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Article
Prevalence of Hypertension in Deep and Lobar Intracerebral Hemorrhage in a Group of Iraqi Patients

Author: Hasan A. Al-Hamadani حسن عزيز الحمداني
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2013 Volume: 55 Issue: 2 Pages: 102-105
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Non-traumatic Intracerebral Hemorrhage (ICH) results from rupture of blood vessels in the brain. ICH categories can also be considered as being either lobar in location or within the deep white matter. Although hypertension is a major risk factor for ICH in general[11], it is commonly considered to be associated more with patients having deep than with those having lobar haemorrhage.Objectives: We investigate the relationship between hypertension and deep versus lobar intracerebral hemorrhage (ICH).Methods: a retrospective review of records of 163 patients aged 18-89 years admitted to Al-Kadhimiya Teaching Hospital (January 2008 - October 2010) and diagnosed with ICH.Results: There was no significant relationship between hypertension in deep versus lobar intracerebral hemorrhage (p=0.814)Conclusions: Although the relation between hypertension and ICH was not found to be significant, our study suggests and recommends age-appropriate investigations for patients with ICH, as well as the need to promote patients’ education with regards to this disease and the importance of adherence to treatment of risk factors. Key words: Hypertension, Intracerebral and Hemorrhage


Article
Epidemiological Aspect of Stroke Cases in Al- Ramadi City
دراسة الاتجاهات الوبائية للطارئة الوعائية الدماغية في مدينة الرمادي

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Abstract

Objectives: To study the subtypes of stroke, prevalence among age groups, sex, and the effect of some risk factors. Patients and methods: 182 Stroke cases admitted to Al-Ramadi General Hospital during the period from November 2001 to August 2002 were studied. Clinical diagnosis of stroke was documented by spiral computerized tomography of the skull. Risk factors analysis was made based on history, clinical examination and laboratory investigations. Results: The study showed that peak of stroke cases was in the sixth and seventh decades of the life with a mean age of 62.77± 12.7 and the incidence in males was 55.5% (101) while in females was 44.5% (81). The frequency of stroke subtype was 71.6% (130) of infraction type and 28.4% of hemorrhagic type. Risk factors were found in 83.6% of cases and hypertension was the most common risk factor and the least one was previous history of transient ischemic attack. These results were nearly similar to other studies in Iraq. Conclusions: Stroke is a common medical problem Al-Ramadi city. Majority of patients were having risks factors and the most common were hypertension cardiovascular disease, and diabetes mellitus

الهدف: دارسة أنواع الطارئة الوعائية الدماغية وتوزيعها من حيث العمر والجنس، وتأثير عوامل الخطورة عليها.الطرق: تمت دراسة (182) مريضا مصابين بطارئة وعائية دماغية أدخلوا إلى ردهة الأمراض الباطنية في مستشفى الرمادي العام خلال الفترة من شهر تشرين الثاني 2001 ولغاية شهر تموز 2002 تمت عملية التشخيص سريريا وتم توثيقها بأشعة المفراس الحلزوني للدماغ وتحليل عوامل الخطورة التي يتم التأكد منها سريريا ومختبريا.النتائج: تبين ان معظم الحالات حديث في العقدين السادس من العمر، وكان معدل عمر المرضى 62077 وان 7106% من الحالات كانت من نوع الجلطة التخثرية، و 2804% كانت طارئة وعائية نزفية داخل الدماغ، ووجدنا ايضا ان عوامل الخطورة في 873-6% من المرضى، ووجد ان ارتفاع ضغط الدم هو اكثر العوامل انتشارا وان اقلها هو وجود نوبة طارئة وقتية سابقة. ان نتائج هذه الدراسة كانت مقاربة لنتائج الدراسات الاخرى في العراق.الاستنتاج: ان الطارئة الوعائية الدماغية تنتشر في مدينة الرمادي وانها تصيب متوسطي العمر والكبار ان غالبية المرضى يحملون عوامل الخطورة وهذه العوامل تحتاج الى المتابعة والعلاج لتقليل الاصابة بالمرض


Article
Performance of computed tomography indiagnosis and evaluation oftraumatic intracerebral hemorrhage

