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Article
Early Detection of Chronic Obstructive Pulmonary Disease in Asymptomatic High Risk Male Smoker

Author: Abdulhamza Rajooj Hmood
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2070-2076
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: COPD is responsible for permanent morbidity, premature mortality, and great burden to the healthcare system. The most commonly encountered risk factor is tobacco smoking. Without screening, patients usually overlook early symptoms of cough and wheezes but commonly seek medical advice when they become dyspnic on mild to moderate exertion. By that time, half of their ventilatory reserves are lost. Spirometry remains the gold standard for diagnosing COPD and monitoring its progression.Aim of study: since COPD is preventable condition, we tried to screen high risk individuals with the aim of early detection and preventionPatients and methods: consecutive asymptomatic male smokers (n=170) were selected by high risk population screening. Participants were eligible if they were ≥ 30 years of age, regular smokers, had smoking history of >10 pack years with no significant respiratory symptoms except for occasional cough and willing to undergo spirometry.Results: a total of 170 asymptomatic male smokers were screened by spirometry according to the American thoracic society and European respiratory society. Overall, airway obstruction was seen in 30 (17.6%) subjects. Mild obstruction was seen in 19 (63.3%) and moderate obstruction in 11 (36.7%) subjects.Discussion: Airway obstruction was linked with duration of smoking (P value <0.001) and number of pack years (P value <0.001).Conclusions and Recommendations: early detection of COPD by spirometry especially in smokers of more than 20 pack years is likely to reduce the overall burden of disease.


Article
Abnormal Blood Pressure Load by Ambulatory Blood Pressure Monitor as a Predictor for Left Ventricular Hypertrophy in Hypertensive Patients.
حمل ضغط الدم بجهاز قياس ضغط الدم المحمول كدليل لتثخن جدران القلب في المرضى المصابين بارتفاع ضغط الدم الشرياني.

Authors: Laith Abdulhussein Aldabbagh --- Abdulhamza Rajooj Hmood
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 3 Pages: 113-122
Publisher: University of Kufa جامعة الكوفة

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Abstract

Aim:The aim of this study is to assess the accuracy of ambulatory blood pressure load as a predictor for LVH in comparison with echo in hypertensive patients.Methods: We report ECG, echo study, and then ABPM findings in 53 individuals during 1 year. All of the referred subjects were hypertensive with variable socio-demographic characteristics.Results: We found 31 patients having LVH on echo study; most of them were male and significantly correlated with duration of hypertension, average 24-hours SBP and DBP, mean day-time and mean night-time SBP and DBP, and with the circadian rhythm. The association between LVH and BP load was also significant.Discussion: Echo was more sensitive than ECG in detecting LVH and ABPM was rather more sensitive than echo. The study had found that BP load measurement had very high sensitivity with an acceptable specificity and an excellent negative predictive value in rolling out LVH. The association between LVH and parameters of ABPM was also significant.Conclusions: Abnormalities on ABPM are very common in hypertensives and are strongly indicated to identify the BP profile. Recommendations: ABPM was more sensitive than ECG and echo study in the detection of LVH. Echo, on the other hand is rather more sensitive than ECG for the same purpose.Male hypertensive should be offered an ABPM at every opportunity for early detection of LVH.

