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Article
A Clinical Study of Vibriosis During 1999 in Al-Mansour Childrens' Teaching Hospital

Authors: Zayir H. Khalid --- Mahjoob N AL-Naddawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 2 Pages: 148-152
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:Cholera is an acute infectious disease characterized by profuse watery diarrhea and vomiting.It is caused by Vibrio Cholerae O1and O139 sero-groupOBJECTIVE:To find out clinical variety of the admitted cases of Vibriosis..METHODS:Clinical features of the illness were studied , and fresh stool specimens were sent for culture.The stool is taken in seawater containers to the laboratory where further processing of the stool is done on alkaline peptone and TCBS medium.RESULT:All patients presented with diarrhea and the majority had vomiting ( 65%) , ( 37.5%) of the patients presented with sever dehydration and no patient died during this study .The epidemic mainly caused by Ogawa serotype (75%) , and there was different antibiotic resistance recorded especially for trimethoprim (47.5%) and tetracycline (25%) .CONCLUSION:Nearly all cases in vitro were susceptible to cefotaxime

Keywords

vibriosis --- children --- diarrhea --- vomiting


Article
Demographic and Clinical Presentations of Pediatric Hydrocephalus in Medical City

Authors: Mahjoob N. Al Naddawi --- Numan Nafie Hameed --- ,Amal A. Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 139-144
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Hydrocephalus is distension of the ventricular system of the brain related to inadequate passage of cerebrospinal fluid from its points of production within the ventricular system to its points of absorption into the systemic circulation.OBJECTIVE:To study the demographic and clinical presentations of pediatric hydrocephalus in medical city complex , Baghdad.PATIENTS AND METHODS:This is a prospective study ,which was carried out on 100 children with a mean age+- standard deviation ( 24.3 +/- 16.06 )months and median 16 months, who were admitted to Children Welfare Teaching Hospital & neurosurgical department ( Surgical Specialties Hospital) / Medical City complex, Baghdad in the period from April first 2009 to October first 2009. A specially designed questionnaires were used to aid the investigators in performing a family interview. General and neurological examinations, and investigations including neuroimaging studies were done.RESULTS:Of 100 patients,(62%)were males and (38%) were females, with male to female ratio of 1.6:1. Family history of congenital anomaly was positive in (26%) of patients, while hydrocephalus was positive in (14%). Seventy-Two percent of patients had congenital hydrocephalus. Eighty–Seven percent of patients were full term. Fifty-Seven percent of patients were products of NVD ,while (43%) were products of CS,(2%) of them were emergency CS& (41%) were elective. The macrocephaly was diagnosed or noted at birth in (32%)of patients. The study showed that U/S finding of hydrocephalus was positive in (49%).CONCLUSION:The majority of the patients had congenital hydrocephalus, but there was delay in the diagnosis of macrocephaly. Prenatal ultrasound diagnosis yield was low in this study. Family history of hydrocephalus and other neural tube defect was important to be elicited


Article
Risk Factors & Clinical Patterns of Cerebral Palsy in Children Welfare Teaching Hospital in Baghdad

Authors: Mahjoob N. AL-Naddawi --- Nebal Waill Saadi --- Aseel Rasheed Abid
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 284-292
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Cerebral palsy (CP) is a disorder of posture , movement & tone due to a static encephalopathy acquired during brain growth in fetal life, infancy or early childhood.OBJECTIVE:To identify the risk factors of CP & its clinical patterns.PATIENTS AND METHODS:This case control study was done from the 1st of January 2009 to the end of September 2009, on 100 patients with CP who attended the neurology clinic or have been admitted to the neurology ward in Children Welfare Teaching Hospital in Medical City complex, Baghdad. For comparative purposes,100 control individuals matched for sex & age were selected. Some of those patients were referred to pediatric clinic & registered with a diagnosis of CP & some of them were brought by the parents or caregivers without referral for various complaints, then we reviewed their full history & examination ( mainly neurological ) to confirm the diagnosis of CP. A specially designed questionnaire form was used .RESULTS:Out of 100 patients with cerebral palsy, male:female ratio was (1.3:1), 89% of the patients were born at term whereas 11% were preterm. Those patients were found to have history of normal vaginal delivery in 70%, with one patient only delivered by assisted delivery, while 29% of them delivered by caesarean section mode of delivery. History of intrauterine growth retardation found in 21% patients, 4% were twin. The mothers of those patients had history of pre-eclampsia in 8% of the cases, regular antenatal care in 65%, history of antipartum haemorrhage in 4%, premature rupture of membrane in 13%. Abnormal presentation was found in 8%, cord prolapse in 4%, neonatal jaundice in 62%, neonatal seizure in 8%, history of head trauma in 4% & history of central nervous system infection in 20%. Spastic CP was the commonest type (67%), while mixed and atonic CP were the least type (1% for each). Quadriplegic CP was the commonest topographical subtype (56%). Delayed social milestone was found in 46% , speech difficulty in 94% , deafness in 2% , ocular problem in 29% , seizure in 58% & all of them had delayed milestone & weakness.CONCLUSION:Neonatal convulsion, neonatal jaundice, neonatal infection, antepartum hemorrhage & head trauma are significant risk factors for cerebral palsy while precipitate labour, caesarean section, twins, toxemia, breech delivery, low birth weight & cord prolapse were not found to be significantly associated with cerebral palsy. The most common clinical pattern of CP was spastic quadriplegic CP


