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تجربة المرضى مع العلاجات البيولوجية الوريدية للمرضى العراقيين المصابين بامراض المفاصل == Patients Experience with Intravenous Biologic Therapies in Iraqi Patients with Rheumatologic Diseases

Author name: ندى علي محمد
Supervisor name: زياد شفيق الراوي
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Intravenous and subcutaneous administration of biologic agents differs not only in routes of administration but also in dosing schedules, costs, onset of efficacy, and immunogenicity which are associated with patients‟ preferences and corresponding persistence in treatment utilization. Additionally, injection issues (depending on route of administration and agent type) have been shown to influence patients‟ utilization of biologic therapies.ObjectiveThe main objective of this study was to describe patients experience with intravenous (IV) biologics for specific rheumatologic conditions including rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Patients and Methods A cross - sectional study was conducted through interviews of 196 patients with the above mentioned autoimmune diseases who were currently receiving an IV biologics at Baghdad Teaching Hospital. Patients were asked to describe the advantages and disadvantages associated with their IV infusion experience. ResultsOn a 7 - point Likert scale (1= not at all satisfied; 7= very satisfied), 90.3% of patients rated satisfaction as 5, 6 or 7. The most frequently perceived benefit of IV therapy were related to Infusion center visits which act as an additional assessment to a regular doctor visit which was equals to 88.8% of patients. Fifty one percent of patientsexperienced t “No disadvantage” in receiving IV biologic therapy and 25% of patients reported that the duration of infusion takes too long as perceived disadvantages. The two most common reasons for preferring IV therapy were the less frequent dosing regimenreported by 81.6 % of patients and 54.1% of patients believes that the intravenous infusion was always effective and they have no experience with subcutaneous therapy.ConclusionsPatients using IV biologics are highly satisfied with their medications and their preferences are due to less frequent dosing, the perceived IV injection effectiveness and the easier to remember dosing when an appointment is scheduled for them.

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
University: University of Baghdad - Faculty Of Medicine
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 .

العوامل المرتبطة بالتسرب من علاج مرض التدرن في بغداد العراق 2016 - 2018 == Factors Associated with Default in TB Management, Baghdad, Iraq, 2016 - 2018

Author name: محمد علي كريم راضي
Supervisor name: ناديه عزيز
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: Tuberculosis (TB) continues to be a global public health problem, with an estimated 9.4 million incident cases of TB and 1.8 million deaths in 2008. Drug resistance and obstacles to successful directly observed therapy short - course (DOTS) impede disease control.OBJECTIVE : The aim of study is to highlighting the epidemiological characteristic of TB defaulter patients by person (age, sex, marital state socioeconomic status), place, time and identifying factors that had put these individuals at risk for default in Iraq, Baghdad, 2016 - 2018.Materials and Methods :  Study design : Cross sectional study of all defaulters attended to T. B centers in Baghdad (National specialized center for chest and Respiratory diseases center of T.B in Iraq, T.B center in Baghdad / Karkh, T.B center in Baghdad / Rusafah). Source of data : using already presents clinic registries and Interview with theme using questionnaire especially constructed for this study or by phone calls. Excel and SPSS program will be used for analysis.IIIRESULT : The highest prevalence of defaulter was found among participants aged (>45) years (60%) with significant association (p=0.001) between participant’s age and prevalence of default. a significant association (P=0.001) between prevalence of default and family income, (92.7%) of participants with default ID (250000 - 500000) income. It was (46.6%) of smokers were default with significant association (P=0.001) between prevalence of default and smoking.A significant association (p=0.031) between prevalence of default and alcohol drinking. Concerning the association between prevalence of default and having chronic disease, we found that (77.8%) have DM and (45.6%) have HT, with a significant association (p=0.001).The proportion of participants with public transportation was (37.5%). With significant association (p=0.024). The proportion of participants with vomiting was (100%). With significant association (p=0.001).The proportion of participants with previous defaulting was (21%). With significant association (p=0.001).Conclusions : In this study we found that there are significant associations between TB defaulters and the following factors; age of >45, ID<250000, smoking, Alcohol drinking, DM, previous defaulting, vomiting and low education.These risk factors should be controlled by a good implementation of the direct observed treatment short coarse therapy (DOTS), cooperation between Private and Public sector and also by enhancing more studies on the same filed.

تقييم اداء نظام مراقبة الحصبة في العراق 2011 - 2017 == Evaluation of Measles Surveillance System Performance in Iraq, 2011 - 2017

Author name: صفاء سعدون علي
Supervisor name: بتول علي غالب ياسين
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: Introduction : Measles is a highly contagious viral disease and an important cause of death among young children globally. Adequate vaccine coverage and enhancing surveillance system are the keys for elimination goal by 2020. Objectives : to evaluate the surveillance system performance and to identify the epidemiological characteristics and vaccine coverage of measles in Iraq from 2011 to 2017. Methods : a descriptive study was done on measles surveillance data from Iraq obtained during the period from 1st of January 2011 to the 31st of December 2017. The performance of surveillance was evaluated according to the WHO performance indicators. Results : Of 9,114 suspected cases, 35% were confirmed, there were three outbreaks at 2013, 2014 & 2015, case fatality rate reached 1.04% in 2014; 74% of confirmed cases were below 5 years. Non - measles non - rubella rate didn’t achieve their targets (≥ 2/100,000) during the last three years at the national level, no governorate achieved the target throughout the whole study period. Suspected measles cases notified ≤ 48 h after rash onset didn’t achieve their targets (≥80%) during 2013, 2014 and 2015 at the national level, only Basrah and Dahuk achieved the target throughout the whole study period. Suspected measles cases investigated ≤ 48 h after notification achieved their target (≥80%) throughout the whole study period at both the national and governorate level. Suspected measles cases with adequate specimen collected within 28 days of rash onset have been achieved (≥ 80%) throughout the whole study period except; Kirkuk, Anbar, Ninawa, Salah Al - Din and Diyala in 2014 and 2015; Babylon, Al - Qadisiyah and Wasit in 2015. Throughout the whole study period; suspected measles cases with specimens received by the laboratoryIIIwithin four days of the collection have never been achieved (≥ 80%) in Dahuk, Erbil, Wasit, Sulaymaniyah, Dhi - Qar, and Babylon; only Najaf, Karbala and Basrah achieved the target. Suspected measles cases with laboratory result reported within seven days achieved their target (≥ 80%) throughout the whole study period at national level except in 2015 at which the target was achieved only in Dahuk and Muthanna. Conclusions and Recommendation : Most measles surveillance performance indicators still need improvement. Expanding vaccine coverage, more education and enhancement of the commitment of the staff about the importance of notification of measles cases and ensuring logistic and financial Supports are crucial for the strengthening of the surveillance system to reach the elimination goal

اكتئاب ما بعد الولادة بين الامهات المراجعات للمراكز الصحية الاولية في بغداد/ الكرخ 2018 == POSTPARTUM DEPRESSION AMONG MOTHERS ATTENDING PRIMARY HEALTH CARE CENTERS IN BAGHDAD/ AL - KARKH, 2018

Author name: زيد وجيه عواد حسن
Supervisor name: فارس حسن اللامي
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

التغيرات الهندسية والوظيفية في البطين الايسر لمرضى العجز الكلوي المزمن الخاضعين لبرنامج الديلزة الدموية == Left Ventricular Geometrical and Functional changes in patients with End Stage Renal Disease on hemodialysis program

