International Journal of Medical Science
International Journal of Medical Sciences (IJMS) is a peer-reviewed, open-access journal dedicated to advancing knowledge and research in the field of medicine. The journal publishes original research articles, comprehensive review papers, case studies, field studies, and expert commentaries that cover a wide spectrum of medical disciplines. IJMS serves as a platform for researchers, clinicians, and healthcare professionals to share innovative findings and contribute to the global medical community. Scope and Categories A – Basic Medical Sciences Anatomy Biochemistry Medical Microbiology and Parasitology Anatomic & Molecular Pathology Pharmacology, Therapeutics, and Toxicology Physiology Biomedical Engineering and Medical Laboratory Science B – Clinical Sciences Allergy and Immunology Anesthesiology Dermatology Diagnostic Radiology Emergency Medicine Family Medicine Internal Medicine Medical Genetics Neurology Nuclear Medicine Obstetrics and Gynecology Ophthalmology Pathology Pediatrics Physical Medicine and Rehabilitation Preventive Medicine Psychiatry Radiation Oncology Surgery Urology Submit your article to the journal system or to this email: info@mespj.com
Infectious Diseases and Microbiology: Patterns of Microbial Infections, Diagnosis, and Antimicrobial Challenges
Infectious diseases remain a major cause of morbidity and mortality worldwide, particularly in developing regions where environmental and healthcare-related factors facilitate disease transmission. Microbiology plays a fundamental role in identifying infectious agents, understanding pathogenic mechanisms, and guiding effective therapeutic strategies. This review addresses key viral, bacterial, and fungal infections of clinical importance, with emphasis on hepatitis E virus infection, Candida albicans, postoperative bacterial infections, Streptococcus pyogenes, foodborne diseases, and antimicrobial resistance. Integrating regional research findings with international evidence highlights ongoing challenges in diagnosis, treatment, and infection control and underscores the need for strengthened surveillance and antimicrobial stewardship.
Infectious diseases, microbiology, hepatitis E, bacterial infections, antimicrobial resistance
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A Prospective Study of Plastibell Ring Circumcision Cases Performed in Private Clinics
Circumcision is one of the oldest and most frequently performed surgical procedures worldwide, with several available techniques including the flap method, Gomco clamp, Smartklamp, and Plastibell, which operates on the clamping principle. This prospective study was conducted in private clinics in Baghdad and Ajman over a three-year period, during which parents were counseled about the procedure and children were assessed for conditions that might affect outcomes. A total of 200 neonates, infants, and children aged one day to three years were enrolled, with the majority (60%) undergoing circumcision within the first 30 days of life. The indication was religious in all cases (100%), and Plastibell sizes ranged from 1.1 to 1.5. Complications were observed in 38 children (19%), the most common being retained Plastibell rings and preputial edema, each affecting 4% of cases. Overall, the findings indicate that Plastibell circumcision is a safe technique with minimal complications when performed by experienced practitioners, making it a good alternative to the open surgical method.
Complication, Circumcision, Indication, Plastibell, Safety
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Heparanase (HPSE) SNPs as A Predictor for Hepatocellular Carcinoma
Introduction: Hepatocellular carcinoma (HCC) is a frequent liver cancer caused by hepatocytes and linked to persistent infections, heavy alcohol intake, and genetic abnormalities. (1) HCC is aggressive and may not show signs until advanced. Surgery, radiation, chemotherapy, and targeted therapies are available depending on cancer stage. Endo-β-D-glycosidase heparanase affects tumour angiogenesis, invasion, and metastasis. (2) Heparanase overexpression in HCC is linked to metastasis and micro-vessel density. Heparanase downregulation reduces HCC cell line invasiveness and metastases. SNPs, the most frequent genetic variation in humans, can affect illness susceptibility and medication response. (3) Metabolic, immunological, and cancer genes have SNPs. Functional studies are needed to identify how SNPs affect gene expression or protein function. Heparanase gene SNPs rs 12331678 and rs 12503843 were linked to HCC in this study. (4) Patients and methods: This study investigated the potential of heparanase (HPSE) single nucleotide polymorphisms (SNPs) as a predictor for hepatocellular carcinoma. It involved 30 cases from various hospitals in Iraq, with 15 cases in a patient group and 15 cases in a control group. The study obtained official approval from the Ethics Committee and collected demographic data, performed clinical examinations, and used laboratory tests to extract and examine genomic DNA. Polymerase chain reaction (PCR) technology was utilised to amplify the DNA samples, and statistical analysis was conducted to establish the significance of the correlation. From July 2019 until September 2020, researchers were actively engaged in this study. Results: The study involved 15 patient and 15 control subjects, with mean ages of 70.2±1.58 and 68.13±1.10, respectively. The patients were 80% male and 20% female, while the control group consisted of 66.7% males and 33.3% females. The study investigated the hematological profile and focal lesions of patients, as well as the correlation between gene polymorphisms and the Child-Pugh score, ALT, and AST levels. The results of the study are presented in various tables and figures, including primer sequences of polymorphisms rs 12331678 and rs 12503843, as well as Pearson correlations between these polymorphisms with ALT, AST, and Child–Pugh scores. Conclusion: In this study of Iraqi patients aged 60 to 80, a statistically significant association between HPSE (rs 12331678 and rs 12503843) and the incidence of HCC was discovered. In this study, we not only discussed the clinical significance of HPSE genetic variation, but also its role as one of the causes of HCC.
