Print ISSN: 2790-0207

Online ISSN: 2790-0215

Issue 1,

Issue 1


Laparoscopic Cholecystectomy in Patients with Empyema of Gall Bladder

Alan Adnan Sabir

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 1-10

Empyema of gallbladder is a potential fatal complication of gallstone. It is characterized by suppuration superimposed on acute cholecystitis. It is considered as a common factor of difficult laparoscopic cholecystectomy.
Aim of the study: to determine the safety and feasibility of laparoscopic cholecystectomy in patients with empyema of gallbladder.
Patient and method:A prospective study of 800 patients suffering from gallstone diseases from 2011 to December 2014 in Azadi teaching hospital in Kirkuk-Iraq. The procedure was performed by standard three – ports technique with a few modifications made to facilitate dissection subjected to situation.
Results: 800 patients with male to female ratio 1:5.25 undergone laparoscopic cholecystectomy. Among these, 50 patients (6.25%) were identified having empyema of gallbladder and were included in the study population. Laparoscopic cholecystectomy was successfully completed for 49 (98%) patients while only one (2%) patient was converted to open cholecystectomy due to uncontrolled bleeding.
Conclusion: In well-trained and skillful hands of an expert, laparoscopic cholecystectomy surgery is a safe and acceptable option for patients with empyema of gallbladder.

Evaluation of Serum Leptin and Ferritin Levels in Children with Major Beta-Thalassemia

Mutaz Sabah A; Khedhair Abbas K; Shaymaa Mohammed Salih

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 11-17

Background: Beta-thalassemia major regarded as one of the major health problems in endemic regions as the Mediterranean basin, part of North and West Africa and South East Asia. Endocrine complication occur in major beta thalassemia due to excessive iron accumulation in endocrine glands that result from frequent blood transfusion and chelation therapy that caused dysfunction in their hypothalamic-pituitary axis. The aim of the study is to determine the level of serum Leptin and to determine the relation of leptin level with ferritin level in children with beta-thalassemia major. Patients & Methods: A cross sectional study was carried out in Kirkuk City from January 2018 to March 2018 on 60 patients (30 female and 30 male) with beta thalassemia major and 30 age and sex matched healthy control (17 female and 13 male). Serum Leptin and ferritin levels were measured for both group by using commercial diagnostic kit. Results: The result of the present study showed that serum level of leptin hormone in children with beta thalassemia major less than control subjects but not statistically significant. While the differences in the serum ferritin level was significantly higher in children with beta –thalassemia major as compare with control subjects. Conclusion: Children with beta thalassemia major had a low level of leptin hormone than control subjects but not significant of same age and gender. Children with beta thalassemia major had a higher serum ferritin level than control subjects. Children with beta thalassemia major had a higher leptin level in female than male.

The Relationship of Waist-Hip Ratio and Body Mass Index to Blood Pressure of Employee in Sulaimani Teaching Hospital

Muthanna Mustafa Hussein

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 18-31

Background: Several studies have shown that the reisa significant relationship between increase in weight and blood pressure. The anatomical distribution of weight has also been shown to be a factor in determining which people are moresusceptible to hypertension and thus, at risk of developing cardiovascular diseases. Objectives: To examine the Body Mass Index profile and Waist Hip Ratio ratio measurements of Sulaimani Teaching Hospital employee and its relationship withblood pressure. Methodology: Two hundred individuals of Sulaimani Teaching Hospital employeeaged20- 65 years (according to inclusion criteria) were selected including males and females. Information was obtained about lifestyle, smoking, and occupation as well as family history of hypertension, diabetes, cardiac and renal diseases, that employee were asked to undergo physical examination, height, weight, waist circumference, hip circumference, mid arm circumference systolic and diastolic blood pressure and pulse rate were recorded. The partial correlation was used to quantify the association between Body Mass Index and Waist Hip Ratio and other anthropometrics with systolic and diastolic blood pressure. Results: Mean Body Mass Index was 27.28 (SD±4.55). Descriptive analysis revealed that 1(0.5%) of the study populationis classified as underweight, 66(33 %) as normal weight, 91(45.5%) as overweight, and 42(21.0 %) as obese. Abdominal adiposity, as measured by increased Waist Hip Ratio, was present in 126 subjects (63%) among them 23(18%) subjects hadnormal Body Mass Index. Inspection of the data obtained for the hypertension, indicated. That (16) subjects of the study population (8.0%) were hypertensive, (6females and10 males) among those (5) males had normal Body Mass Index. Partial correlation controlled for age, revealed that both Body Mass Index and Waist Hip Ratio were independently correlated with both systolic and diastolic blood pressures, this association was more with Waist Hip Ratio than that of Body Mass Index. Conclusions: The present results indicate that there is a high prevalence of overweight and obesity specially among the young and adult sage groups more than that of the old age group in Sulaimani Teaching Hospital employee, additionally there is high prevalence of abdominal obesity specially young females in spite of having normal Body Mass Index. Thereishighincidenceofhypertensionandthisincidencerelatedmorewiththeincreasingweighta ndabdominalfatthan with ageing table (13) and figure (1 -A).

