Al-Kindy College Medical Journal

Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD) as the chief modifiable contributor to residual cardiovascular risk, especially in conditions associated with insulin-resistant,and call to improve awareness and clinical management.The probable benefit of residual CVD risk reductionsuggests a role for treatment of persistently high TGconcentration even in statin – treated patients, with TG lowering agents including fibrates, niacin, omega polyunsaturatedfatty acids, and other non statin treatment.Therapeutic lifestyle changes including; medically assistedweight loss, physical activity, and dietary changes, as well as improvement of glycemic control should be an adjunct to lipid-lowering pharmacological therapies. Therapy should be concomitantly assessed for treatment tolerance and adequacy with focused laboratory evaluations and patient follow-up. Therapy should be boosted to attain goals according to risk level, and that even more intensive therapy might be warranted in patients with CVD history.

Background: Multidrug resistant methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community acquired infections. The glycopeptides vancomycin has been proposed as the drug of choice for treating such infections; this lead to the emergence of vancomycin intermediate sensitive S. aureus (VISA) and vancomycin resistant S.aureus (VRSA).Objectives: To identify the vancomycin resistance both phenotypically and genotypically among MRSA isolates from different hospitals and to determine the sensitivity of these isolates to different antimicrobial agents.Methods: A total of 204 S. aureus isolates were obtained randomly from various clinical specimens including (wound swab, burn swab, ear swab, urine, sputum, blood and other body fluids) from different inpatient and outpatient who were attending different hospitals in Baghdad. The susceptibility pattern of the S. aureus isolates to different antibiotics was determined by disk diffusion method and vancomycin minimum inhibitory concentration (MIC) for MRSA isolates were determined using broth dilution method following clinical laboratory standard institution (CLSI) guidelines. Van A gene was amplified by PCR using standard primers.Results: All VRSA isolates were MRSA. Twelve VRSA isolates were positive for van A gene, while the remaining ten isolates were negative. All VRSA had a vancomycin MIC of 16μg/ml or more. In the present study, VRSA showed resistance to a wide range of antimicrobial agents (ampicillin, cephalothin, cefoxitin, erythromycin, gentamicin, oxacillin, penicillin, rifampin, tetracycline and trimethoprim).Conclusions: There were high incidences of resistance to the commonly used antibiotics among VRSA isolates compared to VISA and VSSA. Further molecular studies such as PCR technique to identify genes rather than van A (e.g. van HAX analogue) might be suitable to predict VRSA lacking the

Background: The strategy for eliminating measles from Iraq includes conducting mass immunization campaign against measles, within the framework of the national strategic plan for the elimination of this disease. Awareness about this campaign is fundamental for their success.Objective: The study aims at finding out the knowledge, attitudes and practices regarding vaccination against measles among two groups of students in two different colleges ( medical and engineering) .To report uptake of Measles vaccine and reasons for declining the vaccine among medical and non-medical students in the campaignMethod: Across sectional study has been conducted at Al-Kindy College of Medicine/ Baghdad University and University of Technology for the period from first of December 2011 till fifteenth of April 2012. A convenience sample of 180 students of the first and second stage including (81 male, 99 female) students from Al- Kindy College of Medicine and 180 students (87 male, 93female) from University of Technology department of Mechanical Engineering. All students were given a questionnaire to assess their knowledge of the campaign and the vaccine.Results: Overall 55.8 % of medical and engineering students accepted the vaccine with higher uptake amongmales than females ( 58.9 % and 53.1% respectively). Almost 44.2 % of students who did not accept the vaccine gave their reason as having little information about the vaccine and said that the vaccine is ineffective.Conclusion: In spite of awareness of the effect of measles campaign among students of the Medical College in Baghdad University and University of Technology but the measles campaign in university students may have been more successful with better use of health education messages.

