First pages:

دراسة وبائيه لالتهاب الكبد الفايروسي نوع ب وج في محافظة بابل == Epidemiological Study of Viral Hepatitis Types B and C in Babylon Province

Author name: ايمان فاضل عبد الحسين

Supervisor name: محمد عبود محسن

General topic: Medicine

Specific topic: Microbiology

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: اجريت هذه الدراسه لتوضيح وبائيه التهاب الكبد الفايروسي نوع (ب,ج) في محافظه بابل وقد شملت على عينه عشوائيه من المجتمع وكذلك على بعض المجاميع الاختصار للاصابه باالمرض وهم المتبرعين باالدم والملامسين للاشخاص المصابين ومرضى فقر دم البحر الابيض المتوسط ومرضى الكليه الصناعيه ومرضى نزف الدم الوراثي والعاملين في المجال الصحي تضمنت هذه الدراسه التي استمرت من تشرين الثاني 2011 الى حزيران 2012 عاى 2114عينه دم كانت قد فحصت لكل من المستضد السطحي للنوع ب والضدIgG للنوع ج شملت على 1408 ذكر و706 انثى وكان متوسط الاعمار 5, 38 سنه اظهرت النتائج ان نسبه الوبائيه للنوع ب في عينه عشوائيه من المجتمع كانت (97,3%) اما الاعمار الاكثر اصابه كانت تتراوح في الفئه العمريه (41 - 50) بنسبه اصابه ( 93,4 % )وكان الذكور اكثر اصابه من الاناث بنسبه (70,3 - 30,7%) كذلك كانت نسبه الاصابه في الريف اكثر من المدينه حيث انه من مجموع 37 عينه موجبه للنوع ب كان هنالك 26 منها كان في المناطق الريفيه في حين كانت البقيه (11عينه) في المدينه اي ان نسبه الاصابه في الريف الى المدينه كانت 1 : 2 على التوالياما في مجموعه متبرعي الدم فقد كانت نسبه الاصابه(76, 0% )و الاعمار الاكثر اصابه كانت ايضا في الفئه العمريه (41 - 50) بنسبه اصابه (87,0%) وايضا كان الذكور اكثر اصابه من الاناث بنسبه (52. 0 - 87,0)% وكذلك كانت نسبه الاصابه في الريف اكثر من المدينه 28,57 - 71,43 %)اما في مجموعه الملامسين فقد كانت نسبه الاصابه (4,92%) وكان الذكور اكثر اصابه من الاناث بنسبه (6,25 - 44,3%) وكان كل الافراد المصابين في هذه الفئه من المناطق الريفيه.ان نسبه الانتشار الوبائي للنوع ب في مجاميع الاختطار كان اكثر شيوعا في عوائل الاشخاص المصابين سابقا مقارنه بالاشخاص الذين ليس لديهم سجل اصابه مسبقه في عوائلهم بنسبه61,7 - 38,3%)ان عيار anti - HBc IgM كان اكثر توافقا مع الحمل الفايروسي للنوع ب بواسطه فحص RT - PCR من عيارفحص HBsAg المقاس بواسطه الاليزااظهرت النتائج ان نسبه الوبائيه للنوع ج في عينه عشوائيه من المجتمع كانت (1.07 %) وهي اقل بكثير مقارنه مع المجاميع المخطره للاصابه حيث كانت نسبه الاصابه في مرضى فقر دم البحر الابيض المتوسط كانت 25% وفي مرضى نزف الدم الوراثي كانت 6.98%,وفي مجموعه متبرعي الدم (0,43% ) بينما لم تسجل اي اصابه بين فئه العاملين في المجال الصحي وكان الذكور هم الاكثر اصابه مقارنه مع الاناث على الرغم من انه لاتوجد فروق معنويه اي انه لايوجد ترابط بين الجنس وبين الاصابه باالمرض.وقد كانت نسبه اصابه الذكور الى الاناث في العينه العشوائيه(1,12 : 1,02) و( 5,26 : 5) ,(8,69 : 6,67),(7,9 : 4,5),(0,53 : 0),(27,27 : 26,00) في كل من مجموعه الملامسين والكليه الصناعيه ومرضى نزف الدم الوراثي ومتبرعي الدم ومرضى فقر دم البحر الابيض المتوسط على التعاقب. ان نسبه الانتشار الوبائي للنوع ج في مجاميع الاختطار كان اكثر شيوعا في عوائل الاشخاص المصابين سابقا مقارنه بالاشخاص الذين ليس لديهم سجل اصابه مسبقه في عوائلهم بنسبه(67,5 : 32,5).هذه النتائج تشير الى احتماليه انتقال العدوى ضمن افراد العائله كما واظهرت الدراسه ان هذا المرض اكثر انتشارا عند الاشخاص ذوي الحاله المعيشيه والمستوى التعليمي المتدنين وان الاصابه بالمدن اكثر انتشارا من االمناطق الريفيه واخيرا ان عيار anti - HCV IgG المقاس بواسطه الاليزا لم يكن باالضروره متوافقا مع الحمل الفايروسي للنوع ج بواسطه فحص RT - PCR | Summary The prevalence of viral hepatitis B and hepatitis C infections in general population and some of high risk groups such as blood donor, house hold contact, thalassemics, haemodialysis, haemophilia, and health worker in Babylon Governorate were covered. From first of November (2011) to end of June (2012); A total of (2114) blood samples from (1408males) and (706 females) with a mean age of (36.5±7.8 years) were tested for anti - HBsAg and anti - HCV IgG antibody The results showed that prevalence of HBV in general population was (3.97%) and patients with age group (41 - 50) had the higher rate of infection (4.93%). According to the sex; male was more infected than female (26 : 11) respectively with prevalence rate (70.3 : 30.7) respectively. A total of (37) positive anti - HBsAg (26) of them were in rural regions while the rest (11) were in urban with rate of infection (2 : 1) respectively. The ratio of infection in blood donors group was (0.76%) and patients with age group (41 - 50) had the higher ratio of infection (57.1%). According to the sex; male was more infected than female with the prevalence rate (0.82 : 0.52).Higher anti - HBsAg prevalence was found among blood donor living in the urban area 71.43 % than those living in rural areas 28.57% . The prevalence of anti - HBsAg in house hold contact group was (4.92%) and the age group (31 - 40) had the higher prevalence of infection (66.7%). Male to female ratio were (6.25 : 3.44) respectively and all tested members were from rural areas. The prevalence of HBV in risk group was more common in subjects with a positive family history for HBV (61.7%) than subjects with negative family history (38.3%).The diagnostic marker anti - HBc IgM were more compatible with viral load /Ml of HBV by RT - PCR than anti - HBsAg which obtained by ELISA test. The prevalence of anti - HCV in general population was (1.07 %) which was much lower than in risk groups of this study since it was in thalassemics (25%), haemodialysis (6.98%) haemophilics (6.67%) and in blood donors (0.43%). No infection recorded HCV cases between health worker in this study. According to sex; male to female rate in the general population was (1.12 : 1.02).The rate were (5.26 : 5), (8.69 : 6.67), (7.9 : 4.5), (0.53 : 0),(25.25 : 26.08) in house hold contact, haemodialysis, haemophilics, blood donors, and thalassemics respectively. The prevalence of HCV in risk group was more common in subjects with a positive family history for HCV (47.5%) than subjects with negative family history (52.5%).This results may support the possibility of sexual and intrafamilial transmission of HCV in all studied groups. The study shows that there is a higher rate of HCV infections in urban residence than in rural areas with prevalence (67.5 : 32.5) . The results of RT - PCR and ELISA technique were not necessary compatible for anti - HCV. The HBV and HCV had more prevalence in people with low economic status, low educational level.

