Print ISSN: 1683-3589

Online ISSN: 2409-501X

Keywords : BASRAH


DUODENAL OBSTRUCTION IN CHILDREN: AN EIGHT YEAR EXPERIENCE IN BASRAH

Abbas Abdulzahra Alhasani

Basrah Journal of Surgery, 2017, Volume 23, Issue 2, Pages 62-68
DOI: 10.33762/bsurg.2017.141322

DUODENAL OBSTRUCTION IN CHILDREN: AN EIGHT YEAR EXPERIENCE IN BASRAH

Abbas Abdulzahra Alhasani
MB, ChB, FIBMS, MRCS Glasgow, Pediatric Surgeon, Lecturer, Department of Surgery, College of Medicine, University of Basrah, IRAQ.

Abstract
Duodenum is a common site for congenital anomalies that might result in partial or complete obstruction. Intestinal rotational anomalies that involve the midgut put the duodenum at a potential risk of obstruction.
This is a retrospective hospital record based study displaying an 8 year single center experience in the Basrah center of pediatric surgery. The study enrolled 60 children with congenital duodenal obstruction with a mean age of 2.8 months and a male to female ratio of 1.14:1. Thirty two patients (53.3%) were diagnosed as duodenal atresia and stenosis, while intestinal malrotation was reported in 28 patients (46.7%). Repeated vomiting was the most common presenting symptom, it was bile stained in 60%. Associated congenital anomalies were seen in 23.3% of the study population, Down's syndrome and congenital heart defects were the most commonly reported abnormalities.
Intraoperatively, fenestrated duodenal web was the commonest finding (59.4%) in duodenal atresia/stenosis, which was corrected by a diamond anastomosis in 1.9% of cases and by duodenotomy with web excision in 28.1%. Malrotation was corrected by Ladd's operation in 92.9%. Postoperative complications were reported in one third of the studied population, and the type of surgical procedure used in duodenal atresia/stenosis did not have a significant impact neither on postoperative complications nor on the hospital stay.

ESTIMATION OF MEAN CENTRAL CORNEAL THICKNESS USING SIRIUS SCHEIMPFLUG–PLACIDO TOPOGRAPHER IN BASRAH

Aymen Majeed Fadil; Salah Zuhair Al-Asadi

Basrah Journal of Surgery, 2017, Volume 23, Issue 1, Pages 26-30
DOI: 10.33762/bsurg.2017.132414

ESTIMATION OF MEAN CENTRAL CORNEAL THICKNESS USING SIRIUS SCHEIMPFLUG–PLACIDO TOPOGRAPHER IN BASRAH

Aymen Majeed Fadil* & Salah Zuhair Al-Asadi@
*FIBMS Ophthalmology, Basrah General Hospital. @FRCS, FIBMS, FICO (Ophthalmology)
Assistant Professor, College of Medicine, University of Basrah, IRAQ.

Abstract
This study aimed to assess the mean of central corneal thickness (CCT) in a sample of normal Iraqi population (Basrah and its surrounds as a sample).
Pachymetry was done by Sirius Scheimpflug–Placido Topographer for 1774 eyes of 887 healthy participants 10–68 years old. The parameters studied included central corneal thickness and the results were compared with other studies.
This study included 414 healthy male and 473 healthy females and it revealed mean CCT equals to 531.49±34.92 μm with range from 426.5–632. The mean CCT in those who are 10-19 years old (543.7±32.3μm) was significantly higher than the other age groups (p value <0.01) there was a significant difference between right and left eyes of the studied participants. There were no correlations of age and sex with CCT (p value >0.1).
In conclusion, normative data regarding central corneal thickness were reported in Iraqi population. Means of central corneal thickness was generally lower than those reported in Turkey and Iran.

MECONIUM ILEUS; A STUDY AND COMPARISON BETWEEN COMMON OPERATIVE PROCEDURES PERFORMED IN BASRAH

Haithem H Ali Almoamin

Basrah Journal of Surgery, 2016, Volume 22, Issue 2, Pages 84-90
DOI: 10.33762/bsurg.2016.116618

