Journal of Ideas in Health
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Chronic pelvic pain and recurrent urinary tract infection in a forgotten intrauterine contraceptive device (IUCD) for 20 years: a case report on misplacement and migrated IUCD
Get PDFBackground: Intrauterine contraceptive device (IUCD) migration into the urinary bladder is a rare complication that may cause recurrent urinary tract infections, hematuria, abdominal pain, and bladder stone formation.
Case presentation: A 47-year-old woman presented to the urology clinic at Life Hospital in Kalar, Iraq, in September 2025 with chronic intermittent lower abdominal pain, hematuria, and recurrent UTIs. Her medical history was unremarkable, and she had a copper-T IUCD inserted in 2005. She reported mild post-insertion bleeding and later experienced an early miscarriage and a term home delivery. Examination revealed left iliac fossa tenderness and a positive urine culture for E. coli. Imaging showed a 22 mm intravesical stone attached to a migrated IUCD. CT confirmed one T-limb in the bladder forming a stone, with the other limb penetrating the abdominal wall. Failed cystoscopic and laparoscopic attempts led to open surgery. The IUCD and stone were successfully removed, and the bladder was repaired. Recovery was uneventful, with catheter removal following a clear cystogram.
Conclusion: Early recognition and prompt surgical removal of migrated IUCDs are crucial to prevent chronic infection, adhesion, and bladder wall damage
Sacroiliitis as rare presentation of brucellosis: a case report
Get PDFBackground: Brucellosis is a zoonotic infection with diverse clinical manifestations and may present with musculoskeletal involvement. Sacroiliitis is common in adults but rare in children, often leading to delayed diagnosis.
Case presentation: We report the case of a 13-year-old boy with brucella sacroiliitis confirmed by positive serology and magnetic resonance imaging. The patient presented with prolonged low-grade fever and back pain without other classical signs of brucellosis. Plain radiography was normal, while MRI revealed sacroiliitis. He responded promptly to appropriate antimicrobial therapy.
Conclusion: This case highlights the importance of considering brucellosis in children presenting with unexplained sacroiliitis, particularly in endemic regions, and emphasizes the diagnostic value of MRI and serological testing
Flexible ureterorenoscopy for renal stones in ectopic malrotated pelvic kidneys: a case report on safety and effectiveness
Get PDFBackground: An ectopic pelvic kidney is a rare congenital anomaly with a high incidence of complications such as reflux, the pelviureteric junction (PUJ) obstruction, nephrolithiasis, and even renal failure. We here report a case of retrograde intrarenal surgery (RIRS) for the treatment of right pelvic kidney stones.
Case presentation: A 65-year-old male presented to the urology clinic at Life Hospital, Kalar, Iraq, on September 10, 2024, with complaints of lower abdominal pain, microscopic hematuria, and dysuria. The patient had a medical history of cardiovascular and unhealthy lifestyle-related diseases. Physical examination revealed lower abdominal pain without fever. Serum creatinine was 1.4 mg/dL and HbA1c was 8.7%, with microscopic hematuria and pyuria in urinalysis. Contrast-enhanced CT revealed an ectopic right iliac kidney with moderate hydronephrosis and two renal stones (11 mm and 13 mm). Flexible ureterorenoscopy (fURS) with Holmium: YAG laser stone dusting was performed under spinal anesthesia. The procedure lasted 50 minutes, achieving complete stone clearance. The patient was discharged the same day without complications, and follow-up confirmed successful outcomes.
Conclusion: A single-session RIRS has successfully disintegrated the stone. Proper preoperative assessment and selection of the most suitable surgical procedure are critical for successful treatment
Impact of asthma on linear growth in preschool children: a cross-sectional study in Iraq
Get PDFBackground: Asthma is a common chronic respiratory condition in children, often emerging during the preschool years. Its long-term effects may extend beyond respiratory health, potentially influencing physical development, including linear growth. This study aims to determine whether a significant association exists between asthma and impaired linear growth of preschool-aged children in Iraq.
Methods: A cross-sectional study was conducted between 1st January and 30th June 2024 at Al-Batool Teaching Hospital, pediatric outpatient clinics, Diyala, Iraq. The cohort analyzed data of 90 children aged 1–5 years who has been divided into two groups: asthmatic (n=45) and non-asthmatic controls (n=45). Height-for-age z-scores (HAZ) were used to assess linear growth. Data were collected through caregiver interviews and medical record reviews, including sociodemographic characteristics and clinical information. Chi-square and logistic regression analyses were employed to identify significant associations between asthma and stunting.