دور دراسة تخطيط الاعصاب في استكشاف اعتلال الاعصاب المحيطية للنساء الحوامل في محافظة بابل == The Role of Nerve Conduction Study In Detecting Peripheral Nerve Dysfunction In Pregnant Women In Babylon Governorate

Author name: رونزا رافع عبد الامير سلمان

Supervisor name: فرح نبيل عباس الصادق | بشرى جابر الربيعي

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: الحمل هو حالة فسيولوجية تؤدي الى اجراء تغييرات تشريحية وفسيولوجية لكي تتمكن الانثى من التعامل مع زيادة المتطلبات البدنية والتمثيل الغذائي للحمل. تبدا التغييرات بعد الحمل وتؤثر على انظمة الاجهزة في الجسم. 80% من النساء الحوامل يحصل لهن تورم خلال مرحلة معينة من الحمل واغلب هذا التورم يحصل خلال فترة 8 اسابيع الاخيرة من الحمل. هذا السائل المتزايد خلال التورم يمكن ان يسبب انضغاط ويؤدي الى حالات الانحباس العصبي, وهذا يعتبر من الاثار الثانوية لتاثير او مفعول هرمون البروجستيرون وهرمون الاستروجين التي تنتجها في الغالب لوتام الجسم (الجسم الاصفر) في الاسابيع 12 الاولى من الحمل وبعد ذلك تنتجها المشيمة.تهدف هذه الدراسة لتقييم دور تخطيط الاعصاب الكهربائي خلال الحمل, تحديد مدى انتشار وشدة الانحباس العصبي في الحمل والتعرف على اعتلال الاعصاب الاخرى خلال فترة الحمل.اجريت هذه الدراسة في وحدة الفسلجة العصبية في كل من مدينة مرجان الطبية ومستشفى الامام الصادق (ع) في محافظة بابل خلال فترة الاول من اكتوبر 2016 ولغاية الاول من مايو 2017. شملت الدراسة 90 من النساء الحوامل اللاتي تم تقسيمهم نساء حوامل يعانين الاعراض والبعض الاخر بدون اعراض وكانت اعمارهن تتراوح بين 17 - 45 سنة وشملت ايضا 90 امراة غير حامل مطابقات من ناحية العمر للنساء الحوامل واللاتي تم اعتبارهن كحالات سيطرة في هذه الدراسة.خضعت كل النساء في هذه الدراسة لتقييم شامل بما في ذلك تاريخ المريض الطبي وقياس وزن الجسم وطوله لحساب مؤشر كتلة الجسم. شمل تقييم الفسلجة العصبية كل من دراسة الاعصاب الحسية والحركية لكل من العصب المتوسط, الزندي, الشظوي المشترك, الطنبوب, الفخذي الجلدي الجانبي, الساعدي الوسطي والجانبي للاعصاب الزارعة.وجدت نتائج هذه الدراسة فرق معنوي عالي في متوسط معايير العصب المتوسط بين الاناث الحوامل (ذوات الاعراض وبدون اعراض) والاناث غير الحوامل حيث كانت قيمة P اقل من 0.01 ووجود فرق معنوي عالي بين حالات الانحباس العصبي المتوسط والنساء غير الحوامل حيث كانت قيمة P اقل من 0.01. وكان هناك فرق معنوي عالي في متوسط معايير العصب الزندي, الشظوي المشترك, الطنبوب, الفخذي الجلدي, الساعدي الوسطي والجانبي للاعصاب الزارعه بين الاناث الحوامل اللاتي تعاني من الانحباس العصبي والاناث غير الحوامل حيث كانت قيمة P اقل من 0.01 . في هذه الدراسة تم تصنيف نسب الانحباس العصبي خلال الحمل كالاتي : نسبة انحباس العصب المتوسط 44.5% (متلازمة النفق الرسغي ومتلازمة برونايتر تيريس), نسبة انحباس العصب الزندي 8.9% (في قناة كيوبيتال وقناة غيونز), نسبة انحباس العصب الفخذي الجلدي 7.8%, نسبة انحباس العصب الشظوي المشترك 4.5% ونسبة متلازمة النفق الرصغي 3.3%. واستنتجت هذه الدراسة الى ان الانحباس العصبي اثناء الحمل يحدث في الغالب خلال الثلث الثاني والثالث من الحمل, الاناث الحوامل ذوات مؤشر كتلة الجسم المصنفة على انهزايادة وزن او سمنة وعند النساء الحوامل اللاتي لديها ولادات سابقة متعددة. كذلك اظهرت الدراسة ان متلازمة النفق الرسغي هو الانحباس العصبي الاكثر شيوعا في الاطراف العليا في حين ان انحباس العصب الفخذي الجلدي هو الاكثر شيوعا في الاطراف السفلى خلال فترة الحمل. | Pregnancy is a physiological condition during which females undergo profound anatomical and physiological changes so that they can cope with the increased physical and metabolic demands of their pregnancies. These changes start after conception and affect every organ system in the body. Eighty percent of pregnant women develop oedema in their last 8 weeks of pregnancy, this can cause compression and lead to conditions of focal nerve entrapment. These are largely secondary to the effects of progesterone and oestrogen which are produced predominantly by the corpus luteam in the first 12 weeks of pregnancy and thereafter are produced by the placenta. This study aims to assess the role of nerve conduction study in pregnancy, to identify severity of focal nerve entrapments in pregnancy and to identify other neuropathies during pregnancy. It's case - control study conducted in the Neurophysiological Unit of both Merjan Medical City and Al Sadiq General Hospital in Al - Hilla Governorate from the first of October, 2016 until first of May, 2017. Included 90 pregnant females which have been subdivided into symptomatic and asymptomatic and their ages ranged from 17 - 45 years and an additional 90 apparently healthy age matched non - pregnant females are considered as a control. The cases and control had been undergone comprehensive assessment including history and measurement of body weight and height to calculate body mass index. Electrophysiological assessment including sensory and motor nerve conduction studies of median, ulnar, common peroneal ,tibial, lateral cutaneous, sural, medial and lateral planter nerves. In our results found that there were highly significant mean difference of median nerve parameters between pregnant females (symptomatic and asymptomatic) and control group, P value is < 0.01, and highly significant difference between median nerve entrapment cases and control group, P value <0.01. There were highly significant mean difference of ulnar, common peroneal, tibial, lateral cutaneous, medial and lateral planter nerves parameters between pregnant females with focal nerve entrapment and control group, P value is <0.01. In this study focal nerve entrapment during pregnancy is classified as median nerve entrapment 44.5% (carpal tunnel syndrome and pronater teres syndrome), ulnar nerve entrapment 8.9% (at the cubital and guyons canal), meralgia parasthetica 7.8%, common peroneal nerve entrapment 4.5% and tarsal tunnel syndrome 3.3%. This study concluded that focal nerve entrapment during pregnancy mostly occur during second and third trimester, pregnant female with body mass index classified as overweight or obese and in multiparous pregnant women. It showed as well that carpal tunnel syndrome was most common entrapment neuropathy of the upper limbs while meralgia parasthetica was the most common entrapment neuropathy of the lower limbs during pregnancy.

