Annals of the College of Medicine, Mosul最新文献

{"title":"The Role Of Selnium On Some Hormones And Histological Structures In Ovaries Of Hypothyroid Female Albino Rats","authors":"E. Alhealy, mayson alkazzaz, W. Al-Nuaimy","doi":"10.33899/MMED.2021.129035.1063","DOIUrl":"https://doi.org/10.33899/MMED.2021.129035.1063","url":null,"abstract":"Background: The appropriate function of the ovary depends on the proper function of other endocrine glands especially the thyroid gland, which is the largest endocrine glands in the body. Hypothyroidism is a common thyroid disorder which commonly affect females and influence the function of reproductive system. Aim of this study : This work is to focus on the structural changes in ovary of adult female rats induced by hypothyroidism and the role of selenium. Methods: Thirty adult female rats were used. They were classify into 3 groups (10 animals in each group): Group I ( control) taken 0.5 ml distilled water orally for 3 months . Group II ( hypothyroid ) they were given antithyroid drug, carbimazole in a dose of 6 mg/ kg orally by gastric tube for 3 months. Group III (hypothyroid + selenium ) this group were treated by carbimazole as same as group II then added selenium in the last 2month in a dose of 10 μg/ kg orally. At the end of experiment , blood samples were taken for assessment of serum TSH ,T4 , FSH, LH, and estradiol, then animals were sacrificed and the ovaries were fixed in 10% formalin solution and prepared to be examined under the light microscope. Results: Serum concentration of TSH was significantly increase while the level of T4, LH, FSH, and estradiol concentrations were significantly decreased in both treated groups. The ovaries of hypothyroid groups showed degenerative changes of most growing follicles. Many atretic follicles and corpus luteum were observed with increase of collagen fibers and edema in the stroma associated with congestion of blood vessels. Treating of hypothyroid rats with selenium for two months produced an improvement in hormonal level and histological structure of the ovarian tissue. Conclusion: Hypothyroidism affect the structure of ovarian tissues but adding selenium has ameliorative role on thyroid function and histological changes of ovary which may be attributed to its antioxidant activity.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90621360","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":"Surgical Outcome and Prognosis of Spinal Missile injuries","authors":"Ali Hikmat Azeez, N. Y. Sallama, S. A. Alsaqa","doi":"10.33899/MMED.2021.129309.1070","DOIUrl":"https://doi.org/10.33899/MMED.2021.129309.1070","url":null,"abstract":"Background: The spinal cord is so sensitive to injury. Once it is damaged; it shall lose its ability to repair itself .Unfortunately spinal cord injuries (SCI)are common in Iraq . It could be either complete or incomplete SCI. In the complete injury there is a total loss of sensation and motor function in the level below the site of the injury, while in the incomplete one there is some remaining neurological functions below the level of the injury. Objectives: The aim of this study is to compare the surgical and conservative management of complete and incomplete spinal cord Injuries due to missile in Mosul city. Patients and methods: A case series study of (60) patients with missile cord injury of the spine who were managed in the Neurosurgical Department at Ibn-Sina Teaching Hospital in Mosul from August 2011 – August 2013. The mean patient age was 30 years. Thirty three (55%) patients were surgically treated. The mean time of follow up was 9 months ranged from 6-18 months. All patients had complete radiological assessment, CT scan and one patient with through and through bullet injury magnetic resonance imaging( MRI) was done after initial resuscitation. Results: All patients with complete spinal cord injury did not improved after non-surgical management, after surgical removal of bullet and it's pressure effect from the spinal cord just one case with conus medullaris injury gets improvement. Those with incomplete injuries show good improvement after surgical management. Conclusion: Conus medullaris and cervical injuries show a better outcome in surgical treatment than those out surgical intervention in incomplete spinal cord injuries. There were no difference between the outcomes of surgical and nonsurgical management of complete neurological injuries of the spinal cord.