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تاثير القلق او الاكتئاب او كلاهما على الالم والتيبس والوظيفة البدنية لعينة من المرضى المصابين بالفصال العظمي الاولي للركبة : دراسة مقطعية عرضية == Impact of Anxiety and/or Depression symptoms on Pain, Stiffness, and Physical Function in Patients with Primary Osteoarthritis of The Knee : A Cross Sectional Study

Author name: عياء عبد الامير محمد

Supervisor name: سامي سلمان شهاب

General topic: Medicine

Specific topic: Diseases - Joints

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

Abstract: Background : Osteoarthritis is the most common articular disease of thedeveloped countries and a leading cause of pain and disability. The presenceof anxiety and depression symptoms in patients with osteoarthritis canadversely affect pain and physical function. There is also a proposed adverseeffect of anxiety and depression symptoms on joint stiffness.Objective : To examine the effect of anxiety and/or depression on pain,stiffness, and physical function in patients with knee osteoarthritis.Patients and Methods : A cross - sectional study was conducted on a totalof 101 patients with diagnosis of primary knee osteoarthritis according tothe American College of Rheumatology criteria. Each patient completed theWestern Ontario and McMaster Universities Osteoarthritis (WOMAC) Indexand the Hopkins Symptoms Checklist - 25 for anxiety and depression (HSCL - 25). The presence of anxiety and/or depressive symptoms was determined,and their effects on the WOMAC scores were assessed.Results : According to the study, 83.2% of patients were found to haveanxiety and/or depression symptoms while only 16.8% have no symptoms ofthese disorders. Patients with anxiety symptoms only had significantlyhigher mean pain score than those with none (p. value = 0.042). while theeffect of anxiety symptoms only on the mean physical function, stiffness,and total WOMAC scores was not statistically significant, (p .value = 0.18,0.87, 0.08) respectively. Patients with depression symptoms only hadsignificantly higher mean pain, physical function, and total WOMAC scoresas compared with those with none, (p .value = 0.044, 0.021, 0.013)respectively. While there is no statistically significant effect for the presenceof depression symptoms only on mean stiffness score (p. value = 0.094).Patients who have symptoms of both anxiety and depression had higherABSTRACTVIImean pain, physical function, stiffness, and total WOMAC scores comparedwith those with none , (p. value <0.001, <0.001, =0.013, <0.001). The totalnumber of patients with anxiety and/or depression symptoms hadsignificantly higher mean pain, physical function, stiffness, and totalWOMAC scores as compared with those with none, (p. value <0.001, <0.001, =0.01, <0.001) respectively. After performing multiple logistic regressions to control any confounding effect, the pain, Stiffness and total WOMAC scores were significantly associated with the presence of anxiety and or depression, (P. value<0.05), after adjustment for other variables.Conclusions : 1. According to anxiety and depression scores most of the patients with KOA had anxiety or depression symptoms or both.2. The presence of anxiety and/or depression symptoms was associated with significantly higher pain, stiffness, and total WOMAC scores, but the association with physical function scores was not significant.

تحليل نتائج ناظور القصبات المرن لردهة الامراض الصدرية والتنفسية في مستشفى بغداد التعليمي لسنة 2015 == Analysis of bronchoscopic findings in respiratory unit at Baghdad teaching hospital in 2015

Author name: حيدر منذر عبود

Supervisor name: محمد وهيب سلمان العبيدي

General topic: Medicine

Specific topic: Diseases - Thoracic

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

علاقة مستوى فيتامين د وهورمون النحافه مع مرض فصال الركبه الاولي في مجموعه من النساء العراقيات == ASSOCIATION OF VITAMIN )D( AND SERUM LEPTIN LEVELS WITH KNEE OSTEOARTHRITIS IN A SAMPLE OF IRAQI FEMALES

