/mmed.2021.130630.1097
Ali H. Azeez, A. Al-Shalchy, O. Agha
Background: Brain abscess by definition is a crucial pus collection inside the brain, resulted from the infection by a variety of bacteria, fungi, and parasite. It can be single or multiple. The size, position, and number of lesions, as well as the organism's pathogenicity, host reactions, and the severity of cerebral edema, all influence the presentation. Objective: To assess how well a brain abscess was managed and to evaluate the patients with favorable and unfavorable Glasgow outcome scale (GOS). Patients and methods: From January 2014 to January 2021, the study was achieved and conducted in the Neurosurgical Department of Ibn-Sina Teaching Hospital on Mosul's left coast. The neurosurgery unit managed a case series investigation of 70 patients who had a brain abscess. Age, sex, duration of illness, initial neurosurgical status, and abscess features are among the clinical data. A comparison was performed between patient with Favorable Glasgow outcome scale (GOS), moderate disability or those with good recovery and those with Unfavorable GOS, death or persist vegetate status outcome at discharge. Results: The study involved 48 male and 22 female patients (male / female ratios 2.2:1). The series consist of 52 patients who experienced favorable outcome and 18 resulted from an unfavorable outcome. The mean of age for those patients was 20 years. The difference between males and females regarding favorable and unfavorable outcomes is insignificant. P-value was significant in cyanotic congenital heart diseases as cause of brain abscess were particularly prevalent among the children (adult VS children = 1:9). The most common site for single abscesses was the frontal lobe (25 patients), and majority of patients treated with burr hole drainage, which had the best results. Conclusion: Although there were technological improvement of imaging and antibiotics treatment, the mortality of brain abscesses is still relatively high, especially among those with decreased level of consciousness on admission.
{"title":"Factors Influencing Outcome and Mortality of Brain Abscess in Mosul City","authors":"Ali H. Azeez, A. Al-Shalchy, O. Agha","doi":"10.33899/mmed.2021.130630.1097","DOIUrl":"https://doi.org/10.33899/mmed.2021.130630.1097","url":null,"abstract":"Background: Brain abscess by definition is a crucial pus collection inside the brain, resulted from the infection by a variety of bacteria, fungi, and parasite. It can be single or multiple. The size, position, and number of lesions, as well as the organism's pathogenicity, host reactions, and the severity of cerebral edema, all influence the presentation. Objective: To assess how well a brain abscess was managed and to evaluate the patients with favorable and unfavorable Glasgow outcome scale (GOS). Patients and methods: From January 2014 to January 2021, the study was achieved and conducted in the Neurosurgical Department of Ibn-Sina Teaching Hospital on Mosul's left coast. The neurosurgery unit managed a case series investigation of 70 patients who had a brain abscess. Age, sex, duration of illness, initial neurosurgical status, and abscess features are among the clinical data. A comparison was performed between patient with Favorable Glasgow outcome scale (GOS), moderate disability or those with good recovery and those with Unfavorable GOS, death or persist vegetate status outcome at discharge. Results: The study involved 48 male and 22 female patients (male / female ratios 2.2:1). The series consist of 52 patients who experienced favorable outcome and 18 resulted from an unfavorable outcome. The mean of age for those patients was 20 years. The difference between males and females regarding favorable and unfavorable outcomes is insignificant. P-value was significant in cyanotic congenital heart diseases as cause of brain abscess were particularly prevalent among the children (adult VS children = 1:9). The most common site for single abscesses was the frontal lobe (25 patients), and majority of patients treated with burr hole drainage, which had the best results. Conclusion: Although there were technological improvement of imaging and antibiotics treatment, the mortality of brain abscesses is still relatively high, especially among those with decreased level of consciousness on admission.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84912380","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 : 2021-12-01DOI: 10.33899/mmed.2021.129832.1085
Omer M. T. Hammodat, B. Alhajjar, Ahmad Hammodat
Background: Hydatid cyst still has worldwide distribution with many cases discovered yearly in endemic areas. It has a predilection to involve the liver and the lung. Capitonnage has been practiced long time to avoid postoperative complications mainly air leak in addition to empyema formation. It may be still controversy concerning the efficiency of capitonnage especially for complicated hydatid cyst which led us to evaluate. Aim of the study: To assess the efficacy of capitonnage surgery in minimizing the postoperative complications and hospital stay in complicated and non complicated pulmonary hydatid cysts. Patients and Methods: A prospective study has been done at the department of thoracic surgery in AlJumhory teaching hospital at right side of Mosul, Department of pediatric surgery in Al-Khansaa teaching hospital and in Al-Rabee private hospital at left side of Mosul / Iraq between February 2017 and December 2019. Totally 118 patients with hydatid cyst of lung, including all ages and on different types of complicated and non-complicated cysts were included for this study. Co-morbid diseases