Advanced medical journal最新文献

{"title":"Hirschsprung’s Disease Diagnosis: A Comparison of Calretinin and CD56 Immunohistochemistry","authors":"Dalya Sabah Najm Aldeen, R. Al-rawi, Kalthuma Salih Hamad Amen","doi":"10.56056/amj.2024.238","DOIUrl":"https://doi.org/10.56056/amj.2024.238","url":null,"abstract":"Background & objectives: Hirschsprung’s disease is attributable to the congenital lack of ganglion cells in the far intestine. Rectal biopsy is deemed critical for its testing. In some instances, regular techniques fail to detect it. This study aims to evaluate the testing role of calretinin and CD56 immunohistochemistry and correlate the results to routine hematoxylin & eosin stained samples. Methods: This retrospective study was conducted in Rizgary Teaching Hospital, Erbil, Kurdistan region, Iraq. Rectal biopsies and colonic resection specimens of the clinically suspected Hirschsprung’s disease patients were collected and stained with calretinin and CD56 then their findings were compared to the hematoxylin and eosin stained sections during the period between February 2016 to October 2021. Results: Fifty patients aged from 3 days to 8 years with a male-to-female ratio of 3.6:1 were examined for rectal and colonic biopsies. Forty out of 50 cases were detected as HD by H&E staining. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of calretinin were coherent with that of H&E-stained samples (100%), the likelihood ratio was 50 and the kappa test was 1, were superior to CD56 results with sensitivity (100%), specificity (90%), positive predictive value (97.5%), negative predictive value (100%), accuracy rate (98%), likelihood ratio was 27.77 and kappa test was 0.805. Conclusions: Immunohistochemical expression of calretinin is more specific and accurate than CD56 in HD diagnosis. Calretinin is a trustworthy, additional diagnostic tool for better morphological evaluation of ganglion cells and thereby assists in making a reliable diagnosis of HD.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"67 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140254869","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":"Optimum Mode of Delivery in Gestations Complicated by Preterm Premature Rupture of Membrane During 32-37 weeks of Gestation","authors":"Shana Pishtiwan Mohammed Baqi, R. Y. Khalil","doi":"10.56056/amj.2024.244","DOIUrl":"https://doi.org/10.56056/amj.2024.244","url":null,"abstract":"Background and objectives: Preterm premature rupture of membrane is amniotic fluid leakage due to fetal membrane rupture before 37 gestational weeks. The aim was to know the optimum mode of delivery in pregnant women with preterm premature rupture of membrane. Methods: A prospective observational study was performed on 50 pregnant ladies with a gestational age of 32-37 weeks with preterm premature rupture of membrane admitted to the Sulaimani Maternity Teaching Hospital from June 2021 to June 2022. Demographic features, medical history,mode of delivery and neonatal outcome were recorded . Results: The mean±SD (standard deviation) of maternal ages was 27.2±5.8 years (ranging from 16 to 38). The mean±SD of gravidity, parity, and abortus was 2.9±1.95, 1.6±1.7, and 1.4±0.6, respectively. The associations of women's age, residency, occupation, educational level, parity, and past medical history with mode of delivery were statistically insignificant (p-values of >0.05). The association of the indications of C/Ss with the delivery outcome was statistically significant (p-value of <0.001). The associations of gestational ages at rupture and birth did not affect the delivery outcome (p-values of >0.05). Besides, the fetal outcome did not affect the delivery outcome, except for fetal gender significantly (p-value = 0.05) affected the delivery outcome. Conclusions:The associations between indications of cesarean section and fetal gender with mode of delivery were statistically significant in pregnant women with preterm premature rupture of membrane between 32-37 gestational weeks.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"37 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255110","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":"Relationship between Different Hematological Parameters and Disease Activity in Patients with Rheumatoid Arthritis","authors":"Dilan Saadaldeen Muhammed, R. Polus, Nawsherwan Sadiq Mohammed","doi":"10.56056/amj.2024.236","DOIUrl":"https://doi.org/10.56056/amj.2024.236","url":null,"abstract":"Background and objectives: Rheumatoid arthritis is a type of immune disorder that has an impact on the entire body. The objective was to measure and compare various hematological parameter values between chronic and new cases also in new patients who exhibited varying degrees of disease activity. Methods: This study was a cross-sectional survey, conducted in Rizgary Hospital and private clinics in Erbil city/ Kurdistan Region of Iraq. Two groups each of 30 patients; with newly diagnosed the 2010 ACR/EULAR criteria are divided into four groups, each of which has a point score: joint symptoms, serology (including Rheumatoid factor and/or Anti-Citrullinated Peptide Antibody), duration of symptoms (less than or more than 6 weeks), and acute-phase reactants (c-reactive protein and/or erythrocyte sedimentation rate) and chronic Rheumatoid Arthritis cases enrolled in this study from October 2021 till