الهدف: يعتبر فحص القلب بجهاز الايكو من الفحوصات المهمة لتشخيص تثخن جدران القلب نتيجة ارتفاع ضغط الدم وذلك لوجود علاقة وثيقة بين تثخن جدار القلب وارتفاع ضغط الدم. في هذه الدراسة تمت المقارنة بين جهاز الضغط المحمول وجهاز الايكو لتشخيص تثخن الجدران.المنهجية: تم بحث 53 شخص مصاب بارتفاع ضغط الدم باستخدام تخطيط القلب الكهربائي وعمل فحص ايكو القلب لدراسة كتلة البطين اليسر ومقارنتها بحمل ضغط الدم بجهاز قياس ضغط الدم المحمول.النتائج: تم تشخيص 31 مريضا لديهم تثخن في جدران القلب. معظمهم كانوا ذكورا وفترة ارتفاع ضغط الدم كانت طويلة. النسبة الإحصائية كانت وثيقة بين تثخن الجدران ومعدل الضغط العالي والواطئ وكانت أيضا وثيقة بين تثخن الجدران وحمل الضغط الذي تم قياسه عن طريق جهاز الضغط المحمول.الاستنتاجات: جهاز الضغط المحمول كان دقيقا في تشخيص تثخن جدران القلب مقارنةبجهاز الايكو. حمل الضغط كان لديه حساسية عالية جدا في التشخيص وخصوصية مقبولة. بالإمكانأيضا استبعاد إمكانية وجود تثخن في جدران القلب لدى المرضى اللذين يكون حمل الضغط لديهم طبيعي.التوصيات: يجب على جميع المرضى المصابين بارتفاع ضغط الدم أن يتم إحالتهم لغرض الفحص باستخدام جهاز الضغط المحمول خصوصا اذا كانوا ذكورا ولديهم المرض منذ فترة طويلة.


Article
Electrocardiography (Holter) study of patients with panic attacks

Authors: Abdulhamza Rajooj Hmood --- Sami A. Al-Badri
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1870-1877
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: many patients complaining of palpitations seem to have normal electrocardiography (ECG).Aim: to study the 24-hours electrocardiography of patients with panic attacks.Material and Methods: fifty patients with panic attacks were studied by Holter monitoring for 24 hours each.Results: Holter monitoring showed ectopic beats in all 50 patients. No other arrhythmia was recorded.Smoking was significantly associated with having more ectopic beats per day.Discussion: panic attacks are not well understood. Some link it to autonomic instability. Some studies had found that some people diagnosed with panic disorder are having paroxysmal supraventricular tachycardia (PSVT). No one of the 50 patients we studied had PSVT. On the other hand, all of the 50 patients had several ectopic beats per day.Conclusion: it seems that ectopic beats are very common among patients with panic attacks.Keywords: panic, Holter, ectopic

Keywords

panic --- Holter --- ectopic


Article
Prevalence Of Viral Hepatitis B And C In Newly Married Persons
انتشار التهاب الكبد الفيروسي ب و ج عند المتزوجين الجدد

Authors: Mohammed Younus Naji --- Ala'a Abdulhussain Abdulzahra --- Abdulhamza Rajooj Hmood
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2013 Volume: 3 Issue: 3 Pages: 146-152
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives: The aim of study is to discover newly married persons infected with HBV and HCV they are received blood and or having dental manipulation in Najaf city and how to Prevent transmission of these diseases. Methods: Total of 200 newly married persons ,100 males and 100 females , with an age ranged from 15-40years (mean age 21.9 ± 6.1 SD years) . The study was conducted in central health laboratory in Al Najaf city. All recruited persons had their ages, sex and case histories recorded on an already prepared data sheet and subjected to virological tests of HBsAg and HCV Abs, also other tests like aspartate transaminase (AST), Alanine transaminase (ALT) , and total serum bilirubin .The data analyzed by using methods of descriptive statistics and inferentialResults: The patients with hepatitis B viral infection were 12 patients , two male and ten female. There were increased incidence of seropositive for HBsAg in patients who were female gender 10 (10%), younger than 25 years 7 (7%), history of dental manipulation 9(22.5%) with personal history of jaundice 5(19.2%), there were statistically significant(p= 0.01 ,0.01, 0.000 and 0.02 respectively) .Also lab finding include raised transaminase 6 (60%) ,and raised total serum bilirubin 2(50%) as compared in those with seronegativeHBsAg , these differenceswere statistically significant(p=0.000, 0.000 and 0.000 respectively) .The patients with hepatitis C viral infection were three patients, one male and two female. There were increased incidence of seropositive for HCV Abs in patients who had history of blood transfusion 2(50%) there was statistically significant(p= 0.000 ) .Also lab finding include raised transaminase 6(60%) as compared in those with seronegativeHBsAg , these differences were statistically significant(p=0.000 and 0.002 respectively) .Conclusions: The total of 200 newly married couple persons were enrolled in the study. The predictors for developing hepatitis B infection in this study that female, younger than 25 years old , with history of dental manipulation as dental polishing or dental extraction , blood transfusion and who had abnormal liver function tests. While the predictors for developing hepatitis C infection in this study that those who were asymptomatic patients with history of blood transfusion and raised transaminase enzymes.Recommendation: The study recommend that all newly married peoples should be investigated for hepatitisB and C and if possible other transmissible viruses to diagnose them earlier and prevent transmission

