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PubMed2003

Maxillofacial war injuries during the Iraq-Iran War: an analysis of 300 cases.

The following study focuses on three hundred maxillofacial war casualties that were admitted to the Basra Republic Hospital during the Iraq-Iran War. These three hundred cases were chosen on the basis of them being only oral and maxillofacial injuries. Of these cases, there was no mortality recorded. This was in part due to the rapid evacuation, immediate resuscitation and proper management of the casualties. An appropriately staffed hospital, efficient surgical techniques and the presence of highly skilled specialists working as a team also made this result possible. This analysis categorizes, evaluates and discusses the treatment of the casualties based on the severity of the injury and outlines several techniques used to treat such patients.

Airway Obstruction↗
PubMed1979

Isoenzyme characterization of Leishmania species from Iraq.

Leishmaniasis in Iraq takes both the visceral and cutaneous forms. The causative organisms are identified according to the electrophoretic variation of the enzymes MDH, GPI, 6PGD, PGM and IDH. The 37 visceral stocks investigated fall into two groups which differ only with respect to GPI. The six cutaneous stocks were divided into three groups. Group 3 represents Leishmania major, while groups 4 and 5 refer to L. tropica showing intraspecific variation with regard to 6PGD.

Animals↗
PubMed1983

Studies on the parasitic helminths of slaughtered animals in Iraq. I. Parasitic helminths of the liver of herbivores.

The livers and lungs of 580 sheep, 160 goats, 418 cattle, 50 camels and 48 buffaloes slaughtered in Baghdad in April-July, 1981 were examined for helminth parasites; 14.3% of the sheep, 0.6% of the goats, 18.2% of the cattle, 72.0% of the camels and 8.3% of the buffaloes were infected with trematodes and cestodes. Dicrocoelium dendriticum is reported from the livers of sheep in Iraq for the first time.

Animals↗
PubMed1991

A prospective study of some diarrhoeagenic Escherichia coli in infants with diarrhoea in Mosul, Iraq.

The incidence of diarrhoeagenic Escherichia coli was investigated in 304 infants with diarrhoea in Mosul, Iraq by using standard biological assays and reversed passive latex agglutination (RPLA) procedures. Enterotoxigenic E. coli (ETEC) were found in 12.8% of the cases--27 (8.8%) strains produced heat-labile toxin (LT) only, 8 (2.6%) heat-stable toxin (ST) only and 4 (1.3%) produced both toxins (LT-ST)--whereas enteropathogenic E. coli (EPEC) were responsible for about 13.8% of the incidence of diarrhoea in the community. Detailed analysis revealed that 12 serotypes were involved. A greater number of cases of acute enteritis were seen in infants aged 0-18 months than in those aged between 19 and 36 months. The data indicate a highly significant level of resistance to most common antimicrobial drugs among diarrhoeagenic E. coli isolated, but most were highly sensitive to nalidixic acid, cephalothin and gentamicin.

Child, Preschool↗
PubMedDate not supplied

Family studies of immunoglobulin levels in Iraq.

The extent of the contribution of genetic and environmental factors to the variation in levels of serum immunoglobulin G, A, M and E was studied among families of Arabs and Kurds of Iraq. Heritability (h2) values were calculated from offspring-parent, offspring-mid-parent and sib-sib comparisons and were all positive and moderate. All values were significant for all four immunoglobulins, being generally lower in Arabs than in Kurds. The h2 estimate based on offspring-parent and offspring-mid-parent were generally lower than those based on sib-sib comparisons, suggesting that these values were inflated by the common environment of full sibs. Genetic correlations between IgG--IgE and IgG--IgA were relatively high, reflecting a common regulation in the level of these immunoglobulins. IgM showed low genetic correlation with other immunoglobulins. All environment correlations were positive, and rather higher in the Kurds than the Arabs, indicating that environmental factors influence the level of all four classes of immunoglobulins.

Ethnicity↗
PubMedDate not supplied

Initial medical reception, intervention and survey work in combined military and civilian humanitarian aid: operation 'Safe Haven', northern Iraq 1991.

Service medical teams were involved in the medical screening and initial reception of displaced Kurds into the first United Nations Relocation Camp in Zakho, Northern Iraq in April 1991. Massive logistic support and adequate security were required for the delivery of the essential elements of relief. The prompt deployment of such teams enabled rapid surveys of the medical extent of the disaster to be undertaken during the screening process whilst individuals were prioritized for rehydration, supplement feeding and therapy. Over 12,000 displaced persons entered the camp in the first 10 days. Reported perinatal mortality during the two-month exodus crisis in an unselected group of 2,200 was 375 per 1,000 births. In the same group of families surviving to tell the tale, one in five of the infants who had been in the mountains had died and the fertility rate may have been as high as 380 per 1,000 women of child-bearing age in the previous year. In a larger survey of 3,825 unselected persons entering the camp, 745 (19.5 per cent) were estimated to be under five years of age and a quarter of these had a significant medical problem. There were 290 (7.6 per cent) estimated to be under two, and a quarter of these were judged to be severely malnourished. A high degree of international cooperation between military and civilian medical and relief teams was demonstrated in dealing with this crisis.

