About Journal

Kirkuk Journal of Medical Sciences is a new title for the Journal of Kırkuk Medıcal College. This journal is a global, scientific, and open access journal that publishes two times a year by the Medical College of Kirkuk University at Kirkuk, Iraq, issued for the first time at 2013  under the name of Journal of KIrkuk Medical College till the Spring issue at 2021, the the journal name was changed. We are using iThenticate to prevent plagiarism and to ensure the originality of our submitted manuscripts. A double-blind peer-reviewing system is also used to assure the quality of the...
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Journal Information

Types of septal deviation rate of each type morbidity and associated sinus pathology

Laith muhamnad Anna Anna

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 1-33
DOI: 10.32894/kjms.2022.174183

Abstract
Background
 

Septal deviation is a common disorder and its role in pathogenesis of sinus pathology remain uncertain ,
Different type of septal deviation affects sinuses in different feature.
Design of study : prospective study

 
Objective

Rate of each type of septal deviation .
Morbidity of septal deviation .
Associated sinonasal pathology .

 
Patient and methods

About 150 patients. collected from out patient clinic from  AL.Yarmouk teaching hospital from April 2017 till Augest 2018 who complain from nasal obstruction, nasal discharge, facial pain others for at least 3month, patients presented without previous diagnosis.
All patients collected due to symtomatic septal deviation, then  examination done  either by ant. Rhinoscopy using head light and killian  nasal speculam, endoscopy rigid type 4mm (00&300) and fibroptic (nasopharyngeal)
Doing C.T scan for each  patient to observe  change in each type on paranasal sinuses ,the shape of deviation which seen by endoscopy and exclude other nasal and paranasal pathology
Data collected in questioner or statistic  reading method using P.value .
Observe rate of each type ,morbidity of septal deviation consequence of pathology of each type regarding of sinuses .

 
 
Results

In this current study for 150 case symptomatic septal deviation we observe :
C-shape (91)60.6%
S-shape (59) 39.3%
we found 70 case associated with sinus pathology
C-shape=32case 45.8%
S-shape =38case 54.2%

 
Conculosion

Deviated nasal septum associated with significant sinonasal disease especial S-shape DNS which show statically significant correlation with  sinus disease .
Nasal obstruction  are the main complain of  septal deviation .
Bilateral  sinus disease more associated with S-shape &unilateral sinus disease with C-shape .

 

Treatment of recurrent pilonidal sinus by flap technique(Limberg flap)

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 34-43
DOI: 10.32894/kjms.2022.174184

Abstract
 
Background: pilonidal sinus (PNS) is a chronic disease that mostly affects young adults. describes a hair-filled cavity in the subcutaneous fat of the post sacral intergluteal region, known as the natal cleft , its name arises from the Latin terms “pilus” and “nidus” meaning  a nest of hair  PNS can be asymptomatic, or may be present  as a recurrent  abscess or as  chronic  inflamed cavity and local  discharge from sinus or sinuses and local pain and discomfort .
Materials and Methods: retrospective  study was done  from (November 2017 to November   2018) at surgical department in  Kirkuk General Hospital in 50 patients with  recurrent PNS all will be treated with  Limberg  flap then follow up for one year  this surgery done  by excision of PNS till  we reach  fascia overlying  sacrum inferiorly  and laterally till  we reach gluteal fascia and dissection was performed with electro cautery and  reconstruction done by  flap (Limberg flap) from gluteal area.
Results: in 50  patient  with recurrent PNS   we have 45 (90%) were male and 5 (10%) were female ,30 patient  (60%) patients had a familial history of PNS and 42 patients(84%) with etiology-related risk factors to develop PNS then  we divided them according first time surgery done either, by excision and primary closure 30 patient(60%) or excision and healing by granulation tissue and secondary intension 20patient (40%)
Discussion: pilonidal sinus not classified as  dangerous condition but any  patients  with PNS live in  non-comfortable   state and may have complications such as abscess formation   or discharging sinus even  severe  pain  therefore Limberg flap is  commonly used method to treat  recurrent PNS and this good  result with  healing in short period  also satisfactory results   in long duration but this method  with  Sacrococcygeal area  disfigure mentation  as one long duration complications  but   less  recurrence rates and  short stay in hospital and better patient  tolerability  in this way if we  compare it  to all other methods even  with  surgical challenge  to create a flap  but it less wound infection,  hematoma ,edema , wound separation  if we compare it  to  other surgical techniques but fluid accumulation in close space under flap is one of important complications in this method and we decrease it   by  using a  drain  and putted  in site until fluid drainage in area  decreased to be less than 50 ml/day .
In this method recurrence rate in our study is 2%  but  reported recurrence rate for Limberg flap are from 0.8 to 2.7% if we compare to 12% recurrent rate   in  primary closure therefore we have very good recurrence rate
Conclusions: the approach for recurrent PNS should be differ  from  primary PNS flap reconstruction methods in treatment for recurrent PNS  is very good  and efficient method even with surgical challenge procedure  to create flap, personal hygiene are the keystones for preventing recurrence

REVIEW OF PATIENTS WITH ABO INCOMPATIBILTY IN HEALTHY NEONATAL JAUNDICE IN KIRKUK

Rana Muhammed Khorsheed

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 44-63
DOI: 10.32894/kjms.2022.174185

Abstract:
             Prospective study involved 63 patient admitted to kirkuk pediatric hospital from 15/5/2008 to 15/7/2008   collectively patients submitted to all required investigations TSB  level , complete blood picture, reticulocyte count  direct coombs test via two methods  antihuman globulin test and old standard technique of o cell technique ,the  most common cause of neonatal jaundice among them was physiological one and ABO incompatibility being the next common one male patients were the commonest among these patients ,blood group of most of patients was Followed by b ,being the mothers blood group o was the predominant one in this study, this disease was mostly seen in low birth patients (<3 kg )in our study ,higher levels of total serum bilirubin(>200mmole/liter)  noticed among these patient
We concluded that ABO incompatibility is a well documented cause of neonatal morbidity in this city finally we recommend performing reticulocyte count , complete blood picture ,total serum bilirubin and direct coombs test in every patient with blood group A or B and mother blood group o sine a lot of complication can be prevented by diagnosing this serious illness.

