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Article
Isolated renal hydatid disease (heterogeneous presentations )

Author: Abdul-ghafoor S. Abdul-Kareem عبد الغفور سليمان عبد الكريم
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2008 Volume: 34 Issue: 1 Pages: 21-27
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: To demonstrate that isolated renal hydatid cysts have heterogeneous presentations.
Methods: a retrospective case series study during the period from Jan 2002 to Jan 2007 in the urosurgical department at Al-Jamhory teaching hospital. Five patients with different preoperative diagnoses were dealt with. After their initial clinical assessment and investigating their pathology by lab and imaging studies including IVU and MRI, provisional diagnoses were put and they were explored through lumbar approach and the pathology dealt with accordingly.
Results: there were three females and two males with six isolated renal hydatid cysts; mean age 28.8 years. Five cysts involving the left kidney. Their initial diagnoses were pyonephrosis, renal tumor, paracolic abscess, uremia due to large bilateral renal cysts and lower moiety hydronephrosis in a duplicated system. The preoperative diagnosis of renal hydatid was certain in two patients (40%) after cyst aspiration and hydatidiuria; the other three cases were diagnosed intraoperatively, and all cases proved by histopathology. Passing daughter cysts with the stool in a left side renal pathology may help in the diagnosis of a complicated renal hydatid cyst.
Conclusion: isolated renal hydatid is a rare disease, has heterogeneous presentations, and preoperative diagnosis may not exceeds 50%, so it needs to be kept in mind in the differential diagnosis of renal space occupying lesion.

اهداف البحث: اكياس العدارية لها تمثيل سريري متغاير.التصميم: دراسة سلسلة من الحالات.موقع الدراسة: دراسة مستعادة في قسم البولية بمستشفى الجمهوري التعليمي خلال الفترة من كانون الثاني 2002 الى كانون الثاني 2007.المشاركون: خمسة مرضى مصابون بأعراض امراض مختلفة في الكلى تم التعامل معها، وبعد الفحوص المختبرية والتصويرية المتمثلة باشعة الكلية المدعمة بالصبغة الوريدية والمغنام وتثبيت التشخيص الاولي تم استكشاف الكلية عن طريق المنطقة القطنية للتعامل مع الحالة.النتائج: خمسة مرضى (3 اناث و2 ذكور) وستة اكياس عدارية تم التعامل معها (معدل العمر 28.8 سنة). خمسة اكياس في الكلية اليسرى وواحدة في اليمنى. التشخيص الاولي للحالات كان تقيح الكلية، ورم الكلية، الفشل الكلوي بسبب ضغط الاكياس، استسقاء الجزء السفلي للكلية وخراج حول القولون. تم تشخيص الاكياس العدارية قبل اجراء العملية لمريضين (40%) بعد بزل احد الاكياس والاخر بعد بيلة عدارية، وتم تشخيص بقية المرضى اثناء العملية. تم دعم التشخيص بالفحص النسيجي للمرضى. ظهور الاكياس العدارية مع الغائط بوجود كتلة معقدة في الكلية اليسرى قد يساعد على تشخيص الاكياس العدارية في الكلية.الاستنتاجات: ندرة حدوث اكياس العدارية في الكلية بصورة منفردة مع تغاير تمثيلها السريري، كما ان التشخيص النهائي قد لا يتعدى 50% من الحالات قبل اجراء العملية الجراحية . الاكياس العدارية في الكلى يجب ان تضمن كأحد التشخيصات التفريقية الاولية للكتل المرضية في الكلى.

Keywords

hydatid --- Renal


Article
Acute renal failure in children under two years of age

Author: Nariman Fahmi Ahmed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2008 Volume: 50 Issue: 2 Pages: 139-144
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:
Background: Acute renal failure (ARF) in children is a catastrophic, life -threatening
event
Aim of the study: the aim of the present study is to find out the etiology and outcome
of patients with acute renal failure below two years of age admitted to the hospital.
Patients and methods: A prospective study was carried out on children below 2
years of age (with exclusion of neonatal period) presented with acute renal shut down
admitted to Children Welfare Teaching Hospital during the period from Jan. 1st
,
2007tojan30th
,2008.
Results: the study group included 100 patients with acute renal failure, 69 males and
31 females with M/F ratio 2.2:1.Age range was between (2 months - 2 years).
Prerenal ARF was the commonest type seen in 67(67%) patients and hypovolemia
due to (gastrointestinal loss) was the prominent etiology it was found in 53(53%)
cases. ARF due to renal and post-renal causes found in 21(21%) and 12(12%) cases
respectively, six (6%) patients only presented with non-Oligouria.
Forty four patients (44%) required peritoneal dialysis, while(56)patients improved on
conservative management only and most of them (53 %) were the pre-renal group.
Ninety two (92%) patients had either complete or partial recovery of their renal
function, eight (8%) patients died from ARF.
Conclusion: prerenal ARF particularly hypovolemia secondary to gastrointestinal
loss was the most common causative group of ARF in our patients, with good
prognosis for the recovery of renal function in most patients. To evaluate and validate
markers of acute kidney injury more prospective clinical studies required.


