Muthanna Medical Journal

Perinatal asphyxia is a common neonatal problem that contribute significantly to neonatal morbidity and mortality. Total number of patient enrolled in our study was one-hundred seventy-one. Data collected from October 01, 2013 to the September 30, 2014. Many variables are included such as GA, BWT, gender, mode of delivery, maternal age, parity and their ANC. In addition, a number of risk factor were encountered; maternal anemia, maternal hypertension, maternal DM, PROM, prolong labor, meconium- stained amniotic fluid, maternal fever, fetal distress, multiple gestation and APH. As a result, there is no gender difference between patient and control. Among patients group, the predominant mode of delivery was induced vaginal delivery (38.02 %), most of the mothers were primipara (61.16%) with irregular ANC seen in 55.37% of them. While among control group, the predominant mode of delivery was elective CS (40%), most of the mothers were multipara (60%) with regular ANC seen in 70% of them. (88.43 % of patients had risk factor versus only 44% of control had history of risk factor). We found that higher rate of induced vaginal delivery, primiparity and irregular ANC was reported among patients with perinatal asphyxia. Risk factors was more reported in patient group than control one. The less the no. of risk factors, the more possibility of good outcome.

The objectives of this study is to study the association of C-reactive protein in the pathogenesis
of meconium stained amniotic fluid in women presented in labour. A case control study, 90
women presented in labour 45 with meconium stained amniotic fluid (MSAF) and 45 clear
amniotic fluid (CAF), from March 2013 to July 2013 in the labour room and operative theater.
Data collected regarding their age, gestational age, mode of delivery, neonatal outcome, parity
and maternal blood for C- reactive protein. Complete physical examination of the neonate
regarding Apgar score, color of baby, response to a catheter in the nostril, muscle tone, heart
rate and breathing was done. There was a significant increment in the level of C- reactive
protein in women with MSAF. We concluded that C- reactive protein may be involved in the
pathogenesis of MSAF.

To evaluate the effect of test duration on the sensitivity and specificity of positive urease test for the detection of Helicobacter pylori in patient with duodenal ulcer and gastropathy, and to evaluate the difference of the results of rapid urease test in patients with duodenal ulcer compared to patients with gastropathy. 117 patient “75 patient with duodenal ulcer group (A) and 42 patient with gastropathy group (B)” were included in the study, two sets of gastric biopsies “each contain one antral and one corpus biopsy” were obtained from each patient, one set used to obtain urease test which was read at 30 minutes, 2, 10 and 24 hour after biopsy insertion into the reagent, and the other set used for histopathological examination. 68/75 (90%) patients were tested positive for Helicobacter Pylori by histopathological examination in group (A), in comparison to 35/42 (83%) patient in group (B). The sensitivities of the urease test at 30 min, 2, 10 and 24 hours in group (A) were 45%, 62%, 73% and 99% respectively, corresponding figures for the specificity were 92%, 83%, 80% and 80% respectively. While in group (B) the sensitivities were 42%, 59%, 69%, and 95% respectively, and the specificity was 96%, 88%, 83%, and 81% respectively. The optimum duration of incubation of urease test for a good sensitivity was 24 hours; rapid urease test does not correlate to disease severity.

We aimed to evaluate the influence of DM on the results of PCI of patents with CTO and to compare that with the results in non-diabetic patients. Prospectively studied 150 consecutive cases of CTO with PCI at Iraqi center for heart diseases- Baghdad/Iraq for the period January– December 2012. Success of revascularization of chronic total occlusion by percutaneous coronary intervention was similar in both sexes (male 69.4%, female 72.4%). Intervention was successful in (40) out of (55) patients with diabetes mellitus (72.7%) which was identical to those without diabetes mellitus (66 patients out of 95 patients 69.47%). The success in diabetic and non- diabetic groups in the absence of other risk factors was (64.2%) and (62%) while in the presence of these risk factors it was (73.1%) and (71.2 %) respectively. In (11) out of the (15) patients with diabetes failed intervention was attributed to inability to pass the wire (73.3 %) compared to (23) out of the (29) non-diabetic patients (79.3%). While failure to pass the balloon was identical in both groups (13.3%) compared (13.7) and failure to pass a stent while it was not reported compared to (3.4%) in both diabetic and non-diabetic patients respectively. As far as failure of procedure, passing the wire into a false lumen occurred in one patient (6.6%) of diabetic group, while creation of perforation had occurred in one patient (6.6%) in diabetics. Successful revascularization has led to a prompt relieve of symptoms; angina and improved exercise tolerance as well as enhanced left ventricular function equally in both groups. Regarding CTO- PCI, there was no much difference between success in diabetic and non-diabetic.