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Article
Provisional versus histopathological diagnosis of periapical lesions

Author: Sabah M SAKA
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2002 Volume: 2 Issue: 3 Pages: 310-313
Publisher: Mosul University جامعة الموصل

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One hundred and thirteen cases of periapical lesions associated with-vital anterior teeth are analysed and reported. The associated teeth were apicoectomised and the lesions were measured grossly and interpreted histopathologically. It was found that(66) out of (72) cases (91.7 %) provisionally diagnosed as periapical granuloma or chronic periapical abscess show correct diagnosis histopathologically, whereas of (41) cases provisionally diagnosed as periapicalradicular cyst only (24)(58.5%) show correct diagnosis histopathologically. It was found also that (29)periapical lesions out of (30)diagnosed histopathologicallyas periapical radicular cyst measured more than (10) mm of(83)periapical lesions diagnosed histopathologically as agranuloma or abscess,(71) measured less than1 (10) mm.


Article
Evaluation of causes of acute hip pain in children at Erbil teaching hospital

Authors: Sherwan J. Shareef شيروان ج شريف --- Zohair M. Al-Saffar زهير الصفار
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2011 Volume: 37 Issue: 1&2 Pages: 103-109
Publisher: Mosul University جامعة الموصل

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Objectives: Painful hip in children is a common pediatric problem and there are several causes for hip pain. In this study we will show the most common causes of hip pain in children and evaluate the procedures performed at our hospital, with a view of establishing which parameters most relevant to make a clinical decision. Methods: This is a case review study which was carried out at Erbil Teaching Hospital between December 2006 and October 2007. Sixty two patients who had con¬sultations and/or been admitted at our hospital complaining of hip pain were included in this study. We did investigations for them and we reviewed their clinical, laboratory and imaging documents.Results: The differential diagnosis was transient synovitis (TS) 54.8%, Legg-Calves-Perthes disease 24.2%, septic arthritis (SA) 8.1%, traumatic synovitis 4.8%, avulsion fractures 3.2 %, brucellosis 1.6%, tuberculosis 1.6%, and non specific synovitis 1.6%. We found that three or more criteria,(the clinical and laboratory parameters), were present in all cases of septic arthritis (100% sensitivity), but also were present in 10% of non septic conditions (90% specificity). Radiographs showed abnormalities in 50% of the cases. Ultrasound showed joint effusion in 43 patients with 100% of sensitivity. Conclusions: Transient synovitis is the most common cause of irritable hip. Application of our scheme might result in a reduction of the number of patients who need hospital admission and also reduction of invasive procedures and containment of the cost. Keywords: Diagnosis of painful hip.

الهدف: تشخيص أهم أسباب الآم مفصل الورك لدى الأطفال مع تقييم الطرق العلاجية المتبعة في المستشفى لإيجاد أكثر الفحوصات أهمية لتشخيص نوع المرض (أسباب الآم مفصل الورك).المواد والطرائق: أجري هذا البحث على 62 مريضا من الذين راجعوا مستشفى أربيل التعليمي لغرض العلاج في الفترة ما بين كانون الثاني عام 2006 و تشرين الاول عام 2007. تم تسجيل عدد من البيانات لكل من المرضى، الفحص الطبي السريري والفحوصات المختبرية مع الأشعة. كما أجري فحص السونار مع بعض الفحوصات المختبرية الأخرى والعمليات الجراحية لعدد من المرضى.النتائج: 54,8% من المرضى كانوا مصابين بالتهاب الغشاء المفصلي الوقتي و24% من المرضى كان لديهم مرض البيرثس و 8% من المرضى كان لديهم التهاب المفصل القيحي و 8% من المرضى كان لديهم شدة خارجية و 1,6% حمى المالطا و 1,6% من المرضى كان لديهم مرض السل و 1,6% التهاب الغشاء المفصلي الغير المحدد.وفد اتضحت لدينا بأن ثلاثة علامات أو أكثر كانت موجودة في المرضى المصابين بالتهاب المفصل القيحي (100%)، ولكن كانت موجودة أيضا في (10%) من المرضى الآخرين.الأشعة كانت طبيعية في (50%) من المرضى و تورم مفصل الحوض وجدت في (43) مريضا بواسطة فحص السونار.الاستنتاج: كان السبب الرئيسي لألم مفصل الحوض لدى الأطفال هو التهاب الغشاء المفصلي الوقتي. نسبة المرضى المصابين بمرض البيرثس كانت كبيرة. فحص السونار ودرجة حرارة الجسم وفحوصات الدم كانت الأكثر أهمية للتميز بين أسباب الآم مفصل الورك لدى الأطفال. استعمال هذه الطريقة في العلاج يؤدي الى التقليل من عدد المرضى الذين يحتاجون الى إدخال الى المستشفى أو أجراء عملية جراحية لهم.


