Al-Nisour Journal for Medical Sciences

Pain is "an uncomfortable sensory and emotional experience related to existing or potential tissue
damage, or defined in terms of such damage," according to the International Association for the Study
of Pain. Following a laparoscopic cholecystectomy, the patient experiences painful shoulder and
abdominal pain. Peritoneal stretching and diaphragmatic irritation by increased intra-abdominal
pressure brought on by pneumoperitoneum are two possible reasons of this pain. Presence of this pain
may cause uses of analgesic drugs, to provide a better level of analgesia for patient undergoing
laparoscopic cholecystectomy and reduce the consumption and the side effects of opioids
Sixty adults males and females (Male was 14 and female was 46) were involved in this study and
they underwent a general anesthesia, In all selected patients, pain score was recorded by used
numerical pain score and Wong-Baker FACES Pain Rating Scale, and After the full recovery of the
patient, we record the pain score (combined numerical and face pain scale) for the patient each 5
minutes until 30 minutes (1min, 5min, 10min, 15min, 20min, 25min and 30 min).
There little difference between intravenous acetaminophen and intravenous morphine in control postoperative pain in laparoscopic cholecystectomy, in comparison between study group and American
Society of Anesthesiologists (ASA) found at (10 min) there was little difference between group A&B
in minimum with mean pain score (A=4.37, B=4.3) and at (15 min), there was little difference
between group A&B in mean pain score (A=3.87, B=3.97).
the acetaminophen (paracetamol) can be used as alternative to morphine to reduce post laparoscopic
cholecystectomy pain and reduce the consumption of opioids and the side effect associated with it.

The general anaesthesia inductions may cause hemodynamics disturbance. These responses are
often suppressed by administration of remifentanil. In this study the aim is to assess the effects of
infusion Remifentanil on hemodynamic stability during general anesthesia. This prospective study
we collects 50 healthy patients aged between 20 to 65 years scheduled for elective surgery in
Baghdad teaching hospital with ASA, (I. II). All these patients received 1mcg/kg/min remifentanil
by continuous infusion over 30 minutes. The recording of mean arterial, heart rate, respiratory rate
and peripheral oxygen saturation 10, 5 minutes pre induction, throughout infusion and at 5, 10, 15
Minutes after induction. The results showed decreases in heart rate and blood pressure values during
infusion of Remifentanil and the value started to increase after the infusion is stopped. The
respiratory rate and SPO2 (peripheral O2 saturation) values reminded in the same limits during and
after infusion of Remifentanil with no major changes. Remifentanil infusion affectively attenuate
the hemodynamic response of the heart rate and blood pressure and there was significant decrease
in them during infusion with no significant effect on respiratory rate and peripheral oxygen
saturation.

Alkaline phosphatase is an enzyme produced primarily by the liver. Tests for alkaline phosphatase
can be part of routine lab work or part of a series of tests called a liver panel, which includes tests for
other liver enzymes, such as aspartate aminotransferase, or alanine aminotransferase. This study aims
to find out the effect of alkaline phosphatase enzyme on liver diseases and gallstones. Alkaline
phosphatase level was measured for fifty patients suffering from gallstone (30 patients), obstructive
disease (10 patients) and liver cirrhosis (10 patients). All patients grouped according to the ages (Each
five years as a group), all female patients grouped according to number of pregnancy. The data in this
study showed that there is a difference between males and females in terms of age in diseases
(gallstones, biliary obstruction and liver diseases) depending on the results of measuring Alkaline
phosphatase, where it appeared that the highest results of this enzyme for males with gallstones in
the age group (36-45 years) with a concentration of (192.75 IU/L), while for females with gallstones
is in the age group (46-55 years) with a concentration of (264 IU/L), as for biliary obstruction, it was
in the same age group for both gender (46-55) years, with a concentration of (203.5 IU/L and 345
IU/L) for males and females respectively). As for liver diseases, the age group for males was more
than 55 years, and females for the age group (45-55) years (170.33 IU/L and 165 IU/L), respectively.
The data also showed the female group with more than 7 time of pregnancy with high concentration
of ALP.