ATRA use in Acute Promyelocytic Leukemia

Susan Mahmood

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 64-86
DOI: 10.32894/kjms.2022.174186

Abstract:
        Acute Leukemia is a the result of malignant event or events occurring in early hematopoietic precursor, instead of proliferation and differentiation normally, the affect cells give rise to progency that fail to differentiate and instead continue to proliferate in an uncontrolled fashion.
         Retrospective study, carried between January 2001, and August 2006, Ninety four children ( 15 years of ages) were diagnosed as AML by bone marrow examination (aspirate and sometimes biopsy), twenty two of these children diagnosed as APL, fourteen were treated by chemotherapy and eight of these children treated by ATRA and specific protocol.
      
        M 2 subtype of AML is most common subtype.
 M 3 second most  common  subtype  of  AML  with  peak  age  of
frequency 10-11 years with female predominance.
 Combined ATRA  with  chemotherapy  for  treatment  of  APL
improves survival rate of children.
 The most  common  complication  of  ATRA  encounter  during
treatment was dryness of skin and mucosa.

Factors associated with poor glycemic control in diabetic patients in Kirkuk

waleed mohammed Ali

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 87-97
DOI: 10.32894/kjms.2022.174187

Abstract
 
Background
 
Iraq's health-care system has faced tremendous obstacles in its recovery from the Islamic State's conflict. There is no public insurance system in place. Iraq has set targets to prevent and control noncommunicable diseases (NCDs) such as diabetes, but safety confrontation  and governmental insecurity have made these objectives difficult to achieve. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications.
 
The goal is to identify the roadblocks to better glycemic management.
 
The participants in this cross-sectional study were recruited from a diabetes out-patient clinic at Baba Gurgur diabetic facility. From April to December 2019, K1 hospital – North oil company in Kirkuk city. A validated questionnaire was used to interview those with an uncontrolled glycemic index (AIC7%). Patients were asked to name the primary causes of inadequate  glucose  control and to select more than one response based on their opinion.
 
The mean A1C was 8.3 2.1 percent, with 256 (22.5 percent) patients having an A1C less than 7% and 880 (77.5 percent) having an A1C equal to or greater than 7. Poor glycemic control is caused by a lack of medication and/or a lack of drug supply from PHC in 51.1 percent of cases. Diet and medication non-compliance, as well as illiteracy, account for 35.1 percent and 19.8 percent of the population, respectively. Glycemic regulation is greatly influenced by one's financial situation. However, security issues and political instability play a significant impact.
 
Conclusion: Diabetic patients confirmed poor glycemic control, with the majority of cases being linked to Iraq's current health situation.

New-Onset Diabetic Ketoacidosis Precipitated by COVID-19 in Children :a case report

Amal Adnan

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 98-103
DOI: 10.32894/kjms.2022.174188

There is increasing evidence that the 2019 coronavirus disease (COVID-19) is considered  as a potential trigger virus for the development of diabetes mellitus in children. This can occur even in patients without factors predisposing to impaired glucose metabolism like obesity . Here, we report a rare case of diabetic ketoacidosis revealing new-onset diabetes and precipitated by COVID-19. The relationship between type 1 diabetes mellitus and COVID-19 is discussed. Results: A 13 years old girl developed symptoms suggestive of diabetic ketoacidosis preceded by polyuria, polydipsia, and lethergy. There is a documented COVID-19 infection in her  parents . An asymptomatic infection was detected on the basis of a reverse transcription polymerase chain reaction (RT-PCR) . she  responded well to treatment, including rehydration regimens and intravenous insulin. On the 4th day of her hospitalization, she was transferred to several injections of subcutaneous insulin with therapeutic and nutritional education from the parents. Conclusion. COVID-19 can induce acute onset diabetes and diabetic ketoacidosis in children. More research data are needed to improve our knowledge of this constellation and to guide the most appropriate therapies.

Antichlamydial Antibodies In Women With Ectopic Pregnancy

Sahar Jalal

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 105-118
DOI: 10.32894/kjms.2022.174201

ABSTRACT


Methods: A case control study that was conducted in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital / Kirkuk-Iraq during the period of 10 months from 1st of Feb till 1st of Dec 2019. It included 86 pregnant women selected from outpatient clinic and those who were admitted to the emergency department. They were divided into two groups: Case group included 43 women diagnosed with ectopic pregnancy and control group included 43 women with early normal intra uterine pregnancies (1st trimester). Women using an intrauterine contraceptive device at the time of conception or had previous history of ectopic pregnancy, infertility, tubal surgery or smoking were excluded . After obtaining verbal consent from them five ml of venous blood was collected from all women to investigate for serum anti chlamydial IgG antibody titer.

Conclusion: Higher proportion of women with ectopic pregnancy had positive anti- chlamydial antibody than those with normal pregnancy. Anti-chlamydial antibody titer may play an important role to predict the risk of ectopic pregnancy as the mean of anti-chlamydial antibody titer was significantly higher in patients who diagnosed with ectopic pregnancy than that in women with normal pregnancy regardless age, gestational age or parity.