like acute myocardial ischemia and uncontrolled diabetes mellitus were excluded from our study. Patients were evaluated in responce to the gender, age, clinical presentation, cyst condition (size, site and where ruptured or not) and postoperative hospital stay. Enucleation of the HC and capitonnage were carried out for all patients. The patient followed for three months at monthly interval, then each year with the mean follow up of 22 months. Results: One hundred eighteen patients with median age of 32 years were operated using capitonnage method. In this study 49 (41.5%) of the patients found to have intact cyst and the remaining 69 (58.5%) had ruptured cyst. We recorded the early postoperative complications which include air leak in 10 cases, Atelectasis 8, pneumothorax 3, wound infection 3 and Hemoptysis in 2 cases. Conclusion: Capitonnage can decrease the incidence of air leak and shorten hospital stay in complicated and non-complicated lung hydatid cysts.
{"title":"Capitonnage surgery is effective in all types of pulmonary hydatid cysts","authors":"Omer M. T. Hammodat, B. Alhajjar, Ahmad Hammodat","doi":"10.33899/mmed.2021.129832.1085","DOIUrl":"https://doi.org/10.33899/mmed.2021.129832.1085","url":null,"abstract":"Background: Hydatid cyst still has worldwide distribution with many cases discovered yearly in endemic areas. It has a predilection to involve the liver and the lung. Capitonnage has been practiced long time to avoid postoperative complications mainly air leak in addition to empyema formation. It may be still controversy concerning the efficiency of capitonnage especially for complicated hydatid cyst which led us to evaluate. Aim of the study: To assess the efficacy of capitonnage surgery in minimizing the postoperative complications and hospital stay in complicated and non complicated pulmonary hydatid cysts. Patients and Methods: A prospective study has been done at the department of thoracic surgery in AlJumhory teaching hospital at right side of Mosul, Department of pediatric surgery in Al-Khansaa teaching hospital and in Al-Rabee private hospital at left side of Mosul / Iraq between February 2017 and December 2019. Totally 118 patients with hydatid cyst of lung, including all ages and on different types of complicated and non-complicated cysts were included for this study. Co-morbid diseases like acute myocardial ischemia and uncontrolled diabetes mellitus were excluded from our study. Patients were evaluated in responce to the gender, age, clinical presentation, cyst condition (size, site and where ruptured or not) and postoperative hospital stay. Enucleation of the HC and capitonnage were carried out for all patients. The patient followed for three months at monthly interval, then each year with the mean follow up of 22 months. Results: One hundred eighteen patients with median age of 32 years were operated using capitonnage method. In this study 49 (41.5%) of the patients found to have intact cyst and the remaining 69 (58.5%) had ruptured cyst. We recorded the early postoperative complications which include air leak in 10 cases, Atelectasis 8, pneumothorax 3, wound infection 3 and Hemoptysis in 2 cases. Conclusion: Capitonnage can decrease the incidence of air leak and shorten hospital stay in complicated and non-complicated lung hydatid cysts.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86348033","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 : 2021-12-01DOI: 10.33899/mmed.2021.130314.1094
F. Ali, Nagham Khalil, Redhaa Rashed
Backgroud: COVID-19 or the disease caused by the SARS – Cov2 – (sever acute respiratory syndrome caused by coronavirus 2 ). Coronavirus has caused a pandemic that has affected patients in more than 188 countries and territories around the world. Prodigious restrictions and safety measures have been adopted by the governments to control the spread of wildfire coronavirus disease 2019 (COVID-19) pandemic. However, the effective implementation of these measures depends upon the knowledge, attitudes, and practices (KAP) of the people. Materials and Methods: A cross-sectional survey was designed for the present study. The study was conducted from May 2020 to Septembet 2020 in Mosul city and include adults who are not working in the medical field and visit family medicine centers or hospitals for any reasons except having a disease Results: this study revealed that about (190) 95% of the participant knows that the disease can be spread by droplet of patient and (136) 68 % of them believe that surfaces touched by patient could be one of the measures to transmit the disease and (156) 78% of them said that the disease may transmited from asymptomatic patient. Regarding the knowledge of the participant about measures used to prevent spread of Covid 19 this research demonstrates that (198) 99% and (190) 95% of them convinced that proper hand wash and maintain appropriate distance between himself and other person specially with symptoms is an effective measure to prevent transmission of the disease . On the other hand , this study check the attitude of the participants toward Covid 19 which found that 76% and 72% of them have a good attitude toward covid 19 which was washing hands regularly and put facemask while only 59% believe that curfew during pandemic state are useful and 58% found that the preventive measures advised by health personnel were useful and 63% still considered that this disease designed as a biological weapon. Conclusions: According to this study about 65% of the participant have good knowledge , 63.4 % of them have good attitude a toward Covid 19 which is very important to limit it's transmission through the population .