Article
Chief complaints of patients attending college of Dentistry at Mosul University

Authors: Baceer A Abdullah --- Ahmad AH Al–Tuhafi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2007 Volume: 7 Issue: 2 Pages: 201-205
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To investigate the characteristic of patients attending College of Dentistry at Mosul University,the chief complaint which make them seeking dental treatment, and the final diagnosis of theirproblems .Materials and Methods: 760 patients attended to oral diagnosis were examined .Thepatients age ,sex & marital state were recorded & the reason for seeking dental treatment. Results: Theresearch revealed that a total of 760 patients presented to the oral diagnosis clinic in a period of aboutone year. Of them 41.18% were males and the remaining 58.82% were females. The single patientpercentage was 55.26%, while percentage of married patients was 44.74%. The predominant age was 20–29 years age group (28.81%). The most common chief complaint was pain (34.73%). The less common complaints were: check up, esthetic, and tooth replacement with percentages of 27.5%, 18.55%, and 6.05% respectively. It was found that the frequency of esthetic and check up were higher in the youngest age groups than in the older age groups. The percentage of esthetic complaint was more in female, while pain and check up were higher in male patients. Pain complaint was higher in married patients, while check up was more frequent in single patients. Esthetic complaint was equal in both groups. Conclusions: It was found that the most common diagnosis was dental caries (31.97%) this followed by pulpitis (21.05%) and periapical lesion (14.07%).


Article
The Role of Magnetic Resonance Imaging and Magnetic Resonance Cholangiopancreatography in Patients with Obstructive Jaundice
استخدام الرنين المغناطيسي وتلوين القنوات الصفراوية لدى مرضى اليرقان الانسدادي

Authors: Najeeb S. Jabbo د. نجيب صليوة جبو --- Ayad Mahmood Subhi د. اياد محمود صبحي --- Ra'ad H. AL-Kayat د. رعد حفظي الخياط
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 3 Pages: 253-258
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Objectives: The aim of this study is to evaluate the sensitivity, specificity and diagnostic accuracy of magnetic resonance cholangio-pancreatography in patients with obstructive jaundice after comparing it with the final diagnosis after surgical exploration and histopathological study. Methods: This study was held at Al-Yarmouk Teaching Hospital where patients with obstructive jaundice were investigated with magnetic resonance cholangio-pancreatography followed by surgical exploration and confirmation of diagnosis. Comparison of both results was carried out.Results: There were 42 patients, 26 females and 16 males. Their mean age was 59 years. 17 patients had common bile duct stones, 17 had malignancy, 3 had hydatid cyst, 2 had benign stricture and one patient had Mirrizi`s syndrome, chronic liver disease and biloma for each. After comparison with the final diagnosis after surgical exploration, the sensitivity, specificity and diagnostic accuracy of magnetic resonance cholangio-pancreatography were 100%, 92% and 95.2% respectively for those with common bile duct stones, while they were 94.1%, 100% and 97.6% respectively for those with malignancy.Conclusion: Magnetic resonance cholangio-pancreatography is of high diagnostic accuracy when used for patients with obstructive jaundice of different causes. In addition to its characters of being a non-invasive technique that need neither specific preparation nor anesthesia. We recommend using it on a wider scale in our country.Keywords: Obstructive jaundice, diagnosis, MRCP