Author name: عبد الله اسماعيل عويد
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: دراسة التغيرات الهندسية (التركيبية) والوظيفية للبطين الايسر لمرضى العجز الكلوي المزمن الخاضعين لبرنامج الديلزة الدموية.المرضى ومنهاج البحث : - شملت الدراسة (50) مريضا مصابين بالعجز الكلوي المزمن الخاضعين لبرنامج الديلزة الدموية و(50) شخص سويز وقد تم استثناء المرضى المصابين بقصور الشرايين التاجية والانصباب التاموري ومرضى الصمامات القلبية من الدراسة.وتم اجراء فحص ايكو القلب لهم وحساب دليل الكتلة للبطين الايسر وحجم البطين الايسر وكذلك حساب القذف الكسري للبطين الايسر وحسب توصيات الجمعية الامريكية لاطباء الايكو كما تم اجراء التقييم للسريري والمختبري لهم.النتائج : - 29 مريضا (58%) لديهم تضخم جدار عضلة البطين الايسر و14 مريضا (28%) لديهم توسع البطين الايسر و10 مرضى (20%) لديهم اختلال الوظيفة الانقباضية للبطين الايسر بينما كان فحص الايكو طبيعيا ل 11 مريضا (22%).ولوحظ وجود علاقة احصائية ذات جدوى بين كل العمر والجنس وارتفاع ضغط الدم وفقر الدم وارتفاع مستوى الكرياتنين في الدم ومدة المرض وبين هذه التغيرات في البطين الايسر.الاستنتاج : - اغلب مرضى عجز الكليتين المزمن الخاضعين للديلزة الدموية لديهم تغيرات تركيبية ووظيفية في البطين الايسر واكثر هذه التغيرات ترددا هو تضخم جدار البطين الايسر.التوصيات : - السيطرة على ضغط الدم وفقر الدم ومستوى الكرياتنين في الدم يساعد على الوقاية من تلك التغيرات | End Stage Renal Disease is associated with increased cardiac morbidity which in turn considered as a main cause of increased mortality in patients with end stage renal disease, cardiovascular complications of end stage renal disease account for about 40% of deaths in these patients.ObjectiveThe aim of study is to estimate the geometrical (structural) and functional changes of the LV in patients of ESRD on hemodialysis.Patients and methodsFifty patients with ESRD on hemodialysis program & 50 normal subjects were included in this cross sectional study.Patients with IHD, pericardial effusion, sever valvular heart disease, regional wall motion abnormality & patients with poor window were excluded from this study Echocardiography performed according to the recommendations of ASE to measure left ventricular mass index, left ventricular volume& ejection fractionClinical& biochemical assessment of patients include body weight, height, blood pressure, hemoglobin, s. creatinine& duration of renal failure.Results The mean age group of patients was (55± 22.1) years , the male to female ratio was 0.78 : 1.Their mean s. creatinine level was ( 8.2±3.1) mg/dl, mean hemoglobin level was (7.8±2.4),mean systolic blood pressure was (148±21.7) mmhg ,  mean diastolic blood pressure was (95.6±22.6) and the duration of renal failure was (2.6±0.9) year.The patients were divided into 4 groups according to the type of echocardiographic abnormalities : Twenty nine patients (58%) with left ventricular hypertrophy, 14 patients (20%) with left ventricular dilatation, 10 patients (20%) with systolic dysfunction and only 11 patients (22%) with normal echocardiogram. Hypertension, high s. creatinine, low level hemoglobin, long duration renal failure, found to be significantly associated with manifestations of left ventricular disorders (p value= 0.001).ConclusionsMost of the patients with ESRD had abnormal echocardiographic abnormalities and the most findings was LVH, aggressive control of blood pressure, anemia, s. creatinine can help to prevent these abnormalities

تشخيص تاثر البطين الايمن عند شموله في حالة احتشاء جدار القلب السفلي من خلال قياس مدى الانحراف الشاقولي لجانب حلقة الصمام الثلاثي الوريقات عند انقباض القلب == Right ventricular involvement in acute inferior wall myocardial infarction by Tricuspid Annular Plane Systolic Excursion method

Author name: جلال حربي سلمان
Supervisor name: هلال بهجت شوقي الصفار
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: ان تاثر البطين الايمن للقلب في حالة قصور الدوره الدمويه للشرايين التاجيه لدى المرضى المصابين باحتشاء حاد للجدار السفلي لعضله القلب له اثاره من حيث نسبه الاعتلال ونسبه الوفيات للمرضى الراقدين في المستشفى .ان الاستدلال على هذا التاثر قد يساعدنا في المعالجه الاستباقيه لمنع حدوث المضاعفات والوقايه منها .ان الاحتشاءالعضلي للبطين الايمن يعرف بازاحه الى الاعلى اكثر من مليمتر لقطعه اس تي في القطب RV4 للتخطيط الكهربائي للقلب.التابسي (الانحراف الشاقولي لجانب الرابط الحلقي الليفي للصمام الثلاثي الوريقات عند انقباض القلب) هي احدى القياسات التي تصف الوظيفه الانقباضيه للبطين الايمن باستخدام جهاز صدى القلب.الهدف من الدراسه : وصف عمل البطين الايمن في حالة حدوث احتشاء حاد للجدار السفلي لعضلة القلب بطريقه قياس(مدى الانحراف الشاقولي لمستوى الرابط الحلقي الليفي للصمام الثلاثي الوريقات عند انقباض القلب).المرضى وطرق البحث : تم اختيار 35 مريضا مصابين باحتشاء حاد للجدار السفلي لعضلة القلب ومقارنتهم مع 30 شخصا مطابقين لهم من حيث العمر (معيار). ان العلاقه بين احتشاء البطين الايمن في حالة احتشاء الجدار السفلي لعضلة القلب عرفت بوجود ازاحه نحو الاعلى باكثر او يساوي ا مليمتر لقطعة اس تي في القطب. RV4 تم قياس مدى الانحراف الشاقولي لجانب الرابط الحلقي الليفي للصمام الثلاثي الوريقات للجدار الحر للبطين الايمن عند انقباض القلب من خلال المنظر الرباعي لمخادع القلب باستخدام جهاز صدى القلب من خلال جدار الصدر .النتائج : لقد ظهر واضحا بان هذا الانحراف قد تدخل بصوره واضحه لدى مرضى الاحتشاء السفلي لعضلة القلب مقارنة بالمعيار( . (p = 0.027 ثم ان مرضى الاحتشاء السفلي قد تم تقسيمهم الى مجموعتين حسب وجود وعدم وجود علامات احتشاء البطين الايمن من خلال التخطيط الكهربائي للقلب , وان مقدار هذا الانحراف كان قليلا وبصوره واضحه لدى المرضى الذين لديهم احتشاء سفلي مع احتشاء البطين الايمن في نفس الوقت مقارنة بالذين لديهم احتشاء سفلي فقط (p = 0.031) .الاستنتاج : ان قياس هذا الانحراف هو طريقه بسيطه الاستخدام وقد تساعد لتقييم وظيفة البطين الايمن لدى مرضى الاحتشاء السفلي لعضلة القلب عن طريق استخدام صدى القلب | Right ventricular ischemia complicating inferior wall myocardial infarction causes increased inhospital morbidity and mortality. Identification of right ventriculatr involvement can help anticpitating and preventing complications . RVMI is defined by >1mm ST segment elevation in the right precordial lead RV4. Tricuspid Annular Plane Systolic Excursion is a parameter that describes systolic function of the right ventricle.AIM OF STUDY : To describe the right ventricular function after acute inferior wall myocardial infarction by the method of tricuspid plane systolic excursion (TAPSE).Materials and Methods : 35 patients with acute inferior wall MI were compared with 30 age matched healthy individuals (control), Diagnosis of RV infarction in inferior MI was defined as the presence of >1 mm ST - segment elevation at the right precordial lead( RV4) of the electrocardiograms. From the echocardiographic apical 4 - chamber views ,the systolic motion of the tricuspid annulus was recorded at the RV free wall with the use of 2 - dimensional guided M - mode recordings.RESULTS : TAPSE value has been significantly reduced in patients with inferior wall MI compared with that control (p = 0.027). Patients with inferior wall MI were divided into 2 subgroups those with and without ECG signs of RVMI. TAPSE was significantly reduced in patients with RVMI compared to those without RVMI (p = 0.031).CONCLUSION : TAPSE is a simple measure and can be used to assess right ventricular function in patients with acute inferior wall MI by means of echocardiography

معدل انتشار مرض التهاب الكبد الفايروسي نوع بي بين مرضى السكري في بغداد / الرصافة 2018 == The Prevalence Rate of Hepatitis - B among Diabetic Patient in Baghdad / Al - Russafa 2018

Author name: حسنين اسماعيل مالك
Supervisor name: سهير محمد محمود الجبوري
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: Diabetes mellitus and Hepatitis B virus infection, each is considered a major public health problem. Diabetic patient may be at risk of having Hepatitis B virus infection.This study aimed to measure the prevalence of Hepatitis B virus among Diabetic patient from Baghdad Al - Russafa and factors that may lead to being infected.1 : 2 Method : A cross - sectional study was conducted. The samples had been taken from Al - Kindy endocrine center. All diabetic patients (type 1 and type 2) who attended to this center were included in the study. ELISA test was performed for each to identify hepatitis B virus infection, at Central Health Laboratory.1 : 3 RESULTS : The total number of patients who included in this study was 317, all of them where diabetic patient. Three diabetic participants from the total number of study participant were with positive result of hepatitis B infection, with a prevalence rate of 0.9%. The three diabetic patient with positive result, had risk factor such as (previous history of dialysis, surgical and dental intervention, blood transfusion and also multiple user for glucometer instrument). Patient’s age was ranging from 5 to 76 years with a mean of 44.05 years and standard deviation (SD) of ± 16.30 years. The highest proportion of study patients (56.2%) were found in age group above 45 years. The proportion of female represented less than two thirds of participants (60.6%) with female to male ratio of 1.53 : 1. About 43.2% had surgical intervention, 14.2% had a dental intervention, 4.4% had blood transfusion, and 0.6% had kidney dialysis and 0.6% with a blood disease. 88.3% had glucometer instrument, from them 86.8% using their instrument to test their blood glucose level. About 53 diabetic patients were type (1) diabetes (16.7%), 52 of them had negative result (98.1%) and one of them with positive result (1.9%). Type (2) diabetes represent (83.3%) from the total study sample, (99.7%) of them with negative result and (0.8%) of them were positive. One patient from the (317) diabetic participants had a positive history of hepatitis B infection (0.3%).1 : 4 Conclusions : The prevalence rate of hepatitis B in the current study was 0.9%. The detected cases were because of bad prophylaxis against contamination of glucometer needle. Also, dialysis, bad surgical, dental intervention and blood transfusion, were detected as a risk factor in hepatitis B infection in diabetic patient

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
University: University of Baghdad - Faculty Of Medicine
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.

