045551   ASHWINIRANI S R, GIRISH S (Oral Medicine & Radiology, and Periodontology Dep, Krishna Institute of Medical Sciences, Karad, Western Maharashtra) : Association between oral potentially malignant disorders with age, gender, site and habits in western part of Maharashtra population. JK Sci 2020, 22(4), 202-6.

The World Health Organization coined the term “potentially malignant disorders (PMDs)” which includes both premalignant lesions and conditions. The oral PMDs include various types like leukoplakia, lichen planus, tobacco pouch keratosis, smokers palate, oral submucous fibrosis, erythroplakia, discoid lupus erythromatosa and proliferative verrucous leukoplakia. Majority of these disorders are caused due to habits like usage of tobacco, alcohol, spicy food and viruses. Purpose: To analyze the association between oral PMDs with age, gender, site and habits in western part of Maharashtra population. A cross sectional prospective study was carried including 130 patients with clinically and histopathologically diagnosed oral PMDs. The information regarding age, gender, site and habits were recorded and descriptive statics (frequency and percentage) was calculated. Out of total 130 patients 63.9 % were males and 36.1 % were females. The predominant oral PMD observed was tobacco pouch keratosis followed by oral submucous fibrosis and lichen planus with least percentage of smokers palate, actinic cheilitis and erythroplakia. The most common site affected was buccal mucosa. Smoking and use of smokeless form of tobacco were the most common etiological factors in our study. Early screening to detect oral PMDs will help to initiate suitable treatment and prevent the risk of malignant transformation of these disorders. Patients should be educated regarding the adverse effects of tobacco and alcohol on general health and oral cavity.

4 illus, 4 tables, 23 ref

045550   SAHITI J S, VAMSEE KRISHNA N, PRASAD S D, KUMAR C S, KUMAR S S, SUMA R B (Conservative Dentistry and Endodontics Dep, CKS Theja Institute of Dental Sciences and Research, Chittoor, Andhra Pradesh) : Frequency of second mesiobuccal canal in permanent maxillary first molars among Tirupathi population: A retrospective study. JK Sci 2020, 22(4), 198-201.

The success or failure of the root canal treatment depends on proper bio-mechanical preparation and obturation. However, a missed canal might be the foremost reason for failure of a tooth that seems to be properly treated. The canal that is often missed without much attention is second mesio-buccal canal of maxillary molars. To investigate the incidence of MB2 canals in Maxillary first molars among Tirupathi population. A survey was carried out in Tirupathi and data was obtained from the dental practitioners and from our dental college for the past one year. Out of 6945 maxillary first molars a total of 2534 MB2 canals were located and filled. A high statistically significant difference (p<0.0001) in the occurrence of MB2 canals in males compared to females and left maxillary first molars comparative to the right molars was observed. The percentage of MB2 canals in maxillary first molar derived in the present study was 36.49 %.

2 tables, 25 ref

046788   NASER A M, ABED Q J O (Southern Technical Univ, Basra, Iraq) : Determination knowledge of nurses’ concerning measurement of blood pressure in emergency department at Al –Hussein Teaching Hospital in Al-Nasiriya City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194439.

A descriptive study at Al Hussein teaching Hospital in AL- Nasiriyah city to determine the knowledge of nurses’ in the emergency depatment. The most nurses working in this department after testing their information through the questionnaire prepared in calibrations did not have sufficient information about the pressure measurement. Nurses should enter courses on blood pressure measurement

6 tables, 10 ref

046787   ALZUBIADI A A M, ALTIMIMI L A, ALAAMIRI F S (Surgery Dep, Kufa Univ, Najaf, Iraq) : Evaluation of the effect of endoscopic sinus surgery with medialization of middle turbinate. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194438.

The main goals and key points of endoscopic sinus surgery are providing a sufficient drainage and ventilation for the diseased paranasal sinus groups. Method: A total of 44 patients (males 22 & 22 females) were included in this study, all of them complaining of chronic rhinosinsitis with or without polyposis not responding to maximal medical treatment and were assigned for ESS. Patients were classified into three groups; Group A: ESS with bolgarization, Group B: ESS with suture medialization of middle turbinate, Group C: ESS without medialization Postoperatively, patients were followed up with subjective (nasal obstruction, nasal discharge, headache, fascial pressure and smell disturbance) and objective (endoscopic evaluation of middle meatal MM patency) parameters in 2 weeks, I month, 3 months, 6 months and 1 year. Result: There improvement in nasal obstruction was reported by patients in all the three groups. Improvement in other symptoms was significantly higher in group A as compared to other groups. MM patency was evaluated by endoscopy and showed improvement of 100 % in group B.

1 illus, 4 tables, 22 ref

046786   FARHAN H J, JASSIM R K, THAIR L (Prosthodontic Dep, Karbala Univ, Karbala, Iraq) : Deposition of Ta2O5 film on commercial pure titanium disk by modified reactive plasma sputtering technique. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194437.

Now days the interest of implantology is to improve Osseo integration by find materials which accelerate bone formation at bone implant interface to provide immediate or early loading after placement of dental implant and eliminate waiting period which is un favorite and disturbs patients. Titanium is most common material for dental implant, but still need some modification for surface properties chemically and physically by using an other material such as tantalum which is gaining more attention as a new metallic biomaterial. Coating the surface of implant is an important way for development of surface properties of titanium. plasma Ta₂O₅ used for surface modification, which has several advantages such as increasing surface roughness, changing surface topography and increasing the wettability of the surface. To evaluate the action of Ta₂O₅ coating by modified plasma sputtering technique of commercially pure titanium disk on surface roughness, wettability and surface chemical composition in comparison to non-coated surface. All tested group were two groups in this study which include un -coated commercial pure titanium disks and Ta₂O₅ coated commercial pure titanium. Modified reactive plasma sputtering technique was used to coat CpTi with Ta₂O₅ at 4,6,8, hr. Analysis of surface characterization by x-ray diffraction (XRD) analysis, scanning electron microscope (SEM), energy dispersive spectroscopy (EDS) were carried out on the coated surfaces of the disks, contact angle measurement was achieved by applying drop of saline on the surface of coated disks and compared to non-coated one. The result of Ta₂O₅ coated specimen at times (4,6,8) showed that 8 hr. coating time was the best time. X-ray diffraction analysis show new peak formation for CpTi coated witht Ta₂O₅ disk which was not present in non- coated CpTi disk. The results showed that the rough surface was more and better distribution in CpTi coated with Ta₂O₅ disk than non- coated CpTi disk which improve by electron scanning microscope, wettability of Ta₂O₅ coated disk was more than wettability of non- coated CpTi disk.

4 illus, 15 ref

046785   ALKAFAJI A Z M, RISUN A H (Al-Qadisiyah Univ, Al-Qadisiyah, Iraq) : Prevalence rate of depression among ischemic heart diseases patients in Al-Diwaneya Province / Iraq. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194436.

Cardiovascular disease is on the upraise in the industrialized and unindustrialized countries, which characterize at the present time one of the chief challenges for the health systems all the world. Depressed Ischemiac Heart disease patients may have a poorer outcome than non-depressed patients, so this study was performed with the aim of finding the link between depression and ischemic heart disease and its association with demographic factors in Iraqi patients. : The study was designed to be a case- control study involving 128 case of IHD patients and120 apparently healthy individuals serving as control group, with an age range from 20y-80y in Al-Diwaniyah Teaching Hospital in Al-Diwaniyah province/ Iraq. were examined for the presence of depressive disorder using ICD-10 diagnostic criteria and then assessing the severity of the depression in the depressed group by using Beck Depressive Inventory(BDI ). : The prevalence rate of depression was 48.3 % in IHD patients while 22.5 % in control groups. Because of high rate of depression among patients with different types of heart diseases, early detection and identification of as possible ,to improve outcome .

5 tables, 25 ref

045549   GOEL A, JEELANI T M (Anaesthesiology and Critical Care Dep, Govt. Medical Coll, Srinagar (J&K)) : Study of role of dexamethasone in critically ill covid-19 patients at covid critical center. JK Sci 2020, 22(4), 193-7.

