About Journal

Basrah journal of surgery The Journal is An Open Access Journal indexed in DOAJ  licensed under a Creative Commons Attribution 4.0 International (CC-BY 4.0)  published biannually by University of Basrah, College of Medicine, Iraq since 1995. From January 2023 the first issue is published from January through June and the second issue from July through  December. Once completing the requirements for publication, the article will appear online according to the belonged issue.  The edittor utilizes iThenticate to check  plagiarism and to ensure the originality manuscripts...
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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

Study about the immunological investigations done before Kidney transplant in Basrah during (2012-2017)

Nibras Saleam Al-Ammar

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 3-7
DOI: 10.33762/bsurg.2022.136517.1031

Kidney transplant considered as alternative treatment in end-stage renal disease. Human leukocyte antigens an important role in graft rejection, donor specific HLA antibodies that measured by panel reactive antibody, lead to increased sensitization. Cytomegalovirus, Epstein-Barr virus, Hepatitis-B, and -C viruses have an association with poor outcome of the transplant. Aim of the study the immunological investigations done before the transplant. The study have carried out in College of Medicine by analyzing the data records for 36 patients undergo kidney transplant in Al-Sadder Teaching Hospital, 5 patients excluded for incomplete data. Data recorded during (2012-2017). HLA matching between recipients and donors including HLA-A, -B, -DR and -DRB1. Presence of PRAs, Hepatitis B virus surface antigen, Hepatitis C virus antibody, Cytomegalovirus IgM and IgG, Epstein-Barr virus IgM and IgG screened in recipients. Out of 31 recipients, 83.9% of were males and 16.1% females. 77.4% of donors and recipients were relatives and 22.6% were not relatives. 22.6% of donors and 25.8% of recipients tested for HLA and only 57.14% showed partially matching within some HLA classes. 9.7% of recipients have PRA. No recipient showed positive results for the presence of HBV sAg and HCV Ab. 6.5% of recipients have CMV IgM, 67.7% have CMV IgG, 9.7% showed positive results for the presence of EBV IgM and 6.5% have EBV IgG. In a conclusion, recipients and donors showed partially matched HLA classes, not all recipients and donors tested for HLA matching. Some recipients have PRA, high percentage of recipients has CMV IgG, and some of them have CMV IgM antibodies. All these factors might effects on the fate of transplant. HLA-DQ have to be tested and screening for the presence of PRA, viral Ag or Abs specific to these viruses in both recipients and donors is recommended.

The Association Between Salivary Procalcitonin and Periodontitis in Type 2 Diabetic Patients

Zahraa Muayad; Alaa Omran

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 8-14
DOI: 10.33762/bsurg.2022.137220.1035

Abstract
Background: One of the most prevalent conditions that affects teeth, periodontitis causes the surrounding and supporting tooth structure to be destroyed. Procalcitonin may be a helpful marker to determine the severity of infection, forecast the prognosis, and track the effectiveness of treatment.
Aim of the study: To assess the association between the salivary procalcitonin level and periodontal bacterial infections in diabetic individuals and contrasting it with non-diabetic people.
Patient and method: A case control study conducted at the department of periodontics during a period from February to April 2022. It included 70 subjects divided into four groups according to periodontitis and diabetes. Five ml of salivary sample was taken from each participant for the quantitative determination of salivary procalcitonin.
Result: In this study, mean of salivary procalcitonin was significantly higher in GP + T2DM group than that in other groups. It was significantly lower in controls than that in other groups and significantly lower in T2DM group than that in GP + T2DM group. There were significant positive correlations between salivary procalcitonin and all of bleeding on probing, probing pocket depth, and clinical attachment loss.
Conclusion: An elevated salivary procalcitonin level has been proposed as a possible biomarker for periodontal disorders because it plays a role in periodontal inflammation. Additionally, subclinical, low grade chronic inflammation in diabetes individuals may be mediated by salivary procalcitonin, a possible proinflammatory mediator.

