Volume 10, Issue 1, Winter and Spring 2022, Page 1-172

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

Laith muhamnad Anna

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


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


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 .


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%


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

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


Rana Khorsheed

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

             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

        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 Ali

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

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

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

Amal Adnan

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

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

Antichlamydial Antibodies In Women With Ectopic Pregnancy

Sahar Jalal

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


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

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

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

Ali Akram

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

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