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

Disease Extension In Active Chronic Otitis Media

ALI HUSSEIN JAMAL

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 1-14
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

Revision Cochlear Implantation in Baghdad Medical City: A Retrospective Study

Mohammed Wajdi

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 96-118
DOI: 10.32894/kjms.2022.135988.1035

Background: Revision cochlear implant surgeries are uncommon but they represent a challenging issue for surgeons. Thoughtful preparation and evaluation of patients with proper counseling are mandatory.
Objectives: To identify the rate of revision surgeries and re-implantations, evaluate the causes, and analysis of clinical and operative findings.
Patients & Methods: A retrospective study including 46 cases underwent revision surgeries out of 1144 patients had cochlear implantation in the department of otolaryngology/Baghdad Medical City in the period from March 2009 to November 2019. The data were collected from 3 statistical record sources (the otolaryngology department records, operative theatre records, and hospital’s main statistic department).
Results: Revision cochlear implantation ratio was 4%. It was found that most of the cases were from pediatric age group (98% of cases with mean age of 6.77 years) with no difference between males and females (male to female ratio was 1.1:1). The most common causes for revision surgeries were non-device related (63%) while device related causes counted (37%). Re-implantation rate was (24%).
Conclusion: Revision cochlear implant surgeries in our center were within lower limits of the universal revision rates. Most commonly encountered cause for revision was wound infection with/without dehiscence followed by hard device failure. No significant complications recorded per and post operatively.

Role of intraoperative frozen section evaluation of sentinel lymph node in breast carcinoma

Sara Wajdi

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 119-134
DOI: 10.32894/kjms.2022.136169.1037

Background Breast carcinoma is the most common malignancy in women worldwide. Intraoperative frozen section of SLNs can detect metastatic disease, allowing immediate axillary dissection and avoiding the need for reoperation, at the same time it avoids unnecessary dissection of uninvolved LNs.

Aim of the study
1. To evaluate the current role of frozen section in identifying patients who could benefit from it.
2. To verify the accuracy of intraoperative frozen section examination for SLNs.

Materials and methods In this combined retrospective and prospective study, we reviewed the outcome for 33 female patients with breast cancer who underwent intraoperative SLN biopsy, at (Al-Shariqa laboratory) and (Ghazi Al-Hariri Hospital, Medical City) Baghdad, Iraq. and compared it with the permanent H&E sections, covering the period between Jan.2019 and Jan.2021

Results: The patients age was ranging from 32 to 79 years with a mean of 50.7 years and the highest proportion was ≥ 40 years (90%).
Only 10 patients (30.3%) of the total cases were diagnosed as having POSITIVE SLNs by intraoperative frozen section examination, while 23 patients (69.7%) had NEGATIVE SLNs. Nine of them (90%) were of ductal type, while only 1 case (10%) was of lobular type. all 10 cases (100%), the primary tumor size measured >2cm, (i.e: pT2). Validity of frozen section examination in comparison with permanent sections showed a sensitivity and specificity of 100%.

Conclusions: Intraoperative frozen section evaluation of SLN biopsy is a reliable method, it offers a high sensitivity, specificity and diagnostic accuracy when compared with permanent section

Covid-19 Vaccines Side Effects in Iraq

Nareen Sabah Zangana; Kosar Mohammad Ali

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 15-47
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, 2022, Volume 10, Issue 2, Pages 47-60
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

EVALUATION OF SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR IN ECTOPIC PREGNANCY

Sahar Yuldurum; Khalidah Amin

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 61-76
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.

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, 2022, Volume 10, Issue 2, Pages 77-83
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.

Iron Deficiency Anemia in Children with Idiopathic Nephrotic Syndrome

Mayyadah Kifah Khawaja

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 84-95
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.

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.

