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Article
Antinociceptive Effect of Silymarin in Experimental Animal

Author: Ahmed S. Sahib احمد صهيب
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 2 Pages: 91-94
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Silymarin is a polyphenolic flavonoid derived from milk thistle (Silybum marianum) that has anti-inflammatory, cytoprotective, anticarcinogenic and antioxidant effects. It has been used medicinally to treat liver disorders including acute and chronic viral hepatitis, toxin/drug induced hepatitis, and alcoholic liver disease. Objective: To evaluate the antinociceptive effect of silymarin in experimental animal model of pain.Methods: The efficacy and dose response effect of silymarin (125, 250, and 500mg/kg) were assessed against control using tail flick test in mice as a model of nociceptive pain. In this model, all doses of silymarin were given intraperitoneally 15 min before immersion of tail in hot water 50°C, and Tail Flick Latency was measured before, and after (15, 30, 60 and 120 min) administration of silymarin.Result: Silymarin in 250 and 500mg/kg significantly increase Tail Flick Latency after 15, 30, 60 and 120 min in a dose dependent manner that the maximum effect seen after 120 min compared to baseline value. Conclusion: Silymarin as a herbal drug produce a significant antinociceptive effect in experimental animal model of pain, and beside its better standardization, quality control, and safety profile, in addition to its availability and relative low cost, represent a good alternative choice for management of pain.

Keywords

Silymarin --- milk thistle --- pain


Article
Assessment of Children's Pain in Oncology Unit

Authors: Dr. Sajid Majeed Hameed. د.ساجد ماجد --- Dr. Raja Hadi Abbas د.رجاء هادي --- Dr. Eqbal Gh, Ali.. د. اقبال علي
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2011 Volume: 8 Issue: 3 Pages: 269-273
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Most children with cancer will be at risk for significant pain at some time duringthe course of their illness. Pain may be a product of the disease itself or the result ofmedical intervention in the form of diagnostic procedures, surgery, and chemotherapy,or radiation therapy. An adequate standard of care requires that the cliniciansystematically assess and effectively manage pain on a routine basis for all childrenwith cancer.Aim of the study was to :- a) Assess pain with invasive monitoring procedures (pre& post procedure): - vein puncture, lumber puncture & bone marrow aspiration &biopsy. - b) Assess Current symptoms pre receiving of chemotherapy, - c) AssessIntensity pain with like methods of chemotherapy, d) Assess Family & child's painexperience within the period of treatmentA total of 50 patients age between (6 – 12 years) in oncology unit in central childteaching hospital & children teaching hospital in medical city, from 25th of January to25th of April 2009. Using questionnaires which has 3 parts, part one – demographiccharacteristics Part two – assessment pain with monitoring procedures, currentsymptoms pre receiving of chemotherapy, intensity of pain with methods receiving ofchemotherapy. Part three – family & Childs experience pain with use facialexpression with poker chips colorResults were analyzed by descriptive statistical including (frequency, percentage,mean of score). Results showed that (50%) of patients were age 6-8 years &diagnosed leukemia, 60% males & number of chemotherapy less than 6th courses,(72%) duration of diseases less than 6th months, 56% number admissions to hospitalwith out chemotherapy were 3-7 time. Vein Puncture (60%) of sample feeling no painpre procedure, (80%) feeling some pain bother post procedure Lumber Puncture(50%) of sample feeling pain that does not bother pre procedure, (80%) feeling severpain post procedure Bone Marrow Aspiration (60%) of sample feeling some painbother pre procedure, (100%) feeling unbearable pain post procedure. (40%) fear Prereceiving chemotherapy. (60%) methods receiving of chemotherapy bothintravenously & intrathecaly, intravenously methods pain is most hurt whileintrathecaly methods pain is the most hurt could ever have. Family experience towardassess pain tool, them showed these easily. Child experience with pain (60%) useword discomfort or no communication when feel painIn conclusions the study revealed the pain more than in post monitoringprocedure specific in lumber puncture & high level in bone marrow aspiration, fear isthe most symptoms syndrome for patients pre receiving of chemotherapy,intravenously methods most methods pain for patient. Most families the tool painshowed easily & easily transport & more children use words to expression pain & nocommunication.


