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التقييم السريري ورصد قياس التاكسج خلال الليل للمرضى المعرضين لخطر توقف التنفس الانسدادي اثناء النوم == Clinical Evaluation and Overnight Oximetry Monitoring of High Risk Patients for Obstructive Sleep Apnea

Author name: محمد شاكر حسن
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Obstructive sleep apnea OSA is a condition of sleep related pharyngeal collapse, in which recurrent episodes of upper airway occlusion occur during sleep causing diminution (hypopnea) or cessation of airflow (apnea) in the pharynx provoking arousals and sleep fragmentation , resulting in daytime sleepiness. Aim of study : To evaluate patients at high risk of OSA, by clinical parameters and overnight oximetry monitoring.Patients and Method : Cross sectional study of 20 patients, 12 male and 8 female with high probability of OSA, attended to respiratory clinic in Baghdad teaching hospital suffering from excessive daytime sleepiness, they were clinically evaluated plus using overnight oximetry as an objective testing method.Results : 20 patients only complete the study, 12 male (60%), 8 female (40%), 4 patients >60 years old (20%), 9 patients 40 - 59 (45%), and 7 patients 20 - 40 (35%), smokers were 11 (55%), patients with hypertension were 8 (40%) all of them with regular anti - hypertensive drugs , 2 (10%) patients were hypothyroidism according to thyroid function test .DI show significant correlation with AHI, BMI, Baseline SPO2 and gender, while no significant correlation with age.AHI show significant correlation with baseline SPO 2 and gender, and no correlation with BMI and age.Conclusion : Desaturation index assessed by nocturnal pulse oximetry maintain its utility as a screening method in the recognition of obstructive sleep apnea in morbidly obese patients with high clinical pretest suspicion, DI > 4% when combined with appropriate clinical evaluation, could be used as an initial diagnostic test for OSA.Obesity is a major risk factor and almost all suspected patients with OSA are obese.

تقييم مرضى توسع القصبات من الناحية السريرية والاشعاعية == Bronchiectasis Clinical and Radiological Assessment

Author name: لمى جواد كاظم
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: BACKGROUND : Bronchiectasis is relatively common disease in developing countries, HRCT is the method of choice for the morphologic evaluation of patients with bronchiectasis.OBJECTIVE : To assess the clinical profile of patients with bronchiectasis and evaluate the clinical relevance of high - resolution CT findings in patients with bronchiectasis by using a quantitative high - resolution CT to assess extent of bronchiectasis, severity of disease, bronchial wall thickening, and presence of smallairway abnormalities and mosaic pattern. METHODS : A cross sectional study of 50 consecutive patients with bronchiectasis in respiratory department of Baghdad teaching hospital between 1st of September 2015 and end of April 2016, clinical features of bronchiectasis and results of HRCT were assessed and correlated. RESULTS : Mean age of participants (70% males, 30% females) was 53.44 ± 9.6 years and 52% of them were lifetime non - smokers. Most common identified causes of bronchiectasis were tuberculosis (48%), pneumonia (18.4%) and cystic fibrosis (4%).The predominant symptoms were productive cough (82%), dyspnea (94%), fever (74%) and chest pain (72%). The most common findings on chest examination were crackles (86%) and wheeze (74%). Types of bronchiectasis in HRCT were cystic in 62%, varicose in 32%, tubular 6%, Involvement was multilober in 46%, diffuse in 18%and right upper lobe in 18%. Of 50 patients, 92% have bronchial wall thickening, whereas 62% show small air way abnormalities, 56%have mosaic pattern. Patients with cystic disease have significant association with productive cough with large amount of sputum, hemoptysis, Crackle and Clubbing (p < 0.05), patients with small air way abnormalities in HRCT have significant correlation with chest pain, dyspnea and amount of sputum (p < 0.05). Patient with diffuse lobe distribution on HRCT have daily significant quantities of sputum production (P < 0.05), while multilober distribution have a significant association with dyspnea and wheeze (P < 0.05).CONCLUSION : Clinical finding in patients with bronchiectasis have significant correlation with HRCT chest finding which be used for monitoring activity of disease.Key words : bronchiectasis, HRCT, amount of sputum , bronchial wall thickening, mosaic pattern. Lobes distribution

المضاعفات الرئوية بعد عمليات البطن الجراحية في الردهات الجراحية لمستشفى بغداد التعليمي == Post - abdominal surgery respiratory complications at surgical wards of Baghdad teaching hospital

Author name: رغيد حازم فاضل
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: Background : Postoperative pulmonary complications (PPCs) followingabdominal surgery are frequent and associated with increased morbidity andmortality, and hospital length of stay.Study objective : The aim of the study was to identify pulmonarycomplications following abdominal surgical procedures and to identifyperioperative risk factors associated with the development of thesecomplications.Patients and Methods : this is a hospitalized - based cross - sectional study. Arandomly selected sample of 52 patients who developed pulmonarysymptom(s) following abdominal surgical procedures at surgical wards ofBaghdad teaching hospital from November 2015 to June 2016. Perioperativedata were collected through interview and char review, and their associationwith the occurrence of PPCs were analyzed. Cross tabulation and Chi - squaretest were used to analyze the discrete variables and their relationship to the PPCs while one way ANOVA was used to analyze the continuous variables and their relationship to the PPCs.Results : The following PPCs were identified : 33 pneumonia, 5 acute respiratory failure, 4 basal atelectasis, 3 pleural effusion, 3 pulmonary embolism, 3 exacerbation of COPD or asthma and 1 pulmonary edema.Perioperative risk factors associated with development of PPCs were identified : current smoking history (p value = 0.042), preexisting comorbid disease (p value = 0.001), emergency surgery (p value = 0.045), upper abdominal (p value = 0.012) or both upper/lower abdominal incisions (p value = 0.026), duration of surgery ≥ 3 hours (p value = 0.049) and NG tube placement postoperatively (p value = 0.043). Conclusions : The most common PPC following abdominal surgery is pneumonia. There is no significant difference between laparoscopy and laparotomy in term of PPCs following abdominal surgery. Six perioperative risk factors associated with the occurrence of PPCs following abdominal surgery were identified which are current smoking history, preexisting comorbid diseases, emergency surgery, upper abdominal or both upper/lower abdominal incisions, duration of surgery more than or equal to three hours and NG tube placement postoperatively.

