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Basrah journal of surgery ( An Open Access Journal ) indexed in DOAJ poblished biannually in June and December  scientific, open access journal licensed under a Creative Commons Attribution 4.0 International (CC-BY 4.0) journal is published biannually by University of Basrah, College of Medicine, Iraq since 1995. The edittor utilizes iThenticate to check  plagiarism and to ensure the originality manuscripts submitted to this journal. A double-blind peer reviewing system is also used to assure the quality of publication. Basrah Journal of Surgery publishes original articles,...
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Journal Information

Publisher: College of Medicine, University of Basrah

Email:  basra.journalsurgery@uobasrah.edu.iq

Editor-in-chief: Professor Dr. Murtadha Almusafer

Print ISSN: 1683-3589

Online ISSN: 2409-501X

A comparison between rural and urban residents attending Basrah Dental College south of Iraq for tooth extraction between 2018-2021 and its relation to the dental health care situation in Iraq

Sundus Abdul Wadood Aljazaeri

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 2-13
DOI: 10.33762/bsurg.2022.133215.1021

Abstract
Most studies confirmed caries are the main cause of tooth extraction in urban and rural areas, especially in young people. There is a relationship between the level of education and dental extraction, particularly in rural areas. In this cross-sectional examination overall 1257 patients were treated in the teaching clinic of the oral and maxillofacial surgery department, College of Dentistry, the University of Basrah between 2018-2021. Data were collected from patients' data after taking the agreement of the ethical committee in the college. The comparisons include age, gender, educational level, occupation, chief complaint, diagnosis and tooth site. reasons and pattern of tooth loss were recorded and data were computed on SPSS. Version 20. The numbers of tooth extraction in urban and rural were very close 632(50.3%) and 624(49.7%) extractions respectively. The male to female percentage was 38.2 %, 61.8% respectively and the highest number of extractions was observed in females in rural areas most of the patients are a housewife. Tooth extraction has seen more in the third, fourth and fifth decade than other age groups 20.4%, 22%, 19.9% respectively. A significant difference between education and dental extraction was noted between urban and rural areas. The main complaint was for prosthetic therapy 45.3% and 43.2% because of pain. The largest proportion considered as the main cause of extraction was dental caries consequences of 80.5% and the lowest 16.9% from periodontal disease.
Key Words: Extraction, Rural, Urban, dental health care, First Molar.

ASSOCIATION BETWEEN URINARY TRACT INFECTION AND PRETERM LABOUR A PROSPECTED STUDY IN BASRAH MATERNITY AND CHILD HOSPITAL

Edewar Z.Khosho; Huda Abbas Jabbar AL.Sharae; Iman Sadiq Abd Alla

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 14-17
DOI: 10.33762/bsurg.2022.174668

Preterm birth is complex condition with multiple risk factors and substantial medical, psychological , economic and social impacts. Preterm is also the most important determinant of short and long term morbidity in infant and children. The aim of this study is to determine the association between preterm labour and urinary tract infection, parity, socioeconomic state, locality and degree of education. A prospective descriptive study had been carried out in Al-Basrah Maternity and Child Hospital from 1st of February 2020 to 1st of October 2020 which include (100) pregnant women admitted to labour room and had spontaneous preterm labour, they evaluated clinically and by investigations . The percentage of urinary tract infected women is 62% among total women with preterm labor, 38% of women had no Urinary Tract Infection (UTI). The UTI diagnosed by presence of 10 or more pus cells and / or bateruria (10) 5 or more . Sixty three percent of women was primgravida and 37% of them was multigravida (not more than gravida 3). Forty-two percent of women was from city center and 58% of them from peripheral areas. Forty-One percent of women have high education level define by having secondary school and more and 59% of them have low education level. Fifty-Eight percent of women having low income defined by family income less than 600000 iraqi dinar and 42% of them have high income. The study showed strong association between preterm labour and urinary tract infection, so we advise to do it on large number of patients to prove the relationship between preterm labour and urinary tract infection. 

Risk factors among patients with ovarian cancer attending oncology hematology center in Basrah city

Rasha Ahmed

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 18-24
DOI: 10.33762/bsurg.2022.132631.1017

Worldwide, approximately 225,500 ovarian cancers are diagnosed annually . The leading cause of gynecological cancer death (140,200 worldwide annually) is the ovarian cancer, which accounts for more deaths than all the other gynecological cancers combined. The ovarian cancer is the fourteenth commonest cancer among population in Basrah city in Iraq.
Methods This is a case control study carried out in the Basrah oncology –hematology
center and primary health care centers in Basrah city . The study include 103 cases of ovarian cancer and 206 control.
Result we found that more than half of case of ovarian cancer aged 50 years and above. History of insulin treatment is a risk factor for ovarian cancer (OR more than one) with significant statistical association. Hysterectomy and tubal ligation are protective against ovarian cancer .
Conclusion There are many risk factors of ovarian cancer some of these are modifiable while the others are not modifiable. Hysterectomy and tubal ligation considered as protective factors.

