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Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta
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Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.

Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering.

Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq  between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.

The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes,

status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.

Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study
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Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compa

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Publication Date
Fri Mar 01 2019
Journal Name
Archives Of Plastic Surgery
Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods
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Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle.

Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a mod

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Publication Date
Fri Dec 01 2023
Journal Name
Endocrine Practice
Abstract #1597564: Insulin Autoimmune Syndrome in an Iraqi Patient With Myasthenia Gravis and Unexplained Hypoglycemia: Rare Coexistence
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Publication Date
Thu Apr 27 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Total L-carnitine and insulin resistance in non-obese and obese Iraqi women with polycystic ovary syndrome
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Background: Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine illnesses affecting reproductive - age women. L-carnitine has important roles in oxidative stress, energy production and glucose metabolism. It affects insulin resistance as decreased plasma carnitine level has been well reported in type II diabetes mellitus. Hence, it means L-carnitine may reduce insulin resistance which is found in PCO disease. Objective: This study aims to measure the level of L-carnitine and insulin resistance in both obese and non- obese patients with PCOS. Patients and Methods: Sixty women within the reproductive age with PCOS (30 obese and 30 non- obese) were recruited from the Gynecology and Obstetrics Outpatient Clinic in Baghdad T

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary Free Testosterone and Gingival Health Condition among a Group of Women with Polycystic Ovary Syndrome
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ABSTRACT Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women in their reproductive age.It is characterized by anovulation or oligo-ovulation and hyperandrogensim.Androgen excess is the central defect in polycystic ovary syndrome. It is a complex disorder affects general health in addition to oral health.This study aimed to assess the gingival health status among a group of women with polycystic ovary syndrome as well as to estimate the levels of salivaryfree testosterone in unstimulated saliva in relation to gingival health condition. Materials and methods: Sixty two women with an age range 20-25 years old and with a body mass index range18.5-24.9 (normal weight) were included in this s

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Serum levels of cross-linked n-telopeptide of Type i collagen before and after non-surgical periodontal therapy in type 2 diabetic patients with chronic periodontitis
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Background: Diabetes mellitus is a major risk factor for chronic periodontitis (CP) and hyperglycemia has an important role in the enhancement of the severity of the periodontitis. It has been reported that the progression of CP causes shifting of the balance between bone formation and resorption toward osteoclastic resorption, and this will lead to the release of collagenous bone breakdown products into the local tissues and the systemic circulation. Cross-linked N-telopeptide of type I collagen (NTx) is the amino-terminal peptides of type I collagen which is released during the process of bone resorption. This study was conducted to determine the effects of nonsurgical periodontal therapy on serum level of NTx in type 2 diabetic patients

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Publication Date
Sat Mar 01 2025
Journal Name
Radiology Case Reports
Intradural extra-medullary spinal cord tumor after dorso-lumbar spine fixation following 12th dorsal vertebra burst fracture: A case report with literature review
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Publication Date
Mon Aug 03 2020
Journal Name
Rawal Medical Journal
Surgical fixation and grafting of traumatic distal tibia atrophic nonunion with or without platelet-rich plasma: A comparative study
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Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group

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Publication Date
Sat Jul 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effect of Systemic Proteolytic Enzymes on Postoperative Inflammatory Response and Quality of Life after Surgical Extraction of Impacted Mandibular Third Molar
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Background: The surgical extraction of impacted third molar usually results in postoperative inflammation manifested as pain, facial swelling and trismus which may cause deterioration in the patient’s quality of life. Methods: This randomized controlled study included 56 patients indicated for surgical extraction of IMTM under local anesthesia. These patients were randomly assigned into two groups: a study group that included patients who received Tibrolin® postoperatively and a control group that did not. The predictor variable was whether to use SET or not. Pain measured by the pain numerical rating scale (NRS), facial swelling, and the degree of trismus were the outcome variables. The Arabic version of the Oral Health Impact P

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Publication Date
Tue Jan 24 2023
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
Influence of the high mobility group A1 genetic polymorphism on indices of metabolic syndrome and insulin resistance in the Iraqi population: Case-control study
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The high mobility group A1 gene (HMGA1) rs139876191 variant has been related to metabolic syndrome and type 2 diabetes, but data are lacking in Middle Eastern populations. The study aimed to assess whether the HMGA1 rs139876191 variant is associated with metabolic syndrome risk and whether this variant predicts the risk of insulin resistance. This case-control study was carried out at single center in Kirkuk city/ Iraq from February to August 2022. Polymorphisms in HMGA1 and genotyping were identified by Sanger sequencing of genomic DNA obtained from 91 Iraqi participants (61 patients with metabolic syndrome and 30 control). Lipid profile, serum (glucose and insulin), glycated hemoglobin, blood pressure, body mass index, and waist circumfer

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