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اختيار السيطرة على الربو مقاسة بالاستجواب مقارن مع قياس حجم الزفير الاجبار في الثانية الاولى العراق

Author name: رؤوف عبيد حسين
Supervisor name: مصطفى نعمة عبد علي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:

قياس محيط الراس بجهاز الامواج فوق الصوتية في التنبؤ بالمرحلة الثانية للولادة عند النساء الخروس (العديمات الاولاد) == Utrasound measurement of head circumference in prediction of 2nd stage duration of labor in nulliparous women

Author name: وفاء عبد الكريم عبيد
Supervisor name: معد مهدي شلال
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: المرحلة الثانية الطويلة من الولادة، تؤدي الى نتائج سلبية للام والجنين .التقييم الاصبعي لموقف راس الجنين اثناء المخاض هو اداة ذاتية، وعرضة لخلاف كبير بين الفاحصين .الامهات الخروس العديمات الاولاد ذوات اجنة بمحيط راس كبير عرضة لزيادة خطر العملية القيصرية الاولية والولادة المهبلية المتعلقة بالعمليات الجراحية . لقد مكنت الموجات فوق الصوتية اثناء الولادة مزيد من الفهم للفسلجة المعقدة لولادة للجنين وقد قدرت التكهن للولادة المهبلية المتعلقة بالعمليات الجراحية والعملية القيصرية الاولية.الهدف من الدراسة : الغرض من هذه الدراسة هو تقييم قدرة الموجات فوق الصوتية اثناء الوضع للتنبؤ بوقت المرحلة الثانية من المخاض عند النساء الخروس ( عديمات الاولاد )عن طريق قياس محيط راس الجنين وكذلك لتقييم محيط الراس بعد الولادة ومدة المرحلة الثانية.مكان الدراسة ونوعهادراسة مقطعية عشوائية اجريت بالفترة ما بين الاول من يناير 2014 ولغاية الاول من شهر مارس 2014 في مستشفى بغداد التعليمي. | Prolonged second stage of labor, has been associated with adverse maternal and fetal outcomes. Digital assessment of fetal head station during labor is a subjective tool, prone to considerable disagreement among examiners. Nulliparous mothers of large - FHC infants are at increased risk of primary cesarean section and operative vaginal delivery . Intrapartum ultrasonography has enabled further understanding of the complex physiology of childbirth. It has been shown to provide objective information on the dynamics of different stages of labor, and has also been used to assess the prognosis for operative vaginal delivery and primary cesarean section. AIM OF STUDY : The purpose of this study is to assess the ability of intrapartum ultrasound to predict the duration of second stage of labour in nulliparous women by measuring fetal head circumference and also to assess head circumference post - delivery and second stage duration

المسح عن مسببات وطرق الوقاية من الجلطات الدموية الوريدية في مرضى مستشفى بغداد التعليمي == Screening of Venous thromboembolism risk factors and prophylaxis in Baghdad teaching hospital patients

Author name: صباح الشاوي
Supervisor name: ايمان عدنان القصير
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Deep vein thrombosis is the silent killer, which complicate many of the hospital admission and the cause for many re - admission. In Iraq, deep vein thrombosis is the iceberg where little is known about the risk with the availability of many risk factors in the Iraqi population. The right selection for the patients who need the prophylaxis decrease the rate of the Deep Venous Thrombosis and the complication, which happen through the first three months of the admission history. Assessment of deep venous thrombosis risk in the admitted patients reduce the risk of the disease and the complications. This study aimed to explore the risk of the Deep Venous Thrombosis and the selection of the right prophylaxis regimen to decrease the Deep Venous Thrombosis and complication outcome. A cross - sectional study conducted on 404 randomly selected admitted patients with various admission causes attending Baghdad teaching hospital in Baghdad. Data collection done through 1st of April to 1st of July 2017 , five to six patients were screened for the risk factors available which were divided in five groups of risk factors according to Capirini risk assessment form which used internationally for this reason .The total score then calculated and divided into three categories (mild, moderate and high). The score of 1 to 2 considered as mild with no need for prophylaxis, the score of 3 to 5 considered as moderate, the score of more than five considered as high - risk patients. Moderate and high - risk patients should have prophylaxis administered to them according to the international guidelines of Deep Venous Thrombosis prophylaxis. Statistical test is applied to find the percentage of the patients at risk of VTE in total and subgroup analysis to see the risk factors in the Medical, surgical & gynecological patients separately. Another statistical test done to compare the patients receiving the VTE prophylaxis versus the international guidelines recommendation. Deep Venous Thrombosis risk found to be high in the study population 65% and 35% were free from deep venous thrombosis risk , the survey include the medical, surgical and gynecological wards. The risk found to be highest in the gynecological patients with 77% at risk of Deep venous thrombosis followed by the surgical patients with 59% and then by the medical patients by 8%.The prophylaxis administration to the eligible patients found to be very low where the patients who received the prophylaxis was 27% from the medical patients and 41% from the surgical patients and 28% from the Obstetric and gynecological patients.

قيمة السلالة الطولية مقابل تصوير الاوعية التاجية في الكشف عن مرض الشريان التاجي == The Value of Longitudinal Strain versus Coronary Angiography in Detection of Coronary Artery Disease

Author name: حسان نوري محمود
Supervisor name: معتز فوزي حسين
General topic: Medicine
Specific topic: Echocardiography
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Introduction : Coronary artery disease is characterized by atherosclerosis in the epicardial coronary arteries. The reduction in coronary artery flow may be symptomatic or asymptomatic, occurs with exertion or at rest, and culminate in a myocardial infarction or angina, depending on obstruction severity and the rapidity of development. Speckle - tracking echocardiography is a new noninvasive ultrasound imaging technique that allows for an objective and quantitative evaluation of global and regional myocardial function independently from the angle of insonation and from cardiac translational movements.Aim of the study : to assess the value of longitudinal strain versus coronary angiography in detection of coronary artery disease Patients and method : A cross sectional study was conducted in Ibn - Albitar hospital during the period between March 2015 and March 2016 and a sample of 72 patients was selected with positive coronary angiography. Results : The mean age of patients was 56.4 ± 10.1 years; furthermore, 73.6% of the patients aged more than 50 years. About half of the patients, (51.4%) were smokers, (73.6%) were diabetic, (33.3%) were hypertensive and (58.3%) had hyperlipidemia. the findings of 2D LV Longitudinal strain - speckle tracking, positive LADA (left anterior descending artery) stenosis was reported in (86.1%), the CX artery stenosis reported in (76.4%) and the RCA stenosis was found in (84.7%) of the patients. for the stenosis in LADA, the current study showed that the longitudinal strain was a good predictor with a sensitivity of (93.8%), specificity (75%) and accuracy (91.7%) compared with coronary angiography, with good performance of the test between tests, good predictive value and accuracy of the test.The longitudinal strain showed that there was a good performance in detection of stenosis in CXA with high sensitivity, specificity and accuracy. The performance and validity of 2D LV longitudinal strain in detection of RCA stenosis in comparison with angiography, it had a sensitivity of (93.5%), specificity of (70.0%) and accuracy of (90.3%).Conclusion : The current study revealed that the Speckle - tracking echocardiography technique has a good performance and validity in detection of coronary artery stenosis with very good agreement with angiography.