ENDOSCOPY IN THE EVALUATION OF PATIENTS WITH UPPER GASTROINTESTINAL SYMPTOMS(DYSPEPSIA).

Hussein Abdul- Jabbar Alkatrani; Mansour Amin Mohammad

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 25-29
DOI: 10.33762/bsurg.2022.174669

A Retrospective study includes records of 1832 patients with dyspeptic symptoms who underwent endoscopic examination in Al-Mawani Teaching Hospital during the period from October 2015 - October 2019 were analyzed. 942 (51.4%) were males and 890(48.6%) were females, 794 (43.3%) had no endoscopic abnormalities,1038 (56.7%) had endoscopic finding. Oesophagitis was seen in 149 (8.1% ) patients , gastritis was seen in 603 (32.9%) patients, duodenal ulcer was seen in 257(14%) patients with male to female ratio (1.8:1) and peak age group between (20-40) years. Gastric ulcer was seen in 47 (2.5%) patients with male to female ratio (1.2:1)and peak age group between (40-60) yrs, and ratio of duodenal to gastric ulcer was (5.5-1). Combined duodenal and gastric ulcer was found in 4(0.2%) patients, gastric cancer was found in 10 (0.54%) patients with peak age group between (50-70) years. It is concluded that endoscopy is golden standard test for diagnosis of gastroduodinal pathology

BREAST CANCER AND MITOCHONDRIAL DNA MUTATIONS IN KURDISH WOMEN: A CASE-CONTROL STUDY FROM SULAYMANIYAH, IRAQ.

Han Nihad Mohammed Fadhl; Dlshad A. Rashid; Farhad M. Abdulkarim

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 37-45
DOI: 10.33762/bsurg.2022.174671

The molecular basis of breast cancer has been thoroughly investigated in the last decade. Many nuclear susceptibility genes were discovered. Moreover, research about mitochondrial DNA (mtDNA) mutations and mitochondrial haplogroup determinants (single nucleotide polymorphism; SNP) has explored their potential role in cancers in general and breast cancer in particular. This study is to identify breast cancer-related SNPs and mtDNA haplogroups among Kurdish women living in Sulaymaniyah/Iraq. This case-control study was conducted in Kurdistan Institute for Strategic and Scientific Research (KISSR) / Molecular Lab in Sulaymaniyah in collaboration with a specialized lab in South Korea. Twenty women with breast cancer and 20 women with benign breast diseases were enrolled. The entire mitochondrial genome of 40 breast tissue specimens was sequenced. Haplogrep 2.0 was utilized for haplogroup identification. Statistical Analysis was performed using Chi-square and Fisher’s exact tests. A total of 547 mutations (Cancer, n=344 and Control, n=203) were identified including 15 first-reported mutations. HV haplogroup in the cancer samples was a risk factor for the development of breast cancer (p=0.002) compared to H haplogroup in the control samples (p =0.006) (Odd Ratio [OR] = 28.00). Furthermore, SNP (A8860G) was an additional risk compared to other randomly selected SNPs (A750G, A1438G, and C7028T) (p ˂0.05 and OR >1). In conclusions; the association of certain mtDNA haplogroups and SNPs with breast cancer risk is not new. Unlike studies performed in other populations of the world figuring out A10398G as the risky SNP, our study identified A8860G in the Kurds. Geographic and ethnic variations between human populations do exist, so an SNP that is common in one population group may be much rarer in another. Hence, more research on the molecular biology of breast cancer in our locality is warranted to clarify the situation.

PROFILE OF MICROORGANISM AND ANTIBIOTIC SENSITIVITY PATTERN IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY FOR PERITONITIS

VISHNU JAYAPRAKASH; POORVI SHARMA; RAJGOPAL SHENOY; SUNIL KRISHNA M

Basrah Journal of Surgery, 2022, Volume 28, Issue 1, Pages 46-60
DOI: 10.33762/bsurg.2022.132161.1015

BACKGROUND: Peritonitis is one of the common emergencies and multiple organisms have been implicated in the pathogenesis. Inappropriate and prolonged use of antibiotics have been attributed to the emergence of antibiotic resistance. METHODS: Retrospective observational study, from 1st January 2018 to 31st December 2019(Two years). Patients with secondary peritonitis undergoing surgery are included in this study. Common pathogens and its antibiotic sensitivity pattern from peritoneal fluid, blood and surgical site were studied. RESULTS: Perforation peritonitis is the most common cause of peritonitis. Cefaperazone-sulbactum and Piperacillin-tazobactum were the common empirical antibiotics prescribed. Escherichia coli followed by Klebsiella pneumonia were the commonest microorganism isolated from the peritoneal fluid and found to have adequate sensitivity for the empirical antibiotics. Enterococus and candida were the common organism isolated in blood culture. E-coli and Klebsiella from wound swab showed higher resistance to the empirical antibiotics. Large intestine perforation has higher percentage of surgical site infection. CONCLUSION: E-coli and Klebsiella pneumoniae were the common cause of secondary peritonitis. The empirical antibiotic is shown to be sensitive to the common organism isolated from peritoneal cavity. Wound swab isolates have shown higher resistance to antibiotics hence isolating the organism and assessing the sensitivity might be prudent. Due to geographical variation of antibiotic resistance trends to microorganism, it is prudent to have antibiotic surveillance on a local basis that can recommend appropriate antibiotics.