Unstable Proximal Phalangeal Fracture of the Hand Case Report and a Technical Note

Adnan Abdilmajeed Faraj

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 32-35

The current technique using K wires for the fixation of unstable proximal phalangeal fracture of the hand provides a stable construct without compromising joint mobility and soft tissue. These features are otherwise very difficult to fix. The technique involved ante grade introduction of K-wires from the proximal part aiming to the condyles and crossing the wires with the wire from the other condyle beyond the fracture plane to avoid distraction. The wires will then be pulled until the proximal end is buried in the condyles. The exit of the wires is proximal to the proximal interphalangeal joint.

Role of Innate Immunity in Patients with HBV Infection

Pinar Faiq Rafeeq; Waleed Mohammed Ali; Ali Akram Ismail

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 36-43

Background: The hepatitis B virus [HBV] is an infectious disease and its one of the great public health problem, its outcome depends on the kinetics of the virus-host interaction and specifically on the strength of the innate and adaptive, humoral and cellular immune response. Thus interactions between the virus and the components of immune systems plays an important role in the pathogenesis of the disease. This study aimed to evaluate innate immune response in different clinical courses of HBV infection by estimation serum levels of granulocytemacrophagecolony stimulating factor (GM-CSF), Interleukin-1 (IL-1 ), Interleukin-8 (IL-8 ) , immunoglobulin A (IgA), IgM, IgG and Complement component (C3and C4) levels. Aim of study: to evaluate role of immune response in clinical course of hepatitis B infection Patients and Method: This study based on 78 patients with HBV infection attending the Public Health Laboratories. Their ages ranged from (14-65) years, (58 males and 20 females) compared with 20 healthy subjects (12 males and 8 females) as control group. This study extended from first of January 2015 to first of January 2017. The patients were classified to three groups on the bases of serologic markers (HBsAg, HBe Ag, HBc Ab IgM) according to WHO department of communicable disease surveillances and response, liver function tests which are used as supportive indicator for the liver injury, history of the illness, and full clinical assessment. The first group includes twenty-eight patients with acute HBV infection, second group include twenty cases identified as chronic healthy HBsAg carriers group and the last third group include thirty cases of chronic HBV group Results: By using enzyme immuno assay [ELISA] technique, serum levels of interleukin1alpha [IL-1α], interleukin-8 [IL-8], and granulocyte-macrophage-colony stimulating factor [GM-CSF] were measured in all patients compared to that of healthy control group. The mean levels of IL-1α and IL-8 showed a significant increase in serum of patients with newly infected (acute) HBV and chronic HBV compared with studied control group [P=0.04 and P=0.001 respectivel]. However, the mean serum levels for IL-1α and IL-8 recorded a non significant increase in patients with chronic healthy HBsAg carriers [P=0.17 and P=0.4 respectively]. While the mean serum levels of GM-CSF showed a significant rise in acute HBV only [P=0.01]. Moreover, serum immunoglobulins [IgG, IgM, IgA] and complement component [C3, C4] levels also evaluated by using single radial immunodiffusion test (SRID). The mean serum IgA, IgG and IgM levels showed a significant increase in chronic HBV group as compared to that of control group [ P=0.000 ,P=0.000 and P=0.001 respectively].. The mean serum C3 and C4 levels showed a significant lower serum level in all groups compared to control studied group [P=0.000]. Conclusion: this data demonstrate that immunological differences do exist between different clinical groups with HBV infection and may reflect the role of the innate immune system in host defense and disease