Heparanase, hepatocellular carcinoma, HPSE gene polymorphism
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Background: The common tumor of the endocrine glands is thyroid cancer. According to the American Cancer Society, in 2023, there will be 43,720 new cases of thyroid cancer in the country, and there will be 2120 mortality due to it. Is the 13th most common cancer overall and its prevalence continue to increase. Is a malignant tumor arising from the cells of thyroid parenchyma. Clinically it is variable, from, slowly progressing indolent tumors to more aggressive tumors with high mortality rates Thyroid cancer exists in various forms, including papillary, follicular, medullary, and anaplastic. Papillary thyroid cancer is the commonest one. If thyroid cancer identified earlier so it can be treated effectively. Surgery, radioactive iodine therapy, and molecularly targeted medicines using tyrosine kinase inhibitors are all a component of the therapy. As a result, the guidelines for the management of thyroid cancer and nodules are presented in this review, with an emphasis on diagnosis, treatment, and follow-up.
thyroid gland neoplasia, tyrosine- kinase inhibitors, radioactive- iodine, fine-needle aspiretion biopsy.
Study of the Thyroid Gland's Cyclin D1 (Immune Histochemical Approach)
One of the most common tumors is thyroid cancer many factors contributed to this cancer one of them is cyclin dependent kinases 1 (CDKs1) which play a role in regulation of cell cycle. The study was aimed to evaluate the expression of CDK1 in thyroid carcinoma by immunohistochemical technique. There were 100 individuals enrolled in this study divided into two groups : patients with thyroid cancer 50 (20 benign thyroid cancer , 30 malignant thyroid cancer) and 50 controls as second group from October 2021 till April 2022 at Imam Hussein medical city Karbala Iraq. The thyroid tissue sample of all individual were undergone for immune histochemistry test for CDK1. The result showed significant difference (P value ˂ 0.00001) in expression of CDK1 between benign and malignant thyroid cancer their expression in benign cases 8(40%), for malignant cases 14(46.1%) {(10 (33.33%) classical type and 4(13.33%) follicular type} only 9 (30%) while only 1% of benign cases were strong staining. All apparently healthy thyroid tissue was negative for expression of CDK1. The study was concluded that Cyclin D1 overexpressed in Papillary thyroid carcinoma in comparison with follicular adenoma.
Advances in tumour diagnosis and treatment, particularly targeted drugs, have considerably improved renal cell carcinoma (RCC) survival while increasing the incidence of hypertension (HTN). As a result, identifying risk factors and enhancing therapeutic treatment for RCC and HTN patients are critical challenges. This study looked at both preclinical and clinical risk factors for HTN-RCC comorbidity. Obesity, smoking, and other lifestyle choices may be risk factors for both RCC and HTN. Second, RCC and HTN medications can interact with one another. Then, HTN treatment and RCC comorbidity reduction were addressed. Additionally discussed current study flaws and potential directions Finally, the goal of this study is to expand cardio-oncology knowledge and to help patients who are at high risk of or suffering from RCC and HTN.
Hypertension, Cardio-oncology Renal cell carcinoma
Can Anemia Be a Confounder in Nt-Probnp Interpretation?
Heart failure is a major clinical issue of concern worldwide. Many biomarkers are used to aid the diagnosis of heart failure patients. One of the increasingly used biomarkers is the biologically inactive NT-proBNP. Several confounding factors affect plasma NT-proBNP levels, and hence, the validity of its interpretation. Heart failure and anemia are well correlated, as evidenced by variety of studies. In, anemia can yield some degree of cardiac stress that leads to the expression of NT-proBNP levels above the cut-off values. This study aimed to test whether anemia can be associated with an elevated peptide level in patients without heart failure. A cross-sectional study in which a total of 108 randomly selected patients, irrespective of their hemoglobin levels, were recruited. Males comprised 39.8% of the total, and the patients were divided based on their hemoglobin levels into anemic (55 patients) and non-anemic (53 patients) groups. Plasma NT-proBNP levels were assessed using ELISA, and the results were interpolated and analyzed against hemoglobin levels. The NT-proBNP level was significantly higher in patients with anemia (p < .0001) where it was 268.7 ± 38.9 vs. 93.55 ± 17.4 ng/dl for both the anemic and non-anemic groups, respectively. Hemoglobin level showed a negative correlation with plasma peptide level ([F (1, 107) = 28.63, p < .0001)], with an r2 of 0.358. Anemia is inversely correlated with the plasma NT-proBNP level. In fact, anemia can raise the peptide level beyond its recommended cutoff levels making the interpretation of the raised NT-proBNP more challenging.
