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

اسم المؤلف: رمزي حلوان طعين
اسم المشرف: ليث احمد خلف | مؤيد عباس فاضل
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: 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

اسم المؤلف: ليث عبد اللطيف كريم
اسم المشرف: سهير محمد محمود الجبوري
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:

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

اسم المؤلف: سنان اكرم عقراوي
اسم المشرف: بتول علي غالب ياسين
الموضوع العام: الطب
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: 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

اسم المؤلف: بشارعبد الرزاق مولان
اسم المشرف: سعد داخل فرحان | سلام محمد جوري
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: 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

اسم المؤلف: فرج عبد الخالق زكي
اسم المشرف: ليث احمد خلف | علي محسن حسن
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: 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

اسم المؤلف: علي مكي حسن
اسم المشرف: فائق ايشو كوريال
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: 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.

مدى صحة استخدام اختيار التحكم بالربو لتقييم شدة الربو القصبي في الاناث الحوامل في الثلث الثالث للحمل : دراسة سريرية == Validity of Asthma Control Test in assessment of asthmatic pregnant females in third trimester (Single center study)

اسم المؤلف: زينب علاء عبد الحسين
اسم المشرف: محمد وهيب سلمان العبيدي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Asthma is a common chronic medical condition in pregnancy, with a worldwide prevalence estimated between 8 - 13%; The ACT has the added advantage that it does not require pulmonary function assessment.Aims of study : To assess asthma control through ACT score and to determine if the ACT can be as useful as the spirometry usage of FEV1 in assessment of asthma status in asthmatic pregnant female.Methods : A cross - sectional study with analytic elements recruiting 55 pregnant asthmatic patients aged 16 - 35 year old were seen in gynecology and obstetrics department of Baghdad Teaching Hospital between 1st of November 2016 and 1ST of April 2017 for pregnant females in third trimester. Asthma control was assessed using the ACT score and FEV1.Results : There were 55 pregnant females in third trimester with history of asthma enrolled in this study.According to ACT score 15 patients (27.3%) were with poorly controlled asthma, 19 patients (34.5%) moderately controlled and 21(38.2 %) well controlled asthma.Of these 55 patients 32 patients (58.2 %) where with ACT score of ≤ 19 and abnormal FEV1, only 2 patients (3.6%) with ACT score of ≤ 19 and normal FEV1, while there was 19 patients (34.5%) with ACT score of ˃19 and normal FEV1, and only 2 patients (3.60%) with ACT score of ˃ 19 and abnormal FEV1.Conclusion :  ACT can serve as an alternative reliable tool in assessing asthma control even without an aid of a spirometer

دراسة نسبة انتشار مرض التهاب الكبد الفايروسي نوعي - "بي" و"سي" بين طلاب كلية الطب جامعة بغداد للعام 2013

اسم المؤلف: بشار عبد اللطيف عبد الرزاق
اسم المشرف: بتول علي غالب ياسين
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Hepatitis B virus and Hepatitis C virus infections have become a serious problem of public health and a major cause of morbidity and mortality, particularly in developing countries. Due to direct contact with patients, the risk of infection for health care workers is higher than for employees in other jobs. Health care workers can also be a source of infection for patients. This is also true for medical students in the framework of their education.Objectives : This study was conducted to estimate the prevalence of Hepatitis B virus and Hepatitis C virus infections amongst medical students at Baghdad University, College of Medicine.Subjects' and Methods : A Cross sectional descriptive analyticstudy conducted from the 1st of May to the 30th of June, 2013 at the College of Medicine, University of Baghdad.Data were collected through a self - administered questionnaire and through blood analysis for Hepatitis B surface antigen (HBsAg), antibodies to theHepatitis B coreantigen (anti - HBc), antibodies to theHepatitis B surfaceantigen (anti - HBs) and antibodies to the Hepatitis C virus (anti - HCV).Results : One student (0.6%) was positive for HBsAg, three (1.7%) were positive for anti - HBc, no one show positive result for anti - HCV (0%) and84 were positive for anti - HBs, giving an overall prevalence rate of (46.7%).Conclusions and Recommendations : This study showed a low prevalence of Hepatitis B virus and Hepatitis C virus infections markers among the medical student, which clearly indicates that the National Program of Immunization for hepatitis B is being efficient.Ninety six (53.3%) students were susceptible to the infection and required vaccination

نوعية حياة مرضى التدرن في بغداد 3102 == Quality of Life of Tuberculosis Patients, Baghdad /2013

اسم المؤلف: اياد كريم حويز
اسم المشرف: صالح جاسم علوان
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الوبائيات التطبيقية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:

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

اسم المؤلف: هند احمد عبد العزيز
اسم المشرف: جواد كاظم الديوان
الموضوع العام: الطب
السنة: 2018
الموضوع الدقيق: طب العائلة
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Breast cancer (BC) is the most prevalent form of cancer in Iraq, accounting for 21% of all female cancers. It is considered to be a progressive disease with a poor prognosis if detected late. The low level of knowledge and practice of breast self - examination is an important method of prevention.The objective of this study to assess knowledge of Iraqi women at Baghdad - Alkarkh about breast cancerrisk factor and their practices of breast self examination Aim of the study To assess knowledge of a sample of Iraqi women at baghdad - Alkarkh about breast cancer risk factors and their practices of breast self - examination , clinical breast examination and mamography .To assess the attitude and practices of breast cancer screening methods .Methods : Across - sectional study was conducted using interviweradmininstered qustionnaires. Samples of 400 feamales were systematic randomly selected from women attending primary health care centers at Baghdad - Alkarkh sector. Statistical package for social sciences(SPSS) version 25 was usedto study the statistical association between variables.Result : this study showed that two third of participiants had knowledge of BSE and poor practicing for BSE. The main sourse of information among all participants via PHCCs.Conclusion : good knowledge was noticed among women attending primery health care centers. Practicing of breast self examination was poor.