الملخص:الهدف: هدف هذه الدراسة هو تقييم حساسية ومدى الوثوق ودقة الشخيص لجهاز الرنين المغناطيسي في مستشفى اليرموك التعليمي في حالات اليرقان الأنسدادي وبعد المقارنة مع التشخيص النهائي بواسطة التداخل الجراحي مع أو بدون الفحص النسيجي.الطرق: اجريت هذه الدراسة التتبعية لحالات اليرقان الأنسدادي في مستشفى اليرموك التعليمي. أجري لجميع المرضى فحص الرنين المغناطيسي ثم تم متابعتهم بالأستكشاف الجراحي وتثبيت التشخيص بالتحليل النسيجي أو اعتمادا على الملاحظات الجراحية. النتائج: شملت الدراسة 42 مريضا ( 25 من الأناث و 16 من الذكور)0 معدل العمر كان 59 سنة0 عدد المرضى المصابين بالأورام الخبيثة وحصى قناة الصفراء 17 مريضا لكل منهم, 3 مصابين بالأكياس المائية ومريضين مصابين بتضيق قناة الصفراء0 بعد التحقق من التشخيص اعتمادا على نتائج الأجراء الجراحي كانت حساسية الفحص بجهاز الرنين المغناطيسي 100 % في حالات الحصى و9401 % في حالات الأورام0 أما دقة التشخيص فكانت95,2 % في حالات الحصى و97,6 % في حالات الأورام.الأستنتاج: أن الفحص بواسطة الرنين المغناطيسي لحالات اليرقان الأنسدادي ذو حساسية ودقة عالية وخالية من المضاعفات. بالأضافة الى أنها لا تحتاج الى التخدير ولا اجراء تحضيرات خاصة.


Article
Diagnostic Errors of Non-Traumatic Acute Abdomen

Author: Hadi Awad Hmoud
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 2 Pages: 2197-2201
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Acute abdomen is a relatively common issue that facing hospital casualties, which make it crucial for physicians to diagnose acute abdomen, as early as possible depending mainly on their clinical skills to avoid unnecessary delay or negative laparotomies. Every physician must be familiar with diagnosis of acute abdomen especially in situations where there is limited diagnostic facilities.Aim: This study was conducted as a comparison between preliminary and final diagnosis for 500 cases of acute abdomen, and to find out the role of clinical skill and diagnostic tools in avoiding diagnostic errors.Method: This study was performed from 1996-1998, and included 500 patients presented to casualty department with signs and symptoms of acute abdomen. Clinical skills were the major tools used for settling the diagnosis, due to shortage of the other diagnostic tools.Results: Acute abdomen was common in the age group of 21-30 years, with male gender predominance (60.80%). Laparotomy was done for 462 out of 500 patients with acute abdomen, and it was similar to the pre-operative diagnosis in 421 patients, so the incorrect post-operative diagnosis rate was 41 patients (8.88%).Also correct preliminary diagnosis was 454 out of 500 patient including the patients who underwent laparotomy, with false preliminary diagnosis rate (9.20%).Appendicitis was the major cause for acute abdomen (70.60%).Limited laboratory and imaging studies were done for some patients, GUE showed the highest negative predicted value (99.42%) and the x-ray showed the highest sensitivity (95.24%). Most of incorrect post-operative diagnosis was related to physiological and pathological gynecological issues.Conclusion: The diagnosis of acute abdomen should be based on the results of a good history and thorough physical examination aided by the secondary role of investigative tools. Diagnostic modalities could guide the physician in confirming the diagnosis. An accurate diagnosis of acute abdomen can minimize unnecessary operations and reduces the rate of negative laparotomies.Keywords: Acute abdomen, Laparotomy, Diagnosis


Article
The Delay in Diagnosis and Treatment of Pulmonary Tuber culosis in AL-Anbar Province
التاخر في تشخيص وعلاج مرض التدرن الرئوي في محافظة الانبار

Authors: Mohammed J.Kadhim محمد جواد --- Najla`a F.Jamil نجلاء فوزي --- Abid AL- Hakeem K.Latef عبدالحكيم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 4 Pages: 446-452
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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AbstractAim: The current work was conducted aiming to determine the patients delay, doctor delay and treatment delay among patients with pulmonary TB and to detect the effect of some socio demographic factors on delay in diagnosis and treatment.Patients & method: Across sectional study was carried out in AL-Anbar province (AL-Anbar center for chest diseases and tuberculosis), for the period from the 1st of October 2003 to the 30th of May 2004. The study depends on inter view questionnaire of newly diagnosed pulmonary TB. (PTB)Results: Patients’ delay: Mean 67.26 + 31.04 days. Doctor delay: Mean 39.71 +24.42 days. Total delay: Mean 106.97 + 51.97 days.Conclusion: There was a delay in diagnosis of PTB both patients and doctors delay, but there was no delay in treatment.

