Print ISSN: 2790-0207

Online ISSN: 2790-0215

Issue 2,

Issue 2


PREDICTORS AND OUTCOMES OF STATUS EPILPTECUS IN PATIENTS WITH CEREBRAL VENOUS THROMBOSIS

Bakr Arslan

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 1-9
DOI: 10.32894/kjms.2021.170288

Background : status epilepticus (SE) is a serious complications of cerebral venous thrombosis (CVT). the risk factors associated with SE occurrence and the out come is a debate issue .
Aim of study : To estimate predictives of development of SE in CVT patient, and compare the relative risk of SE in determining death and disability compared with those patients without SE.
Methods : this is a Comparative case sires study of 29 CVT patient were admitted to Al-Yarmook teaching hospital from January , 2019 to march , 2021. Patients were followed up and re-assed at 3 months and 6 months after discharge and outcomes were classified on the basis of modified rankin scale .
Results : of 29 patient with CVT admitted to Al-yarmook teaching hospital 11 Patients (37.9%) had SE . presence of decrease conscious level (GCS ≤8) (p=0.0001) , motor weakness (p= 0.003 ) and supra tentorial brain lesion on MRI (p= 0.0001) specially Hemorrhagic type (p=0.003) all were risk factors to development of status epilepticus and disability were higher in status epilepticus group 3 months after discharge (p=0.006) but after 6 months both status epilepticus and without SE group all had good recovery (p=0.345) .
Conclusion: predictives of SE development were decreased level of consciousness , motor weakness and supratentorial lesion on brain mri specially hemorrhagic type . The presence of SE were associated with higher rate of disability 3 months after discharge but after 6 months all patients achieved good recovery

Sacroiliac joint dysfunction is one of an important cause of low back pain

Mukaram Noor Alddin Musarhad

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 27-35
DOI: 10.32894/kjms.2021.171290

Objective: This prospective study about importance to consider Sacroiliac joint ( SIJ ) dysfunction as one of important cause of low back pain and estimation the occurrence of SIJ dysfunction in low back pain.
Background: The SIJ is formed by the articular surfaces between the sacral and iliac bones.The joint dysfunction with slightly joint subluxation, which are majority of SIJ disorders. Establishing the diagnosis of SIJ pain are difficult because history, clinical examination and imaging studies are not helpful in confirming the diagnosis.
Patient and Method: fifty patients participated through eighteen months period from October 2017 to March 2019 estimated occurrence SIJ dysfunction in low back pain below L5 group Patients with low back pain and have three or more positive provocative SIJ tests on physical examination these patients candidate diagnostic injection of local lidocaine into the SIJ, patient pain improve more than 70% in his or her pain within 30 to 60 minutes and diagnosis of SIJD confirmed.
Results:Our prospective study included fifty patients, the 20% of LBP group have SIJ dysfunction, more prevalence in obese patients, among female gender.SIJ dysfunction more common on left side 70%, right side in 30%.
Conclusion:Sacroiliac joint dysfunction remarkably missed underestimated cause of low back pain.The prevalence of SIJ dysfunction are15% to 30% of LBP in many studies.High suspicion and accurately diagnosis required of SIJ dysfunction to be cost effective in management of patients with low back pain and avoid unnecessary lumbosacral spine surgical interventions and decrease failed back surgery syndrome (FBSS) incidence.

The role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma

Hussein Hussein Kasim

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 10-26
DOI: 10.32894/kjms.2021.171639

Background:
Blunt abdominal injury is a major cause of death in trauma cases. It will be very helpful if intra-abdominal bleeding can be predicted by laboratory tests. The aim of our study is to evaluate the accuracy of plasma ammonia in detecting intra-abdominal hemorrhage in patients with blunt abdominal injury.
Materials and Methods:
In this study, 60 patients admitted to Azadi teaching hospital complaining from blunt abdominal trauma were included. On admission to emergency room, plasma ammonia levels were measured. Demographic data, vital signs, and GCS reports were written down. Findings of abdomino-pelvic computed tomography scan and intraoperative laparotomy were supposed as a gold standard for abdominal injuries. We excluded patients with preexisting liver diseases or impairment.
Results:
In this study 60 patients were involved. 6 patients had intra-abdominal bleeding and their mean plasma ammonia level was much higher than the rest. (205.33±100.2 vs. 51.29±23.38, P < 0.001). ROC curve analysis revealed Accuracy 96.7% Sensitivity 83.3% Specificity 98.1%.
Conclusion:
The study results advocate that an increase in plasma ammonia level in patients with blunt abdominal trauma would be a useful predictor for intra-abdominal hemorrhage. This can be a great opportunity for hospitals lacking advanced facilities like contrast enhanced CT scan or diagnostic laparoscopy.

