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تقييم فائدة ايكو القلب في تشخيص عملية تغيير شكل البطين الايسر بين مرضى احتشاء عضلة القلب الحاد بالمقارنة مع فحص التتبع النقطي == Usefulness of traditional echocardiographic parameters in assessment of left ventricular function with comparison of speckle tracking in patients with normal ejection fraction early after acute myocardial infarction

Author name: باسم عباس مراد
Supervisor name: حامد الجنابي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: تعين جدوى ايكو القلب ثنائي الابعاد في تشخيص وتقيم تغيير شكل البطين الايسر وازدياد حجمه بعد احتشاء عضلة القلب الحاد مع المقارنة بالفحص الحديث ,التتبع النقطي.الاساليب والنتائجقمنا باجراء فحص ايكو القلب ثنائي الابعاد خلال فترة ثلاثة ايام من نوبة احتشاء عضلة القلب وخلال دخول المستشفى لستون مريض. وقد تم دراسة وعمل مقارنات مختلفة باستخدام عدة متغييرات سريرية ومختبرية بضمنها ايكو القلب ثنائي الابعاد واضافة فحص جديد وهو التتبع النقطي بالاضافة الى البيانات الاساسية الديموغرافية، كضغط الدم والنبض وقد ثبتت القيمة التشخيصة لمختلف معايير ايكو القلب التقليدية كحجم البطين الايسر والكسر القذفي في الكشف المبكر عن تغير شكل ووظيفة البطين الايسر. وقد وجد من هذه الدراسة ان اتساع حجم الاحتشاء القلبي كان له الاثر الاكبر في زيادة حجم البطين الايسر وقصور عمله الوظيفي. كما قمنا بدراسة فحص جديد وهو التتبع النقطي .ان هذا الاثر كان اكثر احتمالا للحدوث عند الاكبر سنا من المصابين وعند الذكور منهم, اضافة الى ان كمية العضلة المصابة وعلى الاخص الاحتشاء الذي يشتمل العضلة الامامية للقلب عما سواها من الجدران كان الاكثر تاثيرا على حجم البطين الايسر وتدهور عمله الوظيفي الاستنتاجاتكان لفحص ايكو القلب ثنائي الابعاد لمرضى الجلطة القلبية الحادة قيمة فعلية في تحديد الاشخاص الاكثر عرضة لمضاعفات الاحتشاء وعلى الاخص زيادة حجم البطين الايسر وتدهور عمله الوظيفي ووجدنا ان المعاير القديمة التي تكون ضمن الطبيعي لا تعكس المخاطر المستقبلية مثل التتبع النقطي. | The role of echocardiography in patients after acute myocardial infarction with normal left ventricular ejection fraction. The normal ejection fraction not reflected left ventricular remodeling after myocardial infarction, so we used other echocardiographic parameter which is the focus of this thesis. We investigated the influence of various traditional echocardiographic parameters on the process of left ventricular remodeling such as left ventricular and left atrial volumes , ejection fraction, wall motion score index, mitral regurgitation and diastolic dysfunction with used newly parameter, speckle tracking .Aims To investigate the usefulness of two - dimensional echocardiography for accurate evaluation of left ventricular (LV) remodeling after acute ST elevation myocardial infarctions (STEMI) according to recent parameter ,Speckle Tracking . Methods and results Two - dimensional echocardiography was performed within 3 days on a 60 patients admitted to the hospital with a first ST - elevation AMI. Several echocardiographic and clinical variables were reviewed . Baseline demographic data, blood pressure, and pulse were obtained. Different traditional echocardiographic parameters have been shown to provide diagnostic information, such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and left atrial pressure . newly parameters used ,speckle tracking studied and different comparison done . Predictors of early LV remodeling were older age, male gender, history of diabetes mellitus or hypertension, high leukocyte count, high admission blood glucose level, high wall motion score and anterior location myocardial infarction.Conclusions After acute ST - elevation myocardial infarction, early determination of the wall motion score index by two - dimensional echocardiography is useful for identifying patients at high risk for complications and to differentiate patients with and without development of LV remodeling accurately and early on the basis of wall motion score index as a measure of infarct size. A highly predictive variable with use of the speckle tracking

تقييم تغيرات جين Topoisomerase II alpha بواسطة التهجين الموضعي الصبغي وعلاقته بمستقبل الاستروجين ER ومستقبل البروجستيرون PR ومعلم ki - وher2/neu67 في سرطان الثدي عند الانسان == Evaluation of Topoisomerase II alpha Gene Alterations by Chromogenic in situ Hybridization in Correlation with ER, PR, HER2/neu, and Ki?67 in Human Breast Cancer

Author name: رشا عبد الرؤوف نعمة الصافي
Supervisor name: منال عدنان حبيب | ساهرة عبود علي
General topic: Medicine
Specific topic: Tissue Diseases
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Breast cancer is a clinically and biologically heterogeneous disease,Characterized by dys - regulation of multiple cellular pathways anddifferent sensitivities and responses to treatment. There is high tendencythat all diagnosed breast cancers should be tested for her2/neu oncogeneamplification with an in situ hybridization tests for further evaluation ofan equivocal cases (2+) detected by immunostaining.Topoisomerase II alpha gene is located on chromosome 17 adjacent toher2/neu gene, and Topoisomerase II alpha gene is responsible for codingtopoisomerases enzymes that modulate the topology of DNA duringcellular proliferative process. Topoisomerase II alpha is a moleculartarget for some important anticancer drugs, including anthracyclines,which are the key chemotherapeutic agents in the treatment of breastcancer.Fluorescent In situ hybridization is widely used technique in clinicaldiagnoses to identify oncogene amplification and chromosomaltranslocation in the cellular genome. Recently it was stated thatchromogenic in situ hybridization is regarded as a good alternative forfluorescent in Situ hybridization. Dual color - chromogenic in situhybridization combines the advantages of both FISH and CISH andallows the assessment of ratio of gene copy number to the chromosomalcentromere along with proper histopathological examination and the easeof bright - field microscopy.VIThe aim of the study is to evaluate Topoisomerase II alpha geneamplification and deletion by dual color chromogenic in situ hybridization in females with invasive breast cancer and to correlate Topoisomerase II alpha gene status with her2/neu, estrogen receptor, progesterone receptor and ki - 67 index and to detect the elation of Topoisomerase II alpha gene with clinico - pathological parameters like age, histological types, stage, grade and lymph node involvement in females with breast cancer.This study was done from July 2014 to February 2015. Females diagnosed to have invasive breast carcinoma reaching Oncology hospital in Baghdad Medical City were enrolled in the study. All females have been experienced modified radical mastectomy with axillary clearance. Immunohistochemical study for Estrogen receptor; Progesterone receptor; Her2/neu and Ki67 were done for their tissue blocks. Patients with Her2/neu equivocal (score 2+) and strong positive her2/neu (score 3+) were selected forming seventy five cases. Dual color chromogenic in situ hybridization was done in central public health laboratory/Baghdad for all cases for evaluation of topoisomerase 2 alpha gene and for further evaluation of her/neu in equivocal cases. Just 53 cases were successfully hybridized and enrolled in the study by applying Her2/neu and Topoisomerase II alpha genes probes. There was no topoisomerase II alpha gene deletion. No significant statistical relationship between topoisomerase alpha gene amplification and age, histological types of breast cancer, stage and lymph nodes while the relation was significant with the grades of breast cancer in that the highest level of gene amplification was in grade III detected in 9 (64.3%) of cases.There was a significant negative relationship between topoisomerase II alpha gene and hormone receptors (estrogen receptor and progesterone receptor) as the highest gene amplification was detected in hormone negative cases. The relation of topoisomerase II alpha gene with ki - 67 was not significant. After Chromogenic in Situ Hybridization study 12 (44.4%) out of 27 equivocal cases show her2/neu gene amplification as 4 (14.8%) cases and 8(29.6%) for high and low her2/neu gene amplification respectively.Accordingly the amplified cases of her2/neu gene were gathered with the strongly positive her2/neu cases from immunohistochemistry to form 38 (71.7%) out of 53 cases which representing the first group of total positive her2/neu cases out of total 53 cases. The second negative her2/neu group of 15 / 53 cases representing cases which were resulted from Chromogenic In Situ Hybridization study.The relation between topoisomerase II alpha gene and her2/neu gene was statistically significant in that 50% of her2/neu amplified cases show topoisomerase II alpha gene amplification (co - amplification). Thirty nine percent 39% of total positive 38 cases show Topoisomerase 2 alpha gene co - amplification, from these 11/ 28.9% cases show high level of amplification. .So a significant positive correlation of topoisomerase 2 alpha gene with her2/neu and its negative correlation with estrogen and progesterone receptors may indicate that it could be considered as a bad prognostic factor.

