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وفيات الامهات بسبب نزف ما بعد الولادة في العراق خلال 2015 - 2017 == Maternal Deaths due to Postpartum Hemorrhage in Iraq (2015 - 2017)

Author name: اسمهان عبد الكاظم قاسم
Supervisor name: بتول علي غالب ياسين
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : According to the world health organization, obstetrics hemorrhage causes 127,000 deaths annually worldwide and is the leading cause of maternal mortality. Post - Partum Hemorrhage (PPH) remains the number one killer of mothers and accounts about 28% of all maternal deaths in developing countries.There is an increase risk in the PPH even in developed countries due to number of changes in recent years. The current study aimed to thoroughly analyze the reported maternal deaths due to PPH, to identify factors associated with the occurrence of PPH.Methods : A cross sectional study was carried out at the Maternal and Child Health (MCH) Section, Public Health Directorate, MOH, Iraq, from Feb. to Jun, 2018. All records of maternal death during 2015 - 2017 that were available at the MCH section were reviewed and those who died because of PPH were retrieved and analyzed.Results : PPH as a cause of maternal death in Iraq during the period (2015 - 2017) ranged from 16.7 % among all reported maternal deaths during 2015 to 26.9% during 2016 and 20.1% during 2017. Half of women who passed because of PPH were among the young age group (20 - 35 years), 56.2% lived in urban areas, more than one third were from Baghdad city, 45.8% of the deceased women did not attend ANC services, 64.2% of them delivered their babies at hospitals, 87.1% of deaths took place at hospitals, uterine atony was the first cause for developing PPH 27.4%, delay 1 was on the top of the list (alone 31.3%, combined with other delays 70.2%), grand multiparous was the first risk reported in 31.8% of the records. Conclusion : Among all deceased during 2015 - 2017, PPH was the cause of death in 20.2%. PPH was higher among those aged 20 - 35, with low educational level, from urban residency, grand multiparous, with no ANC during pregnancy, more than 37 weeks of gestation. Uterine atony was the first cause of PPH followed by traumas (Cervical tear and ruptured uterus) and the least was placental complications. D1, alone or combined with others, was on the top of the list followed by D3 which indicated substandard care.Increased awareness about the importance of safe motherhood, timely decision to seek emergency obstetrics care, ensure that all deliveries should be attended by skilled birth attendance and improving the quality of emergency obstetrics will help in decreasing maternal death.

دراسة نسبة انتشار مرض التهاب الكبد الفيروسي نوعي "بي" و"سي" ومرض العوز المناعي بين مرضى الفشل الكلوي المرحلة النهائية الخاضعين للانفاذ الدموي == Prevalence of Viral Hepatitis (B), (C), and Human Immunodeficiency Virus (HIV) in End Stage Renal Disease Patients on Hemodialysis

Author name: مروة انيس عبد العظيم
Supervisor name: نادية عزيز ناصر
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:

الخصائص الوبائية لاصابات الحروق في بغداد, العراق 2017 == Epidemiological Characteristics of Burn Injuries in Baghdad, Iraq, 2017

Author name: احمد جهاد تقي
Supervisor name: فارس حسن اللامي
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Burn injuries are among the most devastating of all injuries and a major global public health crisis. Burns are the fourth most common type of trauma worldwide and account for 1% of the global burden of diseases. According to the latest report from WHO, there were about 6000 deaths in Iraq in 2015 from fire - related causes and 18,000 disability - related burns.Objectives : To describe epidemiological and clinical characteristics of burn injuries in Baghdad, Iraq 2017, to estimate the case fatality rate, Lethal Area 50 (LA50), Baux score 50 and Futility Point and to identify the main determinants of death among burn cases in Baghdad, Iraq, 2017.Patients and Methods : A cross sectional study was conducted in all the burn hospitals and wards in the public hospitals in Baghdad. The files of all burn patients with different types and degrees of burn injuries who were admitted to these hospitals during 2017 were obtained from the statistical department in these hospitals and included in the study. Patients with minor superficial burns treated in the emergency department as an outpatient and patients admitted for surgical treatment of old scars were excluded. A form was used to collect socio - demographic, clinical and epidemiological data of the patients.Results : The mean age of the patients was 21.08 ± 15.2 years; 55.6% were males; 71.8% were singles; and 86.3% were living in Baghdad, and around 95% had no past medical history. Flame was the cause of burn in 63.6% of the patients; trunk was the most common site affected (69.6%); 42% had second degree of burn, and 29% developed infection after burn. The proportion of mortality was 36.2%. Logistic regression analysis revealed the following significant risk factor : Low duration of