Risk factors and Prevalence of Osteoporosis amidst Postmenopausal females turning up the Diabetes and Endocrinology clinic at Azadi Teaching Hospital at Kirkuk /Iraq

Ali Akram

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 160-172
DOI: 10.32894/kjms.2022.174641

Abstract: for estimation the prevalence of osteoporosis and osteopenia amidst Iraqi postmenopausal females  turning up the Azadi Teaching Hospital's Diabetes and Endocrinology clinic, as well as the relevant venture agents. A descriptive cross-sectional treatise was carried out in a diabetic and endocrinology clinic in Kirkuk, Iraq. An aggregate of 1085 Iraqi postmenopausal females at age 45 to 84 years old were enrolled in this study, which took place between April 2019 and April 2021. The bone mineral density of all patients was measured using a dual-energy X-ray absorptiometry (DEXA) scan. According to World Health Organization recommendations, the DEXA scan was explicated in idioms of T score. Osteoporosis and osteopenia were found to be prevalent in 37.5 percent and 44.6 percent of the population, respectively. The lumbar spine had the highest incidence of osteoporosis (32.40 %), chased via the left femoral neck (14.40 %), and the left femoral neck had the highest frequency of osteopenia (56.10 %), the lumbar spine (41.30 %). Extended menopausal scope, ordinary or overweight BMI, elevated parity, corporal inactivity, affirmative family history of osteoporosis, inconvenient sun exposition, elevated diurnal cafe utilization, low diurnal utilization of calcium, with delayed menarche age were whole linked to osteoporosis. Females with type 2 diabetes, on the other hand, had a decreased incidence of osteoporosis. Iraqi postmenopausal females have a significant frequency of osteoporosis and osteopenia. More generic instruction plus a better publicizing of knowledge about osteoporosis and its prohibition are required.

Types of septal deviation Rate of each type ,morbidity and associated sinus pathology

Laith muhamnad Anna Anna

Kirkuk Journal of Medical Sciences, In Press

Abstract
•Septal deviation is acommon disorder affect sinus pathology
•Design of study : prospective study
Objective
• Rate of each type of septal deviation .
•Morbidity of septal deviation .
•Associated sinonasal pathology .
Patient and methods
•About 150 patients. collected from out patient clinic from AL.Yarmouk teaching hospital from April 2017 till Augest 2018 who complain from nasal obstruction, nasal discharge, facial pain others for at least 3month, patients presented without previous diagnosis.
•All patients collected due to symtomatic septal deviation, then examination done either by ant. Rhinoscopy using head light and killian nasal speculam, endoscopy rigid type 4mm (00&300) and fibroptic (nasopharyngeal)
•Doing C.T scan for each patient to observe change in each type on paranasal sinuses ,the shape of deviation which seen by endoscopy and exclude other nasal and paranasal pathology
• Data collected in questioner or statistic reading method using P.value .
• Observe rate of each type ,morbidity of septal deviation consequence of pathology of each type regarding of sinuses
Results
• In this current study for 150 case symptomatic septal deviation we observe :
• C-shape (91)60.6%
• S-shape (59) 39.3%
• we found 70 case associated with sinus pathology
• C-shape=32case 45.8%
• S-shape =38case 54.2%

Conculosion
• Deviated nasal septum associated with significant sinonasal disease especial S-shape DNS which show statically significant correlation with sinus disease .
• Nasal obstruction are the main complain of septal deviation .
• Bilateral sinus disease more associated with S-shape &unilateral sinus disease with C-shape .

Treatment of recurrent pilonidal sinus by flap technique (Limberg flap )

abdulkareem omer Mohamed salih

Kirkuk Journal of Medical Sciences, In Press

Background: pilonidal sinus(PNS) is a chronic disease that mostly affects young adults. describes a hair-filled cavity in the subcutaneous fat of the post sacral intergluteal region, known as the natal cleft , its name arises from the Latin terms “pilus” and “nidus” meaning a nest of hair PNS can be asymptomatic, or may be present as a recurrent abscess or as chronic inflamed cavity and local discharge from sinus or sinuses and local pain and discomfort .
retrospective study was done from (November 2017 to November 2018) at surgical department in Kirkuk General Hospital in 50 patients with recurrent PNS all will be treated with Limberg flap then follow up for one year this surgery done by excision of PNS till we reach fascia overlying sacrum inferiorly and laterally till we reach gluteal fascia and dissection was performed with electro cautery and reconstruction done by flap (Limberg flap) from gluteal area
in 50 patient with recurrent PNS we have 45 (90%) were male and 5 (10%) were female ,30 patient (60%) patients had a familial history of PNS and 42 patients(84%) with etiology-related risk factors to develop PNS then we divided them according first time surgery done either, by excision and primary closure 30 patient(60%) or excision and healing by granulation tissue and secondary intension 20patient (40%)

REVIEW OF PATIENTS WITH ABO INCOMPATIBILTY IN HEALTHY NEONATAL JAUNDICE IN KIRKUK

Rana Kasab

Kirkuk Journal of Medical Sciences, In Press

SUMMERY:
Prospective study involved 63 patient admitted to kirkuk pediatric hospital from 15/5/2008 to 15/7/2008 collectively patients submitted to all required investigations TSB level , complete blood picture, reticulocyte count direct coombs test via two methods antihuman globulin test and old standard technique of o cell technique ,the most common cause of neonatal jaundice among them was physiological one and ABO incompatibility being the next common one male patients were the commonest among these patients ,blood group of most of patients was Followed by b ,being the mothers blood group o was the predominant one in this study, this disease was mostly seen in low birth patients (200mmole/liter) noticed among these patient
We concluded that ABO incompatibility is a well documented cause of neonatal morbidity in this city finally we recommend performing reticulocyte count , complete blood picture ,total serum bilirubin and direct coombs test in every patient with blood group A or B and mother blood group o sine a lot of complication can be prevented by diagnosing this serious illness.