Background: Since its introduction to musculoskeletal imaging in the early 1980, magnetic resonance imaging (MRI) has revolutionized diagnostic imaging of the knee. It is therefore become the examination of choice in the evaluation of internal joint structures of the knee like menisci, cruciate ligaments, and articular cartilage.Objectives: to describe the MRI finding in various knee injuries.Patients and methods: A cross sectional study was done on 130 patients with history of knee injury in MRI unit at institute of radiology and al-Shaheed Ghazi Al-Hariri Hospital in medical city complex - Baghdad, from October 2011 to February 2013 includes 103 men, 27 women; the mean age was 33.86 years. MR imaging studies of the knee performed using a 1.5 T MR system. The sequences included coronal and sagittal PD, sagittal T2 FSE, fat suppressed T2 FSE, STIR axial and coronal. Knee MR studies were obtained to evaluate ligament, menisci, articular surface and bone pathologies of knee injuries.Results: MR images were normal in 15 patients; it was positive for meniscal tears in 59 patients and maximum involvement was in the medial meniscus and the posteriorhorn. These tears were classified into grade 1 (28.8%), grade 2 (11.5%), grade 3 (53.9%) and grade 4 (5.8%). Ligament tears were seen in 70 patients. Secondary signs associated with ligament tears were also assessed.Conclusions: MRI is an accurate, non-invasive technique for examination of the soft tissues and osseous structures of the knee. It has great capability in diagnosing meniscal tears and classifying them into grades and types, which would avoid unnecessary arthroscopic examination. It is a very good modality to diagnose complete tears of the anterior cruciate ligament (ACL).maging, meniscus

Background: overweight and obesity are the fifth leadingrisk for global deaths. At least 2.8 million adults die eachyear as a result of being overweight or obese. Numerousstudies show that weight loss, even if only 5-10%,significantly improves dyslipidemia, hypertension, diabetesmellitus, risk for osteoarthritis and its symptoms and risk forselected cancers.Objectives: is to evaluate the effect of diet and exerciseprogram on anthropometric and biochemical status of adultobese patients.Methods: descriptive study. 124 adult obese patientsattending Al Kindy obesity research and therapy unit duringDecember 2012 were included. Measurement of Wt, heightHt and WC performed and BMI was calculated. Laboratorytest analysis, on the fasting state, was performed for plasmaglucose, uric acid, Ch, Tg, and HDL, and LDL and VLDLlevels were estimated. Patients were advised aboutdecreasing their weight by decreasing calories intake byabout 500 calories daily with increasing physical activity toone hour of medium tension aerobic exercise for 3 monthsthen reexamined.Results: eighteen point five percents are males and 81.5% are females with mean age of 37.3 years, weight was reduced by 3 kilograms and waist by 6.6 cm and BMI by 1.9Kg/m2 within 3 months. Age groups, 30-39 and 40-49 yearsshowed better response (3.5-4 kg Wt loss), while males lost2.6 kg and female lost 3.8 kg within 3 months. Withreduction of total cholesterol by 17.3 mg/dl and reduction oftotal triglycerides by 24 mg/dl and reduction of LDL by 5mg/dl and of VLDL by 4.3 mg/dl and increment of HDL by1.8 mg/dl. Mean fasting plasma glucose fell by 6.3 mg/dland the uric acid level by 0.13 mg/dl.Conclusions: mean weight loss of this program was modest and middle age group responded to weight loss program better than young significantly, old and males respond less than females but insignificantly. In addition weight loss significantly resulted in correction of lipoproteins, blood glucose, and urate levels.

Published
2015-06-30
Issue
Vol. 11 No. 1 (2015): AL-KINDY COLLEGE MEDICAL JOURNAL vol.11 no.1
Section
Research Articles
How to Cite
Khazaal FAK, Leibi AH, Jasim I, alhergani Z. Weight loss program outcome of obese attending AL-Kindy obesity research and therapy unit. Al-Kindy Col. Med. J [Internet]. 2015 Jun. 30 [cited 2024 Dec. 15];11(1):21-4. Available from: https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/394
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Background: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration.Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniationMethods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were operated on, all of the cases required excision of disc through posterior approach in knee elbow position. The time between MRI taken and surgery was two weeks, from which the data were taken in a questioner forma which include name , age ,gender , occupation , chief complaint , duration, MRI findings and intra operative finding , from June 2011 to October 2013 at Al- Kindy teaching hospital .Results: In our study 75 patients were diagnosed by clinical examination and MRI finding to have disc herniation at lumbar region . The female more than male( 36 females , 12 males) and the ratio was 5-1, the accuracy of MRI against intra operative finding in deciding the provisional diagnosis as disc herniation was 68% .The commonest site was L4-5 disc herniation 43 patients (57.3 % ) , and L5-S1 prolapse is the next common disc herniation level 27 patient (36 % ) , L3-L4 disc herniation was two cases (2.7 %) and L4-L5 ,L5-S1 disc herniation was 3 cases (4% ).Conclusion: The most common level was L4-5 followed by L5S1.The MRI is more accurate in diagnosis of the lumbo-sacral disc herniation and its level in single one is more than multiple levels.Keywords: Disc herniation, MRI, Surgery, posterior approachAl

