Genetic Characterisation of Honey Bees (Apis mellifera) Populations from Kurdistan Region of Iraq via ISSR Markers

In the present study, to investigate genetic diversity and phylogenetic relationships among honey bee populations of Iraq ISSR markers were used. Sampling was carried out during summer 2017 from 5 cities of Iraq (Dahuk, Arbil, Sulaymaniyah, Kirkuk, and Kafri). Total DNA was extracted from the head and thorax sections of each worker honey bee, using salting out method with minor modifications. PCR amplification of genomic DNA was performed using 10 ISSR marker primers (A1, A2, A3, A4, A5, A6, A7, A8, A9 and A10). The primers yielded 50 polymorphic bands and number of bands were variable from 8-12 (average 9.62), and percentage of polymorphic loci was 73.6. The estimated genetic diversity for the populations ranged from 0.39 in Kafri population to 0.47 in Arbil population, and total genetic diversity among loci was calculated as 0.47 while average within population genetic diversity was 0.44. GST value was 0.085. The Phylogenetic tree showed two main clusters; the first one comprised of three populations (Dahuk, Arbil, and Sulaymaniyah), and the second one included two communities (Kirkuk and Kafri). Heterozygosity values, Shannon index and the number of alleles of honey bee populations were minimal that could be caused by low definite geographic structure of honey bee populations. This research provided new information regarding genetic diversity in selected local honeybee in Kurdistan region of Iraq and will be useful for selection, future local biodiversity conservation and controlled breeding programs.

Scroto-perineal hidradenitis suppurativa complicated by giant scrotal elephantiasis

Scrotal elephantiasis has been a recognized complication of inguinal node irradiation, filarial infection, tumor involvement and surgical lymphatic destruction, but has rarely been reported in association with hidradenitis suppurativa [HS]. HS, also known as acne inversa, is a chronic and often debilitating disease primarily affecting the axillae, inframammary regions and perineum. The location of the lesions may lead to social embarrassment and failure to seek medical treatment. Scroto-preineal HS complicated by scrotal elephantiasis is a distressing disease. Excisional surgery with reconstruction is the recommended treatment with a high likelihood of good outcome. We present a 38-year-old male patient with long-standing scroto-perineal HS complicated by giant scrotal elephantiasis

Kochia Indica Wight - an unusual foreign body of the upper airways in children

To highlight the special features of an unusual foreign body of the larynx, the seed of kochia indica wight, and discuss its management. This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital Bannu, District Headquarter Teaching Hospital, Bannu and this department related consultants' private clinics from January 1, 2009 to December 31, 2011. The study included 32 cases. All the patients underwent direct laryngoscopy for removal of foreign body. The main indication for direct laryngoscopy was a definite history of foreign body inhalation and acute onset of hoarseness in predisposed children. The results were analyzed using SPSS 16.0 for windows. A total of 32 cases were included in the study. The age range was 5-15 years. There were 14 males and 18 females. All the patients presented with hoarseness of voice and dry irritating cough. Odynophagia was seen in 56.2% cases whereas breathing difficulty was present only in 9.4% of cases. The foreign body was lodged lateral to anterior 1/3rd of the cord in 62.5% followed by lateral to mid cord in 31.2% cases. Kochia indica wight seed is an unusual but a common foreign body of the larynx in the southern districts of Karak and Bannu. The diagnosis is easy in the predisposed children. Though it does not change its position in the larynx, yet urgent removal should be undertaken as foreign body in the larynx is potentially a life threatening condition.

audit of the mortality due to severe head injuries in a neuro-surgical intensive care unit

To analyze the data of patients died in neurosurgical intensive care unit due to severe head injuries. This retrospective study was conducted in neurosurgical intensive care unit in Lady Reading Hospital, Peshawar from January to December 2007. The Clinical record of all the patients presenting with severe head injuries, who then expired in neurosurgical intensive care unit was collected. The record was analyzed accordingly for discussion and recommendations. Out of 112 patients, majority were young adults [n=64, 57.14%] followed by children [n=34, 30.35%] and elderly [n=10, 8.92%]. Road traffic accidents were the major cause of presentation [n=75, 66.96%] followed by history of fall [n=23, 20.53%] and fire arm injuries [n=13, 11.60%]. The correctable surgical causes were present only in 18 patients [16.07%] and the majority 94 [83.92%] were given conservative management. Among the non-surgical cases, both ventilatory therapy in 7 [6.25%] and tracheostomy in 39 [34.82%] patients failed to change the outcome. Road traffic accident was the major contributor in the mortality in patients presenting to neurosurgical intensive care unit. Most involved were young adults