نتائج حمل المراهقة في العزيزية - محافظة واسط / العراق == Outcome of Teenage Pregnancy in Al - Azyzia - Wasit Province - Iraq2017

Author name: رند رحيم رسن
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
Key words:
  • الحمل العكسية
  • مقارنة الحمل عند البالغات والمراهقات
  • مضاعفات حمل المراهقة.
First pages:
Abstract: خلفية البحث : حمل المراهقات يعتبر مشكلة صحية شائعة في العراق حيث الزواج المبكر والحمل يشجع من قبل المجتمع بسبب الظروف الاقتصادية والخلفية الثقافية. الامهات المراهقات اللواتي يواجهن خلال الحمل وبعد الولادة معدلات اعتلال ووفيات اعلى مقارنة بالامهات البالغات.هدف الدراسة : هدف هذا العمل هو تقييم نتائج حمل المراهقات اثناء الحمل وما بعد الولادة.المنهجية : دراسة الحالات والشواهد طبقت في هذه الدراسة، حيث ان عينة مكونة من 600 حامل باكر جمعوا بطريقة العينات العشوائية المنظمة من قبل الباحثة من ملفات المرضى اللذين رقدوا في ردهات النسائية في مستشفى العزيزية العام - واسط خلال فترة الدراسة من بداية الشهر الثالث حتى نهايةالشهر السادس من عام 2017. المجموعة الاولى (الحالات) : 200 حامل باكر بسن المراهقة والمجموعة الثانية (الشواهد) : 400 حامل باكر بسن البلوغ.نتائج الحمل التي تمت ملاحظتها للامهات : طريقة الولادة، النزف ما بعد الولادة، اضطراب الضغط، السكر خلال الحمل والاسقاط.وكذلك النتائج التي تمت ملاحظتها للوليد : عمر الحمل عند الولادة ووزن الوليد، الولادات المبكرة، دخول الوليد للخدج، التشوهات الولادية نتيجة الولادة.النتائج : الامهات المراهقات اظهروا فروق ذات دلالات احصائية بالنسبة لوزن الطفل، الولادة المبكرة، النزف ما بعد الولادة والاسقاطات بالمقارنة مع الامهات البالغات واعتبرت مهمة احصائيا، حيث ان قيم P هي : 0.001, 0.003, 0.001 و0.008 بالتتابع تمثل حدوث اضطراب الضغط، التشوهات الولادية وسكر الحمل عند الامهات المراهقات اكثر من حدوثها عند الامهات البالغات، لكنها تعتبر غير مهمة احصائيا. كذلك، الاعتلال الولادي، سوء التغذية والاسقاط الطبيعي وجدت عند الامهات المراهقات اكثر من البالغات.الاستنتاج : هذه النتيجة تؤيد الراي المتعارف عليه بالنتائج السلبية للحمل بعمر المراهقة بسبب الاوضاع الاقتصادية، الزيارات الصحية الغير منتظمة خلال فترة الحمل وجهل الابوين بمخاطر الحمل المبكر وسوء التغذية خلال فترة الحمل | Background : Teenage pregnancy is a common health problem in Iraq where early marriage and child bearing is encouraged by communities due to many socioeconomic reasons and cultural backgrounds. Teenage mothers are facing higher maternal and prenatal morbidity and mortality than adult mothers.Objective : The objective of this work was evaluating obstetric, maternal and neonatal outcome.Method : In this study (case control study), a sample consisted of 600 records related to primigravida all gave birth at Al - Azyzia general hospital during the study period. First group (cases) 200 records related to primigravida teenage pregnant and second group (controls) 400 records related to primigravida adult pregnant. Pregnancy outcome were observed for mothers : mode of delivery, post - partum hemorrhage, hypertensive disorder, DM during pregnancy and abortion. While, for neonatal : gestational age at birth, birth weight, preterm labor, admission to neonatal care unit, congenital anomalies and neonatal outcome.Result : - Teenage mothers showed low birth weight, preterm labor, postpartum hemorrhage and abortion as compared with adult mothers and considered as significant statistically, where, P value respectively, 0.001, 0.003, 0.001 and 0.008 the incidence of hypertensive disorder, congenital anomaly and DM more in teenage mother, but not significant statistically. Congenital abnormality, malnutrition and spontaneous abortion were found to be more in teenage mothers also.Conclusion : - This finding challenges the accepted opinion adverse birth outcome associated with teenage pregnancy.Keywords : adverse pregnancy outcome, teenage - adult pregnancy comparison, teenage pregnancy complications.