Background: Polycystic ovarian syndrome is one of the common gynaecological diseases encountered nowadays in the gynaecological clinic. Many criteria and diagnostic test had been evolved to be used with different classifications methods.Objectives: The present study aimed to measure the anti-mullerian hormone levels in serum of the women with Polycystic Ovary Syndrome and to test the possibility that if it can be used as a marker for diagnosis of polycystic ovary syndrome patients.Methods: A cross sectional study that had been conductedat Kamal AL-Samaraee Hospital, AL-Suwayrah Hospital andAl-Elwiya Maternity Teaching Hospital during the periodfrom July, 1st, 2013 – Jan. 1st, 2014. Where forty women withPolycystic ovarian syndrome (with mean body mass index of33.25±6.79kg/m2) were enrolled in the study group andbeing compared to apparently health women as a controlgroup that were matched for age and their (mean bodymass index was 27.63±3.51kg/m2). Clinical history,biochemical and hormonal analysis were determined forboth groups.Results: The mean serum of anti-mullerian hormone showed statically significant difference (P = 0.0001) in poly-Cystic ovarian syndrome patients compare to the controlgroup and when this hormone compared with other hormones that use for predicting the occurrence of PCOS as (LH , FSH , testosterone, prolactin and insulin), anti mullarian hormone showed the highest sensitivity and specificity as 82.10 % and 100 % respectively, with a cut off value of (>7.9) in Iraqi women.Conclusions: Anti - mullerian hormone could be the best marker in comparison with other hormones used for the diagnosis of PCOS.Keywords: Polycystic ovarian syndrome, anti-mullerian hormone, luteinizing hormone, follicular stimulating hormone.

Background: Type 2 diabetes mellitus (T2DM) is considered a global disease as it affects over 150 million people worldwide, a number that is supposed to be doubled by 2025. High glucose levels, in vitro, appear to raise the extent of LDL oxidation, and glycated LDL is more prone to oxidative modification.Objective: To investigate the relationship between serum level of vitamin E and lipid profile in patients with type II DM.Methods: This study involved 28 patients suffering from type II DM diagnosed 1-4 years ago and with age ranged from 17 -60 years old, with different residence around Basra ; In addition to 56 apparently healthy persons matched in age and sex to the patients as a control group. The medical histories were taken and General examinations were done to them with measurement of their height and weight. Four milliliters of venous blood was drawn from each patient and control to measure TG, TC, VLDL, HDL, LDL, HbA1C and Vitamin E and the results were used to assess the presence of any association between Vit E levels and lipid profile.Results: The mean levels for patients and controls of TG were (157.1± 24.9 and 119.8 ± 29.0) mg/dl, of TC were (204.0 ± 43.2 and 168.0 ± 31.5) mg/dl, of VLDL was (31.5 ± 5.0 and 24.2 ± 5.9) mg/dl, of LDL was (129.6 ± 42.8 and 97.6 ± 30.8) mg/dl, of HDL was (42.9 ± 10.2 ± 46.0 ± 9.0) Mg /dl, of HbA1C were (9.4 ± 3.0 and 5.0 ± 0.7) % and of vitamin E were (3.7 ± 1.3 and 6.8 ± 2.0) mg/dl, respectively.There was a significant difference between all the above measured parameters, except of HDL, between cases and controls. Also there was a significant association between DM type II and low level of vitamin E. there was a significant negative correlations between vitamin E and TG, TC, LDL, VLDL but not HDL, even after adjustment for age, sex and BMI.Conclusion: Diabetes mellitus type II has a significant effect on vitamin E which is an important guard against dyslipidemias, one the major causes of diabetes vascular complications

Background: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health information system performance.Results: The overall mean confidence for Health information system tasks was 69.41%, while for tasks competence, it was 37.1% and that of motivation level was 43.4%. The totalscore of promoting a culture of information was 63.96% with department provide reward for a good work revealed a total percent of 56.83%.Conclusion: It can be concluded that overall mean confidence for Health information system tasks is generally high compared to a low competency level for Health information system tasks, with a negative motivation feeling among respondents.Keywords: Health information system, organizational and behavioral determinant, OBAT tool, culture of information.

