Pub Date : 2021-06-01DOI: 10.33899/MMED.2021.129226.1069
S. Rashid, M. Naif, H. Farooq
Background: It is not uncommon to encounter edema like signal within the soft tissue of the posterior lumbar region in MRI of the spine; however the exact explanation of such edema is not established yet. Objectives: To find out relationship between edema like lesion in the soft tissue of the posterior lumbar region on spine MRI with BMI, age and gender. Patients and Methods: Lumbar Spine MRI of 288 outpatients suspected to have disc disease ( 150 females and 138 males ) performed on 1.5 Tesla facility was evaluated. Subjects with systemic or local disease likely to produce edema were excluded to obtain healthier subjects. The scans were reviewed for presence, site, and degree of High T2 edema like signal within the posterior lumbar soft tissue. The subjects were divided into four subgroups according to BMI and two groups according to their age (≤50 or>50 years old). The edema was scored from 0-5 based on its length relative to vertebral-body height. Correlation between the presence and extent of edema was made with BMI, age and gender. Results: Among the 288 cases, 116 (40%) patients had lumbar soft tissue edema. Association was found between the degree of edema and BMI ( P= .001) and with age ( P= .041) . The presence of edema was noticed to be significantly more among women (P=.045) , while the average level of edema epicenters was approximately similar ( L3.6 and L 4 consequently, P = .58). Conclusion: There is a positive relationship between the frequency and extent of posterior lumbar soft tissue edema with BMI and age .
{"title":"Lumbar Spine MR Imaging : Relation Between Edema Like Signal in the Posterior Soft-Tissue and Body Mass Index","authors":"S. Rashid, M. Naif, H. Farooq","doi":"10.33899/MMED.2021.129226.1069","DOIUrl":"https://doi.org/10.33899/MMED.2021.129226.1069","url":null,"abstract":"Background: It is not uncommon to encounter edema like signal within the soft tissue of the posterior lumbar region in MRI of the spine; however the exact explanation of such edema is not established yet. Objectives: To find out relationship between edema like lesion in the soft tissue of the posterior lumbar region on spine MRI with BMI, age and gender. Patients and Methods: Lumbar Spine MRI of 288 outpatients suspected to have disc disease ( 150 females and 138 males ) performed on 1.5 Tesla facility was evaluated. Subjects with systemic or local disease likely to produce edema were excluded to obtain healthier subjects. The scans were reviewed for presence, site, and degree of High T2 edema like signal within the posterior lumbar soft tissue. The subjects were divided into four subgroups according to BMI and two groups according to their age (≤50 or>50 years old). The edema was scored from 0-5 based on its length relative to vertebral-body height. Correlation between the presence and extent of edema was made with BMI, age and gender. Results: Among the 288 cases, 116 (40%) patients had lumbar soft tissue edema. Association was found between the degree of edema and BMI ( P= .001) and with age ( P= .041) . The presence of edema was noticed to be significantly more among women (P=.045) , while the average level of edema epicenters was approximately similar ( L3.6 and L 4 consequently, P = .58). Conclusion: There is a positive relationship between the frequency and extent of posterior lumbar soft tissue edema with BMI and age .","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74688709","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 : 2021-06-01DOI: 10.33899/MMED.2021.129464.1075
Mahmood A. Aljumaily, Y. Saleem, Saher H ALbanna
Background: Intertrochanteric femoral fracture (ITFF) is common injury in old age group, there are many options of treatment. External fixation used in the high risk patients. Objective: To present a case series of ITFFs treated by external fixators. Patients and method: Twenty six patients with ITFF were treated by external fixation in Alzahrawy private hospital in Mosul, during the period from July 2017 through October 2019. Results: The mean time of follow-up was 11 months. Twenty two patients showed full union of the fracture by the end of the 4 th month and the external fixators were removed. Two patients died due to unrelated medical diseases, and one patient developed pathological fracture in the shaft of femur. The patients had good range of motion in both hip and knee joints. Pin tract infection was the commonest complication. Conclusion: External fixation is simple, mini-invasive, cost-effective alternative method in the treatment of intertrochanteric femoral fractures.