Hemoglobin, NT-Probnp, Heart Failure, Anemia, Cardiomyocytes.
The Correlation Between Gleason Score and BMI in Patients with Prostate Cancer
Objective: This study aimed to investigate whether body mass index (BMI) is correlates to severity of prostate. Materials and Methods: Medical records of 50 Iraqi patients who visited the Imam Hussain Center for Oncological and Hematological Diseases Directorate were collected during the period extending between (November 2021 to April 2022), their age was ranged from 51 to 80 years. Results and Discussion: In this study has been observed the relationship between BMI and the severity of prostate cancer based on Gleason scores was a weak positive (when BMI increased, Gleason scores also increased) weak significant correlation between BMI and the severity of prostate cancer based on Gleason scores, and these results revealed of the higher the Gleason scores, the higher of the BMI of prostate cancer patients in this study. Conclusion: Prostate cancer patients' BMI had a weakly positive correlation with their Gleason score.
Prostate cancer, PSA, Body mass index, Gleason score.
Assessment of Specificity and Sensitivity of Tru-Cut Biopsy as Compared with Postoperative Histopathological Results in Young Females with Breast Mass
Breast cancer affects 5-7% of 25-39-year-olds, and early detection increases the chance of recurrence (CBC). African- American women under the age of 40 had the highest rate of breast cancer. After breast cancer radiation and family history, younger persons are more likely to get colon cancer. Some women misdiagnose breast symptoms as cancer due to fear and stress. A clinical examination cannot distinguish between benign and malignant tumours. Stages of treatment the diagnosis decides the treatment. Biopsies and FNAC are used to detect lumps. Plaques. Biopsies of histopathology (CNB) (CNB). OTP biopsy failed. True-cut biopsies minimize the types and grades of malignancy. Bleeds/infects FNAC detects cancer. Cytology is inexpensive. Low sample counts, erroneous negatives, and aggressive tumours According to the study, FNAC assesses breast lumps. False positives and false negatives could be reduced. CNB's results call into question FNAC's mission. CNB. The downsides of CNB include treatment time, patient pain (1.7% to 3.7%), hematoma (0.72%), and pneumothorax. FNAC is less painful and intrusive than CNB for older, weaker patients (more painless). FNAC is not just for radiologists. FNAC examines chemotherapy. Antifreeze. CNB, diagnosis, and anxiety were all improved with FNAC. After neoadjuvant treatment, FNAC reveals tumours, suspicious zones, and a concerning lesion. FNAC replaces mammography.
Assessment of specificity and sensitivity, Tru-cut biopsy Breast mass
A Review on Cartilaginous Endplates and The Degeneration of Intervertebral Disc
Cartilaginous Endplates (CEP) acts as a mechanical barrier and forms the anatomical structure of intervertebral disc. It allows the nutrients to get transported into the disc from the nearby blood vessels. Low back pain is a primary complication raised by Intervertebral Disc Degeneration (IVDD). The objective of the current review article is to provide an overview about the composition and the functions of Cartilaginous Endplates, development and the progression of the IVDD, application of modern techniques for its treatment. CEP primarily contains water, type II collagen, glycosaminoglycans (GAGs) while it also has type X collagen. The study provided an overview about the IVDD, causal factors, diagnostic methods, and the application of different types of treatment methods. The authors recommend validating the stem cell-based therapies at clinical levels since such therapies have been proposed and validated so far, only in in vitro and animal models. Further, the study recommends to develop novel diagnostic tools that are not only cost-effective, but also non-invasive by leveraging the Artificial Intelligence and Machine Learning techniques in the diagnostics methods.
Cartilaginous Endplates, Intervertebral Disc Degeneration, Low back pain, proteoglycans, Magnetic Resonance Imaging, Artificial Intelligence.