دراسة فاعلية وسلامة التغييرات المختبرية ومعلمات التنبؤ للاستجابة لعقار الاداليموماب في علاج المرضى المصابين بالتهاب الفقار المقسط النشط == Efficacy, Safety of Laboratory Changes and Predictors of Response to Adalimumab in Treatment of Patients with Active Ankylosing Spondylitis

اسم المؤلف: ليث محمود شاكر
اسم المشرف: خضير زغير معيوف البدري
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Ankylosing Spondylitis belongs to a family of rheumatic diseases known as spondyloarthritides that characteristically cause spinal joint inflammation and bony fusion of the spine. Ankylosing spondylitis is the prototype of the Spondyloarthritides and is typified by ankylosis of the axial skeleton.There is no cure for ankylosing spondylitis, although treatments and medications are available to reduce joints pain and stiffness with subsequent improvement in quality of life.Adalimumab is a fully human monoclonal antibody of the Immunoglobulin G1isotype that neutralizes the biological function of tumor necrosis factor - α, has been used as effective treatment in ankylosing spondylitis in the last years.Objective : To assess the efficacy and safety of laboratory changes of Adalimumab in treatment of patients with active ankylosing spondylitis, as well as to assess the predictors of response to Adalimumab in treatment of patients with active ankylosing spondylitis.Patients and methods : An open labeled single group prospective study that was conducted over 17 months period on 61 Iraqi patients with ankylosing spondylitis diagnosed according to Modified New York criteria (1984) for diagnosis of ankylosing spondylitis and ASAS classification criteria for axial SpA .All the patients included in the study were given Adalimumab vial at a dose of 40 mg by subcutaneous injection every other week. Each patient was followed at regular intervals of baseline, 3 months and 6 months for disease activity including Bath Ankylosing Spondylitis Disease Activity Index and functional assessment including Bath Ankylosing Spondylitis Functional Index and for laboratory changes in hemoglobin, white blood cell count, aspartate aminotransferase, alanine aminotransferase, blood urea and serum creatinine . In addition, the study assessed eight different patients’ characteristics : age, gender, disease duration, human leukocyte antigensubtype B27, smoking, using steroids, using disease - modifying antirheumatic drugs (methotrexate, sulfasalazine), and drug history of using of other biological drugs (Etanercept, Infliximab) as predictors of response to Adalimumab treatment.Results : Data analysis showed that Bath Ankylosing Spondylitis Disease Activity Index 50% response rate was 59% after three month of treatment and reached to 85.6% after six months of treatment, the analysis also showed that the age and a positive history of using other biologic agents as apart from ( gender, disease duration, human leukocyte antigensubtype B27, smoking status , using steroids, and disease - modifying anti rheumatic drugs ) had a statistically significant association with reduced response to treatment, for each one year increase in age, the risk of being a respondent is decreased by 4% (P=0.026), and a positive history of using biologic agents is associated with decrease in the risk of being a respondent by 2.5 times (P=0.016) , all the variables were statistically significant effect on treatment and were evaluated as a strong effect (Cohen’s d>0.8). In Bath Ankylosing Spondylitis Functional Index ≥5 group, data analysis showed that their is statistically significant reduction by a mean of 2 units after three months of treatment and reached to a mean of 2.5 units after six months of treatment, the data analysis showed that increase age and a positive human leukocyte antigen - subtype B27 had a statistically significant association with reduced response to treatment, all the variables were statistically significant effects on treatment and were evaluated as a strong effect (Cohen’s d>0.8).In Bath Ankylosing Spondylitis Functional Index ˂5 group, data analysis showed that their is statistically insignificant reduction in the score of by a mean of 0.5 units after three months, and 0.6 units after six months of treatment, all the variables were statistically insignificant effects on treatment and were evaluated as a weak to moderate effect.The treatment effect of Adalimumab was evaluated as a moderately strong reduction in white blood cell count (Cohen’s d=0.43). While treatment effect on (hemoglobin, aspartate aminotransferase, alanine aminotransferase, blood urea and serum creatinine) was evaluated as week effects (Cohen’s d<0.3).Conclusion : Adalimumab drug is effective and relatively safe in treatment of patients with active ankylosing spondylitis. Increase in age, positive history of using of other biological drugs (Etanercept, Infliximab) and positive human leukocyte antigen - subtype B27 had significant correlation with reduced response to treatment.

جدوى قياس سرعة الانتشار في الشريان الابهر النازل كمعيار تنبؤي لامراض الشرايين التاجيه في اثنين من مراكز القلب في بغداد == The Value of Measuring Propagation Velocity Of The Descending Aorta as Predictor of Coronary Artery Disease in Two Cardiac Centers in Baghdad

اسم المؤلف: دنيا حامد كاظم
اسم المشرف: امال نوري المراياتي
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: صدى القلب
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Elastic properties of the aorta affect the left ventricular function and epicardial arteries blood flow. Thats why several parameters are used to assess those properties in order to predict the likelihood of atherosclerotic coronary artery disease. Those parameters include aortic strain, aortic distensibility and early diastolic velocity of the anterior aortic wall.Objectives : Testing the value of aortic propagation velocity as a parameter of aortic stiffness in predicting coronary artery disease. The strength of this parameter in predicting the number of affected coronary arteries is also assessed.st of August 2015 to the 1 st Study population and methodology : From the 1 of July 2016, and after applying the inclusion and exclusion criteria, 120 patients were included in this comparative multi - center study. They were assessed for demographic criteria and risk factor profiles. Trans thoracic echocardiographic examination was done, all the needed measurements were obtained as well as measuring the carotid intima media thickness by Doppler, then the results of their coronary angiography were revised, 60 patients were included in the coronary artery disease group and another 60 in the non - coronary artery disease group.Results : Aortic propagation velocity was found to be related to the aortic distensibility, strain, early diastolic anterior aortic wall velocity and the overall carotid intima media thickness to a statistically significant level (r=+0.481, p<0.001; r=+0.548, p<0.001; r=+0.595, p<0.001; r= - 0.361, p<o.oo1 respectively). It was found that aortic propagation velocity predicts coronary artery disease (p<0.001) and correlates with the number of affected coronary arteries (r= - 0.711, p<0.001).Conclusion : Aortic propagation velocity is an easily applied echocardiographic parameter of aortic stiffness that can predict coronary artery disease caused by vascular atherosclerosis in a non - invasive way. It also correlates with the number of the affected coronary arteries.

