Inflammatory Bowel Disease (IBD) in Mosul Hospital: A crossSectional Study - Analysis of Prevalence, Risk Factors, and Clinical Outcomes

@#Introduction: This study aimed to investigate the prevalence, risk factors, and clinical outcomes of Inflammatory Bowel Disease (IBD) in Mosul Hospital, Iraq, in 2022. Methods: A cross-sectional study design was used to collect data from patients diagnosed with IBD in Mosul Hospital. A questionnaire was used to collect demographic and clinical data, including risk factors, symptoms, and treatment outcomes. Data were analyzed using descriptive statistics and logistic regression. Results: The study included 150 participants, with a mean age of (42.5. ± years and 56% being male. Women were found to be less likely to know the type of Crohn’s disease compared to men. 58.7% of participants did not have any other diseases, while 41.3% had multiple diseases. The CH type was known for 56.8% of participants, and the average disease duration was 70.41 months, ranging from 2 to 360 months. Most participants (72.1%) did not have involvement in a particular place, while 27.9% did. All participants had known involvement. 81.8% of participants did not use drugs, while 18.2% did, with partial or unknown drug usage reported in 39 individuals. Only 7.8% of participants had IBD in their family, while 92.2% did not. Most participants (95.2%) were smokers. Conclusion: The study highlights the need for increased awareness and early detection of IBD in Mosul Hospital. The identification of risk factors and symptoms can aid in the diagnosis and management of the disease. Further research is necessary to understand the underlying causes of IBD and to develop effective prevention and treatment strategies.

definition of family medicine and general practice

Definitions of general practice and family medicine have tended to be difficult to understand. We propose a new definition that is brief and clear. General practice / family medicine is defined as the medical specialty that manages common and long-term illnesses in children and adults, focusing on overall health and well-being. The definition should be followed by local examples of diseases within the scope of primary care such as asthma, diabetes as well as end-of-life care. This definition is based on the concept of common illnesses, reflecting the reality that family physicians manage most health conditions in a community. Unlike 'comprehensive care', common illnesses is a scope of practice that is familiar and credible to laypersons. The new definition focuses on a unique and enduring attribute of the specialty: holistic care. This core characteristic of general practice encompasses patient-centred care and continuity across the family lifecycle. By being sharply focused, the definition can guide the nature of clinical care in general practice as well as the content of undergraduate and postgraduate training in family medicine

Phytocompounds of Anonna muricata leaves extract and cytotoxic effects on breast cancer cells

Objective:To identify the phytochemical compounds from Annona muricata (A. muricata) and to determine their in vitro anti-proliferative activities against breast cancer cells, MCF7 and MDA-MB-231.Methods:A. muricata leaves were successively extracted by soxhlet method using n-hexane, ethyl acetate and methanol, and decocted with water. Each extract was analysed by gas chromatography mass spectrometry (GCMS) and characterized with Wiley and NIST library searches. Anti-proliferative activity of each extract was evaluated on MCF7 and MDA-MB-231 breast cancer cells using MTT assay.Results:The GCMS analysis of different solvent extracts of A. muricata leaves showed presence of different chemical groups of compounds such as steroids, terpenoids, phenolic compounds, sugars, sugars alcohol and others including vitamin E. Ethyl acetate leaves extract exhibited the lowest ICConclusion:Steroids and phenolic compounds were the main phytocompound groups identified from all A. muricata leaves extracts. The antiproliferative activity of n-hexane and ethyl acetate extract towards breast cancer MCF7 and MDA-MB-231 respectively might be due to the presence of biologically active compounds in the extracts, hence, providing some scientific evidences of the effectiveness of its traditional usages.