Zakiyah Mohammed Abid Sulayman Ataya Allah
Antimicrobial Resistance “Ecological features influencing the progress and expansion of antibiotic resistance”
Antibiotic resistance has been one of the main negative reasons for obstructing antibiotic entrance into the human body. This has become the reason for a huge number of illnesses and deaths worldwide. The study has focused on reviewing an article that concerns the topic of Ecological features influencing the progress and expansion of antibiotic resistance. The paper has reviewed a research article that several researchers on the development of antibiotic-resistant genes have executed. The study's main aim is to investigate the microbes that resist the antibiotic to combat the harmful bacteria responsible for resisting antibiotics to fight against harmful bacteria.
Antibiotic resistance, Microbial resistance, Resistant genes, Ecological factors, Bacterial infections
Histopathological Results in a Sample of Hysterectomy Patients at Al- Batool Maternity Teaching Hospital in Baquba, Iraq, Who Had Abnormal Uterine Bleeding
Background: The most frequent and complex issue for gynecologists is abnormal uterine bleeding.; It is the cause of many gynecologic outpatient visits Objective: To determine the histological forms in a group of hysterectomized's females who had abnormal uterine bleeding (AUB) Patients and methods: Between fifteen July 2015, and December fourteen, 2015, there was a descriptive study conducted in the department of obstetrics and gynecology at Al-Batool Teaching Hospital in Baquba City. Thirty-three women were admitted for total abdominal hysterectomy after presenting with unexplained uterine bleeding throughout the research period. Complete history and examination are included in the questionnaire that has been prepared for the patient. After the hysterectomy, the uterus and adnexa specimens were sent to a professional histopathologist for histopathological analysis. Results: In this study, the age group 46-55 years had the highest percentage of abnormal uterine bleeding (51.51percentage), and the age group 76-85 years had the lowest percentage (3.03 percent). Low parity had the lowest percentage (9.09 percent), whereas grandmultiparous had the highest rate (60.61percentage). The most frequent histological result were fibroids (42.42 percent), while secretary hemorrhage was found in only 3.03 percent of cases. Age and parity affected the histological results in hysterectomized tissues and specimens. Conclusion: All patients with “abnormal-uterine bleeding” AUB should be searched for structural root problems because fibroids account for most cases that visit our hospital to get a hysterectomy and proliferative endometrium.
Abnormal uterine bleeding, AUB.Hysterectomy.
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Outcome of Laser Management in Glaucoma Disease
he study aimed to evaluate the efficacy and predictive factors of success after selective laser trabeculoplasty (SLT) for treating various types of open-angle glaucoma in Iraq. Design: The study employed a retrospective cohort design. Materials and Methods: The study retrospectively recruited subjects diagnosed with open-angle glaucoma receiving first time selective laser trabeculoplasty. Primary open-angle glaucoma (POAG), ocular hypertension (OHT) and other types of open-angle glaucoma were included. Reduced intraocular pressure (IOP) of 20% or decreased number of antiglaucoma drugs usage after SLT was defined as success. Various parameters were analyzed for association with SLT success. Results: 192 eyes were recruited in the study. Mean pre- and postSLT IOP were 19.31 ±3.59 and 15.04±3.13 mmHg, respectively. IOP decreased significantly in all follow-up visits (p<0.001). Overall, 59.4% met the treatment endpoint. More than 10% postSLT IOP elevation at 1 hour was the only covariate positively associated with SLT success in both univariate (odds ratio (OR) = 1.042, p = 0.037) and multivariate analyses (OR = 1.040, p = 0.046). Underlying hypertension and preSLT IOP were negatively associated with SLT success in both univariate (OR = 0.970, p = 0.026, OR = 0.955, p < 0.001) and multivariate analysis (OR = 0.970, p = 0.026, OR = 0.991, p < 0.001). Conclusion: IOP significantly decreased as well as the number of antiglaucoma drugs needed after SLT. More than 10% postSLT IOP elevation at 1 hour was a positive predictor whereas systemic hypertension and preSLT IOP were negative predictors of SLT success.
selective laser trabeculoplasty, outcome, success, factors.
