Tishreen University Research Articles

فعالية الحقن الدقيق الموضعي داخل الأدمة لحمض الترانكساميك بتركيز 4 ملغ/ مل في علاج الكلف

Background: Melasma is a common acquired hyperpigmented dermatosis due to a disorder in the function of the melanogenesis process. Nowadays, there are many used treatments for melasma but it is still a big cosmetic problem. The Aim of our study is to evaluate the efficacy and safety of intradermal microinjection of tranexamic acid TXA in the treatment of melasma in Syrian women. Methods: A total of 34 women with melasma, attending Tishreen University Hospital in Lattakia-Syria from January 2020 to January 2021 were included in this prospective (before and after) study. We applied topical anesthesia then we injected 0.05 ml TXA (4 mg/ml) intradermally into the melasma lesions at 1 cm intervals by using a 30-gauge insulin syringe. We repeated this procedure every 2 weeks for 12 weeks. A clinical investigator evaluated the results by using the modified Melasma Area and Severity Index (mMASI) at baseline and at 4, 8, and 12 weeks. Patients were followed up after 3 months from completing the treatment. Results: The mean mMASI scores decreased from 6.99±3.4 at baseline to 5.98±3.2, 4.59±2.5 and 3.49±2.3 at weeks 4, 8, 12 respectively. This decrease was clinically and statistically significant with a p-value = 0.0001. Our patients did not show serious side effects. Conclusion: According to that, we suggest that localized intradermal microinjection of tranexamic acid at a concentration of 4 mg/ml is an effective and safe therapeutic method for melasma.

تأثير التدخين أثناء الحمل على حجم الوليد والمشعرات الأنثروبومترية: دراسة حشدية في اللاذقية، سوريا

Objective: To investigate the effect of smoking during pregnancy on the anthropometric measurements of the newborn and the effect of stopping smoking during the first trimester of pregnancy. Patients and methods: Our study was a cohort-analytical study conducted at Tishreen University Hospital in Lattakia-Syria during the period from January 2020 to January 2021. The study included 180 pregnant women with a single live pregnancy who met the inclusion criteria. They were divided into non-smokers, smokers who stopped smoking during the first trimester of pregnancy (group 1), smokers who continued smoking until the end of pregnancy (group 2). After birth. Neonate identified with Small for gestational age and low birth weight. Results: The study was founded that smoking during pregnancy increases the risk of (low birth weight) LBW by 16.3% and the risk of SGA (small for gestational age) by 79%, and smoking was associated with the birth of children with lower anthropometric measurements compared to the children of non-smoking mothers. As for the Ponderal Index >90th, A.OR was 4.9 for group (1) versus 5.8 for group (2) and Head to Length Ratio >90th was 3.4 for group (1) versus 4.6 for group (2), as it was found that increasing the number of cigarettes smoked per day increases the risk of The occurrence of adverse birth outcomes Conclusion: Maternal smoking, regardless of duration of smoking during pregnancy, was associated with neonates abnormal body proportions resulting from greater reductions in body length and head circumference compared to weight, smoking during the first trimester of pregnancy was associated with adverse birth outcomes, but with a lower A.OR than group (2).

مقارنة بين جرعات الميزوبروستول في إنهاء الحمل في الثلث الأول من الحمل

Objective: The aim of this study is to compare the efficacy of vaginal misoprostol with different doses for abortion in the first trimester. Patients and Methods: Descriptive Comparative Study conducted for the period one year (July 2020 –July 2021) at Tishreen University Hospital in Lattakia- Syria. The study included 80 pregnant women in the first trimester who had a therapeutic indication for termination of pregnancy after taken consent from it and her fathers, and were divided into group A was (40 women): were administrated 400 µg of vaginal misoprostol and repeated every 6 h for 48 h, and group B was (40 women): were administrated 800 µg of vaginal misoprostol repeated after 24 h. Results: Abortion rate after the first dose in group B was higher than group A (67.5% vs.10%). The rate of complete abortion was significantly higher in group B (72.5%) vs. (17.5%) in group A, p= 0.0001, and mean induction- abortion interval in group B was significantly shorter than group A (13.8±3.3 vs. 29.4±5.9, p: 0.004). There weren't significant associations between both indications and results of abortion with the number of pregnancies in the two groups (p>0.05). Nausea was the most frequent side effect in the two groups without significant difference (p>0.05). Conclusion: Misoprostol represents a safe and effective alternative to invasive methods for termination early intrauterine pregnancy.