{"title":"Intertrochanteric Femoral Neck Fractures Treated by External Fixation","authors":"Mahmood A. Aljumaily, Y. Saleem, Saher H ALbanna","doi":"10.33899/MMED.2021.129464.1075","DOIUrl":"https://doi.org/10.33899/MMED.2021.129464.1075","url":null,"abstract":"Background: Intertrochanteric femoral fracture (ITFF) is common injury in old age group, there are many options of treatment. External fixation used in the high risk patients. Objective: To present a case series of ITFFs treated by external fixators. Patients and method: Twenty six patients with ITFF were treated by external fixation in Alzahrawy private hospital in Mosul, during the period from July 2017 through October 2019. Results: The mean time of follow-up was 11 months. Twenty two patients showed full union of the fracture by the end of the 4 th month and the external fixators were removed. Two patients died due to unrelated medical diseases, and one patient developed pathological fracture in the shaft of femur. The patients had good range of motion in both hip and knee joints. Pin tract infection was the commonest complication. Conclusion: External fixation is simple, mini-invasive, cost-effective alternative method in the treatment of intertrochanteric femoral fractures.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82620678","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 : 2021-06-01DOI: 10.33899/mmed.2021.129441.1073
M. Khalaf, Israa Basheer Abd Allah
{"title":"The Value of Using Grey Scale Ultrasound in the Estimation of Palpable Breast Lumps in a Specialist Breast Clinic in Mosul City of Iraq","authors":"M. Khalaf, Israa Basheer Abd Allah","doi":"10.33899/mmed.2021.129441.1073","DOIUrl":"https://doi.org/10.33899/mmed.2021.129441.1073","url":null,"abstract":"","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88095099","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 : 2021-06-01DOI: 10.33899/MMED.2021.129534.1077
Samir Ibrahim Hasan AlSaffar
Background: The term "biloma" describes a well-demarcated, encapsulated or not, intra-abdominal (extrahepatic or intrahepatic) bile collection outside the biliary tree, secondary to iatrogenic, traumatic or spontaneous rupture of the biliary tree. The clinical symptoms of bilomas are usually nonspecific, ranging from no symptoms to abdominal pain, jaundice, and fever. There were only few cases of huge bilomas in the literature but no report of conincidental extrahepatic and intrahepatic biloma in the same patient. Case report: We report herein a 12 years boy with huge biloma (20cm in vertical diameter) after blunt abdominal trauma, presented with unique clinical features of marked emaciation and diffuse abdominal distention . To our knowledge this is the largest biloma ever reported in paediatric age group and the first biloma with such unique clinical presentation, and the first case with both extrahepatic and intrahepatic bilomas in single setting. Conclusion: Although biloma is rare condition but it needs to be considered in differential diagnosis of diffuse abdominal distension in patients following abdominal trauma or surgery.
{"title":"Huge Biloma in a child with unusual presentation","authors":"Samir Ibrahim Hasan AlSaffar","doi":"10.33899/MMED.2021.129534.1077","DOIUrl":"https://doi.org/10.33899/MMED.2021.129534.1077","url":null,"abstract":"Background: The term \"biloma\" describes a well-demarcated, encapsulated or not, intra-abdominal (extrahepatic or intrahepatic) bile collection outside the biliary tree, secondary to iatrogenic, traumatic or spontaneous rupture of the biliary tree. The clinical symptoms of bilomas are usually nonspecific, ranging from no symptoms to abdominal pain, jaundice, and fever. There were only few cases of huge bilomas in the literature but no report of conincidental extrahepatic and intrahepatic biloma in the same patient. Case report: We report herein a 12 years boy with huge biloma (20cm in vertical diameter) after blunt abdominal trauma, presented with unique clinical features of marked emaciation and diffuse abdominal distention . To our knowledge this is the largest biloma ever reported in paediatric age group and the first biloma with such unique clinical presentation, and the first case with both extrahepatic and intrahepatic bilomas in single setting. Conclusion: Although biloma is rare condition but it needs to be considered in differential diagnosis of diffuse abdominal distension in patients following abdominal trauma or surgery.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74680061","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 : 2021-06-01DOI: 10.33899/MMED.2020.128004.1044
Harith Al-Ali, L. Al-Allaf
