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Article
Splenic Injuries atAl-Kadhimiya Teaching Hospital

Authors: Nahidh A. Abdulshaheed ناهد عداي عبد الشهيد --- Anees K. Nile انيس نايل --- Hikmat A. Hatam حكمت حاتم
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2009 Volume: 5 Issue: 1 Pages: 83-90
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The spleen is the most common solid organ injured in patients who had sustained abdominal trauma. Such injuries to the spleen represent approximately one quarter of all blunt injuries of the abdominal viscera.Due to its remarkable vasculature and its fragile structure, splenic rupture is the most widespread cause of intra-abdominal hemorrhage.Objective: To assess the magnitude of splenic injury, the management of splenic injury, and to evaluate the postoperative complications.Methods: A prospective study of 57 cases of splenicinjury was performed in Al-Kadhimiya TeachingHospital during the period between the 1st of October2004 and the 1st of October 2006. Statistical analysiswas then performed to identify the causes, managementand postoperative complications. Splenic injuries weregraded into 5 grades.Results: The highest incidence of splenic injury was recorded in age group s31-40 year. Penetrating injury was much more common than blunt trauma (73.68% versus 26.31%).Fifty patients (87 %) were diagnosed by exploratory laparotomy, ultrasonography in 5 patients (8.77 %), CT scan was positive in 2 patients (3.5 %). Associated injuries were recorded in 41 patients 71.92%. Pulmonary complications were the most frequent complications (18 patients, 31.57 %).Conclusion: Splenic injuries are common surgical problems in Al-Kadhimiya Teaching Hospital. Still there are many difficulties in establishing the diagnosis of the splenic injury with shortage in the new diagnostic modalities especially (CT -Scan, MR1 and even U/S scan) in the emergency situations.In spite of the dangerous post-operative complications of splenectomy, it is still the most commonly performed surgical procedure in cases of splenic injury.

Keywords

Spleen --- Splenic Injury --- Splenectomy --- Repair


Article
Deep Vein Thrombosis in Iraqi Spinal Cord Injured Patients

Author: Talal Abdulsamad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 21-26
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:Spinal cord problems is an important complication of spinal cord injury. Deep vein thrombosis is a critical sequel & need early diagnosis and management.OBJECTIVE:To determine the frequency and time of occurrence of deep vein thrombosis (DVT) in Iraqi Spinal Cord Injured patients, and a possible etiologic relationship between DVT and Spinal Cord Injuries (SCI) types.METHODS:One hundred nine Iraqi patients with spinal cord injury admitted at Ibn_Alkuff SCI Hospital from the 1st of January till 30th of June 2006 were studied, full history was taken and complete clinical examination was done for all patients. DVT was diagnosed by physical examination and confirmed by Doppler ultrasound. Special scales and scores were included in this study to assess spinal cord injury impairment (American spinal injury association scale/score and Modified Ashworth spasticity scale).RESULT:A total sample of 109 Iraqi patients were included in this descriptive cross sectional study, 100 males (91.7%) and 9 females (8.3%), the age of patients ranged from 11 to 65 years (mean 33.8 years), the disease duration ranged from 1 to 240 months (mean 20.5 months). Eleven patients (10.1%) were having DVT (were male patients).Our study showed statistically significant association between the presence of deep vein thrombosis and neurological level of spinal cord injury, flaccidity and ASIA scale (A and B). (p=0.011, p=0.017 and p=0.006 respectively) Our results showed no statistical significant association between age, gender, duration of spinal cord injury and causes of spinal cord injury in determining the presence of DVT. (p=0.71, p=0.36, p=0.68 and p=0.34 respectively)CONCLUSION:DVT is more likely to develop in Iraqi spinal cord injured patients who have a lumbar neurological level of injury or who have flaccid paralysis. Also SCI patients with ASIA scale A and B are more liable to develop DVT. These groups of patients needs close observation and monitoring.


Article
Evaluation of Adhesions Induced Intestinal Obstructionfollowing Abdominal Penetrating Missile Injuries

Authors: Bassam Farouk بسام فاروق --- Warqaa Mazin Akram ورقاء مازن اكرم --- Mohammed A. Al-Atroshi محمد التروشي
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2009 Volume: 5 Issue: 1 Pages: 91-98
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: To evaluate the incidence of adhesions induced intestinal obstruction after explorative laparotomy due to bullet/shell injury in Al-Kindi teaching hospital/Baghdad.Results: Thirty-six out of the 76 cases with adhesionsinduced intestinal obstruction (A.I.I.O.) had history oflaparotomy for penetrating missile injury, 26 of them wereexplored as a method of management of A.I.I.O. withmean age (22 for those explored, ٣٧ for those treatedconservatively), 16 of them presented within a year or lessfrom the previous surgery.Methods: Comparative interventional prospective study of cases with adhesions induced intestinal obstruction admitted to the surgical wards in Al-Kindi teaching hospital from the 1st of January 2008 to 31st of December 2008. cases were followed considering the indications of previous laparotomies, the patients age, gender, duration between previous surgery and their presentation with intestinal obstructionConclusion: Cases required surgical interventions for treatment were mainly those following explorative laparotomy for penetrating missile injury they were mainly of young age Groups.

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