Diyala Journal of Medicine <p style="text-align: justify;">Diyala Journal of Medicine (DJM) was established according to agreement of Ministry of Higher Education and Scientific Research-foundation of as per authorization letter Number 12c/2433 in 19th August 2010. Fellow up, Started to receiving different manuscripts in all fields of medicine such as clinical, basic, dentist, pharmacology and scientific original articles. Diyala Journal of Medicine usually Deal with articles closely related with clinical problem more common in Iraq and Middle East. Also considered is a periodic peer-reviewed journal published biannually by the College of Medicine in Diyala University. However, review articles of high standards will be considered Writing in English languages with Arabic abstract.</p> <p><span style="font-size: 20px; font-family: Times New Roman;"><span style="font-size: 20px; color: #17365d;">&nbsp;</span></span></p> College of Medicine - University of Diyala en-US Diyala Journal of Medicine 2219-9764 <p>All Rights Reserved.</p> The incidence of dysrhythmias, their types and outcomes in patients hospitalized with COVID -19 <p><strong>Background</strong>: COVID-19 started in China and became a pandemic, the SARS-CoV-2 virus mainly affect respiratory system but can insult the cardiovascular system as well, higher rate of cardiac arrhythmias noted during the pandemic, and many studies showed that COVID-19 especially hospitalized patients can develop different types of arrhythmias which caused higher mortality rate,</p> <p><strong>Objectives</strong>: the aim of this study is to assess the incidence dysrhythmias and their types and outcomes in hospitalized patients with COVID-19 in Erbil city.&nbsp;&nbsp;&nbsp;</p> <p><strong>Patients and methods</strong>: Patients with documented ECG whom admitted in Erbil Teaching Hospital RCU and CCU had been included (255 patients) in this cross sectional study, demographic data, and outcomes were reported, the ECG analyzed by cardiologists and the type of arrhythmia documented.</p> <p><strong>Results</strong>: Mean age was 47±12 years, 61% of the patients were male, 25% of them had previous cardiac diseases, 20% diabetes, 16% multiple comorbidities, 8% hypertension, 8% obesity and 23% had no comorbidities, 20.7% of in hospital patients developed dysrhythmias, 5.9% of them developed sinus tachycardia, 4.7% atrial fibrillation, 3.9% ventricular premature contractions, 2% ventricular fibrillation, 1.9% ventricular tachycardia and 1.9% heart blocks. Most of the patients whom developed ventricular arrhythmias, atrial fibrillation and heart block had previous comorbidities 82%, 62% and 80% respectively. Arrhythmias caused higher in hospital mortality rate (39.6% versus 21.7%) especially among male patients (61.5% of dead cases were male, versus 38.5% were female).</p> <p><strong>Conclusions</strong>: Most of admitted cases were male, most of them had comorbidities especially previous cardiac diseases, Sinus tachycardia, atrial fibrillation, and ventricular extra systoles were the most frequent arrhythmias, mortality rate increased by arrhythmias mainly in male patients.</p> <p><strong>Key words</strong>: COVID-19, Dysrhythmias, Outcomes.</p> Copyright (c) 20 1 The Incidence and Management of Urethral Stricture in Bladder Carcinoma <p><strong>Background: </strong>Urethral stricture disease is one of the oldest and most difficult maladies known to the urologist. While references&nbsp; to the disease and its treatment date back to the writings of the Hindus, Egyptians, and Greeks.</p> <p><strong>Objective:</strong> To elicit&nbsp; the incidence&nbsp; of urethral strictures, their severity and management&nbsp; in patients with superficial bladder tumor.</p> <p><strong>Patients and Methods:</strong> From January 2018 to January 2020, we followed 98 patients admitted and treated at Baquba Teaching Hospital urology unit for having bladder carcinoma.&nbsp; Theywere all male subjects, their age range from 38-76y with a mean 56.8y.&nbsp; They&nbsp; were required to have a cystoscopically and histologically proven superficial transitional cell carcinoma of the&nbsp; bladder to be enrolled in this study&nbsp; (invasive tumors were excluded).