Advanced medical journal最新文献

{"title":"Outcome of Multilevel Anterior Cervical Discectomy and Fusion without plating","authors":"Amanj Dizhwar Khalid, Raqib Seniar Teto","doi":"10.56056/amj.2022.159","DOIUrl":"https://doi.org/10.56056/amj.2022.159","url":null,"abstract":"Background & objectives: The safety and efficacy profile of stand-alone polyetheretherketone cages has been questioned in the management of patients with more than one cervical disc disease. In this article, we evaluated the idea of safety of multilevel anterior cervical discectomy and fusion, without using a plate and the achieved pain relief. Methods: In this study, retrospectively we reviewed 30 patients diagnosed with multilevel cervical disc disease (total 69 segments) due to degenerative changes, disc herniation, and/or osteophyte formation. They complained of axial neck pain and/or radiculopathy not responding to non-surgical measures. All the included subjects treated for more than one-disc disease using stand-alone polyetheretherketone. With minimum 2-years of regular, clinical and radiological follow up. We have assessed the patient for criterions defined for cage subsidence and protrusion, as well as pain assessment pre and postoperatively using the visual analog score. Results: we assessed 22 patients (73.3%) for two level pathology and 8 patients (26.7%) with three level diseases. Mean age was 48.2±8.9 years. Female to male ratio was (1.1:1). The most common segment involved was C5-6 segment in 83.3%. The pre-operative visual Analogue Score for axial neck pain 6.3±3.05 and radiculopathy 6.8±2.2 was decreased post-operatively to 2±1.3 points respectively. Subsidence and protrusion assessed by measurement of serial X rays and one patient 3.3% developed subsidence in 2 adjacent levels which is statistically not significant. No incidence of cage protrusion was detected. Conclusions: Multilevel anterior cervical discectomy and fusion without plating provide good fusion, low subsidence rate, stability provided by the cage with excellent pain improvement.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122064635","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":"The impact of iron deficiency on the diagnostic level of HbA2 in beta- thalassemia trait from the Sulaimani hemoglobinopathies screening program","authors":"A. Shalli, S. Jalal, Dler Jaza Mohammed","doi":"10.56056/amj.2022.164","DOIUrl":"https://doi.org/10.56056/amj.2022.164","url":null,"abstract":"Background and objectives: The identification of carriers of beta- thalassemia depends on the detection of a high level of hemoglobin A2. The hemoglobin A2 level is influenced by some elements including iron. The consequence of concomitant iron deficiency on the hemoglobin A2 level is critical in screening laboratories for hemoglobinopathies, particularly in resource-limited ones where molecular identification of hemoglobin A2 levels is unavailable. The aim of this study is to evaluate the consequence of iron deficiency on hemoglobin A2 level to obtain a definite diagnosis of beta- thalassemia trait. Methods: A total of one hundred forty -five subjects were involved, divided into three groups: (50) healthy controls, (50) beta-thalassemia trait, and (45) coincident iron deficiency with beta-thalassemia trait. Full blood count, Iron status including serum iron with total iron-binding capacity, lastly hemoglobin A2 with hemoglobin F estimation were performed for all enrollees. Results: The age range in the beta-thalassemia trait group was 7-40 years, with mean of (26.6± 5.3) years, while the concomitant group has an age range of 15-36 years, with a mean of (24.4 ±5.1) years. Meanwhile the age of control group ranged from 19-36 years with a mean of (24.6 ±3.8) years. The hematological parameters were significantly reduced in beta- thalassemia trait and concomitant iron deficiency in comparison to the controls with no significant difference in hemoglobin A2 between beta thalassemia trait and concomitant iron deficiency (5.1± 0.9) and beta-thalassemia minor (5.2 ± 0.9). Conclusion: No influence of iron deficiency on the identification of beta-thalassemia minor detected in the screened population.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129994373","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":"Immunohistochemical expression of E-Cadherin in gastric carcinoma in Erbil city, Kurdistan Region","authors":"Ara Azad Mustafa, J. Jalal","doi":"10.56056/amj.2022.156","DOIUrl":"https://doi.org/10.56056/amj.2022.156","url":null,"abstract":"Background and objectives: Gastric carcinoma is at fourth position incidence-wise and holds a second place for deaths due to cancer. The Cadherins represent an important class of the adhesiveness molecules, which play an essential role in the homotypical cell-cell adhesion and in the complex process of invasion and metastasis. The point of this study is to identify the rate of the E-Cadherin immunoexpression in gastric carcinoma in Erbil locality and investigate its association with the clinico pathological parameters. Methods: A retrospective study was carried out in Rizgary teaching hospital and private laboratories in Erbil city for the period from Jan.2018 - Jan.2020. A total of 75 formalin fixed, paraffin embedded archival