No abstract
Introduction: Low back pain (LBP) is the most common health problem between men and women between 20 and 50. Although most LBP's exact origin remains unknown, it is understood that degenerative damage to the intervertebral disk (IVD) plays a central role in the pathogenic mechanism leading to back pain. The study aims to study the incidence, clinical features, and presentations of the lumbar disc prolapse and clinical outcome of lumbar microdiscectomy for a period of 1 year post operatively. Methods: 28 male's patient and 22 female patients qualified. The data were obtained by direct interrogation and clinical examination. The information that was taken from the patients includes the patient's age, gender, occupation, and chief complaint, history of present illness, and neurological signs and symptoms. Plain X-ray of the lumbosacral spine obtained for each patient in anteroposterior, lateral view and stress views. Results: 15 male patients (53.5%) and eight females (36.3%). The most common site for the prolapsed disc was L4-L5 (58%); the next common site was L5-S1 (38%), backache was the most common presenting symptoms. It presents in all 50 patients (100%). Sciatica present in 45 patients (90%), in 13 patients the radiation of the pain was to the right leg, whereas 26 patients have radiation of pain to the left leg and six patients have bilateral radiation, 45 patients (90%) of total 50 patients complaint from backache recovered,36 patients (86.7%) of real 45 patients compliant from sciatica improved, paresthesia represented in 32 patients (64%) and 28 patients (87.5%) of them recovered, whereas 16 patients (32%) had motor weakness and 12 patients (75%) recovered. Conclusion: Lumbar microdiscectomy may be associated with a more rapid initial recovery in patients with sciatica; most patients had good outcomes with lumbar microdiscectomy.
Introduction: It has been well established and evidence-based fact that serum levels of proteins, cholesterol, trace elements, andpseudouridines may suffer changes during a neoplastic disease process. This report encompassed four prospective studies, original in Iraq to our knowledge, had explored the serum total proteins (TP), pseudouridines levels, total serum cholesterol (TSC), and serum trace elements (TE), in groups of patients harboring primary brain tumours (PBT) compared to healthy persons. Patients and Methods:Study number 1: A group of 107 patients, from both sexes, aged 2-75 years, harboring PBT were admitted to and operated upon via formal craniotomy by staff neurosurgeons at The Teaching Hospital at Kadhimiyah (TTHK) and Neurosurgical Hospital (NH); their sera were tested for serum total proteins (TP); the latter biochemical parameters were compared with those of 40 healthy persons. Study number II: the same patients and healthy controls were tested for pseudouridine measurement. Study number III: Another group of 30 patients with PBT were studied for TSC levels and were compared with 30 healthy volunteers. Study number IV: A third group of 26 patients with PBT, from both sexes, their sera were tested and measured for TE; the measurements were compared to 1630 volunteers from both sexes and of different age groups. The sera and brain tumor tissue samples were analysed and examined by appropriate methods at relevant laboratories of the TTHK, NH, The Medical Research Centre (MRC) of The College of Medicine, Al-Nahrain University and the Iraqi Atomic Energy Committee (IAEC). Results and Discussion: The serum TP and PBT study: Results are shown in table 1. The serum pseudouridines and PBT study: Mean levels of pseudouridine in serum of PBT patients, were significantly higher (p < 0.01) than its levels in the (normal) controls, table 2. The TSC and PBT study: 1. Hesalthy persons from both sexes: age range, in years, 15 – 75, mean 40.5, SD ± 19.8; TSC range 142 – 230 mg / dl, mean 185.6 mg / dl, SD ± 24.9, (3.7 – 5.9 mmol / l, mean 4.8 mmol / l, SD± 0.6), table 3. 2. Thirty persons from both sexes having peripheral tumors, with no clinical evidence of brain tumors: age range, in years, 15 – 75, mean 54.3 ± 12.8; TSC range 90 – 220 mg / dl, 143 ± 36.3 (2.3 – 5.7 mmol / l, mean 3.7 ± 0.9), table 4. 3. Thirty patients from both sexes with primary and secondary brain tumors, age range, in years, 15 - 75, mean 41.3 ± 20.9; TSC range 140 – 284 mg / dl, 217.6 ± 41.2 (3.6 – 7.3 mmol / l, 5.6 ±1.1), table 4. Study number IV: Serum mean values (and S.D.) of all measured TEs were as follow: Se 0.045 +/- 0.011, Zn 0.320 +/- 0.095, Cu 0.607 +/- 0.154, Fe 0.880 +/- 0.456, Mg 13.625 +/- 3.994, Co 0.020 +/- 0.036, Ni 0.016 +/- 0.030, Mn 0.016 +/- 0.009, Cd 0.050 (one sample), and Cr 0.015 +/- 0.005 micrograms per milliliter (mcg / ml). All mean concentrations were consistently lower in the patients than healthy volunteers; both the Student’s (t) and probability (p value) tests were performed; for Se, Zn, Cu, Mg, Co, Ni, Mn, and Cr the p value was <0.01 showing