المعلمات اللتي تزيد من خطر الاصابه بامراض الرئه الخلاليه في مريض التهاب المفاصل الرثياني == Parameters that Increase Risk of Interstitial Lung Disease in Rheumatoid Arthritis Patient

اسم المؤلف: زينب عزيز
اسم المشرف: عدنان الجبوري
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Several studies have been focused on interstitial lung disease among patients with established rheumatoid arthritis, with fluctuating incidence and prevalence depending on the methods used.Objective : This study has been carried out to determine the risk of developing of interstitial lung disease according patients’ socio - demographic characteristics and other study variables.Patients and Methods : A case - control study design was used in this study performed on 100 cases with RA (50 cases with ILD). Data were analyzed by using Statistical Package of Social Sciences (SPSS) version18. Categorical variables were presented as frequencies and percentages. Continuous variables were presented as means with their 95% confidence interval (CI) and standard deviation. The Pearson's chi - square test (x2) was used to determine the associations between categorical variables. A p - value of < 0.05 was considered as statistically significant.Results : The overall mean age patients with rheumatoid arthritis were (49.65±11.94) years old and majority (54.0%) and (58.0%) of rheumatoid arthritis patients with and without interstitial lung disease were between 41 - 60 years, respectively. Female gender with rheumatoid arthritis patients about (66%) without interstitial lung disease & only (50.0%) of rheumatoid arthritis patients with interstitial lung disease are female. There was significant association between rheumatoid arthritis patients with and without interstitial lung disease with residence, rheumatoid arthritis patients who lived away from generators and factories areas were 15 times more likely to be without interstitial lung disease.Conclusion : The present study finding was reported significant higher rate 15 times of interstitial lung disease in rheumatoid arthritis patients who live near area of generators and or factories, as well as, current smokers in present study were two times higher in presenting interstitial lung disease among rheumatoid arthritis patients as well as non - smokers were three times higher to be without interstitial lung disease.

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

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

دقة فحص رنين قنوات الصفراء بالمقارنه مع ناظور قنوات الصفراء في تقييم انسداد قنوات الصفراء == ACCURACY OF MRCP VERSUS ERCP IN THEEVALUATION OF BILIARY OBSTRUCTION

اسم المؤلف: ايمان سامي سوادي العطية
اسم المشرف: ليث احمد خلف
الموضوع العام: الطب
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: ان انسداد قنوات الصفراء من الحالات المتكرر مشاهدتها في قسمي الجراحه والباطنيه وان تشخيصها يحتاج الى الكثير من الفحوصات المختبريه والشعاعيه للتمكن من معالجتها واصبح فحص الرنين المغناطيسي من الفحوصات الاساسيه لغرض التشخيص الدقيق لاسباب الانسداد لتسهيل العلاج وفي بحثنا هذا اجريت مقارنه لنتائج فحص قنوات الصفراء بالرنين مع نتائج الفحص الناظوري الارتجاعي لللقنوات الصفرايه والبنكرياسيه باعتباره المعيار الذهبي لقد تم اجراء هذه الدراسه خلال الفتره من شهر كانون الاول لسنة 2015 لغاية شهر ايلول 2016 واجريت على 50 مريض اجري لهم فحص رنين قنوات الصفراء بعد الشك بوجود انسداد قنوات الصفراء بالاعتماد على نتائج فحص السونار او ارتفاع نسبة الماده الصفراء في الدم بعد ذالك اجريت لهم عمليه فحص القنوات الصفراء بالناظورالهدف من الدراسه : لغرض اثبات مدى دقة فحص الرنين المغناطيسي في تشخيص وجود انسداد في القنوات الصفراويه فقد تم فحص المرضى من قبل استشاري الامراض الباطنيه تخصص دقيق في امراض الجهاز الهضمي واحيلوا لفحص الرنين المغناطيسي في قسم الاشعه في مستشفى بغداد التعليمي او في معهد الاشعه وتمت مراجعه الفحص من قبل اخصائي الاشعه وتحدد سبب الانسداد اعتمادا على نتائج الرنين المغناطيسي بعد ذالك اجريت لهم عملية ناظور القنوات الصفراويه في الطابق السادس في مستشفى بغداد التعليمي او في مستشفى امراض الجهاز الهضمي والكبد من قبل استشاري امراض الجهاز الهضمي ثم تمت مقارنة النتائج لكلا الفحصين وقد تم التوصل ال مايلي : ان فحص الرنين المغناطيسي ذو كفاءه تصل الى ( 97.6بالمائه) مقارنة بنتائج الناظور لذلك يمكن استغلاله للتشيخص بحساسيه وكفاءه عاليه وابقاء الناظور للحالات التي يتوقع احتياج تداخل كسحب الحصى من القنوات الصفراويه او اخذ خزعه للفحص النسيجي او لوضع عباره خاصه في حالات التضيق او تلك التي لا يمكن فيها سحب الحصى | Biliary obstruction is one of the common problems in both medical and surgical departments and its diagnosis needs many investigations and radiological in order to reach the correct giagonsis to arrange for possible treatment Aim of the study : To assess the accuracy of MRCP versus ERCP in the evaluation of biliary obstruction as the ERCP is a gold standard and to asses the validity of row data and MIP sequences for evaluation of the final results of MRCP study. Materials and method : During the period from December 2015 to September 2016, 50 patients with initial diagnosis of biliary obstruction based on ultrasound, and or clinical and biochemical evidence of cholestatic jaundice, were examined in the radiology department in medical city hospitals with MRCP to evaluate the cause and site of obstruction followed by ERCP done within few days.Results : By comparing the MRCP and ERCP findings in identifying the cause of obstruction reveals that .The sensitivity, specificity and accuracy of MRCP versus ERCP was found to be 97.6%, 66% and 92% respectively the major cause of biliary obstruction ound to be intraluminal CBD stone , luminal stricture and ampullary tumors are other causes of obstruction, according to the site 0f obstruction , distal obstruction found to be more common than mid or proximal. Conclusion : MRCP was found to be of high diagnostic accuracy in diagnosing biliary obstructionAnd ERCP should be reserved for therapeutic intervention since it was found that the sensitivity and specificity of MRCP were high and it can precisely define the site and cause of obstruction when compared to ERCP