Enlarged solitary neck node: a study of 75 patients

The objective of the study was to evaluate the causes of enlarged solitary lymph node of wore than one month duration in the neck. This study was conducted at Departments of ENT and Head and Neck Surgery Postgraduate Medical Institutes, Peshawar from January 2005 to Dec, 2006. A total of 75 patients were included. All the patients were evaluated through detailed history and clinical examinations. Beside these, laboratory, radiological, endoscopic. Fine Needle Aspiration Cytology and histological studies were performed. A total of 75 patients with mean age of 35 years were studied during this period Male to female ratio was 1.2:1. Out of 75 patients, 29 [39%] were metastatic, 27 [36%] tuberculous, 16 [22%] had lymphoma and 1 [1.5%] each of toxoplasmosis, infectious mononucleosis and sarcoidosis. As malignancy was the commonest cause of solitary neck lymphadenopathy, so every patient especially old age group should he properly investigated to exclude metastatic diseases

Frequency of HLA-B27 antigen in iranian patients with brucellosisand it's relationship with osteoarticular complication

To determine frequency of HLA-B27 in brucellosis patients and to investigate a possible association between osteoarticular bruceltosis and HLA-B27 antigen. Sixty patients with serotogicatly confirmed brucettosis and 100 healthy controls were screened for HLA-B27 by using standard microlymphocytotoxicity method. Osteoarticular involvement was suggested by clinical presentation and confirmed by nuclear scan. Patients were placed in two groups and compared, patients with osteoarticular involvement [OAP group] and without osteoarticular involvement [OAN group]. All data were analyzed by SPSS [versionl 11.5, USA] and using Fisher's exact X2 test. Out of total 60 patients with brucellosis 38 [63.3%] were male. Mean age of the patients were 36.2 +/- 12.3 with the range of 18-65 years. HLA-B27 test was positive in 11 patients [18.33%] with brucellosis, whereas in control group HLA-B27 positivity was 7% [p<0.05].The prevalence of HLA-B27 in OAP and OAN groups was 33.33% and 8.33%, respectively [p<0.05]. The prevalence of HLA-B27 in our bruceltosis patients is higher than normal population and there is a significant association between HLA-B27 and bruceltar osteoarthritis in the region of study

Yield of diagnostic rigid bronchoscopy in children

To highlight yield of rigid bronchoscopy in cases of suspected foreign body [FB] tracheobronchial tree [TBT] in children. This is a prospective analytical study of 78 cases, conducted in the E.N.T-Head and Neck Surgery department of Post Graduate Medical Institute [PGMI], Hayatabad Medical Complex Peshawar during six years i.e. from April 2000 to March 2006. All patient underwent rigid bronchoscopy for removal of suspected inhaled foreign body [FB] from tracheobronchial tree. Cases included were of paediatric age group [12 years and below] and of either sex. Out of total 78 cases 42 were male and 36 were female with male to female ratio of 1. 7:1. All patients were of paediatric age group [12 years and below]. The eldest patient was of 12 years and the youngest was two months of age. Most of the patients [47%] were referred from paediatric units of this hospital. Twelve cases [15%] were referred from other hospitals. Nineteen [24%] cases were referred through casualty while another 10 patients [13%] came directly through OPD. Twenty three patients [29%] were Afghani nationals. All 78[100%] cases underwent rigid bronchoscopy on the basis of suspicion of inhalation of FB. In [13%] cases history of inhalation of FB was obtained retrospectively after successful procedure. In the remaining 77% cases it was the failure to respond to medical treatment that lead to referral for the procedure. In 62% cases FB was recovered on bronchoscopy while in 38% cases no FB was found. Other pathologies were recorded in 18% cases while 20% cases bronchoscopy yielded no FR or other pathology: Right main bronchus was the most common site where FB was lodged [42% cases] followed by left main bronchus [28% cases], smaller bronchiole on right side [18% cases] and smaller bronchiole on left side [12% cases]. No FB was found in trachea or subglottic area. 75 patients [96%] had complete removal of FBs with first intervention. Only 3 [4%] cases a second attempt was required. One [1.3%] mortality occurred in the study. Over all complication rate recorded was 7%. It was included that index of suspicion should be kept very high in all cases presenting with respiratory symptoms not responding to medical treatment or those with recurrence of symptoms. All such patients should undergo rigid bronchoscopy

Saudi patient's knowledge and attitude toward anesthesia and anesthesiologists: a prospective cross-sectional interview questionnaire