Article
Subdural Effusion in Bacterial Meningitis Experience in Children Welfare Teaching Hospital

Authors: Mahjoob N. Al-Naddawi --- Hula Raoof abdul Rasool --- Nameer Mahdi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 1-10
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Subdural effusions occur in (10 - 33 %) of children with acute bacterial meningitis. Usually occur bilateral over frontoparietal region, although localized collections can develop over occipital region. Effusions are most common when meningitis results from H.influenzae .(45% of all effusions).OBJECTIVE:To find out the incidence , age distribution and type of bacteria involved in occurrence of subdural effusion in bacterial meningitis, to know the risk factors that might associated with subdural effusion .PATIENTS AND METHODS:from march 2010 – feb.2011 a Prospective study was done on 50 patients diagnosed and treated as meningitis, information's obtained from patients include (patient name, date of birth, sex, residency, duration of illness before admission, clinical presentation, and if antibiotics used prior to admission. Diagnostic inclusion criteria clinical and laboratory based. daily follow up of them .Brain CT was done to all of patients with meningitis after 7 days of treatment to roll out subdural effusion because some of the patients were asymptomatic.RESULTS:The study shows that incidence of subdural effusion in bacterial meningitis was (22.0%).It is most commonly occur in children below the age of (1) year, there was no significant difference between male and female . Regarding CSF analysis, there were no specific findings that indicate presence of subdural effusion. The majority of the patients show no growth of bacteria on CSF culture, blood culture and gram stain, the others show equal growth of (streptococcus pneumonia, H.influenzae and N.meningitidis). Regarding outcome the majority of the patients discharged well, only one patient had focal deficit and one patient died.CONCLUSION:There were no significant risk factors associated with development of subdural effusion. The majority of patients was discharged without any intervention and required follow up only. It's important for physician to maintain a high index of suspicion for diagnosis of subdural effusion .It is important to follow-up patients with meningitis by imaging study, because majority of patients with subdural effusion are asymptomatic.


Article
Clinical types and possible etiologies of neonatal seizures:A hospital based study

Authors: Meisloon J. Kadum محجوب النداوي --- Numan N.Hameed --- Mahjoob N.AL-Naddawi محجوب النداوي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 1 Pages: 1-5
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Seizures in the neonatal period are common. They can present asfocal clonic, focal tonic, myoclonic, generalized tonic and subtle seizures.They can be caused by a variety of conditions, ranging from benign self-limited illnesses to severe life-threatening disorders.Patients and methods: A prospective study included 75 neonates with seizures in the first 28 days of life were admitted to neonatal care unit in Children Welfare Teaching Hospital from January 15th 2009 to August 15th 2009.A Full history was obtained and patients were examined by a specialist in the neonatal care unit and the researcher. Laboratory investigations and neuroimaging studies were done for all patients.Results:Out of 75 neonates,(55%) were males and (45%) were females with a male: female ratio of 1.2:1, (76%) of them was delivered at term. The onset of seizures was reported in the first 72 hours of life in(42.6%) of neonates. The most common type of seizure was tonic type (48%) followed by subtle type (24%), focal clonic 16% and multifocal clonic(12%).Hypoxic ischemic encephalopathy (HIE) was the commonest etiology (25.34%) then sepsis (24%), hypocalcaemia (14.67%), pyogenic meningitis (13.33%), hypoglycemia (9.33%),Kernicetrus(8%), IVH 4%and TORCH (1.33%).The consanguinity was detected in (26.7%) of patients. A response to Phenobarbitone alone was found in (42.1%) and to a combination of bothphenobarbitone and phenytoin in(19.1%).The case fatality was (8%), (50%)of themwere due to IVH.Conclusions: Neonatal seizures occurred mainly in full term neonates with male sex preponderance with the majority reported in their first 72 hours of life and the tonic seizures were the commonest pattern. Hypoxic ischemic encephalopathy is the main etiologic factor of neonatal seizures followed by sepsis. Intraventricular hemorrhage occurs mainly in preterm infants and it was a major cause of death.Keywords: Neonatal seizures, etiology, clinical types.


