Al-Kindy College Medical Journal

Electrosurgeryis the application of a high radio frequency of alternating polarity, electrical current to biological tissue as a means among many functions like cut, coagulate, desiccate, or fulguratetissue in surgical practice . Many surgeons have faced during their lifetime one or more of thecomplications of these devices . It is either electrical, laser, ultrasonic and mechanical

Background:Osteoporosis is a skeletal defect manifested by a reduction of bone strengthas a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma.Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.Type of the study: Cross –sectional study.Method: 84premenopausal females post hysterectomy aged between 40 –50 years, wereenrolled in thisrandomized controlled double blinded trailat Al Yarmouk teaching hospital and private clinic in Baghdad for a period of two years from Augest 2011 till July 2013. Participants were assigned as: 1stgroup (study group 42 women): received risedronate treatment "over a period of one year" with calcium and vitamin D;and 2ndgroup (control group 42 women) were taken as a matched group for:"age, body mass index (BMI) and fracture history", received only calcium and vitamin D as a placebo. Bonedensity had been assayed at the end of the year for all participants and evaluated for osteopenia and osteoporosis.Results:Osteopenia and osteoporosis were significantly lower in the risedronate arm as compared to those not received the drug "14.3% & 11.9% versus 26.1% & 19% respectively".Conclusion:The bone mineral density results were significantly better in those who received risedronate than those not received the drug.

Background:Conventional MR imaging is essential for diagnosis and evaluation of the posterior fossa tumors Objectives:To assess the value of diffusion weighted imaging and apparent diffusion coefficient in making distinction between different histological types ofposterior fossa tumors. Type of the study:Cross-sectional study.Methods:Brain MRI and DWI assessed 19 patients (12 female and 7 male) with MRI diagnosis of posterior fossa tumors. absolute ADC values of contrast -enhancing solid tumor region and ADC ratio of solid tumor to ADC of normal -appearing deep White matter were compared with histological diagnosis postoperatively .The mean ADC value and ratio were determined by using a 2-tailed T test. Results:In eight of medulloblastoma ,The mean ADC valuewas 0.67±0.14x 10-3 mm 2/s and ratio 0.86±0.19 , ependymoma (n=3), ADC value 1.09 ±0.14 x10 -3 mm 2 /s and ratio 1,43±0.13 , pilocytic astrocytoma (n=4) ADC value 1,72 ±0.27x10 -3 mm2/s and ratio 2.19±0.4, brainstem glioma(n=2) with ADC value1.18±0.06 x10-3mm2/s and ratio 1.64±0.08 , haemangioblastoma (n=1) with ADC value1.46x10-1mm2/s and ratio 1.87 , and meningioma with ADC value 0.72x10-3mm2/s and ratio 0.85. ADC values were higher in JPA than in ependymomas and medulloblastoma (P value 1. :

Background:Modifications of life style are often critically important to adequately control excising hypertension.Objective::to determine the source of information regarding hypertension and lifestyle modification practices in the management of hypertension in a sample of Iraqi hypertensive patients.Type of the study:Across-sectional study.:Methods: The study was conducted over a period of two months during November and December 2015 at Primary Health Care center of Baghdad Al-GidedaAwaland Bab Al Mudhum primary health care centers. The sample included 219 hypertensive patients (102 females and 117males). They were subjected to a structured questionnaire consist of socio-demographic characteristics, duration of disease and source of information and different questions related to life style modification practices in the management of hypertension, also all participants were subjected to height and weight and blood pressure measurement. Data analysis by using SPSS programme vertion18.Frequeny, percentage for each question responses was calculated andpercent score was measured .Results:The main sourceof information regarding lifestyle modifications was the health workers (37.8%). The included patients were in the 5thdecade, mean duration of disease was 5.55±5.12year, with mean systolic/diastolic blood pressure 142.6/ 89.3mmHg, obese with mean BMI 32.14±5.19 kg/m2.The dietary and drug intakelifestyle modification practices of patients were with higherpercent score (90% , 88% and 84%) regarding decrease alcohol intake ,intake of healthy oils,stop smoking and intake of fresh fruits and vegetablesrespectively while the lower percent score56% for intake of folic acid . Conclusions:The lifestyle modification practices regarding body fitness was highest 82% for enough rest while for regular physical exercise was 68%

BSTRACTBackground:The recognized procedures that have been used to treat gynecomastiaare said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade ofgynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia.Objectives:to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type GynecomastiaType of the study:This is a retrospective studyMethods:The study includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016.Results:23 patients (46 breasts) were successfully treated using thistechnique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), andno revisions were required.Conclusions:The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

BSTRACTBackground:The treatment of articular cartilage defects is one of the most clinical challengfor orthopedic surgeons. Articular cartilage is a highly organized tissue with complex biomechanical properties and substantial durability. However, it has a poor ability for healing, and damage from trauma or degeneration can result in morbidity and functional impairment. debilitating joint pain, dysfunction, and degenerative arthritis Objectives:The purpose of study is to show effectiveness of micro fracture arthroscopy as a method of treatment for such problem .Typeof the study:Cross-sectional study.Methods: Arthroscopic surgerywas doneto 52 patients who complain of knee pain limping and show clinical or radiological evidence of cartilaginous injury and we used arthroscopic micro fracture technique for those patient who have injury of no more than4cm2then we instruct patient to not putany weight over knee for 2-3 months and followed clinically according to Lyshlom scor and by MRI and some of them by second look arthroscopyto assess the healing.Results: Fifty two patients under go micro fracture arthroscopy .Thirty four patients (65.4%) reported good or excellent subjective results , thirteen patients (25%) had fair knee function, and only five patients (9.6%) reported poor resultConclusions:Micro fracture arthroscopy is a cheap effective method for repairing cartilaginous lesion .