Author: Haider Q. Hamood حيدر حمود
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 2 Pages: 156-159
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:The intracerebral hemorrhage (ICH) can be classified as traumatic and spontaneous. The frontal and temporal lobes are classic sites for traumatic ICH, which are less commonly affected by spontaneous episodes. Computed tomography (CT) scanning is the most accurate radiological method for demonstrating the acute lesion of intracerebral hemorrhage (ICH). Both types are of high density, but traumatic bleeding is more frequently multifocal, in this study we are dealing with traumatic type of intracerebralhematoma. Aim of the study is to identify the accuracy and performance of CT scan in diagnosis and evaluation of intracerebralhemorrhage.
Patients and methods: 60 patients were examined, their agesrange from 30-70 years with means age 48 years old, they were 36males (60%), and 24females (40%).
Results: Our study reveals, the male patients (36 patients) were more affected than femalepatients (24 patients). Most affected age group in our study was 60-70 years old, 18 patients (30%) with no gender difference. Acute ICH was more than other ICH types, patients with acute ICH were 24 patients (40%) 15 male patients and 9 female patients, patients with subacute ICH were 20 patients (33%) and patients with chronic ICH were 16 patients (27%). In our study, the RTA was the most causative mechanism of ICH, 27 patients with RTA were seen in our study (45%), followed by shell injury which were 24 patients (40%) and then the fall from hight (FFH)which were 9 patients (15%). The most common CT feature noted in our study is the brain edema and it is seen in 27 patients (45%). Basal ganglia were most affected brain region (45%) of cases.
Conclusion:CT is available,rapid imaging modality in the diagnosis of ICH, so it is suitable for diagnosis and evaluation of ICH as emergency cases in casualty department and it is valuable in evaluation of traumatic I.C.H. especially in acute stages.


Article
The effect of pre-operative intravenous Cyklokapron on the amount of blood loss during and after caesarean section for anemic patients At Al Yarmouk teaching hospital in Baghdad.

Authors: Hind Abdul Khaliq --- Ban Hadi Hameed
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 3 Pages: 23-27
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Back ground: caesarean section carries significant morbidity and mortality over vaginal delivery. Anemia with hemorrhagic complications add significantly for this morbidity and mortality. Aim of the study: to assess the effectiveness of Cyklokapron in reducing the intra-operative blood loss at time of caesarean section and postpartum hemorrhage in anemic patients and to evaluate its safety when used prophylactically. Patients and method: A hundred pregnant women aged 19 - 41 years with term gestation were recruited in this randomized, case control, prospective therapeutic trial, which was conducted for a period of one year at Al Yarmouk teaching hospital Baghdad Iraq, the participants were admitted for caesarean section. They were divided randomly into two groups; the study group 50 patients received intravenous Cyklokapron pre-operatively and a control group matched for the indication of caesarean section, the intra-operative, post-operative blood loss and hematocrit were evaluated and compared for both groups. Results: The intra-operative blood loss was measured in both groups, the total loss was significantly lower in the study group (170.12 ± 68.4 ml) compared to the control group (420.39 ± 130.6 ml) as P value was 0.0001 Concerning the post-operative blood loss, it was comparable in both groups and blood transfusion was required for two patients in the control group because of severe anemia (hemoglobin less than 8 gmdl) with no transfusion in the study group and this difference was not significant statistically. The mean reduction in hematocrit was significantly lower in the study group compared to control group (1.52 ± 0.81%) versus (2.58±0.85%) respectively and P value was less than 0.05 Conclusion and recommendations: The current study revealed that Cyklokapron is significantly effective in reducing blood loss at time of caesarean section. We recommend further studies with higher doses and more patients to evaluate its effect in reducing the intra-operative loss and preventing postpartum hemorrhage.


Article
The Potential Effect of Lipid Profile on Deep Seated Versus Lobar Intracerebral Hemorrhage

