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احداث الشريان التاجي بعد عام واحد من اعادة التوعية تجربة مركز واحدة == Coronary artery events one year after revascularization : a single center experience

اسم المؤلف: مروان كامل عبود
اسم المشرف: حسن يوسف النجار
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - القلب
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: associated with concerns about their potential adverse effects. In - stent restenosis and stent thrombosis definitely affect the PCI outcome. However, review of recent relevant studies suggests that stent - related problems may have been somewhat overestimated when compared to coronary artery disease (CAD) progression at non stented coronary segments as causative factors of adverse cardiac clinical events late post - PCI.Both stent - related problems and native CAD progression have to be equally addressed to optimize the PCI clinical benefitAim of the study : To study the major adverse cardiac events and one year outcome after PCI.Patients & Methods : This study is cross - sectional study of all patients who were referred to Iraqi Center for heart disease, for further evaluation of suspected coronary artery disease (CAD) for the period January to July 2018. The total number of patients was fifty (50).Results : The total No. of patients were 50, mean age was 59.1±11.3, (22%) were below age 45 and (78%) equal and above age 45 year.54% were male and (46%) were female. The frequency risk factors were DM (62%), HT (56%), Dyslipidemias (52%), Obesity (21%) and Smoking (21%). The most common clinical presentations were chronic stable angina (98%) of cases and one case (2%) acute coronary syndrome. The outcome of PCI after one year divided in to four groups, group A : patients with ISR (5/50) (10 %), group B : patients with new stenosis (8/50) (16 %),group C : patients combined lesions (16/50) (32%) and group D (21/50) (42%) cases were normal.Conclusion : After one year from PCI there was high frequency of recurrence of symptoms exceeding half of the patients, most of them due to development of new lesion.

اتجاه مرض التهاب السحايا للاطفال دون سن 51 عام في مستشفى حماية الطفل التعليمي ومستشفى الطفل المركزي التعليمي قبل وبعد ادخال اللقاح المستدمية النزلية نوع ب في البرنامج الوطني للقاح الاطفال من 2011 - الى 2014 == Trend of Meningitis in children below 15 years old in Welfare Teaching children Hospital and Central Children Teaching Hospital before and after introduction of Haemophillus influenza type b vaccine From 2011 To 2014

اسم المؤلف: ميس حسن جاسب
اسم المشرف: نادية عزيز ناصر
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: طب العائلة
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Meningitis is serious threat to children health (esp. bacterial) particularly in developing countries. Early diagnosis and management may prevent children from death and serious complication ObjectivesTo determine type of meningitis and characteristic and outcome in children below 15 years old in a period before and after introduction of Haemophillus influenza type b (2011 - 2012 - 2013 - 2013(.Method A retrospective cross sectional study of children below 15 years old diagnosed with acute meningitis who were admitted to welfare children teaching hospital and central children teaching hospital in Baghdad for year : 2011 - 2012 - 2013 - 2014. Statistical analysis done by using SPSS version 23.ResultIn 290 patients, The mean age of children with meningitis was 32.46 month (2.6year). Bacterial meningitis was 25.2%, probable meningitis was 26.6%, and viral meningitis was 45.2%. The most frequent type of bacteria in 73 patient was streptococcal Pneumonia 47.9% followed by Neisseria meningitis 24.7% followed by E coli 9.6% then haemophillus influenza 6.8%. There was significant statistical association between type of meningitis with residence area. Case fatality rate was 4.8%, case fatality rate from bacterial meningitis was 10.9%, case fatality from streptococcal pneumonia was 11.4% and from Neisseria meningitis was 22.2%.Conclusion and recommendation Meningitis is more frequent in age below one year. Streptococcal pneumonia was the most frequent bacterial pathogen. The study recommend more study about misuse antibiotic.

تقييم وظائف البطين الايمن لمرضى العيب الاذيني للقلب قبل وبعد القسطرة العلاجية بواسطة تتبع ضربات القلب == Evaluation of RV functions in ASD patients pre & post transcatheter occlusion by speckle tracking

اسم المؤلف: فينوس عبد الواحد علوان
اسم المشرف: علاء عبد الحسين الانباري
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - القلب
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الكلمات الدلالية:
  • Atrial septal defect
  • Speckle tracking defect
  • Right ventricular function
الصفحات الاولى:
المستخلص: Background : The atrial septal defect is a common congenital heart disease. Speckle tracking echocardiography is non - invasive diagnostic technique used in assessment of myocardial function. Aim of study : To evaluate the feasibility and reproducibility of right ventricular 2D Strain assessed by speckle tracking in patients undergoing atrial septal defect transcatheter occlusion compared with conventional markers before and after transcatheter occlusion.Patients and methods : A prospective follow up study conducted in Ibn AL - Bitar Specialized Center for Cardiac Surgery in Baghdad during the period from 1st of July, 2017 to 30th of June, 2018 on sample of 30 patients with atrial septal defect and sample of 30 healthy controls. All patients were investigated with echocardiography and speckle tracking one month before transcatheter occlusion and one month after the transcatheter occlusion.Results : Post transcatheter occlusion, there was a significant decrease in mean right ventricular end diastolic dimension (p<0.001) and a significant decrease in mean of tricuspid annular plain systolic excursion (p<0.001). There was a significant increase in global strain speckle tracking echocardiography mean post transcatheter occlusion (p<0.001). The global strain speckle tracking echocardiography mean was significantly higher among controls and atrial septal defect patients in post occlusion while lower among patients in pre - occlusion (p<0.001) with no significant difference in global strain mean between controls and patients in post occlusion (p=0.1). Conclusions : The speckle tracking echocardiography is a valuable diagnostic technique for evaluation of right ventricular function before and after transcatheter occlusion of atrial septal defect in adults

دراسة مقارنة للجرعة الاشعاعية القلبية بانواع مختلفة من العمليات الجراحية لمرضى سرطان الثدي في مركز بغداد للعلاج الشعاعي == Comparative study of cardiac radiation dose with different types of surgery in breast cancer patients in Baghdad radiotherapy center

اسم المؤلف: سجاد عباس خير الله
اسم المشرف: خضير جاسم صبيح الرواق
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة العلاجية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Radiotherapy has been shown to decreases breast cancer recurrence as well as reduce in breast cancer mortality. The dose of radiation is important to be calculated accurately for both the site to be treated and for the organs to be protected such as the heart as it has major impact on morbidity and mortality on patients if received high dose of radiotherapy.Aim of study : To compare the mean heart dose of radiation in breast cancer patients between breast conserving surgery VS mastectomy, between different radiotherapy doses and fractionation schedules and between right and left breast cancer irradiation.Patients & Methods : This is a cross - sectional descriptive retrospective comparative study that was conducted in Baghdad Radiotherapy Center from January 2018 to June 2018 , carried on 174 breast cancer patients of different age groups selected randomly and their mean heart dose data collected from their files and database in Baghdad Radiotherapy Center. Patients are divided into two groups : Breast conserving surgery and modified radical mastectomy .each group is further subdivided according to dose of radiotherapy and side of breast cancer.VResults : The overall average of the mean dose was 372 cGy (range from 76.4 to 716.2).The greatest difference in the mean heart dose was between (BCS) patients who received 5000 cGy with regional nodal irradiation and (BCS) patients who received 4005 cGy also with regional nodal irradiation ( difference in the mean is 639.8 , the P - value <0.001 ) .In regard to the side of breast cancer , the greatest difference in mean heart dose seen between left and right breast cancer patients who did the same type of surgery (MRM) and received the same dose of radiotherapy (4256 cGy) (difference in the mean is 565cGy and the P - value <0.001 ) .No statistically significant difference in the mean dose between breast conserving surgery and mastectomy was recorded.Conclusion : The mean heart dose of radiotherapy is significantly increased in left sided breast cancer irradiation as compared to the right side. A dose of 5000 cGy has the greatest effect on the dose received by the heart especially in left breast cancer. The type of surgery whether breast conserving surgery or mastectomy did not affect the mean dose received by the heart

مقارنة الجرعة التي تستلمها الرئة من الاشعاع المستخدم في علاج سرطان الثدي حسب اختلاف نوع العملية الجراحية المستخدمة في مرضى مركز بغداد للعلاج الشعاعي : دراسة وصفية == Comparative study of lung radiation dose with different types of surgery in breast cancer patients in Baghdad radiotherapy center descriptive study)