الملخص:الهدف: الغرض من الدراسة الحالية هو معرفة مدة التخر في تشخيص وعلاج مرض التدرن الرئوي وكذلك معرفة تأثير بعض العوامل الاجتماعية والديموغرافية علة التاخر في التشخيص والعلاج0طريقة اجراء البحث: اجريت هذه الدراسة المقطعية في محافظة الانبار( مركز الامراض الصدرية والتدرن) للفترة من تشرين الاول 2003 الى نهاية ايار 2004, اعتمدت الدراسة على مقابلة المرضى المشخصين حديثا بمرض التدرن الرئوي0النتائج: التاخر بسبب المريض المعدل 26, 67 يوما (7-240) يوما بسبب المؤسسات الصحية المعدل 39,71 يوما(7-210) يوما التاخر الكلي المعدل 106,97 يوما+ (51,97) يوماالاستنتاج: كان هناك تاخر في تشخيص المرض( بسبب المريض والمؤسسات الصحية) ولكن لم يكن هناك اي تاخير في اعطاء العلاج المناسب بعد التشخيص مباشرة

Keywords

delay --- diagnosis --- treatment --- PTB


Article
Incidence rate of breast cancer, clinical and ultrasound approaches to diagnosing the same in dogs
معدل الإصابة بسرطان الثدي، والتشخيص بالطرق السريرية والامواج فوق الصوتية في الكلاب

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Mammary gland tumors in dogs rank second among all newly diagnosed tumors in this species. Research goal was to study clinical/morphological characteristics of breast cancer in dogs with the use of ultrasound investigation. 34 dogs of different breeds and age groups with spontaneously emerging neoplasms of mammary glands were chosen for the study. To classify malignant tumors, the histological classification was applied. Complete examination of breast tumors was carried out with the help of clinical observation, ultrasound, radiologic, hematological and ultrasonographic methods applied. The largest percentage (23.5%) of animals with mammary gland neoplasms are mongrel female dogs. The breed predisposition was detected in dogs of the following breeds: Miniature Schnauzer - 11.9%, Standard Dachshund - 11.9%, American Bulldog, American Cocker Spaniel and Miniature Poodle - 8% each. Breast cancer was diagnosed in 29 animals (85.3%), 100% of those cases in the nodular form with microcalcifications in the tumor parenchyma. The horizontal orientation of growth is more often typical of breast cancer in the mammary gland pairs I and II at the initial stage of carcinogenesis, and is characterized by an inhomogeneous hypoechoic structure with sufficiently pronounced boundaries detected during the ultrasound investigation. The vertical orientation of growth is mainly typical of breast cancer in the mammary gland pairs III, IV and V from the very beginning of the disease. The ultrasonography usually shows: inhomogeneous hypoechoic structure containing inclusions in the form of cords or foci of a higher acoustic solidity; also clearly defined lateral acoustic shadows and dorsal echo enhancement; as well as unevenness and indistinctness of borders. The performed histological study within the current research revealed a multifocal, infiltrating epithelial neoplasm with distinct edges, surrounded by a large amount of fibrous tissue. The tumor consisted of a number of acini with a tendency of forming a network structure. The shape of cells was detected from round to irregular, the cytoplasm was found scarce, often with uneven borders, with the large central core, with chromophilic substance and 1-2 nucleoli. The cells were characterized by the pronounced anisocytosis and anisocariosis, and a great number of mitotic figures. Lymphatic invasion was observed. Ultrasound investigation of the mammary gland allows for performing percutaneous minimally invasive interventions and differential diagnostics of cystic and solid lesions of the mammary gland (96-100% accuracy), mastopathy and carcinoma conditions.

