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Article
The Frequency of Autonomic Neuropathy in Type 2 Diabetic Patients

Authors: Asaad Abdullah Abbas --- Abbas K. Ressan --- Ali HAshim Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 127-131
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

Abbas K. Ressan, Asaad Abdullah Abbas,Ali HAshim HusseinINTRODUCTION:Autonomic nervous system (ANS)The ANS supplies and influences every organ inthe body and closely integrate vital processes,such as Blood Pressure (BP), temperature andadaptation to environmental change (1).Accordingly, sensory, motor, visceral andneuroendocrine function can be modulated bythis system (2).Baghdad Teaching Hospital.The clinical signs and symptoms that occur indisturbances of autonomic response which isinfluenced by the organ involved. The normalbalance of sympathetic (ST) and parasympathetic(pst) innervations, the nature of underlying illnessand stage of progression of the disease (3).To investigate the prevalence of D.A.N. wasdefined by simple non- invasive tests in type 2diabetic Iraqi patients and it is relation to theduration of the disease.ABSTACT:BACKGROUND:Autonomic Nervous System Innervates vascular and visceral smooth muscle, exocrine andendocrine glands and parenchymal cells through out the various organ system. Diabetic autonomicneuropathy is classified as subclinical or clinical upon the presence or absence of symptoms Awidespectrum of symptoms affecting many different organ system can occur including CVS, GUS,pupillary, automotor and neuroendocrine systems.OBJECTIVE:To investigate the frequency of diabetic A.N.P as defined by simple non – invasive test in type 2diabetic Iraqi patients and it is relation to the duration of disease.PATIENTS AND METHODS:Fifty type 2 diabetic patients , were evaluated with a five bed side tests to detect autonomicneuropathy and a history of related symptoms was taken there were 30 ( 60%) males and 20 (40%) females in the age range 30– 70 years .The five tests were carried out were, heart rate variation during deep breathing, HR response tovalsalva, HR response to standing, BP response to sustained hand grip, BP fall in response tostanding.Resting ECG (to measure QTc interval) fasting plasma glucose and 2hr., post prandial plasmaglucose were done to each patient.RESULTS:Of these 50 patients 34(68%) had evidence of neuropathic abnormality of parasympatheticinvolvement 19(38%)patients 13(26%), patients had evidence of combined parasympathatic andsympathatic involvement and only 2(4%), patients had only sympathetic involvement. Increaseincidence was seen in older age group and poor glycemic control. Autonomic neuropathy morecommon in patients who had the disease for more than 5 yrs. There was no correlation withprolonged QTC intervals.CONCLUSION:Diabetic ANP is a common complication and related to poor diabetic control and the duration ofdiabetes. While it is not associated with prolonged QTC interval .


Article
Echocardiographic Assessment of Left Ventricular Remodeling Process Among Acute Myocardial Infarction Patients

Author: Mayyadah Dheyauldeen Mohsin*, Abbas Khalifa Ressan**, Asaad Abdullah Abbas**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 4 Pages: 465-473
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Echocardiography is use for assessment of left ventricular remodeling after myocardial infarction, which is the focus of this thesis. We investigated the influence of various traditional echocardiographic parameters to assess the process of left ventricular remodeling such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and diastolic dysfunctionOBJECTIVE: To invistigate the usefulness of two-dimensional echocardiography for accurate evaluation of left ventricular (LV) remodeling after acute ST elevation myocardial infarctions (STEMI).METHODS AND RESULTS:Two-dimensional echocardiography was performed within 5 days on a 100 patients admitted to the hospital with a first ST-elevation AMI. Several clinical and echocardiographic variables were analyzed. Baseline demographic data, blood pressure, and pulse were obtained. Various traditional echocardiographic parameters have been shown to provide diagnostic information, such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and left atrial pressure. A left ventricular wall motion score index was derived from analysis of regional wall motion; an index of 1.5 or more within 5 days of admission identified patients at high risk for remodeling and LV dysfunction. Predictors of early LV remodeling were older age, male gender, history of diabetes mellitus or hypertension, high leukocyte count, high admission blood glucose level, high wall motion score and anterior location myocardial infarction.CONCLUSION:After acute ST-elevation myocardial infarction, early determination of the wall motion score index by two-dimensional echocardiography is useful for identifying patients at high risk for complications and to differentiate patients with and without development of LV remodeling accurately and early on the basis of wall motion score index as a measure of infarct size, a highly predictive variable..


