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Article
5- PATTERN OF INTESTINAL OBSTRUCTION IN BASRAH; A PROSPECTIVE STUDY

Authors: Zaki Al-Faddagh --- Adel Salih Mushari
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 22
Publisher: Basrah University جامعة البصرة

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PATTERN OF INTESTINAL OBSTRUCTION INBASRAH; A PROSPECTIVE STUDYAdel Salih Mushari@& Zaki Al-Faddagh#@MB,ChB, FICMS, AlQurna Hospital. # MB,ChB, CABS, Professor, Department of Surgery, BasrahCollege of Medicine, Basrah University.AbstractIntestinal obstruction remains one of the commonest surgical emergencies, with hernias beingelectively repaired; adhesive obstruction has emerged as the leading cause of intestinalobstruction in the west, while the obstructed hernia remaining the main cause in developingcountries.This is a prospective study involving 464 patients admitted with intestinal obstruction to thesurgical unit in AL-Mawane general hospital, Al-Sadir teaching hospital, Al-Basrah maternity andchild hospital and Al-Basrah general hospital during the period between (January 2004-December 2007).All patients were admitted and thorough careful history, particularly history of previous surgeryand examination were done involved the hernial orifice. Type of treatment, time surgicalintervention, operative finding and period of hospital stay were noted.Most of our patients were attended for postoperative followed up for complications and recordingthe mortality in the hospital.The study included 464 patients, their age ranged from 2 days to 75 years. (Mean 33.8years),and they are more frequent in female 258 patients (55.7%) than male206 patients (44.3%).Acute onset of presentation was found in 296 patients (63.7%). Constipation in 419 patients(90%) and abdominal pain in 380 patients (82%) were the main presenting symptoms. Previousadmissions for same complain were reported by 64 patients (13.7%). History of previoussurgery were reported by 71 patients (15.4%), and time interval from previous surgery, variesfrom one month to (5) years. Simple obstruction was the most common form of intestinalobstruction (67.7%). Of all patients included in the study, 288 patients (62%) present with smallbowel obstruction and 176 patients (38%) with large bowel obstruction. The commonest causeof intestinal obstruction was strangulated external hernia in 99 patients (21.3%), intestinaladhesions in 73 patients (15.7%). The hernia (29.2%) together with adhesions from previoussurgery (25.4%) constitute the bulk of causes of small bowel obstruction , while volvulus ofsigmoid colon (23.6%)and tumours (22.7%) form the main cause of large bowel obstruction.Intussusception was the most prevalent variety of intestinal obstruction in child age group(27.2%), followed by hirschsprungs disease (22.2%). Of strangulated hernia, inguinal herniawas the most frequent type of hernia seen (71.7%). Surgical intervention was necessary in 409patients (88.2 %).The period of conservative treatment ranges from 3-14 days, with average(6.3) days. Post operative complication occurred in 167 patients (40.8%). The mortality was 6.8% and it was related to extreme of life, delay in presentation and mismanagements.The study concluded that simple intestinal obstruction is the commonest type of obstruction,higher rate of strangulated hernia than the rate of obstruction due to adhesions, which isopposite to a typical pattern of developed countries. Intussusception is the most frequentscause of intestinal obstruction in children, early presentation and diagnosis is the key toreducing morbidity and mortality.

Keywords

Intestine --- Basrah


Article
Childhood Cancer(Leukaemias and Lymphoma) in Basrah- A case-control study
سرطان الطفولة ( ابيضاض الدم وسرطان الغدد اللمفاوية ) في البصرة - دراسة تحليلية

Authors: dr. Hanadi L Obeid د. هنادي لازم عبيد --- Omran S Habib د. عمران سكر حبيب --- Ganan G. Hassan د. جنان غالب حسن
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2008 Volume: 2 Issue: 1 Pages: 1-9
Publisher: Thi-Qar University جامعة ذي قار

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ABSTRACTThis is a case-control study carried out in Basrah during 2006. It involved 120 cases of leukaemia and lymphoma among children aged less than 15 years. The cases were compared with 180 controls matched for age, sex and area of residence. The study aimed at exploring certain sociodemographic and environmental risk factors.The results showed significant association between these two cancers and each of probable exposure to radiation, pesticides and chemicals related to automobiles and other sources. No clear association could be elicited between the studied cancers and education, age and occupation of parents.The study came to the conclusion that leukaemia and lymphoma were important childhood cancers and continuing efforts to register cancer in Basrah is vital for effective planning and research. It is also recommended that this small scale study could be expanded in the near future to confirm or refute the present study findings.