Anti-elastase, anti-tyrosinase and matrix metalloproteinase-1 inhibitory activity of earthworm extracts as potential new anti-aging agent

<p><b>OBJECTIVE</b>To examine whether earthworms of Eisenia fetida, Lumbricus rubellus and Eudrilus eugeniae extracts have elastase, tyrosinase and matrix metalloproteinase-1 (MMP-1) inhibitory activity.</p><p><b>METHODS</b>The earthworms extract was screened for elastase, tyrosinase and MMP-1 inhibitory activity and compared with the positive controls. It was also evaluated for whitening and anti-wrinkle capacity.</p><p><b>RESULTS</b>The extract showed significantly (P<0.05) good elastase and tyrosinase inhibition and excellent MMP-1 inhibition compared to N-Isobutyl-N-(4-methoxyphenylsulfonyl)-glycylhydroxamic acid.</p><p><b>CONCLUSIONS</b>Earthworms extract showed effective inhibition of tyrosinase, elastase and MMP-1 activities. Therefore, this experiment further rationalizes the traditional use of this worm extracts which may be useful as an anti-wrinkle agent.</p>

Complete pain relief after combining radiofrequency and phenol for lumbar sympathectomy

Lumbar sympathectomy alleviates pain such as complex regional pain syndrome, phantom limb pain and other peripheral neuropathies. Different modalities have been used to manage complex syndromes including sympathectomy. Both radiofrequency [RF] and phenol injection are established methods of performing sympathectomy. We present a case with possible diagnosis of chronic regional pain syndrome in a 56 year old lady who presented as an emergency with severe unbearable pain in her right leg. As a result of compromised circulation in the legs, the distal phalanx of second toe was amputated. Diagnostic lumbar sympathectomy with local anaesthetics provided short and temporary pain relief. Lumbar sympathectomy by means of radiofrequency combined with phenol injection was used; the symptoms were alleviated within 12 hours. Follow-up at different intervals has shown remarkable subjective and objective recovery with improved circulation, discoloration and complete healing. To the best of our knowledge this is the first case report of sympathectomy combining the two modes of RF and phenol injection in the same session

Procalcitonin as a diagnostic marker in acute exacerbation of COPD

Rational prescription of antibiotics in acute exacerbations of COPD [AECOPD] requires predictive markers. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin [PCT] levels appears to be useful in order to minimize this problem. We aimed to evaluate the diagnostic and prognostic role of procalcitonin in [AECOPD]. A total of 50 patients with AECOPD and 10 of apparently healthy individuals [control group] were studied. On presentation, serum PCT concentrations were measured, and quantitative sputum culture was performed for AECOPD. The patients were reevaluated when they had returned to their stable clinical state. Pathogenic bacterial microorganism [PBM] was only regarded as significant if they reached a growth 105CFU/ml, indicating the presence of bacterial exacerbation of COPD. The patients were classified into two subgroups: group A included patients with bacterial AECOPD [n = 20], group B included patients with nonbacterial AECOPD [n = 30]. On presentation, the levels of PCT for patients of group A [2.69 +/- 0.62 ng/mL] were significantly higher than group B [0.07 +/- 0.02 ng/mL] and control group [0.05 +/- 0.02 ng/mL] [p < 0.001]. When they had returned to their stable state, the levels of PCT for patients of group A decreased to [0.06 +/- 0.03 ng/mL], which was significantly lower than that in exacerbation [2.69 +/- 0.62 ng/mL] [p < 0.001]; But in patients of group B compared with exacerbation the levels of PCT did not changed [0.068 +/- 0.02 ng/mL] [p > 0.05]. In the stable state, there were no differences in the PCT measurement between the two subgroups as well as between patients and control. Furthermore, a significant correlation was recorded between PCT levels in group A at time of presentation and temperature [r = 0.898, p < 0.05], leucocytic count [r = 0.889, p < 0.05], FEV1% of predicted [r = 0.898, p < 0.05], ESR [r = 0.899, p < 0.05], CRP [r = 0.895, p < 0.05] and duration of hospital stay [r = 0.897, p < 0.05]. Procalcitonin is a good marker for differentiation between bacterial and nonbacterial AECOPD and could be used to guide antibiotic therapy and reduce antibiotic overuse in hospitalized patients with AECOPD