Background: Prolactin is a hormone, as well as a cytokine which is synthesized and secreted from the anterior pituitary gland and various extra pituitary sites including immune cells under control of a superdistal promoter that contains a single nucleotide polymorphism -1149 G/T. Rheumatoid Arthritis has been associated with increased serum prolactin levels.Objectives: To investigate the association of the extra pituitary -1149 G/T promoter polymorphism among Iraqi rheumatoid arthritis patients and prolactin levels.Methods: We tested 73 patients with rheumatoid arthritis and 40 healthy individuals. The DNA samples were genotyped using the Polymerase Chain Reaction-Restriction fragment Length Polymorphism method and the levels of prolactin serum were measured using Enzyme linked immunosorbent assay.Results: The parameters rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate and serum prolactin concentrations of rheumatoid arthritis patients were significantly increased compared with healthy controls. The frequency of T allele and TT genotype was highest in control group compared with their frequency in rheumatoid arthritispatients, vice versa the G allele and GG genotype. There issignificant differences in prolactin levels in rheumatoid arthritis patients compared with healthy controls according to PRL-1149 G/T polymorphism. In rheumatoid arthritis patients, carriers of the GG, GT genotypes had higher prolactin levels in comparison to TT genotype but did not show any significant difference.Conclusions: There is a possible association between prolactin levels and rheumatoid arthritis. We found correlation between rheumatoid arthritis and prolactin -1149 G/T polymorphism. The prolactin -1149 G allele is a genetic marker for increased rheumatoid arthritis susceptibility in Iraqi population. In addition, influence of prolactin -1149 G/T polymorphism on prolactin levels

Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild systemic diseases) of ASA (American society of anesthetists) undergoing elective orthopaedic surgeries were randomly assigned in two groups and (both of them have general anesthesia); Group A (10patients) received local infiltration of 0.5% bupivacaine before closure of surgical wounds and group B (10 patients) received local infiltration of 0.9% of normal saline. We use uniform technique of anesthesia in both at rest and on passive mobilization by nurses and residents groups. Visual analogue pain scale scores were assessedblinded to analgesic treatment and we check the needs for analgesic drugs post-operative in both groups.Results: Group A showed a significant reduction inpostoperative pain at rest and on mobilization afterinfiltration of 0.5% bupivacaine with short hospital stay andonly 3 patients need for post-operative analgesia ,while allpatients in group B require at least single dose of analgesialike pethidine or non-steroidal anti-inflammatory drugs.Conclusion: The use of 0.5% Bupivacaine by wound infiltration is effective for post-operative pain relief, as it reduces the requirements for additional post-operative analgesia after total hip and knee replacements.

Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were males, 209 (52%) case were females. Swabs for aural discharge were taken from those patients. Discharge is cultured by inoculating it into blood, Mac Conkey agar, chocolate agars and Sabouraud agar (for fungi).If the isolate shows to be Pseudomonas isolate growth then another culture of the isolate is performed on Muller Hinton Agar. Then the antibiotic susceptibility and resistance of Pseudomonas isolate is assessed by (Kirby-Bauer Method)Results: 196 (48%) case were males, 209 (52%) case were females with a male to female ratio 1:1. One hundred fifteen(73%) cases were infected with Pseudomonas species (PS).The sensitivity of the Pseudomonas isolates to the followingantibiotics was Amikacin 91.7%, Imipenem 89.7%, Ceftazidime 81.8%, Ciprofloxacin 73.7%, Garamycin 72.9%, Tobramycin 67.7%, Ticarcillin 66.7%,Cefoperazone 42.9%Conclusion: Pseudomonas species is the commonest microorganism in cases of CSOM. Microbiological identifications and antibiotic resistance determination of pathogens isolated from the middle ear in patients with CSOM not responding to empirical antibiotic treatment gives possibility of the choice of an effective antibiotic and its proper dosage. Cefoperazone , a relatively new antibiotic that is used in Iraq to combat pseudomonal infections has proven to be poorly effective compared with other previously used antibiotics