العلاقة بين التهاب الحلزونية البوابية وسرطان الرئة بالتحليل النسيجي المرضي == Helicobacter pylori infection related to lung cancer histopathologically

Author name: غسان سماح محي
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:

نوعية حياة مرضى التدرن في المركز الوطني التخصصي للامراض الصدرية والتنفسية / بغداد 2017 == Quality of life of the tuberculosis patients attended The National Specialized Centre of the Chest and Respiratory Diseases / Baghdad 2017

Author name: حيدر عبد الامام حميدان
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Tuberculosis (TB) is one of the major public health problems. Apartfrom physical symptoms, TB patients have various general physical activities,social environmental and psychological problems. Which is important toconsider the overall TB on patients' perception of health and wellbeing.Aim of the study : To estimate the quality of life of TB patients, beside the routine clinical,radiological and bacteriological assessments and we want to determine theeffects of socioeconomic, demographic and the adjectives of the Tb diseases onthe domains of the quality of life (QOL).Methods : A cross sectional study involving 67 TB patients with or without comorbiddiseases, pulmonary and extra pulmonary Tb attending The NationalSpecialized Centre of the Chest and Respiratory Diseases in Baghdad. Dataobtained through direct interview using a standard questionnaire of WHOQOLBREF(26 questions) highlighting four domains : physical, psychological, socialand environmental, and also using of a structured form of identity information,socioeconomic and demographic information, we estimate the effects of variousaspect in this structured form on the four domains of WHOQOL - BREF (26questions) .Results : Regarding our results we found that general aspect of quality of life was(48.9%) of the quality of life rating, and (32.9%) of the general aspect of health satisfaction, concerning specific part of quality of life of TB patients, Physical domain (29.2 ± 12.3), Psychological domain (46.1±16.2), Social domain (47.4±20.6) and Environmental domain (38.6±13.8), with variation within each domain according to demographic and socioeconomic variation with significant correlation between domains of quality of life.Conclusions : Tb is a disease associated with low scoring of quality of life specially when associated with low socioeconomic state, while the marriage give positive effort to total perception of the QOL especially social domain. And the financial state of the TB patients is with direct effect on social domain of the QOL. And also highly educated TB patients and those with low crowded index have better environmental domain in their QOL among the other TB patients

تحليل نتائج ناظور القصبات المرن لردهه الامراض الصدريه والتنفسيه في مستشفى الديوانيه التعليمي للسنتين 2014 - 2015

Author name: اثير محمود علي
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:

دراسة حول قيم توسع الصدر بين الاصحاء البالغين في العراق == The chest expansion values among adult healthy Iraqi people

Author name: محمد احمد رحمان
Supervisor name: مصطفى نعمة عبد علي
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: Chest expansion measurements are used to evaluate a patient’s baseline status, treatment effectiveness, and progression of disease with regards to chest wall mobility and respiratory muscle function.Objectives : To establishing basic information about normal range of chest expansion measures among healthy Iraqis and to establish the variation of the chest expansion among Iraqi population and exploration of the relationship with age, sex and body built.Methods : A stratified random sampling technique was used to select a sample of 1020 persons (530 male and 490 female) aged between 20 to 70 years old from Baghdad and Al - Najaf city, Participants without any neurological, orthopedic, rheumatological or respiratory diseases or having pneumonia during the last month and smokers were excluded from the study, the chest expansion measured in 2 sites , for upper , at the level of the fifth thoracic spinous process and the third intercostal space at the mid clavicular line and for the lower thoracic excursion, the tape measure was placed at the level of the 10th thoracic spinous process and the tip of the xiphoid process by using inelastic tape measure.Results : The study shows that male participants have significant higher chest expansion than female participants in upper thoracic (5±0.6cm, 4.2±0.7cm) for male and female respectively and at lower thoracic (4.5±0.6cm, 3.7±0.6cm) (p< 0.05) for male and female respectively.Chest expansion of male and female participants at both upper and lower thoracic peak at age 20 - 29 and decreases thereafter with increasing age. In female participants, chest expansion was significantly correlated with BMI, which is decreased in the obese female.Conclusion : It was concluded that chest expansion of both upper and lower thoracic increase with age increases until the 3rd decade of life, and then steadily declines after this. Male chest expansion was significantly higher than female participants

الوضع الوبائي لمرض الهيموفيليا في بغداد - العراق 2016 == Epidemiological Profile of Hemophilia in Baghdad - Iraq, 2016

Author name: كمال عبد الرزاق كاظم
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:
Abstract: Background : Hemophilia is an X - linked bleeding disorder that affects males mainly. Globally, there are about 400,000 people with hemophilia and only 25%of them receive adequate treatment. There is insufficient epidemiological data on hemophilia in Iraq, so this study was conducted to estimate the prevalence, incidence and other epidemiological characteristics of hemophilia patients in Baghdad, 2016.Methods : A cross sectional study was conducted by reviewing all records of hemophilia patients for 2016 that retrieved through visiting all hemophilia centers in Baghdad. Corresponding population data of Baghdad was obtained from the Ministry of Planning.Results : The total number of the registered hemophilia patients in Baghdad centers who are residents of Baghdad was 654. The current prevalence of hemophilia was 7.7/100,000 population and it was 3.6/100,000 population in 2007. The current incidence of hemophilia was 16.3/100,000 livebirths and it was 8.4/100,000 livebirths in 2007. Severe hemophilia represented 63.4% from all types and the male patients represented 97.1%. The prevalence of HCV was 22.9%, for HBV was 0.9% and 0.2% for HIV. Inhibitors werepositive in 11.6% of hemophilia patients. Target joints found among 45.1% of patients. About 27% of patients were on prophylactic therapy. Only one death was recorded among hemophilia patients in Baghdad, 2016.Conclusions : The prevalence and incidence of hemophilia in Baghdad was doubled in 10 years' period. We recommended establishing an electronic national registry to have a perfect database for hemophilia and enhancing the prophylactic treatment.

الصفات الوبائية لمرض الاسهال الحاد في الاطفال دون سن الخامسة في العراق 2016 == Epidemiological Characteristics of Acute Diarrhea in Children under Five Years in Iraq, 2016

Author name: عمار عبد الله حمد
Supervisor name: ايمان عدنان القصير
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 : Diarrhea is one of the principle causes of morbidity and mortality among children in developing countries. It was the second leading cause of death in children under five years, accounting for 9 % of all deaths among children under age 5 worldwide in 2015. Despite the availability of simple effective treatment, about 1,400 young children die each day which is equivalent to 526,000 children a year. According to Multiple Indicator Cluster Survey (MICS - 4), the incidence of diarrhea in Iraq was 15% .Theobjective of this study was to identify the incidence and deaths of acute diarrhea in children under five year in Iraq, 2016. Methods : A descriptive cross - sectional study by reviewing all reported data from the directorate of health all over Iraq to the surveillance section in the Communicable Diseases Control Center in Baghdad. Incidence and case fatality rate (CFR) for <5 years population were calculated.Results : The total number of acute diarrheal cases was 251,388. A total of outpatient was 211,665(84%) and 39723(16%) was admitted cases. Male to female ratio was 1.1 : 1. Incidence of acute diarrhea was 47/1,000, the highest incidence was in Diwaniya (119.2 / 1,000), Erbil (89.8 /1,000), and Thiqar (77/1,000). The total death due to acute diarrhea was 154, male : female ratio was 1.2 : 1 and most deaths occur in children <1year (60.4%). CFR was 0. 77/1,000, the highest case fatality rate was in : Baghdad - Karkh (3.70/1,000), Diyala (2.49/1,000), and Diwaniya (1.14/1,000).Proportional mortality rate (PMR) was 7.7/1,000; the highest PMR was in Diwaniya (24.8/1,000), Salah aldin (18.9/1,000), and Diyala (17.5/1,000). Percentage of ORS used was 85%.The completeness of reported site for all provinces was 88%.Conclusion Diarrhea is still a major cause of morbidity and mortality in children under five years, which need to pay more attention for PHC intersectoral cooperation and community participation, and encouragement of Breast feeding.

