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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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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 Kamal Jalal

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 105-159
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.

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.

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 (

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.

Using Multiple Serum Biomarkers in Detecting the Outcome of Threatened Miscarriage

Ozlam Fadhil Yousif; Khalidah Mohammed Amin

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 149-158
DOI: 10.32894/kjms.2020.169376

Background: Threatened abortion is presumed when there is a bloody vaginal discharge or bleeding through a closed cervical os. cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) are biochemical markers that have been studied to establish if they can predict the outcome of threatened miscarriage. Methods: A prospective observational study that was conducted at the Department of Obstetrics and Gynecology at Azadi Teaching Hospital/ Kirkuk-Iraq, over a period of eight months from first of April 2019 till first of December 2019. It included 96 pregnant women at 7 – 13 weeks of gestation with singleton pregnancy, viable fetus, and closed cervical os they presented with signs and symptoms of first trimester threatened miscarriage. After the first visit, follow up was done until they passed into the second trimester of pregnancy, and patients from the study group were divided into group 1: Included 19 patients who ended with miscarriage and group 2: Included 69 women who continued their pregnancy into the second trimester. We compared the level of the Cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) between the two study groups to assess their utility for prediction of the outcome of first-trimester threatened miscarriage. Results: Mean of CA 125 marker was significantly higher in participants who ended with miscarriage than that in participants who continued to second trimester. Means of B-hCG and sFlt-1markers were significantly lower in participants who ended with miscarriage than that in participants who continued to second trimester Serum CA-125 marker > 38.8 IU/ml, Serum β-hCG marker < 20211.3 mIU/ml, and serum sFlt-1 marker < 1731.7 pg/ml are predictors for risk of miscarriage. Conclusion: Serum CA 125, B-hCG, and sFlt-1 biomarkers represent non-invasive, early, fast and excellent predictors of pregnancy outcome in women with threatened miscarriage. Taking into account the feasibility and cost, using serum β-hCG instead of the more accurate one (i.e. serum sFlt-1) would be more logical decision. Further studies are needed in this field.

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.

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

CHRACTERISTICS OF KEROSENE POISONING IN CHILDREN IN KIRKUK CITY

Jameel Azeez

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 30-46
DOI: 10.32894/kjms.2021.169936

Abstract:
Background: Kerosene poisoning is one of the most common accidental poisoning in children in developing countries due common use of kerosene in house-hold and unsafe storage practices
Aim Of The Study: The aim of this study was to identify the demographics, incidence, clinical features, radiological findings and treatment of kerosene poisoning in children in Kirkuk city.
Patients And Methods: Seventy two cases were admitted immediately to the emergency department in Kirkuk pediatric hospitals, Kerosene ingestion during the period from the 1st of june 2020 to the 1st of june 2021. Fifty four cases (75%) were boys and 18 cases (25%) were girls, and age ranges from 10 months to 10 years. Information regarding the history was taken from their parents , by special questionnaire paper (appendix) statistical method is used in this study.


Conclusions:
1. It appears clearly that kerosene pneumonia in Iraq is most often of mild to moderate degree of severity with no mortality.

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.

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 (

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