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Article
The Risk Factors of Inhibitor Development and Hepatitis C Virus among Hemophilic Patients in Children Welfare Teaching hospital

Author: Dhia H. Al-Beldawi ضياء البلداوي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2010 Volume: 52 Issue: 1 Pages: 4-8
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Inhibitor development and HCV are considered the most serious complications of hemophilia treatment. Many factors may increase the risk of complications which include: type of hemophilia, age of the patient, age of onset, duration of the disease, & number of replacement per month.Patients and methods: A descriptive study included 200 patients less than 20 years of age admitted to the Hemophilia Center in Children Welfare Teaching Hospital , medical city in Baghdad , their data ( ag , sex , disease onset and duration , severity of hemophilia ) were collected over 8 months period from 1st January to 31st August 2006. Mixing tests and serology tests for HCV and HBV were performed for all patients.Results: The study showed that 156 (78%) patients had hemophilia A, 44(22%) patients had hemophilia B, and 122 (61%) patients were older than 10 years, in 166 (83%) patients the disease was diagnosed before 2 years of age. Twenty (12.8 %) patients with hemophilia A and 4(9%) patients with hemophilia B developed inhibitors (+ve mixing test). Age more than 10 years, disease onset before 2 years and severe hemophilia were the most common associated findings in patients with inhibitors in 19(79%) , 22(91%), 15(62.5%) patients respectively. Eighty (40%) patients had HCV and 6(3%) patients had HBV, patients older than 10 years , disease duration more than 5 years and severe hemophilia were the most common associated findings with HCV in 68(57.6%), 64 (56%), and 44(45%) patients respectively.Conclusions: The risk of inhibitor development was associated more with Hemophilia A, age more than 10 years, early onset and severe disease but the association was statistically insignificant. The rate of HCV infection was high, that needs special attention and effective screening program. Keywords: Hemophilia, Inhibitors, and Hepatitis.


Article
Assessment of Mothers Knowledge and Practices with Hemophilic Children type A at Azadi Teaching Hospital in Kirkuk City
تقييم معارف وممارساتِ أمهات الأطفال الناعور الوراثي نوع- أ - في مستشفى أزادي التعليمي بمدينةِ كركوك

Authors: Khatam M. hattab --- Aram O. Mohammed
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2013 Volume: 26 Issue: 2 Pages: 35-48
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: The study aims to assess the knowledge and practices of mothers with hemophilia children type - A - , socio-economic status and association between mother demographic information with their knowledge and prac-tices toward their children in Azadi Teaching Hospital in Kirkuk. Methodology: Descriptive study no probability (purposive) sample. Selected Fifty-five of mothers having hemophilia children, started from November 2012 to May 2013. Study was carried out in the Azadi teaching hospital in Kirkuk. By using questionnaire which consists from five parts include demographic characteristics for mother and children, socio-economic, Knowledge and practices data gathered, by direct interview with the mothers in the hospital. Reliability and content validity of questioner were identified form of the pilot study. Descriptive and inferential statistical used to analysis of data. Results: The results of the study (30.9%) of the mothers were aged (40 - 44) and (43.6%) were graduates from pri-mary school. And their hemophilia children in all sample sex male, (41.8%) of hemophilia children were aged be-tween (5-9) years though (30.9 %) are not in school and that (69.1%) of the families have one child hemophilia in-fected and (27.6%) were diagnosis bleeding in joint , level of severity of the disease (65.5%) was moderate ,(98.2%) of family depended on hospital to provide factor eight and other treatment to hemophilia child when bleeding. socio – economic status of family show ( 61.8%) low status. (83.6%) of mothers uncertain of their information about hemophilia, mother practices were (72.7%) sometimes and (23.6%) never done good practice to their hemophilia children.Recommendations: Develop special booklet for mothers local languages (Kurdish , Turkish ) develop programs and awareness courses (theoretical and practical) for mothers and support family financial improve and provide factor eighth for hospitals and health center where patients found.