تقييم استخدام مضادات التخثر الوقائي لمنع الجلطات الدموية الوريدية في المرضى البالغين الراقدين في مستشفى بغداد التعليمي == Assessment of Prophylactic anticoagulant use for prevention of venous thromboembolism in adult inpatients at Baghdad teaching hospital

Author name: عمار محمد عبد الرضا
Supervisor name: عبد الله جنجر الفرطوسي
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: Deep venous thrombosis is one of the most problems that faces hospitalized patients and if does not treated or prevented well may lead to pulmonary embolism and it ’s complications and as a consequence increase cost effectiveness, the duration of admission and mortality.Aim of study : Evaluate the use of prophylactic anticoagulants for prevention of DVT and PE in various medical, surgical, and gynecological wards.Patients and methods : Cross sectional study of 374 patients who are indicated for VTE prophylaxis admitted to medical, surgical and gynecological wards in Baghdad teaching hospital and were assessed wither they took VTE prophylaxis or not , had any contraindications and if they developed DVT and PE during admission.Results : 374 patients involved in the study, 152 males (41%) and 222 females (59%).195 patients (52%) received VTE prophylaxis and the rest 179 patients (48%) did not received it and from the latter only 25 patients (14%) had contraindications that prevent the use of VTE prophylactic.Only 4 patients developed DVT and 1 patient developed PE in those who received VTE prophylaxis compared to 13 patients developed DVT and 7 patients developed PE in those who did not received VTE prophylaxis.There was inverse relationship between receiving VTE prophylaxis and development of DVT and PE.Conclusion : The study reveals that there was an underuse of prophylactic anticoagulants for patients who are indicated for VTE prophylaxis in medical, surgical and gynecological wards

دراسة الحصيلة التشخيصية لخزعة الرئة المفتوحة في المرضى المشتبه باصابتهم بمرض الرئة الخلالي == The Diagnostic Yield of Open Lung Biopsy in Patients with Suspected Interstitial Lung Disease

Author name: سجى علي حسين
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : The diagnosis of interstitial lung disease (ILD) is frequently delayed, because clinical clues are neglected and respiratory symptoms are ascribed to more common pulmonary diagnosis such as chronic obstructive pulmonary disease in the primary care setting. Objective : The present study was aimed to evaluate the yield of open lung biopsy in patients with suspected ILD. Subjects and methods : Thirty five patients were admitted with suspected interstitial lung disease (ILD), and scheduled for open lung biopsy (OLB) in Ghazi AL - Hariri hospital for surgical specialty, were the cohort of this study. Data collected from the patients files (who subjected to open lung biopsies which had been histopathologically studied) in the period from 1st of January 2013 through 31st of May 2015 and were studied retrospectively.Results : There were 11 (31.4%) males and 24( 68.6%) females, the mean age was 46±14 years , dyspnea was the common presenting symptoms in patients 24(68.6%) , dry cough was the presenting symptoms in10 (28.6%)patients , bilateral diffuse crepetations were heard in 20 (57.2%) patients, bilateral fine basal crepitation were heard in 11 (31.4%) , clubbing with bilateral fine basal crepitations heard in 4 (11.4%) ,chestx - rays findings were : lower zone infiltration in 11 (31.4%),reticulonodular infiltration in 10 (28.6), nodular infiltration in8 (22.9%) and opacities in6 (17.1%). CT findings were : basal infiltration in11 (31.4%), reticulonodular infiltration in 10 (28.6%), nodular infiltration in 8 (22.9%) and ground glass appearance s in 6 (17.1%). Histopathological examination (obtained from Open lung biopsy) results were : had usual interstitial pneumonia (idiopathic pulmonary fibrosis) 21(60%) ,7 (20%) metastasis, 5 (14.3%) pulmonary TB and 2( 5.7%) broncho - alveolar cell carcinoma.Conclusion : Open lung biopsy can safely be performed in patients with suspected interstitial lung disease. It gave a high diagnostic yield and alters the diagnosis and management in a significant number of patients

التنبؤ بوسائل غير باضعة عن ارتفاع ضغط الدم الرئوي في مرض الانسداد الرئوي المزمن عن طريق تخطيط صدى القلب وعلاقته المشتركة مع شدة المرض في مستشفى بغداد التعليمي == Noninvasive Prediction of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease By Echocardiography and It's co - Relation With The Severity of Disease (Hospital Based Study)

Author name: رنا احسان عبد الجبار
Supervisor name: عدنان محمد 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: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is a chronic condition which affects the respiratory system and worsens over time. Pulmonary hypertension, one of the major and under diagnosed complications of COPD which have a great impact on outcome of the disease and associated with frequent exacerbations and poor prognosis.Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate changes related to pulmonary hypertension in COPD.Aim of Study : To study pulmonary artery systolic pressure and TAPSE(Tricuspid annular plane systolic excursion) in patients with COPD by 2D ECHO Doppler and correlate them with severity of COPD.Method : Cross sectional study was conducted on 50 COPD patients in Baghdad teaching hospital (age>40 year)from first of January to the end of June, 2017.First, the diagnosis of COPD was confirmed and evaluated for staging by history, clinical examination , and spirometry.All patients have undergone ECG and 2D echocardiography and systolic pulmonary artery pressure and Tricuspid Annular Plane Systolic Excursion (TAPSE) were calculated. Patients with other cardiac or respiratory problems (asthma, pulmonary TB, lung malignancy, connective tissue diseases, interstitial lung disease, ischemic heart disease, left side heart failure) were excluded from this study.VIIResults : Study of PASP by TR jet with the use of 2D ECHO on 50 patients with COPD showed that 20 patients had normal echo study , mild increase in PASP was found in 15 patients, moderate 11, and severe increase in 4 patients.Study of TAPSE by 2D ECHO showed that 35 patients had normal TAPSE values ,while others 15 had abnormal values classified as mild ,moderate, and severe : 3,9,3,respectively.There were significant associations between echo findings of increasing PASP and abnormal TAPSE, with decrease in FEV1, and oxygen saturation measured by pulse oximeter, duration since COPD was diagnosed and MRC dyspnea scale.Conclusion : There is a high incidence of pulmonary hypertension with increasing severity of COPD . Echocardiography is useful and effective tool for detection of PHT secondary to COPD.

تحليل نتائج ناظور القصبات المرن لردهة الامراض الصدرية والتنفسية في مستشفى بغداد التعليمي لسنة 2015 == Analysis of bronchoscopic findings in respiratory unit at Baghdad teaching hospital in 2015

Author name: حيدر منذر عبود
Supervisor name: محمد وهيب سلمان العبيدي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Internal Medicine Department
Language: English
University location: Baghdad
First pages:
Abstract: Fiber - Optic bronchoscopy is a safe and useful diagnostic and therapeutic tool for the management of the pulmonary diseases. Aim of study : To analysis the outcome of fiberoptic bronchoscopy in respiratory unit at Baghdad teaching hospital in 2015.Patients and Methods : A retrospective study was done to find out the demographic profiles, indications, bronchoscopic findings, diagnosis and complications of the patients who underwent bronchoscopic examination. 151 patients underwent bronchoscopies in the respiratory unit at Baghdad teaching hospital in one year (2015).Results : Amongst the 151 patients, commonest indication of bronchoscopy was radiological opacity found in 70.20% of patients, followed by diffuse pulmonary infiltrates 18.54% of patients. Most common clinical presentation of the patients was Cough (91%), followed by dyspnea (59%).Out of 151 patients, 93 patients (61.59%) were males, 58 patients were current smokers, 23 patients were non - smokers and 12 patients were former smokers.A 58 patients (38.41%) were females, 18 patients were current smokers, 35 patients were non - smokers and 5 patients were former smokers.The patient's age range from 17 to 77 years, the mean age of males were 58 ± 9 and for females were 54 ± 12.The most common finding on bronchoscopy was endobronchial growth found in about 22.52% of patients. Malignancy was seen in 55.6% cases, while Tuberculosis seen in 10.5%.Conclusion : Fiberoptic bronchoscopy is extremely useful in finding specific etiologies of various lung diseases