Adolescent↗
PubMedDate not supplied

Healthcare under sanctions in Iraq: an elective experience.

As a consequence of the 1991 Gulf War and the ensuing UN sanctions, not only was the Iraqi government destroyed, but also the general infrastructure of the country was disrupted, with the civilian population and public services bearing much of the aftermath. Ten years after the war, the health system in Iraq is still in a perilous situation. The effects of sanctions have affected almost every aspect of medical care. There has been a mass exodus of health care professionals, many of whom were foreign nationals. Doctors' salaries fell rapidly to only $30 a month, barely enough to buy the necessities of daily living. Iraqi hospitals have no access to foreign journals, textbooks or the internet; leading to a generation of out-dated and under-skilled health professionals. Most worrying is the ever-present embargo on many essential medicines. Only one-third of the medicines are available for chemotherapy for the treatment of acute lymphoblastic leukaemia in children (UKALL 97 modified 99 protocol). At the Al-Mansour paediatric teaching hospital this shortfall has led to a substantial increase in childhood mortality, with disease-free survival rates falling to 25 per cent compared to 60 per cent in 1988.

Allied Health Personnel↗
PubMedDate not supplied

After Kosovo, Afghanistan and Iraq: what is the future for the UN?

There have been enormous changes in the world order over the last 15 years, which have seen the United States, closely supported by the United Kingdom, become more unilateral in its actions, and in doing so damaging the United Nations. Attempts to create an ethical dimension in foreign policy have failed. The brief consensus after 9/11 has been lost in the war against terror, whilst other more appropriate measures to diminish the risks of terrorism, such as creating greater equity in trade and meeting the UN millennium goals, have been left to one side. Iraq and the ongoing failure to resolve the Palestinian issues have left the world a less safe place. The need for the UN to establish itself as a dominant force for global justice is paramount. To do so there must be reform, particularly of the Security Council.

Afghanistan↗
PubMed2006

Q fever in members of the United States armed forces returning from Iraq.

Large numbers of armed forces personnel returning from southwest Asia may present with infections that are not endemic to the United States or that occur rarely and are underdiagnosed in the United States. We report 2 cases of acute Q fever in members of the US Military recently returned from Iraq. Because a number of recent reports suggest that the risk of Q fever may be higher than initially thought among US forces deployed to this region, clinicians need to have a high index of clinical suspicion, an understanding of the available diagnostic tests, and knowledge regarding the methodology and capabilities of the laboratory to which specimens are submitted.

Adult↗
PubMed1986

The determinants of health services utilization in southern Iraq: a household interview survey.

A household survey was conducted in 1982-83 in a sample of 324 households served by five health centres in two different areas of Southern Iraq. Information from each household was collected on socioeconomic factors, access to curative health services, sickness within the previous four weeks and the subsequent use of health services. Thirty seven per cent of people reported some sickness during the four-week recall period, giving an average of 40 episodes per 100 people per four weeks. The average consultation rate was 33 per 100 people and the annual estimated rate was 4.3 consultations per person per year. There was an average of 82 consultations per 100 sickness episodes with the highest rates for infectious and parasitic diseases (111) and hypertension and heart diseases (108), and the lowest for eye and ear diseases (52). The most important factors affecting utilization were level of perceived sickness in the household and the distance to the nearest health centre. Household income did not appear to be an important factor except for attendance at private clinics. The study suggests that the overall rate of utilization is sufficient for curative services but that now it is the quality of this care that needs to be examined.

Community Health Services↗
PubMed1979

The prevalence of diabetes mellitus in a rural community in Iraq.

A survey was undertaken to estimate the prevalence of diabetes mellitus in a rural community in Iraq. Blood-sugar estimations after glucose-loading were performed on a sample of a village population 15 + years. 4.8% had diabetes and a majority of them had symptoms referable to their diabetic state. Diabetes was totally unknown among this rural population before the survey.

Adolescent↗
PubMedDate not supplied

Verification of exposure to sulfur mustard in two casualties of the Iran-Iraq conflict.

The exposure of two Iranian victims of the Iran-Iraq conflict (1980-1988) to sulfur mustard was established by immunochemical and mass spectrometric analysis of blood samples taken 22 and 26 days after alleged exposure. One victim suffered from skin injuries compatible with sulfur mustard intoxication but did not have lung injuries; the symptoms of the other victim were only vaguely compatible with sulfur mustard intoxication. Both patients recovered. Immunochemical analysis was based on detection of the N7-guanine adduct of the agent in DNA from lymphocytes and granulocytes, whereas the N-terminal valine adduct in globin was determined by gas chromatography-mass spectrometry after a modified Edman degradation. The valine adduct levels correspond with those found in human blood after in vitro treatment with 0.9 microM sulfur mustard.

Blood Cells↗
PubMed1999

The postwar hospitalization experience of Gulf War Veterans possibly exposed to chemical munitions destruction at Khamisiyah, Iraq.