المستخلص:الهدف: تهدف الدراسة لتقييم معارف وممارسات الأمهات تجاه أطفالهن المصابين بمرض الناعور نوع-أ- وتقييم حالتهم الاجتماعية ولاقتصادية و إيجاد العلاقة بين المعلومات الديموغرافية , معارف وممارسات الأمهات اتجاه أطفالهن المصابين بمرض الناعور بمستشفى أزادي التعليمي بمحافظة كركوك.المنهجية: دراسة وصفية تم اختيار عينة غير عشوائية (غرضية) مكونة من خمس وخمسون أم أطفالهن مصابين بمرض الناعور نوع –أ-,بدأت من تشرين الثاني2012 إلى أيار2013.وتم إجراء الدراسة في مستشفى أزادي العام التعليمي بمحافظة كركوك .تكونت الاستمارة الإستبيانية من خمس أجزاء تشمل الخصائص الديموغرافية لكل من الأم والطفل والحالة الاجتماعية الاقتصادية للعائلة ومعارف وممارسات الأم من خلال إجراء المقابلة المباشرة مع الأمهات في المستشفى.وتم تحديد صدق المحتوى وثبات الأستمارة الأستبيانية من خلال دراسة أولية واستخدام التحليل الإحصائي الوصفي الإستنتاجي في تحليل البيانات.النتائج: تشير نتائج الدراسة إن (30.9%)من الأمهات كانت أعمارهم من (40- 44)و(43.9%) كانوا من خريجي الابتدائية. و أطفالهن كلهم ذكورا وأن(41.8%) من الأطفال كانت أعمارهم بين (5-9)سنوات وأن(30.9%) ليسوا في المدرسة وأن (69.1%)من العائلة لديهم طفل واحد مصابا بالمرض و(27.6%) كانت إصابتهم بالمفصل, بالنسبة إلى مستوى شدة المرض (65.5%)كانت متوسطة و(98.2%) من العائلة يعتمدون على المستشفى لإعطاء العامل الثامن للطفل عند حدوث النزف .وإن(61.8%) حالتهم الاجتماعية-الاقتصادية ضعيفة.و إن (83.6%)من الأمهات غير متأكدين من معلوماتهم وإن ممارساتهم كانوا(72.7%)أحيانا.وإن (23.6%) أبدا اتجاه أطفالهن المصابين.التوصيات: تطوير برنامج وكتيب خاص للأمهات باللغات المحلية(كردية والتركمانية...) واستحداث برامج ودورات التوعية نظرية وعملية للأمهات وتحسين واقعهم الاقتصادي لتقليل معاناة العائلة وتجهيز عامل التخثر الثامن للمستشفيات والمراكز الصحية بأطراف المدينة لمناطق تواجد المرضى.


Article
Prevalence of anti-hepatitis C virus antibodies among blood donors and risky groups in Diyala

Author: Abdul-Razak S. Hassan
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2008 Volume: 50 Issue: 4 Pages: 467-470
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: To determine the prevalence of hepatitis C virus (HCV) infection among blood donors and risky population in Diyala province.
Materials and methods: In this retrospective study, the records of HCV screening and confirmatory tests were reviewed for the period 1996-2001.Third generation Enzyme-linked immunosorbant assay (ELISA) and Enzyme immunoblot assay were used as screening and confirmatory tests respectively.
Results: The prevalence of HCV infection among blood donors was 0.15%, with the highest in 1997. The highest prevalence rates were found among multiple blood recipient; hemophilia, thalassemia and hemodialysis patients (27.3%, 16.9% & 14.3%) respectively. Whereas, the patients with chronic hepatitis B infection and those with acute icteric hepatitis showed slightly elevated prevalence (2.9% & 2.1%) respectively. The overall prevalence in the province was 9.9/105 population. The mean age of infected patients was 29.7 years and the male: female ratio was 3:1.
Conclusion: The prevalence of HCV infection in Diyala population is relatively low. However, the HCV infection is concentrated in certain risky groups, particularly multiple blood recipients.


