Journal of the Faculty of Medicine Baghdad <h3>Journal of the Faculty of Medicine – University of Baghdad</h3> <h3>A peer-reviewed journal published Quarterly by the college of medicine –Baghdad University</h3> <h3>ISSN:&nbsp; &nbsp;0041-9419</h3> <h3>E-ISSN: 2410-8057</h3> <h3>The Journal interested in the publication of clinical and basic medical research.</h3> <h3>The first issue of this Journal was published under the name of (Journal of the Royal Iraqi Medical College) in April /1936, approved by the council of the College as a general journal dealing with the news of the college and few scientific articles to encourage the teaching staff for research publication. The journal was published randomly and ceased during World War II due to financial difficulties.</h3> <h3>In 1946 Prof. Dr. Hashim Al Witri, the college dean, assigned republication of the journal and urged the teaching staff to participate and publish their research in the journal. Despite his effort, the journal remained irregular in publication. In 1959&nbsp; Prof. Dr. Faisal Al-Sabih became the Editor in Chief of the journal when he returned from the United Kingdom and appointed on the teaching staff, restructured the journal and changed its name to (The Journal of the Faculty of Medicine) and used a new scientific system for publication of articles.</h3> <h3>The first issue of the new series started in June 1959. The journal continued to be published on a regular basis since then without interruption in (four issues during the year). The journal became registered the international number (ISSN) in 2000 and entered in many important international indexes.</h3> <h3>After 2003 the journal continued despite the difficulties involved in every aspect of the country and by the beginning of 2004, the journal progressed through a series of changes to reach a level that can be recognized internationally.</h3> <h3>After 2010 the journal became published electronically of the same edited issues.</h3> en-US <p>&nbsp;For all articles published in Journal of the Faculty of Medicine Baghdad, copyright is retained by the authors. Articles are licensed under an open access<a href="">&nbsp;Creative Commons CC BY NC 4.0 license</a>,&nbsp;meaning that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. These conditions allow for maximum use and exposure of the work, while ensuring that the authors receive proper rights.</p> <p>&nbsp;</p> (prof. Ali K. Al-Shalchy) (assistant Lecturer Sara Mohammed Abdullah) Tue, 13 Jul 2021 08:57:06 +0000 OJS 60 Prevalence of peripheral arterial disease among patients with acute coronary syndrome, a sample of Iraqi patients in Al-Yarmook Teaching Hospital 2016 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> A significant proportion of patients with ischemic heart disease have been associated with peripheral arterial disease, yet it is still underestimated by our health system as many of patients are asymptomatic and this condition remains under diagnosed and therefore undertreated.</p> <p><strong>Objective: </strong>To study prevalence of peripheral arterial disease of the lower limbs in patient with acute coronary syndrome and its association with certain risk factors.</p> <p><strong>Method:</strong> A cross sectional descriptive study was conducted in the coronary care unit at Al-Yarmouk Teaching Hospital from the 1<sup>st</sup> of January 2016 to the 1<sup>st</sup> of November 2016 where hundred and fifty (150) patients enrolled to the coronary care unit with approved acute coronary syndrome, had been evaluated for peripheral arterial disease by assessing Demographic, risk factors and clinical features of the patients, including age groups, gender, hypertension, diabetes mellitus, smoking, dyslipidemia, family history. of coronary artery disease, previous history of cerebrovascular accident, body mass index, leg pain, measurement of ankle brachial index using hand held continuous wave Doppler device.</p> <p><strong>Results:</strong> in 150 acute coronary syndrome patients were included male were (70.7%) , peripheral arterial disease was found in 31.2% through measuring ankle brachial index, 51% of those patients were asymptomatic and 29.8% with atypical leg pain and 12.8% with intermittent leg pain and 6.4% had pain at rest. And ankle brachial index in the 150 patients with acute coronary syndrome were 68.8% normal (ankle brachial index =1.4-0.91) and 21.3% (ankle brachial index =0.9-0.71) and 7.3 %( ankle brachial index =0.69-0.41) and 2.6% (ankle brachial index ≤0.40).&nbsp;</p> <p>Factors independently related to peripheral arterial disease were old age (&gt;60 years) which constitutes 51% and p value was 0.013, and smoking which constitutes 46.8% and P value was 0.04, and dyslipidemia which constitutes 74% and P value was 0.03, and finally previous history of cerebrovascular accident which constitutes 21.2% and P value was 0.0018.</p> <p><strong>Conclusion:</strong> The prevalence of peripheral arterial disease in patients presenting with acute coronary syndrome is considerable and significant, the majority of patients were asymptomatic, it is associated with increased cardiovascular risk. Factors like aging, hypertension, diabetes mellitus, smoking, previous history of cerebrovascular accident, and dyslipidemia were strong predictors of peripheral arterial disease.