سوء معاملة الاطفال في بغداد == Child Maltreatment in Baghdad

Author name: زهراء ناطق شحاذة
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Child maltreatment is a universal problem with significant consequences for children, families, communities.It is preventable through identification its roots and implementation of effective solutions and preventive programs.Objectives : To estimate the prevalence of maltreatment in primary school and to study the associated factors.Methods : A cross sectional study was carried out in the primary schools in Baghdad / AL - Rusafa / Educational directorate is the first of AL - Rusafa in three public schools and two private schools from the period of 20Th of February 2018 - 30th of April 2018, age of them (10 - 12) years, demographic data and short child maltreatment questionnaires were used to gather the necessary information and filled through direct interview with children in their schools.Results : Among the 426 child, emotional abuse was the most common, noticed in (80.9% ) of children, followed by physical abuse (63.8% ) , then witnessing parental violence (26.3%) then sexual abuse (verbal) (7.7%), emotional neglect (6.6%) , physical neglect ( 2.6%) and no sexual abuse (physical).Education of parents, divorce and widows, crowding index , parent state and mental health problem, addiction or alcoholism were determinants in child maltreatment. Conclusion : Childhood maltreatment is prevalent phenomenon, the likelihood of occurrence of maltreatment varied across many sociodemographic characteristic .

معدل انتشار وتاثير والممارسات العلاجية لعصر الطمث الاولي بين طالبات المدارس الثانوية في بغداد 2018 == Prevalence, Impact and Management Practice of Primary Dysmenorrhea among Female Students in Secondary Schools in Baghdad 2018

Author name: عائشة عامر
Supervisor name: سهير محمد محمود الجبوري
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Dysmenorrhea is a common menstrual complaint which is painful period experienced by adolescents, with the major impact on their daily activities .it responsible for school absenteeism or interruption of social activities.Aim of the study : The aim of this study is to explore the depth of the problem, management practice that are related to dysmenorrhea and validate factors that are related to dysmenorrhea and impact of dysmenorrhea on daily life system among female students in secondary schools in Baghdad. Methods : A cross - sectional study that was conducted on (693) students in six female secondary schools in Baghdad. Questionnaires were used to gather the necessary information and filled by the students themselves.Multidimensional Scoring System was used to measure severity of menstrual pain.Results : The prevalence of dysmenorrhea among the study sample was 80.5 % (No. =558), (mean age 17.11 ±1.228), mild pain was found in 20.7%, moderate in 43.8% and sever in 15% according to Multidimensional Scoring System. Menstrual problems (irregularity), longer cycle and family history of dysmenorrhea were important risk factor for dysmenorrhea. Of dysmenorrheic student, 13.2% of participants reported absenteeism from school, 55.2%of participants reported school performance affected by dysmenorrhea, 57.1%of participants reported Concentration in study affected by dysmenorrhea. Of those who experienced dysmenorrhea, 93.2% reported they needed rest in bed, 60.3% needed analgesic and only 5.7% consulted doctor.Conclusions : The prevalence of dysmenorrhea was high among females.Dysmenorrhea was significantly more among female student withirregular and longer cycles and positive family history. Female studentwith sever dysmenorrhea had significant effects on their schoolperformance, class concentration and school absenteeism.