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

اسم المؤلف: ميرفت عبد علي عبد الوهاب
اسم المشرف: بتول علي غالب ياسين
الموضوع العام: الطب
السنة: 2016
الموضوع الدقيق: طب العائلة
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Although intrauterine contraceptive device (IUCD) is the most widely used of long acting reversible method of fertility regulation in the world today, only 10% of Iraqi women aged 15 to 44 were using IUCD in 2011..Objective : To assess the knowledge and attitude towards intrauterine contraceptive device among women in reproductive age in Baghdad city, and to identify the effect of certain factors on their knowledge and attitude.Methods : A cross sectional study was conducted in Baghdad Teaching Hospital and Al - Shaheed Abdul - Sahib Dakhil PHCC. Any woman aged (15 - 45 years) who agreed to participate was included in the study. Data was collected through direct interview with the participants and the scores of knowledge were classified into : Good, fair and poor for knowledge and positive, neutral and negative for attitude.Results : Assessing the knowledge and attitude of the 301 participants revealed that 97.3% knew what IUCD is and 96.6% were aware of the aim of using the Copper IUCD, 42.8% were aware of its side effects, whereas only 5.9% of them were aware of the types, 13.9% aware of complications and 3.3% aware of who is eligible for using IUCD. In spite of this only 1.0 % of the participants got good knowledge score and 76.1 % got poor scores. Regarding attitude 15.0% had a positive attitude toward the use of IUCD.Knowledge scores of the respondents increased with increasing age (p<0.001), level of education (P = 0.026), being married (P=0.008),number of children (P<0.001) and history of previous abortions (P=0.04). Friends, neighbors and relatives were the main source of knowledge (77.4 %(.Conclusions : Most of participants were with poor knowledge score and the main source of them were friends, neighbors and relatives.Attitude score of Less than one - fifth of them was positive

اورام الدماغ الثانوية المنتشرة ضمن الاورام السرطانية الصلبة == Secondary brain metastasis in solid tumors

اسم المؤلف: افيل نديم كاظم
اسم المشرف: خضير جاسم صبيح الرواق
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Title : Secondary brain metastasis in solid tumors.Background : Brain metastases are among the most feared complications of cancer because they often cause profound neurologic symptoms that severely impair the quality of life. They represent a common complication, occurring in 10 - 30% of cancer patients. The prevalence of brain metastases in cancer patients has been rising over the past three decades.Aims of the study : To investigate the distributions of secondary Brain metastases and their percentage of frequency among common solid tumors and to correlate the strength of the relationship with different prognostic criteria that are obtained from common primary diseases which ended up with secondary brain metastases in Al - Amal hospital for radiation oncology and nuclear medicine .Patients and methods : Clinical data of 40 patients with brain metastatic cancers were collected and analyzed for the relationship between survival time and age, gender, primary diseases, quantity of brain metastatic foci, their position, extra cranial lesions, and therapeutic regimens used before brain metastasis detection.Results : The average female to male ratio was 3.4 : 1, with highest frequency were among patients in the 4th and 5th decades, females with breast cancer showed the highest frequency to develop brain metastases. Highest frequency was seen at 1 - 5 years after diagnosis of the primary disease. Majority of patients were treated with surgery and chemotherapy showed a high frequency for brain metastases.Conclusion : Female gender 30 - 50 years age having breast cancer, between 1 - 5 years after the diagnosis of the primary disease are at high risk for secondary brain metastases.Keywords : Secondary brain tumor, brain metastases, cerebral cancer treatment, brain neoplasm, metastasis

دراسة معدل انتشار التدرن الكامن في سجن اصلاح الكبار في محافظة بابل == Prevalence of Latent Tuberculosis in Hilla Male Prison

اسم المؤلف: مرتضى نجاح جواد
اسم المشرف: قاسم محمد سلطان
الموضوع العام: الطب
السنة: 2014
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Tuberculosis (TB) is one of the oldest diseases known toaffect humans, it caused by infection with Mycobacterium Tuberculosis(M.TB). M.TB is most commonly transmitted from a patient withinfectious pulmonary TB to other person by droplet nuclei .prisoners areexposed to a variety of infections, including TB. the standard test fordetecting Latent TB infection (LTBI) is tuberculin skin test (TST).Objectives : determination the prevalence of latent tuberculosis amongAL - Hilla male prisoners .and Assessing its correlations with various riskfactors.Methods : A stratified random sampling technique was used to select asample of 120 male prisoners aged >20years old from the AL - Hillaprison. The selected inmates were interviewed using a structured pretestedquestionnaire,5 units of PPD(0.1mL) had been injectedintradermally to the volar surface of forearm to be seen within 48 - 72hours. The test was considered positive if ( >=10mm induration)developed.Results : The study shows the rate of tuberculin reactivity amongprisoners is 23.3% (28/120). A significant relationship between age ofprisoner, mean area of accommodation per prisoner in the prison and TSTpositivity. The overall mean age of prisoners was (34.43± 12.70) yearsold and (47.5%) of the prisoners was aged between 20 - 30 years. Majority(77.5%) of the prisoners were living in urban area. (57.5%) of theprisoners were married. The alliterated prisoners were(53.3%). selfemployedprisoners were(61.7%). (53.3%) of prisoners had monthlyincome between 500 000 - 1 Million IQD. (39.2%) of prisoners spent oneyear of their prison period .The prevalence of smokers were(76.7%) andVIIonly (14.2%) of prisoners had contact with TB patients, meanwhile,(6.7%) of prisoners had contact with TB patients in prisons. Theprisoners had BCG vaccine signs were (74.2%).the prisoners who did notshare their house holding were (57.5%). The overall mean prisoners BMIwas (22.21± 3.19) kg/m2. The mean space of each cell in prison was(120.67± 85.38) m2, meanwhile the mean prisoners per each cell was(43.07± 17.72).So space of each prisoner approximately is : 2.8 m2 .Conclusion : significant relationship between age, area of accommodationfor each prisoner inside cell and positivity of TST.