tissue blocks of total or partial gastrectomy samples for gastric carcinoma cases were collected, then E-cadherin immunohistochemistry was tested. Results: Twenty-one cases (28%) were categorized as high expression for E-Cadherin immunoexpression. At the same time 38 (50.7%) of the cases were classified as low expression and 16 (21.3%) of cases were labelled with no expression. E-Cadherin status was significantly associated with the tumor type and tumor grade, in which high E-Cadherin expression about (61.9%) was demonstrated in intestinal type tumors, (38.1%) in diffuse type tumors and about (57.1%) was performed in well-moderately differentiated tumors and (42.9%) in poorly differentiated tumors. While no significant association was found between E-Cadherin expression and other clinico. Conclusions: Our result support the hypothesis that the E-Cadherin immunostain is commonly expressed in Gastric cancer, and it was significantly related with type and grade of the tumor.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"13 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128901551","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":"The Role of Cardiotocography in Monitoring Fetal Condition During Labour in High Risk Pregnancy and Its Correlation with Perinatal Outcome","authors":"Muhabad Ameen Ameen, Amal Abdulhakim Ahmed, M. Shamdeen","doi":"10.56056/amj.2022.161","DOIUrl":"https://doi.org/10.56056/amj.2022.161","url":null,"abstract":"Background: Cardiotocography (CTG) is considered to be a non-invasive prenatal screening technique. It is used to monitor fetal condition during labor. Objectives: this study aimed to evaluate the role of Cardiotocography as a screening tool during labor in high risk pregnancy for determining perinatal outcomes. Methods: In this cross-sectional study, Cardiotocography was performed randomly on 200 pregnant women with risk factors (postdate, oligohydronomia, Pregnancy-induced hypertension, diabetes mellitus, anemia, intrauterine growth retardation, Antepartum hemorrhage, and pre-labor rupture of membrane who attended the labor ward of Duhok Teaching Hospital of Obstetrics and Gynecology from 20 October 2019 to 15 February 2020 and the results of CTG were categorized a reactive and non-reactive cardiotocography tracing groups and the perinatal outcomes were correlated with cardiotocography results. Results: In this study, the mean age of patients was 27.41±6.09 years; ranged 18-42 years. There was no significant difference in the mean age of the patients (27.48±6.17 vs. 27.33±6.05 years), gravida (2.49±1.73 vs. 2.10±1.53) and gestational age (39.85±1.40 vs. 39.84±1.41weeks) between patients with reactive and non-reactive cardiotocography tracing, respectively. Patients with reactive cardiotocography were significantly more likely to have live babies (1.52±1.77 vs. 0.54±0.67) and no dead babies was recorded between reactive and non-reactive cardiotocography groups. The rate of caesarean section was significantly higher in patients with non-reactive cardiotocography (64.4% vs. 38.4%) and for bloody liquor (7.9% vs. 2.0%). It was also observed that low Apgar score 0-4 in first minute (12.9% vs. 4.0%) and 5-7 Apgar score in five minutes (34.7% vs. 9.1%) and admission to neonatal intensive care unit were significantly higher in patients with non-reactive than in those with reactive cardiotocography (59.4% vs. 26.3%), respectively. Conclusions: This study showed that cardiotocography is a useful technique to determine perinatal outcomes in high-risk pregnancies.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122436106","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":"Pathological and therapeutic profiles of umbilical sinus","authors":"Izzat Bihnam Muttosh, Bader. Saeed., Haitham Issa Albanna","doi":"10.56056/amj.2022.163","DOIUrl":"https://doi.org/10.56056/amj.2022.163","url":null,"abstract":"Background and objective: Umbilical sinus develops either in an abnormal embryonal remnant of Omphalomesenteric & Urachal ducts, or secondary to hair insertion in the umbilical skin with resultant suppuration ending in what is named umbilical pilonidal sinus.This study viewed the relative distribution of these pathologic variants and results of management options adopted. Methods: All patients (n=28) suffering from umbilical sinus disease during the period of 5 years, between 1st Jan 2015 to 31st Dec 2019 are evaluated according to their pathologic types and therapeutic options. For hair sinuses, the conservative approach was initiated, its failure demanded exploration without excision. For sinuses secondary to embryonal remnants, the treatment was complete tract excision. Results: Umbilical pilonidal sinus constitutes the majority of sinuses in the umbilicus (n=26) (92.86%), suppuration in Embryonal remnants was far less common (n=2) (7.14%). The conservative management was effective in 24 (92.3%) out of 26 patients who were presented with umbilical pilonidal sinus, two patients got recurrence (7.14%), and necessitated tract exploration. Sinuses secondary to embryonal remnants (7.14%), were dealt with complete tract excision. In the results also; umbilical pilonidal sinuses were associated with young age group, (78.57% were between 21 and 30 years of age), male gender (85.71%) and overweight, (60.71%). Conclusion: The conservative approach was successful in the majority of cases, failure was mainly due to incomplete hair removal, for such cases a valid alternative was sinus exploration. Sinus tract excisions were spared for sinuses secondary to Omphalomesenteric & Urachal sinuses.