Article
Results of Kidney Biopsies among Adult Iraqi Patients in a Single Center

Authors: Nawar S.Jameel نوار جميل --- Mohammad Abdul Mahdi محمد عبد المهدي --- Ali Jasim H. Al-Saedi علي جاسم الساعدي
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 1 Pages: 82-84
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/IraqMaterial and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).Results: Primary glomerulonephritis (GN) was seen in 102 of 120 patients (85%), focal segmental glomerulosclerosis, and membranous nephropathy were the most common histological diagnosis (33.3% and 21.5% respectively).Conclusion: The study further emphasize the need for national GN registry and long term follow up, to recognize the common pattern of GN, their natural history, the appropriate line of management, and to try to halt their progression to end stage renal disease (ESRD).Key Words: Iraq, Glomerulonephritis, Renal Biopsy.


Article
Lower Ureteral Obstruction and Leakage in the FirstMonth Following Renal Transplantation

Authors: Usama N Rifat --- Usama S Alnasiri --- Ausama Saadi Abdul muhsin
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 47-52
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Transplantation has revolutionized treatment of end- stage renal disease (ESRD) by proving more cost effective than hemodialysis, with a lower morbidity and improved quality of life.
Objective: To evaluate the development of these complications in the first month postoperatively and correlate their development to the type of donation whether related or unrelated.
Methods: Fifty (50) patients aged (15-62) years, with a mean age (34.46 ± 12.4 SD) years with (ESRD), who underwent renal transplantation from September 2000 to October 2002, were followed-up for one month postoperatively clinically and by assessment of renal function tests, sonographic and Doppler examinations. Ureteral obstruction was considered in those patients who had allograft dysfunction, ultrasonic evidence of peritransplant collection, moderate-severe dilatation of upper urinary tract of transplanted kidney and postoperative ipsilateral or bilateral leg edema. Ureteral leakage was considered in those patients who had persistent drainage of urine with or without allograft dysfunction. Two patients were excluded from the follow-up due to death in the first 24-hour postoperatively.
Results: Six (6) patients (12.5% of cases) developed ureteral obstruction due to peri-ureteral fluid collection. In five patients the collection decreased and upper urinary tract dilatation improved gradually, as shown by ultrasound, on watchful waiting. One patient had surgical evacuation of a large hematoma. Four (4) patients (8.3% of cases) developed ureteral leakage. The leakage stopped in one patient after keeping the urethral catheter for a longer period. Three patients had surgical exploration due to persistent urinary leakage. Redo implantation of allograft ureter was done in two cases.
Development of ureteral complications was compared with the type of donation (related or unrelated). The comparison was not statistically significant.
Conclusions: The development of ureteral complications in not related to the type of donation. Extravesical ureteral anastamosis with the use of a stent is less likely to be associated with postoperative ureteral complications.
Key words: Renal transplantation, Extravesical ureteroneocystostomy


Article
PREVALENCE OF URINARY TRACT INFECTIONS IN PATIENTS WITH RENAL STONES
مدى انتشار التهاب المجاري البوليه في المرضى المصابين بحصاة الكليه

Authors: Mohammed A. Kadir --- Majida N. Ibrahim --- Najeeba M. Salih
Journal: AL-TAQANI مجلة التقني ISSN: 1818653X Year: 2010 Volume: 23 Issue: 5 Pages: 128-134
Publisher: Foundation of technical education هيئة التعليم التقني

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Abstract

The study was carried out in Kirkuk province, on patients attending Kirkuk hospitals, and private clinics from the 15th December 2004 until the 1st July 2005. Urine and blood samples were collected from 152 persons including 102 patients with urinary tract stones (61 males, 41 females), and 50 control healthy subjects (30 males, 20 females). General urine examination was done, and the results showed that 74 of the patients group were suffering from urinary tract infection, 25 of them were on antibiotics, and urine culture was done for the remaining patients. The results of urine culture showed that Escherichia coli infection (10.8%) was the commonest among patients with urinary tract stones, followed by proteus species (5.4%), Acinetobacter spp, Klebsiella spp (2.7%) for each and Pseudomonas spp, Staphylococci saprophyticus, Enterococci faecalis (1.35%) respectively. Significant increase in prevalence of urinary tract stones was demonstrated at age group (21-30 year), the highest rate was among housewives and officials, and (41.18%) of them had familial history of urinary tract stones.