{"title":"Knowledge , Attitude and Practice Toward COVID – 19 in Mosul City","authors":"F. Ali, Nagham Khalil, Redhaa Rashed","doi":"10.33899/mmed.2021.130314.1094","DOIUrl":"https://doi.org/10.33899/mmed.2021.130314.1094","url":null,"abstract":"Backgroud: COVID-19 or the disease caused by the SARS – Cov2 – (sever acute respiratory syndrome caused by coronavirus 2 ). Coronavirus has caused a pandemic that has affected patients in more than 188 countries and territories around the world. Prodigious restrictions and safety measures have been adopted by the governments to control the spread of wildfire coronavirus disease 2019 (COVID-19) pandemic. However, the effective implementation of these measures depends upon the knowledge, attitudes, and practices (KAP) of the people. Materials and Methods: A cross-sectional survey was designed for the present study. The study was conducted from May 2020 to Septembet 2020 in Mosul city and include adults who are not working in the medical field and visit family medicine centers or hospitals for any reasons except having a disease Results: this study revealed that about (190) 95% of the participant knows that the disease can be spread by droplet of patient and (136) 68 % of them believe that surfaces touched by patient could be one of the measures to transmit the disease and (156) 78% of them said that the disease may transmited from asymptomatic patient. Regarding the knowledge of the participant about measures used to prevent spread of Covid 19 this research demonstrates that (198) 99% and (190) 95% of them convinced that proper hand wash and maintain appropriate distance between himself and other person specially with symptoms is an effective measure to prevent transmission of the disease . On the other hand , this study check the attitude of the participants toward Covid 19 which found that 76% and 72% of them have a good attitude toward covid 19 which was washing hands regularly and put facemask while only 59% believe that curfew during pandemic state are useful and 58% found that the preventive measures advised by health personnel were useful and 63% still considered that this disease designed as a biological weapon. Conclusions: According to this study about 65% of the participant have good knowledge , 63.4 % of them have good attitude a toward Covid 19 which is very important to limit it's transmission through the population .","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87923435","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 : 2021-12-01DOI: 10.33899/mmed.2021.130671.1098
H. Abdulwahid, Anmar Jassim, I. Mahmood, Raghdan Dawood
Background: The obstruction of the nasal is known as the most distinct disturbing complain of nasal disease and nasal sinus. The nasal obstruction could either be found unilateral (in one nasal cavity), bilateral (in both cavities), intermittent, progressive or persistent. The rhino-scopy (anterior and posterior) provides limited information when compared to nasal endoscopy. In certain cases, the structure which lies under the sight line and the posterior rhino-scopy is not possible. Furthermore, the early diagnosis of many unpleasant lesions will be very difficult unless using nasal endoscopy. Objectives: This study was designed to identify the real & precise causes of nasal obstruction in adults & properly evaluate the condition of nasal cavity ,post nasal space and nasal mucosa by direct vision through nasal endoscopy. and evaluate the value of naso endoscopy in diagnosis of the cause of nasal obstruction. Methods: This study was conducted to analyze noses related to 75 patients with nasal obstruction who underwent clinical and endoscopic nasal examination for the period from May 2014 to April 2015 in Mosul namely; Al-jumhoori Teaching hospital. Results: This case series study included 75 patients complaining from nasal obstruction The study include 43 male patients (57.3%), and 32 female patients (42.6%) with a M:F ratio of (1.3:1). The patients’ ages ranged between 15-70 years of age whose mean age was 42.5 years. endoscopic findings for adults patients with nasal obstruction in our study were: congested nasal mucosa 40 (53.3%) patients, septal deviation 26 (34.6%) patients, inferior turbinate hypertrophy 18 (24.0%) patients, pale swollen mucosa with watery nasal secretion 14 (18.6%) patients, bilateral nasal polyposis 10 (13.3%), post nasal drip 10 (13.3%), crustation 8 (10.6%), mucopurulent discharge from middle