Corneal stromal demarcation line depth after corneal collagen cross-linking following conventional versus customized corneal epithelial debridement

Salah Al-Asadi

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 15-20
DOI: 10.33762/bsurg.2022.136657.1032

Aim of the Study:
Using anterior segment optical coherence tomography (AS-OCT) to compare the depth of corneal demarcation line (DL) after corneal collagen cross-linking (CXL) with subtotal versus customized corneal epithelium debridement.
Design:
Prospective multi centric case-control study.
Materials and Methods:
The study enrolled 18 patients with bilateral progressive keratoconus. Both eyes treated by CXL using 3 mW/cm2 / 30 minutes setting. One eye with subtotal epithelial debridement ( about 9 mm diameter) and the contralateral eye with customized debridement ( approximately 1 mm single horizontal scratch ). One month postoperatively, patients had AS-OCT imaging to detect and measure the depth of DL.
Results:
Patients’ age mean was 25.17 years +/- 4.81 SD . Epithelial healing completed with in 3-7 days in conventional treatment group and demarcation line was evident in 16 eyes ( 89% ) with a mean depth of 290.31 micro m while in customized epi-off treatment group, the epithelial healing lasted less than 24 hours and DL was detectable in 10 patients ( 55.5 % ) with a mean DL depth of 221 micro m with a statistically significant difference ( p < 0.05 )
Subjective postoperative pain graded as “moderate to severe” in about 77% of eyes underwent 9 mm epi-off CXL compared with 55% of those with customized treatment.




Conclusions:
Although the DL if found in majority cases, but the shallow location in customized corneal debridement cases questioned the efficacy of this technique despite the quick re-epithelialization and less postoperative pain that accompanied it.

LAPAROSCOPIC VERSUS OPEN APPENDICECTOMY: A SINGLE CENTER STUDY

Manish Bhadoo; Ankit Meena; Deepak Sethi; Rajveer Singh

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 21-26
DOI: 10.33762/bsurg.2022.176623

INTRODUCTION: Acute appendicitis is one of the commonest causes of acute abdomen encountered in surgical practice, requiring emergency surgery. Open appendicectomy by Grid Iron incision had been gold standard for many years. Laparoscopic technique provided an opportunity to explore new method of management of the suspected cases of the acute appendicitis.
AIMS & OBJECTIVES: To compare laparoscopic and open appendicectomy in terms of intra-operative duration, complication of surgery and post operative outcome.
MATERIALS AND METHODS: A total of 50 patients with clinical diagnosis of appendicitis were studied. After pre-operative work up, patients were randomly assigned for laparoscopic appendicectomy or open appendicectomy. All cases were observed in the intra- and post-operative period till they were discharged and then later followed up for a period of 4 weeks in the outpatient department.
OBSERVATIONS AND RESULTS: A total of 25 patients assigned for laparoscopic appendectomy and 25 patients assigned for open appendectomy were analysed. Majority of patients were male in 3rd or 4th decade of life and had acute appendicitis. There was statistically significant difference of duration of surgery, post-operative pain, duration of hospital stay and return to work in both the groups. There was statistically insignificant difference of post-operative complication in both the groups.

CONCLUSION: laparoscopic appendectomy is better than open appendectomy in a properly prepared and selected patient in terms of Duration of surgery, Post operative pain & need of analgesic, Post operative complications like wound infection, Duration of the postoperative hospital stay and Time period to return to work.

AN OBSERVATIONAL STUDY ON PREDICTION OF DIFFICULTIES DURING LAPROSCOPIC CHOLECYSTECTOMY IN CASES OF CHOLELITHIASIS BY PREOPERATIVE ULTRASONOGRAPHY

sanjay kumawat; lakshman agarwal; Amit yadav

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 27-33
DOI: 10.33762/bsurg.2022.176624

