Muthanna Medical Journal

Thyroid Stimulating Hormone (TSH) levels can be measured accurately down to a very low serum concentration with an immunoassay. When the serum TSH level is in the normal range, measuring the T3 and T4 levels is redundant. The objective of this study is to study the relation of TSH levels postoperatively in thyroid surgeries with the timing for thyroxin treatment as a supplemental and suppressive therapy. A prospective cohort study was done on 84 patients underwent thyroid operations in Al-Yarmouk Teaching Hospital from March 2010 through November 2012. Patients underwent different thyroid operations (lobectomy, subtotal thyroidectomy and total thyroidectomy) for different thyroid pathology. Later, they were followed up by TSH assay in periods of 2, 4, 6 and 12 months postoperatively. Variables were compared by using the analysis of variance, ANOVA test. P – values equal or less than 0.05 and 0.01 were considered to be statistically significant and highly significant, respectively. The mean age of patients was 43.30 ± 10.19 years. The females made the vast majority of study sample (85.7%). Patients were divided into six groups: simple colloid goiters (17 patients), multinodular goiters (32 patients), solitary thyroid nodules (11 patients), Hashimoto’s thyroiditis (8 patients), Graves’ disease (8 patients) and papillary and follicular carcinomas (8 patients). The study revealed that all patients with malignant thyroid nodules (i.e. those with total thyroidectomies) and the vast majority of patients with Hashimoto’s thyroiditis were in definite need for thyroxin treatment post-operatively. Other patients were variable in their need and timing of treatment according to the histopathological results and the type of operations. In conclusion, measurement of TSH level postoperatively is a good indicator for need of thyroxin treatment and for dose adjustment with the help of pathological results and the type of surgery.

Cerebral palsy was a primary neuromotor disorder that affects the development of movement, muscular tone and posture due to injury to the developing brain in prenatal, natal, or post-natal period. cp is non progressive disease but it is changeable features with period. The objective of this study is to identify clinical types of cerebral palsy and neuro-disabilities associated with cerebral palsy patient. Data (2019-2020) on 100 children of cerebral palsy in central teaching hospital in Baghdad analysis include clinical patterns of cerebral palsy and topographic classification of spastic cerebral palsy. also, the complication and neurological disabilities associated with cerebral palsy. In this analysis found most of cerebral palsy patients (84%) were spastic according to topographic classification, (47%) of spastic cerebral palsy was diplegic type. (29%) quadriplegic cerebral palsy and (8%) of hemiplegic cerebral palsy. About neurological complication and disabilities associated with cerebral palsy, (79%) of cerebral palsy patients had speech disturbance. (53%) had epilepsy, (43%) Micro acephaly, (32%) of patients had growth retardation, (29 %) had ocular problems, and (15%) of cerebral palsy patients had mental retardation. In conclusions; the most common type of cerebral palsy was spastic cerebral palsy & according to a topographic classification diplegic spastic cerebral palsy was the most common type of Spastic cerebral palsy. About neurodisabilities associated with cerebral palsy, the most common disabilities were speech disturbance and epilepsy.

Paroxysmal symptoms are brief (lasting seconds to minutes) stereotyped symptoms occurring suddenly and many times a day, for days up to a few months. The Objective of this study is to investigate the prevalence of paroxysmal symptoms in multiple sclerosis patients and their correlation with the demographic data of the patient, type of MS, duration of the illness, severity of the disease, radiological findings and disease modifying therapies. A cross-sectional survey enrolled (100) patients with multiple sclerosis, conducted in the Multiple Sclerosis Clinic in Dr. Saad Al-Witri Neurosciences Hospital – Baghdad during June 2019 – December 2019. (29%) of the participants had reported paroxysmal attacks of various types. Betaferon® and Rebif® were found to be significantly correlated with absence of PS. Patients with paroxysmal attacks had longer duration of disease. Patients with PS had significantly lower EDSS score. Highest proportion of patients had paroxysmal paresthesia (34.48%). In conclusions; paroxysmal symptoms are common presentations in multiple sclerosis initially or during the course of the disease, with paroxysmal paresthesia being the most common among them. Betaferon® or Rebif® might be a good choice for patients who are experiencing paroxysmal symptoms. Paroxysmal symptoms tend to occur with the least disabled MS patients and longer disease duration.

The objective of this study is to evaluate the effectiveness of Epley’s maneuver and Betahistine dihydrochloride on the improvement of patients from BPPV and to comparing the outcome of the use of Betahistine dihydrochloride with the outcome of the use of Epley’s maneuver.
This is a prospective and comparative randomized study in Basra Teaching Center of Otolaryngology in which fifty patients were included in this study their age range between (42-65) years, all of them complaining from BPPV. These patients divided into two groups. The first group was treated by Epley’s maneuver and the second group was treated by oral intake of Betahistine dihydrochloride tablet. All patients evaluated at the end of this period by presence or relieving from symptoms and by positive or negative Dix-Hallpike test. A 50 patients were 33 males (66%) and 17 females (34%) and the mean age value for all the patients were in the sixth decade (56.5) years. The improvement from vertigo symptom was statistically significant for the two groups and it was also significant when comparing the two groups which was better in first group and the improvement from associated symptoms like nausea and vomiting and headache was significantly different between the two groups and it was better in the second group.
Epley’s maneuver gave a good result in relieving patients of vertigo in patients had BPPV while Betahistine dihydrochloride gave a good result in relieving patients from associated symptoms of BPPV.

Breast cancer commonest cancer of urban Indian women and the second commonest in the rural women. It has different epidemio-clinical characteristics compared with European countries. The purpose of this study is to investigate prognosis and survival rate of breast cancer patients related with Ki-67 proliferation index in multicenter through retrospective study. We reviewed all patient’s data in registration center of Medical Oncology Departments, in the period 2016-2020. Data has been collected on 760 breast cancer patients. Our resulted data showed most prevalent comorbidities associated with breast cancer were cardiovascular diseases, diabetes and anemia. Ki-67 index >28% mostly associated with early age female, lymph node involvement (p=0.001), advanced tumor grade (p=0.00012) and risk of relapse (p=0.004). Survival rate was decreased in patients with (ER, PR, Her2 negative (triple negative breast cancer.

Osteoid osteoma is a benign tumor formed of osteoid and woven bone surrounded by a halo of reactive bone. This lesion is most common in young patients. The classical surgical treatment for this tumor include curettage, en bloc resection and wide resection and have been applied for many years, the success of classical surgery has been reported as 88-100%. Minimally invasive method which is represented by radiofrequency ablation has been proven to be a safe and effective method. The objective of this study is to evaluate the clinical success of radiofrequency ablation in treatment of osteoid osteoma at various sites (except spine and pelvis) and comparing the results with open surgical curettage. Thirteen patients with Osteoid osteoma (7 female and 6 male). Their ages were between 7-36 years, the osteoid osteoma localized in extremities, (six were treated by x- ray guided radiofrequency ablation and seven treated by open surgical curettage) at Al-Sader medical city and the Iraqi specialized center in Al-Najaf city. From June 2018 to August 2019 with a follow up period ranged from 6-12 months. Pain severity were evaluated by using visual analogue scale before and after the procedure. The VAS scores for all osteoid osteoma patients treated either with radiofrequency ablation or with surgical excision significantly decreased except for one case treated with radiofrequency ablation in which recurrence had been reported. There was absence of few patients at time of six months follow up visit. There were no significant intraoperative complications, like pathological fracture. In conclusions, surgical curettage is potentially an effective method without any recurrence. RFA is a safe and effective minimally invasive treatment.