تقييم كثافة العظام لدى مرضى المصابين بالانسداد الرئوي المزمن

Author name: سجا محمد كاظم
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:

ارتفاع ضغط الدم الرئوي في مرضى السل الرئوي النشط == Pulmonary Hypertension in Active Pulmonary Tuberculosis Patients

Author name: مروة بسام عيدان
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: الخلفية : السل الرئوي هو واحد من اكثر الامراض المعدية شيوعا التي تواجهها في الممارسة السريرية، واكثر من ذلك في البلدان النامية. وقد تم الابلاغ عن عدد قليل جدا من الدراسات بشان ارتفاع ضغط الدم الرئوي في السل الرئوي النشط اهداف الدراسة : لتقييم حدوث ارتفاع ضغط الدم الرئوي في مرضى السل الرئوي النشط في غياب امراض الرئة الاخرى او امراض القلب الاولية .المواد والطرق : خلال الفترة من 1 ديسمبر 2016 الى 30 مايو 2017 اجريت دراسة مستعرضة على 50 مريضا بالسل الرئوي النشط. لجميع المرضى، تاريخ مفصل، الفحص السريري الدقيق، تخطيط القلب , الاشعة السينية للصدر، واختبارات الدم الروتينية. جميع المرضى الذين تم تقييمهم عن طريق دوبلرصدى القلب خلال الصدر بما في ذلك تقدير الضغط الانقباضي الشريان الرئوي وثلاثي الشرف الحلقي خطة الحلقة الانقباضي النتائج : . وجد انه من 50 مريض بالسل الرئوي النشط، كان 4 (8٪) ضغط الشريان الانقباضي الشريان الرئوي ≥40 ملم زئبق، اثنان منهم كان تمدد البطين الايمن <16ملموكان هناك ارتباط كبير بين مرضى السل وارتفاع متوسط العمر، (ع = 0.01 )وارتفاع معدل تعديل ضيق مجلس البحث الطبي (ع <0.0001)، والام في الصدر (ع = 0.01)، وانخفاض تركيز الاوكسجين الدم (ع = 0.001) وتسارع دقات القلب الجيبي (ع = 0.01) وانصباب التامور (ع = 0.01). لا توجد فروق ذات دلالة احصائية بين مرضى السل مع وبدون ارتفاع ضغط الرئوي فيما يتعلق بتاريخ البتدخين واستنتاجات اشعة الصدر فيما يتعلق بالمشاركة من جانب واحد وثنائية الجانب وافة تجويفية.الاستنتاج : ارتفاع ضغط الدم الرئوي بين مرضى السل الرئوي النشط في غياب امراض الرئة الاخرى او امراض القلب الاولية ليس بالامرالغير شائع. | Background : Pulmonary tuberculosis is one of the commonest infectious diseases which are encountered in clinical practice, more so in developing countries. Very few studies have been reported regarding the pulmonary hypertension in active pulmonary tuberculosis. Aims of study : To assess the incidence of pulmonary hypertension in active pulmonary tuberculosis patients in the absence of other lung disease or primary cardiac disease. Materials and Methods : During the period from 1st of December 2016 to 30th of May 2017, a cross - sectional study was done on 50 patients with active pulmonary tuberculosis. For all patients, detailed history, careful clinical examination, electrocardiography (ECG), chest x ray (CXR), and routine blood tests were done. All patients evaluated by transthoracic Doppler echocardiography including estimation of pulmonary artery systolic pressure (PASP) and tricuspid annular plane systolic excursion (TAPSE). Results : Among 50 active pulmonary tuberculosis (PTB) patients, 4 had pulmonary artery systolic pressure (PASP) ≥40 mm Hg, 2 of them had right ventricular dilation and TAPSE <16mm. The incidence of pulmonary hypertension (PHT) among active pulmonary tuberculosis (PTB) patients was 8%.There was a significant association between PTB patients with PHT and higher mean age (p=0.01), higher Modified Medical Research Council dyspnea scale (p<0.0001), chest pain (p=0.01), lower oxygen saturation (SpO2) (p=0.001), sinus tachycardia (p=0.01) and Pericardial effusion (p=0.01). No significant differences between PTB patients with and without PHT regarding smoking history and CXR finding of pulmonary tuberculosis lesion regarding unilateral and bilateral involvement and cavitary lesion. Conclusion : Pulmonary hypertension among active pulmonary tuberculosis patients in the absence of other lung disease or primary cardiac disease is not uncommon in this study.

طراز الامراض التنفسية في مستشفى الحسين التعليمي في مدينة السماوة == The Pattern of Respiratory Diseases in Al - Hussain Teaching Hospital in Samawa City

Author name: مثنى فيصل الظالمي
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Respiratory diseases are responsible for a major burden of morbidity and untimely death, with conditions such as asthma, pneumonia, tuberculosis, and chronic obstructive pulmonary disease the most important in world health terms..Objective : to estimate the pattern and to determine the incidence of respiratory diseases among patients admitted to medical wards.Patients and Methods : A retrospective study carried out at AL Hussain Teaching hospital in Samawa city )ALMuthana governoret) during a period from October 2013 to July 2014. 951 patient of both genders were enrolled in this study.Results : The mean age of the studied patients was 49.4 ± 18.1 (range : 15 - 99) years; the higher proportion of patients 244/951 (25.7%) aged > 60 years and the least proportion of patients 75/951 (7.9%) aged < 20 year females were the dominant gender among the studied group; 510/951 (53.6%) and the remaining 441/951 patients (46.4%) were males, with a female to male ratio of 1.16 : 1, Smoker patients were 263/951 represented 27.7% of the studied group, Asthma was the more frequent respiratory disease among the studied group (33.3%) followed by Pneumonia in (22.4%),andChronic obstructive pulmonary disease in (22.1%) . The higher mortality rate was reported among the patients with lung cancer (33.3%), followed by ILD (12.5%) .Conclusion : female was the dominant gender among studied group. Asthma was the more prevalent respiratory disease followed by Pneumonia, .the longer duration of admission was reported in patients with lung abscess.The higher mortality rate was reported in patient with Lung cancer followed by Interstitial Lung Disease and Chronic Obstructive Pulmonary Disease.