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117155701","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":"Correlation of serum Insulin-Like Growth Factor one with acne severity","authors":"Saedi Khaleel Fattah, A. M. D. Elethawi","doi":"10.56056/amj.2022.165","DOIUrl":"https://doi.org/10.56056/amj.2022.165","url":null,"abstract":"Background and Objectives: Acne is a common chronic inflammatory skin condition; Acne could present as inflammatory or non-inflammatory lesion. Acne can be varied in severity from patient to another, generally, it can present in mild, moderate or severe degree. Excessive production of sebum by sebaceous glands in the skin contributes in acne formation. One of the factors associated with the production of sebum is Insulin-Like Growth Factor in serum. Current study tries to find any association between acne severity and serum Insulin-Like Growth Factor. Method: On a sample of 40 female patients with acne, aged 14-26 years at the outpatient clinic as a cross sectional study. Serum IGF-1 level was compared to their acne severity across three groups, mild, moderate and severe acne. Global acne grading system was used to classify the acne severity. Results: Median levels of IGF-1 were 208.09 ng/ml. Mean serum level of IGF-1 is 254.53ng/ml, 200.03ng/ml and 172.39ng/ml in severe, moderate and mild acne respectively. Acne severity strongly associated with serum level of IGF-1 which is statistically significant. No significantly association between serum level of Insulin-Like Growth Factor and the age of patients was found. Likewise, the severity degree of acne has no association with body mass index Conclusion: There is a direct relationship between mean level of IGF-1 in patients with AV with degree of their acne severity","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116294122","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":"Prevalence of color vision deficiency among primary school pupils in Duhok city, Kurdistan Region, Iraq","authors":"Azad Jameel Hussein, S. Al-Dabbagh","doi":"10.56056/amj.2022.153","DOIUrl":"https://doi.org/10.56056/amj.2022.153","url":null,"abstract":"Background and objectives: Color vision deficiency or color blindness is a difficulty in recognizing certain colors. The color vision deficient persons remain unmindful about their condition and only become aware accidentally when tested for color vision. Color vision deficiency may affect job performance in certain careers like drivers, pilots, electrical and electronic engineers, policemen, artists, and medical practitioners. The study aims to detect the color vision deficiency prevalence among the primary school pupils in Duhok city. Methods: A cross sectional study was conducted among randomely selected two primary school children in Duhok city, Iraq from 1st February 2019 to 1st May 2019. Socio-demographic data was collected by interview using a questionnaire. All participants underwent color vision evaluation using Ishihara’s pseudo isochromatic test 24 plate editions. Data analysis was done using SPSS version 24. Results: Out of 978 pupils, 491 were males (50.21%) and 487 were females (49.79%), color vision deficiency was detected in 55 pupils giving a prevalence of (5.63%); among them, 38 pupils have had deutan defects (3.89%) and 17 had protan defects (1.74%). Color vision deficient pupils were 47 males (9.6%) and 8 females (1.64%). Conclusions: This study found that 5.63% of pupils were color deficient, with male gender predominance. All of the color deficient pupils were unmindful of their condition. Green color deficient pupils (deutans) were more than red color deficient (protans), with zero cases of total color blindness.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127932202","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":"Early post-transplant urinary tract infection epidemiology and risk factor","authors":"Muhammed Suhaib Almufti","doi":"10.56056/amj.2022.158","DOIUrl":"https://doi.org/10.56056/amj.2022.158","url":null,"abstract":"Background and objectives: Renal Transplantation became the most successful management for end stage renal failure; postoperative urinary tract infection is the most common complication. The aim is to evaluate the outcome and risk factors of posttransplant urinary tract infection. Methods: This is a prospective study for renal transplant patients between 2018-2019 in Hawler/ Rizgary and Paky hospital. Patients, who underwent renal transplant, with 1 year follow up. Variable risk factors assessment done including chronic renal failure etiology, preoperative dialysis duration, operation time, length of drain and Foley’s catheter, type of immune suppressive therapy used, time and numbers of hospitalization associated with posttransplant urinary tract infection were examined, the relation between the risk factors and urinary tract infection was evaluated. Results: Total of 63 patients was involved, 12 had a total of 24 urinary