العلاقة بين مستوى حامض البوليك في الدم وكثافة المعادن في العظام بين عينة من متوسطي وكبار السن العراقيين == Association Between Level of Serum Uric Acid and Bone Mineral Density Among a Sample of Middle Aged and Elderly Iraqis

اسم المؤلف: سندس عدنان جوامير
اسم المشرف: محمد هادي العصامي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: خلفية البحث : حامض البوليك هو حامض ضعيف وناتج نهائي من تحلل وايض البيورينات ويتواجد تحت الظروف الفسلجية على شكل ملح الصوديوم الاحادي , بداية اعتبر حامض البوليك كناتج خامل يتبلور في التراكيز العالية مكونا حصاة الكلية والتهاب المفاصل النقرسي , بالتالي ادرك انه من مضادات الاكسدة القوية يمسح الاوكسجين الدري , مختبريا وحسب الدراسات الخلوية اعتبر حامض البوليك ايضا كمؤيد للاكسدة حسب الكيميائية المكروية. كثافة العظام المعدنية هي مقياس المحتوى المعدني للعظام بوحدة الغرام والمساحة المتوقعة ذات البعدين بوحدة السنتيمتر المربع والوسيلة المستخدمة هي مقياس امتصاصية الطاقة المزدوجة للاشعة السينية.الهدف : تقييم العلاقة بين مستوى حامض البوليك في مصل الدم ومقياس كثافة المعادن للعظام ان وجد.المرضى والطرائق : شملت الدراسة (60) رجلا وامراة منهم (35)امراة والباقي رجال (25) اعمارهم تتراوح من 40الى 70سنة .تم جمع بيانات المرضى الديموغرافية والسريرية بما في ذلك العمر والجنس والطول والوزن ومعيار كتلة الجسم وحالة التدخين والحالة الوظيفية والدورة الشهرية والحالة المرضية ومستوى النشاط والتحصيل الدراسي . تم قياس نسبة الحامض بوحدة ملغرام لكل ديسيلتر مربع لكل وكدلك كثافة المعادن للعظام للفقرات القطنية من الواحد الى الاربعة وعنق عظم الفخذ الايمن لكل شخص مع حساب مقياس تي ومقياس زت عن طريق مقياس الامتصاص للطاقة المزدوجة للاشعة السينية النتائج : هناك علاقة احصائية مباشرة ضعيفة بين مستوى حامض البوليك وكثافة العظم للفقرات القطنية في جميع الاشخاص القيمة الاحتمالية (0,176). العلاقة بين مستوى الحامض وكثافة العظام للذكور مباشرة في عنق الفخذ الايمن ومعتدة احصائيا القيمة الاحتمالية (0,040) . توجد علاقة مباشرة ضعيفة بين مستوى حامض البوليك وكثافة عظام الفقرات القطنية في الاناث في سن الياس (0,225) .الاستنتاجات : هناك اثار وقائية منطقية لحامض البوليك للعظام في الذكور | Background : Uric acid is the final breakdown product of purine metabolism in humans, it is a weak organic acid that under physiologic condition exists mainly as a monosodium urate salt , initially, uric acid was considered an inert waste product that crystallizes at high concentrations to form renal stones and provoke gouty arthritis , subsequently, uric acid was recognized to be a powerful antioxidant that scavenges oxygen radicals. Cellular studies have nevertheless demonstrated that depending on its chemical microenvironment, uric acid may also be pro - oxidant. Bone mineral density measurements are widely used to diagnose osteoporosis and measurement in bone mass are commonly used as a surrogate for fracture risk . Bone mineral density is the measured parameter, and allows the calculation of the bone mineral content in grams and the two - dimensional projected area in square centimeter of the bone being measured; thus the units of is gram per square centimeter. Objectives : The aim of this study was to evaluate the relationship between the serum uric acid and bone mineral density in a sample of middle and elderly Iraqis Patients and methods : This cross - sectional study involved sixty participants , thirty five were female and twenty five were male, based on exclusion (systemic rheumatic diseases , malignancy , gout , chronic kidney and liver diseases, diabetes mellitus , thyroid disease, pregnancy, medications : thiazide , calcium , vitamin D, steroid , bisphosphonate) and inclusion (Iraqi consenting men and women , aged from forty to seventy years) criteria. Demographics and clinical data were collected including age, sex, body mass index, smoking status, employment, educational status, menstrual history, level of physical activity, comorbidities .Serum uric acid was measured and bone mineral density was calculated for each individual by dual energy x ray absorptiometry scan , Z - score and T - score at first lumbar - forth lumbar spine and right femoral neck were measured . Results : There is weak direct relationship between bone mineral density, T and Z score with uric acid (stronger in bone mineral density than the others probability value ( 0.176) in lumber spine bones for all patients , but no relationship was found between bone mineral density , with uric for right femoral neck in all participants probability values (0.346) , while in females, there was no relationship between uric acid and bone mineral density , T and Z score of the lumbar vertebral spine , while; there was weak inverse relationship between bone mineral density , T and Z score with uric acid in right femoral bone . In postmenopausal female; in lumbar vertebral spine bone there was weak direct relationship between uric acid with bone mineral , Z and T score, while; in right femoral bone there was no relationship between uric acid with bone mineral density , Z and T score. In males for right femoral bone; there was significant direct relationship between bone mineral density with uric acid probability value (0.04), while the relationship between uric acid with T and Z score was non - significant (however it is direct and weak correlation),while ; no relationship was observed between uric acid with bone mineral density, T and Z score for lumbar vertebral spine bones.Conclusion : Significant direct relationship was found between bone mineral with uric acid , so uric acid is protective against bone loss in male

مصاحبة الاختلافات التشريحية للجيوب الانفية مع امراض الجيوب الانفية في المفراس الحلزوني متعدد المقاطع == Co - existence of anatomical variations of paranasal sinuses and sinonasal abnormalities on multislice computed tomography

