Prediction of preeclampsia and low birthwejght for gestation by uterine and umbilical arteries blood flow velocity waveforms analyses in low risk nullipafious women

To assess the predictive performance of Doppler abnormalities of uterine and umbilical arteries blood flow velocity waveforms [uterine artery protodiastolic notch, Systolic/Diastolic ratio; S/D and Resistive Index; RI] to predict Preeclampsia; [PE] and Intrauterine Growth Restriction;[IUGR]. A prospective study included 70 low risk nulliparous women at 19-26 weeks of gestation, in the Obstetrics unit at Al-Yarmouk Teaching Hospital in Baghdad in the period from January 2004 to January 2005. Their arterial blood pressure; was measured, as they underwent transabdominal ultrasound and pulsed Doppler examinations for evaluating the uterine and umbilical arteries blood flow velocity waveforms, for predicting the development of Preeclanipsia and/or Intrauterine Growth Restriction later in pregnancy when the same women were reexamined at 30-35 weeks of gestation and then followed at delivery time. The incidence of the outcome was 37.1%. All the abnormalities of the studied Doppler indices were not significantly associated with preeclampsia and intrauterine growth restriction as reflected by the variable sensitivities [9.5% to 100%], specificities [29.5% to 97.4%] and low positive predictive values at pretest probability of 10% [12.3 to 28.9]. Uterine and umbilical arteries Doppler blood flow velocity waveforms analysis does not fulfill the requirements for a screening test in unselected low risk population, but may be useful in selected high risk population

Granulosa cell tumor: Clinical review of four cases.

Patients with a diagnosis of granulosa cell tumor should be followed carefully for the Rest of their lives. Patients treated with surgery only, develop recurrent cancer. Management of recurrent cancer should be aggressive debulking surgery followed by combination chemotherapy. The first choice of chemotherapy is the [cis-platinum, adriamycin, cyclophosphamide]. Hormonal therapy may play a role in managing recurrent disease but the experience is extremely limited. Recently patients with stage I [A] were treated with aggressive surgery plus chemotherapy and hormonal treatment. Review of the experience at Yarmouk Teaching Hospital provided two additional patients with a confirmed diagnosis of granulosa cell tumor of the ovary whom their treatment has been substituted with hormonal treatment of whom all are alive and disease free except one who died because of failure to follow up the treatment. A review of clinical and morrhage which was found to be a frequent preterminal event in advanced recurrent granulosa cell tumors. We are trying here to use the hormonal treatment as an important drug after surgery and to be continued after chemotherapy is stopped

Ovarian teratoma with peritoneal gliomatosis followed up to 18 years

This is a case of an 18-year-old female who, in 1968, presented with grade 2 ovarian of the solid type with peritoneal implants composed of glial tissue. Diagnosis was made by exploratory laparotomy and treatment was simple removal of the primary tumor with the peritoneal implant, following which no additional treatment was given. The patient later married and now has 2 children 18 years after the original diagnosis. The survival of this patient suggests that a conservative surgical approach without therapy to the implant is adequate to effect cure, and, that the presence of mature glial implants does not affect adversely the prognosis of ovarian teratoma

case of postpartum hemolytic uremic syndrome with mild elevation of liver enzymes and severe hyperbilirubinemia

An unusual case of multifocused postpartum thrombotic micro angiopathy seen in a woman who had pregnancy induced hypertension with the so-called HELLP syndrome diagnosed pre-delivery. The clinical features in this case differ from those seen in postpartum haemolytic uraemic syndrome or thrombotic thrombocytopenic purpura. The patient had acute disseminated intravascular coagulation, mild elevation of liver enzymes with severe hyperbilirubinaemia, severe renal dysfunction and hemolytic anaemia. She was treated succesfully with fresh whole blood, frequent hemodialysis and large doses of corticosteroids with antibiotics

Analysis of 1237 malignant neoplasms at Al-Yarmook hospital

An analysis of 1237 malignant neoplasms seen during a 3-year period at AI-Yarmook Teaching Hospital is done, and the date compared with reports from this and other countries. The peak presentation of cancer for both sexes is in the 7th decade; the peak presentation for females appears to be 2 decades younger than males. The most striking feature of the results is the high frequency of cancers of the cervix; this was twice as common as cancer of the breast in the female. Leukaemias are the commonest malignancy in both sexes. Following Ieukaemia, the most frequent cancer site in males includes the larynx [14.5%], urinary bladder [14%], skin [8.4%], lymphomas [8.4%], and pharynx [4.8%]. In the female cervical cancer is the dominant tumour [16.5%] followed by the breast [9.2%], ovary [7.7%], urinary bladder [7.4%], and lymphomas [7.2%]. The high frequency of cancers in children and adolescents below the age of 20 years [17.7%] is probably due to the young age structure of the Iraqi population. The biases in the frequency of cancer using hospital records as the source of information are discussed