tract infection attacks; the most common isolated microorganisms were E-coli and Klepsiella. The infection frequently appeared during the first 120 days postoperatively. Among the analyzed variables, there was no significant difference. Assessing all the variables, number of hospitalization after discharge were significantly more frequent in the 12 patients with infection attacks, although 31 patients out of 63 had hospitalized, as compared to patients without infection, but this difference was statistically insignificant. Conclusions: The most significant period for infection in renal transplanted patients after 1 year follow up is the first 4 months postoperatively. Patients who were admitted to hospital for different reasons and those who had preoperative history of urinary tract infection, have a higher risk.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"16 20","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133424419","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 and fetal outcomes in meconium-stained amniotic fluid deliveries in a tertiary center","authors":"Payman Ghiyath Al-deen Abdulghafor, M. Shamdeen, Khalida Hassan Muho","doi":"10.56056/amj.2022.170","DOIUrl":"https://doi.org/10.56056/amj.2022.170","url":null,"abstract":"Backgrounds and objectives: Meconium -stained liquor could be an alarming sign of fetal distress and needs continuous fetal heart rate monitoring and urgent interventions. The study aimed to determine maternal and fetal outcomes among women presented with meconium-stained amniotic fluid during labor in relation to mode of delivery, rate of caesarian section, Admission to neonatal intensive care unit and neonatal complications and mortality. Methods: A cross-sectional study was carried out in Duhok Obestetric and Gynecology Teaching Hospital between 1st of September 2019 and 1st of April 2020 where 100 women in labor diagnosed with meconium stained amniotic fluid gestational age between (37_40+6 weeks) included in this study, all participants were meet inclusion criteria for this study and a written consent obtained from them. Results: The study showed that out of 100 participants with meconium stained liquor 48% of them delivered by lower segment cesarean section and the cause of 76.6% of them was fetal distress .The study showed significant statistical association between meconium stained liquor and lower mean scores of APGAR scores at 1 and 5 min , and rate of neonatal intensive care unit admission which was 74 (74.0%) and neonatal complications rate such as meconium Aspiration Syndrome (31.0%), Respiratory Distress Syndrome (14.0%), and Early Neonatal Death (3.0%) ,the study showed that women with spontaneous rupture membrane and thick meconium were significantly more likely to have infants with meconium aspiration syndrome; 46.2% and 48.1% respectively. Conclusions: This study showed that women in labor with meconium-stained amniotic fluid had higher fetal and maternal complications","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130927419","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":"Percutaneous Pinning Versus Volar Locking Plate Fixation in the Treatment of Intra_articular Distal Radius Fracture in Adults above 18 Years of Age","authors":"Thaqaf Alauldeen Fadhil Al-bayati, Dr.Omer Ali Rafiq i Baraw, Hasan Mazin Shekheel Mercalose","doi":"10.56056/amj.2022.167","DOIUrl":"https://doi.org/10.56056/amj.2022.167","url":null,"abstract":"Background and objectives: Distal radius fractures account for more than 20% of all fractures seen in the emergency department, unstable distal radial fractures can be managed by several treatment options including cast immobilization, percutaneous pinning, plate fixation and external fixation, the aim of the study is to compare percutaneous pinning and volar locking plate in the treatment of distal radius fracture AO C1 subtype. Methods: Thirty patients were included and divided into 2 equal groups, group 1 underwent volar locking plate fixation and group 2 underwent percutaneous k wire fixation, the functional and radiological outcomes were assessed by DASH and Stewart’s score respectively and range of motion was measured. Results: Plate group has significantly higher mean flexion at 3 and 12 months than those of the pin group, DASH score at 3 and 6 months was significantly higher in pin group (28.43 and 10.59 respectively) than plate group (20.47 and 16.75 respectively) but no significant difference was showed between the pin and plate groups at 12 months (14.58 vs 13.23 respectively). When the difference between preoperative and 12 months radiographs was measured ulnar variance, radial inclination, and palmar tilt were significantly higher in the plating group, however, the Stewart’s score distribution between both groups showed no significant differences. Conclusions: While there was no functional outcome difference at one year of follow up between patients treated with either treatments modality, patients requiring faster recovery and return to function can be offered open reduction and volar locking plate fixation.","PeriodicalId":314832,"journal":{"name":"Advanced medical journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121498483","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}