اسم المؤلف: يحيى علي دشر
اسم المشرف: خضير جاسم صبيح الرواق
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة العلاجية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Breast cancer is a complex , multifactorial disease that have different treatment approaches. Adjuvant radiation therapy is an important locoregional management , however it has many drawbacks and side effects on the adjacent organs including lung , heart and others .Objective : To compare the mean lung dose between breast conserving surgery and mastectomy, and their different radiation doses .Patients & Methods : This is a cross - sectional descriptive comparative study that was conducted in Baghdad Radiotherapy Center , carried on 174 patients, their ages range from 18 to 77 year old, all of them treated by mastectomy or breast conserving surgery, and radiotherapy offered for them with or without axillary irradiation.Results : The highest Mean Lung Dose seen in patients with Breast Conserving Surgery received 5000 cGy to chest and lymphatics (1483 cGy ± SD 133 ) followed by those with Modified Radical Mastectomy received 4005 cGy to chest wall and lymphatics (1285 cGy ± SD 138 ); there is a statistically significant difference (P = <0.001).Conclusions : The highest Mean Lung Dose seen in patients receiving higher radiotherapy dose regardless of type of surgery. There is Significant correlation between the mean lung dose and the lymphatic irradiation P - value > 0.001

انتشار نوبة الاكئاب العظمى عند النساء العراقيات المصابات بهشاشة العظم في فترة ما بعد انقطاع الطمث == Prevalence of Major Depressive Disorder Among Postmenopausal Iraqi women with Osteoporosis

اسم المؤلف: سرى قاسم عباس
اسم المشرف: نزار عبد اللطيف جاسم
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Osteoporosis is a reduction in bone mineral density thatincreases susceptibility to fractures. Major depressive disorder is one of themost prevalent psychiatric conditions characterized by depressive mood,anhedonia, and sleep abnormalities. They are chronic diseases that affectlarge population groups with great impact on morbidity, mortality andquality of life. In fact, little researches has focused on the relationshipbetween low BMD and depression.Objectives : The aim of this study was to evaluate the prevalence of majordepressive disorder among postmenopausal Iraqi women with osteoporosisand its association with osteoporotic vertebral fracture and other low traumafractures.Patients and methods : This cross sectional study involved 100 postmenopausalIraqi women with osteoporosis diagnosed according to WHOcriteria for classification of osteopenia and osteoporosis. Thoracolumbarspine x - ray (lateral view) were performed for all women and osteoporoticvertebral fracture assessed by using the semi - quantitative method. Allwomen were screened for major depressive disorder by using the DSM5diagnostic criteria of depression and severity of their depression wasassessed by using the Beck Depression Inventory scale .Results : the prevalence of major depressive disorder among postmenopausalIraqi women with osteoporosis was 18%. There is no statistically significantassociation between bone mineral density and major depressive disorder(p≥0.05), with statistically significant association (p=0.01) of majorVIIdepressive disorder with osteoporotic vertebral fracture in comparison toprevious history of other type of low trauma fractures or no fractures.Conclusions : The prevalence of major depressive disorder inpostmenopausal women with osteoporosis was 18% with statisticallysignificant association with osteoporotic vertebral fracture.

مدى تاثير العلاج الاشعاعي التلطيفي للدماغ في البقاء على قيد الحياة للمرضى الذين يعانون من ورم منتشر في الدماغ من مختلف انواع السرطانات == Impact of whole cranium Radiotherapy on Survival in Patients With Brain Metastasis of Different Cancers

اسم المؤلف: زينب علاء مكي الربيعي
اسم المشرف: خضير جاسم صبيح الرواق
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة العلاجية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Brain metastases are the most common intracranial brain tumor and a common complication of systemic cancer. The incidence ranges from 20% to 40% of all patients diagnosed with cancer ,The most common primary site is the lung followed by breast. Metastatic brain tumors outnumber primary brain tumors by a factor of 10 to 1 , The prognosis of brain metastases is poor and the impact on the patient’s quality of life is important as a result of the functional neurologic deficits associated. The mainstay of treatment for brain metastases has been corticosteroids and whole brain radiotherapy.Objective : the aim of the study to determined the impact of whole cranium irradiation (2000cGy) on median and mean survival of brain metastasis and to analyze prognostic factors affecting survival of patients receiving whole brain irradiation (WBI).Patients & Methods : This study retrospectively reviewed the records of 80 patients with BMs who were not eligible for surgical resection and who underwent WBRT in Baghdad oncology teaching hospital between 1stof July 2015 and 1st of January 2017. The patients enrolled in this study, About 47 Patients were diagnosed as primary breast cancer,20 patients as primary lung cancer and 13 patients from other site of body. All patients were treated with conventional external beam radiotherapy with atotal dose of 20 Gy in five fractions over 1 week for all patients.Results : Breast cancer represented the most common primary cancer type 47 patients (58.8%), followed by lung cancer 20 patients (25%) ,other types of primary represent 13 patients(16.3%), The median survival for the total population Who were receiving Whole cranium radiotherapy was 7 months and mean survival was 9.8 months,For breast cancer the median survival time was 8 months, for lung cancer patients was 6 months and for primary metastasis from other sites of body was 6 months, In general, the result is that patients with breast cancer had better survival than patients with other primary cancers. In regard of time to develop to brain metastasis ,median time for breast cancer, lung cancer and for other sites (22,5,12 months)respectively The breast cancer has the longest time before progress to brain metastasis, According to the stage of primary breast tumor, The highest frequency was seen among patients with T3A followed by T2B and T3B respectively, while the lowest frequency with T1B. Our study reported a strong correlation between the tumer stage and time to brain metastasis with significant P value = 0.033In regards of primary breast cancer metastasis ,The results showed that HER2 overexpressed were 19 patients (40.4%), Triple negative were 10 patients (21.3%) ,Luminal A - like were 9 patients (19.1%) and Luminal B - like were 9 patients (19.1%),. The highest frequency was seen among patients with HER2 overexpressed followed by triple negative.Our results showed a negative correlation between the molecular subtypes and time to develop of brain metastasis with P value = 0.482 which was statistically not significant

تقييم الكالسيوم في الدم في مرضى الدرن الرئوي النشط : دراسة مقدمة الى كلية الطب ولجنة الدراسات العليا لجامعة بغداد في جزء الاستيفاء لمتطلبات الحصول على درجة الدبلوم في طب الجهاز التنفسي == Assessment of serum calcium in active pulmonary Tuberculosis patients

اسم المؤلف: هدى مؤيد حميد
اسم المشرف: عدنان الجبوري
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الجهاز التنفسي
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: السل هو عدوى بكتيرية تسببها المتفطرة السلية ، وعادة ما تتميز هذه الامراض بتشكيل الاورام الحبيبية. الموقع الاكثر شيوعا للعدوى هو الرئة ، لكن الاجهزة الاخرى قد تكون متورطة. ينتشر عن طريق الهواء عند الاشخاص الذين يعانون من مرض السعال او العطس او البصاق. لا يزال مرض السل يمثل مشكلة صحية رئيسية في العالم ، حيث يتسبب في اعتلال الصحة بين ملايين الناس كل عام ، ويحتل المرتبة الثانية كسبب رئيسي للوفاة من جراء الامراض المعدية في جميع انحاء العالم.الهدف من الدراسة : تقييم مستوى الكالسيوم في الدم عند المرضى البالغين ومصابين بالسل الرئوي النشط.المرضى والطريقة : تم اجراء دراسة السيطره والضابطه في المركز المتخصص في امراض الصدر والجهاز التنفسي ، في الفترة من 1 كانون الاول / ديسمبر 2017 حتى نهاية ايار / مايو 2018. (80) تم تضمين المستجيبين في الدراسة الحالية وعددهم (80 شخصا) وتم تقسيمهم الى مجموعتين. : 40 مريضا مصابين بالسل ومجموعة اخرى تحتوي على 40 عنصر بصحه جيده كمجموعه ضابطه. تم تشخيص مرضى السل سابقا في المركز التنفسي والصدر.النتائج : كان نطاق السن بالنسبة لمجموعة السل من 17 - 59 سنة مع متوسط عمر 36.95 ± 12.6 سنة. تتراوح الفئة العمرية الرئيسية بين 30 - 39 عاما بينما تقل الفئة العمرية اقل من 20 عاما. حوالي 77.5 ٪ من مرضى السل كانوا في سن اقل من 50 سنة والبقية (22.5 ٪) في عمر اكبر من 50 سنة. الذكور كانت سائدة اكثر من الاناث حيث تمثل 22 (55٪) في مجموعة الحالات ، في الارضاء الى المجموعة الضابطة كانت المراة المهيمنة على الذكور (24٪) في المجموعات المدروسة ، فقد تراوح مستوى الكالسيوم في المصل بين (6.6 - 10.4مغ/مل). مع متوسط مستوى 8.99 ± 0.64 مغ / دل في المجموعة الضابطة ، تفاوت مستوى الكالسيوم في المصل من 8.2 الى 10.0 ملغم / ديسيلتر مع قراءة متوسطة قدرها 9.01 ± 0.43 ملغ / ديسيلتر. لم يكن هناك فرق معنوي في المستويات الوسطية بين مرضى السل ومجموعة المقارنة حسب هذه الدراسة الخلاصة : مستويات الكالسيوم في المصل تميل الى الهبوط في مرضى السل الرئوي النشط ولكن دون اختلافات احصائية كبيرة | Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis, usually characterized pathologically by the formation of granulomas. The most common site of infection is the lung, but other organs may be involved. It is spread through the air when people who have the disease cough, sneeze, or spit. Aim of the study : To assess the level of serum calcium in adult patients with active pulmonary tuberculosis.Patients and method : A case control study was carried out in respiratory and chest disease specialized center/medical city complex from the 1st of December 2017 to the end of May 2018. (80) Respondents were included in the current study and divided into 2 groups : 40 patients with pulmonary Tuberculosis and other group contain 40 healthy controls. TB patients were previously diagnosed in the Respiratory and chest center.Results : The range of age regarding to the Tuberculosis group were from 17 - 59 years old with the mean age of 36.95±12.6 years. The main age group is between 30 - 39 age group. Male were dominant than female in which it represents 22(55%) in the cases group. Serum calcium level in studied groups, it varied from (6.6 - 10.4 mg/dl) in Tuberculosis group with a mean level of 8.99±0.64 mg/dl. In control group, serum calcium level varied from 8.2 to 10.0 mg/dl with a mean reading of 9.01±0.43 mg/dl. There was no significant difference in mean levels between TB patients and comparison group according to this study (P > 0.05)Conclusion : Serum calcium levels tend to be lower in active pulmonary tuberculosis patients than normal (control) group but with no statistically significant differences

