Print ISSN: 2790-0207

Online ISSN: 2790-0215

Issue 2,

Issue 2


Detection of Trichomonas vaginalis among Females Attending Private Gynaecological Clinics in Kirkuk Province Using Different Laboratory Methods

Yahya Jirjees Salman; Esraa Abdul Kareem

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 1-8

Background: Trichomonas vaginalis infection is a common sexually transmitted protozoal infection and is associated with several adverse health outcomes, such as preterm birth, delivery of a low–birth weight infant, and facilitation of sexual transmission of human immunodeficiency virus. The annual incidence rate in Iraq has been estimated range between 1.33% to 34%. However; there are no data on the prevalence of trichomoniasis among all reproductive-age women. Patients and methods: Total of 161 women from 15- 61 years who participated in the study form 1st October 2011 to 30th September 2012 with collection of vaginal swab specimens after taking consent from each patient. The vaginal fluids extracted from these swabs were evaluated for the presence of Trichomonas vaginalis using direct wet mount preparations, staining, and cultivation on special culture media. Results: Over all, 33 (20.49%) of 161 women were positive for trichomoniasis with 98.12 % of specificity and 100% of accuracy of wet mount preparations technique for parasite detection. Compared to culture methods that show low sensitivity and specificity P< 0.05 .Women aging from 50 years and above and those aging from 20 to 30 years revealed high rate of trichomoniais than other age groups P<0.05. Relationships between Trichomonas vaginalis distribution and color of vaginal discharges, pH, signs, symptoms, residency of women, occupation, height and body weight were statistically significant, greenish vaginal discharge with pH ranging from 4 to 6 reveal more trichomoniaisis mostly associated with high dominancy of burning sensation and vaginal itches, P < 0.05. While thin and short women from urban area and officers, their vaginal discharges examination show high frequency of trichomoniasis in contrast to other women, P<0.05 . Trichomonas coexists were recognized with high rates of Gardnerella vaginalis and Candida albicans in vaginal discharges especially among women aging from 20 to 30 years, P < 0.05. Conclusions: Under clinical examination women with abnormal vaginal discharges, burning sensation and genital itches should be checked for trichomoniasis using high sensitive and specific tests: direct wet amount preparations and fixed slide stained with giemsa stain, in addition to measuring the pH of the vaginal fluid and performing germ tube and whiff test for detecting vaginal thrush and bacterial vaginosis caused by Candida albicans and Gardnerella vaginal respectively.

Hypospadias Fistula Repair; Should a Stent be Left?

Ali Adwal Ali

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 9-13

Objectives: to evaluate the role of stenting in a children undergoing fistula repair, as a stent free fistula repair has been successful without prolonged discomfort. Patients and methods: The study included all Hypospadias repaired patients with fistula formation; both primary surgery and fistula repair surgery done by one surgeon, between July 2005 and September 2011, patients were prospetively randomized at the end of surgery to either leaving a stent (folyes catheter) for one week or no stent at all. The study included 74 patients (40 stented and 34 not stented). Median age of patients was 6 years, range (4-7) years. For the stented group, the stent placed in the bladder for continuous bladder drainage. Results: The median range follow up was 8 months (6-12) months. Voiding was painful in the first week, in 5(12.5%) and 13(38%) of the stented and unstented patients respectively, none of the stented patients developed urinary retention, compared with 7(20.5%) patients in the unstented group. Although the re-operation rate was 0% for the stented group, while it was 20.5% for unstented group, the difference was statistically not significant (p> 0.05). Conclusions: The use of stent in Hypospadias urethrocutaneous fistula repair is advantageous, it eliminates the risk of urinary retention and extravasations, reducing the overall patient discomfort adding to that, lower re-operation rate.