حدوث الاصابة بهشاشة العظام في مرضى الانسداد الرئوي المزمن في مستشفى بغداد وعلاقته بمختلف العوامل الخطره == Occurance of Osteoporosis in COPD Patients in Baghdad Teaching Hospital and Its Relation to Varios Risk Factors

Author name: عباس مصطفى حسن
Supervisor name: عدنان محمد الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease (COPD) is a syndrome of progressive airflow limitation caused by the abnormal inflammatory reaction of the airway and lung parenchyma. Osteoporosis is one of the major extrapulmonary manifestations of COPD. The, prevalence of osteoporosis in COPD patients in Iraqi population is unknown.Objectives : To study the incidence of osteoporosis among COPD patients and its relations to various risk factors.Materials and Methods : The study was done in Baghdad Teaching hospital.All the diagnosed cases of 70 COPD patients according to the GOLD guidelines were included in this study. The present study was a cross sectional study during a period of August 2014 - Octoper 2015 . A brief history of the patients was taken, especially regarding duration of illness, number of exacerbations in the past 3 years, smoking in pack years, and history of steroid use (both systemic and inhaled steroids) after which cumulative dose of steroids was calculated. Spirometry was done in all these patients to stage the severity of COPD according to GOLD criteria. DEXA scan of the lumbar spine was done using bone densitometer to determine osteoporosis. (WHO) criterion for definition of osteoporosis was applied and patients with T - score of below −2.5 standarddeviation (SD) were diagnosed to have osteoporosis, −1 SD to −2.5 SD were diagnosed to have osteopenia and more than −1 SD as normal.Results : A total of 70 COPD patients were included in this study, Among these, 36 patients (51.4%) had osteoporosis and 23 patients (32.8%) had osteopenia.Majority (94.4%) of the patients who had osteoporosis had stage III and stage IV COPD disease. It was observed that as the severity grade of COPD increased , the risk of osteoporosis also increased. The bone mineral density (BMD) showed a significant difference among different stages of COPD. It was also observed that patients with lower body mass index (BMI) had higher prevalence of osteoporosis (91.7%) as compared to overweight patients. On univariate analysis, it was observed that risk factors for osteoporosis were female sex, higher number of exacerbations, BMI, and severity of COPD. After using multivariate analysis, stage IV COPD , number of acute exacerbations >3 in the previous 3 years , and steroid cumulative dose >1000 mg were observed to be significant risk factors for osteoporosis in COPD patients.

تحليل نتائج وخز الرئة القطعي لاربعين مريض في مستشفى بغداد التعليمي == Analysis of Tru - Cut Biopsy Findings In Forty Patients with PERIPHERAL Lung Lesions in Baghdad Teaching Hospital

Author name: احسان سلمان
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: وخزة الرئة التحت الجلدية هي من اكثر الطرق شيوعا في الوقت الحالي معها العديد من الطرق المستخدمة في امراض الجهاز التنفسي .واحده من اهم الطرق هي طريقة الوخز القطعي بمساعدة المفراس الحلزوني .اهداف دراسة البحثلاجل تحليل النتائج من جراء عملية الوخز القطعي في مستشفى بغداد التعليمي لسنة 2015 - 2016.الطرق والمرضىاجريت دراسة مرجعه عن هذه الطريقة ووجدت كثير من النتائج ما يخص الديموغرافية والدلائل الاشعاعية والتشخيص والمضاعفات الناتجة من المرضى الذين اجروا هذه العملية الوخز القطعي تحت السيطرة للمفراس الحلزوني .النتائجاربعون مريض كانوا تحت الدراسة الخاصة للبحث ثلاثون مريض كانوراجال وعشر مرضى نساء .اعمار المرضى تتراوح ما بين 18 - 80 ومعدل العمر للمرضى هو 14.1 سنه . ±58.6 21 مريض من الرجال حاليا مدخنين و6 غير مدخنين و3 مدخنين سابقين بينما من النساء كانوا 3 مدخنين حاليا و5 غير مدخنين و2 مدخنين سابقات .اكثر الاعراض شيوعا بين المرضى في البحث هي ضيق التنفس والسعال ونفث الدم وقلة وزن الجسم.اكثر الدراسات الهستوبايولوجي للمرضى الذين اجروا هذه العملية كانت مسرطنه بنسبة 70% ,شامل بنسبة 12.5%, حميد بنسبة 7.5 % , ذات الرئة بنسبة 7.5%, تحليل غير كافي بنسبة 2.5%.من اكثر المضاعفات شيوعا بين المرضى كانت الاسترواح الصدري ونفث الدم.الاستنتاجعملية الوخز القطعي مع مساعدة المفراس الحلزوني يعتبر من اكثر العمليات الكفؤة في الكشف عن الاوليات والاسباب التي تخص امراض الرئة المحيطية. | Percutaneous lung biopsy is now a common procedure in pulmonary medicine, and several different techniques are in use. The most important one is the use of a tru - cut biopsy under computed tomography (CT) guidance.Aim of Study : To analyze the outcome of tru - cut biopsy in patients with peripheral pulmonary lesions in Baghdad teaching hospital 2016.Patients and Methods : A cross sectional study was done to find out the demographic profiles, indications, radiological findings, diagnosis and complications of the patients who were underwent tru - cut biopsy under CT guided. Forty patients underwent tru - cut biopsy under CT guided in Baghdad teaching hospital( 2015 - 2016).Results : Forty patients were included in our study.Thirty patients (75%) were males, 10 patients (25%) were females. The patients age range from 18 to 80 years, the mean age of the patients was 58.6±14.1 years. In males, 21 patients were current smokers, 6 patients were non smokers and 3 patients ex smokers. In females, 3 patients were current smokers, 5 patients were non smokers and 2 patients were ex smokers. Most common clinical presentation of the patients was chest pain (30%), dyspnea (17.5%), cough (15%), hemoptysis (7.5%), and weight loss (12.5%). The commonest histopathological result of the lesions was malignancy (70%), inconclusive (12.5%), benign (7.5%), organizing pneumonia (7.5%) and inadequate sample (2.5%). The most common complication was pneumothorax (10%) and haemoptysis (5%).Conclusion : Tru - cut biopsy under CT guided is extremely useful in finding specific etiologies of peripheral lung lesions

دراسة الكشف المبكر لمرض الانسداد الرئوي المزمن في الذكور الخالين من الاعراض المدخنين والمدخنين السابقين == Early Detection of Chronic Obstructive Pulmonary Disease in Asymptomatic Male Current Smokers and Ex - smokers By Spirometry