Article
Analgesia in labor: Evaluating clinical trial comparing between Entonox versus parenteral pethidine during the first stage of labor

Author: Ali H. Muslih
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2011 Volume: 10 Issue: 1 Pages: 39-42
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background An adequate analgesia during labor is important to minimize the deleterious effects of sever labor pain on maternal and fetal condition and also on the progress of labor. Aim To compare the clinical effectiveness of inhalational analgesia by using Entonox versus systemic analgesia by using I.V pethidine for pain relief in the first stage of labor. Patients and methods 48 multiparous women were selected in the first stage of labor, were randomly allocated into 2 groups, group A had received I.V pethidine and group B had received Entonox. Total pain score measurement was done by using the parameters of Mc Gill pain questionnaire which include pain rating index (PRI) and present pain intensity (PPI). Results A comparison between group A&B done, the difference in PPI between pethidine & Entonox was showing a statistical significance P<0.001. The difference in PRI between pethidine &Entonox was carrying no statistical significance. Conclusions Inhalational analgesia by using Entonox in a proper intermittent technique is more effective than systemic analgesia by using parenteral pethidine for reducing present pain intensity in the 1st stage of labor.

Keywords

Pethidine --- Entonox --- Labor pain --- PPI --- PRI


Article
DOES POST-LAPAROSCOPIC CHOLECYSTECTOMY INTRA-ABDOMINAL DRAIN REDUCES POSTOPERATIVE SHOULDER PAIN?

Authors: Ahmed H. Ismael احمد حقي اسماعيل --- Anees K. Nile انيس خليل نايل --- Hassan A. Hassan حسن احمد حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 1 Pages: 4-10
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: In the context of the much-heralded advantages of laparoscopic surgery, it can be easy to overlook post-laparoscopy pain as a serious problem, yet as many as 80% of patients will require opioid analgesia. It is generally accepted that pain after laparoscopy is multifactorial, and the surgeon is in a unique position to influence many of the putative causes by relatively minor changes in technique.Objective: To determine whether a drain placed in the peritoneal cavity during laparoscopy is both clinical and cost-effective method of reducing postoperative shoulder pain.Methods: One hundred female patients were having laparoscopic cholecystectomy were divided into two groups, a control group (50 patients) where no intra-peritoneal drain was inserted and second group (50 patients) in which the patients had intra-peritoneal gas drain sited in the subhepatic area. Patients' age, weight, height, operative time, total amount of CO2 and amount of analgesia used were recorded for each patient in both groups. Shoulder pain was assessed using visual analogue score (VAS) from 1-5 scale at 4, 8, 24 & 48 hours postoperatively, where as abdominal pain was assessed at 48 hour post-operatively. pH of the abdominal fluid was assessed in the second group of patients by using pH meter 48 hours postoperatively. ResultsShoulder pain may occur in many of patients of the control group more frequent than those of the second group, where as postoperative abdominal pain was found to be greater in patients with subhepatic drain after laparoscopic cholecystectomy.Conclusion: Low-cost drain decreased the frequency of shoulder pain and reduced the need for analgesia, but increases the abdominal pain; however it is less cost-effective than simple oral analgesia after laparoscopy.Keywords: laparoscopic cholecystectomy, intra-abdominal drain, shoulder pain


Article
A Clinical Association of Dry Socket and Postoperative Pain with Typhoid fever as Risk Factor

Authors: Mahmoud YM Taha --- Faraed D Salman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2011 Volume: 11 Issue: 17 Pages: 71-77
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To identify the clinical picture and the association between dry socket and severe postoperative development with one of the systemic risk factors (typhoid fever). Materials and Methods: Twenty adult (both sexes) patients attended dental clinic searching for different dental treatments were studied. The clinical picture of 6 months period study was evaluated by completing two case sheet forms. They were diagnosed having dry sockets and severe postoperative pain. Blood samples were taken for bacte-riological, serological and hematological study to diagnose typhoid fever. These tests included WAT, WFT, WBCs and blood culture. Results: Significant correlation existed between postoperative pain and typhoid fever examined by BC and the highest percentage was with dry socket (61.5%) followed by WFT (57.1%(, WAT (44.4%) using two tests for diagnosis showed that WFT and BC gave 97.9% positive for dry socket and Kappa test was 88%, while WAT and WBCs or WFT and WAT gave the least non significant correlation. Conclusion: There was a strong correlation between dry socket and typhoid fever and the most sensitive tests for diagnosis was BC followed by WFT, WBCs and WAT.


Article
The Dialectic of Pleasure and Pain In Selected Poems of Emily Dickinson

Author: Makki Muhammed Muthanna
Journal: journal of Human Sciences مجلة العلوم الانسانية ISSN: 19922876/25239899 Year: 2011 Volume: 1 Issue: 8( خاص بالمؤتمر) Pages: 326-337
Publisher: Babylon University جامعة بابل

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Abstract

This paper is concerned with exploring Emily Dickinson’s views on pleasurand pain and the conflict between them that results in a synthesis in which the two opposites are reconciled. The paper begins with a historical perspective on the concepts of pleasure and pain as they were tackled in different ancient schools of thought till the recent time. This is followed by an explanation of the philosophic term of “dialectic” in reference to George Wilhelm Friedrich Hegel (1770-1831), the German idealist philosopher, who is considered one of the most prominent thinkers of the 19th century. The paper then moves to discuss the major factors that led to the appearance of the dialectic phenomenon in Dickinson’s works. The second section of the paper is devoted to investigating a group of Dickinson’s poems that tackle her musings on the sensation of pleasure which represent the thesis in her dialectics.