Urinary Tract Infection among Diabetic Women in Kirkuk City

Dilshad Sabir Mohammed

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 14-22

Background: Urinary tract infection (UTI) is the most common of all bacterial infections in diabetes mellitus; it affects persons throughout their life spans. The term UTI encompasses a variety of clinical entities ranging from asymptomatic bacteriuria to cystitis, prostatitis and pyelonephritis. Patients and methods: In the present study, 200 diabetic women,100 of them were at active age group(AAG) their ages range from (25-35)years with mean age of 31 years. Another 100 women were post-menopausal (PM) their ages range from (55-75) years with mean age of 64 years. Two hundred non diabetic women were taken as control group and were divided into 100 at AAG and 100 PM. The patients and control groups were attendant of Kirkuk general hospital. Results: UTI was found to be present in 28 out of 100 cases of AAG diabetic women (p value =0.02) while it presents in 25 out of 100 PM diabetic women (p value =0.04). Also this study shows that 13 out of 25 PM diabetic women received insulin for treatment while 7 out of 25 PM diabetic women received oral antidiabetic drugs, and only 5 out of 25 PM diabetic women didn't receive any treatment (p value=0.03). The present findings shows that 14 out of 28 AAG diabetic women received insulin for treatment, while 8 out of 28 of them received oral antidiabetic drugs and only 6 out of 28 AAG diabetic women didn't receive any treatment (p value =0.043) Conclusion: The prevalence of UTI is higher among diabetic patient compared to nondiabetic patient regardless of age .Diabetes treated with insulin is related to substantial increases in the risk of UTI among both age groups included in the present study

The Effect of Plaster Immobilisation on the Proprioception of the Limb

Adnan Abdulmajeed Faraj; Mohammad Hasson Elanbari

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 23-29

Background: It is difficult to establish the effect cast immobilisation has upon a patient and whether or not it causes a significant detriment to the proprioceptive mechanisms within the body. An observational pilot study on random group of patients collected from the fracture clinic. Patients and methods: Twenty two male and sixteen female fracture clinic patients from Airedale general hospital were included within this study, with ages spanning from six to eighty years old. A comparison between patients drinking alcohol and patients not drinking, were made. Also the effect of age was analyzed. A subjective analysis using a questionnaire and an objective examination on modalities of light touch, vibration and position sense, to investigate any variation in proprioceptive awareness. Results: Highlighted a correlation between time in cast and sensorimotor deficit especially in patients above the age of 50 years. An increased time lead to an increased deficit with an eleven week duration following Achilles tendon rupture being the most significant. The results also indicated the profound negative effect of alcohol consumption on the proprioception of the patient, regardless of quantity. Conclusion: Individuals who are known to consume alcohol are suggested to receive assistance with their proprioceptive function by means of physiotherapy and limb movement re-training prior to driving. Individuals who have Achilles rupture should be subjected to clinical review three months post-cast-removal prior to returning to drive.

Deferoxamine vs. Deferasirox in the Treatment of Thalassemia Major with Iron Overload: Retrospective Study in Thalassemia Center, Kirkuk, Iraq

Jamal Qasim Weli; Mohammed Saleem Mohammed

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 30-36

Background: Iron overload is a major problem in patients with Thalassemia major. An effective and safe iron chelator protocol with high compliance rate plays an important role deciding the best treatment option in these patients. This study was done to assess the efficacy and safety of both Deferoxamine and Deferasirox in Thalassemia major patients in Kirkuk province, Iraq. Patients and methods: In this retrospective study we have included serum ferritin records of 280 Thalassemia major patients treated with two types of iron chelating therapy at Thalassemia center, Azadi teaching Hospital, Kirkuk province, Iraq. The study started since March 2012 till December 2012 and they were categorized in to two groups; First group Thalassemia major patients who had been treated with subcutaneous (SC infusion) Deferoxamine, while second group had been treated with oral Deferasirox (Exjade) with serum ferritin records of both base line and 9 month later had been compared. Most patients with relatively high serum ferritin had been treated with SC Deferoxamine. As a secondary end point, side effect profile had been analyzed in the two studied groups. Results: 173 Thalassemia major patients (mean age 11 year) treated with oral Deferasirox (Exjade) had mean decrease in their serum ferritin after 9 month was 840 ng/ml while the mean decrease in the 107 patients (mean age=17 year) treated with SC infusion Deferoxamine was (1527 ng/ml) with very significant difference between the two studied groups and (p-value = 0.0005). Abdominal cramp, nausea and vomiting, skin rash were more with oral Desferosix (Exjade) than SC Deferoxamine treated patients [52 (30%), 62 (35%), 13 (7%) versus 23 (21%), 11 (10%), 0 (0%) consecutively]. Renal impairment especially elevation of serum Creatinine to a degree requiring dose modification were found in 15 patients treated with oral Deferasirox (Exjade) while it has not been noticed in patients treated with Deferoxamine. Conclusion: In spite of less side effects and more compliance of Thalassemia Major Patients treated with Deferasirox than Deferoxamine; Deferoxamine still is more effective treatment modality than Deferasirox in decreasing serum ferritin level.