حياة مرضى سرطان الثدي العراقيات اللواتي عولجن بالعلاج الاشعاعي الثلاثي الابعاد الخالية من الانتكاسة المرضية في مركز بغداد للعلاج الاشعاعي في دائرة مدينة الطب == Progression Free Survival in Iraqi Breast Cancer patients treated by Adjuvant 3D Conformal Radiotherapy in Baghdad Radiation Oncology Center Medical City Complex

اسم المؤلف: ايناس خضير البدير
اسم المشرف: منور عبد الاله النقاش
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة العلاجية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الكلمات الدلالية:
  • Adjuvant 3D conformal radiotherapy
  • Breast cancer
  • Progression free survival
  • Luminal A subtype
  • HER2 neu receptors
الصفحات الاولى:
المستخلص: سرطانات النساء المسجلة وفقا لاخر احصائية مسجلة في العراق. العلاج الاشعاعي ذو فائدة من اجل السيطرة على سرطان الثدي الموضعي الراجع وايضا في الحفاظ على حياة النساء المصابات بسرطان الثدي المستقبلية بدون مضاعفات.اهداف البحث : هدفت الدراسة الى استخلاص PFS لمريضات سرطان الثدي اللاتي عولجن بواسطة العلاج الاشعاعي الثلاثي الابعاد ، ولمعرفة العلاقة التي تربط بين PFS مع الاعراض السريرية والمرضية .طرق البحث : استعرضنا باثر رجعي 299 حالة من النساء المصابات بسرطان الثدي اللواتي تم علاجهن في مركز بغداد لعلاج الاورام بالاشعاع في الفترة ما بين شهر اكتوبر 2017 وشهر ايار 2018. استخدمنا 4005 cGy في 15 جلسة على مدى 3 اسابيع كعلاج اشعاعي للمرضى اللاتي قمن باستئصال الثدي كاملة واستخدمنا 4005 cG في 15 جلسة مضافة اليها 1000cG في 5 جلسات كجرعة معززة للنساء اللاتي اجرين جراحة لازالة الورم فقط . النتائج : تراوحت اعمار المريضات في هذه الدراسة من 25 سنة الى 75 سنة مع متوسط اعمار 49.9 ± 10.99 سنة من النساء المصابات بسرطان الثدي. في المرحلة T ، وجدت انها تمثل المرحلة الاكثر شيوعا في دراستنا 156 (53.9٪) ، والتي كانت في معظمها نمطا A 105 (36.3٪) من المرضى. اظهرت نتائج هذه الدراسة ان نسبة عالية من N1 109 (37.2 %) من النساء عن جميع المراحل الاخرى وفيما يتعلق بالانواع الجزيئية لسرطان الثدي ، والتي تمثل Luminal A النمط الظاهري الرئيسي 69 (23.4 ٪). نتائج هامة تم الحصول عليها من معامل ارتباط بيرسون [(r) = 1] ، بين العمر ، ومؤشر كتلة الجسم ، ومراحل T عندما ترتبط بالانواع الجزيئية للمرض ، ER ومستقبلات HER2 neu في نساء سرطان الثدي. تم تطبيق منحنى البقاء على قيد الحياة (كابلان ميير (وتم تقدير PFS لمرضى سرطان الثدي وقد سجلنراجوع سرطان الثدي مرة اخرى في 35/299 حالة من المرضى في هذه الدراسة 11.7 ٪. في حين الرجوع الموضعي لسرطان الثدي في جدار الصدر حدثت في 9 (25.9 %) من الحالات. الاستنتاجات : ان العلاج الاشعاعي المساعد يقلل من الارتجاع الموضعي للمرض ، ويقلل ظهور الاورام الثانوية ، ويقلل معدل الوفيات وذلك من خلال التاثير في PFS . | Background : Breast cancer is one of the most common malignancies in Iraq, accounting one - third of female cancers in the latest Iraqi Cancer Registry. Radiotherapy of benefits for locoregional control and for progression free survival (PFS) of breast cancer.Objectives : The study aimed for asses progression free survival for patients treated by hypofractionated three dimensional conformal radiotherapy (3DCRT) and for correlation this progression with patients' clinical and pathological profiles. Methods : Retrospectively reviewed 299 females with breast cancer, treated at Baghdad Radiation Oncology Center and the study conducted in period between October 2017 and May 2018. 4005 cGy in 15 fractions over 3 weeks has been adopted as standard practice in radiotherapy for those done mastectomy and 4005 cG/15 fractions + 1000 cG/5 fractions as booster dose for women undergo breast conserving surgery (BCS). Results : Age in this study ranged from 25 years to 75 years with a mean (49.9±10.99 years) of breast cancer women. The most common stage was T2 156 (53.9%), which was mostly a luminal A phenotype as 105 (36.3%). The results showed high frequent of N1 staging 109 (37.2%) women overall other stages, with a luminal A 69 (23.4%). A significant results obtained from correlation coefficient [( r ) = 1], between age, BMI, and T stages when correlated to molecular subtypes, ER and HER2 neu receptors. Kaplan Meier survival curve performed and estimation of PFS. Relapsing of breast cancer occurred in 35/299 (11.7%). Chest wall relapse occurred in 9 (25.9%), which was the commonest pattern of relapsing. Conclusions : Adjuvant radiotherapy treatments reduce locoregional recurrence, distant metastasis and death rate by affecting progression free survival of patients.

انتشار كتلة العضلة غير الطبيعي لدى المرضى العراقيين المصابين بفصال الركبة وتاثيرها على نوعية الحياة == Prevalence of Abnormal Muscle Mass in Iraqi Patients With Knee Osteoarthritis and its Effect on Quality of Life

اسم المؤلف: رغد دريد يحيى
اسم المشرف: فائق ايشو كوريال
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Age - related osteoarthritis is characterized by degradation of articular cartilage and substantial loss of matrix, as a consequence of senescence; Intra - articular cell senescence and cartilage matrix degradation, extraarticular loss of skeletal muscle mass and deteriorated proprioception contribute to development of osteoarthritis. Age - related degenerative loss of skeletal muscle mass and strength is referred to as Sarcopenia, skeletal muscle mass is the metabolically active body component, however, fat massis metabolically inactive, so that the changes of skeletal muscle mass and fat mass with aging can be one of the most relevant biomarkers of senescence.Aim of the study This study was conduc ted to assess the prevalence of abnormal muscle mass (sarcopenia) in Iraqi patients with knee osteoarthritis and to evaluate the effect of sarcopenia on knee osteoarthritis patient's quality of life.Patients and methods This was a cross sectional study conducted at Baghdad Teaching Hospital, Unit of Rheumatology during the period from august 2017 to the end of June 2018, a total of 150 Iraqi females aged 50 years old and older with knee osteoarthritis. Plain X - rays of the weight bearing bilateral knee joints were obtained from the anterio - posterior and lateral aspects with 30º of knee flexion, quality of life and disease impact assessment was done by using Western Ontario and McMaster Universities Osteoarthritis Index, Physical activity measurement was done by using The leisure - time Physical Activity Index. Assessment of sarcopenia was done by using a dual energy x - ray absorptiometry scan for the body composition analysis, fat mass, lean mass, and bone mineral density. Diagnosis of sarcopenia was made via measuring skeletal mass index which defined as appendicular skeletal muscle mass /height m², cut off point ≤ 5.6 kg/m² for female and handgrip strength was measured using a Dynamometer, cut off point < 20 kg. Body mass index (BMI) was measured. History of sociodemographic and medications including steroid and NSAIDs were taken.Results : The current study revealed that 14 (9.3%) of Iraqi women with knee osteoarthritis had sarcopenia. BMI appear to significantly predict sarcopenia (negative correlation), since the OR less than 1.0, both T score and Z predict sarcopenia (negative correlation) and T score appear to predict sarcopenia better than Z score (since the OR is lower in T score compared to Z score), LM and FMI negatively correlated with sarcopenia, gripe strength negatively correlated with sarcopenia.Age, menopausal duration, and sarcopenia appear to directly correlate with osteoporosis, while BMI, LM, FMI, negatively correlated with osteoporosis. Patients with sarcopenia had 7 folds increase risk of having osteoporosis. There was no significant association between WOMAC scoring (quality of life indicator) and sarcopenia and osteoporosis in women with knee osteoarthritis.

