The Medical Journal of Basrah University

Background: postpartum haemorrhage (PPH) remains a serious problem for pregnant women worldwide. Anaemia is one of the most prevalent nutritional deficiency illnesses affecting pregnant women. Anaemia has been linked to an increased incidence of postpartum bleeding. The study aimed to Evaluate the relationship between postpartum haemorrhage and anaemia, particularly to determine whether anaemia is a risk factor for PPH or not. Subjects and Methods: a prospective case-control study was conducted in the Basra Maternity and Children Hospital in Basra, Iraq, during the period from January 1, 2023, to September 1, 2023. Each woman included is subjected to a full history, examination, and Hb level to determine the level of anaemia.Results: the study involved 125 women including 81 pregnant women who had anaemia and developed post-partum haemorrhage and 44 pregnant women who had anaemia but didn’t develop PPH after normal vaginal delivery. PPH was developed in 64.8% of the pregnant ladies, and it was mild in 65.4% of the cases and severe in 34.6% of them. Multiparity, higher gestational age, and lack of antenatal care (ANC) are associated with a high prevalence of PPH, but this association was not significant with parity and gestational age and only significant with ANC (P < 0.05). Severe anaemia with Hb levels below 8 g/dl is significantly associated with the development of PPH (P < 0.05), and severe anaemia is also significantly associated with the occurrence of severe PPH (P < 0.01).Conclusion: severe anaemia with an Hb level below 8 g/dl is significantly associated with an increase in the risk of PPH. It is also associated with significantly increasing the severity of PPH.

Background: anaemia is a significant global health concern. Hereditary haemoglobin abnormalities are one of the most frequent causes of anaemia in pregnant women. Pregnant women with Hemoglobinopathies are at increased risk for adverse pregnancy outcomes, such as preterm birth, intrauterine growth restriction, and low birth weight. The study aimed to determine the fate of pregnancies in women with hemoglobinopathies and to identify the predictors for adverse outcomes among these ladies.Subjects and Methods: a case-control study was conducted in Basrah Teaching Hospital for maternity and children from the 1st of September 2022 to the 1st of July 2023. One hundred nine women were included in the study, 33 ladies with sickle cell trait group, 22 ladies with thalassemia minor and 57 ladies as healthy controls. The socio-demographic, pregnancy-related characteristics, maternal morbidity, and maternal and fetal outcomes were assessed in this study. Results: the current study found that sickle cell trait has a higher risk of emergency C-section (20%), while Thalassemia minor has a higher risk of elective C-section (22.7%). Sickle cell traits significantly increase the risk of puerperal infection (23.3%), and they also increase the risk of urinary tract infection (20%). Hemoglobinopathies, particularly sickle cell trait, significantly increase the risk of gestational diabetes mellitus (16.7%), but there is no significant increment in the risk of other maternal outcomes. Both sickle cell trait and thalassemia minor are significantly associated with lower BMI, lower Hb, and lower serum ferritin levels (P-value < 0.05).Conclusion: sickle cell trait and thalassemia minor increase the risk of poor maternal and fetal outcomes.

Background: after antigens of the ABO system, which are the most immunogenic, Rh D antigen comes second, followed by K antigen in the Kell blood group system and other antigens of the Rhesus system, including Rh c, Rh E, Rh C and Rh e. Determination of these antigens before any blood transfusion is vital to prevent alloimmunization and subsequent transfusion-associated hemolytic complications.Aim of the study: this study aimed to know the frequency of Rhesus (Rh) and Kell (K) antigens among a sample of the Basrah population. Methods: this retrospective study included a total of 3357 tests for Rh C, Rh c, Rh D, Rh E, Rh e and K antigens. These tests were done in The Main Blood Bank of Basrah and The Basrah Center for Hemoglobinopathies.Results: the most frequent antigen was the Rh e antigen (96.7%), followed by Rh D antigen (88.8%), Rh c antigen (77.7%), Rh C antigen (68.3%), Rh E antigen (52.6%), and K antigen (8.5%) which was the least frequent.Conclusion: the prevalence of Rhesus and Kell antigens among the Basrah population doesn't stray from the results around the world.

Background: vitamin D is a fat-soluble vitamin that is crucial for calcium homeostasis and bone metabolism and is obtained through diet and solar exposure. The prevalence of vitamin D deficiency among pregnant women ranges from 4% to 60%. There's an association between vitamin D deficiency and a variety of obstetric complications, such as gestational hypertension and preeclampsia, gestational diabetes, and delivery timing and mode. The study aimed to estimate the prevalence of vitamin D deficiency among pregnant women in Basrah city and detection of the possible aetiologies of vitamin D deficiency.Subjects and Methods: this is a descriptive cross-sectional study conducted at Al-Basrah Maternity and Child Hospital for the period from January 1st, 2023, to June 30, 2023. 102 pregnant women in the 1st and 2nd trimesters were drawn by systematic random sampling while they were visiting the outpatient department, labour ward, and obstetric ward in Al-Basrah Maternity and Child Hospital.Results: vitamin D deficiency was prevalent among pregnant women in Basrah (45.1%). There was a significant association between the history of sun exposure, time, and duration of sun exposure and an increasing risk of vitamin D deficiency(the P-value < 0.05). There was a significant association between BMI and vitamin D deficiency (P-value = 0.011), as well as the use of multivitamin supplements and vitamin D supplements (P-value = 0.001), which has a significant association with decreasing the risk of vitamin D deficiency.Conclusion: vitamin D deficiency is common among pregnant women in Basrah, with many risk factors predisposing to it, such as reduced sun exposure and a high BMI.