تم إجراء هذه الدراسة في مدينة كركوك للفترة من 15 شهر كانون الأول عام 2004 حتى الاول من شهر تموز عام 2005 للمرضى المراجعين للمستشفيات والعيادات الخاصة في مدينة كركوك0 شملت هذه الدراسة 152 شخصا, 102 منهم كانوا يعانون من حصيات المجاري البولية ( 61 ذكور, 41 إناث ), وخمسون أصحاء لغرض المقارنة (30 ذكور, 20 إناث ), ولقد تم جمع نماذج من الدم الوريدي والإدرار وتاريخ الحالة لكل واحد منهم0 تم إجراء فحص الإدرار العام لجميع نماذج الإدرار وقد بينت النتائج بان 74 مريضا كانوا يعانون من التهابات المجاري, 25 منهم كانوا في طور العلاج بالمضادات الحيوية0 تم إجراء زرع عينات الإدرار للمرضى الذين يعانون من التهابات المجاري البولية وكانت النتائج كالأتي: إن الاشيريشيا القولونية ( Escherichia coli ) كانت الأكثر شيوعا بين العوامل المرضية المسببة لالتهابات الجهاز البولي (10.18% ), Proteus spp (5.4 % ),Acinetobacter spp, Klebsiella spp (2.7 %) لكل منهما, و (1.35 % ) لكل من (Enterococci fecalis),(Staphylococci saprophyticus),(Pseudomonas spp). كما وأظهرت هذه الدراسة بأن النسبة الأعلى للإصابة بحصيات المجاري البولية كانت بين المجاميع العمرية ( 21-30 سنة), مع أعلى نسبة في ربات البيوت(33.34%) والموظفين (15.68%). كما تبين من الدراسة أن (41.18%) من المرضى كان لديهم تأريخ عائلي للإصابة بحصيات المجاري البولية.

Keywords

UTI --- Renal stone.


Article
Chronic Renal Failure in Children Admitted to Children Welfare Teaching Hospital

Author: Nariman Fahmi Ahmed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 1 Pages: 12-17
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Chroic renal failure (CRF) is a devastating medical, psychological, social and economic problem forpatients and their families.AIM OF THE STUDY:The aim of the present study was to determine the etiology, clinical presentations and highlighttreatment modalities used for patients with CRF admitted to children welfare teaching hospital.PATIENTS' AND METHODS:A Retrospective study of all children with CRF admitted to children welfare teaching hospital duringthe period from 1stof jan.2002 to 1st of jan.2007 were included in the study .CRF was defined ashaving glomerular filtration rate less than 80m1 /min/1.73m2.RESULTS:The study group included 50 patients with CRF below 17 years of age,29(58%) males and 21(42%)females. Male: female ratio 1.38:1Their age ranged between (1m -17 year).Twenty (40%) patients were above 10 years of age. In thisstudy the mean glomerularFiltration rate was (29.5 + 18.5m1 /min/1.73m2).Congenital abnormalities were the major cause of CRF, it was found in 18 patients (36%), followedby hereditary conditions in 14 (28%) patients and glomerular diseases in 13 (26%) patients.The most common presenting symptom was anemia. It was found in 16(32%) patients followed byhypertension in 12 patients (24%) and failure to thrive in 12(24%) patients.Twenty-one patients (42%) received peritoneal dialysis, four (8%) received hemodialysis. Renaltransplant was done to 3 patients (6%).CONCLUSION:Congenital abnormalities was to the most common cause of CRF in our patients. Establishing registrysystem that provide detailed information concerning the incidence, causes, and overall outcomes ofmild to severe renal functional impairment acquired during developmental age can clarify further thenatural history of the disease and the factors that influence its course.


Article
Renal Involvement in 25 Patients with Systemic Sclerosis

Authors: Nizar Abdulateef Jassim --- Ziad Shafeek Al-Rawi --- Ali Abdumajeed Diab --- Ali Nazar Mohammed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 1-6
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Renal involvement is considered a poor prognostic factor and not frequently a cause of death in patients with scleroderma. Renal involvement can be divided into scleroderma renal crisis and non-renal crisis abnormalities.OBJECTIVE:To evaluate the frequency of renal involvement in 25 Iraqi patients with systemic sclerosis (SSc).METHODS:Twenty five patients with SSc (21 female and 4 male) were included in a case-controlled study. All patients fulfilled the American College of Rheumatology criteria for SSc. All patients were of diffuse type. Other types of SSc were excluded. All patients underwent measurement of blood pressure and investigations had been done for them which included: hemoglobin (Hb), white blood cell (WBC) count, platelet count, erythrocyte sedimentation rate (ESR), blood urea (BU), serum creatinine (SCr), general urine examination (GUE), and rheumatoid factor (RF). Same investigations were done for 25 healthy person (considered as control group).RESULT:All patients (100%) had Raynaud’s phenomenon, 23 patients (29%) had dysphagia, 21 patients (84%) had arthralgia, 10 patients (40%) had telangiectasia and 2 patients (8%) had subcutaneous calcification. Three patients (12%) had moderate hypertension. Fourteen patients (56%) had anemia, 2 patients (8%) had leukocytosis, 6 patients (24%) had elevated ESR, 1 patient (4%) had elevated BU, 1 patient (4%) had albuminuria and 4 patients (16%) had positive RF. Platelet count and SCr were normal in all patients. Only 1 patient (4%) had renal involvement in form of combination of azotemia, albuminuria and hypertension.CONCLUSION:Renal involvement in systemic sclerosis among Iraqi patients is rare.