سرطان الثدي لدى النساء العراقيات في العقد الخامس من العمر == Iraqi Female Breast Cancer In Their Fifth Decade (Retrospective Study

اسم المؤلف: ضحى محمد كاسب
اسم المشرف: منور عبد الاله النقاش
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة العلاجية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الكلمات الدلالية:
  • Iraqi breast cancer
  • molecular classification
  • Luminal A like
  • DFS
الصفحات الاولى:
المستخلص: the United States, breast cancer remains the most frequent cancer in women and the second most frequent cause of cancer death.Breast cancer incidence generally increases with age. Age of the patients is an important factor both for the occurrence and management of the disease Objective : The aim of this study to assess Iraqi female breast cancer patients’ clinical profile in their fifth decade, Evaluate patients’ molecular profile and 5years DFS.Patients and methods This is aretrospective study was conducted in Baghdad oncology teaching hospital fromJanuary12012 toDecember122016, carried on979breast cancer female patients 285patients of them ranging between(40to49)years with their histopathology reports and immunohistochemichal (IHC) results including ER, PgR, HER2/neu The patients in this study underwent surgical intervention either by a biopsy or mastectomy with axillary clearance, and the formalin - fixed paraffin - embedded tissue blocks were sent to the hospital’s laboratory for H&E and IHC.ResultsThe mean age 45 years, the highest incidence of breast cancer among patients in 5th (40 - 49 years) and 6th (50 - 59 years) decades of life(29% and 28%)respectively , while the lowest incidence in 80 years and more female. Regarding the stage ;stage II and III were the most common stages at diagnosis (40.8% and 39.5%) respectively ,while CIS is the lowest stage(3.1%).XIILuminal A like were 124 patients (58.5%), Luminal B like were 30 patients (14.2%), Triple negative were 29 patients (13.7%) and HER2 overexpressed were 29 patients (13.7%). The highest frequency was seen among patients with Luminal A like followed by Luminal B - like . Denovo metastatic patients occupy only 6.7% from all studied group. DFS was 48 months with (95% CI : 41.4 - 54.5 months).ConclusionsHighest prevelance of breast cancer was seen in 5thand 6th decades. Stage II breast cancer is the most common stage at diagnosis. Luminal A was the most common molecular subtype of the breast cancer patients in the studied group.Her2overexpressed and triple negative were the lowest with the same percentage. Most patient s in our study were overweight or obese.Median DFS was 48 months.

التاثيرات الصحية لداء الفقار المقسط على جودة الحياة والاداء الوظيفي للمرضى العراقيين == Health - Related Quality of Life and Work Outcome in Iraqi Patients with Ankylosing Spondylitis

اسم المؤلف: نورا صباح مهدي
اسم المشرف: نزار عبد اللطيف جاسم
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease, mainly affecting the axial skeleton, and less frequently the peripheral joints, entheses as well as other extra - articular organs such as the eyes, heart and lungs. AS has a considerable effect on the individual’s healthrelated quality of life. Work disabled patients with AS experience a significantly reduced quality of life.Objective : To evaluate health - related quality of life and factors influencing it in patients with Ankylosing Spondylitis, as well as, to assess work outcome and its correlation with quality of life in AS patients.Patients and Methods : A case - control study was conducted at the Rheumatology Unit in Baghdad Teaching Hospital during the period from August 2017 to March 2018. A total of 168 patients (151 male : 17 female) with Ankylosing Spondylitis were enrolled in the study, all of them fulfilled the modified New York criteria for Ankylosing Spondylitis, and Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axial spondyloarthropathy, and compared with 169 healthy controls (149 male : 20 female) matched for age and sex. Socio - demographic and clinical data of the patients and controls were collected. Health - related quality of life and work outcome were evaluated by the medical outcome survey short form - 36 (SF - 36) and work productivity and activity impairment - specific health problem (WPAI - SHP) scores respectively.Results : the mean age of the studied groups was 37.4 ± 9.4 years and 36.9 ± 9.5 years in Ankylosing Spondylitis and control groups, respectively. The median disease duration in AS patients was 11.3 ± 7.6. The quality of life in Ankylosing Spondylitis patients on all the scales of the short form 36 (SF - 36), was significantly worse than in the control group. Mental health quality of life was mostly affected than physical health overall. Role - physical was the most affected subscale of the short form - 36 (SF - 36). Male gender, smoking,fatigue, bath Ankylosing Spondylitis functional index (BASFI), treatment with biologics (anti - tumor necrosis factor) were significantly associated with the components of physical & mental health - related quality of life. Of 168 patients, 126 were employed (75%). Patients with Ankylosing Spondylitis reported work absenteeism loss, work productivity loss, overall work impairment, and daily activity impairment of 9.19%, 48.17%, 36.19%, 50.82% respectively. Work productivity and activity impairment - specific health problem (WPAI - SHP) summary scores were significantly correlated with all scores of quality of life (short form - 36).Conclusions : Ankylosing Spondylitis has negative impact on patients’ healthrelated quality of life, affecting both physical & mental health. Male gender, smoking, fatigue, poor functional status, treatment with biologics were the most associated factors with better or worse quality of life in patients with Ankylosing Spondylitis. AS has a significant effect on working conditions, quality of life has a direct relationship with a patient’s ability to work.

تقييم نوعية الحياة لدى المرضى العراقيين المصابين بمرض بهجت وعلاقتها مع فاعلية المرض == Quality of life assessment in Iraqi patients with Behçet’s disease and its relationship with disease activity

اسم المؤلف: میس عجیل جبار
اسم المشرف: فائق ايشو كوريال
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Behçet’s disease is a multisystem inflammatory disorder characterized by recurrent exacerbations affecting mucocutaneous tissues, eyes, blood vessels, and several other tissues. Among them, vascular and nervous system involvement are the most common causes of mortality in Behçet’s disease. The previous studies have shown that Quality of Life in patients with Behçet disease was negatively affected by the disease.Aim of the study : To evaluate Quality of Life in patients with Behçet’s disease compared with healthy controls, To assess the correlation of Quality of Life with organ involvements of Behçet’s disease and To assess the effect of demographic and clinical features of Behçet’s disease on Quality of Life. Patients and Methods : A case - control study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital in Medical City from July 2017 to January 2018 . A total of seventy - one consecutive patients (45 male : 26 female) were classified as Behçet’s disease by fulfilling the International Study Group criteria 1990 for Behçet’s disease and compared with seventy - one healthy controls (45 male : 26 female) matched for age and gender. After acquiring their consent, findings were gathered using a preconstructed data collection sheet for patients and controls that evaluate Age, gender, smoking status, disease duration, age at disease onset, Behçet’s disease organ involvements were reported. Disease activity was assessed using Behçet's disease current activity form and health - related quality - of - life was evaluated using The Short Form - 36 (SF - 36) .Results : All the components of Short Form - 36 (SF - 36) , it’s summary scores and Total Short Form - 36 (Total SF - 36) score was significantly lower ( p - value <0.001 ) in patients compared to control . Patients with eye involvement had significantly higher Physical functioning (p - value = 0.023), role - physical ( p - value <0.001), and bodily pain (p - value <0.010) subscores when compared to those without eye involvement. Patients with skin involvement did not show a significant impairment in all SF - 36 subscales when compared to those without skin involvement. Behçet's disease Patients with articular involvement, Physical functioning (p - value = 0.027), bodily pain (p - value <0.001), and general health (p - value = 0.018) subscores are significantly impaired when compared to those without articular involvement .Behçet’s disease patients with myalgia, Physical functioning (p - value = 0.001), bodily pain (p - value = 0.018), and vitality (p - value = 0.038) subscores are significantly impaired when compared to those without myalgia. patients with Central nervous system involvement, physical functioning (p - value = 0.006), rolephysical (p - value <0.001), bodily pain (p - value = 0.001) , general health (p - value = 0.001) and vitality (p - value = 0.042) subscores are significantly impaired when compared to those without Central nervous system involvement. There are certain demographic and treatment modalities had a significant positive impact on Total SF - 36 score : Male gender (p - value = 0.020) , use of cyclosporine (p - value = 0.043 ), use of infliximab (p - value = 0.001), and use of adalimumab (p - value = 0.001) . While others had a significant negative impact on Total SF - 36 score : Disease duration (pvalue = 0.019) , Behçet’s Disease Current Activity Form (BDCAF) (p - value = 0.043 ), and use of Mycophenolate mofetil (p - value = 0.043 ).