Article
Experience Of Gastric Cancer In Al- Sadder City in Baghdad

Author: Maytham Hatam Shahid, Saad Ramadan Jawad, Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 129-137
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The aim of the study is to assess the following points among the patients with gastric cancer admitted to the surgical wards in Imam Ali Hospital- Al- Sadder City- Baghdad.•Sex and age distribution. •Mode of presentation.•Results of endoscopic findings and histopathology.•Risk factors and tumour staging.•Treatment options.PATIENTS AND METHODS:A prospective study was done in Imam Ali Hospital for a period of six years from (January 2009 to December 2014) where fifty cases with biopsy proved gastric cancer had been assessed. The age and sex distribution, mode of presentation, site of the tumour, macrosopical appearances histopathological findings, risk factors and treatment options were analysed.RESULTS: The male to Female ratio was 1.4:1, peak age incidence was 60-70 years, non-specific symptoms such as vague epigastric pain, dyspepsia, anorexia, weight loss were the most common symptoms; esophagogastric junction was the commonest site, polypoid type was the commonest endoscopic finding (44%); upper gastrointestinal endoscopy with biopsy was the most accurate method of diagnosing gastric cancer; Adencarcinoma was the most frequent histopathological type (96%); cigarette smoking is the predominant risk factor (64%) (32, 33, 34, 35); In the majority of those patients the disease was advanced and the curative measures were not possible.CONCLUSION: Gastric cancer remains a significant problem in Iraq, it's one of the most popular malignancies (ninth most common in Iraq) (37). No age group of both sexes can be excluded. Late presentation is a stigmata of the disease and the gloomy prognosis can only be improved by early detection based on a more vigorous diagnostic approach following a high risk index of suspicion in individuals at risk.


Article
Angiographic Findings in Comparison with of Ankle Arm Pressure Index Among Patients with Coronary Heart Disease Referred for Coronary Angiography

Author: Ali Hussein Mttanish , Edmon Khammo Benjamin , Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 3 Pages: 261-265
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Epidemiological studies had been demonstrated that subclinical cardiovascular disease in one vascular bed is associated with the presence of clinical disease in another bed; as well as subsequer cardiovascular and total mortalities. Degree of peripheral vascular disease(PVD) in the legs as measured non invasively are common in old adults without overt signs and symptoms of PVD .an ankle —arm index has been shown to be a strong predictor of total cardiovascular morbidity and mortality in those without prior history of clinical cardiovascular disease at the baseline examination. PATIENTS AND METHODS: A cross sectional study done in IBN AL NAFEES teaching hospital for cardiology and cardiac Surgery. from 1st of June 2015 to 30th of Feb. 2016, for different age groups and multiple different risk factors (smoking, D.M, hypertension, family history of Ischemic heart disease, previous Ischemic heart disease,, hyperlipidemia) have their ankle-arm index measured by Doppler study and reported as abnormal (<0.9)and normal (>9). Then ‘ their coronary angiographic findings were obtained and correlated to the level of Ankle Brachial Index .RESULT: Study showed that 18 patients with low ABI value have abnormal angiographic findings (100%) i.e. High specificity; while 28 patients with normal ABl value proved to have coronary artery disease by (39.1%) i.e. Low sensitivity; but on the other hand low ABI significant relation for both multiplicity and severity of coronary disease diagnosed by angiography (p value 0.0001) for both. CONCLUSION: Ankle-brachial index (ABI) index despite it is easy, quick and inexpensive bed side test for cardiovascular diseases it is of low sensitivity ;but its high specificity.


Article
Survey of Pulmonary Embolism Characteristics, A Hospital Based Study

Author: Salman Hachim Al-Nuami *, Basil Fawzi Jameel **, Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 1 Pages: 58-64
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Pulmonary embolism is a common complication of hospitalization and contributes to 5 to 10 percent of deaths in hospitalized patients, making it one of the leading causes of preventable hospital deaths.OBJECTIVE:Is to evaluate patients with pulmonary embolism admitted to Ibn Alnafees Hospital, Baghdad, Iraq.PATIENTS AND METHOD: Cross-sectional study in one year( 2016) , We treated 52 cases of Pulmonary embolism in Ibn Alnafees Hospital in the CCU and we collected their data on admission to the hospital on different age group, gender, sign and symptoms, investigation, predisposing factors, treatments with thrombolytic therapy and the outcome of the patient. Seven patients died after admission, two of them same of day of admission.RESULT: In this study, the surgery was the most common risk factor for pulmonary embolism followed by deep Venus thrombosis. However, there was no obvious risk factor present in 11.5% of cases, and 28.7% of cases had have more than one risk factor. CONCLUSION: The surgery was the most common risk factor for pulmonary embolism followed by deep vein thrombosis. The CT pulmonary angiography is positive in vast majority of cases, so it's useful and effective diagnostic tool for pulmonary embolism.