نتائج فحص السلين باختبار الجلد عند المرضى المصابين بالربو والذين يستخدمون الستيرويدات كجزء من علاجهم == THE RESULTS OF TUBERCULIN SKIN TEST IN ADULT ASTHMATIC PATEINTS USING STEROIDS AS PART OF THEIR MANAGEMENT

Author name: سرى علي حسين
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: بالنظر لكون مرض التهاب السل احد اهم العوامل المسببة للوفيات والمراضة في البلدان النامية وفقا لاحصائيات منظمة الصحة العالمية ومركز السيطرة على الامراض الانتقالية فان امكانية الاصابة بهذا المرض تزيد بنسب متطاردة مع نقص المناعة.استخدام الستيرويدات كجزء من علاج مرض الربو (البردنيزولون او مايعادله) بجرعة تقارب 15 مليغرام باليوم لمدة تتجاوز الاربع اسابيع يصاحبها هبوط واضح للمناعة مما يزيد من امكانية الاصابو بالربو بحوالي الثمان اضعافالهدف من البحثحاولنا في هذا البحث ايجاد مخاطر الاصابة بالسل عند المرضى المصابين بالربو والذين يستخدمون الستيرويد كجزء من علاجهمطرق اعداد البحثدراسة انية مصممة لاستيعاب المرضى المصابين بالربو الذين يراجعون مستشفى بغداد التعليمي للفترة من حزيران 2016 ولغاية حزيران 2017 بوحدة المرضى الراقدين ومرضى العياددة الخارجيةتم اعداد استبيان لتسجيل المعلومات المهمة لاعداد هذا البحث من قبل الباحثة وتدوين كل ما يمت بصلة من اجل اكمال هذه الاطروحةالنتائجتم ضم 60 مريضا لهذه الدراسة خلال مدة سنة واحدة. نسبة الذكور الى الاناث كانت 7 : 23. 80 % من المرضى كانوا من سكنة المدينة بينما 20 % كانوا يسكنون القرى المحيطة . 33.3 % من المرضى كانوا يعانون من مرض السكري كاعتلال مشترك. 21.7% من المرضى كانوا يستخدمون الستيرويد عن طريق الاستنشاق, بينما 45 % كانوا يستخدمون الستيرويد النظامي, و33.3 % كانول يستخدمون الطرق المشتركة. من ضمن المرضى الذين تم ضمهم للبحث, 18.3 % كانوا قد استخدموا الستيرويد لمدة لاتزيد عن اربع اسابيع, بينما البقية اجتازوا ذلك. بلنسبة لفحص السلين 11.7% من المرضى اعطوا نتيجة موجبة للفحص.كانت هناك علاقة واضحة بين فحص السلين وزيادة العمر (p=0.01), وكذلك مع زيادة مدة استخدام الستيرويد (p=0.001), وكذلك مع وجود تاريخ مرضي للسل سابقا (p=0.04).الاستنتاجبعد تحليل النتائج المستقاة من هذا البحث تبين التالي : 1. لا توجد علاقة واضحة بين نوع الستيرويد وخطورة الاصابة بمرض السل2. خطورة الستيرويد على اضعاف المناعة تزيد مع زيادة العمر للشخص3. زيادة مدة التعرض للستيرويد ستزيد بلا شك من امكانية لاصابة بمرض السلالتوصياتننصح باجراء بحث على نطاق اوسع واشمل ليتضمن اكثر من مركز تخصصي للامراض الصدرية على نطاق البلد لاعطاء صورة اوضح واكثر دقة لكشف مخاطر الاصابة بمرض السلان اجراء بحث اوسع سيعطي حساسية وخصوصية اكثر دقة عن دور الستيرويد بظهور والاصابة بمرض السل, ويمكن من خلالها توضيح الجرعة والنوع والمدة اللازمة لظهور المرض وسبل الكشف المبكر ومنع الاصابة | For tuberculosis infection being one of the major risk factor for morbidity and mortality in developing countries according to WHO and CDC. The risk of developing TB increases significantly with the drop of immunity.Using steroid (prednisolone or its equivalent) at a dose of more than 15 mg/day more than 4 weeks is associated with significant drop in immunity, hence increasing the risks of being infected with TB to eight folds Aim of the studyIn this study we tried to assess the risk of developing TB infection in asthmatic patients that use steroid in their asthma treatment regime.Materials& MethodsA prospective study designed to include patients complaining from Asthma who have visited Baghdad teaching hospital in the period from (June 2016 to June 2017) that included in - patients and out - patients A questionnaire prepared to document the related information of most concern to the researcher and for the sake of study. ResultsIn this study, we managed to enroll 60 patients. Male to female ratio was 7 : 23. 80% of the study cohort lived in urban residence, and 20 % in suburban neighborhood. 33.3% of the patients had diabetes as comorbidity. 21.7 % of the patients used inhaled steroid as a modality of management of asthma, while 45% used systemic steroids, and 33.3 % used combined modality. Of the study cohort, 18.3 % used steroid for no more than 4 weeks, and the rest used it for more than 4 weeks. Regarding tuberculin test results, 11.7 % test positive.A significant correlations were found between the tuberculin test and the increasing age of the patient p=0.01, and the TST and the duration of use of steroids p=0.001, also, between TST and previous history of TB p=0.04. ConclusionData analysis of our study have revealed the following points1. There is no relationship between the type of steroid and the risk of getting TB infection2. The risk of steroid on immune system and the raise of risk increase with increasing subject age3. The extended period of exposure to steroid will definitely increase the risk of TB infection Recommendations Our research have been conducted in a period of almost one year and included only the patients that visited the outpatients and in - patients ward of Baghdad Teaching hospital.We recommend to carry on a larger scale research and include more than one respiratory center across the country to obtain a more conclusive picture regarding the risk of catching TB infection after using steroid.A larger scale research will obtain more data and will elucidate the sensitivity and specificity of the contribution of steroid to development of TB, and to clarify more concerning the dose, type, and duration of exposure