Incidence and Updates Management of Diabetic Retinopathy
One of the biggest causes of vision loss in the globe is diabetic retinopathy (DR), a consequence of diabetes. Despite significant attempts to lower the prevalence of vision impairment, DR continues to grow. There is damage to the vascular endothelial cells as the first pathophysiology of DRcells and a decrease in pericytes. As a result of the hypoxic reactions that follow, vascular endothelialvascular endothelial growth factor (VEGF) The most effective treatment available right nowControlling blood sugar levels is the key to preventing diabetic retinopathy and diabetic macular edema (DME). Superior in every way Laser therapy, anti-VEGF therapy, steroid therapy, and vitrectomy are all necessary treatments in these situations. Photocoagulation of the retinal pigment epithelium There is strong evidence that non-proliferative diabetic retinopathy (NPDR) is a viable treatment option.results that can be used to keep DR from progressing further. Furthermore, laser therapy has proven to be effective. For example, grid and subthreshold diode laser micropulse photocoagulation (SDM) for DME has been used.reported. In cases of vitreous hemorrhage or tractional retinal detachment in PDR patients, vitrectomy has been undertaken. There has also been significant interest in the ability of anti-VEGF medication to slow the progression of PDR from DME patients. Even with these therapies, many individuals with DR are still at risk of losing their eyesight and developing potentially dangerous side effects.. In the most advanced stages of DR, laser photocoagulation and vitrectomy are effective treatments for preventing severe vision loss. Both approaches, however, have their limitations. Evidence from preclinical and clinical studies shows that targeting renin-angiotensin system inhibition, vascular endothelial growth factor, and renin-angiotensin system blockade can reduce cardiovascular disease risk.the growth hormone, corticosteroids and protein kinase C.DR may be treated with these methodsMethodsThe study between January 2017 and November 2020 total number of patients 2968, Retrospective three year analysis.ResultsIncidence of referable retinopathy was independently associated with known duration of diabetes, age at diagnosis, and use of insulin treatment. For participants needing insulin treatment with a duration of diabetes of 10 years or more, cumulative incidence of referable retinopathy at one and three years was 9.61 and 30.99 per 1000 people, respectively.
diabetic retinopathy; diabetic macula edema; anti-VEGF therapy; vitrectomy; laserphotocoagulation. corticosteroids, protein kinase C,
Electrophysiological Evaluation of Patients with Post-Covid Acute Motor Neuropathy
Long-term "mechanical ventilation", which is frequently required for patients suffering from serious COVID-19, is predicted to cause major complications. Many of the survivors had ICUAW (intensive care unit-acquired weakness). Howeverin the course of our post-COVID-19 follow-up, we discovered that In our clinic, we discovered that, in addition to the expected global weakness associated with muscle mass loss, a a sizable number of patients have a a sizable number of patients who have a a sizable number of patients who have a a sizable number of patients who have a sizable Multiple axonal mononeuropathies have caused debilitating localized neurological impairments in some of these patients. Among the many We have encountered 50 individuals with serious COVID-19who have been released from our hospital's ICU. There were 16 percent of people with a "mononeuritis multiplex". In several instances, the "multi-focal character" of the flaw in these systems Patients were initially misdiagnosed because their symptoms were mistakenly attributed to "critical disease neuromyopathy." While "mononeuropathy" is well-known as a rare complication of critical care, our experience implies that it is extra frequent than that. In patients recovering from serious COVID-19, impairments are surprisingly common and often disabling
Thaier Kareem Abdul- Aa'ama, Sarah Ali Al Kindy and Alkhansaa Sabah Ibrahim Harba. Electrophysiological Evaluation Of Patients With Post-Covid Acute Motor Neuropathy..
The Role of Caffeine in Noninvasive Respiratory Support Versus Aminophylline in Prematurity Apnea
Caffeine plays a key role in noninvasive respiratory support, easing the transition from invasive to noninvasive support, shortening the length of positive airway pressure support, and lowering BPD risk. Caffeine and aminophylline are effective in decreasing apnoea and facilitating and ventilator weaning in extremely preterm newborns. This study aims to investigate the clinical significance of caffeine and aminophylline in treating premature infants with apnea under varying conditions of oxygen (O2) delivery. The current study included 38 preterm babies with apnea who underwent caffeine or aminophylline treatment at the Al-Mahaweel General Hospital between January and December 2020; the infants were 20 boys and 18 girls, with birth weights ranging from 500 to 1,250 grams. The study came out to the result that caffeine plays a key role in noninvasive respiratory support, easing the transition from invasive to noninvasive support, shortening the length of positive airway pressure support, and lowering BPD risk. Caffeine and aminophylline both are effective in decreasing apnoea and facilitating and ventilator weaning in extremely preterm newborns. Caffeine has therapeutic advantages over aminophylline, such as better enteral absorption, a longer half-life that allows for a single daily dose, reduced side effects, and a good long-term cost/benefit ratio, making it the first choice drug for the cure of apnoea in premature neonates.