تطبيق تصنيف الاكياس المائية وفقا لصوتها في الامواج فوق الصوتية في الشعب العراقي == Application of Ultrasound Classification of Hepatic Hydatid Cyst in Iraqi Population

Author name: ايناس محمد سهيل العاني
Supervisor name: مظفر بالي مهدي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Cystic Echinococcosis (CE) is an endemic disease in Iraq. Its classification is crucial for proper management. Aim of the study Applying ultrasound study in classifying hepatic hydatid cyst disease in Iraqi population, which is essential in treatment planning. Patient and method : A prospective study was conducted throughout the period from March 2017 to March 2018, in the Gastroenterology and Hepatology Teaching Hospital/ medical city/ Baghdad. A total 100 patients with a diagnosis of hydatid cyst by ultrasound were followed up after surgery and histopathology were proved hydatid cyst. Their age range was 10 - 79 years, female to male ratio 1.6 : 1.WHO - IWGE; WHO Informal Working Group Echinococcus classification), was used in this study.Results : Cystic Echinococcus class I was noticed in (35%), Cystic Echinococcus class II was noticed in (35%), Cystic Echinococcus class III was observed in (17%) , Cystic Echinococcus class IV was noticed in (7%) and Cystic Echinococcus class V was noticed in (6%).ConclusionCystic Echinococcus class I and Cystic Echi

حصيلة الولادة للنساء اللاتي اجرين عملية قيصرية واحدة سابقا في مستشفى بغداد التعليمي == Delivery outcome for patients with previous one caesarean section in Baghdad Teaching Hospital

Author name: رفاه خليل ابراهيم
Supervisor name: عفراء محجوب النداوي
General topic: Medicine
Specific topic: Obstetrics and Gynecology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

الدلالة السريرية للزيادة في كل من الاقراص الدموية والمستضاد السرطاني (125) كاداة تنبؤ بالاورام الخبيثة في الكتلة النسائية الحوضية == CLINICAL SIGNIFICANCE OF THROMBOCYTOSIS AND CA125 AS PREDICTOR OF MALIGNANCY IN GYNAECOLOGICAL PELVIC MASS

Author name: عبير مكي خليل
Supervisor name: نجمة محمود الخزعلي
General topic: Medicine
Specific topic: Obstetrics and Gynecology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: الهدف من الدراسه : تحديد كل من الزيادة في عدد الصفائح الدموية (>450X 10 9 / مايكروليتر) ومستوى المستضاد السرطاني 125 (> 35 وحدة/مل) كادوات تنبؤية مفيدة لتاكيد خبثية الكتلة النسائية الحوضية.طريقة العمل : دراسه انية مستندة على حالات سريرية وحالات ضابطه غير متشابه اجريت على 110 امراة والتي تم تسجيلهم في هذه الدراسة ومقسمين الى مجموعتين ، 60 امراة وهي المجموعة الضابطه (خالين من الكتلة الحوضية) والتي اعتبرت كدواخل مختارة في الدراسة. في حين المجموعة الاخرى تضمنت 50 امراة فوق 15 سنة مع كتلة نسائية حوضية وقد خضعن الى عمليات جراحية استكشافية وباستخدم مختلف الطرق التسخيصية مثل الفحص السرير وتنقنيات التصوير بـ (الامواج فوق الصوتية والمفراس الحلوزني والرنين المغناطيسي) والفحوصات المختبرية (عدد الصفائح الدموية ، المستضاد السرطاني 125 والنسيج المرضي)وان بياناتهم قد خضت الى تحليل الاحصائي لمعرفة الحساسيه وفاصل الثقه والدقه والقيمه التنبئيه السالبه والموجبه .محل اجراء الدراسه : قسم النسائية والتوليد في مستفى بغداد التعليمي / كلية الطب - جامعة بغداد .النتائج : قد اختبر كل من المستضاد السرطاني 125 في الدم وعدد الصفائح الدموية لمعرفة مدى صدق استخدامهما كتحليل تنبؤي بتشخيص الخبيثة في الكتلة النسائية الحوضية وان كلا التحليلين اظهرا صدقا عاليا في التشخيص اذ كان مساحة استقبال خاصية التشغيل > 0.95 وقد اظهر المستضاد السرطاني 125 هامش الصدق الاعلى مساحة استقبال خاصية التشغيل > 0.017 .وان كلا مساحة استقبال خصائص التشغيل ROC كانا ذا ذلالة اعلى من 0.5 للمساحة المرتبطة باختبار الشك (الغموض).لقد كانت افضل قيمة قطعية لعدد الصفائح الدموية هي (≥ 385) وان كل الدراسات توصلت الى ان ان كل حالة مع عدد صفائح دموية (≥ 385) هي خبيثة بينما كل حالة تحت هذه القيمة القطعية هي سليمة او معافى.وان اختبار المستضاد السرطاني 125 في الدم يكون سالبا في اعلى حالات الحساسية (100%) للقيمة القطعية (27.1≥ ) والتي يجب ان يتم استثناء احتمالية تشخيصها كورم خبيث في مقابل اعتبارها حالة سليمة وموثوقة (100%) وان اعلى قيمة قطعية هي (≥ 41.7) والتي هي ايضا ذات موثوقية (100%) ولذلك فهي (100%) تمثل القيمة القطعية للتشخيص.الاستنتاج : ان ازدياد كلا عدد الكريات الدموية (≥385X10 9 / مايكروليتر) ومستوى المستضاد السرطاني 125 في الدم (≥ 41.7وحدة /مل) هما ادوات تنبؤ مفيدة لاثبات خبثية الكتلة النسائية الحوضية. | Objective : We attempted to determine the increasing of platelet counts (> 450.000 /microliter) and CA125 serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynaecological pelvic mass.Patients and methods : A prospective unmatched hospital based case - control study carried out about One hundred & ten women were enrolled in our study, divided into two group 60 women were control group (free of gynaecological pelvic mass) which were considered as “eligible entrants” into the study. Other group include 50 women above 15 years old with gynaecological pelvic mass were all candidate for laparotomy and using different diagnostic methods like clinical examination, imaging techniques (U/S, CT scan and MRI) and laboratory test (platelet count, CA125 and Histopathology). The data of those were subjected to statistical analysis (sensitivity, specificity, accuracy, NPV and PPV) which calculated to considered if it is statistically significant or not. Setting : Obstetrics And Gynaecology Department At Baghdad Teaching Hospital / College Of Medicine - Baghdad University.Results : Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynaecological pelvic mass differentiating it from benign gynaecological pelvic mass. Both tests showed a very high validity in diagnosis (ROC area >0.95), with serum CA125 showing a marginally higher validity (ROC area larger by 0.017 only). Both ROC areas were significantly higher than the 0.5 area associated with an equivocal test.Platelets counts had a perfect cut - off value of ≥385.000 All study subjects with a blood platelets count equal or greater than 385.000 were malignant, while everybody below this cut - off value was healthy.For serum CA125 testing negative at the highest sensitivity (100% sensitive) cut - off value of (≥ 27.1( would excluded a possible diagnosis of malignancy in favor of being healthy with 100% confidence. The optimum cut - off value is ≥41.7, which is also the 100% specific and thus 100% diagnostic cut - off value.Conclusion : Both blood platelet count (≥ 385 X 103microlitter) & serum level of CA125 (≥ 41.7 U/mL) are useful predictor tools to confirm malignancy in gynaecological pelvic mass

دراسة استعادية لنتائج تنظير القصبات والنتائج المختبرية في عينة من المرضى يعانون من نفث دموي == Bronchoscopic findings and Final diagnosis in sample of patients presented with Haemoptysis

Author name: رعد مطر شمران
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: يعتبر نفث الدم من الاعراض المثيرة للقلق بين مرضى الجهاز التنفسي . ومع ذلك ، فانه من الاعراض غير المحددة ويمكن ان يحدث في كثير من الحالات السريرية المختلفة .ان تقشع كمية من الدم وان كانت قليلة نسبيا يمكن ان يكون مؤشرا لمرض خطير مثل سرطان القصبات الهوائية .تنظير القصبات ذي الالياف البصرية التشخيصي هو الاجراء الاستقصائي المختار الموصى به في الوقت الحالي.ان التقنيات القياسية المستخدمة عالميا في اقسام الجهاز التنفسي تشمل خزعة الشعب الهوائية ، غسل القصبات الهوائية ، غسيل الشعب الهوائية بواسطة فرشاة وغسيل الشعبة الهوائية السنخية .الهدف : اجريت هذه الدراسة لتحديد نتائج تنظير القصبات وانواع الامراض في عينة من المرضى يعانون من نفث الدم .المرضى والطرق : شملت هذه الدراسة مجموعة من 53 مريضا يعانون من نفث الدم خضعوا لعملية تنظير القصبات المرنة وتم ارسال العينات الى الفحوصات الخلوية ، الامراض النسيجية ، والميكروبيولوجية.جميع هذه الحالات تم تشخيصها خلال الفترة من 1 اكتوبر 2010 الى 30 يونيو 2013. تم تحليل بيانات الحالات المسجلة من ( المركز الوطني للكشف المبكر عن اورام ) خلال الفترة المذكورة احصائيا بطريقة الدراسة الاستعاديةالنتائج : تضمنت هذه الدراسة 53 مريض يعانون من نفث الدم ، وكانت اعمار المرضى المسجلين تتراوح بين 19 - 87 عاما مع متوسط عمري 56.8 ± 15 سنة. كانت نسبة الذكور الى الاناث في هذه الدراسة 1 : 2,1. لوحظ بان نتائج تنظير القصبات من المرضى الخاضعين للدراسة طبيعية في (11.3 ٪ )و افرازات دموية في ( 41.6 ٪ ) وتضيق او انسداد في القصبات الهوائية ( 22.6 ٪ ) واحتقان او التهاب في الشعب الهوائية ( 22.6٪) وكتلة في ( 20.8 ٪ ) وافرازات قيحية كثيفة في (17 ٪ ) وافة داخل الشعب الهوائية في (13.2 ٪ ) وضغط خارجي على القصبات الهوائية في (7.6 ٪ ) وافرازات مخاطية في (7.6 ٪ ) والتليف الفحمي في ( 3.8 ٪ ) وانفراج جؤجؤ الرغامي في مريض واحد ( 1.9 ٪ ).كما كانت النتائج المجهرية لمرضى نفث الدم سرطان القصبات الهوائية في ( 54.7 ٪ ) والسل في( 7.5٪ ) ، وعدوى بكتيرية في (13.2 ٪ ) والعدوى الفطرية في ( 3.77 ٪ ) وتوسع القصبات في ( 5.66 ٪ ) وعدم وجود نتائج في (15.1 ٪ ).الاستنتاج : كانت نتائج تنظير القصبات الاكثر شيوعا هي افرازات دموية وانسداد الشعب الهوائية والكتلة.كانت النتائج المختبرية الاكثر شيوعا هي الاورام الخبيثة والعدوى البكتيرية السل وتوسع القصبات والعدوى الفطرية. | Haemoptysis is considered as an alarming symptom among the respiratory patients. However, it is a non - specific symptom and can occur in many different clinical conditions. Currently, diagnostic fiberoptic bronchoscopy is recommended as the investigative procedure of choice.Objective : To determine the prevalence of bronchoscopic findings and the types of diseases in a sample of patients presented with haemoptysis.Patients and Methods : A total of 53 patients with haemoptysis were underwent a flexible bronchoscope were targeted by this study . All of their sample were sent for cytological , histopathological, and microbiological investigations.All of these patients diagnosed during a period from 1st of October 2010 to the 30th of June 2013 were retrospectively analyzed based on the data of the ( National Centre of early detection of Tumors)Results : A fifty three patients with hemoptysis were enrolled in this study with a mean age of 56.8±15.7 years and the range was 19 - 87 years. Male to female ratio in this study was 2.1 : 1.The bronchscopic findings of studied patients were bloody discharge in (41.6%) , bronchial narrowing and\or obstruction in (22.6%) , bronchial congestion and\or inflammation in (22.6%) , mass in (20.8%) , thick purulent discharge in (17%) , endo - bronchial growth in (13.2%) , normal in (11.3%), external compression of bronchus in (7.6%) , mucous discharge in (7.6%) , anthrocho fibrosis in (3.8%) and splaying of carina in one (1.9%) .Microscopic findings for hemoptysis patients revealed CA bronchus in (54.7%), no findings in (15.1%), bacterial infection in (13.2%), TB in (7.5%), bronchiectasis in (5.66%) , and fungal infection in (3.77%). Conclusion : The commonest bronchoscopic findings were bloody discharge, bronchial obstruction, and mass.The most common laboratory findings were malignancy, bacterial infection, TB, bronchiectasis, and fungal infection.