ATRA use in Acute Promyelocytic Leukemia

Susan Mahmood

Kirkuk Journal of Medical Sciences, In Press

Retrospective study, carried between January 2001, and August 2006, Ninety four children (c 15 years of ages) were diagnosed as AML by bone marrow examination (aspirate and sometimes biopsy), twenty two of these children diagnosed as APL, fourteen were treated by chemotherapy and eight of these children treated by ATRA and specific protocol.
The information of this study was obtained from files of patients in hematology and oncology unit in central teaching hospital from children regarding age, sex, resistance, type of AML, complete blood count at diagnosis, response to treatment complication during treatment.
The treatment plan of these eight patient in induction was ATRA (25 mg/m2/day) administrated orally in two equally divided doses associated with daunorubicin (25 mg/m2/day) for two consecutive day only for those with WBCc >10 ×109/L at day one, WBCc > 5×10 9/L at day fifteen at which bone marrow aspiration done this cycle continued for thirty day. In consolidation cycle which includes cycles of daunorubicin stander dose cytorabine by subcutaneous injection with ATRA orally in two divided doses. Oral 6- mercaptopurine and methotrexate combined with ATRA every 3 month was administrated to all patient who obtained complete remission (CR) (

Factors associated with poor glycemic control in diabetic patients in Kirkuk

waleed mohammed Ali

Kirkuk Journal of Medical Sciences, In Press

Background
Iraq's health-care system has faced tremendous obstacles in its recovery from the Islamic State's conflict. Iraq has set targets to prevent and control noncommunicable diseases (NCDs) such as diabetes, but safety confrontation and governmental insecurity have made these objectives difficult to achieve. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications.The goal is to identify the roadblocks to better glycemic management.The participants in this cross-sectional study were recruited from a diabetes out-patient clinic at Baba Gurgur diabetic facility. From April to December 2019, K1 hospital – North oil company in Kirkuk city. A validated questionnaire was used to interview those with an uncontrolled glycemic index (AIC7%). Patients were asked to name the primary causes of inadequate glucose control and to select more than one response based on their opinion.The mean A1C was 8.3 2.1 percent, with 256 (22.5 percent) patients having an A1C less than 7% and 880 (77.5 percent) having an A1C equal to or greater than 7. Poor glycemic control is caused by a lack of medication and/or a lack of drug supply from PHC in 51.1 percent of cases. Diet and medication non-compliance, as well as illiteracy,. Glycemic regulation is greatly influenced by one's financial situation. However, security issues and political instability play a significant impact.Conclusion: Diabetic patients confirmed poor glycemic control, with the majority of cases being linked to Iraq's current health situation.
key words :- Diabetes Mellitus, Management, and Iraq are.

New-Onset Diabetic Ketoacidosis Precipitated by COVID-19 in Children :a casa report

Amal Adnan

Kirkuk Journal of Medical Sciences, In Press

Abstract
There is increasing evidence that the 2019 coronavirus disease (COVID-19) is considered as a potential trigger virus for the development of diabetes mellitus in children. This can occur even in patients without factors predisposing to impaired glucose metabolism like obesity . Here, we report a rare case of diabetic ketoacidosis revealing new-onset diabetes and precipitated by COVID-19. The relationship between type 1 diabetes mellitus and COVID-19 is discussed. Results: A 13 years old girl developed symptoms suggestive of diabetic ketoacidosis preceded by polyuria, polydipsia, and lethergy. There is a documented COVID-19 infection in her parents . An asymptomatic infection was detected on the basis of a reverse transcription polymerase chain reaction (RT-PCR) . she responded well to treatment, including rehydration regimens and intravenous insulin. On the 4th day of her hospitalization, she was transferred to several injections of subcutaneous insulin with therapeutic and nutritional education from the parents. Conclusion. COVID-19 can induce acute onset diabetes and diabetic ketoacidosis in children. More research data are needed to improve our knowledge of this constellation and to guide the most appropriate therapies.

The irritable bowel syndrome prevalence of amidst Iraqi inhabitance in Kirkuk via utilizing of Rome IV gauge

Ali Akram Ismael; waleed mohammed Ali; Mohammed Yawoz Nooraldin

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.133974.1027

Background: The most common functional gastrointestinal disorder is irritable bowel syndrome (IBS). food can act a function in stimulation presentations. Using the Rome IV criteria, we calculated the prevalence of irritable bowel syndrome and it’s types amidst Iraqi inhabitance.
Method and patient: A descriptive cross-sectional treatise carried out in the outpatient clinics at two prime Kirkuk infirmary. Between November 2019 and February 2022, a total of 2638 people (1412 men and 1226 women) completed a questionnaire with three sections (sociodemographic, Rome IV, and food constraints). We used appropriateness sampling.

Result: irritable bowel syndrome was documented in 208 people (7.90%), with 52 percent of them having IBSM (mixed) type. Women had a higher prevalence than men (4.90 versus 3.00 %; P value = 0.006). There was a presumed link inter alia having Irritable bowel syndrome presentation and having a minimal revenue (P value = 0.0100) and idle (P value= 0.0001).

Conclusions: Irritable bowel syndrome is less prevalent in Iraqi society. The highest correlations with IBS are female genus, minimal family revenue, plus occupational situation. outlook society treatises can provide a chance to discuss educational varies and diet priorities.

Risk factors and Prevalence of Osteoporosis amidst Postmenopausal females turning up the Diabetes and Endocrinology clinic at Azadi Teaching Hospital at Kirkuk /Iraq

ali akram Ismael; Zahraa G. Abdullah; aydin othman aydin

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.134077.1028

for estimation the prevalence of osteoporosis and osteopenia amidst Iraqi postmenopausal females turning up the Azadi Teaching Hospital's Diabetes and Endocrinology clinic, as well as the relevant venture agents. A descriptive cross-sectional treatise was carried out in a diabetic and endocrinology clinic in Kirkuk, Iraq. An aggregate of 1085 Iraqi postmenopausal females at age 45 to 84 years old were enrolled in this study, which took place between April 2019 and April 2021. The bone mineral density of all patients was measured using a dual-energy X-ray absorptiometry (DEXA) scan. According to World Health Organization recommendations, the DEXA scan was explicated in idioms of T score. Osteoporosis and osteopenia were found to be prevalent in 37.5 percent and 44.6 percent of the population, respectively. The lumbar spine had the highest incidence of osteoporosis (32.40 %), chased via the left femoral neck (14.40 %), and the left femoral neck had the highest frequency of osteopenia (56.10 %), the lumbar spine (41.30 %). Extended menopausal scope, ordinary or overweight BMI, elevated parity, corporal inactivity, affirmative family history of osteoporosis, inconvenient sun exposition, elevated diurnal cafe utilization, low diurnal utilization of calcium, with delayed menarche age were whole linked to osteoporosis. Females with type 2 diabetes, on the other hand, had a decreased incidence of osteoporosis. Iraqi postmenopausal females have a significant frequency of osteoporosis and osteopenia. More generic instruction plus a better publicizing of knowledge about osteoporosis and its prohibition are required