Evaluation of Referral System Patterns in Azadi - Teaching Hospital/ Kirkuk

Eman N. Mohammad; Taghlub H. Ryhan; Saad S. Mustafa

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 44-53

Background: Referral system constitutes a key element of health system and one of the strategies for ensuring the best use of hospital resources and health care services.. Aim and objectives: a) Causes behind of direct attendance of patients to hospital. b) Find out the main reasons of patients referral to hospital. c) Patients' opinion about the hospital services. d) Assess consultants view about referral system. Methods: A cross sectional study was carried out since 1st of March 2018 till end of September 2018. 1000 patients attending seven consultation units in Azadi teaching hospital were involved in the study. Anevaluation of main causes of direct attendance was done, review of the information on the referral form, patient satisfaction with referral was inquired and specialist doctors' evaluation of the referral was obtained. Results: The rate of referral with referral form was (81%). Main cause of direct attendance was that patients don’t trust the Primary health care center (PHCC) doctor. The provisional diagnosis,a reason for the referral and name of the referring doctor were absent or unclear on (94.6, 84.1 and 61.9 %) of referral forms..Patient satisfaction with the services of secondary health care facilities was (80.1%), and the highest rates of dissatisfaction were because of drug unavailability in hospitals. Specialist doctors considered (55.1%) of all referrals as inappropriate and the need for further treatment was the main reason for indicated referrals. Conclusion: The rate of patient’s referral with referral form was high. The main cause of directly attending hospital with no referral form is that patients do not trust doctors in PHC level. Patients are generally satisfied with the services of secondary health care facilities. More than half of referred cases not need referral from the specialists’ point of view.

Serum Copeptin and Neonatal Outcome in Pre-eclampsia

Sarah Fakhradeen Abdul-Kader; Ayla Khedher Ghalib

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 54-63

Background: Pre-eclampsia (PE) is an idiopathic specific syndrome that affects every organ system during pregnancy.It is a leading cause of both fetal and maternal morbidity and mortality worldwide. Setting: Antenatal and Obstetric Department in Azadi Teaching Hospital. Study design: Case-Control study (prospective). Duration: From April - December 2017.
Patients and methods: The study included 90 pregnant women, who were divided into three groups. 30 normotensive women (control), 30 women with mild pre-eclampsia and last 30 were with severe pre-eclampsia.
Results: Plasma level of Copeptin were 6.87 pmol/l in normotensive pregnant group, 51.70 pmol/l in mild pre-eclamptic group and 54.17 pmol/l in severe pre-eclamptic group (p-value<0.05). Copeptin was significantly elevated in pre-eclamptic subjects compared with controls and in severe pre-eclamptic group compared with mild ones. Assessing the diagnostic property of Copeptin for PE, (2) still births were recorded in severe PE, while no still births in mild PE and controls. Copeptin levels in pre-eclamptic patients with adverse neonatal outcomes as low birth weight, admission to NICU were significantly higher than the normotensive group.
Conclusion: This research suggest that increased maternal levels of Copeptin may be involved in the pathogenesis of pre-eclampsia and it may be useful in the assessment of the severity of the disease in the third trimester and this associated with adverse perinatal outcomes

Percutanous Crossed Pinning Versus Two Lateral Pinning for Treating Supracondylar Humeral Fracture in Children: Comparative Study