Maternal Serum Creatine Kinase and Single Serum Progesterone Measurement as Predictors of Ectopic Pregnancy

Aseel Ghazi Rifat; Maha Mohammed Al-Bayati; Abdul Wahab Razooqi Hamad

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 37-47

Objective: To evaluate the role of serum creatine kinase (CK) and progesterone (p) in the prediction of ectopic pregnancy (E.P). Patients and methods: A prospective study was carried out on 60 pregnant women of comparable gestational age and they were divided into 3 groups: Group A: 20 patients with confirmed E.P. Group B: 20 patients with missed or spontaneous miscarriage. Group C: 20 women with normal intrauterine pregnancy (IUP). The following laboratory measurements were performed for the studied groups: 1- Test for serum CK level for all groups. 2- Test for serum progesterone for all groups. 3- Histopathological study to determine the depth of invasion of the trophoblast to the muscular layer of fallopian tube for group A. Results: 1- The serum CK level was significantly higher in group A than in group B and C and was significantly higher in ruptured than in unruptured and in isthmic compared to ampullary EP. 2- The serum progesterone level was significantly lower in group A and B than in group C, but there was no significant difference between group A and B. 3- The serum progesterone level was significantly higher in ruptured than in unruptured EP. 4- There was significant positive correlation between serum CK and progesterone level in group A. Conclusion: 1- An increase in serum CK levels probably antedates tubal rupture and could help in discriminating ruptured from unruptured EP. 2- Serum progesterone discriminates EP from normal IUP but it does not differentiate it from miscarriage. 3- The combination of both serum CK and progesterone in suspected EP has a higher differential accuracy than either analysis alone

Development of Chronic Conjunctival Swelling in Association with Congenital Lymphedema

Brian Campolattaro; Abdulhameed Abdulmajeed Hassan; Francine Beli

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 48-51

Although the association between the conjunctival swelling & lymphedema is rare, but this may occur, most of the cases described are part of the lymphedema distichiasis syndrome, this is the first case reported in North America where patient developed many years after birth (when the patient is 9 years old) an isolated chronic conjunctival swelling (not associated with any syndrome affecting the eyes) in association with congenital lymphedema of the feet.

Evaluation of the Employment of Four Laboratory Diagnostic Methods in Detecting of Giardia lamblia among Children in Kirkuk City

Yahya Jirjees Salman; Maha Ismaiel Mussttafa

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 52-60

Background: Giardiasis is the most common cause of diarrhea among people in Iraq, caused by Giardia lamblia parasite. Laboratory diagnosis requires diversity usage of method to reveal the parasite with in different types of specimens. Aim: The aim of this study were to determine the prevalence of giardiasis in Kirkuk city, to assess the efficacy of four different methods employee in detecting Giardia parasite and an attempt to extract and amplify DNA of this parasite using mixed primers of Giardia assemblages A and B. Material and Methods Cross sectional study was carried on a total of 310 stool samples were collected and tested for giardiasis by using direct microscopy, ELISA-corpo-antigen, Lateral immune-chromatography assay (Triage panel) and PCR technique. Results: The overall rate of parasitic infection was (51.93%); Giardia lamblia rate was (20.32%). Giardiasis among males was higher than in females. Traige panel show high efficacy for detecting Giardia lamblia than detecting of Entamoeba histolytica and cryptosporidium. Statistically the differences among direct microscopy, ELISA and Triage panel were not significant. Application of PCR single step technique show high rate of sensitivity than other methods in detecting giardiasis. Amplified Giardia genome length extended from 280 to 750 bps with mean of 437.6 bps. Conclusions: Giardiasis among peoples in Kirkuk city was high especially among males. Triage panel and ELISA were simple and easy, but were less sensitive than conventional microscopy methods. PCR technique using k 725 gene (Mixed primers of assemblages A1, A2 and B) loci was performed for the first time in Kirkuk city with high sensitivity and specificity than other laboratory methods.