اسم المؤلف: ميثاق محي عبد الله
اسم المشرف: عبد اللطيف علي اصغر | محمد ضياء احمد
الموضوع العام: الطب
السنة: 2013
الموضوع الدقيق: الاشعة التشخيصية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Background : Certain anatomic variations ( as concha bullosa and nasal septal deviation) are common in general population and are often predispose the patients to inflammatory diseases because they may obstruct the infundibulum or any part of the osteomeatal complex resulting in interference of air flow or mucociliary clearance. Computed tomography is the imaging modality of choice since the advent of functional endoscopic sinus surgery. It is now mandatory and a medicolegal requirement to evaluate the paranasal sinuses as this provide a road map with excellent details regarding anatomy, anatomical variants with type and extension of the pathology.Objectives : to identify the incidence of different types of paranasal sinus variants and their coexistence with sinonasal abnormalities by using multislice computed tomography.Patients and methods : This is a cross sectional study was done on 87 patients referred for computed tomography scan of the paranasal sinuses in Al - shaheed Ghazi Al.Hariri Teaching Hospital in medical city - Baghdad, from January 2013 to June 2013, patients were clinically suspected to have sinonasal diseases. The sample of this study was consist of 52 males and 35 females. The age of patients ranged from 12 - 60 years. All patients were examined by computed tomography scan of paranasal sinus protocol in axial sections with coronal reformat.Results : From 87 patients in our study, 76 patients were have diseased sinuses, we reported 5 mucosal abnormalities; mucosal thickening, opacification, air fluid level, mucosal polyp and cyst. The most commonly involved sinus was the maxillary (62 patients) followed by anterior ethmoid, and the commonest abnormality was mucosal thickening. Types of variations were seen in this study; nasal septal deviation(52.4%), concha bullosa(49%), enlarged ethmoidal bullae (15.9%), large Aggar nasi (15.9%), Haller cells(19.1%), bent uncinate process(11.4%),Onodi cells(11.4%), paradoxical middle turbinate(9.1%), maxillary sinus hypoplasia(7.9%), pneumatized crista galli(6.8%), and both pneumatized nasal septum and asymmetrical ethmoid roof were of (3.4%). the total number of patients having anatomical variants but with no associated sinonasal mucosal abnormalities were (17.1%), while (82.9%) of patients were associated with sinonasal abnormalities.Conclusion : by using multislice computed tomography we find correlation between certain anatomical variations and specific inflammatory sinonasal mucosal abnormalities due to defect in the drainage of the sinus secretions and secondary infection. Also there was another group of variants which may lead to intraoperative complications if surgery indicated.

تقنية غير لائقة في استخدام جهاز الانشاق ذات الجرعة المعايرة في عينة من المرضى العراقيين المصابون بالربو == The effect of improper technique in using meter dose inhaler in a sample of Iraqi asthmatic patients

اسم المؤلف: زياد طارق ملغوث
اسم المشرف: قاسم محمد سلطان
الموضوع العام: الطب
السنة: 2015
الموضوع الدقيق: الامراض - الصدرية
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: Improper asthma inhaler device use was most likely one of the major causes associated with uncontrolled asthma and frequent respiratory clinic visits. Therefore assessment the effect of the improper use of metered dose inhaler device in the control of bronchial asthma, and the factors that have important impact on asthma management and control.Objectives : The aim of study is to assess the effect of the improper use of meter dose inhaler device in the control of bronchial asthma. And the factors that affect the inhaler technique.Methods : A cross - sectional study of 100 patients who visited respiratory clinic at Baghdad Teaching Hospital with bronchial asthma from 1st of August 2014 to 28th February 2015. Information was collected about demographic data and asthma control and we assessed the inhaler techniques for each patient using an inhaler technique checklist.Results : Among the 100 asthma patients, 50(50%) were male, 50(50%) female. There was a statistically significant association between MDI technique use defect and all the following factors (the gender (P value ‹0.05),VIIAge (P value = 0.01), the education level of patients (P value = 0.00), the duration of disease of the patient (P value = 0.03), the asthma health education of the patient (P value = 0.00) and asthma control test (ACT)).Conclusion : Improper inhaler device use is major factor associated with poor asthma control.Keywords : Iraqi asthmatic patient, MDI, inhaler technique and Patient education.

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

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

متوسط حجم الصفائح الدموية وعرض توزيع الخلايا الحمراء في المرضى العراقيين المصابين بالتهاب المفاصل الروماتويدي == Mean Platelet Volume and Red Cell Distribution Width in Iraqi Patients with Rheumatoid Arthritis