تقييم ممارسات الجلسة التلقيحية في مراكز الرعاية الصحية الاولية - محافظة واسط, العراق 2017 == Assessment of Immunization Session Practices in Primary Healthcare Centers - Wasit Province, Iraq, 2017

Author name: علي صادق جعفر
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:
Abstract: Vaccination is a great public health achievement in human history. Annually, vaccines prevent more than 2.5 million child deaths globally. In 2016, about 19.5 million infants worldwide were not covered by DTP3, 60% of them live in 10 countries including Iraq. According to WHO and UNICEF, one third of below one year infants did not complete their immunization schedule. Wasit is among the governorates with a large number of underimmunized children. High quality immunization session practices (ISPs) can ensure safer, more effective vaccination and higher coverage rates. Objectives : To assess ISPs in Primary Healthcare Centers (PHCs) in Wasit, and if ISPs are correlated to some PHCs’ characteristics.Methods : A cross sectional study was conducted on 14 PHCs. One fourth of PHCs in each district were selected using simple random sampling. Each PHC was visited once to assess ISPs, using a modified WHO immunization session checklists. Information on vaccinators and PHC’s were collected using two, self - designed questionnaires.Results : PHCs were scoring variably in ISPs, ranging from 0.52 to 0.78 with a mean of 0.68 ± 0.07. ISPs were grouped into seven domains (mean) : vaccine management (0.51), cold chain management (0.40), session equipment (0.88), communication (0.27), vaccine preparation and administration (0.72), registration (0.83) and waste management (0.84). Three of PHCs’ characteristics : population size, below one - year monthly target and average number of daily vaccinees showed statistically significant, negative correlation with ISPs which was of intermediate strength.Conclusion : None of the PHCs was practicing near standard ISPs. ISPs showed statistically significant, negative correlation, of intermediate strength with population size, below one - year monthly target and average number of daily vaccinees for each PHC

الاضطرابات النفسية لدى كبار السن بين مراجعي عيادة كبار السن في مدينة الطب بغداد/ العراق 2017 == Mental Disorders among the Elderly People Attending Geriatric Clinic of Baghdad Medical City, Baghdad/ Iraq, 2017

Author name: احمد عبد الامير ابراهيم
Supervisor name: جواد كاظم الديوان
General topic: Medicine
Specific topic: Applied Epidemiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : The aging population is currently one of the main issues facing international health care systems. Between 2015 and 2050, the proportion of the world’s population 60 years and over will increase from 12% to 22%. Iraqi population was exposed to wars and conflicts, which are in turn, affect their mental health. We conducted this study to measure the prevalence and identify types and potential associated factors of MDs among elderly people attending Geriatric Clinic of Baghdad Medical City. Methodology : A cross - sectional study conducted and a systematic random sampling technique was used to select 320 elderly people attending Geriatric Clinic of Baghdad Medical City for non - psychiatric complaints. We collected data on basic demographics and associated risk factors using a questionnaire filled through self - reported questionnaire.Mental disorders (MDs) were defined based on Kessler Psychological Distress Scale (K10) with a cutoff score of 20+. Accredited tools used by WHO were used to identify the types of MDs.Results : The prevalence of MDs in the study sample was 24.4%. The prevalence of MDs types were : Depression 16.6%, anxiety 12.8%, dementia 5.3%, substance abuse 2.5%, suicide thoughts 5.6%, and suicide attempts 2.5%. Logistic regression analysis was used to examine the determinant factors of elderly MDs revealed the following significant factors : Aging, smokers, living depends on others, loneliness and social isolation, visual impairment, economic state deterioration, neglect and mishandling, and chronic diseases are the determinant factors of elderly MDs.Conclusions : Mental disorders are wide spread among elderly people and enhanced elderly mental health care services should be provided

عوامل الخطورة وتصنيــف اورام الرحــم وتدريجاتـه == Risk factors and histopathological types of uterine cancer 2016

Author name: رشا زكــــي شكــــــر
Supervisor name: خضير جاسم صبيح الرواق
General topic: Medicine
Specific topic: Therapeutic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: سرطان الرحم نسبيا يعتبر من الاورام الشائعه بين النساء حيث انه ياتي في المرتبه الرابعه بين الاورام الخبيثه التي تصيب النساء خاصة النوع الشبيه ببطانة الرحم.ان التصنيف حسب التشريح النسيجي المرضي ومرحلة الورم وعوامل الخطوره للمرض لم يتم تقييمها بصوره جيده في النساء العراقيات من اللواتي اصبن بهذا المرض.الغرض من الدراسةان الغرض من هذه الدراسة هو لمعرفة نوع الورم حسب التشريح النسيجي المرضي ومرحلة المرض عند تشخيص المرض وعوامل الخطوره للمرض بين المريضات العراقيات المرضى وطرق البحثتشمل هذه الدراسة خمسه واربعون مريضة مصابة بسرطان الرحم من مراجعات مستشفى الاورام التعليمي في مدينة الطب في بغداد للفترة من شهر كانون الثاني لغاية شهر نيسان 2016.لقد تم جمع المعلومات الضروريه من خلال الاستبيان المعد مسبقا من قبل فريق البحث وقد تم جمع المعلومات المطلوبه من فايلات المرضى المراجعين لمستشفى الاورام التعليمي في مدينة الطبالنتائجفي هذه الدراسة كانت 77.8% مريضة بعمر اكثر من 50 سنة ,86.7% من المريضات كان لديهن تاريخ احاظه مبكره,86.7% من المريضات كن في مرحلة سن الياس.كانت هناك نسبه قليله من المريضات ممن كان لدين تاريخ دوائي باستخدام الهورمونات او عدم الانجاب او وجود تاريخ مرضي للمرض في العائله وان نسبة 51% كن في المرحله الاولى من المرض اثناء تشخيص المرض ابتدائيا | Uterine cancer is relatively common; it’s the fourth most common malignancy in women. Histopathological types, staging and risk factors for uterine cancer are not yet well evaluated in Iraqi patients with uterine malignancy.Aim of study : - To classify uterine carcinoma patients according to histopathological type, risk factors and stageing.Patients and method : Cross - sectional study was conducted for 45 patients in Oncology Teaching Hospital, Medical city, Baghdad, Iraq between Jan.1st - April 1st2016. The data were collected from the medical records of patients with uterine cancer who’s attending to the hospital for completion of treatment through questionnaire which was developed by research team.Results : - The results of this current study on total of 45 patients showed that 77.8% 35 patients were older than 50 years, 86.7% 39 patients with history of early menarche, 86.7% 39 patients were in post - menopause phase, 33.3% of patients had history of hormonal therapy, infertility and family history of the disease. Endometrioid and Papillary serous types represented the highest percentage (42.2%, 28.9%) respectively. Highest percentages (51%) of patients were in stage one at the time of diagnosis.Recommendation : - - Further studies on uterine tumor. - Early detection programs should be activated. - Close follow up on patients from Stage 1. - Awareness programs on risk factors should be activated. - Patients educational sessions should be conducted regularly in the Hospitals.

معالجة اورام الدماغ في العراق 2016 == Management of brain Tumors in Iraq 2016

Author name: هدير رياض سعيد
Supervisor name: خضير جاسم صبيح الرواق
General topic: Medicine
Specific topic: Therapeutic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: CNS tumors constitute 2% of all cancers, and are observed in 4 - 5 in 100,000. CNS tumors exhibit different behaviors according to age, histology, and location.Aim of study1 - Detect the rate of incidence of CNS tumors in relation to age, sex, geographical distribution, environmental factors & genetic factors in our country2 - Explaining of the associated clinical features3 - Determine the effect of radiotherapy & chemotherapy on the patient’s outcome.Patients and methodsProspective study of CNS tumors started from the beginning of Jan 2016 to the end of Apr 2016. The patients were taken from the outpatient clinic of Oncology Teaching Hospital / Medical City in BaghdadAll patients (47) underwent surgery and the surgeons then sent them to our out patients clinic with their Histopathological reports seeking for further management.(42) Patients received Chemotherapy and/or Radiotherapy while the remaining (5) patients didn’t followed up after surgery because they didn’t attend to our out patients clinic according to their dates.The outcome of management was divided into : Good outcome, Fair outcome and Poor outcome.ResultsThe 5th decade is the most commonly involved age with male incidence more than females and the incidence is higher in the south of Iraq. There is little IIassociation of CNS tumors with family history and high association with environmental factors. Neurological deficit was the main chief compliant and headache was present in most of the patients at time of diagnosis. Frontal region was the commonest site for CNS tumors with size of 1 - 5cm and mostly associated with edema and +ve enhancement. Meningioma was the commonest histological type.Conclusions1 - There is a poor relationship between family history & CNS tumors2 - There is significant relationship between environmental factors & CNS tumors.3 - Headache is not the dominant chief compliant in compare with neurological deficit .4 - Total resection of the tumor followed by radio and/or chemotherapy has the best prognosis.Recommendations1 - Further researches with larger sample size to be collected from all oncology hospitals in Iraq are needed to generalize the results to national level .2 - Make the total resection of the brain tumor the aim of the surgeon because it is the golden stone in brain tumor management.3 - Use the new technique of radiotherapy like gamma knife and IMRT for the

التقييم الكهروفسلجي للانواع الفرعيه لمتلازمة غوليان - باريه لشريحه من الاطفال العراقيين == ELECTROPHYSIOLOGICAL ASSESSMENT OF GUILLAIN - BARRE SUBTYPES IN A SAMPLE OF IRAQI CHILDREN