Coronavirus disease 2019 (COVID-19) is a global pandemic and a substantial proportion of older individuals with COVID-19 develop a respiratory illness requiring intensive care, which can progress to critical illness with hypoxemic respiratory failure requiring prolonged ventilatory support. Corticosteroids reduces systemic inflammation & exudative fluid in the lung tissue and thus prevents further damage to diffuse alveolar tissue, thereby improving the hypoxia and minimizes the risk of respiratory failure. To study clinical characteristics and early outcomes in critically ill patients with COVID-19 receiving dexamethasone.  In present prospective, interventional study, intravenous dexamethasone was started depending on clinical condition either at admission or when they became hypoxic or when they did not improve with conventional therapy or became critically ill.  Primary outcome was 28-day mortality which was 28 %, while secondary outcomes were discharged from hospital within 28 days (82 %), invasive mechanical ventilation required (73 %), duration of mechanical ventilation (6.3 ± 4.5 days), length of stay in the hospital (13.9 ± 8.4 days).  Intravenous dexamethasone decrease the overall mortality in critically ill COVID 19 patients. Early use of dexamethasone in patients with moderate to severe COVID-19 may prevent progression of disease and improve outcomes.

3 tables, 17 ref

046784   ASSER A J, MOHAMMED H J (Babylon Univ, Babylon, Iraq) : Nutritional status of primary school children in Babylon Governorate. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194435.

To assess the nutritional status of school children.To identify some associated factors of school children related to nutritional status. And To find out some associated factors of school children and their nutritional status. A cross-sectional descriptive study consisting of (1013) pupil,to assess nutritional status of primary school children in Babylon Governorate. Analysis of data reveals that there is a 47.4 % of children have a normalbody mass index, and 43.0 % have underweight, 7.6 % overweight, while 2.0 % only have obesity. The study showed that 76.4 % has normal blood hemoglobin, 21.2 % low blood hemoglobin and 2.4 % increase blood hemoglobin. :Just under half of children has a normal body mass index and about half of study sample have underweightthis considered as a result of malnutrition of primary school children. And Observed there are high percentage of children have anemia this can be result from many factors contribute in children anemic. 

6 tables, 19 ref

046783   AL-AZAWI R S A, AL-HADY F N A (Physiology Dep, AL-Qasim Green Univ, Babylon, Iraq) : Testosterone and progesterone levels, gene expression of androgen and progesterone receptors in albino male rats treated with phenolic flower extract of Hibiscus rosa - Sinensis L. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194731.

Hibiscus rosa sinensis L. is one of medicinal plant and belongs to the family Malvaceae , Hibiscus species are used in the treatment of many disease, flowers are used to stimulate hair growth , wounds healing activity, anti-parasitic effect , Antidiabetic anti-hyperlipidemic activity. and have many pharmacological properties including anti-fertility , antipyretic, antispasmodic, antifungal, anti-inflammatory and many more. This study was conducted in the department of Biology /College of Science/University of Babylon/Iraq , to evaluate the Effect of Phenolic Extract of Hibiscus rosa - sinensis L. flowers on some biomarkers and gene expression in Albino male Rats .The overall number of animals used were 32 male rats aged 2-3 months. The results showed a significant decrease (p<0.05) in the level of Testosterone and Progesterone in treated rats as compared with control groups for 30 and 60 days. Also the result revealed a significant decrease ( p< 0.05) in the expression of the androgen receptors and progesterone receptor in the testicular cells treatment group with phenolic compounds of H. rosa- sinensis flowers at a dose of 300mg / kg /day of body weight for 60 days compared to control groups.

4 illus, 1 table, 24 ref

046782   HASAN N S, YASIR M K, KHASAL Q A, JABBAR M Z, JASIM A A, AL-SADOON I (Nasiriyah Heart Center, Nasiriyah, Iraq) : The use of complementary and alternative medicine among diabetic patients in Nasiriya City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194730.

Diabetes is a predominant public health concern that has increased steadily worldwide . The disease causes substantial morbidity, mortality and long term complications. Herbs and natural products have been used in treatment of diabetes mellitus . Herbs and other plant products are considered more natural. They are a kind of home treatment and can be a part of home usual diet . Use of herbs is becoming popular more and more and is more appropriate for use in developing countries. The aim of this study was to examine the prevalence of use of herbal remedies among diabetic population in Nasiriya and to identify factors which might predict the likelihood of using herbal remedies. Cinnamon (Darcien) 12.3 % and Black cumin (Habba soda) 11 % . On univariant analysis , the factors which were found to affect the herbs use were education ,occupation , type of diabetes mellitus , duration of diabetes ,marital status and age . Using data analysis ,the significantly associated factors were occupation type of treatment and drug regularity . Health care providers should respect patients’ wishes to use herbal remedies and should provide advices about treatment by herbal remedies.

6 tables, 27 ref

045548   HASSAN M J, REHMAN M, IMTEYAZ S P, KHAN S, AHMAD N, JETLEY S (Pathology Dep, Hamdard Institute of Medical Sciences & Research, Jamia Hamdard, New Delhi) : A clinical and hematological profile in geriatric patients with special emphasis on morphological and etiological classification of anemia in these patients - A pilot study. JK Sci 2020, 22(4), 187-92.

Anemia in geriatric population is a very common problem and if untreated, anemia in elderly age group is associated with impairment of functional capacities, poorer health related quality of life, increased morbidity and mortality. Purpose: To study the clinical and anemia profile of geriatric patients and to classify anemia in this age group according to morphology and etiology. After obtaining informed and written consent from patients, each patient’s particulars were noted in a structured proforma. This was followed by detailed physical and systemic examination. Complete blood count was done on automated 6-part hematology analyzer XN-1000i (Sysmex Corporation, Kobe, Japan). Peripheral blood smear was stained by Leishman stain and subsequently studied under microscope. Iron studies, serum B12 levels and folic acid levels were estimated as per the protocol of our lab. During a period of 2 months, 60 patients aged 60 years and above admitted in our hospital were evaluated for anemia. Male to female ratio was 1:2. The age of our cases ranged from 60 - 87 years with mean age of patient being 64.2 years. Clinically majority of our patients presented with generalized weakness and fatigue (66.6 %), followed by dyspnea (36.6 %) and fever (33.3 %). Majority of our patients presented with moderate anemia (65 %) followed by severe anemia (18.33 %) and mild anemia (16.67 %). Morphologically normocytic anemia (75 %) was most common type in our study, followed by microcytic anemia (21.7 %) and macrocytic anemia (3.3 %). Etiologically, anemia of chronic disease was the most common type followed by iron deficiency anemia and Vitamin-B12 deficiency anemia. Keeping in mind the deleterious effect of even mild anemia in geriatric population, an extensive evaluation of anemia in these population is essential so as to make an early diagnosis of potentially treatable cause of anemia.

3 illus, 2 tables, 13 ref

046781   AL-JUBOORI A K K, KHUDHUR I A G, FARIS S H (Psychiatric Mental Health Dep, Kerbala Univ, Kerbala, Iraq) : Depression among patients with renal failure undergoing haemodialysis treatment in holy Kerbala City in Iraq. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194729.

Renal dialysis patients face many challenges during the treatment period and are subjected to many psychological stresses, but depressive symptoms of dialysis patients are associated with higher mortality. This study aims to assess the level of depression in patients with chronic renal disease undergoing haemodialysis treatment; 60 patients with chronic renal failure receiving haemodialysis treatment were recruited from AlHussian hospital in one of the religious cities in Iraq. Depression was assessed using the Beck Depression Inventory.The results showed that most participants had severe and extreme levels of depression, and higher scores were representative of somatic depressive symptoms. There was no significant association between depression and patient demographic data. Depression should be assessed by nurses, and patients should be referred for treatment to decrease mortality and improve disease outcome.

2 tables, 30 ref

046781   AL-ASADY A M, AL-MARZOOK F A, ALHAMED T A (Warith Al-anbiya’a Univ, Warith Al-anbiya’a , Iraq) : Catalase gene polymorphism in patient with diabetes disease type 1 in Karbala City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194728.

Diabetes Mellitus (DM) is a collection of metabolic diseases categorized by hyperglycemia caused by insulin excretion deficiencies, insulin performance, or both DM are categorized into distinct kinds. Type 1 diabetes (T1D) is defined by breakdown of β-cells, generally resulting in complete insulin deficiency. Type 2 diabetes (T2D) is a consequence of peripheral tissue insulin resistance. a complete of fifty patients and fifty control subjects were collected between February to October 2018. The genotyping of catalase were attained consuming polymerase chain reaction (PCR) in addition to restriction fragment length polymorphism (RFLP). We tend to firm vigorous changes within the genotype occurrences of catalase between patients with diabetes and controls using the P=0.038, OR =0.58 (0.48-0.78).

2 illus, 1 table, 22 ref

046780   ABDULLAH A N, ABBAS Q K (Surgery Dep, Al-Diwaniyah Teaching Hospital, Al-Diwaniyah, Iraq) : The efficacy and safety of Cinnarizine in the treatment of vertigo in a sample of Iraqi patients in Al-Diwaniyah Province. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194727.