تقييم الاصابات بالفايروس الدوار والطفيليات الابتدائية المعوية في الاطفال في محافظة بابل == Evaluation of Rota Virus and Intestinal Protozoal Infections in Children in Babylon Province

Author name: رائد صبحي فليح

Supervisor name: هيام خالص المسعودي | جاسم محمد المرزوكي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: خلال الفترة الممتدة من تشرين الثاني 2016 حتى نيسان 2017 ، تم جمع ما مجموعه (120) عينة براز للاعمار الاقل من خمس سنوات للاطفال المصابين بالاسهال في مستشفى بابل التعليمي لامراض النسائية والاطفال ومستشفى النور لطب الاطفال والعديد من مراكز الرعاية الصحية الاولية حيث تم جمع عينات البراز والدم بالاضافة الى معلومات حول كل حالة بما في ذلك العمر والجنس ومدة المرض والدخول الى المستشفى ام لا , تم ايضا ادراج (60) من الاطفال الاصحاء ظاهريا ومن نفس الفئة العمرية كمجموعة سيطرة , تم فحص مرضى الاسهال عن طريق اختبارالكروموتوغرافي السريع لفيروس الروتا حيث اظهرت النتائج 24 عينة (20 ٪) ، العدوى الفيروسية كانت (20.83 ٪) في الذكور و(18.75 ٪) في الاناث مع وجود اختلافات كبيرة في معدلات العدوى وفقا لنوع الجنس كما وجد ان من بين (120) عينة من البراز في الدراسة الحالية كانت موجبة للابتدائيات (18) ٪15 التي ظهرت فيها بينما كانت (10) 8.3 ٪ E.histolytica و(8) 6.6٪ Giardia lamblia كانت العدوى بفيروس الروتا مرتفعة عند المرضى من المناطق الريفية (59٪) مقارنة مع المرضى من المناطق الحضرية (41٪) ، وكان الاطفال الذين تم تلقيحهم بجرعة ثانية مصابين بالفيروس روتا اكثر من اولئك الذين تلقوا الجرعة الاولى (83٪) ، (٪17)على التوالي.كان الاطفال الذين تم تلقيحهم (94٪) والاطفال غير الملقحين (6٪)ان معظم الاطفال المصابين تقل اعمارهم عن سنتين ، مع اعلى نسبة مئوية في للفئة العمرية بين (19 - 24) شهرا و(7 - 12) شهرا والاعمار التي اقل من 6 شهور 33.33٪ و٪22.7 و٪18.5.اظهرت الدراسة الحالية اعلى نسبة اصابة في الاطفال المعتمدين على الرضاعة الاصطناعية بنسبة ٪63, كان متوسط تركيز انترلوكين - 6 (123 ± 25 بيكوغرام / مل) ، في حين ان المجموعة الضابطة (58 ± 24 بيكوغرام / مل) مع وجود اختلافات كبيرة (P˃0.05) بينهما ، كانت نتائج انترلوكين - 17 مرتفعة ايضا في مجموعة المرضى (111 ± 17 بيكوغرام / مل) بينما كانت (31 ±9 بيكوغرام / مل) في المجموعة الضابطة مع وجود اختلافات كبيرة (P˃0.05) بينهما.تم عزل وتنقية الجزيئات الفيروسية باستخدام اختبار استخراج الحمض النووي الريبي وتقنية PCR شبه المتداخلة. كان هناك نوعان من النمط الجيني المكتشف P وG. تم الكشف عن ستة انماط جينية G1 مع (٪37.50) والتي كانت اعلى واحد تليها G2 (16.66٪( واقل نسبة G4 وG8 4.16٪)كليهما.تم الكشف عن خمسة طرز جينية) P [8] (33.33٪( ، والتي كانت اعلى واحد تليها P [4] 20.83٪) واقلها كان (4.16٪ , P [9] تم ملاحظة وجود عدوى مختلطة باكثر من نمط وراثي واحد G1 P [8] وتم العثور عليها بشكل مشترك في 9 عينات من 24 عينة موجبة ، بينما لوحظ G1 P [4] في 3 عينات ، G2 P [4] في 5 عينات ، G3 P [8] في عينة واحدة ، G9 P [8] وG4 P [8] في عينتين.وجود اصابات مشتركة بفيروس الروتا مع Giardia lamblia في ثلث اعداد المصابين بفيروس الروتا . | During a period from November 2016 till April 2017, a total of (120) stool samples under (5) years old were collected of diarrheal infected children in the Babylon Teaching Hospital for gynecology and children, Al - Noor Pediatrics Hospital and many Primary health care centers. Stool and blood samples were collected, combined with information about each case including age, sex, duration of disease; and being hospitalized or not hospitalized. (60) of apparently healthy infants and children of the same age group were also included as a control group. Diarrheic patients were investigated by rapid chromatography test for rotavirus, 24 samples (20 %) showed positive results to rotavirus,among them 15 (20.83 %) Male while 9 (18.75 %) Females ,with significant differences in rates of infection according to gender. From (120) stool samples in present study found that (18) 15 % were positive to intestinal protozoa in which (10) 8.3 % show Entamoeba histolytica and (8) 6.6 % show Giardia lamblia.A. Viral infection was (20.83 %) in male and (18.75 % ) in female while which was (18) 15% for protozoal infection, The main causative agents of potozoal by E.histolytica (10) 8.3 % and Giardia lamblia (8) 6.6 % .B. The infection with rotavirus was high in patients from rural areas (59 %) than those from urban area (41 %), The vaccinated children with second dose were infected with rotavirus were more than those who received first dose ( 83 %, 17%) respectively. Vaccinated children were (94%) and non - vaccinated children ( 6 %).C. Reveals that most of infected children were under two years age, with highest percentage in those between (19 - 24) months and (7 - 12) months also (up tp 6) months 33.33 % , 22.7 % and 18.5 % respectively.D. The highest percentage of infection was shown in children which were 63 % on bottle feeding. E. The mean concentration of IL - 6 recorded (123 ± 25 pg/ml),while the control group (58 ± 24 pg/ml) with a significant differences (P˃0.05) between them, The results of Interleukin - 17 was elevated too in patients group (111 ± 17 pg/ml) while it was (31 ± 9 pg/ml) in healthy control group with a significant differences (P˃0.05) between them.F. The viral particles purification by using RNA extraction assay and semi nested PCR technique. There was two genotype detected P and G. Six genotypes were detected G1 with (37.50 %) which was the highest one followed by G2 (16.66 %) and the lowest percentage for G4 and G8 (4.16 %) for both. G. Five genotypes were detected P[8] (33.33 %),which was the highest one followed by P[4] (20.83 %) and the lowest one was P[9] (4.16 %).H. A mixed infections with more than one genotype G1 P[8] were observed and was found jointly in 9 samples from 24 positive samples ,while G1 P[4] observed in 3 samples , G2 P[4] in 5 samples, G3 P[8] in one sample , G9 P[8] and G4 P[8] in 2 samples. I. Co - infections were observed by rotavirus with Giardia lamblia in one third of positive rotavirus infections.

تاثير عملية البدانة على مستوى هرمون المضاد الموليرين وهرمون اللبتين في النساء البدينات == Effect of Bariatric Surgery on Antimullarian Hormone and Leptin level in Obese Women