Tilt table practice improved ventilation in a patient with prolonged artificial ventilation support in intensive care unit

Patients who are on prolonged ventilator support in critical care unit present wide variety of complications, which range from reduction in oxygen uptake to various musculoskeletal impairments. Early mobilization and rehabilitation are encouraged to manage these complications effectively. Use of tilt table to motivate early mobilization in the intensive care unit for ventilator practices is not a usual practice. However, this new technique has attracted involvements of clinicians and therapists for its therapeutic benefits to the patient. Herein we describe a case of a seventy eight-year-old male patient who suffered Motor car accident, and was on ventilator support in intensive care unit for more than one month. He underwent treatment using a tilt table protocol with other routine treatment, which benefited him based on clinical as well as physiological variables. For practitioners in intensive care units, this report may offer perceptivity into the alternate practice of early mobilization using tilt table, and for investigators it may promote interest for further studies

Investigation of anti -nociceptive activity of zingabeel [zingiber offlcinale] on acetic acid induced writhing in rats

This study was carried out to test for antinociceptive effect of the methanolic extract of ginger using acetic acid induced writhing in rats and compared to morphine and diclofenac sodium as standard drugs. The methanolic extract of ginger, showed dose dependent responses whereas 50 and 100mg/kg produced 100%protection against writhing induced by acetic acid [0.6% i.p.]. This protection supersedes the effect of diclofenac sodium [25, 50 and 75 mg/kg] On the other hand morphine [2.5- 10 mg/kg], exhibited 100% protection against writhing induced by acetic acid. Therefore we can conclude and recommend that, ginger is a potential source of new and effective anti-nociceptive agent[s] Bioassay guided fractionation for the methanolic extract of ginger should be investigated for the determination of active ingredient[s], and to elucidate their mechanism of action

Outcome of cloward technique in cervical disc prolapse

To determine the association of pre-operative assessment of MRI findings, neurological status and symptoms with postoperative Cloward surgical outcome in cervical disc prolapse. Descriptive study. The Neurosurgery Department of Jinnah Postgraduate Medical Centre [JPMC], Karachi, from May 2008 to May 2009. Patients presenting with neck pain, brachialgia, limb weakness and spasticity were clinically examined for pre-operative neurological status of power, reflexes and sensation. The exclusion criteria were, cervical disc prolapsed patients, planned for smith-Robinson and micro-discectomy, traumatic cervical disc prolapse and cervical spondylosis. Neuroradiological investigations included cervical spine X-rays and MRI. All patients were surgically treated for cervical prolapsed intervertebral disc with anterior cervical discectomy and interbody fusion with Cloward technique. Postoperative neck immobilization was done with cervical collar for 7-8 weeks. Drain was removed on first postoperative day while check plain cervical X-rays were taken on third day. Results were analysed using chi-squre test with significance at p < 0.05. There were 30 patients including, 27 [90%] males and 03 [10%] females with mean age of 44.3 years. The commonest symptom was neck pain. The duration of symptoms ranges from 2 to 6 months. On MRI, prevalent levels of cervical disc prolapse were C 5-6 [43.3%] and C 6-7 [23.3%]; 26 [86.6%] patients had disc herniation causing thecal effacement with cord compression and 04 [13.3%] patients showed ischemia of cord. Single-level Cloward surgery done in 26 [86.3%] patients while two-level Cloward surgery performed in 04 [13.3%] only. About 83.3% patients improved and 13.3% did not while 01 patient was re-operated. No complications and mortality was related to the surgical procedure. Statistically different variables identified, related to outcome were pre-operative neurological status [p=0.001] and spinal cord involvement on MRI [p=0.001]. Cloward technique for cervical disc prolase was simple and safe surgical procedure with favourable results and few complications; 100% fusion occurred after Cloward surgery, even without instrumentation. Outcome was significantly affected by pre-operative neurological status and cord involvement