Author name: لميس منصور حسين
Supervisor name: نجيب حسن محمد
General topic: Medicine
Specific topic: Neurophysiology
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Guillain - Barre syndrome represents the most common cause of acute motor paralysis in children. It is clinically characterized by an acute non - febrile, post - infectious illness marked as ascending weakness, and areflexia. However; sensory, autonomic and brainstem abnormalities may also be seen.This study aimed to assess the role of electrophysiological study (NCS and EMG) in the diagnosis of Guillain - Barre syndrome subtypes in children, estimate the frequency of subtypes whether demyelinating or axonal form of Guillain - Barre syndrome and match the electrophysiological results with the findings of CSF protein analysis.Two groups of either sex are involved in this study, children with Guillain - Barre (19 males and 11 females) with a mean age of (5 ± 2) years and normal healthy children served as control group (16 males and 14 females) matched for gender and age with a mean age of (6 ± 3) years. Each child submitted to medical history, brief clinical examination, and electrophysiological study. This study was performed at the unit of neurophysiology of Baghdad teaching hospital and Nursing house hospital in a period from December/2015 to June/2016.The electrophysiological assessments involve the following tests : 1 - Sensory NCS for bilateral median, right ulnar and bilateral medial plantar nerves in which latency, sensory nerve action potential amplitude (SNAP) and sensory nerve conduction velocity (SNCV) were studied.2 - Motor NCS for bilateral median, right ulnar and bilateral common peroneal nerves (fibular nerve) in which, distal motor latency (DML),compound muscle action potential amplitude (CMAP), motor nerve onduction velocity (MNCV), conduction block and temporal dispersio were performed.3 - Minimal F - wave latency for bilateral median, right ulnar and bilateral fibular nerves.4 - H - reflex latency of bilateral tibial nerve.5 - Needle EMG for bilateral proximal and distal muscles of upper (first dorsal interosseous) and lower limbs (tibialis anterior and extensor digitorum brevis) in which insertional activity, spontaneous activity, motor unit action potential MUAP and interference pattern were applied.The results of this study revealed that acute inflammatory demyelinating polyneuropathy (AIDP) is the most frequent subtype followed by acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) respectively. Children with an age (3 - 6) years among other age groups are more vulnerable to develop GBS following infection in the preceding 3 months.The sensory nerve parameters (sensory latency is prolonged, SNAP is reduced and SNCV is slowed) are significantly changed between GBS children and control groups.The motor nerve parameters (DML is prolonged, CMAP is reduced and MNCV is slowed) are significantly changed between GBS children and control groups. Moreover among the GBS subtypes, there were significant differences in which the prolonged (DML) mostly in AIDP subtype, while the reduced (CMAP) mostly in axonal subtype was reported.Concerning minimal F - wave, it was absent in lower limbs more than upper limbs (46.6% and 26.6% respectively). Whereas H - reflex was absent in (73.3%) of children.Needle EMG had showed reduced recruitment in all GBS subtypes in addition to the evidence of spontaneous activity particularly in axonal subtype.In conclusion, this study detected that the AIDP was the most frequent subtype of GBS compared to others. Motor nerve conduction study is more useful than sensory nerve conduction study in GBS subtyping.Additionally Late responses (minimal F - wave and H - reflex) are very informative in the early course of the disease since they reflect the involvement of proximal nerve segment, which is more vulnerable to demyelination than terminal and intermediate nerve trunk segments, in addition CSF protein analysis showed no significant differences between GBS subtypes.

العلاقة بين مختلف مؤشرات فعالية المرض والحالة الوظيفية في عينة من المرضى العراقيين المصابين بالتهاب الفقار المقسط == Correlation Among Different Disease Activity Parameters and Functional Status in a Sample of Iraqi Patients with Axial Spondyloarthritis

Author name: اروى حمدان خضير
Supervisor name: نزار عبد اللطيف جاسم
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Axial spondyloarthritis is an inflammatory rheumatic diseasethat comprises the whole spectrum of patients with radiographic sacroiliitis(ankylosing spondylitis or radiographic axial spondyloarthritis) and withoutradiographic sacroiliitis (non - radiographic axial spondyloarthritis). It ischaracterized predominantly by inflammatory back pain and involvement ofthe spine and sacroiliac joints. Disease activity scores like Bath AnkylosingSpondylitis Disease Activity Index and Ankylosing Spondylitis DiseaseActivity Score are used for monitoring the disease activity, while BathAnkylosing Spondylitis Functional Index is used to evaluate the functionalstate of the patients.Aim of the study : to assess the correlation among disease activity scoresand the functional status of patients with axial spondyloarthritis andevaluating the discriminative power of Ankylosing Spondylitis DiseaseActivity Score (ability to reflect disease activity).Patients and methods : A cross sectional study enrolled a total of 251patients with axial spondyloarthritis , all of them were fulfilling the modifiedNew York criteria for Ankylosing Spondylitis and Assessment ofSpondyloarthritis International Society classification criteria for diagnosingspondyloarthropathy. Demographic data, disease duration, type of treatment,Bath Ankylosing Spondylitis Disease Activity Index, AnkylosingSpondylitis Disease Activity Score and Bath Ankylosing SpondylitisFunctional Index were calculated for the patients. They were alsoinvestigated for C - reactive protein and erythrocyte sedimentation rate.VIIResults : The mean age of the patients was (37.2 ± 8)years, males constitute 90.4% of them and the median disease duration was 7 (0.25_42) years. The disease activity scores were positively correlated with each other and with Bath Ankylosing Spondylitis Functional Index with significant p values(<0.005). There was no significant difference between areas under the curve for both Bath Ankylosing Spondylitis Disease Activity Index & Ankylosing Spondylitis Disease Activity Score - Erythrocyte sedimentation rate(0.94 and 0.93 respectively) in comparison to Ankylosing Spondylitis Disease Activity Score - C - reactive protein with area under the curve 0.57, when using patient global assessment as a reference guide to evaluate the ability of the these scores to reflect disease activity.Conclusions : There was a positive correlation among disease activity scores and functional status measured by Bath Ankylosing Spondylitis Functional Index. Ankylosing Spondylitis Disease Activity Score - Erythrocyte sedimentation rate was as good as Bath Ankylosing Spondylitis Disease Activity Index in discrimination of disease activity, while Ankylosing Spondylitis Disease Activity Score - C - reactive protein showed less accuracy in reflecting disease activity.

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

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

تقييم المعايير الالزاميه لسلامة المرضى في عينه من المستشفيات التعليميه في بغداد 2014 == Assessment of Critical Standards of Patients Safety in a Sample of Teaching Hospitals in Baghdad 2014