Author name: مها صاحب ارحيم عبد الله

Supervisor name: حنان عبد الجبار الطائي

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: السمنة هي حالة طبية مرضية ، وهو اكثر شيوعا في النساء من الرجال. في عام 2013، صنفت الجمعية الطبية الامريكية السمنة كمرض. العلاج الاكثر فعالية للسمنة المفرطة هو جراحة علاج البدانة، والتي ترتبط على المدى الطويل مع فقدان الوزن وانخفاض معدل الوفيات عموما.ومن التغيرات الهرمونية التي تحدث بعد جراحة علاج البدانة هي التغيير في مؤشرات احتياطي المبيض ، وافضل علامة هو هرمون الانتيموليرين اما هرمون اللبتين وهو يفرز في الغالب من الانسجة الدهنية في الدورة الدموية، كذلك يطرا عليه التغير بعد اجراء عمليات علاج البدانة. الهدف من هذه الدراسة تحديد تاثير جراحة البدانة على هرمون احتياطي المبيض والسمنة.تم تسجيل ستين امراة مصابة بالسمنة، حضرن الى مستشفى الحلة التعليمي الجراحي في محافظة بابل ومستشفى التعليمي بمدينة الحسين الطبية ومستشفى الكفيل الجراحي في محافظة كربلاء خلال الفترة من شهر اب 2016 - ايار 2017.قيمت هذه الدراسة الخصائص الديموغرافية من المجموعة المدروسة (العمر والاقامة والتعليم والحالة الاجتماعية) ومؤشرات الجسم البشري (مؤشر كتلة الجسم، محيط الخصر، محيط الورك، ونسبة الخصر الورك،) لجميع المشاركين والملف الهرموني (هرمون انتيموليرين وهرمون اللبتين) للمشاركين قبل جراحة علاج البدانة وبعد شهرين منها.واظهرت نتائج الدراسة ان المرضى لديهم تغييرات كبيرة في نمط انتظام الدورة الشهرية (تطبيع دورة الطمث بعد جراحة السمنة)، وانخفاض كبير في مؤشر كتلة الجسم، محيط الخصر، محيط الورك، ونسبة الخصر الورك من قاعدة القيم الخطية لقيم ما بعد الجراحة.انخفض مستوى مصل الدم انتيموليرين واللبتين بشكل ملحوظ بعد جراحة علاج البدانة (قيمة P <0.05)، كما يوجد ارتباط سلبي معنوي بين مؤشر كتلة الجسم والهرمون انتيموليرين قبل وبعد جراحة علاج البدانة. اضافة الى الارتباط الايجابي بين هرمون اللبتين ومؤشر كتلة الجسم.توصلت الدراسة الى ان جراحة البدانة تؤثر على المعلمات الانثروبومترية، كما اثرت على مستويات المصل انتيموليرين وهرمون اللبتين .المريضات اللواتي يعانين من السمنة المفرطة يبدو انهن استفدن من جراحات انتيموليرين علاج البدانة من حيث تنظيم نمط الحيض. اعتمد الباحث في تعريب المصطلحات العلمية على : المعجم الطبي الموحد - انكليزي - عربي - رئيس التحرير د. محمود الجليلي - الطبعة الثانية 1978 م مطبعة المجمع العلمي العراقي. | Obesity is a medical condition, which is more common in women than men. In 2013, the American Medical Association classified obesity as a disease. The most effective treatment for severe obesity is Bariatric surgery, which is associated with long - term weight loss and decreased overall mortality.Antimullarian hormone is best markers for ovarian reserve, usually changes after Bariatric surgery, leptin is secreted predominantly from adipose tissue into the circulation, also will change after Bariatric surgery.This study aim was to determine serum level of antimullarian hormone and leptin hormone in obese females and estimate the impact of Bariatric surgery on antimullarian hormone and obesity. Sixty obese females were enrolled, they attended Al Hilla Surgical Teaching Hospital in Babylon Government, Teaching Hospital of Al Hussein Medical City and Al Kafeel Surgical Hospital in Karbala Government, through the period from August 2016 till May 2017.This study evaluated demographic characters of studied group (age, residence, education and marital status), anthropometric indices (body mass index, waist circumference, hip circumference, waist hip ratio) and hormonal profile (antimullarian hormone and leptin hormone) for all participants before Bariatric surgery and follow up after two months of operation. The results of the study showed that patients who have significant normalization of the menstrual cycle after Bariatric surgery, and significant reduction of body mass index, waist circumference, hip circumference, and waist hip ratio from baseline values to the postoperative values. Serum level of antimullarian hormone and leptin hormone are significantly declining after Bariatric surgery (p < 0.05), Also there is a significant negative correlation between body mass index and antimullarian hormone while positive correlation between body mass index and leptin hormone before and after Bariatric surgery. The present study concluded that Bariatric surgery affects the anthropometric parameters of patients, also effects on the levels of serum antimullarian hormone and leptin hormone. Morbidly obese patients got benefit from Bariatric surgery in terms of regularization of menstrual function

دور بعض العناصر النزرة في مرض التشنج الحمي البسيط عند الاطفال == The Role of Some Trace Elements in Simple Febrile Convulsion

Author name: ازاد فرحان هواس اسد

Supervisor name: حيدر هاشم الشلاه | عدنان حنظل الجوذري

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Febrile convulsion is one of the most common seizure disturbances in children with an approximate rate of 2 to 5 percent. Febrile seizures are seizures that occur between the age of 6 months and 60 months with a temperature of 38°C or higher, that are not the result of central nervous system infection or any metabolic imbalance, and that occur in the absence of a history of prior a febrile seizures. This study was carried out in Babylon Teaching Hospital for Gynecology and Pediatrics, Hilla City, Babylon Province. The samples of the patients are collected from the outpatient clinic and emergency room, during the period between August 2016 till February 2017.The sample population included 150 children, fifty of them were patients, 25 males (50%) and 25 females (50%) diagnosed with simple febrile convulsion and the other one hundred ,fifty with only fever, 30 males (60%) and 20 females (40%) and finally fifty of healthy subjects, 28 males (56%) and 22 females (44%).The parameter included in this study were (copper, zinc, selenium, magnesium, free ionized calcium, sodium and potassium) and comparative study between two techniques (atomic absorption spectrophotometry and manual spectrophotometer) in determination of trace elements.In the present study, the results showed significant increase in copper level in patient group in comparison with fever without convulsion group and healthy group p.value (< 0.05).Furthermore, it showed a significant low level of zinc and magnesium, in patients with febrile convulsion in comparison with other groups (only fever without convulsion and healthy person), p.value (<0.05).IIThe present study showed significant differences, in the means of potassium and sodium in group of patients with febrile convulsion and only fever without convulsion. Also there were significant differences between means of potassium and sodium in group of patients with febrile convulsion and healthy group, p.value (<0.05).There were no significant differences in means of the results of free ionized calcium and selenium in group of patients with febrile convulsion with other groups.Also the trace elements rather than selenium in the present study were done by two methods, atomic absorption spectrometry techniques, and spectrophotometric method. It was found differences between the two methods and the results obtained by these two methods were highly variant, according to validity test and ROC curve (receiver operating characteristic curve), which done to compare between atomic absorption technique and colorimetric method and the results obtained from atomic absorption showed highly (sensitivity, specificity and accuracy) in compared with the results of colorimetric method. the study concluded that changes in zinc, copper and magnesium levels could play a role in the development of simple febrile convulsion, also depending on the results obtained, the atomic absorption technique is considered superior for trace elements determination.

تقدير انزيم اللايييز الدهني، اييولييويروتين E واييولييويروتين C2 في الذكور المدخنين وغيرفي الذكور المدخنين وغير == Estimation of Lipoprotein Lipase Enzyme, Apolipoprotein E and Apolipoprotein C2 in Smokers and Nonsmokers Males in Hilla city