Management of Missile Injuries of the Knee

Adnan Abdulmajeed Faraj

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 61-67

Background and Objectives: Iraq continues to be a troublesome area, missile injuries around the large joints of the extremity remains to be a challenging injury to the under resourced and poorly equipped unsafe hospitals. The aim of this study is to report our experience in the management of such injuries. patients and methods: Thirteen patients (14 knees) with grade III Gustillo open fractures of the knee caused by war injury including bullets, shells of blast and missiles were treated by wound debridement, washout, repair of arterial injury after external or internal fixation of the fracture. Five patients (38%) required Dacron arterial graft for associated vascular injury, there was a case of permanent nerve damage (7%). Results: The outcome was satisfactory in 6 patients (46%), fair in five (38%) and poor in the remaining (16%). One limb remained was ischemic; one case of infection required amputation. These patients underwent wound debridement, skeletal fixation and vascular and or plastic reconstruction. Conclusion: There is high association of open war injuries of the knee with neurovascular injuries. Awareness of the associated vascular injury and team approach, is vital in the management of these injuries. Skeletal stabilization using any method deem to be appropriate is associated with good outcome provided appropriate early wound debridement is performed.

An Epidemiological Study of Irritable Bowel Syndrome among Students of Medical and Nursing Colleges in Kirkuk University

Dilshad Sabir Mohammed; Amanj Mohammed Salih; Mohammed Mustafa Mohammed

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 68-73

Background: Irritable Bowel syndrome is a functional bowel disease characterized by abdominal pain associated with change in the frequency and consistency of stool, this study was carried out to study the prevalence and the clinical characteristics of irritable bowel syndrome among students of medical school of Kirkuk university. Subjects and Methods: This is a cross sectional study done among students in medical and nursing college of Kirkuk university from September 2012 to March 2013 according to a standardized questionnaire based on Rome II criteria for the diagnosis of IBS. Results: This study showed that symptoms of IBS is present in (35%) of students in nursing college and (31%) of students in medical college with overall frequency of (33%), also this study showed a frequency of IBS among (24.3%) of female and (11.2%) of male in nursing college while (18.6%) among female, (12.9%) of male in college of medicine. Regarding the type of IBS according to the bowel motion, diarrheal type was present in (41.6%), constipation type in (30.5%) and the mixed type in (27.7%). Conclusion: The present study showed that symptoms of IBS are frequent among students in medical and nursing college and it is commoner in females more than males.

Correlation of Handedness with High Cerebral Function

Osama Hassan Othman; Mohammed Mustafa Mohammed; Summer Saad Abdulhussain

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 74-80

Background: Handedness in human kind means a lot apart from social impact. It gives a hint to localization of dominant hemisphere. This study was done on Kirkuk University students & well concluded that activities other than only hand writing are well correlated to high cerebral function like learning & memory, speech & language. Family history is important in this aspect. Objective: To explore correlation of handedness to candidate performance & other daily activities which need high cerebral function. It's relation to family history is well addressed. The patterns of speech fluency were studied. Subjects and methods: Subjects included in this cross sectional study were selected randomly from students in different colleges in Kirkuk University from Jan. 2012 – Jan. 2013. Proposing sheets of information & asking candidates directly by researchers about wanted data & the result were fixed in appropriate boxes and then analyzed properly. Results: Among 242 students 148 (61.15%) were using right hand during writing while 94 (38.85%) using left hand during writing. Some of them were in forced by their parents to change handedness during early childhood. Handedness were different during other activates, correlated well with performance & got family history. Conclusion: Handedness correlated with many parameters other than hand writing. Important daily activities, performance at college, ability in mathematics, drawing, quality of hand writing were all observed.

Knowledge of Women Attending Two Primary Health Care Centers / Sulaimany City/Iraq Regarding Breast Cancer

Bushra Muhammed Ali

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 81-91

Background: Breast cancer in Iraq is the most dangerous disease which has the highest incidence that threats women lives in Iraq for the last twenty years. Objectives: To assess the knowledge level of women about breast cancer in relation to some socio-demographic and other relevant factors. Subjects and methods: A cross-sectional study included women attending Ibrahim Pasha and Ali Kamal Health Centers/Sulaimany City. Data were collected by self-administered and interviewing questionnaires from 1st October to 31th December 2012. Total number of the women was 802. The data were analyzed using SPSS version 19.0. Results: There was a significant association between the knowledge score of breast cancer risk factors and protective factors (P=0.001) with the age and level of education. There is a significant association between those with knowledge score of risk factors and protective factors of breast cancer and history of breast mass (P= 0.045, family history of breast mass (P= 0.042). There is a significant association between knowledge score of symptoms of breast cancer and age (P= 0.001) occupation (P= 0.0002), marital status (P= 0.041), those with use of hormonal replacement therapy (P= 0.016) and had history of breast infection (P= 0.031). Conclusion: Participants had an accepted knowledge about breast cancer. There was a significant association between the knowledge level of women about breast cancer in relation to some socio-demographic, and other relevant factors.