تقييم نسبة خلايا الدم المتعادلة الى الخلايا اللمفاوية وعرض توزيع الصفائح الدموية كعلامات التهابية في عينة من المرضى العراقيين المصابين بمتلازمة الالم الليفي العضلي == Evaluation of blood neutrophil - lymphocyte ratio and platelet distribution width as inflammatory markers in a sample of Iraqi patients with fibromyalgia

اسم المؤلف: فادية علي شعلان
اسم المشرف: زياد شفيق الراوي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Fibromyalgia syndrome is a diminished quality of life related to generalized body pain with physical and psychological symptoms that occurs in the absence of a clear pathologic cause. Neutrophil to lymphocyte ratio is a simple parameter to assess easily the inflammatory status of a subjects. Platelet distribution width is a regular parameter in blood routine examination which reflects variation of platelet size distribution. Mean platelet volume is a part of the complete blood count test and correlates with the platelets function and activation.Objective : To evaluate Neutrophil to lymphocyte ratio, Platelet distribution width and Mean platelet volume in patients with Fibromyalgia as an inflammatory markers.Patients and Methods : This case - controlled study was conducted at Baghdad Teaching Hospital, Unit of Rheumatology, from July 2017 till November 2017. A total of 100 Iraqi patients with Fibromyalgia diagnosed according to 2012 Canadian Guidelines in addition to 50 healthy subjects worked as a control group were recruited. Data were collected using a paper clinical research form through interview and questionnaires. It consisted of two parts : the first part for the demographic data and full history, the second part laboratory data when the samples collected and sent for laboratories to obtain Platelet distribution width and Mean platelet volume while Neutrophil/lymphocyte ratio was calculated manually.Results : The neutrophil to lymphocyte ratio was significantly higher among patients with fibromyalgia (2.18) compared to healthy controls (1.92) (p =0.033). The Mean platelet volume was significantly higher in patients with fibromyalgia (8.3) compared to healthy controls (8) (p =0.045). In contrast, the Platelet distribution width was significantly lower among patients with fibromyalgia (16.7) compared to healthy controls (17) (p=0.01). No statistically significant differences had been found in demographic variables. None of the tested parameters qualified as an acceptable test for predicting a diagnosis of fibromyalgia, since the Receiver operating characteristic area associated with any of them did not reach the minimum value of (0.65).Conclusions : The Neutrophil to lymphocyte ratio is significantly higher in fibromyalgia patients compared to the healthy controls. The Mean platelet volume is significantly higher in the patients compared to the controls. The Platelet distribution width was significantly lower among the patients compared to the healthy controls. None of these tested parameters qualified as an acceptable test for predicting a diagnosis of Fibromyalgia.

العلاقة بين الخصائص السريرية وبروز القرص القطني وانتقامة المثبت بفحص الرنين المغناطيسي == The Relationship between Clinical Features and Magnetic Resonance Imaging Proven Lumbar Disc Bulging and Herniation

اسم المؤلف: ابان ناظم علي
اسم المشرف: خضير زغير معيوف البدري
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Lumbar disc herniation is one of the commonest causes of low backpain. The Magnetic resonance imaging is a gold standard noninvasiveinvestigation for viewing lumbar anatomy and physiology in great details.Obesity is strongly linked to biomechanical changes that damage thespine and contribute to a range of spinal diseases including intervertebraldisc herniation.Aim of the studyTo evaluate the effects of body mass index and waist to hip ratio on thepresence, extent and severity of lumbar disc bulging and herniation as wellas to determine the relationship between clinical features and magneticresonance imaging proven lumbar disc bulging and herniation.Patients and methodsA cross - sectional study was conducted at Baghdad Teaching Hospital,Rheumatology Unit during the period from October 2017 to May 2018. Atotal of 100 patients with lumbar disc bulging and herniation proven by MRIwere included in this study. The patients were examined neurologically andtheir body mass index was calculated as well as the waist to hip ratio.ResultsThe magnetic resonance imaging findings demonstrated that (72%) ofthe studied group had disc bulge, (13%) had disc protrusion and (15%) haddisc extrusion with no cases of disc sequestration. Multiple discinvolvements were seen in (73%) of those patients. The correlation betweenbody mass index and the total disc bulge/extrusion score was statisticallysignificant. There was a significant association between neurological deficitand body mass index as well as between straight leg raising test, femoralVIstretch test, neurological deficit and the waist to hip ratio. On the other hand,there was no significant association between clinical features and nerve root compression for patients with both normal body mass index as well as overweight and obese ones, although the frequency of patients with positive clinical findings was higher in patients with nerve root compression but the difference did not reach the significant level (P - value >0.05). The sensitivity of straight leg raising test, femoral stretch test and crossed straight leg raising test were (39.6%), (25.3%) and (6.6%) respectively.ConclusionsThere is an increase in the likelihood of having lumbar disc herniation and its global severity in overweight and obese patients. The clinical findings were more severe in overweight and obese patients especially in patients with central obesity. There was no significant association between the clinical features and the nerve root compression in patients with both normal body mass index as well as overweight and obese ones. The type of disc displacement associated poorly with clinical signs and symptoms as well as with the obesity.

الارتباط بين الموجات فوق الصوتية للوريد البابي الكبدي والنتائج التنظيرية في دوالي المرئ == Correlation between portal vein Doppler ultrasound and endoscopic findings in esophageal varices

اسم المؤلف: اسراء مزاحم ذاكر
اسم المشرف: ليث احمد خلف
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: خلفية عن الموضوع : دوالي المريء ، وهو احد المضاعفات الرئيسية لتليف الكبد ، يمكن ان يؤدي الى تهيدد للحياة نتيجة نزيف الجهاز الهضمي.الهدف من البحث : تقييم الاداة التشخيصية للكشف عن دوبلر الوريد البابي (سرعة ، قطر ، مؤشر الازدحام ، وحجم الطحال) للتنبؤ بدوالي المريء.الطرائق : تم تضمين 51 مريضا بالغا يعانون من تليف الكبد في الدراسة. خضع جميع الاشخاص الى الموجات فوق الصوتية في البطن وتنظير المريء. تضمنت مؤشرات الوريد البابي التي تمت دراستها مؤشر الاحتقان الكبدي ، وقطر الوريد البابي ، سرعة الوريد البابي وحجم الطحال. تم حساب حساسيتها ونوعيتها والقيم التنبؤية باستخدام التنظير المريء كمعيار ذهبيالنتائج : كانت الارتباط بين سرعة الوريد البابي ومؤشر الاحتقان الكبدي مع وجود دوالي المريء ذات دلالة احصائية (قيمة p <0.05). كان سرعة الوريد البابي اعلى حساسية 92.7 ٪ للكشف عن وجود دوالي المريء. وكان مؤشر الاحتقان الكبدي اعلى خصوصية من 99 ٪ واعلى قيمة تنبؤية ايجابية من 99 ٪. كانت القيمة التنبؤية السلبية اعلى سرعة الوريد البابي بنسبة 66.7 ٪.استنتاج : يمكن ان يكون دوبلر بالموجات فوق الصوتية بديلا سهلا ، رخيصا وامنا . حيث لا يتوفر تنظير المريء . مؤشرات دوالي الوريد البوابي مفيدة للكشف عن دوالي المريء وافضل مؤشرات الدوبلر سرعة الوريد البابي ومؤشر الاحتقان الكبدي ، في حين ان قطر الوريد البابي قد يكون لها قيمة محدودة للتنبؤ بدوالي المريء | Background : Esophageal varices, a major complication of liver cirrhosis, can lead to life threatening gastrointestinal bleeding.Objective : Evaluate the diagnostic utility of portal vein Doppler findings (velocity, diameter, congestion index ) and spleen size to predict esophageal varices.Methods : A cross sectional study of 51 adult patients with cirrhosis were included in the study. All of them underwent an abdominal ultrasound and esophageal endoscopy. The portal vein indices that were studied included hepatic congestion index, portal vein diameter portal vein velocity and splenic size. Their sensitivity, specificity and predictive values were calculated using esophageal endoscopy as a gold standard. Results : Association of PVV and HCI with presence of EV was statistically significant (p - value <0.05). PVV had the highest sensitivity 92.7% for detecting the presence of EV. HCI had the highest specificity of 99% and the highest positive predictive value of 99%. Negative predictive value was highest for PVV at 66.7%.Conclusion : Doppler Ultrasound can be an easy, cheap and safe alternative, where esophageal endoscopy is not available, available, for triaging patients for referral for esophageal endoscopy. Portal vein Doppler indices are useful for detecting esophageal varices, the best Doppler indices PVV and HCI, while PVD may have a limited value for predicting esophageal varices.