دراسة تحليلية لموجودات اللفائفي النهائي في سياق تنظير القولونات الكامل

This study aimed at determine the diagnostic value of terminal ileoscopy according to indications for colonoscopy. In addition to, evaluating the duration of the procedure and the rate of success. The Methods An observational descriptive study was conducted for the period of one year (January2020 -January2021) at Tishreen University Hospital in Lattakia-Syria. The study included 198 patients referred for colonoscopy due to various indications. Results: The median age was 53 years, the most frequent age group was 40-60 years (42.9%), followed by the group ≤ 60 (32.8%). Males represented 58.6 % of the patients, and abdominal pain was the most frequent indication for colonoscopy. The success rate of terminal ileal intubation was 83.8% with a mean duration of the procedure 2.15±1.6 m. Abnormal macroscopic findings were found in 23 patients (13.9%) and ulceration was the most frequent feature (4.5%). Significant pathological findings were present in 11 cases (47.8%), and included Crohn's disease (10 cases) and infectious colitis with Yersinia (1 case). The diagnostic yield was 5.5% in all ileoscopies, which was significant in patients with weight loss (20%) and right iliac fossa pain (16.7%). Conclusion: Our study findings demonstrated high percentage of ileal intubation success with variable diagnostic yield according to the indications of colonoscopy.

تقييم مستوى الكالسيوم المصلي عند مرضى الصداف

Background: Psoriasis is a chronic immune- mediated skin disease, with a genetic predisposition. Many factors can trigger or exacerbate psoriasis. Recently, some studies found that psoriasis was associated with hypocalcemia. So we did this study to find this association in our patients. Objective: To evaluate serum calcium level in psoriatic patients and compare it with controls. Methods: This case- control study included 160 subjects (80 patients with psoriasis and 80 controls) admitted to dermatology clinic at Tishreen University Hospital, Latakia, Syria, from 2020- 2021. Serum calcium and serum albumin levels were estimated in all patients. Results: Calcium levels were significantly lower in psoriatic patients than in the control group (mean = 8.98±0.5 in patients vs 9.48±0.5 in controls, p- value<0.001). Calcium levels were significantly lower in patients with severe types of psoriasis (p- value<0.05). There was an inverse correlation between serum calcium levels and PASI score (r =- 0.3, p- value<0.05). There was also an inverse correlation between serum calcium levels and each of age and disease duration. Conclusion: In this study, a low calcium level was observed in psoriatic patients. Hypocalcemia may be a marker for the severity of psoriasis. In addition, Calcium seems to have a role in the pathogenesis of psoriasis.

Prevalence of Keratoconus in a Population-Based Study in Syria.

Aim To determine the prevalence and associations of keratoconus (KC) in a university student population in Syria. Methods A prospective multicentre cross-sectional cohort study was conducted at two universities in Syria. Student volunteers were recruited from Tishreen University (Latakia governorate) and Damascus University (Damascus governorate). All participants underwent a comprehensive ocular examination. Placido/Scheimpflug-based corneal imaging using the Sirius (CSO, Florence. Italy), and a questionnaire to evaluate the baseline characteristics and medical history, as well as to highlight possible risk factors of KC. Univariate and bivariate analyses were performed. Results The estimated prevalence of KC among all subjects was 1.43% (n = 12). A strong association between eye rubbing and keratoconus was found (OR 9.33, 95% CI 2.94–29.63, P < 0.001). Damascus University participants had a higher prevalence of KC than Tishreen University. However, the difference was not statistically significant. Conclusion The prevalence of keratoconus in this Syrian student population was 1.43%. The results of this study demonstrate a high prevalence of keratoconus in the study population. Early detection of keratoconus through screening may yield benefits in preventing devastating sequelae of KC in populations with a high prevalence.

Cystoscopy Findings in Females with Recurrent Lower Urinary Tract Infections who were referred to Tishreen University Hospital between 2021 - 2022

The importance of our study comes from that recurrent lower urinary tract infection in females is one of the most common cases that referred to the urology clinic, and it is considered a challenge to treatment in the case of reliance on clinical, radiological and laboratory diagnosis only, while cystoscopy may provide information that may be useful in managing the reviewed cases.

Comparison of surgical and conservative treatment of muscular invasive urothelial carcinoma in bladder: A study at Tishreen University hospital (2016-2022)

This research aims to study muscular invasive urothelial carcinoma patients in the bladder in terms of their disease progression, after studying the management methods used and the treatments used after surgical intervention, and the consequent change in survival rate and quality of life.