Article
Prevalence of Fibromyalgia Syndrome in Patients with Haemophilia A

Authors: Khudir Z. Mayouf --- Faiq Isho Gorial --- Najem Abd Jasim --- Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 1 Pages: 80-83
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Fibromyalgia syndrome is a common rheumatological syndrome with multiple systemic manifestations which could occur alone or associated with many diseases.OBJECTIVE:To detect the possible relation between fibromyalgia and haemophilia-A patients.PATIENTS AND METHODS:One hundred patients with haemophilia-a were studied and compared with another hundred, healthy individuals matched for age and sex, serving as control group. Full history was taken and complete clinical examination was done for all individuals in both groups.The american college of rheumatology 1990 criteria for fibromyalgia were applied for both groups. They were questioned about presence of chronic widespread pain, sleep disturbance, headache fatigue and parasthesia . Detection of at least 11 of 18 tender points by digital palpation of specific soft tissue sites were needed for diagnosis of fibromyalgia.RESULTS:There was a significant increase in the frequency of fibromyalgia among individuals with haemophilia-a (25%) compared to healthy control group (3%) (p=0.000004, odd ratio=0.093, 95% confidence interval 0.027-0.319).CONCLUSION:Fibromyalgia occurs with high frequency in hemophilia A patients


Article
Growth Delay in Steroid Sensitive Nephrotic Patients

Authors: Salim Zyara Abdullah --- Faris Matti Frankul --- Asaad Abdullah Abbas --- Shatha Hussein Ali --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 2 Pages: 129-135
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Growth in patients with idiopathic nephrotic syndrome (INS) is influenced by several factors, they suffer the influence of the disease itself as long as there is proteinuria, caused by the increase of the glomerular permeability and leading to hypoproteinemia. The effects of the glucocorticoid treatment, which alters growth by a direct action on the growth cartilage, or via disturbances of growth factors. In this study we assess the effect of nephrotic syndrome, it's relapse rate and it's treatment (i.e. steroid), in the statural growth of steroid sensitive nephrotic patients.METHODS:A Prospective study of 110 steroid responsive nephrotic patients collected from AL- Kadhemia Teaching Hospital, Central Child Teaching Hospital, Child Wellfaire Teaching Hospital & AL-Karama Teaching Hospital. The study started from first of June 2005 to first of June 2006. Data collected as following: age, sex, date of first diagnosis, duration of disease, number of relapses per year, measurement of the height, weight and body mass index and sign of steroid toxicity.RESULTS:Total number of our patients were 110, 74(67.3%) were males and 36(32.7%) were females, with male to female ratio of 2:1. The age of our patients range from 2-18 years with a mean of 7.9+3.8 years.Thirty-one (28.2%) of them were with height below 3rd percentile for their age, 24(77.4%) were males and 7(22.6%) were females.Twenty- five (22.7%) patients were at pubertal age. Eighteen (72%) were males and 7(28%) were females, and 17(68%) of them have height below 3rd percentile.Seventy –six (69%) patients have their onset of the disease at age between 2 and 6 years. Forty-six (41.8%) of patients have disease duration of less than 3 years, 3 (6.5%) of them were have height below 3rd percentile, 46(41.8%) with duration of 3-6years, 14(30.4%) them were have height below 3rd percentile and 18(16.4%) with duration of more than 6 years, 14(77.8%) of them have height below 3rd percentile.Fifty-five (50%) patients had frequent relapses, twenty-seven (49.1%) of them have height below 3rd percentile, compared to 4(7.3%) of those with infrequent relapse had height below 3rd percentile.Forty-seven (42.7%) patients show sign of steroid toxicity(cushigoid facial appearance with or with out hypertention,obesity,hirsutism..etc) 25(53.2%) of them have height below 3rd percentile, compared to 6(9.5%) of those who have no sign of toxicity.CONCLUSSION:Nephrotic syndrome is a potentially chronic disease with patients suffering a relapsing course and being at risk of frequent courses of prednisolone therapy with increase the risk of growth delay especially in patients reaching pubertal age and still taking steroid therapy.

Keywords

Growth Delay --- Steroid --- Nephrotic.