Author name: مثنى فليح حسن جلوب

Supervisor name: مها فاضل سميسم | عدي جاسم الصالحي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: moking is associated with an increase circulating low - density lipoprotein cholesterol (LDL - C), plasma triglycerides (TGs) and very lowdensity lipoprotein (VLDL) levels.The aim of this study is to investigate the cause of increasing (LDL) level in smoking men by measuring lipoprotein lipase (LPL), lipoprotein lipase receptor, apolipoprotein C2 (apoC2), apolipoprotein C2 receptor, apolipoprotein E (apo E), apo E receptor, (TG), (VLDL) and (LDL). To achieve this aim (87) men were included in this study, their ages between (40 - 50) years with normal body mass index. (58) of them were heavy smokers who smoked one to two packets (≥ 30 cigarettes per day for 10 years), (29) smokers (group A) without hypertension were included. The other (29) men were smokers with hypertension (group B), while the other (29) men were the control group. The sera sample of all groups were used to measure the concentration of lipid parameters TG, VLDL and LDL byusing colorimetric methods, and ELISA method for determination of LPL, LPL receptor, apo C2, apo C2 receptor, apo E and, apo E receptor. The results of the present study show : There is a significant increase (P <0.001) in mean of TG, VLDL and LDL - C in group (A) and (B) when compared to the control group, in addition, there is a significant increase in the mean of TG, LDL (p=0.05, P=0.015) respectively in the smoking group (B) when compared to group (A). The result showed there were no significant differences in mean of VLDL - C between group (A) and (B) (P=0.26). There is a significant decrease in the mean of LPL in groups (A, B) (p <0.001, P=0.011) respectively when compared to the control group. In addition, there is a significant increase in the mean of LPL in group (B) when compared to group (A) (P =0.02).There is a significant increase in the mean of lipoprotein lipase receptor in groups (A, B) (p=0.005, P=0.012) respectively when compared to the control group, and there are no significant differences in LPL receptor between group (A) and group (B) (P=0.66).There is a significant increase in the mean of apo C2 in group (A) and (B) (p<0.001, P=0.028) respectively, when compared to the control group, and there are no significant differences in the mean of apo C2 between groups (A) and (B) (P=0.85).There is a significant increase in the mean of apo C2 receptor in groups (A, B) (p=0.004, P=0.017) respectively, when compared to the control group, and there are no significant differences in the mean of apo C2 receptor between groups (A) and (B) (P=0.62).There is a significant increase in the mean of apo E in groups (A, B) (p=0.002, P<0.001) respectively, when compared to the control group. In addition, there are no significant differences in the mean of apo E between groups (A) and (B) (P=0.94).There is no significant differences in the mean of apo E receptor in study groups (A), (B) and control There is a significant negative correlation between LPL and TG in the control group (P<0.001, r = - 0.635) and in group (A) (P=0.001, r= - 0.498), but there is no significant correlation between LPL and TG level in group (B) (P=0.076, r = - 0.329).A significant negative correlation is found between LPL and VLDL control group (P<0.001, r= - 0.611), group A (P=0.002, r = - 0.546) and group B (P=0.004, r = - 0.513).There is a significant positive correlation between LPL and apo C2 in control group (P=0.022, r= 0.469). In addition, there is a significant negative correlation between LPL and apo C2 in group A (P=0.038, r = - 0.388) and there is no significant correlation in group (B) (P=0.070, r = - 0.341). There is a significant negative correlation of apo C2 with TG in control group (P=0.003, r = - 0.529). In addition, there is a significant positive correlation between apo C2 and TG in group A (P=0.011, r=0.464), and group B (P=0.004, r=0.508).There is a significant negative correlation of apo E with LDL in the control group (P=0.008, r = - 0.474). In addition, there is a significant positive correlation between apo E and LDL in group A (P=0.041, r =0.399) and group B (P<0.001, r =0.660).There is a significant negative correlation between apo E and TG in the control group (P=0.012, r = - 0.461). In addition, there is a significant positive correlation between apo E and TG in group A (P=0.034, r =0.395), and there is no significant correlation between apo E and TG in group (B) (P=0.079, r =0.325).The study concludes that smoking is as sociated with increase Apo E level that may alter VLDL resulting to increase LDL, also shows that the decreased level of LPL is related to smoking that causes hypertriglyceridemia and increasing Apo C2 as a response to enzyme deficiency. LPL receptor increased in smoking leading to decrease bindingof LPL to its legend lipoprotein.

وعي النساء المتزوجات مبكرا فيما يتعلق بتنظيم الاسرة في مراكز الرعاية الصحية الاولية في الفرات الاوسط == Awareness of Early Married Women Regarding Family Planning in Primary Health Care Centers in Middle Euphrates

Author name: رنا رزاق حميدي

Supervisor name: وفاء عبد الكريم عباس | امين عجيل الياسري

General topic: Medicine

Specific topic: Nursing

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Background : Adolescence is the most important and sensitive period of one’s life. Early marriage of girls, close to age of menarche, is a widespread practice in Arab countries. Knowledge on the cumulative effect of early maternal marriage on maternal and infant health during the childbearing period is insufficient. Understanding why people do not use family planning is critical to address unmet needs and to increase awareness about contraceptive use .( WHO, 2017)Methods : A descriptive design was conducted throughout the present study. The study was conducted in the primary health care centers in Middle Euphrate ( Babylon , Al Najaf , Karbala And Al Dewanya Province ). The sample of the study is non probability ( purposive sample ) which consist of (200) women attended the selected primary health care centers located at middle Euphrate for the age group ( 10 - 19 ) years . the questionnaire is used as a means of data collection.Results : The mean of current age of study sample was (18.98 ). The mean age at marriage was ( 15.37) . The high percent of study sample (58.0%) with current residency (urban).With regard to reproductive health awareness, the high percent of study sample (62% ) was aware of the legal age of marriage. High percent of the sample (75 %) showed a low level of awareness about the physical health needs of adolescents. With regard to family planning awareness, (64.5% ) of the study sample showed a lack of awareness about the term of family planning. While (71%) of the study sample confirmed that the source of knowledge about family planning methods is mother. (56% ) of the study sample reported that they had not used any contraceptive method before. With regard to perception of the use of contraception, the high percent of study sample ( 51% ) showed a moderate level of perception.Conclusion & Recommendation : With regard to reproductive health awareness, the highest percentage of the sample showed a high level of awareness in compared with the mean score. With regard to family planning awareness, the highest percentage of study sample had a moderate level of awareness as compared to mean score. With regard to perception of the use of contraception, the high percent of study sample showed a moderate level of perception. This study recommended to work with many institutions to increase awareness of adolescent women in regard with education and services.

العلاقة بين جين الانزيم المحول للانجيوتنسين متعدد الاشكال والانجيوتنسين 2 والانزيم المثبط لمحفز البلازمينوجين في المرضى الرجال المصابين باحتشاء العضلة القلبية وارتفاع ضغط الدم == The Association Between Angiotensin Converting Enzyme Gene Polymorphisms With Angiotensin II and Plasminogen Activator Inhibitor Levels in Male Patients With Myocardial Infarction And Hypertension

Author name: فلاح حسن محمد حسن

Supervisor name: مها فاضل سميسم | مشتاق وتوت

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Myocardial infarction (MI) is a necrosis of myocardial cell secondary to interruption of coronary blood supply caused by ischemia, Myocardial ischemia occurs when the oxygen supply to the heart is not sufficient to meet metabolic needs. The most common underlying cause of myocardial ischemia is obstruction of the coronary arteries by atherosclerosis.Many genetic factors that affect Blood Pressure, these Genetic factors include an inappropriately high activity of the Renin - angiotensin - system (RAS) and susceptibility to the effects of salts in the circulation.The aim of the study is to evaluate the role of Angiotensin converting enzyme - 1 (ACE - 1) polymorphism on the level of angiotensin II (Ang II), and the relation between Plasminogen activator inhibitor - 1 (PAI - 1) concentration and Ang II in (MI) and hypertension patients.This study was conducted in Hilla city, from the 1st of November 2016until 25th of February 2017. The MI samples were collected from the coronary care Unit (CCU) in Marjan Teaching Hospital in Babylon / Hilla city and Shaheed al mehrab center. The patients with hypertension sample were collected from Advisory Unit in the Marjan hospital. The control subject samples were collected from out of the hospitals.The study includes (100) males ageing between (50 - 60 years) and BMI (18.5 - 24.9) : 25 control, 75 patient groups, the groups of patient subdivided into {25 hypertensive patients for 10 to 15 years (group A), 25 hypertensive patients for ≥20 years (group B), 25 patients with MI plus hypertension (group C)}.XIIThe sera obtained from the blood of all groups were used to measure the concentrations of plasminogen activator inhibitor 1, angiotensin II, and lipid profile, while whole blood samples from study subjects were used to extract DNA for the study of polymorphisms in the angiotensin converting enzyme gene.The results show : 1. There is a significant increase in the mean of Ang II, PAI - 1 in groups (A, B and C) as compared to the control group, (p<0.01), but there was no significant difference between A and B groups2. The significant increase (P <0.01) in total cholesterol (TC), TG, LDL - C and VLDL - C, while serum HDL - C concentration was found to significantly decrease (P<0.01) in A, B and C groups as compared with the control groups, and no significant increase or decrease in lipid profiles in comparison between A and B groups.3. Groups (A, B and C) show significant positive correlations (p<0.01) (R = 0.7848, R= 0.6855, R = 0.8871) of Ang II concentration with PAI - 1 concentration respectively.In the genetic part of the study, genotypes angiotensin - converting enzyme gene determined by allele specific polymerase chain reactionThe result observed significantly increase of ACE - 1 deletion - deletion (DD) in group (C) (88%) compared with the control groups (44%), while there were no significant difference in the groups (A, B) compared with the control group, also the result showed ACE - 1 (DD) genotype was (66%),XIIIinsertion - deletion (ID) genotype was (34%) and ACE insertion - insertion II genotype was (0%) in all the study groupsConclusion : the (DD) genotype of the Angiotensin - converting enzyme - 1(ACE - 1) polymorphism was the most frequent among Babylon patients with myocardial infarction. This suggests that Babylon individuals with the (DD) genotype might be at high risk for myocardial infarction. Furthermore, D allele of the ACE - 1 polymorphism might confer increased risk for MIPlasminogen activator inhibitor - 1 (PAI - 1) may consider as a risk factor for myocardial infarction. And there was a positive correlation between Ang II and PAI - 1in all patient groups. Therefore DD genotype is lead to an increase of PAI - 1 level.