Author name: حسام محمد علي صالح
Supervisor name: عبد الله جنجر الفرطوسي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease is responsible for permanent morbidity, premature mortality and great burden to the healthcare system. The most commonly encountered risk factor is tobacco smoking. Without screening, patients usually overlook early symptoms of cough wheezes but commonly seek medical advice when they become dyspnic on mild to moderate exertion. By that time, half of their ventilatory reserves are lost. Spirometry remains the gold standard for diagnosing chronic obstructive pulmonary disease and monitoring its progression.Aim of study : Early detection of chronic obstructive pulmonary disease in asymptomatic male current smokers and ex - smokers by spirometry.Patients and methods : Consecutive asymptomatic male current smokers (n=100) and ex - smokers (n=100) were participated in screening. All Participants have no history of chronic obstructive pulmonary disease, asthma, chronic respiratory illness or active pulmonary symptoms. Also all of them not on bronchodilators, inhaled corticosteroids, Montelukast, or theophylline.Results : A total of 100 asymptomatic male current smokers and 100 asymptomatic male ex - smokers were screened by spirometry according to the American Thoracic Society and European Respiratory Society guidelines. Overall, airway obstruction was seen in 49 (49%) current smokers, mild obstruction was seen in 22 (22%) and moderate obstruction in 27 (27%) subjects, while in ex - smokers airway obstruction was seen in 52 (52%), mild obstruction was seen in 13 (13%) and moderate obstruction was seen in 39 (39%) subjects.Conclusions and recommendations : Early diagnosis of chronic obstructive pulmonary disease by spirometry will encourage smoking cessation and enable earlier interventions to help prevent exacerbations and hopefully preserve lung function, quality of life and decrease mortality

تاثير تدخين الشيشة الاركيله مقارنة بتدخين السكائر على اختبار وظائف الرئة بين الذكور في مدينة الناصرية == The Effect of Water Pipe (Negril) Smoking on Pulmonary Function Test in compare to cigarate smoking among Males in Al Nasiriya City

Author name: مهند عادل جايان
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Shisha (wp) smoking is becoming a more prevalent form of tobacc consumption, and is growing worldwide, particularly among the young generation in the Middle East especially among urban youth, college students, and young professionals. However there is limited data about the effects of water - pipe smoking. Publicly considered as aharmless entertainment. Many studies have shown that water pipe smoking associated with development of varying degrees of reduction in the lung function.Objectives : The aim of this study is to assess the effect of water pipe smoking on pulmonary functions with regard to the duration and amount of smoking among different groups of male smokers : water pipe smokers, cigarette smokers, and compare it with a control (nonsmokers) group. Methods : This is a comparative crosssectional study which conducted on 300 male subjects, subdivided into two groups of smokers : 100 water pipe smokers, 100 cigarette smokers and 100 nonsmokers as a control group, all participants were apparently healthy and matched for gender, they were selected from random cafes in al nassirryha city. Data were collected through structured questionnaire and pulmonary function test was performed by portable Spiro lab III spirometer after gaining the participant consent. Results : There was significant differences between the mean ages of the study groups (p value<0.05).water pipe smokers (35.44±10.79) cigarette smokers (46.09±10.54), and nonsmokers (35.55±11.07). The present study revealed that there was a significant reduction in the parameters of the pulmonary function test ( FEV1 ), (FVC )(FEV1/FVC),(PEF),(FEF25 - 75%)and(MVV)for the two groups of smokers as compared to the control group ( P < 0.01 ) .Lung function impairments were very severe in water pipe smokers as compare with cigarette smokers( P < 0.05 ). There were significant inverse correlations between all PFT values and duration and total amount of WP smoking and number of WP smoked per week(P < 0.01) .Conclusion : The results from this study showed that there was a profound effect of WP smoking on PFT values, which were more severe to the effects of cigarette smoking.Keyword : water pipe smoker ,pulmonary function test, nassiryha - Iraq.

نتائج تخطيط صدى القلب عند المرضى المصابين بمرض الانسداد الرئوي المزمن ومدى ارتباطها بشدة المرض == Echocardiographic Findings in Patients with Chronic Obstructive Pulmonary Disease and Their Correlation with Disease Severity

Author name: شذى سلمان كاظم
Supervisor name: عدنان محمد الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease (COPD) is a common disease and a leading cause of morbidity and mortality worldwide and result in an economic and social burden that is substantial and increasing.COPD has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography(Echo) provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes.Aim of study : To assess cardiac changes secondary to COPD by echocardiography and to find if there is a correlation between echocardiographic findings and severity of COPD.Materials and Methods : A total 50 of patients with COPD were diagnosed and staged by pulmonary function test (PFT) according to GOLD criteria into 4 stages . For all patients,detailed history, carful clinical examination, electrocardiography(ECG), chest x ray(CXR), and routine blood tests were done. All patients evaluated by echocardiography.Results : On echocardiographic evaluation of COPD,40% of cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 25/50 (50.0%) of cases . Pulmonary hypertension (PHT), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 14/25 (56.0%) of patients with TR (28.0% of total patients) , in which prevalence of mild, moderate, and severe PHT were 7/14 (50.0%), 4/14 (28.6%), and 3/14 (21.4%), respectively. The frequencies of PHT in mild, moderate, severe, and very severe COPD were 7.1%, 14.3 %, 35.7%, and 42.9%, respectively. Cor pulmonale was observed in 6/14 (42.9%) of cases (12.0% of total patients) ; The frequencies of cor pulmonale in patients with mild, moderate, and sever PHT were 0 , 75.0% ,100.0 % ,respectively ; 2.0% cases had left ventricle systolic dysfunction(LVSD) and 10.0% cases had evidence of left ventricle diastolic dysfunction(LVDD). Left ventricle hypertrophy (LVH) was found in 4.0% of cases. There was a significant decrease in forced expiratory volume in one second(FEV1) means associated with Echo findings especially with PHT and cor pulmonale.Conclusion : Prevalence of cardiovascular complications (especially PHT and cor pulmonale) is high among COPD patients and has a linear relationship with increasing severity of COPD. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.