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85607630","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":"Spontaneous Rupture of Hydatid Cyst of the Liver in Pediatric Age Group Four Rare Cases with Literature Review","authors":"A. sulaiman","doi":"10.33899/MMED.2021.129224.1068","DOIUrl":"https://doi.org/10.33899/MMED.2021.129224.1068","url":null,"abstract":"Introduction: Hydatid cyst of the liver is usually asymptomatic,diagnosed accidentally or when there is complications such as infection or rupture.Rupture may occur spontaneously or related to trauma. Spontaneous rupture is more seen in endemic areas like Iraq and frequently seen in children. Method: Four cases with spontaneous rupture of liver hydatid cyst were reported at Mosul Pediatric Surgical Center at AL-KHANSA A Teaching Hospital. They were diagnosed by ultrasound, chest xrays and C T Scan. They underwent surgical exploration and removal of the cysts. Post-operative medical treatment with Albendazole were used prophylactly in all of them. Results: There were three males and one female, their age ranged from 5.5 to 10 years. Their main presentations were abdominal pain, one of them had respiratory symptoms while the forth had allergic reactions. Ultra sound examination was the main tool of diagnosis , chest x-rays was useful in one and C T Scan was needed in two of the cases .Surgical approach to these patients were by laparotomy in three and right lower thoracotomy in one .Removal of the cyst and cleaning of the cavity with antiseptic solution . These four hydatid cysts ruptured at different sites two of them to peritoneal cavity, one to thoracic cavity and one to extra peritoneal space. Conclusion: Liver H C rupture is a serious complication, it comes in the differential diagnosis of acute abdomen in endemic area .It needs urgent management. It can rupture at any points of liver surface to peritoneal cavity. Rupture can extend to pleura, biliary passages and extra peritoneal space when there is adhesion and erosion of the ectocyst to these structures. Rupture H.C of the liver to pleura can be dealt through thoracotomy approach without opening the abdomen. Extra peritoneal rupture of liver hydatid cyst can be dealt extra peritoneally without opening the peritoneal cavity and without contaminating the peritoneal cavity.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81966156","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":"Implementing a modified intraoperative grading system for a difficult laparoscopic cholecystectomy","authors":"Yarub Momtaz Tawfeek Al-Hakeem, Nashwan Q. Mahgoob","doi":"10.33899/MMED.2021.128336.1047","DOIUrl":"https://doi.org/10.33899/MMED.2021.128336.1047","url":null,"abstract":"Objective: To analyze intraoperative grading findings during elective laparoscopic cholecystectomy by which we can assess the surgical performance regarding its safety, achievability and to determine a safe operative approach and/or time for conversion. Design: An observational prospective case series study. Setting: During the period from June 2018 to January 2020, operations were done by 4 qualified consultant surgeons and their teams at 4 hospitals in Mosul and Erbil. Participants: Two hundred and fifty-five patients. Patients and Methods: All patients underwent elective laparoscopic cholecystectomy for symptomatic gallbladder disease after full evaluation and taking their informed consents. An intraoperative difficulty calculation score has been implemented that divide the situation into 4 grades: easy, difficult, very difficult and extremely difficult, depending on the appearance of the gall bladder wall color, amount of adhesion, the presence of anatomical abnormalities, and the ability to achieve the critical view of safety. Perforation of the gallbladder, slipped stones, bleeding, using extra instruments, the need for extending the epigastric incision, the use of a drain and conversion to open procedure as well as the duration of surgical intervention had been recorded as predictors for the assessment of the difficulty level during surgery. Results: The first grade included 168 (66%) patients, the second grade included 62 (24%) patients, while grades 3 and 4 represent 15 (6%) and 10 (4%) of patients respectively. Perforation showed no significance in the grading. Bleeding was more common in grades 3 and 4. Using accessory equipment was mandatory to complete the operation in grade 4 as well as an extension of epigastric port and the need for putting a drain. Conversion to open cholecystectomy was done in 2 operations (0.7%), both belonged to grade 3 and 4. The time needed to accomplish the operation was significantly high in grades 3 and 4. Conclusion: This modified grading score can provide a tool for reporting operative findings and technical difficulties during laparoscopic cholecystectomy that allow the surgeon to know the seriousness of the situation and taking effective measures to overcome it.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83721379","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":"Superior Mediastinal Teratoma- A Case Report with review of literature","authors":"E. A. Hamdi, Rabea Salim Abd Aljabbar Sofi Ali, W. Al-Nuaimy","doi":"10.33899/MMED.2021.129189.1065","DOIUrl":"https://doi.org/10.33899/MMED.2021.129189.1065","url":null,"abstract":"\"A teratoma is a germ cell tumor composed of tissue derived from two or three germ layers-ectoderm, mesoderm, and endoderm\". Teratomas are mostly found in children & young adults & usually originated in gonads & extragonadal midline tissues such as retroperitoneum, sacrococcygeal region & mediastinum. Mediastinal teratomas are relatively rare representing 3% of all tumors within the chest with an average incidence of 8 cases per year and the anterior mediastinum being the most common site for these tumors, benign