The Medical Journal of Basrah University

Background: Caesarean section is increasing as a means of delivery. A decision on this choice need to be joint among doctors, women and others. An appropriate decision will be facilitated with good knowledge of women about this operation. Objectives: To assess the knowledge and attitude of women in the reproductive age about Caesarean Section.Methods: This is a descriptive cross sectional study carried out in Basrah city among women in the reproductive age group who visited two primary health centers(Al-Razi and Al-Seef centers). The study involved 242 women with age range from 15-45 years, Results: History of one or more Caesarean Section was reported by 35.5%. The results of study showed that all the women involved in this study heard about Caesarean Section and a good number of them had an idea about the effect of Caesarean Section on the number of children, the possibility of vaginal delivery after first Caesarean Section and about some chronic diseases (hypertension and diabetes) which might increase the prospect of Caesarean Section. Majority of participants preferred normal vaginal delivery because of rapid recovery and less complication than Caesarean Section.Conclusions: Caesarean section is a prevailing practice in Basrah city. Women had good knowledge about it but in general they prefer normal vaginal delivery.

Background: Diabetes mellitus has an effect on the peripheral nerves. Such effect may start as asymptomatic peripheral neuropathy.Objectives: To assess the role of electrodiagnostic study in the diagnosis of patients with different types of diabetic peripheral neuropathy (DPN) and evaluate the usefulness of it in early detecting diabetic peripheral neuropathy in asymptomatic patients and to correlate the findings of nerve conduction study in patients with asymptomatic diabetic peripheral neuropathy with various risk factors.Subjects and Methods: subjects were allocated into three groups: 50 normal (non-diabetics apparently healthy subjects without peripheral neuropathy), 50 asymptomatic DPN patients and 50 symptomatic DPN patients. Clinical questionnaire, blood sugar, neurological examination and nerve conduction studies were performed for each subject.Results: This study showed that the prevalence of positive nerve conduction studies was 58% in asymptomatic diabetic patients, 100% for symptomatic diabetic patients and negative for control. The positive nerve conduction study findings in asymptomatic diabetic patients involved sensory more than motor fibers and the lower limbs nerves were affected more than that of the upper limbs. The most commonly involved nerve is the sural nerve sensory fiber which was more prevalent in old age patients (87.5%), patients with longer duration of diabetes (81.8%), over weight (71.4%), patient taking only oral antihyperglycemic drugs (76.9%) and in diabetic patients with poor glycemic control (84.2%) (86.3%) in fasting blood glucose (FBG) and HbA1c respectively. Using the logistic regression, only oral antihyperglycemic drugs (without insulin) and poor control HbA1c were significant predictors of abnormal nerve conduction.Conclusion: Even in asymptomatic patients, nerve conduction studies show diffuse changes, in a predictable pattern. Electrophysiological finding correlate with age, duration of disease, glycosylated hemoglobin levels, fasting blood glucose, type of the treatment if only oral antidiabetic and body mass index.

Objective: To study the risk factors aggravating bronchial asthmatic attacks among adult patients in BasrahMethods: Ninety six asthmatic patients, their ages ranged from 15 to 47 with a mean ages 29.66±7.37 years and a mean weight of 70.15 ± 12.74, were studied prospectively from January 2015to April 2016 from two consultation clinics. It was a paper questionnaire based study, the questions and answers were completed by the patients and sometimes with help of close relative, if necessary. Because of the increasing number of aggravating factors in modern life and the pollutions of community, the patients were classified into three groups according to number of triggering factors.Results: Atopic individual was more liable to multiple allergens in comparison to non-atopic individual with 95% CI (.051-0.424) and a value (0.010). The commonest risk factors that had been found aggravating attacks of bronchial asthma in the presence of history of atopy was upper respiratory tract infection with 95% CI ( 0.099-0.441), humidity(95%CI of 0.054-0.414), seasonal allergy (95%CI of 0.008-0.474), spicy food intake with 95% CI of 0.256-0.277, perfumes (odorous) with 95% CI 0f (0.197-0.568), Low corticosteroid medications with 95% CI OF (0.069-0.433) and dusty environments with 95% CI of (0.133-0.490). Asthma was more common at younger age group and older age group constitutes only 11.4%.Conclusion: In allergic individuals in Basrah, respiratory tract infection, humidity, seasonal changes, indoor perfumes, spicy food diet, low dose of cortico steroid, dusty environments, all are common association with asthma symptoms in atopic individual.