ABSTRACTBackground: Concerns about hepatitis A infections is increasing worldwide specially after improving economic and sanitary conditions in many countries making older age groups who escape infection on early life vulnerable to infection.Objectives: The objectives were to estimate the frequency of hepatitis A among children consulting Al Alwyia pediatric Teaching Hospital during the year 2013 and to study some demographic characteristics of the disease.Methods: This cross - sectional hospital -based study wasconducted during 2013-2014 and include pediatric patients(43525 patients) who consult Al Alwyia pediatric hospitalduring that time. The outcome is total IgM antibodies tohepatitis A virus detected using Enzyme Linked FluorescentAssay (ELFA) the test is performed on 380 clinicallysuspected cases. The age distribution of the susceptiblepopulation is estimated using a simple catalytic model.Results: The age groups (1-4 and 5-–9) constitute 43.6% and 42 % of sero-positive cases respectively with a P valueof 0.001. The incidence is more among males (56%). Incidence is more during June and July 40 %and 15.6% respectively with a p value of 0.001. 1.2% needed causality or ward admissions.Conclusions: High incidence in school age group might indicate the transition to older age groups and vaccinations should be considered at near future.

Background: The study of human leukocytes (HLA) alleles, and haplotype frequencies within populations provide an important source of information for anthropological investigation, organ and hematopoietic stem cell transplantation as well as disease association, certain diseases showed association with specific alleles specially those of known or suspected hereditary origin or immunological basis, whether simple renal cyst is congenital or acquired is still unclear and need to be investigated.Objectives: To study the genetic aspect of simple renal cysts by detecting the gene frequency and the haplotype of HLA class I of patients with simple renal cysts, and to find the presence of these cysts in other family members.Method: Thirty patients with simple renal cysts who were attending the outpatient clinic of urosurgery in the medical city were tested for HLA class I antigen using the microlymphocytotoxicity technique, in the period from February to June 2004 compared to 50 unrelated apparently healthy individuals. Gene frequency were calculated using square root formula (g=1-√1-f), full history were taken including the family history.Results: Certain gene frequencies were higher in the patients group than in the controls, yet not reached to a statistical significant level. No haplotype association with simple renal cysts was detected in this study; family history was detected in two patients which were proved by ultrasound examination.Conclusion: Increasing the sample size may contribute to best results regarding gene frequency, haplotype and family study.Key words: Gene frequency, Haplotype, Human Leukocyte Antigens.

Background: Many studies had stated that there are marked variations in the clinical presentation of depressive states between different cultures.Objectives: The main aim of the study is to identify the symptoms profile of patients with major depressive disorder living in Baghdad.Method: Ninety two patients with major depressive disorder consulting Ibn-Rushd psychiatric teaching hospital were studied thoroughly to identify the frequency of symptoms among them. The fifth edition of the Arabic version of the Mini-International Neuropsychiatric Interview (M.I.N.I) was used to identify the Diagnostic and Statistical Manual – fourth edition (DSM-IV) symptoms. A list of other symptoms, which were found to present variably in depression according to culture, was gathered from previous studies and modified was included to calculate their frequency and to compare them to the DSM-IV symptoms.Results: All the 9 DSM-IV symptoms were more common than all the other symptoms. The DSM-IV symptoms did not differ significantly according to sociodemographic variables.Regarding the other symptoms: “Numbness or crawlingsensation”, “sex and libido”and “crying “symptoms were allsignificantly more common in females than in males; “Sex and libido” symptoms differ significantly according to themarital status and to education; &“Hypochondriasis” was significantly more common in elderly group Patients with major depressive disorder with psychotic features were presented with less auditory hallucinations and more visual hallucinations as compared to studies in western societies.Conclusion: The presentation of depression in patients from Baghdad is not different from patients around the world, and the DSM-IV symptoms are the most common symptoms in patients with major depressive disorder from Baghdad.Background: Many studies had stated that there are marked variations in the clinical presentation of depressive states between different cultures.Objectives: The main aim of the study is to identify the symptoms profile of patients with major depressive disorder living in Baghdad.Method: Ninety two patients with major depressive disorder consulting Ibn-Rushd psychiatric teaching hospital were studied thoroughly to identify the frequency of symptoms among them. The fifth edition of the Arabic version of the Mini-International Neuropsychiatric Interview (M.I.N.I) was used to identify the Diagnostic and Statistical Manual – fourth edition (DSM-IV) symptoms. A list of other symptoms, which were found to present variably in depression according to culture, was gathered from previous studies and modified was included to calculate their frequency and to compare them to the DSM-IV symptoms.Results: All the 9 DSM-IV symptoms were more common than all the other symptoms. The DSM-IV symptoms did not differ significantly according to sociodemographic variables.Regarding the other symptoms: “Numbness or crawlingsensation”, “sex and libido”and “crying “symptoms were allsignificantly more common in females than in males; “Sex and libido” symptoms differ significantly according to themarital status and to education; &“Hypochondriasis” was significantly more common in elderly group Patients with major depressive disorder with psychotic features were presented with less auditory hallucinations and more visual hallucinations as compared to studies in western societies.Conclusion: The presentation of depression in patients from Baghdad is not different from patients around the world, and the DSM-IV symptoms are the most common symptoms in patients with major depressive disorder from Baghdad.

