Infleunce of Body Mass Index (BMI) on Outcome of Colon Cancer in Relationships with Other Clinicopathological Factors

Background: Colon cancer is the third most common cancer. High (BMI) contributes hazardously for several types of malignancies including colon cancer while the effect of BMI as a prognostic factor is poorly defined. Objective: Demonstrating the influence of increasing (BMI) on colon cancer recurrence. Patients and Methods: Case-control study involved a sample of 312 patients and 131 patients were excluded from this study and only 181 patients of colon cancer are included in the study with stage 2 and 3 who did underwent a surgical operation and received adjuvant chemotherapy recruited from an oncology teaching hospital, Al Jawad oncology center (Alkadhemiya hospital) and Babylon Oncology center. Results: The study involved 181 patients of colon cancer patients with mean age of 56.25 ±11.74years the highest proportion of study patients (90.6%) were aged more than 40yrs with a male to female ratio (1.2:1). Overweight patients constituted 39.2% and obese 23.8% and normal body weight 37%. In this study majority of tumors are ulcerating for about 72.5% and sigmoid and left side colon was the most common site of the tumor in about 53% with stage three is a most common type. Regarding recurrence, 54.1% of study patients have recurrence, and the majority of the 41.8% occurs between 1-3years after primary tumors diagnoses and treatment with a high prevalence of recurrence was seen in obese patients (74.4%) with a significant association between prevalence of recurrence and increasing BMI. In this study, 61.2% of patients with lymphovascular invasion have recurrences of malignancy with significant associations between recurrences and LVIe. Also more than 50% of patient older than 40years got recurrences with significant associations between recurrences with age of patients. In this study we take the effect of each clinicopathological feature on the outcome of colon cancer and then to excluded its effect by logistic regression to see the effect of only BMI on the outcome of colon cancer. Conclusion: Increase body mass index is associated with increase recurrence of colon cancer Keywords: Colon cancer recurrence, body mass index, Clinicopathological Factors

The Incidence of Dysarrhythmias, Their Types and Outcomes in Patients Hospitalized with COVID -19

Background: COVID-19 infection started in China and became a pandemic, the SARS-CoV-2 virus mainly affects the respiratory system but can insult the cardiovascular system as well, higher rate of cardiac arrhythmias noted during the pandemic, and many studies showed that COVID-19 (especially hospitalized patients) can develop different types of arrhythmias which cause higher mortality rate. Objective: To assess the incidence of dysrhythmias and their types and outcomes in hospitalized patients with COVID-19 in Erbil city. Patients and Methods: Patients with documented COVID-19 infection admitted in Erbil Teaching Hospital respiratory care unit and coronary care unit from 1-8-2020 to 30-10-2020 had been included (255 patients) in this cross-sectional study, demographic data, and outcomes were reported, the ECG analyzed by cardiologists and the type of arrhythmia documented. Results: Mean age was 47±12 years, 61% of the patients were male, 25% of them had previous cardiac diseases, 20% diabetes, 16% multiple comorbidities, 8% hypertension, 8% obesity and 23% had no comorbidities, 20.7% of in-hospital patients developed dysrhythmias, 5.9% of them developed sinus tachycardia, 4.7% atrial fibrillation, 3.9% ventricular premature contractions, 2% ventricular fibrillation, 1.9% ventricular tachycardia and 1.9% heart blocks. Most of the patients who developed ventricular arrhythmias, atrial fibrillation, and heart block had previous comorbidities 82%, 62%, and 80% respectively. Arrhythmias caused a higher in-hospital mortality rate (39.6% versus 21.7%) especially among male patients (mortality rate in male patients 43% compared with female patients 33%). Conclusion: Most of the admitted cases were male. Most of them had comorbidities especially previous cardiac diseases. Sinus tachycardia, atrial fibrillation, and ventricular extra-systoles were the most frequent arrhythmias. The mortality rate was increased by arrhythmias mainly in male patients. Keywords: COVID-19, Dysrhythmias, Outcomes, Pandemic

Prevalence of chickenpox in primary school children in Baquba city

Background: Chickenpox is a viral disease caused by a virus called Varicella Zoster Virus (VZV). It is more prevalent among children less than 10 years. Objective: To estimate the prevalence of chickenpox among the different age groups and monthly distribution per year in Baquba city sectors recorded in Baquba teaching hospital. Patients and Methods: Data was collected of 82 patients from 1st January –31 th July 2019, and the statistical data was recorded as name, age, sectored where patients' lives. Results: Eighty-two patients with chickenpox data were collected in Baquba teaching hospital, male 52(63.4%) , and female 30(36.5%) of cases in different age groups, were highest prevalence in(9-12) years age group (30) cases, and lowest in cases older than 12 years old were (6) cases reported, t-test (2.671). Conclusion: Chickenpox more common in male, highest infections were reported in winter months. Keywords: Chickenpox, Varicella-Zoster Virus, children