LEFT VENTICULAR DIASTOLIC DYSFUNCTION BY TISSUE DOPPLER IN PATIENT WITH TYPE TWO DIABETES MELLITUS

Author name: HAMZA O.JELED
Supervisor name: علي محمد حسين ال ياسين
General topic: Medicine
Specific topic: Diseases - Heart
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Cardiovascular complications of diabetes are the main cause of mortality & morbidity in diabetic population. Asymptomatic Left venticular dysfunction is a common problem in this type of patients and require specific evaluation. Objectives : This study is designed to determine the frequency of LV diastolic dysfunction in patients with type 2 diabetes using conventional echocardiography and tissue Doppler imaging, and to evaluate the effect of different factors on this frequency. Methods : This study is a cross sectional study. It included 50 type 2 diabetics with negative cardiac history and 50 age and sex matched healthy control individuals. The sample of this study had been randomly selected from the patients attending the out patients clinic or admitted to the medical wards of Baghdad Teaching Hospital during the period from the 1st of January, 2012 to the 30th of June, 2012. Conventional echocardiography and tissue Doppler imaging had been performed on each patient. Results : This study revealed that diastolic dysfunction present in 16 patients (32% of the sample). Furthermore, none of the 3 patients who were younger than 40 year - old had diastolic dysfunction, compared to 7 out of 11 patients aging 60 year or older. It had been found that 11 out of 31 male patients and 5 out of 19 female patients had diastolic dysfunction, comprising 68.75% and 31.25% of those with diastolic dysfunction respectively. About 68.75% of the sample had diabetes for 5 years or more. this study showed that 13 out of 16 diabetic patients with diastolic dysfunction had un controlled diabetes in form of HbA1c level of 7% or more with a mean HbA1c level of 8.2+2.4%,compared to a mean of about 6.8+3.1% which had been observed in the group of diabetics with normal diastolic function this study showed that none of the 2 patients who were average in their weight had abnormal diastolic function ,compared to 2 out of 3 patients who had morbid obesity it had been found that the mean body mass index was 29.7+2.4 kg /m in the group of patients with diastolic dysfunction while it was 26.2+3.1 kg/m in the group of patients with normal diastolic function. Conclusion : Diastolic dysfunction is relatively frequent problem in asymptomatic type 2 diabetics. There is direct relationship between the age, duration of diabetes, HbA1c level and body mass index and the risk of having diastolic dysfunction

نمط التسمم الكميائي بين الطلبات الاستشارية المقدمة للمركز الاستشاري للسموم العراقي : دراسة معتمدة على الملفات 2102 == Pattern of Chemical Poisoning among Consultation Requests to Poisoning Consultation Center, Iraq during the year 2012 : A record based study

Author name: منير طالب سلمان
Supervisor name: احمد سمير النعيمي
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

التغيب المرضي بين العمال في الشركة العامة للصناعات القطنية، بغداد، العراق 2013 == Sickness Absenteeism Among the Workers of State Company of Cotton Industries, Baghdad, Iraq - 3102

Author name: عبد الرحمن عمران ضاحي
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : In Iraq, several workers pay attention to sickness absence.However, in the 1990s, the manufacturing sector had been severely hurt by the UN sanctions and has shrunk considerably as a result. Widespread violence and civil war affect Iraqi industry, research, administration of industry and medical services. Therefore, this work was carried out to throw a light on sickness absence in State Company for cotton industries in Baghdad.Methods : A total 200 workers was included in this study. They were selected randomly (systemic random sample). The sample size was determined by the time spent to review one record. Review of worker’s records in the administrative department in the state company for cotton industries during the years 2008 to 2012. A cross - sectional study is carried out. Documents of sickness absence in the administrative records from 1st Jan to 31 Dec each year were reviewed. Chi square was used to examine the association of sickness absence (dependent variable) with age, sex, duration of job and education (independent variables). Regression was used to study the trend of sickness absence during the studied years. P value < 0.05 was considered significant.Result : The rate of sickness absence was 81%. No significant difference in sickness absence between male and female workers. Age, education and duration of employment had no significant effect on sickness absence.Sickness absence was increasing with years. Production was not affected by sickness absence.Conclusion : surprisingly high rate of sickness absence was noticed with no effect of sex, age, education and duration of employment on sickness absence which in turn had no effect on production

تقييم فترة Tp - e ونسبة Tp - e/QT في المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي == Evaluation of Tp - e interval and Tp - e/QT ratio in Iraqi Patients with Rheumatoid Arthritis

Author name: وسام ابراهيم محمد
Supervisor name: نزار عبد اللطيف جاسم
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp - e) may correspond to the transmural dispersion of repolarization and that increased Tp - e interval and Tp - e/QT ratio are associated with malignant ventricular arrhythmias.Objectives : The aim of this study was to evaluate ventricular repolarization by using the Tp - e interval and Tp - e/QT ratio in patients with rheumatoid arthritis (RA), and to assess the relation with inflammation.Patients and methods : A case - control study includes Seventy patients (57 females, 13 male mean age 48.3±12.3years) with RA and 46 controls(39 females , 7males ; mean age , 46.8 ±13.1 years) were studied. From the 12 - lead electrocardiogram, Tp - e interval and Tp - e/QT ratio were measured. Blood samples were taken for erythrocyte sedimentation rate (ESR) .These parameters were compared between studied groups. The relationship between ventricular repolarization and inflammation was assessed by Pearson correlation coefficients. Results : Tp - e interval and Tp - e/QT ratio were increased in RA patients compared to the controls (72.47 ±6.6vs 66.17 ±3.4ms, 0.19 ±0.01 vs 0.17±0.01; p<0.001 and p<0.001, respectively). The Tp - e/QT ratio was also correlated with ESR(R=0.3, P=0.02) Conclusion : In RA patients, the increased frequency of ventricular arrhythmias may be explained by increased indexes of ventricular repolarization and their relationship with inflammation

ترداد المشيمة المتقدمة والنتائج الناجمة عنها في مستشفى بغداد التعليمي == The Frequency of Placenta Previa and its Outcome in Baghdad teaching Hospital

Author name: نضال عبد الرزاق حسين
Supervisor name: عفراء محجوب النداوي
General topic: Medicine
Specific topic: Obstetrics and Gynecology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Placenta praevia is the implantation of the placenta partially or wholly in the lower segment of the uterus. It is graded in two ways, as either grade 1 - 4 or minor/major. It is a major cause of obstetrical hemorrhage which leads to increase in maternal morbidity & perinatal mortality, its incidence is still rising worldwide.Objectives : To determine the frequency and outcome of placenta previa at Baghdad teaching hospital Patients and methods : A prospective observational study was carried out during the period between 1st October 2013 and 31 January 2014 at Baghdad Teaching Hospital, medical city complex. During the study period, total number of deliveries was 4128, of them 2322 were delivered by cesarean section and 1806 were vaginal deliveries. Of all those, 92 pregnant ladies who had placenta previa diagnosed ultrasonographically& confirmed during cesarean delivery had placenta previa and were included. Pregnant ladies with normally situated placenta were excluded from the study. Data were collected through Detailed history taking, and clinical examinations of patients. Preparations and interventional procedures included cross matching of at least 6 pints of blood & preparation of fresh frozen plasma and cryoprecipitate, Single course of antenatal corticosteroids was given. All cases in this study where delivered by ceserean section. All mothers were monitored for signs of complication like disseminated intravascular coagulation DIC during and after surgery and for post - partum hemorrhage. Official agreements and verbal consent of all women were obtained prior to participation. Statistical analysis performed by using the statistical package for social sciences and appropriate statistical tests were used with the aid of expert statician.Results : There were 92 women who had placenta previa out of 4128, and the proportion of placenta previa was 2.2%, The mean age of the studied group was 32.2 ± 5.9 (range : 20 - 44) years. More than half (56.3%) of the studied group were gravida 5 or more. Nulliparous were only 3 patients (3.3%). History of miscarriage was found in 23 patients (25%). One or more previous cesarean sections were found in 78 (84.8%) patients. At time of delivery 72 (78.3%) patients were at < 37 weeks of gestation and 20 patients (21.7%) were at ≥ 37 weeks. Cesarean sections were performed in 61 patients (66.3%).Caeserian hysterectomy was conducted in 31 patients (33.7%), internal artery ligation was performed in 7 patients (7.6%), uterine artery ligation in 5 patients (5.4%). Morbidly adherent placenta was the more frequent cause of hysterectomy in 18 patients represented (58.1%) and bleeding in 13 patients (41.9%). Conclusion : In the present study the incidence of placenta previa was increased with the advancing age, particularly > 35 years, the incidence of placenta previa was highest in the multiparous group than nulliparous and directly associated with parity and gravidity. Previous caesarean section was an important and significant risk factor and none of the cases died

