Thi-Qar Medical Journal

Background: the cutaneous manifestations of COVID-19 are increasingly reported and they are important clues
for early detection of SARS-CoV-2 infection.
Objective: To describe the different morphologies of skin and/or mucosal lesions associated with confirmed
COVID-19 adult patients who have been admitted to the main quarantine hospital in Dhi-Qar province.
Patients and methods: All confirmed COVID-19 patients were examined for mucosal and/or cutaneous lesion,
and those who had such manifestations were evaluated and subjected to a detailed history, a complete physical
examination and photography for documentation. The patients were classified into five groups according to
lesions’ morphology; maculopapular, urticarial, pustular and papulovesicular, vasculitic and miscellaneous
groups.
Results: Out of 3554 confirmed COVID-19 patients only 157 showed mucocutaneous manifestations, of
them116 patients were excluded for many reasons as cutaneous adverse drug reactions (CADR), other
infections …etc. The remaining 41 patients who represent (1.15%) were included and classified into;
maculopapular (29.26%), urticarial (24.39%), pustular and papulovesicular (17.07%), vasculitic (14.63%) and
miscellaneous (14.63%).
Conclusions: This study has shown that there are many cutaneous manifestations in COVID-19 disease that
may differ from one country to another, while some are constant around the globe, so it is important for any
doctor, not just the dermatologists, to recognize and bear these presentations in mind during this pandemic for
early detection, better treatment and prevention of SARS-CoV-2 infection, hopefully that one day this pandemic
is over by the collaboration of all of us.

Background: bacterial diarrhea is the most frequent gastroenterological disorder, and the main
cause of dehydration in many children, especially in Iraq, therefore the aim of this study
investigation the relationship between bacterial diarrhea and food types in children under two
years age.
Patients and methods: About 200 children suffering from frequent diarrhea in Al-alwiyah
Pediatric Teaching Hospital were enrolled during the period (April – August) 2020. Feacal
specimens were taken and examined by microscopy, and cultured on agar, incubated at 37°C for
18–24/ 8 h. The bacterial isolates were identified by different biochemical tests and serotyping.
Results: current study show about (40%) of bacteria causing diarrhea in child under two yea ce
Shigella species highest percentage
(21.25%) followed by E.coli (17.5%), so (26.3%) of child had rs, compare to non- bacterial
causing (60%).so highest percentages of bacterial diarrhea were recorded in male with age (1-6
months) as (21.3%) followed by (7-12 months) as (12.5 %); and females were having bacterial
diarrhea (55%) more than males (45%). As well as our study appearan an exclusive
breastfeeding compare to Bottle feeding (58.7 %). Conclusions: about (40%) of bacteria
causing diarrhea in child under two years, highest percentages of bacterial diarrhea were
recorded in male with age (1-6 months) as (21.3%), females were having bacterial diarrhea more
than males, as well as our study appearance Shigella species highest percentage followed by
E.coli so the type of feeding play an important role in increasing diarrhea rates in children under
2 years.

Acute myeloid leukemia comprises only 15% to 20% of acute leukemia in children. It remains a
challenging disease with an inferior treatment outcome in comparison with acute lymphoblastic
leukaemia (ALL).
This study aimed to document the clinical presentation and some lab. findings in children with Acute
Myeloid Leukemia (AML) treated in the Child's Central Teaching Hospital (CCTH) in Baghdad /
Iraq.
This retrospective study was conducted at CCTH in Baghdad, during the period from 1st January
2009 to 31st December 2012 on 49 cases who were diagnosed as AML. Down syndrome (DS) and
acute promyelocytic leukemia (APL), with undifferentiated leukemia were excluded from this study.
The average age of presentation was 5 years, and the median duration of symptoms was 4 weeks,
with male (M): female (F) ratio = 1.13:1. Eleven patients not received treatment either died or lost
follow-up. The most common presenting feature was fever & pallor in 100% followed by bleeding in
69%. Initial white blood cell count (WBC) > of 100×109/L was seen in 30.6% of patients. It can be
concluded that there was slight male predominance. Most common presenting feature was fever and
pallor, and the patients developed anemia (low levels of Hb%), leukocytosis (high WBC counts) and
thrombocytopenia (decreased platelet counts).