تحتل اورام الغدة الثديية المرتبة الثانية بين جميع الأورام التي تم تشخيصها حديثا في الكلاب. كان الهدف من البحث هو دراسة الخصائص السريرية/المورفولوجية لسرطان الثدي في الكلاب باستخدام فحص الموجات فوق الصوتية. تم اختيار 34 كلب من مختلف السلالات والفئات العمرية تعاني من الاصابة بسرطان الغدة الثديية للدراسة. لتصنيف الأورام الخبيثة، حيث تم تطبيق التصنيف النسيجي لتلك الاورام. تم إجراء فحص كامل لأورام الثدي بمساعدة المراقبة الإكلينيكية، والموجات فوق الصوتية، والطرق الإشعاعية، وأمراض الدم. حيث سجلت أكبر نسبة (23,5 ٪) من الأورام الغدة الثديية في الكلاب الإناث الهجينة. اختلفت نسبة الاصابة في الكلاب حسب السلالة اذ كانت 11,9% في كل من سلالة Miniature Schnauzer و Standard Dachshund في حين كانت النسبة 8% في كل من سلالة American Bulldo و American Cocker Spaniel وMiniature Poodle. شخيص سرطان الثدي في 29 كلب من الكلاب قيد الدراسة وبنسبة (85,3 ٪)، كانت جميع الاصابات لتلك الحالات بشكل عقدي مع وجود تكلس ورمي في النسيج. غالبا ما يكون الاتجاه الأفقي للنمو نموذجياً لسرطان الثدي في أزواج الغدة اللبنية الأولى والثانية في المرحلة الأولية من التسرطن، ويتميز ببنية ناقصة الصيغ غير متجانسة مع حدود واضحة بشكل كافٍ تم الكشف عنها أثناء الفحص بالموجات فوق الصوتية. الاتجاه الرأسي للنمو هو النمط الرئيسي لسرطان الثدي في أزواج الغدد اللبنية الثالث والرابع والخامس منذ بداية المرض. عادة ما يظهر التصوير بالموجات فوق الصوتية: بنية ناقصة الصمغ غير متجانسة تحتوي على شوائب في شكل حبال أو بؤر صلابة صوتية أعلى ؛ كما تحدد بوضوح الظلال الصوتية الجانبية وتعزيز الصدى الظهراني؛ فضلا عن التفاوت وعدم وضوح الحدود. وكشفت الدراسة النسيجية التي أجريت في إطار البحث الحالي عن وجود ورم ظهاري متعدد البؤر يتسلل إلى حواف متميزة تحيط به كمية كبيرة من الأنسجة الليفية. يتألف الورم من عدد من الحويصلات مع ميل لتشكيل شبكة. كان شكل الخلايا دائري الى غير منتظممع ندرة في وجود السايتوبلازم، وغالبا مع حدود غير متساوية، مع جوهر مركزي كبير، مع مادة كروموفيلية 1-2 نواة. تميزت الخلايا السرطانية بوضوح الـ anisocytosis و الـ anisocariosis والعدد الكبير من اشكال الانقسام. كما لوحظ الغزو اللمفاوي. فحص الضرع بالامواج فوق الصوتية يتيح الية الية تشخيص عبر الجلد مما يقلل من الحاجة للتداخلات بعمل فتح كما ان هذه التقنية تساعد في التمييز بين الافات الصلدة والتكيسات في الضرع (بدقة 96-100%)، وكذلك امراض وسرطانات الضرع.

Keywords

Prevalence --- Dogs --- Cancerts --- Diagnosis


Article
The use of D-dimer in exclusion of diagnosis of suspected Deep Vein Thrombosis