Article
Radiological finding in pediatric patients with urinary tract infections
الموجودات الشعاعية عند الاطفال المصابون بالالتهابات المجاري البولية .

Authors: Mahjoob N. Al-naddawi محجوب نفل النداوي --- Muneera F. Rida منيرة فاضل رضا
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 3 Pages: 257-260
Publisher: Baghdad University جامعة بغداد

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Abstract

Background; determining what radiologic studies to obtain following the diagnosis of a urinary tract infection(uti) is an area of medicine that is still not agreed upon, nor is there a gold standard.Objective; to study the radiological abnormalities in paediatric patients with urinary tract infections.Patients and methods; this prospective study was done from the first of june 2008 to the first of may 2009 include 104 pediatric patients who were referred to children welfare hospital ,(pediatric nephrological out patient clinic) with signs and symptoms of urinary tract infections, all of them had culture positive urine examination , ultrasonograhy was done for all patients, voiding cystouretherography was done for patients with recurrent attacks of urinary tracts infections (58 patients),and intravenous urography was done for patients with urinary tract abnormalities on ultrasonography (41patients).Results; the results of the present study showed that about 63( 59.4%)of infants and children with (culture positive) urinary tract infections had positive ultrasonic findings ,the most frequent ultrasonic findings was pelvicalyceal and ureteral dilatation whichwas observed in 32.6%. Thirty four(32.6% )of patients had positive findings on voiding cystography ,( grade 5&4 reflux found in 22.4%). The intravenous urography study was beneficial in diagnosis of pelviureteric junction obstruction in 12.2% and visualized the obstructive effect of renal and ureteric stones in 24.4%.Conclusion; the positive radiological findings supported the idea that the patients with recurent urinary tract infections need imaging work up.

خلفية البحث : تحديد الدراسات الشعاعية التي يجب اجرائها بعد تشخيص التهابات المجاري البولية عند الاطفال هي محل خلاف علمي اهداف الدراسة :دراسة الموجودات الاشعاعية عند الاطفال المصابون بالتهابات المجاري البولية المتكررة طرائق العمل : شملت الدراسة (104) اطفال مصابون بالتهابات المجاري البولية , اجريت لهم فحوصات التشخيص بالامواج فوق الصوتية ( السونار ) لجميع المرضى , تلوين المثانة والاحليل خلال التبول للاطفال المصابون بالتهابات المجاري البولية المتكررة (58) مريضاً وفحص الاشعة الملونة الوريدي للاطفال الذين لديهم مشاكل في الجهاز البولي العلوي (41) مريضا النتائج : نتائج الدراسة تظهر بان 59.4% من الاطفال المصابين بالتهابات المجاري البولية لديهم موجودات خلال الفحص بالامواج فوق الصوتية , 32.6% لديهم موجودات خلال الفحص بتلوين المثانة والاحليل خلال التبول , و12.2% لديهم موجودات خلال الفحص بالاشعة الملونة الوريدية .الاستنتاجات : النسب المبينة اعلاه من الموجودات الشعاعية عند المرضى الاطفال المصابين بالتهابات المجاري البولية تدعم فكرة اجراء الدراسات الاشعاعية عند الاطفال المصابين بالتهابات المجاري البولية المتكررة .