Article
Hemolytic Uremic Syndrome Epidemiological and Clinical Facts

Authors: Najla Ibrahiem Ayoub --- Ahmed Hameed Mohammed --- Jinan Soaod Orabi , --- Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 11-17
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Hemolytic uremic syndrome is the most common cause of acute renal failure in children and has high mortality rate. OBJECTIVE: To study the epidemiology, clinical course, management, complications and the important risk factors that affect the outcome of the patients with hemolytic uremic syndrome. PATIENTS AND METHOD: In this retrospective study we collect fifty two patients who were admitted to the Child´s Central Teaching Hospital from the period 1st of Jan. 2005 till 30th May 2008. The data collected from the case records includes: name, sex, age, season, presence of diarrhea, jaundice, family history of HUS, complications, associated clinical features such as: pallor, edema, rash, hypertension, hepatosplenomegaly, and coarse of the disease. Also Laboratory. Findings as Haemlglobin (Hb), Packet Cell Volume (PCV)%, White Blood Cell (WBC), Red Blood Cell (RBC) morphology, platelets counts, blood urea and serum creatinine; and managements were included in the study. RESULTS: Of total 52 , there were 21 (40.4%) cases below 2 years, the males account 33 (63.46%) from the total. There were seasonal and annual increments. Eighty four percent had diarrheal prodrome, and 1.91% had familial history of HUS. All patients had pallor and acute renal failure. The mean of the hemoglobin was 8.6 gm/dl, WBC count mean was 18 × 109/L, platelets mean was 35 × 109/L, blood urea mean was 180 mg/dl, and the mean of serum creatinine was 3.8 mg/dl. The GIT complications was the commonest 23 (44.23%) followed by CNS complication 16 (30.7%), hypertension was present in 25%. During acute phase of disease 12 (23.07%) patients died. CONCLUSION: HUS affect mainly age between 3 months and 4 years. There was seasonal variation with peak at wormer months.There were statistically significance correlation between high risk patients and age group below 2 years, CNS complication, and non diarrheal prodrome.


Article
Growth Assessment in Asthmatic Patients

Authors: Jinan Soaod Oraiby --- Haider Talib Hussain --- Asaad Abdullah Abbas --- Maher Mohammed Hassan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 3 Pages: 376-382
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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BSTRACT: BACKGROUND:Asthma is a chronic disease &the chronic disease states regardless etiology can cause growth failure ininfant &toddler. OBJECTIVE :To assess growth of asthmatic patients PATIENT AND METHODS: One hundred asthmatic children between (5-15 years) of age . Both asthmatic & control group studied in term of height, weight & Skin fold thickness, all anthropometric measurements of height, weight &skinfold thickness measured for both groups.RESULT: Height, weight &skin fold thickness were significantly retarded in asthmatic, the more severe thedisease &longer duration the more retardation in the height & weight.The height was affected more than the weight by the disease duration & severity .The diminution in skinfold thickness was retarded both with increase disease duration & severity but the female was lessretarded than male as the disease duration prolonged.CONCLUSION: All growth parameter (height, weight, SFT) affected by asthma (duration & severity), so the growthparameters can be used in asthmatic children to evaluate the effect of treatment


Article
Effect of Hypertension on Aortic Root Size and Prevalence of Aortic Regurgitation

Authors: Ghassan Abbod Ahmed --- Amal Noori Al –Marayati --- Basil Najeeb --- Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 1 Pages: 61-69
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Although early reports suggested that hypertension predisposed to aortic root enlargement and consequent aortic regurgitation, more recent pathological and M-mode echocardiographic studies have not found an association between hypertension and aortic root enlargement when age is considered. OBJECTIVE:The aim of this study is to asses the effect of hypertension on aortic root size and to estimate the prevalence of aortic regurgitation.METHODS:measurement of two-dimensional echocardiographic diameters of the aortic root at four locations and compared findings with resting blood pressures and measures of body BMI in 110 normotensive and 110 hypertensive men and women matched for age and sex.Colour and continuous wave Doppler study are used to diagnose and assess severity of aortic regurgitation.RESULTS:Aortic diameters at the anulus (2.40±0.29 versus 2.33±0.24 cm, P=.06) and sinuses (3.45±0.43 versus 3.35±0.35cm, P=.08) were marginally higher, whereas diameters at the supra-aortic ridge (2.93±0.39versus 2.73±0.33cm, P<.01) and ascending aorta (3.27±0.44versus 3.12±0.31 cm, P<.01) were significantly increased in hypertensive subjects. Aortic diameters increased with increasing quartiles of diastolic and systolic pressures, particularly at the supra-aortic ridge and ascending aorta. In multivariate analyses, blood pressure remained an independent determinant of distal aortic diameters after body size and age were considered. Aortic regurgitation was seen in 6 normotensive and 8 hypertensive subjects and did not differ in severity.CONCLUSION:Hypertension is associated with a slight increase in aortic root size, most notably of the supra-aortic ridge and proximal ascending aorta. Although dilatation at the commissural attachment might be expected to predispose to an increase in aortic regurgitation, we did not detect such a difference in this population of, asymptomatic hypertensive individuals.

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