Advanced medical journal最新文献

{"title":"The role of antiplatelet therapy on arteriovenous fistula malfunctioning among hemodialysis patients","authors":"M. A. Wahab, Majeed Hassan Mahmood","doi":"10.56056/amj.2023.220","DOIUrl":"https://doi.org/10.56056/amj.2023.220","url":null,"abstract":"Background and objectives: The vascular access of choice for hemodialysis is the Arteriovenous fistula. A functional vascular access is required for a successful hemodialysis performance. The aim of the study is to examine the effect of antiplatelet therapy on arteriovenous fistula malfunctioning among hemodialysis patients. Methods: A cross-sectional study on 78 end-stage renal disease patients who undergone hemodialysis and had arteriovenous fistula was conducted. The data were collected during the period of 1st April 2020 to 1st April 2021, taking information about socio-demographic data of the patients such as age, gender, past medical history and hemodialysis status. Results: The mean age of patients was 63.87 (± 8.44) years; most of them were female and smokers. Only 17.9% of the patients were not on erythropoietin, while the rest were taking 8000 IU/week (55.1%) or 4000 IU/week (26.9%). After one year of having arteriovenous fistula, more than half (52.6%) of the patients developed arteriovenous fistula malfunctioning in the form of stenosis (17.95%) or thrombosis (34.62%). There were significant statistical associations between arteriovenous fistula malfunctioning and comorbidities, type of anti-platelet and use of erythropoietin. However, non-significant statistical association was found between the development of arteriovenous fistula malfunctioning and gender, duration of hemodialysis and smoking. Conclusions: Antiplatelet therapy and lower doses of erythropoietin use is associated with lower arteriovenous fistula malfunctioning. Prior to the arteriovenous fistula creation, patients should be assessed appropriately.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"123 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for SARS-CoV-2 infection in women prepared for elective Cesarean Section: A tertiary hospital study","authors":"Naz Mohammed Ahmed, S. Alalaf","doi":"10.56056/amj.2023.228","DOIUrl":"https://doi.org/10.56056/amj.2023.228","url":null,"abstract":"Background and objectives: The SARS-CoV-2 infection is a major concern as universal testing should be undertaken to pregnant women due to the high danger of transmission from a pregnant woman to her newborn. This study was conducted to report the rate of SARS-CoV-2 infection in women admitted to hospital for purpose of preparation for elective cesarean section and to find out their risk factors and any histories of the infection previously. Methods: A cross sectional study was conducted on 1000 on late third trimester pregnant women whom were prepared for elective cesarean section at department of Obstetrics and Gynecology, Erbil-Iraq from 1st Aug 2021 till 30th Jul 2022, History of previous SARS-CoV-2 infection and current signs and symptoms of the infection were recorded. All women underwent SARS-CoV-2 infection screening using nasal and throat swabs using polymerase chain reaction procedure. Results: Only (21.2%) of them were positive for the virus. There was a significant association between the current confirmed polymerase chain test with education, being a smoker, and all known signs and symptoms of the infection, such as fever, cough, and shortness of breath. When the clinical and social characteristics of women with low-risk and high-risk pregnancies were compared, there was a strong link between education, smoking, and loss of taste. Conclusion: Pregnant women may be advised to be tested for SARS-CoV-2 before cesarean section as almost one-quarter of participant were positive for the infection regardless of having sign and symptoms or not.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of urehtrocutaneous fistula formation during the first three postoperative months period of hypospadias reconstruction surgeries","authors":"Muhammad Abdullah Rahman Shwani, Halgurd Azad Abdullah, L. S. Miran","doi":"10.56056/amj.2023.211","DOIUrl":"https://doi.org/10.56056/amj.2023.211","url":null,"abstract":"Background and objectives: Urethrocutaneous fistula is one of the most frequent complications of hypospadias reconstructive surgeries. This study aimed to find the rate of fistula development following different types of reconstructive surgeries and their risk factors. Method: This study was conducted at Hawler teaching hospital, Rizgary teaching hospital, and Zheen international hospital in Erbil – Iraq from September 2020 to March 2021. A total number of 39 patients who underwent single-step surgery for reconstruction of hypospadias were included in this study and they were followed up for the first three months postoperatively for post-operative complications especially urethrocutaneuos fistula development. Results: Four patients out of thirty-nine developed urethral-cutaneous fistula (10.3%). A statistically significant relation was found between those aged older than 5 years and the rate of fistula development (three out of ten) (p-value = 0.023). Also, tourniquet time during the operation had a statistically significant relation with the incidence of fistula formation (mean time < 17.66 vs. > 20.5 minutes) in the fistula free vs. fistula group respectively (p =0.046). Conclusion: Reconstructive surgeries for hypospadias at earlier ages and with as short as possible tourniquet time reduce the incidence of fistula formation post-operatively.