Iraqi National journal of Medicine

Abstract:





Background: Cleft lip deformity is one of the most common congenital anomalies. Repair of cleft lip may create too much tension especially when done in wide cleft lip, and this may result in unacceptable scar.





Aim of study: To evaluate the efficacy of botulinum toxin in reducing or preventing post cheiloplasty hypertrophic scar.





Patient and method: Between the period from October 2019 to August 2021, 10 patients with cleft lip were subjected to primary cheiloplasty using Millard rotation advancement flap technique followed by botulinum toxin injection into the site of repair. Follow up period was 6 months postoperatively.





Results: All of our patients showed excellent result which was evaluated using visual analogue scale assessment which was done by tow independent surgeons. Our patients showed barely visible scar at 6 months postoperatively with no recorded hypertrophic scar. No side effect was recorded related to botulinum toxin injection.





Conclusion: Botulinum toxin injection after primary cheiloplsty showed to be safe and effective in prevention of development of unacceptable hypertrophic scar.

Background After data has been sorted, statistical analysis is used to compare it. Statistical analysis was used to compare tuberculosis data from two different and distinct years in order to determine the extent of the development of this disease.


Aim This study aimed to estimate the annual incidence of registered tuberculosis cases in the Nineveh Governorate before and after the (COVID-19) pandemic outbreak. These injuries were compared with data on this disease recorded in Iraq, neighboring countries, and the world. To investigate the personal characteristics and fate of diagnosed patients was yet another aim.


Methods Data on diagnosed tuberculosis patients 654, and 249 registered in the Specialized Chest Disease Center in Nineveh for 1993, and 2021 respectively. Data for the year 1993 were recorded in a complete form for statistical analysis, while data for the year 2021 were recorded on the computer.


Results Despite the governorate\\'s population growth, the infection rate decreased from 37 cases per 100,000 people in 1993 to 4 cases per 100,000 people in 2021. In contrast, the incidence of extrapulmonary tuberculosis increased from 25% to 33% between 1993 and 2021, based on the number of recorded cases. In 1993, the age group (25-45) was the most affected, and the rate of infection in urban areas was 81% in 2021, with the rest of the rates being close.


Conclusion The study concluded that the results are consistent with Iraqi and global statistics, as there has been a significant and gradual decrease in injuries recently compared to previous years. This was attributed to vaccinations and raising health awareness among all age groups, as well as rural and urban residents, as well as the spread of COVID-19.

BACKGROUND: Choledochal cysts are rare congenital biliary tract malformations. Presentation is variable based on age at presentation and type of the cyst. Total cyst excision with biliary reconstruction is the treatment of choice.


AIM OF THE STUDY: to present our experience with the presentation and management of these rare malformations with literature review.


MATERIALS AND METHODS: A retrospective analysis of a series of seven patients managed during the period from June 2015 to July 2020 in our institution. Recorded clinical data included sex, age at presentation, mode of presentation, diagnostic modality, cyst type and histopathology, preoperative course, operative procedure, and intraoperative and postoperative complications.


RESULTS: Of the patients enrolled in the study, 5 (71.4%) were female and 2 (28.6%) were male. Age at presentation ranged from 7-36 months. Abdominal pain was the most frequent manifestation and was recorded in 6 (85.7%) patients. The diagnosis was confirmed in all patients with MRCP. Cysts were type I in all (100%) patients. Open total cyst excision with Reux-en-Y hepaticojejunostomy was the standard procedure in all patients. No significant intraoperative vascular or structural injury was recorded. Early postoperative complications were recorded in only 1 (14.3%) patient. All patients achieved good clinical outcome, and none have shown significant findings on long term follow up.


CONCLUSIONS: Choledochal cysts are rare congenital malformations with variable presentation. Total cyst excision with hepaticojujenostomy is a standard therapeutic option and is associated with an excellent outcome and decreased incidence of long term risks.

Pleuropulmonary blastoma (PPB) is Avery uncommon, mesenchymal malignant tumor in chest cavity that occurs mostly in children before preschool age (less than 6year old) . while it is the most popular primary pleural and lung tumor in children and adolescent malignancy. PPB has three macroscopically subtypes on a tumor have poor progression pathway start from cystic PPB (type I) to mixed cystic and solid (type II) and pure solid (type III). In the majority of PPB cases A gremlin mutation `need multimodal aggressive therapies including surgery and chemotherapy and/or radiotherapy. the study perform in Basra oncology center during eight years between 2012 -2019 have six cases of PPB male to female 1:1 most of cases less five years of old. most of cases were poor prognosis type II / III (mixed / pure solid) three cases type II and other three cases are type III and inspite of forceful treated by multimodal of treatment involved surgical ,chemotherapy and radiotherapy have poor destiny and the death rate 33.3%.

SUMMARY:


Phyllodes tumor (PT) of the breast is rare in adolescent females, particularly malignant ones. It usually occurs in middle aged and older women. Malignant phyllodes (MP) do have a recurrence and a metastatic potential, unlike benign or borderline PT. We present the case of a 16-years old female presenting with a 6- month history of a progressive enlarged left breast mass. Tumor was excised as a mass of 7 cm in maximum diameter and sent for histopathological examination. The Histopathology revealed features of malignant phyllodes tumor that were confirmed by immunohistochemistry.