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Article
Prevalence of myofascial pain in students of selected secondary schools in Baghdad city

Authors: Toka T. Alnesary --- Rafil H. Rasheed رافل رشيد --- Raja H. AL-Jubouri رجاء الجبوري --- Raya R. Al-Dafaai ريا الدفاعي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 2 Pages: 84-87
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Myofascial face pain (MFP) is painful disorder of masticatory muscles thought to be the most commontype of temporomandibular disorder (TMD).This study was done to evaluate the prevalence of MFP in students ofsecondary schools of Baghdad cityMaterials and methods: The sample comprised 242 females' students and 222 males' students of secondary schools,aged 17-18 years. The MFP evaluated according to the specific screening questionnaire of research diagnosticcriteria of temporomandibular disorders (RDC/TMD) axis I with clinical examination.Results: the study revealed that (50.8%) of the students had history of pain where females reported higherpercentage than males with statistical significant difference. The history of pain in muscles of mastication was higherthan joint pain in both genders. After clinical examination this study also showed that (25.4%) of students with historyof pain had MFP. The differences between both genders regarding the diagnosis of MFP were higher in females thanmales but statistically not significant.Conclusion: high percentage of students reported a history of pain which could be attributed to MFP in (25.4%) ofthe students. The prevalence of pain history and MFP was higher in females’ than males


Article
QUANTIFICATION OF PAIN THRESHOLD IN PARKINSON’S DISEASE

Authors: Aqeel K Hatim عقيل كريم حاتم --- Munther T Hamzah منذر طاهر حمزة --- Hasan A Hasan حسن عزيز حسن --- Zaki N Hasan زكي نوح حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 1 Pages: 83-86
Publisher: Al-Nahrain University جامعة النهرين

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BackgroundParkinson's disease (PD) is the second most common degenerative neurologic disorder after Alzheimer’s disease. Pain is one of the major clinical symptoms of Parkinson's disease, occurring in 50-83% of patients. Pathways mediating pain are complex and include basal ganglia and thalamocortical-basalganglia circuits.ObjectiveTo quantitatively assess pain perception in Parkinson disease patients, by determining pain threshold in patients with and without pain through using electrical stimulation.MethodsA cross sectional observational study recruiting 18 patients with a clinical diagnosis of Parkinson disease and healthy controls from the neurologic unit in Al-Kadhimiya Teaching Hospital in Baghdad; between May 2010 to Jan 2011. There were 13 men and 5 women with a mean age of (66.5 ± 10.2 years). The control group includes 18 healthy subjects, [12 males/ 8 females] with a mean age of 56.6±6.74 years. Quantitative sensory testing was carried at the neurophysiology laboratory in Al-Kadhimiya hospital; using bipolar stimulating electrodes on the forearm, index finger, mid leg, and big toe.ResultsFourteen Out of 18 patients (77.7%) reported pain, while 4 (22.3%) had no pain. There was a highly significant statistical difference in electrical perception between the affected and unaffected side, and between Parkinson disease patients and the controls. There was no statistically significant difference between males and females [p =0.8248], and between patients with and those without pain [p =0.3279]. And between upper and lower limbs on the affected side [p =0.1412], and body side involvement whether right or left in both the patients and controls.ConclusionChronic pain is present in 77.7% of Parkinson disease. Patients with Parkinson disease had lower pain threshold compared to controls. The affected side had lower pain threshold. The left or right body side and gender had no effect on pain threshold.Key worldsParkinson disease, Pain

Keywords

Parkinson disease --- Pain


Article
Relationship between the eating out home and infection with Giardiasis

Author: Atheer Kadhim Ibadi Zeid
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2012 Volume: 2 Issue: 1 Pages: 7-14
Publisher: University of Kufa جامعة الكوفة

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Abstract

Abstract This study carried out in primary health care center of Muslim Ibn Akeel , in al-Kufa town –Al –Najaf Al- ashraf province from 2/1/2010 to 1/1/2011.The study aims to determine the causes of abdominal pain and repeated diarrhoea in adult males only who were eating outdoor, 33 persons of them were diagnosed as an irritable bowel syndrome. The total number of cases was 150 patients. This study had done in a large area with low-income , poor water, food hygiene, swallowing water (such as from a swimming pool, lake, river, pond, or stream) contaminated with sewage or stool from Giardia-infected people or animals and sanitation are common in communities with repeated diarrhea. These factors combine to facilitate the spread of enteropathogen including, precoded questionnaires with demographic details, clinical history, and physical signs were completed. In this study ; 150 samples of stools were collected for routinely general stool examination. The results were showing high rates of G. lamblia 84.7% , followed by motile monilia, motile bacteria, Ent.Histolytica, Enterobious vermicularis, E. coli, , H.nana & others. The study showed that the highest percentage of infected persons occurs in age group of 25-29 years and lowest in 40-44 years, also highest percentage occurs in the persons who were eating three times daily and in summer more than in other seasons.Only 30 patients 20% were with negative stool examination. This study recommended by practice good hygiene in day care centers, retirement homes, and at home to prevent the spread of infection, wash hands frequently with soap and water for at least 15 seconds, avoid contact with the feces of an infected person, when traveling in areas where giardiasis is common, infection with Giardiasis can be prevented by using only bottled water and avoiding consumption of raw fruits , vegetables and do not use untreated water in areas where the parasite might be present, such as lakes, rivers and streams. Boil the water for at least one minute before using it.