المستويات والانماط الجينية المتعددة لعامل نخر الورم ا الفا في مرضى التهاب المفاصل الرثوي في محافظة بابل == Tumor Necrosis Factor - Alpha ( - 308 G/A) Gene Polymorphisms and Levels in Rheumatoid Arthritis Patients in Babylon Province

Author name: احمد خفيف خشان فرج

Supervisor name: عبد السميع حسن الطائي | صباح جاسم الربيعي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Rheumatoid arthritis is a systemic autoimmune disease affects 0.5 - 1% of the worldwide population, characterized by chronic inflammation of the synovial joints, hyperplasia and overgrowth of synoviocytes, with destruction of articular cartilage of unknown etiology that can cause serious weakness and inability to work. Tumor necrosis factor - α (TNF - α) proinflammatory cytokines, that plays an important role in the inflammatory and immune responses in several diseases, including RA are responsible for progress of RA.The present study aims to estimated the levels of TNF - α and anti - cyclic citrullinated peptide (ACCPA) in patients with RA and healthy controls in the case - control study.The present study also aims to investigate the possible association between TNF - α levels and ( - 308 G/A) TNF - α promoter polymorphism in patients with RA in Babylon Province.This study was designed as a case control. Forty - five (10 males and 35 females) patients with RA and forty - five ( 9 males and 36 females) apparently healthy persons as control with the compatible age and sex were enrolled in this study. Measurement the levels of TNF - α and (ACCP) antibodies were estimated by enzyme - linked immunoassay ELISA technique. Measurement of rheumatoid factor (RF) was assayed by use slide agglutination test for the qualitative and semi quantitative. Whereas, C - reactive protein (CRP) was determined using latex - enhanced nephelometry. Disease severity score of RA patients was determined by use DAS - 28. DNA was isolated from white blood cells (WBCs) and TNF - α ( - 308 G/A) gene promoter polymorphism was determined by polymerasechain reaction - restriction fragment length polymorphism (PCR - RFLP) technique.The present study was found a significantly high levels of serum TNF - α and ACCPA in patients with RA when compared to healthy controls. The RF of patients with RA in the present study was found to be positive in 69.3% and negative in 30.7 % in overall RA patients, whereas was negative in 97.2% and positive in 2.8% of healthy control. The CRP of patients with RA in the present study was found to be positive in 75% and negative in 25 % of overall patients with RA and was positive in 11% and negative in 89% of healthy control. Correlation between TNF - α levels with both of DAS - 28 and ACCPA in RA patients found to be a significant positive correlation. Correlation between DAS - 28 and ACCPA in RA patients was a significant positive correlation. The genotype of ( - 308 G/A) TNF - α gene promoter polymorphisms the GG genotype was 60% in RA patients and 42.2% in control group, while the GA genotype was 40% in RA patients and 53.3% in control group. The AA genotype was 0% in RA patients and 4.4% in control group. The relation between both of TNF - α levels and DAS - 28 with genotyping of ( - 308 G/A) TNF - α gene promoter polymorphism in RA patients were found to be a non - significant correlation.Based on the results of the present study, it can be concluded that Babylon RA patients may have different genetic or environmental factors contributing to the pathogenesis of RA. Further studies are necessary to search for other genetic polymorphisms and/or genes that contribute to the increased expression of TNF - α and hence the pathogenesis of RA in Babylon patients. The TNF - α ( - 308 G/A) promoter polymorphism may not be associated with the presence of RA in Babylon patients. An increase in the circulating TNF - α concentration, the capacity to produce TNF - α in the WBC, or the cytotoxic activity of TNF - α were found. Thus, other factors may be important in determining the circulating levels of TNF - α in RA. And this SNP cannot affect the serum level of TNF - α in RA patients. In addition, the different genotypes of TNF - α ( - 308 G/A) have no influence on disease activity of the disease.

العلاقه بين الهموسستين,البروتين الرابط للرتينول,البري البومين,والالبومين في الحمل العنقودي الجزئي

Author name: قاسم عبد عزيز عيدان

Supervisor name: حيدر هاشم الشلاه | نادية مضر الحلي

General topic: Medicine

Specific topic: Clinical Biochemistry

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Hydatidiform mole is a premalignant condition, refers to an abnormal pregnancy characterized by varying degrees of abnormal trophoblastic proliferation. Several potential etiologic risk factors have been evaluated for the development of Hydatidiform Mole. These include the extreme of maternal age, prior Hydatidiform Mole, deficiency of Beta - carotene and animal fat intake.The aims of this study were to assess nutritional status as a possible cause of partial Hydatidiform mole and to investigate the changes in these markers in the first trimester pregnant women compared to non - pregnant.This study was conducted in Babylon Maternity and Pediatrics Teaching Hospital in Babylon Province and Al Zahraa teaching hospital in Al Najaf Province from the first of September 2016 to the end of March 2017.This study included 75 subjects, 25 were patients diagnosed with partial hydatidiform mole, the other 25 pregnant women in the first trimester were healthy subject (first control group), and the remainder 25 non pregnant women were healthy subject (second control group). Patients who suffered from metabolic or endocrine disease, renal dysfunction, and BMI > 30 were excluded.The sera obtained from the fasting blood of subjects were used to measure the level of homocysteine, Retinol binding protein, pre albumin, and albumin).The results of the present study showed that the mean age of patients group was (27.44 ± 5.36) years, ranging from 18 - 39 years and the peak incidence of partial hydatidiform mole between 22 - 29 years. The majority (76%) of patient with partial hydatidiform mole came from rural area. Accident finding at ultrasonography was the commonest way of presentation (44%) followed by vaginal bleeding (40%) while (16%)XIhyperemesis gravidram. the mean level of retinol binding protein was non significantly higher in the control group (366.4 ± 118.2 ng/ml vs. 326.5 ± 109.4 ng/ml; P=0.222). The Prealbumin levels were significantly lower in the pregnant patient women with partial hydatidiform mole compared with healthy pregnant women control group (18.71 ± 5.08 mg/dl vs. 23.40 ± 2.39 mg/dl; P < 0.001). There were no significant differences between blood levels of homocysteine and albumin in patient's women compared to healthy pregnant women (7.3 ± 2.0 mmol/l vs. 6.5 ± 1.92 mmol/l, P = 0.146), (3.98 ± 0.56 g/dl vs. 4.10 ± 0.25 g/dl, P = 0.337) respectively. The mean plasma homocysteine levels between first trimester pregnant women and non - pregnant was statistically lower (6.5 ± 1.92 mmol/l vs 10.02 ± 2.48 mmol/l; P < 0.001) respectively. The mean of serum albumin levels between first trimester pregnant women and non - pregnant was found statistically significant difference (4.10 ± 0.25 g/dl vs 4.58 ± 0.44 g/dl; P < 0.001) respectively. In conclusion, the highest percentage of patients with Partial Hydatidiform Mole belonging to the rural area, in nulliparous and low parous patients having 1 - 2 children. This study suggests that there was an association between prealbumin and Partial Hydatidiform Mole. There was no association between homocysteine and Partial Hydatidiform Mole.