Clinical and Social Findings of Childhood Epilepsy

Background: Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive, or synchronous neuronal activity in the brain characterized by abrupt and involuntary skeletal muscle activity. Seizure is related to specific risk factors like positive family history, fever, infections, neurological comorbidity, premature birth, mother’s alcohol abuse, and smoking in pregnancy. Epilepsy is the most frequent chronic neurologic condition in children. Studies have suggested declining incidence rates of childhood epilepsy in high-income countries during the last decades. Objective: To describe the clinical features and social findings of epilepsy in children, and to evaluate some risk factors associated with control of epilepsy. Patients and Methods: This cross-sectional study was conducted in the pediatric department of Albatool teaching hospital in Diyala province, Iraq. A total of 100 children were included in the study from February 2020 to May 2020. All children diagnosed with epilepsy in this study. Results: One hundred children with epilepsy, their mean age was 5.96± 3.33 years (range 1-14 years). Of the 48(48%) children were male and 52(52%). Of the total patients, 79% were free from seizure on AED, 21% of them were refractory to treatment.Patients without developmental delay (88.7%, p=0.012) can be controlled by AED. Patients who had idiopathic seizures (87.5%, p=0.04) can be controlled by AED. Patients who had seizure attacks can be controlled by AED more than patients who had weekly or monthly seizure attacks (97.4%) (p<0.001). Patients who had been treated by monotherapy (94.7%, p=0.012) can be controlled more than patients who were treated by multidrug therapy. Affected social interaction and need more supervision were factors that detected more in patients with refractory epilepsy, p=0.04, 0.01 respectively. While there was no association between frightened other people and epilepsy control. Conclusion: Most of the patients are characterized by: treatment approach monotherapy, less affected by social interaction and need less supervision. Patients with refractory epilepsy had opposite factors. Keywords: Epilepsy, Albatool teaching hospital.

Multiple Fat- Containing Hepatic Hydatid Cysts: A Case Report in The X- Ray Institute at Medical City Health Directorate in Iraq

Background: Hydatidosis is a zoonotic disease caused by Echinococcus granulosus and Echinococcus multilocularis parasite which is still endemic in many countries all over the world especially in the developing countries. The liver is the primary site to be infested by the parasite with a rate of 60 – 75%. The right lobe of the liver gets infected in about 80% of cases. Hydatid disease of the liver is usually asymptomatic and most cases discovered accidentally on routine clinical or radiological examinations for other illness. Symptoms usually appear in complicated cases either due to rupture, secondary bacterial infection, or due to the large size of the cyst which might cause pain in the right upper quadrant of the abdomen, discomfort, and sometimes swelling. In this case report, we reported the presence of fat globules within the hepatic hydatid cysts which is most probably due to rupture of hepatic hydatid cysts into the biliary tree. Keywords: Hepatic, hydatid cyst, fat globule and CT scan

The Role of The Doppler Study (Umbilical, Middle, Cerebral Arteries and Ductus Venosus) to Predict General Adverse Pregnancy Outcomes in Patients With Hypertensive Diseases in The Third Trimester

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. Keywords: Hypertensive disorder, Middle cerebral artery, Umbilical artery, Ductus venosus

Effect of Irregular Treatment on Severity of Osteoporosis in Rheumatoid Arthritis Patients

Background:Rheumatoid arthritis is a chronic systemic inflammatory disorder that is associated with progressive disability and systemic complications. One of these complications is osteoporosis. Patients with severe osteoporosis have one or more fragility fractures in addition to T-score -2.5 or lower. Osteoporosis is more prevalent in rheumatoid arthritis patients who have higher disease activity. Objective: To show the effect of irregular treatment in patients with rheumatoid arthritis on the severity of osteoporosis. Patients and Methods: A cross-sectional study enrolled a total of 40 female patients who had rheumatoid arthritis. The data collected from patients include disease duration, disease activity and patients’ compliance to their drugs. They were sent to dual-energy x- ray absorptiometry scan and results were recorded. Results: The mean age was 45.95 ± 10.0 years; 45% of them had rheumatoid arthritis for less than five years; 55% had a low level of disease activity; and 65% of them had received treatment irregularly. Osteoporosis was diagnosed in 60% of them and 41.7% of them had severe osteoporosis. The highest prevalence of osteoporosis among patients with rheumatoid arthritis was seen significantly among older patients, patients with longer duration of rheumatoid arthritis, those with higher activity of rheumatoid arthritis, and those with irregular treatment. More than half of those who received treatment irregularly had severe osteoporosis with a significant association between treatment regularity of rheumatoid arthritis and severity of osteoporosis. Conclusion: Severe osteoporosis occurs in rheumatoid arthritis patients with a history of irregular treatment which occurs either due to patient incompliance or delay in diagnosis. Osteoporosis is more prevalent in rheumatoid arthritis patients with longer disease duration, older age, higher disease activity and those who received treatment irregularly. Keywords: Rheumatoid arthritis, Osteoporosis, Irregular Treatment