Background: obesity is a multifactorial condition influenced by a complex interplay of genetic, environmental, behavioural, and socio-cultural factors. Obesity among Health Care Workers can significantly impact their occupation. It affects their physical health, increasing the risk of medical conditions and limiting their mobility and energy levels. The study aims to estimate the prevalence of overweight and obesity among resident doctors and to describe the risk factors for obesity among them.Methodology: this is a cross-sectional study on 511 doctors conducted at Al Basrah Center Hospitals, which include 8 Hospitals. For the period from the 1st of February to the 30th of June 2023. All participants were interviewed, and a special questionnaire was used for this study's purpose.Results: the doctor's ages ranged from 24-45 years. 36.6% were males 63.4% were females, and 16.2% of them were obese. Obesity was found to be associated with increasing age, gender, marital status, the number of children, and smoking status. 18.2% of senior residents were obese. Senior residents, in medical specialities such as medicine and paediatrics are at higher risk of being overweight and obese. Conclusion: the study reveals that the prevalence of overweight and obesity among the doctors at Al Basrah Center Hospitals is on the high, which highlights the importance of promoting a healthy lifestyle, good eating habits, and regular physical activity.

Lymphoid malignancies are the most common primary orbital tumours but they constitute only 2% of extranodal lymphomas. A fifty-year-old lady known case of SS presented with progressive blurred vision and left deep orbital pain for about 5 months duration, with time, she started to develop left eye protrusion with ophthalmoplegia. The histopathological diagnosis was a low-grade follicular (nodular) B cell subtype of non-Hodgkin lymphoma (Grade 2). Immunohistochemically, it displayed CD45 and CD20 positive, stained whole neoplastic variables sizes follicles, CD3 stained rime of non-neoplastic T cells around the follicles. Positron Emission Scan (PET scan) exhibited mild hyper-metabolic multiple right cervical and supraclavicular lymph nodes and moderately hypermetabolic enlarged abdominal lymph nodes. The patient after the 4th cycle of chemotherapy has no palpable cervical lymphadenopathy and restores the normal vision in the left eye.

Background: During Covid 19 pandemic, the utilization of maternal healthcare services by pregnant women was disrupted mainly due to Covid-19-related factors like curfew and fear of acquiring the infection while visiting the healthcare centers, because of this only a few numbers of pregnant women maintained their visiting schedule so this study aimed to study the sociodemographic and other characteristics of pregnant women who misused health care services during Covid-19 pandemic. Method: This is a cross-sectional record-based study. A form of questionnaire was applied to records, and a sample of pregnant women who defaulted from receiving antenatal & postnatal services were selected randomly during the period from 1st of March 2020 to 31st of June 2020 in Basrah. Results: 44.3% of the women were between 20 and 29 years old. Thirty-four of the studied women and thirty of their husbands had only primary education, most of those women worked as housewives (91%) and their husbands were self-employed (69%). About 28% of women were of gravida five and above and only 12% were primigravida, while (22%) had only one child. Most of those women (87%) had no chronic or gestational disease and no history of abortion or stillbirth (81%). The highest percentage of the defaulters (59%) had only one visit during their pregnancy with the booking age of first visit at 13-20 weeks (43%) and only (22%) had a postnatal visit, while (32%) had completed their tetanus toxoid doses. Conclusion: There is a significant association between the number of visits during pregnancy with the education and occupation of mothers. Also, Previous history of abortion, parity, and booking age of visit had significant associations with the number of visits during pregnancy.