معارف الامهات وعلاقتها بالسيطرة على الازيز المتكرر عند الاطفال دون سن الخامسة من العمر في مستشفيات الحلة للاطفال == Mothers Knowledge and Its relation to Control Recurrent Wheezy Chest among Children under Age five years old at AL - Hilla Hospitals

Author name: رغد ناظم صاحب ال نصيف

Supervisor name: نهاد محمد قاسم الدوري | عدنان حنظل الجوذري

General topic: Medicine

Specific topic: Nursing

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: A descriptive study was carried out on mothers who have children with recurrent wheezy chest under age five years old at Children's Hospitals in Hilla. The study was conducted through the period of 8January 2017 to October 2017. A purposive sample of (250) mothers have children with recurrent wheezy chest who were selected throughout the use of non - probability sampling approach, that include children who were diagnosed with recurrent wheezy chest and admitted to emergency and wards in Babylon teaching hospital for maternity and Children and AL - Noor hospital for children. Data were collected through the use of the questionnaire which was constructed by the researcher stranded on (RAND, 2001), for the purpose of present study. In order to ensure the validity of preliminary questionnaire, it was presented to panel of (15) experts from different fields to make it more valid. Data have been analyzed by using descriptive and inferential statistics, thus the finding of the study respected that mothers knowledge have poor level ( 47.6.0%). As well as self - Efficacy and perceived control the result were found poor level (51.2%) and the final result total scores of all the items (55.2%) with poor level. Also other finding of the study showed that there were association between (the mothers knowledge and their level education ,monthly income and gestation age )and child demographical information confirmed that there were significant association between (type of feeding and Child's order among sibling) with mothers knowledge.The study recommended an educational training programs application about asthma and its control, at children's hospitals for mothers, to understand and know how to deal with recurrent wheezy chest in order to overcome challenges of asthma control, moreover that similar studies should be conducted on a larger sample of children with different age and regions.

تقييم الالم والرضا عن طرق معالجة الالم للمرضى الراقدين في وحدات العناية الحرجه في مستشفيات الحلة التعليمية == Pain Assessment and Patient's Satisfaction on Pain Management for Adult Patients in Critical Care units in Al - Hilla Teaching Hospitals

Author name: امنه عبد الحسن جبر الجشعمي

Supervisor name: سحر ادهم علي | حسن علوان بيعي

General topic: Medicine

Specific topic: Nursing

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: Background : Pain is almost considered a significant problem for critically ill patients. Assessment is essential to reach the optimal pain management to improve quality of care which provided for critically adult patients who suffered acute pain especially with cardiac disease mainly chest pain, either prevent complications which occurs or prevention of the adverse effects of drug that associated with overdose from analgesics, Therefore the WHO recommended that the importance of pain management is one of the major challenges in medical field.Objectives : A current study aims to assess the level of pain of critically adult patients who admitted to the Coronary care Unit (C.C.U), as well as patient's satisfaction on pain management, and findout the relationship between pain level and patient's satisfaction.Methodology : Descriptive Cross - sectional design was carried out to assess pain for critically adult patients and their satisfaction on pain management in Al Hillah teaching hospitals. From 11 October.2016 to 31 August.2017 to achieve the objectives by selected purposive (Non - probability) sample consisted of (92) patients who admitted to C.C.U who were selected according to the specific criteria, data were collected from 12th March - to 26th May 2017 by using designed questionnaire through direct face - to - face interview method.The questionnaire divided of (5) parts, part one : contained demographical data, part two : contained general information, part threeVIIMcGill Pain Questionnaire, part four : contained pain killer medications while the last part is the satisfaction scale.The validity of the questionnaire obtained by reviews of (15) experts in different field, a Cronbach alpha used as statistical method to calculate the reliability of the study questionnaire which recorded as α = (0.742) which is statistically accepted, the statistical package of social sciences (SPSS, version 22) was used to analyze data.Results : Most of the study sample (57.61%) were male (61.96%) middle adult age group between (41 - 65) years, married, with low educational level who recorded sever pain intensity and moderate satisfaction related to the pain management strategies which received during their study in critical care units.Conclusion : Pain is stilled unsolved problem for adult patients in critical care units, who reported sever pain level, most of the sample expressed moderate satisfied level related to pain management.Recommendations : According to results of this study the researcher recommended : 1. Pain assessment and its documentation is essential by using a validated and accurate pain scale.2. Health care professionals should change their concept related to pain and be aware to assessing and managing their patient's pain, furthermore health planning department should concentrate more on patient's pain management within the criteria as important aspect of care when evaluating the quality of care.

Author name: نور هادي شعلان الاعرجي

Supervisor name: فرح نبيل عباس الصادق | صباح جاسم الربيعي

General topic: Medicine

Specific topic: Physiology

Degree: Master

University: University of Babylon - Faculty Of Medicine

Language: English

University location: Babylon

First pages:

