The Medical Journal of Basrah University

ABSTRACT This study was done in Basrah Maternity and Child hospital from January 2002 till the end of December 2002 to determine the proportion of children less than two years of age with diarrheal diseases among hospitalized children and to study the morbidity and mortality of these patients. A child less than two years of age with diarrhea represents the leading cause of hospitalization and constituted (35%) of the total admission during the study period. Infants less than one year of age represent (64.9%) of all cases of diarrhea and the remaining were above one year of age. About (74.9%) of these cases were acute diarrhea and (25.1%) were chronic cases. Age of less than one year and associated malnutrition were the two most important predictors of development of chronic diarrhea. Sex of patients did not influence the occurrence of acute and chronic diarrhea. The duration of diarrhea and the age of patient determined the outcome of cases. Acute cases among infants less than one year of age have higher mortality than those children above one year of age. No death reported for acute cases above one year. The case fatality for chronic diarrhea was (49 % for under I year and 7.15 % for those above 1 year) and it is about 8 times more than that of acute cases. This mortality rate is more than the reported rate in the literatures by about two times, reflecting the need for improving the management of these of children.

Abstract

ABSTRACT
Aim and Objectives: The aim of the present study is to determine a baseline data and estimates of maternal and neonatal health indicators, which can be used in establishing a pilot surveillance system in Mosul City. Study Design: Cohort study design. Participants: Nine hundred and forty three women and their live births new borns (n = 948). Study Setting: Al–Khansaa and Al–Batool maternity hospitals and related community. Methods: Cases were those pregnant women in the last trimester, who attended the mentioned maternity hospitals for delivery. Selection of the cases was on consecutive sampling basis. All information needed was included in a special questionnaire form prepared for this purpose. Cases were interviewed and examined at the time of admission and at the 7th and 42nd days after delivery (together with their newborns). Results: It has been found that 94.0% of the studied women received antenatal care. Maternal morbidity occurred in 99.4% in one or more of periods: the last four weeks of gestation, at the time of labour and puerperium. There was only one maternal death making a maternal mortality ratio of 106/100,000 live births. Almost all pregnancies ended with live births. Four fifth (86.6%) were within normal range of birth weight, and 77.2% showed Apgar score >7 at first five minutes of life. The estimated total neonatal morbidity was 61.6%, while neonatal mortality approached 17/1000 live births. Conclusion: The present study tried to indicate a set of indicators that can be used in a surveillance system to monitor the progress of maternal and neonatal health.

ABSTRACT
The study initially included 66 patients with clinical suspicion of celiac disease (CD). Forty-four (17 males and 27 females) fulfilled the diagnostic criteria of CD. The study revealed that the common histopathological finding of duodenal mucosa in CD was subtotal villous atrophy 22(50%), while total villous atrophy was found only in 6(13.6%) of patients. Also, 88.6% of patients had changes of gastric mucosa ranging from superficial gastritis to intestinal metaplasia. Gastric intraepithelial lymphocytosis (IEL) was found in 12(27.3%) of patients, and was significantly associated with both, the degree of duodenal changes and with H. pylori infection (P<0.05). On the other hand, H. pylori documented by histopathology was found in 30(68.2%) patients and by urease test in 33(75.4%) patients. We conclude that H. pylori infection is not uncommon in patients with CD, & Gastric IEL is an important histopathological finding, correlating with duodenal changes as well as H. pylori infection.

ABSTRACT
Objective: To compare the route of delivery among nulliparous women with & without an engaged vertex in the early, active phase of labor & to evaluate the significance of unengaged vertex in early active labor as a risk factor for cesarean delivery. Setting: labor room in Basra maternity hospital. Design: This is a prospective case- control study; the station of the fetal head was assessed among 80 nulliparous women at ≥37 weeks gestation in early, active labor (cervical dilatation ≥4 cm. with adequate uterine contractions). Variables were analyzed using Z-test. Results: among the 80 nulliparous, 36 had an engaged vertex & 44 had an unengaged vertex. The cesarean section rate for arrest disorders was significantly higher in the unengaged group (38.6%) than that in the engaged group (8.33%). 61.4% of nulliparous women with unengaged vertex had vaginal delivery. The sensitivity & specificity of unengaged vertex in nulliparous women in active labor as a test to predict cesarean section delivery were (38.6%) & (91.7%) respectively. Conclusion: among nulliparous parturients, an unengaged vertex is a significant risk factor for cesarean delivery but those parturients should have a trial of labor because about (61.4%) of them were succeeded in achieving vaginal delivery.