teratomas form only 10% of them. We are presenting a case of 39 years old male who presented with progressive exertional dyspnea, orthopnea with frequent attacks of cough for 3years and feeling of pulsatile mass in left upper parasternal area in the last 4 months. Chest x-ray showed superior mediastinal shadow projecting to left upper chest zone and deviating the trachea to the right side of chest, provisional diagnosis was aneurysm of aortic arch. Computed tomography (CT) scan of chest and CT angiography done and revealed a superior mediastinal mass of heterogeneous opacity containing fluid, soft tissue, bones and calcification encroaching the right pulmonary artery and compressing and deviating the trachea to the right. Complete surgical removal done through left thoracotomy, Final diagnosis of a mature cystic teratoma was given on histopathology. This case is being presented here because mediastinum is a rare site for teratoma and superior mediastinal teratoma was reported in only few cases from review of literature.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90199357","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":"RARE AND DEMANDING: PARATHYROID ADENOMA LOCALIZATION, SURGERY AND OUTCOME.","authors":"S. Attash, N. Jawhar, Mohammed Yahya, Muzahm Al-khyatt","doi":"10.33899/MMED.2020.128441.1050","DOIUrl":"https://doi.org/10.33899/MMED.2020.128441.1050","url":null,"abstract":"Objectives: We report our experience with parathyroid adenoma localization and surgical removal Patients and methods: Between June 2017 and June 2019, we had operated 8 cases of parathyroid adenoma. Three patients were males and 5 patients were females. Age ranged from 26 year old to 72 year old with average of 42 year old. Results: preoperative localization was achieved in 7 patients (87%) and intraoperative localization in one case (13%). Seven cases (87%) were sporadic while one case was part of MEN2a. Single adenoma was found in 6 patients (75%) and two adenomas in two patients (25%). The adenomas were located in the neck in 7 patients ( 87%) and in the anterior mediastinum in one patient ( 13%). Surgical removal of the adenomas was done without difficulties in all the cases through a neck incision in 7 cases and midline sternotomy in one patient. All the patients had resolution of symptoms within the follow up period. Conclusion: parathyroid surgery is one of the challenging procedures, but with adequate localization and technique, the outcome can be excellent for the patient.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90245310","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 Interleukin- 6 in Lymphoma","authors":"Anfal Saleh Mohammed AL-jubory, Sanaa mohammed taib Al Hayali","doi":"10.33899/MMED.2020.128731.1057","DOIUrl":"https://doi.org/10.33899/MMED.2020.128731.1057","url":null,"abstract":"Background: Cytokines play a pivotal role in lymphoma ,cytokines either can be produced or exert effects on neoplastic or reactive cells. The elevated level of cytokines can contribute to the clinical and histopathologic alterations associated with malignant lymphoma. Objectives: to assess the level of IL-6 in newly diagnosed lymphoma patients in relation to their level in normal control subjects and to evaluate the correlation between IL-6 and hemoglobin (Hb), stage of disease and B-symptoms ,age and sex. Methods: This is a case control study, a total of 40 patients with lymphoma (HL & NHL) who attended private Clincs and hospitals in Mosul city and 40 age and sex matched control were included. A venous blood sample were taken for Complete blood count, Retic and IL-6 level. Enzyme-linked immunosorbent assay(ELISA)was used to determined IL-6 level. Results: There were a significant difference between the mean level of IL-6 of lymphoma cases and control (p-value=0.00). In the subset of patients with anemia, IL-6 levels inversely correlated with hemoglobin levels (p-value=0.00). There was significant correlation between IL-6 and patients with more advanced stage IIIIV disease(p-value=0.04). there was positive correlation between IL-6 level and B-symptoms)p=0.05( Conclusion: IL-6 level was elevated in lymphoma and it was significantly higher in lymphoma patients .IL-6 plays important role in the development of anemia in lymphoma.The adverse impact of elevated IL-6 is consistent with demonstration of higher level of IL-6 in patients with advanced stage of disease.