TO TREAT OR TO SATISFY THE PATIENT; WHICH ONE IS THE BEST?

Thamer A Hamdan

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 1-2
DOI: 10.33762/bsurg.2017.141312

L
uckily, there is increasing interest in patient satisfaction in the present days. Many writers started differentiating between the two issues; treatment or satisfaction. Patient satisfaction is a top priority and it should be the target. Perfect treatment is not always satisfactory to the patient. Some surgeons, sadly, spoil their ideal treatment by misconduct. They are good enough to offer treatment, but not good enough in performing the art of communication, which is really vital. They do not know how to respect the dignity, the honor and rights of the patient. The first meeting is the key for success in achieving life-long friendship or, on the other hand “putting salt on the wound”

SILENT OSTEOPOROSIS IN ASSOCIATION WITH OTHER ORTHOPEDIC DISEASES

Thamer A Hamdan; Mubder A Mohammed Saeed; Saad J Abdulsalam

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 3-8
DOI: 10.33762/bsurg.2017.141313

Thamer A Hamdan*, Mubder A Mohammed Saeed# & Saad J Abdulsalam@
*FRCS, FRCP, FACS, FICS, Professor Of Orthopedic Surgery, Chancellor of Basrah University. #FICMS, Assistant Professor Of Orthopaedic Surgery, Basrah General Hospital, @FACMS, Orthopedic Surgeon, Al-Karkh General Hospital, Baghdad.

Abstract
Osteoporosis is the most common metabolic bone disease. It is a major global health problem that increases dramatically as people getting older than before because of good health services.
The aim of the study is to assess how far osteoporosis is associated with orthopedic diseases and to increase the awareness in the mind of orthopedic surgeons for osteoporosis in patients who are not suspected apparently to have this disease.
A sample of 522 patients referred to Dual-energy X-ray absorptiometry (DXA) clinic by orthopedic surgeons or rheumatologists was taken during a seven months period, in two centers, Basrah, 259 patients and Mosul, 263 patients. All the patients had back pain, joint pain, bone pain, fracture or other musculoskeletal complains. The only method used to assess osteoporosis in our patients was the DXA scan.
Of the total 522 patients, the results of DXA scan was normal in 136 patients (26%), osteopenia in 178 patients (34%), and osteoporosis in 208 patients (40%). Back pain was the main cause of referral 184 (35%), followed by joint pain 138 (26.5%), bone pain 74 (14%), fracture 28 (5.5%), and others 98 (19%).
In conclusion, osteoporosis may be a silent disease, even in patients with complains like joint pain, bone pain, or radicular symptoms.

COMPARATIVE STUDY BETWEEN STAPLER AND HAND SEWING IN GASTROINTESTINAL ANASTOMOSIS

Mustafa Adnan Maatooq; ssam Merdan

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 21-25
DOI: 10.33762/bsurg.2017.141316

COMPARATIVE STUDY BETWEEN STAPLER AND HAND SEWING IN GASTROINTESTINAL ANASTOMOSIS

Mustafa Adnan Maatooq* & Issam Merdan@
*MB,ChB, Board candidate, Al-Sadir Teaching Hospital, Basrah. @MB,ChB, FICMS, CABS, Professor of Surgery, Department of Surgery, College of Medicine, University of Basrah, IRAQ.

Abstract
Gastrointestinal anastomosis is an important part of gastrointestinal operations and can be achieved by hand sewn anastomosis or by the newly developed staplers.
The study aims to compare between the two surgical methods of anastomosis in a prospective , randomized design, regarding: operation time, post operative hospital stay and the incidence of post operative anastomotic leak in both groups. The study was carried out in Department of Surgery at Alsader Teaching Hospital in Basrah, Iraq from October 2015 to December 2016, it included 40 patients of both gender and with a different age, they divided into 2 groups (hand sewn and stapler groups), each group included 20 patients, comparing the following parameters: time of anastomosis, duration of surgery, post operative leak and hospital stay.
There were no significant differences in the age, gender distribution, the indication for resection, post operative anastomotic leak (p=1) and hospital stay (P Value 0.15 ) in both group but there was significant differences in duration of anastomosis (P Value0 .00001) and operation time (P Value 0.00001). Our study concluded the superiority of stapler on hand sewing in gastrointestinal anastomosis in term of reducing operative time.