Background: Obesity becomes one of the most universal medical problems that affects women at reproductive period. Aim: To highlight the placental changes in obese mothers and to determine their relation to the oxidative stress. Methods: This work is a prospective casecontrol study in which placentas were obtained from 60 singleton pregnant women who delivered at Al-Khansaa Maternity Teaching Hospital, Mosul, Northern of Iraq, starting from January 2020 to March 2020. The women were classified into three groups: Group 1: includes (control) women who have BMI ranged between 18-24.9 kg/m 2 (N=20), Group2: (Overweight) includes women who have BMI ranged between25-29.9 kg/m 2 (N=20), Group 3: (Obese) includes women with BMI ≥30 kg/m 2 (N=20).Two placental biopsies were obtained from maternal side and fetal side of each case and submitted for histological examination via light microscope. In addition, Fresh placental specimens (0.5gm) had been taken from all study groups and frozen until the time of procedure for oxidative stress analysis. Results: The Histological sections of group 2 and 3 placental discs revealed different histological changes in comparison with those of group 1. These changes include syncytial knotting ,villous hypovascularity, villous fibrinoid necrosis, thickening of trophoblastic basement membrane, cytotrophoblastic hyperplasia, perivillous fibrin deposition ,increase in number of nucleated red blood cells (NRBC), stromal fibrosis, chorangiosis ,paucity of vasculosyncytial membrane (VSM), villous edema, features of deciduitis, villitis, and increase the thickening of tunica media of the placental blood vessels. The biochemical analysis of the level of malondialdehyde (MDA) in the placental homogenates of the three study groups revealed a significant increase in homogenates of group 2 and 3 in comparison with that in group 1 indicating the presence of the oxidative stress. Conclusion: this work reveals a marked increase in the level of MDA in placental homogenates of the obese and overweight groups in comparison with that of control group suggesting the role of the oxidative stress.
{"title":"Evaluation of the histology and the oxidative stress status in the placentas of obese mothers","authors":"Harith Al-Ali, L. Al-Allaf","doi":"10.33899/MMED.2020.128004.1044","DOIUrl":"https://doi.org/10.33899/MMED.2020.128004.1044","url":null,"abstract":"Background: Obesity becomes one of the most universal medical problems that affects women at reproductive period. Aim: To highlight the placental changes in obese mothers and to determine their relation to the oxidative stress. Methods: This work is a prospective casecontrol study in which placentas were obtained from 60 singleton pregnant women who delivered at Al-Khansaa Maternity Teaching Hospital, Mosul, Northern of Iraq, starting from January 2020 to March 2020. The women were classified into three groups: Group 1: includes (control) women who have BMI ranged between 18-24.9 kg/m 2 (N=20), Group2: (Overweight) includes women who have BMI ranged between25-29.9 kg/m 2 (N=20), Group 3: (Obese) includes women with BMI ≥30 kg/m 2 (N=20).Two placental biopsies were obtained from maternal side and fetal side of each case and submitted for histological examination via light microscope. In addition, Fresh placental specimens (0.5gm) had been taken from all study groups and frozen until the time of procedure for oxidative stress analysis. Results: The Histological sections of group 2 and 3 placental discs revealed different histological changes in comparison with those of group 1. These changes include syncytial knotting ,villous hypovascularity, villous fibrinoid necrosis, thickening of trophoblastic basement membrane, cytotrophoblastic hyperplasia, perivillous fibrin deposition ,increase in number of nucleated red blood cells (NRBC), stromal fibrosis, chorangiosis ,paucity of vasculosyncytial membrane (VSM), villous edema, features of deciduitis, villitis, and increase the thickening of tunica media of the placental blood vessels. The biochemical analysis of the level of malondialdehyde (MDA) in the placental homogenates of the three study groups revealed a significant increase in homogenates of group 2 and 3 in comparison with that in group 1 indicating the presence of the oxidative stress. Conclusion: this work reveals a marked increase in the level of MDA in placental homogenates of the obese and overweight groups in comparison with that of control group suggesting the role of the oxidative stress.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81820666","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 : 2021-06-01DOI: 10.33899/MMED.2020.128677.1054
Inam Al-abady, Muna A. Kashmoola, Khalid N. M. Al-khero
