Basrah Journal of Surgery

This is a main conventional surgical procedure with making a large incision to replace or repair tissue or an organ in the body. The surgeon may make an incision of up to ten inches to allow access to the organ.

What Is Laparoscopic Surgery?

Also known as keyhole surgery, Band-Aid surgery, diagnostic laparoscopy, and minimally invasive surgery. Laparoscopy is a surgery that is initiated by a small incisor.

The biggest benefit of laparoscopic surgery is that it is minimally invasive and therefore less painful. It is typically used for diagnosis and treatment. They heal faster and do not leave big scars too. Because the incisions are small, a lot of blood lose will be unlikely during the procedure.

Background: Kidney transplantation gives the best quality of life to chronic kidney disease patients and also increases
longevity.
Aim: Analysis of factors responsible for the early and delayed graft functioning in live and cadaver renal transplants
Patients and Methods: It was a retrospective observational study. Donor and recipient age, sex, BMI, comorbid illness,
and functioning status of the donor kidney, duration and severity of chronic kidney disease and associated bladder
disorders were collected. Operative factors like perfusion time, cold ischemia time, blood pressure fall, need for blood
transfusion, vasopressor support was recorded. Patients were divided into two groups based on early versus delayed
graft function.
Results: 27 cases of Live donor renal transplant and 23 cadaver transplants were included. The average age in live
donor and cadaveric transplants was 43.5 ±7.6 years and 38.3 ±10.5 years, respectively. 24 Live Transplant Recipients
had Early Graft function (89%). Seven Cadaveric Transplant Recipients had Early Graft function (31%) and 16 of them
had Delayed Graft Function (69%). HLA Mismatch, Perioperative Hypotension and BMI of recipient had statistically
significant relationship to Early Graft Function with p values of 0.02, 0.004 and 0.007, respectively. With p-value of
0.021 and of 0.046, respectively, perioperative hypotension and cold ischemic time in Cadaveric renal transplantation
had statistically significant relationship to Early Graft Function.
Conclusion: Live donor transplants have better early graft function. HLA Mismatch, Perioperative Hypotension, BMI of
recipient and cold ischemic time in Cadaveric renal transplantation are the predictors of early graft function.