Author name: هناء عبد اللطيف عبد الرزاق
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:
Abstract: سلامة المريض هو نظام الرعاية الصحية الجديد الذي يؤكد على التقارير والتحاليل والوقاية من الخطا الطبي الذي غالبا ما يؤدي الى احداث الرعاية الصحية السلبية . مع الاعتراف بان لاخطاء الرعاية الصحية الاثر في 1 من كل 10 مرضى في جميع انحاء العالم . تعتبر منظمة الصحة العالمية بان سلامة المريض قلق مستوطن . في عام 1970 حددت الابحاث الاضرار التي تصيب 36% من الراقدين في وحدات طبية عامة و13% من الراقدين في وحدات العناية المركزة من المرضى غالبا ما يكون نتيجة للعلاجات . الهدف من هذه الدراسة هو اجراء تقييم اساسي لتحديد الفجوات في المعيار الالزامي لسلامة المريض في بعض المستشفيات التعليمية في بغداد وذلك لغرض ملئ هذه الفجوات في هذه المستشفيات بحيث تصبح جاهزة للانضمام في مبادرة المستشفى الصديقة لسلامة المريض .الطرق : اجريت دراسة مقطعية وصفية مع العنصر التحليلي باستخدام دليل تقييم سلامة المريض لمنظمة الصحة العالمية لسنة 2011 كاستبيانات لتقييم المعايير الحرجة التي هي المعايير الالزامية التي يجب ان تمتثل لها المستشفى لتصبح جاهزة للانضمام في مبادرة المستشفى الصديقة لسلامة المرضى . اخذت عينة من اربعة مستشفيات تعليمية عامة في بغداد . تم استخدام الاساليب الاحصائية واتجاه واحد انوفا للتعرف على الاختلافات بين المتغيرات .النتائج : اظهرت الدراسة ان مستشفى غازي الحريري للجراحات التخصصية قد حققت نسبة عاليه 80% في حين حققت مستشفى بغداد التعليمي متوسط 67% من مجموع درجات المعايير الالزامية .الاستنتاج : تم تقييم مستوى الامتثال الكلي للبنية التحتية لسلامة المريض في المستشفيات بانها عالية لكن الحصول على 100% من المعايير الالزامية في المجالات الاربعه ضروريه كي تعتبر في المستوى الاساسي من المستشفى الصديقة لسلامة المريض . | emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse health care events. Recognizing that health care errors impact 1 in every 10 patients around the world, the WHO calls patient safety an endemic concern. In 1970, research identified that 36% of admissions to general medical units and 13% of admission to intensive care units followed adverse events in which patients had been harmed most often as result of medications. The objective of this study is to conduct a baseline assessment to identify the gaps in the critical standard of patient safety in a sample of teaching hospitals in Baghdad for fill in these gaps so that these hospitals become ready to be enrolled in the Patient Safety Friendly Hospital Initiative .Methodology : A descriptive cross sectional study with analytic element was conducted in a convenient sample of four public teaching hospitals in Baghdad governorate using the checklist of WHO patient safety assessment manual, 2011 as questionnaires to assess the critical standards which are compulsory standards with which a hospital has to comply to become enrolled in the PSFHI. Convenience sample of four public teaching hospitals in Baghdad. Statistical methods and one way anova were used to identify the differences among the variables.Results : the study showed that Gazi Al - Hareery Specialized Surgeries Hospital had the highest percentage 80% while Baghdad Teaching Hospital with average 67% of the total scores for critical standards.Conclusion : The overall compliance level of patient safety infrastructure was evaluated high in the studied hospitals but acquiring 100% of critical standards in the four domains are essential to be considered at the basic level of PSFHI

العوامل المصاحبة للرضاعة من الثدي الغير حصرية : دراسة مقطعية (ممارسات ومعارف واتجاهات) == Factors Associated with Non - Exclusive Breast Feeding a Cross Sectional KAP Study

Author name: الهام رشيد حميد
Supervisor name: احمد سمير النعيمي
General topic: Medicine
Specific topic: Community Medicine
Degree: Master
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: ان لموضوع الرضاعه الحصرية من الثدي صلة بمجموعة من الابعاد المختلفة في حياة الام وهي من المواضيع ذات الاولوية بالنسبة لمنظمة الصحة العالمية في مسعاها لتقليل الامراض والوفيات بين الاطفال في شتى انحاء العالم . صممت هذه الدراسة المقطعية العرضية لتقييم انتشار الرضاعة من الثدي الغير حصرية بين 317 من الامهات العراقيات من اللواتي يمتلكن طفلا واحدا على الاقل يبلغ عمره (6 - 24) شهرا والذي كانت رضاعته من الثدي على الدوام. علاقة مواقف ومعرفة الام بممارسة الرضاعة الحصرية من الثدي . جمعت البيانات من خلال المقابلة المباشرة مع كل ام على حدة . اجريت الدراسة للفترة من الخامس عشر من شباط الى الخامس عشر من نيسان لسنة 2014 في مدينة بغداد / العراق في مركز السلام للرعاية الصحية الا ولية .البيانات تتعلق بالعوامل الاجتماعيه والديموغرافيه للام ومواقف الام ومعرفتها بالرضاعة من الثدي مثل العمر والمهنه, وقت البدء بالرضاعه من الثدي, الفتره المثلى للرضاعه الحصرية من الثدي, تكرار الرضاعه من الثدي, والرضاعه من الثدي بالعلن وبيانات اخرى. كشفت الدراسة بان النسبة المئوية للرضاعة الحصرية من الثدي كانت 14.5% وشكلت نسبة الرضاعه من الثدي غير الحصرية 85.5% من عينة الدراسة (مع وجود فترة ثقة تبلغ 95% من نسبة 81.6% - 89.4 % من السكان المرجعية) . كان التردد النسبي بين الامهات ممن قمن بالرضاعة من الثدي غير الحصرية اعلى على نحو واضح داخل المجتمعات ذات المستوى الاقتصادي والاجتماعي العالي حيث بلغ (89.3%) واقل بين الامهات داخل المجتمعات ذات المستوى الاقتصادي والاجتماعي المنخفض حيث بلغ (78.8%) . توضح الدراسة بان متوسط درجة الموقف للامهات اللواتي قمن بالرضاعة الحصرية من الثدي كان (76.2) اعلى بكثير منه بالنسبة للامهات اللواتي قمن بالرضاعة من الثدي الغير الحصرية (67.1 ). وكان متوسط درجة المعرفة بين الامهات اللواتي قمن بالرضاعة الحصرية من الثدي (32.1) اعلى بوضوح منه بالنسبة للامهات اللواتي قمن بالرضاعة الغير الحصرية من الثدي (28.8) غير ان الفروقات في المتوسط فشلت قليلا بالنسبة للدلالة الاحصائية .كان التردد النسبي للامهات اللواتي قمن بالرضاعة غير الحصرية من الثدي اقل بين الامهات الاكبر سنا (35 - 44) سنه. لم نكن هناك اية علاقة بين توفر المساعدة ( الدعم) من الاسرة والاقارب او الجيران في العناية بالطفل مع الرضاعة الحصرية من الثدي . كان التردد النسبي بين الامهات اللواتي يتلقين النصائح من الكوادر الطبية ضد اعطاء السوائل للطفل المولود حديثا اعلى بصورة ملحوضة داخل مجموعة الامهات اللواتي قمن بالرضاعـــة الحصرية من الثدي حيث بلغ (19.6%) من الامهات اللواتي قمن بالرضاعة غير الحصرية من الثدي والذي بلغ (7.7%). هنالك علاقة كبيرة بين الرضاعة من الثدي العلنية مع الاختطار الاقل للرضاعة غير الحصرية من الثدي. | The topic of exclusive breast feeding is related to a combination of different dimensions of mother's life. It's one of the priority topics for World Health Organization in its quest to reduce childhood morbidity and mortality worldwide.This cross sectional study was designed to assess the prevalence of non exclusive breast feeding among 317 Iraqi mothers with at least one baby aged (6 - 24) months who were ever breastfeed, the association of mother's attitude and knowledge on the practice of exclusive breast feeding.Data was collected through a direct interview with each mother. Those data include sociodemographic factors and concepts related to breastfeeding knowledge and attitude like age, occupation, time of initiation of breastfeeding, optimum duration of exclusive breastfeeding, breastfeeding frequency, breastfeeding in public and others. The study was conducted from the 15th of February to the 15th of April 2014, in Baghdad/ Iraq in Al - Salam primary health care center.The study revealed that the rate of exclusive breastfeeding was 14.5%. Non - exclusive breastfeeding constituted 85.5% of study sample (with a 95% confidence interval of 81.6% - 89.4 in the reference population). The relative frequency of non exclusive breastfeeding mothers was obviously higher among mothers in high SES (89.3%) and lowest for mothers with low socioeconomic status (78.8%). The study illustrates that the mean attitude score for mothers with exclusive breast feeding (76.2) was significantly higher than that for non exclusive breastfeeding mothers (67.1). Mean knowledge score for mothers with exclusive breastfeeding (32.4) was obviously higher than that for non exclusive breastfeeding mothers (28.8), but the differences in mean failed short of statistical significance. The relative frequency of non exclusive breastfeeding mothers was lowest among older age mothers (35 - 44 ) years. The availability of assistance (support) from family, relatives or neighbors in caring for the baby had no association with exclusive breastfeeding. The relative frequency of mothers having advice from medical staff against administration of fluids to the newborn was noticeably higher among exclusive breastfeeding group (19.6%) than those with non exclusive breast feeding (7.7%). Breastfeeding in public is significantly associated with a lower risk of non exclusive breastfeeding.