Patients' awareness of the duties of anesthesiologists in the operating theatres may sometimes be limited. Many studies around the world proved lack of patient perception of the anesthesiologist's role in surgical practice. One hundred and seventy operative patients were interviewed by anesthesiologists in the pen-operative period in King Khalid University Hospital at Riyadh KSA This paper reports the results of a prospective study on these patient's interviews by filling predetermined questionnaire by the interviewer. The survey was conducted on two sessions namely before anesthesia and surgery, and in the first post operative day. It included three sections exploring the demographical profile of the participant, knowledge about anesthesia procedure, assessment, anesthesiologists personnel, postoperative pain relief and the attitude toward the service given to him. Patients who recognized the anesthesiologists as specialized doctor consisted of 55.3%. But those who recognized anesthesia services during surgical intervention were only 16.5%. This result reflect ignorance of the public of the function of anesthesiologists, showed lack of perception regarding anesthesia procedures during surgery, and the role of the anesthesiologist in monitoring resuscitation and postoperative analgesia. Patients showed inclination to know more about the anesthesia services and choices and ranked the services from very good to excellent. The illiterate section of the studied population showed statistically significant correlation between their information on anesthesiologists and anesthesia, and their degree of education, level of income and habitat. Reasonable percentage of the patients knew that the anesthesiologist is a doctor who administers anesthesia. Services of anesthesiologists were highly appreciated, but their function during the operation and nature of anesthetics administered were poorly known. These results call for the necessity to educate the surgical patient by the anesthesiologists preoperative interview allow more time to establish rapport, by distributing educational material related to anesthesia and use of the media to educate illiterate section of the public on subjects pertaining to anesthesia

Iatrogenic brain foreign body

We describe a case of an adult patient admitted following severe head injury. His condition necessitated the insertion of intracranial pressure monitoring catheter for brain protection management. When the initial crisis was settled, the ICP catheter was gently removed. However after extracting the catheter it was noted that a considerable part of the tip was missing. Plain X-ray of skull confirmed the presence of radio-opaque fragment inside the brain tissue. The patient needed drainage operation within one week of the episode when the catheter fragment was removed with complete recovery. The aim of this paper is to review the literature and to present warning notes on the untoward effects of iatrogenic brain foreign body

Anesthesia for encephalo-trigeminal angiomatosis [Sturge-Weber syndrome]

A case report of rare congenital disease of encephalo-trigeminal angiomatosis [Sturge-Weber Syndrome] [SWS], is presented to alert the anesthesiologist of its potential risk. The case was anesthetized for emergency orthopedic surgery. Anesthesia management is directed towards observing the clinical manifestations of localized superficial skin lesions, extensive systemic involvement, evaluating its associated anomalies and anticipating difficult intubation due to angiomas of the mouth and upper airway and be a ware of concurrent therapy. The authors reviewed the English-language literature and reported findings regarding the SWS pathophysiologic features, interventions, and outcomes, with emphasis on issues relevant to anesthesiologists. This patient tolerated balanced anesthesia well. Anesthesia should be planned to avoid trauma to the hemangiomata, increases in intraocular and intracranial pressure, and be cognizent of current anticonvulsant therapy

Evaluation of aetiology and efficacy of management protocol of epistaxis

Epistaxis is one of the commonest medical emergencies. It affects all age groups and both sexes. The cause may be local or systemic but in majority it is spontaneous and idiopathic. Trauma is considered to be a major aetiological factor. Various treatment protocols are utilized to control epistaxis derpending upon the type, severity and cause of bleeding. This descriptive study was designed to evaluate the aetiology and efficacy of management protocol of epistaxis in a tertiary care setting. 313 patients underwent prospective evaluation by consultant and non-consultant doctors with considerable experience in Ear, Nose and Throat [ENT] emergencies management. Standard principles were followed in the management. This study demonstrated a bimodal distribution with incidence peaks in below 25 years and above 50 years of age. Males were affected twice more than the females [2.15:1.04]. Anterior nasal bleeding was noted in majority of the patients. Anterior nasal packing was the most effective method of controlling anterior epistaxis. While posterior bleeding was controlled by posterior nasal packing with Foley's catheter. The most common cause was found to be trauma, followed by hypertension. It may be concluded from this study that epistaxis is the most common ENT emergency, affecting all age groups. It has a bimodal age presentation and affects males twice more than females. Anterior bleeding is more common than posterior bleeding. Epistaxis may be controlled with chemical/electro-cautery if the bleeding point is visible. In case of failure to localize or access a bleeding point or profuse bleeding, anterior nasal packing can effectively control majority of epistaxis. Foley's catheter is a good option that can be used for posterior nasal packing. Gelfoam may be used for controlling epistaxis in cases of bleeding disorders, when there is mucosal ooze