Author: Saif M. Tawfeeq*, Hasan Azeez Al-Hamadani**, Munther Taher Hamzah***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 1 Pages: 57-63
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Brain hemorrhage is defined as the extravasation of blood from the vascular bed into the intracranial space, resulting in clinical dysfunction of nervous system. Intracerebral hemorrhage is a heterogeneous disease with deep and lobar subtypes. The amount of serum lipid may also affect the integrity of blood vessel wall and abnormal lipid profile may consider as a risk factor for intracerebral hemorrhage.OBJECTIVE: The present study was designed to evaluate the relationship between serum lipids and the site of intracerebral hemorrhage.METHOD: A cross-sectional study for 100 patients (50 with deep seated, 50 with lobar intracerebral hemorrhage) from Al-Kadhymia teaching hospital and Bagdad Teaching Hospital between August 2012 and June 2014. Case subjects included those patients from 20 to 89 years of age experiencing ICH within first 48 hours of presentation. Total cholesterol (TC), High-density lipoprotein (HDL) cholesterol, Low-density lipoprotein (LDL) cholesterol and Triglycerides (TG) serum level, was compared in deep seated and lobar intracerebral hemorrhage.RESULTS: There was significant relationship between high HDL level in deep seated compared to lobar hemorrhage, while there was no statistical significant relationship between the site of hemorrhage by TC, LDL and TG levelCONCLUSION: High HDL level is a risk factor for deep seated rather for lobar intracerebral hemorrhage.TC, TG, LDL have no effect on the site of hemorrhage.


Article
Illustrated Correlation of Brain C.T. Scan Findings in Clinical Assessment of Spontaneous Intracerebral Haematoma in Patients with Positive Risk Factors

Author: Yasir Mohammed Hasan Hamandi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 4 Pages: 270-275
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Spontaneous intracerebral hemorrhage (SICH) is defined as non-traumatic bleeding into the parenchyma of the brain that may extend into the . head computed tomography scan is the standard diagnostic toolOBJECTIVE: Find out the most important risk factor for SICH.and Illustrate the correlation between the sites of hemorrhage detected by CT scan images and patients presentations. PATIENTS AND METHODS:A prospective study between May 2010 and May 2012; this study was done in the CT unit in AL- Imamain Kadhimmain medical city, Baghdad, The study included 224 consecutive patients with the diagnosis of primary SICH.All the patients had primary spontaneous intracerebral hemorrhage clinically diagnosed plus CT findings that showed evidence of intra-cerebral hemorrhage. Statistical analysis was done using SPSS 15.RESULTS:This study included 224 patients, 128males and 96 females. Forty two patients lie in the age group of 50-59 years, 66 between 60-69 years, 48 between 70-79 years, 52 patients are seventy years old and older and only 16 are below fifty years of age. Regarding the site of bleeding 160 patients (71.4%) had bleeding in deep seated areas of the brain and 64 patients (28.6%) had bleeding in a superficial location. Regarding the deep seated hemorrhage basal ganglia was in 96 (42.8%) of the patients, followed by Thalamus in 48 (21.4%), and cerebellum in 16 (7.2%) of the patients. In the superficial sites of hemorrhage parietal lobe was in 40 patients (17.8%), then parieto-occipital hemorrhage was in 16 (7.2%) patients and 8 patients (3.6%) had temporal lobe hemorrhage. Hypertension was the most common risk factors, found in 75% of patients, followed by antigcoagulant use in 57.2% of patients. A history of diabetes mellitus was positive in 39.3% of the patients, 39.3% of them were smokers, and 25% patients had no history of any risk factors. A statistically significant difference between deep & superficial bleeding is seen in correlation with hypertension and smoking (P value is 0.00001 and 0.002 respectively) The focal neurological signs, found in 66 patients, facial palsy in 48 patients, loss of consciousness in 40 patients, 32 patients had both focal neurological signs and loss of consciousness as a presentation, 22 of them presented with speech difficulty, 8patients presented with ataxia and 8 with dementia. Significant relationship was found between the site of hemorrhage and patients’ presentation (P value 0.001). 120patients had intra-ventricular extension of hemorrhage in their CT films, 120 patients had pressure effect of the hemorrhage, and 104 were complicated by edema.CONCLUSION:Males are more affected than females by spontaneous intra-cerebral hemorrhage which tends to occur more commonly in a deep seated area of the brain.Hypertension is the most important risk factor. There is great correlation between patients’ presentations and the site of hemorrhage. Patients 50 years and older are more liable for spontaneous intra-cerebral hemorrhage..