قياس كثافة معدن العظم ومستوى فيتاميهن د في عينة من المرض العراقيين المصابين بمرض بهجت == Bone Mineral Density and Serum Vitamin D Level in A Sample of Iraqi Patients with Behcet’s Disease

Author name: نور حسن عبد الرسول
Supervisor name: نزار عبد اللطيف جاسم
General topic: Medicine
Specific topic: Diseases - Joints
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Behcet’s disease (BD) is a multisystemic vasculitis characterized by recurrent orogenital aphthous ulcers , uveitis and skin lesions with chronic relapsing course. The chronicity and vasculitic background of Behcet's disease (BD) and the drugs used for its treatment may result in low bone mineral density. Low serum vitamin D status is closely associated with disease risk of BD.Aim of the study : To evaluate if there is a change in bone mineral density (BMD) and vitamin D level in Iraqi patients with BD.Patients and methods : In this case control study a forty two BD patients who were diagnosed according to International Study Group Criteria, and a total of 24 healthy persons recruited as a control group were enrolled in the study.Patients with histories of chronic disease affecting bone metabolism were excluded from the study. All female patients were premenopausal women.All BD patients and control group were subjected to detailed history taking & thorough clinical examination. Weights and heights of all subjects were recorded and body mass index (BMI) was calculated. A signed consent was taken from the individuals in both groups for admission in the study.Venous blood samples were obtained from all patients and controls for complete blood count, erythrocyte sedimentation rate (ESR), C - reactive protein (CRP), total serum calcium, total serum phosphorus and total serum alkaline phosphatase. Total serum 25 - hydroxyvitamin D (vitamin D) was assessed and levels ≥22 ng/ml were considered sufficient, while levels of <22 ng/ml were considered low. Bone mineral density measured in the lumbar spine (L2 - L4) and right femur neck using dual - energy x - ray absorptiometry (DXA) machine were performed.VIIResults : The mean age for BD patients was 34.2±9.6 years compared to 31.8±6.5 years in control group. Male represented 69% in BD and 70% of healthy controls. Mean disease duration for BD was 5.9±6.7 years.The mean BMI of BD patients was 27.1±4.5 Kg/m2 compared to 27.4±3.5 Kg/m2 in controls.The personal and clinical characteristics of study sample show no clinical significant difference between patients and controls apart from current smoking which was significantly associated with BD (P < 0.05). Osteoporosis and osteopenia that are found by T score at both spine (L2 - L4) and right femur neck were significantly higher in patients with BD (P<0.05). Serum vitamin D levels were significantly lower in patients with BD than controls (P<0.001). Serum vitamin D levels were significantly inversely correlated with BD duration.Conclusion : Osteoporosis, osteopenia and lower serum vitamin D levels are significantly more common in BD patients compared to controls.

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

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

الدراسة الكهروفسلجية وحالة الاجهاد التاكسدي في مرض تصلب الاعصاب المنتشر == NEUROPHYSIOLOGICAL STUDY AND OXIDATIVE STATUS IN MULTIPLE SCLEROSIS

Author name: عمار احمــد ثامـــر
General topic: Medicine
Specific topic: Neurophysiology
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
Key words:
  • قسم الفسلجة السريرية
First pages:
Abstract: تصلب الاعصاب المنتشر مرض التهابي مزمن مجهول السبب، يتصف بفقدان الميالين (النخاعين) مع الميل الى اصابة محور الليف العصبي، ويصيب الاشخاص في الاعمار المتوسطة من حياتهم مع ارجحية اصابة النساء اكثر من الرجال.اشتملت الدراسة على فحوص الكهروفسلجية والكيمياء الحيوية بالاضافة الى فحوص شعاعية، لمئة واثني عشر مريضا مشخصا سريريا وفقا لمعايير مكدونالد (McDonald's criteria) وقورنت نتائجهم مع مجموعة ضابطة تضم خمسين شخصا متطوعا ومعافي.احتوت الفحوص الكهروفسلجية دراسة كامن العصب البصري المثار، في حين اشتملت الفحوص الكيميائيحيوية على قياس تراكيز النحاس ، الزنك ، المغنيسيوم ونسبة الزنك/النحاس في مصل الدم بالاضافة الى الفحوص الشعاعية بواسطة جهاز الرنين المغناطيسي.اشارت النتائج الى وجود زيادة معنوية في متوسط كمون الموجه الموجبة (P100) ولمتوسط فرق الكمون بين العينين مع نقصان معنوي لمتوسط مدى المركب (N75 - P100) لمرضى تصلب الاعصاب المنتشر، في حين لم يوجد فرق معنوي في متوسط فرق المدى للمركب (N75 - P100) بين العينين عندما قورنت بقيم المجوعة الضابطة. وكان الاكثر شذوذا في فحص كامن العصب البصري المثار لمرضى تصلب الاعصاب المنتشر هو الاطالة في كمون الموجة الموجبة (P100) ثم الاطالة في فرق الكمون بين العينين ومن ثم التغير في شكل الموجة ثم الاختزال في متوسط فرق المدى المركب (N75 - P100)، في حين كان الاختزال في متوسط مدى المركب (N75 - P100) الاقل تغيرا. وذلك يرجح التاثير الرئيسي لازالة الميالين على التوصيل والمتمثل كهروفسلجيا بزيادة الكمون.كانت هناك علاقة خطية موجبة بين نسبة العجز السريري للمرضى حسب مقياس كرتزك (Kurtzke) مع كمون الموجة الموجبة (P100) بينما كانت العلاقة الخطية سالبة مع مدى المركب (N75 - P100). وهذا يعني ان زيادة معدل العجز للمرضى يترافق بزيادة في عمليات ازالة الميالين مع الميل الى اصابة محور العصب.اظهرت دراسة الفحص الشعاعي ان جميع المرضى كانت لديهم لطخات في جهازهم العصبي المركزي حسب الفحص بالنموذج الثاني، وان توزيع اللطخات لا يتاثر مع العمر او نوع مرض تصلب الاعصاب المنتشر. بالاضافة لذلك كانت هناك علاقة خطية موجبة بين العدد الكلي للطخات مع نسبة العجز السريري، كذلك زيادة نسبة العجز السريري لدى المرضى المصابين بنوع الازدياد الاولي والثانوي عن غيرهم من الانواع، اضافة الى زيادة عدد اللطخات عند المرضى المصابين بنوع الازدياد الاولي والثاني على غيرهم من انواع المرضى.اظهرت الدراسة زيادة معنوية في تركيز النحاس ونقصان معنوي في تركيز الزنك والمغنيسيوم ونسبة الزنك/النحاس في مصل الدم عند المرضى، مما يشير لوجود عملية اجهاد تاكسدي لدى مرضى تصلب الاعصاب المنتشر.بالاضافة لذلك وجد ان هناك علاقة خطية موجبة بين نسبة العجز السريري للمرضى حسب مقياس كرتزك (Kurtzke) مع تركيز النحاس بينما كانت العلاقة الخطية سالبة مع تركيز كل من الزنك والمغنيسيوم ونسبة الزنك/النحاس في مصل الدم عند المرضى.يستنتج من هذه الدراسة ما يلي : 1. ان فحص كامن العصب البصري المثار يعكس انحدار في وظيفة المجال الكلي للنظر ويؤيد الدراسات السابقة في كشف الافات غير الظاهرة سريريا.2. امكانية جعل عجز مرضى تصلب الاعصاب ان يكون بشكل محسا وموضوعيا عن طريق هذا الفحص الكهروفسلجي.3. ان فحص الرنين المغناطيسي يستطيع ان يكشف اللطخات اكثر في نوع الازدياد الاولي والثانوي اكثر من بقية انواع مرض تصلب الاعصاب المنتشر.4. ان نسبة العجز السريري لدى مرضى تصلب الاعصاب المنتشر بنوعيه الازدياد الاولي والثانوي هي اكثر من بقية الانواع.5. كلما ازداد عدد اللطخات في الجهاز العصبي المركزي للمرضى كلمزاادت نسبة العجز السريري.6. وجود اختلال في التوازن الطبيعي بين الجذور الحرة ومضادات الاكسدة مع الميل باتجاه زيادة الاجهاد التاكسدي لدى مرضى تصلب الاعصاب المنتشر.7. امكانية الوصول الى تقييم مستوى العجز الحركي للمرضى بطرق كيميائيحيوية مثل قياس تركيز النحاس، الزنك والمغنيسيوم في مصل الدم.8. التغيرات الحاصلة نحو الاجهاد التاكسدي واختلاف االعناصر الزهيدة قد يكون السبب للمرض، او مرحلة من مراحل الامراض او نتيجة للمرض، وبكل الحالات يظهر انه يلعب دورا فعالا في هذا المرض ويحتاج الى المزيد من الدراسات المستقبلية. | Multiple sclerosis (MS) is an idiopathic chronic inflammatory disease characterized by demyelination that can be associated with axonal degeneration and is the leading cause of a non - traumatic neurological disability in young adults, with female affection more than male. This study was designated to assess the (1) changes in Visual Evoked Potential (VEP), (2) their frequency in MS patients with and without visual symptoms, (3) evaluate the oxidative status and trace elements in patients with MS, (4) correlate the results of VEP and biochemical studies with the disability of MS patients, in addition to assessing the Magnetic Resonance Imaging (MRI) findings in these patients and their changes with the disability status of patients with MS.Electrophysiological and biochemical studies in addition to imaging examination, had been carried out on 112 patients (35 males and 77 females) who were assessed clinically having definite MS, and fulfilled McDonald's Committee criteria and 50 normal control subjects (17 males and 33 females).Electrophysiological study involved visual evoked potential (VEP) of both eyes, in which P100 latency and P100 interocular (IO) latencies with amplitudes of N75 - P100 complex in addition to P100 interocular amplitude were examined, while Biochemical assay involved the evaluation of the oxidative stress by measuring the concentration of serum Copper, Zinc and Magnesium, in addition to the zinc/copper ratio measurement.This study reported statistically significant increase in the P100 latency and interocular latency difference, and a significant decrease in the N75 - P100 complex amplitude, while there was no significant difference in the IO amplitude difference between MS patients and control.The changes in the P100 latencies were more frequently recorded then the IO latency difference, while IO amplitude difference, N75 - P100 complex amplitude and the wave - form of potentials were the least, which is due to the demyelination effects on nerve conduction, and collectively, VEP abnormality was present in (79.46 %) of the examined MS patients.The changes in the VEP parameters recorded in MS patients who have clinical visual presentations, and the changes were also present in those patients without visual clinical picture, which indicates the presence of subclinical lesions in the visual pathways, this fact makes VEP test as an important diagnostic aid in MS patients.Moreover, the results of this study present a positive correlation between the P100 latencies with the patients disability (EDSS score), while with a negative correlation between the amplitudes of VEP potentials with the same score of MS disability.Regarding, neuroimaging, the distribution of MS lesions in the CNS is neither correlated with the type of MS nor the age of patients. While, the patients disability is increased with the increase of total number of MRI lesions. However, patients disability is more with the progressive forms of MS in which more number of MRI lesions in their CNS than other forms of MS disease are detected.Biochemically, the study for oxidative stress reveal a highly significant increase in the serum copper, and a significant decrease in the serum zinc, magnesium and zinc/copper ratio levels.The association between different clinical presentations and biochemical findings was not evident, however, there was a positive correlation between the clinical disability score (EDSS) with the serum concentration of Copper, and a negative correlation with that of Zinc, Magnesium and Zinc/Copper ratio.In conclusion, this study shows : 1 - VEP study can reveal a suspected deterioration of visual function and objectivate unsuspected clinically silent lesions.2 - Disability and physical deterioration of MS patients can be quantified and clarified by using this electrophysiological test. 3 - It manifests that MRI reveals CNS lesions in progressive forms more than other forms of MS.4 - Patients with the progressive forms associate with more disability.5 - The patients disability correlates with the total number of MRI lesion in MS patients.6 - It suggested the existence of a clear imbalance in oxidant - antioxidant status, towards an increasing oxidative state in MS patients.7 - Physical disability of MS patients can also be quantified by biochemical studies and serum Copper, Zinc, Magnesium and Zinc/Copper ratio levels can be used as biological markers of patients disability. 8 - The changes in the oxidative state and trace elements metabolism in MS, may be the cause behind the disease, a stage during its pathogenesis, or as a results of it, in all states they seems to have a potential role in this disease and need further studies to clarify it.