تاثير العلاج الشعاعي لمرضى سرطان الثدي على المنسوب القذفي لعضلة القلب

Author name: زينب محمد دخيل علي
Supervisor name: خضير جاسم صبيح الرواق
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: ان سرطان الثدي في الوقت الحالي يعتبر من اكثر انواع السرطانات شيوعا واصابة للنساء حول العالم وكذلك يعتبر السبب الرئيسي للموت للمراه بسبب السرطان حول العالم .في العراق يعتبر سرطان الثدي من اكثر انواع السرطانات انتشارا بين النساء , حيث تصل نسبة الحصائيات لسنه 2011 الى 18,96% , وان احد اهم الخطوات في علاجه هو العلاج بالاشعاع .الغرض من الدراسهتسليط الضوء على تاثير العلاج الشعاعي لسرطان الثدي في المنسوب القذفي لعضلة القلب .المرضى وطرق البحثان هذه الدراسه هي دراسه جدوليه منظوريه وان المعلومات الخاصه بمرضى سرطان الثدي وفحوصات القلب قد تم جمعها من مستشفى الاورام التعليمي منذ بداية شهر شباط/2016 ولغاية شهر كانون الثاني/2017.النتائجان هذه الدراسه التي تضمنت (50) مريضا جميعهم من النساء اللاتي تتراوح اعمارهم مابين 32 - 70 سنه , وقد اظهرت نتائجها وجود تاثر للمنسوب القذفي لعضل القلب بعد اربعة اشهر من العلادج الشعاعي مقارنة بنسبته ماقبل العلاج.حيث انه تم ملاحظة ان المريضات اللاتي يعانين من سرطان الثدي الايسر واللاتي قد استلمن جرعة من العلاج الشعاعي بمقدرا4260 سينتي غرايو لديهن النسبه الاعلى في التغير وبمعدل وسط حسابي مقداره 66% قبل العلاج و65,5% مابعد العلاج .و كذلك لاحظنا ان المريضات اللاتي استلمن جرعه شعاعيه مقدارها 5000 سينتي غراي سواء للثدي الايمن او الايسر , كان لديهن نسبة تغيير بمعدا حسابي للثدي الايمن ومقداره 66,3% قبل العلاج الشعاعي الى 64,3 % بعد العلاج الشعاعي , اما بالنسبه للثدي الايسر فكانت النسبه بمقدار 66,8% قبل العلاج الشعاعي الى 65,2% بعده . الاستنتاجاتان المرضات اللاتي يعانين من سرطان الثدي واللاتي عولجن بالعلاج الشعاعي ثلاثي الابعاد الموحد سواء كان لنسيج الثدي او لجدار القفص الصدري , وبعد المتابعه لفحوصات القلب التي تمت , قد لوحظ ان هناك تغيرا في المنسوب القذفي لعضلة القلب وخصوصا بين الثدي الايمن والثدي الايسر وكذلك بين مقدار الجرعه الشعاعيه المستلمه والسبب على الاغلب في الاشعاع المتطاير الواصل للشرايين المحيطه بالقلب اثناء العلاج | Breast cancer now represents the most common female malignancy in both developing and developed world, and is the primary cause of death in woman globally. In Iraq breast cancer constitute 18.96 % of all other types of cancers up to 2011. One of the main steps in the management of early breast cancer is radiotherapy.Aim of studyTo shade the light on the radiation therapy effect on the ejection fraction of the heart in breast cancer patients.Patients and methodsThis is a prospective observational study that was conducted in Radiotherapy and nuclear medicine center of the oncology teaching hospital/medical city complex using Echo cardiograph for following up the patients. Data recruitment included patients received Adjuvent 3D conformal radiotherapy as a whole breast irradiation or as a chest wall irradiation from August/2016 to January/2017 and followed with Echo study four months later until January/2017.ResultsIn our registry 50 patients were recorded; patient’s age was between 32 and 70 years old female gender. We found that there was a significant effect of radiation on the ejection fraction percentage of pre radiotherapy and post radiotherapy of both radiotherapy doses (P - value=0.001).2We noticed that patients with left sided breast whom received 4260 centigray had the highest significant result of a mean difference of pre - radiation =66%, and post radiotherapy =65.5 %.Also we noticed that patients whom had received 5000 centigray of either left or right sided breast cancer, have substantial difference between pre - radiotherapy of 66.3% and 66.8% to 64.3% and65.2% for right and left side respectively.ConclusionIn patients with breast cancer treated with adjuvant 3D conformal radiotherapy as a whole breast irradiation or as a chest wall irradiation, an evaluation for the cardiac ejection fraction after four months of completing their radiotherapy, to either right sided or left sided breast, there was a marked difference in the ejection fraction size between the left sided treated BC and right sided BC, and between different doses mainly due to scattered and transmitted irradiation to the coronary arteries.

استخدام تعقب الوصلة النقطية للاجهاد الاذيني الايسر لتقييم خطر الانصمام الدماغي في مرضى الارتجاف الاذيني غير الصمامي في مركز قلبي واحد == USING SPECKLE TRACKING STRAIN OF LEFT ATRIUM FOR RISK STRATIFICATION OF EMBOLIC STROKE IN NON VALVULAR ATRIAL FIBRILLATION IN SINGLE CARDIAC CENTER

Author name: اسماعيل عطية حسين
Supervisor name: غازي فرحان حاجي
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 : Atrial fibrillation (AF) is the most common arrhythmia treated in clinical practice and the most common arrhythmia for which patients are hospitalized. AF is associated with an approximately five fold increase in the risk for stroke and a two fold increase in the risk for allcause mortality.Objective of study : To investigate myocardial deformation of the left atrium (LA) assessed by two - dimensional speckle tracking echocardiography in patients with nonvalvular atrial fibrillation and its value for risk stratification of embolic stroke. Patient and Methods : A prospective cohort study in Baghdad teaching hospital cardiac center from June 2016 to May 2017 We recruited 107 consecutive patients who were referred to echocardiography unit for evaluation by 2D full echocardiographic study with speckle tracking strain of left atrium. These patients were divided into two groups control and AF. those with AF further divided into two groups according to the presence or absence of stroke .Results : The left atrial strain among patients with AF and stroke had significantly reduced from those patient with AF without stroke(9.8 ±3.0 ,18.5±5.6 respectively).P - value= 0.001.Where as left atrial volume index and left ventricular filling index( E/Eratio) did not show significant differences .After multi - variant analysis, global LA strain were independently associated with stroke in patients with AF. Those with LA GLS <12.8 % had a significantly higher rates of stroke than those with LA GLS > 12.8 %.Conclusion : This study demonstrated that LA deformation reduced inpatients with AF and stroke. Global LA strain measured by speckle tracking echocardiography can be used for risk stratification for stroke in patients with AF and has incremental diagnostic values in addition to clinical risk stratification.Keywords : Atrial fibrillation, Left atrial Strain, , Stroke

عادة الشيشة بين طلاب كلية الطب وكلية طب الاسنان - جامعة بغداد == Shisha Habit among Medical Students at College Of Medicine & College Of Dentistry - Baghdad University

Author name: حسن خلف عبد
Supervisor name: بتول علي غالب یاسین
General topic: Medicine
Specific topic: Community Medicine
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Tobacco is a preventable cause of morbidity and mortality across the globe. Low and middle income countries (LMICs) are the most severely affected (1). The shisha is used to smoke specially made tobacco by heating the tobacco indirectly, usually with burning charcoal or embers, filtering the smoke through a bowl of water (sometimes mixed with other liquids such as wine) and then drawn to a mouthpiece through a rubber hose (6). Shisha has been shown to be associated with a wide range of detrimental health effects and smoking shisha is associated with three main detrimental health effects : CV damage, infection and cancer formation (30)P.The Objective of this study is to measure the prevalence of shisha smoking among medical students at College of Medicine & College of Dentistry - Baghdad University, Identify the characteristics of Shisha smokers that have numerous public health and clinical implications and to identify factors associated with shisha smoking.Subjects and Methods : A cross - sectional study was conducted on a sample of 654 students at the College of Medicine and College of Dentistry in Baghdad University from the 1st of February till the 30th of June 2017. Under graduate students from the selected colleges were included. A questionnaire was used to gather the necessary information and filled by the study participants themselves. It included questions to gather information on certain socio - demographic variables, the family of the participants, and believes about smoking. Information about shisha smoking, medical history and habits of the participants and their parents were gathered.Results : This study involved 654 students. The mean age of the participants was 20.6±1.93 years; 64.7% were females; 95.9% were currently single; and 90.6% were from Baghdad.About 44.6% were in the 2nd stage; 91.4% were living with family; 70.4% were living with crowding index 1 - 2. Regarding parents of participants, 90.9% of fathers andII81.2% of mothers were highly educated; 82.8% of fathers and 88.6% of mothers were present and live with; and 49.1% of fathers and 49.4% of mothers were governmental employees.The prevalence of shisha smoking was 12.1%; 57.5% of them were smoking for more than three years, 76.2% preferred café for smoking; 87.5% preferred friends for smoking with. The factors that significantly associated with prevalence of shisha smoking were (gender, address, marital status, living condition, presence of private work, parents smoking history, and belief about which type of smoking is more harmful).Conclusion : Although the prevalence of shisha smoking was still not high (12.1%), it was increasing during the last few years and becoming a community acceptable behavior, especially among college students. There was a significant positive effect for male gender, being divorced or widowed, living alone and outside Baghdad, and having own job on smoking prevalence among students. Also parent's positive history of tobacco smoking and students beliefs about shisha and cigarette harm were significantly associated with the use of shisha.