Vertigo is acoomon vestibular disorder in daily clinical practice that is frequently described as rotational sensation by patients and caused by a variety of causes that can be central or peripheral in origin. Treatment should be directed toward underlying etiology, but symptomatic relief is required to improve patients’ quality of life. Cinnarizine is frequently prescribed to relieve symptoms associated with vertigo; however little is known about its efficacy in daily clinical practice in Al-Diwaniyah province. : To evaluate the safety and efficacy of cinnarizne in the treatment of vertigo in patients visiting ENT unit at Al-Diwaniayh teaching hospital. The present cohort study included 66 patients of vertigo who were treated medically by cinarrizine (stugeron) and followed up for treatment response evaluation. The study was carried out in Ear Nose and Throat (ENT) unit in Al-Diwaniyah Teaching Hospital, Mid-Euphrates region, Iraq. The study started on June 2018 and ended on July 2019. The main variables included in the study were age, residency, level of education, occupation, other associated ENT manifestations and chronic illnesses. The primary outcome was response to treatment classified into satisfactory and unsatisfactory. Mean age of patients with satisfactory response was significantly less than that of patients with unsatisfactory response, 45.73 ±13.31 years versus 54.95 ±15.67 years, respectively (P = 0.016). Response to treatment was not significantly associated to gender, residency, occupation and education (P > 0.05). Response to treatment was not significantly associated to bilateral ear wax, acute otitis media, chronic suppurative otitis media, Meniere’s disease and common cold (P > 0.05); however, it was significantly in the absence of hearing impairment and tinnitus (P < 0.05). Response to treatment was no significantly associated to uremia, trauma, anemia, hypothyroidism, anxiety, hypotension, arthritis and urinary tract infection (UTI) (P > 0.05), but significantly better in the absence of diabetes mellitus and hypertension (P < 0.05). 

2 tables, 20 ref

046778   AL-JOTHERY A H, BAIEE H A (Babylon Univ, Babylon, Iraq, Email: hassanbaey@yahoo.com) : Epidemiological aspects of attention deficit hyperactivity disorder among pupils in Al-Hilla City – Babylon Province –Iraq. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194725.

Attention Deficit Hyperactivity disorder was an important issue of mental health and welfare affecting pupils at the primary school specially in conflict affected areas including Iraq. To identify the prevalence and the epidemiological profile of ADHD among pupils in Al-Hilla city –Babylon province/Iraq. This was a cross sectional study which was conducted in 4 randomly selected groups by lottery , the pupils at the primary schools located in AL-Hilla city center, the study was conducted during the academic year 2016-2017 , 100 children were randomly selected from the first three primary school grades. A structured questionnaire was used to assess the behavior of pupils by both teachers and parents after obtaining their verbal consents. The questionnaire was designed according to the formula of diagnostic criteria of attention deficit and hyperactivity disorders used by American Academy of Pediatrics. The overall prevalence of ADHD in the study group was 14 %,.The male to female ratio was 3.5:1, there was a highly significant association between this disorder and the presence of family history of this health problem p<0.001, parents tobacco smoking habit was significantly associated with the presence of attention deficit hyperactivity disorder among their children (the combined type) p<0.05, there was significant relationship between poor school achievement and this behavioral problem p<0.05. In conclusion, ADHD is an important health problem among pupils in Hilla city . Intervention should be made to improve health care providers and teachers’ knowledge about this problem and control the modifiable risk factors.

5 tables, 31 ref

046777   BAIEE H A, KIZAR Z F, JASIM H S, JASIM S S, RAHEEM L Q (Babylon Univ, Babylon, Iraq, Email: hassanbaey@yahoo.com) : Potential risk factors of breast cancer among women attending teaching hospitals in Babylon Province. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194724.

Breast cancer is the most common cancer among women worldwide and the leading cause of cancer deaths among Iraqi women. To determine the potential risk factors associated with breast cancer. This was a hospital based case control study which was conducted at Merjan and Al-Hilla teaching hospitals. A sample of three hundred women participants who were selected and divided into 100 patients with established breast cancer (cases) and 200 healthy women without breast cancer who were considered as healthy control group. Data were collected by interviewing both groups using a structured questionnaire which includes information about(tobacco smoking, economic status, age of menarche ,age of menopause , use of contraceptives level of education ,family history of breast cancer). medical records of patients and control group were reviewed to complete the data needed ,chi square statistical test and Odds Ratios were calculated. Results of this study showed that the following factors like low economic status, ,late age of menopause ,positive family history, use of contraceptives were significantly associated with breast cancer(Unadjusted Odds Ratios more than one ,p values <0.05).Exposure to cigarette tobacco smoking, levels of education, and age of menarche did not show significant association with breast cancer in this study. Breast cancer was associated positively with the presence of positive family history, Low socioeconomic status, late menopause and using contraceptive pills regularly. 

6 tables, 36 ref

045547   DALAI S P, SAHU S, SAHOO N, SOHAIL, MOBIN S A M (PG Medicine Dep, IMS & SUM Hospital, Bhubaneswar, Odisha) : Hyperinsulinemia and insulin resistance in newly detected non-diabetic hypertensives. JK Sci 2020, 22(4), 181-6.

Hypertension is one of the most important cause of increased morbidity and mortality across the world and India alike. Research into newer pathophysiologic mechanisms such as hyperinsulinemia and Insulin resistance independent of obesity needs to be carried out extensively to address these potential therapeutic areas. To measure the serum insulin levels and levels of insulin resistance in newly detected hypertensive patients and to check for any possible correlation between grades of hypertension and levels of insulin resistance. Material and Methods: 100 newly detected hypertensive cases and 100 age and sex matched normotensive controls were included in our study over 2 years at our hospital in Bhubaneswar. The study revealed that newly detected hypertensive cases had higher mean serum fasting insulin levels and higher Insulin resistance as calculated by HOMA2-IR model as compared to controls (p<0.001). It was found in our study that there was a statistically significant increase in values of serum fasting insulin levels and Insulin resistance (HOMA2-IR) with severity (grades) of hypertension.

5 illus, 4 tables, 17 ref

045545   SINGH K, PATNAM H K (ENT Dep, Command Hospital, Bangalore, Karnataka) : A prospective study to correlate the preoperative CT scan findings with operative findings in patients undergoing functional endoscopic sinus surgery. JK Sci 2020, 22(4), 169-74.

Functional Endoscopic Sinus Surgery (FESS) is a surgical procedure used in the treatment of Chronic Rhinosinusitis (CRS). NCCT PNS is mandatory for all patients undergoing FESS and Rhinologist should know all the variations that can be found and diagnosed by CT scan. Purpose: The main aim of the study is to correlate the Computerized Tomography (CT) scan findings of Chronic Rhinosinusitis (CRS) with intra operative findings of Functional Endoscopic Sinus Surgery (FESS). Other objectives are to assess the clinical profile of patients with CRS and to determine the presence of anatomical variations. Material and Methods: All the patients were subjected to Diagnostic Nasal Endoscopy (DNE), CT Paranasal sinuses and findings recorded. The scoring systems used were Lund Mackay scoring system for CT scan. All the cases underwent FESS and the operative findings were correlated with preoperative CT findings. Statistical analysis was performed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa’s measure of agreement. Results: The Lund Mackay scores on CT scan were 5.42 on right side and 5.64 on left side. Kappa scores varied from 0-1.0. The findings related to septum, posterior ethmoids and sphenoid sinus have perfect agreement (kappa-1.0) with operative findings whereas frontal sinus and inferior turbinate have almost perfect agreement (kappa 0.81-0.99). Middle turbinate has substantial agreement with 0.79 kappa score. In maxillary sinus, anterior ethmoids and OMU, agreement was by chance. Conclusion: CT scan has excellent sensitivity and PPV for CRS but specificity and NPV is low in diagnosing disease in Osteomeatal unit (OMU), middle turbinate (MT) and anterior ethmoids. So, it should always be complimented by thorough history and DNE.

2 illus, 3 tables, 20 ref

046775   AL-NAJJAR S G (Thi-Qar Univ, Thi-Qar, Iraq) : The prevalence of sperm parameters for infertile males in Thi-Qar City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194722.