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

Imaging Findings in Idiopathic Granulomatous Mastitis (IGM) among Women in Sulaimani, the Kurdistan Region of Iraq

Alla Abdulrahman Ahmed; Kawa Abdulla Mahmood; Lana Rezan Abdulaziz

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136307.1040

Abstract
Background
Idiopathic Granulomatous mastitis is known as a rare condition, but it can mimic significant breast lesions like cancer. Variable nonspecific characteristics are present in idiopathic granulomatous mastitis (IGM) imaging.
Objectives
This study aimed to determine the imaging findings of IGM.
Patients and Methods
A retro prospective observational study was performed on 80 patients with IGM admitted to the Breast Center of Shar Hospital from January 2014 to May 2022. The inclusion criterion was patients diagnosed histopathologically with IGM. However, the exclusion criteria were secondary granulomatous processes and incomplete patient data. We also reviewed ultrasonography (US), mammography, and magnetic resonance imaging (MRI) findings.
Results
The mean± (SD) standard deviation of the patients' ages was 35.8±5.7 years, and most (65; 81.3%) were between 31 and 45. Most were married & multiparous. Both breasts were nearly equally affected. Most patients (75%) presented with pain, followed by mass (70%). The commonest US finding was multiple hypoechoic masses and collections with tubular extension. Focal asymmetric increased density was the most frequent mammographic finding. MRI findings were asymmetric signal intensity change 10.0%, non-mass-like enhancement10.0%, type 1 enhancement 12.5%, and BI-RADS 3 in 10.0% of the patients. The BI-RADS score of most women who had MRI was upgraded.
Conclusions
Imaging characteristics of IGM are variable; the US and mammography are helpful as initial exams. MRI gives more details on the disease and can be used to assess the extent of the disease, especially in complicated cases, and monitor treatment. Definitive diagnosis is by histopathology.

Generalized anxiwty disorder among adult patients attending paychiatry clinic at baghdad teaching hospital

Hamid Ahmed Wahbie Qutub

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136173.1038

Abstract
Background: Generalized anxiety disorder is characterized by chronic and persistent worry which is multifocal, excessive, and difficult to control, and accompanied by nonspecific psychological and physical symptoms. Objectives: Determine the proportion of GAD, evaluate clinical symptoms with socio-demographic data and determine whether such patients have co-morbid mental illnesses. Methods: this cross sectional study was conducted at Baghdad teaching hospital, 263 patients included; the study took 17 weeks starting in June 2021 till mid October 2021. Results: 2.6% of patients (7 patients from 263) found to have GAD, men and women were almost equally affected, most of the patients were employed and married, had secondary school achievements and all of them were from urban areas. Restlessness and irritability were the most frequent symptoms and sleep disturbance was the least among other symptoms. Depression was the most frequent comorbid illness; other anxiety disorders and personality disorder were the least comorbidities. Conclusion: The proportion of GAD is slightly lesser than other studies, higher proportion seen in older adults than the younger patients, common symptoms of GAD are also seen in other psychiatric disorders leading to under-diagnosing of the illness, and mental health comorbidities are high among patients with GAD, mainly depression.

Evaluation of maternal serum homocysteine in pre eclampsia

maha azeez

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136213.1039

ABSTRACT

Background: Pre-eclampsia affects about 2–8% of all pregnancies. It is one of the leading causes of maternal and perinatal morbidity and mortality hyperhomocysteinemia is considered as a risk factor for endothelial dysfunction and vascular disease. The vascular changes induced by homocysteine are similar to those with pre-eclampsia.

Aim of study: To identify the relationship between maternal serum homocysteine and pre-eclampsia.

Methods: A case control study t carried out in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital in Kirkuk-Iraq, from 1st of Feb. till 1st of oct.. 2021. included 80 pregnant women, singleton viable pregnancy, gestational age of > 20 weeks. divided into two groups: Case group included 40 pregnant who had diagnosed as preeclampsia (mild and severe) and control group included 40 healthy normotensive pregnant Patients with multiple pregnancy, history of medical disease or tacking treatment for hypertension were excluded. Blood sample was taken from each woman for biochemical study, serum homocysteine level was measured using ELISA technique.

Results: In this study, pregnant women with pre-eclampsia had significantly higher mean of serum homocysteine compared with controls. Homocysteine level > 8.95 μmol/l is a predictor for pre-eclampsia. Out of 40 women with pre-eclampsia, 42.5% were mild; while the remaining 57.5% were severe. Pregnant women with severe pre-eclampsia had significantly higher mean of serum homocysteine compared to those with mild pre-eclampsia.

