Kurdistan Journal of Applied Research (KJAR)
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Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital
Get PDFDiagnosis of acute appendicitis can be challenging in some cases as the differentials can be exhaustive. Previous studies have demonstrated that hyperbilirubinemia is a more specific marker for appendicitis than white blood count (WBC) and C-reactive protein (CRP), but this investigation is still not commonly used in the diagnostic workup of appendicitis. This prospective study aims to evaluate serum bilirubin as a laboratory marker for simple and complicated appendicitis. We also investigated the diagnostic value of bilirubin in acute appendicitis and compared it with the WBC. In this prospective study, all patients who underwent appendicectomy at the Sulaimani Emergency Teaching Hospital between 1st November 2016 to 1st January 2017 were included. Preoperative total serum bilirubin was measured and compared with the final histopathology report. Patients were divided into 3 groups: non-inflamed appendix, simple appendicitis and complicated appendicitis. One hundred and 75 patients were analysed, 90 of them were females and 85 were males. Hyperbilirubinemia was found in 63% of patients with complicated appendicitis (p=0.001). Mean of bilirubin was significantly different between patients with complicated appendicitis and non-complicated appendicitis (1.101 vs 0.75 mg/dl; p= 0.0017). Bilirubin had a higher specificity (85%) than WBC (36%), but a lower sensitivity (63% vs 89%) for differentiating complicated appendicitis. Patients with suggestive features of acute appendicitis and raised serum bilirubin indicate a complicated case requiring early intervention to prevent peritonitis and septicaemia. Hyperbilirubinemia is a good indicator for complicated appendicitis and serum bilirubin measurement can be included in the work up of patients with suspected appendicitis.  
Assessment of Knowledge, Attitude and Breast Self-Examination Practice among Female Students in Sulaimani Polytechnic University
Get PDFBreast cancer is the most common cancer affecting women all over the world. it is estimated to account for around 25% of all malignant in women, and incidence shows continuously increasing trend in many countries all over the world. The aim of the study is to determine level of knowledge, awareness, and BSE practice for breast among SPU female students. A descriptive study was conducted a pre- tested questionnaire was used to determine knowledge, attitude and practices of female students in SPU regarding breast cancer and BSE. The face to face interview questionnaire was filled by systematic random sampling to 216 female students from 4 different colleges belongs to SPU, after getting verbal consent to participate voluntary in the study. Data were entered into Epi-data version 3.1.1 and exported to analyse in SPSS version 17. Descriptive analysis was performed and frequencies and percentages were reported. The mean age of participants was 20.7, the study result shows that the knowledge mean score of participants was 3.95 (SD ± 1.78).181(83.8%) have information of breast cancer, and 157(72.7%) have information on breast cancer sign,136(63.0%) have information on factor that increase change to get breast cancer,150(69.4%)have information on (BSE),86(39.8%)have information how to do (BSE),101(46.8%)have information on mammography .91(42.1%)practice of (BSE), only 10 ( 4.6 %) female students has performing this examination regularly , percentage of students that did not done mammography was 193 (89.4%) . only 2 (0.9 %) performs mammography screening regularly, 18 (8.3 %) have a family member that get breast cancer. Knowledge of female student about breast cancer was at unsatisfactorylevel. Knowledge of female student about S.B.E was also at unsatisfactory level. Poor practice was observed, regarding BSE. Knowledge regarding mammography was also poor
Total Colectomy with Subtotal Proctocolectomy of High Risk Colorectal Cancer Patients
Get PDFLynch syndrome is known by an early incidence colorectal cancer and comparatively common synchronous and metachronous neoplastic polyps or cancer or both. The aim of the current study to explore the beneficial of prophylactic colectomy in high risk patients with colorectal cancer. The medical records of 42 colorectal patients whom underwent surgery between 2006 and 2017 of the above hospitals diagnosed as colorectal cancer diseases were retrospectively reviewed. A Structured interview questionnaire was used. The questionnaire was including information on Socio- demographic data such as; age, gender, address, occupation and marital status. In addition, data on the presentation of the disease was obtained and data on complications and post-operative outcomes were also recorded. 42 patients were studied and the mean age ±SD of their age were 49.5± (10.2), 52.4% were male and 47.6% were female.76.1 % of the patients present with a bleeding per-rectum,71.4, 66.6, 61.9 present with abdominal pain, change in bowel habit and abdominal pain respectively. Abdominal mass and rectal mass were 11.9 and 9.5, the most common site of cancer was sigmoid, rectum and caecum 26.19, 14.3 and 11.9 respectively. The post-operative outcome was very less among patients, wound infection, seroma, incisional hernia and chest infection (7%, 7%, 4% and 4% respectively. We concluded from the current study that colorectal cancer with the technique of prophylactic total colectomy with or without subtotal proctectomy that increase the survival, decrease the morbidity and make the endoscopic follow –up easier and more comfortable to the patients for short and long follow-up interval. 