Article
Genetic Analysis of Coagulation Factor IX (FIX) Gene in Sample of Iraqi Patients With Hemophilia B.

Author: Ismail H. Aziz1 , Ali H. AL-Musawi2
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2017 Volume: 16 Issue: 4 Pages: 47-54
Publisher: Baghdad University جامعة بغداد

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Abstract

Hemophilia B (HB) is an X-linked recessive bleeding disorder caused by mutations in the coagulation factor IX (FIX) gene. Genotyping patients with HB is essential for genetic counseling and provides useful information for patient management. The aim of this study was to characterize the factor IX gene mutations in 20 unrelated Iraqi males hemophilia B patients from Thi-qar provence. This study was carried out in the Institute of Genetic Engineering and Biotechnology –University of Baghdad, during the period from April, 2016 to April, 2017.Their ages ranged from 4 -30 years .Polymerase chain reaction (PCR) and direct sequencing was performed to detect the mutations in patients. Three functionally regions of the gene (exon 4,exon 5 and exon 7)were screened. Twenty four point mutations were identified, including two missense variant (g15340 del G , p.Aspartic acid convert to Methionine acid) and (.22639 del A, p. Asparagine convert to Threonine) , two mutations were silent (g. 22632 del A, g. 22635 del A), while the rest of mutations were intronic mutations. These results conclude that mutations related with of haemophilia B disease.


Article
The Treatment of Flexion Contracture of the Knee Joint in Hemophilic Patients Using Gradual Manipulation and Serial Casting

Author: Ali Bakir Al-Hilli
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 407-412
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Hemophilia is a bleeding disorder caused by deficiency of clotting factor VIII or IX; it is inherited as sex linked recessive pattern. Musculoskeletal complications in haemophilic patients are disabling. Bleeding in to the large joints and soft tissues are associated with arthritic changes in the joints and contractures in the soft tissues. Deformities of the large joints especially flexion contractures are commonly seen in knee joint. It is important to prevent deformities, treat existing contractures and prevent recurrence to improve the patient's quality of life. OBJECTIVE:This is a retrospective study analyzing the effectiveness of gradual manipulation and serial casting for treatment of knee joint flexion contracture in Hemophilic Iraqi patients.PATIENTS AND METHOD:We included ten Hemophilic patients type A, treated between 2006-2008, six with unilateral and four with bilateral knee joint flexion contractures, excluding patients with multiple joint contractures other than knees, have severe arthritic changes, have subluxated unstable knees or have acute bleeding. Their age is between 16-22 years, the duration of deformity is 4-9 months, knee flexion contractures between 20-80 degrees and all of them don’t have significant pain but their daily life is severely restricted by the deformity. Under factor cover, general anaesthesia and haematological care, we started serial manipulations and plaster of Paris casting, the number of casts is between 2-6 casts, till we get straight knees. After that splints are prescribed for the patient and followed up for a minimum 6 months, physiotherapy to strengthen the muscles around knee is initiated from the start and gradually increasing after the application of the removable splints.RESULTS:We have ten patients with fourteen deformed knees, after manipulations and serial casting 8 knees get full correction, and 6 knees still have less than 10 degrees of flexion which is acceptable for the patients, all the patients have improvement of their quality of life and walk free of pain after 2 months.CONCLUSION:Serial manipulation and casting under general anaesthesia is a very good maneuver to correct knee joint flexion contractures in hemophilic patients.


Article
Molecular Study of the Correlation between Hemophilia and the Thrombophilic Risk Factors in Dohuk Province by using CVD Strip Assay.

