Correlation of glycated hemoglobin with serum uric acid levels among type 2 diabetic patients: a cross-sectional study

Background: Diabetes Mellitus Type 2 (DMT2) is one of the commonest disorders of endocrinology which is characterized by the raised blood glucose level due to insulin resistance in body cells. This study was aimed to determine the correlation between the glycated hemoglobin (HbA1c) and serum uric acid (SUA) in patients with DMT2. Methods: This cross-sectional study was conducted in a tertiary care hospital of Lahore. 73 Patients’ recruitment was made via convenient sampling technique and a developed inclusion and exclusion criteria. Self-structured proforma was used for data collection. Data analysis was done in SPSS version 25.0. Results: From total patients, 40 (54.79%) were women while 33 (45.21%) were men. Means of different variables like age, HbA1c, and serum uric acid level were 54.98 years with standard deviation (SD) of ±11.67 years, 7.90 with SD of ±1.85%, and 7.51 with SD of ±0.81 respectively. 32 (43.83%) patients had good glycemic control whereas 41 (56.17%) patients had poor glycemic control. The frequencies of hyperuricemia and normal SUA in study population were 35 (47.94%) and 38 (52.06%) respectively. The means of the HbA1c across gender had statistically significant difference. Difference in the means of the SUA level, across gender and between patients with hyperuricemia and normal SUA level, was also statistically significant. Moreover, correlation between the HbA1c and SUA was positive and statistically significant. Conclusions: In a nutshell, this study suggests that increase in SUA level, worsen the glycemic control by raising glycated hemoglobin level among patients with DMT2.

Assessment of knowledge, attitude and practice toward acne vulgaris among community in Jeddah City, 2016

Background: acne vulgaris is the most common skin condition seen by the dermatologists. It is a chronic inflammatory disease of pilosebaceous unit characterized by seborrhea, comedones, papules, pustules, nodules, cysts and in some cases scars and keloids, which persist for rest of the life

Objectives: the present work aimed at evaluating the level of awareness, Attitude and Practice toward acne vulgaris in Jeddah city

Methods: a cross sectional analytical questionnaire based study was carried out among the general population in Jeddah city. This study started in the year [2016] and composed of 461 subjects. The mean age of citizens was 28, 82. To assess citizens' demographic factors and beliefs about acne vulgaris, consenting citizens completed an anonymous online questionnaire. The data was entered and analyzed using SPSS version 20

Results: The sample is consisted of 65, 8% women and 34, 2% men. Among the respondents 7, 7% reported suffering from acne vulgaris and 13, 6% confirmed having a history of acne vulgaris illness in their family. The results of the study showed that 153 [34, 8%] subjects had weak knowledge related to the disease, 260 [59, 1%] subjects had average level of knowledge while only 27 [6, 1%] subjects had good knowledge regarding acne vulgaris. There was a statistical significant association between gender, educational level and the level of awareness about acne vulgaris

Conclusion: acne vulgaris is a disease that is potentially controllable but that cannot be cured. Education still be important overall the treatment of the patients

Distribution of doctors' workforce in Erbil governorate

Background and objective: Imbalance in the distribution of health workforce might result in inequities in health services delivery. The aim of this study was to assess the distribution of doctors' workforce in Erbil governorate and identify the possible reasons for rapid turnover of doctors

Methods: This descriptive cross-sectional study included all the 962 doctors working in the health facilities of Erbil governorate. A questionnaire was used to collect data that included 40 questions divided into four broad sections of identification information, socio-demographic characteristics, information on professional characteristics and factors influencing employment process in rural areas

Results: There were 5.1 doctors per 10,000 populations. Most of the doctors were deployed in urban areas [83.6%]. Most doctors were working in hospitals [74.2%] and 23.3% in primary health centers. Specialists constituted the largest categories of doctors [33.5%] and general practitioners the smallest [6.7%]. Doctors' willingness to stay at the current workplace was significantly associated with being married, having opportunities to select workplace, working in private clinics and having the workplace inside Erbil

Conclusion: The density of doctors per 10,000 populations in Erbil governorate is below the regional and international average, with a remarkable urban-rural imbalance in numerical, geographical and institutional terms

Reduction Corporoplasty

Objective Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Introduction Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. Results The patient tolerated the procedure well and has resolution of his corporal disfigurement. Conclusions Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement. .