اسم المؤلف: انمار عبد الوهاب البياتي
اسم المشرف: زياد شفيق الراوي
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: خلفية البحث : التهاب المفاصل الروماتويدي هو التهاب مناعي ذاتي جهازي مزمن يصيب المفاصل واجهزة الجسم الاخرى. متوسط حجم الصفائح الدموية هو جزء من اختبار العد الكامل للدم ويرتبط مع وظيفة الصفائح الدموية وفاعليتها. عرض توزيع الخلايا الحمراء هو جزء من اختبار العد الكامل للدم ويقدر تغيرات كريات الدم الحمراء.الهدف : لتقييم عرض توزيع الخلايا الحمراء ومتوسط حجم الصفائح الدموية في مصل المرضى الذين يعانون من التهاب المفاصل الروماتويدي وتقييم علاقاتهما مع الخصائص الديموغرافية والسريرية الاساسية للمرضى.المرضى والطرائق : شملت دراسة تضبيط الحالة هذه تشخيص ما مجموعه 111 مريضا مصابا بمرض التهاب المفاصل الروماتويدي (98 انثى : 13 ذكرا) وفقا لمعايير التصنيف الامريكية لامراض الروماتيزم / الرابطة الاوروبية لمكافحة الروماتيزم لالتهاب المفاصل الروماتويدي، متوافقين بالعمر والجنس مع 97 شخصا من الاصحاء كمجموعة ضبط (سيطرة) (76 انثى : 21 ذكر). وتم قياس كل من البيانات الديموغرافية، ودرجات نشاط المرض، والتاريخ الطبي، والادوية المستعملة، والعامل الروماتويدي، ومضاد سيترولينيتد الببتايد الضد ، ومعدل ترسيب كريات الدم الحمراء ، واختبار العد الكامل للدم.النتائج : كان متوسط العمر للمرضى والسيطرة 46.53 ± 11.89 و48.19 ± 12.06 سنة على التوالي (p=0,321). لم تكن فروقات متوسط حجم الصفائح لمرضى التهاب المفاصل الروماتويدي (8.0 ± 1.4) والسيطرة (7.7 ± 1.2) معتد احصائيا(P=0.4)، بينما وجد ان عرض توزيع الخلايا الحمراء اعلى بكثير في المرضى (14.5 ± 2.8) مقارنة مع مجموعة الضبط (12.4 ± 1.1) (p => 0.001). لم يكن هناك ارتباط معنوي بين عرض توزيع الخلايا الحمراء ومتغيرات مختلفة كـ(العمر، مؤشر كتلة الجسم ، مدة المرض، درجة فاعلية المرض 28، ومؤشر نشاط المرض السريري، معدل ترسيب كريات الدم الحمراء، الجنس، العامل الروماتويدي ومضاد سيترولينيتد الببتايد الضد). ان لعرض توزيع الخلايا الحمراء قدرة جيدة على التفريق بين مرضى التهاب المفاصل الروماتويدي ومجموعة الضبط،وكذلك فان لمعدل ترسيب كريات الدم الحمراء قدرة ممتازة على التفريق بين مرضى التهاب المفاصل الروماتويدي ومجموعة الضبط.الاستنتاجات : كان عرض توزيع الخلايا الحمراء اعلى بكثير في مرضى التهاب المفاصل الروماتويدي من مجموعة الضبط، في حين كان متوسط حجم الصفائح الدموية اعلى في مرضى التهاب المفاصل الروماتويدي مقارنة مع مجموعة الضبط غير ان الفروقات لم تكن معتدة احصائيا. لم يكن هناك ارتباط كبير في مرضى التهاب المفاصل الروماتويدي بين عرض توزيع الخلايا الحمراء ومتغيرات مختلفة كـ(العمر، مؤشر كتلة الجسم، مدة المرض، ، درجة فعالية المرض 28 ، ومؤشر نشاط المرض السريري ، معدل ترسيب كريات الدم الحمراء، الجنس، العامل الروماتويدي ومضاد سيترولينيتد الببتايد الضد). | Background : Rheumatoid arthritis is a chronic systemic autoimmune inflammatory disease, which affects the joints and other body systems. Mean platelet volume is part of the complete blood count test and correlates with the platelet function and activation. Red cell distribution width is part of the complete blood count test and estimates erythrocyte variability in volume.Objective : To evaluate red cell distribution and mean platelet volume in patients with rheumatoid arthritis and to assess their relationships with baseline demographic and clinical characteristics of rheumatoid arthritis .Patients and Methods : A total of 111 patients (98 female : 13 male) with rheumatoid arthritis diagnosed according to the American College of Rheumatology/European League Against Rheumatism classification criteria for Rheumatoid arthritis 2010 and age sex matched 97 control healthy individuals (76 female : 21 male) were involved in this case - control study. Demographic data, disease activity scores, medical history, current medications were reported. Rheumatoid Factor, Anti Citrullinated Peptide Anti body, complete blood count erythrocyte Sedimentation Rate, and were all measured.Results : The red cell distribution width was significantly higher in patients (14.5 ± 2.8) compared to controls (12.4 ± 1.1) (p=>0.001). While Mean platelet volume in rheumatoid arthritis patients was (8.0 ± 1.4) and that for controls (7.7 ± 1.2), the differences were insignificant (P=0.4). Mean age for patients and controls were 46.53 ± 11.89 and 48.19 ± 12.06 years respectively (p=0.321). There were no significant correlation between red cell distribution width and various variables (Age, Body Mass Index, disease duration, Disease Activity Score28, Clinical Disease Activity Index, ESR, Sex, Rheumatoid factor, and Anti Citrullinated Peptide Anti body).The red cell distribution width had good validity to differentiate rheumatoid arthritis patients from controls, while erythrocyte sedimentation rate had excellent validity to differentiate between rheumatoid arthritis patients and controls.Conclusions : Red cell distribution was significantly higher in rheumatoid arthritis patients than in controls, While mean platelet volume was higher in rheumatoid arthritis patients compared to controls, but not reach statistically significant. In rheumatoid arthritis patients there were no significant correlation between red cell distribution and various variables (Age, Body mass index, Disease duration, Disease activity score 28, Clinical disease activity index , Erythrocyte sedimentation rate, Sex, Rheumatoid factor, and Anti Citrullinated Peptide Anti body).

ارتفاع المؤشرات الالتهابية كمتنبئ للاستجابة للادوية المضادة لعامل تنخر الورم (الايتانرسبت والانفلكسماب) في عينة من المرضى العراقيين المصابين بتشمع الصلب == Raised Inflammatory Markers as Predictors of Response to Anti - Tumor Necrosis Factor Drugs (Etanercept and Infliximab) in a Sample of Iraqi Patients with Ankylosing Spondyl