الهدف: تهدف الدراسة الى تحديد المتزوجين الجدد المصابين بالتهاب الكبد الفيروسي نوع B و C في محافظة النجف الاشرف والحد من انتشارها في المدينــــــــــــة. المنهجيه: تم دراسة 200 شخصِ متزوجون حديثاً، 100 ذكر و100 أنثى . الدراسة أجرتْ في مختبر الصحة العام في مدينةِ النجف الاشرف. تم تسجيل كُلّ الأشخاص من أعمارُهم وجنسُهم وسِيَرُهم على ورقِ بيانات مُحَضّرِ من قبل الباحث وأخضعوا إلى اختباراتِ انزيمات الكبد ، أيضا إختباراتَ أخرى و إلتهاب كبد الفيروسي نوع B و C ابتدأت الدراسة من كانون الثاني 2011 الى كانون الثاني 2012 . تم وصف وتحليل البيانات باستخدام اساليب الاحصاء الوصفي والاستدلالي . النتائج : ان المرضى المصابين بالتهاب الكبد نوع بي وعددهم 12 (2) ذكورِ و(10) نساء. في هذا البحث هناك زيادة في المرضى النساء 10 (10 %)، أصغر مِنْ 25 سنةِ 7 (7 %)،عندهم تأريخ مرضي لعملية الأسنانِ وتأريخِ شخصيِ لمرض اليرقانِ وكذلك الذين عندهم صعود في انزيمات الكبد وهذه الإختلافاتِ كَانتْ هامّة بشكل إحصائي . ان المرضى المصابين بألتهاب الكبد الفايروسي نوع سي وعددهم 3 (1) ذكر و(2) نساء. في هذا البحث هناك زيادة في المرضى الذين لديهم تأريخ مرضي لاستلام دم وكذلك الذين عندهم صعود في انزيمات الكبد وهذه الاختلافات كَانتْ هامّة بشكل إحصائي .التوصيات : الدراسة توصي بانه لابد من فحص الاشخاص المتزوجين الجدد واخضاعهم لفحص الدم المتضمن التهاب الكبد الفيروسي نوعB و C واذا امكن فحص الفايروسات الاخرى التي تنتقل عن طريق الدم والسوائل الاخرى من اجل تشخيصهم مبكراً و منع انتقال هكذا امراض بين المتزوجين .


Article
Routine Office Spirometry Versus European Community Respiratory Health Study Questionnaire

Authors: Abdulhamza Rajooj Hmood --- Hassan Salim Abdulsada --- Hameed Abdulhussan Alhibaly --- Laith Abdulhussien Aldabbagh
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 3 Pages: 658-666
Publisher: Babylon University جامعة بابل

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Abstract

Methods: We report spirometric findings in 108 individuals. All were to complete a short questionnaire and were studied by spirometry.Results: Positive response to questionnaire was noticed in 66.7%; 33.3% had no clinical complain and thus negative response. The positive response was particularly common in males who were smoker or ex-smokers. All patients were studied by spirometry which showed that 70.4% had normal spirometric pattern and 29.6% had obstructive pattern. The patients' mean age was not significantly correlated to the response of questionnaire and in determining the spirometric pattern. On the contrary to the questionnaire response, the correlation between spirometric results and socio-demographic characteristics of patients was not significant. Most importantly, the study had shown no significant association between the spirometric results (obstructive or normal) and the clinical response to questionnaire.Conclusions: Routine office spirometry has to be offered to all individuals elder than 33 years whether they have positive or negative response to questionnaire.