Using Department of Defense hospital data, the authors examined the postwar hospitalization experience from March 1991 through September 1995 of US Gulf War veterans who were near Khamisiyah, Iraq, during nerve agent munition destruction in March 1991. Multiple sources of meteorologic, munition, and toxicology data were used to circumscribe geographic areas of low level, vaporized nerve agent for 4 days after the destruction. Plume estimates were overlaid on military unit positions, and exposure was estimated for the 349,291 US Army Gulf War veterans. Exposure was classified as not exposed (n = 224,804), uncertain low dose exposure (n = 75,717), and specific estimated subclinical exposure (n = 48,770) categorized into three groups for dose-response evaluation. Using Cox proportional hazard modeling, the authors compared the postwar experiences of these exposure groups for hospitalization due to any cause, for diagnoses in 15 unique categories, and for specific diagnoses an expert panel proposed as most likely to reflect latent disease from such subclinical exposure. There was little evidence that veterans possibly exposed to the nerve agent plumes experienced unusual postwar morbidity. While there were several differences in hospitalization risk, none of the models suggested a dose-response relation or neurologic sequelae. These data, having a number of limitations, do not support the hypothesis that Gulf War veterans are suffering postwar morbidity from subclinical nerve agent exposure.

Adolescent↗
PubMed1985

Joint mobility among university students in Iraq.

The prevalence of joint hypermobility among 1774 university students, aged 20-24 years, in Iraq has been determined from a survey made in 1981. The degree of joint hypermobility was scored on a scale between 0 and 9 using the method described by Beighton in his modification of the Carter and Wilkinson scoring system. Joint hypermobility, defined as a score of 4 out of 9 or greater was found in 25.4% of males and 38.5% of females. The presence of joint complaints, ligamentous sprains, flat feet, Raynaud's phenomenon, easy bruising, high palate and varicose veins correlated well with joint hypermobility and were seen significantly more frequently in students scoring 7 out of 9 or more than in students scoring 3 out of 9 or less. The right (usually dominant) side was significantly less mobile than the left side, whatever the hypermobility score. Physique as expressed by body weight and height did not show any relation to joint mobility.

Adult↗
PubMedDate not supplied

Military TBI during the Iraq and Afghanistan wars.

Traumatic brain injury (TBI) is an important source of morbidity in the Iraq and Afghanistan wars. Although penetrating brain injuries are more readily identified, closed brain injuries occur more commonly. Explosion or blast injury is the most common cause of war injuries. The contribution of the primary blast wave (primary blast injury) in brain injury is an area of active research. Lessons learned from the sports concussion and civilian mild TBI literature are useful. Individuals with TBI and posttraumatic stress disorder require treatment of both conditions. Families and communities need to be cognizant of the needs of these returning veterans.

Afghanistan↗
PubMed2006

Evaluation of immediate phase of management of missile injuries affecting maxillofacial region in iraq.

In the past two years Iraq was, and still is, subjecting to a confluence of conventional war, civil unrest, guerrilla and terrorist attacks as well as an increasing crime rates. This study evaluates the immediate phase of management of 100 patients suffering from missile injuries to the maxillofacial region. Patients were treated in the maxillofacial unit in the Specialized Surgeries Hospital Medical City, Baghdad during one year (from 2003 to 2004). We had 79 men and 21 women. Age ranged from three to 72 years (mean 37.5 years). The majority of injuries were caused by rifle bullets (49%) followed by fragments (29%), handgun bullets (15%), airgun pellets (6%), and shotgun (1%). Injuries consisted mainly of mandibular fractures found in 56 patients. Urgent airway management was needed in (27%) of patients. Nineteen patients were presented with active bleeding which would not stop without intervention. Most entrance and exit wounds as well as retained missiles were located in the cheek (54.8%, 39.4%, and 27.5% respectively). There were three mortalities due to complications related to head injury. Distribution of missiles used in any conflict reflects the type of this conflict, the prevailing local conditions, and the technological efficiency of weapons used by the opposing teams. Particularly challenging are missile injuries that involve the face, not only because of problems with reconstructing bone and soft tissue defects but also because of emergent problems with airway obstruction and neurovascular compromise.

Adult↗
PubMed1989

Causes of infections in penetrating head wounds in the Iran-Iraq War.

Factors seemingly influential in postoperative central nervous system infections were evaluated in 379 patients who sustained missile wounds to the head during the Iran-Iraq War. The mean wound age was 49 hours. The site of injury and presence of retained bone and/or shell fragments did not have a significant effect on infection rate. Thirty-three of 379 patients developed cerebrospinal fluid (CSF) fistulas of which 12 (36%) were associated with infection. The infection rate was 6 of 346 (1.7%) in the absence of CSF leaks. There was a statistically significant association between CSF fistula and infection. All 6 positive cultures in patients with CSF fistulas were gram-negative. Thirty-two patients died during the study, a mortality rate of 8.4%. The mortality rate from infection was 1.8%. Two hundred seventy-seven of 347 patients were followed for a mean of 22 +/- 17 months during which time 2 patients were readmitted with central nervous system infections, both due to CSF leakage. CSF fistulas were the main predisposing factor in postdebridement central nervous system infections in this study.

Anti-Bacterial Agents↗