September 2022. Hematological parameter and disease activity monitored and compared between both groups, in addition to comparison between cases in the same group. Results: The majority (81.7%) of patients were female and (18.3%) of them were male, mean age ± std. deviation of respondents was 48.80 ± 9.13 years. There was significant statistical association between study groups and joint swelling, multiple or single joint and disease activity (DAS 28), also, the difference between both groups was statistically significant regarding mean pain score, white blood cells, serum folate, and rheumatoid factor. Likewise; the association was significant between study groups and multiple or single joint. There was significant statistical association between study groups and DAS 28, the majority (86.7%) of newly diagnosed patients had low – moderate level of DAS 28 while 40% of chronic subjects measured high level of DAS 28. Conclusion: Hematological markers including disease activity score, white blood cells, serum folate, C-reactive protein and rheumatoid factor were good indicators for measurement of rheumatoid arthritis severity and activity in the selected sample of patients.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"31 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140254733","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":"Two years recurrence rate of ovarian and endometrial malignancies following Surgical versus clinical staging","authors":"Dr. Shokhan Faeq Rashid, Dr. Maryam Bakir Mahmood, Prof. Dr. Taher Abdullah Hussein Hawramy","doi":"10.56056/amj.2024.239","DOIUrl":"https://doi.org/10.56056/amj.2024.239","url":null,"abstract":"Background and objectives: Gynecological cancers represent a big burden on national health institutes. Recurrences of these cancers are documented frequently that needed more efforts to prevent or reduce them. The aim of the study was to know the difference between Standard Surgical Staging and Non-Standard Surgical Staging in gynecological cancers in terms of recurrence rate. Methods: This study was a retrospective cross-sectional study conducted at the Maternity Teaching Hospital and Hiwa Hospital in Sulaymaniyah city-Kurdistan region/Iraq over two years from June 2020 to June 2022, on sample of 86 women with gynecological cancer divided into two study groups (42 women underwent standard surgical staging and 44 women underwent non-standard surgical staging). Standard surgical staging for endometrial and ovarian cancers included midline laparotomy, peritoneal washout, samples from the right and left sub-diaphragmatic surfaces, infracoloic Omentectomy, total abdominal hysterectomy & bilateral salpingo-oophorectomy, any peritoneal deposits and pelvic and para-aortic Lymphadenectomy in maternity hospital Results: The recurrence rate in women with non-standard surgical staging were 25% (p=0.009), while in women with standard surgical staging were 4.8%. 11 women with non-standard surgical staging had advanced cancer stages at recurrence compared to 2 cases with standard surgical staging. Although no significant difference in death outcome between both study groups (p=0.09), no woman who underwent standard surgical staging with recurrence died, while the death rate of women underwent non-standard surgical staging with recurrence was (63.6%) Conclusions: The standard surgical staging in women with gynecological cancer is important in the recurrence rate of these cancers.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"37 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255108","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":"Evaluation of the outcome of proximal femoral nail in the treatment of unstable Intertrochanteric fracture in adult","authors":"Omar Ameen Saeed","doi":"10.56056/amj.2024.235","DOIUrl":"https://doi.org/10.56056/amj.2024.235","url":null,"abstract":"Background & Objectives: The incidence of intertrochanteric fractures among elderly patients is expected to be increased even further with the advancing age of the population, proximal femoral nail was introduced as a method of treatment for this fracture, which is currently the most effective surgical method. The goal is to find out the role of a proximal femoral nail in treating intertrochanteric fractures and assess the advantages and complications of this treatment method. Methods: This prospective study was conducted on seventy patients with unstable intertrochanteric fractures treated with Proximal femoral nails at Erbil teaching hospital. They were followed up for one year, from (May 2016 to May 2017). Patients were examined for the union of fracture and complications clinically and radiologically. The functional outcome was evaluated using the Harris Hip Score. Results: Total number of 70 patients were included in this study, 44 (62.85%) were females, and 26 (37.15%) were males. The mean operative time was (90.885 min. ±11.38SD). Infection developed in (1.42%) of the patients. The most common complication was Varus malalignment which was found in (5.7%) of the cases. Harris Hip Score-based findings were excellent-good in (85.7%) of patients Conclusion: Proximal femoral nail is a relatively effective treatment possibility for most unstable intertrochanteric fractures with good biological stabilization, better short-term outcomes, and minimal complications.