Management of myelomeningocele

T To find out best possible protocol to provide productive life to children born with Myelomeningocele. Descriptive study. Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006. The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical and medical management protocol used for different sites of myelomeningocele was studied.The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All paraplegic patients with dorsolumbar myelomeningocele were treated with either a low-pressure ventriculoperitoneal [VP] shunt only, direct repair or both. Patients with cervical, dorsal and lumbo-sacral myelomeningocele requiring VP shunt were operated either simultaneously for both procedures or with delayed insertions of a VP shunt after treatment of ventriculitis All 16 patients with ruptured myelomeningocele [3.8%] were treated for repair as well as ventriculitis. Complications including CSF leak, wound infection or necrosis after repair of myelomeningocele occurred in 22 cases [5.3%]. The postoperative follow up for all patients was 1- 2 years Surgical intervention with a low-pressure VP shunt in large dorsolumbar myelomeningocele produced good results

Molecular detection of uroplakin II in the peripheral blood of patients with urothelial carcinoma of the urinary bladder

To investigate the clinical value of' nested reverse transcription polymerase chain reaction [RT-PCR] of uroplakin II [UP-Il] in cells separated from the peripheral blood of' patients with urothelial cancer. The study included 45 patients with urothelial cancer, 7 apparently healthy subjects. 5 patients with untreated cystitis. and 3 patients with untreated renal cell carcinomas. Patients were divided into three groups. including 7 patients with superficial disease [group I]. 18 patients with invasive disease [group II] aid 20 patients with metastatic disease [group III]. Follow up samples were obtained after receiving 4 cycles of chemotherapy from 10 metastatic patients to evaluate the effect of chemotherapy on detection of UP-Il positive cells in the peripheral blood. Detection of circulating UPIL-mRNA-positive cells in the peripheral blood of' urothelal cancer patients was done by nested UP II-mRNA. UPIL mRNA-specific PCR products was detected in I [14.3%] of 7 patients with superficial cancers, in 8[44.4%] of 18 patients with musculary invasive disease and in 9 [45%] of 20 patients with metastatic cancer [p<0.05]. Within the metastatic group UPLI was positive in 4 [36.4%] of II patients with lymph node metastases and in 5 [55.6%] of 9 patients with distant metastases. As regards the grades of the urothelial cancers . nested RT-PCR for UP-Il was positive in 30% of grade I. in 3 1.8% of grade II and in 61.5% of' grade III. Two of the 10 metastatic patients who received systemic chemotherapy showed disappearance of UP-Il positive cells in their blood. As regards the control group. none showed positive expression of U P-Il by the nested RT-PCR in the peripheral blood. Expression of UPII mRNA was detected in 18 primary and in 6 metastatic transitional cell carcinoma [TCC] of patients and not detected in a bladder squamous cell carcinoma and in 3 renal cell carcinomas. Nested reverse transeriptmon-PCR assay for UP-Il is highly specific and might he used as a molecular tumor marker for staging of' urothelial cancers

Clinical presentation of epilepsy among adult Sudanese epileptic patients seen in Sheik, Mohamed Kheirs Friday epileptic clinic-Sudan

To study the pattern of clinical presentation of epilepsy among adult Sudanese epileptic patients. 120 patients with epilepsy were included in a prospective cross-sectional study. The study was conducted at Sheik Mohamed Kheir Friday Epileptic Clinic. May 2003- Oct 2006. Males were [54.15%] while females were [45.85%]. In 80 patients [67%] no cause was identified. Cerebrovascular accident was found to be the commonest risk factor, 24 patients [20%] had a family history of epilepsy. 103 patients had generalized epilepsy while 18 patients had focal epilepsy. The prodromal symptoms and neurological signs were common among patients with partial epilepsy. 78 patients [64.8%] showed abnormal EEG. 12 patients [10%] with generalize epilepsy had abnormal CT of the brain, while 50% of those who had focal epilepsy had abnormal CT of the brain. Generalized epilepsy is more common than partial epilepsy. Prodromal symptoms and neurological signs were common among patients with partial epilepsy. EEG and CT Brain play an important role in supporting the diagnosis of epilepsy