Risky driving behaviours among medical students in Erbil, Iraq

This study aimed to assess risky driving behaviours among medical students in Erbil, Iraq, and to explore the relationship between risky driving behaviours and perceptions of risky driving. This self-administered questionnaire-based survey was conducted from January to May 2014 among a random sample of 400 medical students at Hawler Medical University in Erbil. The questionnaire was designed to assess the frequency of engagement in 21 risky driving behaviours, the perceived risk of each behaviour and the preference for each behaviour as ranked on a 5-point scale. A total of 386 students responded to the survey [response rate: 96.5%]. Of these, 211 reported that they currently drove a vehicle [54.7%]. Drivers most frequently engaged in the following behaviours: playing loud music [35.9%], speeding [30.4%], allowing front seat passengers to not wear seat belts [27.9%] and using mobile phones [27.7%]. Least frequent driving behaviours included not stopping at a red light [3.9%], driving while sleepy [4.4%], driving after a mild to moderate intake of alcohol [4.5%] and drunk driving [6.4%]. Mean risky driving behaviour scores were significantly higher among males [P <0.001] and those who owned a car [P = 0.002]. The mean risk perception score was higher among >20-year-olds [P = 0.028]. There was a significant positive relationship between the preference for risky behaviours and risky driving behaviours [beta = 0.44; P <0.001]. Medical students in Erbil reported high frequencies of several serious risky driving behaviours. The preference for risky behaviours was found to be an important predictor of risky driving behaviours among medical students in Erbil

A Single-Institution Experience with Metallic Ureteral Stents: A Cost-Effective Method of Managing Deficiencies in Ureteral Drainage

IntroductionThe limitations of traditional ureteral stents in patients with deficiencies in ureteral drainage have resulted in frequent stent exchanges. The implementation of metallic stents was introduced to improve the patency rates of patients with chronic upper urinary tract obstruction, obviating the need for frequent stent exchanges. We report our clinical experiences with the use of metallic ureteral stents in the management of poor ureteral drainage.Materials and MethodsFifty patients underwent metallic ureteral stent placement from 2009 to 2012. Stent failure was defined as an unplanned stent exchange, need for nephrostomy tube placement, increasing hydronephrosis with stent in place, or an elevation in serum creatinine. Stent life was analyzed using the Kaplan-Meier methodology, as this was a time dependent continuous variable. A cost analysis was similarly conducted.ResultsA total of 97 metallic stents were placed among our cohort of patients: 63 in cases of malignant obstruction, 33 in the setting of cutaneous ureterostomies, and 1 in an ileal conduit urinary diversion. Overall, stent failure occurred in 8.2% of the stents placed. Median stent life was 288.4 days (95% CI: 277.4-321.2 days). The estimated annual cost for traditional polymer stents (exchanged every 90 days) was $9,648-$13,128, while the estimated cost for metallic stents was $4,211-$5,313.ConclusionOur results indicate that metallic ureteral stent placement is a technically feasible procedure with minimal complications and is well tolerated among patients. Metallic stents can be left in situ for longer durations and provide a significant financial benefit when compared to traditional polymer stents.