meatus & congested mucosa 7 patients (9.3%), adenoid hypertrophy 5 patients (6.6%), no abnormal findings 4 patients (5.3%), bluish tinged mucosa with watery nasal secretion 3 patients (4.0%). Conclusion: Nasal endoscopy includes evaluating the passages of the nasal cavity and the nasal sinus, and post nasal space using a magnified high-quality view and serves as an objective diagnostic tool in the evaluating of nasal mucosa, sinonasal anatomy, nasal cavity, and post nasal space pathology. In this study, nasal endoscopy is recommended in cases where patients complain of obstruction in the nasal specifically when anterior and posterior rhino-scopic examinations do not succeed in diagnosing causes of nasal obstruction
{"title":"Endoscopic Findings in Adults with Nasal Obstruction: A case series study","authors":"H. Abdulwahid, Anmar Jassim, I. Mahmood, Raghdan Dawood","doi":"10.33899/mmed.2021.130671.1098","DOIUrl":"https://doi.org/10.33899/mmed.2021.130671.1098","url":null,"abstract":"Background: The obstruction of the nasal is known as the most distinct disturbing complain of nasal disease and nasal sinus. The nasal obstruction could either be found unilateral (in one nasal cavity), bilateral (in both cavities), intermittent, progressive or persistent. The rhino-scopy (anterior and posterior) provides limited information when compared to nasal endoscopy. In certain cases, the structure which lies under the sight line and the posterior rhino-scopy is not possible. Furthermore, the early diagnosis of many unpleasant lesions will be very difficult unless using nasal endoscopy. Objectives: This study was designed to identify the real & precise causes of nasal obstruction in adults & properly evaluate the condition of nasal cavity ,post nasal space and nasal mucosa by direct vision through nasal endoscopy. and evaluate the value of naso endoscopy in diagnosis of the cause of nasal obstruction. Methods: This study was conducted to analyze noses related to 75 patients with nasal obstruction who underwent clinical and endoscopic nasal examination for the period from May 2014 to April 2015 in Mosul namely; Al-jumhoori Teaching hospital. Results: This case series study included 75 patients complaining from nasal obstruction The study include 43 male patients (57.3%), and 32 female patients (42.6%) with a M:F ratio of (1.3:1). The patients’ ages ranged between 15-70 years of age whose mean age was 42.5 years. endoscopic findings for adults patients with nasal obstruction in our study were: congested nasal mucosa 40 (53.3%) patients, septal deviation 26 (34.6%) patients, inferior turbinate hypertrophy 18 (24.0%) patients, pale swollen mucosa with watery nasal secretion 14 (18.6%) patients, bilateral nasal polyposis 10 (13.3%), post nasal drip 10 (13.3%), crustation 8 (10.6%), mucopurulent discharge from middle meatus & congested mucosa 7 patients (9.3%), adenoid hypertrophy 5 patients (6.6%), no abnormal findings 4 patients (5.3%), bluish tinged mucosa with watery nasal secretion 3 patients (4.0%). Conclusion: Nasal endoscopy includes evaluating the passages of the nasal cavity and the nasal sinus, and post nasal space using a magnified high-quality view and serves as an objective diagnostic tool in the evaluating of nasal mucosa, sinonasal anatomy, nasal cavity, and post nasal space pathology. In this study, nasal endoscopy is recommended in cases where patients complain of obstruction in the nasal specifically when anterior and posterior rhino-scopic examinations do not succeed in diagnosing causes of nasal obstruction","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76384809","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 : 2021-12-01DOI: 10.33899/mmed.2021.131592.1114
S. Hasan
Case report : To the best of our knowledge this could be the first report of a successfully performed laparoscopic surgery for female patient having had multiple liver hydatid cysts ( 7 in number) in both lobes of
病例报告:据我们所知,这可能是第一例成功进行腹腔镜手术的女性患者有多个肝包虫囊肿(7个)在双叶
{"title":"A successful Laparoscopic surgery for multiple hydatid cysts (7 cysts) of liver : Case Report","authors":"S. Hasan","doi":"10.33899/mmed.2021.131592.1114","DOIUrl":"https://doi.org/10.33899/mmed.2021.131592.1114","url":null,"abstract":"Case report : To the best of our knowledge this could be the first report of a successfully performed laparoscopic surgery for female patient having had multiple liver hydatid cysts ( 7 in number) in both lobes of","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73668224","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 : 2021-12-01DOI: 10.33899/mmed.2021.130724.1099