Muhammed Kamal Othman; Sherwan Hamawand

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 64-77

Objectives: The study done to identify the advantage and disadvantage of two pinning types used for supracondylar fracture in children. The Baumann`s angle difference, ulnar nerve injury incidence and elbow flexion-extension loss.
Methods: Conducting a prospective randomized controlled study on 30 patients with extension type III supracondylar fracture from 1st January 2018 to 1st January 2019 operated by medaial-lateral pinning (n=15) or two lateral pinning (n=15).
Results: 30 patients with mean age of 6.73 years were included in the study. The mean follow-up period was 2.75 months. The Baumann`s angle mean difference between normal and injured elbow in crossed pinning and two lateral pinning was 5.46 and 4.96 and the difference was statistically not signoficant (p=0.58).The mean flexion-extension loss in crossed pinning was 8.3 and 6.25 degrees, in two lateral pinning was 11.25 and 7 degrees respectively. Mean difference of carrying angle in crossed pinning was 2.1 degrees; in two lateral pinning was 2.73 degrees. The differences between two groups were not statistically significant (p=0.65). Two iatrogenic ulnar nerve damage developed in crossed pinning while in two lateral pinning, no incidence of nerve damage seen. This difference also was not significant (p=0.14).
Conclusion: From both fixation types, we found that there isn`t statistical difference in terms of clinical outcomes.

Anemia in Pregnant Women in Kirkuk Governorate

Mohammed Ali Khalaf; Dalia Maher Khider; Bilal Jamal Kamal

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 78-85

Background: Anemia is defined as hemoglobin levels of ≤ 11 g/dl , is one of the world's leading causes of disability , and thus one of the most serious global public health problems .More than (50%) of the pregnant women in the world are anemic. Knowledge about the anemia is very important in our community. This knowledge will encourage those who work in primary health care (PHCS) provider for pregnant women to detect the problem earlier and treat the problem properly.
Aims: Is to determine the effective factors related to anemia in pregnant women in Kirkuk governorate. Patient & Method: A total of 250 pregnant women were asked while attending antenatal unit in Azadi Teaching Hospital and several Primary Health Centers in Kirkuk City out patients clinic from 25.10. 2014 to1.3.2015. Data were taken involve: age, residency, educational level, history of last menstrual period, onset of anemia and level of hemoglobin (Hb). These data were organized in special questionnaire prepared for this purpose.
Results: From the total (250) pregnant women (61.6%) of them have low Hemoglobin (Hb) level mild, moderate or severe anemia the majority of them (75.33%) with mild anemia. according to severity the rate was (3.2%).
Conclusions and Recommendations: The prevalence of anemia among women in Kirkuk city during pregnancy is high (61.6%) in compare to (52%) in the world wide in developing countries.

Relation of Human Cytomegalovirus Antibodies with Some Serum Proteins Levels among Pregnant Women in Kirkuk Province/ Iraq

Abdulla Kamil Abdulla; Staar Mohammed Qader

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 86-94

Human cytomegalovirus (HCMV) is a beta-herpesvirus that causes lifelong infection in humans especially during pregnancy can cause of congenital abnormalities. The process of viral entry and replication mainly depending on the interactions between virus proteins and host cell proteins. Objectives: The present study aimed to detect the relation of HCMV antibodies with some serum proteins levels among pregnant women in Kirkuk province. Methods: The current study was done in Kirkuk city from 15 January to 15 July 2017. It was included a total of 260 pregnant and 110 non-pregnant women (control group) aged (18-24 years old); who showed up at some private main laboratories in Kirkuk City (Mainly at Saya Main Lab. Which is Located at Dibis district). They were examined for the presence of HCMV antibodies (HCMV-IgG and HCMV-IgM) by using of Enzyme Linked Immunosorbent Assay (ELISA) technique, and they were also examined for the total serum protein, serum albumin, and serum globulin levels using spectrophotometry technique. Results: The present study revealed that IgG antibodies rate (71.53 %) was the highest among the seropositive antibodies in pregnant women. The highest rate (47.05 %) of decreased level of serum albumin was found in those pregnant women who showed seropositivity for both (IgM and IgG) to HCMV at that same time. The study also showed non-significant relation between seropositive HCMV antibodies and total serum protein and globulin levels in pregnant women. Conclusions: High rate of pregnant women infected by Human Cytomegalovirus in Kirkuk province. The study also concluded that the HCMV infection may affect the rate of the serum albumin levels in pregnant women.