Abstract

ABSTRACT A prospective study was carried out during nine-month period (from 1st of December 2001 until the end of August 2002) in Basrah Maternity and Children Teaching Hospital. The aim is to assess the timing, frequency and severity of symptomatic effects of combined oral contraceptive (COC) users specifically to compare 21 days of active pill intervals with 7 days of hormone- free intervals in both current (COC user for ≥12 months) and new users (COC user for 3 months). Current users had pattern of symptoms that were observed significantly worse during hormone-free interval than during the three active-pill weeks for both 1st and 2nd cycles. 57% and 56% of them experienced mild pelvic pain during free period versus 19% and 16% during active-pills weeks in both cycles respectively (P=0.001), while moderate to severe pelvic pain, the corresponding percentages were 22% and 22% versus 9% and 8% (P=0.042). For Nausea, the percentages were 48% and 46% versus 31% and 30%. For bloating the corresponding percentages were 46% and 46% versus 18% and 16% (P>0.0001) and for breast tenderness the corresponding percentage in free period were 29% and 29% versus 16% and 15% in active pill interval in both cycles respectively (P=0.0004). The reverse was true when other symptoms were assessed like headache and mood changes. Regarding headache the corresponding percentages were 35% and 33% during free period versus 60% and 58% during active pill interval in both cycles respectively, and for mood changes, the percentages were 21% and 19% versus 50% and 47% respectively. Similar patterns for all previous symptoms were observed in new start COC users in both cycle 1 and 2 for pelvic pain, nausea, bloating and breast tenderness. These symptoms increased and became worse during hormone free interval while headache and mood changes became more severe during active hormone period than during hormone free interval. Breakthrough vaginal bleeding occurred more frequently in new start COC in comparison to current users. The percentages were 20% and 16% versus 5% and 3% in both cycles respectively. Menstrual flow decreased significantly in current users in comparison to new start COC (5% and 16%) respectively (Table-4). This study confirmed that most symptoms assessed were significantly worse during the 7 day hormone-free interval than during the 21 day of hormone-containing pills.

Abstract

ABSTRACT Skin diseases are common among children. However, only few epidemiological surveys are available in the literature. This study was conducted at Basrah Maternity and Children Hospital to determine the spectrum and pattern of skin diseases among children attended the pediatric outpatient clinic in this hospital. The study was carried out from January 2002 to January 2004. The total number of those children who had been examined was1251 with skin disorders and many of them had more than one disorder resulting in1274 skin disorders. The infections and infestations together were the most common (44.2%). The eczema / dermatitis constituted (39.0%) followed by bacterial infection (13.6%), parasitic infestations (13.2%), viral infections (9.6%) and fungal infections (7.8%). Atopic dermatitis was the most common type of eczema in children which constituted 12.5%. The most common disorders among infants was diaper dermatitis (31.3%), while in preschool and school age groups were impetigo (13.0%) and pityriasis alba (11.2%) respectively. The study documents that skin diseases in childhood are common and these data may be useful in planning for health care for children.

ABSTRACT
This is a cross sectional study carried out to study the factors that may affect the academic performance of 3rd
intermediate school pupils. Ten intermediate schools were chosen randomly from different areas in Basrah
Governorate for the period from 1st march-1st of May in 2004 (5 schools for girls and 5 schools for boys). The
study involved 480 pupils (240 girls & 240 boys), chosen randomly systematically (one of two). They were
interviewed and examined by the researcher using special questionnaire designed for the purpose of the study.
The school performance of the pupils were classified in 2 classes according to the result of the mid year exam.
It was found that the factors that had a significant effect on school performance include father’s education
level and occupation, mother’s education level, vision and hearing problems, school attendance, crowding index
and birth order. The study recommended provision of and proposal for education program to the parents to
help them to motivate their children, improve communication with teachers and administration staff, periodic
screening of vision and hearing, and education of teachers to be aware of pupils with problem and to recognize
their needs.