Distribution of chronotypes among a sample of Iraqi Kurdish medical students

The aim of this study was to assess the distribution of chronotypes in a sample of Iraqi Kurdish medical students. A descriptive cross-sectional study was conducted at the Hawler Medical University College of Medicine in Erbil City, Iraq, between 1[st] January and 31[st] March 2013. A total of 580 students were given the reduced version of the Horne and Ostberg Morningness-Eveningness Questionnaire [MEQr], a close-ended self-administered questionnaire. Of the 580 students, 130 [22.4%] were male and 450 [77.6%] were female. The mean age +/- standard deviation was 20.3 +/- 1.45 years, with a range of 17-24 years. Most of the students [52.6%] were in the intermediate class, followed by morning type [24.1%] and evening type [23.3%]. Significant gender differences were detected in the proportion of morning, intermediate and evening types [P <0.001]. The mean scores for the female students were 14.8 +/- 2.2 and the mean scores for the male students were 14.6 +/- 7.3, with no statistically significant differences [P = 0.45]. Students in the College of Medicine were mostly classified as intermediate types. The morning type was more common among this student population, particularly male students, than has been reported in similar age groups in some Western countries. There was a significant gender difference in the proportion of MEQr types

Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient ...

Early versus delayed laparoscopic cholecystectomy for management of acute calculus cholecystitis: our experience at King Hussein medical center

To compare early laparoscopic cholecystectomy during index admission with delayed [interval] laparoscopic cholecystectomy in the management of acute cholecystitis at King Hussein Medical Center. Over the study period of 48 months [June 2005 to May 2009], a total of 317 patients with clinical and radiographic diagnosis of acute cholecystitis were studied. One hundred-thirty one patients underwent laparoscopic cholecystectomy during the index admission [group A] while 186 patients [Group B] underwent cholecystectomy at least six weeks after the attack. Data analyzed included patients' age, gender, duration of symptoms, white blood cell count, operative time, hospital stay, overall surgical outcomes and postoperative morbidity and mortality. Both groups were demographically and clinically comparable. Surgical outcomes were comparable in group A and B with conversion rates of 8.3% and 7.4% [p = 0.6645], and complication rates of 12.25% and 12.6% [p = 0.9352] respectively. Although delayed surgery shortens operative time significantly [60 versus 100 min, p<0.0001], the overall hospital stay is significantly reduced by early operation [5 versus 14.6 days, p<0.0001]. Although both the early and delayed approaches in management of acute calculus cholecystitis are comparable in terms of complication and conversion rates, the early approach has the advantage of offering patients a definitive treatment while reducing the overall total hospital stay and avoiding the problems of failure of delayed therapy

Association of certain sociodemographic and clinical characteristics of diabetic patients with quality of life

Diabetes mellitus is a common and demanding health problem that has a great effect on everyday life of patients. This study was done to determine sociodemographic and clinical characteristics that affect the quality of life [QOL] of diabetic patients. A total of 300 patients with diabetes mellitus in Erbil city were included in this study. The World Health Organization Quality of Life [WHOQOL-100] questionnaire was applied for assessment of 6 domains of QOL using multiple regression analysis. Type of work and body weight were the most significant factors shown to affect diabetic patients QOL domains. Type of work was significantly affecting physical [P=0.006], psychological [0.004], level of independence [P<0.001] environmental [P=0.007] and spiritual [P=0.009] QOL domains. Duration of diabetes was significantly affecting physical [P=0.002], psychological [P=0.037] and level of independence [P<0.001] domains. Body weight was significantly affecting physical [P=0.039], psychological [P=0.012], level of independence [P=0.036], social relationships [P=0.022] and spiritual [P=0.030] QOL domains. QOL had a variable significant association with certain sociodemographic and clinical characteristics of diabetics. There should be an emphasis on improving QOL of diabetics and consequently achieving better metabolic control

