Kirkuk Journal of Medical Sciences

Background: Neonatal jaundice is a frequent cause of hospital admission. Its incidence has
increased in the last decade, affecting 65% of term babies and 80% of preterm babies. This study
aims to identify risk factors for severe hyperbilirubinemia and exchange transfusion in neonates.
 Methods: In Kirkuk city, a prospective follow-up study was conducted in the neonatal care unit (NCU)
of Azadi Teaching Hospital from 1st June 2019, to 1st June 2020. One hundred and sixty-four neonates
with hyperbilirubinemia were enrolled. Relevant data were collected upon hospital admission, and
patient management followed by American Academy of Pediatrics (AAP) guidelines, utilizing either
phototherapy or exchange transfusion with phototherapy.
 Result: Among 164 cases, the mean TSB level was 16.6 mg/dL. Significant TSB elevations were
seen in male neonates, Rh-negative mothers with Rh-positive babies, >37 weeks' gestation,
admission after 72 hours, history of affected siblings or received phototherapy, and family history of
hemolytic diseases. Mode of delivery, birth weight, cephalohematoma, infants of diabetic mothers,
and feeding types were not significant. Phototherapy was primary treatment. Infants needing
exchange transfusion had mean age 4.97 ± 2.24 days at NCU admission, TSB level 20.2 ± 2.84
mg/dL. Leading causes for ET were early maternity discharge and delayed NCU admission (72.4%).
 Conclusions: Neonatal severe hyperbilirubinemia was more prevalent in male neonates born >37
weeks, with Rh-negative mothers and Rh-positive babies, admitted after 72 hours, with a family
history of hemolytic diseases, affected siblings, or received phototherapy. Phototherapy was the
primary treatment, while the leading cause of ET was early maternity discharge and delayed NCU
admission.

 Background: Sore throat is a commonly observed condition in pediatric clinics and emergency
departments, with viral infections being the most frequent cause. This study aimed to assess the
impact of serum levels of ASO (anti-streptolysin O) and ADNB (anti-DNase B) in patients with sore
throat infected with streptococcus pyogenes.
 Methods: A cross-sectional study was conducted between December 15, 2022, and March 15, 2023.
A total of 317 sore throat patients aged 5 to 17 years were recruited from Samarra General Hospital,
Salahuddin General Hospital, private clinics, and ear healthcare centers. The control group comprised
80 healthy individuals matched with the study participants. Throat swabs were collected and inoculated
on blood agar and MacConkey media for microbial examination. Blood samples were also collected
from patients and controls to determine ASO and ADNB levels using ELISA-based assays.
 Result: The study's results indicate that 30.28% of the children were infected with streptococcus
pyogenes, with varying percentages of other bacterial infections observed. A significant association
was found between S. pyogenes infection and urban residence. Additionally, elevated levels of ADNB
(171.4±33.5 pg/ml) and ASO (390.5±108.1 IU/ml) were detected in S. pyogenes infected children
compared to the control group (p-value = 0.0001). The lower limit of ASO in infected children was
209.4 IU/ml, while the upper limit in the control group was 172.1 IU/ml.
 Conclusions: The study highlights significant alterations in immune markers ASO and ADNB levels
among children infected with streptococcus pyogenes, implicating their potential role in the
pathogenesis of the infection.

 Background: The liver, situated in the upper right abdomen, is vital for detoxification, protein
synthesis, bile production, and nutrient storage. This study aims to investigate the anatomical and
morphometric characteristics of neonatal livers in Kirkuk city.
 Methods: Between November 2022 and June 2023, an autopsy of 31 cadavers (aged 1-28 days, 40-55
cm in length, 2.9-5.4 kg) was performed in Kirkuk governorates. After cleaning with tap water, the
bodies were placed supine with an elevated chest. A longitudinal midline thoracoabdominal incision
allowed examination of the liver's anatomical position and surrounding structures.
 Result: The neonatal liver displayed a rubbery, solid consistency and had a reddish-brown color. It
occupied the upper portion of the abdominal cavity in the right hypochondrium. Anatomically, it
consisted of the right and left lobes, with small caudate and quadrate lobes present in the right lobe.
The right lobe constituted approximately half to two-thirds of the total liver volume. Gross inspection
revealed that the left lobe was smaller and more flattened compared to the right lobe. Its upper surface
was slightly convex and conformed to the diaphragm. The weight of the neonatal liver was 108.366
±32.11 grams, with maximum dimensions of 4.85-6.45 cm in height and 5.7-7.8 cm in length. The
transverse and anteroposterior dimensions of the right and left lobes measured (5.72, 3.15, 3.57, 2.93
cm) respectively.
 Conclusions: This study offers evidence on the anatomical features, location, shape, weight, and
morphometric parameters of the neonatal liver, utilizing caliper measurements to provide dependable
estimates of normal liver volume. It may serve as a valuable reference for future research endeavors.

 Background: The differentiation between Entamoeba histolytica (pathogenic) and Entamoeba dispar
(nonpathogenic), two morphologically indistinguishable species of Amoeba, is crucial for making
treatment decisions and advancing public health understanding.
 Methods: In the present investigation, spanning from January 1, 2023, to May 20, 2023, fecal
samples were procured from a cohort of 220 pediatric patients, aged below 15 years, who presented
with symptoms of diarrhea and/or abdominal discomfort. These patients sought medical attention at
the Pediatric Hospital, Azadi Teaching Hospital, and Kirkuk Teaching Hospital, all located in Kirkuk
City. The samples that exhibited positive results under microscopy were subjected to additional
analysis using ELISA technique.
 Result: The current data revealed that out of 220 stool samples examined with microscopy and iodin
preparation, 93(42.27%) specimens were positive for E. histolytica/E. dispar trophozoites and cysts,
while the remaining 127(57.73%) were negative for any amoebic stages. the male more infected than
women and highest among children 1-5 years. The percentage of positive specimens that were tested
with E. histolytica / dispar ELISA, these samples were microscopy positive and further confirmed
with DRG ELISA. Out of 93 stool specimens, 59(63.44%) were positive, while the remaining
specimens 34(36.56%) were negative despite been tested positive by microscopy. The DRG stool
ELISA revealed sensitivity and specificity (69.28 % and 97.91 %) respectively and predictive value
of (97 %).
 Conclusions: The standard diagnostic tool in the health sector is microscopic inspection, which
cannot distinguish between pathogenic and nonpathogenic amoeba ELISA is an alternate method for
microscopy screening confirmation. males infected more than women and 1-5-year-olds more than
others.