A COMPARATIVE STUDY BETWEEN HARMONIC SCALPEL HEMOSTASIS AND CONVENTIONAL HEMOSTASIS IN TOTAL AND SUBTOTAL THYROIDECTOMY

Mohammed Salim Mohammed; Jasim D Saud; Mansour Amin Mohammed; Mazin H Al-Hawaz

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 15-20
DOI: 10.33762/bsurg.2017.141315

A COMPARATIVE STUDY BETWEEN HARMONIC SCALPEL HEMOSTASIS AND CONVENTIONAL HEMOSTASIS IN TOTAL AND SUBTOTAL THYROIDECTOMY

Mohammed Salim Mohammed*, Jasim D Saud#, Mansour Amin Mohammed$ & Mazin H Al-Hawaz@
*MB,ChB, Board Candidate. #MB,ChB, FICMS, CABS, Consultant Surgeon, Basrah General Hospital. $MB,ChB, DS, CABS, MRCS, Lecturer, Dept. of Surgery, College of Medicine. @ MB,ChB, CABS, DGS, FRCS, Prof. of General Surgery, Basrah Medical College., Basrah, IRAQ.

Abstract
Thyroid gland is highly vascularized organ, so good hemostasis during total or sub-total thyroidectomy is crucial to decrease the complications and to improve the outcome.
This study aimed to evaluate the advantages and disadvantages of using harmonic scalpel device in comparison with conventional hemostasis for total and subtotal thyroidectomy in terms of operative time, nerves injury, post-operative blood loss, hematoma development, hypocalcemia and length of hospital stay.
This study included 80 patients who underwent total or subtotal thyroidectomy. They were divided into two groups according to the type of hemostasis: conventional hemostasis group and harmonic hemostasis group. Different diseases were included (multinodular goiter, toxic goiter and malignant diseases).
The results showed that time of operation was significantly shorter in the harmonic hemostasis group (79.52±14.98 min) than conventional hemostasis group (100.92 ±10.64 min) with p value 0.0001, also post-operative blood loss was lower in harmonic hemostasis group (52.5±26.23 ml) than conventional hemostasis group (75.13±17.8 ml) with p value 0.0001. Other outcome such as recurrent laryngeal nerve injury, post-operative hematoma, post-operative hypocalcemia and length of hospital stay did not show significant difference between the groups.
In conclusion, using harmonic scalpel device in total or subtotal thyroidectomy reduced the operative time and post-operative blood loss, without any change in the incidence of nerve injury, hematoma, hypocalcemia and the length of hospital stay.

ENDOSCOPIC BIOPSIES , CELIAC DISEASE, SEROLOGICAL TEST

Zahraa A Hashim; Sarkis K Strak; Wassan M Jazi; Sura A AL-Namil

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 34-39
DOI: 10.33762/bsurg.2017.141318

THE VALUE OF ENDOSCOPIC BIOPSIES FROM FIRST AND SECOND PARTS OF DUODENUM IN THE DIAGNOSIS OF CELIAC DISEASE IN CORRELATION WITH A SEROLOGICAL TEST
Zahraa A Hashim*, Sura A AL-Namil@, Wassan M Jazi# & Sarkis K Strak$
*MB,ChB, Postgraduate board student. @MB,ChB, FIBMS, Consultant pathologist. #MB,ChB, FIBMS, Consultant pathologist, Al-Sadir Teaching Hospital. $MRCP, FRCPLond., FRCPI., Professor of Medicine, University of Basrah, IRAQ.

Abstract
Celiac disease is a chronic immune-mediated enteropathy of the small intestine caused by environmental exposure to gluten in genetically susceptible individuals. This study was conducted to evaluate and correlate the serological with histopathological findings of duodenal biopsies for the diagnosis of celiac disease.
Sixty-eight patients, 40 (59%) females whose ages ranged from 13-75 year (mean age 36.4 years), and 28 (41%) males whose ages ranged from 13-65 year (mean age 37.8 years), with symptoms of chronic diarrhea, weight loss, bloating and unexplained iron deficiency anemia, were tested for anti-tissue transglutaminase IgA tTG, and correlated with histopathological findings of duodenal biopsies obtained from 1st and 2nd parts according to modified Marsh's classification. Histopathological findings from the 1st and 2nd duodenal parts were also compared with each other.
The results of the 68 patients who were enrolled in the study showed that: 24(35.3%) patients tested positive for anti-tissue transglutaminase (titer >18U/ml), 37(55.8%) patients had positive histopathological changes (stage I–III). Twenty-three (33.8%) patients who had both positive anti tTG and histopathological changes were classified as a celiac disease. The sensitivity of 1st and 2nd parts of duodenal biopsies in detecting celiac disease were 83.7% and 100% respectively.
In conclusion; the histopathological changes from the 1st and 2nd parts of duodenum in detecting celiac disease were equally representative especially in stage IIIa, b, and c.

8- TONSILLECTOMY FOR THE TREATMENT OF HALITOSISY!