Abstract Meconium ileus accounts for 9–33% of all neonatal intestinal obstructions, with an incidence of 1:2500 newborns, representing the third most common cause of neonatal small bowel obstruction after atresia and malrotation. This study aimed to compare various surgical procedures used in the treatment of meconium ileus and to assess their efficacy regarding survival and complications. A retrospective study was done to all cases of meconium ileus admitted to the neonatal intensive care unit of Basrah hospital of maternity and children and Basrah children specialty hospital during the period of 10 years (2005 to 2015). The medical records of 57 cases of meconium ileus were studied. The comparison included: Mikulicz procedure, Bishop-Koop procedure and resection with primary anastomosis in both simple and complex meconium ileus. The parameters used for comparison were anastomotic leaks, high output diarrhea with dehydration and failure to thrive, sepsis, need for reoperation, wound complications, early adhesions, hospital stay and mortality. The mean age of presentation of neonates with meconium ileus was 3.9 days. Male to female ratio was 0.9: 1. About 10.5% were preterm. About 33.3% of cases were diagnosed as simple meconium ileus. Intestinal Volvulus is the predominant complications encountered (47.4%). Non-operative treatment was effective in 45.5%. The most common procedures done in our center were Mikulicz procedure (61.5%), followed by Bishop-Koop procedure (30.8%), and resection with primary anastomosis (7.7%). There was a significant association between mortality and high output fistula, anastomotic leaks, sepsis, and reoperation. Predominant complications in Mikulicz procedures were high output fistula (50%) and skin excoriation (53.1%), while in Bishop-Koop procedure were sepsis (75%), reoperation (50%), and adhesions (25%). In primary anastomosis, significant complications were anastomotic leak (75%), sepsis (50%), and reoperation (50%). Mortality was highest in primary anastomosis (75%), followed by Bishop-Koop procedure (62.5%), and lowest with Mikulicz procedure (40.6%). The overall mortality of meconium ileus was high 45.6% (42.9% for simple meconium ileus and 52.6% for complex meconium ileus). All neonates treated non-operatively survived, while the survival rate for those treated surgically was 50%. In conclusion, resection with stoma creation is superior to primary anastomosis. Mikulicz procedure is the safest procedure to be done with best survival and less complications. Bishop- Koop procedure is of value in a situation where the surgeon is afraid from high output diarrhea so proximal stoma is mandatory.

EVALUATION OF EPIDIDYMAL AND TESTICULAR SPERM ASPIRATION IN AZOOSPERMIC INFERTILE MALES IN BASRAH

Murtadha MS Majeed Al-Musafer; Safaa T Al-Maatooq

Basrah Journal of Surgery, 2014, Volume 20, Issue 2, Pages 81-88
DOI: 10.33762/bsurg.2014.99135

This study aimed to evaluate the safety and efficacy of percutaneous epididymal and testicular sperm aspiration as a diagnostic technique to confirm sperm production and as a therapeutic technique to harvest sperms for use in the intracytoplasmic sperm injection and the indications for performing testicular biopsy in azoospermic infertile males.
Thirty married patients were included in this prospective study from February 2011 to December 2012 seen in Basrah General Hospital. Their age ranged from 20 to 40 years. All patients underwent full medical examination with laboratory tests which included seminal fluid analysis, serum leutinising hormone (LH), follicular stimulating hormone (FSH), testosterone, and prolactin in addition to color Doppler ultrasonography of the scrotum. Patients with history of undescended testes, varicocele, & testicular pathology were excluded from this study.
All patients showed normal physical examination with normal secondary sexual characters. The external genitalia were normal with normal sizes of their testes. The percutaneous epididymal and testicular sperm aspirations were positive in 12 out of 30 patients (40%). The rest had negative aspirations (60%). The testicular biopsy which performed in the patients with negative aspiration showed normal germinal epithelium with mature spermatozoa in only 5 patients out of 18 (28%) while the rest 13 patients had spermatogenic arrest (72%).
In conclusion, percutaneous epididymal and testicular sperm aspiration has been found helpful as a diagnostic technique for patients with non-reconstructable azoospermia. It is a minimally invasive sperm retrieval technique and appears to be an effective alternative to microsurgical epididymal sperm aspiration, which is more invasive and costly. It is less invasive than testicular biopsy and preferably performed as a first step procedure in an attempt to obtain sperms for both diagnostic and therapeutic purposes.

OBSTRUCTIVE JAUNDICE IN BASRAH

Abutalib Bader Abdullah; Zeki A Al-Faddagh

Basrah Journal of Surgery, 2011, Volume 17, Issue 2, Pages 45-57
DOI: 10.33762/bsurg.2011.55378