أجريت هذه الدراسة في البصرة في عام 2006. شملت عينة تتكون من 120 حالة سرطانية (ابيضاض الدم وسرطان الغدد اللمفاوية الأولي ) بعمر أقل من 15 سنة وعينة ضابطة من 180 طفلا مطابقة من حيث العمر والجنس ومنطقة السكن.توخت الدراسة استطلاع العلاقة بين هذين النوعين من السرطان و احتمالية التعرض لمؤثرات بيئية (إشعاع مبيدات او مواد كيماوية أخرى).أظهرت النتائج وجود ترابط معتد إحصائيا بين السرطان وكل من التعرض المحتمل للإشعاع والمبيدات والمواد الكيماوية ولم تظهر علاقات مهمة مع عمرو تعليم او مهنة الأبوين. وينصح بضرورة توسيع الدراسات التحليلية بحثا عن مسببات السرطان و تعزيز التسجيل السرطاني لتكوين قاعدة معلومات رصينة.


Article
MATERNAL MORTALITY IN BASRAH HOSPITALS; AN OVERVIEW OF THE LAST TWO DECADES

Authors: Salman K Ajlaan --- Edward Zaia --- Faiz A Alwaeely --- Fouad H Al-Dahhan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 3-3
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to determine the MMR in Basra hospitals for 20 years (1983-2002), to determine the main causes of maternal deaths with regards to direct, indirect & fortuitous causes & to verify the impact of major events including wars & sanction on the trend of maternal deaths. This is a retrospective study included all maternal deaths occurred in hospitals as well as deaths recorded in emergency departments, forensic medicine department & statistical units throughout the study period. Detailed information was taken to verify the cause of death in each woman. A total of 206 deaths occurred during the study period, MMR did not run a steady fashion, they showed gradual decline during 1980s. Following the second gulf war, there was considerable increase in MMR with the peak one observed in 1996. There after the ratio decline gradually to pre 2nd war levels. Direct obstetric causes remain the major causes of maternal death throughout the 20 years with, in a decreasing frequency, hemorrhage, sepsis & AFE were the major direct causes. However, indirect causes showed some, but noticeable increment during the sanction years. We concluded that the major political events, including wars that Iraq & Iraqi peoples exposed to had substantial adverse influence on the trends of maternal deaths. Although a direct maternal death outweigh indirect death, however, sanction years caused obvious increment in direct deaths.

Keywords

MATERNAL --- MORTALITY --- BASRAH


Article
OBSTRUCTIVE JAUNDICE IN BASRAH

Authors: Abutalib Bader Abdullah --- Zeki A Al-Faddagh
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 2 Pages: 45-57
Publisher: Basrah University جامعة البصرة

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Obstructive Jaundice is a common surgical problem presenting to hospitals as it resulted from many etiological factors like choledocholithiasis or periampullary tumors especially CA head of pancreas. According to the difference in these etiological factors and their progress, symptoms and signs vary in different patients. Diagnostic tools like US, CT scan, MRCP, ERCP and others vary in their ability in diagnosing the main etiology and the operative procedures also differs according to the etiologies, ranging from least invasive like ERCP to very sophisticated procedures like Whipple's procedure for CA head of pancreas. Many factors may affect the morbidity and mortality like the age of patients, presenting etiology and the presence of associated comorbid diseases. This study aimed to demonstrate the main etiological factors of obstructive jaundice in Basrah and the commonest presenting symptoms and signs. Also to study the most applicable investigations and compare their results according to their accuracy in diagnosing the etiology, and to study the most common surgical intervention applied to relieve the obstruction in obstructive jaundice and hospital morbidity and mortality. Both retrospective and prospective study was done in Basrah between January 2006 and December 2009, 243 patients with obstructive jaundice were included in this study from the main general hospitals and private hospitals in Basrah. Data were collected about the presenting clinical features, the diagnostic techniques, operative procedures and the causes of in hospital mortality and morbidity and were analyzed so that a complete picture of these details can be assessed for obstructive jaundice in Basrah. The study shows no significant difference between male and female in obstructive jaundice. The majority of cases found in the age group 50-59 years. Most common etiology was choledocholithiasis. The most frequent applied investigation was the liver function test which was done to all patients. Imaging techniques were applied variably with the US was the most applied while MRCP and ERCP were the least; however, the accuracy was higher with the latter two techniques. Intervention depends on the main etiology: for the choledocholithiasis, most common operation was CBD exploration, for CA head of pancreas the most common operation done was bypass procedure and for complicated hepato-biliary hydatid disease the CBD exploration with T-tube was the common. The post operative morbidity was 20.07% mostly due to respiratory complications, while mortality was 9.86 % mostly due to sepsis. In conclusion, the most common cause of obstructive jaundice in Basrah is choledocholithiasis and CA head of pancreas comes second. ERCP and MRCP are the least applied imaging techniques in diagnosis of obstructive jaundice. The threshold for their application was very high. The least applied intervention to treat obstructive jaundice was the therapeutic ERCP, while the most common was open surgical procedures.