Background: Chronic myeloid leukemia (CML) is a clonal malignant neoplasms of pluripotent hematopoietic stem cell described by the excessive proliferation of mature granulocytes and their precursors in the bone marrow and peripheral blood. It is characterized by the presence of Philadelphia chromosome, a translocation between chromosome 9 and 22 or BCR-ABL1 gene. Objectives: To evaluate clinical and hematological parameters in patients with chronic myeloid leukemia and to assess the risk stratification of these patients according to Sokal and European Treatment Outcome Study (EUTOS) scoring systems. Setting: This case series study conducted at Ibn-Sina Teaching Hospital/Outpatients Hematology Department from November 2019 to April 2020. Patients and methods: Total seventy patients with chronic myeloid leukemia included in this study. They involved 64 old cases and 6 new cases. The records of old cases were reviewed for clinical history, clinical examination, previous blood counts, bone marrow study and genetic study, where ever it was available. For new cases clinical history and physical examinations were noted. Complete blood pictures, biochemical tests and molecular study (BCR-ABL) were done at private laboratory. The BCR-ABL done by real-time reverse transcription polymerase chain reaction using Xpert BCR-ABL Ultra test on Cepheid GeneXpert® Dx System. All patients were categorized into different risk groups by using Sokal and European Treatment Outcome Study scores that calculated according to standard formulae. Results: The males were (57.1%) of patients and females were (42.9%) with male to female ratio was 1.33:1, their age ranged from 16-82 years with a mean of 41.9 years. The most common complains were fatigue (87.1%), fullness in the abdomen (78.6%) and constitutional symptoms (64.3-74.3%). About 96% of patients had splenomegaly at presentation. The mean total leucocyte count was 153.7 x10 9 /L, basophilia found in (72.9%) of patients and anemia in (85.7%) of them. By Sokal score, (25.7%) of patients were categorized as low risk, (52.8%) as intermediate risk and (21.4%) as high risk. According to EUTOS score, (60%) of patients were categorized as low risk, while (40%) of them as high risk. There were significant differences in high and low risk groups between two scoring systems (P-values 0.016, 0.000). Conclusion: Middle age groups (35-54 years) were commonly affected by chronic myeloid leukemia and males were predominance over females. Fatigue, fullness in the abdomen were the most common complains, while splenomegaly was the most common clinical sign. Majority of the patients, when categorized by the Sokal score, fall under the lowand intermediate-risk groups, the same is true for the EUTOS score, which, however, does not have an intermediate risk category.
{"title":"Clinico-Hematological Profile in Patients with Chronic Myeloid Leukemia","authors":"Inam Al-abady, Muna A. Kashmoola, Khalid N. M. Al-khero","doi":"10.33899/MMED.2020.128677.1054","DOIUrl":"https://doi.org/10.33899/MMED.2020.128677.1054","url":null,"abstract":"Background: Chronic myeloid leukemia (CML) is a clonal malignant neoplasms of pluripotent hematopoietic stem cell described by the excessive proliferation of mature granulocytes and their precursors in the bone marrow and peripheral blood. It is characterized by the presence of Philadelphia chromosome, a translocation between chromosome 9 and 22 or BCR-ABL1 gene. Objectives: To evaluate clinical and hematological parameters in patients with chronic myeloid leukemia and to assess the risk stratification of these patients according to Sokal and European Treatment Outcome Study (EUTOS) scoring systems. Setting: This case series study conducted at Ibn-Sina Teaching Hospital/Outpatients Hematology Department from November 2019 to April 2020. Patients and methods: Total seventy patients with chronic myeloid leukemia included in this study. They involved 64 old cases and 6 new cases. The records of old cases were reviewed for clinical history, clinical examination, previous blood counts, bone marrow study and genetic study, where ever it was available. For new cases clinical history and physical examinations were noted. Complete blood pictures, biochemical tests and molecular study (BCR-ABL) were done at private laboratory. The BCR-ABL done by real-time reverse transcription polymerase chain reaction using Xpert BCR-ABL Ultra test on Cepheid GeneXpert® Dx System. All patients were categorized into different risk groups by using Sokal and European Treatment Outcome Study scores that calculated according to standard formulae. Results: The males were (57.1%) of patients and females were (42.9%) with male to female ratio was 1.33:1, their age ranged from 16-82 years with a mean of 41.9 years. The most common complains were fatigue (87.1%), fullness in the abdomen (78.6%) and constitutional symptoms (64.3-74.3%). About 96% of patients had splenomegaly at presentation. The mean total leucocyte count was 153.7 x10 9 /L, basophilia found in (72.9%) of patients and anemia in (85.7%) of them. By Sokal score, (25.7%) of patients were categorized as low risk, (52.8%) as intermediate risk and (21.4%) as high risk. According to EUTOS score, (60%) of patients were categorized as low risk, while (40%) of them as high risk. There were significant differences in high and low risk groups between two scoring systems (P-values 0.016, 0.000). Conclusion: Middle age groups (35-54 years) were commonly affected by chronic myeloid leukemia and males were predominance over females. Fatigue, fullness in the abdomen were the most common complains, while splenomegaly was the most common clinical sign. Majority of the patients, when categorized by the Sokal score, fall under the lowand intermediate-risk groups, the same is true for the EUTOS score, which, however, does not have an intermediate risk category.