Male infertility is a term in which the male is not capable to attain pregnancy in a female. It occurs due to a lack of semen and low-quality semen. Semen Quality is referred to as a surrogate measure of male fecundity. This study aims to assess the frequency of sperm factors in infertile men in Thi-Qar City. This study involved an infertile couple, seminal fluid analysis (SFA) was done to evaluate male factors. Males with normal seminal fluid parameters were excluded. Regarding male, SFA was examined according to WHO 2010. Information such as age, duration of infertility and type of infertility were taken. Among the percentage of abnormal sperm parameters for infertile couples in which the largest percentage was for asthenozoospermia that represent 66.70 % of all infertile males. The second sperm abnormality is 12.13 % for oligoasthenozoospermia. Asthenoteratozoospermia and oligoasthenoteratozoospermia have the same percentage (4.4). Azoospermia represents 6.7 % while the lower percentage for teratozoospermia. largest percentage was for asthenozoospermia that represents 66.70 % of all infertile males .

4 tables, 14 ref

045543   AL- ATRAM A, ILANGO S, JAYAKUMAR S, KANNAN K (Psychiatry Dep, Majmaah Univ, Kingdom of Saudi Arabia) : Overcoming challenges posed by covid-19 pandemic in continuing medical education globally. JK Sci 2020, 22(4), 159-62.

COVID-19 pandemic has derailed the medical education system globally and setting it back on the track is a great challenge for the medical educationists. With the lockdown and social distancing being critical in curbing this pandemic, there is no denying the impact it has on medical education. Various medical schools have suspended all classes and live patient interactions for the students because of the recommended social isolation and quarantine. We are being hampered in our responsibility to educate future doctors and hence a vigorous focus on alternate measures is the need of the hour. Any alternative for the accustomed medical education system should be designed with the objective of facilitating the development of essential aptitudes in medical knowledge, patient care and ethics, personal care like proficient use of PPE, clinical and diagnostic skills. Swift measures need to be taken to prepare us for current and future crisis, if any arises. Hence an approach with the aim of risks outweighing benefits or vice versa should be properly scrutinised.

13 ref

045542   DASS B, GUPTA A, LUKOSE K (Medicine Dep, Florida Atlantic Univ, DC, United States) : Fighting covid-19: Time to revisit primary health care and healthcare allocation. JK Sci 2020, 22(4), 155-8.

As the epidemic of COVID-19 is surging on and so are the deaths. Trends show that people belonging to certain races and ethnicities, and with abysmal exposure to primary health care, are more vulnerable to the disease. A disproportionately higher number of deaths of African Americans and Hispanics have highlighted the lacunae of existing healthcare systems and access to care. Factors like poor living standards and housing, inadequate testing and treatment, lack of communication, and predominance of comorbidities, are major contributing factors in this dissimilarity. Also, this pandemic has made us comprehend that timely and proficient primary health care, can decrease the proneness to major complications with COVID-19. Inability to alleviate this incoherence will eventually intensify the strain due to the disease. Intuitive measures needed to be taken, for cessation of the current disease prevalence and brace the community for a future surge.

3 illus, 1 table, 20 ref

045540   SHARMA A K, SHARMA H R, CHOUDHARY U (Ophthalmology Dep , Govt. Medical Coll, Jammu and Kashmir) : E-learning versus traditional teaching in medical education: A comparative study. JK Sci 2020, 22(3), 137-40.

Traditional method of learning via face to face lecture has been in curriculum since times immemorial. E-learning via multimedia has been a recent introduction in education system. To compare e-learning with the traditional method of teaching in medical education. The two different methods of teaching were applied on the same group of students. A total of six lectures were conducted. Three of them were taught by traditional method of teaching and three by e-leaning. Formative assessment in the form of written examination was carried out, followed by qualitative assessment at the end of session. The mean marks obtained after Exam-1 (i.e. following traditional teaching method) was 6.46 ± 1.48 and mean marks obtained after Exam-2 (i.e. following e-learning) was 8.37 ± 1.27. The mean difference score was 1.91 ± 1.55. The paired t-test was applied, and the value of t was 11.96 with p-value <0.001. The results between two teaching methods were statistically significant. For qualitative analysis Likert scale was used. 66 % of students strongly agreed that e-learning is a superior method than traditional method of learning. The e-learning proved to be more efficient and uniform method of student learning with revision facilities.

1 illus, 3 tables, 13 ref

045539   MAHAJAN R, MEHTA A, GUPTA V (Anaesthesia and ICU Dep, Govt. Medical Coll, Jammu and Kashmir) : To study the effect of i.v. dexmedetomidine by two different means for prevention of pain due to propofol injection. JK Sci 2020, 22(3), 133-6.

The incidence of propofol injection pain during induction of general anaesthesia varies from 28 % to 85 %. To Study the Effect of I.V. Dexmedetomidine by Two Different Means for Prevention of Pain Due to Propofol Injection. This prospective, randomized study we evaluated the effect of dexmedetomidine for reducing the incidence and severity of propofol injection pain by two different approaches while evaluating the hemodynamic stability. 120 Patients undergoing elective surgical procedures were randomly divided into four groups; in group I and II with the aim of keeping the drug within the vein the forearm was squeezed with a tourniquet up to 70 mmHg for 20 sec; the patients were administered 0.5µg/kg dexmedetomidine in Group 1 (n 30), 0.75µg/kg dexmedetomidine in Group 2 (n 30) for 5 min, followed by 15 ml of 1 % propofol in all patients over 25 seconds to induce anaesthesia. In Group 3 and 4; 0.5µg/kg and 0.75µg/kg dexmedetomidine was premixed with 15ml propofol respectively and administered for induction. Pain is graded on a 0– 6 scale. Overall median propofol injection pain score reduction was 65.75 % with the maximum reduction of 80 % seen in group 4 and minimum reduction of 50 % in group 1. There were statistically significant differences (p Â0.05) in both SBP and DBP and heart rate with the maximum decrease in all hemodynamic parameters in group 2 and 4. Pre-treatment with intravenous dexmedetomidine 0.75µg/kg, 5min prior to injection of long-chain triglyceride propofol is effective and safe in reducing the incidence and severity of pain due to propofol injection.

4 tables, 17 ref

045538   SABHARWAL R, MAHAJAN P, MAHAJAN A (Biochemistry Dep, Govt. Medical Coll, Jammu (J&K)) : Vitamin D deficiency in patients with type 2 diabetes mellitus in Jammu region. JK Sci 2020, 22(3), 129-32.

The present study was undertaken to estimate the serum vitamin D levels in type 2 diabetic patients and compare it with normal healthy individuals. The study was conducted in the department of Biochemistry, Government Medical College, Jammu. 50 patients with type 2 diabetes mellitus diagnosed on the basis of raised serum glucose levels and 50 healthy adults in the age group of 40 years and above were selected irrespective of their sex. Serum sample was taken for the estimation of serum glucose levels and the vitamin D levels in both the groups. The mean levels of vitamin D in diabetic males were 24.27 ng/dl which was much less as compared to normal healthy males in whom the levels were 34.11 ng/dl, and the difference was statistically significant (P=0.0042). Similarly, the levels of vitamin D in diabetic females were 19.56 ng/dl which was very low, as compared to the healthy females, and the p-value was also statistically significant (0.0041). It was observed, that the type 2 diabetic patients had significantly lower vitamin D levels irrespective of their gender.

1 illus, 4 tables, 17 ref

045537   JAIN R, GUMASHTA R, PANDEY A, JAIN A (Community Medicine Dep, People’s Univ, Bhopal) : Exploring biodiversity for prevention and control of cancer and other non-communicable diseases using indigenous environmental resources: An interdisciplinary research. JK Sci 2020, 22(3), 122-8.

An interdisciplinary research of public health, biomedical and pharmaceutical sciences is needed for integrating qualitative and quantitative researches undertaken. It hence requires focus on public beneficence for non-communicable diseases. To study anticancer activities of soil samples of Central India and its stability for applied public health use. Screening on Actinomycetes isolates obtained from rural and urban farm soils illustrating arginase production was conducted from equated soil samples of geo-representative localities and adjoining areas of Bhopal, India. Enrichment Technique (CDSEA) was used for detection of extracellular production of L-arginase and their anticancer activities using MTT 3-(4,5- dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay along with characterization and probiotic properties of selected isolate. L-Arginase activity quantified by ornithine (21.06-117.92 U/mg) was found in isolates BRD-21, KAR-73, BHA-162, BAR-199, ARH-210, HAB-228. Urea release (15.88 – 59.79 U/ mg protein) depicted L- arginase activity in crude enzyme samples. It shows noticeable anticancer activity. Morphological and biochemical characterization of these isolates revealed metabolic diversity. Isolate KAR 73 produced collagenase (specific activity 57.8 U/mg), L-asparaginase (specific activity 116 U/mg) and L-arginase with tolerance to higher temperature (45 °C) and salt concentration (2-8 % w/v). Equal concentrations of crude L- arginase from these isolates inhibited growth and proliferation of colorectal adenocarcinoma cell lines (19.99 %-38.65 %) under in-vitro conditions. Arginine depletion through arginase activity is evidenced for potential effectiveness in cancer treatment especially adenocarcinomas and squamous cell carcinoma. It is useful for wider public health purposes.