تقييم هشاشة العظام في المرضى البالغين المصابين بابيضاض الدم الحاد == Evaluation of Osteoporosis In Adult Patients with Acute Leukemia

Author name: ميادة محمد جاسم
Supervisor name: محمد هادي العصامي | علاء الدين سهام
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: تقييم هشاشة العظام في المرضى البالغين المصابين بابيضاض الدم الحادالخلفيه العلميه : يعد مرض هشاشة العظام مشكله صحيه عامه متزايدة ذات تاثير طبي واجتماعي واقتصادي.اهداف الدراسة : معرفة امكانية حدوث هشاشة العظام في مرض ابيضاض الدم الحاد.المرضى والطرق : اجريت هذه الدراسة في العيادة الاستشاريةلامراض الدم والعيادة الاستشاريةلامراض المفاصل في مستشفى بغداد التعليمي خلال سنه من شهر تموز 2013ولغاية تموز 2014.الدراسة شملت 100 مريض تم تشخيصهم حديثا بابيضاض الدم الحاد وقبل بدء العلاج وعينه من 50 شخص اصحاء كانت اعمارهم متطابقة.المرضى كانت اعمارهم 20 - 50 سنه, وقد تم اخذ التاريخ المرضي الكامل والفحص السريري الكامل والفحوصات المختبرية وقياس كثافة العظم(DEXA).النتائج : من 100 ذكر وانثى في هذه الدراسه, متوسط العمر(30.49±7.7 )سنه,50ذكر وانثى عينه اصحاء متوسط العمر(27.30±5.87) سنه, كثافه العظم لعنق الفخذ والفقرات القطنيه في المرضى اقل من الاصحاء.(T - score) الفقرات القطنيه للمرضى مقابل الاصحاء طبيعيه في 47 شخص, قله كثافة العظم في 44 شخص, وهشاشة العظم في 9 اشخاص.فيما كانت (T - score) في عينة الاصحاء طبيعيه في 50 شخص. ( Z - score) للفقرات القطنية للمرضى مقابل الاصحاء طبيعي في 40 شخص, قلة كثافة العظم في 48 شخص, وهشاشة العظم في 12 شخص.فيما كانت (Z - score) في عينة الاصحاء طبيعية في 43 شخص, وقلة كثافة العظم في 7 اشخاص.(T - score) لعنق عظم الفخذ للمرضى مقابل الاصحاء 42, قلة كثافة العظم في 55 شخص, وهشاشة العظم في 3 اشخاص.اما في الاصحاء فكانت (Z - score) طبيعيه في 50 شخص.(Z - score) لعنق عظم الفخذ للمرضى مقابل الاصحاء طبيعيه في 34 شخص, قلة كثافة العظم في 55 شخص, وهشاشة العظم في 11 شخص.اما في الاصحاء فكانت (Z - score) طبيعيه في 45 شخص, وقلة كثافة العظم في 5 اشخاص.النتيجة : 1 - قلة كثافة العظم موجود في 4848)% (مريض, هشاشة العظم موجود في )1212%( في المرضى المصابين بابيضاض الدم الحاد بالاعتماد على (Z - score) للفقرات القطنية.2 - قلة العظم موجود في 55(55%) مريض, هشاشة العظم موجود في 11(11% ) في المرضى المصابين بابيضاض الدم الحاد بالاعتماد على (Z - score) لعنق عظم الفخذ. | Osteoporosis is a silent condition characterized by low bone density and deterioration of bone microarchitecture .ObjectiveTo study the association between osteoporosis and acute leukemias .Patient and methods This is a Cohort study was conducted in haematological department and Rheumatological department in Baghdad teaching hospital, over a period of one year from July 2013 to July 2014. The study included 100 patient who were newly diagnosed with acute leukemia before starting treatment, and 50 healthy controls, who were age and sex matched with the patients. Patients age between 20 year to 50 year. Full history was taken, complete clinical examination, and laboratory investigation were done, and Dual Energy X ray absorptiometry were performed for patient and control group.Exclusion criteriaDiabetes mellitus, thyroid and parathyroid diseases, smoking, drug induced osteoporosis.Result 100 adult Iraqi patients with acute leukemia included in this study, the mean age was 30.49 ± 7.76 year; 50 healthy individuals were included in this study, with mean age 27.30 ± 5.87year. The results of BMD femur and lumbar in patients were less than control. T - score lumbar spines of patients versus control were normal in 47(47%) patient, osteopenia in 44(44%) and osteoporosis in 9(9%). While in control all 50(100%) are normal. Z - score lumbar spines of patients versus control were normal in 40(40%), osteopenia in 48(48%) and osteoporosis in 12(12%). While in control 43(86%) are normal, 7(14%) osteopenia. T - score neck of femur in patients versus control was normal in 42(42%) patient, osteopenia in 55(55%) and osteoporosis in 3(3%). While in control all 50(100%) are normal. Z - score neck of femur in patients versus control was normal in 34(34%) patient, osteopenia in 55(55%) and osteoporosis in 11(11%). While in control 45(90%) were normal, 5(10%) osteopenia.Conclusion : Osteopenia was present in 48(48%) and osteoporosis in 12(12%) patients.Osteopenia was present in 55(55%) patient and osteoporosis in 11(11%) depending on Z - score of neck of femur

تقييم العمل الانقباضي للبطين الايسر باستخدام الايكو ذو البعد الرابع بالمقارنة مع طرق الايكو الخطية والحجمية الاخرى للمرضى ذوي القصور في الشرايين التاجية وامراض القلب الصمامية == ESTEMATION OF LEFT VENTRICULAR EJECTION FRACTION BY REAL - TIME THREE DIMENSIONAL ECHOCARDIOGRAPHY IN COMPARISON TO OTHER LINEAR AND VOLUMETRIC METHODS IN CORONARY AND VALVULAR HEART DISEASES