Covid-19 Vaccines Side Effects in Iraq

Nareen Sabah Zangana; Kosar Mohammad Ali

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.135250.1029

BAckground
The "Severe Acute Respiratory Syndrome Coronavirus 2" (SARS-CoV-2)
disease has resulted in a worldwide challenging and dangerous pandemic,
COVID-19 vaccines have beenpreventing serious morbidities and mortality
associated with the infection. However, in addition to these findings, some
unusualadverse effects have been reported.
Vaccine side effects are common. They demonstrate that immunizations are
effective and that the immune system is responding. For assessing the safety
of the vaccine, side effects and adverse events are fundamental.
Objective
To evaluate side effects of corona virus vaccines
Method
A prospective cohort study using a pre‐organized questionnaire
encompassing, demographic, general health, the status of SARS‐CoV‐2
infection, vaccination, associated adverse events, breakthrough infections and
their IgG anti-spike antibody titers; in a population comprising 200
individuals aged 18 and above who received 2 doses of one of covid-19
vaccines.
Results
The responses of 200 individuals were analyzed statistically. Revealing that
most utilized vaccine in the population was the Pfeizer-BioNtech vaccine.
Side effects were generally subtle, in all three vaccines, with no serious
3
adeverse events. Oxford-AstraZeneca
vaccine however, showed fiercer side effects compared to the other two
vaccines. Several side effects were more prevalent in male gender, but there
was no noteworthy correlation with other factors.
Conclusion
COVID-19 vaccinations appear to be safe. Although adverse events are rare
on a worldwide scale, a large proportion of the world's population will be
exposed to these vaccines. for this reason, their safety and tolerance must be
carefully evaluated.

Causes and management of hoarseness of voice in benign laryngeal disorders in Azadi Teaching Hospital

ALI HUSSEIN JAMAL

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.135648.1030

Background:Hoarseness remain one of the major complain of patients visiting Otolaryngology clinic and regarded as one of the intractable conditions for treatment.It is almost a benign condition and could be treated by medical or surgical treatment according to the severity of symptoms and duration of patient complain. Patients and Methods: A prospective study had been carried out on 120 patients who attended ENT out patient clinic in Azadi teaching hospital from January 2018 to January 2019. All the cases had been diagnosed with either indirect laryngeal mirror or by flexible laryngoscope. The cases treated in the out patient as a conservative measures or the patients had been admitted and treated with a surgical maneuvers. Results: The patients consisted of 55%(64) males and 45%(56) females with an average age of 40 years. In this study the incidence of chronic hoarseness(65.84%) was more common than acute hoarseness(34.16%) and acute laryngitis(26.66%) was the most common cause of acute hoarseness,while Vocal cord polyp was the most common cause of chronic hoarseness (22.5%) . Conclusions: The commonest cause of hoarseness was found to be acute laryngitis of Larynx which predominantly affects young males. The peak age incidence is between 21-30 years, Males are affected more than females

Disease Extension In Active Chronic Otitis Media

ALI HUSSEIN JAMAL

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.135653.1032

Background: Active chronic otitis media present with multiple findings within the middle ear like, granulation tissue and cholesteatoma which has extension and origin from similar pathological conditions within the attic and mastoid air cell system.
Objectives: to assess the operativel finding in middle ear cleft including the attic and air cells during mastoid exploration.
Study design: Prospective study
Setting: E.N.T department Kirkuk Azadi Teaching Hospitals
Patient’s selection: 20 Ears; on whom decision of mastoid exploration was taken. Extensions of granulation tissue and cholesteatoma assessed.
Results: 60% belonged to active mucosal COM with granulation tissue found in the mastoid cavity.40% belonged to active squamous COM with cholesteatoma and granulation tissue found in the mastoid air cell system.
Aural polyp found with extensive mucosal disease, bone erosion and 50% associated with cholesteatoma.
Conclusion : Active mucosal chronic oitis media was found more frequently during mastoid exploration in the selected ears for our study

EVALUATION OF SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR IN ECTOPIC PREGNANCY The

Sahar Yuldurum; Khalidah Amin

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136116.1034

Background:Ectopic pregnancy is a common life threatening complication of early pregnancy refers to a gestation in which the fertilized ovum implants on any tissue other than the endometrium.Vascular endothelial growth factor(VEGF)is an angiogenic factor,and plays a key role in the establishment of a viable pregnancy.
Aim of study:To determine serum level of vascular endothelial growth factor and evaluate their capacity to serve as a marker for diagnosis of ectopic pregnancy.
Methods:A case-control study that was conducted in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital/Kirkuk-Iraq,from the 1st of February until30th of October 2021.The statistical analysis included 90women with early pregnancy at6 weeks of gestation who attended obstetrical emergency unit and outpatient clinic.They were divided into three groups included 30cases in each group.Group one diagnosed as ectopic pregnancy,group two diagnosed as arrested intrauterine pregnancy and group three as normal intrauterine pregnancy.They are diagnosed based on combination of their last menstrual period, transvaginal ultrasound,serum beta human chorionic gonadotropin results.After verbal consent Serum vascular endothelial growth factor was measured by a kit uses enzyme linked immune sorbent assay for all study participants.
Result:There was significant higher mean of vascular endothelial growth among ectopic pregnancy in comparison to arrested intrauterine pregnancy and normal intrauterine pregnancy.When cut-off concentrations ≥200 pg/ml for VEGF were used and correlated it BhCG showed that it could distinguish intrauterine pregnancy from Ectopic pregnancy with98%sensitivity and96.3%specificity.
Conclusion:VEGF is a potential marker for Ectopic pregnancy,its concentrations in ectopic pregnancy are higher than in those with normal and arrested IUP.