1 illus, 2 tables, 20 ref

045536   KHURANA I, BHUTANI G, RANI S, SAINI R (Pharmacology Dep, Bhagat Phool Singh Govt. Medical Coll for Women, Sonepat, Haryana) : Prescribing pattern and medication inappropriateness in geriatric patients in a Tertiary Care Teaching Hospital. JK Sci 2020, 22(3), 116-21.

Altered hepatic, renal and GIT function along with multiple comorbidities makes use of certain drugs inappropriate in geriatric population. Identification and rectification of mistakes and lacunae in the current prescribing pattern is crucial for ensuring appropriate and rational prescribing. To study the prescribing pattern and medication inappropriateness in geriatric patients in a tertiary care teaching hospital. Details of the prescribed drugs were obtained from the files of the 60 hospitalised geriatric patients and the prescribing pattern was studied. Medication inappropriateness was assessed and the inappropriate drugs were classified into various categories using Beers criteria given by American Geriatric Society. Number of prescriptions having potential for drug interactions was also calculated. Results: Average number of drugs per prescription was 7.7 with antibiotics being the most commonly prescribed drugs. 49.13 % were prescribed by brand names. 12.12 % drugs were prescribed inappropriately and 20 % prescriptions had one or more inappropriate drug. Potential drug-drug interactions that should be avoided in older adults were found in 11.6 % prescriptions.  A considerable fraction of the prescriptions of geriatric patients were inappropriate and incidence of polypharmacy was very high. There is a pressing need to educate the physicians about the mistakes in the prescribing pattern of geriatric patients and the adverse effect it can have on the health of these patients.

1 illus, 3 tables, 18 ref

045535   KOTHARI S, TRIKHA M, GUPTA D (Medicine Dep, DY Patil Medical Coll, Navi Mumbai, Maharashtra) : Microalbuminuria and essential hypertension: A critical evaluation. JK Sci 2020, 22(3), 110-5.

Recent advancements in diagnostic modalities for microalbuminuria have shown that urinary excretion of albumin is more in hypertensive patients as compared to subjects with normal blood pressure. Microalbuminuria is known to be associated with certain complications like dyslipidemia, cardiac complications, atherosclerosis and kidney disease. To analyze the prevalence of microalbuminuria and its clinical correlation with essential hypertension. The study was of cross-sectional design, which was carried out in outpatient and inpatient departments of Medicine in DY Patil Medical School and Hospital, Nerul, Navi Mumbai. Out of total 190 study participants 96 were normotensive controls, while 94 were hypertensive patients. Mean age in control group was 48 ± 9.4 years, while that in hypertensive group, it was 49.2 ± 10.2 years. The 24 hours mean urinary excretion of albumin in hypertensive patients with microalbuminuria was found to be 80.21, while it was 12.91 and 7.89 in hypertensive patients without microalbuminuria and control groups, respectively. Early screening to detect microalbuminuria in early stages will help to initiate appropriate treatment regimen and prevent the risk of complications and thus improvement in prognosis.

2 illus, 4 tables, 25 ref

045534   BALI S, GURU K (Physiotherapy Dep , Srinivas Coll of Physiotherapy and Research Centre, Mangalore, Karnataka) : Comparative effect of static stretching and mulligan stretching on hip adductor flexibility in footballers - A two group trial. JK Sci 2020, 22(2), 96-100.

Groin pain due to adductor strain is commonly seen in footballers. Many methods of stretching a muscle like ballistic stretching, static stretching etc are used to increase flexibility of hip adductors and prevent groin strain. Static hip adductor stretching till now is more favored technique whereas mulligan adductor stretching is very new and popular method of increasing muscle flexibility. The present study was undertaken to compare the effectiveness of 2 stretching programs i.e. Mulligan adductor stretching and static stretching on tight hip adductor. In this trial, 42 athletes who fulfilled the selection criteria were selected and then divided into two groups based on block randomization. Group-1 received Mulligan’s adductor stretching while Group-2 received static stretching of hip adductors for 3 alternative days. Hip abduction range of motion (Abd-ROM) was measured on baseline, after first day treatment and finally after third day treatment by a universal goniometer. Mean difference of Abd-ROM within groups on baseline, 1st day after treatment and 3rd day after treatment were -8.07, -12.76, -4.69 which shows highly significant difference (p = 0.00) between 3 sessions. Mean Abd-ROM between two groups has not shown significant different (F = 2.99, p > 0.05). It is concluded that Mulligan’s adductor stretching and static stretching both are equally effective in increasing Abd-ROM.

1 illus, 3 tables, 22 ref

045533   BADYAL A, KUMAR K (Biochemistry and Paediatrics Dep, Govt. Medical Coll, J&K) : Evaluation of vitamin d status in children with nephrotic syndrome in remission in a tertiary care hospital of North India. JK Sci 2020, 22(2), 92-5.

Childhood nephrotic syndrome (NS) is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia associated with peripheral edema. Children with NS lose 25-OH vitamin D binding protein in urine, and can have low blood levels of this metabolite. The present hospital-based study was carried out on a total of 50 children with nephrotic syndrome who are in remission, in the age group of 1-15 years of either gender, attending to our pediatric nephrology clinic. 46 % had clear deficiency of vitamin D, while insufficiency was present in 28 % and normal levels in only 26 % of patients. There was significant difference (p<0.05) in 25-OH vitamin D levels between frequent relapsers (FR) as compared to infrequent relapsers (IR) and first episode of nephrotic syndrome. Hypocalcemia was present in 86 % of patients, hypophosphatemia in 10 % of patients, hyperphosphatemia in 50 % and raised alkaline phosphatase in 36 % of patients. Strong positive correlation is observed between serum calcium and vitamin D levels (r=0.720; p<0.001) and moderate negative correlation between phosphorous and vitamin D levels (r= -0.577; p<0.001, but insignificant relation between vitamin D and alkaline phosphate levels (r= -0.248; p<0.082). It is concluded that vitamin D deficiency is common among children with nephrotic syndrome even after remission of proteinuria. There exists a strong positive correlation between serum calcium and vitamin D levels.

4 illus, 16 ref

045532   BHUTANI G, SINGH K, SAINI R, RANI S, KUMAR S (Pharmacology Dep, Bhagat Phool Singh Govt. Medical Coll for Women, Sonepat, Haryana) : Prescription quality index based analysis of prescriptions of outdoor patients in a tertiary care centre in Haryana. JK Sci 2020, 22(2), 88-91.

Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. Analysis of quality of prescriptions can be carried out by various methods and by using certain tools as well. Prescription Quality Index (PQI) is one such validated tool for analyzing the prescription quality. The present study was undertaken on 2155 prescriptions to analyse the prescriptions of outdoor patients by using Prescription Quality Index tool. Each prescription was evaluated by using questionnaire of PQI tool. The tool consists of 22 questions, based on the answers of which a score was calculated for each prescription. Then a collective mean score for all the prescriptions was calculated. Depending upon individual scores, the prescriptions were graded in to poor, medium and high-quality prescriptions. The mean PQI score for all the 2155 prescriptions was 28.94 ± 0.23. We found that 1015 (46.10 %) prescriptions were of poor quality, 46 (2.13 %) were of medium quality and 1094 (50.77 %) were of good quality. The overall mean score of all the prescriptions falls in to the poor-quality prescription category according to PQI. It was concluded that there were many lacunas that require the attention of prescribers in order to attain and maintain high standard prescription quality

1 illus, 2 tables, 11 ref

045531   GUPTA R, SHARMA A, SHARMA H R (Ophthalmology Dep , Govt. Medical Coll, Jammu and Kashmir) : Dyslipidemia in primary open angle glaucoma. JK Sci 2020, 22(2), 84-7.

Glaucoma is the leading cause of irreversible blindness worldwide. Primary Open Angle Glaucoma (POAG) is usually asymptomatic till advanced stages of the disease. Intraocular pressure (IOP) is the primary risk factor for development of POAG. But in spite of control of IOP, some cases progress which strengthens the view that there must be other independent risk factors in the pathogenesis of glaucoma. Serum lipids have been found to be associated with glaucoma in few studies. We conducted a study to assess the relation between dyslipidemia and glaucoma on 100 cases of glaucoma and 100 age-matched controls. Detailed ophthalmic examination was done in all subjects and fasting lipid profile was compared between cases and controls. Levels of total cholesterol, total triglycerides and LDL were significantly higher in cases than in controls with a p value < 0.0001. We conclude that dyslipidemia is an independent risk factor for POAG.