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"24 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison between modified Kessler and modified Tsuge suture techniques in flexor tendon repair","authors":"Gulstan Taimur Bakhshi, J. H. Fattah","doi":"10.56056/amj.2023.224","DOIUrl":"https://doi.org/10.56056/amj.2023.224","url":null,"abstract":"Background and Objective: Severed digital flexor tendon needs to be repaired to restore flexion function of the finger. The aim is to evaluate tendon repair outcomes by using two different suturing techniques modified Kessler and modified Tsuge. Patients and Methods: This is a comparative study performed in Rozhawa Emergency Hospital and Emergency Medical Center in Erbil city, Kurdistan region-Iraq between 1st of December 2019 to 1st of June 2021. The study included (33) patients of both genders who presented with acute flexor tendons laceration in fingers which their number were (44) fingers underwent digital flexor repair by using two different suture techniques modified Tsuge and modified Kessler. Results: This study includes (30) males and (3) females, patients with digital flexor tendon cut the age ranged from 18 years to 58 years, mean age was 30.1 ± (10.5) years SD. The majority of the injuries (90.9%) were in zone 2, and the right hand was injured in 56.8% of the total injuries. The most common injured fingers were the ring (25%) and the little finger (25%). The Flexor digitorum profundus was the most common (79.5%) injured tendon. The proportion of the patients who were satisfied with the operation's outcome is 60.6%. Conclusions: Tendon repair by using modified Tsuge 4 strands suture technique showed significant strength and less complication rate.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"117 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of ultrasound in the assessment of acute abdomen in the pediatric age group","authors":"Bayan Rasool Hama, Salwa Al Najjar","doi":"10.56056/amj.2023.229","DOIUrl":"https://doi.org/10.56056/amj.2023.229","url":null,"abstract":"Background & objectives: Acute abdominal pain in pediatric age groups is the most common presentation in an emergency room. The study aimed to diagnose cases of pediatric acute abdomen based on the ultrasound findings and determine the value of ultrasound in decision-making. Methods: A cross-sectional prospective study was conducted in the Raparin Hospital in Erbil City/Iraq from Feb 2021 to June 2022. A convenience sampling method was used, and 200 patients who complained of acute abdominal pain were included in the study. The questionnaire was designed for data collection. A specialist pediatrician clinically examined the children; investigations were done then referred to the radiology department for an ultrasound examination. Results: The ages of the involved cases ranged from one month to 15 years. Among them, 56.0% were males compared to 44.0% females, with a male-to-female ratio of 1.27:1. Regarding provisional clinical diagnosis of the patients, 60.0% presented with gastrointestinal problems among them, 39.2% had Gastroenteritis, 28.3% had appendicitis, 5.8% intestinal obstruction, 4.2% appendicular mass, 1.7% perforated appendix with the same percentage for intussusception, 23.0% suffered from mesenteric lymphadenitis, 7.0% had genitourinary symptoms and 6.0% were presented with non-specific symptoms. There was a highly significant association between the management plan and the surgical outcome of the cases, where the ultrasound was diagnostic among the majority (95.3%) of the operated patients. Conclusions: Ultrasound helped in earlier diagnoses of acute abdominal conditions and reduced radiation exposure to the pediatric age group.