نوعية الحياة صحيا لمرضى الانسداد الرئوي المزمن == Health - related Quality of Life of Chronic Obstructive Pulmonary Disease patients

Author name: علي اياد طارق
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease (COPD) is a common health problem, characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities.COPD usually caused by significant exposure to noxious particles or gases.Worldwide, COPD is also increasing as a cigarette smoking, the primary risk factor for COPD development, is increasing in prevalence throughout the world. It has a large impact on quality of life for patients and their families and kills millions of people worldwide yearly. .Study Objective : To assess the impact of COPD on health - related quality of life (HRQOL) of COPD patients.Patients and Methods : A cross sectional descriptive study assessed HRQOL of 60 stable COPD patients without significant comorbidity , not in acute severe exacerbation, were interviewed at chest consultant clinic of Baghdad Teaching Hospital by using 14 questions of CDC Health Related Quality of Life Questionnaire between May 2017 and February 2018.Results : From 60 participants (80 % male, 20% female)&#34; all of them were cigarettes smokers (current 57%, ex - smoker 43%)&#34; about 62% of them said that their general health is poor with COPD and 95 % of them said they were limited in any way in their activities from the disease.Statically significant results (p

السرطان الرئوي : دراسة سريرية في مجمع مدينة الطب (2010 - 2014) == Lung Cancer : A Hospital Based Study

Author name: مهند عبد اللطيف
Supervisor name: محمد وهيب سلمان العبيدي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: خلفية الموضوع : سرطان الرئة هو السبب الاكثر شيوعا لحالات الوفاة.اذ تسبب بوفاة 1.4مليون سنويا. اذ يعتبر التدخين المسبب الرئيسي له. وكلمزاادت نسبة المدخنين ازدادت نسبة الحالات السرطانات الرئوية. وهناك خطر اخر ينحصر في التعرض الى استنشاق دخان المعادن الثقيلة والزرنيخ والاسبستوس. الهدف من الدراسة : الهدف من دراستنا هو دراسة سلوك السرطان الخلوي لحالات السرطان الرئوي في العراق. ودراسة العلاقة بين التدخين (نسبته وشدته) وانتشار حالات السرطان الرئوي.طرق الدراسة : تم احصاء 675 حالة تتعلق بالسرطان كان قد ادخلت المجمع خلال فترة خمسة سنوات من (2010 - 2014). وكانت فقط 500 حالة سرطانية رئوية مشخصة عن طريق الفحص الشعاعي للصدر والفحص المختبري الخلوي لكل من العينات كان قد اخذت من انسجة عن طريق الناظور القصبي او خزعة الغشاء الرئوي اوخزعة عملية الصدر المفتوح.النتائج : معظم المصابين من المرضى كانوا هم مدخنين وبنسبة (90%) وكان معظم هؤلاء المصابين من الرجال المدخنين. ومزاالت نسبة السرطان الحرشفي هي السائدة ونسبة (42%) يتبعه سرطان الغدي وبنسبة (26%) وسرطان الخلايا الصغيرة وبنسبة (17%) وسرطان الخلايا الكبيرة وبنسبة (10%).الاستنتاج : يعتبر مرض السرطان الرئوي من الامراض التي تحتاج الى وقفة جدية للنظر فيه وخصوصا وهو زيادة في نسبة الاصابات السنوية. شعاعيا كانت اصابات الجهى اليمنى في الرئة اكثر شيوعا. نحتاج الى الاعتماد على فحص الناظور القصبي وفحص خزعة الرئة عن طريق عملية الصدر المفتوح كونهما اكثر دقة وتفصيلا. | Background : Lung cancer is one of the most common causes of death in the world. It's causing 1.4 million deaths per year. Tobacco is the major preventable cause. However the risk of lung cancer increased by asbestos, arsenic and heavy metal exposure.Aim of study : In our study we are looking of prevalence, incidence rates of lung cancer. Patients and Methods : A retrospective study, are deal with 675 case of Lung cancer were admitted to medical city complex hospitals over period of five years (2010 - 2014). Only 500 cases have been established to have lung cancer by one or more of investigation as : sputum cytology, bronchoscope, pleural study, and open lung biopsy.Results : The commonest lung cancer is Squamous cell cancer (40%) is still commonest type, followed by adenocarcinoma (26%), small cell lung cancer (17%) and the large cell Cancer (10%), carcinoid (5%), and anaplastic (2%). The great majority of the patients (90%) of 500 patients were smoker. The average annual incidence is about 100 patient/year. Conclusion : The lung cancer is serious medical problem with increasing incidence annually. The most important risk factor for all cell types carcinoma is smoking (90%).

العلاقة بين متلازمة الالم الليفي العضلي والعد الشائع لدى عينة من المرضى العراقيين == Relationship Between Fibromyalgia Syndrome and Acne Vulgaris in a Sample of Iraqi Patients

Author name: داليا محمد جاسم
Supervisor name: محمد هادي العصامي | احسان علي الطرفي
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Fibromyalgia syndrome is a chronic disorder characterized by widespreadmuscles and bones pain, general fatigue, non - restorative sleep, cognitivedisturbance, mood disorder in addition to variable somatic symptoms.Acne vulgaris is a common multifactorial skin disease of adolescents withsignificant physical and psychological morbidity particularly anxiety anddepression.Aim of the study : To assess the relationship between fibromyalgia syndrome and its relatedsymptoms with acne vulgaris in a sample of Iraqi patients.Subjects and Methods : This case - control study was carried out from the first of October 2016 tothe end of May 2017. One hundred acne patients and one hundred age - and sexmatchedapparently healthy individuals were enrolled in the study.A special questionnaire designed for the purpose of the study was usedfor recording information from the patients and controls, which included : name, age, sex, employment, menstrual cycle, marital status and smoking.Additional information were collected from the patients including duration ofacne, drug history including local and systemic steroids and hormonal therapy.The 2012 Canadian Guidelines for diagnosis of fibromyalgia were used todiagnose FMS among patients and controls and acne severity was assessedusing Global Acne Grading System method.VIResults : This study showed that there was a three - folds increase in the risk ofdeveloping fibromyalgia syndrome among acne patients compared to normalindividuals (12% vs. 4%). Moreover, widespread pain, cognitive disturbanceand anxiety were significantly higher among acne patients compared to healthyindividuals. It was found that there was a four times increase in the risk ofhaving fibromyalgia syndrome with the increase in the duration of acne.Somatic symptoms such as muscle cramps, irritable bowel syndrome,altered bowel motion, gases and hair loss were significantly more frequentamong acne patients.Conclusion : This study had revealed that fibromyalgia syndrome was more commonin acne patients and increase with the increase in acne duration.

التشخيص المتاخر وارتباطه بالنتائج السيئة والاستجابة الغير ملائمة للعلاج في المرضى المصابين بالتهاب الفقار اللاصق == Delayed Diagnosis is Linked to Worse Outcomes and Unfavourable Treatment Responses in Patients with Ankylosing Spondylitis

Author name: حيدر احمد نوري
Supervisor name: زياد شفيق الراوي
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Ankylosing spondylitis is a chronic inflammatory disease that affect the axial skeleton(spine and sacroiliac joints) , peripheral joints, enthesitis and specific organ involvement such as anterior uveitis, aortic valve disease. The hall mark of AS is inflammatory back pain associated with radiographic sacroiliitis and often spondylitis.Objective : This study was conducted to evaluate the period from symptom onset to diagnosis of ankylosing spondylitis (AS) in Iraqi patients and the effect of delayed diagnosis on response to treatment.Patients and Methods : A retrospective cohort study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital with a total of 108 consecutive patients with AS according to the modified New York criteria . Diagnostic delay was defined as the gap between the first spondylo - arthropathic symptom and diagnosis of AS,The patients ,then, were classified into early and late diagnosis groups based on the median interval of the diagnostic delay, and a comparison was done between both groups for multiple parameters before and after 3months of etanercept or infliximab therapy.Results : the average of disease duration was 12.8yrs(range1 - 29).the average of age at disease onset was 25 years(range12 - 46) and average of age at time of diagnosis was 32.9 years(range15 - 54). The average of diagnostic delay was 6.9 years(range1 - 25) and the median was 7 years, on that basis our patients classified into early diagnosed group (<7years) and delay diagnosed group(≥7years). Mechanical back pain was the most common diagnosis prior to AS and Patients without articular involvement experienced a significantly longer delay in diagnosis compared to patients with articular involvement (29.1%vs 54.7%,p=0.001).At the time of diagnosis all parameters included in study were worse in late diagnosis group as compared with early diagnosis group, although none was statistically significant. After 3 months of treatment, BASDAI and BASFI score were significantly worse in delay diagnosis group(p=0.001).Conclusion : Patients with delayed diagnoses showed worse outcomes in activity and function scores and less favourable treatment response

دور التصو ر المقطعي عديم التباين منخفض الجرعة في توقع نجاح علاج تفتيت حصاة الكلية بالموجات الصادمة من خراج الجسم == Role of Low Dose Noncontrast Computed Tomography in Predicting the Success of Extracorporeal Shock Wave Lithotripsy Treatment of Renal Stone