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77468123","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 : 2021-06-01DOI: 10.33899/MMED.2021.129023.1061
Noor Nazar Fadhl, Omaima Abdul Razzaq Zubair, R. Al-Wazzan
Background: Caesarean section is traditionally done when a vaginal delivery would put the mother or fetus's life at risk. Knowing the indications of the caesarean section will help to have an impression of this common type of the obstetric procedures. The aim of the current study was to examine the indications of caesarean sections which are undertaken in Mosul city hospitals. Methods: A cross-sectional study was done at eight hospitals in Mosul city and a sample of 671 women who were delivered by caesarean section was included in this study. The necessary agreement was obtained from all the participants in the sample. Study period: the study was done during the period from 15 th November 2019 to 15 th April 2020. The information was taken by direct interview with the women who were delivered by caesarean section and from their hospital case sheets. Results: Primary caesarean section was reported in 45.2% of cases followed by previous two or more CS in 32.3% and those with previous one caesarean section with other causes 22.5% with a very highly statistically significant difference (P=0.001). Fetal distress was the indication for primary caesarean section in one-quarter of cases 25.4% with a very highly statistically significant difference (P=0.000) from other causes. Maternal request constituted 11.5% of indications among the participant women and it constituted onequarter of causes among women with previous one caesarean section (P=0.000). Conclusions and recommendations: Primary caesarean section constituted the highest number among caesarean section indications in the current study, followed by previous two or more caesarean section and then previous caesarean section with other causes. Fetal distress was the highest indication in primary caesarean section cases. The study recommends to improve health education to the mother about the risk of caesarean section and possibility of normal delivery after primary caesarean section.
{"title":"Assessment of Clinical Indications for Caesarean Section in Mosul City Hospitals: A Cross-Sectional Study","authors":"Noor Nazar Fadhl, Omaima Abdul Razzaq Zubair, R. Al-Wazzan","doi":"10.33899/MMED.2021.129023.1061","DOIUrl":"https://doi.org/10.33899/MMED.2021.129023.1061","url":null,"abstract":"Background: Caesarean section is traditionally done when a vaginal delivery would put the mother or fetus's life at risk. Knowing the indications of the caesarean section will help to have an impression of this common type of the obstetric procedures. The aim of the current study was to examine the indications of caesarean sections which are undertaken in Mosul city hospitals. Methods: A cross-sectional study was done at eight hospitals in Mosul city and a sample of 671 women who were delivered by caesarean section was included in this study. The necessary agreement was obtained from all the participants in the sample. Study period: the study was done during the period from 15 th November 2019 to 15 th April 2020. The information was taken by direct interview with the women who were delivered by caesarean section and from their hospital case sheets. Results: Primary caesarean section was reported in 45.2% of cases followed by previous two or more CS in 32.3% and those with previous one caesarean section with other causes 22.5% with a very highly statistically significant difference (P=0.001). Fetal distress was the indication for primary caesarean section in one-quarter of cases 25.4% with a very highly statistically significant difference (P=0.000) from other causes. Maternal request constituted 11.5% of indications among the participant women and it constituted onequarter of causes among women with previous one caesarean section (P=0.000). Conclusions and recommendations: Primary caesarean section constituted the highest number among caesarean section indications in the current study, followed by previous two or more caesarean section and then previous caesarean section with other causes. Fetal distress was the highest indication in primary caesarean section cases. The study recommends to improve health education to the mother about the risk of caesarean section and possibility of normal delivery after primary caesarean section.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90729560","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 : 2021-06-01DOI: 10.33899/MMED.2021.129046.1064