Background: Ensuring compliance to IFA (iron and folic acid) supplementation is crucial in the context of preventing and treating iron deficiency anemia, among pregnant women. This is particularly relevant since the need for iron often begins to rise during the second trimester of pregnancy. The study aimed to evaluate the level of compliance among pregnant women to Iron and Folic Acid Supplementation (IFAS).Method: This cross-sectional study involved women who had attended six randomly selected primary health care centres in Basrah for antenatal care (ANC). Four hundred pregnant women were included in this study which was conducted from May to August 2023. A special questionnaire form was designed for the study.Results: the study showed a 59% compliance rate with iron and folic acid among pregnant women who visited primary health care centres in Basrah. The most common reason for non-compliance was “forgetfulness” (24.39%).The results of this study showed a significant association between the compliance of iron and folic acid and the educational status of women, occupation, gravidity, number of live births, Early booking visit time, frequency of antenatal care visits, and previous history of anaemia are significantly associated with compliance to IFAS. compliance is higher among those who take 30 minutes or less to reach the health care centre by walking.Conclusion: The majority of pregnant women in the second and third trimesters are compliant with IFAS. Being aged 20-29 years, educated, employed, with early booking visits, and Pregnant women with normal current HB levels, and good knowledge about anemia and IFAS were more compliant than others.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication in cancer patients especially those treated with neurotoxic chemotherapeutic agents. CIPN is usually diagnosed clinically; However, electrophysiologic testing confirms the diagnosis and rules out other potential causes of neuropathic manifestations.Aims: This study aimed to look for electrophysiological changes and clinical features of peripheral neuropathy among patients with haematological malignancies treated with chemotherapy in Basrah governorate, southern IraqMethods: A comparative cross-sectional conducted in Basrah City, southern Iraq. The study involved 109 patients with confirmed diagnoses of multiple myeloma, leukaemia, and lymphoma. Their clinical, and electrophysiological characteristics using nerve conduction studies and needle electromyography have been registered. Results: The proportion of CIPN among patients with hematological malignancies is 38.53%. All of the cases were axonal polyneuropathy, with 54.76% being sensory followed by 45.24% mixed sensory motor neuropathy. Clinically, 55.96% of the cases reported lower limb paresthesia and numbness and 11.01% reported limb weakness. Sensory nerve conduction studies showed a reduction in the amplitude of sural and ulnar nerves. Moreover, motor nerve conduction studies also showed a reduction in the amplitude of peroneal and ulnar nervesConclusions: The chemotherapy regimen induced peripheral neuropathy; the pattern was distal, symmetrical, length-dependent, axonal polyneuropathy of pure sensory mainly followed by mixed sensory-motor type. We recommend early detection, monitoring and appropriate management of CIPN.

Background: Diabetes mellitus is a chronic metabolic illness that causes hyperglycaemia. This hyperglycaemia may be the consequence of a malfunction in insulin synthesis, insulin action, or both. DM can raise the risk for the development of microvascular as well as macrovascular problems. An increase in oxidative stress and inflammation are two of the hallmarks of diabetes, which is recognized as a disorder in and of itself. TGF-beta is a member of the TGF-beta subfamily, which is a part of the TGF-beta superfamily.Methods: The current research comprised a total of 130 individuals, all were placed into three primary groups; 50 diabetic patients without nephropathy, 50 diabetic patients with nephropathy, and 30 persons in good health who were the same age and gender as the patients being studied,50 urine sample has been taken from participants to measure the concentrations of the parameters, the standard procedures and techniques were used.Results: The results of the present study revealed that the mean value of serum TGF β1 was significantly higher in diabetic patients without nephropathy and diabetic patients with nephropathy (40.19 ± 3.56ng ̷ ml), (51.21 ± 5.20ng ̷ ml) respectively as compared to controls (24.80 ± 3.51 ng ̷/ml) with a high significant difference (P <0.01). The level of TGF β1 showed a positive correlation in the study population with fasting blood sugar (r = 0.273, P = 0.006).Conclusion: The main finding of the present study is that there was a significant difference (p < 0.05) between serum TGF-β1 in diabetic patients with nephropathy, diabetic patients without nephropathy and controls.

Background: Obesity is a widespread health issue worldwide, marked by long-lasting, low-level inflammation and resistance to insulin. Procalcitonin (PCT) has been recognized as a probable indicator of inflammation linked to obesity, given that high levels of PCT in the blood are strongly associated with measures of fatness and insulin resistance. Nevertheless, the exact role of PCT in insulin resistance remains uncertain. Objectives: The study aims to provide insights into the role of PCT in obesity-related inflammation and evaluate its potential as a diagnostic tool for insulin resistance. Methods: The study included 120 subjects with obesity and insulin resistance, and 80 control group. The study also included anthropometric measurements (BMI, WC, and blood pressure) and laboratory tests (fasting serum insulin, fasting serum glucose, and plasma procalcitonin).Results: In the study, 120 patients diagnosed with obesity were compared to 80 controls. The research found that the average level of procalcitonin (PCT) was significantly higher in obese patients (P < 0.05) when compared to the control group. Specifically, the mean PCT level in obese patients was 0.122±0.168 ng/ml, while in controls, it was 0.086±0.0047 ng/ml. The analysis also showed a significant correlation between PCT and insulin resistance, as measured by HOMA-IR, with a Pearson correlation coefficient of 0.187 and a (P-value 0.040). Conclusion: The study found that the mean level of procalcitonin (PCT) was significantly higher in patients with obesity and insulin resistance compared to controls.

Synovial sarcoma is a malignant tumor of mesenchymal origin which can develop at any location, with deep soft tissues of extremities being the commonest site involved, typically in young aged individuals, nevertheless it is uncommon in head and neck region and is enormously unusual in the tonsil. We represent a 30-year-old male with a right tonsillar mass who complained of difficulty in swallowing, odynophagia, right sided otalgia and sore throat for 6-months. The mass was excised and sent for histopathology and immunohistochemical studies that established the diagnosis of biphasic synovial sarcoma of the right tonsil.