The Elecroencephalographic Study Findings in Patients with Migraine without Aura

Wafaa Raoof Rashid

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 95-97

Background: There are different EEG findings in patients with migraine without aura, but still the majority of patients have normal EEG recordings. Aim of the study: To evaluate EEG abnormalities in patients with migraine without aura. Methods: Thirty patients with common migraine are evaluated by EEG test. Age of patients rage from 18-45 years, eighteen of them was females and twelve were males. EEG was performed during headache and as soon as possible after attacks of headache. Results: Out of the 30 patients who are studied, only 6(20%) show EEG changes, 4 females and 2 males, while the rest 24(80%) migraineurs had normal EEG. Of the 6 patients with EEG changes, 3 have left sided headache, 2 right sided headache and one bilateral headache. The EEG findings was slow waves in 4 patients (50%), sharp waves in 3 patients (37.5%), and spike in one patient (12.5%). The sites of EEG changes were 4 in frontal area, 3 in occipital area and 2 in temporal area. Bilateral EEG changes present in all 6 patients. Conclusion: Our study shows significant EEG abnormalities in a good proportion of patients with migraine without aura, but these findings are not specific and cannot replace clinical and neurologic diagnosis.

Assessment the Knowledge and Attitude of Breast Self Examination among Secondary School Female Students in Mosul City

Marab Younis Abdullah Al-Fathy

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 98-104

Background: the examination of the Breast is regarded as the secondary method of breast cancer protection which must be done by all females during the age 20 years and above. Aim: To assess knowledge and attitude level of females secondary school student’s towards breast self examination (BSE). Subject and method: Cross-sectional study design involved 1000 female student in secondary school in Mosul city .The study started from (1st March till 1st June) 2019, lasting for about (3 months ) by using a self-administer standardized questionnaire include knowledge and attitudes toward , source of knowledge Result: the study revealed that grand mean assessment value regarding BSE general information was 2.09 just above the (cut – off point = 2). The main source of knowledge was health professional (32.3%), followed by TV and social media (27.6%). Nearly two third of study sample had positive attitude to consult doctor and period of consultation within one week with mean score 2.3 and 2.4 respectively. In general the mean score assessment value of attitude toward BSE among study sample was below the cut of point 1.7. Recommendation: Provision of intensive educational program to secondary school students by health professional and encourage school teachers to teach and complete educational curriculum which focus to BSE and take attention to the subject to increase awareness and improve attitude toward it.

Prevalence of Iron Deficiency Anemia (I.D.A.) among 6-24 Months Old Children Admitted to Azadi Teaching Hospital in Kirkuk Governorate in 2019

May Muhammad Shareef; Suhair Shareef Abdulkareem; Jameel Ibrahim Azeez

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 105-112

Background: Iron deficiency anemia is a common nutritional problem worldwide and present in developing countries more than developed country. Aims: 1. To assess how widespread is the Iron deficiency anemia among anemic children between 6 -24 months of age. 2. Study the significant relation of age, sex, and residence of children and education status of the mother of a child with I.D.A. 3. To illustrate the relation of feeding practices and the development of I.D.A. and the relation between nutritional status (Weight for age) of children and I.D.A. 4. To study the relation between gestational age and development of I.D.A. Patients and methods: This study is performed in Azadi Teaching Hospital in Kirkuk pediatric department during 2019 to investigate the prevalence of IDA in children between six months and 2 years of age. A detailed history taken and physical examination done. serum iron, total iron binding capacity and serum ferritin were checked for the anemic cases. Results: A total of (90) cases, 60 cases of them (66%) had anemia (P.C.V. less than 33%). Iron deficiency anemia constitutes 50 cases (55.5%) of all cases of anemia. The cases came to hospital complaining from pallor and poor appetite. The peak age incidence of I.D.A. was between 6-12 months of age. There was no great variation between affected males and females. Most of the cases (32) (64%) were referred from rural areas. It was noticed that artificial feeding was a common feeding practice in most of the cases. Seventy percent of cases were under 10th centile of their weight for age. A large numbers of mothers had low educational level .Also the mean age of early introduction of food was (5-12) month. Conclusion: 1. Peak age of Iron deficiency anemia (I.D.A) is between 6-12 months of age. 2. Iron deficiency anemia is more common among rural children. 3. The majority of infants with I.D.A. were underweight. 4. Early introduction of food from 6 months of age with bad nutritional supplement with no iron contents can lead to I.D.A.