</p> <p>&nbsp;</p> <p><strong>Key word: </strong>peripheral arterial disease , acute coronary syndrome, hypertension, diabetes mellitus.</p> Osama A. Altaei, Abbass N. Al-Sharifi ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 Surgery of Eventration of the Diaphragm <h1>Abstract</h1> <p><strong><u>Background:</u></strong> Eventration of diaphragm is an abnormal elevation of the diaphragm. Publishing on eventration of diaphragm in Iraq is scarce.</p> <p><strong><u>Objective</u></strong><u>:</u> This study was carried out to report on the Iraqi experience on eventration of diaphragm.</p> <p><strong><u>Methods</u></strong><u>:</u> A total of 18 patients with eventration diaphragm were included in this study. A review of case records of patients with eventration diaphragm treated in Ibn Al-Nafees Teaching Hospital was done. Review of records took place for the period of March 2012 to Dec. 2017.</p> <p><strong><u>Results:</u></strong> The age of patients was ranged 5 months to 70 years, giving male to female ratio of 2:1. Dyspnea was dominating presenting symptoms followed by cough. The left hemidiaphragm was the most affected site (83.3%). The cause of eventration of diaphragm was idiopathic in 72.2% of patients. Chest X ray showed the elevation of the affected hemidiaphragm. CT scan demonstrated the thinned-out raised hemidiaphragm. The most common complications were atelectasis, and recurrent chest infection. Hospital stay was ranging 4-14 days.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Eventration of diaphragm is not uncommon in Iraq. Presentation, management, and complication are similar to that reported in global centers. &nbsp;</p> <p><strong><u>Key words:</u></strong><strong>&nbsp; </strong></p> <p>Diaphragm. Eventration.&nbsp; Plication. Surgical repair. Phrenic nerve injury&nbsp;&nbsp;</p> waleed M. hussen, Ahmed M. Mohammed, Akeel S. Yuser ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 Germ cell tumor: A seven-year experience Children Welfare Teaching Hospital <p>Background: Germ cell tumors are a rare heterogeneous group of cancers with high cure rates in the pediatric age group.<br>Objectives: To study the clinical and pathological features in a group of patients with germ cell tumors and to evaluate their outcomes.<br>Patients and methods: A record review was undertaken on a group of patients with germ cell tumor who were admitted to the Children Welfare Teaching Hospital in Baghdad during the years 2009 - 2015. Information on gender, age, clinical signs, pathological findings, treatment and overall survival rate were reviewed.<br>Results: The patients had a mean age of 4.2 years (ranging from 1 month - 14 years). There were 45 girls and 16 boys. Abdominal pain was the most common presentation in 17 patients followed by a lower back mass in 16 patients. Primary sites included extra gonadal (sacrococcygeal 18, pelvis 5, vagina 4, gluteal 3, intra-cardiac, and one each for the mediastinum, orbit and rectum), and gonadal (18 ovarian and 9 testicular). After a mean period of follow-up of 42 months, the overall survival at 1 year was 59%.<br>Conclusion: The prognosis of children with germ cell tumors is favorable, regardless the site and histopathology.</p> raghad majid alsaeed, Afrah M. Jassim, Samaher A. Razaq, Mazin F. AL-Jadiry ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 Scabies outbreaks during 2019 in Al- Daseem, Al-Rusafa-Baghdad: A retrospective study <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Scabies is a skin infestation by the Sarcoptes scabiei mite. Scabies is transmitted through close personal contact. Settings like hospitals, prisons and childcare centers are at greater risk of outbreaks. Both male and female may be infected with scabies in any age groups. It is common in tropical climate countries poor people who live in rural areas and among displaced patients. It rises significantly among low economic status because skin diseases are significantly associated with a higher crowding index.</p> <p><strong>Objectives:</strong> To estimate the prevalence of scabies in Al- Daseem region and identify factors associated with an increased risk of scabies among patients.</p> <p>&nbsp;</p> <p><strong>Methodology:</strong> A retrospective cross sectional study was carried out about scabies outbreak in Al- Daseem area which located at Al-Rusafa side in Baghdad during 2019. Basic data were obtained from records of communicable disease section/public health director / Al-Rusafa health directorate. All registered cases during 2019 were included in the study, and then data computerized and analyzed using SPSS version 23 using frequency tables for the selected variables under study. Participants represented by students of Ali Al Wardi School (the only school in Al Daseem area) and from people live in this area (20% of them selected randomly). Data included socio-demographic information (age, sex, family member, and treatment). The diagnosis of scabies was based on their typical history of (itching that worsens at night, the distribution of lesions, and a history of contact with other family member infected with scabies).