Background: A review of articles of method in treating compound phalangeal fractures by using mini-external fixator, elaborating the anatomy, mechanics, modalities of treatment, and complications of these types of fractures. Also, it compares between different studies regarding the functional results and final outcome. External fixation of phalangeal fractures is a good method for osteo synthesis in certain situations. The simplicity of the surgical procedure and the minimal disruption of the normal bone architecture also make it appealing.Objectives: Evaluating the functional results of the use of mini-external fixator for the treatment of compound fractures of phalangeal bones of the hand.Method: Our study consists of 15 patients, 12 were male and 3 was female, treated with external fixator for sever open hand fractures at Al-Kindy teaching hospital during the period from June 2011 – June 2013, using 2 K-wires bonded by IV needle cover, or 2 K-wires bonded by bone cement.Results: In comparison between different studies, external fixation offers several advantages. It allows preservation of the bone architecture, union of the fracture, facilitatinghealing of the disrupted area, and good functional results. External fixation is versatile, adapting to a wide range of clinical situations. This method of fixation provides good stability and adequate control of comminuted fractures, allowing not only anatomic restoration but also early active motion.Conclusion: External fixators are appropriate in cases of open, comminuted, unstable fractures. Other appropriate settings for external fixation include temporal management of fractures and length preservation of a functional digit

Background: Breast cancer remains a substantial cause of morbidity and mortality, there is a need for continued efforts to understand the etiology of the disease, maintain screening effort, implement prevention strategies, and develop better treatments.Objective: To analyze the risk factors, improve early detection and prevention of breast cancer in Al-Russafa district- Baghdad, aiming to increase survival rate and improve the quality of life.Methods: A cross sectional audit of 258 breast cancer cases seen at Al-Elwiya maternity teaching hospital from January2009 to December 2011,data collected from patients files were: age, gender , residency, marital status, parity, age at menarche and menopause age at first live birth, hormonal therapy, social habit, previous breast diseases, breast feeding and family history of breast cancer.Results: Two hundred fifty eight female diagnosed with breast cancer, age ranging from 20 to 79 years. Breast cancer was more prevalent in the fourth and fifth decade of life. The distribution was according to residency sectors, 10% were unmarried; fourteen percent nultiparous, the age at menarche was prevalent in 12 and 13 years old. Menopa-ausal age was at the fifth decade and age of patients at first live child at twenties. Forty two % received contraceptive hormonal therapy, 15% had previous breast diseases, 20% with family history of breast cancer, 24% non-breastfeeding and 6% smokers.Conclusion: Risk factors of breast cancer in Baghdad is a perplexing issue and needs a privy analysis as the disease has a para amount importance with increasing incidence in last decade. Knowing the risk factors for breast cancer may help us take preventive measures to reduce the likelihood of developing the disease and develop better treatment.Keywords: Breast cancer, Risk factors, surgical audit.Background: Breast cancer remains a substantial cause of morbidity and mortality, there is a need for continued efforts to understand the etiology of the disease, maintain screening effort, implement prevention strategies, and develop better treatments.Objective: To analyze the risk factors, improve early detection and prevention of breast cancer in Al-Russafa district- Baghdad, aiming to increase survival rate and improve the quality of life.Methods: A cross sectional audit of 258 breast cancer cases seen at Al-Elwiya maternity teaching hospital from January2009 to December 2011,data collected from patients files were: age, gender , residency, marital status, parity, age at menarche and menopause age at first live birth, hormonal therapy, social habit, previous breast diseases, breast feeding and family history of breast cancer.Results: Two hundred fifty eight female diagnosed with breast cancer, age ranging from 20 to 79 years. Breast cancer was more prevalent in the fourth and fifth decade of life. The distribution was according to residency sectors, 10% were unmarried; fourteen percent nultiparous, the age at menarche was prevalent in 12 and 13 years old. Menopa-ausal age was at the fifth decade and age of patients at first live child at twenties. Forty two % received contraceptive hormonal therapy, 15% had previous breast diseases, 20% with family history of breast cancer, 24% non-breastfeeding and 6% smokers.Conclusion: Risk factors of breast cancer in Baghdad is a perplexing issue and needs a privy analysis as the disease has a para amount importance with increasing incidence in last decade. Knowing the risk factors for breast cancer may help us take preventive measures to reduce the likelihood of developing the disease and develop better treatment.