Author: Rana Adel Hanoon
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 670-675
Publisher: Babylon University جامعة بابل

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Abstract

Haemophilia A is an X-linked, recessively inherited bleeding disorder which results from deficiency of procoagulant factor VIII (FVIII). Forty hemophilic patients were enrolled in the current study. Blood sample were collected and DNA was extracted and subjected to multiplex PCR amplification using specific primers which resulted in bands containing all the suspected mutations associated with hemophilia; CVD Strip Assay was also used to differentiate the obtained mutations. The results showed that out of the (40) hemophilic individuals, the higher incidence (55%) was for the MTHFR (A1298C) heterozygotic type of mutation while the lower incidence (5%) for a mutation recorded for factor V (G1691A, leiden), factor V (H1299R, R2), prothrombin (G20210A), and facto XIII (V34L). For the Apo type mutation, B type hasn’t been detected while E type observed in all cases; A1/A2 mutation created the higher incidence with 25% on the other hand, A3/A3 hasn’t been detected and thus it represented 0% of all the Apo mutations


Article
Descriptive Study of Hemophilia in Al-Ramadi City

Author: Ayyed Mohammed Namoos AL- Zubaidy
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2014 Volume: 6 Issue: 1 Pages: 55-59
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Hemophilia is hereditary bleeding distorted, and widespread in the world.The Objective: to identify the epidemiological characteristics of sample.Methodology: descriptive of study was conducted in genetic blood disease center in the AL-Ramadi Teaching Hospital for maternity & children during six months period of October to April (2012-2013).The data were collected by reviewing part of registered record in the center.Results: The study included (60) patients with hemophilia registered, (76,7%) was hemophilia A and (23,3%) hemophilia B. Age distribution revealed that the highest affected age group were those from age 6-15 years (33.3%). Gender distribution revealed that (88.3%) were males & (11.7%) were female. Residency distribution revealed that 65% were Rural & 35% were urban. The study showed that (56.7%) of cases were marriages among first cousins, (15%) of cases were marriages among close family or tribe & (28.3%) are marriages unrelated with family.Conclusion: from this study we can conclude that the most common is hemophilia A followed by hemophilia B & the number of newly registered cases is increasing with consanguineous marriages.


Article
Magnitude of arthropathy in patients with hemophilia: A single‑center experience

Author: Rawand Polus Shamoon
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2017 Volume: 6 Issue: 2 Pages: 78-83
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

BACKGROUND: Hemophilia is a sex‑linked bleeding disorder. Affected patients suffer spontaneousor post-traumatic bleeding into various sites of the body, mainly into joints, depending on the levelof coagulation factor deficiency.AIMS: This descriptive study is designed to assess the prevalence and extent of arthropathy andevaluate the functional status of hemophiliacs in Erbil, Northern Iraq.SETTINGS AND DESIGN: A descriptive study of all registered hemophiliacs at NanakaliHemato‑Oncology Teaching Centre, Erbil, Iraq.PATIENTS AND METHODS: Over 15 months (October 2015 to February 2017), a total of 133hemophilia patients were studied. Their hospital records were used to retrieve clinical and laboratorydata, mainly their coagulation profile. All patients were clinically examined at the daycare center;plain radiography was used to evaluate the degree of joint damage based on Petterson score. Themagnitude of joint disease was assessed, and patients’ functional status was evaluated dependingon Functional Independence Score in Hemophilia (FISH).STATISTICAL ANALYSIS USED: Statistical analysis used MS Excel 2010.RESULTS: Hemophiliacs mean age was 12.9 years. Patients with severe hemophilia presented earlierand had more bleeding episodes. At least one bout of hemarthrosis was recorded in 103/133 patientsduring the course of their disease with knee joint most frequently involved (in eighty patients) followedby elbow, ankle, wrist, and shoulder. The Petterson score related significantly to age of the patient,number of bleeds, and severity of hemophilia. Majority, 67%, of hemophiliacs found to have thelimitation of movement. FISH score significantly related with factor activity level. Functional disabilitywas encountered in 9.7% of cases; majority had severe hemophilia.CONCLUSIONS: The incidence and severity of joint bleeding and functional disability were high.The FISH and Pettersson scoring systems are very useful tools in assessing patients with hemophilicarthropathy.


