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Monitoring of patients undergoing examination of bone marrow aspiration and biopsy
مراقبة المرضى الذين تحملوا فحص سحب واخذ خزعة من نخاع العظم

Author: Hakemia Shaker Hasian حكيمه شاكر
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 4 Pages: 102-106
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: Monitoring of the patient is to improve the outcome of the bone marrow aspiration and biopsy procedure by decreasing the risk of the procedure itself Objective: 1-To monitor the heart rate , and blood pressure of the patient before ,during ,and until 6 minutes after the needle of bone marrow biopsy and aspiration has been with drawn,2- Early detection of any signs and symptoms of distress 3-to monitor the ECG abnormalities that might occur during the bone marrow aspiration and biopsyMethods: The study consisted of 33 patients referred consecutively to the Baghdad teaching hospital 7th floor ( bone marrow aspiration and biopsy clinic) Before bone marrow aspiration and biopsy , baseline 12 leads ECG ,blood pressure, and heart rate were recorded .Lead II ECG, heart rate ,blood pressure were continuously recorded during the procedure until 6 minutes after the needle had been with drawn and 12 lead ECG ,blood pressure and heart rate gain recorded at the time .Results: Heart rate , systolic, diastolic blood pressure before the procedure were significantly increase in comparison with during period of the bone marrow aspiration and biopsy and decreases in number of patients suffering from nausea, vomiting ,pallor, chest pain, dyspnea, general pain when comparing to non suffering from signs and symptomsConclusion: Electrocardiographic changes are rarely found in patients undergoing bone marrow aspiration. According to the results the investigatore recommended to preparing and training of bone marrow aspiration and biopsy clinic staff for patient care before, during and after bone marrow aspiration and biopsy

الملخص:خلفية الدراسة:-مراقبة المريض بحسين من أجراء سحب واحذ خزعة من نخاع العظم وذلك بتقليل نتائج خطورة الأجراءالهدف: 1- مراقبة ضربات القلب وضغط الدم للمرض قبل وخلال و لفترة زمنية لمدة 6 دقائق بعد سحب الإبرة. 2- الكشف المبكر عن أي علامة وعرض من علامات الإجهاد. 3- مراقبة الحالات الشاذة في تخطيط القلب الكهربائي خلال اجراء سحب واخذ خزعة من نخاع العظم.الطريقة :شملت الدراسة على (33)مريضا أحيلوا بصورة متعاقبة إلى مستشفى بغداد التعليمي / الطابق السابع (عيادة مرضى سحب واخذ خزعة من نخاع العظم ) . قبل أجراء سحب واخذ خزعة من نخاع العظم الخطوات الرئيسية تم تسجيل 12 قطب من تخطيط آلقلب الكهربائي وضغط الدم وسرعة ضربات القلب وباستمرار تم تسجيل سرعة ضربات القلب من القطب الثاني لتخطيط القلب الكهربائي مع ضغط الدم خلال أجراء سحب واخذ خزعة من نخاع العظم ولمدة 6 دقائق بعد أجراء سحب واخذ خزعة من نخاع العظم.حيث سجل مرة ثانية 12 قطب من تخطيط القلب الكهربائي ,وضغط الدم وسرعة ضربات القلب في ذلك الوقت.النتائج :هنالك زيادة ذات دلالة معنوية في سرعة نبضات القلب. و ضغط الدم العالي مقارنة بفترة قبل وخلال أجراء سحب واخذ خزعة من نخاع العظم وقلة في عدد المرضى الذين عانوا من غثيان وتقيء وشحوب لون الجلد والآلام في الصدر مع ضيق في التنفس وألم عام وشامل مقارنة بأولئك الذين لم يعانوا من العلامات والأعراض المرضية . النصائح: التغير في تخطيط القلب نادر حدوثه مع المرضى الذين يخضعون لأجراء سحب واخذ خزعة من نخاع العظم . وطبقا لهذه النتائج توصى الباحثة بتهيئة وتدريب الملاكات العاملة بوحدة عيادة مرضى سحب واخذ خزعة من نخاع العظم حول العناية التمريضية قبل ,خلال وبعد سحب واخذ خزعة من نخاع العظم


Article
BONE MARROW NECROSIS IN SICKLE CELL DISEASE, A CLINICAL & PATHOLOGICAL STUDY

Authors: Zuhair A Al-Barazanchi --- Alwan H Al-Shiwaeli
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 1 Pages: 1-88
Publisher: Basrah University جامعة البصرة

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Abstract

Zuhair A Al-Barazanchi*, Alwan H Al-Shiwaeli#*M.Sc Haematol. Consultant Haematologist, Post-graduate Supervisor & Lecturer, Laboratory Department, Basrah General Hospital.#M.Sc Haematol. Specialist Haematologist, Al-Faeha General Hospital.Bone marrow necrosis (BMN) is a rare clinical-pathological entity. It is mostly associated with post-mortem changes. Ante-mortem existence of BMN is quite rare and usually indicates a poor prognosis. However, its association with non-hematological malignancies seems not to be as poor prognostic feature as in post-mortem changes. One of the most commonly disorders associated with BMN is sickle cell disease (SCD), which is common among people in Basrah province. The current study probably can put light on the incidence of such pathology among those with SCD, its most clinical presenting features and its relation with specific sickle disease genotypes. The incidence of BMN in this study was 4.9 %. The mostly encountered features with wide spread necrosis were bone pains, fever, and pallor. Peripheral blood showed a florid leuco-erythroblastic picture with reticulocytosis and leucopenia in another case with focal necrosis. On comparison with those patients without BMN, patients with BMN showed a significantly lower Hb concentration, higher Hb S concentration, lower Hb F concentration, smaller splenic size, higher number of irreversibly-sickled cells and more frequent painful crises during their life. Those results were compatible with some observations and contradict with other. However, there is no previous study conducted in Iraq to compare with.

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