I. Mahmood, Ali Abdulmuttalib Mohammed, H. Abdulwahid
Background: Dacryocystorhinosty is a technique applied to patients who complain of excessive tearing (epiphora) and demonstrate obstruction of the lacrimal outflow system. Objectives: The present study aims at studying the outcome and complications of endoscopic dacryocystorhinostomy EnDCR. Methods: This case series study was conducted to analyze 70 eyes related to 66 patients with epiphora and recurrent attacks of dacryocystitis who underwent EnDCR for the period from January 2018 to June 2019. Surgeries were done in 2 hospitals in Mosul namely; Al-jumhoory Teaching hospital and Al-Rabee Private hospital. Results: This case series study included 70 eyes of 66 patients (62 unilateral and 4 bilateral cases) complaining from epiphora excessive tearing and/or chronic dacryocystitis. There was 45 females (68.2%) and 21 males (31.8%) with F:M ratio of 2.1:1. The patients , ages ranged between 4-74 years of age with a mean age of 39 ± 18.31. The success rate of endoscopic dacryocystorhinostomy EnDCR in the present study was 97.15 % depending on clinical improvement of epiphora , endoscopic assessment for patency of the new ostium and passage of tears aided by pressing over the medial canthus. Hemorrhage was the most common complication and there was no serious orbital complication in our study neither during surgery nor in the follow up period. Conclusion: Endoscopic dacryocystorhinostomy EnDCR carries very good success rate with relatively not critical and low complication rate. Moreover, it has the advantage of overlooking unnecessary scar, the ability to operate both sides simultaneously and revising the operation in case of failure of surgery.
{"title":"Endoscopic Dacryocystorhinostomy: A Case Series Study from Mosul City","authors":"I. Mahmood, Ali Abdulmuttalib Mohammed, H. Abdulwahid","doi":"10.33899/MMED.2021.129046.1064","DOIUrl":"https://doi.org/10.33899/MMED.2021.129046.1064","url":null,"abstract":"Background: Dacryocystorhinosty is a technique applied to patients who complain of excessive tearing (epiphora) and demonstrate obstruction of the lacrimal outflow system. Objectives: The present study aims at studying the outcome and complications of endoscopic dacryocystorhinostomy EnDCR. Methods: This case series study was conducted to analyze 70 eyes related to 66 patients with epiphora and recurrent attacks of dacryocystitis who underwent EnDCR for the period from January 2018 to June 2019. Surgeries were done in 2 hospitals in Mosul namely; Al-jumhoory Teaching hospital and Al-Rabee Private hospital. Results: This case series study included 70 eyes of 66 patients (62 unilateral and 4 bilateral cases) complaining from epiphora excessive tearing and/or chronic dacryocystitis. There was 45 females (68.2%) and 21 males (31.8%) with F:M ratio of 2.1:1. The patients , ages ranged between 4-74 years of age with a mean age of 39 ± 18.31. The success rate of endoscopic dacryocystorhinostomy EnDCR in the present study was 97.15 % depending on clinical improvement of epiphora , endoscopic assessment for patency of the new ostium and passage of tears aided by pressing over the medial canthus. Hemorrhage was the most common complication and there was no serious orbital complication in our study neither during surgery nor in the follow up period. Conclusion: Endoscopic dacryocystorhinostomy EnDCR carries very good success rate with relatively not critical and low complication rate. Moreover, it has the advantage of overlooking unnecessary scar, the ability to operate both sides simultaneously and revising the operation in case of failure of surgery.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79266097","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 : 2021-06-01DOI: 10.33899/MMED.2021.129601.1079
Haitham Alnori
Uncinectomy is a safe procedure in experienced hands whatever technique is used. It is usually the first step in endoscopic sinus surgery and the first surgical maneuver the new rhinologist has to learn. The most familiar two methods of doing uncinectomy are the classic method, introduced by Stammberger in 1986, and Wormald‘s swing-door technique in 1998. The swing-door technique appears to be associated with a slightly higher risk of injury to the lacrimal duct. Simultaneously, failure to identify maxillary ostium and orbital penetration are both more common in the classic method. This study aims to review the different methods of doing uncinectomy during endoscopic sinus surgery and compare the most standard techniques regarding their efficiency and safety.