In vitro hypoglycemic activity of methanolic extract of some indigenous plants

Pakistan is rich in medicinally important plants and has ancient herbal treatment methods. Present work is based on the study of six indigenous plants Eugenia jambolana, Lawsonia inermis, Momordica charantia, Morus alba, Nigella sativa and Trigonella foenum graecum which show the inhibitory effect of glucose utilization, and are in use as hypoglycemic agents of varying degree in traditional system of medicine. The glucose uptake activity of [methanolic extracts] of these plants was tested in vitro and glucose was estimated by glucose oxidase method. The results in three different media revealed that, hypoglycemic activity is more prominent in neutral and basic media as compared to acidic medium

Surgical management of tethered spinal cord syndrome: an analysis of 248 cases

To define the presentation, exact mechanism, and surgical treatment of tethered spinal cord syndrome [TSCS] with particular emphasis on timing of surgery and outcome. Department of Neurosurgery, Jinnah Postgraduate Medical Centre [JPMC] from January 2001 to December 2006. A total of 248 patients were included in this study who presented for treatment between 6 days and 32 years of age with a median age of 6.5 months. One hundred patients presented before the age of 6 months. Most common complaint was cosmetic defect/swelling on their back [n 156]. Sixty-six patients had urinary incontinence, 35 patients had deformed or weak leg and 15 had ulcers on their feet. There were 172 female and 76 male patients. The most frequent tethering lesions were lipoma in 156, un-repaired myelomeningocele in 15, post repair myelomeningocele in 18, hypertrichosis in 17, spilt cord malformation in 10, tight filum terminate in 15, dermal sinus or dimple with stalk in 12, sacral agenesis in 3 and appendage with stalk in 2 patients. Out of 100 operated before 6 months of age, only 2 patients returned back with incontinence of urine and required un-tethering again. Improvement of symptoms at 6 months after surgery was noted in 78% patients operated after 6 months of age. Stabilization of symptoms was achieved in 8 patients having adult age at time of surgery. Minimum follow up was two years in 210 and maximum of 4 years in 17 surgically treated patients with stable neurological condition. Best outcome is achieved after complete un-tethering of cord at younger age. To avoid irreversible neurological damage, early diagnosis and repair is recommended. The symptoms most resistant to surgical treatment were orthopedic abnormalities where as bladder dysfunction and motor weaknesses were amendable to surgical therapy

Spectrophotometric methods for the simultaneous analysis of meclizine hydrochloride and pyridoxine hydrochloride in bulk drug and pharmaceutical formulations

Three new spectrophotometric procedures for the simultaneous determination of pyridoxine hydrochloride and meclezine hydrochloride are described. The first method depends on the application of simultaneous equation to resolve the interference due to spectral overlapping. The analytical signals were measured at 231 and 220 nm. Calibration graphs were established for 1 to 20 micro GmL-1 for pyridoxine hydrochloride and 0.5 to 10 micro GmL-1 for meclezine hydrochloride in binary mixture. In the second method, the determination of pyridoxine hydrochloride and meclezine hydrochloride was performed by measuring the absorbances at 290 and 235 nm in the simple absorbance spectra of their mixture. In third method a yellowish orange complex of pyridoxine hydrochloride was formed with ferric chloride, which absorbs in the visible region with