Author name: احمد عباس محمد
Supervisor name: ليث احمد خلف | عادل حفظي حمودي
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Currently, extracorporeal shock wave lithotripsy (ESWL) is the most common mode of therapy for small renal stones. Many studies have attempted to correlate the radiographic findings of non - contrast computed tomography (NCCT) with ESWL success and prospective assessment of patients with renal calculi.Objective : To assess the role of low dose non - contrast computed tomography in predicting the success of extracorporeal shock wave lithotripsy for renal stone treatment.Patients and Methods : A prospective study was conducted at Al - Shaheed Ghazi Al - Hariri teaching hospital in Baghdad medical city during the period from the 15th of December 2013 to the 30th of July 2014. Fifty patients who met the inclusion criteria and agreed to participate in this study were recruited . Data collected using a pre constructed data collection form in which the demographics and clinical data were reported. Stone characteristics were based on the pre - treatment non - contrast CT scanning reviewed and reported by one urologist and one radiologist. Diagnosis of renal stone was made by a specialist urologist depending on the clinical features and proved by urinalysis , KUB, Ultrasound and the non - contrast CT images. The SSD was calculated by measuring the 90° distance from the center of the stone to the skin .Patients received one session of ESWL and followed up for two weeks. Successful treatment considered if there was complete clearance of the stone with no residual fragments (stone - free) or presence of gravels less than 4 mm . Those who failed received another session 2 week after the first one. Data wereXIIanalysed using the statistical package for social sciences (SPSS) version 21, and appropriate statistical tests were used to assess the significance which set at ≤ 0.05 to be significant.Results : The age of the studied group ranged (23 - 74) years with a mean of (41.5± 12.5) years. Only 20% of the patients aged 30 years or less. Male to female ratio was (2.3 : 1). After the 1st session , 40% of patients had successful treatment and they became stone free. After the second session, the overall response rate (successful ESWL) was (66%). Success of treatment was significantly affected by the initial stone size . patients with successful treatment had the lower stone area (96.4 ± 34.4 mm2) compared to (150.8 ± 81.2 mm2) in those with unsuccessful treatment , (P=0.016). Stone density showed an inverse correlation with the success rate, the mean stone density was the lower among those with successful treatment (640.3 ± 301.2) HU , (P<0.001). Multiple logistic regression showed that stone size and density were the most significant predictors for successful treatment. Patients characteristics (age and sex), site of the stone and SSD didn’t reach the statistical significance for prediction (P>0.05) .Conclusion : Non - contrast Computed Tomography (NCCT) is a noninvasive and useful for obtaining a lot of information about the patient and renal calculi and can predict the success of ESWL. Stone density and size were significant predictors of the outcome of ESWL . Lower stone density and size predicted by NCCT associated with higher success rate of ESWL.

شمول مفصل الورك لدى عينة من المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي == Hip Joint Involvement in a Sample of Adult Iraqi Patients with Rheumatoid Arthritis

Author name: حيدر ثامر محمد
Supervisor name: خضير زغير معيوف البدري
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: التهاب المفاصل الروماتويدي هو مرض التهابي مجموعي مزمن يستهدف المفاصل الزليلية بشكل اساسي. يؤثر هذا المرض على كل الفئات العرقية في جميع انحاء العالم وتسببه عوامل متعددة. اذا ترك هذا المرض بدون علاج، فانه عادة ما ينتج عنه التدمير التدريجي للمفصل والعجز الكبير للمريض. قد يتاثر مفصل الورك لدى 10% الى 40% من مرضى التهاب المفاصل الروماتويدي وتشتمل العلامات الشعاعية لشمول مفصل الورك على تضيق مساحة المفصل وانصباب وتقرحات وتبارز الحق والنخر اللاوعائي لراس عظم الفخذ. الاهدافلتقدير تواترشمول مفصل الورك ولتقييم الترابط بين شمول مفصل الورك ومختلف الميزات للمرضى العراقيين البالغين المصابين بالتهاب المفاصل الروماتويدي .المرضى وطريقة البحثشملت الدراسة المقطعية 60 مريضا عراقيا بالغا مستوفيا لمعايير الكلية الامريكية للمفاصل لتصنيف التهاب المفاصل الروماتويدي لسنة 1987 . تم استبعاد المرضى الذين يعانون من امراض وحالات اخرى التي قد تؤثر على مفصل الورك. تم جمع بيانات المرضى بما في ذلك : العمر، الجنس، الوزن، الطول، مؤشر كتلة الجسم، مدة المرض، التاريخ العائلي للمريض، التاريخ الدوائي للمرض، تشوهات اليد، العلامات الدالة على شمول مفصل الورك، بروتين سي التفاعلي، العامل الروماتويدي، مضاد الببتيد الموسوم بالسترولين. تم تقييم فعالية المرض لكل مريض وفقا لنقاط مؤشر فعالية المرض السريرية واجراء فحص الاشعة السينية للحوض (منظر امامي _خلفي) والتصوير بالرنين المغناطيسي لمفصل الورك.النتائجشملت الدراسة (60) مريضا بالتهاب المفاصل الروماتويدي, بلغ عدد الذكور 48 وعدد الاناث 12.كان متوسط اعمار المرضى (46.2 ± 11.6) سنوات وكان متوسط مدة المرض ( 8.8 ± 0.92) سنوات. وجد شمول مفصل الورك في (17) مصابا يمثلون (28.3%) : في كلا الطرفين عند 14مريض (23.3%) وفي طرف واحد عند 3 مرضى (5%) .اظهرت الدراسة ان المرضى الذين لديهم شمول مفصل الورك كانوا اصغر سنا من اولئك الذين لم يوجد لديهم شمول. كما اظهرت الدراسة بان هناك علاقة ذات جدوى احصائية بين شمول مفصل الورك مع : مدة المرض, فعاليته, تشوهات اليد والنتيجة الموجبة لفحص العامل الروماتويدي وفحص مضاد الببتيد الموسوم بالسترولين.لم يلاحظ وجود علاقة ذات جدوى احصائية بين شمول مفصل الورك للمصابين بمرض التهاب المفاصل الروماتويدي مع : الجنس ومؤشر كتلة الجسم والتاريخ العائلي.الاستنتاجاتلدى عينة من المرضى العراقيين البالغين المصابين بالتهاب المفاصل الروماتويدي، وجد ان نسبة شمول مفصل الورك هي 28.3% : في كلا الطرفين بنسبة 23.3% وفي طرف واحد بنسبة 5%.اوضحت الدراسة ان شمول مفصل الورك يرتبط بعلاقة ذات جدوى احصائية مع مدة المرض، فعاليته، تشوهات اليد والنتيجة الموجبة لفحص العامل الروماتويدي وفحص مضاد الببتيد الموسوم بالسترولين. لم يلاحظ وجود علاقة ذات جدوى احصائية مع : الجنس ومؤشر كتلة الجسم والتاريخ العائلي للمريض. | Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that mainly targets the synovial joints. It affects all ethnic groups with worldwide distribution and multifactorial etiology. If left untreated, it commonly results in progressive joint destruction and significant disability. The hip joint may be affected in 10% to 40% of patients with rheumatoid arthritis. Radiographic evidence of hip joint involvement includes concentric joint space narrowing, effusion, erosions, acetabular prortrusion and avascular necrosis of femoral heads.Objectives To estimate the frequency of hip joint involvement and the correlations of hip joint involvement with variable characteristic features of adult Iraqi patients with RA.Patients and methods : A cross sectional study was conducted on 60 adult Iraqi patients who fulfill the American college of rheumatology criteria for the classification of RA. Data of the Patients were obtained , including : : age, gender, weight, height, body mass index (BMI), duration of illness, family history of RA, drug history, hand deformities, symptoms suggestive of hip joint involvement, CRP (C - Reactive Protein), RF (Rheumatoid Factor) and ACPA (Anti - Citrullinated Peptide Antibody). Disease activity for each patient was assessed according to clinical disease activity index score (CDAI). Anteroposterior pelvic x - ray and MRI of hip joints were obtained for all patients.Results Sixty adult Iraqi patients with RA were enrolled in this study, there were 48 women and 12 men. Mean age of them was 46.2±11.6 years and mean duration of disease was 8.8±0.92 years. Hip joint involvement was found in 17 patients representing (28.3%) of them, bilateral in 14 patients (23.3%) and unilateral in 3 patients (5%). The study revealed that patients with hip joint involvement were younger than those without and hip joint involvement was significantly correlated with disease duration, disease activity, hand deformity and seropositivity for RF and ACPA. This study revealed no significant correlation of hip joint involvement with the gender of the patient, BMI and family history.Conclusions Hip joint involvement occurred in 28.3% in a sample of Iraqi patients with RA, bilateral in 23.3% and unilateral in 5%. Hip joint involvement was significantly associated with : disease duration, disease activity, hand deformity and seropositivity for RF and ACPA, but there were no significant correlations with gender of the patients, BMI and family history.

تقييم تضييق الصمام التاجي باستخدام طريقة PISA للمرضى العراقيين بواسطة الايكو == Assessment of Mitral Valve stenosis by Simplifying proximal Isovelocity surface area in Iraqi Patients by Trans thoracic Echocardiography

Author name: محمد جاسم حتروش
Supervisor name: غازي فرحان حاجي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Internal Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Mitral Stenosis refers to narrowing of the mitral valve orifice, resulting in impairment of filling of the left ventricle in diastole. It is usually caused by rheumatic heart disease. Proximal isovelocity surface area measurement, also known as the “flow convergence” method, can be used in Transthoracic Echocardiography to estimate the area of an orifice through which blood flows.Objectives : To compare simple PISA equation, created by combined fixing the angle to 1000 and the Val to 33 cm/s, with mitral valve area measured by pressure half time and planimetry which was taken as reference method.Patients and Methods : A cross sectional prospective study was conducted in multi teaching centers (Baghdad teaching hospital, Ibin AL Nafees hospital, Ibn AL Bitar hospital and Ghazi AL Harriry teaching hospital) from the June 2015 to the June 2016. 104 patients were enrolled in this study, 41 were excluded from the study (patients with mild mitral stenosis, with aortic regurgitation, mitral regurgitation and those with poor window were excluded from the study). Transthoracic echocardiographic examination include para sternal long axis, apical four chamber and parasternal short axis view were used to analyze parameters were selected by M - mode, 2D, and pulse doppler Results : There were 63 patients enrolled in this study with a mean age of 45.4 ± 7.1years, (23.8%) of them within the age group 30 - 39 years and the remaining (76.2%) were > 40 years. Female patients were the dominant represented 73.0% while male were 7.0% of the studied group (female : male ratio was 3 : 1); (61.9%) were in sinus rhythm and (38.1%) in atrial fibrillation. 58.7% of the patients are with Wilkin's score less than8, the mean mitral valve area according to planimetry method was (1.14 ± 0.32) cm2 and it was (1.12 ± 0.28) cm2 by PISA while the mean mitral valve area by pressure half time method was (1.19 ± 0.30) cm2. The agreement between PISA and planimetry revealed that PISA had good agreement with planimetry in diagnosis of mitral stenosis, (kappa= 0.835, P< 0.001). On the other hand, there was a fair significant agreement between pressure half time and planimetry.Conclusions : PISA method can effectively predict mitral valve area and severity of mitral stenosis by the equation; mitral valve area = 115 _ r2/Vmax, Provided that aliasing velocity is fixed at 33 cm/s, with the advantage of easy calculation over other methods used to evaluate mitral valve area by Trans thoracic Echocardiography.