Article
Pregnancy outcome in women with subchorionic haemorrhage detected in first and second trimester of pregnancy
نتائج الحمل في النساء المصابات بنزيف تحت الغشاء المخاطي في الثلث الأول والثاني من الحمل

Authors: Parween Omer Hassen --- Samira S. Shekh Mohammed --- Parez Retha
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 2 Pages: 1035-1040
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Subchorionic hemorrhage is the most common sonographic abnormalities and the most common cause of first trimester miscarriage and mainly associated with vaginal bleeding. The present study was conducted with an aim to find out the effect of subchorionic hemorrhage in first and second trimester of pregnancy outcome.Methods: A case cohort prospective study was designed to investigate 100 patients having a subchorionic hematoma in the presence of singleton live embryo or fetus. The study assessed the association of the volume size of subchorionic hematoma, maternal age and gestational age at time of the diagnosis with adverse pregnancy outcomes.Results: The incidence of miscarriage and preterm delivery was 35% and 21% respectively. The mean (±SD) age of those who aborted was 29.97 ± 7.0 years, slightly higher than the mean age of those who ended with preterm delivery (27.7 ± 5.87 years) and those continued with their pregnancies to viability (28.3 ± 6.2 years). There was a statistically significant association between previous histories of preterm delivery and pregnancy outcome (P =0.015). Miscarriage was significantly high among women with gestational age <12 weeks, while term pregnancy was significantly high among women with gestational age >13 weeks (P <0.001). The estimated volume of the hematoma did not correlate with the outcome of the pregnancy, perhaps it is the presence or absence of a hematoma as a marker of the integrity of placentation and not its size.Conclusion: Subchorionic hematoma in first and second trimester of pregnancy associated with adverse pregnancy outcome (spontaneous miscarriage and preterm delivery.


Article
Comparison of Oral Misoprostol with Conventional Uterotonics in the Management of Third Stage of Labor

Authors: Hameedah Hadi --- Zahida A. Al- Saadi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4103-4110
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Randomized prospective control study it is objective to compare effect of oral misoprostol with conventional uterotonics in the management of the third stage of labor.Aim of study: The incidence of Hemorrhage and the decrease in hemoglobin concentration is the main out comes of the trial. Secondary outcomes included the occurrences of sever postpartum hemorrhage.Patient and method: This study was done in Department of obstetrics and gynecology at Baghdad Teaching Hospital. In controlled trials a pregnant women total number 280 were randomized into four groups, as followed: Group I: received oral misoprostol 400 Mg, followed by two doses of oral misoprostol 100 Mg 4hours a part. (n=72), group 2: received intravenous infusion of oxytocin10 IU plus oral misoprostol 400 Mg followed by two doses of 100Mg oral misoprostol 4 hours apart group 3: received intravenous infusion of oxytocin 10 IU. (n=69), group 4: received intravenous infusion of 10 IU oxytocin plus intramuscular administration of methylergometrine (methergine) 0.2 mg. (n=77). The data of 40 women were excluded from the study because of loss to follow up, previous cesarean deliveries performed after randomization n=25, pre delivery hemoglobin was unavailable n= 10, postpartum percentage of hematocrit unavailable n=5. Main measures, the incidences of postpartum hemorrhage and the changes in hematocrit concentration from before delivery to 24 hours postpartum, in those women used oral misoprostol in management of third stage of labor with or without the use of other uterotonicsResult: Shows, Mean blood loss in misoprostol group was not significantly higher than blood loss in oxytocin group and oxytocin misoprostol group, but there was statistically significant difference when compared with oxytocin-methylergometrine group.Conclusion: Oral administrated misoprostol is as effective as conventional oxytocic in prevention of postpartum hemorrhage


Article
Extraction and Evaluation the Activity of Urtica dioica as Bleeding Stop Material

Author: Hashim M. Zehraw , Zynab Muotaz , Muamer Taleb , Bydaa Mukhlif , Saad Abed Al-Jabbar
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2019 Volume: 18 Issue: 2 Pages: 77-87
Publisher: Baghdad University جامعة بغداد

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Abstract

Urtica dioica From the medicinal herbs group, with many uses, the extract of the plant was prepared in order to study effect on the process of stopping hemorrhage of various pathological causes, collection of plants in the pre-blooming phase of the Jadiriyah area, Baghdad, Iraq. Prepare a sample of it by way of alcohol extraction for all parts of the plant. The substances and active groups were identified using chemical analysis. The results showed the presence of the necessary phytol in the blood clotting process as well as the glycosides, tannins, proteins, flavonoids and others. Some antioxidant, anti-inflammatory and anticancer compounds were found using gas chromatography technique. High-performance liquid chromatography was used as the important morphine was identified in the manufacture of a number of vitamins. The trace sample showed a high concentration of sodium and iron and a low concentration of zinc. The tested sample passed the toxicity test carried out on laboratory animals and proved its non toxic in the doses used. The results of the treatment of blood hemorrhage in mice found that the plant extract had an effect on reducing the duration of bleeding cessation to 1.14 seconds compared to the non-treated group (3.21) seconds, about 60% less, the hemoglobin level in rabbits was reduced to a significant level (P <0.01) to 13.2 g / dl compared with the control (14.5) g / dl and decreased packed cell volume (PCV) to 41 ml compared to 46 ml with control. It is noted that the number of white blood cells decreased with a significant value (P <0.01) to 5900 × 10 3 μl compared with control 8200 × 10 3 μl and found a decrease (P <0.01) at the time of bleeding by 50% after treatment with the extract and reduced the coagulation time by one third and with a significant value P <0.01).