Obstructive Jaundice is a common surgical problem presenting to hospitals as it resulted from many etiological factors like choledocholithiasis or periampullary tumors especially CA head of pancreas. According to the difference in these etiological factors and their progress, symptoms and signs vary in different patients. Diagnostic tools like US, CT scan, MRCP, ERCP and others vary in their ability in diagnosing the main etiology and the operative procedures also differs according to the etiologies, ranging from least invasive like ERCP to very sophisticated procedures like Whipple's procedure for CA head of pancreas. Many factors may affect the morbidity and mortality like the age of patients, presenting etiology and the presence of associated comorbid diseases. This study aimed to demonstrate the main etiological factors of obstructive jaundice in Basrah and the commonest presenting symptoms and signs. Also to study the most applicable investigations and compare their results according to their accuracy in diagnosing the etiology, and to study the most common surgical intervention applied to relieve the obstruction in obstructive jaundice and hospital morbidity and mortality. Both retrospective and prospective study was done in Basrah between January 2006 and December 2009, 243 patients with obstructive jaundice were included in this study from the main general hospitals and private hospitals in Basrah. Data were collected about the presenting clinical features, the diagnostic techniques, operative procedures and the causes of in hospital mortality and morbidity and were analyzed so that a complete picture of these details can be assessed for obstructive jaundice in Basrah. The study shows no significant difference between male and female in obstructive jaundice. The majority of cases found in the age group 50-59 years. Most common etiology was choledocholithiasis. The most frequent applied investigation was the liver function test which was done to all patients. Imaging techniques were applied variably with the US was the most applied while MRCP and ERCP were the least; however, the accuracy was higher with the latter two techniques. Intervention depends on the main etiology: for the choledocholithiasis, most common operation was CBD exploration, for CA head of pancreas the most common operation done was bypass procedure and for complicated hepato-biliary hydatid disease the CBD exploration with T-tube was the common. The post operative morbidity was 20.07% mostly due to respiratory complications, while mortality was 9.86 % mostly due to sepsis. In conclusion, the most common cause of obstructive jaundice in Basrah is choledocholithiasis and CA head of pancreas comes second. ERCP and MRCP are the least applied imaging techniques in diagnosis of obstructive jaundice. The threshold for their application was very high. The least applied intervention to treat obstructive jaundice was the therapeutic ERCP, while the most common was open surgical procedures.

THE DISTRIBUTION OF ABO BLOOD GROUPS AMONG BASRAH GOVERNORATE POPULATION

Zuhair A ALBarazanchi; Talib A Al-Buslimy; Dhamia K Suker

Basrah Journal of Surgery, 2010, Volume 16, Issue 2, Pages 0-0
DOI: 10.33762/bsurg.2010.55453

ABO blood grouping is currently considered as one of the essential immunological tests done
before many clinical interventions; on the top of them are clinical blood transfusion procedures.
In a period of 14 months, 620 blood samples were collected from normal individuals including
294 males & 326 females after demographic study of each one. Samples were tested for ABO
grouping using the standardized methods.
Results were analyzed statistically using the SPSS analytical system. Results showed that
blood group O was the most prevalent type among the whole Basrah Governorate, in all its
districts & among both sexes, while the blood groups B & A came next, where as B group was a
little bit higher in the whole sample of the Governorate & among females while the A was a little
bit higher among males. The AB blood group was the least of the four among all. There was
little variation in the distribution of the four blood groups among the different regions of Basrah
Governorate but with conservation of the above mentioned graduation. Those results were
comparable to the results registered in some neighboring countries, but differ more or less from
other far countries.

MATERNAL MORTALITY IN BASRAH HOSPITALS; AN OVERVIEW OF THE LAST TWO DECADES

Salman K Ajlaan; Edward Zaia; Faiz A Alwaeely; Fouad H Al-Dahhan

Basrah Journal of Surgery, 2006, Volume 12, Issue 1, Pages 3-3
DOI: 10.33762/bsurg.2006.55318

This study aimed to determine the MMR in Basra hospitals for 20 years (1983-2002), to determine the main causes of maternal deaths with regards to direct, indirect & fortuitous causes & to verify the impact of major events including wars & sanction on the trend of maternal deaths. This is a retrospective study included all maternal deaths occurred in hospitals as well as deaths recorded in emergency departments, forensic medicine department & statistical units throughout the study period. Detailed information was taken to verify the cause of death in each woman. A total of 206 deaths occurred during the study period, MMR did not run a steady fashion, they showed gradual decline during 1980s. Following the second gulf war, there was considerable increase in MMR with the peak one observed in 1996. There after the ratio decline gradually to pre 2nd war levels. Direct obstetric causes remain the major causes of maternal death throughout the 20 years with, in a decreasing frequency, hemorrhage, sepsis & AFE were the major direct causes. However, indirect causes showed some, but noticeable increment during the sanction years. We concluded that the major political events, including wars that Iraq & Iraqi peoples exposed to had substantial adverse influence on the trends of maternal deaths. Although a direct maternal death outweigh indirect death, however, sanction years caused obvious increment in direct deaths.