3 tables, 19 ref

045530   KISHAN J, YADAV A, SINGHAL S (Respiratory Medicine Dep, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana) : To determine the previlance of fungal infection among patient with sputum negative old treated pulmonary tuberculosis. JK Sci 2020, 22(2), 80-3.

A descriptive study was conducted in the Department of Respiratory Medicine in a tertiary care center of Ambala. Aim of the study was to determine the prevalence of fungal infection among patient presents with sputum negative old treated pulmonary tuberculosis. The study was carried out among 39 post treated cases of Pulmonary Tuberculosis, whose sputum or bronchial wash showed isolation of Aspergillus. Demographic details and clinical findings were noted. Data collected were entered into Excel spreadsheet and quantitative data were expressed as number and percentage. The presentation of pulmonary aspergillosis in treated cases of pulmonary TB varies from aspergilloma (51.3 %) to chronic necrotizing pulmonary aspergillosis (38.4 %) to allergic bronchopulmonary aspergillosis (10.3 %). Hemoptysis (79.5 %) of varying severity was the most common symptom. Most of the patients were farmers by occupation. The most common species were Aspergillus fumigatus; others were Aspergillus flavus, Aspergillus niger and Aspergillus terrus in 23.2 %, 20.5 %, and 12.8 %, respectively. Here we conclude that Aspergillus fumigatus was the most frequently isolated species in our region and aspergilloma was the commonest pulmonary manifestation as post-TB sequel.

4 tables, 20 ref

045529   SINGH S K, AGGARWAL J, KATHARIYA G, MANZOOR S (Biochemistry and Cardiology Dep, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana) : Usefulness of the tg/hdl ratio in predicting cardiovascular risk: A mmimsr experience. JK Sci 2020, 22(2), 75-9.

The present study was aimed to compare traditional lipid measures with the lipid ratios to establish a better marker for the assessment of coronary artery disease (CAD) risk. The comparison of traditional lipid parameters and lipid ratios were made in terms of independent ‘t’ test, area under receiver operating characteristic (AUROC) curve and logistic regression analysis. LDL-C and HDL-C could not correlate well with CAD risk prediction. Strikingly, TG/HDL ratio was found to be more significantly associated in comparison to any of the individual lipid parameters as well as TC/HDL and LDL/HDL ratios when compared in terms of AUROC and logistic regression analysis, while LDL/HDL ratio could not correlate. Altogether, these findings infer that TG/HDL ratio is a better parameter in CAD risk prediction. Additionally, the TG/HDL ratio being calculated parameter incurs no additional cost to the patients and health care system. Henceforth, the authors suggest the incorporation of the TG/HDL ratio in the routine lipid panel for the better diagnosis and treatment of dyslipidemia.

2 illus, 3 tables, 22 ref

045528   BASHIR H, GUPTA S, MEHTA N (Anaesthesiology and Intensive Care Dep, Ascoms & Hospitals, Sidhra, Jammu) : King vision videolaryngoscopy versus direct laryngoscopy in patients requiring endotracheal intubation for general anaesthesia: A comparative study. JK Sci 2020, 22(2), 70-4.

With new advances in technology, intubation using video laryngoscopy has been gaining popularity, particularly in patients with difficult airways or as rescue devices in failed intubation attempts. This study was done to compare the effectiveness of King Vision video laryngoscope (KVL) and Macintosh laryngoscope when performing tracheal intubation under general anesthesia Eighty patients requiring endotracheal intubation during general anaesthesia were randomly assigned into two groups to undergo tracheal intubation using either a King Vision video laryngoscope (n=40) or Macintosh laryngoscope (n=40). The primary outcomes were the time of intubation and Cormack-Lehane grading and secondary outcomes were number of attempts and optimisation manoeuvres required and complications related to laryngoscopy and intubation. King Vision video laryngoscope was found to be significantly better than the Macintosh laryngoscope in terms of Cormack and Lehane grading, requirement of optimisation manoeuvres and need of second attempt for intubation except time of intubation which was comparable between the two groups.

5 illus, 1 table, 18 ref

045527   BARGOTRA R, SHARMA R (PG Pathology Dep, GMC Jammu, Jammu) : Computed tomography guided fine needle aspiration of lung lesions suspected to be bronchogenic carcinoma: Experience of a Tertiary Care Hospital. JK Sci 2020, 22(2), 65-9.

CT guided FNAC is a simple and safe procedure of diagnostic value in patients with lung lesions suspected to have lung malignancy. We undertook a study on 41 patients and were able to diagnose/ rule out malignancy in 85.37 % of these patients, while in 14.63 % of patients the smears were non diagnostic. Once malignancy was diagnosed in these patients, then the next most important step was to categorize the lesions. 44% of patients had squamous cell carcinoma, 12.12 % had adenocarcinoma, 9.75 % had small cell carcinoma, 7.31 % had poorly differentiated carcinoma, 4.87 % each had metastasis & tuberculosis and 2.43 % had aspergillosis. Squamous cell carcinoma was the commonest subtype in our study, which is contrary to changing trends in incidence of lung carcinoma where adenocarcinoma has replaced squamous cell carcinoma as the commonest lung malignancy. Three of our patients had minor complication in the form of mild pneumothorax, and it resolved in all patients within 24 hours.

7 illus, 4 tables, 18 ref

045526   SHARMA A, ISHA, LONE A H, KAUR R, NIJHAWAN V S (Pathology Dep, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana) : Comparative analysis of leucocyte count (total and differential) in patients with leucocytosis using sysmex xn550-l series (5 part) automated analyzer and conventional manual technique in a tertiary care hospital in rural Haryana. JK Sci 2020, 22(2), 61-4.

Normal concentration of WBCs in blood varies between 4000 and 11,000 per microliter and are classified into two variants namely granulocytes and agranulocytes on the basis of presence and absence of granules. Manual methods of calculation of TLC include- Neubauer chamber and estimating WBC on leishman stained slides whereas automated methods are based on impedance or light scattering technology. The study compared the efficacy of both these methods in statistical terms using Chi Square test. 100 cases of leucocytosis analyzed over a period of 1 year at MMIMSR, Mullana, Haryana revealed leucocytosis prevalent in 4-6 decade of life with slight male predominance. The pearson coefficient for TLC came out to be p value =0.215 (not significant) but for DLC, calculations revealed p values for polymorphs, lymphocytes, eosinophils and monocytes to be significant (p value =0.000 each). To conclude, standard manual methods should be advocated as special practice where there is definite need of morphological and quantitative evaluation of WBCs and to validate the automated methods by which the laboratories can optimize patient care and not as a replacement.

1 illus, 4 tables, 18 ref

045526   SHARMA A, ISHA, LONE A H, KAUR R, NIJHAWAN V S (Pathology Dep, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana) : Comparative analysis of leucocyte count (total and differential) in patients with leucocytosis using sysmex xn550-l series (5 part) automated analyzer and conventional manual technique in a tertiary care hospital in rural Haryana. JK Sci 2020, 22(2), 61-4.

Normal concentration of WBCs in blood varies between 4000 and 11,000 per microliter and are classified into two variants namely granulocytes and agranulocytes on the basis of presence and absence of granules. Manual methods of calculation of TLC include- Neubauer chamber and estimating WBC on leishman stained slides whereas automated methods are based on impedance or light scattering technology. The study compared the efficacy of both these methods in statistical terms using Chi Square test. 100 cases of leucocytosis analyzed over a period of 1 year at MMIMSR, Mullana, Haryana revealed leucocytosis prevalent in 4-6 decade of life with slight male predominance. The pearson coefficient for TLC came out to be p value =0.215 (not significant) but for DLC, calculations revealed p values for polymorphs, lymphocytes, eosinophils and monocytes to be significant (p value =0.000 each). To conclude, standard manual methods should be advocated as special practice where there is definite need of morphological and quantitative evaluation of WBCs and to validate the automated methods by which the laboratories can optimize patient care and not as a replacement.

1 illus, 4 tables, 18 ref

046774   ABDULHUSSEIN Z Q, ABD-ALI D K (Kufa Univ, Kufa, Iraq) : Factors affecting self-care behaviors of patients with heart failure. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194721.