تواتر التدرن الكامن في المرضى المرشحين للعلاج البيولوجي في مستشفى بغداد التعليمي == The frequency of Latent tuberculosis infection in patients who are candidates for biological therapy in Baghdad Teaching hospital

اسم المؤلف: امل خالد علي
اسم المشرف: مصطفى نعمة عبد علي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الجهاز التنفسي
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Introduction : Tuberculosis remains one of the biggest global human killers accounting for 9.4 million new cases of active tuberculosis and 3 million tuberculosis - related deaths with an incidence of 140/100,000 inhabitants. More than 90% (up to 8 million) of total TB Tuberculosis cases occurring in developing countries and more than half of all deaths (2 million) occurring in Asia.Aim of the study : To assess the burden of latent TB in patients candidate for biological therapy.Patients and method : A descriptive cross sectional study conducted at Baghdad teaching hospital during the period from the 1st of April 2017 to the end of March 2018. A consecutive sampling included 150 respondents candidate for biological therapy were included in this study Results : The mean age of patients was 38.9±11.4 years. TST was positive in 23.3% of studied patients. Significant association between positive TST findings and middle age group (p=0.05). A significant association was observed between positive TST results and gender (p=0.001). Also significant association between prolonged duration of the disease, and positive TST.Conclusions : The TST were positive in about only one quarter of patients with chronic immunomediated diseases who are candidates for biological therapy, and significant associations were found between age group , and TST results.

نتائج الفحص بالرنين المغناطيسي لمرض سرطان المبايض بالارتباط مع الفحص النسيجي == Magnetic Resonance Imaging Findings Of Ovarian Malignancy In Correlation With Histopathology

اسم المؤلف: صبا قيس عيسى
اسم المشرف: خليل ابراهيم محسن
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: نبذة : التشخيص المبكر والعلاج من الاورام الخبيثة للمبيض مصحوبان بتنبؤات حياتية جيدة. التصوير بالرنين المغناطيسي له درجة عالية من الدقة في التصنيف المبكر لاورام المبيض.الهدف من الدراسة : لتحديد دقة التصوير بالرنين المغناطيسي في تشخيص الاورام الخبيثة في المبيض بالمقارنة مع التشريح المرضي كاختبار ذهبي.المرضى وطرق البحث : دراسة متابعة مستقبلية اجريت في وحدة التصوير بالرنين المغنطيسي في قسم الاشعة بمستشفى بغداد التعليمي في مجمع مدينة الطب في بغداد خلال الفترة من 1 فبراير 2017 الى 31 ديسمبر 2017 على عينة من 30 امراة مشتبهة بالاصابة بورم المبيض. تم فحص جميع المرضى مع التصوير بالرنين المغناطيسي الموزون الانتشار وتم جمع العينات لفحص التشريح المرضي.النتائج : كشف التصوير بالرنين المغنطيسي للنساء المصابات بورم خبيث في المبيض في 73.3٪ من النساء كما كشف تحليل الانسجة عن وجود ورم خبيث في المبيض في 73.3٪ من النساء. كانت نتائج صلاحية التصوير بالرنين المغنطيسي فيما يتعلق باورام المبيض الخبيثة حساسية (90.9٪) وخصوصية (75٪) وقيمة تنبؤيه موجبة (90.9٪) وقيمة تنبؤيه سالبة (75٪) ودقة (86.6٪). كانت قيمة القطع المناسبة لمعامل الانتشار الظاهر في التمايز بين الكتلة الضامة الخبيثة والحميدة 0.97 مع حساسية 100٪ وخصوصية 90.9٪.الاستنتاجات : ان التصوير بالرنين المغناطيسي الموزون الانتشار هو تقنية صالحة ويمكن الاعتماد عليها في تشخيص وتوصيف اورام المبيض. | Early diagnosis and treatment of adnexal malignancy is accompanied with good prognosis. The magnetic resonance imaging has high accuracy in early categorization of adnexal masses. Aim of study : To determine accuracy of magnetic resonance imaging in diagnosing ovarian malignancy in comparison to histopathology as golden test.Patients and methods : A prospective follow up study conducted in magnetic resonance imaging unit of Radiology Department in Baghdad Teaching Hospital in Baghdad Medical City Complex during the period from 1st of February, 2017 to 31st of December, 2017 on sample of 30 women with suspected adnexal masses. All patients were examined with diffusion - weighted magnetic resonance imaging and specimens were collected for histopathology examination.Results : The magnetic resonance imaging of women with adnexal mass revealed malignancy in (73.3%) of women and the histopathology revealed also malignancy in (73.3%) of women with adnexal mass. The validity results of magnetic resonance imaging regarding malignant adnexal mass were sensitivity (90.9%), specificity (75%), +ve predictive value (90.9%), - ve predictive value (75%) and accuracy (86.6%). The appropriate cut off value for apparent diffusion coefficient in differentiation between malignant and benign adnexal mass was 0.97 with (100%) sensitivity & 90.9% specificity.Conclusions : The diffusion - weighted magnetic resonance imaging among other MRI sequences that play valid and reliable role in diagnosis and characterization of adnexal masses. Keywords : Adnexal masses, Ovarian Malignancy Magnetic Resonance Imaging, Histopathology

نسبة الصفيحات الدموية الى الخلايا اللمفاوية ونسبة الخلايا اللمفاوية الى الخلايا الوحيدة لدى عينة من المرضى العراقيين المصابين بمرض بهجت == Platelet - Lymphocyte Ratio and Lymphocyte - Monocyte Ratio in a Sample of Iraqi Patients with Behçet’s Disease

اسم المؤلف: زهراء مصطفى كامل
اسم المشرف: فائق ايشو كوريال
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Behçet’s disease is a multi - systemic disorder, characterized bya remission and relapse , associated with a major morbidity and mortality.the principal pathological process is inflammation of blood vessels of allsizes and types (variable - vessel vasculitis).Platelet - lymphocyte ratio (PLR) and lymphocyte - monocyte ratio(LMR)regards simple, cheap parameters and was introduced as a novel marker todetermine inflammation in other diseases.ObjectiveTo evaluate the association between activity of Behçet’s disease withplatelet - lymphocyte and lymphocyte - monocyte ratio.Patients and MethodsThis case - control study conducted at Baghdad Teaching Hospital,Unit of Rheumatology from July 2017 to the end of February 2018. A total of 66 Iraqi patients who were diagnosed with Behçet's disease and met the inclusion criteria, and 66 apparently healthy individuals matched in age and sex as controls were enrolled. After acquiring their consent, data were collected using a pre - constructed data collection sheet, questionnaire including demographic and clinical data of the patients. Disease activity was assessed using Behçet's disease current activity form. Total White Blood Cells count and differential , C - reactive protein (CRP), erythrocytes sedimentation rate (ESR) were measured. platelet - lymphocyte and lymphocyte - monocyte ratio was calculated manually after obtaining the results from laboratory

الوضع الوبائي لمتلازمة العوز المناعي في العراق من 1990 - 2017 == Epidemiological Profile of HIV in Iraq From 1990 - 2017

اسم المؤلف: قيس عبد العزيز عبد المطلب
اسم المشرف: جواد كاظم الديوان
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : HIV/acquired immune deficiency syndrome (HIV/AIDS) is a disease of far greater demographic diversity, affecting all ages, sexes, races, and income levels; involving multiple transmission risk behaviors; and having a broad geographic distribution worldwide.Globally, there are about 36.7 million people living with HIV, and 1.81 million new HIV infections occurred worldwide in 2016. There is insufficient epidemiological data on HIV infection in Iraq, so this study was conducted to estimate the prevalence, incidence and other epidemiological characteristics of HIV patients in Iraq.Methods : Descriptive cross sectional study was conducted by reviewing all records of HIV patients that retrieved from the Iraqi HIV Surveillance Center from1990 - 2017. Corresponding population data of Iraqi population was obtained from the Ministry of Health (MOH) - Directorate of Planning and Resource Development - Health and Vital Statistics Department. Results : The total number of the registered HIV patients in the Iraqi HIV Surveillance Center from 1990 - 2017 were 385 documented HIV cases. The prevalence and incidence of HIV infection in Iraq in 2017 were 0.66/ 100,000 populations and 0.24/100,000 population respectively, and they increased gradually over the last 27 years.The mean age of patients with HIV at time of detection was 31±12 years. Most of the patients aged 25 years and above that account for (86.8%).Males showed much higher percentage of HIV infection than females about 82%.Most of the cases concentrated in Baghdad governorate (123 cases) that represent 52.8%, followed by Erbil governorate (21,8.4%).Clinically suspecting HIV infection was the main route for detecting cases (22.07%), followed by blood donation (20%) of the cases.Sexual activities represent the major role of transmission about 57%, followed by blood and blood products consumption that represent 22.5%.Conclusions : The prevalence and incidence of HIV infection continue to rise over the last 27 years especially in the last five years. We recommend paying more attention to the control and prevention measures and enhancement of surveillance system.Keywords : HIV, Iraq, Epidemiology, ART.