Conclusion: Maternal serum homocysteine biomarker represents an early non-invasive marker for diagnosis of preeclampsia and to name disease according to the severity.

DURATION OF FIRST ADMISSION AND ITS RELATION TO THE READMISSION RATE IN IBN RUSHED PSYCHIATRIC HOSPITAL

Moathe Khaleel

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136324.1041

Background: Most of the mental health illnesses in psychiatry have chronic relapsing course.
It is estimated that the readmission rate for discharged patients is approximately 40-50%
within one year of their discharge from the hospital [1]
Aim: understand the relationship between the duration of first admission in the hospital
and rates of readmission in a psychiatric hospital.
Materials and Methods: Collect all the patients admitted to Ibn rushed psychiatric hospital
in Baghdad for the first time between first of January, 2018 to first of May, 2018, were
included in this study. The hospital records of these patients were examined and the data was
collected on various variables, which included demographic variables, duration of hospital
stay, diagnosis, and the number of readmissions for a period of approximately three years.
The duration of the first hospital stay was divided into three categories, Group 1: 1-7 days,
Group 2: 8 to 14 days, Group 3:15 to 30 days.
Results: The whole sample whom entered and accepted in the study consisted of 200
patients. There was 133 patients belonged to Group 1 (1 to 7 days), 53 patients in Group 2 (8
to 14 days) and 14 patients was belong to Group 3 (15 to 30 days).
Conclusion: The length of the initial hospital stay is the only important predictor to prevent
future hospitalization. No other definite predictors for readmission that could be detected in
the study except for the length of stay in the initial admission.
Key words: First admission, readmission, psychiatric hospital

Correlation between HbA1c and lipid profile in type 2diabetes mellitus

Abdulwahed Mohammed

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136535.1043

Abstract:
Objectives: Diabetes mellitus is one of the greatest health threats of recent times for global population,T2DM is associated with atwo to four excess risk of cardiovascular disease, Serum lipids are frequently abnormal and are likely to contribute to the risk of coronary artery disease,and there an 18% increase risk of cardiovascular disease for each 1% increase of HbA1c in diabetic population,
Method: this is across sectional study which was carried out on 100 diabetic patients ,62 male and 38 female with age from 38-75yrs,after fasting of at least 8 hours,fasting blood sugar,HBA1C and lipid profile were measured.
Result:patients were divided into two groups;the controlled group with HbA1c of 7% or less, and uncontrolled group with HbA1c of more than 7% ,the controlled group include 28% of the patients while the uncontrolled group include 72% of the patients with mean age of 50.50+_12.60 and 53.94+_7.99 respectively, with no significant difference(p-value=0.187), while there was significant difference in lipid profil between the two groups,
• Conclusion: most diabetic patients are uncontrolled and dyslipidemic, and HbA1c is used as adual marker for dyslipidemia and diabetic control.

In vitro Antimicrobial Activity of Salvadora persica (Miswak) and of Syzigium aromaticum (Clove) Extracts against Dental Plaque Pathogens

Suhayla Hamad Shareef; Chiman Hameed Saeed; Pshtiwan Dhahir Majeed

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136715.1044

Objective: Some periodontal bacteria on tooth plaque were shown to be sensitive to extracts from Syzigium aromaticum and Salvadora persica. Our study was an assessment of the antimicrobial effect of Syzigium aromaticum and Salvadora persica extracts against dental plague pathogens.
Materials and Methods: Thirty-five 35 oral swabs were taken from the patients who had the dental plague and isolated microorganisms were identified by standard bacteriological methods. Syzigium aromaticum and Salvadora persica extracts were tested against dental plaque microorganisms on Muller Hinton agar, antimicrobial activity of the two extracts was done by paper disks-diffusion technique at 50% concentration and characterized by inhibition zones.
Results: Forty-six (46) microorganisms were isolated from 35 dental plague samples,18 isolates were Staphylococcus aureus, 3 isolates were Staphylococcus epidermidis, 6 isolates were Streptococcus mutans, 12 isolates were Streptococcus viridans, 1 isolate each of Pseudomonas aeruginosa., Proteus spp., Bacillus spp., 2 isolates were Actinobacillus actinomycetemcomitans and 2 isolates were Candida albicans. The zones of inhibition for two different extracts were measured. According to the findings, Syzigium aromaticum and Salvadora persica have antibacterial and antifungal effects against gram-positive and gram-negative bacteria, as well as fungi.
Conclusion: Our study has shown that Syzigium aromaticum and Salvadora persica extracts have antimicrobial efficacy and concluded that the extracts have shown a greater effect on oral microorganisms and are recommended to be used for treatment and prevention against oral hygiene.