Background: Neonatal macrosomia is defined as a birth weight of more than 4000 g. Significant maternal and neonatal complications can result from the birth of macrosomic infants like hypoglycemia and birth injuries.Objectives: To determine the frequency of hypoglycemia in neonates with macrosomia in Amarah, IraqMethods: The study involved 146 macrosomic newborn neonates delivered in 2 maternity hospitals in Amarah, Iraq during a period from June 2011 to June 2014.Results: Hypoglycemia was observed in 16% of neonates affected by macrosomia. Maternal diabetes was the most common cause of fetal macrosomia (28%).Our results were compared with those from other parts of the world.Conclusion Macrosomia is associated with increase rate ofneonatal hypoglycemia especially among infants of diabeticmothers.

ABSTRACTBackground: In Iraq smoking is a common habit in both the urban and rural areas. There are many respiratory diseases like chronic bronchitis, bronchial carcinoma and emphysema which are related to chronic tobacco smoking.Objectives: To study the effect of tobacco smoking on the respiratory system, to establish a correlation between chronic tobacco smoking and its effects on the parameters which were studied and to create awareness in tobacco smokers about the effects of tobacco on their healthMethod: In this study 100 male subjects, 50 chronic smokers and 50 non- smokers were assessed for their pulmonary function tests by using a computerized spirometer.Results: Almost all their respiratory parameters were significantly reduced. In the present study obstructive lung dysfunction was the commonest finding in smoker

Introduction: An aneurysmal bone cyst are enigmatic lesionof unknown cause and presentation and are difficult todistinguish from other lesions, it is a benign, but expansibletumor like lesion that generally occurs in the long bones. Ananeurysmal bone cyst arising from the flat bone like clavicleis rare .Case presentation: We report a 12-year-old girl child with ananeurysmal bone cyst of the lateral third of left clavicletreated with enblock resection. The pathologic findingsconfirmed the diagnosis of aneurysmal bone cyst. Thepatient has been followed up for one year with no evidenceof recurrence .Conclusion: En bloc resection can be curative and provide good results for this rare type of clavicle tumour.

Background: Goiter is one of the most common conditions that affect people’s at different age groups with its effect on the metabolic status of the body through the hyper&/hypo functioning gland that may needs surgical resection. This prospective study had been conducted on 100 patient (85 females&15 males} at the specialized center for endocrinology and diabetes mellitus in Baghdad city, between Jan.2013-Oct.2014;Their ages were ranging between 11-75 years ; the median age is (40.5 years) .Objectives: define the clinic-pathological pattern of goiter in the center .Methods: This is a prospective study at the specialized center for endocrinology & diabetes in Baghdad at ALRissafa district; including 100 patients (84 females&16 males). They have their thyroid operation at Al-Kindy teaching hospital and AL-Jadirya privet hospital during the period extending between January 2013 to October 2014. The histopathological results were grouped into Colloid nodular goiter ,thyroid adenoma , thyroiditis ,toxic nodular goiter ;diffuse toxic goiter and thyroid malignancy.Results:Goiter affect females (85%) more than males (15%) with ratio of 5.6/ 1 & the most affected age group is those between 30-49 years68%. The most common presenting symptom was mass in the neck (45%).The most common pathology of goiter was colloid nodular goiter (69%) the most common malignant lesion was papillary carcinoma(4%)& follicular (1%).(7%) of goiterous patients were affected by diabetes mellitus type 2 . (35%) of the patients give positive family history for goiter.