SUMMERY
Background:
Type 2 diabetes mellitus is a major public health issue. FGF21 is a key endocrine regulating protein factor
involved in ontogenesis and metabolism.
Aim: To assess the association of FGF21 gene polymorphism (rs499765 and rs838133) in Iraqi type 2
diabetic patients.
Methods: To assess the relationship between SNPs (rs499765 and rs838133) of the FGF21 gene and
T2DM, a case-control study of 200 people (100 T2DM and 100 controls) was undertaken. Tetra ARMS
PCR was used to genotype SNPs (rs499765 and rs838133) using specified primers after extracting DNA
from blood. Various statistical analyses were used to analyze the results.
Results: The differences in total cholesterol, VLDL, TG and HDL between healthy and diabetic groups are
significant. Genotyping of FGF21 gene for rs838133 SNP revealed a significant elevation of the number of
the AC carriers in the patient's group versus the controls group under the co-dominant model, the dominant
model and the over dominant were significantly increased the risk of T2DM by 1.91, 1.8 and 1.94 folds
(OR=1.91, P=0.0320), (OR=1.87, P=0.037) and (OR=1.94, P=0.0270) respectively. The analysis of the
rs499765 SNP failed to exhibit a significant variation under all examined inheritance models.
Conclusion: Carriers of the AC genotype of rs838133 SNP in FGF21 gene have a 1.9 folds risk to develop
T2DM in comparison to those of the wild genotype, rs499765 (C>G), is not linked to the T2DM in the Iraqi
population.

Background: Urolithiasis is a very common renal diseases.The management of patients that
suffering from urinary tract calculi may considered to be a health care difficult because of its
prevalence and recurrence
Aim: To compare the PCNL efficiency and complications in two groups of patients, one group
without history of previous renal stone surgery, and other group with recurrent renal stone after
previous PCNL or open surgery .
Materials and methods: A cross-sectional study that extended between January of 2019 till the
March of 2021, in Al Hussain Teaching Hospital , Thi-Qar governorate, involving 65 patients,
when they underwent PNCL . 40 cases classified as primary PNCL ( patient had no previous renal
surgery), and the rest of the cases (25 cases) are classified as secondary PNCL. These total cases
had been assessed for their age, gender, body mass index, stone criteria (in form of location, size,
site, opacification) .The outcome also assessed in form of operative time, hospital stay, stone
clearance, average hemoglobin drop, development of Pseudo aneurysm, pelvic injury, fever
postoperatively and whether the patient require blood transfusion or no.
Results: Even though male constituting a largest number among study population of the two
group, but there was no significant statistical difference their distribution according to the types ,
where p value less than 0. 05. As a clinical criteria regarding the distribution of the sites , locations
of the stones and stone opacity according to the types of surgical intervention, there was no
significant statistical difference.
As an acute and late complication, there was significant statistical difference in the blood transfusion
and post-operative fever, it was undependable because of the small number of the cases exposed to
such complication .Operative time was significally shorter in primary group ,also stone free rate was
significantly better in primary PCNL.
Conclusions: PCNL is effective and safe surgery ,done without fear of failure or higher risk of
complications .Previous renal surgery either open or PCNL not significantly affect outcome of
surgery

Background: COVID-19 is a dramatic event that covered almost all countries, regions and territories
across the world. Characteristically, the disease has high incidence rate, high mortality and enormous
impact on life and health.
Objective: This article describes the main epidemiological features of COVIUD-19 in Iraq during one
year period.
Methods: The data used in this study were record-based related to confirmed cases of COVID-19 over a
one-year period of time (February 24, 2020 to February 23, 2021). Data were compiled in an inventory
containing numbers of cases confirmed by the Ministry of health official outlets supported by two more
sources to affirm the consistency in numbers of daily cases. Excel sheets and functions were used to
prepare epidemic curves. The tables were prepared manually. The study was approved by The Council
of College of Medicine (Order No 7/37. 2656 on October 5, 2020), and by the Central Research
Committee at Directorate General of Basrah Health Services
Results: The results at national and governorate levels showed an early low scale incidence rate with
subsequent characteristics wavy pattern, with two major waves the first started by the end of May 2020
and the second by the end of January 2021. Apart from the fluctuation, no other uniform feature could
be identified across different governorates. In general incidence rate and cause-specific mortality rates
steadily increasing with time. The cases fatality ratio was declining with time. Governorates showed
great variation in the three epidemiological parameters (incidence rate, case-fatality ratio and cause
specific mortality rate.
Conclusion: The behaviour of COVID-19 in Iraq as elsewhere in the world is difficult to understand.
The characteristic fluctuations are likely to reflect factors related to virus behaviour, population
behaviour and public health interventions.

Osteomyelitis of symphysis pubis is rarefied existence with ensuing deleterious sequela if not
diagnosed swiftly and treated decently. Diverse reviews in publications about inflammatory,
infective, and septic insult at this locus. As a matter of fact the diagnosis of this entity is oftentimes
overlooked due to rareness,ambiguity,and resemblance with other simulating ailment thus impeding
the diagnosis with accompanying ramifications incorporating abscess. We present a case of
osteomyelitis of symphysis pubis in 23 years old male who misdiagnosed with durable deferral and
displaying as an abscess that mandating invasive intervention highlighting that physician should have
had lower threshold for maintaining suspicion of this infrequently encountered entity.