Abstract

ABSTRACT Metabolic syndrome increases the risk for coronary heart disease and stroke by three folds with marked increase in cardiovascular mortality. The aim of this work is to study metabolic syndrome in adult’s persons in Basrah in single center. A cross sectional hospital based study of adults persons including persons seen in the in-patient and out-patient clinic of the Al-Faiha General hospital over a period from January to August 2004, who agree to participate. The presence of 3 metabolic abnormalities is enough to establish the diagnosis of metabolic syndrome. The metabolic abnormalities were abdominal obesity, high serum triglycerides, low high-density lipoprotein cholesterol, hypertension, and high fasting plasma glucose. Total number of persons was 500, of them 152 women and 348 men. Age range 20-88 year, with mean age of 49.9± 11.3 year. Metabolic syndrome was seen in 332 persons (66.4%), 214 of males (61.4%), and 118 females (77.6%). There was a clear increase in the prevalence of the metabolic syndrome with increasing age up to the age of 79 year. In conclusion: This study reported high figure of metabolic syndrome. Adoption of Westeraern life in our society with overweight, physical inactivity, sedentary behavior, and unhealthy dietary habits may be the cause.

ABSTRACT
A seroepidemiological study was carried out in Basrah, southern Iraq from November 1997 until the end of
April 1998. Blood samples were collected from 3 sources; Basrah Maternity and Child Hospital, the primary
health care centers in Al-Zubair and Abu-AlKhasib. The relevant information’s were obtained from mothers
through interview and/or vaccination cards. An Enzyme linked Immunosorbent assay (ELISA) was used for
the detection of poliovirus IgG antibodies. Poliovirus antibodies were found in 92.85% with almost full
seroconversion among children above 2 years of age, while seronegative cases were present among infant’s
children below the age of two years and those with old vaccination history and not boosted with additional
booster doses. Malnourished children have relatively lower levels of antibody titer than well nourished children.
Number of vaccine doses given to the child have a significant effect on antibody prevalence where high levels
of immunity were found in children who received 5 doses or more while seronegative cases were detected
among children who had been given 4 doses or less, There were relatively higher seropositivity among
children who received an extra doses during the National Immunization Days (NID) than among those
who did not receive extra dose(s).The antibody levels in the blood is partially affected by age and the number
of vaccine doses given to the child where the proportion of samples with low antibody levels decreased as the
age and number of vaccine doses increases. There was clear evidence for the overtime antibody losses among the
unboosted children.

ABSTRACT
Knowledge of the frequencies and the phenotype of Rhesus system is very important for Blood Bank and transfusion service policies. This study was conducted on 2875 blood samples from Blood Bank in Teaching Hospital in Basrah to study different Rh phenotype in blood donors. The result showed that the frequency of Rh positive was found to be (93.1%) and Rh negative was (6.99%). The Rh phenotypes in 87 Rh negative blood samples present in decreasing order of frequency were as follows: rr, r1r, r11r, r1r11, r1r1, r11r11, ry . The results of this study were compared with the results of other studies.

Abstract

ABSTRACT This is a cross sectional study, carried out to study the profile of patients with headache, 300 patients attending the out-patient clinic in Al-Sadder Teaching Hospital in Basrah for the period 1st January-31st December 2003, were interviewed & examined by the researcher by using special question form. Primary headache found in 41.3% (tension type headache 25.7% and migraine 15.7% of the total) with a higher rate among females. Tension type headache was higher among age group 20-39 years and increasing with educational state, common among professional and administrative occupations, with higher rates among females. Migraine was higher among young male and older females and there was an inverse relationship with education and was higher among unskilled workers. Nearly ¾ of primary headache patients were using medication with a higher rate among migraine patients. Secondary headache contributed to 58.7% (mainly due to hypertension, febrile illness and 4 cases were due to brain tumor). The study recommended careful history and physical examination for establishing the diagnosis, &to prescribe appropriate treatment. Cranial CT scan and MRI may be needed for assurance of the patient of the absence of structural internal cranial lesion.