Article
Door to Needle Time in Administering Thrombolytic Therapy for Acute Myocardial Infarction

Author: Abdul Ameer Jaleel Awad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 328-331
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Thrombolytic therapy is a standard treatment for patients presenting with acute myocardial infarction (MI). Early administration of these agents is crucial for the outcome of management.OBJECTIVE:This audit was conducted to evaluate the time between arrival to emergency department (ED) and the administration of thrombolysis (door to needle time).METHODS:Data was collected from patients admitted to the Coronary Care Unit of Al-Yarmook Teaching Hospital ,with a diagnosis of acute MI and received thrombolytic therapy over a one-year period (April 2009 to April 2010). The time between arrival to the ED to the time of administration of thrombolytic therapy was obtained as well as the time of onset of chest pain up to presentation to the hospital, and the outcome (all cause mortality) post treatment.RESULTS:A total of 271 patients (256 males) admitted to the Coronary Care Unit of Al-Yarmook Teaching Hospital with a diagnosis of acute MI received thrombolytic therapy over a one-year duration. The median door to needle time was 95 minutes. The median time of onset of chest pain to arrival to ED was 5 hours (300 minutes). The outcome of these patients obtained either alive was 260 (96%) or dead was 11 (4%) (P < 0.00001).CONCLUSION:The door to needle time was relatively similar to other centers. Delay in presentation to the hospital was more important and factors contributing to this delay should be looked for and corrected. Another audit is needed to evaluate the implementation of these recommendations.


Article
Helicobacter Pylori positivity in Children with Recurrent Abdominal Pain and possible Risk factors

Author: Dr. Shaker K. Gatea C.A.B.P; D.C.H أ.م.د. شاكر كريم گاطع
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2011 Volume: 14 Issue: 2 Pages: 78-84
Publisher: University of Kufa جامعة الكوفة

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Abstract

OBJECTIVE: To assses the association of H -pylori infection and recurrent abdominaal pain in children.Material and methods: The association of H -pylori infection and recurrent abdominal pain were studied in 44 children, aged 4-12 yrs. Using stool antigen test (HpSA) and serlogical identification of IgG by ELISA. 26 children without RAP were subject for HP identification also as acontrol group. Cases with specific causes for abdominal pain were excluded from the study.Information about demographic ,socioeconomic, envirometal living state were obtained to lable possible risk factors. High percentage (85%) of HpSA and sero positive children with abdominal pain had complete symptomatic relief after eradication of organism.Results: High percentage (64%) of children with recurrent abdominal pain show positivite result for H-pylori stool antigen test and IgG identification in comporism with asymptometc children (46%).Conclusion: There is apossible association of H –pylori infection and recurrent abdominaal pain in children and these patients should be consider for H –pylori eradication.

هدف الدراسة : لتقييم علاقة الاصابة بالجرثومة الحلزونية وألام البطن المتكررة عند الاطفال .طريقة العمل: تم فحص 44 طفلا يعانون من الام البطن المتكررة وخاصة في المنطقة الشرسوفية و26 لا يعانون من نفس الاعراض (كونترول) أعمارهم مابين ال4 سنوات وال12 سنة وخلال فترة 9 أشهر, تم الفحص بواسطة البحث عن المضادات الخاصة بالجرثومة الحلزونية في مصل الدم والمستضد في الخروج, دونت معلومات عن هؤلاء الاطفال تخص الحالة الاجتماعية والاقتصادية ومعلومات تخص السكن والعمر والجنس والازدحام في السكن.النتائج:أوضحت الدراسة ان نسبة الاطفال الذين يعانون من امراض البطن المتكررة والمصابون بالجرثومة الحلزونية (64%) بينما النسبة في الاطفال الذين لا يعانون من الام البطن هي (46 %) , وان انتشار هذه الجرثومة يتأثر عكسيا مع الحالة الاقتصادية والاجتماعية بينما تزداد نسبة الاصابة مع العمر .الاستنتاجات: أوضحت الدراسة ان هناك احتمال علاقة بين الام البطن المتكررة عند الاطفال والاصابة بالجرثومة الحلزونية وهؤلاء الاطفال يجب ان يعرضون للبحث عن الاصابة بالجرثومة الحلزونية ومن ثم اعطاء العلاج اللازم لاستئصالهاالكلمة المرجعية: الجرثومة الحلزونية, والام البطن المتكررة