Authors: Rasha Tariq Jawad --- Hussein Hasan Abed --- Lamyaa Jaafar Hammoodi Alqaisi
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 2 Pages: 45-58
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Deep venous thrombosis is a common disorder associated with significantmorbidity, chronic venous insufficiency as well as fatal pulmonary embolism. venography hasbeen the gold standard of diagnosis, however it has been replaced in most areas by duplexultrasound which is generally very good method .An interesting new approach to the diagnosis ofDVT is D-dimer testing, D-dimer levels reflect the amount of lysed, crossed-linked fibrin andmay be useful diagnostic marker in the clinically suspected DVT .D-dimer can be measuredeither quantitatively by ELISA or qualitatively by latex agglutination.Objectives: The aim of the study was to evaluate the use of D-dimer in exclusion of the diagnosisof DVT.Patient and methods: A total of 50 patients presented to vascular outpatient department withclinical suspicion of DVT have been studied ,patients with old DVT ,patients on anticoagulant,and patient with severe infection or inflammation were excluded .Venous duplex ultrasonographyof the affected limb or limbs was done and citrated blood sample was analyzed for D-dimer by aVIDAS method for all patients blindly to the results of venous duplex .Sensitivity ,specificity,negative and positive predictive values were calculated .ROC curve then was generated fromsensitivity and 1 _ specificity values at a continuum of D-dimer level to determine the optimalcut-off level of VIDAS D-dimer for exclusion of DVT.Results: The mean age of DVT group was 43 year. DVT was confirmed in 37 patients (74%),and excluded in 13 patients (26%) by venous duplex .The mean D-dimer level in the DVT groupwas 5498.021ng/dl while in non DVT group was 1906.384ng/dl this difference was statisticallysignificant (P=0.0003). The sensitivity , specificity , negative and positive predictive values ofVIDAS method at cut-off points(500 and 900) ng/dl were ( 100% , 33% , 100% , 82% )respectively ,and at 3000ng/dl ( 71% ,75%, 47%,90% ) respectively Conclusions: VIDAS D-dimer method is a sensitive method that can be used in the initialmanagement of deep vein thrombosis if a level of 900ng/dl is used as a cut-off point for exclusionof deep vein thrombosis. VIDAS D-dimer method is not a specific test so it cannot be used for thediagnosis of deep vein thrombosis.

Keywords

D-Dimer --- Diagnosis --- DVT


Article
Colorectal cancer in a group of Iraqi patients

Author: Sabeha Moosa Al‐Bayati
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 36-39
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background Colorectal cancer is the second most common internal malignancy and the second leading cause of cancer death (after lung cancer).The condition becomes increasingly common after the age of 50.Because it is a common problem in certain areas of the world and because its insidious nature of onset that sometimes is too late when diagnosed, keeping high index of suspicion with developing screening tests that are reliable and easily performed are vital in diagnosis. Objective: To highlight some of the demographic, laboratory, and histopathological criteria of colorectal cancer in a group of Iraqi patients. Methods This study is a descriptive cross sectional study that had enrolled 30 patients with colorectal cancer. The patients included in this study had been selected from those patients who had attended the endoscopic unit / department of medicine at Al-Yarmouk teaching hospital during the period between the 1st of September 2006 to the 1st of September 2007. Patients diagnosed to have colorectal cancer by colonoscopy, and biopsy samples were taken for histopathological study, and blood samples were taken for carcinoembryonic antigen. Results This study revealed that 80% of the patients were older than 50 years of age with a male: female ratio of 2.75:1.63.33% of the patients were smokers. The study revealed that the presentation of the disease is usually insidious with abdominal pain, change in bowel habit and haematochezia and melena seen in 83.34% of the patients. 66.67% of the tumors were located in the rectosigmoid.All the tumors were adenocarcinoma. Carcinoembryonic antigen was +ve in 60% of the patients. Conclusion Colorectal cancer is more common in old male patients with smoking habit.


Article
Chances of Misdiagnosis between Acute Appendicitis & Ureteric Colic

Author: Hamdan A. Abbas
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2010 Volume: 9 Issue: 1 Pages: 13-16
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background The symptoms of acute appendicitis (A.A.) mimic sometimes the symptoms of ureteric colic (U.C.) due to stone leading to mistake in the diagnosis and delay in the management hence increased mortality and morbidity. Aim To compare the features of differential diagnosis between the two groups and to see how frequent cases of U.C managed and treated as A.A. Method Prospective study of 100 patients who are proved A.A and 100 patients proved U.C were taken to compare the features of differential diagnosis while 50 patients of histologically proved negative appendicectomies were followed up for ureteric stone. Result No urinary stones in the 50 cases of negative appendicectopmies have been found when followed up. A.A cause more often fever, localized pain in the right iliac fossa, nausea with or without vomiting, C - reactive protein (C.R.P) and white blood cell (W.B.C) count elevation more than U.C while general urine examination (G.U.E.) revealed more red blood cells (R.B.C) and pus cells in cases of U.C as compare with A.A. Conclusion Misdiagnosis between A.A and U.C is a rare clinical event in our hospital. U.C causes pain and tenderness in the flanks and revealed more R.B.C in the urine while A.A causes more fever, leucocytosis and elevated C.R.P.

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