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Article
Modalities of Management of Radial Nerve Injury presented with Fracture in different Sites of Humerus

Author: Hamza N. Aboud
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2010 Volume: 9 Issue: 1 Pages: 63-66
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background This topic has been the subject of interest for many authors for many years, because still there is a recurrent theme …should the nerve be explored routinely along with internal fixation of fracture or should exploration be limited to those cases in which spontaneous recovery has not occurred within expected time ? or when justify? Objectives This study is designed is to shed a light on the dilemma of management radial nerve injury, in surgically treated patients versus conservatively treated others. Methods A series of 25 patients presented with any degree of radial nerve palsy complicating140 case of closed fracture shaft humerus , were treated by surgical & conservative method , according to certain indicators and evaluated during three years period, in two teaching hospital in Baghdad, from 2006 to 2008. Most of patients were males 19 case & the remaining patients were females 6 cases ,their age ranging from 3 days old baby to 45 years old & the mean age was 25 years .Ten (10) patients treated conservatively , Fifteen (15 ) patient treated surgically by either early exploration ( too early & late early ) or delayed exploration. Results The radial nerve was explore in seventeen patients from total number of study 25 patients. Eight treated by early exploration .. ( five by too early exp. within few days & three by late early exp. within next two weeks).Nine patients treated by delayed exploration after ( 3.5~ 4 ) months post traumatic period .In the last eight patients , the radial nerve was not explored & treated conservatively? The overall useful recovery rate from applying our policy was (84 % ). Conclusion Treatment of radial nerve palsy complicated closed fracture shaft humerus should be programmed well, depending on many factors , such as severity & onset of nerve lesion and type & site of associated fractures.

Keywords

Radial --- Nerve --- Fracture --- Management.


Article
Evaluation of New Reduction Technique for Anterior Shoulder Dislocation
تقييم طريقة جديدة لارجاع خلع مفصل الكتف

Author: Hamza N. Aboud د. حمزة العبادي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 1 Pages: 66-69
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Traumatic shoulder dislocation is a relatively common & serious injury in sports activities, because of its inherent anatomy & biomechanics. Shoulder joint is one of the most unstable & frequently dislocated joints in the body, accounting for about 50% of all dislocations . Aim of study:-to evaluate efficacy of newly developed simple & gentle method of reduction technique for anterior shoulder dislocation.Material & Methods:-Thirty patients were evaluated & treated by using this method, in a study done within 18 months period in outpatient clinic & emergency department of Al-Kahdymia teaching hospital in Baghdad through 2006 - 2007. Twenty six patients were male and only four patients were female, their age ranging from 18 – 55 years. Reduction technique represent gentle & slow abduction of the extended arm up to 90o , with the same physician’s hand gentle axial traction applied, then horizontal adduction of extended arm of dislocated shoulder and thumb of other hand placed against humeral head to assist a reduction while the patient in supine position Results:-Twenty-four cases which represent 80% from thirty cases of dislocations were reduced successfully from first trail of reduction without using any anesthesia or assistance. Only six cases were failed to reduced by using this method, which represent 20% failure rate.Conclusion :-Still we can say that, this method have superiority to other methods of reduction , due to its simplicity, efficiency, painlessness , and without reported complications in spite of its limited percentage of failure .Keywords:- New, Reduction , Shoulder, Dislocation ,