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"114 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Ischemic stroke risk factors in young Adults","authors":"Ahmed Kawa Fathi, Abdulrahman Aziz Rasoul","doi":"10.56056/amj.2023.227","DOIUrl":"https://doi.org/10.56056/amj.2023.227","url":null,"abstract":"Background and objectives: Keeping in mind stroke is the leading cause of disability globally, with increasing incidence of Ischemic stroke in young age reaching approximately more than 5-10 % according to multiple studies worldwide especially in developing countries. Methods: This observational cross-sectional study was conducted at the Neurology Department of the Rizgary Hospital, Erbil, Iraq over 12 months from July 2020 until July 2021. We included consecutive patients whom their age was between 18-45 years with first-ever ischemic stroke fulfilling the definition of The American Stroke Association. All patients underwent thorough history and clinical examination. Each patient underwent routine stroke assessment, including full blood workup and vascular imaging. Results: Out of 70 patients, 41 (58.8%) were males and 29 (41.4%) were females. There is a male predominance over females, which is comparable with other studies. Our present study showed that the most obvious risk factor for stroke in young people was hypertension, which was present in (38.6%) of cases followed by diabetes mellitus (20 %.), obesity (17.1%), smoking (17%), alcohol consumption (11.4%). Regarding stroke subtypes; small vessel disease was the commonest, subtype, it was present in 25.7% of cases. A stroke from a cardiac source is the second most common (24.3%). About (17.1%) of cases were in the large vessel category. The cause of the stroke was undetermined in (14.5 %) percent of cases (cryptogenic). Conclusion: Our study demonstrated that traditional atherosclerotic risk factors such as hypertension, diabetes, dyslipidemia, and smoking are responsible for most cases in young adults.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"140 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138598699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Risk Factors & Perinatal Outcomes in Women with Placenta Previa: A Cross Sectional Study","authors":"Zanwer Sabir Mahmood, A. Jawad","doi":"10.56056/amj.2023.218","DOIUrl":"https://doi.org/10.56056/amj.2023.218","url":null,"abstract":"Background and objectives: Placenta previa is one of the main factors in adverse maternal and neonatal outcomes. This study was conducted to determine risk factors for placenta previa and subsequent maternal and perinatal outcomes. Methods: This cross sectional study was conducted at Maternity Teaching Hospital, Erbil City, Kurdistan region, Iraq, from August 2020 to August 2021. Sixty Patients with placenta previa who presented with antepartum hemorrhage after 24 weeks of gestational age were included in the study. Participants underwent complete obstetrical and clinical assessment including history of risk factors, general physical, abdominal and pelvic examinations. Imaging methods used included transabdominal and transvaginal ultrasound. Patients were managed according to maternal and fetal conditions, and any maternal and fetal complications were recorded. Results: previous history of placenta previa was observed in 16.7% and previous cesarean section in 60% of women. Maternal outcome was good in majority (91.7%) of cases. Hysterectomy was performed on two women (3.3%). Emergency caesarean section was performed on 58.3% of women, and elective caesarean section was performed on 36.7% of women and neonatal death rate was 66.7% among those delivered by spontaneous vaginal delivery. Greater gestational age, lesser neonatal death rate. Women with grade IV placenta previa had worse neonatal and maternal outcomes than women with lower grades of placenta previa. Conclusion: A higher incidence of placenta previa is seen in patients with previous cesarean section, advanced maternal age, and high parity. No significant association was detected between neonatal outcomes and maternal risk factors.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vitro Evaluation of Push-Out Bond Strength in Three Different Post Systems","authors":"Tara Kamal Talib Bajlan, R. Salman","doi":"10.56056/amj.2023.223","DOIUrl":"https://doi.org/10.56056/amj.2023.223","url":null,"abstract":"Background and objectives: Intimate adaptation to the canal walls is accomplished by custom-made posts which leave an even thickness of cement layer. Therefore, this study has been conducted for assessing the strength of push-out bond among prefabricated fiber posts, relined fiberglass posts, and zirconium posts using resin cement of self-adhesive and adhesive. The mode of failure was also assessed. Materials and Methods: Sixty uniradicular teeth were endodontically treated. According to the kind of post system and cement utilized (n=10), the specimens were separated randomly into six groups. Zirconium oxide post, customized glass fiber post, and glass fiber post were used. The roots were divided into three discs: apical, middle, and cervical sections. After that, the discs were put through a push-out test, and the fracture mode was examined using a stereomicroscopic loupe. Results: The highest push-out value was recorded for the relined post (8±2.83 MPa), and the lowest was registered with no significant differences for the prefabricated post (7.27±3.76 MPa). There were no significant differences in strength bond across the various posts and root regions (P?.05). Adhesive failure at the dentin-cement interfaces for the prefabricated and relined post was (60, 57) % respectively, and zirconium oxide post was (22%). Conclusions: Relined posts may be a suitable clinical situation as a post material selection with reduced clinical steps. When posts are joined using self-adhesive and adhesive resin cement, the root region has no important influence on the strength of the bond.