معدل انتشار الداء السكري لدى مرضى الانسداد الرئوي المزمن في المرحلة الشديدة والشديدة جدا == The Prevalence of Diabetes Mellitus Type 2 in chronic obstructive pulmonary disease Patients with Severe and very severe Stage of the Disease

Author name: نادية عبد الكريم حمدان
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: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide.. There is an evidence to support a connection between COPD and diabetes mellitus Type 2 (T2DM). T2DM affects 2 - 37% of COPD patients, with results being highly variable between studies.Objective : To determine the prevalence of T2DM among COPD patients in severe and very severe stages of COPD patients. To assess the risk factors affecting the prevalence of T2DM among COPD patients. Subjects and methods A cross sectional study was conducted on 140 patients with COPD attending Out - patient and Inpatient of Respiratory Unit at Baghdad Teaching Hospital. The data were collected between the10th of October 2016 to the 10th of August 2017. These data included demographic parameters such as : age, sex, educational status, body mass index (BMI), smoking habit, and respiratory parameters from history& clinical examination. Spirometry was used to assess the severity of COPD patients. Random blood sugar testing was used for identification of COPD patients having T2DM when they are not clear or not known as a case of T2DM previously.Results : The prevalence of T2DM among COPD patients was 19.38%. (The prevalence of DM in those with severe stage was 10.9%, while in very severe stage was 35.4%).The prevalence of T2DM was higher in males than in females. The prevalence of T2DM was increased in the elderly COPD patients (>61 years). Increasing with increased BMI, and also VIP a g eincreased more among current smokers followed in order by former smokers and never smokers. Lung function tests decline more in COPD patients with presence of T2DM.Conclusions : Diabetes Mellitus Type 2 is more prevalent among COPD patients; it increased with increased severity of the COPD patients and subjects with DM are at increased risk of declining pulmonary function among COPD patients.

تقييم الطفرات الوراثية ل BRAF, IDH1 وفقدان 1p/19q في الاورام الدبقية للمرضى القراقيين : دراسة نسيجية مناعية كيميائية مع التهجين الموضعي المتفلور == Assessment of BRAF, IDH1 mutations and 1p/19q loss in Gliomas in Iraqi patients. Immunohistochemical and Fluorescence in Situ Hybridization study

Author name: زهراء مروان شعبان العمر
Supervisor name: سالم رشيد حمودي العبيدي
General topic: Medicine
Specific topic: Diseases - Genetics
Degree: Doctorate
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : - Gliomas account for almost 80% of primary malignant brain tumors, so, they considered the most common primary malignant brain tumors in adults. The major types of glial tumors are astrocytomas, oligodendrogliomas, and ependymomas. Isocitrate dehydrogenases 1, BRAFV600E and 1p/19q co - deletion are important molecular markers nowadays for diagnosis and prognosis of gliomas. Isocitrate dehydrogenase mutation might be encounter in the low - grade glioma, occurs in early stages of development and directs the progression of the tumor to a higher grade. BRAFV600E is a point mutation, resulting in a valine to glutamic acid substitution at position 600 and this mutation occurs more in pediatric gliomas but less frequent in adult gliomas. Co - deletion of 1p/19q results from a non - balanced translocation t (1 : 19) (q10 : p10) with subsequent loss of one of the derivative chromosomes and highly associated with oligodendroglial tumors morphology and improved survival.Aim of the study : - To assess the frequency of Isocitrate dehydrogenases 1 and BRAF mutations in Iraqi patients with gliomas by immunohistochemical study, to correlate their immunoreactivity with some clinicopathological parameters. To validate frequency of 1p/19q loss by Fluorescence in Situ Hybridization study and correlate the deletion with the some parameters.Patients and Methods : Formalin fixed, paraffin embedded tumor tissue from 66 patients with different grades of intracranial gliomas of both gender and all age groups in Baghdad city were collected in this retrospective selective study. Ten normal brain tissue samples in form of paraffin blocks took from forensic medicine unit. New technique used, that is manual tissue microarray, in which twenty - four small cores (each measure 2mm) of represented tissue made, then cut by microtome. IHC detection of Isocitrate dehydrogenases 1 and BRAFV600E antibodies did by Dako autostainer link 48. Assessment of co - deletion of 1p/19qAbstractIII