معرفة وموقف وممارسات النساء اللواتي يحضرن الى مراكز الرعاية الصحيه الاوليه من فحص الثدي الذاتي في بغداد الكرخ 2018 == Knowledge, Attitude and Practices of Women Attending Primary Health Care Centers toward Breast Self - Examination in Al - Karkh Baghdad, 2018

Author name: هند احمد عبد العزيز
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Breast cancer (BC) is the most prevalent form of cancer in Iraq, accounting for 21% of all female cancers. It is considered to be a progressive disease with a poor prognosis if detected late. The low level of knowledge and practice of breast self - examination is an important method of prevention.The objective of this study to assess knowledge of Iraqi women at Baghdad - Alkarkh about breast cancerrisk factor and their practices of breast self examination Aim of the study To assess knowledge of a sample of Iraqi women at baghdad - Alkarkh about breast cancer risk factors and their practices of breast self - examination , clinical breast examination and mamography .To assess the attitude and practices of breast cancer screening methods .Methods : Across - sectional study was conducted using interviweradmininstered qustionnaires. Samples of 400 feamales were systematic randomly selected from women attending primary health care centers at Baghdad - Alkarkh sector. Statistical package for social sciences(SPSS) version 25 was usedto study the statistical association between variables.Result : this study showed that two third of participiants had knowledge of BSE and poor practicing for BSE. The main sourse of information among all participants via PHCCs.Conclusion : good knowledge was noticed among women attending primery health care centers. Practicing of breast self examination was poor.

معرفة ومواقف النساء الحوامل حول طرق الولادة == Knowledge and Attitudes of Pregnant Women towards mode of Delivery In Baghdad Teaching Hospital - 2016

Author name: هند عامر ناهي الخفاجي
Supervisor name: نادية عزيز ناصر
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Delivery is one of the most important issues for human being and generation in the world. The process through which childbirth naturally occurs is called natural vaginal delivery. Caesarean is delivery of child through incisions in abdominal wall (Laparotomy) or uterus (Histrotomy).Aim of the study : To assess the knowledge, attitude of pregnant women and the associated factors with attitude towards the mode of delivery.Patients and method : A cross sectional study conducted in prenatal clinic in Baghdad teaching hospital for four months duration from the 1st of Feb. 2016 to the end of the May 2016.Results : A total of 300 pregnant women were included in present study with mean age as 28.3±9.8 years; Most of studied women were housewives. More than half of pregnant women (54.3%) married at younger age. The information of pregnant women about delivery modes were obtained mainly from social relationships (82.6). Half of pregnant women had good knowledge of delivery modes, 90.3% of them had good attitude toward normal vaginal delivery, 51.3% of them had poor attitude toward cesarean section .A significant association was observed between older age women and poor knowledge of them regarding delivery modes (p=0.01). There was a significant association between employed women and good knowledge score.Conclusion : The knowledge of pregnant women regarding vaginal delivery was relatively low and the attitude was high, while their attitude toward cesarean section was low. The main associated factors for women's knowledge were women's age, job, educational level, husband's age and abortion history and the main factors for women's attitude were women's age, educational level of women and their husbands and history of previous cesarean section.