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"77 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138598032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible ureteroscopy and laser lithotripsy in unilateral multiple renal stones","authors":"Aso Omer Rashid, Lawan Twana Kamal, G. F. Abdulla","doi":"10.56056/amj.2023.222","DOIUrl":"https://doi.org/10.56056/amj.2023.222","url":null,"abstract":"Background and Objectives: To identify the factors contributing to stone-free rates and postoperative complications of flexible ureteroscopy and laser lithotripsy in unilateral multiple renal stones. Methods: A total of 20 patients had retrograde intrarenal surgery procedures to treat unilateral multiple renal stones, less than 50 mm collectively were reviewed from May 2021 to December 2021. Stone numbers were calculated, and stone size was measured as the cumulative stone diameter of all intrarenal stones. The clinical insignificant residual stones were defined as the absence of stone fragments <4 mm in the kidney at the end of the procedures. Baseline patient characteristics, operation time, hospital stay, stone-free rates, and complications were recorded. Results: Retrograde intrarenal surgery was performed on 20 patients (12 males and 8 females). The overall success rate was 80%. Depending on the sizes of the stones, patients with stones <20 mm had a stone-free rate of 100% (10/10 patients) and patients with stone size? 20mm had a stone-free rate of 60% (6/10) with a (p < 0.003). The number of stones per renal unit was two in 13 patients with a stone-free rate of (92.3%), three in 7 patients, and a stone-free rate was (57.1%) with a (p= 0.06). Postoperative complications were encountered in 4 patients (20%), and all were treated conservatively. Conclusions: Retrograde intrarenal surgery provides a satisfactory stone-free rate with a low complication rate when treating multiple renal stones. However, the success rate, stone-free rate, and the number of sessions significantly depend on the size and the number of stones.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"75 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Hyperprolactinemia in Clinical Practice","authors":"Bayar Qasim, K. Hussein, M. Ahmed, S. Salih, Mohammed Aziz Sulaiman","doi":"10.56056/amj.2023.221","DOIUrl":"https://doi.org/10.56056/amj.2023.221","url":null,"abstract":"Background & objectives: Hyperprolactinemia is defined as an increased prolactin level above the normal reference range, in women more than 25 ng/dl; with a prevalence rate of 10% in the general population. Hyperprolactinemia is associated with different clinical presentations various from oligomenorrhea, amenorrhea, galactorrhea, and infertility. This study aims to be to assess the current practice regarding the management of hyperprolactinemia in non-pregnant women in the Kurdistan region, Iraq. Subjects and Methods: An electronic questionnaire on current practice concerning diagnosis and treatment of hyperprolactinemia in non-pregnant women was sent through e-mail to 167 clinicians, 166 of them completed the survey and they were from different cities (Duhok, Sulaymaniyah, Erbil, and Halabja) of the Kurdistan region, Iraq. Results: A total of 166 valid questionnaires were collected. The response received from 166 clinicians. Almost 97 % of the responders were asking about the presence of symptoms of prolactinoma in patients with hyperprolactinemia and the majority of responders were made an exclusion of physiological causes related to hyperprolactinemia. When hyperprolactinemia occurred, only 81.3% of the respondents would test for thyroid-stimulating hormone routinely. Majority of the responders (79.5%) did not confirm the biochemical diagnosis of hyperprolactinemia before starting treatment and only two-thirds of them do pituitary imaging. Also, our results show an important role of clinician’s characteristics like age group on the management outcome, as the age group 25-35 was better when compared to the age group 46-55 (p-value =0.044) and the internist specialty and family medicine specialty have a better impact on management outcome in comparison to endocrinologist with (p-value =0.046 and 0.043 respectively). Conclusions: We found that the current clinical practice for the management of hyperprolactinemia is not uniform with some scientific defects. Therefore, it is necessary to develop national guidelines for the management and treatment of hyperprolactinemia.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138601183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}