Muthanna Medical Journal

Although tonsillectomy was the commonest procedure performed by otolaryngologists, there is no consensus among them to send the excised tonsils for histopathological study. The objective of this study is to determine the unique histopathological features of chronically infected tonsils and to evaluate the necessity for routine histopathological examination of excised tonsillar tissues. This prospective study was conducted in Al-Ramadi Teaching Hospital/ENT Department and Pathology and Forensic Medicine Department in Anbar Medical College, Iraq. Hundred adult patients with chronic tonsillitis were subjected to histopathological examination during the period from 1 January 2012 to 31 December 2012. The histopathological results showed features of chronicity in form of hyperplasia 200(100%), fibrosis 144(72%), surface ulceration 112(56%), crypt abscess 80(40%), bacterial colonies 48(24%), focal suppuration 16(8%) and focal necrosis 8(4%). No malignant or granulomatous changes were found in the examined tissues. In conclusion, there is a strong correlation between the clinical and pathological findings of patient with chronic tonsillitis. Granulomatous or malignant lesions were not recorded. This study support previous studies which reported that routine histopathological examination of the removed tonsils is not recommended unless suspicious findings like weight loss, history of cancer, neck mass, asymmetry of the tonsils and fungating or ulcerative tonsillar mass.

Despite wide spread use of epinephrine β2-agonists in infants with bronchiolitis since the late
1950s, the efficacy of these drugs remains unproven. The objective of the study is to determine
the effective treatment with subcutaneous (s.c) epinephrine versus nebulized salbutamol on O2
saturation and rate of admission to hospital in patients (age 2 years or less) with bronchiolitis.
Single dose of epinephrine (0.01 mg/kg) has been used across various age groups of 2 years or
less (maximum dose used was 0.15 mg) and no complications were reported suggesting that
the dose is safe; however, the maximum safe dose cannot be interpreted from this study. The
response to sc epinephrine in patients younger than 12 months was significantly better than in
older patients, suggesting a useful role of s.c epinephrine in bronchiolitis in this age. The s.c
epinephrine relieves clinical manifestations of respiratory distress (wheezing, chest retractions,
flaring of alanasi, cyanosis) and improves parameters of respiratory distress (oxygen saturation,
respiratory rate) in infants treated for acute bronchiolitis with maximal effectiveness at 30-60
minute. For s.c epinephrine, every patient had his own disposable syringe; while for nebulized
salbutamol, all patients share the same nebulizer. So that, s.c epinephrine may decrease the
likelihood of transmission of infection between the patients. The s.c epinephrine reduces the
admission rate (13%), compared to nebulized salbutamol (24%). The observation that peak
action of s.c epinephrine occurs 30-60 minutes after administration suggests the need for
caution in repetitive administration during this period

Poisoning in any medical centre is considered as one of the most common medical emergencies in children. Acute poisoning in children constitute about less than three percent of all pediatric emergency admissions. The aim of study; to evaluate acute poisoning in children below 15 year old admitted to emergency unit. Hydrocarbons were the most common poisonous substances leading to hospitalization; we had the highest frequency of admissions in winter. Further, the highest number of poisonous cases was in January and December 79 case and lowest rate 23 case was observed in October; there is an increasing trend in proportion of kerosene poisoning from December to February. The rate of suicidal attempt is very low in our study only 6 cases this result is contrary to other two studies, these are common in adolescent also related to the nature of social environment and learning in each area. In our society accidental kerosene poisoning, which the most common cause of the intoxicated patient admitted to the emergency unit, occur when the patient try to do procedure to prepare kerosene heater stove or for light (lantern). Only very few cases is related to suicidal attack in our study, We recommend to remove all the poisoning agent as soon as possible from the areas easily reach by the child (removal of poisonous plants and removal of fuel sources like kerosene). Poison control centre to triage poisonings, prepare service accurate and timely advice to health personnel and caregiver should be available in each governorate.

The goals of this study are detection of the prevalence of ESR elevation in patients whosuffering from pulmonary tuberculosis with positive sputum for acid fast bacilli and negative serological test for HIV, and showingthe effect of normal ESR ondiagnosis of active pulmonary tuberculosis. 37 patients of pulmonary TB with sputum positive for AFB and negative serological test for HIV, were involved in this retrospective study over145 days,at major TB center of Al-Hillacity, Iraq.The Westergren method used for detection of ESR for all patients. Of the total 37 patients involved in this study 21(57%) were males and 16(43%) were females. The ages of the male patients ranged from 21-82 years, and the females from 23-75 years in addition to one girl with age of 5-year. 22(59.5%) patients cigarette smoker and 15(40.5%) non smoker. 3 patients (8.1%) with ESR less than 20mm/hr, 13 patients (35.1%) with ESR 20-40mm/hr,12 patients (32.4%) with ESR 41-60mm/hr and 9 patients (24.3%) more than 60 mm/hr. According to dependent normal range in this study 7(19 %) patientswith normal ESR. 19% of patients involved in this study have normal ESR, so the pulmonary TB should be expected in any patient with suggestive clinical features even when the ESR is normal specially in an endemic area as in Iraq, and it is clear from result above that the smoking is important risk factor for pulmonary TB.