Peri-surgical Complications Related to Anterior Cervical Spine Surgery: Smith-Robinson Approach

The primary goal is to identify the genuine incidence of peri-surgical complications associated with anterior cervical spine surgery in a low-income country. The secondary goal is to identify any risk factors predisposed to these complications; Especially dysphagia, as it is the most common perioperative complication, and to clarify the prognosis of these complications, as well as their proper management. This is a retrospective case-control study, including 109 patients who underwent anterior cervical spine intervention from the right side in Tishreen University Hospital in Lattakia, Syria, during the period between 1-1-2018 and 15-12-2021. Data was collected regarding gender, age, diagnosis (radiculopathy or myelopathy), surgical procedure, number of levels, plate addition, smoking, diabetes mellitus, and peri-surgical complications occurred during surgery proceeding to the next 14 days of follow-up. Male: female ratio was (1.4:1), 30.3% of cases were from a grouping (41-50) years of age. Myelopathy consists 56% of cases, anterior cervical discectomy and fusion (ACDF) consist of 47.7% of procedures. Intervention at one level represented the highest percentage at 52% of cases. The peri-surgical complication rate was 12.8%; divided into dysphagia 6.4%, recurrent laryngeal nerve (RLN) injury, superficial infection 1.8% each, dural tear, compressive hematoma, and neurological deterioration 0.9% each. Plate addition, 3 or more levels of intervention, and (ACDF+P) or (ACCF) surgery are all determined to be risk factors for the development of perioperative dysphagia. The majority of peri-surgical complications of anterior cervical spine surgery are minor and can be managed conservatively with a good prognosis. Early recognition of these complications with appropriate management is of paramount importance for improving the outcomes. Plate addition, 3 or more levels of intervention, and (ACDF+P) or (ACCF) surgery are all determined to be risk factors for the development of perioperative dysphagia.

Clinicopathological features of idiopathic granulomatous mastitis: A retrospective study & educational lessons from Syria

Objectiveto determine the clinical presentations and histopathological findings of idiopathic granulomatous mastitis, and to evaluate clinical outcomes after management. Methodsbetween 2007 and 2021, the files and histopathology reports of 17 patients with idiopathic granulomatous mastitis at Tishreen University Hospital, Latakia, Syria were reviewed. The data were analyzed and a scan through relevant literature was carried out to review related cases. Resultsthe age of patients ranged from 23 years to 57 years, and the mean age was 37.2 ± 9.57 years. All patients were female. The most common clinical presentation was breast lumps and the most common mammographic finding was ill-defined masses, which mimics breast carcinoma. Multinucleated giant cells, polymorphonuclear leukocytes, lipogranuloma-like changes and lobulocentric abscesses were the most common histopathological findings. Treatment options include: drainage of abscess along with antibiotics, steroid administration, and surgical excision. Antibiotic treatment was associated with a higher rate of complications, while use of steroids showed complete remission of the disease. Conclusionidiopathic granulomatous mastitis is a spectrum of entities that should be differentiated from breast carcinoma and other mastitis conditions, the infectious or the non-infectious ones. The clinical and radiological features resemble those of breast carcinoma and infectious mastitis. The histopathological study is considered as the most crucial element in the multidisciplinary approach to diagnose idiopathic granulomatous mastitis (IGM) and determine the optimal management to be administered.

Swimming with the “Current”: An Access-Informed Exploration of Envisioned Blended Learning at Tishreen University in Syria

Today, Tishreen university in Syria is translating its emergency response to crises-prompted disruptions into an intentional blended learning model through the official inception of Moodle. The present study adopts a holistic approach to explore faculty's perceptions of this transition at the Higher Institute of languages. To this end, four pilot interviews, the researcher’s lived experience and the literature were used to design a web-based questionnaire. The questionnaire, completed by 23 teachers, elicited comparative reflections on teachers’ access to Moodle as opposed to their other digitally mediated informal experiences of access, mainly to YouTube. Analysis was largely informed by the digital divide layers: physical-material, instrumental (tool-related), substantial (content-related), motivational, and usage-related. The article argues that re-thinking academic structure and infrastructure is irreducibly grounded in formal-informal networked experiences. Although access divide models have evolved vertically into layers or generations, the current study suggests the need for a horizontal expansion. Firstly, current access divide models do not lucidly reflect distinctions between formal and informal access. Since the digital landscape we increasingly inhabit is not monthlithic in terms of its affordances, structure, modality or genre of information; formal and informal access outcomes are necessarily diverse, yet dynamically intersecting. Secondly, despite accentuating the role of digital proficiency theoretically, access research only tangentially differentiates between the consumption versus production dimensions of substantial content-related skills access. Questions regarding the impact of access on effective blended learning models in general and on academic knowledge in particular, emerge from the data. It is hoped that future research will fathom these distinctions and the relationships between them more profoundly to empower similar initiatives of transition. This is particularly impactful in a country like Syria where an added political-economic affordability layer engulfs the existing physical divide, resulting in mounting boundaries to digital academic and professional knowledge.