A Descriptive Correlational Design is carried out in Al-Najaf City/Al-Najaf Al-Ashraf Health Directorate / Al-Sadder Medical City, from October, 17th, 2018 to June, 13th, 2019, in order to assess Self-Care Behaviors of Heart Failure Patients, and to assess the factors affecting patients with heart failure. A Non-Probability (Purposive Sample) of (110) patients who had heart failure, those who visit Al-Sadder Medical City for follow up, treatment, or both. Reliability of the questionnaire is determined through a pilot study and the face validity is determine through a panel of experts. The data are collected through the utilization of the developed questionnaire after the validity and reliability are estimated, and by means of interview technique. The data are described statistically and analyzed through use of the descriptive and inferential statistical analysis approaches. The findings of the present study indicate that the overall assessment for the patients’ self-care behaviors is fair. In addition, the overall assessment of patients’ self-efficacy toward self-care behaviors is fair, and the overall assessment of patients’ attitude toward self-care behaviors is good.

4 tables, 25 ref

046772   NUMAN H A, ALI H A (Kufa Univ, Kufa, Iraq) : Serum Salusin-α and Salusin -b levels with some biochemical parameters in patients with major thalassemia. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194719.

Thalassemias are a heterogeneous group of genetic disorders in which the production of normal hemoglobin partially or completely is suppressed because of defective synthesis of one or more globin chain. It is sometimes called Mediterranean anemia. Many biochemical changes in the blood accompany this disease. In this research, some biochemical parameters were measured in thalassemic patients and compared with healthy control group. These parameters include serum Iron, ferritin , TIBC, transferrin, transferrin saturation percentage, Salusin-α , salusin-β, insulin ,and lipid profile. The aim of this study was to Measuring the level of cytokine(salusin- α and salusin -b ) lipid profile, blood sugar level and resistance to insulin in serum of thalassemia patients and Find interconnectivity between cytokine(salusin- α and salusin -b ), iron , lipid profile, blood sugar level and insulin resistance. The results of the research showed that there is a significant increase (P0.05) in Age,TIBC,Transferrin, and VLDL-C.

3 tables, 27 ref

046771   AL-TAMEEMI S H A, AL-TORIAHI A M (Maternity and Children Hospital, Al Diwaniyah, Iraq) : Is Glycosylated hemoglobin a marker of infertility? Prospective analytic study. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194718.

Infertility: Is the inability of a couple to naturally conceive, carry or deliver a healthy child after a year of unprotected intercourse (1) . Causes: Female factors :- Problems with ovulation. Blocked fallopian tubes; this can happen as the result of pelvic inflammatory disease, endometriosis, or an ectopic pregnancy. Hormonal problems such as polycystic ovarian syndrome (pcos). In ability of the fertilized egg to implant in the uterus. Cervical hostility. Premature ovarian failure. Age; A women’s fertility decline after the age of 30, both in her ability to conceive and her ability to carry pregnancy to term. Male factors: The chief factor in male infertility is sperm quality, the man may have poor motility ‹ affecting its ability to reach ovum. Alcohol, marijuana and other drug abuse can affect sperm quality. Other possible factors include erectile dysfunction and retrograde ejaculation. Female infertility account for one third of infertility cases, male infertility for another third, combined male and female infertility for another 15 %, and the remainder of cases are “ unexplained”.

4 tables, 15 ref

046770   KAWEN A A, DAFFAR A A (Dermatology Dep, Thi-Qar Univ, Thi-Qar, Iraq, Email: ahmedpath.@yahoo.com) : Treatment of congenital capillary Hemangioma: Review of 30 Cases in Nasiriyah (2013-2018). Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194716.

The study is designed to identify the peak age of incidence of hemangioma and the most common site of involvement, presentation, different types, types of surgical procedures and the perioperative complications as well as the variation of sizes in hemangiomas. A retrospective study was done on a sample size of (30) persons. They were selected from Al_Hussein teaching hospital in Nasiriyah between (2013-2018) which included 13 males and 17 females starting from age of less than 6 months til the age of more than 3 years. The peak incidence was in those aged more than 6 months and up to three years (66 %) .The most common place involved being the trunk ( 50 % ), then the lower limb ( 16 % ), upper limb ( 16 % ), the the face and neck ( 16 % ). The most common presentation was increment in size in 50 % of patients, recurrent ulceration in 20 % and recurrent bleeding in 16 % of patients. The patients in the study had three types: capillary hemangioma ( 66 % ), cavernous hemangioma ( 20 % ) and combined hemangioma (14 % ). The size of hemangioma varied from smaller than 5 cm (33 %),5-10 cm (33 %) and larger than 10 cm (33 %).

4 illus, 2 tables, 18 ref

046767   ALI N S M, BASIM R (Oral Diagnosis Dep, Baghdad Univ, Baghdad, Iraq) : Clinical characteristics of headache among a sample of Iraqi medical and dental students. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194713.

Headache is a painful condition related to a major lack of productivity, limitation of social activities and impairment of quality of life. In this study a structured questionnaire was formulated in a form of multiple choices questions to gather information on the clinical characteristics, associated factors and the triggering factors along with the mode of treatment adopted by dental and medical undergraduate students of the University of Baghdad in the period from January to March 2019. Language of questionnaire was made simple and easily understandable to students. Students were assured of confidentiality and the participation was entirely voluntary. In this study a total number of 340 students participated, 170 of them were medical students 76 (44.7 %) males and 94 (55.3 %) females, and the other 170 were dental students 45 (26 %) males and 125 (74 %) females .It was found that 170 medical students had 161 associated symptoms with headache , the most common associated symptoms was scalp tenderness 44 (25.9 %), while the least common associated symptom was diarrhea 4 (2.4 %). While 170 dental students had 162 associated symptoms, the most common associated symptoms was scalp tenderness 46 (27.2 %), while the least common associated symptom was seizures 2 (1.2 %). 170 medical students expressed 385 triggering factors for causation of headache. It was found that the most common triggering factors was irregular sleep 118 (69.4 %). And 170 dental students expressed 437 triggering factors for causation of headache. It was found that the most common triggering factors was stress 136 (80.5 %). In this study the percentage of medical students who taking self medications was 88.82 % and 92.35 % for dental students also it was found that both medical & dental students had the highest percentage for using Paracetamol as analgesic, 119 (70 %) for medical students, and 126 (74.6 %) for dental students. The results of this study show that the majority of both medical and dental students suffer from headache with self medications used by the majority.

4 tables, 15 ref

046765   AL-DULAIMI F H A, ALAJEELY A A A , AIL Y M (Babylon Univ, Hillah, Iraq) : Incidence of Entamoeba gingivalis and Trichomonas tenax in periodontitis and gingivitis patients who attended to private clincs in Babylon Province. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194711.

Trichomonas tenax, a commensal flagellated protozoan, inhabits in human oral cavity. This parasite is cosmopolitan and frequently found in patients with poor oral hygiene and advanced periodontal disease. By using wet mount smear and giemsa staining to detect the prevalence of oral protozoa in patients with oral diseases and a healthy control group. From October 2014 to April 2015, the subgingival dental plaques of 310 patients with gingivitis or periodontitis and 310 controls who attended to clinics periodontics , in Babylon province. 64 (20.6 %) of patients were positive (40.2 % periodontitis ,14.2 % gingivitis) by using wet preparation and Giemsa staining. The prevalence of oral Trichomonas tenax in our study (20.6 %) and Entamoeba gingivalis was (42.9 %) was compatible with many other published reports which mostly has ranged from 12 %-32 %.The study revealed dependence between the frequency of occurrence of protozoa and the state of periodontitis.the age group (41-50)yr. Have high incidence of T.tenax compared with an other groups,as well as the males have high incidence (24.7 %) than females (16.8 %).

5 tables, 22 ref

046764   KHALAF M H, KASSEM N M (Babylon Univ, Hillah, Iraq) : Physical preventive strategies related to children with leukemia from mothers’ perspective in Al.Basrah Province. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194710.

To assess mother’s preventive strategies concerning physical complication for children with leukemia. A cross-sectional descriptive study consisting of (150) mothers were interviewed at Basrah specialist hospital for children in Basrah Province in a period from 3 February to 21 March 2019. Findings of the study revealed that the highest percent of studied mothers 73(48.7 %) had high level related to physical preventive strategies and 74(49.3 %) had moderate level related to chemotherapy physical preventive strategies. systematic application a protocol of home care for children having leukemia to help mothers to provide appropriate home care and reduce the incidence of physical complication in children undergoing chemotherapy.