Author name: زهراء عبد الله

Supervisor name: سامي سلمان شهاب

General topic: Medicine

Specific topic: Diseases - Joints

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

Abstract: Osteoarthritis (OA) is a biomechanical process whereby joints respond pathologically mechanical stress, resulting in cartilage degradation and changes in subchondral bone. It has many risk factors as known female gender, obesity, and aging. Vitamin D may exert its effect on OA through bone; its deficiency could impair the ability of bone to respond optimally to insults. Leptin is a peptide hormone secreted by adipocytes and plays an important role in regulation of body weight, its level more in obese subjects and female gender regardless of obesity, so it may play a metabolic link between obesity and osteoarthritis. So both vitamin deficiency and increase leptin level may be risk factors for osteoarthritis Objective : To examine the cross - sectional association of vitamin D and serum leptin levels in a sample of Iraqi female with knee osteoarthritis.Method : A total of 180 women divided into 2 groups 90 subjects the first group for vitamin D levels and 90 subjects the second group for serum leptin levels and each group further classified into patients and equal number of their matched healthy controls in age and sex.In each group osteoarthritis was diagnosed according to ACR criteria for osteoarthritis and their body mass index (BMI) classified according to WHO classification of BMI into 3 groups : normal weight, overweight, obese Radiological grading done according to kellegren and Laurence radiological classification for osteoarthritis. Both vitamin D and leptin levels were assessed using ELIZA method.The first group (vitamin D and osteoarthritis) mean vitamin D levels in cases (45cases) were (0.309_+0.641) compared to (0.2614_+0.386) in controls. So vitamin D deficiency is prevalent among cases and controls and its level was inversely associated with body mass index, the deficiency was more severe among female in obese and overweight than normal weight.Associations of vitamin D levels with radiological grading, cases with grade ||| and |\/ are more deficiency than grade ||.The second group (serum leptin level and osteoarthritis), leptin was significantly higher in cases compared to controls, the mean serum leptin was (52.41_+28.26) and (40.39_+ 25.67) respectively. Its level directly correlated with body mass index, higher levels in obese and overweight than normal weight subjects, the difference was significant among both cases and controls.Association of leptin levels with radiological grading, the mean serum leptin was higher in cases with grade ||| , |\/ than grade ||.Conclusion : Vitamin D deficiency was prevalent among middle age Iraqi women, so it is difficult to establish a clear association between vitamin D deficiency and osteoarthritis in this study, and the deficiency was more in women with higher body mass index.Serum leptin level was higher in osteoarthritis women than their matched controls, and its level directly associated with increased in body mass index

عرض توزيع الخلايا الحمراء ومتوسط حجم الصفائح الدموية لدى عينه من المرضى العراقيين البالغين المصابين بمرض التهاب الفقار اللاصق == Red cell Distribution Width and Mean Platelets Volume in sample of adult Iraqi patients with Ankylosing Spondylitis

Author name: علي مكي حسن

Supervisor name: فائق ايشو كوريال

General topic: Medicine

Specific topic: Diseases - Joints

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

Abstract: Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease that affects the axial skeleton causing characteristic back pain, and lead to structural and functional impairment and decrease in the quality of life.Mean platelet volume (MPV) is a part of the complete blood count (CBC) test and correlates with the platelets function and activation. Red cell distribution width (RDW) is a part of the complete blood count (CBC) and estimates erythrocyte variability.Objective : To analyse RDW and MPV in patients with AS and to evaluate their relationships with acute phase reactants (APRs) and disease activity index.Patients and Methods : A total of 100 patients with AS (78 males : 22 females) diagnosed according to the modified New York classification criteria for AS and 146 (99male : 47female) healthy individuals matched in age and gender as controls enrolled in the study. Demographic data, disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), medical history, Creactive protein (CRP), erythrocytes sedimentation rate (ESR), and complete blood count (CBC) were all measured.Results : The mean age for patients and control was 38.0 ± 9.0 and 35.8 ± 9.0 years respectively (p=0.057). Both MPV and RDW were significantly higher in patients with AS (9.215 ± 1.570 p < 0.001 and 14.133 ± 1.613 p < 0.001 respectively) compared with controls (7.753 ± 0.857 p < 0.001 and 12.299 ± 1.031 p < 0.001 respectively). There was a direct correlation of (RDW and MPV with both ESR and CRP (P < 0.001 for RDW and 0.01 for MPV), RDW had r=0.38 for C - reactive protein (CRP) and 0.413 for ESR, and MPV had r=0.23 for CRP and 0.232 for Abstract VIESR. Also BASDAI was directly correlated with RDW (r=0.326 p<0.001) and MPV (r=0.333, p<0.001).Conclusion : Both MPV and RDW were higher in AS patients than in controls and are directly correlated with ESR, CRP, and BASDAI.

المقارنة بين مؤشر اداء عضلة القلب بطريقة الدوبلر الموجي النابض مع مؤشر اداء عضلة القلب بطريقة الدوبلر النسيجي لصدى القلب لمرضى الاختلال الوظيفي الانقباضي للبطين الايسر == Comparison Between Pulsed - Wave Doppler Derived Myocardial Performance Index with Tissue - Doppler Tie index in patients with Left Ventricular Systolic Dysfunction

Author name: اسيل اقبال سعيد

Supervisor name: حسن علي الفرحان

General topic: Medicine

Specific topic: Echocardiography

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

Abstract: Background : MPI is one of the methods used to assess global cardiac function, the Calculation of MPI using TDI may have advantages over conventional left ventricle inflow/outflow tract pulsed - wave Doppler (PWD) method that might be due to heart rariability; for example, all of the data needed for TDI - MPI calculation can be derived from one single cardiac cycle, whereas with PWD at least two different cycles are needed. Thus, heart rate variability does not interfere with TDI - MPI.Aim : Myocardial performance index (MPI) is usually measured with pulsed wave Doppler (PWD). Our aim was to compare this method with TDI - MPI in patients with LV systolic dysfunction and to assess the degree of agreement between PWD and a method based on tissue Doppler imaging (TDI).Patients and methods : Sixty - five patients with LV systolic dysfunction EF by Simpson method (38.6 ± 5.8) and 35 control subjects (with normal LV systolic function and diastole) EF (67.6 ± 2.8) underwent measurement of time intervals and MPI with PWD and pulsed TDI at septal, lateral, anterior, inferior sides of mitral annulus.Results : The agreement was moderate between two methods {Agreement = 46.7% Repeatability (for alpha = 0.05) = 0.609 (NS)}.Receiver operating characteristic curves showed very high accuracy for both methods to discriminate patients with LV systolic dysfunction from healthy subjects; the optimal cutoff point was different and specific to each method : 0.44 for the conventional method and 0.56 for the TDI - MPI method.TDI - MPI values were higher than conventional MPI values in both groups (55% ± 1% vs 44% ± 3%, P < 0.001 in the healthy subjects; 88% ± 23% vs 61% ± 16%, P <0.001 in the patients with HF).Conclusion : We performed a study in healthy adults and in patients with congestive heart failure to investigate the clinical agreement between MPI measured conventionally and by PW - TD of the mitral annulus. We found moderate agreement between MPI measured by the conventional method and by TDI.Both methods had high diagnostic accuracy for detection of systolic dysfunction and TDI - MPI was more sensitive