BACKGROUND: Laparoscopic cholecystectomy has become the treatment of choice for cholelithiasis. Some reliable factors are needed to predict difficulties during laparoscopic cholecystectomy. So, our aim was to study various preoperative ultrasonographic parameters which may predict difficulties in performing laparoscopic cholecystectomy.
METHOD: One twenty five patients of cholelithiasis admitted for elective laparoscopic cholecystectomy were studied. Preoperative ultrasonographic parameters such as gall bladder(GB) wall thickness, transverse diameter of GB, pericholecystic fluid collection, gall stone mobility, number of stones & size of largest stone, common bile duct(CBD) diameter and emphysematous cholecystitis were given a score of 0 or 1 based on findings being negative or positive respectively. Total score was correlated with the difficulties faced during laparoscopic cholecystectomy.
RESULT: Out of 125 cases, 42(33.6%) cases were found to be difficult during laparoscopic cholecystectomy and 6 cases (4.8%) required conversion to open cholecystectomy. GB wall thickness (p value= 0.00001), transverse diameter of GB (p value= 0.001), pericholecystic fluid collection (p value= 0.00001), dilated CBD (p value=0.007), size of stone (p value= 0.007) found to be statistically significant in predicting difficulties during laparoscopic cholecystectomy. Higher the preoperative USG score, higher were the chances of difficult laparoscopic cholecystectomy and conversion to open cholecystectomy.
CONCLUSION: Pre operative ultrasonography in the form of a formulated score is a good predictor of difficulties during laparoscopic cholecystectomy.

Desarda’s repair versus Mesh hernioplasty for a strangulated inguinal hernia a randomized double-blind comparative study

Srinivas Rao Kancharla; Venkataharish Nimmagadda; Praneeth Bobba

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 34-41
DOI: 10.33762/bsurg.2022.134293.1024

Groin hernias are the commonest abdominal wall hernias; these hernias are known to develop various complications. Strangulation is a serious and life-threatening complication. Various surgical procedures like primary tissue repair, mesh repair, keep open with secondary repair, etc. are in practice for strangulated groin hernias. Post-operative infection and recurrence are the main concerns with these procedures. The aim of conducting this study was to compare the outcomes of the mesh hernioplasty with Desarda’s purely tissue hernioplasty in the treatment of strangulated inguinal hernia.
A total of one hundred and twenty-four patients were included in the study. These patients were grouped into group A (mesh hernioplasty group) and group B (Desarda’s tissue repair group) and randomization was done. Results of these two techniques were compared with respect to post-operative seroma, surgical site infection, recurrence, and chronic pain.
Seroma formation was more in group A, which accounts for 35.48%(22) of patients than in group B patients accounts for 19.35%(12). Operative site infection was more in group A, which accounts for 35.48%(22) patients than in group B 9.67%(6) patients. Recurrence was more in Group A patients which accounts for 22.58%(14) than in Group B patients which accounts for 3.22%(2). More patients account for 19.35%(12) in group A experienced chronic pain than the patients 1.61%(1) in Group B.
The current study showed that Desarda’s technique is a safe, effective, and single-sitting technique with a significantly reduced risk of seroma, surgical site infection, chronic pain, and recurrence than mesh hernioplasty for strangulated inguinal hernia

STAPLED VERSUS HANDSEWN INTESTINAL ANASTOMOSIS IN EMERGENCY SURGERY

Mebin Mathew; Metty Mathews; Prem Kumar Anandan

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 42-46
DOI: 10.33762/bsurg.2022.135980.1030

Introduction

The major problem following bowel anastomoses is the anastomotic failure leading to leakage peritonitis, fistula, abscess, sepsis, necrosis, stricture etc. adding to the morbidity and mortality. (e.g., 22% mortality in patients with a leak vs. 7.2% mortality in those without leak).The present study compares the complication rates of sutured and stapled anastomotic techniques in an emergency setting of a tertiary care institute in Kerala.

Methodology

The study evaluates the complications (leak /intra-abdominal abscess) of both stapled and hand-sewn techniques of intestinal anastomosis in emergency setting. The study is conducted in a tertiary care centre in Kerala and the data is collected from the medical records and emergency register. A total of 112 cases that meet the inclusion and exclusion criteria are included during the period from 2017 to 2021

Results

Among the 61 patients who had undergone hand sewn anastomosis 7 (11.5%) had anastomotic leak and 54 (88.5%) patients had no leak. Among the 51 patients underwent stapled anastomosis, 6 (11.8%) had anastomotic leak and 45 (88.2%) patients developed no leak. This data is statistically analyzed using Chi Squared test and found that there is no significant difference between the occurrence of anastomotic leak between the two study groups irrespective of whether the anastomosis is hand sewn or stapled.
The average time taken for surgery in the hand sewn group is about 192.1 minutes and in stapled group is 162.5 minutes. This difference in the average duration of surgery is analyzed statistically and it showed that the difference in of the duration of surgery is statistically significant.