Role of Interleukin-28B in clearance of HCV in acute and chronic hepatitis patients in Kirkuk city
Get PDFA cross sectional study was conducted in Kirkuk city from June 2017 to March 2018. The number of hepatitis patient understudy were 62 hepatitis C (27 acute and 35 chronic) whose ages were between 20-75 years old. The purpose of this study was to evaluate the effect of IL28B in the clearance of HCV. These patients admitted to Hepatology and Gastroenterology centers of Kirkuk. The control group who were matched to the patients studied, included 30 individuals who admitted to blood bank for blood donation, for molecular test of HCV Real-time quantitative test and serum IL-28B ELISA. The study exhibited that 81.48 % of acute HCV patient who positive by ELISA were positive by PCR and 82.86 % of chronic HCV patients were positive by PCR with highly significant relation between them. Regarding the relation of IL-28B with HCV infection, the study presented that the highest mean of IL-28B was recorded among PCR –ve acute HCV patients (17.78 pg/ml) followed by PCR +ve acute HCV and the lowest means was found in the control group with highly significant differences among the groups. The study indicated that the highest mean of IL-28B was recorded among PCR –ve chronic HCV patients (17.78 pg/ml) followed by PCR +ve chronic HCV and the lowest means was found in the control group with highly significant relation. The study showed that the highest mean of ALT and AST were found in acute HCV patients (72.06 and 36.73 IU/ml) respectively followed by chronic HCV and the control group with highly significant relation among the groups
Evaluation the Efficacy of ELISA IgG, IgM and IgA Tests for Diagnosis of Helicobacter pylori
Get PDF It has been well recognized throughout the world that Helicobacter pylori is the main cause of gastric ulcer and stomach carcinoma. Laboratory diagnosis of H. pylori infection is made by invasive and non-invasive methods. Invasive methods require endoscopy which is uncomfortable an unacceptable by the most patients. Therefore, non-invasive methods particularly serological tests are easier and comfortable for patients. A total of 86 patients with ages ranging from 18-77 years old (43 males and 43 females) who were referred to the Duhok Hepatology & Gastroenterology center/Azadi Teaching Hospital for endoscopic examination from June to October, 2013 were enrolled in the study. From each patient 5 ml of blood was collected under a septic condition and sera were separated for serology. Data from each participant were recorded in a special questionnaire form after consent agreed upon on ethical and scientific committee of the Azadi hospital. The efficacy of three different ELISA tests (IgG, IgM, IgA) was assessed taking culture as a gold standard method. pylori was found in 70.93%, 30.23% and 5.81% by ELISA IgG, IgA and IgM tests respectively. The highest percentage (70.93%) of H. pylori positive cases were found by ELISA IgG and the lowest percentage (5.81%) was recorded in ELISA IgM. The study found a significant relationship between age groups and H. pylori positive cases by ELISA IgG in which positive cases increased with the increase of ages.
No statistical correlation was found between the sex, smoking status and residency of studied patients with H. pylori infection. A significant correlation was found between patients without endoscopic lesions and positive cases for H. pylori by ELISA IgG in which 75.67% of patients without endoscopic lesions were positive for anti-H. pylori antibodies compared to 41.66% in patients with endoscopic lesions.