M. Muzahim, Adil AL- aqabi
Background: Obesity, a global public health concern, has been repeatedly linked to the development of different cancers in epidemiologic and basic research studies, Prostate cancer is the most frequently encountered solid tissue cancer in men. Gleason score of the prostate cancer is one of the most important parameter, which provides the most important data about biological behavior of the cancer and affect on the selection of the treatment and its outcomes. Therefore, accuracy of Gleason score, based on histopathological analysis of the biopsy material, has a critical importance Patients and Methods: A cross-sectional study with retrospective analytical elements, among prostate cancer patients who were diagnosed based on histopathology of prostate gland ,then classified accorrding to G.S (gleasson score) and body mass index. Aim of this study: To evaluate the association between high body mass index and Gleason grade of prostate cancer. Results: The results of this study showed that patients with high body mass index Significantly associated with high grade of prostate cancer, as ( 46.4% and 62.2% of overweight and obese patients respectively had high Gleason score above 7 while 12.5% of overweight and 8.1% of obese patients had low Gleason score and the p Value was (0.002). Conclusion: This study found that high body mass index associated with increase high grade of prostate cancer.
{"title":"The Association Of Body Mass Index And Prostatic Cancer Histopathological Grade","authors":"M. Muzahim, Adil AL- aqabi","doi":"10.33899/mmed.2021.130724.1099","DOIUrl":"https://doi.org/10.33899/mmed.2021.130724.1099","url":null,"abstract":"Background: Obesity, a global public health concern, has been repeatedly linked to the development of different cancers in epidemiologic and basic research studies, Prostate cancer is the most frequently encountered solid tissue cancer in men. Gleason score of the prostate cancer is one of the most important parameter, which provides the most important data about biological behavior of the cancer and affect on the selection of the treatment and its outcomes. Therefore, accuracy of Gleason score, based on histopathological analysis of the biopsy material, has a critical importance Patients and Methods: A cross-sectional study with retrospective analytical elements, among prostate cancer patients who were diagnosed based on histopathology of prostate gland ,then classified accorrding to G.S (gleasson score) and body mass index. Aim of this study: To evaluate the association between high body mass index and Gleason grade of prostate cancer. Results: The results of this study showed that patients with high body mass index Significantly associated with high grade of prostate cancer, as ( 46.4% and 62.2% of overweight and obese patients respectively had high Gleason score above 7 while 12.5% of overweight and 8.1% of obese patients had low Gleason score and the p Value was (0.002). Conclusion: This study found that high body mass index associated with increase high grade of prostate cancer.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88403188","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 : 2021-12-01DOI: 10.33899/mmed.2021.130832.1102
Mazin Mahmoud Fawzi
Background: Folate is essential for metabolism and development. So, folate metabolism abnormalities are common in infants with some congenital defects. An infant born to mothers with normal folate status has more resistant to congenital heart diseases (CHDs). Evidence on risk factors for developmental defects resulting from drug use before conception and during pregnancy is still very limited. The relationship between folic acid for mothers before and throughout pregnancy and the incidence of fetal malformations and diseases have been recognized. Aims: This article is a rapid review for assessment of the folic acid supplementation as a preventive measure of CHDs during fetal development, and what is already recognized about a policy of this subject, by using systematic review methods to search some of the existing researches. Materials: publications related to determining and quantifying the use of folate by pregnant mothers to decrease the risk of congenital heart diseases were reviewed. Many studies have confirmed the reduction of congenital heart diseases by folic acid supplementation prior to pregnancy. Conclusion: the protective effect of folic acid against congenital heart abnormalities has been established. Though, the dose and time of supplementation are not known; more researches are needed to explain the