Beta-carotene, glycemic control and dyslipidemia in type 2 diabetes mellitus

Diabetes mellitus is a stressful condition in which the increased production of free radicals impairs the generation of naturally occurring antioxidants like vitamins and carotenoids. The present study deals with the changes in serum fl'-carotene in type 2 diabetes mellitus, as modulated by glycemic control and oxidative stress. Multiple biochemical parameters were obtained from plasma of 57 patients with type 2 diabetes mellitus [25 males and 32 females], on oral hypoglycemic with a disease duration of 1- 15 years and 37 healthy normal subject s of matching age and sex to serve as controls. The biochemical parameters measured in the present study included the glycated Hb [HbAlc], serum lipids [total cholesterol TC, triglycerides TG, high and low density lipoprotein cholesterols, HDL-C and LDL-C], lipid peroxides and serum beta-carotene. Results revealed a marked reduction of beta-carotene in the diabetics in a pattern proportional to that of the glycemic control, dyslipidemia and oxidative stress. Possible causes, mechanisms and suggestions underlining these changes are discussed

House dust mites and bronchial asthma in Libyan children

A total of 300 asthmatic patients [children from 6 months to 13 years], who were attending paediatrics respiratory clinic at Ibn Sina Teaching Hospital and Out-Patient Clinic in Central Polyclinic, Sirt-Libya, were tested for their responses to skin prick test using purified house dust mites [HDM] allergens. Out of the 300 patients suffering from bronchial asthma, 204 [68%] showed variable allergic response to various HDM purified allergens.57% of the positive cases showed positive response to Dermatophagoide pteronyssinus [Der pter] antigens, and 28% of cases to Dermatophagoide farinae [Der far] antigens and 14% showed positive response to Lepidoglyphus destructor [L.d] antigens. Of the 204 patients with positive reaction, 64.2% gave severe reaction while 21% gave moderate and 14.8% gave mild reactions. These reactions were more severe in males than females

Leiomyosarcoma of the bladder in a 16-year-old girl with a history of cyclophosphamide therapy for bilateral retinoblastoma during infancy

A 16-year-old female with bladder leiomyosarcoma had a history of bilateral retinoblastoma at 6 months of life. She received cyclophosphamide chemotherapy after surgical enucleation. In this report, we discussed the possible role of retinoblastoma or cyclophosphamide as a target for the development of bladder leiomyosarcoma

Somatic embryogenesis in wild relatives of cotton (Gossypium Spp.) / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Wild cotton species can contribute a valuable gene pool for agronomically desirable cultivated tetraploid cultivars. In order to exploit diploid cotton a regeneration system is required to achieve transformation based goals. The present studies aimed at optimizing the conditions for regeneration of local varieties as well as wild species of cotton. Different callus induction media were tested with varying concentrations of hormones in which sucrose was used as nutritional source. Different explants (hypocotyls, cotyledon, root) were used to check the regeneration of both local cotton plants and wild relatives using T & G medium, BAP medium, CIM medium, EMMS medium, and cell suspension medium. Different stages of embryogenicity such as early torpedo stage, late torpedo stage, heart stage, globular stage and cotyledonary stage were observed in wild relatives of cotton. The results of this study pave the way for establishing future transformation methods.

Newborn screening for certain treatable inborn errors of metabolism in Alexandria

As outlined in the Newborn Screening Task Force report published in August 2000, the newborn screening system is more than the just testing, but also involves follow up, diagnosis, treatment, and evaluation. Newborn screening is aimed at early detection and intervention of treatable inborn errors of metabolism and also at establishing the incidence of these disorders. Specimens of dried blood spots were collected from infants born in Alexandria, attending 13 Health Offices in different Districts of Alexandria for BCG vaccination, and the tests were done in the Human Genetics Department, Medical Research Institute, Alexandria University. The total number screened was 3000 infants, of them; one [0.033%] infant had hyperphenylalaninemia, one [0.033%] infant had classic galactosemia and 11 [0.37%] infants had high level of thyroid stimulating hormone [TSH], on confirmatory test, 9 of them were found to be euthyroid