A comparison of use microdebrider with conventional endoscopic surgery for nasal polyps

Background: Nasal polyps are chronic and benign inflammatory lesions that arise from the mucous membrane of the nasal cavity and paranasal sinuses. And it represents a challenge in treatment due to its uncertain causes and recurrent relapse. Because of that the surgical treatment is considered as the best choice for the removal of nasal polyps. And, it contains endoscopic sinus surgery using either conventional instruments or the microdebrider which is an automatic device used to remove the obstructing tissue. And, it represents a modern technology in the treatment of nasal polyps. Objectives: Studying and comparing the microdebrider assisted endoscopic surgery and conventional methods using sinus endoscopes in the surgical management of nasal polyps, and evaluating the advantages of the microdebrider. Methods: The study was a comparative prospective study conducted at the department of ENT, tishreen university hospital, lattakia, Syria done between 2020 to 2021. 76 patients (46 male and 30 females) were enrolled in the study and divided into two groups depending on the used surgical method. Group1: conventional endoscopic sinus surgery method, Group2: microdebrider assisted endoscopic surgery. Then, comparing the results during and after 3 months of the surgery. Results: There were a significant difference between study groups in the mean time required for surgery (shorter in group2 with p-value &lt;0.01) and the average intraoperative blood loss (less in group2 with p-value&lt;0.01). Endoscopic sinus surgery with the microdebrider noted a low rate of postoperative synechiae formation after three monthes and there is no significant difference between the two groups in recurrence of nasal polyps after three monthes. Conclusion: Using the microdebrider in the surgical treatment of nasal polyposis is an effective and safe method because it has the advantage of saving time, decreasing blood loss during surgery, and reducing the rate of postoperative synechiae formation. but there is no significant difference in recurrence between the microdebrider and conventional methods.

Studying the changes of corneal endothelium cells in patients with spherical refractive errors

Objective: To study of the relationship between spherical refractive errors and the changes in corneal endothelial cells. Methods: This sectional study, 1098 eyes of 663 persons attending the ophthalmological clinic at Tishreen University Hospital were studied between the years 2020-2021, they were divided into three groups according to the spherical equivalent value (193 nearsighted, 254 partially sighted, 216 long sighted), and also each was divided into three groups according to the value of the spherical equivalent. From the farsightedness and myopia groups to groups according to the severity of the refraction present (mild, moderate, severe), all participants underwent a complete ophthalmological examination including corneal endothelial cell counts by Endothelium Mic. Non contact, Specular Microscope, where the average of three successive measurements of endothelial cell density (MCD), coefficient of variation (CV) for cell volume, and hexogram (EX%) were taken. Results: The values of endothelial cell density (MCD) (P ˂ 0.05) and hexameric cell percentage (EX%) (P ˂ 0.05) decreased statistically significantly, while the value of the covariance (CV) increased (P ˂ 0.05) with increasing myopia, This change was at the expense of moderate myopia and severe myopia, while mild myopia did not have a statistically significant effect, as well as for hyperopia, where we did not find significant statistical differences in the three variables (MCD) (EX%) (CV) (P ˃ 0.05). Conclusion: Hyperopia does not affect the endothelial cells of the cornea, while moderate to severe myopia causes a significant change in the endothelial cells of the cornea.

