Iraqi National journal of Medicine

Background:
Peptic ulcers and other gastric lesions are significant
medical conditions. Endoscopy is one useful diagnostic tool, the use of
which is dependent on patient selection
Objectives:
This study attempts to explore how predictive selected
symptoms may be, along with their characteristics in diagnosing peptic
ulcer s and other gastric lesions in patients undergoing endoscopy.
Methods:
A cross-sectional study was conducted with 15 2 patients
referred to the endoscopic unit at Al Sadr teaching hospital in Basrah.
The patients were carefully interviewed to determine clinical and
sociodemographic characteristics. They were subjected to endoscopic
examination by a specialist physician, and their results were recorded
on the same information sheet. Data were analyzed using the
Statistical Package for Social Science, version 20.
Results:
Given the complexity of the risk factors, clinical
manifestations, and diagnostic techniques, it seems difficult to predict
which patients are likely to have peptic ulcers and which are not. In
this study, only self-reported stress and H pylori infection were found
to significantly predict the likelihood of peptic ulcers among patients
subjected to endoscopic examination.
Conclusions:
Patients subjected to endoscopy are expected to have a
variety of gastric lesions including peptic ulcer. A substantial
proportion of these patients were entirely lesion free

Intussusception is a very rare cause of neonatal intestinal obstruction particularly in preterm neonates T his rarity may lead to a significant delay in diagnosis. We present a case report of ileo ileal intussusception occurring in a preterm neonate. Intussusception should be suspected in any neonate suffering from intestinal obstruction performing an abdominal ultrasound may confirm the
diagnosis.

Background:


Lymphedema of the upper extremity is a serious consequence of breast cancer surgery. Postmastectomy lymphedema of the upper limb is usually related to many risk factors, like axillary surgery, radiotherapy, venous obstruction, obesity, and infection. In the current study, the objective was to identify the relationship between the extent of lymph node involvement and axillary dissection on the development of lymphedema.
Patients and methods:


One hundred and seventy patients managed by modified radical mastectomy with axillary dissection for mammary invasive adenocarcinoma between January 2009 and December 2016 in Al Fayhaa Teaching Hospital. The patients were divided into three groups according to the number of lymph nodes involved, by pathology. The patients had been followed up for at least two years and assessed by standard lymphedema assessment, then categorized into three groups, according to the severity of lymphedema.
Results:
After the analysis of patient parameters, the highest age group was 36-45 years. More than 60% of the patients had 4 9 lymph nodes involved. Forty-one patients from 170 developed lymphedema postoperatively. Forty patients had seroma and twenty-one patients had wound infection postoperatively.
Conclusion:
Post-mastectomy lymphedema is a sequela of disease process related to the extent of lymph node involvement and resection rather than an operative fault.

Background:
Sewage workers, who maintain the sewage system and provide an essential service for public health protection, may come in direct contact with sewage hazards which then may induce DNA damage and oxidative stress. The aim of this study
is to assess the level of nitric oxide, homocysteine, 8 OHdG, and vitamin s A & E in the plasma of sewage workers for different periods of exposure.
Results:
Nitric oxide, vitamin A, and vitamin E showed a significant reduction in sewage workers when compared with a
non-exposed control group. However, homocysteine and 8 OHdG
levels were increased in sewage workers when compared with the
non-exposed control group.
Conclusions:
Sew age workers are exposed to different pathways to a variety of toxicants that cause an increase in homocysteine. Homocysteine, in increased the DNA oxidative damage by increasing the concentration of 8 OHdG and decreasing nitric oxide and vitamins E & A through a decrease in the antioxidant and an increase in oxidative damage.

Background. Flexor tendon injuries are frequent, due to variable hand activities, and the repair is challenging to hand surgeons, especially in zone II, because of the coexistence of two tendons within a tight fibro-osseous tunnel. Flexor tendon repair under tumescent infiltration provides anesthesia and a bloodless field so that no tourniquet or sedation is needed.


Aim of the study. The goal of this study was to identify a surgical adjustment and intraoperative total active movement examination of the repaired tendon so that no gapping is formed, and smooth gliding is obtained, avoiding tendon rupture and producing an optimal range of motion.


Patients and method. From January 2016 to April 2017, 9 patients (17 tendons), with a mean age of 31.8 years, presented within 3 to 14 days of injury to zone I or zone II of their flexor tendons. Tendon repair was done under tumescent infiltration (lidocaine 1% with adrenaline 1:200,000) only, with no tourniquet or sedation, and with an intraoperative total active movement examination.


Result. After 6 months of follow-up, all the patients had an excellent range of motion according to the Boyes outcome scale, and none showed signs of postoperative tendon rupture.


Conclusion. Tumescent infiltration for flexor tendon repair allows intraoperative surgical adjustment and total active movement examination, which will minimize postoperative rupture and adhesion. This procedure will also facilitate the surgeon’s work by eliminating the need for general anesthesia or sedation; however, this procedure is not applicable for children, major trauma, or those who are mentally challenged.