Author name: كوثر علي عبد
Supervisor name: امال نوري المراياتي
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: ان قياس العمل الانقباضي للبطين الايسر يعد مؤشرا مهما جدا لمعرفة حدة امراض القلب حيث ان حجم البطين الايسر يعطي معلومات تشخيصية دقيقة ومفيدة في اختيار العلاج المناسب او تحديد الوقت المناسب لاجراء التداخل الجراحي .وحيث ان هناك طرق عديدة لهذا الغرض ,فطريقة (ام - مود ) القديمة لاتزال تستخدم في بلدنا بالرغم من كونها تعتمد قياس مساحة سطح واحد وهذا لا يكفي لتحديد حجم البطين الايسر المخروطي ,اما الايكو ذو البعد الثنائي فهو الطريقة الاكثر شيوعا لقياس حجم وكفاءة القلب ,الا ان هناك العديد من النواقص في قياسها لذلك ,حيث انها تعتمد على حساب الحجم بالهندسة الافتراضية (لكونها تعتمد على بعدين فقط ).الايكو ذو البعد الرابع اصبح متوفرا منذ العقدين الماضيين ,وبالرغم من ان استخدام هذه الطريقة لم تحصل على الانتشار الواسع الا انها تستطيع التغلب على نواقص الايكو ذو البعد الثنائي انفة الذكر وذلك لانها لا تعتمد على الهندسة الافتراضية في قياس الحجم وكفاءة العمل الانقباضي للبطين الايسر. ولقد اثبتت العديد من الدراسات انه الاكثر دقة وموضوعية بالنسبة لقياس حجم البطين وعمله الانقباضي. فقد قمنا باجراء دراسة على ٦٠ مريض ممن لديه امراض القلب الصمامية وكان محضرا لعملية تبديل الصمام وكانوا ۲۲مريض والباقي ممن لديه امراض الشرايين التاجية وكان محضرا لعملية زراعة الشرايين التاجية ‚ وذلك بقياس كفاءة العمل الانقباضي للبطين الايسر بطريقة (ام - مود), الايكو ثنائي الابعاد ذو السطحين ,الايكو ثلاثي الابعاد ذو السطوح الثلاثة والايكو رباعي الابعاد‚ وقياس الوقت الذي تحتاجه كل طريقة من هذه الطرق لاكمال عملية قياس كفاءة الفعل الانقباضي للبطين الايسر. هدفنا من هذه الدراسة ذلك لمعرفة مدى دقة وصحة الطرق الشائعة (ام - مود) والايكو ثنائي الابعاد ثنائي السطوح - والايكو ثلاثي الابعاد ثلاثي السطوح بالمقارنة مع الايكو ذو البعد الرابع في قياس حجم وكفاءة العمل الانقباضي للبطين الايس مع دراسة خصوصيتها وحساسيتها بالنسبة للايكو ذو البعد الرابع بالاعتماد على التوافق العالي بين الايكو رباعي الابعاد والرنين المغناطيسي القلبي والذي يعتبر الطريقة القياسية الذهبية في قياس حجم وكفاءة العمل الانقباضي للبطين الايسر٠ ان نتائج البحث اثبتت ان الطريقة الاقرب الى الايكو ذو البعد الرابع هي الايكو ثلاثي الابعاد ذو السطوح الثلاثة في امراض القلب الصمامية وامراض الشرايين التاجية كما ان حساسيتها وخصوصيتها في كشف ضعف او عدم كفاءة العمل الانقباضي للبطين الايسر عالية لانها لا تعتمد على الهندسة الافتراضية اما بالنسبة للايكو ثنائي الابعاد ذو السطحين فكان هناك اختلاف ملحوظ بينه وبين الايكو رباعي الابعاد في كل من امراض القلب االصمامية وامراض الشرايين التاجية , الا ان حساسيتها وخصوصيتها في كشف عدم كفاءة او ضعف العمل الانقباضي كان عاليا ,واما الطريقة الاكثر شيوعا في بلدنا وهي (ام - مود)فتبين من خلال هذه الدراسة ان هناك فرقا ملحوظا بينها وبين الايكو رباعي الابعاد في كل من امراض القلب الصمامية وامراض الشرايين التاجية بالاضافة الى ان خصوصيتها في معرفة العمل الانقباضي الطبيعي للبطين الايسر عالية الا ان حساسيتها في كشف الاعتلال او ضعف العمل الانقباضي للبطين الايسر كانت متوسطة | Left ventricular volumes and ejection fraction are important predictor of cardiac morbidity and mortality. It provides valuable prognostic information which is particularly useful in the selection of therapy or determination of the optimal time for surgery. Two - dimensional echocardiography is the most widely used non - invasive method for assessment of cardiac function, two dimensional echocardiography has however several limitations in measuring left ventricular volumes and ejection fraction since the formulas for quantifications are based on geometrical assumptions. Three - dimensional echocardiography has been available for almost two decades, although the use of this modality has not gained wide spread acceptance. Three dimensional echocardiography can overcome the above mentioned limitation in left ventricular volume and ejection fraction evaluation since it is not based on geometrical assumption. Aim of study : Is to investigate the accuracy of linear﴾ M - MODE﴿ and volumetric (BIPLANE AND TRIPLANE) echocardiographic method versus the REAL - TIME three dimensional echocardiography in assessment of regional and global left ventricular systolic function.METHOD : Prospective study evaluating left ventricular systolic function for sixty patients ,38 patients with coronary heart disease prepared for Coronary artery bypass graft and 22 patients have valvular heart disease prepared for valve replacement , LV EF% was measured according to the American society of echocardiography guidelines for all of them by four methods 2D guided M - mode ,2D Biplane (Simpson ,s method ),Three Dimensional Guided - Triplane and Real time - three dimensional echocardiography(4D) , also the total time (acquisition and analysis) needed for each one of these methods was calculated.RESULTS : It was found that 2D Guided M - mode sensitivity and specificity in detection of LV systolic dysfunction i.e ejection fraction <55% was 74.3% , 95.2% respectively giving negative predictive value of 66.6% and positive predictive value 96.6%, 2D - Biplane sensitivity and specificity was 97.4% ,95.2% respectively , giving negative predictive value of 95.2% and positive predictive value of 97.4% while 3D - guided triplane was 97.4%,100% respectively, giving negative predictive value 95.2% and positive predictive value of 97.4% . (We considered RT - 3DE as standard method depending on its high agreement with Cardiac magnetic resonance which represents the gold standard method for assessment of LV systolic function worldwide although it is not available in our country). From other point of view the mean value of difference in ischemic heart disease between RT - 3DE and 2D - Guided M - mode, 2D - Biplane ,3D Guided - Triplane, was(<0.001 ,0.004, 0.481 )respectively. While the mean value of difference in valvular heart disease between RT - 3DE and 2D - Guided M - mode, 2D - Biplane, 3D - Guided Triplane was (< 0.001, 0.025, 0.266) respectively. Also the time need for ﴾data acquisition and analysis﴿ for 2D - guided M - mode ,2D - Biplane ,3D - guided Triplane and RT - 3DE was﴾2 min ,4 min ,5 min ,5min﴿ respectively.Conclusion : M - mode method has high specificity but modest sensitivity to detect LV dysfunction while 2D - Biplane ,and 3D - guided Triplane has high specificity and sensitivity in detection of LV systolic dysfuction. There is a significant difference between RT - 3DE and both 2D - guided M - mode, 2D - Biplane method in assessment of LV global and regional systolic dysfunction, while there is no significant difference between RT - 3DE and 3D - guided Triplane method . Also the time need for data acquisition for each three method is nearly similar while it is shorter by M - MODE

مقارنة المقاطع السهمية لسلسلتي الرنين المغناطيسي : استرداد الانقلاب قصير T1 وT2 الموزونة ذوات صدى الانفتال السريع في الكشف عن افات الحبل الشوكي الناجمة عن تصلب الاعصاب المتعدد == A Comparison of Sagittal Sections of Short T1inversion Recovery and T2 Weighted Fast Spin Echo Magnetic Resonance Sequences for Detection of Multiple Sclerosis Spinal Cord Lesions

Author name: شيماء فاضل عبيد
Supervisor name: امير شاكر هادي
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 : Multiple sclerosis (MS) is a chronic autoimmune inflammatory demyelinating disease of the CNS of unknown etiology. Age of onset is 20 - 50 years in 50 - 60% of cases, with female propensity. MRI of the spinal cord is thought reliable for investigation lesions. Different techniques and MRI sequences are widely used and compared to each other to improve the detection of MS lesions in the spinal cord. Objective : To evaluate the ability of MRI STIR sequences in improvement of MS spinal cord lesion detection when compared to T2 WI sequences.Patients and Methods : A cross sectional study conducted during the period from 15th of August 2013 to 30th of June 2014. A total of 22 MS patients who had clinically definite MS with clinical features suggestive of spinal cord involvement, and had no contraindication for MRI examination were included. Spinal cord lesions which had artifacts significantly reduce the reading confidence of the images or those which did not show the typical characteristics of MS spinal cord plaques and lesions due to spondyloticmyelopathy were excluded. Patients were imaged with unified MRI protocol for all patients and two MRI sequences were used in imaging; sagittal STIR sequences and sagittal T2 weighted. All images were read by the same radiologist. The study protocol was approved by the ethical committee and the data of the patients were kept confidentially.Results : The mean age of the patients was 32.5 ± 6.7 (range : 23 - 45) years and 54.5% of the patients aged 30 - 39 years. Females were the dominant and represented 72.7% with a female to male ratio of 2.7 : 1. The total number of spinal cord MS lesions was 44,of them 86.4% in the cervical spine, 68.2% of the lesions had less than one vertebra extension,79.6% of the lesions did not associated with changes in the spinal cord morphology. There was a significant upgrading in the lesions conspicuity at STIR sequence comparingto T2 WI, P<0.001. A significant difference had been found in artifact grading between both sequences; P<0.001.Conclusions and Recommendations : STIR MRI sequence improves detection of MS spinal cord plaques compared with T2 WI and it increases the conspicuity of the visualized T2 WI lesions, but also it accentuates the artifacts more than T2WI. The STIR sequence should be included in the standard spinal cord MR imaging protocols and should be obtained routinely with T2 WI. Further studies are suggested.

تقييم فرط مرونة المفاصل لدى المرضى العراقيين المصابين بمرض الجزر المعدي المريئي == Assessment of Joint Hypermobility in Iraqi Patients With Gastro - esophageal Reflux Disease