Article
Neurological Manifestations In Type- 1 DiabetesMellitus In Children

Authors: Hamid B. Al-kafaji محجوب النداوي، محي الجنابي ، حامد الخفاجي --- Muhi K. Al-janabi --- Mahjoob N. Al-Naddawi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2006 Volume: 48 Issue: 3 Pages: 255-257
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Diabetes mellitus type-1 is the most common endocrine metabolic disorder in childhood. Mononeuropathy, generalized polyneuro-pathy and autonomic neuropathy are frequent complications of diabetes mellitus and may give rise to troublesome manifestations. Methods: sixty children suffering from type 1 diabetes mellitus admitted in Children Welfare Hospital- Medical City-Baghdad in the period from 1st Dec2000-31stJuly 2001 were included in this prospective descriptive study. History, especially symptoms of peripheral neuropathy, examination specially signs of peripheral neuropathy, absent sinus arrhythmia and postural hypotension and investigations like nerve conduction study were all performed and analyzed.
Results:
The study showed that out of 60 diabetic children 26(43.3%) had symptomatic polyneuropathy, 18 (30%) had postural hypotension and 16 (26.6%) had absent sinus arrhythmia. Neurological manifestations of diabetes mellitus occur frequently in diabetic children with long duration of illness. Polyneuropathy is sensory more than motor and affected the lower limbs more than the upper limbs. Conclusion: Early diagnosis of autonomic neuropathy in diabetic children is simple easy and requires minimum cooperation, so as detection of peripheral neuropathy in asymptomatic by nerve conduction study.


Article
Causes &clinical presentation of hypotonia in children

Author: Mahjoob N. AL-Naddawi* DCH, MRCP UK) FRCP(ED), FRCP (Lond), FRCPCH Russul F. Mussa* MBChB د. محجوب نفل النداوي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2009 Volume: 51 Issue: 4 Pages: 348-352
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary: Background: Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders. The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. Patients &Methods: A prospective, cross sectional descriptive study in which 62 patients with hypotonia, age 3months to13 years, were evaluated in children welfare teaching hospital /Baghdad (a tertiary care center), over 4months Period (1st of January to 1st of May,2008 ) . Children were categorized into groups of central , peripheral& systemic hypotonia, and specific diagnosis of each of groups was made by clinical findings, neuroimaging, metabolic, muscular enzymes, Electromyography-Nerve conduction velocity, thyroid function tests, Serum Calicium&X- RAY of left wrist,& TORCH (Toxoplasmosis,others, rubella, CMV, herps simplex) assay in our medical teaching laboratories.Results: The most common cause of hypotonia was central in 30 patients (48.4 %). (Four patient with unknown causes), the most common lesion was brain atrophy detected by CT scan examination in 23/30 (76.7%). Peripheral causes found in 14/58 (22.6%) which include myopathies in 7 patients (11.3%), anterior horn cell lesion in 7 patients (11.3%). Systemic causes were found in 14/58 (22.6%). Early Onset in 46/62 (74.2%), while late onset constituted 16/62 (25.8%).The most common mode of presentation is delayed mile stones found in 32 patients (51.6%). Conclusions: The most common cause of hypotonia in children enrolled in the study is central lesion and commonly occurs in pre natal, natal & post natal periods. The most common finding is brain atrophy diagnosed by CT scan, while the most common presentation is delayed milestones, and most common type of weakness is proximal. Keywords Hypotonia, presentation, central, peripheral, onset

Keywords

Hypotonia --- presentation --- central --- peripheral --- onset.


Article
Ultrasound assessment of normal splenic length and spleen to left kidney ratio in sample of Iraqi population

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Abstract

Background: Spleen is a hemopoietic organ which is capable of supporting elements of different systems. It is affected by several groups of diseases; inflammatory, hematopoietic, reticuloendothelial proliferation, portal hypertension and storage diseases. Ultrasound (US) may detect mild splenomegaly before it is clinically palpable. Knowledge of the normal range of spleen size in the population being examined is a prerequisite. Racial differences in splenic length could result in incorrect interpretation of splenic measurements and such differences would make it difficult to standardize expected splenic length and to determine non- palpable splenic enlargement.Objectives: To measure the normal values of splenic lengthin Iraqi subjects and compare the results with western,Chinese and Jordanian data; to determine whether there is aconstant ratio of the length of the spleen to the left kidney,which could be used to diagnose splenomegaly withoutreference to a nomogram.Methods: This is a cross-sectional study conducted among a total of 280 subjects ranging in age from birth to 20 years (159 males and 121 females). US was used to measure maximum splenic and left kidney lengths to obtain normal values for splenic length and to determine spleen to left kidney ratio. The subjects were divided into the same age groups as those used by other similar international studies in order that comparisons with their results could be made.Results: Splenic lengths in Iraqi subjects are similar to those in American, Chinese and Jordanian subjects up to the age of 15 years. The spleen to left kidney ratio is strikingly constant with a mean value of 1. Using 2 SD above the mean as a guide, the upper limit of normal for spleen to left kidney ratio is 1.25.Conclusion: Splenomegaly should be suspected in children if the spleen is more than 1.25 times longer than the adjacent kidney.Key words: Spleen, subjects, ultrasound

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