حدوث الارتباط بين نمط شد البطين الايسر في تخطيط القلب الكهربائي والاصابة بامراض الشراين التاجية والجلطات الدماغية للمرضى المصابين بارتفاع ضغط الدم الشرياني == The Association of Electrocardiographic Left Ventricular Strain Pattern and Coronary Artery Disease and Cerebrovascular Accident in Systemic Hypertensive Patients

Author name: قيس نعمة رحيم
Supervisor name: حسن الفرحان
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: خلفية البحث : المرضى الذين يعانون من ارتفاع ضغط الدم وتضخم البطين الايسر قد يوجد لديهم تغيرات في التخطيط الكهربائي للقلب وهذه التغيرات قد تتمثل بعلامات تضخم البطين الايسر للقلب المتلازمة بعلامات الشد على البطين الايسر او بدونها وهولاء المرضى يكونون اكثر عرضة للاصابة بامراض شرايين القلب وجلطات الدماغ لذلك تعتبر هذه العلامات هي مؤشر للاصابة بامراض شرايين القلب والجلطات الدماغية, الهدف من الدراسة : اثبات ان التغيرات في التخطيط الكهربائي في القلبfixed ST depression) inversion in lead (I, avl, v5 and v6) (T التي تطرا على المرضى المصابين بارتفاع ضغط الدم وتضخم البطين الايسرتعتبر كمؤشر للاصابة بالجلطات الدماغية وامراض الشراين التاجية.المرضى والطرق : اجريت هذه الدراسة في المركز العراقي لامراض القلب, مدينة الطب, بغداد, العراق, للفترة من كانون الثاني 2012 لغاية الاول من كانون الثاني 2017 .المرضى اللذين تم تشخيص اصابتهم بمرض ارتفاع ضغط الدم واثبات اصابتهم بتضخم البطين الايسر تم شمولهم بهذه الدراسم الوصفية ,ايضا تم تشخيص بقية الامراض المصاحبة مثل اصابات الاوعية الدماغية وامراض الشراين التاجية. تم اجراء تخطيط القلب الكهربائي, الايكو والتداخل القسطاري لجميع المرضى.وقد جمعت كل المعلومات من ملفات المرضى الراقدين في المركز العراقي لامراض القلب ,مدينة الطب ,بغداد ,العراق. النتائج : شملت الدراسة 401 مريض [262 (65,3 %)ذكور و139 (34,7%)اناث] مصابين بمرض ارتفاع ضغط الدم. تراوحت الاعمار من (94 - 40) ومعدل الاعمار (54). بعد اجراء التداخل القسطاري وجد ان 207 (51,6%)من المرضى يعانون من امراض الشراين التاجية بينما 194 (%48,3)من المرضى لايعانون من امراض الشراين التاجية وكانت الدلالة الاحصائية (P= 0. 625). بالنسبة للاصابة بالجلطات الدماغية, وجد ان 280 (69,8%)مريض قد تعرضو لحدوث الجلطات الدماغية بينما 121 مريض لم يتعرضو لحدوث الجلطات الدماغية, والدلالة الاحصائية كانت (P <0.001). اما بالنسبة للتغيرات في التخطيط الكهربائي للقلب على مستوى المرضى فكانت النتيجة كالاتي, 301 (75%)مريض وجد لديهم تغيرات في التخطيط الكهربائي للقلب بينما 100 (25%)مريض لم يكن لديهم تغيرات في التخطيط الكهربائي للقلب. وكانت الدلالة الاحصائية (P <0.001). من ناحية اخرى اضهرت النتائج دلالة احصائية واضحة (P <0.001) عند المقارنة بين التغيرات في التخطيط الكهربائي للقلب ونتائج التداخل القسطاري للمرضى وكانت على النحو الاتي, 205 (51,1%)مريض لديهم تغيرات في التخطيط الكهربائي للقلب ولديهم امراض الشراين التاجية بينما 96 (23,9%)مريض لديهم تغيرات في التخطيط الكهربائي للقلب وليس لديهم امراض الشراين التاجية اثنان من المرضى ليس لديهم تيغيرات في التخطيط الكهربائي للقلب ولديهم امراض الشراين التاجية بينما 98 (24,4%)مريض ليس لديهم تغيرات في التخطيط الكهربائي للقلب ولم يشخصوا بامراض الشراين التاجية. من ناحية اخرى اضهرت النتائج دلالة احصائية(P <0.001) . خلال المقارنة بين التغيرات في التخطيط الكهربائي للقلب والاصابة بالجلطات الدماغية على مستوى المرضى وكانت النتيجة كالاتي, 279 (69,5%)مريض كانت لديهم تغيرات في التخطيط الكهربائي للقلب وتم تشخيصهم بالاصابة بالجلطة الدماغية بينما 22 (5.4%)مريض كانت لديهم تغيرات في التخطيط الكهربائي للقلب ولكن لم يصابو بالجلطة الدماغية. من ناحي اخرى وجد ان مريض واحد لم يجد لديه تغيرات في التخطيط الكهربائي للقلب ولكن تطورت حالته واصاب بالجلطة الدماغية بينما 99 (24,6%)مريض لم يجد لديهم تغيرات في التخطيط الكهربائي للقلب وايضا لم يصابو بالجلطة الدماغية. الاستنتاجات : تم التوصل الى ان معضم المرضى الذين لديهم تغيرات في التخطيط الكهربائي للقلب fixed ST depression وinversion in lead (I, avl, v5 and v6) (T هم مؤهلين للاصابة بالجلطات الدماغية وامراض الشراين التاجية ويمكن استخدام هذة التغيرات للتنبؤ بالاصابة بالجلطات الدماغية | Background : Patients diagnosed with hypertension and left ventricular hypertrophy could presented with electrocardiographic changes including criteria of left ventricular hypertrophy, and left ventricular strain pattern( fixed ST depression and T inversion in leads I, avL, V5&6) Aim of the study : To study the impact of electrocardiographic left ventricular strain pattern in hypertensive patient as predictor for coronary artery disease and cerebrovascular accident development.Patients and methods : a cross sectional hospital based study was conducted during 2012 - 2017 at Iraqi center for heart diseases including hypertensive patients with normal ECG or LV strain pattern criteria, all patients underwent coronary angiography and the data were collected from patients files including age, sex, history of hypertension, coronary artery disease and cerebrovascular accident. The result of electrocardiography, echocardiography and coronary angiography were reviewed and recorded. Results : The records of 401 hypertensive patients [262(65.3%) males/139(34.7%) females] were included in this study. The ages ranges 40 - 60year, while the ages mean ±SD of patients were (60.07 ± 10.83year). The results of coronary angiography showed that there are 207(51.6%) patients were positive for coronary artery disease while 194(48.3%) patients were with normal coronary angiography. History of cerebrovascular accident was found in 280(69.8%) patients, while 121 (30.1%) patients had no history of cerebrovascular accident.301(75%) patients had electrocardiographic changes of left ventricular strain pattern and 100 (25%) patients had no electrocardiographic changes of left ventricular strain pattern. The relation between electrocardiographic left ventricular strain pattern and Coronary Angiography among patients was analyzed. 205(51.1%) patients were positive to electrocardiographic left ventricular strain pattern strain and for coronary artery disease in coronary angiography. This study showed highly significant relation between electrocardiographic left ventricular strain pattern and coronary artery disease among studied group of patients (P <0.001). The relation between electrocardiographic left ventricular strain pattern and cerebrovascular accident among patients was analyzed. 279 (69.5%) patients were positive for electrocardiographic left ventricular strain pattern and cerebrovascular accident. The study shows highly significance in relation between electrocardiographic left ventricular strain pattern and cerebrovascular accident among studied group (P <0.001). Conclusions : The current study conclude that the electrocardiographic left ventricular strain in hypertensive patients is highly associated with coronary artery disease and cerebrovascular accident, therefore the electrocardiographic left ventricular strain could be considered a predictor for coronary artery disease & cerebrovascular accident development in patients with hypertension which could be considered as criteria for risk stratification of hypertensive patient mandate a close and precise follow up and control of patients risk factors
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