Zahra Kadum Saeed; Ahmed M Al-Abbasi

Basrah Journal of Surgery, 2008, Volume 14, Issue 1, Pages 37-41
DOI: 10.33762/bsurg.2008.55518

This study aimed to investigate the tonsils as an origin of halitosis and to assess the efficacy of
tonsillectomy for the treatment of oral bad breath caused by chronic tonsillitis. After excluding
dental, periodontal, sinonasal, oral, pulmonary, and gastroenterological diseases as the origin of
halitosis, fourty-four patients with halitosis caused by chronic tonsillitis which proved by positive
Finkelstein's tonsil smelling test (pressing the tonsils and smelling the squeezed discharge),
were included in the study. All patients were treated by tonsillectomy. Subjective and objective
postoperative assessment was based on self-and-family report and clinical assessment.
Patients were reviewed after 4 and 8 weeks postoperatively. Complete improvement of halitosis
occurred in 31 patients (70.4%) after 4 weeks, this value increased to 35 patients (79.5%) in the
second review after 8 weeks. It is concluded that tonsillectomy is significantly effective
procedure for the treatment of halitosis caused by chronic tonsillitis.

ANTHROPOMETRIC FACE IN BASRAH

Nada H Al-jassim; Zuhair F Fathallah; Nawal M Abdullah

Basrah Journal of Surgery, 2014, Volume 20, Issue 2, Pages 29-40
DOI: 10.33762/bsurg.2014.98486

ANTHROPOMETRIC FACE IN BASRAH

Nada H Al-jassim , Zuhair F Fathallah & Nawal M Abdullah
MB,ChB, DGO.
Anatomy.

Abstract
Anthropometry is the systematic quantitative representation of the human body, it is used to measure the absolute and relative variability in size and shape of the human body. Over the
centuries, there have been remarkable changes in anthropometric measurements due to geographical, cultural, genetic and environmental factors. The studying of human face and the
assessment of facial dimensions attract the attention of the artists, poets and scientists and takes a prime importance in medical and dental fields in both diagnosis and treatment planning.
Anthropometry also used for the design of clothing and equipment, e.g. Gas masks, oxygen masks, dust masks and respirators as well as design of military and industrial helmets. There
had been no studies done on facial measurement in Basrah therefore, this study is to be considered as the first in this field and the baseline for further studies. This study had attempted
to quantitatively measure the human face in different ethnic groups of the local population and to identify the differences between individuals of different races and sexes, also to identify the differences between the people of Basrah and other people worldwide. These differences which
are responsible for the special facial features in different ethnic groups should be maintained during reconstructive or aesthetic surgery otherwise the patients will lose their ethnic features.
The people of Basrah have different racial and ethnic background, there are Semites which are the Arabs and Syrian (Assyrian & Chaldean), Arian, who are the Armenian, Kurdish and
Persian, and then there is the mixed group result from interracial marriages.
This study is a cross sectional study with a comparative component conducted in Basrah governorate. The data was randomly collected from volunteers, for the period from February to
July 2013. Raw data used in this study was originated from a total number of 1000 Iraqi adults (526 females and 474 males) living throughout Basrah governorate and were used to create a
database for statistical analysis.
The result of this study shows that there are differences between the races and between the local people and the surrounding countries and indeed there is a great difference from the
standard measurement advocated by western researchers.

Introduction
he human face is a living mirror held
Tout to the world, it has the power to common expression is “I may forget a
name, but I’d never forget a face’
Anthropometry
quantitative representation of the human
individual
understanding human physical variations .
Over
remarkable
measurements
cultural,







Bas J Surg, December, 20, 2014
Original Article
MEASUREMENTS
OF
HUMAN

MB,ChB, MSc, Assist. Prof. Plastic Surgeon. MB,ChB, MSc, Assist.Prof. o

HEMORRHOIDAL ARTERY LIGATION WITH RECTO-ANAL REPAIR VERSUS TRADITIONAL HEMORRHOID-ECTOMY, A COMPARATIVE STUDY

Basrah Journal of Surgery, 2018, Volume 24, Issue 2, Pages 61-66
DOI: 10.33762/bsurg.2018.160090

Hemorrhoids, are vascular structures present in the anal canal as cushions that facilitate stool control. When swollen or inflamed they are regarded as hemorrhoidal disease; sometimes they are asymptomatic specially in the internal type which are presented with painless rectal bleeding while external type may present with painful swelling.
Although the traditional open hemorrhoidectomy (Milligan Morgan) is standard and effective technique, it is associated with many complications; the most important is post-operative pain and delayed return to normal activities. Nowadays Doppler-guided hemorrhoidal artery ligation (DG-HAL) with recto-anal repair (RAR) is a minimally-invasive technique for hemorrhoids, it is developed recently to overcome these complications.
The purpose of this prospective study is to compare between the classical open hemorrhoidectomy and HAL-RAR procedure, by assessment of post-operative pain, postoperative complications and outcome of the procedures.
This prospective, study was done between September 2014 and September 2016. Ninety six patients complaining of hemorrhoids were studied at Al-Sadr Teaching Hospital, Basrah, Iraq. They were divided equally into two groups; group A and B, group A underwent surgery by DG HAL and RAR, and group B were subjected to traditional procedure. Patients were followed for one year by evaluation at 1 week, 1 month, 6 months, and 1 year.
In conclusion, DG-HAL with RAR is an effective technique compared with traditional hemorrhoidectomy regarding complications, postoperative pain, in hospital stay, and time of return to normal activities.