EVALUATION OF SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR IN ECTOPIC PREGNANCY

Sahar Yuldurum; Khalidah Amin

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.135840.1033

ABSTRACT
Background:Ectopic pregnancy is a common life threatening complication of early pregnancy refers to a gestation in which the fertilized ovum implants on any tissue other than the endometrium.Vascular endothelial growth factor(VEGF)is an angiogenic factor,and plays a key role in the establishment of a viable pregnancy.
Aim of study:To determine serum level of vascular endothelial growth factor and evaluate their capacity to serve as a marker for diagnosis of ectopic pregnancy.
Methods:A case-control study that was conducted in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital/Kirkuk-Iraq,from the 1st of February until30th of October 2021.The statistical analysis included 90women with early pregnancy at6 weeks of gestation who attended obstetrical emergency unit and outpatient clinic.They were divided into three groups included 30cases in each group.Group one diagnosed as ectopic pregnancy,group two diagnosed as arrested intrauterine pregnancy and group three as normal intrauterine pregnancy.They are diagnosed based on combination of their last menstrual period, transvaginal ultrasound,serum beta human chorionic gonadotropin results.After verbal consent Serum vascular endothelial growth factor was measured by a kit uses enzyme linked immune sorbent assay for all study participants.
Result:There was significant higher mean of vascular endothelial growth among ectopic pregnancy in comparison to arrested intrauterine pregnancy and normal intrauterine pregnancy.When cut-off concentrations ≥200 pg/ml for VEGF were used and correlated it BhCG showed that it could distinguish intrauterine pregnancy from Ectopic pregnancy with98%sensitivity and96.3%specificity.
Conclusion:VEGF is a potential marker for Ectopic pregnancy,its concentrations in ectopic pregnancy are higher than in those with normal and arrested IUP.

Iron Deficiency Anemia in Children with Idiopathic Nephrotic Syndrome

Mayyadah Kifah Khawaja

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136168.1036

Abstract
Anemia is one of the many complications seen in patients with persistent nephrotic syndrome and may occur as a result of excessive urinary losses of iron, transferrin, erythropoietin, transcobalamin and/or metals.
Aim of the study: search for iron deficiency in children with nephrotic syndrome.
Patient and method: This cross-sectional study included two groups of patients, 40 patients with steroid sensitive and resistant nephrotic syndrome, aged 2-12 year of age, of either sex, who attended Child Central Teaching hospital during the period from June 2018 to April 2019. A thorough full history and clinical examination was done and all patients have been sent for investigation to search for anemia.
Results: 35% of patients with steroid resistant nephrotic syndrome were complaining from anemia, while none of patients with steroid responsive had anemia of any cause.
There was a significant difference (P= 0.001) between study group in Blood Film results as all patients of responsive group showed normal blood film compared to only seventy-five percent in resistant group.
Conclusion: iron deficiency anemia has been observed to occur in higher frequency in steroid resistant nephrotic syndrome due to difficulty in controlling proteinuria and the continuing iron losses.

Prevalence of acute Myocardial infarction in young patients in Kirkuk city

Omar Albustany

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 47-83
DOI: 10.32894/kjms.2021.170072

Background: acute myocardial infarction (acute MI) in young age population is characterized by bad prognosis. Many modifiable risk factors for acute myocardial infarction in young age population are reported.
Aim of study: To measure the prevalence of acute MI among young age population and identifying the common risk factors related to acute MI in young patients.
Patients and methods: This study is a clinical follow up prospective study conducted in Coronary Care Unit (CCU) of Azadi Teaching Hospital and Kirkuk General Hospital in Kirkuk city through the period from 1st of June to 30th of November, 2018 on convenient sample of 250 patients with acute MI . The patients were categorized into two groups; young age (

Transfusion-Related Infections in Thalassemia Major Patients: Kirkuk Thalassemia Center Experience

Jamal Qassim Welli; Majed Najii Agha; Mohammed Saleem Mohammed

Kirkuk Journal of Medical Sciences, 2015, Volume 3, Issue 1, Pages 22-28
DOI: 10.32894/kjms.2021.169514

Introduction: Thalassemia Major is one of the commonest causes of hereditary anemia in Iraq. Patients usually require frequent blood transfusion. This study tried to estimate the problem of transfusion-related infections among β-thalassemia major patients in Kirkuk governorate-Iraq.
Patients and Methods: The study involved 254 multi-transfused thalassemia major patients attending the Thalassemia Center at Kirkuk governorate over twoyears periodstarting from January 2010 to January 2012. Blood samples were tested for HBsAg, anti HCV antibodies, and HIV antibody using an enzyme-linked immunosorbent assay. A control group of 150 Thalassemia minor with nearly matched age and sex to thalassemia major patients was included.
Results: Anti-HCV antibody was positive in 85 out of 254 thalassemia major patients (33.5%), while HBsAg was positive in only one out of 254 patients (0.4%). HIV infection was not found in any thalassemia major patients. The rate of positive anti-HCV antibodies was significantly higher in comparison with the control group (P value <0.000) while it was not significant for HBsAg (P value=0.9). Age categorization for thalassemia major patients with positive HCV test shows that more than three quarters of them are above 10 years old.
Conclusion:HCV is the current major problem in multi-transfused children with thalassemia major and more careful pre-transfusion screening of blood for anti-HCV must be introduced in blood bank centers.

Bacterial neonatal sepsis and outcome in kirkuk city 2021

Jameel Azeez

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 84-100
DOI: 10.32894/kjms.2021.169937

Background
Sepsis is the commonest cause of neonatal mortality, it is responsible for about (30 - 50% ) of neonatal deaths every year in developing countries.