تعتبر حالات خلع مفصل الكتف شائعة نسبيا , ويعتبر مفصل الكتف واحد من اكثر مفاصل الجسم الغير مستقرة نسبيا ايضا , وغالبا ما يتعرض الى الخلع , والتي تشكل حالات خلعه حوالي... 50% من حالات خلع مفاصل الجسم الاخرى ؟؟تهدف الدراسة الى تقييم كفاءة طريقة جديدة لارجاع الخلع الامامي الحاد لمفصل الكتف, شملت الدراسة 30 مريضا اصيبوا بحالات الخلع الامامي الحاد لمفصل الكتف... حيث كان عدد المرضى الذكور 26 مريضا وعدد الاناث 4 فقط , وتتراوح اعمارهم مابين 18 – 55 سنة , تمت معالجتهم في قسم الطؤارى في كلا من مستشفى الكاظمية التعليمي ومستشفى اليرموك التعليمي خلال فترة 18 شهرا" من عام 2006 – 2008 , باستخدام هذه الطريقة والتي تعتمد على سحب الذراع بطريقة معينة...( Abduction –Horizontal Adduction).اظهرت نتائج الدراسة بان 24 مريضا من اصل ثلاثون مريضا والذين يمثلون ما نسبتهم ( 80% ) من حالات عينة الدراسة , تمت معالجتهم بنجاح تام ومن المحاولة الاولى لارجاع الخلع, وبدون اعطاء المريض اية مواد مخدرة , ودون الحاجة الى مساعدة شخص اخر في عملية ارجاع الخلع كما هو الحال في حالات ارجاع الخلع بالطرق المتبعة الاخرى ؟اخيرا ... يمكن القول بان هذه الطريقة لها افضلية على الطرق الاخرى المتبعة حاليا, وذلك لبساطة تطبيقها وكفائتها ودون الحاجة لاعطاء المريض ادوية تخدير , حيث يمكن اجراؤها في وقت حدوثها وفي مكان الاصابة من قبل الطبيب المرافق في النشاطات والمسابقات الرياضية .

Keywords

- New --- Reduction --- Shoulder --- Dislocation


Article
تقييم جودة الخدمات الصحية في مستشفة الديوانية التعليمي

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Abstract

Health services have a vital role the consideration of all because of their importance in keeping man and increasing his ability in building and development . In this sens , they represent the most important thing that can be advanced to man , Who makes life and development there is nothing similar to such services but food and education.because even though it reflects human necessity, it also represents economic necessity to make a society ablo to do the best in the development , economic , and social fields. Going from this importance for the health services, researchers have targeted , in this research , the knowledge of the reality of the health services in Al-diwaniya education hospital and know the obstructions that prevent the presentation of gppd health services.The based on their evaluation to the excellence of these services on the five based standards by Philip kother with making necessary adjustments on some their phrases. Dependence have been made on the equation of ((Rollon)) to measure the factor of constancy and veracity that respective to the questioner that distributed on the sample of the research..The researchers have concluded that the reality of health services in Al-diwaniyah education hospital was weak , thus they presented sets of recommendation to improve these services which is the most important is the obligation with the standards of morality, medical, and administrative with the patients.

تحتل الخدمات الصحية مكانة بارزة في اهتمامات الجميع نظرا لاهميتها في الحفاظ على سلامة الانسان وزيادة قدرته على البناء والتنمية ، وهي في هذا المعنى تمثل أهم مايمكن ان يقدم للانسان صانع الحياة والتطور ، ولايماثلها في ذلك إلا الغذاء والتعليم فهي وان كانت تعكس ضرورة انسانية فانها ايضا تمثل ضرورة اقتصادية لبناء مجتمع قادر على الاداء الافضل في مجالات التنمية الاقتصادية والاجتماعية...
وانطلاقا من تلك الاهمية للخدمات الصحية استهدف الباحثون في هذا البحث الوقوف على واقع الخدمات الصحية في مستشفى الديوانية التعليمي ومعرفة المعوقات التي تحول دون تقديم خدمة صحية جيدة . وقد استندوا في تقييمهم لجودة تلك الخدمات على المعايير الخمسة الموضوعة من قبل Philip Kother مع اجراء التعديلات الضرورية في بعض عباراتها. وجرى الاعتماد على معادلة (رولون) لقياس معامل الثبات والصدق الخاصة بالاستبيان الموزع على عينة البحث.
وتوصل الباحثون الى استنتاج مهم مفاده ان واقع الخدمات الصحية في مستشفى الديوانية التعليمي كان ضعيفا. لذا فانهم قدموا مجموعة من التوصيات لتحسين تلك الخدمات لعل اهمها الالتزام بالمعايير الاخلاقية والطبية والادارية في التعامل مع المريض.

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