ABSTRACTBackground:The world health organization estimates that worldwide 2 billion people still have iodine deficiencyObjectives:Is to make comparison between the effect of identification ofrecurrent laryngeal nerve (RLN) and non-identification of the nerve on incidence of recurrent laryngeal nerve injury (RLNI) in different thyroidectomy procedures.Type of the study:cross –sectional study.Methods:132 patients with goiters underwent thyroidectomy .Identification of RLN visually by exposure were done for agroup of them and non-identification of the nerves for the other group. The outcomes of RLNI in the two groupsanalyzed statistically for the effectof Identification of RLN on decreasing the incidence of the nerveinjury .The benefits of identification of RLN evaluated in each procedure ofthyroidectomy which were total thyroidectomy (TT), near totalthyroidectomy (NTT), and subtotal thyroidectomy (STT).Patients were followed up monthly for 6 months by indirect laryngoscopy for mobility of the vocal cords.Results:132 patients underwent thyroidectomy,258 RLNswereat risk, 124 nerves were identified and134 nerves were not identified,1 RLN was injured in identified group, and 8 RLN were injured in non-identified group. The pvalue was (0.0393) which was significant. TT were performed for 56 patients (42.4%) and total hemi thyroidectomy(THT) for 6patients(4.5%), there were 118 RLNs at risk, 64RLNs were identified and 54 RLNs were not identified.1RLN was injured in identified group, and 7RLNs were injured in non-identifiedgroup, the pvalue was(0.023)which was significant.NTT procedure were performed for 38 patients(28.8%) , 76 RLNs were at risk. 30 RLNswere identified and none of themwas injured, 46 RLNswere not identified, 1 RLN was injured the p value was(1)which was not significant.STT were performed for 32patients(24.4%),64 RLNs were at risk. 30 RLNs were identified and 34 RLNs not identified,there was no nerve injury in both groups .Conclusions:identification of RLN decrease incidence of RLNI in TT, while there was no significant increase of RLNI in NTT and STT when the nerve was not identified

Background:Several studies suggested that skeletal system is adversely affected by diabetes and is associated with increased risk of osteoporosis and fragility fracturesObjectives:The study was a case-control study that designed to assess the level of bone turnover markers (BTMs) among patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of body weight and diabetic control on the level of bone turnover Type of the study:Cross-sectional study.Methods:The present study included 100 postmenopausal women with type 2 diabetes mellitus. Sixty-six non-diabetic postmenopausal women were enrolled as a control. Fasting blood samples were collected to measure Alkaline phosphatase (ALP),stoeocalcin(OC), fasting blood sugar (FBS)and glycated hemoglobin (HbA1c). Urine samples were collected to measure deoxypyridinolin(DPD). The results were expressed as a ratio to urine creatinineResults:The mean level of serum osteocalcin was significantly lower in the diabetic group than in the control group,while the level of urinary deoxypyridinolinwas significantly higher in the diabetic group than in the control group . There was no significant difference in the level of Alkaline phosphatase between diabetic patients and control. An inverse association was found between osteocalcin with body mass index(BMI), glycated hemoglobin and fasting blood sugar. On the other hand appositive association was found between the level of deoxypyridinolin with body mass indexConclusions:Altered bone metabolic markers in patients with T2DM with more significant alterations in those who hsd poor glycemic control . Decrease in formation marker osteocalcin and increased resorption markers such as (DPD) has been found.

Background:Thalassemiasare a group of heterogeneous genetic disorders, in which the rate of production of hemoglobin is partially or completely suppressed due to reduced rate of synthesis of α or β-chain Objectives:to estimate the prevalence of Hepatitis C infectionamong B thalassemia patients attending Ibn-AL-Baladi center of blooddiseases in AL-Sader city, in AL-Resafa Quarter of Baghdad and to determine the possible risk factors.Type of the study: Cross-sectional study.Methods:A cross sectional study conducted on B Thalassemia patients attending the blood diseases center in Ibn-AL-Baladi hospital during the period from 1stof July till the 31stof December 2015. Results:All of 400 eligible patients, who were recruited to be included in this study, were accepted to participate in the study giving an overall response rate 100%. The prevalence rate of Hepatitis C according to anti HCV antibody test among the study group was 26%.Conclusions:we conclude that about quarter of Iraqi thalassemic patients visiting the thalassemia center in Ibn-AL-Baladi hospital have HCV infection