Caffeine, Noninvasive Respiratory Support, Aminophylline, Apnea
Urinary Tract Infection in Kerbala Governorate Children, Causes and Influencing Factors
Urinary tract infections (UTI) is one of the most frequent types of bacterial infection in humans; children are not an exemption, UTI is so common among young ages; it caused by pathological germs (kidneys, bladder, urethra, prostate). It is one of the significant difficulties facing the health sector in third-world nations, affecting children of all ages. UTI is are one of the severe problems that place a financial burden on the healthcare system, as the number of incidents worldwide might exceed 150 million in a single year, and infants and children are more prone to the disease's risks. This study was conducted on (1334) children ( males 611/ 45.8%, females723/54.2%) between the ages of one day - 12 years who visited Karbala governorate hospitals and some children's clinics in the governorate to determine whether the injuries are related to the months of the year, the environment, the parent's educational level and if females or males are more affected. The number of samples that gave positive results was 525(66.62%), and the number of negative samples was 263(33.38%). This study showed that the highest percentage of positive samples was recorded in January 54(10.29%), and the lowest rate of infection was recorded on April 36 (6.86%). This study found significant differences in the distribution of disease cases between residents of the rural environment 356 (69.13% and residents of the urban environment 169(61.9%). The educational level of the parents directly and significantly affects urinary tract infections in children. The highest incidence of urinary tract infection was in school-aged 143 (27,24%). The lowest incidence was in newborns, 42(8.0%) among all gender. The study showed significant differences (0.05) in the distribution of injuries between males and females between different age groups, where the highest injury was recorded among females school-aged 102 (33.77%).
Assessment of Diastolic Function in Patients with Diabetic Neuropathy
"Diastolic dysfunction" is thought to be an indication of "diabetic cardiomyopathy" ", and "diabetic cardiovascular autonomic neuropathy" is linked to increased mortality risk. The goal of this study was to see how "diastolic dysfunction" and "cardiovascular autonomic neuropathy" are linked both of which were diagnosed in accordance with the guidelines. Methods: We assessed at seventy-three participants Whose elective coronary angiography was referred, Diabetes mellitus was present in twenty-six of them, and twenty-four of whom had impaired glucose tolerance, the other twenty-three people had normal "glucose tolerance". To identify "cardiovascular autonomic neuropathy", "autonomic function" tests were done, and "tissue Doppler imaging echocardiography" was employed to confirm "diastolic dysfunction". Results Autonomical cardiovascular neuropathy has been detected with diabetes type 2 diabetes in (28.8%) and with glucose-impaired tolerance in 6 (12.5%) patients. "Diastolic dysfunction" was found in 81 and 33 percent of patients with and without "cardiovascular autonomic neuropathy", respectively (P <0.001). "Early diastolic relaxation velocity" (Em) was considerably less in comparison to the group without cardiovascular autonomic neuropathy. ("5.4 0.9 vs. 7.3 2.1 cm⁄ s;P; P 0.001"), Moreover, the E⁄Em ratio was much higher. ("13.6 4.6 vs. 10.3 3.4 cm⁄ s;P, 0.001"). The significance of these data remained after controlling for "age, gender, coronary artery disease, hypertension, and HbA1c". In individuals with and without "cardiovascular autonomic neuropathy", significant "diastolic dysfunction" was found in 33 and 15% of patients, accordingly (P = 0.001).
Aspirin Plus Heparin Versus Aspirin and Oral Prednisolone in the Management of Women with Recurrent Miscarriage
Recurrent pregnancy loss RPL is characterized by at minimum 2 or 3 consecutive losses before the 20th week of gestation. In 1percentage to 5percentage of all pregnancies. Aim of the Work: assessing the effectiveness of low dosage aspirin and steroid therapy in the management of women with recurrent miscarriage vs. Aspirin and heparin LMWH study. Patients and Methods: In repeated miscarriage clinics, this randomized clinical experiment was performed in the Obstetrics and Gynecology Department, in Iraqi Hospital on 50 pregnant women, who fulfilled the inclusion criteria and after taking an informed consent. Group 1: included 25 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily) and prednisolone 5mg two tablets twice daily (20mg). Group 2: included 25 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily) and heparin. Both groups were followed in hospital recurrent miscarriage clinic every two weeks by ultrasonography from the incidence of the pregnancy till delivery. Results: Prednisolone (PSL) plus LDA increased the live birth rate by 32.2 percent compared to group II. and according to on-going pregnancy data was in group I 37/50(74%) and in group II 21/50(42%) OR (C.I. 95% 4.128 [2.142-7.952] RR (C.I. 95%1.875 [1.401-2.505] p<0.001, between the two groups, with a substantial differential. When it came to the development of contusion, there was a substantial variance (P<0.05). among the two groups. Conclusion: For women with idiopathic pregnancy loss, a combination of prednisone and low-dose aspirin could be a beneficial treatment.