الوفيات والمراضة الناتجة عن حالات التهاب المعدة والامعاء بين الاطفال دون سن الخمسة سنوات في بابل, 2007 - 2017 == THE MORTALITY and MORBIDITY of GASTROENTERITIS in UNDER 5 YEARS CHILDREN, BABYLON PROVNCE (2007?2017)

اسم المؤلف: رزاق هاشم محمد
اسم المشرف: علياء مكي حسن الصافي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Diarrhea is one of the main causes of morbidity and mortality among children in developing countries. It was the second leading cause of death in children under five years, accounting for 9 % of all deaths among children under age 5 worldwide in 2015. Despite the availability of simple effective treatment, about 1,400 young children die each day which is equivalent to 526,000 children a year. According to Multiple Indicator Cluster Survey (MICS - 4), the incidence of diarrhea in Iraq was 15% .The objective of this study was to identify the incidence and deaths of gastroenteritis in children under five year in Babylon, 2007 - 2017.Methods : A descriptive cross - sectional study by reviewing all reported cases of gastroenteritis in hospitals and districts of Babylon province between 2007 - 2017.Incidence, mortality rate and case fatality rate (CFR) for <5 years population were calculated.Results : The mean of cases was 69,436 patients. A mean of outpatient was 60,243(86.8%) and 9,194(13.2%) were admitted cases. Male to female ratio was 1.1 : 1. Incidence of gastroenteritis was 237.8/1,000, the highest incidence was in 2012(302 /1,000), the lowest was in 2016(163/1,000), most deaths occur in children <1year (82.1%). CFR was (1.1/10,000), the highest case fatality rate was in2007 (3.9/10,000), there was no deaths in 2013 and 2015, therefore CFR was 0%.Proportional mortality rate (PMR) the mean was (0.3%); the highest PMR was in 2007 (0.8%), because there was no deaths in 2013 and 2015 PMR (0%).The incidence was higher in infants (477/1,000), than1 - <5 years (168.2/1,000) as means, which represented 2.8 times more in infants.Conclusion Diarrhea is still a major cause of morbidity and mortality in children under five years, which need to pay more attention for PHC efforts and community cooperation, improvements of living situations and encouragement of Breast feeding.Key words : Gastroenteritis, Babylon, Under 5 years children, Incidence, Case fatality rate, Proportional mortality rate.

دراسة العلاقه بين ارتفاع ضغط الدم الشرياني ومرض الانسداد الرئوي المزمن : دراسة مستندة الى المستشفى == Study of relation between systemic arterial hypertension and Chronic Obstructive Pulmonary Disease (Hospital Based Study

اسم المؤلف: زينب مهاوي هادي
اسم المشرف: محمد وهيب سلمان العبيدي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: ان مرض الانسداد الرئوي المزمن هو سبب رئيسي للوفاة في جميع انحاء العالم . ويسبب العديد من الامراض خارج الرئه مثل داء السكري وامراض القلب والاوعيه الدموية .الهدف من الدراسة : لتقييم العلاقة المتبادلة بين مرض الانسداد الرئوي المزمن وارتفاع ضغط الدم الشرياني طريقــــــــــــــة البحث : اجريت دراسة مقطعيه على مئة مريض مشخص مسبقا بالانسداد الرئوي المزمن في ( مستشفى بغداد التعليمي ) و( مستشفى البصرة التعليمي ) وبعمر (35سنة واكثر. المرضى المصابون بامراض الاضطرابات التنفسية والقلبية والغدد الصماء الاخرى والذين لديهم تاريخ بارتفاع ضغط الدم المشخص قبل مرض الانسداد الرئوي تم استثنائهم من هذه الدراسة .النتائـــــــــــج : الدراسةاجريت ل( 100) مريض تم تشخيصهم مسبقا بــمرض الانسداد الرئوي المــــــــــــــــــــــــزمن حيث تبين ان (23 ) مريضا لديهم تاريخ ايجابي لارتفاع ضغط الدم الشرياني تم تشخيصهم بعد تطور مرض الانسداد الرئوي ؛ و(77) مريضا لديهم تاريخ سلبي لارتفاع ضغط الدم الشرياني.وبعد قياس ضغط الدم لذوي التاريخ السلبي السابق في ارتفاع ضغط الدم الشرياني وجد ان (14) لديهم ضغط دم طبيعي و( 36 ) مريضا لديهم ارتفاع ضغط الدم الشرياني للمرحلة الثانية .كانت هناك علاقة بارزة بين زيادة حدة مرض الانسداد الرئوي المزمن وزيادة القراءة لضغط الدم. الاستــنــــــــــــــــتاج : توجد علاقة بارزة بين مرض الانسداد الرئوي المزمن وتطور ارتفاع ضغط الدم الشرياني.الكلمات الدالة : ارتفاع ضغط الدم الشرياني , مرض الانسداد الرئوي المزمن , ضغط الدم . | Background : Chronic obstructive airway disease (COPD) is a leading cause of death worldwide. And it cause various extrapulmonary comorbidities as diabetes mellitus and cardiovascular diseases .Aim of Study : To assess the correlation between COPD and systemic arterial hypertension .Method : Cross sectional study was conducted on 100 patients diagnosed previously as COPD in Baghdad teaching hospital and Basrah teaching hospital (age≥35 year), Patients with other chronic respiratory disorder and cardiac and endocrine diseases and who had history of systemic arterial hypertension diagnosed before COPD were excluded from this study.Results : The study done on 100 patients diagnosed previously with COPD and found 23 patients had positive history of systemic arterial hypertension diagnosed after COPD developed and 77 patients had negative history of systemic arterial hypertension. and after measured blood pressure for the patients with negative previous history of systemic arterial hypertension 14 patients found having normal reading and 36 patients had stage 2 systemic arterial hypertension . There were significant association between increase in severity of COPD and increase in blood pressure reading.Conclusion : There is significant association between COPD and development of systemic hypertension.Keyword : Systemic arterial hypertension , Chronic obstructive pulmonary disease , blood pressure.

تقييم القصور الكلوي عند مرضى الانسداد الرئوي المزمن == Assessment of renal impairment in patients with chronic obstructive pulmonary disease