خلفية الدراسة: يتم عادة تشخيص مرض التهاب القصبات المزمن او الربو القصبي عن طريق فحص وظائف الرئتين. في هذه الدراسة تمت المقارنة بين الاستجابة لبعض الاسئلة المعدة سلفا من قبل الجمعية الاوربية لأمراض الجهاز التنفسي وبين جهاز فحص وظائف الرئتين لغرض الكشف المبكر عن الامراض الرئوية الانسدادية المزمنة . طريقة البحث: تم بحث 108 شخص خلال سنة كاملة حيث تم سؤالهم بعض الاسئلة القياسية ومن ثم فحص وظائف الرئتين لديهم خلال فترة سنة. النتائج: كان هناك 66.7 % من الاشخاص لديهم استجابة موجبة للأسئلة و33.3% ليس لديهم. الكثير من المجموعة الاولى كانو ذكورا ومدخنين حاليين او مدخنين سابقيين. كلا المجموعتين تمت فحص وظائف الرئتين لديهم والتي اظهرت 70.4 لديهم مظهر طبيعي و29.6% لديهم مظهر انسدادي (انغلاقي). معدل العمر لم يكن مهما للاستجابة للأسئلة او لتبيان مظهر فحص وظائف الرئتين. التدخين ونوع الجنس كان له تأثير واضح في الاستجابة للأسئلة وليس فحص وظائف الرئتين. واهم ما في هذه الدراسة انها اوضحت ان لا علاقة مهمة بين الاستجابة للأسئلة وفحص الوظائف.الحقائق: يجب على جميع المرضى اللذين يفوق عمرهم الثالثة والثلاثين ان يقومو بفحص وظائف الرئتين بغض النظر عن الاستجابة للأسئلة.مفردات البحث: جهاز فحص وظائف الرئتين, الامراض الرئوية الانسدادية المزمنة.


Article
Analysis of Patients with White Coat Hypertension by Ambulatory Blood Pressure Monitoring

Authors: Abdulhamza Rajooj Hmood --- Hassan Salim Abdulsada --- Ala'a Abdulhussain Abdulzahra --- Sami Adil, CABMS (Psychiatry)
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2014 Volume: 22 Issue: 9 Pages: 2567-2559
Publisher: Babylon University جامعة بابل

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Abstract

Ambulatory blood pressure measurement is the best method of detecting white coat hypertension. We report ambulatory blood pressure measurement findings in 100 individuals during 1 year. All of the referred subjects underwent casual and ambulatory blood pressure measurement.Mean age (± SD) was 36 (± 13) years; 82% male and 18% female; 68% were non-smokers and 32% were smokers . white coat hypertension is found in 68% of individuals who had completely normal blood pressure profile. Among the hypertensive group (32%), blood pressure load was normal in 96% and rose in 4%. Studying of the nocturnal drop had categorized the hypertensive group into reverse dipper (1%), non-dipper (3%), extreme dipper (0%), and dipper 96%. No significant correlation between ambulatory blood pressure measurement and socio-demographic characteristics. Thirty-two were hypertensive and 68% were normotensive on ambulatory blood pressure measurement with a statically significant value. Blood pressure load was elevated in 50%. There was a significant association between ambulatory blood pressure measurement results and blood pressure load and blood pressure drop, abnormalities on ambulatory blood pressure measurement are common in individuals with hypertension and are strongly indicated to identify the blood pressure profile. Indeed, ambulatory blood pressure measurement should be strongly indicated in individual with suspected white coat effect to avoid false diagnosis of hypertension and long term costly therapy.

