Copmarison between Endoscopic band ligation and Sclerotheraby in management of upper Gastro-intestinal hemorrhage due to esophageal varices

Upper gastrointestinal bleeding is serious complication of portal hypertension which can be treated by different medical and surgical methods with possibility of failure, re-bleeding and death. Objective: To evaluate the efficacy of band ligation and Sclerotherapy in controlling initial bleeding, failure of control [during first 24 hours] and re-bleeding within 5 days. Patients and Methods: This prospective study was conducted at Gastroenterology and Hepatology Teaching Hospital in Medical city complex in Baghdad from the 1st of January 2010 to the 1st of March 2012. The study engaged 100 consecutive patients who were divided equally into two groups [50 patients each], first group were treated with banding procedure while patients in second group were treated with sclerotherapy and both groups were followed up for 5 days. Results: Neither failure to control bleeding [during first 24 hours] nor death occurred in both groups. Successfulness [no re-bleeding within 5 days] was more common in Band ligation group [94%] rather than sclerotherapy group [90%]. On the other hand, 8 patients in both groups all were child-pugh C developed re-bleeding, 3 patients [6%] in Band group and 5 patients [10%] in sclerotherapy group and need second session which was successful in all patients in both procedures, comparison statistically was significant and Band procedure was better than Sclerotherapy procedure, [P. value=0.029]. Conclusion: Endoscopic Band ligation is more effective than Sclerotherapy in controlling initial attacks of esophageal varices bleeding and decreasing recurrent attacks of bleeding

Wilson's disease: laboratory evaluation of a sample of patients attending Baghdad teaching hospital

Wilson's disease [WD] is an inherited defect in copper metabolism that causes accumulation of copper in various body organs. It is a treatable; if it is diagnosed promptly and treated consistently. Laboratory; hematological, biochemical, and diagnostic evaluation of a sample of Iraqi patients with WD, and study any association between clinical presentations and studied variables. A case series study was conducted during 2011, from the 1[st] of February till the 10[th] of June. Sampling method was a convenient non-random one, through consecutive pooling of registered WD patients. A questionnaire-form paper had been developed for data collection, and required investigations were done in qualified laboratories. The study had enrolled 29 patients, with a male to female ratio of [1.07:1], The mean hemoglobin level was 10.64 +/- 2.53g/dl. Hemolysis was presented in 27.6% of patients, normochromic-normocytic RBCs in blood film were seen in 3.4% patient, platelet count was 243.97 +/- 89.35ccX10[9]/L, WBC count was 5.70 +/- 2.84ccX10[9]/L. ESR was 24.98 +/- 17.16mm/hr., serum bilirubin was 6.17 +/- 5.18mg/dl, serum cholesterol was 146.21 +/- 44.93mg/dl, serum triglycerides was 95.34 +/- 52.23mg/dl. Total serum protein was 72.86 +/- 11.15g/L, serum Albumin 39.17 +/- 7.88g/L and serum Globulin 31.07 +/- 7.89g/L. Penicillamine challenge test was positive in 96.6% patients. Serum ceruloplasmin level was 123.38 +/- 48.48mg/L, total serum copper was 72.48 +/- 25.11 micro g/dl, and 24h urinary copper excretion was 174.97 +/- 109.58 micro g/24hr. Most patients with WD are; anemic, with low serum levels of copper and cerulloplasmin, positive penicillamine challenge test, with abnormal liver function tests. With detected hemolysis in some of them; though no statistical difference or association was approved regarding laboratory values among patients with different presentations

Fibromyalgia syndrome in 104 Iraqi patients with inflammatory bowel disease

Fibromyalgia syndrome [FMS] is a common rheumatologic syndrome with multiple systemic manifestations and associated with many diseases. To assess fibromyalgia syndrome in inflammatory bowel disease. One hundred four Iraqi patients with inflammatory bowel disease were studied and compared with another [112] healthy individuals matched for age and sex as a control group. Full history was taken and complete clinical examination was done for all individuals in both groups. Fibromyalgia syndrome was diagnosed in all patients on base of the American College of Rheumatology [ACR] 1990 Criteria for the classification of FMS. Inflammatory bowel disease was detected by colonoscopy and tissue biopsy. There was a significant increase in the frequency of FMS among individuals with IBD [24%] compared to healthy control group [5.4%] [[P-value=0.0001, Odd ratio=0.18, 95% CI=0.07-0.46]. FMS occurs with increased frequency in IBD