Keywords

OBSTRUCTIVE --- JAUNDICE --- BASRAH


Article
NEUROENDOSCOPY EXPERIENCE IN BASRAH

Author: Khalid N Mayah
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 1 Pages: 1-12
Publisher: Basrah University جامعة البصرة

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Abstract

In the last decade the endoscope became one of the most important neurosurgical tools, its use increasing with time and gaining popularity.Since May 2005, forty six neuroendoscopy procedures were performed in two hospitals in Basrah, 34 were Endoscopic third ventriculostomies (ETV) to treat hydrocephalus, three arachnoids cyst fenestrations, three ventricular tumor biopsies, and one operation to remove third ventricle tumor partially that already biopsied, three colloid cyst removed and one septotomy to treat encysted hydrocephalus, One case of craniopharyngioma had catheter implanted via the endoscope.The patients� age ranged from 3 weeks to 70 years, However of the patients who had ETV, 37% (11/34) were younger than one year age.Over one week to twenty months (mean follow up period were 11 months), During that time and for patients who had ETV symptoms of raised intracranial pressure that necessitated a shunt define the failure of treatment, That encountered in two patients , both were younger than one year age. Although time of follow up was rather short, the success rate was 100% for patients older than one year of age who had definite obstructive hydrocephalus.ETV has become the treatment of choice for certain pediatric and adult hydrocephalic conditions. Saving patients from shunt dependence and complications improving the outcomes and avoiding subsequent morbidity and mortality.


Article
A CASE REPORT OF CUTANEOUS MYIASIS BY CHRYSOMYA BEZZIANA (OWS) IN CAMEL AT BASRA PROVINCE
تسجيل حاله تدويد جلدي بيرقات ذبابة العالم القديم Chrysomya bezziana في الجمال في محافظة البصرة

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A first case was reported of cutaneous myiasis by old world screw worm Chrysomya bezziana in camels in Basra province south of Iraq in 2006. Camels were brought from Al-Zubair city and then to Basra marshes. Many larvae were isolated from injury in the knee and thigh region which exposed to stress during transportation. Larvae was sent to a laboratory which classified to belong Diptera- Chrysomya bezziana (OWS). The animal was treated by using ammonia 36% , iodine , and antibiotic as spray locally, after that the animal take a rest and the healing occur within three days of treatment. This case considers as the first case report of myiasis by chrysomyia bezziana in camel at Basra province south of Iraq.

Keywords

Chrysomya bezziana --- Camel --- Basrah


Article
Pattern of leukaemia in Basrah
طراز إبيضاض الدم في البصرة

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ABSTRACTBackground: In Basrah, previous studies reported increased risk of certain cancers including leukaemia. Two important features were reported: a rise in the incidence rate of leukaemias in children and an age shift towards younger children. These studies were limited by the incompleteness of data they used.Objectives: This paper is intended to present a profile on leukaemia in Basrah over the years 2005-2008. Methods: The cases of leukaemia presented in this paper represent all cases diagnosed, treated and registered in Basrah during the years 2005-2008. The cases were drawn from the pool of cancer registries in various health care institutions dealing with cancer using a case series study design. All available and verifiable cases were included in the study. Relevant incidence rates were calculated by dividing the average annual number of cases by mid-period population for each category used.Results: During the four – year study period, it was possible to identify 608 cases of leukaemia; 56.4% were among males and 43.6% were among females. More than half of the cases (52.8%) were from Basrah, 26.5% were from Thi Qar, 13.6% were from Missan, and 7.1% were from other governorates. The age-specific incidence rate in Basrah showed a bimodal distribution with higher rates at extreme ages. The crude incidence rate was 3.6 per 100000 population (3.9 per 100000 males and 3.2 per 100000 females). The age standardized incidence rate was 4.3 per 100000 males and 3.9 per 100000 females.Conclusion: Leukaemia is a significant malignant disease in Basrah. The figures of incidence rate point towards an upward trend, but still comparable to the figures from other Gulf countries. Keywords: Leukaemia, incidence, Basrah