دراسة العلاقه بين ارتفاع ضغط الدم الشرياني ومرض الانسداد الرئوي المزمن : دراسة مستندة الى المستشفى == Study of relation between systemic arterial hypertension and Chronic Obstructive Pulmonary Disease (Hospital Based Study

Author name: زينب مهاوي هادي
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: ان مرض الانسداد الرئوي المزمن هو سبب رئيسي للوفاة في جميع انحاء العالم . ويسبب العديد من الامراض خارج الرئه مثل داء السكري وامراض القلب والاوعيه الدموية .الهدف من الدراسة : لتقييم العلاقة المتبادلة بين مرض الانسداد الرئوي المزمن وارتفاع ضغط الدم الشرياني طريقــــــــــــــة البحث : اجريت دراسة مقطعيه على مئة مريض مشخص مسبقا بالانسداد الرئوي المزمن في ( مستشفى بغداد التعليمي ) و( مستشفى البصرة التعليمي ) وبعمر (35سنة واكثر. المرضى المصابون بامراض الاضطرابات التنفسية والقلبية والغدد الصماء الاخرى والذين لديهم تاريخ بارتفاع ضغط الدم المشخص قبل مرض الانسداد الرئوي تم استثنائهم من هذه الدراسة .النتائـــــــــــج : الدراسةاجريت ل( 100) مريض تم تشخيصهم مسبقا بــمرض الانسداد الرئوي المــــــــــــــــــــــــزمن حيث تبين ان (23 ) مريضا لديهم تاريخ ايجابي لارتفاع ضغط الدم الشرياني تم تشخيصهم بعد تطور مرض الانسداد الرئوي ؛ و(77) مريضا لديهم تاريخ سلبي لارتفاع ضغط الدم الشرياني.وبعد قياس ضغط الدم لذوي التاريخ السلبي السابق في ارتفاع ضغط الدم الشرياني وجد ان (14) لديهم ضغط دم طبيعي و( 36 ) مريضا لديهم ارتفاع ضغط الدم الشرياني للمرحلة الثانية .كانت هناك علاقة بارزة بين زيادة حدة مرض الانسداد الرئوي المزمن وزيادة القراءة لضغط الدم. الاستــنــــــــــــــــتاج : توجد علاقة بارزة بين مرض الانسداد الرئوي المزمن وتطور ارتفاع ضغط الدم الشرياني.الكلمات الدالة : ارتفاع ضغط الدم الشرياني , مرض الانسداد الرئوي المزمن , ضغط الدم . | Background : Chronic obstructive airway disease (COPD) is a leading cause of death worldwide. And it cause various extrapulmonary comorbidities as diabetes mellitus and cardiovascular diseases .Aim of Study : To assess the correlation between COPD and systemic arterial hypertension .Method : Cross sectional study was conducted on 100 patients diagnosed previously as COPD in Baghdad teaching hospital and Basrah teaching hospital (age≥35 year), Patients with other chronic respiratory disorder and cardiac and endocrine diseases and who had history of systemic arterial hypertension diagnosed before COPD were excluded from this study.Results : The study done on 100 patients diagnosed previously with COPD and found 23 patients had positive history of systemic arterial hypertension diagnosed after COPD developed and 77 patients had negative history of systemic arterial hypertension. and after measured blood pressure for the patients with negative previous history of systemic arterial hypertension 14 patients found having normal reading and 36 patients had stage 2 systemic arterial hypertension . There were significant association between increase in severity of COPD and increase in blood pressure reading.Conclusion : There is significant association between COPD and development of systemic hypertension.Keyword : Systemic arterial hypertension , Chronic obstructive pulmonary disease , blood pressure.

تقييم مستوى مصل حمض البوليك لمرض الانسداد الرئوي المزمن وعلاقته بشدة المرض وتكرار الانتكاسات : دراسة الحالات والشواهد == ASSESSMENT OF SERUM URIC ACID LEVEL IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ITS RELATION TO DISEASE SEVERITY AND EXACERBATION FREQUENCY (Case - Control Study

Author name: الاء عبد الجبار
Supervisor name: عدنان محمد الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : Chronic obstructive pulmonary disease (COPD) is a major contributor to morbidity worldwide,and lead to damage lung tissue and so lead to reduce oxygen intake resulting in tissue hypoxia.Tissue hypoxia induces the degradation of adenosine triphosphate, resulting in production of serum uric acid.Identification of prognostic biomarker for COPD as serum uric acid(sUA) may aid in improving survival .Objective of the study : Evaluate role of hyperuricemia in disease severity and exacerbation frequency in COPD patients.Method : Case - control study was conducted from 1st of December 2017 to 1st of June 2018, on 80 subjects in Baghdad teaching hospital\medical city, 40 subjects with COPD, other 40 subjects are healthy persons consider as control, all >40 years old<70 .Serum uric acid level measured for all study sample.Excluded from this study those with Hx of Diabetes mellitus, Hypertension, Malignancy, Cardiac disease, Gout and persons on drugs affect sUA level.Results : The mean age for COPD was 61.9 while for control was 49.3 years.Serum utic acid higher in male than female in both group. In COPD cases there are higher level of serum uric acid compared to control and COPD patients had 3.16 time more risk to developed high serum uric acid than persons without disease also there was a significant statistical association between mean sUA and duration and degree of COPD (P value<0.05).Conclusion : Patients with COPD have higher serum uric acid level than control group, which tend to increase with increase in duration and severity of disease.

صلاحية معيار بروتين سي التفاعلي في تقييم شدة مرض الانسداد الرئوي المزمن : دراسة مستندة الى المستشفى == VALIDITY OF C - REACTIVE PROTEIN TITER IN ASSESSMENT OF SEVERITY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (HOSPITAL STUDY BASE)

Author name: رشا مناور عبد
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 one of the most important causes of morbidity and mortality all over the world.C - Reactive Protein (CRP) : a biomarker of systemic inflammation and as an indicator of malnutrition or severity of Chronic Obstructive Pulmonary Disease (COPD). An assessment the relationship between serum C - reactive protein (CRP) levels and well - known clinical parameters in severity of Chronic Obstructive Pulmonary Disease (COPD) considering the impact of smoking behavior.Aim of study : To evaluate the interrelationship between C - reactive protein and chronic obstructive pulmonary diseaseMethodsWe studied (69) diagnosed COPD patients according to GOLDstages all patients didspirometry, body mass index andserum CRP titer levels were investigated in diseased COPD patients.Results : Patients sample, 72.5% male and 27.5% female, the ratio (3 to 1) of COPD included (75.4%) had positive CRP and (24.6%) had negative CRP. CRP titer levels were higher in severe COPD patients and there’s inversely relationship between Body Mass and the incidence of the C - Reactive Protein. There’s close relationship between cigarette smoking, body mass and chronic obstructive pulmonary disease.Conclusion : The circulating levels of the inflammatory marker CRP are significantly elevated in patients with COPD, supporting the view that COPD is in part an inflammatory disorder. This risk increase with increased severity of disease and cigarette smoking and this level elevated with decreasing body mass index.

دراسة عدوى التدرن الكامن في مرضى السكري البالغين == Study of latent tuberculosis infection in adult diabetic patients at Baghdad teaching hospital

Author name: شهد حامد مكي
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: Latent TB is state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB. The WHO reports that 10% of TB cases around the world are linked to diabetes. The course of the infections is also more complicated in this patient group. One of the possible causes of this increased prevalence of infections is defects in immunity.Aim of the study : This study tested for relationship between LTBI and DM and attempted to determine if DM status influenced the result of LTBI. Materials and Methods : - The study was comparative case control with analytical elements.The data collection was carried out in medical clinic in Baghdad teaching hospital at Baghdad city, Iraq. The data collection was done between the 1stOctobar 2017 to 1st March 2018, two days weekly, four hours per day. Total sample was 102 participants, 51 diabetic patients and 51 non diabetic patients. Results : - Total of 102 patients were involved in the study. The age and body mass index (BMI) of patients of both groups was matched and there was a significant difference of the mean years of age of the patients with positive TST and those with negative TST, while no such significant difference was found between the BMI of the patients with positive TST and those with negative TST significant association was found between diabetic history and latent tuberculosis which identify by positive result of TST, while no association found between smoking history and educational level with latent tuberculosis.Conclusion : - This study show significant relation between DM and development of latent TB.