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

A comparative study betwee Medulloblastoma And Cerebellar astrocytoma In children

Salim Aljabbary

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 97-110
DOI: 10.32894/kjms.2021.172831

study was conducted between 2000 & 2002, 50 children with histopathologyically verified medulloblastoma and cerebellar astrocytoma in neurosurgical department of Surgical Specialties Hospital. Ages ranged from 2-19 years, peak incidence between 5-10 years. No significant gender differences found.

CT scan confirmed features of medulloblastoma: midline location, well defined margin & hyperdensity of lesion with homogenous enhancement after I.V. contrast infusion. In cerebellar astrocytoma, 60% were midline tumor, most of which were solid & 40% were hemispheric lesion, most of which were cystic. Calcification on CT scans seen more in medulloblastoma.
Shunt operation was the main procedure conducted for treatment of hydrocephalus associated with these tumors, but other CSF diversion procedures, especially safety burrhole at time of tumor resection was carried on in cystic lesion located off the midline. Total removal was achieved in 46.7% of children with medulloblastomas & 50% of children with cerebellar astrocytomas. Brain stem violation was evident more in medulloblastoma & was the main factor behind the incomplete tumor removal in significant number of cases that adversely affected the outcome.
postoperative complications (pseudomeningocele, cerebellar mutism, meningitis, CSF leak, cranial nerve palsy…etc.) encountered more in children with medulloblastoma.
Mortality rate was 6.7% in medulloblastomas & 10% in cerebellar astrocytoma. The cause of death in patients with medulloblastoma was meningitis & patients with cerebellar astrocytomas was brain stem injury.
early diagnosis & total removal of tumor with proper postoperative care would essentially decrease the postoperative morbidity & mortality

The Etiology of Dry Eye Syndrome in a Group of Patients visited Ophthalmic Department of Azady Teaching Hospital in Kirkuk

Raad Albayati

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 111-124
DOI: 10.32894/kjms.2021.172832

Abstract: Purpose: To clarify the etiology of dry eye syndrome, distribution of age and
gender among study group and to identify risk factors for dry eye. Method: A descriptive
study done in Azady Teaching Hospital from 1 of July 2020 to 1 September 2021. The
research included 946 patients above 40 years of mixed population. Result: the mean age of
study group was 55,5 years, mean age of dry eye group was 57,2 years, The prevalence of dry
eye in was 17.8 % and founded to be maximum in the elderly as majority of diagnosed dry
eye patients were in their sixties 42%. Dry eye syndrome funded to be more common in
female (19.4%) than in male (15.8%). The main etiological factors in our study were either:
1-Ocular causes: eye lid diseases (blepharitis and MGD) 20%, abnormal ocular surface 12%,
old trachoma 4.8%, ocular surgery (3.6%). 2-systemic disease: were founded to be
rheumatoid arthritis (12%), diabetes (10.8%), thyroid disease (4.8%) Sjogren disease (2.4%)
and pemphigus (1.2%). 3-Drug induced dry eye: Drugs that contribute to dry eye syndrome
discovered to be mainly antihypertensive (15.4%), antiglaucoma (8.4%), antihistamine (2.4%)
and anticholinergic (1.2%). Conclusions: Dry eye disease is more common in people over 40,
and this should be taken into account when examining patients in ophthalmology clinics, Dry
is more common in women, especially postmenopausal Dry eye is a frequent disease and
correct diagnosis is the main line in treatment and, so we need to keep in mind those at higher
risk.

Hypertension in children in Kirkuk city

Shan Nadhmi

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 2, Pages 125-138
DOI: 10.32894/kjms.2021.172928

Abstract:
The predominant type of hypertension in pediatric age group is the secondary hypertension, with chronic kidney disease being the most common cause, but, nowadays, there is a rising incidence of primary hypertension due to the rising incidence of obesity in children. 260 patients (from 1-14 years old) were collected from pediatric hospital in Kirkuk city and Baghdad road polyclinic at Kirkuk city, BMI was measured, renal function test, serum electrolyte and lipid profile are done for all the patients, serum cortisol done for the hypertensive patients, hypertension was found in 13 (5%) of our patients; 5 patients (2%) were complaining from primary hypertension and their BMI was > 30 kg/m2 , and 8 (3%) patients were complaining from secondary hypertension, renal impairment was the commonest cause. Secondary hypertension has found to be more common than the primary with the renal cause being the commonest one, all the cases were complaining from dyslipidemia.