شكل موجة الدوبلر النبضي لمخرج البطين الايمن وعلاقتها بشدة ارتفاع ضغط الدم الرئوي == Shape of the right ventricular outflow Doppler envelope and severity of pulmonary hypertension

Author name: محمد خالد عبد الكريم
Supervisor name: باسل نجيب سعيد الدليمي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Design : cross sectional descriptive study .Setting : Baghdad teaching hospital and Iraqi center of heart diseases.Duration : Beginning of September 2014 to end of August 2015 .Background : Pulmonary arterial hypertension is defined as a group of diseases characterized by a progressive increase in pulmonary vascular load, leading to marked increase in pulmonary artery pressure(PAP) . Although direct pressure measurement with right heart catheterization is the reference method and “gold standard” for quantification of pulmonary artery pressure, The invasive nature of catheterization makes it unsuitable for frequent and repeated use. Alternatively, echocardiography offers the advantages of noninvasiveness and versatility and is commonly used to estimate systolic pulmonary artery pressure . Unfortunately, not all of these echocardiographic variables are always present and at times an adequate jet of tricuspid regurgitation (TR) is not available to provide a very satisfactory estimate of the magnitude of pulmonary hypertension (PH) . The pulsed - wave Doppler of Right ventricular outflow tract (RVOT) velocity curve provides a wealth of physiologic information about RV and pulmonary vascular function. Doppler recordings from the RVOT are available in virtually all patients . Moreover, the shape of the Doppler profile in the Right ventricular outflow contains other physiological insights and it is simple to use in clinical practice .Aim : We devised a study to determine whether visual assessment of the right ventricular outflow Doppler signals can be useful identifying the severity of pulmonary hypertension .Patients and methods : We used a pulsed Doppler technique to examine the flow velocity pattern in the RVOT in 127 patients. Inclusion criteria all patients had a complete echocardiogram including pulsed Doppler spectral signals across the RVOT, discernible tricuspid regurgitation signal, good endocardial border resolution of both right and left ventricular chambers for tracing of the end - systole and end - diastole , as well as M - mode of the lateral tricuspid annulus .In addition, all these patients included for the analysis were in normal sinus rhythm . Exclusion criteria : no atrial or ventricular ectopy or other cardiac arrhythmia was present at the time of the study, none of the patients had a pacer or defibrillator wire in the right ventricle (RV). No previous cardiac surgery .Result : Visual inspection of RVOT spectral Doppler signals from the 127 showed four dynamic patterns , pulmonary artery systolic pressure (PASP)was significantly correlated with these different types of RVOT spectral Doppler signals . Both TR pressure gradient (PG) and PASP increased significantly from groups I to IV with p value ˂ 0.05, mean pulmonary PASP was 32.92 in pattern I, 56.07 in pattern II , 73.65 in pattern III and 113.45 in pattern IV and mean TR PG was 27.57 in pattern I , 47.28 in pattern II, 64.32 in patternIII and 102.27 in pattern IV. Furthermore, Right ventricular outflow velocity time integral (VTI) , acceleration time (ACT) , pulmonary vascular resistance (PVR) showed significant correlation with the four right ventricular outflow Doppler patterns with p value ˂ 0.05.Conclusion : In this study, we show that easily appreciated differences in the shape or morphology of the right ventricular outflow tract Doppler signal provide rapid, powerful hemodynamic insight into the presence and severity of pulmonary hypertension . Keywords Echocardiography , Pulsed wave Doppler , Right ventricular outflow tract , Pulmonary hypertension

تاثير العملية القيصرية على وزن الجسم ومحيط الخصر بين النساء في مدينة الناصرية : دراسة مقطعية مستعرضة

Author name: ايمان عبد العباس حسين
Supervisor name: مسلم ناهي سعيد
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Thi-Qar - Faculty Of Medicine
Language: English
University location: Dhi Qar
First pages:
Abstract: خلفية البحث : ان معدل انتشار السمنة يزداد في البلدان النامية ودول العالم الثالث. والسمنة هي احدى عوامل الخطر الرئيسية لعدد من الامراض المزمنة كالسكر وارتفاع ضغط الدم وامراض القلب ، ولذلك تعتبر من مشاكل الصحة العامة الرئيسية .الاهداف : تم اجراء هذه الدراسة لقياس مدى تاثير العملية القيصرية على وزن الجسم ومحيط الخصر بين النساء غير الحوامل اللواتي لديهن عملية قيصرية سابقة بالمقارنة مع النساء اللواتي لديهن ولادات طبيعية في مدينة الناصرية.الطرائق : تعتبر هذه الدراسة دراسة مقطعية منفذة في اثنين من المستشفيات التعليمية لمدينة الناصرية ( مستشفى الحبوبي التعليمي ومستشفى بنت الهدى التعليمي) للفترة ما بين الاول من شهر تشرين الثاني 2016 ولغاية الاول من تشرين الثاني2017 . النساء غير الحوامل اللواتي لديهن عملية قيصرية سابقة بالمقارنة مع النساء اللواتي لديهن ولادات طبيعية واللواتي راجعن العيادات الخارجية لاقسام النسائية في هذه المستشفيات اختيروا بشكل عشوائي, تم تضمينها في هذه الدراسة. تم احتساب العينة البحثية بناء على نسبة انتشار السمنة بين النساء في العراق(42.6٪)، وبنسبة دقة انتشار 5% ومستوى ثقة 95%, يكون حجم العينة البحثية (490) مشاركة وبعد اضافة 10 % لتغطية النساء اللائي رفضن الاشتراك في هذا البحث ,فيكون حجم العينة (500). تم جمع البيانات بواسطة استمارة استبيان. شملت استمارة الاستبيان معلومات عن العمر ،الوظيفة ،عدد افراد الاسرة ،الدخل الشهري للاسرة ،المستوى التعليمي ،السكن ،عدد الولادات الحية, نمط الولادة ,نمط الرضاعة بعد الولادة ، ،نوع النشاط الممارس اثناء اوقات الفراغ ، تم قياس الوزن ،الطول ،محيط الخصر، ودليل كتلة الجسم لتقييم الحالة التغذوية . تم تحليل البيانات باستعمال الرزمة الاحصائية للعلوم الاجتماعية (اس بي اس اس ) النسخة 23 اعتبرت قيمة p اصغر من 0.05 ذات قيمة معنوية احصائيا . النتائج : كان معدل كتلة الجسم(29.5+4.6)كغم /م 2. فكان معدل انتشار السمنة 82.2% ومعدت انتشار السمنة البطنية 64.2%. معدل انتشار السمنة اكثر بين النساء اللواتي لديهن عمليات قيصرية 56% بينما44 % بين النساء اللواتي لديهن ولادة طبيعية ، بينما كان معدل انتشار السمنة البطنية اكثر شيوعا بين النساء اللواتي ليهن عملية قيصرية مقارنة بالنساء اللواتي لديهن ولادة طبيعية (71.7%مقابل28.3 % على التوالي ).الاستنتاجات : تدعم هذه الدراسة بانه نمط الولادة له دور في تغير وزن الجسم ومحيط الخصر واتضح ان العملية القيصرية لها دور كبير في زيادة محيط الخصر مقارنة مع النساء اللواتي لديهن ولادة طبيعية.

تقييم التغيرات الفزيولوجيه الحاصله في المسالك التنفسيه الصغيره : دراسه مستنده الى المستشفى == EVALUATION OF THE SMALL AIRWAYS CHANGES IN PREGNANCY (HOSPITAL BASED STUDY) AT BAGHDAD TEACHING HOSPITAL