Efficacy and safety of topical application of 45% hydrogen peroxide solution in the treatment of common warts

Objective: The study aimed to evaluate the effectiveness and safety of hydrogen peroxide topical solution, 45% (HP45) for treatment common warts. Patients and Methods: A Prospective study (Before&amp; After) conducted for the period one year (January 2020- January 2021) at Tishreen University Hospital in Lattakia- Syria. 35 patients with common warts who received treatment with HP45 were included in the study. Results: The median age was 21years, 51.4% of patients were females. Most common sites of warts involvement were dorsum of the hands (44.6%), followed by palm of hands (41.3%). A statistically significantly reduction in mean warts size was occurred at the end of treatment (0.2±0.18 vs. 0.62±0.6, p:0.0001). Complete clearance was achieved in 51.2% of patients, most of these cases were in the last session. The best response to the treatment was in warts located on the dorsum of hands, with size less than 1 cm and duration of disease less than one year. Regarding of side effects, itching and stinging were more frequently seen, followed by edema. Conclusion: Topical application of HP45 was effective in removal of common warts. Except of itching and stinging, serious side effects not occurred.

The prevalence of hepatitis C virus infection in patients with lichen planus: Case- Control Study

Background: Lichen planus (LP) is an idiopathic inflammatory disease of the skin and mucous membranes. It has been reported to be associated with diseases such as hepatitis C virus infection. However, this association vary from one geographic area to another. Objective: The aim of this study is to assess the prevalence of hepatitis C virus infection and liver enzymes abnormalities among patients with lichen planus compared to controls. Materials and Methods: This case- control study included 204 participants (102 with L.P. and 102 controls) from the dermatology clinic at Tishreen University Hospital, Lattakia, Syria, during the period (2020- 2021). The diagnosis was made clinically and confirmed histologically whenever the clinical features were not inclusive. Sera were analyzed for anti- HCV antibodies and liver enzymes; aspartate aminotransferase (AST), alanine aminotransferase (ALT). Results: Out of 102 cases and 102 controls, none was tested positive for Anti- HCV antibodies. There were no statistically significant differences neither in serum levels of liver enzymes; alanine aminotransferase (ALT) (P.value= 0.4), aspartate aminotransferase (AST) (P.value= 0.08) nor in frequencies of its abnormalities; alanine aminotransferase (ALT) (P.value= 0.2), aspartate aminotransferase (AST) (P.value= 0.1) in any of the studied groups. Conclusion: This study did not reveal association between lichen planus and HCV infection, neither revealed any statistically significant elevation in serum levels of liver enzymes among patients with lichen planus compared to controls.

Risk factors of cerebral palsy in children, patterns and associated troubles

Introduction: Cerebral palsy is the most common neurological disorder seen in childhood, and part of chronic diseases at this stage, which poses a great social and economic challenge at the family level, medical staff and rehabilitation centers. To assess the actual needs for patient management in various fields, it was necessary to study the problem at the local level. The main objectives: To study the risk factors associated with cerebral palsy in children attending the Neurological Clinic in Tishreen University Hospital. Materials and methods: The study included all children diagnosed with cerebral palsy up to the age of 14 who attended the Neurology Clinic at Tishreen University Hospital during the study period from May 2020 to June 2021. Data were analyzed according to: gender distribution, age of the injured, method of delivery, and the age at which the child first attended the clinic. In addition to studying potential risk factors during pregnancy, and causes in the perinatal and postpartum period. Cerebral palsy was stereotyped and the degree of disability was determined based on the clinical examination and the need for aids. The accompanying disorders and the various complaints that these children were referred to were recorded and included in categories. The diagnosis was based on clinical examination, pathological history, radiological investigations and available laboratory analyzes. Results: The sample included 163 children with a male preponderance of 68%. In the research sample, there was a relationship between the parents of 40 children at a rate of 24.5%. The risk factors that were found in the mothers of the children were sepsis during pregnancy, diabetes and preeclampsia. The form of perinatal asphyxia was the most dangerous perinatal factor seen and there was no differences in the method of delivery. The most causative factor after birth is the need for oxygen or a ventilator. Delayed milestone, speech delay, and convulsions constituted the most associated troubles. The spastic pattern is the most frequently seen pattern. As for the applied procedures, the most common was CT scan with 71.8.