Conclusion

There is no significant difference between the complication rates of both type of anastomosis is identified in the emergency setting. But there is a clear advantage of less operating time for stapled anastomosis.

DIFFERENT APPROACHES IN THE MANAGEMENT OF DIABETIC FOOT ULCERS – EXPERIENCE AT A TERTIARY CARE HOSPITAL

Manjunath Kotennavar; Rajendra Benakatti; Sanjeev Rathod; Aravind Patil; Manjunath Savant; SricharanRaj Kothuri; Santhan Gutta; Pramod Patil

Basrah Journal of Surgery, 2022, Volume 28, Issue 2, Pages 52-59
DOI: 10.33762/bsurg.2022.134154.1023

ABSTRACT

Aims and Objectives: To compare the outcomes of the usage of the negative pressure wound therapy (NPWT) using vacuum assisted wound closure/ Collagen granules/ Offloading techniques with the conventional moist gauze dressing in the treatment of diabetic foot ulcers (DFU).

Methods: Prospective, interventional study.
Study conducted at B.L.D.E (DU)’s Shri B.M.Patil Medical College Hospital and Research Center, Vijayapur over a period of 5 years. The demographic characteristics, type of foot lesions and treatment with different modalities of dressings and outcome were studied. 50 cases in each group – NPWT/Collagen granules dressing/ offloading techniques and conventional moist gauze dressings were allocated alternatively.

Results: 200 patients were included in the study, saw the gradual increase in the granulation tissue development, but the results were better in other groups than the conventional group and the collagen dressing group had more granulation tissue from week 1. There was early recovery among the other groups when compared to the conventional methods. The mean recovery were least in the collagen dressing group. 90% had good outcome in the negative dressing group. The outcome was 92% among the off loading group and 96% good outcome among the collagen group. But the conventional group had only 64% good outcome. And the difference was statistically significant.

Conclusion: The comparison of different methods to treat the diabetic foot ulcer showed that collagen method of dressing to be superior to others followed by offloading and then by topical negative pressure dressing. The conventional method had less favorable and slow outcome.

PREDICTORS OF EARLY AND DELAYED GRAFT FUNCTION IN LIVE AND CADAVERIC RENAL TRANSPLANTATION

SUNIL SATIHAL; Sandeep Kumar Reddy; Ifrah Ahmad Qazi; RAHUL DEVRAJ; DHEERAJ SSS

Basrah Journal of Surgery, In Press
DOI: 10.33762/bsurg.2022.135361.1029

Background: Kidney transplantation gives the best quality of life to chronic kidney disease patients and also increases longevity.
Aim: Analysis of factors responsible for the early and delayed graft functioning in live and cadaver renal transplants
Methods: It was a retrospective observational study. Donor and recipient age, sex, BMI, comorbid illness, and functioning status of the donor kidney, duration and severity of chronic kidney disease and associated bladder disorders were collected. Operative factors like perfusion time, cold ischemia time, blood pressure fall, need for blood transfusion, vasopressor support was recorded. Patients were divided into two groups based on early versus delayed graft function.
Results: 27 cases of Live donor renal transplant and 23 cadaver transplants were included. The average age in live donor and cadaveric transplants was 43.5 ±7.6 years and 38.3 ±10.5 years, respectively. 24 Live Transplant Recipients had Early Graft function (89%). Seven Cadaveric Transplant Recipients had Early Graft function (31%) and 16 of them had Delayed Graft Function (69%). HLA Mismatch, Perioperative Hypotension and BMI of recipient had statistically significant relationship to Early Graft Function with p values of 0.02, 0.004 and 0.007, respectively. With p-value of 0.021 and of 0.046, respectively, perioperative hypotension and cold ischemic time in Cadaveric renal transplantation had statistically significant relationship to Early Graft Function.
Conclusion: Live donor transplants have better early graft function. HLA Mismatch, Perioperative Hypotension, BMI of recipient and cold ischemic time in Cadaveric renal transplantation are the predictors of early graft function.

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

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

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.

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

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

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.

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