6-FACTORS AFFECTING MORBIDITY AND MORTALITY IN PERFORATED DUODENAL ULCER

Adnan Yassin Abdul-Wahab; kassim Trayem Hayef

Basrah Journal of Surgery, 2011, Volume 17, Issue 1, Pages 0-0
DOI: 10.33762/bsurg.2011.55109

kassim Trayem Hayef* & Adnan Yassin Abdul-Wahab@
*MBChB, Al-Sader Teaching Hospital, Basrah. @MBChB, FRCS, Assist. Professor, Department of
Surgery, College of Medicine, University of Basrah, Basrah, Iraq.
Abstract
Duodenal ulcer is a particular type of peptic ulcer disease that afflicts the lining of the
duodenum. The indications for surgery in duodenal ulcers are; bleeding, perforation, obstruction
and intractability or non-healing. Today, most patients undergoing operation for duodenal ulcer
disease have simple over-sewing of bleeding ulcer or simple patch of perforated ulcer.
Simultaneous performance of vagotomy either truncal or highly selective is increasingly
uncommon because of reliance on postoperative proton-pump inhibitor to decrease acid
secretion and eradication therapy for helicobacter pylori infection. Despite of the widespread
use of gastric anti-secretary agents and eradication therapy, the incidence of perforated
duodenal ulcer has changed little.
This study aimed to assess the factors that lead to increase the rate of morbidity and mortality
in patients with perforated duodenal ulcer in different age groups and to know the effect of time
lapsed between onset of symptoms and surgery.
This is a prospective study that included 100 patients who underwent emergency laparotomy
for perforated duodenal ulcer during a period from May 2008 to January 2011. The operations
were done in Al-Sader Teaching Hospital and Al-Basrah General Hospital. The clinical finding,
general risk factors, co-morbid medical diseases, operative finding and post–operative
complications were all taken in consideration. Follow-up period ranged from 2 weeks to 18
months.
Of the hundred cases who included in this study, 96% were males and 4% were females with
mean age of 43.13 years (range from 10 to more than 70 years). The disease was more
common in rural areas (58%) than in urban areas (42%). Fifty five percent of patients gave
previous history of duodenal ulcer and 45% had no previous history of duodenal ulcer. The most
common risk factors are smoking (32%) and NSIADs (25%). In this study most of elderly
patients presented with medical diseases such as hypertension, diabetes mellitus, ischemic
heart disease and chronic obstructive pulmonary disease. Most patients admitted to hospital
between 19–24 hours (21%), (8%) admitted during 6 hours and (2%) admitted after 120 hours.
Regarding the complications occurs in this study, wound infections, chest infections and
paralytic ileus were the most common complications. Mortality rate was 2%.
In conclusion, the most common factor that leading to development of postoperative
complications is delayed in hospital admission, so to improve the results of treatment of
perforated duodenal ulcer, the diagnosis and treatment should not be delayed and the
associated medical illness should be treated.

THE ROLE OF N-ACETYLCYSTEINE IN THE TREATMENT OF OTITIS MEDIA WITH EFFUSION

Dhiaa Abdullah Fadhel; Isam M Al-Shareda; Haider MS Al-Attar; Ahmed A Alansary

Basrah Journal of Surgery, 2019, Volume 25, Issue 2, Pages 70-75
DOI: 10.33762/bsurg.2019.164517

Otitis media with effusion (OME) is a chronic accumulation of fluid within the middle ear cleft and sometimes the mastoid air cells system. The disease is more common among children. Surgical management is cost effective and carry complications from anaesthesia and surgical intervention. The condition can be resolved with high percentage by using mucopeptide breaking agent N-acetylcysteine
 The aim of this study is to evaluate the effect of N-acetylcysteine on the resolution of otitis media with effusion in children.
 Fifty seven children (107 ears) aged between 4-15 years with OME were included in this study. Patients underwent a thorough otorhinolaryngological examination and were divided into two groups; in the study group of 30 patients, N-acetylcysteine was administered, and the control group of 27 patients did not receive this treatment.
  Patient were followed-up at attendance, one month, two months and three months later with microscopical ear examination, tympanometric and pure tone audiometric examination.
 Patients were 39 males (68.4%) and 18 females(31.6%), 50 of them were with bilateral and 7 with unilateral disease. Following the treatment, there was improvement in the hearing loss as air bone gap was decreased. This improvement was statically significant in comparing the study and control groups (P value= 0.022). Number of ears with type A tympanogram increased to a rate of 74%, 71% in the right and left ears respectively in the study group. This rate was statically significant in comparing with the control group (P value=0.014).
 In conclusion, N-acetylcysteine is effective in the treatment of children with OME as well as that N-acetylcysteine has minimal side effect and can be used safely in patients who are medically unfit for general anaesthesia

8- TONSILLECTOMY FOR THE TREATMENT OF HALITOSISY!