statistically significant results; however, for Fe, though the mean concentration was also lower in the brain tumor group, there was no statistical significance, p > 0.05. Due to technical difficulties and very low concentration of Cd, it was not measured in healthy volunteers; however, it was measured in only one patient’s serum sample; this has been discarded from the study, table 5. Conclusions: Levels of serum TP, TC, and pseudouridine are higher in patients with PBT than in healthy people; however, those of serum TE are lower in the PBT group than healthy persons; the results of this report are in keeping with those of other researchers. The biochemical parameters can be an additional laboratory monitor in the investigation of PBT patients; however, both the specificity and sensitivity need to be ascertained. To our knowledge, this was the first study to be performed in Iraq in the setting of PBT
Objectives: To study the frequency of pattern, types and anatomical location of SF, in relation to the mechanism of injury, occupation and other important social and demographic variables. Also, to assess the outcome of SF within one year. Methods: A prospective, cross-sectional study on cases having SF attending Accident and Emergency Hospital (Teaching) (AEH) in Duhok City. This study has involved patients having a fresh SF; they were clinically evaluated, stabilized and thereafter subjected to plain skull X-ray (PSXR) and spiral computed tomography (CT) scan examination; no contrast was given; only few of them had magnetic resonance imaging (MRI) study. Results: There were 88 (62.7 %) males and 52 (37.3 %) females. Age ranged from 4 months 70 years, mean 10 years ± 13.5 standard deviation. Patients coming from urban regions formed 85 (60.7%), those from rural areas constituted 55 (39.3%).The most common causes were fall from height (FFH) 98 (70%), followed by road traffic accidents (RTA) 25 (17.9%), assault 4 (2.86%), ceiling fan injury 4 (2.86%), fall of heavy object on the head 3 (2.14%), penetrating injuries by missiles 4 (2.86%) and 2 (1.43 %) injured by unusual material (trauma by a thrown rock 1), and by sharp rotating machine –Kosara. The Glasgow Coma Scale (GCS) score was as follow: 13-15 in 110 (78.6 %), 9-12 in 19 (13.6%) and 3-8 in 11(7.9%) patients. Conclusions: Patients sustaining HI are mainly young age groups; males are more involved than females. The main causes were FFH, RTA, and assault. The majority of SFs are single, simple, and linear in their patterns.
Background: Stroke remains an outstanding worldwide disease process that results in high mortality and significant mental and physical disabilities. Stroke inflicts profound economic burden on both individual and governmental budgets. Patients and Methods: This study has been designed to describe the profile of stroke patients in our locality. A cross sectional study design with consecutive sampling procedure were used to enroll nine hundred fifty patients who were admitted the Neurology Ward of Azadi General Teaching Hospital in Duhok during the period between January and December 2014. A suitable data sheet was designed to accommodate the relevant patient's data. Patients suspected of having vascular anomalies and / or neoplastic lesions and traumatic cases were excluded. Results: Out of 950 patients, the females were 510 (53.7%) age range 23-105 years (mean 63.9±SD 13.1 years), while the rest were 440 (46.3%) males, age range 25-98 years (mean 65.4±SD 13.1years). The majority of patients 684 (70%) had their ages between 50-79 years. There were 803 (84.5%) ischaemic strokes, while haemorrhagic strokes accounted for 147 (15.5%) of cases. The patients' populations suffering identifiable RFs were as follow: obesity 734 (77.3%), hypertension 568 (59.8%), hyperlipidaemia 235 (24.7%), smoking 191 (20.1%), previous stroke 190 (20%), heart disease 153 (16.1.3%), diabetes mellitus 77 (8.1 %). Although 21 (2.2%) patients had no gross identifiable RFs, however, the rest of patients had one or more apparent risk factors. Regarding outcome during the admission period, 133 (14%) patients had died; mortality rate among ischaemic stroke had been 86/803 (10.7%) while among haemorrhagic stroke 47/147 (32%). Conclusions: The findings in this study show many similarities to other studies worldwide. Although the present study has thrown the light on few common risk factors for stroke, both of modifiable and non-modifiable nature, at a tertiary referral teaching hospital in Duhok City, which includes a multiethnic community, it is recommended that further detailed and well-designed medical and statistical research to be conducted in this community in order to study genetic predisposition to stroke, setup preventive measures, implement proper management protocols aiming at improving the outcome, and directing health authorities planning health services for those surviving the stroke disorder.
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