علي فوزي عبدالصاحب

Background: The d-dimer test is positive even in cases of natural pregnancies. Due to the pregnancy-related hypercoagulable condition, this shows elevated activity of thrombin and enhanced fibrinolysis after formation of fibrin throughout gestation. As a result, this test is unreliable and non-specific for diagnosing venous thrombosis in pregnancy. Objective of the research: the current research was aiming at exploring the role of ultrasound examination in addition to d-dimer investigation in detecting “thrombosis of deep veins” in suspected pregnant women. Patients and methods: A cross observational sectional study was carried out by the researcher in the department of medicine in Adiwaniyah Teaching Hospital, Diwaniyah Province, Iraq between February 2022 and March 2023. Inclusion criteria were as following: pregnant women with clinical suspicion of deep venous thrombosis based on clinical features identified by 2 specialists in internal medicine and who were referred by the Department of Gynecology and Obstetrics. A vacuum tube was used to collect a sample of venous blood from a peripheral vein and was send to central laboratory in the teaching hospital in order to measure d-dimer level. Results: The current study included 90 women of whom 31 (34.4 %) had positive Doppler findings consistent with deep venous thrombosis. There was statistical disparity in the level of d dimer between those with positive DVT Doppler findings and women with negative DVT Doppler findings, 3523.30 ±1773.65ng/ml versus 2553.50 ±1737.96 ng/ml, respectively (p = 0.014). Performance of receiver operating characteristic (ROC) test, showed a cutoff value of > 2200 ng/ml which is a reliable predictor of deep venous thrombosis in pregnant woman with 69 % sensitivity level and 71.8 % specificity level. Conclusion: assessment of serum level of d-dimer is an essential adjunct in the work up for assessment of pregnant women with suspicion of deep venous thrombosis despite the fact that pregnancy is a hypercoagulable state.

Objective: To compare the outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) in patients with acute appendicitis at Al-Diwaniyah Teaching Hospital. Study Design: Prospective study Place and Duration of Study: This study was conducted at the AL-Diwaniyah Teaching Hospital, Al-Diwaniyah City Iraq from 1 st May 2021 to 30 th April 2022. Methods: One hundred patients with a clinical diagnosis of appendicitis were chosen. They were divided in two groups; group A treated with laparoscopic appendectomy and group B managed with open appendectomy. Results: The average operative time was 45min in group Abetween 30 to 60 minutes while in group B, the average was 25min.Regarding the complicationspostoperatively, were mainly observed in group B as compared to group A. Paralytic ileus was 2 (4%) in group A . Conclusion: Laparoscopic appendicectomy is regarding as a safe and effective technique with lower postoperative pain, less hospital stay then less cost, quicker recovery and best looking scar than in classical Open appendectomy.

Background: The COVID-19 infection may manifest with a range of symptoms, spanning mild or asymptomatic cases to severe illness or fatal outcomes. Typical symptoms include pyrexia, cough, and difficulty breathing. Other possible manifestations consist of fatigue, muscle aches, general discomfort, sore throat, respiratory issues, and inability to perceive smell or taste. Diagnosis of COVID-19 entails the utilization of clinical indicators, computed tomography (CT) scans or chest radiographs, serological assays, and molecular testing, such as RT-PCR to identify the virus's genetic material, by healthcare professionals. Objective: In the present investigation, our aim was to clarify the length of pyrexia, the predominant feature of the illness, and its relation to different patient characteristics. Subjects and Methodology: An investigation (cross-sectional) was carried out in the Province of Al-Diwaniyah, located in Iraq. A total of 99 COVID-19 cases were included in the study, consisting of 49 women and 50 men, spanning from 16 to 81 years of age. The primary variables examined in this research encompassed the patients' gender, age, lymphocyte percentage, count of leukocytes, pulmonary participation evaluated through CT imaging, length of pyrexia upon presentation, duration of fever subsiding after treatment initiation, and the existence of co-morbid conditions such as pulmonary tuberculosis, asthma, essential hypertension, and diabetes mellitus. Results: The average age of total participants was 50.4±16.3 years, with no notable variation in age averagebetween women and men (p=0.924). Similarly, there was an absence of significant variation. in averagesof lymphocyte % and WBC count between the two genders (p>0.05). Pulmonary participation, as discerned through CT imaging, varied from 0 to 80%, with a mean of 26.77±21.43 %; notably, there existed no substantial disparity in lung participation between the female and male cohorts (p=0.770). The participants' average fever duration upon arrival was 6.6±3.6 days, varying from 1-21 days. The lengthfor high temperature to diminish ranged from 2 to 25 day, and an average of 5.82±3.53 day. There was no significant disparity in duration between women and men (p=0.214). The length of fever at presentation, the presence of diabetes mellitus, and the WBC count were all found to have a significant and positive association with the time it took for the fever to subside (p<0.05). Conclusion: Prolonged fever following the detection and management of COVID-19 may be anticipated in individuals with elevated WBC count, extended fever duration, and a history of diabetes. Such patients are more likely to face severe consequences and mortality