Author name: سيف عبد الحسين حسن
Supervisor name: محمد وهيب سلمان العبيدي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: يرتبط الحمل بتغيرات فزيولوجيه في السيطره على عملية التفس,حجم الرئه ,ميكانيكية التنفس وعلى التوازن الموجود بين الحوامض والقواعد داخل الجسمالهدف من الدراسه : 1 - مقارنة فحوصات وظائف الرئه للمسالك التنفسيه الصغيره 25% - 75% بين الحامل خلال فترات الحمل المختلفه وغير الحامل.2 - لتحديد التغيرات الحاصله في فحوصات الرئه بالنسبه للمسالك التنفسيه الصغيره قبل الولاده.3 - لتحديد اذا ما كان هنالك اي تاثير لفترة الحمل على فحوصات الرئه الخاصه بالمسالك التنفسيه الصغيره.طريقة العمل : دراسه مقطعيه مستنده الى المستشفى.اجري هذا البحث في مستشفى بغداد التعليمي بالتنسيق بين استشارية الجهاز التنفسي واستشارية النسائيه وشعبة فحص وظائف الرئه.تم اختيار 120 امراه حامل في مختلف فترات الحمل وباوزان واطوال مختلفه ومقارنتها بنساء غير حوامل(40 امراه).جميع المتطوعين للدراسه لم يعانو من امراض مزمنه ولم يكونو مدخنين. تم اخذ موافقة الجميع قبل الفحص بواسطة جهاز فحص وظائف الرئه الالكتروني.تم ادخال البيانات بواسطة SSPS22.النتائج : لوحظ وجود تغيرات في فحوصات المسالك التنفسيه الصغيره 25%بين الحوامل وغير الحوامل حيث كانت القيمه اقل من 0.05كما لوحظ وجود تغيرات بالنسبه لذروة معدل تدفق الزفيرPEFRكانت القيمه اقل من 0.05 الاستنتاج : ان للحمل تاثير على المسالك التنفسيه الصغيره.التوصيات : استخدام فحص وظائف الرئه وخاصه المسالك التنفسيه الصغيره لغرض متابعة كفاءةالجهاز التنفسي للمراه الحامل | BACKGROUND : Pregnancy is associated with physiological changes in the control of breathing, in lung volumes, in the mechanics of respiration and in acid base balance.OBJECTIVE : to assess the effect of single normal pregnancy on small airways.STUDY SETTING : Baghdad teaching hospital.PATIENTS AND METHODS : This study : cross sectional descriptive analytical study. carried out at Baghdad teaching hospital .Started from JUNE 2016 to JUNE 2017 .140 ladies aged 16 - 44 yrs of different height, weight and different conception from 1 st , 2nd and 3 rd trimesters were included also there was a control group which contains 40 ladies.All of them did spirometry .I focused mainly on the small airways parameters(Forced expiratory flow 25% - 50% - 75%) and peak expiratory flow rate for the study(pregnant) and the control(non - pregnant) groupsRESULTS : FEF25% was the only small airway parameter that is affected between the pregnant and the non - pregnant (P value was less than 0.05) BUT not in different trimesters of same pregnancy. Also there was change in the PEFR between the pregnant and the non - pregnant (P value was less than 0.05), But no change between the different trimesters

مدى شيوع مرض السمنة والعوامل المرتبطة به بين طلبة جامعة ذي قار وكلية مزايا للعام الدراسي 2016 == Prevalence of Obesity and its associated factors Among Thi - Qar University and Mazaya college Students,2016

Author name: Alaa Jassim Mohammod
Supervisor name: Dheyaa k. Al - Omar
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Thi-Qar - Faculty Of Medicine
Language: English
University location: Dhi Qar
First pages:
Abstract: خلفية البحث : ان معدل انتشار السمنة يزداد في البلدان النامية ودول العلم الثالث .و السمنة هي احدى عوامل الخطر الرئيسية لعدد من الامراض المزمنة كالسكر وارتفاع ضغط الدم وامراض القلب ، ولذلك تعتبر من مشاكل الصحة العامة الرئيسية .الهدف : دراسة معدل انتشار السمنة والعوامل المرتبطة بها بين طلبة الجامعات في محافظة ذي قار . كذلك دراسة الانماط والعادات الغذائية بينهم.اشخاص وطريقة الدراسة : بدات هذه الدراسة المقطعية في الاول من نيسان وانتهت في العاشر من شهر ايار2016، تم من خلالها دراسة مجموعة تتكون من 841طالب وطالبة (358 و456 على التوالي ) بعمر 18 - 36 سنة (بمعدل7. 21 +2.3 سنة ) اختيروا بشكل عشوائي طلبة جامعة ذي قار الحكومية وكلية مزايا الاهلية . شملت استمارة الاستبيان معلومات عن العمر ،الجنس،عدد افراد الاسرة ،الدخل الشهري للاسرة ،المستوى التعليمي للابوين ،السكن ،عدد ساعات النوم خلال اليوم ، وسيلة المجيئ للكلية ،نوع النشاط الممارس اثناء اوقات الفراغ ،العادات الغذائية وقائمة تحتوي انواع مختلفة من الاطعمة ، تم قياس الوزن ،الطول ،محيط الخصر، ودليل كتلة الجسم لتقييم الحالة التغذوية . تم تحليل البيانات باستعمال الرزمة الاحصائية للعلوم الاجتماعية (اس بي اس اس )النسخة 23 اعتبرت قيمة p اصغر من 0.05 ذات قيمة معنوية احصائيا .النتائج : كان معدل كتلة الجسم للطلبة24.17+4.0 كغم /م 2 وكان اكثر من نصفهم من (59.2) من ذوي الوزن الطبيعي (63.8 %من الطلاب و55.2 %من الطالبات ) ، بينما كان معدل انتشار زيادة الوزن وكذلك السمنة بينهم 28.3 % و8.1 % على التوالي . كان معدل انتشار السمنة متقاربا بين الذكور والاناث ، بينما كان معدل انتشار زيادة الوزن اكثر شيوعا بين الطالبات مقارنة بالطلاب (32 %مقابل 23.1 % على التوالي ).كان معدل انتشار قلة الوزن اكثر شيوعا بين الطلاب مقارنة بالطالبات (5.1 %من الطلاب مقابل 3.7 % من الطالبات ) .اعتمادا على محيط الخصر كان 3 % من الذكور و18 % من الاناث اكثر عرضة لخطر الاصابة بالامراض المصاحبة للسمنة .كان معدل انتشار السمنة ومحيط الخصر اعلى لدى الطلبة الذين تتجاوز اعمارهم السادسة والعشرين وكذلك الطلبة من ذوي الاسر التي لاتتجاوز اعداد افرادها الست اشخاص(p<.05) لكلا المتغيرين . نسبيا ، هناك نسبة عالية نسبيا (42.7 %من الطلاب و35.8 % من الطالبات )يقضون اكثر من ساعتين في اليوم امام شاشات الحاسوب . الطالبات اقل نشاطا وحركة من الطلاب (p<.05) نسبة عالية من الطلاب والطالبات لا يتناولون وجبة الافطار والحليب وكذلك الخضروات والفواكه يوميا .الاستنتاجات : تدعم هذه الدراسة بانه هناك عوامل متعددة مسببة للسمنة . واظهرت ان العمر والاسر المكونة من اقل من ستة اشخاص من عوامل الخطر . | Background : The prevalence of overweight and obesity is increasing in both developed and developing countries. Obesity is a major risk factor for many chronic diseases including diabetes, hypertension and ischemic heart diseases, so it is considered a major Public health problem. Objectives : to study the prevalence of obesity and its associated factors among Thi - Qar university students. Dietary habit and food consumption pattern are also assessed.Subjects and methods : A cross sectional study started from 1st of April 2016 - 10th of May 2016, A total of 841 students (358 were males and 456 were females) between 18 years and 36 years of age (mean 21.7 ± 2.3years) were selected randomly from 24 colleges of both Thi - Qar and Mazaya private college. A questionnaire was distributed to each participant : Age, gender, family member numbers, monthly family income, level of parent educations, residency, time of sleep per night, types of activity during leisure times, dietary habit and different food items were considered, Height, weight and waist circumference were measured and BMI was calculated and used to assess weight status. The data were analyzed by using SPSS. p value less than 0.05 was considered as statistically significant.Results : The mean BMI was 24.17 ± 4.0 kg/m2; more than half (59.2%) of students were of normal weight (63.8% of male students and 55.2% of female students); whereas the prevalence of overweight and that of obesity among them was 28.3% and 8.1% respectively. The prevalence of obesity was nearly similar for both male and female students, while the prevalence of overweight was more common among female’s students than among males (32 %of females vs. 23.1% of males). The prevalence of underweight was more common among male than female students (5.1 % of male vs. 3.7 % of female). Depending on their waist circumference 3% of male and 18 % of female students were at a higher risk of developing abdominal obesity co morbidities. There was a significant higher prevalence of obesity and mean waist circumference within students of more than 26 years old aged and of less than 6 household family number (p < .05 for both variables).A relatively high proportion (42.7 % for males and 35.8 % for females) spend more than two hours on screen time daily. Females were significantly (p< .05) much less physically active than males. A high proportion of students (male and female) didn’t have a daily intake of breakfast, milk vegetable or fruitConclusion : The prevalence of obesity and overweight were more than the obesity reported among university students in previous local studies in Iraq, however it still lower than obesity and overweight reported among the university students of the neighborhood countries. The study supports the multi factorial etiology of obesity; it demonstrates that age, parent’s education and household number are risk factors. The study also shows high prevalence of sedentary behaviors, physical inactivity and unhealthy dietary habit among Thi - Qar university students.Recommendation : the study results mandate the need for public health strategies to prevent overweight and obesity and adopt a healthy dietary habit and life style.Key word : Prevalence, Obesity, Overweight, Cross sectional study, Dietary habit, Life style.Abbreviations : WHO, World Health Organization; BMI, body mass index; SPSS, Statistical Package for Social Sciences.