Zahra Kadum Saeed; Ahmed M Al-Abbasi

Basrah Journal of Surgery, 2008, Volume 14, Issue 1, Pages 37-41
DOI: 10.33762/bsurg.2008.55518

This study aimed to investigate the tonsils as an origin of halitosis and to assess the efficacy of
tonsillectomy for the treatment of oral bad breath caused by chronic tonsillitis. After excluding
dental, periodontal, sinonasal, oral, pulmonary, and gastroenterological diseases as the origin of
halitosis, fourty-four patients with halitosis caused by chronic tonsillitis which proved by positive
Finkelstein's tonsil smelling test (pressing the tonsils and smelling the squeezed discharge),
were included in the study. All patients were treated by tonsillectomy. Subjective and objective
postoperative assessment was based on self-and-family report and clinical assessment.
Patients were reviewed after 4 and 8 weeks postoperatively. Complete improvement of halitosis
occurred in 31 patients (70.4%) after 4 weeks, this value increased to 35 patients (79.5%) in the
second review after 8 weeks. It is concluded that tonsillectomy is significantly effective
procedure for the treatment of halitosis caused by chronic tonsillitis.

ANTHROPOMETRIC FACE IN BASRAH

Nada H Al-jassim; Zuhair F Fathallah; Nawal M Abdullah

Basrah Journal of Surgery, 2014, Volume 20, Issue 2, Pages 29-40
DOI: 10.33762/bsurg.2014.98486

ANTHROPOMETRIC FACE IN BASRAH

Nada H Al-jassim , Zuhair F Fathallah & Nawal M Abdullah
MB,ChB, DGO.
Anatomy.

Abstract
Anthropometry is the systematic quantitative representation of the human body, it is used to measure the absolute and relative variability in size and shape of the human body. Over the
centuries, there have been remarkable changes in anthropometric measurements due to geographical, cultural, genetic and environmental factors. The studying of human face and the
assessment of facial dimensions attract the attention of the artists, poets and scientists and takes a prime importance in medical and dental fields in both diagnosis and treatment planning.
Anthropometry also used for the design of clothing and equipment, e.g. Gas masks, oxygen masks, dust masks and respirators as well as design of military and industrial helmets. There
had been no studies done on facial measurement in Basrah therefore, this study is to be considered as the first in this field and the baseline for further studies. This study had attempted
to quantitatively measure the human face in different ethnic groups of the local population and to identify the differences between individuals of different races and sexes, also to identify the differences between the people of Basrah and other people worldwide. These differences which
are responsible for the special facial features in different ethnic groups should be maintained during reconstructive or aesthetic surgery otherwise the patients will lose their ethnic features.
The people of Basrah have different racial and ethnic background, there are Semites which are the Arabs and Syrian (Assyrian & Chaldean), Arian, who are the Armenian, Kurdish and
Persian, and then there is the mixed group result from interracial marriages.
This study is a cross sectional study with a comparative component conducted in Basrah governorate. The data was randomly collected from volunteers, for the period from February to
July 2013. Raw data used in this study was originated from a total number of 1000 Iraqi adults (526 females and 474 males) living throughout Basrah governorate and were used to create a
database for statistical analysis.
The result of this study shows that there are differences between the races and between the local people and the surrounding countries and indeed there is a great difference from the
standard measurement advocated by western researchers.

Introduction
he human face is a living mirror held
Tout to the world, it has the power to common expression is “I may forget a
name, but I’d never forget a face’
Anthropometry
quantitative representation of the human
individual
understanding human physical variations .
Over
remarkable
measurements
cultural,







Bas J Surg, December, 20, 2014
Original Article
MEASUREMENTS
OF
HUMAN

MB,ChB, MSc, Assist. Prof. Plastic Surgeon. MB,ChB, MSc, Assist.Prof. o

HEMORRHOIDAL ARTERY LIGATION WITH RECTO-ANAL REPAIR VERSUS TRADITIONAL HEMORRHOID-ECTOMY, A COMPARATIVE STUDY

Basrah Journal of Surgery, 2018, Volume 24, Issue 2, Pages 61-66
DOI: 10.33762/bsurg.2018.160090

Hemorrhoids, are vascular structures present in the anal canal as cushions that facilitate stool control. When swollen or inflamed they are regarded as hemorrhoidal disease; sometimes they are asymptomatic specially in the internal type which are presented with painless rectal bleeding while external type may present with painful swelling.
Although the traditional open hemorrhoidectomy (Milligan Morgan) is standard and effective technique, it is associated with many complications; the most important is post-operative pain and delayed return to normal activities. Nowadays Doppler-guided hemorrhoidal artery ligation (DG-HAL) with recto-anal repair (RAR) is a minimally-invasive technique for hemorrhoids, it is developed recently to overcome these complications.
The purpose of this prospective study is to compare between the classical open hemorrhoidectomy and HAL-RAR procedure, by assessment of post-operative pain, postoperative complications and outcome of the procedures.
This prospective, study was done between September 2014 and September 2016. Ninety six patients complaining of hemorrhoids were studied at Al-Sadr Teaching Hospital, Basrah, Iraq. They were divided equally into two groups; group A and B, group A underwent surgery by DG HAL and RAR, and group B were subjected to traditional procedure. Patients were followed for one year by evaluation at 1 week, 1 month, 6 months, and 1 year.
In conclusion, DG-HAL with RAR is an effective technique compared with traditional hemorrhoidectomy regarding complications, postoperative pain, in hospital stay, and time of return to normal activities.