Abstract: متلازمة النفق الرسغي (CTS) هو الاعتلال العصبي الانضغاطي الاكثر شيوعا في الاطراف العليا. يعاني المريض عادة مع تنمل والم في توزيع العصب المتوسط (median nerve) في اليد التي قد تمتد الى الساعد والذراع. ومع ذلك، فانه يسبب ضمور العضلة الرانفة (thenar muscle) في الحالات الشديدة. تحدث علامات واعراض المرض بسبب انضغاط العصب المتوسط في الرسغ كنتيجة لزيادة ضغط النفق الرسغي من قبل اي حالة.تهدف هذه الدراسة الى : 1.معرفة تاثير اصابة العصب المتوسط الموضعي في المريض المصاب بمتلازمة النفق الرسغي على متوسط الموجة ف للعصب المتوسط والعصب الزندي.2.تحديد اهمية انقلاب الموجة ف في المرضى الذين يعانون من متلازمة النفق الرسغي ذو الشدة الخفيفة.3.دراسة تاثير زيادة مؤشر كتلة الجسم على العصب المتوسط وارتباطه بشدة الاصابة بمتلازمة النفق الرسغي. اجريت هذه الدراسة في وحدة الفسلجة العصبية في مدينة مرجان الطبية، في الفترة من ايلول 2015 الى مارس 2016. تضمنت الدراسة مجموعة من المرضى الذين يعانون من اعراض سريرية لمتلازمة النفق الرسغي بالاضافة الى تاكيد هذه الاعراض عن طريق دراسة توصيل الاعصاب التي اظهرت ان جميع المرضى مصابين بالمتلازمة اعلاه ويبلغ عددهم 139 مريض تراوحت اعمارهم بين 20 - 60 سنة. وتشمل الدراسة ايضا 139 شخص من الاصحاء كمجموعة مقارنة وتطابقت هذه المجموعة مع المرضى من ناحية العمر والجنس ومؤشر كتلة الجسم.خضعت مجموعتي المرضى والاصحاء المشمولين بالدراسة لفحوصات شاملة تضمنت : التاريخ المرضي وقياس وزن الجسم والطول لحساب مؤشر كتلة الجسم. اجري لجميع المرضى والاصحاء فحوصات التقييم الكهروفسيولوجي (تقييم كهربائية العصب) والمتضمنة دراسة توصيل الاعصاب الحسية ، الحركية والموجة ف (دراسة توصيل الاعصاب) لكل من العصبين الزندي والوسطي لتاكيد التشخيص وتقييم شدة المرض.وجدت الدراسة ان خطر متلازمة النفق الرسغي تزداد بزيادة التقدم بالعمر مع ارتفاع معدل انتشار المرض بين الاناث مما هو عليه في الذكور، والعلاقة بين متلازمة النفق الرسغي ووظيفة الشخص هي علاقة هامة للغاية (p <0.01).ويظهر وجود تاريخ عائلي لمتلازمة النفق الرسغي اختلاف كبير بين مجموعات المرضى والاصحاء (P <0.05). كما بينت الدراسة ان مؤشر كتلة الجسم يعمل كعامل خطر لحدوث هذا المرض، ومعظم المرضى المصابين بمتلازمة النفق الرسغي يعانون من السمنة وزيادة الوزن. وكشفت الدراسة ان معايير الدراسة الكهروفسيولوجية الحسية والحركية للعصب المتوسط بما في ذلك (الكمون، السعة وسرعة التوصيل) بين المرضى ومجموعة الاصحاء عن ظهور تغييرات بفروقات معنوية عالية (P <0.01). اظهرت الدراسة ان علاقة الموجة ف للعصبين المتوسط والزندي، الفرق بين الموجتين لكلا العصبين، نسبة الموجة ف واستمرارها هامة جدا (P <0.01) في المرضى الذين يعانون من متلازمة النفق الرسغي بعكس مجموعة الاصحاء. كما اكدت الدراسة وجود ارتباط كبير بين متوسط كمون الموجة ف واستمرار الموجة ف للعصب المتوسط وشدة متلازمة النفق الرسغي حيث ان معظم الحالات الشديدة كانت لديها معدلات متوسط عالية للموجة ف وتنافص في استمرار الموجة. هناك علاقة ذات دلالة احصائية بين انقلاب الموجة ف في الحالات خفيفة الشدة لمتلازمة النفق الرسغي مقارنة بمجموعة الاشخاص الاصحاء. كما اكدت الدراسة وجود علاقة ارتباط كبيرة بين مؤشر كتلة الجسم وشدة متلازمة النفق الرسغي حيث ان معظم المرضى الذين يعانون من اصابات خفيفة، معتدلة وحادة كانوا يعانون من السمنة المفرطة (P <0.05)، بالاضافة الى اختلاف كبير جدا في مدة المرض بين ثلاث مجموعات من درجات شدة المرض(P <0.01). هناك علاقة ارتباط معنوية عالية بين شدة متلازمة النفق الرسغي والايدي المهيمنة (اليمنى) المتضررة حيث ان اصاباتها كانت تتراوح بين متوسطة الشدة وحادة. وهناك علاقة ذات دلالة احصائية عالية بين العمر وشدة المرض يتم تحديدها عن طريق دراسة توصيل الاعصاب (P <0.01).توصلت هذه الدراسة الى ان اضافة قياسات اخرى الى دراسة توصيل الاعصاب التي تعتبر المعيار الاساسي لتشخيص متلازمة النفق الرسغي تزيد من دقتها. وتشير البيانات المتوفرة لدينا الى جانب دراسة التوصيل الحسية والحركية للعصبين المتوسط والزندي ، الى علاقة ذات دلالة احصائية بين متوسط واستمرار الموجة ف وشدة متلازمة النفق الرسغي. كما اظهرت ان انقلاب الموجة ف يساعد في تاكيد تشخيص الحالات خفيفة الشدة للمرض. تستنتج هذه الدراسة ان اضافة دراسة الموجة ف للعصب المتوسط والزندي الى دراسة توصيل الاعصاب في تشخيص المرضى المصابين بمتلازمة النفق الرسغي يزيد من موثوقيتها في التشخيص وتحديد شدة المرض. واظهرت الدراسة ان متلازمة النفق الرسغي في الغالب تصيب الاناث اكثر من الذكور وتزداد نسبة الاصابة بالمرض مع تقدم العمر. ان معظم الايدي الاكثر تضررا هي الايدي المهيمنة وفي كثير من الاحيان تكون درجة اصابتها عالية الشدة. وتمثل السمنة ومهنة الشخص عوامل خطورة مهمة لمتلازمة النفق الرسغي. ترتبط شدة المرض بشكل كبير مع التقدم في العمر، مدة الاصابة التي يعاني فيها المريض ومؤشر كتلة الجسم. | Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy of the upper limbs. The patient usually presented with paresthesia and pain in the distribution of the median nerve in the hand that may extend to the forearm and arm. However, it causes thenar atrophy in severe cases. The signs and symptoms occur as a result of compression of median nerve at wrist due to increasing of the carpal tunnel pressure by any condition.This study aims to : 1. Assess the effect of focal median nerve entrapment in patient with CTS on F - wave parameters of median and ulnar nerves.2. Determine the importance of F - wave inversion in the patients with mild CTS.3. Find out the effect of increasing body mass index (BMI) on median nerve and its association with the severity of CTS. The study was conducted in neurophysiological unit at Merjan Medical City, in the period from September 2015 to March 2016. Including (139) patient with clinical presentation of CTS as well as positive nerve conduction studies (NCS) with age ranged for (20 - 60) years. The study also includes (139) apparently healthy person as control group of which were matched in age, gender and BMI to patients group. The patients and control enrolled in the study had undergone comprehensive assessment that includes : history and measurement of the body weight and height to calculate BMI. Electrophysiological assessment includes sensory, motor and F - wave by nerve conduction studies for both median and ulnar nerves to confirm the diagnosis and assess the severity of CTS. The results of the study find that the risk of CTS increases as the age increase with high prevalence among female than male, the relationship between CTS and occupation is highly significant (p < 0.01). Having family history of CTS shows significant difference between patients and control groups (P < 0.05). Body mass index acts as an independent risk factor to develop CTS and most of patients with CTS are obese and overweight. The electrophysiological findings of sensory and motor parameters of median nerve including (latency, amplitude and conduction velocity) between patients and control groups all show highly significant difference (p <0.01). F - wave of median, ulnar and median - ulnar nerve difference are highly significant (p <0.01) in patients than control group. F ratio and F persistence of median nerve are significantly lower (p < 0.01) in patients than control group. There is significant association between mean median F - wave minimal latency (FWML) and F persistence with the severity of CTS as most severe cases have higher mean and lower number of F response. There is significant relationship between F - wave inversions in mild CTS as compared to control group. There is significant association between BMI and severity of CTS and most cases with mild, moderate and severe are obese (P < 0.05), In addition to highly significant difference in the duration of disease between three groups grades severity of CTS (P < 0.01). A high significant association between the severity of CTS and affected dominant hand and most of dominant hands are moderately and severely affected. There is a high significant relationship between age and severity of disease is determined by NCS (P < 0.01). The study concludes that addition of other measurement to NCS which is the gold standard for diagnosis of CTS will increase its accuracy. Besides sensory and motor conduction study of median and ulnar nerves, our data show significant relation between mean median F - wave latency and F persistence with the severity of CTS. F - wave inversion helps in confirming the diagnosis of mild CTS. The study concludes that addition of F - wave studies of median and ulnar nerves to conventional NCS in patients with CTS increases its reliability in the diagnosis and assessing the severity CTS. CTS is mostly affected female than male. The incidence of the disease is increased with increasing age. The most affected hands are right dominant hands and frequently with higher degree of severity. Obesity and occupation represent important predisposing factors for CTS. The severity of CTS is significantly associated with age, duration of complaint and BMI