{"title":"Periconceptional folate supplementation for the prevention of congenital heart diseases: A review of literatures","authors":"Mazin Mahmoud Fawzi","doi":"10.33899/mmed.2021.130832.1102","DOIUrl":"https://doi.org/10.33899/mmed.2021.130832.1102","url":null,"abstract":"Background: Folate is essential for metabolism and development. So, folate metabolism abnormalities are common in infants with some congenital defects. An infant born to mothers with normal folate status has more resistant to congenital heart diseases (CHDs). Evidence on risk factors for developmental defects resulting from drug use before conception and during pregnancy is still very limited. The relationship between folic acid for mothers before and throughout pregnancy and the incidence of fetal malformations and diseases have been recognized. Aims: This article is a rapid review for assessment of the folic acid supplementation as a preventive measure of CHDs during fetal development, and what is already recognized about a policy of this subject, by using systematic review methods to search some of the existing researches. Materials: publications related to determining and quantifying the use of folate by pregnant mothers to decrease the risk of congenital heart diseases were reviewed. Many studies have confirmed the reduction of congenital heart diseases by folic acid supplementation prior to pregnancy. Conclusion: the protective effect of folic acid against congenital heart abnormalities has been established. Though, the dose and time of supplementation are not known; more researches are needed to explain the","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82092686","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 : 2021-12-01DOI: 10.33899/mmed.2021.131144.1108
R. Ibrahim, Firas M D Al-Tae
Objective: To 1) assess IL-6 levels in the serum of patients with rheumatoid arthritis (RA). 2) study IL-6 promoter -174 G>C “single nucleotide polymorphism (SNP)” as an imminent factor for the disease development. 3) find any relation between the level of serum IL-6 cytokine and other parameters such as age, gender, clinical severity of diseases and “disease activity scores (DAS28)”. Materials & methods: This research was carried out through a case – control approach at “Ibn – Senna Teaching Hospital” in Mosul city between November 2020 and July 2021. It included 61 RA patients diagnosed according to “ACR / EULAR 2010 criteria” and 50 healthy individuals. IL-6 serum levels were ascertained by ELISA and genotyping of IL-6 promoter was accomplished by “sequence-specific primerpolymerase chain reaction (SSP-PCR)”. Results: Mean IL-6 level in RA (69.42 ng /l ± 62.99) was elevated in comparison to healthy people (14.66 ng /l ± 23.58), P < 0.001. No age or gender effects on IL-6 concentration were noted. The ideal cut-off of IL-6 for discrimination of RA with best discriminative utility compared to healthy controls was 22.80 ng/l. At this value the IL-6 sensitivity was 91.8%, specificity 82.0% and accuracy rate 73.80%. G/G genotype was the most pervasive genotype in both RA patients and controls (70.5% in RA and 64% in healthy controls). However, it did not seem to be a risk factor for RA development compared to G/C or C/C genotypes “(OR = 1.3438, 95% CI=0.605-2.984,P=0.469)”. The mean IL-6 level in patients with GG genotype was (73.70 ng / l ± 71.09) compared to (58.37 ng /l ± 37.86) in patients with GC genotype. There was no significant difference in the IL-6 level between patients with GG and patients with GC genotypes (P = 0.2375). Although higher IL-6 mean concentration was reported in severe RA, however, no significant difference was found between patients with mild, moderate and severe RA respectively. No correlation of serum levels of IL-6 with genetic promoter polymorphism, clinical severity of diseases or DAS 28 score were reported. Conclusion: The concentration of serum IL-6 was elevated in RA in regard to healthy controls which confirmed its pivotal role in RA pathogenesis. Our data did not support the role of IL-6 promoter -174 G> C polymorphism as a risk factor for RA, nor seem to play a major role in the increase of IL-6 level among our patients with RA.
