Objective: To compare the efficacy and safety of isosorbide mononitrate (IMN) versus misoprostol used to induce labour for overdue pregnancy.
Setting: A prospective randomized clinical study conducted at AL-Elwiya Maternity Teaching Hospital in Baghdad from Jan. 2008 to Dec. 2008.
Method: One hundred and fifty women with over due pregnancy (past date and posterm pregnancy) referred for induction of labour with Bishop scores <_ 5 were randomly allocated to receive either forty mg isosorbide mononitrate (IMN) tablet as a single vaginal dose (n=75) or fifty mcg misoprostol vaginally (n=75) every six hrs for a maximum of three doses. Amniotomy and/or oxytocin infusion is considered when Bishop scores frankly progressed (augmentation) or used when no improvement achieved after 24 hour (induction). Adverse effects of medications, induction - delivery interval, mode of delivery and neonatal outcome were recorded and subjected to statistical analysis.
Results: Isosorbide mononitrate was associated with less adverse effects than misoprostol especially regarding uterine tachysystol (0 with isosorbide mononitrate vs 12% with misoprostol, P<0.01) and hyperstimulation (0 with isosorbide mononitrate vs 16% with misoprostol, p<0.01) but the induction - delivery interval with isosorbide mononitrate group was significantly longer compared with misoprostol (26.3±7.3hrs vs 15.4±5.4 hrs , p<0.01). Oxytocin was added to 70 women (93.3%) used isosorbide mononitrate while to 15 women (20%) used misoprostol (p<0.001). Caesarean rate was not significantly different between the two groups, but the indications were different, dystocia is the major cause (73.3%) with isosorbide mononitrate while persistent non-assuring fetal heart rate pattern (64%) in the misoprostol group.
Conclusion: Cervical ripening and induction of labour using isosorbide mononitrate resulted in fewer adverse effects but it was less effective than misoprostol.
Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies.
Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis..
Resu
... Show MoreThis paper aims to find out if FOXP-3 was expressed in samples from Iraqi cervical cancer patients. Expression of FOXP-3 was detected in 55 cervical tissue samples by immunohistochemistry. Since thirty-five cases of aggressive cervical cancer were included, along with 20 normal samples used as controls. The nucleus and cytoplasm levels of FOXP-3 were counted, considering the ratio of positive cells and intensity. FOXP3 cytoplasmic staining was found in 27 out of 35 cases. Only 11 out of 35 samples displayed nuclear lymphocyte staining. Furthermore, four samples expressed this marker in both the nuclear and cytoplasm of the cervical cells. There is a highly significant difference in FOXP3 expression in the cytoplasm of
... Show MoreBACKGROUND: Coronavirus current pandemic (COVID-19) is the striking subject worldwide hitting countries in an unexplained non-universal pattern. Bacillus Calmette–Guérin (BCG) vaccine was an adopted recent justification depending on its non-specific immune activation properties. Still the problem of post-vaccine short duration of protection needs to be solved. The same protective mechanism was identified in active or latent tuberculosis (TB). For each single patient of active TB, there are about nine cases of asymptomatic latent TB apparently normal individuals living within the community without restrictions carrying benefits of immune activation and involved in re-infection cycles in an excellent example of repeated immunity tr
... Show MoreBack ground: In Iraq, after 2003 had more
accidents of the shell, bullet and stab abdominal
wounds, more over colon injuries.
Objective: The aim of this study is to evaluate
the most appropriate management of penetrating
colon injuries, comparing the primary repair with
the diversion.
Methods: Eighty patient series with shell, bullet
and stab colonic injuries during 4.5 years period
from June 2006-december 2010 at Al-Yarmouk
teaching hospital. The study compared the use of
primary repair versus diversion, analyzing
variables such as sex, age, severity of injury and
mortality rate.
Results: there were total 80 patients ,62 (77.5%)
male and 18(22.5%) female .male :female ratio
3.4:1. the most
Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the
Background: Alveolar ridge expansion is proposed when the alveolar crest thickness is ≤5 mm. The screw expansion technique has been utilized for many years to expand narrow alveolar ridges. Recently, the osseodensification technique has been suggested as a reliable technique to expand narrow alveolar ridges with effective width gain and as little surgical operating time as possible. The current study aimed to compare osseodensification and screw expansion in terms of clinical width gain and operating time. Materials and methods: Forty implant osteotomies were performed in deficient horizontal alveolar ridges (3–5 mm). A total of 19 patients aged 21–59 years were randomized into two groups: the screw expansion group, which invo
... Show MoreBackground: long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment, several studies have correlated poor outcome with malalignment of the components. The debate on the optimal system for femoral alignment is now largely resolved, but there is still controversy about whether intramedullary or extramedullary systems are better for the tibial side.
Objecives : is to determine whether intramedullary or extramedullary tibial alignment guide is better for accurate sagital tibial prosthesis alignment in total knee replacement arthroplasty.
Patients and methods: Of 65 patients recruited, only 48 patients (55 knees) were met the
... Show MoreObjective Using two complementary techniques of virus detection human papillomavirus (HPV)[capture of hybrids (CH) and polymerase chain reaction (PCR)], relate the cytological study and/or cervical biopsy with high-risk HPV (HPV-HR) genotypes presence, as well as relating their viral load (VL). Methods About 272 women, who presented most cell alterations compatible with lesions cervical HPV, which has been detected in all high risk by the CH method and HPV genotype detection by PCR. Results In 22% of the patients it was not detected HPV DNA. Genotype 16 and/or 18 was prevalent and was found in 33% of the 212 women studied, meanwhile, mixed infections were found by several genotypes in 25%. In as for the histological lesions found, in 61 pat
... Show MoreBackground: Sonographic examination is an important tool in assessment of normal and abnormal cervical lymph nodes. The aim of the study is to assess the distribution and the characteristic features of normal cervical lymph nodes in a sample of Syrian population. Materials and Methods: Fifty healthy Syrian subjects (25 men and 25 women) with an age of 20 -60years old, who had their cervical lymph nodes examined by ultrasound. Three hundred and two lymph nodes were detected. Lymph nodes were evaluated for their number, size, site, echogenic hilus, shape, as well as for the border sharpness. The subjects were categorized by age into four groups, (20 -30, 31 - 40 , 41 - 50 , 51- 60 years ). Statistical analysis of data was done using SP
... Show MoreThe design of this paper is to find the possible correlation of Epstein Barr virus infection ina group of Iraqi women with cervical carcinoma though detection of Latent Membrane Protein 1 (LMP1) in these cervical tissues. Paraffinized blocks of two groups were included. The first sample of 30 cervical carcinomatous tissues and 15 biopsies from an apparently normal cervical tissues. All the samples were sectioned on a positive charged slides with 4 mm – thickness then submitted for immunohistochemical (IHC) staining to detect viral LMP1 expression. Sixty three percentage (19 out of 30) of the studies group showed positive overexpression as shown in with a significant association of the expression with cervical cancer with a significant ass
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