Evaluation of the Modified Distally Based Perichonderio-AdipoDermal Flap Technique for Treatment of Prominent Ear Deformity

Murad Ali Akbar Ameen; yasir N. Qassim

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 113-122

Background: Prominent ear is a common congenital deformity .Many operative procedure used to correct this condition which means no single method has been adopted. Some of these procedures adopt cartilage cutting technique while the others preserve the cartilage. Children with prominent ear may be concerned major psychological problem. Recently otoplasty is considered as corrective surgery for pre-school age children to get rid them from social embarrassment. Aim: To evaluate of the modified Distally Based Perichondrio –adipo-dermal flap Technique for reconstruction of prominent ear. Patients and methods: Eleven patients (21 ears), were involved in this prospective study at AL -Shaheed Ghazi AL Hariri Hospital and Sulaymaniyah Burn and Plastic Surgery Hospital between March 2017 to December 2017. We excluded the patients who had previously operated on (recurrent cases) and patients with combined congenital auricle deformity. Modified Distally Based Perichondrio –adipo-dermal flap Technique was used as a cartilage sparing technique for correction of prominent ear deformity. Results: As a subjective perception and according to visual analogue scale ,most of our patients or their parents were satisfied with final results. Apart from one case of recurrence, no major complications were seen. Objectively, set back of the prominent ear was reached acceptable value. Conclusion: Modified Distally Based Perichondrio –adipo-dermal flap Technique flap for correction of prominent ear deformity is simple and provide promising aesthetic outcome with minimal drawbacks, except those patients with deep concha

Screening for Helicobacter PyloriIgG among Undergraduate Student of Hawler Medical University/ College of Health Sciences

Amer Ali Khaleel; Sahar Mohammed Zaki Abdullah; Abdulrazzaq Bahaulddin Mohammed; Sewgil Saaduldeen Anwer

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 123-129

Background: Helicobacter pylori is a significant pathogen of the gastrointestinal tract infection connected with gastritis, peptic ulcers, and gastric carcinoma. Its infection influences more than half of the world’s inhabitants. Objective: To reveal the prevalence rate of H. pylori infection and linked factors (age, gender, residency, blood group, sources of drinking water and type of food) among students in College of Health Sciences, Erbil, Iraq. Material and Methods: 141 students (73.75% female and 26.24% male) in Colleges of Health Sciences at Hawler Medical University were taken on. Seroepidemiologic method used for detection of H. pyloriIgG antigens using rapid immune chromatographic assay (Camp Medica Group, Bucharest, Romania). A questionnaire sheet was prepared and used for each study subject. Results: Among 141 students, 33(23.40%) were infected with H. pylori. The infection was more prevalent in female students (26%) of total female participant comparing with male students (7%) of total male participant. The higher rate of infected showed in age 20 (29.78%) and high rate of infected students showed no symptoms. Conclusions: H. pylori are highly prevalent among University students in our region. The great prevalence of H. pylori was found in the students with O blood group, elder age groups, urban area, and females.

Relationship between Vulvovaginitis in Women with the Candida Species

Sahar Mohammed Zaki Abdullah

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 130-141

Background: Vulvovaginal candidiasis refers to the vaginal infection that is caused most commonly by candida species, especially candida albicans, women in their lifetime at risk to infect by candida species. The objectives of this study were to determine the relationship of Vulvovaginal infection with Candidiasis and its association with some risk factors and the incidence of different species of Candida among patients with vulvovaginitis. Methods: 300 samples from high vaginal swabs obtained from females attending maternity teaching hospital in Erbil City complained from signs and symptoms of valvovaginitis from the period September 2019 to February 2020. A questionnaire form prepared for each patient, who includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High vaginal swabs collected from patients and direct microscopic examination performed, cultured onto Sabouraud Dextrose Agar (SDA), Blood agar and Macconkey agar and species identification done by using an automated VITEK 2 compact system. Results: From the total of 300 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was (57%). The highest prevalence of positive cases were in the age range (30-34) years and the positive culture among pregnant women was 73(63.4%) and also the incidence of vulvovaginal candidiasis was higher among diabetic females 49(80.3%), The incidence of positive cultures of Candida spp. in the antibiotic users group were 61(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills 40(60.6%) however for IUCD user the positive culture was 31(68.9%). The species of Candida species which identified by using Vitek system were distribute as follow: Candida albicans was 147(86%) Candida glabrata16 (9.4%),CandidaParapsilosis 6(3.5%)and, Candida krusei 2(1.2%). Conclusion: In the present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.