</p> <p>&nbsp;</p> <p><strong>Results:</strong> A total of 11363 participants information were obtained from database, 6473were male and 4873 were female. There were 746 (6.6% of total) participants infected with scabies of them, there were 457 (7%) male patients and 289 (5.9%) female patients. There was significant association between scabies and gender of patients, P=0.018.</p> <p>According to the age groups of patients, there were 161 (6.4%) patients 6 years old, 337 (8.8%) patients within (7-12 years) age group, 82&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (6.7%) patients within (13-19 years) age group, and there were 166 (4.3%) patients 20 years old. There was a significant difference between scabies and age group, p&lt;0.001. Of the total patients, there were 622 (85%) patients had another family member infected with scabies. There was a significant association between patients and having another family member infected with it, P&lt;0.001.</p> <p><strong>Conclusion:</strong> prevalence of scabies in Al-Daseem region was (6.6%). Scabies was dominant among male, age group of (7-12 years), and having other family member infected with scabies.&nbsp;</p> <p>&nbsp;</p> <p><strong>Key words:&nbsp; Scabies, Al-Desame, outbreak, mite, school.</strong></p> Bashar A. Abdul Razzaq, Tuka Y. Hassan ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 A Comparative Study of Colorectal Cancer Based on Patient’s Age <p><strong><u>Abstract:</u></strong></p> <p><strong>Background:</strong> The alteration of bowel habits, bleeding per-rectum and anemia were common features in both groups in this study, but in young patients there was a delay of 6 months between the presenting symptoms and the definitive diagnosis because the disease was not suspected and investigated in them. The most common site for the tumors in young patients was the rectum and in patients above the age of 40 years was the Sigmoid.</p> <p>The pathological finding showed that classification of the colorectal tumors in young patients appear moderately to poorly differentiated adenocarcinoma , this indicate a more malignant course of the disease in young patients.</p> <p>This study send a message to all clinicians that the incidence of colorectal cancer is increasing in young patients and therefore we should be alert when dealing with young patients presenting with abdominal pain, bleeding per-rectum and alteration of bowel habit to diagnose the disease at an early stage to undertake curative surgery .</p> <p><strong>Aim of the study:</strong> To study the clinical coarse of colorectal cancer in age between (less than 40 to above 40), and the most frequent site and distribution, and the types of surgical intervention.</p> <p><strong>Patients and methods:</strong> In the period between January 2012 to March 2013, 35 patients with colorectal cancer were treated at Al-Yarmouk Hospital,10 patients were below the age of 40 years ,( 5 Males and 5 Females ) with age ranging from 22-40 years , 25 patients were above the age of 40 years (12 males and13 females).</p> <p><strong>Results:</strong>100% of patients less than 40 years presenting as anemia and 50% bleeding per rectum<strong>, </strong>while 88% of patients above 40 years with weakness and lethargy.30% of patients less 40years age, and 36% of patients above 40 years consider as an emergency cases, and others as elective cases. Surgical treatment involving 50% of patients less than 40 are right, left hemicolectomy and anterior resection, and in age of above 40 56% by left hemicolectomy. More common stages in young patents are&nbsp; C and B&nbsp; but in old&nbsp; A ,B , C.</p> <p><strong>Recommendations: </strong>Researchers recommend periodic screening by a doctor to diagnose the tumor early with the need to develop educational programs on early signs of colorectal cancer.</p> Nasir K. Dhahir, Aqeel Abbas Noaman ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq <p><strong>Abstract </strong></p> <p>As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onset of thromboses, they were successfully managed by catheter directed thrombolysis (CDT) using tissue plasminogen activator (tPA). Owing to the increased morbidity and mortality of vascular thrombosis, there is a need to identify COVID-19 patients who need prophylaxis and prescribe them the right prophylactic drug (s). The excellent outcome of CDT in these two patients, from Sulaymaniyah/Iraq, supports the use of this treatment modality as a valid, safe and effective option for acute arterial and venous thromboses.</p> <p>&nbsp;</p> Aram Jamal Mirza, Abdulsalam Yaseen Taha ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000 Geopolitical factors affecting childhood nutrition: Iraqi case <p>In Iraq, child’s health had been deteriorated over three turbulent decades starting from the huge and rapid degradation of the country infrastructure by Iraq –Iran war (1980-1988), Gulf War in 1991, and economic sanction.</p> Huda Sabah Al-Jadiri, Besmah M. Ali, Jawad K. Al-Diwan ##submission.copyrightStatement## Tue, 13 Jul 2021 00:00:00 +0000