Oxidative Stress in Multiple Sclerosis Disease (Review Article)

Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system, in which the myelin sheaths got injured. The prevalence of MS is on grow, as well as, it affects the young ages. Females are most common to have MS compared to males. Oxidative stress is the situation of imbalance between oxidants (free radicals and reactive oxygen species (ROS)) and antioxidants in a living system, in which either the oxidants are elevated or antioxidants are reduced, or sometimes both. ROS and oxidative stress have been implicated in the progression of many degenerative diseases, which is important in cracking the unrevealed mysteries of MS. In this review article, some of the proposed mechanisms that link oxidative stress with MS disease would be described. Keywords: Oxidative stress, ROS, multiple sclerosis, antioxidants

Serum Creatinine and Creatine Kinase as an Indicator for Gingival Wound Healing in Rabbits by Supplementation of Pomegranate Seed Extract

Background: Pomegranate (Punica granatum) is an edible fruit that has been described as a medical and therapeutic functional food in the Middle East and the Mediterranean. Objective: To investigate the use of serum creatinine (Cr) level and creatine kinase (CK) activity as indicators for gingival wound healing process rate in rabbits, supplemented on pomegranate seed extract (PSE). Patients and Methods: A total of 45 rabbit males were used. They were divided into 3 groups; 5 rabbits as a baseline group that left without a buccal gingival wound. 20 rabbits (5 rabbits per each time interval) as a study group with buccal gingival wound with PSE supplementation, and another 20 rabbits (5 rabbits per each time interval) as a control group with gingival wound without PSE supplementation. A buccal gingival wound was created on the lower right central incisor, and the suture was removed after (7) days. Blood samples were collected for the baseline group and at time intervals; 3 hour, 1, 3, 7 days after creating the wound for both control and study groups to determine serum Cr and serum CK. Results: Serum Cr and CK significantly increased in all time intervals after gingival wounds, in the control group compared with baseline values. Whereas the levels significantly increased in rabbits receiving PSE at intervals of 3 hours, 1 and 3 days after gingival wound, they returned to the baseline values, seven days after gingival wound incision. Conclusion: Serum Cr and CK increase in the buccal gingival wound, while oral supplementation of PSE can decline them to the baseline value after a period of time, therefore these parameters can be used as indicators for gingival wound healing rate. Keywords: Punicagranatum seed extract, gingival wound healing, creatinine, creatine kinase.

The Importance of CT Pneumocolon in Detecting Colonic Lesions

Background: Colonic masses are clinically important because some of them are malignant and others have a tendency to become malignant such as polyps. CT pneumocolon may have a role in the evaluation and diagnosis of these masses. Objective: To determine the accuracy of computed tomography (CT) pmeumocolon in the detection of colonic masses compared with colonoscopy. Patients and Methods: A total of 60 patients with colorectal symptoms underwent evaluation for the presence of colorectal neoplasms by using both colonoscopy and CT pneumocolon and a comparison was made between them. Results: On colonoscopy, 10 out of 60 patients were having a negative colonoscopy. The results of colonoscopy of the other 50 patients were as follow; three out of fifty colonoscopies revealed invasive colorectal carcinomas in threse patients. The remaining 47 colonoscopies for 47 patients revealed benign polyps. The sizes of these polyps were as follows; (6 polyps were ˃1 cm in diameter), (17 polyps were 6-9 mm), and (24 polyps were ≤5 mm). CT pneumocolon detected all 3 malignant masses seen and biopsied by colonoscopy, but only (28 single polyps) which according to their size (4 polyps were ≥ 1cm), (11 polyps were 6-9 mm) and (13 polyps ≤5 mm), this gives CT pneumocolon a sensitivity of (63%), specificity of (70%) and accuracy (63%). Conclusion: CT pneumocolon has high sensitivity and specificity for a detection of large-sized masses, but not for small ones. CT pneumocolon may be suitable for investigating patients with symptomatic colorectal masses noninvasively. Keywords: Pneumocolon, colonoscopy, polyp, colonic carcinoma