The efficacy of IgG, IgM and IgA tests was calculated compared with golden standard tests and ELISA IgG characterized by the highest values of sensitivity (75.75%), negative predictive value (36.00%) and accuracy (86.00%) but with lowest specificity (45.00%) and similar positive predictive value (81.96%) with IgM and IgA. The lowest sensitivity was 5.97% and accuracy 25.56% with ELISA Ig M. From the results of the present study we can conclude that among ELISA tests, anti-H. pylori IgG is a reliable serological test for the diagnosis of H. pylori infection
Effect of manganese and ascorbic acid on the growth and yield of faba bean (Vicia faba L.)
Get PDFThis study was carried out in field of Halabja technical college of applied sciences, Sulaimani polytechnic university, during the year 2015-2016. The objective of the study is to investigate effect of the foliar application of manganese and ascorbic acid on the growth and yield of (Vicia faba L.).The experiment contains nine concentrations and combination Mn and AsA were applied, using complete randomized block design with three replicates. The highest value of yield and number of branches were 160 g, 4.11 and 4.46 when plant applied Mn 40 ppm+ AsA 60 ppm. The maximum number of pods per plant (6.23) was given from T5 Mn 20 ppm+ AsA 30 ppm. Highest seed per pods was obtained from T8 (2.26), and the maximum 100-seeds weight was received from T2 AsA 30 ppm (45.43 g). Thus, the greatest weight of pods was found from control and T2 AsA 30ppm (13.4 g). The best length of pods and height of plant were given from both T4 Mn 20ppm and T3 AsA 60ppm (9.49 cm) (106.87 cm) respectively. The lowest seed per pods, 100-seed weight and length of pods were given from control 1.71, 36.86 g and 8.06 cm. Then the minimum yield, weight of pods, plant height, number of branches and number of pods were given from T8, T4, T5and T9 ( 41.66 g, 10.10 g, 81.98 cm, 3.25 and 4.46). From the results in this study we can recommend to applied more studies for micronutrients about different crops
Evaluation of Four Tomato Genotypes Resistance to Root-Knot Nematode
Get PDFThe root-knot nematode incited by Meloidogyne incognita is one of the top diseases affecting tomato production worldwide. Nematicides can be effectively used to control the disease, but is costly and harmful to human life and environmental pollution. Alternatively resistant cultivars can be used inexpensive and eco-friendly. Resistance evaluation of five tomato cultivars (Red Rock, King Rock, Presto F1, Super Queen and Super Regina) were tested using randomized complete block design with five replications and three nematode inoculums (0, 500 and 1500 egg/second juvenile per pot). The statistical analysis gave significant differences among the genotypes, nematode densities level with their interactions. Among genotypes, Red Rock recorded significantly highest plant height (57.0) cm, Presto F1 (37.8) cm, King Rock (35.2) cm, Super Regina (30.1) cm and Super queen showed lowest (25.4) cm. As an alternative for managing the nematodes, further experiments are required in the field for applying plant resistances
Outcome and Management of Sepsis at RozhHalat Emergency Hospital in Erbil –Kurdistan region of Iraq
Get PDFSepsis is a very common condition in emergency hospitals and presentation is variable, it is under diagnosed with very high mortality rate. All patients with infection are at risk of developing sepsis.
