Print ISSN: 2790-0207

Online ISSN: 2790-0215

Volume 10, Issue 2

Volume 10, Issue 2, Summer and Autumn 2022, Page 1-134


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.