المعرفة والمواقف حول اجهزة منع الحمل داخل الرحم بين عينة من النساء في بغداد == KNOWLEDGE AND ATTITUDE CONCERNING INTRAUTERINE CONTRACEPTIVE DEVICE AMONG A SAMPLE OF WOMEN IN BAGHDAD

Author name: ميرفت عبد علي عبد الوهاب
Supervisor name: بتول علي غالب ياسين
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Although intrauterine contraceptive device (IUCD) is the most widely used of long acting reversible method of fertility regulation in the world today, only 10% of Iraqi women aged 15 to 44 were using IUCD in 2011..Objective : To assess the knowledge and attitude towards intrauterine contraceptive device among women in reproductive age in Baghdad city, and to identify the effect of certain factors on their knowledge and attitude.Methods : A cross sectional study was conducted in Baghdad Teaching Hospital and Al - Shaheed Abdul - Sahib Dakhil PHCC. Any woman aged (15 - 45 years) who agreed to participate was included in the study. Data was collected through direct interview with the participants and the scores of knowledge were classified into : Good, fair and poor for knowledge and positive, neutral and negative for attitude.Results : Assessing the knowledge and attitude of the 301 participants revealed that 97.3% knew what IUCD is and 96.6% were aware of the aim of using the Copper IUCD, 42.8% were aware of its side effects, whereas only 5.9% of them were aware of the types, 13.9% aware of complications and 3.3% aware of who is eligible for using IUCD. In spite of this only 1.0 % of the participants got good knowledge score and 76.1 % got poor scores. Regarding attitude 15.0% had a positive attitude toward the use of IUCD.Knowledge scores of the respondents increased with increasing age (p<0.001), level of education (P = 0.026), being married (P=0.008),number of children (P<0.001) and history of previous abortions (P=0.04). Friends, neighbors and relatives were the main source of knowledge (77.4 %(.Conclusions : Most of participants were with poor knowledge score and the main source of them were friends, neighbors and relatives.Attitude score of Less than one - fifth of them was positive

انواع التغذية والعدوى وامراض المناعة الذاتية وعوامل الخطر البيئي الاخرى لدى الاطفال المصابين بالسكري من النوع الاول في مركزين صحيين عامين == Types of feeding, Infection, Autoimmune Diseases & Other environmental risk factors in Diabetic Children at two tertiary public health centers in Baghdad

Author name: شهد محمد جاسم
Supervisor name: نادية عزيز ناصر
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Type 1 Diabetes is an autoimmune disorder in which the immune system attacks the insulin producing cells in the pancreas and destroy them, it is also called ( Juvenile diabetes) because it mainly occurs in children and teenagers , though it can develop at any age. The study of epidemiology of T1DM in Basrah showed that the overall mean age at first diagnosis was 15.3 ± 9 years and it was significantly higher in men. The prevalence was 87 per 100,000 and it is lower than neighboring countries. The average annual incidence rate of type 1 diabetes was 7.4 per 100,000 which place Iraq in the intermediate group. This provided a baseline for assessing future changes in the epidemiology of type 1 diabetes mellitus in Iraq.Objectives : To describe pattern of feeding during infancy among children with type 1 diabetes mellitus, frequency of childhood infections (Measles and Mumps), and prevalence of autoimmune disease in children with T1DM.Patients and methods : A cross sectional study was carried out at Central Child teaching hospital and Al Yarmook teaching hospital, Iraq. A total of 248 patients with type 1 diabetes who attended the consultation clinic in the period from February 1st to the 30th of May,2017, and were investigated in order to describe the patterns of feeding in infancy, frequency of childhood infections )measles and mumps), and also prevalence of autoimmune disease in children with T1DM.Results : The mean age of diagnosis of type 1 diabetes among children was 5.7 years ± 3.3 and the mean weight of children at delivery was 3.2 Kg± 0.6 . The sociodemographic distribution showed that 38% of cases occurred in the 5 - 8 years age group followed by 8 - 11 years age group which accounts for 30.6% of cases. Sex distribution was nearly equal with slight male predominance. 50.8% of T1DM children have a positive family history for diabetes, most of them had a history of type 2 Dm (38.7%), and (9.3%) of type 1 DM, while 7% had both type 1 and 2. Only 23.4 % of cases have positive family history of other autoimmune diseases (autoimmune thyroid disease, celiac disease, ulcerative colitis, vitiligo, systemic lupus erythematosus, rheumatoid arthritis, pernicious anemia, psoriasis, Addison disease). About 23 % of children had autoimmune illnesses other than diabetes. More than 61% of patients with T1DM had exclusive bottle feeding history, 30% had exclusive breast feeding history, while 8.5 % had mixed feeding history.Conclusion• About two thirds of children with type 1 DM were bottle fed.• About a quarter of children with T1DM had autoimmune diseases other than diabetes.• The sociodemographic aspects showed that more children were diagnosed in the 5 - 8 years, those with urban residence were found to be more frequent than those with rural residence while frequency of T1DM was almost the same in males and females, more parents were with no college education.• Only a small proportion of children had a positive pre - diagnosis Measles and Mumps infections if they achieve the milestone of 1 year.Keywords : T1DM, bottle feeding, autoimmune diseases