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255268","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":"Cholelithiasis in Patients with Sickle Cell Disease and Sickle/Beta-Thalassemia in Akre City, Kurdistan Region of Iraq","authors":"Esraa Hasan Abdullah, Rawand P. Shamoon, N. Mohammad","doi":"10.56056/amj.2024.233","DOIUrl":"https://doi.org/10.56056/amj.2024.233","url":null,"abstract":"Background and objectives: Sickle cell disease and sickle β-thalassemia are hemolytic diseases characterized by chronic destruction of the abnormal red cells with consequent hyperbilirubinemia. The present study aimed to determine the association of gallstone with Sickle cell disease and sickle β-thal patients compared to the control healthy group and to determine gallstone's association with several demographic and laboratory parameters among the patients themselves. Methods: Patients visiting the Akre thalassemia center for routine checks have been recruited for this study (patients=73; control=36). Blood samples were collected for biochemical and haematological analyses. All participants were subjected to abdominal ultrasonography for confirmation of gallstones. These parameters were compared with patients' subtype traits. Additional information regarding blood transfusion, hospital admission, and the use of chelating agents was also allocated. Results: The prevalence of gallstone was significantly higher in patients (12%) than in the control (3%) group (P<0.05), with similar prevalence in both trait; homozygous haemoglobin S (14%) and compound heterozygous of hemoglobin S and β-thalassemia (11%), together with significant differences in the biochemical and haematological parameters. The haemoglobin concentration was significantly (P<0.05) reduced in patients (8.5±0.86) versus control (12±1.6). Reticulocytes, lactate dehydrogenase enzyme, and bilirubin were significantly (P<0.05) elevated in patients compared to the control. No differences existed between control versus patients regarding hospital admission, blood transfusion, and the use of medication including chelating agent or hydroxyurea. Conclusion: Sickle-diseased and sickle beta-thalassemia patients have a higher risk of developing gallstones than the general population alongside interruption of metabolic and biochemical parameters with co-association with sub-traits of type of haemoglobin.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"42 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140254710","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 Risk Factors of Acute Coronary Syndrome in Erbil Cardiac Center: comparing ST-elevation with non ST-elevation Acute Coronary Syndrome","authors":"Omar Hama Radha Qader, Mariwan Saka","doi":"10.56056/amj.2024.246","DOIUrl":"https://doi.org/10.56056/amj.2024.246","url":null,"abstract":"Background and objectives: Acute coronary syndrome is the leading cause of death all over the world, there are many different risk factors as important etiology for this acute condition, this syndrome has been studied in different countries with a variety of results.  The aim was to define different risk factors for the patients admitted to Erbil cardiac center and to find out the most common of these factors and the relationship between different clinical types of this syndrome (namely ST-elevation myocardial infarction, non-ST elevation myocardial infarction/unstable angina) with varying types of risk factors.  Methods: This was a cross-sectional descriptive nonrandomized study that included 100 patients with acute coronary syndrome, mean age of 57.5, the age range of 27—90 years, the majority of patients were male (78%), all patients were interviewed and investigated properly, and according to coronary angiographic findings treated by percutaneous coronary intervention or surgery.  Results: The prevalence of acute coronary syndrome was significantly higher in male gender, the commonest risk factor was overweight and obesity 77% , followed in reduced frequency by other risk factors, More than half of patients(58.6%)with ST-elevation myocardial infarction were≤55years age, while 66.7% of patients with non ST-elevation myocardial infarction were >55years age. The most common artery involved was the left anterior descending artery, significant number 26.2% of non ST- elevation myocardial infarction/UA patients had three vessel stenosis and higher number34.5% of ST- elevation myocardial infarction patients had right coronary artery stenosis. Conclusions: The most common risk factor was overweight and obesity, no significant relation between clinical types and risk factors, low number of unstable angina cases seen in the emergency unit.