目的:1)评价类风湿关节炎(RA)患者血清IL-6水平。2)研究IL-6启动子-174 G>C“单核苷酸多态性(SNP)”作为疾病发展的迫在眉睫的因素。3)寻找血清IL-6细胞因子水平与年龄、性别、疾病临床严重程度、“疾病活动性评分(DAS28)”等参数的关系。材料和方法:本研究于2020年11月至2021年7月在摩苏尔市“伊本-塞纳教学医院”通过病例对照方法进行。该研究包括61名根据“ACR / EULAR 2010标准”诊断的RA患者和50名健康个体。ELISA检测血清IL-6水平,“序列特异性引物聚合酶链式反应(SSP-PCR)”完成IL-6启动子基因分型。结果:RA组平均IL-6水平(69.42 ng /l±62.99)高于健康组(14.66 ng /l±23.58),P < 0.001。年龄和性别对IL-6浓度没有影响。与健康对照相比,IL-6鉴别RA的理想临界值为22.80 ng/l。在此值下,IL-6的敏感性为91.8%,特异性为82.0%,准确率为73.80%。G/G基因型是RA患者和对照组中最普遍的基因型(RA为70.5%,健康对照组为64%)。然而,与G/C或C/C基因型相比,它似乎不是RA发展的危险因素(or = 1.3438, 95% CI=0.605-2.984,P=0.469)。GG基因型患者IL-6平均水平为(73.70 ng /l±71.09),GC基因型患者IL-6平均水平为(58.37 ng /l±37.86)。GG患者与GC基因型患者IL-6水平差异无统计学意义(P = 0.2375)。虽然重度RA患者IL-6平均浓度较高,但轻、中、重度RA患者IL-6平均浓度差异无统计学意义。血清IL-6水平与基因启动子多态性、临床疾病严重程度或DAS 28评分无相关性报道。结论:RA患者血清IL-6水平明显高于正常对照组,证实了其在RA发病过程中的关键作用。我们的数据不支持IL-6启动子-174 G> C多态性作为RA的危险因素,似乎也不是RA患者IL-6水平升高的主要因素。
{"title":"Interleukin – 6 Serum Level and Single Nucleotide Gene -174 G/C promoter Polymorphism in Patients with Rheumatoid Arthritis / Iraq","authors":"R. Ibrahim, Firas M D Al-Tae","doi":"10.33899/mmed.2021.131144.1108","DOIUrl":"https://doi.org/10.33899/mmed.2021.131144.1108","url":null,"abstract":"Objective: To 1) assess IL-6 levels in the serum of patients with rheumatoid arthritis (RA). 2) study IL-6 promoter -174 G>C “single nucleotide polymorphism (SNP)” as an imminent factor for the disease development. 3) find any relation between the level of serum IL-6 cytokine and other parameters such as age, gender, clinical severity of diseases and “disease activity scores (DAS28)”. Materials & methods: This research was carried out through a case – control approach at “Ibn – Senna Teaching Hospital” in Mosul city between November 2020 and July 2021. It included 61 RA patients diagnosed according to “ACR / EULAR 2010 criteria” and 50 healthy individuals. IL-6 serum levels were ascertained by ELISA and genotyping of IL-6 promoter was accomplished by “sequence-specific primerpolymerase chain reaction (SSP-PCR)”. Results: Mean IL-6 level in RA (69.42 ng /l ± 62.99) was elevated in comparison to healthy people (14.66 ng /l ± 23.58), P < 0.001. No age or gender effects on IL-6 concentration were noted. The ideal cut-off of IL-6 for discrimination of RA with best discriminative utility compared to healthy controls was 22.80 ng/l. At this value the IL-6 sensitivity was 91.8%, specificity 82.0% and accuracy rate 73.80%. G/G genotype was the most pervasive genotype in both RA patients and controls (70.5% in RA and 64% in healthy controls). However, it did not seem to be a risk factor for RA development compared to G/C or C/C genotypes “(OR = 1.3438, 95% CI=0.605-2.984,P=0.469)”. The mean IL-6 level in patients with GG genotype was (73.70 ng / l ± 71.09) compared to (58.37 ng /l ± 37.86) in patients with GC genotype. There was no significant difference in the IL-6 level between patients with GG and patients with GC genotypes (P = 0.2375). Although higher IL-6 mean concentration was reported in severe RA, however, no significant difference was found between patients with mild, moderate and severe RA respectively. No correlation of serum levels of IL-6 with genetic promoter polymorphism, clinical severity of diseases or DAS 28 score were reported. Conclusion: The concentration of serum IL-6 was elevated in RA in regard to healthy controls which confirmed its pivotal role in RA pathogenesis. Our data did not support the role of IL-6 promoter -174 G> C polymorphism as a risk factor for RA, nor seem to play a major role in the increase of IL-6 level among our patients with RA.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78567826","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}