Results
Two hundred neonates were studied, sepsis was confirmed in 175 neonates (87.5%) by positive blood culture. Preterm neonates in this study were118 (59%), Prolonged rupture of amniotic membranes( > 18-hrs), was reported in 123 (61.5%), history of maternal fever was reported in 130 (65%). incidence in males was 120 (60%) while in females was 80 (40%). Early-onset disease (0-7 days) had occurred in 69 (34.5%), while 131 (65.5%) was the percentage of late-onset disease(8-30 days) . most of the late-onset disease was nosocomial infections 60 (53.57%). The predominant isolates in both early and late-onset diseases were Gram-negative bacteria 138 (78.8%) . the common organism in early-onset sepsis was E.coli 31 (49.20%), while the common organism in late-onset sepsis was Klebsiella 50 (44.64%). The total mortality rate was 82 (41%), in the early neonatal onset was 26 (42.02%) and while in the late neonatal-onset disease was 56 (42.7%) was. Candida albicans and Pseudomonas aeroginosa have high mortality (100%), but there is no death was recorded in pneumococcal sepsis.
Conclusion Neonatal septicemia generally is present in developing countries more common than in developed countries.

Antichlamydial Antibodies In Women With Ectopic Pregnancy

Sahar Jalal

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 105-118
DOI: 10.32894/kjms.2022.174201

ABSTRACT


Methods: A case control study that was conducted in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital / Kirkuk-Iraq during the period of 10 months from 1st of Feb till 1st of Dec 2019. It included 86 pregnant women selected from outpatient clinic and those who were admitted to the emergency department. They were divided into two groups: Case group included 43 women diagnosed with ectopic pregnancy and control group included 43 women with early normal intra uterine pregnancies (1st trimester). Women using an intrauterine contraceptive device at the time of conception or had previous history of ectopic pregnancy, infertility, tubal surgery or smoking were excluded . After obtaining verbal consent from them five ml of venous blood was collected from all women to investigate for serum anti chlamydial IgG antibody titer.

Conclusion: Higher proportion of women with ectopic pregnancy had positive anti- chlamydial antibody than those with normal pregnancy. Anti-chlamydial antibody titer may play an important role to predict the risk of ectopic pregnancy as the mean of anti-chlamydial antibody titer was significantly higher in patients who diagnosed with ectopic pregnancy than that in women with normal pregnancy regardless age, gestational age or parity.

Common Bacterial Causes of Lower Respiratory Tract Infection Other than Acid Fast Bacilli in Erbil City

Kamaran Mahmood Saydoka; Sahar Muhammad Zaki Abdullah; Mahmood Shakir Shukur

Kirkuk Journal of Medical Sciences, 2019, Volume 7, Issue 1, Pages 89-102
DOI: 10.32894/kjms.2021.169394

Background and objectives: Lower respiratory tract infection (LRTI) is one of the major causes of morbidity and mortality in young children and elderly. The most important lower respiratory infection is pneumonia, the fourth leading cause of death. Most cases of bronchitis are of viral etiology. Most common lower respiratory infections are acute bronchitis, chronic bronchitis, and pneumonia; the common causative agents are Streptococcus pneumoniae, Haemophilu influenzae, Enterococcus spp, Klebsiella pneumonia. Aims of the study was to find the common bacterial causes of lower respiratory tract other than acid fast bacilli in Erbil city and to determine if there is any relation between the causative agents with gender of the patients, also to determine the antibacterial susceptibility profile of the bacteria that isolated from patients with lower respiratory tract infection. Method: 250 sputum samples collected from patients suffering from lower respiratory tract infection attending the Microbiology Laboratory of Rezgary Hospital, Raparin Hospital and Par Hospital within period of 6 months (from August 2016 to February 2017). A questionnaire form sheet prepared for each patient who includes the following information: Patient name, age, gender, residence, symptoms, Drug history, past medical history and antimicrobial susceptibility done for each pathogen either by vitek or disk susceptibility tests. Result: From 250 patients only 142 patients showed positive growth, 100 (70.4%) were males and 42(29.6%) were females. Lower respiratory tract infection was mostly seen in age group of (41-50) years. The age range in this study varied between six months and 97 years with mean age (47±25.23) years. All together 10 different species of bacteria were identified, majority of which were gram negative (89.42%). The gram-negative bacteria were: Klebsiella pneumonia (30.29%), Acinetobacrebaumanaii (28.9%), Pseudomonas aeruginosa (11.9%), Escherchia coli (8.45%), Pseudomonas oryzihabitans (4.94%), Serratia marcescens (2.82%) and Proteus mirabilis (2.12%) isolated from sputum samples. The gram-positive bacteria were: Staphylococcus aureus (7.04%), Streptococcuspneumonia (2.12%) and Streptococcus oralis (1.42%) isolated from sputum samples. On performing antimicrobial susceptibility testing, in gram-positive bacteria, they were resistant to Amoxicillin and Penicillin while most of them were sensitive to Tetracycline. While in gram negative bacteria, they were resistant to Amoxicillin and Ampicillin and most of them were sensitive to Amikacin. Conclusion: Most of the isolated bacteria were gram negative which was (89.44%) while (10.56%) were gram positive. The prevalence of lower respiratory tract infection caused by bacterial infection is higher in males than females. Most of the gram positive and gram negative were resistant to most of the common antibiotics that used by the patients. Varieties of pathogens are responsible for lower respiratory tract infection and antimicrobial resistance has become significant public health problem.