Article
Oral Health Status and Caries Related Microflora Among Children with Congenital Coagulation Disorders (Comparative study)

Authors: Abeer M.H.Zwain --- Maha M.Misbah Al- Ameen.. --- Wael S. Al-Alousi
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2012 Volume: 20 Issue: 1 Pages: 335-342
Publisher: Babylon University جامعة بابل

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Abstract

Background: Congenital coagulation disorders are hereditary bleeding disorders characterized by a lifelong defect in the clotting mechanism. Maintaining a good oral health might be a problem for those patients because of the potential bleeding tendency. The aims of the present study are to assess the condition of the dental health and the changes in the caries related micro flora in children with these disorders. Materials and methods: 45 children with congenital coagulation disorder and 45 healthy controlled children matching the study group in age and gender were examined and indices recorded for PI, GI and dental caries (DMFS, dmfs) and caries related micro flora was sampled and cultured for Streptococcus mutans( on mitis salivarius agar supplemented with Bacitracin), Candida species (on sabouraud dextrose agar) and Lactobacilli (inoculated on Glucose yeast extract acetic acid agar)counts, the results then compared between the two groups.Results: The mean values of the plaque index and gingival index of the study group were more than that of the control group (highly significant difference P<0.01for PI and a significant difference P<0.05 for GI). Regarding dental caries, no significant difference was found between the two groups for primary dentition, while for the permanent dentition the study group had significantly higher caries experience than the control group(P<0.01).The mean values of colony forming units of Streptococcus mutans, Lactobacilli and Candida species in the oral micro flora of congenital coagulation disorder children were higher than that of the healthy children(P<0.01). Conclusions: children with congenital coagulation disorders have more plaque accumulation, sever gingival inflammation, higher prevalence of dental caries and there is a change in the oral micro flora and when dealing with them a great deal of emphasis should be placed on pediatric dentistry. They need regular dental programs and continued proper oral hygiene care can be instrumental in preventing dental treatment of those children


Article
Impact of Bleeding Disorders: Hemophilia A, B And C on Dental Hygiene in a Sample of Children In Hilla city

Authors: Wissam Hamid Edan AL-Janabi --- Moukhlad Louay Ali Al-Falluji
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2018 Volume: 26 Issue: 2 Pages: 275-279
Publisher: Babylon University جامعة بابل

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Abstract

Bleeding tendency is the manifestation of a wide range of abnormalities that can basically classify into two major categories according to etiology; these are the inherited and acquired categories. The pathologic defect resides in one of the three major sequential physiologic processes of blood homeostasis. Defects in coagulation include mainly inherited defect in the synthesis of one of the members of factors of coagulation such as factor VIII (Hemophilia A) and factor IX (Hemophilia B) and to a much less extent factor XI (Hemophilia C). The current study aimed to explore the oral health status in a sample of hemophilia male children. The present case control study included 22 children with hemophilia disorders and 50 apparently healthy aged matched control children. The age of hemophilia children ranged from 2-14 years. Dmft and DMFT were assessed and the results showed that patients had significantly higher scores indicating poor oral hygiene.Conclusion: hemophilia is a predisposing factor for poor dental hygiene and that protective measures should be seriously considered in such population to avoid serious complication following invasive dental procedures.

نزف الدم الوراثي احد الامراض التي تحدث نتيجة لنقص في تصنيع احد عوامل التخثر ويوجد بثلاث انواع حسب نوعية العامل المفقود. اجريت هذه الدراسة علي مجموعة من الاشخاص الحاملين للمرض باعمار تتراوح مابين (2-14) سنة في مركز الدم الوراثي في بابل . تم فحص نسبة التسوس لهؤلاء الشخاص ومقارنتها مع مجموعة ضابطة ووجد انه هنالك فرق معنوي واضح احصائيا. لذلك الاهتمام بصحة الفم لهؤلاء الشخاص يجنبهم الاصابة بامراض الفم التي من الممكن ان تحتاج الي علاجات صعبة تعرضهم للخطر.

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