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"29 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255262","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 High Sensitive C-Reactive Protein with the Extent of Coronary Atherosclerotic Disease","authors":"Saud Sherwan Anwer","doi":"10.56056/amj.2024.249","DOIUrl":"https://doi.org/10.56056/amj.2024.249","url":null,"abstract":"Background and objectives: The inflammatory process of the intima of coronary vessels is significant in the atherosclerotic process. We aimed to evaluate the role of high sensitive C-reactive protein in diagnosing and prognosis of ischemic heart disease and atherosclerosis. Methods: From 2021-2022, we randomly enrolled 100 patients referred to surgical specialty hospital/ cardiac center in Erbil City (Jan 2021- Jan 2022) for angiography complaining of a chronic coronary syndrome. Blood sampling was taken to measure (high sensitive C-reactive protein). Coronary artery angiography was done, and the extent of atherosclerosis was measured using the Syntax score and clinical syntax score using the calculator from internet site www.syntaxscore.org. Results: We enrolled 58 males and 42 females; 39% of patients had Diabetes mellitus, 49% had hypertension, 41% were smoker, 18% with peripheral arterial disease, 8% had chronic obstructive disease, and 3% with left primary illness. The study showed a highly significant linear correlation between high sensitive C-reactive protein and syntax score of 15±10.52 and clinical syntax score 26.68±12.17. Conclusion: The study concluded that a high sensitive C-reactive protein level is a reliable method to independently predict coronary artery disease in ischemic heart disease patients and the extent of severity; these results were not affected by sex category and other risk factors like diabetes mellitus, hypertension, or smoking.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"27 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255126","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 Relation Of Placenta Previa With History Of Previous Cesarean Section And Miscarriages","authors":"Tarza Taha Ahmed, S. Nasir","doi":"10.56056/amj.2024.245","DOIUrl":"https://doi.org/10.56056/amj.2024.245","url":null,"abstract":"Background and objectives: The factors that increase the risk of placenta previa in subsequent pregnancies include past miscarriages and the scar from a previous cesarean operation. This study aimed to determine whether a history of cesarean section or miscarriage was related to placenta previa at Sulaimani Maternity Teaching Hospital. Methods: At the Sulaimani Maternity Teaching Hospital, this case-control study was conducted between the 11th of September 2021 to the 31st of June.2022. A total of 100 women provided information, which was divided into two groups: Group A, which included 50 pregnant women with gestational ages between 30 and 40 weeks and confirmed placenta previa, and Group B, which included 50 pregnant women randomly selected with pregnancy lengths of 30 to 40 weeks and the placenta was in its usual location. Detailed history was taken from each woman, through this the relationship of placenta previa with previous cesarean section and miscarriages was studied. Results: The results of this study revealed that prior cesarean sections were previously performed in 74% of cases of placenta previa, compared to 46% of controls (p value = 0.004). In addition; there was no correlation between placenta previa and prior miscarriages (p value= 1.000), and a highly significant correlation was seen between the rise in previous cesarean deliveries and the presence of accreta (p value = 0.003). Conclusion: The likelihood of placenta previa in subsequent pregnancies is dramatically increased in this study by past cesarean deliveries; previous miscarriages have no significant impact on placenta previa development.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255144","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 methotrexate intolerance among patients with rheumatoid arthritis in Erbil city using methotrexate intolerance severity score","authors":"Zhala Kakamin Mawlood, D. Albustany","doi":"10.56056/amj.2024.241","DOIUrl":"https://doi.org/10.56056/amj.2024.241","url":null,"abstract":"Background and objectives: Rheumatoid arthritis is classified as an autoimmune disease characterized by inflammation of the joints and membranes surrounding the joints. The aim of this study was to find the frequency of methotrexate intolerance among rheumatoid arthritis patients and to detect factors contributing to intolerance. Methods: An observational cross-sectional study was conducted in Rizgary and Hawler Teaching Hospital in Erbil/ Iraq. The study period started from the 1st of July 2021 to the 1st of July 2022. A convenient sample of hundred patients was included in the study. A validated version of the methotrexate intolerance severity score questionnaire was used for data collection. Each element in the methotrexate intolerance severity score questionnaire was given a score ranging from 0-3 depending on the absence of symptoms or the presence of mild, moderate or severe symptoms. The intolerance was diagnosed based on a cut-off score of 6 and more. Results: Females constituted 93% of the sample, 49% were obese, and only 13% were smokers. Among the rheumatoid arthritis patients, 66% tolerated Methotrexate, and only 34% did not tolerate the treatment. The oral dose was tolerated by 71%, and the only significant relation(p=0.050) was reported for the route of Methotrexate administration. The differences were significant for restlessness (p<0.001), crying (p=0.002), irritability(p<0.001), and not taking medication. Conclusions: The study concluded that Methotrexate intolerance is prevalent among Rheumatoid arthritis patients in Erbil city. The prevalence of intolerance was significant among steroid users.","PeriodicalId":486511,"journal":{"name":"Advanced medical journal","volume":"59 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255015","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}