Transfusion-Related Infections in Thalassemia Major Patients: Kirkuk Thalassemia Center Experience

Jamal Qassim Welli; Majed Najii Agha; Mohammed Saleem Mohammed

Kirkuk Journal of Medical Sciences, 2015, Volume 3, Issue 1, Pages 22-28
DOI: 10.32894/kjms.2021.169514

Introduction: Thalassemia Major is one of the commonest causes of hereditary anemia in Iraq. Patients usually require frequent blood transfusion. This study tried to estimate the problem of transfusion-related infections among β-thalassemia major patients in Kirkuk governorate-Iraq.
Patients and Methods: The study involved 254 multi-transfused thalassemia major patients attending the Thalassemia Center at Kirkuk governorate over twoyears periodstarting from January 2010 to January 2012. Blood samples were tested for HBsAg, anti HCV antibodies, and HIV antibody using an enzyme-linked immunosorbent assay. A control group of 150 Thalassemia minor with nearly matched age and sex to thalassemia major patients was included.
Results: Anti-HCV antibody was positive in 85 out of 254 thalassemia major patients (33.5%), while HBsAg was positive in only one out of 254 patients (0.4%). HIV infection was not found in any thalassemia major patients. The rate of positive anti-HCV antibodies was significantly higher in comparison with the control group (P value <0.000) while it was not significant for HBsAg (P value=0.9). Age categorization for thalassemia major patients with positive HCV test shows that more than three quarters of them are above 10 years old.
Conclusion:HCV is the current major problem in multi-transfused children with thalassemia major and more careful pre-transfusion screening of blood for anti-HCV must be introduced in blood bank centers.

Blood sugar measurements in non-diabetic patients presented with COVID-19

Omer Yilmaz; Omer Yilmaz

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 36-96
DOI: 10.32894/kjms.2021.172520

Abstract

Background: The new coronavirus disease 2019 (COVID-19) pandemic outbreak resulted in millions of co-morbidities and mortalities all over the world. The hyperglycemia with or without diabetes mellitus is prevalent in COVID-19 disease.
Aim of study: To identify the prevalence of hyperglycemia in COVID-19 patients and to evaluate the relationship between hyperglycemia and severity of COVID-19 disease.
Patients and methods: This study is a descriptive cross sectional study conducted in AL-Shifaa 14 Hospital in Kirkuk city-Iraq for duration of six months during the period from 1st of January till 30th of June, 2021 on convenient sample of 250 non-diabetic COVID-19 patients. The diagnosis of COVID-19 disease was confirmed by the supervisor according to clinical symptoms and signs, RT-PCR finding and CT-scan finding. The severity of COVID-19 disease was categorized by the supervisor according to Iraqi Ministry of Health guidelines.
Results: The prevalence of hyperglycemia among COVID-19 patients was (8%). The COVID-19 severity of patients was classified into; mild (27.2%), moderate (13.6%) and severe (59.2%). The means of random blood sugar and HBA1c were significantly increased among patients with severe COVID-19 disease (p

Relationship between Vulvovaginitis in Women with the Candida Species

Sahar Mohammed Zaki Abdullah

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 130-141
DOI: 10.32894/kjms.2020.169372

Background: Vulvovaginal candidiasis refers to the vaginal infection that is caused most commonly by candida species, especially candida albicans, women in their lifetime at risk to infect by candida species. The objectives of this study were to determine the relationship of Vulvovaginal infection with Candidiasis and its association with some risk factors and the incidence of different species of Candida among patients with vulvovaginitis. Methods: 300 samples from high vaginal swabs obtained from females attending maternity teaching hospital in Erbil City complained from signs and symptoms of valvovaginitis from the period September 2019 to February 2020. A questionnaire form prepared for each patient, who includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High vaginal swabs collected from patients and direct microscopic examination performed, cultured onto Sabouraud Dextrose Agar (SDA), Blood agar and Macconkey agar and species identification done by using an automated VITEK 2 compact system. Results: From the total of 300 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was (57%). The highest prevalence of positive cases were in the age range (30-34) years and the positive culture among pregnant women was 73(63.4%) and also the incidence of vulvovaginal candidiasis was higher among diabetic females 49(80.3%), The incidence of positive cultures of Candida spp. in the antibiotic users group were 61(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills 40(60.6%) however for IUCD user the positive culture was 31(68.9%). The species of Candida species which identified by using Vitek system were distribute as follow: Candida albicans was 147(86%) Candida glabrata16 (9.4%),CandidaParapsilosis 6(3.5%)and, Candida krusei 2(1.2%). Conclusion: In the present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.

Prevalence of acute Myocardial infarction in young patients in Kirkuk city

Omar Albustany

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 47-83
DOI: 10.32894/kjms.2021.170072

Background: acute myocardial infarction (acute MI) in young age population is characterized by bad prognosis. Many modifiable risk factors for acute myocardial infarction in young age population are reported.
Aim of study: To measure the prevalence of acute MI among young age population and identifying the common risk factors related to acute MI in young patients.
Patients and methods: This study is a clinical follow up prospective study conducted in Coronary Care Unit (CCU) of Azadi Teaching Hospital and Kirkuk General Hospital in Kirkuk city through the period from 1st of June to 30th of November, 2018 on convenient sample of 250 patients with acute MI . The patients were categorized into two groups; young age (

Assessment the Knowledge and Attitude of Breast Self Examination among Secondary School Female Students in Mosul City

Marab Younis Abdullah Al-Fathy

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 98-104
DOI: 10.32894/kjms.2020.169366

Background: the examination of the Breast is regarded as the secondary method of breast cancer protection which must be done by all females during the age 20 years and above. Aim: To assess knowledge and attitude level of females secondary school student’s towards breast self examination (BSE). Subject and method: Cross-sectional study design involved 1000 female student in secondary school in Mosul city .The study started from (1st March till 1st June) 2019, lasting for about (3 months ) by using a self-administer standardized questionnaire include knowledge and attitudes toward , source of knowledge Result: the study revealed that grand mean assessment value regarding BSE general information was 2.09 just above the (cut – off point = 2). The main source of knowledge was health professional (32.3%), followed by TV and social media (27.6%). Nearly two third of study sample had positive attitude to consult doctor and period of consultation within one week with mean score 2.3 and 2.4 respectively. In general the mean score assessment value of attitude toward BSE among study sample was below the cut of point 1.7. Recommendation: Provision of intensive educational program to secondary school students by health professional and encourage school teachers to teach and complete educational curriculum which focus to BSE and take attention to the subject to increase awareness and improve attitude toward it.

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