&nbsp; For all the patients and after having the cystoscopic diagnosis ,transurethral resection of the tumor done and in most of them this is followed by six&nbsp; week courses of intravesical chemotherapy (either mitomycin or doxorubicin according to the availability). Intravesical Doxorubicin used in 13 cases (56.5%), Mitomycin C in 6 cases (26.1%) and 3 patients (13.0%) received both drugs (through multiple courses).while 1 patient (4.3%) received no chemotherapy. Thirteen strictures (56.5%) were managed by optical urethrotomy while 10 cases (43.5%) were mild strictures and opened just by introducing the cystoscope.</p> <p><strong>Results:</strong> During the period of the study, a total of 23 urethral strictures were identified in the 98 male patients with superficial bladder tumor enrolled in this study, which constitutes an incidence of 23.5% all were diagnosed by the follow -up check cystoscopies . Patient age ranged from 38-75 years with a mean age 59.30+- 10.58 . Among those patients with urethral stricture ,14 patients had also B.P.H (60.9%), but only 7 patients (30.4%) had a history of retention of urine . The urethral stricture was bulbar in all patients and it was mild stricture in 10 cases (43.5%), moderate in 6 cases (26.1%) and severe in 7 cases (30.4%) . Prior to the diagnosis of stricture , 13 patients had been subjected to a single check cystoscopy (56.5%) ,6 patients (26.1%) had twice , while 4 patients (17.4%) had 3 or more cystoscopies prior to the occurence of stricture . Regarding intravesical chemotherapy prior to the occurance of stricture ,4 patients (17.4%) received 1-3 sessions , 10 patients (43.5%) received 4-6 sessions and 9 patients (39.1%) received more than 6 sessions . Intravesical Doxorubicin used in 13 cases (56.5%), Mitomycin C in 6 cases (26.1%) and 3 patients (13.0%) received both drugs (through multiple courses).while 1 patient (4.3%) received no chemotherapy. Thirteen strictures (56.5%) were managed by optical urethrotomy while 10 cases (43.5%) were mild strictures and opened just by introducing the cystoscope.</p> <p><strong>Conclusion:</strong> Urethra stricture in patients with bladder carcinoma may be a substantial source of preventable morbidity, implementing a nursing education program may significantly decrease the incidence&nbsp; of stricture.</p> Reyad Ahmed Farhood Othman Jasim Mohammed Alzaidy Aiad Abd Al Hameed Hassen Copyright (c) 2021 2021-04-17 2021-04-17 20 1 76 82 Antibiotic Sensitivity of High Vaginal Swabs from Asymptomatic Pregnant Women <p><strong>Background: </strong>Vaginal microbiota considered as a complex microbial population consisting of a multitude of microbial species and causes many vaginal infections including bacterial vaginosis.</p> <p><strong>Objective:</strong> The study is investigating the antibiotic sensitivity of predominant vaginal microbiota.</p> <p><strong>Patients and Methods:</strong> 250 pregnant women in Erbil city in the North of Iraq, from October 2018 to March 2019. Samples were collected from pregnant women who visited Maternity, Rizgary and Raparin Hospitals’ laboratory department under medical precautions. The samples were cultures to investigate to identify the bacteria types and sensitivity for common antibiotics.</p> <p><strong>Results:</strong> About 72% of samples showed positive microbial growth and the higher distribution percentage of isolated microorganisms was 27.2%, 23.8%, 21.6 and 11.6% for <em>Candida sp., Staphylococcus aureus, Escherichia coli</em> and <em>Streptococcus pyogenes</em> respectively.&nbsp;&nbsp; Moreover, antibiotic sensitivity tests declared that ciprofloxacin was effectively inhibited the growth of both <em>Staphylococcus aureus</em> and <em>Streptococcus pyogenes</em> while Norfloxacin was 95% which inhibited the growth of <em>E. coli.</em></p> <p><strong>Conclusion:</strong> <em>Candida albicans, Staphylococcus aureus, Escherichia coli</em> and <em>Streptococcus pyogenes </em>are among the most predominant microorganisms in pregnant women.</p> Abdulrazzaq Bahaulddin Mohammed Haval Abdulkhalik Hamadamin Alla’a Miyasar Ahmed Copyright (c) 2021 2021-04-17 2021-04-17 20 1 70 75