Background: Burns are injuries to the skin that might be caused by high temperatures, chemicals or different other mechanisms. In Iraq and other developing countries, burns represent an important health problem with many effects on life causing morbidity and mortality, and exert many consequences including disability, psychological impact and financial loss. The aim of this study was to explore the demographics and types of burns, factors associated with burn fatalities, and to evaluate the magnitude of this problem with focusing on causes and manner of thermal deaths among the victims.Methods: Data were collected retrospectively from autopsies of burn-related deaths reported to Department of Forensic Medicine in Basrah province, southern part of Iraq during a period of 4 years from 1st of January 2013 to 31st of December 2016, along with information retrieved from hospital records, history and information from close relatives.Results: Out of total of 4244 autopsies conducted during that period, 373 of them were burn-related deaths. The majority of the victims were females (75%). Most of the injuries (89%) were caused by flame. The commonest age group involved in both males and females was (20-29) years. Suicidal burns constituted 62%, and the higher proportion was seen among females. Domestic problems along with psychiatric illnesses were the main factors associated with self-inflicted burns.Conclusion: Burning deaths represent a large proportion among the overall unnatural deaths in Basrah city, the higher proportion of burn-related deaths was observed in females, and among suicidal burn deaths, females constituted more than ninety percent.

Background: A variety of methods are now available to measure blood pressure, blood glucose and body temperature using different devices. As an example, blood pressure can be measured by the standard mercury sphygmomanometer method, it can also be measured electronically. It is not known to what extent they are correlated with each other when used in our locality. Objectives: To compare the quality and accuracy of different methods used to measure blood pressure (manual versus automated office blood pressure measurements), blood glucose (glucometer with the laboratory reference method) and body temperature (glass mercury thermometer and digital thermometer). Methods: All measurements were done at Basrah General Hospital during the period from 5th of March to 15th of March, 2017. Measurements for each patient were performed by the same subject. Patients were selected from the surgical wards of Basrah General Hospital. Blood pressure was recorded using both automated oscillometric blood pressure device (Beurer blood pressure monitor) and the standard manual mercury sphygmomanometer for each patient. Blood glucose was estimated using the Accu-Chek glucometer and compared with laboratory data of the same hospital. Capillary blood samples were collected and checked on a glucometer and venous blood sample was sent to the laboratory for glucose estimation at the same time. The laboratory value was used as a reference for comparison. Temperature was recorded using glass mercury thermometer and two types of digital thermometers; one used on forehead (Pic thermometer) and the other used orally (Beurer thermometer). SPSS version 20 was used for statistical analysis.Results: There was no significant difference in the measurement of systolic and diastolic blood pressure by the two methods used in this study; mercury sphygmomanometer and automated oscillometric device (systolic blood pressure 127.75 ± 22.01 mercury versus 128.95 ± 18.7 electronic; similarly for diastolic). The two methods were significantly correlated with each other. Random blood glucose measured by a glucometer and a hospital laboratory method showed that glucometers gave significantly higher values by around 30%. Despite these higher readings, the two methods were still significantly correlated. The three methods used to measure body temperature showed a significant correlation with similar mean values (36.46 ± 0.58, 36.62 ± 0.57, and 36.41 ± 0.51 for forehead electronic, oral electronic, and oral mercury respectively).Conclusion: The methods used to measure blood pressure, blood glucose and body temperature are well correlated with each other, and gave approximately similar readings except the measurement of blood glucose by Accu-check glucometer which gave higher values than the reference laboratory method

Introduction: Extramedullary hematopoiesis in the adrenal gland is rare and is usually discovered incidentally. Thalassemia is one of the hematological disorders in which extramedullary hematopoiesis could be seen in many organs including adrenalsCase report: Our patient was a nineteen years old Iraqi man. He is a known case of thalassemia major since the age of 5 months. He was discovered to has a right suprarenal mass by ultrasound examination as part of investigation for nocturia. The mass was surgically excised and the histopathological examination revealed extramedullary hematopoiesis.Conclusion: Awareness should be raised to consider the diagnosis of extramedullary hematopoiesis in any thalassemic patient with a tissue mass

Coronary stent under expansion is a strong risk factor for stent thrombosis and cardiac events. And once occurred it is a challenging condition, due to the fact that no uniform acceptance about how is the best strategy to solve the problem, the literature review summarize some cases that respond to cutting balloon, rotational atherectomy, laser therapy after failure of high pressure ballooning by noncompliant balloon, I report a case of stent under expansion treated successfully using a high pressure inflated second stent after failing repeated attempt to dilate the lesion by single and double balloons
The learning object: stent under expansion frequently observed in the setting of calcified rigid lesion, however this can be prevented to great extent by adequate lesion preparation. Once occurred it should be managed aggressively according to the facility of the cath lab, and experience of operator.