Article
Comparative study between ultrasound findings and intra-operative findings in non-traumatic Abdominal Pain:
دراسة مقارنة بين نتائج الموجات فوق الصوتية والنتائج أثناء العملية الجراحية في حالات آلام البطن الحادة غير المسببة بالصدمة

Author: Basim R. Gadban باسم رسام غضبان
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 4 Pages: 377-380
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: acute abdominal pain is one of the most common presentations in surgical wards. Ultrasound has been grown in popularity as an easy, quick and non-invasive imaging the abdomen. US is very useful means of non-invasively, modality for assessment of acute abdominal pain.Objective: Study of the most common acute none traumatic abdominal diseases in adult patients admitted to Baghdad Teaching Hospital in department of surgery .Correlate the operative findings with sonographic features as to make the initial diagnosis of the diseases included in this study. Compare the diagnostic yield of abdominal ultrasound with that of computed tomography (CT). Methods :The present study included eighty nine consecutive adult patients with non traumatic abdominal pain as their chief complaint were admitted in the department of surgery at Baghdad Teaching Hospital during the period from April 2009 to January 2010.Ultrasound was performed in all patients in addition to CT scan as the first techniquesResults: The results showed that acute non traumatic abdominal pain was more frequently in female patients(73.46%) than male (26.53%).Gall bladder disease was the most common cause of upper abdominal surgeries (n= 45). No differences were observed between surgeries for intestinal obstruction or acute appendicitis(n=6) at P < 0.05 High accuracy of using of US, CT scan in the diagnosis of acute abdominal pain ,the compatibility with the operative finding was %89.79 , 83.33% respectively Conclusion: Sonography should be the first imaging technique in adult patients for the diagnosis of acute abdominal pain. CT scan should be used as a complementary study for suspected abdominal cases.

تعد آلام البطن الحادة واحدة من أهم الأسباب الشائعة لمراجعة المرضى لقسم الجراحة التابع للمستشفيات ويعتبر جهاز الأمواج فوق الصوتية واحدا من أهم الأجهزة المستخدمة على نطاق واسع لتشخيص الأمراض الجراحية نظرا لسهولة استخدامه وسرعته ولعدم اختراقه للبطن وأيضا يعتبر من أهم الأجهزة التي تحدد لنا السبب الرئيسي لألام البطن الحادة .الهدف :دراسة أمراض البطن الأكثر شيوعاً المسببة لألام البطن الحادة غير المسببة بالصدمة للمرضى البالغين الذين ادخلوا إلى قسم الجراحة العامة في مستشفى بغداد التعليمي.ربط نتائج العملية الجراحية مع مميزات الموجات فوق الصوتية لجعل التشخيص الأولي للإمراض المدرجة في هذه الدراسة .مقارنة التشخيص بواسطة الأمواج فوق الصوتية مع تلك بواسطة التصوير الطبقي .طريقة العمل:تضمنت الدراسة الحالية إحدى وتسعون مريضا بالغا يعانون من آلام البطن الحادة كانوا قد ادخلوا قسم الجراحة التابع لمستشفى بغداد التعليمي للفترة مابين نيسان 2009 ولغاية كانون الثاني 2010 وقد تم فحصهم جميعا بجهاز الأمواج فوق الصوتية إضافة إلى جهاز المفراس تشخيص تقني أولي للمرض الذي يعانون منه .النتائج: لقد تم التوصل من خلال الدراسة إلى أن آلام البطن الحادة كانت أكثر تكرارا في النساء المريضات (73.46 %) منه في الرجال (26،53%) . أيضا تم ملاحظة أن مرض المرارة كان من أكثر الأمراض شيوعا بالنسبة للمرضى موضوع الدراسة n=45 والتي اجري لهم تداخلا جراحيا فيما بعد . ولم يلاحظ وجود فروقاً معنوية بين المصابين بالانسدادات المعوية والمرضى المصابين بالتهاب الزائدة الدودية. ولوحظ أيضا دقة عالية لكل من جهازي الأمواج فوق الصوتية والمفراس عند مقارنتها بما تم ملاحظته خلال العمليات الجراحية حيث كانت النسب على التوالي 89،79% و 83،33% .الاستنتاجات :أن جهاز الأمواج فوق الصوتية كان يتمتع بدقة عالية في تشخيص آلام البطن الحادة ويمكننا استخدام جهاز المفراس كجهاز تكميلي للتشخيص التأكيدي للحالات المشكوك بها لبعض الأمراض الحادة . 89،79% و 83،33% .

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