Prevalence and Detection of Helicobacter Pylori among Patients in Rizgary Hospital Using Stool Antigen Test- Erbil City

Hangaw O.Haji; Sewgil. S.Anwer; Sahar M.Zaki; Basoz B. Mustafa; Asma A. Abdulla; Gashbin J. Hassan

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 142-148

Background and Objectives: Helicobacter pylori is a spiral shaped, Gram-negative rod with 5-7 flagella at one end and have been considered as a primary risk factor for peptic ulcer disease and gastric cancer. This study aimed to the prevalence and detection of H.pyori among Rizary Teaching Hospital/ Erbil City. Objective: Study the prevalence and detection of H. pyori among Rizary Teaching Hospital. Methods: Seven hundred and twenty- six (726) human stool samples were collected from Rizgary Teaching Hospital /Erbil City from October 2018 to February 2019. The samples were collected and the test performed in the microbiology laboratory Collage of Health Sciences by using antigen stool detection tests. Results: The study showed that among 726 samples in Rizgary Teaching Hospital H. pylori positive results showed in 380(52%) and H. pylori infection in female was higher than male, the infection was higher among (16-45) years than patients aged between (15- 16 and 55-65) years, when we studied H. pylori infection according to months it was showed that the prevalence of H. pylori infection appeared in all studied months the higher infection showed during October 94 and November 84 and there was a significant difference between the samples related to months. Conclusion: Among 726 samples H. pylori was positive in 380(52%), H. pylori infection in female was higher than male. The infection was higher among (16-45) years than patients aged among (55-65) years.

Using Multiple Serum Biomarkers in Detecting the Outcome of Threatened Miscarriage

Ozlam Fadhil Yousif; Khalidah Mohammed Amin

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 149-158

Background: Threatened abortion is presumed when there is a bloody vaginal discharge or bleeding through a closed cervical os. cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) are biochemical markers that have been studied to establish if they can predict the outcome of threatened miscarriage. Methods: A prospective observational study that was conducted at the Department of Obstetrics and Gynecology at Azadi Teaching Hospital/ Kirkuk-Iraq, over a period of eight months from first of April 2019 till first of December 2019. It included 96 pregnant women at 7 – 13 weeks of gestation with singleton pregnancy, viable fetus, and closed cervical os they presented with signs and symptoms of first trimester threatened miscarriage. After the first visit, follow up was done until they passed into the second trimester of pregnancy, and patients from the study group were divided into group 1: Included 19 patients who ended with miscarriage and group 2: Included 69 women who continued their pregnancy into the second trimester. We compared the level of the Cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) between the two study groups to assess their utility for prediction of the outcome of first-trimester threatened miscarriage. Results: Mean of CA 125 marker was significantly higher in participants who ended with miscarriage than that in participants who continued to second trimester. Means of B-hCG and sFlt-1markers were significantly lower in participants who ended with miscarriage than that in participants who continued to second trimester Serum CA-125 marker > 38.8 IU/ml, Serum β-hCG marker < 20211.3 mIU/ml, and serum sFlt-1 marker < 1731.7 pg/ml are predictors for risk of miscarriage. Conclusion: Serum CA 125, B-hCG, and sFlt-1 biomarkers represent non-invasive, early, fast and excellent predictors of pregnancy outcome in women with threatened miscarriage. Taking into account the feasibility and cost, using serum β-hCG instead of the more accurate one (i.e. serum sFlt-1) would be more logical decision. Further studies are needed in this field.