Keywords

Urtica dioica --- Hemorrhage --- phytol --- Morin.


Article
The prevalence of Von-¬¬¬Willebrand disease in menorrhagia and post partum hemorrhage
تقييم أنتشار مرض فون ويلبراند في النساء ذوات الحيض الشديد والنساء المصابات بالنزف ما بعد الولادة

Author: Ali Mohamed Murad د.علي محمد مراد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 1 Pages: 24-29
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Objective: To estimate the prevalence of Von-Willebrand disease in women with menorrhagia and post partum hemorrhage. Patients & method: It is a cross sectional study done in the department of obstetrics and gynecology in Al Yarmouk teaching hospital from 1st of October 2004 to 30th of October 2005.Ninety nine women participated in this study. Thirty nine women with menorrhagia,30 women with post partum hemorrhage and 30 women as control. Blood sample from each case was drawn for von Willebrand factor antigen (vWf-Ag), factor 8(fvIIIc), prothrombin time (P.T.), activated partial thromboplastine time (APTT),bleeding time, C.B.P, renal function test and liver function test. Laboratory results for menorrhagia and post partum hemorrhage patients were compared with those of control group to estimate the prevalence of von Willebrand disease.Results: Von-Willebrand disease was found in five(12.8%), four (13.3%)and zero(0.0%)from women with menorrhagia, post partum hemorrhage and control groups respectively.Conclusion: The measurement of the laboratory investigations for Von- Willebrand factor should be incorporated into the diagnostic evaluation of patients referred to gynecological clinic with menorrhagia or post partum hemorrhage of certain criteria, otherwise; it may lead to hemorrhagic complications associated with surgical intervention in patients with Von- Willebrand disease.Key wards: Von-Willebrand disease, menorrhagia, post partum hemorrhage.

الملخص:الخلفية:دراسة مستقبلية اجريت في قسم النسائية والتوليد في مستشفى اليرموك التعليمي من الاول من تشرين الأول 2004 ولغاية الثلاثين من شهر تشرين الأول 2005. الهدف: هو تقييم نسبة مرض فون ويلبراند في النساء المصابات بالحيض الشديد والمصابات بالنزف ما بعد الولادة .طريقة العمل : تتضمن الدراسة(99) مريضة . (39) مريضة مصابة بالحيض الشديد و (30) مريضة مصابة بالنزف ما بعد الولادة و(30)حالة اعتيادية لا تعاني من الحيض الشديد او النزف ما بعد الولادة وارسل نموذج من الدم لكل حالة لاجراء الفحوصات لنسبة عامل فون ويلبراند المستضد ونسبة عامل الثمانية المستضد ، وقت النزف ، دراسة التخثر وفحص الدم الكامل وفحص وظائف الكلى والكبد . وقد قارنت نتائج المختبر للمرضى المصابات بالحيض الشديد والمرضى المصابات بالنزف مابعد الولادة مع الحالة الاعتيادية لمعرفة نسبة مرض فون ويلبراند.الاستنتاج:اثبتت الدراسة ان نسبة 12.8% من النساء المصابات بالحيض الشديد ونسبة 13.3%من النساء اللواتي يعانين من نزف بعد الولادة مصابات بمرض فون ويلبراند .نستنتج من هذه الدراسة ان اجراء التحاليل المختبرية يجب ان يشمل قياس عامل مرض فون ويلبراند للمرضى المحالين الى قسم النسائية المصابات بنزف الحيض الشديد والمرضى المصابات بنزف ما بعد الولادة للتاكد من وجود مرض فون ويلبراند والذي يجنبها اجراء تداخلات جراحية غير لازمة .

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