Sepsis is a complex condition characterized by activation of inflammatory process and coagulation system in response to microbial insult. An observational prospective study was carried out at RozhHalat emergency hospital in Erbil-Kurdistan region of Iraq between February 2017 to January 2018.The study was approved by the scientific and ethical committee of Kurdistan board of medical specialties. 50 patients aged between (10 - 80) years old presented to this hospital with sign and symptoms of infection were recruited to this study. 50 patients with signs and symptoms of sepsis were recorded in this study. The mean age was 47 with male to female ration of 2:3 (42% male and 58% female). The overall mortality rate was high at 68% with higher rate among female and older age group. The blood culture was positive in 74% of cases of which 52% were gram positive and 22% were gram-negative microorganisms. A Positive blood culture associated with higher mortality rate of 81% compared with 21% if the blood culture was negative. In majority of cases the site of infection was from multiple source (34%) followed by respiratory infection (26%).Skin and soft tissue infection was associated with the lowest mortality of 2.9%. High number of cases (82%) developed complications and 52% of cases developed more than 2 organ failures. All patients received empirical antibiotic therapy however 46% of cases received the wrong antimicrobials. The survival rate was higher
(44%) among patients given the right antibiotics. Similarly patients had better chance of survival if appropriate fluid resuscitation therapy was give. The overall mortality among vasopressor treated patients were 72% compared with 78% chance of mortality if they were not treated with any vasopressor therapy, among those who received inotropic support Noradrenaline associated with higher survival rate(72%). A qSOFA score of more than 2 associated with 86.4 % of mortality compared with 75.5% mortality with similar SIRS criteria. Factors associated with high mortality were: female gender, older age group, positive blood culture, wrong antibiotics therapy, less fluid resuscitation, multisource of infection, multi-organ failure, high lactic acid level and high qSOFA score. This study shows that sepsis is associated with high overall mortality rate of 68% in the RozhHalat emergency hospital and higher rate of death among female and older age group. Negative blood culture, appropriate use of antibiotics and fluid therapy associated with better chance of survival. Vasopressor therapy did not result in better survival outcome except for Noradrenaline. The qSOFA score is as good as SIRS criteria in predicting mortality. High lactate, multi-organ failure and multisource of infection associated with the worst outcome
The Effect of Planting Distance and Spraying with Different Concentrations of (Micronate15) on Vegetative Growth and Yield Traits of Pea Plant (Pisum Sativum L.)
Get PDFThe aim of this study was to find the effect of planting distances and spraying with different concentrations of leaf fertilizer with micronate15 on some vegetative growth traits and yield of pea variety Green Canada in non-heated greenhouses, by using three planting distance (factor A) which includes: A1:20, A2: 30, and A3:40 cm and four spray concentrations as foliar application (factor B) which includes: B0: zero, B1: 0.5, b2: 1.5 and b3: 2.5 liter of water). According to the results of this study the highest plant (124.82cm), number of branches (4.58), fresh weight,(95.94 g) and the total yield (142.41 g)were observed in the distance of planting (30 cm), while the highest value of the pod length was observed from the distance planting in 40 cm which is 8.39 cm. The concentration of 1.5 mL / liter of micronate15 gave the highest values of branches 4.53 branches, fresh weight 97.47 g, number of pods 36.73 pods, number of seeds 8.55 oats, length of the pod 8.83 cm and the total yield 150.78 g. The highest values of the number of branches 5.14 branch, fresh weight 105.72 g, the number of seeds 8.90 seed and the total yield 159.78 g were observed from the interaction between the planting distance of 30 cm and 1.5 mL / liter of nutrient micronate15. Also, the interaction between 20 cm distance and foliar application with 2.5 mL l of micronate15 gave the highest value in the number of leaves which is 53.36
Effect of Low Dose Aspirin in Low Risk Pregnant Ladies with Abnormal Uterine Artery Doppler Results, and the Evaluation of Maternal and Fetal outcomes: A Randomized Clinical Trial
Get PDFThis study aimed to identify the effect of low dose aspirin administration in low risk pregnant ladies who have abnormal uterine artery Doppler results. Patients and Methods: A randomized clinical trial was performed on 50 pregnant ladies (?16 weeks of gestation) in Sulaymaniyah Maternity Teaching Hospital during January 2017 to January 2018. The participants were randomly enrolled into two groups; the participants in the first group were given 100 mg of aspirin tablet each but the other group was given nothing. Results: Preeclampsia was significantly (P-value of <0.001) less in the aspirin group as compared to the other group (16% and 40% respectively). The pulsatility index (PI) was not significantly different in both the groups (P-value = 0.69), but resistance index (RI) was significantly lower in the aspirin group (P-value of <0.001). Conclusion: Doppler study of the uterine artery at 16 weeks or higher in low risk pregnant women appears to be useful as a screening test and low dose of aspirin therapy at early stage of pregnancy will decrease the incidence of preeclampsia.