تحليل نتائج ناظور القصبات المرن في وحدة الامراض الصدريه والتنفسيه في مستشفى الحسين ع التعليمي في محافظة كربلاء للسنتين 2016 - 2017 == Analysis of fiberoptic bronchoscopic findings in Al - Hussain teaching hospital in Karbalaa Governorate in 2016 - 2017

Author name: عمار عباس نعمة
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: Fiber - Optic bronchoscopy is a safe and useful diagnostic andtherapeutic tool for the management of many pulmonary diseases.Aim of study : To analyse the outcome of fiberoptic bronchoscopy in respiratoryunit at Al - hussain teaching hospital in Karbalaa governorate in years 2016 - 2017.Patients and Methods : A retrospective study was done to find out the demographic profiles, indications, bronchoscopic findings, diagnosis and complications of the patients who underwent bronchoscopic examination. 105 patients underwent bronchoscopies in the respiratory unit in Al - hussain teaching hospital in Karbalaa governorate in 2016 - 2017.Results : Amongst the 105 patients where 54.3% of them was female and 45.7% was male, 61% of total number was non - smoker, 26.7% currently smoker and ex - smoker of 12.4 %.The highest percentage (30.5%) of partiptants fall to age group of 60 - 69 years followed by age group 0f 70 - 79 years (22.9%), 50 - 59 years (17.1%) and the remains fall to other age groups in lower percentages.Commonest indication of bronchoscopy was radiological opacity found in 79.05% of patients, followed by productive cough (11.34%) and hemoptysis (9.52%) as the second and third indications respectively.The most common finding on bronchoscopy was abnormal bronchial mucosa found in about 65.7% of patients. Malignancy was seen in 29.5% of the cases, while Tuberculosis seen in 17.1%.In the 105 patient the bronchoscopy done with neither death nor serious complications occurrence likes pneumothorax or cardiac arrest.Conclusion : Fiberoptic bronchoscopy is extremely useful in finding specific etiologies of various lung diseases.

عنصر المغنسيوم في الدم مؤشر على مستوى شدة الربو القصبي والانتكاسات الحادة للمرضى == Evaluation of Serum Magnesium as Indicator of Asthma Severity in Stable Asthma and Acute Exacerbation

Author name: طاهر بلاش محمد
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: Asthma is a chronic inflammatory disorder of the airways characterized by marked variability in airflow obstruction that is often reversible, either spontaneously or with treatment.Magnesium is the second most abundant intracellular cataion after potassium.Magnesium has been shown to relax bronchial smooth muscles and influence the function of respiratory muscles.Aim : To assess the serum magnesium levels in asthmatic patients during stable and exacerbating clinical condition and to compare serum magnesium values in asthmatic patient and healthy subjects.Patients and methods : 110 Subjects were enrolled, 70 patients diagnosed with asthma and 40 healthy individuals as a control group. The asthmatic patients were divided into : (I) stable asthma group (II) acute exacerbation asthma group.Blood had been taken from all subjects and serum magnesium measured by spectrometer.Results : Serum magnesium levels were significantly lower in asthmatic patients compared with healthy subjects.Conclusion : There is a significant association between lower serum magnesium level and asthma.

انتشار مرض السل الكامن بين مرضى الربو الذين يستخدمون الستيرويدات كدواء اساسي في علاجهم == Prevalence of latent TB in Asthmatic Patients who are Using Steroids as Essential Drug of Their Management

Author name: احمد عباس قدوري
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: ان مرض السل يعد من اخطر العوامل التي تسبب الوفاة خاصة في البلدان النامية وفقا لاحصائيات منظمة الصحة العالمية ومركز السيطرة على الامراض الانتقالية وتبين ان نسبة الاصابة تتناسب طرديا مع نقص مناعة المريض.وحسب النظرية التي تنص على ان المناعة ممكن ان تضعف بتناول جرعة لا تقل عن 15 غم يوميا ولمدة تزيد على اربعة اسابيع نجد ان مرضى الربو ممكن ان تزداد احتمالية اصابتهم بمرض السل بحوالي 8 اضعاف .الهدف من الدراسة معرفة مدى الاصابة بمرض االسل بين الاشخاص المصابين بالربو مستخدمي الستيرويدات كدواء اساسي ضمن علاجهم .طريقة اعداد البحثدراسة انية مصممة لاستيعاب مرضى الربو ممن يراجعون مستشفى مدينة بغداد الطبية التعليمي للفترة من نيسان 2017 الى نيسان 2018 بمركز التدرن الرئوي ووحدة المرضى الراقدين ومرضى العيادة الخارجية.تم اعداد استمارة الاستبيان الخاصة بالبحث لتسجيل اهم المعلومات المتوافقة مع الموضوع من قبل الباحث .النتائجتم اختيار 60 مريضا من مرضى الربو للدراسة خلال مدة سنة واحدة وكان عدد الاناث 41 مريضة واما عدد الذكور 19 مريضا ونسبة الذكور الى الاناث هو 7 : 3 على التوالي , 95 % منهم من سكنة المدن و5% منهم يسكنون في المناطق النائية , وكانت الاعمار بين سن 18 الى سن 60 سنة اي معدل العمر 31.4 .51.6% منهم كانوا يستخدمون الستيرويد بجهاز البخاخ وبالشكل الصحيح 40% من المرضى كانوا يستخدمون جهاز البخاخ بطريقة خاطئة بحيث يبتلعون المادة الستيرويدية دون استنشاقها و8.4 % منهم كان يستخدم جهاز البخاخ كعلاج مع الحبوب ولمدة لا تقل عن ستة اشهر . كانت نتائج فحص السلين بالجلد موجبة ل 7 ( 11.7 % )مرضى وكالتالي : شخص واحد فقط من مستخدمي جهاز البخاخ بطريقة خاطئة اي بلعا لمدة لا تقل عن 3 سنوات (1.7 %) ومريض واحد من مستخدمي البخاخ بطريقة صحيحة لمدة تزيد على 20 سنة (1.7 % ) و5 اشخاص ممن كانوا يستخدمون الستيرويد على شكل حبوب مضاف له البخاخ لمدة تزيد على 4 اشهر ( 8.3 % ) واما نتائج بقية ال 53 مريض كانت سالبة , على ان هنالك علاقة واضحة بين عمر المريض وزيادة نسبة الاصابة طرديا ( p=0.01)وايضا تزداد النسبة مع ازدياد الجرعة ومدة استخدام الستيرويد( p=0.001) الاستنتاجبعد تحليل النتائج المنتقاة من هذه الدراسة تبين لنا ما يلي : 1. تزداد خطورة الاصابة بداء السل مع ازدياد العمر 2. طريقة تناول الستيرويد له علاقة قوية مع معدل الاصابة بالسل 3. زيادة جرعة الستيرويد ووزيادة مدة تناوله يزيد من فرص الاصابة بالسل 4. ظهرت علاقة جديدة واضحة بين استخدام جهاز البخاخ بطريقة خاطئة من خلال بلع المادة الواجب استنشاقها وبين فحص السلين للجلد.5. تبين انه لا توجد علاقة واضحة بين فحص السلين وجنس المريض واما الزيادة في النتائج الموجبة بين الاناث فسببه هو ان عدد الاناث المصابات بالربو هو اصلا اعلى من الرجال . | Back ground Asthma is a common chronic inflammatory airways disease which need steroid as essential drug of its management. Latent TB is when person is infected with Mycobacterium.TB with no symptoms and it's not contagious as active TB. The risk of developing TB increases with the drop of immunity. Using of steroid >15 mg/day > 4 weeks is associated with drop in immunity, so asthmatic patient might be infect with TB.Aim of the study : To assess the impact of steroid treatment on the risk of developing latent TB in asthmatic patientsPatients and Methods : a cross - sectional study conducted between April 2017 to April 2018 at respiratory clinic and TB center of Baghdad Teaching Hospital. Convenient sample of 60 asthmatic patients on steroid include 19 males and 41 females. Results : the mean age of patients is 31±2, 41 females and 19 males, f / m ratio was 7 : 3. 31 used ICS correctly, 24 take ICS materials as wrong technique by swallowing it, and 5 are using oral and ICS as combined treatment modality. Regarding TST results, 6 persons were tested positive, 4 are from those who are using combined modality for more than 4 months, 1 from those who swallow the materials for more than 3 years, and 1 from those who using inhaler device correctly for more than 20 years. A significant correlations were found between TST and increasing age of the patient p=0.001, and the TST and the duration of use of steroids p=0.01.Conclusion : the prevalence of positive TST among asthmatic patients obviously related to type of steroid administration (orally is higher risk), aging and duration of steroid use