Author name: ايمن رزاق علي
Supervisor name: زياد شفيق الراوي | فائق ايشو كوريال
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: فرط مرونة المفاصل هو حركة المفصل الى خارج الحد الطبيعي لحركته .وان مرض الجزر المعدي المريئي هو الاسترجاع غير الطبيعي لمحتويات المعده الى المرئ . ان خلل او اعتلال النسيج الرابط المتسبب في فرط مرونة المفصل قد يكون هو نفسه المتسبب في الجزر المعدي المريئي .الهدف : تقييم فرط مرونة المفاصل لدى المرضى العراقيين المصابين بمرض الجزر المعدي المريئي .المرضى ومنهاج البحث : تضمنت الدراسة 100 مريض عراقي مصاب بالجزر المعدي المريئي الذي تم تشخيصه بالفحص السريري والفحص الناظوري و100 فرد سوي كعينة ضبط متطابقتين في العمر والجنس .تم ملا استمارة استبانه لكل مريض وتحتوي على معلومات عامه عن المريض ومدة اصابته بالمرض وشدة المرض المثبته ناظوريا ونتيجة الفحص السريري لفرط مرونة المفاصل .تم اعتماد نتائج فرط مرونة المفاصل باستخدام ضوابط بايتون على العينتين .النتائج : اظهرت الدراسة ان 46 (71.9%) من المرضى المصابين بالجزر المعدي المريئي لديهم فرط مرونة المفاصل, وان 18(28.1%) من الاصحاء لديهم فرط مرونة المفاصل( p<0.001) كذلك اظهرت الدراسة ان مجموع مقياس مرونة المفاصل حسب ضوابط بايتون للمرضى المصابين بالجزر المعدي المريئي كان اعلى بكثير من مجموع ناتج نفس المقياس لدى الاصحاء (p<0.001) .كذلك اوضحت الدراسه ان العمر المبكر للافراد (≤ 30 year) الذين لديهم فرط مرونة المفاصل هو عامل ذو جدوى احصائي للاصابة بداء الجزر المعدي المريئي .الاستنتاجات : ان ظاهرة فرط مرونة المفاصل اكثر شيوعا عند المرضى المصابين بالجزر المعدي المريئي , مجموع مقياس فرط مرونة المفاصل لدى مرضى الجزر المعدي المريئي اكثر من مجموع المقياس ذاته لدى الاصحاء وان العمر الاصغر((≤ 30 سنة عامل متنبئ للاصابه بفرط مرونة المفاصل في مرض الجزر المعدي المريئي. | Joint hypermobility is the movement of a joint beyond it,s normal range of motion due to joints laxity. Gastro - esophageal reflux disease (GERD) is an abnormal reversed movement of gastric contents into the esophagus due to many mechanisms, one of them is the laxity of lower esophageal sphincter. Probably, a defective connective tissue matrix is the link between both disorders.Objective : To assess joint hypermobility in Iraqi patients with GERD.Patients and methods : A total of 200 individuals were included in this study, 100 patients had GERD diagnosed by a gastro - enterologist upon clinical & endoscopic findings and 100 healthy individuals matched in age & sex as a control group.A questionnaire paper consisted of personal data including : Age, sex, weight, height, body mass index (BMI), upper gastro - intestinal symptoms, duration of GERD, severity of GERD by endoscopic grading, and total score of joint mobility. The assessment of joint mobility were measured according to Beighton score method for all the participants in the study.Results : One hundred patients with GERD, 57 female & 43 male, and 100 healthy control group, 64 females and 36 males. The mean BMI was (24 ± 2.9) kg/m2 for patients and (24 ± 3.4) kg/m2 for controls. No statistical significant difference between patients and controls (P>0.05).JHM was significantly more in GERD patients than in controls (46(71.9%) of vs 18(28.1%), p<0.001, OR=3.88; 95% CI = 2.04 - 7.39).The total mobility scores for all GERD patients was 341 compared to 125 in the control group (p<0.001).A younger age(≤ 30 year) was significant predictor for JHM in GERD (p=0.000, odd=1.243, 95%CI : 1.124 - 1.376).Conclusions : JHM was more prevalent among patients with GERD, the total mobility score was much higher in GERD patients, and patients with younger age ≤30 year were a significant associate with JHM in GERD patients.

نسبة وفيات الامهات في قسم النسائية والتوليد في مستشفى بغداد التعليمي للعام 2013 == Causes of Maternal Mortality in Obstetrics& Gynecology Department in Baghdad Teaching Hospital for the Year 2013

Author name: سجى زيدان ضمد
Supervisor name: حيدر باقر الشماع
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: Maternal deaths is the death of a women while pregnant or within 42days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental cause.Aim of study : To study the causes and risk factors related to maternal deaths in obstetrics &gynecology department in Baghdad teaching hospital & to provide information to improve maternal care.Objective : To study causes of maternal mortality in Baghdad teaching hospital and the possible measures that may be taken to reduce mortality rate. Study design : A retrospective study.Setting : The study was carried out in the Department of Gynecology and Obstetrics at Baghdad teaching hospital for the period 1st of January to end of December 2013.Method : A retrospective study carried out on 8 died women ,who referred to Baghdad teaching hospital with serious morbidity ,6 of them delivered by CS and 2 of them delivered vaginally, each case studied in depth to determine the most likely cause of death.Result : The total maternal deaths for Baghdad Teaching hospital in 2013 were 8 women and the live births were 10488; as a result, the maternal mortality ratio per 100000 live births was 76.3, many Factors analyzed included the sociodemographic characteristics of the women who died the main causes of death, pattern of health - seeking behavior for antenatal care / delivery, and place of labor and delivery.There is statistically significant difference for some of these factors as between employment and unemployment also there is significant difference between vaginal and cesarean delivery.Conclusion : Major causes of deaths in Baghdad teaching hospital was hemorrhage ,as agreed by WHO estimates of causes of maternal death.This provide stimulus for health providers, hospital managers ,individuals and government to maintain downward trends in our maternal mortality ratios to meet the expectation of the millennium goal of reduction of 75% in maternal deaths in 2015

استخدام معامل التغير DP/DT في مرض متلازمة قصور الشرايين التاجية الطارئة == Use of Doppler Derived Index DP/DT in Acute Coronary Syndrome

Author name: هدى جميل ابراهيم
Supervisor name: معتز فوزي حسين
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: متلازمة الشريان التاجي الحادة (ACS) هي مظهر من المظاهر السريرية لامدادات الدم في تقلص الشرايين التاجية. في متلازمة الشريان التاجي الحادة ، يتم استخدام تخطيط صدى القلب من خلال تقييم حركة الجدار في كل من شرائح البطين الايسر (LV). وينبغي ان يشمل تقييم وظيفة البطين الايسر ايضا تقييما لابعاد البطين الايسر، والمورفولوجيا والوظيفة الانقباضية والانبساطية للبطين الايسر. معامل التغير dP/dtالذي يمثل معدل تغير الضغط خلال الزمن هو واحد من المؤشرات الاكثر حساسية للانقباض.الهدف من الدراسة لتقييم فائدة معامل التغير dP/dt في تقييم وظيفة البطين الايسر في المرضى الذين يعانون من متلازمة الشريان التاجي الحادة وعلاقتها ببعض المظاهر السريرية وتخطيط صدى القلب.المرضى والطرق شملت هذه الدراسة خمسين مريضا تم ادخالهم في وحدة العناية القلبية في المستشفيات التعليمية بغداد والشهيد غازي مع تشخيص متلازمة الشريان التاجي الحادة في الفترة 2/2/2013 الى 5/3/2014. تم القيام بالفحص السريري وجرى تخطيط صدى القلب في جميع المرضى وتم حساب المشتقة دوبلرdP/dt . واعتبرت المستويات اقل من 1000 منخفضة. وجاء التحليل الاحصائي باستخدام Med Calc النسخة 12.5.0.0و باستخدام برنامج Microsoft Office Excel 2010.واختبار Chi scure لدراسة العلاقة بين المجموعات المختلفة فيما يتعلق بالقيمة P ,و اعتبرت القيمة اقل من 0.05 ذات دلالة احصائية.النتائج كان متوسط عمر المرضى الذين يعانون من انخفاض معامل التغير ) dP/dt 1000) يساوي (65.62±5) سنوات وفي المرضى الذين كانت قراءة dP/dt عادية(1000) كان(63.38 ±5) سنوات وويشكل الذكور 62٪ من عينة الدراسة. وقد تم العثور على قيمة منخفضة من dP/dt 42 مريضا (84) ٪. وتم العثور على قيم dP/dt منخفضة اكثر في الفئة العمرية (51 - 60) عاما . ارتبط انخفاض قيمة dP/dt بشكل كبير مع التدخين والتاريخ العائلي.الاستنتاج استخدام معامل التغير dP/dt مفيد لتقييم وظيفة البطين الايسر في المرضى الذين يعانون من متلازمة قصور الشريان التاجي الحادة. | Background : Acute coronary syndrome (ACS) is the clinical manifestation of a diminished coronary arterial blood supply. In the ACS, echocardiography is used by assessing wall motion in each of the left ventricle (LV) segments. The assessment of regional LV function should also include an assessment of LV dimensions, morphology and global LV systolic and diastolic function. dP/dt which represents the rate of change of pressure during ejection is one of the most sensitive indices of contractility.Aims of study : To evaluate the usefulness of dP/dt in evaluating left ventricular function in patients with acute coronary syndrome and mitral regurgetation and its relation to certain clinical and echocardiographic features.Patients and Methods : This study included fifty patients who were admitted to the coronary care units of Baghdad and Al - Shaheed Gazy teaching hospitals with the diagnosis of acute coronary syndrome with ischemic mitral regurgitation for the period from 2/2/2013 to 5/3/2014. History and clinical examination were done and echocardiography was done in all patients and Doppler - derived dP/dt was calculated. Levels less than 1000 were considered low. Statistical analysis was made using Med Calc version 12.5.0.0. and Microsoft Office Excel 2010. Chisquare test was used to study relation among different groups with regard to numeric variables. P - value less than 0.05 was considered statistically significant.Results : The mean age of patients with low dP/dt (<1000) was (65.62 ± 5yrs) and that of patients with normal (dP/dt ≥ 1000) was (63.38 ± 5 yrs) (p value 0.9296). Males constituted 62% of study sample. Low dP/dt value was found in 42 patients (84%). Low dP/dt values were found more in the age group (51 - 60 yrs) (P = 0.0110). Low dP/dt value was significantly associated with smoking and positive family history. It was significantly associated with LV diastolic dysfunction (P value= 0.0005), left atrial size (P value < 0.0001), left atrial pressure (P value = 0.0006), and left ventricular size (P value < 0.0001). Conclusions : The use of dP/dt is useful for evaluating left ventricular function in patients with acute coronary syndrome