Background : Globally, Diabetes Mellitus is a common health problem that occurs as a systemic disease
affecting vascular, nervous, skeletal, immune, and integumentary systems.
The aim: The aim of this study is to evaluate and highlight on the management outcome of diabetic foot in
AL-Hussein Teaching Hospital – Samawa / AL-Muthanna province and determine the risk factors
adversely affecting the treatment prognosis.
Patient and Methods: Fifty patients diagnosed with Diabetic Foot Ulcer (DFU) ulcer were included in this
study. The lesions were managed by removing dead tissue, triple antibiotic therapy, avoiding weight
bearing, and proper diabetes control.
Results:According to gender, the percentage of DF was 34 (68%) and 16 (32%) for males and females,
respectively. Moreover, the results showed that 22 (44%) and 28 (56%) display type I and type II DM,
respectively. Also, 23 out of 50 (46%) patients were poorly controlled, and ten of these cases (43%)
underwent amputation. According to Wagner Grading System; the patient's grade percentages were 2%,
30%, 20%, 22%, 14%, and 12 % for Grade 0, Grade I, Grade II, Grade III, Grade IV, and Grade V,
respectively. All non-responded patients were those treated at home, had poor cooperation, neglect, and
out-patient follow-up refusal and were subjected to amputation. The poorly controlled or uncontrolled DM,
Ischemic heart disease (IHD), leukocytosis, anemia, impalpable dorsalis pedis pulse/s, smoking,
neuropathy, patient's neglection and traditional home treatment were the common factors that revealed
significant adverse effects on conservative treatment. While hyperglycemia, hypertension and site of
management (surgical, orthopedic, out-patient or emergency departments) factors that revealed less or
non-significant adverse effects on conservative treatment.
Conclusion: this study showed that type II DM was the most diabetic foot lesion. The study also approved
that most patients were poorly controlled DM that ended with amputation, and most patients presented with
Wagner's grade I.
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Background : sexual disorder is very common after delivery and it's rate is still under researches . the
purpose of this study is to compare the effect of vaginal delivery versus caesarean section (C\S) on sexual
function
Patients: retrospective study have been done at AL Jenainah and Al Rebat Antenatal care clinic in Basrah
over a period of six months (10th May -10th November 2016 ) . 100 participant answered questionnaires
(6 months after delivery) were included in this study
Results :56women delivered vaginally with episiotomy and 44 delivered by caesarean section. mean age
is 28 years, all of them primiparous patients (had only one child).
80.4% who delivered vaginally and 72.7% who delivered by c\s were housewives ,44.6% (25 women),
30.4% (17 women) who delivered vaginally were finished secondary and high education respectively, while
31.8% (14women) , 38.6% (17women) who delivered by c\s were finished secondary and high education
respectively .
Out of the women only orgasm and satisfaction appear to be in high association with mode of delivery with
p-value (0.000, 0.002) respectively.
Conclusion: although our result showed strong association between orgasm and satisfaction with mode of
delivery still the other variables may be affected by other factors like breast feeding and contraception which
are not taken in consideration in our study
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Background : Background: Body weight and its perception are important aspects of health and constitute
a significant role in physical and mental well-being.
Aims: To estimate the prevalence of body weight misperception among adult females in Basrah city and to
show the main determinants that affect their weights,
perception.
Materials and Methods: This is a cross–sectional study conducted during the period from the 2nd of January
to the 1st of December 2020 on a sample of adult females who attended primary health care centers in the
city center of Basrah Governorate/South of Iraq, 400 adults agreed to participate and completed the
interview. The researchers designed and used an interview questionnaire, all females who included in the
study were interviewed, their weights and heights were measured.
Results: The study showed that about half of the studied females 211(52.7%) misperceived their body
weights. The association between body weight misperception and age was highly significant (p=0.001),
there is no significant association with the other studied characteristics.
Conclusions : The study showed that approximately half of the studied females misperceived their body
weights. Females tend to perceive their weights accurately as their ages increase. Highest percents of
weight misconception are for obese females who misperceived themselves as overweight and then for
underweight ones who misperceived their weights as normal. Recommendations: Comprehensive
intervention programs for women could be devised to raise self-awareness of their weight status, to
overcome weight misperception, and to prevent obesity and its related health risks

Background: Helicobacter Pylori(H.Pylori) is a very common bacterium infecting nearly half of population
worldwide. Its eradication is related to multiple factors including host immune state and treatment regimens.
Sufficient Serum Vitamin D may be associated with H. Pylori and its eradication rate.
The aim of this study is to find any association of serum Vitamin D and H. Pylori eradication success rate.
Patients and methods: 40 patients with upper gastrointestinal symptoms were involved in the study who
were infected with Pylori and their urea breath were over 50 count per minute .They were treated by
Levofloxacin- based triple therapy for 14 days, with estimation of their serum vitamin D. Re-testing done
after 8 weeks to assess the success rate of eradication.
Results: There was no association between serum level of vitamin D level and success rate of eradication
as p value was 0.111. The eradication success rate was 54%.
Conclusion: No association was found between serum vitamin D level and the eradication success rate of
H. Pylori.