ULTRASOUND MEASUREMENT OF OPTIC NERVE SHEATH DIAMETER IN A SAMPLE OF IRAQI ADULTS

Mustafa yashar; Suzan AbdulMohsen AbdulKareem

Kirkuk Journal of Medical Sciences, In Press
DOI: 10.32894/kjms.2022.136982.1047

Background : Intracranial hypertension is a common life and vision threatening condition, intracranial pressure (ICP) can only be measured by invasive procedures. Distension of optic nerve sheath in association with raised ICP has been proven by the clinical trials. Transorbital sonographic measurement of optic nerve sheath diameter (ONSD) can be a simple noninvasive method for detection of raised ICP, however until now there is no consensus on upper normal limit of ONSD.
Aim of the study : Measurement of optic nerve sheath diameter (ONSD) in healthy adults to provide normative data in a sample of Iraqi population.
Method : an observational cross-sectional study was conducted in IbnAlhaitham eye teaching hospital, Baghdad, Iraq. Both eyes of 98 healthy adult volunteers aged 19 to 77 were examined using Absulu ultrasound machine with 20 MHz annular probe. Two measurements of ONSD was taken 3mm behind the eye globe and the average was calculated.
Results : Optic nerve sheath diameter measurements ranged from 3.78mm to 7.13mm.The mean was 5.54mm with standard deviation of 0.59mm and a median of 5.56mm. The 95% percentile was 6.53mm. There was no statistically significant relationship between ONSD measurement and gender or age.
Conclusion : The mean ONSD measured by transorbital ultrasound was 5.54mm and the upper normal limit was 6.5mm (95% percentile) in a sample of Iraqi population.

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.

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 (

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.

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.

Assessment the Relation between Introduction of the Solid Foods and Napkins Rash Occurrence in Children below Two Years Old

Fatimah M. N. Raouf; Ahmed H. Al-Anee; Thikraa A. Hamada

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 9-17
DOI: 10.32894/kjms.2021.169408

Background: Baby feeding went in to two phases; the 1St phase when the baby is on milk usually up to 4-6 months, in the 2nd phase the milk is not enough so the addition of the solid diets is recommended. Napkins rash is common complaint of the nursing mother and infant which may be due to solid diets. The aim of the study: Is to evaluate whether the early introduction of solid diets to infant has any rule in increasing or decreasing the occurrence of napkins rash. Patients and Methods: A convenient sample hospital based study was done on children between 4-24months who start solid diets, to evaluate the role of introduction of the solid diets on occurrence of the napkins rash. Each group evaluated by prepared questionnaire. Results: The total number of the study cases are (52) cases, (22) male and (30) female and the results of this study were: Most of the cases were female (57.7%), between 13-24 months (50%), from the rural areas (71.2%), on the solid diet and bottle feeding (40.4%), normal (weight 57.7% and height 94.2%), with very early introduction of the solid foods between ages 4-6 months (61.5%). Most of the cases with recurrent napkins rash (51.9%) were used readymade napkins (48.1%), were on the bottle feeding and the solid diets (19.2%) (not significant), with very early introducing solids to their diet (28.8%) (not significant), female about (32.7%) (significant). And were from the rural areas (26.9%) (significant). Conclusion: The study concluded that early introduction of the solid foods has no significant effect in occurrence of the napkins rash.

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.

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

EVALUATION OF SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR IN ECTOPIC PREGNANCY

Sahar Yuldurum; Khalidah Amin

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 2, Pages 61-76
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.

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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