اسم المؤلف: مروة حمدي صالح
اسم المشرف: محمد وهيب سلمان العبيدي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الجهاز التنفسي
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلفية : مرض الانسداد الرئوي المزمن هو احد الاسباب الرئيسية للمراضة والوفيات في جميع انحاء العالم. من المتوقع ان يرتبط مرض الانسداد الرئوي المزمن بشكل كبير مع الاعتلال المشترك ، وقد افادت بعض الدراسات عن وجود اختلال كلوي في مرض الانسداد الرئوي المزمن في مجموعات مختارة من السكان.الهدف من الدراسة : لتقدير وتيرة الضعف الكلوي في عدد السكان من مرضى مرض الانسداد الرئوي المزمن.المرضى والطريقة : تم اجراء دراسة الحالة والضابطه للفتره من 1 يونيو 2017 حتى نهاية ابريل 2018 في مستشفى بغداد التعليمي. اجريت الدراسه على 100 شخص تم تصنيفهم الى مجموعتين : مجموعة مرض الانسداد الرئوي المزمن 50) مريضا يعانون من مرض الانسداد الرئوي المزمن) والمجموعة الضابطة (50 شخص دون مرض طبي مزمن)في البداية تم تاكيد تشخيص مرض الانسداد الرئوي المزمن وتقييمه للتدريج حسب التاريخ والفحص السريري وقياس التنفس. وقد تم تقدير معدل الترشيح الكبيبي وتم تصنيف المرضى وفقا لوظيفة الكلى لديهم وظيفة الكلى المستقرة ، اختلال وظائف الكلى المخفي واختلال وظائف الكلى العلني.النتائج : في مجموعة مرض الانسداد الرئوي المزمن ، كان متوسط قيمة نيتروجين اليوريا في الدم هي 44±19.4 ، وكان متوسط تركيز الكرياتينين في المصل 1.25 ± 0.53 وكان متوسط معدل الترشيح الكبيبي التقديري 67.6 ± 27.5 في المجموعه الضابطه, وان متوسط قيمة قيمة نيتروجين اليوريا في الدم هي 28.5± 5.8 ، وكان متوسط تركيز الكرياتينين في المصل 0.7 ± 0.1 وكان متوسط معدل الترشيح الكبيبي هو 97.3 ± 16.8 ( قيمة بي (<0,001) للجميع مقارنة مرض الانسداد الرئوي المزمن) . وجد ان معدلات انتشار كل من : وظيفة الكلى مستقرة ، خلل وظيفي كلوي مخفي واختلال وظيفي كلوي علني في مجموعة مرض الانسداد الرئوي المزمن هي 29 ٪ ، 16 ٪ و26 ٪ على التوالي. كان معدل الانتشار العام للضعف الكلوي ) معدل الترشيح الكبيبي اقل من 60مل /دقيقه/1.73م2 )يساوي 42٪ في مجموعة مرض الانسداد الرئوي المزمن و2 ٪ في المجموعة الضابطة ( قيمة بي<0.001) كان هنالك ارتباط احصائي لمرض الانسداد الرئوي المزمن مع كلا من الخلل وظيفي المخفي والعلني.للكلى.وقد وجد ان العمر ، وحالة التدخين العلبه/ العام ، ومدة المرض وانخفاض متوسط حجم الزفير القسري ارتبطت بشكل كبير مع الخلل الكلوي العلني.الاستنتاجات : هنالك ارتباط ملحوظ بين زيادة شدة مرض الانسداد الرئوي المزمن وارتفاع اليوريا في الدم، كرياتينين المصل ونقصان معدل الترشيح الكبيبي. | Background : Chronic obstructive pulmonary disease is a leading cause of death worldwide. COPD is expected to be significantly associated with comorbidity, and some studies have reported renal impairments in COPD subjects in selected populationsAim of the study : To estimate the frequency of renal impairment in a population of COPD patients Patients and method : A case control study carried out from the 1st of Jun. 2017 to the end of April 2018 in Baghdad teaching hospital. This study was conducted on 100 persons who were classified into two groups : case group (50 patients with COPD) and control group (50 persons healthy without chronic medical illness). First, the diagnosis of COPD was confirmed and evaluated for staging by history, clinical examination and spirometry. The glomerular filtration rate was estimated and the patients were categorized according to their renal function as having stable renal function, concealed renal dysfunction and overt renal dysfunction. Results : in the COPD group, the mean Blood Urea Nitrogen value was 44±19.4, the mean serum creatinine concentration was 1.25 ±0.53 and the mean estimated GFR was 67.6±27.5.In the control group, the mean BUN value was 28.5±5.8, the mean serum creatinine concentration was 0.7 ±0.1 and the mean estimated GFR was 97.3±16.8 (P<0.001) for all in comparison with the COPD). The prevalence of stable renal function, concealed renal dysfunction and overt renal dysfunction in COPD group was 29%, 16% and 26% respectively.The overall prevalence of renal impairment (GFR<60ml/min/1.73 m2) was 42% in COPD group and 2% in control group (P<0.001).Chronic obstructive pulmonary disease was significantly associated with both concealed and overt renal dysfunction. Age, Pack/year, duration of disease and decrease of FEV1 were significantly associated with overt renal dysfunction(GFR <60 ml/min/1.73 m2 with elevated blood urea and serum creatinine). Conclusions : there is significant association between increased COPD severity and elevated blood urea, serum creatinine and reduced glomerular filtration rate.

تقييم مستوى مصل حمض البوليك لمرض الانسداد الرئوي المزمن وعلاقته بشدة المرض وتكرار الانتكاسات : دراسة الحالات والشواهد == ASSESSMENT OF SERUM URIC ACID LEVEL IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ITS RELATION TO DISEASE SEVERITY AND EXACERBATION FREQUENCY (Case - Control Study

اسم المؤلف: الاء عبد الجبار
اسم المشرف: عدنان محمد الجبوري
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Chronic obstructive pulmonary disease (COPD) is a major contributor to morbidity worldwide,and lead to damage lung tissue and so lead to reduce oxygen intake resulting in tissue hypoxia.Tissue hypoxia induces the degradation of adenosine triphosphate, resulting in production of serum uric acid.Identification of prognostic biomarker for COPD as serum uric acid(sUA) may aid in improving survival .Objective of the study : Evaluate role of hyperuricemia in disease severity and exacerbation frequency in COPD patients.Method : Case - control study was conducted from 1st of December 2017 to 1st of June 2018, on 80 subjects in Baghdad teaching hospital\medical city, 40 subjects with COPD, other 40 subjects are healthy persons consider as control, all >40 years old<70 .Serum uric acid level measured for all study sample.Excluded from this study those with Hx of Diabetes mellitus, Hypertension, Malignancy, Cardiac disease, Gout and persons on drugs affect sUA level.Results : The mean age for COPD was 61.9 while for control was 49.3 years.Serum utic acid higher in male than female in both group. In COPD cases there are higher level of serum uric acid compared to control and COPD patients had 3.16 time more risk to developed high serum uric acid than persons without disease also there was a significant statistical association between mean sUA and duration and degree of COPD (P value<0.05).Conclusion : Patients with COPD have higher serum uric acid level than control group, which tend to increase with increase in duration and severity of disease.

اهمية حالة استخدام جهاز الاستنشاق في السيطرة على الربو عند البالغين == Importance of inhaler device use in the control of asthma in adult

اسم المؤلف: حواء خالد علوان
اسم المشرف: مصطفى نعمة عبد علي
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: الجهاز التنفسي
الدرجة: دبلوم عالي
الجامعة: جامعة بغداد - كلية الطب
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلفية : يعتبر الربو من الامراض المزمنة العرضية للممرات الهوائية التي ينظر اليها بشكل افضل على انها متلازمة. في عام 1997 ، شمل المعهد الوطني للقلب والرئة والدم السمات التالية كجزء لا يتجزا من تعريف نوبات الربو المتكررة من الاعراض التنفسية ؛ انسداد تدفق الهواء المتغير الذي غالبا ما يكون قابلا للعكس ، اما بشكل عفوي او مع العلاج ؛ وجود تفاعل فرط مجرى الهواء. والاهم من ذلك ، التهاب المسالك الهوائية المزمن الذي تلعب فيه العديد من الخلايا والعناصر الخلوية دورا ، على وجه الخصوص ، الخلايا البدينة ، الحمضات ، اللمفاويات التائية ، الضامة ، العدلات ، والخلايا الظهارية.الهدف من الدراسة : لتقييم تقنية الاستنشاق المريض الربوالمرضى والطريقة : اجريت دراسة مقطعية مستعرضة في وحدة الامراض التنفسية في مستشفى بغداد التعليمي من 1 يوليو 2017 حتى نهاية فبراير 2018. واشتملت على 400 بالغ يعانون من الربو المستمر لمدة 6 اشهر على الاقل ، ووفقا للمبادرة العالمية لالمعايير الربو وادرجت في هذه الدراسة.النتائج : كانت اخطاء اعداد الجهاز موجودة في 47.2 ٪ من مرضى الربو ، وكان الفشل في الزفير قبل الاستنشاق في 80.2 ٪ من المرضى ، وزفير اثناء الاستنشاق كان موجودا في 10 ٪ من المرضى ، كان الوقت قصير للاستنشاق في 51.7 ٪ من المرضى ، والفشل في ان تحبس الانفاس لمدة 5 - 10 ثواني في 68٪ من المرضى ، ولم يكن الشطف بالماء بعد الاستنشاق موجودا في 85.5٪ من المرضى وكان التكرار اكثر من الموصى به في 22.8٪ من مرضى الربو . وجد ان هنالك ارتباط مهم للغاية بين المرضى الاصغر سنا ومسبار التركيز واجهزة الاستنشاق المقننة الجرعة.الاستنتاجات : هناك خطا في استخدام تقنية علاج الاستنشاق الربو. | Background : Asthma is a chronic, episodic disease of the airways that is best viewed as a syndrome. In 1997, the National Heart, Lung, and Blood Institute included the following features as integral to the definition of asthma recurrent episodes of respiratory symptoms; variable airflow obstruction that is often reversible, either spontaneously or with treatment; presence of airway hyper reactivity; and, importantly, chronic airway inflammation in which many cells and cellular elements play a role, in particular, mast cells, eosinophils, T lymphocytes, macrophages, neutrophils, and epithelial cells.Aim of the study : To assess the asthmatic patient's inhaler use technique,any error if present Any effect on asthma control from use technique error or type of inhaler.Patients and method : A cross sectional study conducted in consulting respiratory unit in Baghdad teaching hospital from the 1st of July 2017 to the end of February 2018. In which 400 adults with persistent asthma for at least 6 months duration, and according to the Global Initiative for Asthma criteria were included in this study. Results : Device preparing errors was present in 47.2% of asthmatic patients, failure to exhale before inhalation was present in 80.2% of patients, exhalation during inhalation was present in 10% of patients, short inhalation time was present in 51.7% of patients, failure to hold breath for 5 - 10 seconds in 68% of patients, not rinsing mouth with water after inhalation was present in 85.5% of patients and repetition more than recommended was present in 22.8% of asthmatic patients. Highly significant association between younger age patients and MDI & spacer,Conclusions : There is error in using the asthmatic inhalers treatment technique
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