Mental health of Iraqi adolescents

To estimate the prevalence of flourishing and the association of mental health status with the socio-demographic characteristics and conduct problems of adolescents. A total of 8807 adolescents were included in this study. Data were obtained from knowledge, attitudes and practices household survey carried out in 2004. Each adolescent was interviewed by a trained team and a specially designed questionnaire was filled. Emotional, psychological and social well-beings were assessed through a series of measurements. Conduct problems were measured by self-reporting of school skipping, smoking, alcohol drinking, inhalant use and arrestment. The prevalence of flourishing, moderate mental health status and languishing were 5.6%, 20.3% and 74.1%, respectively. The prevalence rates of school skipping, smoking, and other conduct problems [alcohol drinking, inhalant use, and arrestment] were 60.1%, 62.8% and 59.2%, respectively. Mental health was significantly associated with age, educational level, and various conduct problems [p<0.001]. No significant sex variation was demonstrated. Flourishing was significantly decreasing with advancing age [p<0.0001] and it was significantly lower among smokers [p<0.0001], and those with other conduct problems [p<0.0001]. The low rate of flourishing among adolescents was associated with a high rate of conduct problems which could be a psychological response to the stressful condition prevailing in the country during the last 3 decades

Prevalence of skin diseases among primary school children in Erbil city

Skin diseases constitute serious public health problems through the world, especially in children. The aim of the study was to determine the prevalence of skin diseases in primary school children in Erbil city, and its relation to various socio-demographic factors. A total of 6915 pupils aged 6-15 years were randomly selected from 32 primary schools using multistage random sampling technique. Data regarding general socio-demographic variables were collected from each student in a specially designed questionnaire. Children were clinically examined and the dermatological findings were recorded. The overall prevalence of skin diseases was 40.6%, Infectious dermatoses have the highest prevalence rate [15.27%], followed by eczematous skin diseases [13.13%]. The overall prevalence of skin diseases and infectious dermatoses were significantly higher among females, younger age groups and those of low socioeconomic status, while eczematous skin diseases were significantly higher among males. Skin conditions are common among school children, which may reflect prevailing low socio-economic conditions. Relevant health education programs and preventive measures should be implemented

Epidemiology of burn injury in Erbil government: a hospital based study

The aim of this study was to find out the burden of burn injury and identify the high risk groups in Erbil city which could help in implementing effective preventive measures. The case records of patients with burn injury admitted to the Emergency Management Center in Erbil city from January 1st 2006 to December 31st 2007 were reviewed. Data on age and sex of patients, extent and aetiology of burn injury, and monthly and seasonal variations of injury were extracted from the case records. Out of 1920 burn patients admitted to the hospital; 452 died with an overall mortality rate of 23.54%; 70 [15.49%] were children and 382 [84.51%] were adults. The mortality rate was significantly higher among adults than children, 35.30% and 8.35%, respectively [p<0.001] and among females than males, 34.38% and 9.63% respectively [p<0.001], giving a male: female ratio of 0.22:1. The highest mortality rate was among adult females [47.88%] particularly the 15-29 years age group [53.07%]. The trend of injury and mortality showed fluctuation with increasing frequencies during the summer months. Flame injury was the main aetiology of burn [94.47%], which was significantly more common than scald injury among adults compared to children and among females compared to males. The study reports a high rate of mortality from burn injury with very high total body surface area [TBSA] burned especially among young adult females, and identifies the significance of burn injury as a public health problem and a social concern

Case fatality rate of first-ever stroke in erbil city

Stroke is the third most common cause of death. The objective of this study was to find out the case fatality rate of first-ever stroke in Erbil city. This cross-sectional study included 228 first-ever stroke patients hospitalized to teaching hospitals in Erbil city from January, 1[st] 2009 to August, 31st 2009. Stroke was diagnosed by the consultant internist or neurologist and confirmed by brain CT-scan. Patients were followed-up and one month case-fatality rate was calculated. The one month case-fatality rate was 23.7% with a higher proportion of deaths occurred in females [26.4%] than in males [21.2%] [P= 0.358]. The case-fatality increased with age [P= 0.019]; around 75% of deaths occurred in the 7[th] and 8th decades of life and more than 95% occurred among those 60 years and more. More deaths occurred from haemorrhagic [31.3%] than ischaemic [20.7%] strokes [P= 0.093]. The mean +/- SD ages of dead and alive were 68.56 +/- 11.52 and 61.32 +/- 12.91 years, respectively [P=0.001]. Multiple logistic regression revealed significant association of stroke outcome with age [P= 0.037] and atrial fibrillation [P=0.001]. The one month case-fatality rate was relatively comparable to that reported in other developing countries