انواع الرضاعة والاستجابة للعلاج الضوئي كعلاج للاطفال حديثي الولادة المصابين بمرض اليرقان الغير مباشر في المستشفيات التعليمية في بغداد == Types of Infant Feeding and Response to Phototherapy as a Treatment for Fullterm Newborns with Neonatal Indirect Hyperbilirubinemia in Tertiary Teaching Hospitals in Baghdad

Author name: شيماء خضير عباس
Supervisor name: احمد سمير النعيمي
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
Abstract: Background : Neonatal jaundice remains the most common and the most controversial problem in full - term newborns during the immediate postnatal period.Aim of the study : To assess the association between types of feeding and response to phototherapy in full - term infants with indirect hyperbilirubinemia.Method : In the period from the 25th of January to the 22th of July 2016, 120 full - term newborns admitted to the neonatal care unit in Tertiary Teaching Hospitals (Pediatric Teaching Hospital in medical city, AI - Imamein Al - Kadhimein medical city and Child Center Teaching Hospital) were studied by cohort study. The newborns diagnosed by pediatrician as cases of indirect hyperbilirubinemia and phototherapy started when TSB level>14.9 mg/dl. TSB was measured twice daily and phototherapy terminated when TSB level< 10.8 mg/dl. All infants were weighed at start and end of phototherapy. The duration of phototherapy had been recorded.Results : The infants divided into three groups according to type of feeding; group1, Breast - fed infants (n=37); group2, Formula - fed infants (n=51); group3, Mixed - fed infants (n=32).Phototherapy was highly effective in reducing serum bilirubin concentration in all of three groups but with a significant less efficacy for breast - fed neonates ( mean duration of phototherapy 32.2± 2.1 hrs) in comparison to mix - fed neonates (30.4 ± 2.5 hrs) and formula - fed neonates (29.9± 2.7 hrs).There was a weight loss during phototherapy. There was significant difference in the weight loss in the three groups, the more weight loss in breast - fed neonates than mixed - fed and formula - fed neonates. Conclusion and recommendations : Phototherapy had effectively reduced bilirubin levels in breast - fed newborns with hyperbilirubinemia, but these patients showed a significantly slower response to this modality of treatment than mixed and formula - fed newborns. Therefore; in breast - fed infants with severe jaundice that requires phototherapy, the addition of formula - feeding will enhance the response to phototherapy without any interruption of breastfeeding.

التاثيرات النفسية والاجتماعية للزواج المبكر لدى اليافعات في واسط 2017 == Psychosocial Effects of Early Marriage on Adolescent Married Girls in Wasit - Iraq, 2017

Author name: زينب بلاسم حمزة
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Family Medicine
Degree: Higher Diploma
Language: English
University location: Baghdad
First pages:
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