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Article
Prevalence of clinically significant Hepatopulmonary Syndrome among Patients with Chronic Liver Disease and Portal Hypertension

Author: Sadiq Almohana صادق المحنا
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 1 Pages: 61-66
Publisher: Baghdad University جامعة بغداد

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Abstract

Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a decrease of ≥ 4% after change from supine to upright position) to detect hypoxia and ortheodeoxia.Result : Eleven of thirty patients (36.6%) with chronic liver disease and portal hypertension were found to have contrast echocardiographic evidence of intrapulmonary right-to-left shunting. Arterial oxygen desaturation was present in 3 patients (27.3%) of those with intra-pulmonary right-to-left shunting ,they were considered as clinically significant HPS ,the remaining 8 patients were considered as subclinical HPS. Dyspnoea was more often present in patients with clinically significant HPS (100%) compared with subclinical HPS (25%), and patients without HPS (9%). HPS correlated significantly with severity of liver disease according to the Child-Pugh score.Conclusion: hepatopulmonary syndrome is not uncommon , the prevalence of clinically significant hepatopulmonary syndrome (in this study) was 10% of patients with chronic liver disease and it correlated with disease severity according to the Child-Pugh score.


Article
Chronic Obstructive Pulmonary Disease: Impact Of Hypoxia

Author: Amjed Hassan Abbas
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1971-1979
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Chronic obstructive lung disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Many people suffer from this disease for years and die prematurely from it or its complications.Objective: This study was aimed to:1.Study and compare some demographic and physiological changes in hypoxic and non-hypoxic groups of patients with COPD. 2. Assessment of effect of smoking in both groups. 3. Correlate these findings with severity of the COPD.Patients and method: The study was performed in Merjan Teaching Hospital in Babylon Province in the period from November 2012 to October 2013, the study included one hundred eighty two (182) patients with history of COPD who were studied clinically and each patient was submitted for spirometry, pulse oximetry, chest x-ray and electrocardiography. According to the results of oximeter, patients were divided into two groups, hypoxic and non-hypoxic group, hypoxic group included 96 patients ( mean age was 57.14±11.24, 66% were males) while the non-hypoxic group included 86 patients (mean age was 54.42±12.75, 62% were males).Results & Discussion: Study showed that the mean pack years of tobacco use in hypoxic group was 42.83±47.95 pack years while in non-hypoxic group the mean duration was 24.91±32.84 and there was significant differences between groups (P=0.000),it also revealed that pack year was significantly correlated with the severity of obstruction in hypoxic group (P value= 0.000) in contrast to non-hypoxic group (P value= 0.2).The study also showed significant negative linear relation between degree of dyspnea (functional state) and oxygen saturation (SpO2) (r=-0.2, p=0.04) in reverse to non-hypoxic group (r=-0.11, p=0.3). Furthermore, the study clarified that most patients in both groups had normal ECG changes (73% in hypoxic group and 90% in non-hypoxic group) and the most common ECG finding in both groups was P pulmonale (11% in hypoxic group and 6% in non-hypoxic group).When linear regression analysis of the results of this study was considered, there was significant positive linear correlation between oxygen saturation (SpO2) and severity of obstruction in hypoxic group while non-significant linear correlation between SpO2 and severity of obstruction in non-hypoxic group.Conclusion: From the results of this study, we conclude that lung hypoxia has a relation with severity of obstruction, pack years, functional state and ECG changes. Females were more sensitive to the effects of smoking than males.

Keywords

COPD --- hypoxia --- pack year --- obstruction.


Article
nucleated red blood cells in cord blood of singleton term neonates and the risk factors affecting their count

Authors: ghada A.Salman --- RiyadhA. Hussain --- raja N.AL-Dahwi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 1 Pages: 73-77
Publisher: Baghdad University جامعة بغداد

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