Keywords

renal --- iraqi --- systemic sclerosis.


Article
Laparoscopic Management of Symptomatic Renal Cysts

Author: Saad D. Farhan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 163-168
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Simple renal cysts are common, with incidence increasing with age. Symptomatic renal cysts have traditionally been initially treated by percutaneous aspiration with or without injection of sclerosant agents; however, this has a high rate of recurrence.Open surgical cyst decortication for pain relief through a flank or chevron incision is associated with considerable morbidity and protracted convalescence.OBJECTIVE:To assess the efficacy of laparoscopic Surgery in the treatment of symptomatic simple renal cysts. Renal cysts are common in the adult population.METHODS:From April 2007 to July2009 ,11patients (7 males and 4 females) underwent laparoscopic decortications of symptomatic simple renal cysts with renal cyst wall excision and fulguration of the epithelial lining. Complex renal cysts were excluded. The Wong-Baker pain scale was used to assess the preoperative and postoperative pain scores. Radiologic success was indicated as no recurrence on the most recent computed tomography scan.RESULTS:Of the 11 procedures were completed laparoscopically , the mean operative time was 100 minutes (range 80 to 120). Symptomatic and radiographic success was achieved in 90.9% of patients, with a median follow-up of 12 months (range 6 to 18).CONCLUSION:Long-term follow-up has confirmed that laparoscopic cyst decortication is an effective and durable treatment option for symptomatic simple renal cysts during long-term follow-up. The greater and durable success rates of this minimally invasive technique may favor this treatment option over other treatment modalities.


Article
Intraoperative Albumin Plus Crystalloid Solution Versus Crystalloid Alone in Renal Transplant Surgery

Author: Alaa Hussein Ali
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 526-530
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Chronic renal failure is defined as an irreversible deterioration in renal function which classicallydevelops over a period of months or years. renal transplantation is the treatment of choice for endstage renal failure and during surgery the maintenance and restoration of intravascular volume areessential tasks to achieve sufficient organ function in renal transplants.OBJECTIVE:To study the comparison between normal saline 0.9% with glucose 5 % and normal saline 0.9% ,glucose 5 % with albumin in renal transplantation.METHODS:The study data from 50 patients 47 patients underwent living donor kidney transplants three wereexcluded because they are diabetics .twenty three patients received normal saline 0.9% , glucosesaline 5%,and twenty four received normal saline 0.9 with glucose 5% and albumin 100 milliliter .RESULT:There was no statistical difference between the two groups in the primary measurement of outcomemeasure in the urine output in the 1st day and the serum creatinine in the 1stand 3rd day .CONCLUSION:Although statistically there was no difference in the two groups, it might be its useful to combine acolloid with a crystalloid in the fluid management regimen to improve microcirculation, oxygenperfusion and to ovoid large volumes of crystalloid.


Article
Intraoperative Albumin Plus Crystalloid Solution Versus Crystalloid Alone in Renal Transplant Surgery

Author: Alaa Hussein Ali
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 526-530
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Chronic renal failure is defined as an irreversible deterioration in renal function which classicallydevelops over a period of months or years. renal transplantation is the treatment of choice for endstage renal failure and during surgery the maintenance and restoration of intravascular volume areessential tasks to achieve sufficient organ function in renal transplants.OBJECTIVE:To study the comparison between normal saline 0.9% with glucose 5 % and normal saline 0.9% ,glucose 5 % with albumin in renal transplantation.METHODS:The study data from 50 patients 47 patients underwent living donor kidney transplants three wereexcluded because they are diabetics .twenty three patients received normal saline 0.9% , glucosesaline 5%,and twenty four received normal saline 0.9 with glucose 5% and albumin 100 milliliter .RESULT:There was no statistical difference between the two groups in the primary measurement of outcomemeasure in the urine output in the 1st day and the serum creatinine in the 1stand 3rd day .CONCLUSION:Although statistically there was no difference in the two groups, it might be its useful to combine acolloid with a crystalloid in the fluid management regimen to improve microcirculation, oxygenperfusion and to ovoid large volumes of crystalloid

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