6-FACTORS AFFECTING MORBIDITY AND MORTALITY IN PERFORATED DUODENAL ULCER

Adnan Yassin Abdul-Wahab; kassim Trayem Hayef

Basrah Journal of Surgery, 2011, Volume 17, Issue 1, Pages 0-0
DOI: 10.33762/bsurg.2011.55109

kassim Trayem Hayef* & Adnan Yassin Abdul-Wahab@
*MBChB, Al-Sader Teaching Hospital, Basrah. @MBChB, FRCS, Assist. Professor, Department of
Surgery, College of Medicine, University of Basrah, Basrah, Iraq.
Abstract
Duodenal ulcer is a particular type of peptic ulcer disease that afflicts the lining of the
duodenum. The indications for surgery in duodenal ulcers are; bleeding, perforation, obstruction
and intractability or non-healing. Today, most patients undergoing operation for duodenal ulcer
disease have simple over-sewing of bleeding ulcer or simple patch of perforated ulcer.
Simultaneous performance of vagotomy either truncal or highly selective is increasingly
uncommon because of reliance on postoperative proton-pump inhibitor to decrease acid
secretion and eradication therapy for helicobacter pylori infection. Despite of the widespread
use of gastric anti-secretary agents and eradication therapy, the incidence of perforated
duodenal ulcer has changed little.
This study aimed to assess the factors that lead to increase the rate of morbidity and mortality
in patients with perforated duodenal ulcer in different age groups and to know the effect of time
lapsed between onset of symptoms and surgery.
This is a prospective study that included 100 patients who underwent emergency laparotomy
for perforated duodenal ulcer during a period from May 2008 to January 2011. The operations
were done in Al-Sader Teaching Hospital and Al-Basrah General Hospital. The clinical finding,
general risk factors, co-morbid medical diseases, operative finding and post–operative
complications were all taken in consideration. Follow-up period ranged from 2 weeks to 18
months.
Of the hundred cases who included in this study, 96% were males and 4% were females with
mean age of 43.13 years (range from 10 to more than 70 years). The disease was more
common in rural areas (58%) than in urban areas (42%). Fifty five percent of patients gave
previous history of duodenal ulcer and 45% had no previous history of duodenal ulcer. The most
common risk factors are smoking (32%) and NSIADs (25%). In this study most of elderly
patients presented with medical diseases such as hypertension, diabetes mellitus, ischemic
heart disease and chronic obstructive pulmonary disease. Most patients admitted to hospital
between 19–24 hours (21%), (8%) admitted during 6 hours and (2%) admitted after 120 hours.
Regarding the complications occurs in this study, wound infections, chest infections and
paralytic ileus were the most common complications. Mortality rate was 2%.
In conclusion, the most common factor that leading to development of postoperative
complications is delayed in hospital admission, so to improve the results of treatment of
perforated duodenal ulcer, the diagnosis and treatment should not be delayed and the
associated medical illness should be treated.

THE ROLE OF N-ACETYLCYSTEINE IN THE TREATMENT OF OTITIS MEDIA WITH EFFUSION

Dhiaa Abdullah Fadhel; Isam M Al-Shareda; Haider MS Al-Attar; Ahmed A Alansary

Basrah Journal of Surgery, 2019, Volume 25, Issue 2, Pages 70-75
DOI: 10.33762/bsurg.2019.164517

Otitis media with effusion (OME) is a chronic accumulation of fluid within the middle ear cleft and sometimes the mastoid air cells system. The disease is more common among children. Surgical management is cost effective and carry complications from anaesthesia and surgical intervention. The condition can be resolved with high percentage by using mucopeptide breaking agent N-acetylcysteine
 The aim of this study is to evaluate the effect of N-acetylcysteine on the resolution of otitis media with effusion in children.
 Fifty seven children (107 ears) aged between 4-15 years with OME were included in this study. Patients underwent a thorough otorhinolaryngological examination and were divided into two groups; in the study group of 30 patients, N-acetylcysteine was administered, and the control group of 27 patients did not receive this treatment.
  Patient were followed-up at attendance, one month, two months and three months later with microscopical ear examination, tympanometric and pure tone audiometric examination.
 Patients were 39 males (68.4%) and 18 females(31.6%), 50 of them were with bilateral and 7 with unilateral disease. Following the treatment, there was improvement in the hearing loss as air bone gap was decreased. This improvement was statically significant in comparing the study and control groups (P value= 0.022). Number of ears with type A tympanogram increased to a rate of 74%, 71% in the right and left ears respectively in the study group. This rate was statically significant in comparing with the control group (P value=0.014).
 In conclusion, N-acetylcysteine is effective in the treatment of children with OME as well as that N-acetylcysteine has minimal side effect and can be used safely in patients who are medically unfit for general anaesthesia

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