Risk factors for stroke in erbil city: a case-control study

Stroke is a worldwide health problem. This study was carried out to find out the risk factors associated with stroke in Erbil city. A hospital based case-control study was carried out in Erbil city from January, 1[st] 2009 to June, 30[th] 2009. The sample included [173 cases and 173 controls] cases admitted to Erbil teaching hospitals with first-ever stroke diagnosed by the consultant internist or neurologists and confirmed by brain CT-scan. Sex and age-matched [ +/- 5 years] patients admitted to the same hospital, who do not have stroke, were taken as a control group. The mean +/- SD ages of cases and controls were 62.2 +/- 13.4 and 61.54 +/- 13.16 years, respectively with a male: female ratio of 1.1:1. Nearly 70% were ischaemic and 30% were haemorrhagic. A slightly more than half [51.45%] of strokes occurred in the 7[th] and 8[th] decades of life. Multiple logistic regression analysis revealed statistically significant association between smoking [P<0.001], exercise [P<0.001], hypertension [P=0.001], family history of stroke [P=0.004], BMI [P=0.012] and PCV% [P<0.001] with stroke. However multiple logistic regressions of risk factors for ischaemic and haemorrhagic strokes separately revealed that diabetes was significantly associated with ischaemic stroke [P=0.025] while body mass index was significantly associated with haemorrhagic stroke [P=0.001]. Majority of stroke patients were of older age. The most frequent risk factor among stroke cases were lack of exercise, overweight and obesity and hypertension

Prevalence of hepatitis C virus antibodies among health care workers in Baghdad, Iraq

There are several reports on the occupational risk of hepatitis C virus infection of health care workers [HCWs] by accidental inoculation of infected blood. This study was carried out to determine the prevalence of anti-HCV among a sample of Iraqi HCWs. A total of 1656 HCWs selected from various hospitals and medical units in Baghdad, together with 238 "apparently" healthy subjects [controls] were tested for anti-HCV from June 1995 to April !998. Serum testing was carried out by a third generation of enzyme immunoassay [EIA] for screening for anti-HCV and a third generation recombinant immunoblot assay [RIA-111] for confirmation of the presence of HCV antibodies. A higher rate of anti-HCV [1.51%] was observed among HCWs than controls [0.84%]. The highest prevalence rate of anti-HCV was detected in the renal dialysis group [6.25%] followed by the dentistry group [4.26%]. These were the only groups having a statistically significant higher prevalence of anti-HCV than controls when each group was compared with controls. An increase in the prevalence of anti-HCV with duration of professional practice was demonstrated. The highest rate of anti-HCV was detected among HCWs in cardiovascular surgery hospitals [4.21%] followed by infectious disease hospitals [3.37%]. Efforts to reduce exposure to blood and other body fluids are needed to reduce the risk of the occupational transmission of HCV infection, as no vaccine against HCV infection is available yet

Brain abscess in Iraq during a 10 years period: part 1. epidemiology, aetiology and clinical picture

This study comprises two parts, [this part deals with epidemiology, aetiology and clinical features of brain abscess during a 10 years period, while the second will deal with diagnostic investigation, management and final outcome of brain abscess. The case records of patients with brain abscess admitted to the neurosurgical specialties hospital in Baghdad over a 10 years period extending from 1[st] Jan. 1993 to 31[s] Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. A total of 78 cases [1.2% of total admission] of brain abscess were admitted. Their age ranged from one month to 68 years. The most common aetiological factor was cyanotic heart disease, with the congenital anomaly being unrepaired in all cases. Remote infection foci other than the heart represented minority. Half of the cases had a rapid onset and fluminant progression. The presenting features of the patients older than one year were raised intracranial pressure, and focal neurological deficit and infection. Maintaining a high index of clinical suspicions in patients having one of the infection sources together with neurological signs should be emphasized