الخلاصةالخلفية: أشارت دراسات سابقة في البصرة الى زيادة في الإصابات ببعض أنواع السرطان، ومنها إبيضاض الدم. وقد تمت الإشارة الى نقطتين: الأولى زيادة في نسبة الإصابة بين الأطفال، والثانية تغير في نمط العمر للمصابين بإتجاه الأعمار الأصغر، الإ أن تلك الدراسات إستندت الى بيانات ناقصة مما حدد دقة نتائجها.الأهداف: يهدف البحث الحالي الى إعطاء لمحة عن إبيضاض الدم في البصرة للسنوات 2005-2008.الطرائق: تمثل البيانات المعروضة في البحث جميع حالات إبيضاض الدم الجديدة المشخّصة والمعالجة والمسجلة في محافظة البصرة خلال السنوات 2005-2008. وقد تم الحصول عليها من جميع مصادر تسجيل البيانات، حيث تم تدقيقها وتوثيقها تباعا. ولغرض حساب نسب الإصابة تم تقسيم المعدل السنوي للإصابات على عدد سكان محافظة البصرة في منتصف سنوات الدراسة.النتائج: تم توثيق 608 حالات جديدة (56,4% منهم من الذكور، 43,6% من الإناث) خلال السنوات الأربع 2005-2008، وكان 52,8% من الإصابات من سكان محافظة البصرة فيما مثلت الإصابات من محافظة ذي قار 26,5%، ومن محافظة ميسان 13,6%، والمحافظات الأخرى ساهمت بنسبة 7,1%. أظهرت نسبة الإصابة حسب العمر وجود ثنائية المنوال حيث الإصابة أعلى في طرفي العمر، وكانت نسبة الإصابة الخام 3,6 لكل 100000 نسمة وهي أعلى في الذكور (3,9) منها في النساء (3,2)، أما النسبة المعيارية فكانت 4,3 لكل 100000 من الذكور و3,9 لكل 100000 من الإناث.الإستنتاجات: يمثل إبيضاض الدم مرضا خبيثا مهما في البصرة، ومن المحتمل أن تكون نسب الإصابات قد إزدادت في السنوات الأخيرة ولكن المستوى العام مازال ضمن مستويات الإصابة في المنطقة العربية.كلمات دالة: إبيضاض الدم، إصابات، البصرة، وبائيات السرطان.

Keywords

Leukaemia --- incidence --- Basrah


Article
MICROSURGICAL WORK IN BASRAH

Authors: Zuhair F Fathallah --- Alaa H Al-Farhan --- Jaber R Hameed --- Amer S Daood
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 1 Pages: 3-11
Publisher: Basrah University جامعة البصرة

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Abstract

Reconstructive microsurgery represents one of the most significant surgical advancement in the second half of the twentieth century. To start such kind of work for the first time in a big city is a great challenge. In this study, we will try to evaluate our work in free flap in Basrah Plastic Surgery unit, and how we manage to start this kind of work in a location and situations not ideal for it. The aim of this study is to evaluate our work (the success and failure) that Basrah center faced in the free flap work and microsurgery, so other centers in Iraq who wish to start this kind of work to benefit from our experience and avoid the mistakes that we had to solve it. This is a retrospective study of thirteen cases which were done in Al-Sadder teaching hospital in Basrah,Iraq from August 2007 to March 2013. They were 10 males and 3 females, with age range from 4-40 y (median age 17y). In all cases, the lower limb was injuries except in one case where there was scalp loss. In all of the cases Latissimus Dorsi muscle was used as a donor muscle. Seven out of the 13 cases were successful (54%). In 6 of the cases there was failure due to variety of causes discussed later in detail so as to be avoided in future work. In conclusion, it is possible to start free flap work in any Plastic Surgery unit if the facilities are available. Team work, proper preoperative evaluation and planning, team decision and equal division of roles are the key points for success.