كفاءة استعمال الشريط العلاجي لعلاج الفصال العظمي في مفصل الركبة دراسة عشوائية مسيطر عليها == Efficacy of Knee Tape in Management of Knee Osteoarthritis : Randomized Controlled Trail

Author name: رشا كاظم حسوني

Supervisor name: سامي سلمان شهاب

General topic: Medicine

Specific topic: Diseases - Joints

Degree: Higher Diploma

University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department

Language: English

University location: Baghdad

First pages:

Abstract: الفصال العظمي هو اضطراب تنكسي مزمن متعدد الاسباب ، يمتاز باضمحلال الغضروف المفصلي. الفصال العظمي هو سبب رئيسي للالم والاعاقه عند كبار السن على نطاق عالمي . في غضون ذلك تم احراز تقدم محدود باتجاه علاج المرض,معالجة الاعراض هو الركن الاساسي في العلاج. من المهم توفيرعلاجات بسيطه وغير مكلفه التي تزيد من تشكيلة الخيارات للمرضى.الهدف : لفحص تاثير استخدام الشريط العلاجي للركبه في تحسين الالم ، والوظيفة البدنية في مرضى الفصال العظمي للركبة وان الفائده تستمر حتى بعد ايقاف العلاج.المرضى والطرق : الدراسة هي عشوائية متحكم بها, شملت 170 مريضا والذين يعانون مرض فصال الركبة الاولي حسب الكلية الامريكية لامراض المفاصل.تم توزيعهم عشوائيا على ثلاثة مجاميع .تلقت المجموعة الاولى الشريط العلاجي , وتلقت المجموعة الثانية الشريط المتحكم به,وجموعة بدون شريط. كان المقياس لمدى الفعالية للعلاج هو التغير الحاصل في مؤشر فصال العظام لجامعات ماكماستر واونتاريو الغربية (وماك ) (WOMAC ) شاملا الالم، التيبس والوظيفة البدنية.النتائج : وجدت الدراسة ان هناك انخفاضا واضحا ذو دلالة احصائيه في مؤشر الالم ,التيبس ,الوظيفة البدنية عند الزيارة الثانية (3اسابيع من النظام العلاجي) في مجموعة الشريط العلاجي والشريط المتحكم به هو اكبر مما هو بالنسبه لمجوعه بدون شريط.لوحظ عند الزيارة الثالثة بعد مرور 3 اسابيع على قطع العلاج ان مؤشرات الالم ،التيبس ، الوظيفة بقيت تقريبا مقاربه للزياره الثانيه لدى مرضى المجموعة الاولى بينما كان النقصان طفيف في المجموعة الثانية .الفائده للشريط امتدت لثلاثة اسابيع بعد توقف العلاج. الاستنتاجات : الشريط العلاجي كانت طريقه فعالة في تحسين الاعراض لدى مرضى الفصال العظمي لمفصل الركبة فيما يتعلق بالالم، التيبس | Osteoarthritis (OA) is a chronic degenerative disease of multifactorial etiology described by loss of articular cartilage. Osteoarthritis is a leading cause of pain and disability in elderly people worldwide. Meanwhile limited progress has been made towards curing the disease, management of symptoms is the mainstay of treatment. Simple, inexpensive treatments that increase the range of options for patients with the disease are necessary.Aim of the studyTo test the suggestions that therapeutic taping of the knee improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment.Patients and methodsA randomized, control study included 170 patients were diagnosed to have knee OA according to the American College of Rheumatology (ACR) criteria for classification of (KOA).Patients were randomly allocated to receive e either therapeutic tape, control tape, or no tape. The efficacy outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) including the pain, stiffness and physical function subscales.ResultsSignificant reduction in the pain, stiffness , physical function in the 2nd visit (after 3 weeks of treatment regimen) (P<0.001) in tape group and control group (p=0.003) than no tape group (p=0.056).At the third visit 3weeks after cessation of treatment these scores remain to approximate the 2nd visit value in tape group , while slightly decreased in control group. Benefits of therapeutic tape were maintained three weeks after stopping treatment.ConclusionTherapeutic knee taping is an efficacious treatment for the management of pain and disability in patients with knee osteoarthritis