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88790822","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":"Incidentally diagnosed papillary carcinoma in a thyroglossal duct cyst. What is the next step? A case report and review of the literature","authors":"Nashwan Q. Mahgoob","doi":"10.33899/MMED.2020.127674.1042","DOIUrl":"https://doi.org/10.33899/MMED.2020.127674.1042","url":null,"abstract":"Thyroglossal duct cyst is the commonest congenital disorders of the thyroid gland. Rarely, it can be a malignant tumor which is picked up incidentally in postoperative histopathology. Although management is still a controversy, a careful treatment and follow up planning is necessary for the management of such condition. We present a case of a 16-year-old female patient with thyroglossal duct cyst carcinoma .","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89957015","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 white banner test. A simple intra-operative leak test during laparoscopic sleeve gastrectomy.","authors":"Nashwan Q. Mahgoob","doi":"10.33899/MMED.2020.127882.1043","DOIUrl":"https://doi.org/10.33899/MMED.2020.127882.1043","url":null,"abstract":"Objective: To evaluate the efficacy of a simple intra-operative test (white banner test) for the detection of a leak during laparoscopic sleeve gastrectomy. Design: A prospective case series study.Setting: Obesity center at Soran private hospital, Erbil, Iraq, during the period from January 2017 to June 2019. Participants: eighty patients underwent the white banner test during laparoscopic sleeve gastrectomy. The records of intraoperative findings and post-operative follow up were analyzed. Patients and methods: After completing the sleeve process and hemostasis, a gauze of 4*12 cm was introduced through the 12mm trocar and displayed along the course of remaining sleeved stomach, nasogastric tube inserted to the upper portion of the stomach, compression of the pylorus by grasper against the vertebrae, 100 milliliters of saline stained by methylene blue dye were injected slowly by the anesthetist through the nasogastric tube, waiting for 30 seconds, any discoloration of the gauze was recorded and the site of leak (if any) was identified and managed. If the gauze appeared white, gauze withdrawn and the procedure finished. Results: In 80 patients, only two patients showed a blue spot at the gauze, which were fixed by suture. In all other patients, the gauzes were completely clean and (white). Postoperatively no early leak was detected. Conclusion: This is a simple and not time-consuming intraoperative procedure that can be used to detect intra-operative leaks during laparoscopic sleeve gastrectomy.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90306705","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":"Application of FISH Technique in Evaluation of Equivocal Cases of HER2/neu in Breast Carcinoma","authors":"S. Jaafar, E. Ali, Nazar M. T. Jawher","doi":"10.33899/MMED.2020.128713.1056","DOIUrl":"https://doi.org/10.33899/MMED.2020.128713.1056","url":null,"abstract":"Background: Breast cancer in Iraqi females is one of the extreme popular malignant tumors. It represents the third of registered female cancers. Management and outcome of breast cancer are affected by variables such as tumor size and grade, as well as histologic type, HER2/neu status of the tumor and hormone receptor status. HER2/neu (or erbB-2) is a proto-oncogene found on chromosome 17, that is overexpressed and/or amplified in 15% to 25% of invasive breast carcinomas and is connected to worse clinical outcome. Patients with HER2/neu positive breast carcinoma have showed a good response to targeted therapy (Herceptin) that improving the prognosis. Objectives: To assess the immunohistochemical overexpression of HER2/neu in breast carcinoma, to detect the frequency of amplified HER2/neu by FISH on immunohistochemically equivocal cases, and to correlate HER2 overexpression & or amplification with various clinicopathological parameters. Patients and Method: A total of hundred breast carcinoma patients at different ages were included in this retrospective and prospective case series study design. Formalin fixed paraffin embedded blocks were collected from different private labs in Mosul, between 1st November 2019 to 1st April 2020. FISH technique was performed on 25 equivocal cases of HER2/neu tested by immunohistochemistry technique using Leica Kreatech TM FISH Dual Probe (Red/Green). Results: Among a total of 100 patients with mean age was (52) years old diagnosed as breast carcinoma via histopathological findings, 58% were tested negative for HER2/neu,17% positives for HER2/neu, and 25% were equivocal by Immunohistochemistry. However, FISH method is conducted for those patients indicated as equivocal at immunohistochemistry and has identified 7(28%) positive cases and 18(72%) negative cases. The association between HER2/neu and the grade of the tumor was statistically considerable (P value=0.03). Furthermore, the analysis indicated that the HER2/neu was not statistically related with histological type of the tumor and age of the patients (P value=0.35, P value= 0.75, respectively). In this study, HER2/neu was statistically inversely associated with both ER and PR receptors (P value=0.03, P value=0.05, respectively). Conclusion: HER2/neu is overexpressed by immunohistochemistry in 17%. HER2/neu is amplified by FISH (in equivocal cases) in 28%. HER2/neu is statistically significant correlation with tumor grade, and is in inverse statistically significant correlation with estrogen and progesterone receptors while not statistically significant with age and histological types of tumors.","PeriodicalId":8334,"journal":{"name":"Annals of the College of Medicine, Mosul","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82139989","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}