Print ISSN: 1683-3589

Online ISSN: 2409-501X

Volume 25, Issue 1

Volume 25, Issue 1, Spring 2019


Thamer hamdan

Basrah Journal of Surgery, Volume 25, Issue 1, Pages 1-2
DOI: 10.33762/bsurg.2019.162889

The patient's complaint should be considered seriously as the father of medicine
Hippocrates says; Listen to the patient, he is the one concerned, listen to the
patient; he is telling you the diagnosis. This is very true, provided that the patient is
capable of expressing his symptoms and suffering.


Thamer A Hamdan; Mohammed S hashim; Nazar S Haddad; Abdullah M Jawad

Basrah Journal of Surgery, Volume 25, Issue 1, Pages 3-9
DOI: 10.33762/bsurg.2031.162890

The intervertebral disc is an avascular tissue, and penetration of antibiotics occurs by passive
diffusion. Cefotaxime penetration has not been well studied. The aim is to investigate the
penetration of cefotaxime into the intervertebral disc removed from patients undergoing
Twenty-six patients undergoing discectomy were recruited for this study. They were given one
gram of cefotaxime intravenously as a prophylactic antibiotic. Cefotaxime was extracted from
nucleus pulposus and serum and analyzed using an HPLC method with cefuroxime axetil as
internal standard.
Cefotaxime penetrated into all the 26 samples of nucleus pulposus resulting in a mean
concentration of 0.66±0.13 µg/gm. The mean serum concentration at time of disc removal was
13.61±3.54 µg/ml. The concentration in 16 samples were below the minimum inhibitory
concentration against Staph. aureus with an average of 0.27±0.03 µg/g. There is a statistically
significant correlation between time after intravenous cefotaxime administration and its
concentration in the nucleus pulposus. The greater increase is in the third hour after
administration. Factors like age, body weight, gender, number of associated diseases and
surgical history did not seem to affect nucleus pulposus cefotaxime concentration.
In conclusion, cefotaxime can penetrate into the nucleus pulposus but its concentration is
relatively low. This concentration has a strong positive correlation with time after cefotaxime
intravenous administration. Cefotaxime, therefore, needs to be given at least two hours before
disc removal, with re-dosing immediately before operation to maintain high serum concentration.


Thamer A Hamdan; Khalil I Sadek; Mohammed Abed Yasir

Basrah Journal of Surgery, Volume 25, Issue 1, Pages 10-15
DOI: 10.33762/bsurg.2031.162891

LOCAL EXPERIENCE OF TOTAL KNEE REPLACEMENT IN BASRAH Thamer A Hamdan@, Khalil I Sadek# & Mohammed AbedYasir* @FRCS, FICS, FACS, FRCP, American Board of Neurological & Orthopedic Surgery, Professor of Orthopedic Surgery. # FICMS, Orthopedic specialist, Basrah Teaching Hospital. * CABHS Orthopedic specialist, Al-Sadr Teaching Hospital, Basrah, IRAQ. Abstract Total knee arthroplasty (TKA) represents a major advance in the treatment of degenerative joint disease providing excellent restoration of joint function and pain relief. This is a prospective study undertaken in the Department of Orthopedic Surgery in Basrah Teaching Hospital, from October 2009 to June 2011. Thirty-three patients who underwent primary total knee arthroplasty were included (25 females 75.7% and 8 males 24.2%). The diagnosis was osteoarthritis in 20 knees and rheumatoid arthritis in 13 knees. The operation included primary cemented TKA (25 cruciate-retaining and 8 cruciate-substituting), by anterior approach. The knee function was evaluated by knee society score system. Preoperative functional knee scores were uniformly poor and improved postoperatively with excellent results in 18 knees (54.54%), good in 9 knees (27.27%), fair in 5 knees (15.15%), and poor in 1 knee (3%). Thus, excellent and good results were achieved in 81.8% of the cases (27 of 33 knees). For knee scores, 2 knees (6%) were fair preoperatively and another 31 knees (93.9%) were poor. Post TKA results were excellent in 28 knees (84.84%), good in 5 knees (15.15%), fair in (0%) and poor in (0%). Excellent and good results were achieved in 100% of cases. The most common complications were superficial infection and deep venous thrombosis In conclusion, this study showed good outcome for total knee replacement surgery in our region. Excellent relief of pain, range of motion, and restoration of function. Keywords: Total Knee Replacement, Osteoarthritis, Rheumatoid arthritis, Basrah, Surgery.