Results: Among asthmatic children, 42.2% had low HAZ scores compared to 20.0% of non-asthmatic children (p=0.03). Logistic regression showed that asthma was significantly associated with linear growth impairment (OR = 2.8, 95% CI: 1.1–7.2, p=0.028), even after adjusting for confounders such as nutrition and parental education.
Conclusion: Asthma in preschool children is significantly associated with impaired linear growth. Early detection, asthma control, and integrated nutrition strategies are crucial to improving both respiratory and growth outcomes. Further longitudinal studies are needed to explore causality and long-term developmental impacts
Navigating the complexities of anesthetic management in a preterm neonate with double outlet right ventricle posted for noncardiac surgery
Get PDFBackground: Double outlet right ventricle (DORV) is an uncommon congenital heart defect characterized by the simultaneous emergence of both the aorta and pulmonary artery from the right ventricle. This condition is frequently linked with other congenital anomalies, such as imperforate anus, which presents considerable challenges for anesthesiologists. This case report outlines the effective anesthetic management of a preterm neonate diagnosed with DORV and imperforate anus, who was scheduled for an urgent sigmoid colostomy.
Case presentation: A 6-day-old preterm female weighing 2.2 kg, exhibited DORV along with a subaortic ventricular septal defect, mild pulmonary stenosis, adequate biventricular function, and moderate pulmonary hypertension. Additionally, she presented with an imperforate anus accompanied by a recto-vaginal fistula. The preoperative assessment involved echocardiography, electrocardiography, and various laboratory tests. The pediatric cardiologist advised that the patient\u27s oxygen saturation should be maintained within the range of 80-85% throughout the emergency colostomy procedure. Anesthetic management involved premedication with glycopyrrolate, ondansetron, fentanyl, and dexamethasone. The patient was induced with sevoflurane and intubated with a 2 mm endotracheal tube. Anesthesia was maintained with a mixture of air and oxygen, sevoflurane, and atracurium. Hypothermia was prevented using a warmer, and fluid management was guided by the patient\u27s hemodynamic parameters. After the 1-hour surgery, the patient was transferred to the neonatal intensive care unit, where she was initially supported with synchronized intermittent mandatory ventilation and later extubated
Conclusion: The effective anesthetic management of this preterm neonate with DORV and imperforate anus necessitated a comprehensive understanding of the associated cardiac and anorectal anomalies, meticulous preoperative planning, and a collaborative multidisciplinary approach to perioperative care. The anesthesiologist was instrumental in ensuring the patient\u27s safety and enhancing the surgical conditions throughout the emergency colostomy procedure
Isolated biliary tract injury: necessity to heighten vigilance following blunt abdominal trauma in children
Get PDFBackground: Bile duct injury after blunt abdominal trauma is a rare entity in the pediatric population. Its occurrence has been highly linked to the primary injuries of the liver or duodenum as explained by their anatomical affiliation.
Case presentation: Here we present a case of a 4-year-old female brought in with a history of generalized abdominal pain that was associated with distension and absolute constipation. This was preceded by a blunt abdominal traumatic incident four days prior. On examination, she was ill-looking, tachypneic, and had a grossly distended abdomen with a positive Blumberg\u27s sign. After the baseline laboratory and radiographic investigations, she was taken for exploration where Bile peritonitis was found secondarily to a perforated common bile duct (CBD). All other visceral structures and organs were fine; a meticulous primary closure of the 2 by 1 cm defect was done as superimposed by an omental patch. She fared well post-operatively and was discharged on the seventh day.
Conclusion: Though rare, biliary tract injury should always be considered among the differential diagnoses in blunt abdominal trauma, as its early diagnosis precipitates early intervention which will in turn positively affect the patient\u27s outcome
Association of vitamin D and digital screen time with dry eye syndrome among Duhok health science students
Get PDFBackground: Dry eye disease (DED) is a growing issue, especially in younger groups that use digital devices extensively and among those with vitamin deficiencies. The purpose of this study was to evaluate the relationship between DED among health science students and their digital device use and vitamin D levels.
Methods: A cross-sectional study was performed with ninety health science students in Duhok. Participants filled out a standardized questionnaire that asked about their screen time, how they used devices, and their Ocular Surface Disease Index (OSDI) scores. We checked the levels of vitamin D in the blood. Statistical analyses encompassed t-tests, one-way ANOVA, chi-square tests, and Pearson correlation coefficients.
