Volume 16, Issue 1, Winter and Spring 2020, Page 1-24


Application of Ultrasound Classification of Hepatic Hydatid Cyst in Iraqi Population

Inas M. Al-Ani; Mudhaffar B. Mahdi; Ghassan M. Khalaf

Al- Anbar Medical Journal, 2020, Volume 16, Issue 1, Pages 3-7

Background:Cystic Echinococcosis (CE) is an endemic disease in Iraq. Its classification is crucial
for proper management.
Objectives:To apply ultrasound study in classifying hepatic hydatid cyst disease in the Iraqi
population, which is essential in treatment planning.
Materials and methods:This prospective study conducted during a period from March 2017 to
March 2018, in the Gastroenterology and Hepatology Teaching Hospital/ Medical City/ Baghdad.
A total of 100 patients with a diagnosis of hydatid cyst by ultrasound were followed-up after
surgery and histopathology were proved hydatid cyst. Their age range was 10-79 years (mean age
32±12.5), female to male ratio 1.6:1.The standardized WHO classification of CE was used in
this study.
Results:CE class I was noticing in (35%), class II (35%), class III (17%), class IV (7%), and class
V (6%).
Conclusion:WHO ultrasound classification of hepatic hydatid cyst becomes more popular and
preferable than other classifications. CE class I and II were the most common classes in the Iraqi
population. We strongly advise to use this classification in clinical practice and scientific researches.

Incidence of Rota Virus Gastroenteritis among Vaccinated and Non-vaccinated Children Less Than Two Years Old in Ramadi City, Iraq

Muneam A. Ayyed; Mohsen F. Al-Dulaim; Rafi K. Al-Ani; Saleem O. G. Al-Mawla

Al- Anbar Medical Journal, 2020, Volume 16, Issue 1, Pages 8-11

Background:Acutegastroenteritisisamajorcauseofhealthproblemamongchildrenin
undeveloped countries, where the rotavirus is the most widely recognized etiology.
Objectives:This study aimed to find out the incidence of rotavirus in diarrheal children less than
two years of age in both vaccinated and non-vaccinated children with rotavirus vaccine.Also to
determine some risk factors associated with this disease.
Materials and methods:A cross-sectional study was conducted for 6 months, from the first
of June 2018 to the first of December 2018. Six hundred child less than two years old with acute
gastroenteritis was included in the study.Stool tests were sent to the lab for identification of
rotavirus antigen using the ELISA technique in the stool.Stool samples belong to 300 cases of
vaccinated children with the rota vaccine and the other 300 cases belong to non-vaccinated children.
A questionnaire data form regarding age, gender, maternal education, residence and type of feeding
was taken from each infected child.
Results:Out of a total of 600 stool samples of children with acute gastroenteritis, rotavirus was
detected in 192 (32%) samples.Among 300 non-vaccinated patients, 123 (41%) were rotavirus
positive, and among other 300 vaccinated patients 69 (23%) were rotavirus positive. The majority
of cases were reported in the age group 6-12 months. Bottle-feeding and mothers of the low
educational level were found to increase the incidence of rotavirus infection.
Conclusion:Incidence of rotavirus gastroenteritis was predominant in diarrheal children. Vacci-
nation with the rotavirus vaccine decreases the rotavirus gastroenteritis in diarrheal children.

Incidence of Typhoid Fever and the Validity of the Widal Test in Some Districts in Iraq

Mousa A. Shubbar; Shakir M. Zighar

Al- Anbar Medical Journal, 2020, Volume 16, Issue 1, Pages 12-16

Background:Typhoid fever is a serious infectious disease. In Iraq, the disease has a public health
burden because it’s endemicity and there is an overestimation of the cases because the diagnosis
almost depends on the Widal test.
Objectives:The study aimed to determine the occurrence of typhoid fever in four sentinel sites
in Iraq and to assess Widal test sensitivity and specificity.
Materials and methods:This cross-sectional observational study conducted in four districts
in Iraq which has a population ranging from 170 000 to 431 000.A consecutive sample of
(757) patients attended the outpatient or admitted to hospitals with any Widal positive case,
probable typhoid case and suspected typhoid case were included in the study.A questionnaire
including demographic, clinical, laboratory and exposure data was filled for each suspected case.
Confirmation of the diagnosis of typhoid fever was done by serological examination and culture
(blood, urine or feces) for each patient included in the study.
Results:Theoccurrenceoftyphoidfever(per100000population)was34,9.4,3.5,0in
Al-Haweeja, Al-Hay, Al-Majar, and North Najaf districts respectively and this occurrence was
lower in three study districts when compared with the same period of 2010 and 2011. The mean of
the age of cases was 25.8 years±16.03 and the male to female ratio of confirmed cases was 0.7:1.
Also, this study showed that the sensitivity of the Widal test was 16.7% and the specificity was
36.2% when compared with culture results.
Conclusion:The incidence rate of typhoid fever was low in the four selected sites except for the
Al-Haweeja district. The sensitivity and specificity of the Widal test were low.

Application of 40% Trichloroacetic Acid in the Treatment for Recurrent Genital Herpes

Dawood S. Idan

Al- Anbar Medical Journal, 2020, Volume 16, Issue 1, Pages 17-20

Background:Genital herpes is one of the common sexually transmitted diseases affect more than
400,000,000 individuals worldwide.The disease characterized by relapse and remission courses
and caused by herpes simplex virus (HSV) type 2.However, satisfactory curative agents are still
unavailable.
Objectives:This study intends to evaluate the benefit of 40% Trichloroacetic acid (TCA) in the
management of recurrent genital herpes lesions of the external male genitalia and to detect the
recurrence rate during this therapeutic regimen.
Materials and methods:The study extended between 1998 to 2017 and totally, 175 patients
with active disease were treated by oral administration of acyclovir 400mg 5 times per day for 5
days. Only 99 patients were followed up for one year and enrolled in the study. After 2 weeks, the
recurrent cases were subjected to the chemical peeling using topical application of 40% TCA at the
site of reactivation.
Results:The most affected age group was 40-50 years (n=45, 45.45%). The neck of the penis was
the most affected site (n=56, 56.57%).Forty patients had only one recurrence during a one-year
follow-up after treatment with 40% TCA.
Conclusion:This study approved the clinical effectiveness of the topical application of 40% TCA
in reducing the recurrence rate of the genital herpes lesions.We recommend using this chemical
peeling method in the treatment of patients with genital herpe

Cystic Hygroma of the Spermatic Cord: A Case Report

Omar A. Ajaj

Al- Anbar Medical Journal, 2020, Volume 16, Issue 1, Pages 21-23

A lymphatic malformation is usually present at birth but can manifest at any age.The most
common location sites are the neck (75%), axilla (20%), while, one of the unusual sites is the
scrotum.To avoid misdiagnosis of cystic swellings in the inguinoscrotal area, Cystic Hygroma
should be considered in the differential diagnosis.We reported a case of a 3-years-old male child
presented to the pediatric surgery clinic with a painless lump in the right inguinoscrotal area of
2-years duration.On the ultrasound imaging, there was a large inguinoscrotal cystic swelling
containing clear fluid. The mass was excised under general anesthesia through an inguinal incision.
Intra-operative macroscopic examination and the histopathological result of this mass disclosed it
as a Cystic Hygroma located in the spermatic cord. After 6-months of follow up no recurrence was
detected.