At Poly-cystic ovarian syndrome (PCOS) pathway and duration, there are Hormonic elevations in
Androgen and testosterone. Since PCOS is a metabolic disorder, the present study is designed to
monitor Leptin levels at PCOS, being there is a common cause between metabolic disorder and
PCOS.
All potential biological factors that affect Leptin levels were isolated, in order to monitor exclusively
BMI effect on serum Leptin levels at PCOS. The result illustrated that serum leptin level is not
associated with the duration of PCOS in proportion to non-significant statistics of the present results
which showed between leptin and PCOS duration, hence leptin hormone couldn't be a biomarker for
PCOS investigation or prediction. MI are associated statistically with PCOS duration according to A
two-tailed t-test, whereas BMI doesn't influence serum blood Leptin levels.

In a study where all patients (50) were chosen, the causes of the eccentricity issue with low energy
lenses (0.25D to 1.0D) and treatment options were examined. who wore visual techniques teaching
clinic at the College of Health and Medical Technologies-Bagdad. For the period from (1-9-2021 up
to 1-5-2022). The causes of deviation in the center of the lenses were studied determined the treatment
methods, it appeared that they occurred in the process of smoothing and centering. Process of the
lenses was determined by using Newton's rings examination kit and the diameter of the lens after
centrifuging and edges with several tools. In our study, it is to find suitable solutions for most of the
low-grade lenses available in the local markets, including physical therapy for patients, Itis used to
solve the problem of people with squint and others. most patients a treatment (56%) for patients within
physical exercises for them and the most common problems that occur in lenses (0.25 and 0.5D), with
a rate of 64% of the total number of lenses under study.

Thyroidectomy is a common surgical procedure that has several potential complications or sequels
including hemorrhage, vocal cord palsy, and laryngeal edema. Aim of study: To study the incidence
of complication that occurs during induction, maintenance and recovery from subtotal
thyroidectomy surgery. The current study began on November the 1st, 2021 till April the 17th, 2022
in Baghdad Teaching Hospital at the General and ENT surgical departments; it included 50 patients
(45 females, and 5 males). Pre-operative Medical history and physical examination was practiced
and recorded, all surgeries was performed under general anasthesia with endotracheal intubation,
with continuous monitoring during and after surgery.
According to their age the patients categorized into group of 20-29 years of age (16 patients, 32%
of the total cases) 14 female 28%; 2 male patients 4%. Group of 30-39 years age (12 patients 24%
of the total cases) female 10 patients 20%; male 2 patients 4%. Group of 40-49 years age (15
patients, 30% of the total cases) female 15 patients 30%; male 0. Group of 50-59 years of age (7
patients 14% of the total cases) female 6 patients 12%; male 1 patient 2%. According to the gender
females was 45 patients (90%); while the males was 5 patients (10%). Total toxic goiter was 29
cases 58% and nontoxic goiter 21 cases 42%. The goiter was toxic in 25 female patients (50%) and
in 4 male patients (8%). Nontoxic goiter in females 20 patients (40%) and in males 1 patient (2%).
As expected this study concluded that thyroid diseases are more common in females than in
males. Complications can be reduced by limiting the practicing of thyroid surgery to the surgeons
specialized in thyroid surgery.

Klebsiella pneumonia is a very deleterious microbes that is essentially take gram dye staining &
considered gram negative when stained by gram staining method and appear microscopically as bar
or rod in shape which have very mucoid large specific colonies on blood agar medium due to potential
ability to produce large glycocalyx and muco- polysaccharides that link together to secrete large
biofilm and slime layer which in turn increase invasive ability of microbes to host and become
resistant to several effective drugs , increase these ability being widely observed in highly
evolutionary strains that have multi-virulent factors like muco-polysaccharide capsule , slime layer ,
biofilm in association with extremely drug resistant genes , so these bacterial strains now is
demonstrated as hypervirulent Klebsiella pneumonia (hvKp) involved in several chronic infections
worldwide .To identify the new resistant hypervirulent strains of Klebsiella pneumonia in hospitalized
patients suffering from chronic urinary tract infections (UTI) along with catheters related patients and
to determine the ability of these dangerous strains to resist strong effective antibiotics like Imipenem
.Urine samples were collected from 150 urinary tract infection patients admitted in different hospitals
and specialized centers of Baghdad province , then all specimens were manipulated in laboratory and
cultured in special bacterial media to improve Klebsiella pneumonia species and to exclude other
bacteria , also further identification were done by selective tests like biochemical estimation of
IMVIC and vitic-2 system along with biofilm determination and antibiotic sensitivity for certain
antibacterial agents.
This study have results that depend on hypervirulent ability of new emergence bacterial strains
to resists the lethal action of strong bactericidal agents like imipenem, so 70% females and 30% males
from 100 Klebsiella pneumonia isolates were 41% resistant to imipenem were as only 4%
Esherishia.coli (E. coli) resistant strains to imipenem from a total of 150 urine samples (100 were
Klebsiella pneumonia & 50 were E. coli). High percentage of imipenem resistance by Klebsiella
pneumonia bacteria indicates that these isolates differ in virulence ability to classical nosocomial
strains of klebsiella and have multi-resistant genes on their plasmid and chromosomal DNA that play essential role in wide distribution among peoples and from a medical points that become a very sever
to be treated and controlled.