Stem cell research has revolutionized our understanding of human development and regenerative medicine over the past decades [1]. These remarkable cells, characterized by their ability to self-renew and differentiate into specialized cell types, hold immense potential for treating previously incurable diseases and understanding developmental processes at the molecular level [2,3]. The field has witnessed remarkable progress since the first isolation of human embryonic stem cells in 1998, followed by the groundbreaking discovery of induced pluripotent stem cells in 2006 [4,5]. A new and incredibly promising technology is 3-Dimensional (3D) printing, which first emerged in the 1980s and has been continuously advancing since then. It is a distinct way of layer-by-layer material deposition that sets itself apart from other conventional modelling techniques through material molding and removal. Modelling by adding material, 3D printing can produce things with incredibly intricate geometries and even with previously unheard-of accuracy. It may be applied in a variety of fields, including aviation, the automobile industry, production, science, education, and medicine. Printing by adding material is a significant breakthrough for several writers in these latter domains of application. The spectrum of potential applications for 3D printing is enormous and highly promising, including modelling learning and training prototypes, producing tailored prostheses, and printing biological and functioning organs. In General, this article will focusing on the Major applications of 3D printers in education and medicine
3D printer, Medical application, Rapid prototyping
Transradial Coronary Angiography and Intervention
Objective: to study transradial (tr) diagnostic coronary angiography and percutaneous coronary intervention (pci) for patients and their complications. Study design: randomized prospective study. Setting: sulaimany center for heart disease and harem private hospital. Patients and methods: the total number of patients in our study was (148) patients who underwent tr coronary angiography & pci, of them (91) males and (57) females. The mean age of patients were (57.46 ± 9.86) years, (126) tr coronary angiography and (58) pci procedures, throughout the period (1-1-2013) to (30-6-2013) with 1 and 3 months follow up. Results: during the first 2 months (learning period), only twelve tr coronary angiography and two tr pci were done, and in the last month, increased to 47 coronary angiographies and 24 pci. the percentage of females was more in tr coronary angiography and less for tr pci. With experience, in tr coronary angiography, the contrast volume decreased from (80 ± 6.35) milliliters (ml) to (40 ± 3.75) ml with highly significant p-value (0.001) and ft from (4.40 ± 2.03) minutes (min) to (1.1 ± 0.5) min with highly significant p-value (0.001). for tr pci, the contrast volume decreased from (160 ± 5.67) ml to (90 ± 1.98) ml with highly significant p-value (0.001) and ft from (19.47 ± 2.89) min to (7.50 ± 0.96) min with highly significant p-value (0.001). after good experience the complications like spasm, hematoma, and ra occlusion became less, especially at the end of our study. conclusion: tr coronary angiography and tr pci are feasible and preferable by most of the patients, especially females in our locality, and high success rate with low complications, more comfort, early ambulation, and discharge and lower costs.
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Pre-And Post-Operative Care for Cardiac Catheterization and Complications
Cardiac catheterization (Coronary angiogram) is a common medical procedure that rarely. Results in serious complications. It is used to examine the function of the cardiac valves and arteries, as well as the cardiac muscle. It's often utilized to address a variety of heart problems. A catheter is placed into an artery or vein in the groin, neck, or arm and threaded through the blood vessels to the heart during cardiac catheterization. X-ray scans of coronary arteries, which supply blood to the heart muscle, are also part of the operation.
Cardiac catheterization, Coronary angiogram, Medical procedure, Cardiac valves
Ectopic Pregnancy (E.P) Risk Factors, Diagnosis and Management
Ectopic pregnancy, which is any pregnancy implanted outside the uterinecavity, remains the leading cause of pregnancy-related first-trimester deathamong women in the Iraq. Fertilization of the ovum occurs inthe fallopian tube. As the zygote divides, it becomes first a morula andthen a blastocyst, normally arriving in the uterine cavity and beginning implantationon day 6 after fertilization. Anything that delays or impedestubal transport may allow implantation to begin while the blastocyst is stillin the tube; approximately 97% of ectopic pregnancies are tubal in location.Ectopic pregnancies represent approximately 2% of all pregnancies [1,2].This estimate is conservative, as the analysis did not include patients whosecondition was diagnosed and managed exclusively as outpatients. While theincidence of ectopic pregnancy has continued to increase, the case fatalityrate has dropped from 69% in 1876 [3], to 0.35% in 1970, and to 0.05%in 1986. The death rate for African American and other minority womenremains over double that for white women, and the highest death rate occursin the 15- to 19-year-old age group [4].With documented intrauterine pregnancy, the risk of coexisting ectopic(heterotopic pregnancy) is approximated at 1 case in 10,000 patients to 1 casein 30,000 [5,6]. This risk increases to approximately 1 case in 100 patientsif the woman is being treated for infertility [7].