{"title":"Review of Different Methods of Uncinectomy in Endoscopic Sinus Surgery","authors":"Haitham Alnori","doi":"10.33899/MMED.2021.129601.1079","DOIUrl":"https://doi.org/10.33899/MMED.2021.129601.1079","url":null,"abstract":"Uncinectomy is a safe procedure in experienced hands whatever technique is used. It is usually the first step in endoscopic sinus surgery and the first surgical maneuver the new rhinologist has to learn. The most familiar two methods of doing uncinectomy are the classic method, introduced by Stammberger in 1986, and Wormald‘s swing-door technique in 1998. The swing-door technique appears to be associated with a slightly higher risk of injury to the lacrimal duct. Simultaneously, failure to identify maxillary ostium and orbital penetration are both more common in the classic method. This study aims to review the different methods of doing uncinectomy during endoscopic sinus surgery and compare the most standard techniques regarding their efficiency and safety.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76023835","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 : 2021-06-01DOI: 10.33899/MMED.2021.129565.1078
Arwa Albarhawi, Muhsin A. Sahib
Objective: To make a cyto-histological correlation and to evaluate the diagnostic efficacy of urine cytology in routine practice. Materials & methods: From January 2015 to June 2020, one hundred and thirty-nine cases have been included in this case series retrospective study. Subjects were collected from the Ghazi al-Hariri Surgical Specialties Hospital, Medical city, Baghdad, Iraq. Ranging in age from fourteen to eighty-six years, presented most frequently with hematuria, or diagnosed radiologically with bladder tumor, who underwent cytological examination with the histological examination at the same time or within one year. Results: Patients were mostly between sixty-one and seventy years old (36.7%). The studied group was made of male (61.2%) and female (38.8 %). Fifty-five patients who were diagnosed as negative/ benign in cytology examination, and histological examination at the same time, eight patients were diagnosed as high-grade urothelial carcinoma when they were diagnosed negative/ benign in cytological examination, four patients were diagnosed negative in histological examination when they were reported as high-grade urothelial carcinoma in cytological exam, thirty-four patients were reported as high-grade urothelial carcinoma, cytologically and histologically. The sensitivity of high grade urothelial carcinoma detection in suspicious or malignant cases in urine cytology was (80.95%), while the specificity (92.98%). positive predictive value was (89.47%) when negative predictive value was (86.88%). Conclusion: It has always been known that urine cytology is a powerful and an effective method for the screening of urothelial carcinoma; specifically, for high-grade urothelial carcinoma, and in follow up of patients after surgery or cystoscopy.
{"title":"Efficacy of Urine Cytology in the Detection of Bladder Urothelial Carcinoma: A Retrospective Study in Medical City-Baghdad","authors":"Arwa Albarhawi, Muhsin A. Sahib","doi":"10.33899/MMED.2021.129565.1078","DOIUrl":"https://doi.org/10.33899/MMED.2021.129565.1078","url":null,"abstract":"Objective: To make a cyto-histological correlation and to evaluate the diagnostic efficacy of urine cytology in routine practice. Materials & methods: From January 2015 to June 2020, one hundred and thirty-nine cases have been included in this case series retrospective study. Subjects were collected from the Ghazi al-Hariri Surgical Specialties Hospital, Medical city, Baghdad, Iraq. Ranging in age from fourteen to eighty-six years, presented most frequently with hematuria, or diagnosed radiologically with bladder tumor, who underwent cytological examination with the histological examination at the same time or within one year. Results: Patients were mostly between sixty-one and seventy years old (36.7%). The studied group was made of male (61.2%) and female (38.8 %). Fifty-five patients who were diagnosed as negative/ benign in cytology examination, and histological examination at the same time, eight patients were diagnosed as high-grade urothelial carcinoma when they were diagnosed negative/ benign in cytological examination, four patients were diagnosed negative in histological examination when they were reported as high-grade urothelial carcinoma in cytological exam, thirty-four patients were reported as high-grade urothelial carcinoma, cytologically and histologically. The sensitivity of high grade urothelial carcinoma detection in suspicious or malignant cases in urine cytology was (80.95%), while the specificity (92.98%). positive predictive value was (89.47%) when negative predictive value was (86.88%). Conclusion: It has always been known that urine cytology is a powerful and an effective method for the screening of urothelial carcinoma; specifically, for high-grade urothelial carcinoma, and in follow up of patients after surgery or cystoscopy.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73952454","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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