Several studies are exploring the possibility that people who are already nearsighted, have unusually
high levels of aberration or show greater adaptive delays. The main aim of this project is to calculate
accommodation & its effect on hypermetropic & myopic subjects Were had been 80 cases in a normal
state but of her cases, 34 were myopic and hypermetropic when examination found differences
between the amount of accommodation in hypermetropic and myopic. In myopic, the patients were
very comfortable because have a high degree of accommodation, but in hypermetropic the patients
had a low amount of accommodation because it has little accommodation and cannot uses at the high
degree when we examine the accommodation amplitude.

The impact of heat on the eye can lead to potential risks to ocular structures and visual function.
Prolonged or intense heat exposure can lead to various ocular manifestations. Dry Eye Syndrome is
a common consequence, attributed to increased tear evaporation and resulting in symptoms such as
redness, irritation, and blurred vision. The aims of study to evaluate the effect of heat on the eyes of
workers and people who use thermal bakeries while working on them during the day and to know the
surrounding factors in the workplace and their effect on the eyes. This study was conducted at
Baghdad (Mahmoudia Hospital) including some rural areas such as Yusufiya for six months from
1/December/2022 to 1/June/2023 for 100 patients (70) males and (30) females between 15-45 years
of age. A questionnaire was made for the demographic data, symptoms, refractive errors, period of
exposure and were examined by several visual instruments such as Snellen chart and retinoscope.
Among the most important problems they suffer from: headach and dry eye. The percentage of their
problems varied from mild to severe, depending on the severity of symptoms (period of exposure to
heat) and age. Treatment began to reduce the effect of exposure to heat. And also by giving them
moisturizing drops under the supervision of a doctor

Cholera is an infectious, acute bacterial disease caused by Vibrio Cholera. Watery diarrhea is the
predominant clinical sign of the disease. Around the world, it is thought to be responsible for up to 4
million cases annually. This digestive contagious is characterized by high-volume fluid loss and
electrolyte disturbances that may advance to hypovolemic shock and finally death. This survey study
seeks to discover how well-informed, how individuals in Diyala, Iraq, feel about cholera epidemics,
and how they behave in practice. In the present research, there were a total of 272 participants, with
a mean age of 20 to 29 years, 114 participant men and 158 participant women, 74% of them residing
in urban regions, and 68% having a college degree. The biggest number of those at risk 90.07% are
those who live in areas with polluted water, and the highest percentage of accurate illness diagnoses
76.84% While just a small portion of participants 51.84% are aware of illness treatments. Despite the
fact that a large majority of people—nearly 90%—know how to avoid cholera, only 51% of the
sample understood how to cure it. The results showed that there was no statistically significant
association between the demographic variables and the current study (age, Work, and residency).
Even if they are closely related to (gender, educational level), 69.49% of participants had excellent
understanding of the condition, while 27.21% have fair knowledge. The remaining percentage
respectively, had little expertise. There are simple main steps when taking into considered can
dramatically reduce risk of being infected with this disease particularly in area where the illness is
widespread include: washing hands routinely and ensure thatfood and water are safe to consumed

Corona virus disease is an infectious, viral disease caused by SARS-CoV-2 and resulted in high
percentage of morbidity and mortality throughout the world since December 2019. Several kinds of
vaccines developed after short period of time. Is determine the knowledge about Corona (covid_19)
among attendance in primary health care centers in Baghdad city. A cross sectional study performed
in Baghdad city with 100 persons selected conveniently who visit primary health care centers, which
are (Abdul-Saheb Al-dakhil, first Al-Hurriya and second Al-Hurriya primary health care center); the
study begun at December 2022 to March 2023. From the participants there were 32% aged 35-39
years old, 50% male and 50% female, 46% were married, 60% get bachelor degree or above. The
highest percentages of study sample were employee 28%. All participants were infected previously
with COVID-19. 85% know that virus has mutation. 73% think that vaccination is the best preventive
measure against this pandemic this paper has found overall good Knowledge levels among the sample
of Iraqi people.