تقييم السيطرة على الربو في مستشفى بغداد التعليمي == Assessment of Asthma Control in Baghdad Teaching Hospital

Author name: يعرب مظلوم عباس
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: الخلفية : الربو هو مشكلة صحية عالمية تصيب 300 مليون من الافراد من جميع الاعمار حول العالم. على الرغم من المبادئ التوجيهية الدولية،مزاالت السيطرة على الربو بعيدة عن الاهداف في مختلف انحاء العالم.اهداف الدراسة : لتحديد ما اذا كان اختبار السيطرة على الربو (ACT) يمكن ان تكون مفيدة مثل معايير المبادرة الدولية للربو (GINA)في تقييم السيطرة على الربو. طرائق البحث : دراسة مستعرضة تضمنت 64 مريضا اعمارهم> 18 سنة يعانون من الربو في عيادة الامراض الصدرية في مستشفى بغداد التعليمي بين شباط 2015 وايار 2015. وجرى تقييم السيطرة على الربو باستخدام المبادرة الدولية للربو ( (GINAواختبار السيطرة على الربو ACT)).النتائج : كان هناك 64 من المرضى المسجلين في هذه الدراسة، كان 44 مريضا(68.8٪) من الاناث وكان 20 مريضا (31.2٪) من الذكور. وفقا لاختبار السيطرة على الربو (ACT) 43 مريض (67.2٪) حصلوا على درجة (<15) و21 مريضا (32.8٪) حصلوا على درجة (15 - 19) . وفقا لتصنيف (GINA) 49 مريض (76.56٪) صنفوا كمرضى غير مسيطرين على الربو 15 مريض (23.44) صنفوا على انهم مسيطرين جزئيا على الربو . الاستنتاج : في دراستنا وجدنا اتفاق كبير بين اختبار السيطرة على الربو (ACT) وتصنيف (GINA) وبذلك ACT يمكن ان تكون بديلا لتصنيف (GINA)في تقييم السيطرة على الربو. | Background : Asthma is a global health problem that affects 300 million individuals of all ages around a world. Despite international guidelines, asthma control is short of the goal in different parts of the world. Aims of study : To determine if the ACT can be as useful as the GINA - guidelines criteria in assessing asthma control . Methods : A cross - sectional study recruiting 64 patients aged >18 years with asthma were seen at chest clinic of Baghdad Teaching Hospital between February 2015 and May 2015. Asthma control was assessed using the GINA algorithm and the ACT score . Results : There were 64 patients enrolled in this study, 44 patients (68.8%) were female and 20 patients (31.2%) were male . According to ACT score 43 patient (67.2%) had an ACT score of (<15) and 21 patients (32.8%) had an ACT score of (15 - 19) and none patients had ACT (20 - 25) . According to GINA classification , 49 patient (76.56%) classified as uncontrolled and 15 patients (23.44) classified as partly controlled and none patients classified as controlled .Conclusion : In our study we found high agreement between ACT score and GINA classification thus ACT score can substitute GINA in assessment of asthma control . Asthma control was also dependently associated with the individual patient's age group.

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:

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

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.

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

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

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)

Author name: زينب علاء عبد الحسين
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: 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

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

Author name: زينب عزيز
Supervisor name: عدنان الجبوري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: Background : 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.

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

Author name: مرتضى نجاح جواد
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: 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.

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

Author name: زياد طارق ملغوث
Supervisor name: قاسم محمد سلطان
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages:
Abstract: 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.

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

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

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

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

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

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

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

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

دراسة موضوعية حول مرض ذات الرئة

Author name: جنان محمد البدري
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Master
University: University of Al Mosul - Faculty Of Medicine - Department Of Pathology
University location: Mosul

التغيرات البايوكيمياوية المصاحبة لمرض السل

Author name: خالد خلف احمد
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine - Department Of Pathology And Forensic Medicine
University location: Baghdad

التغيرات الميكانيكية في الدورة الدموية اثناء النوبات الربوية

Author name: رياض سليمان ابراهيم
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Master
University: University of Baghdad - Faculty Of Medicine
University location: Baghdad

انبوب غالق المرئ التنفسي وسيلة تنقية بديلة لانبوب الرغامي : مقارنة بالمنفذ الهوائي البلعومي الفموي في اجراء العمليات الجراحية المتخذة

Author name: هاني خلف الديلمي
General topic: Medicine
Specific topic: Diseases - Thoracic
Degree: Master
University: University Of Basrah - Faculty Of Medicine - Department Of Pathology And Forensic Medicine
University location: Basrah