اسم المؤلف: سيف عبد الكريم رؤوف
اسم المشرف: نزار عبد اللطيف جاسم
الموضوع العام: الطب
السنة: 2017
الموضوع الدقيق: الامراض - المفاصل
الدرجة: دبلوم عالي
اللغة: الانكليزية
مكان الجامعة: بغداد
الصفحات الاولى:
المستخلص: الخلفية : تشمع الصلب هو مرض التهابي جهازي مزمن يؤثر بشكل اساسي على الهيكل العظمي المحوري، على الرغم من ذلك فان المفاصل الطرفية وانسجة الارتكاز والانسجة خارج المفصل قد تتاثر ايضا بالمرض مثل العيون والقلب والرئتين. يرتبط ارتفاع المؤشرات الالتهابية ( بروتين سي التفاعلي او معدل ترسيب كريات الدم الحمراء) في المرضى المصابين بتشمع الصلب في بداية اعطاء الادوية المضادة لعامل تنخر الورم مع استجابة سريرية افضل. الهدف من الدراسة : تقييم دور ارتفاع المؤشرات الالتهابية ( بروتين سي التفاعلي او معدل ترسيب كريات الدم الحمراء) في تنبؤ الاستجابة للادوية المضادة لعامل تنخر الورم في المرضى المصابين بتشمع الصلب.المرضى والطرائق : ادخل في الدراسة الاترابية 71 مريضا من المصابين بتشمع الصلب كعدد كلي، كلهم كانوا مطابقين لمعايير نيويورك المعدلة لتشخيص تشمع الصلب ومعايير تصنيف الجمعية الدولية لتقييم التهاب المفاصل الصلبي لغرض تشخيص التهاب المفاصل الصلبي. تم استثناء 19 مريضا من الدراسة نتيجة انقطاعهم عن استخدام الادوية المضادة لعامل تنخر الورم واستمر 52 مريضا بالدراسة وتمت متابعتهم لمدة ثلاثة اشهر . تم جمع البيانات الديموغرافية ، مدة المرض ، نوع العلاج ، مؤشر نشاط مرض التشمع الصلب والمؤشر الوظيفي لمرض تشمع الصلب من المرضى. وتم ايضا فحصهم مختبريا لبروتين سي التفاعلي، معدل ترسيب كريات الدم الحمراء ، كريات الدم البيضاء ، الهيموغلوبين وعدد الصفائح الدموية.النتائج : كان متوسط عمر المرضى 35.2 ± 9.6 سنوات ، شكل الذكور 84.6% منهم وكان متوسط مدة المرض 5 (3 - 10) سنوات. اظهر التحليل احادي المتغير بان المتنبئات للاستجابة للادوية المضادة لعامل تنخر الورم شملت الارتفاع الاساسي لبروتين سي التفاعلي ، معدل ترسيب كريات الدم الحمراء ، مؤشر نشاط مرض التشمع الصلب والمؤشر الوظيفي لمرض تشمع الصلب. اظهر التحليل متعدد المتغير بان المتنبئ المستقل الوحيد للاستجابة للادوية المضادة لعامل تنخر الورم هو الارتفاع الاساسي لبروتين سي التفاعلي. كانت نقطة القطع المثلى لبروتين سي للاستجابة للادوية المضادة لعامل تنخر الورم اكثر من 7.5 ملغم/ لتر بحساسية 94.29% ونوعية 88.24%, بينما لمعدل ترسيب كريات الدم الحمراء كانت اكثر من 32 ملم/ ساعة بحساسية 74.29% ونوعية 94.12%. كان هنالك نزول واضح في مؤشر نشاط مرض التشمع الصلب والمؤشر الوظيفي لمرض تشمع الصلب بعد ثلاثة اشهر من العلاج (لكلا العلاجين ايتانرسيبت وانفلكسماب). لم تتنبا المتغيرات الاخرى التي تم دراستها والتي تشمل البيانات الديموغرافية، مدة المرض، الهيموغلوبين، كريات الدم البيضاء، الصفائح الدموية، نوع العلاج، وجود التهاب المفاصل الطرفية، التهاب انسجة الارتكاز او التهاب القزحية بالاستجابة.الاستنتاجات : يتنبا الارتفاع الاساسي للمؤشرات الالتهابية ( بروتين سي التفاعلي او معدل ترسيب كريات الدم الحمراء) باستجابة افضل للادوية المضادة لعامل تنخر الورم في المرضى المصابين بتشمع الصلب. بروتين سي التفاعلي لديه تنبؤ افضل للاستجابة للادوية المضادة لعامل تنخر الورم من معدل ترسيب كريات الدم الحمراء | Background : Ankylosing spondylitis is a chronic systemic inflammatory disorder mainly affecting the axial skeleton, although peripheral joints, entheses and extra - articular tissues may also be involved such as eyes, heart and lungs. Raised inflammatory markers (C - reactive protein or erythrocyte sedimentation rate) in patients with AS at the start of anti - tumor necrosis factor therapy associated with more clinical response.Aim of the study : To assess the role of raised inflammatory markers (C - reactive protein and erythrocyte sedimentation rate) in predicting response to anti - tumor necrosis factor drugs in patients with ankylosing spondylitis.Patients and methods : A prospective cohort study enrolled a total of 71 patients with AS, all of them were fulfilling the modified New York criteria for Ankylosing Spondylitis and Assessment of Spondyloarthritis International Society classification criteria for diagnosing spondyloarthropathy. Nineteen patients were excluded from the study due to discontinuation of anti - TNF therapy and 52 patients continued in the study and were followed for three months. Demographic data, disease duration, type of treatment, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index were collected from the patients. They were also investigated for C - reactive protein, erythrocyte sedimentation rate, white blood cell, hemoglobin and platelet count. Results : The mean age of the patients was 35.2±9.6 years, males constitute 84.6% of them and the median disease duration was 5 (3 - 10) years. Univarite analysis showed that the predictors of response to anti - TNF were raised baseline C - reactive protein, erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. Multivariate analysis showed that the only independent predictor for response to anti - tumor drugs was raised baseline C - reactive protein. The optimal cut point for C - reactive protein to predict response was >7.5 mg/l with a sensitivity 94.29% and specificity 88.24% , while for erythrocyte sedimentation rate was > 32 mm/hour with a sensitivity 74.29% and specificity 94.12%. For both drugs (etanercept and infliximab) there was significant reduction in Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index after 3 months of therapy. Other variables which were studied including demographic data, disease duration, hemoglobin, white blood cell, platelet, type of treatment, presence of peripheral arthritis, enthesitis or uveitis did not predict response.Conclusions : Raised inflammatory markers (C - reactive protein and erythrocyte sedimentation rate) at baseline predict better response to anti - tumor necrosis factor drugs in Ankylosing Spondylitis patients. C - reactive protein had better prediction of response to anti - tumor necrosis factor dugs than erythrocyte sedimentation rate.
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