2 illus,16 ref

045524   BARGOTRA R, SHARMA R (PG Pathology Dep, GMC Jammu, Jammu) : Ultrasound guided fine needle aspiration cytology of gallbladder lesions suspected to be carcinoma gallbladder: Experience of a tertiary care hospital. JK Sci 2020, 22(2), 51-4.

Gallbladder carcinoma is the most common biliary tract malignancy in the world. Radiological investigations are helpful in diagnosing the gallbladder diseases especially carcinoma in most of the cases, but confirmation of diagnosis requires cytopathological correlation. We have undertaken a study on 29 patients, who underwent ultrasound guided FNAC for evaluation of gallbladder lesions suspected to be carcinoma gallbladder. 82.75% of patients had malignancy or suspicion of malignancy and 10.34% patients had abscesses, while in 6.9 % patients FNAC was inconclusive. Adenocarcinoma (NOS) was the most common diagnosis and was found in 62.6 % of patients. Poorly differentiated carcinoma, cytology suspicious of malignancy and abscesses were present in 7 % of patients each. Papillary carcinoma and squamous cell carcinoma were only seen in 3.44 % patients each. None of the patients in our study developed any minor or major complications during the procedure. A precise cytological examination is required not only to diagnose or rule out gallbladder malignancy, but also for prognostication of these carcinomas.

3 tables, 19 ref

045523   GARG S, GUMASHTA R (Community Medicine Dep, People’s Coll of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh) : Spectrum of behavioral disorders among children aged 5-15 years in tertiary care hospital of Bhopal. JK Sci 2020, 22(1), 41-5.

The current study was done to determine various behavioral disorders among 5-15 years of children attending Paediatric OPD and to determine underlying risk factors associated with behavioral disorders among children. This observational cross-sectional study was carried out among 200 children between 5-15 years of age using DSM IV Diagnostic Criteria. Some risk factors that lead to the manifestation of the disorder were also studied by history taking. The increasing sequence of disorders positivity was 0.5 %, 1 %, 1.5 %, 1.5 %, 2.5 %, 12.5 % for CD, LD, GAD, ADHD, AD and ODD, while observing 51.28 % ODD cases among males, 12.5 % ODD among overall subjects, 19.5 % ADHD cases, 27.02 % GAD, 1 % LD and 0.5 % CD cases. The overall observance of any one disorder was 39 (19.5 %). Herein observed high prevalence of behavioral disorders requires behavioral, technical and managerial interventions and therefore is the priority intervention area in the field of public health globally, nationally and locally.

7 tables, 20 ref

045522   RAZAQ M, CHOUHAN M (Paediatrics Dep, Govt. Medical Coll, Jammu and Kashmir) : Clinical profile of hemophilia in children in a tertiary care hospital in North India. JK Sci 2020, 22(1), 36-40.

Hemophilia is congenital X-linked disorder of the coagulation system whereby deficiency of factor VIII (hemophilia A) or factor IX (hemophilia B) predisposes the affected male to a lifelong risk of bleeds. Early and adequate support with factor replacement will prevent death from fatal bleeds. However, awareness levels among students and general practitioners continued to be very low resulting in delayed and inappropriate management. The present study designed to focus on the presentation, genetic aspects and management of hemophiliac children. Clinical profile of 119 diagnosed cases of hemophilia up to 18 years of age was analyzed. Out of a total 119 cases enrolled mean age of the patients was 9.5 years with an age range of 6 months to 18 years. 97(81 %) cases were hemophilia A and 22 (18.4 %) cases were hemophilia B. Only 48(40.0 %) cases had family history of bleeding with 71 (60 %) had no history of bleeding in family. Among the hemophilia A 50.4 % (52.5 %) cases had mild, 45.2 (47.5 %) cases had moderate disease and among the hemophilia B, 9.5 (40 %) cases had mild, 11.5 (50 %) cases had moderate and 2.3 (10 %) cases had severe disease. Hemarthrosis of knee joint was the major presentation followed by ankle, elbow, shoulder followed by circumcision and tooth extraction bleeding. 62 % of the hemophiliacs in our study had initial bleeding episode before 1 year of age and by 6 years of age 94 % of cases had developed symptoms of bleeding evidence. No patient had history of bleeding during neonatal period. It is concluded that hemarthrosis found to be the leading cause of presentation; bruises and hematomas either spontaneous or traumatic were the chief complaints at the presentation of these children.

7 tables, 27 ref

045521   KUMAR P, HUSSAIN Z, HELA A H, GOEL R (Surgery Dep, Govt. Medical Coll, Jammu and Kashmir) : To study the outcome of inguinal hernia repair with sutureless self-gripping mesh in terms of postoperative pain, complications and recurrence. JK Sci 2020, 22(1), 32-5.

The concept of sutureless mesh as well as light weight mesh came into play because of inguinodynia. This study was chosen most importantly to determine the post-operative persisting chronic pain after the use of sutureless mesh. Data was collected from patients attending Govt. Medical College & Hospital, Jammu OPD, admitted in the department of surgery that underwent sutureless mesh hernioplasty for inguinal hernias. These patients were followed up at 3 days, 3 weeks, 3 months and 6 months for postoperative pain, any recurrence or development of complications. In this study, 40 patients having inguinal hernia were taken. 38 (95 %) were males and 2 (5 %) were females. The age of the patients ranged between 30 to 80 years with mean age of 54.53±14.88 years. Post-operative pain was studied according to VISUAL ANALOG SCALE scoring, out of 10. Mean post-operative pain score after 3 days was 2.70±1.16, which decreased to 0.85± 1.10 at 3 weeks (68.52 % decrease) and after 3 months it was 0.30±0.72 (with an 88.89 % decrease). There were no other complications. The study concluded that the use of self-fixating mesh in open inguinal hernia repair is a simple, safe, rapid and effective option and is associated with low post-operative pain.

7 tables, 17 ref

046760   KADHUIM A F (Nursing Dep, Middle Technical Univ, Baghdad, Iraq) : Estimation of serum lipid profile among pre and post menopausal women in Baghdad City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194706.

This study aimed to determine the lipid profile concentration in the sera of women before and after the menopausal age in Baghdad city, since it is one of the main causes of cardiovascular diseases. The study included 100 women (40 premenopausal women with their ages ranged between (25-45 years) and 60 postmenopausal women with their ages ranged between (50-65 years). Blood samples were collected and total serum cholesterol (TC), S. triglycerides (TG), S. high density lipoprotein (HDL),S. low density lipoprotein (LDL) and S. very low density lipoprotein (VLDL) were measured. The results showed no significant difference (P>0.05) in the level of total cholesterol (TC) between the two groups of women, while there was a statistically significant increase (P<0.05) in the level of serum triglyceride (TG) in postmenopausal women (144.32 ± 43.16) mg/dl when comparison with premenopausal women (101.92 ± 32.44) mg/dl, and a significant decrease (P<0.05) in HDL level in postmenopausal women (33.56 ± 10.65) mg/dl when compared with premenopausal women (43.13 ± 14.23) mg/dl. The results of LDL level also showed a significant increase (P<0.05) in postmenopausal women (107.57 ± 21.28) mg/dl when compared with premenopausal women (77.23 ± 30.40) mg/dl, and a significant increase (P<0.05) in VLDL level in postmenopausal women (31.86 ± 8.16) mg/dl when compared with premenopausal women (21.32 ± 7.12) mg/dl.

3 tables, 20 ref

046759   KHALEEFAH L S, SALMAN H N, SHAWKAT S M (Food Science & Technology Dep, Al-Qasim Green Univ, Al Qasim, Iraq, Email: luaysalam@fosci.uoqasim.edu.iq) : Hygienic practices of street food vendors and schools in some Iraqi governorates. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194705.

The study was conducted during the period from December 2018 to May 2019, to asses hygiene practice in schools and street food venders inside two Iraqi cities (Babylon and Thiqar). The Codex code for practice of general principles on food hygiene, observations and other relevant documents to provide information that may clarify certain misconceptions on hygienic practices related to street food venders. 110 street food vendors and schools were studied in all Babylon and Thiqar. Specially designed questionnaire form was used, allowed fast data collection. Many noncompliance was found in the hygienic practices and requirement, personal hygiene, hygiene of equipment, food preparation and food service. Babylon Governorates in term of hygiene of equipment and food preparation generally showed higher conformity than in Thiqar Governorates. The level of fulfillment of the hygienic requirements was most strongly influenced by the type of schools and street food vendor in both section of personal hygiene and hygiene of equipment and food preparation and serving for Babylon and Thiqar. The results of this work should not discourage to eat street food, but to minimize food poisoning risk, support the reasonable choice of eating-places according to basic food hygiene knowledge.

6 illus, 21 ref