CPK(creatine Phosphokinase), β human chorionic gonadotropin,, methotrexate, Ectopic
Role of Ocular Ultrasound Before Cataract Surgery
Cataract is a treatable cause of blindness. A good post-operative outcome can be achieved with appropriate evaluation of unsuspected posterior segment disorders before the surgery by B san Ultrasonography evaluation. This study assess use B- scan ultrasonogram to visualize status of posterior segment of eye glob, hidden disorders and their percentage that affect the prognosis outcome of cataract surgery. A prospective study was done at the radiological department, using B -scan ultrasound examination of 151 patient candidates for cataract surgery, characterized as 128 patient of non-traumatized and 23 patient with a history of trauma for more than one month. Out of 151 patient, there was 38 patient (25.1%) with abnormal posterior segment disorders. In the non-traumatic group, out of 128 patient, there are 23 patients (17.96%) with abnormal posterior segment disorders. In the traumatic group, out of 23 patient, there are 15 patients (65%) of the abnormal posterior segment. The highest posterior segment disorder in non-traumatic cataract was retinal detachment of 10 patient (43.47%) and at traumatic patient of retinal detachment of 5 patient (33.33%) and vitreous body haemorrhage of 5 patient (33.33%). For patients with systemic risk factors as diabetes mellitus and hypertension, the most frequent lesion was vitreous haemorrhage. In conclusion B-scan ultrasonogram is highly valuable, sensitive and specific, and widely available for detection of posterior segment disorders and its recommended to be a routine examination before the cataract surgery.
B-Scan ultra-sonogram, Cataract, Posterior Segment lesions, surgery.
Value of Metacarpophalangeal and Proximal Interphalangeal Joints Ultrasound in Early Rheumatoid Arthritis, Comparison with Magnetic Resonance Imaging, A Cross-Sectional Study
Background: The metacarpophalangeal and interphalangeal joints are very early sites of affection by Rheumatoid arthritis and are suitable for ultrasound evaluation; the purpose of the study is to evaluate the diagnostic value of ultrasound in detecting radiological signs of early Rheumatoid arthritis as compared to magnetic resonance imaging. Results: The most frequent radiological finding was synovial thickening in both US and MRI (84.3% versus 89.3%), followed by erosion (34.3% versus 32.1%) and effusion (11.4%versus 10%), while the least was tenosynovitis (4.3%in both US and MRI). US showed high sensitivity (94.4%, 100% and 100%), specificity (100%, 98.4% and 100%) and accuracy(95%, 98.5% and 100%) for synovial thickening, effusion and tenosynovitis respectively and a lower sensitivity(84.4%), specificity(89.5%) and accuracy(87.8%) in detecting bone erosions in the finger joints compared to MRI. Conclusion: US is a reliable method in diagnosing most features of early Rheumatoid arthritis compared to MRI. Therefore, the US can be implemented as a primary diagnostic tool in evaluating early Rheumatoid arthritis.
Ultrasonography, magnetic resonance imaging, rheumatoid arthritis metacarpophalangeal joints, proximal interphalangeal joints, erosions, synovial effusion, synovial thickening, tenosynovitis .
Diabetes Mellitus Type I, Diagnostic Criteria, Epidemiology, Sex Differences & Growth Parameters
Type 1 diabetes mellitus(T1DM) has characteristical Classification, Diagnosis & epidemiological pattern. To compare sex differences, epidemiological pattern, consanguinity & family history & growth parameters of patient’s withT1DM with results of other studies. Patient and methods: the study was done between 1st of January 2019 & 30th of June 2019 in Jalawla general hospital, were 50 newly diagnosed children ofT1DM& 50 control cases with no chronic illnesses, all below 15 years included in this Study, classified according to age, sex, area of living, history of recent infection, consanguinity of parents, family history ofT1DM, & growth parameters (weight, height & body mass index), at the onset of diagnosis. In our study, TIDM incidence with two peaks of ages at diagnosis, one at 6-9 years & the other at puberty, male incidence more than female(although little difference). Family history with T1DM was present in 40% of cases, consanguinity positive in 64% of cases, history of recent infections in 64%, 60% of patients live in an urban area, & 32% of patients with weight ˂ 5thcentile, 16% of them height ˂5thcentile,64% of patients with BMI ˂5th centile. In our study, children withT1DM share clinical presentation & epidemiological pattern, differences in growth parameters with other studies but differ in some of them.
Interpretation Of Blood Culture and Sensitivity in The Febrile Thalassemic Patient in The Pediatrics Age Group
Across sectional study done in the thalassemic care centre in Najaf governorate from the 1st of February to the 1st of July 2009 to identify the most causative microorganism for bacteremia thalassemic patient and sensitivity of these organisms to antibiotics. Seventy patients included in the study age range from (4 months- 12 years) M: F ration 2:1those with positive blood culture was 10%. The study concluded that bacteremia in thalassemic patient correlated with splenectomy. So we need regular use of antibiotics and vaccination after splenectomy because the splenectomized patient is immunocompromised and are more liable for bacteremia. Early detection of sign and symptoms of bacteremia prevent complication.