Results: Many participants had sustained severe DED (61.1%). The majority of participants (69%) used digital devices for more than 6 hours daily. The average OSDI scores were significantly higher in prolonged users (>6 hours/day: 51.94 ± 20.273) compared to moderate and light users (p = 0.001). Almost 80% of participants had a low level of vitamin D (deficient or insufficient). Vitamin D levels and OSDI scores were strongly negatively correlated (r = -0.622, p < 0.001), while screen time and OSDI scores were positively correlated (r = 0.573, p < 0.001), accounting for 32.8% of the variance. There was a strong link between OSDI intensity and device type (χ² = 19.69, p = 0.02), with people who used more than one device reporting the worst symptoms. There were no strong links between gender (p = 0.146) or educational stress (p = 0.462).
Conclusion: Health science students who use digital devices for long periods of time and don\u27t get enough vitamin D have higher OSDI scores. Interventions should concentrate on regulating screen time, enhancing blink efficiency, and tackling nutritional aspects such as vitamin D supplementation
Gasoline and vehicle-exhaust inhalation in an 11-year-old with autism spectrum disorder: a case report and management considerations
Get PDFBackground: Volatile substance abuse in children with neurodevelopmental disorders remains under-recognized, particularly in low-resource settings. Sensory-seeking behavior and environmental access can reinforce such patterns, posing medical and psychosocial risks.
Case presentation: We report the case of an11-year-old boy with attention-deficit/hyperactivity disorder (ADHD) presented with repetitive inhalation of gasoline and other volatile fuel vapors. The behavior, initially interpreted as enjoyment habit, escalated to habitual sniffing from fuel containers and vehicle exhaust. No acute intoxication condition was reported, but intermittent dizziness and cough were reported. Laboratory tests and electrocardiogram were within normal limits, whereas electroencephalography (EEG) is suggestive of ADHD. Multidisciplinary intervention was adapted including environmental modification, behavioral replacement strategies, psychoeducation, and referral to pediatric toxicology and psychiatry. Early follow-up showed reduced exposure frequency and improved parental management.
Conclusion: This case highlights the need for early recognition of solvent-related behaviors in neurodivergent children, emphasizing environmental control, behavioral therapy, and multidisciplinary coordination
Unprovoked crying spells in a child with ADHD: a case of dacrystic seizures
Get PDFBackground: Dacrystic seizures are uncommon epileptic events that manifest as brief episodes of uncontrollable crying. Because these episodes mimic emotional outbursts, they are often confused with behavioral or psychiatric problems, particularly in individuals with attention-deficit/hyperactivity disorder (ADHD).
Case presentation: We report the case of a 9-year-old boy with a medical history of ADHD who presented with recurrent, sudden crying spells without apparent triggers for nearly three years. The patient had no prior history of head trauma, central nervous system infection, or developmental regression. Neurological examination and brain magnetic resonance imaging (MRI) revealed no abnormalities, and routine laboratory tests were unremarkable. Following the exclusion of other possible etiologies, electroencephalography (EEG) conducted by a senior neurophysiologist in the pediatric neurology department confirmed the diagnosis of dacrystic epilepsy. The patient was started on a combination therapy of valproic acid (300 mg/day), lamotrigine (25 mg/day), and clonazepam (0.25 mg/day), which resulted in approximately 60% reduction in the frequency and intensity of the episodes within two months, without any significant adverse effects.
Conclusion: Unexplained crying attacks in children, especially those with developmental disorders, should raise the possibility of dacrystic seizures. Careful neurological assessment and prompt use of antiepileptic therapy can markedly reduce symptoms and improve quality of life
A case report of apert syndrome in a 13-year-old girl presenting with dental pain
Get PDFBackground: Apert syndrome is a rare congenital craniosynostosis syndrome caused by mutations in the FGFR2 gene, with an incidence of 1 in 65,000 to 200,000 live births. It is characterized by premature cranial suture fusion, midfacial hypoplasia, and syndactyly of the hands and feet. In addition to craniofacial and skeletal anomalies, patients often present with dental, airway, and ophthalmological complications requiring long-term multidisciplinary management.
Case Presentation: We describe a 13-year-old female with a known diagnosis of Apert syndrome who presented with progressively worsening dental pain over one month, associated with temporal headaches and difficulty chewing. Examination revealed brachycephaly, midfacial hypoplasia, exophthalmos, and significant oral findings including high-arched palate, malocclusion, and dental crowding. Bilateral surgical scars from previous syndactyly correction were present, with residual deformities of the hands and feet. Laboratory evaluation demonstrated normal thyroid and gonadotropin profiles. Pelvic ultrasound showed normal uterus and ovaries with multiple immature follicles. She was referred for orthodontic assessment and multidisciplinary follow-up.
Conclusion: Apert syndrome is a multisystem disorder that requires coordinated, lifelong management. This case emphasizes the importance of early and continuous dental surveillance, endocrinological monitoring, and psychosocial support in optimizing outcomes for adolescents with Apert syndrome