جهاز مراقبة ضغط الدم المحمول يعتبر افضل طريقة لتشخيص المرضى المصابين بارتفاع ضغط الدم نتيجة الرداء الابيض. هولاء الاشخاص يكون معدل ضغط الدم لديهم عاليا عند قياسه في العيادة بينما يكون طبيعي عند قياسه خارج العيادة، تم بحث 100 شخص خلال سنة كاملة حيث تم قياس الضغط في العيادة والتأكد من كونه مرتفعا وتم بعد ذلك استخدام جهاز الضغط المحمول لمدة 24 ساعة. معدل العمر كان 36 سنة وبنسبة 82% ذكور و18% اناث. 68% كانو غير مدخنين و32% مدخنين. لم يرتفع ضغط الدم في 68% من المرضى هولاء الاشخاص يعتبر لديهم ارتفاع ضغط الدم نتيجة الرداء الابيض. 32% تم تشخيصهم مصابين بأرتفاع ضغط الدم. في هذه المجموعة تم ملاحظة ارتفاع حمل الضغط في 50%. بعد دراسة هبوط الضغط اثناء الليل تم ملاحظة ان 96% ينخفض الضغط لديهم بصورة طبيعية و3% ينخفض الضغط بدرجة اقل و1% ارتفع لديهم الضغط ولم يلاحظ اي انخفاض اكثر من المتوقع، لم تكن النسبة الاحصائية مهمة لكن النسبة الاحصائية كانت وثيقة بالنسبة لحمل الضغط وانخفاض الضغط. يجب على جميع المرضى المصابين بأرتفاع ضغط الدم الرداء الابيض ان يتم احالتهم لغرض الفحص باستخدام جهاز الضغط المحمول كما ويجب ذلك للمرضى المصابين بأرتفاع ضغط الدم لمعرفة تفاصيل ارتفاع ضغط الدم.


Article
Perception of OSCE Examination in Iraqi Undergraduate Medical Students

Authors: Riyadh Muhi Abbood Al-Saegh1 --- Albert J. J. A. Scherpbier --- Hameed A.Alhibaly --- Abdulhamza Rajooj Hmood --- et al.
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2056-2069
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: The objective structured clinical examination (OSCE) is an approach to student assessment in which aspects of clinical competence are evaluated in a comprehensive, consistent and structured manner, with close attention to the objectivity of the process.Aims: This study aims to evaluate students‟ perception about the fairness, objectivity, comprehensiveness and overall organization and administration of OSCE in the 4th year medical students.Methods: 24-item questionnaire was used to gather data regarding perception of students about the quality of OSCE, its fairness and its organization. A 5-point Likert scale, with responses ranging from “strongly agree” to “strongly disagree” was used. Students were asked post exam questions related to positive and negative aspects of the OSCE and to do suggestions for improvement.Results: Out of 71 eligible medical students, 66 (92.9%) completed the survey questionnaire. A sizable proportion of 59.1% of the respondents agreed that OSCE was well administered. 51.5% of the students agreed that the objectives of clinical courses were covered. Significant percent of students 61.8% agreed to the facilitators‟ behavior.36, 4% of the respondents stated that the time allocated for each station was not adequate. 79.4% of the respondents felt that OSCE allowed them to compensate in some areas of their weakness. Great majority of students 81.9% regarded OSCE as a practical and useful assessment tool in early years of medical education.Discussion: It is assumed that overloading the students by trying to assess too many skill subsets of performance at a single station, and inadequate practice at being examined in the OSCE format might have contributed to the dissatisfaction with the time allocation.Conclusion and recommendations: OSCE exam covers most of the objectives of the students, clinical rotation. However, at some stations the students felt that instructions were ambiguous and time allocation was inadequate for the assigned tasks. The overall feedback was very useful and facilitated a critical review of the process. Our recommendations are; increasing the duration of stations especially for history taking and cardiac auscultation, modifying the administration of the OSCE aiming at reducing the waiting time especially for the students in the last batch, ensuring clear instructions, having real patients for the expected tasks, and finally more training with the OSCE.Keywords: OSCE, perception, medical students.

Keywords

OSCE --- perception --- medical students

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