The Predictive Value Of Umbilical Cord Blood Total IgE Levels In Allergic Diseases

Allergic diseases in children have increased significantly. In recent years, it affects up to 35% of children. The current study aimed to investigate the value of the umbilical cord blood total IgE levels in the prediction of the development of allergic diseases during 8 years of follow-up. Methods — In cross-sectional study included 500 infants who were born in the obstetrics department at Tishreen and Al-Assad University Hospitals during the period 2007-2015. Questionnaires were administered after the birth included gender, gestational age, birth weight, mode and season of delivery, smoking during pregnancy, and family history of allergic diseases. Umbilical cord blood total IgE levels were measured. The infants were followed up for eight years for subsequent development of allergic disorders. Results — 214 (42.8%) of 500 newborns had high umbilical cord blood total IgE levels. We followed 143 of 214 newborns for 8 years; there was an allergic family history in 51.7% of newborns. During the following period, allergic diseases developed in 76.22% of the children with high umbilical cord blood total IgE levels. Allergic symptoms in children varied between nasal allergy (19.6%), skin allergy (eczema and urticarial) (25.2%), childhood asthma (31.5%). The rate of allergic symptoms development in the presence of two factors (family history and high umbilical cord blood total IgE) was 51.7%. Conclusion — We found a high prevalence of allergic diseases in children with high umbilical cord blood total IgE. The current study could be used as a preventative strategy to reduce the risk of allergic diseases by predictive of subsequent.

Determination of Maturity and reproductive cycle of Small Spotted Catshark Scyliorhinus canicula (Linnaeus, 1758)(Scyliorhinidae: Elasmobranchii) From the Syrian marine water

This study was carried out in the Marine Sciences Laboratory of Agriculture Faculty at Tishreen University, in collaboration with the Higher Commission for Scientific Research, on the Small Spotted Catshark Scyliorhinus canicula (Linnaeus, 1758) in the Syrian marine water (Eastern Levant of Mediterranean sea); From Rass Albassit northward ( 35° 55  N), to the Lebanese borders southward (°34 50´ N). During the period January 2012 to September 2013. 417 specimens (231 females, 186males) were collected at depths 50-250 m, from sandy or sandy-muddy bottoms by different fishing gears; mainly hook sub bottom. S. canicula suffers an overfishing into the Syrian marine water. The highest fishing quantity was during spring and summer. The total length of specimens ranged from 225 to 515 mm TL, and weighed from 22 - 380 g. Smallest specimens matured of males and females were 355, 350 mm, respectively. The total length ranged from 355 -500 mm TL for adult males, and 350 -515 mm TL for adult females. S. canicula is an oviparous species. The largest yolky oocytes diameter was 12 mm, and weighed 1.3 g. The ripe oocytes is covered and ovulated as an egg capsule. The length of egg capsules ranged from 42 -50 mm, their width from 16-18 mm, and their mass reached to 4.8 g.

Perinatal Risk Factors and Early Onset of Neonatal Sepsis

In a cross-sectional study that included all newborns admitted to the neonatal intensive care of Tishreen University Hospital from October 2019 for one year and who fulfilled clinical and laboratory criteria for early neonatal sepsis, blood samples were drawn for laboratory analysis (CBC, CRP) with a blood culture.

Study of Indications and Early Complications of Bronchoscopy at TUH- Lattakia During 2020 – 2021

Flexible bronchoscopy is a major diagnostic and therapeutic tool employed largely in respiratory medicine. This study was designed to determine the indications and outcome of a bronchoscopic workup at Tishreen University Hospital during the period from March 2020 to March 2021. All patients undergoing flexible bronchoscopy were subjected to full history and clinical examination, and data about patient's demographic details, indications for bronchoscopy, sedation given, specimen obtained and results of the investigation, and complications encountered were recorded. The study results revealed that of 176 bronchoscopies, 171 (97.2%) were diagnostic, and the remaining five (2.8%) were therapeutic. The mean age of patients was 54.3 ± 11.8 years, with males constituting the majority, 71.6%. Malignancy and hemoptysis were the two main indications for bronchoscopy (34.1% and 27.8%, respectively). The overall complication rate was 5.7%. The complications included bleeding in five cases, hypoxemia in three cases, laryngeal spasm in two cases, and hypertension in one case. There were no deaths related to the procedures. The overall diagnostic yield was 61.4%. Malignancy was confirmed in 70% of suspected cases; endobronchial malignancies were diagnosed in 30 patients (93.7%) out of 32 who had a macroscopically visible tumor. Tuberculosis was diagnosed in 69.2% of suspected cases, whereas bacterial pneumonia was diagnosed in 62.5%. Bronchoscopy diagnosed 81.8% of patients with lobar atelectasis. The diagnostic yield was 47% for hemoptysis. Our results confirm that flexible bronchoscopy is a valuable diagnostic tool, with a low rate of complications, particularly in patients with lung cancer. The diagnostic yield in our locality is almost similar to that reported in other series.