Article
Water resources of Basrah province
دراسة انتشار أكياس طفيلي الابواغ الخبيئةCryptosporidium sp. في بعض مصادرمياه محافظة البصرة

Authors: عبد الحسين حبش عواد --- ساره كامل ناصر
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2014 Volume: 4 Issue: 3 Pages: 9-12
Publisher: Thi-Qar University جامعة ذي قار

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This study was done during the period from December 2012 until May 2013. The watersamples were collected from rivers (Shatt-Al-Arab, Robat, Khora, Khandq),sewage water(Al-Asmai, Hay Al-Rafadin and Nadhran), Taps water (Qurna, Karmit Ali, Zabir and Basrah old city) and water treatment plant (Al-Bradai and Karmit Ali ). Modifieds acid fast stain and flotation in saturated sugars solution method were used for diagnosis parasite oocyst. The results of the present study showed that the height concentration of oocyst were in February (119 /litter) and April (147 / litter) and the less concentration were in May (61 / litter) and January/2013 (58 / litter).

أجريت هذه الدراسة للفترة من كانون الاول 2012 وحتى نهاية أيار2013 تم فيها جمع عينات المياه من أربعة محطات هي مياه انهر شط العرب والرباط والخورة والخندق ,ومياه المجاري في مناطق الأصمعي وحي الرافدين ونظران ,ومياه إسالة منزلية في القرنة والكرمة والزبير والبصرة القديمة ,اضافة إلى مياه محطتي تصفية البراضيعية والكرمة.استعملت طريقة التطويف بالمحلول السكري المشبع وصبغة زيل نيلسن المحورة الحارة للكشف عن ألاكياس البيضية للطفيلي .اتضح من خلال الدراسة الحالية ان اعلى وجود للأكياس البيضية كان في العينات المأخوذة من مياه المجاري( 104.6/لتر)ومياه الأنهر(24.6/لتر)على التوالي . وان اعلى تركيز للأكياس البيضية كان في شهري شباط (119/لتر) ونيسان (147/لتر) على التوالي واقل تركيز كان خلال شهري ايار(61/لتر )وكانون الثاني (58/لتر).(2013)

Keywords

Cryptosporidium --- water --- Basrah


Article
ANTHROPOMETRIC FACE IN BASRAH

Authors: Nada H Al-jassim --- Zuhair F Fathallah --- Nawal M Abdullah
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 2 Pages: 29-40
Publisher: Basrah University جامعة البصرة

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Abstract

ANTHROPOMETRIC FACE IN BASRAHNada H Al-jassim , Zuhair F Fathallah & Nawal M AbdullahMB,ChB, DGO.Anatomy.Abstract Anthropometry is the systematic quantitative representation of the human body, it is used to measure the absolute and relative variability in size and shape of the human body. Over thecenturies, there have been remarkable changes in anthropometric measurements due to geographical, cultural, genetic and environmental factors. The studying of human face and theassessment of facial dimensions attract the attention of the artists, poets and scientists and takes a prime importance in medical and dental fields in both diagnosis and treatment planning.Anthropometry also used for the design of clothing and equipment, e.g. Gas masks, oxygen masks, dust masks and respirators as well as design of military and industrial helmets. Therehad been no studies done on facial measurement in Basrah therefore, this study is to be considered as the first in this field and the baseline for further studies. This study had attemptedto quantitatively measure the human face in different ethnic groups of the local population and to identify the differences between individuals of different races and sexes, also to identify the differences between the people of Basrah and other people worldwide. These differences whichare responsible for the special facial features in different ethnic groups should be maintained during reconstructive or aesthetic surgery otherwise the patients will lose their ethnic features. The people of Basrah have different racial and ethnic background, there are Semites which are the Arabs and Syrian (Assyrian & Chaldean), Arian, who are the Armenian, Kurdish andPersian, and then there is the mixed group result from interracial marriages. This study is a cross sectional study with a comparative component conducted in Basrah governorate. The data was randomly collected from volunteers, for the period from February toJuly 2013. Raw data used in this study was originated from a total number of 1000 Iraqi adults (526 females and 474 males) living throughout Basrah governorate and were used to create adatabase for statistical analysis. The result of this study shows that there are differences between the races and between the local people and the surrounding countries and indeed there is a great difference from thestandard measurement advocated by western researchers. Introductionhe human face is a living mirror heldTout to the world, it has the power to common expression is “I may forget aname, but I’d never forget a face’ Anthropometryquantitative representation of the humanindividualunderstanding human physical variations . Overremarkablemeasurementscultural,Bas J Surg, December, 20, 2014Original ArticleMEASUREMENTSOFHUMANMB,ChB, MSc, Assist. Prof. Plastic Surgeon. MB,ChB, MSc, Assist.Prof. o

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