Background: Alveolar bone loss is a significant factor in the breakdown of tissues in periodontal disease.
The condition compromises the structural integrity of alveolar bone by altering its microenvironment.
Numerous molecular activities, such as Alkaline Phosphatase (ALP), control the process.
Aims: This study aims to assess the level of salivary Alkaline Phosphatase with healthy gingiva on the
reduced periodontium and compare them to their level in periodontitis patients.
Patients and Methods: Seventy five participants, both male and female, who took part in this study had
their salivary ALP assessed. There were three groups formed from the participants: the first group clinically
healthy periodontium control group (n=15), second group consisted of generalized periodontitis stage II and
III (n=30), and third group healthy gingiva on reduced periodontium (n=30). Each group systemically
healthy. The entire unstimulated salivary samples were taken, and all subjects underwent a periodontal
evaluation, which included the assessment of clinical periodontal parameters (PLI, GI, BOP, PPD, and
CAL). The concentration of ALP in saliva is measured using the ELISA method.
Results: A moderate positive significant correlation was found between ALP with CAL in periodontitis and
positive weak significant correlation between ALP and CAL in excessive brushing group , as well as; the
result revealed that The mean of salivary ALP was significantly lower in the control group(20.33IU/L) than
both the periodontitis and the excessive brushing group, while between periodontitis(72.50 IU/L) and
excessive brushing (68.73 IU/L) there was no significant difference.
Conclusion: Healthy gingiva on reduced periodontium caused by excessive brushing is associated with
high salivary levels of ALP

Thyroid hormones affect practically all organs in the body and control the organism's basal metabolism.
The stomach and viscera are not spared, and thyroid dysfunction causes a variety of gastrointestinal
symptoms, the true prevalence of which is unknown. Digestive symptoms or manifestations may also
disclose thyroid disease clues, and if ignored or underestimated, diagnosis may be delayed, with dangerous
consequences. Thyroid interactions with the gastrointestinal system have been widely recorded, however,
there is no comprehensive report on the various effects of hypothyroidism in the literature. Although
gastrointestinal motor dysfunction is largely acknowledged as the primary cause of
symptoms, many complex phenomenaremain unknown. Hemorrhoids are a prevalent gastrointestinal
condition that is being identified in general health screenings. Many clinical signs, such as asymptomatic
piles or rectal bleeding, have a negative impact on quality of life.High intra-abdominal pressure and a fragile
supporting structure are also risk factors for hemorrhoids. Obesity, constipation, diarrhea, chronic or
persistent cough, pregnancy or delivery, and prolonged standing are all circumstances that might raise
intra-abdominal pressure. Hypothyroidism manifests itself in a variety of organs and tissues. Constipation
is the most prevalent gastrointestinal complaint in individuals with hypothyroidism, which can lead to
hemorrhoids.
Recent research suggests that a thyroid hormone deficit causes the muscles that lining the digestive system
to contract less forcefully. The accumulation of mucopolysaccharides, particularly hyaluronic acid, in the
digestive tissue, which causes intestinal edema, is the most likely pathogenic cause. This decrease in motor
activity lengthens the time that feces spend transiting through the digestive tract, allowing more water to be
absorbed and finally leading to constipation that increases the intraluminal pressure, and causes
compromisation of blood supply to the posterior anal wall and finally causes anal fissure.

Background : Periodontitis is caused by a microbial invasion and an inappropriate immunological reaction
of the host One of the mechanisms in the etiopathogenesis of periodontitis is alterations in the local and/or
general markers of oxidative stress. In order to defend themselves from the action of oxygen-free radicals,
Organisms that use oxygen in their cellular metabolism are supplied with defense systems. The term "the
system's antioxidative barrier" is frequently used to describe them. superoxide dismutase (SOD) is one of
the enzymatic antioxidants that preserves the cell against reactive oxygen species by removing superoxide
radicals and hydrogen peroxide, Melatonin is natural hormone in the body with antioxidant effects.
Aims: T he aim of this study is to evaluate the salivary levels of superoxide dismutase (SOD) and Melatonin
in patients with localized periodontitis versus generalized periodontitis.
Patients and Methods: Whole saliva samples were collected from 90 patients that divide into three groups:
35 generlized periodontitis , 35 localized periodontitis ,and 20 healthy subjects, Salivary samples were
collected from patients prior to clinical examination, Then levels of (SOD) and melatonin in saliva were
determined spectrophotometrically using enzyme linked immunosorbent assay (ELISA).
Results : salivary levels of both SOD and MLT were highest in control group and decreased in Localized
periodontitis and generalized periodontitis with lowest level in generalized periodontitis with significant
differences between groups.
Conclusion: Both localized and generlized periodontitis are associated with a decrease level of antioxidants