دراسة مقارنة بين نتائج الدوبلر والاعراض السريرية في مرضى القدم السكري == CORRELATION STUDY OF TRIPLEX ULTRASOUND AND CLINICAL FINDINGS IN DIABETIC FOOT PATIENTS

Author name: رمزي حلوان طعين
Supervisor name: ليث احمد خلف | مؤيد عباس فاضل
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: Diabetes mellitus is a common ailment in our community, diabetes affects about 10% of our population and the prevalence of diabetes varies form 5.3% to 16.2%. Diabetic foot disease is a common cause of admission in the surgical wards and sometimes the first presentation of this debilitating disease. Foot ulcers carry a 25% risk of major amputation. The diabetic foot disease classified according to Wagner’s Classification, and to manage it according to the standard protocols. The ultrasound scanning for lower limb arteries clearly show that it can provide information about the vascularity of the lower limb arteries. It is established as a valuable noninvasive method to investigate lower limb arteries. Objective : Evaluation of Doppler ultrasound finding in correlation with clinical finding (Wagner's classification ) of diabetic foot. Patient and method : A cross sectional study from August 2012 to August 2013, for 58 patients referring to ultrasound unit for triplex ultrasound examination of lower limbs at medical city complex in Baghdad. Patient were randomly selected and consisted of 21 female and 37 male. Age ranged between 40 and 75 year. Result : The mean age of patients was 57.9±7.8 years with predominance ofIIImale gender (63.8%) and type II DM(8602%). Mean duration of DM for selected patients in our study was 12.33±6.2 years. . In the present study approximately half of the diabetic patients were in fourth Wagner grades. Doppler USG revealed a pathological finding of lower limbs arteries in 89.7% of the patients. The most frequent site of occlusion was found in the dorsalis paedis artery (12.1%). There is a significant association of impaired blood flow diagnosed by Doppler USG and clinical deterioration of DM detected by Wagner's grade (p<0.001).The normal blood flow in all arteries of lower limbs had been found in 10.3% with Wagner's grade II, III and IV. Conclusion : There is correlation between clinical finding of diabetic foot (Wagner grade ) and Doppler finding (degree of stenosis) which mean when increase Wagner's grade, this is associated with increase degree of stenosis, therefor lower extremity artery triplex US is an excellent method, which can monitor the grade of Diabetic foot. The normal blood flow in all arteries of the lower limbs was 10.3% in spite of patient present with Wagner grade II, III and IV, these should be remembered during management of diabetic foot.

العوامل التي تؤثر على مرضى الفشل في علاج مرضى التدرن في بغداد، العراق، 2009 - 2012 == Factors associated with Tuberculosis Treatment Failure in Baghdad, Iraq, 2009 - 2012

Author name: ليث عبد اللطيف كريم
Supervisor name: سهير محمد محمود الجبوري
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

حدوث مرض الاسهال الحاد بين الاطفال دون سن الخامسة للاطفال في بغداد قبل وبعد التطعيم بلقاح الفيروس العجلي حزيران 2013 == Occurrence of Acute Diarrheal Disease among under Five Years Children in Baghdad before and after Rota Virus Vaccination, June 2013

Author name: سنان اكرم عقراوي
Supervisor name: بتول علي غالب ياسين
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 : Approximately 39% of the global diarrhea deaths in children aged 5 years may be attributable to rotavirus infection. Two rotavirus vaccines were recently introduced to the market, with evidence of efficacy in the USA, Europe and Latin America. We sought to estimate the effectiveness of these vaccines against rotavirus morbidity and mortality.Objectives : To determine the association between infant rotavirus vaccination in Baghdad and the occurrence of acute diarrheal diseases, the rate of hospital admission for gastroenteritis and mortality among under five years children Methods : An observational, cross - sectional study of two time periods : 1 January - 31 August 2011 (prior to initiating rotavirus vaccination) and 1 January - 31 August 2013 (one year after introducing rotavirus vaccination). All cases of acute diarrhea among infants and under five years children during 2011 and 2013 were retrieved from surveillance section /CDC Baghdad, from Health and Vital statistics Department - MOH - Iraq and Pediatrics Hospital’s Statistical Units and analyzed. Discrete variables were presented as numbers and percentages. Z test for difference between two proportions was calculated with a 95% confidence interval (95% CI) Findings with P value less than 0.05 were considered significant.Results : The current study revealed a 32.7% decrease of acute diarrhea among under five years children (Z value= 7.967, p <0.0001, C.I. =0.0087 - 0.0143) and a decrease by 33.2% acute diarrhea infants (Z value= 41.4458, p > 0.0001, C.I. =0.0362 - 0.0398). The disease burden decreased by 51.9% for under five years and 28.2% for infants reductions in hospitalizations due to acute diarrhea and the case fatality rate decreased by 23% for under five years.Conclusions : A noticeable reduction in the occurrence of acute diarrhea among infants and under five years children, in hospital utilization and to less extent in the mortalities due to acute diarrhea after implementing the Rota virus vaccination for infants in Iraq.

دور فحص المرونة النسيجية للخصيتين لمرضى العقم والدوالي == The role of Testicular Elastography in patients with varicocele and infertility

Author name: بشارعبد الرزاق مولان
Supervisor name: سعد داخل فرحان | سلام محمد جوري
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: To assess the value of Real - time Elastography (RTE) in evaluation of the effect of varicocele on the elasticity of the testicular interstitium and ability to predict the effect of varicocele on the sperm motility.Methods : In total of 73 candidate. 50 patient with varicocele and 23 control normal volunteer were examined by ultrasound B mode gray scale, color Doppler and elastography . Elasticity images of the testicles were assigned the color - coded score of Itoh , according to the distribution of strain induced by light compression. RTE findings were analyzed and compare the result of affected patient with normal volunteer.Results : Most of the testicles of the varicocele patient showed elevated elastography ratio as compared with the same side of normal volunteer, also there was positive correlation between the varicocele grade and the elasto ratio. When I compared the percentage of active motile sperm with elasto ratio I found negative correlation.Conclusions : RTE is non - invasive, bed side test, useful technique in assessing the changes which happen in the interstitium of the affected testicles with varicocele and in the prediction of the active motile sperm status.This is relevant in clinical practice allowing expectant management according to elasto ratio in selected cases.(as the testicular elasto ratio will predict the outcome of varicocele operation in at the point of sperm quality improvement).

دوبلر الشريان السباتي للمرضى المرشحيه لعملياث تبديل الشراييه التاجية == Doppler of Carotid Artery Assessment in Evaluation of Patients indicated for Coronary Artery Bypass Graft

Author name: فرج عبد الخالق زكي
Supervisor name: ليث احمد خلف | علي محسن حسن
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: Atherosclerosis is a generalized disease, mainly manifested in all vascular trees. An association between carotid artery stenosis and coronary artery disease has been well established. Carotid artery stenosis is an important etiologic factor for cerebrovascular accidents, is associated with coronary artery disease .Methods;A prospective study of 86 patients, who were scheduled for CABG, was done at radiology department, Medical city Baghdad,Gazzi Al - Harirri hospital from Nov.2016 to July 2017. The majority were males, (73) and (13) were Females.All patients , after a clinical history was taken by the cardiac surgery team, they underwent a physical examinations ,and investigations ; chest x - ray , ECG , blood was taken for fasting blood suger and cholesterol study , Doppler ultrasonography for bilateral carotid arteries were performed by aspescailized radiologist for carotid artery atherosclerosis Results; The majority of the patients were above 50 years of age, 73 patients (84.45%) and only 15% were below the age of 50 years. Male affected by carotid artery atherosclerosis, (76.7%) more than females above the age of 50 years, while below the age of 50 years females (46.7%) more affected than males (9.58%). Risk factors were significantly correlated with both carotid and coronary artery stenosis like age, sex, smoking hypertension, cholesterol and diabetes mellitus.Doppler Ultrasonography was performed to screen the presence of carotid artery stenosis. Carotid artery atherosclerosis was present in 66 patients, (76.7%).Ten patients ( 15.1%) with one coronary artery disease , 17 (25.75%) with two coronary artery disease , and 39 patients ( 59.09%) with three coronary artery disease.The location of atherosclerosis is mostly in ICA, (53%), of which 15% in the bulb, in the CCA (32%) .Conclusions; Our finding indicated significant associations between carotid artery atherosclerosis and coronary artery disease.there is strong association between increase in intma media thickness of carotid arteries and the presence of coronary artery disease.

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

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