مدى انتشار الامراض غير الانتقالية بين الناس المسنين في مدينة الناصرية 2015 : دراسة مسحية سكانية == Prevalence and patterns of non - communicable diseases among a geriatric population in Al - Nasiriya city 2015

Author name: رحيم نايف ناصر
Supervisor name: علي عبد سعدون الغزي
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine
Language: English
University location: Dhi Qar
First pages:
Abstract: دراسة مدى انتشارالامراض المزمنة غير الانتقالية بين الناس المسنين في مدينة الناصرية وتقييم الوضع الصحي العام لهم وتقييم خدمات الرعاية الصحية المقدمة لهذه الفئة من السكان.المواد والاساليب : دراسة مقطعية وصفية وتحليلية من خلال اجراء المسح السكاني للعوائل في بعض الاحياء السكنية. اجريت هذه الدراسة في منطقة حضرية جغرافيا من مدينة الناصرية التي تبعد عن العاصمة بغداد 360 كم جنوبا. تمت الدراسة خلال فترة امتدت اكثر من سنة (من 1 ايلول 2015 الى نهاية شهر تشرين الاول 2016). تم جمع البيانات من عينة تمثيلية من 423 من الاشخاص الذين تتراوح اعمارهم من 60 سنة فما فوق ومن خلال اخذ عينات متعددة المراحل (عنقودية).النتائج : كان معدل انتشار الامراض المزمنة غير الانتقالية بنسبة 89.8% بين الاشخاص المسنين، وفي مقدمتها الحالات الخمسة التالية : ارتفاع ضغط الدم (67%)، مرض السكري (31,2%)، امراض العظام والعضلات (15,4%)، امراض القلب (11,1%)، اعتام عدسة العين (12,8%) وكان انتشار مرضين او اكثر في ان واحد بمعدل 59%.اما اعراض ومشاكل الشيخوخة الرئيسية فكانت : مشاكل في الرؤيا (77,8%), الشعور بالحزن او الاكتئاب (36,4%)، مشاكل السمع (31,7%)، السقوط (30%), مشاكل في الذاكرة (22,9%)، والاعراض البولية (11,1%).اثبتت هذه الدراسة ان معدل انتشار الامراض المزمنة غير الانتقالية في مدينة الناصرية كان مرتفعا ومثيرا للقلق وخاصة امراض القلب والاوعية الدموية التي تحتاج الى الجهود الفعلية والتركيز في مجال الوقاية وكذلك تحسين وتعزيز نظام الرعاية الصحية خاصة في مجال الرعاية الصحية لكبار السن للحد من الاصابة بالامراض المزمنة ومضاعفاتها والاثر السلبي على الحياة والتطور الاقتصادي | More than one year starting from the 1st September 2015 to the end of October 2016, an observational, analytical - cross - sectional study through a household survey was conducted in Al - Nasiriya city to study the prevalence of non - communicable diseases among a geriatric population, other objectives were to describe the symptomatology (geriatric review of system for elderly), subjective general health status of wellbeing, and the accessibility and satisfaction of patients to health care services provided in this segment of the population. A representative sample of 423 individual aged ≥ 60 years through multistage sampling had been included in the study. Special form of questionnaire was planned to collect information, which tested by three experts in the field of community medicine and family medicine for the validity before its use in the collection of data. The diagnosis of cases (the inclusion and exclusion criteria) was clearly depending on the chronic disease card or any available documentations that support the definite diagnosis (medical reports, investigation, or current treatment). In contrast to self - reporting studies, the direct observation from the researcher as an advantage of a cross - sectional household survey study plays an important role in minimizing the information bias during the stage of data collection. In addition, it was based mainly on the doctors - diagnoses conditions and consistent with the definition of chronic diseases A pilot study was conducted on 18 elderly individuals prior to the proper study in order to test the feasibility of the research, time requirement and the cost. The results were discussed with the supervisor for any change or modification needed. All those 18 cases were included in the proper study. For statistical analysis, Statistical Package for Social Sciences (SPSS)version (23) was used for data analysis including frequencies, percentages, test of significance (Chi - square test, Monte Carlo test, Fisher exact test), correlation and logistic regression analysis. A p - value of <0.05 was considered to be significant. The overall prevalence of at least one chronic NCD was 89.8%. The top five chronic conditions : hypertension (67.8%), diabetes mellitus (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). The prevalence of multi - morbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision related problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). The main limitations in this study were its performance in an urban area, some cautions must be taken regarding the generalization of the results. Also not all types of chronic disease and geriatric symptoms were discussed in this study, however all the available data in the sample were collected and studied. Nevertheless, further studies are required specially to estimate the prevalence of risk factors, to estimate the cost of care and health, expenditure, quality of health services and geriatric health need. This study will help in establishing the priorities to act on according to the magnitude of the problems and their impact. Also to design the strategies for prevention and control of NCDs. According to the results obtained from this study and the current situation regarding the care of geriatric population in Iraq and specifically in Al - Nasiriya city, the most important and practical recommendation is to activate the geriatric health care at PHCCs or at least in every hospital with a geriatric clinic with well - trained doctors and other heath staff in the field of geriatrics.

الاستدلال عن مستقبلات الاستروجين ، البروجستيرون وعامل النمو البشري لدى مرضى سرطان الثدي في الناصرية2014 - 2015 == Expression of Estrogen, Progesterone and Human epidermal growth factor Receptors in Breast Cancer in Al - Nasiriya 2014 - 2015

Author name: اصيل ضيول حسن
Supervisor name: حميد نعيم موسى
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine
Language: English
University location: Dhi Qar
First pages:
Abstract: الخلفية : سرطان الثدي هو الورم الخبيث الاكثر شيوعا ومشكلة الصحة العامة للسيدات في جميع انحاء العالم وفي العراق. سرطان الثدي هو مرض متغير الخواص للغاية، هناك ثلاث علامات تنبؤيه : مستقبلات الاستروجين، مستقبلات بروجسترون ومستقبلات عامل النمو عندها قيمة تنبؤيه مستقلة. يظهر تعبيرERفي 80 - 90% من المرضى بسرطان الثدي، بينما يظهر تعبيرPRفي 70 - 80 % من الحالات. مستقبلات عامل النمو موجود في 15 - 20% من الحالات. لهذاسرطان الثدي يمثل بشكل افضل بتعبير المستقبل المشترك من التمثيل بمستقبل واحد 0علامات الواسم المناعي - الكيميائي النسيجي (IHC) من مستقبلات هرمون الاستروجين (ER)،مستقبلات هرمون البروجسترون (العلاقات العامة) ومستقبلات عامل النمو (HER2) يمكن تصنيف التعبير الهرموني لسرطان الثدي الى 4 انواع فرعية : النوع الاول ثلاثي موجب مستقبلات الهرمونات(هرمون الاستروجين موجب والعلاقات العامة موجب ومستقبلات عامل النمو موجب)؛النوع الثاني (هرمون الاستروجين موجب والعلاقات العامة موجب ومستقبلات عامل النمو سالب)؛ النوع الثالث ثلاثي سالب مستقبلات الهرمونات (هرمون الاستروجين سالب والعلاقات العامة سالب ومستقبلات عامل النمو سالب)والنوع الرابع (هرمون الاستروجين سالب والعلاقات العامة سالب ومستقبلات عامل النمو موجب).الدراسات السابقة اظهرت ادلة على الفرق الجزيئية التي تكون مسؤولة عن الفرق النتيجة0الهدف من الدراسة : هو تقييم حالة الهرمونات وعلاقتهم بدرجة ومرحلة الورم لحظة تشخيص المرض0المرضى وطريقة العمل : كان نوع الدراسة دراسة مقطعية في محافظة ذي قارفي مدينة الناصرية في مستشفى الحبوبي مركز الاورام ،تضمنت 165 حالة من المرضى الذين شخصت اصابتهم بسرطان الثدي خلال فترة (كانون الثاني 2014 - كانون الاول 2015) تم تجميع معلومات كل مريض وتحليلها : عمر المريض ،الجنس، مكان الاقامة ومعلومات متعلقة بالورم مثل درجة الورم ومرحلة الورم، ومنزلة المستقبلات (ER،PR،her2مستقبلات)0النتائج : العمري الوسطي = 49 ± 11.1. وكانت معظم الحالات 75,2% هرمون البروجسترون موجب بينما هرمون الاستروجين موجب في (72.7٪)،ولكن معظمهم كانواHER2سالب(78.2٪). كان معظم المرضى من الدرجة الثانية (64.2 ٪ ) والمرحلة الثانية (50.3 ٪ )؛كان النوع الفرعي الاكثر شيوعا (ER / PR موجب وher2سالب )والتي تمثل 64.8٪ 0بالنسبة لمقارنة التعبير الهرموني للمرض مع درجة ومرحلة الورم لوحظ ان اعلى درجة الورم (الثاني) (76.93٪) وجدت في النوع الرابع (ER / PRسالب،HER2موجب) وكانت هناك علاقة بين التعبير الهرموني ومرحلة المرض0 الاستنتاجات : سرطان الثدي يمتلك خصوصية مستقبلات هرمونية0الكثير من الحالات توجد في المرحلة الثانية والدرجة الثانية لحظة التشخيص0 التعبير الهرموني السلبي متعلق بمرحلة متقدمة من المرض 0ينبغي توجيه الجهود في توحيد اساليب وتطوير اختبارات اكثر وثوقا لتشخيص المرض بمرحلة مبكرة0

Epidemiology of Acute Childhood and Adolescent Poisoning in Al - Nassiryia Poison Center (2013 - 2015)

Author name: Khashaa Abdulkadhum Jaber
Supervisor name: Raid Kareem Dehiol
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Thi-Qar - Faculty Of Medicine - Department Of Family And Community Medicine
Language: English
University location: Dhi Qar
First pages:
Abstract: Background : Acute childhood and adolescent poisoning remain one of the important emergencies causing a significant burden to the populations with important morbidity and mortality rates. Epidemiological studies are so important to determine the extent of the problem, according to which the preventive strategies are related. Objectives : This study aimed to determine the epidemiological features of poisoning for the patients less than 19 years old in Thi - qar governorate, involving the main types, clinical presentations, management, outcome, and seasonal variation of poisoning. Methods : A descriptive cross sectional study was involved 340 patients recorded in Al - Nasiriyah poison center from (January 2013 to December 2015), data that collected from the case sheets and records of phone cases. These data was analysed by the statistical package of social science (SPSS) for analysis. Results : Toddler age group seen in 45% of cases with predominance of accidental type, while adolescents (14 - 18yrs.) are mostly intentional with female preponderance, two hundred cases (58.8%) of the exposed patients were male, urban populations are more prone to poisoning 236 cases (69.4%), accidental exposure is the commonest (83.2%), oral route is (99.4%), (62.9%) of the causative agents are pharmaceutical, and (50.7%) are asymptomatic. most of them treated conservatively (96.5%) with survival rate of (97.9%), mortality seen in those presented after the first 24 hrs. of exposure. One third of acute poisoning occurred in summer season.Conclusion : Toddler age group commonly prone to acute poisoning, male are more in accidental pattern, majority of patients were from urban population, one third of the poisoning occur at summer, and there is a strong relationship between time of arrival to the hospital and outcome of the patient
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