Background: hypospadias is a congenital anomaly of the urethra that is seen increasingly
in clinical practice. Distal hypospadias is the most common type of this anomaly and a
variety of repairs had been used to correct the deformity. The tubularized incised plate
urethroplasty (TIP) is one of the widely used techniques for this purpose .
The aim of this study was to evaluate the outcome of TIP repair in adolescents regarding
sexual and voiding functions.
patients and methods: A retrospective study including 38 male patients aged 15-16 years
was done in multicenter from 2003 to 2020.All the patients were having a distal type of
hypospadias which was repaired by TIP repair at childhood. The patients were assessed
for the presence of complications and for their voiding function. In addition, they were
asked about the occurrence of normal ejaculation.
Results: The mean age at surgery was 2.5 years .The study showed that 10 patients (26.3
%) gave a history of ejaculation with masturbation versus 28 (73.7 %) patients who denied
the history of ejaculation. The results showed that urethrocutaneous fistula was seen in 4
patients (10.5 %).Three patients (7.9 %) had meatal stenosis, one patient (2.6 %) had
urethral stenosis and another one (2.6%) had persistent chordee.
Conclusion: Snodgrass (TIP) repair is considered as an appealing surgical technique for
repair of distal type of hypospadias which accounts for the majority of hypospadias. It has
very good results regarding the outcome of surgery even at the long term period.

Solitary fibrous tumor (SFT) is a spindle cell neoplasm of mesenchymal origin. First reported in 1931, the pleura is the
most common localization of SFT, and it’s exceptionally rare in the kidney. Overall, it represents less than 2% of all
soft tissue tumors. In most cases, renal SFT (rSFT) presents with hematuria, flank pain, and a palpable mass. To our
knowledge, less than 112 cases of rSFT have been reported. We report a case of rSFT of a 30-year-old male thought
to be a renal cell carcinoma (RCC). Radical nephrectomy (RN) was done to remove a large right-sided mass invading
the inferior vena cava. Immunohistochemistry confirmed the diagnosis of SFT showing positivity for CD34, CD99, and
Bcl-2 protein, with no staining for cytokeratin. A post-operative CT (15 months) showed tumor recurrence in the renal
compartment with huge inferior vena cava thrombus extending to the external iliac veins. With this case, we illustrate
and highlight the importance of this diagnosis because of the uncertain biological behavior and prognosis of these
tumors

Basidiobolomycosis of the colon is a very rare fungal infection disease. We report here primary
colonic Basidiobolomycosis as the first female case in Iraq. A 48 years old Insulin dependent
diabetic patient presented with abdominal pain , right side abdominal mass and weight loss for few
months duration. CT scan revealed caecal wall thickening without intestinal obstruction.
Colonoscopy revealed large fungative ulcerated mass in caecum but the mucosal biopsy was
negative for malignancy and in favour of chronic inflammation .Laparotomy with right
hemicolectomy and ilio-transverse anastomosis done. Histopathological examination of the
excised specimen prove Basidiobolomycosis of colon for which she received 6 months course of
oral Itraconazole . She recovered well from the disease with no sequela or recurrence .

Because paragangliomas of the urinary bladder are extremely rare and difficult to diagnose, histological evaluation is sometimes the sole leading indication for diagnosis. We present a case of an adult woman with paraganglioma of the urinary bladder who presented with a single episode of hematuria and severe hypertensive crisis during its transurethral resection and whose diagnosis was only confirmed after histological analysis of a transurethral resection specimen, which was later treated with open radical cystectomy and Studer Ileal orthotopic neobladder.