أجريت هذه الدراسة في مركز الرعاية الصحية الأولية (مسلم بن عقيل في الكوفة, محافظة النجف الأشرف) للفترة من 2010/02/01 إلى 2011/01/01. كانت الدراسة تهدف إلى تحديد أسباب آلام البطن والإسهال المتكرر في الذكور البالغين الذين كانوا يتناولون الطعام خارج بيوتهم فقط، 33 شخصا منهم مصابون بمتلازمة القولون المتهيج. وكان العدد الإجمالي للحالات 150 مريضا. وقد أظهرت هذه الدراسة التي أجريت في منطقة كبيرة تمتاز بانخفاض الدخل وقلة الإصحاح المائي و الغذائي، إن ابتلاع ا لماء(في المسابح و البحيرات و الأنهر, الراكدة و الجارية) الملوثة بمياه المجاري و فضلات الإنسان و الحيوانات والصرف الصحي و هي من الأمور الشائعة في المجتمعات التي ينتشر فيها الإسهال المتكرر. وكانت هذه العوامل تتضافر لتسهيل انتشار المسببات المرضية المعوية، بما في ذلك استكمال الاستبيانات المطلوبة مع التفاصيل الديموغرافية، والتاريخ السريري، والعلامات الفسيولوجية. تم جمع 150 عينة من براز الأشخاص المصابين لإجراء فحص البراز العام الروتيني. أظهرت هذه الدراسة ارتفاع معدلات الإصابة بالجياريا اللمبلية 84.7%، تليها المونيليا المتحركة، البكتيريا المتحركة، الطفيليات ألحاله للنسيج،الديدان الدبوسية , اشريشية القولونية، الدودة القزمة وغيرها. كما أظهرت نتائج هذه الدراسة أن أعلى نسبة من الأشخاص المصابين تحدث في الفئة العمرية من 25-29 سنة و 40-44 سنة هي ألأدنى، كما أن أعلى نسبة مئوية تحدث في الأشخاص الذين يتناولون ثلاثة مرات يوميا و في الصيف أكثر مما كان عليه في المواسم ألأخرى.فقط 30 شخصا20% كان فحص خروجهم سالبا. توصي هذه الدراسة بممارسات النظافة الجيدة في مراكز الرعاية النهارية، ودور المسنين، والمنزل لمنع انتشار العدوى, غسل الأيدي بشكل متكرر بالماء والصابون لمدة لا تقل عن 15 ثانية, تجنب التماس مع براز الشخص المصاب,كما يمكن الوقاية عند السفر إلى المناطق التي ينتشر بها مرض الجيارديا باستخدام المياه المعبأة في زجاجات فقط، وتجنب استهلاك الفواكه والخضار النيئة.كما يجب عدم استخدم المياه غير المعالجة في المناطق التي قد يكون الطفيلي فيها موجودا ، مثل الأنهار والبحيرات ومجاري المياه. غلي الماء لمدة دقيقة واحدة على الأقل قبل استخدامها.


Article
Dental Anxiety and it's Relation to Serum Cortisol Level Before

Author: Dunia W. Alfayad دنيا وديع الفياض
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2012 Volume: Vol.10 Issue: 1 Pages: 35-40
Publisher: University of Anbar جامعة الانبار

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Abstract

Background: Dental anxiety is still prevalent, despite advances in treatment methods, and it affects the utilization of health does not only decrease the pain threshold, but actually leads to the perception of painless stimuli as painful. services. Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in many functions.Objectives: To evaluate the relation between the level of serum cortisol and increase anxiety in dental patients before minor oral surgery.Materials and Method: Sixty patients were included in this study were attended Alkatana Specialized Dental Center from October/4/2010 till December/1/2010, their age ranged from (16-54 years) 27 patients were females and 33 were males. They were divided into two groups, 30 of them as controls (they didn't need any dental surgery) who match the other 30 patients study group in age, sex and their general health status but they needed minor oral surgery. Blood samples were collected from all patients between 10-11 Am., and about 5 minutes before surgery to the patients of the study group. Serum cortisol level was measured by using radioimmunoassay analysis.Results: A total of 60 patients were enrolled in this study. Regarding the control group 15 were females and 15 were males while for the study group patients12 were females and 18 were males. Serum cortisol level was significantly different between two groups the mean was13.05 ±6.51 for control patients and 23.62 ±10.12 respectively and the Coefficient correlation (r)between serum cortisol level and pulse rate in both groups were 0.16 (p>0.05) for the control patients and 0.58 (p<0.01) for the study group patients. When serum cortisol concentrations in study group were distributed according to the age of the sample, there was a highly significant positive correlation between these variables (r=0.36, p< 0.05). Also pulse rat in study group was found highly positive association with age (r=0.55, p < 0.01).Conclusions: It is concluded that the study group patients exhibited significantly higher levels of serum cortisol and pulse rate than that of the control group. This deference is suggested to be due to phobia from dental surgical work. As recommendation we suggest giving patient 5 mg of diazepam at the night before the operation.

القلق النفسي لدى مرضى الاسنان وعلاقة هرمون الكورتيزول قبل عمليات الاسنان الصغرى

Keywords

dental anxiety --- pain --- cortisol


Article
Analgesic Effect of Melatonin in Mice

Author: Imad Hashim Mohammad, M.Sc., Ph.D.
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 2 Pages: 28-31
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Melatonin is the main hormone secreted by the pineal gland. This indole compound (N-acetyl-5-methoxytryptamine) is derived from serotonin after two biochemical steps. Melatonin has been implicated in some pharmacological effects including sedative/hypnotic, anticonvulsant activity and others. The aim of this study was to investigate the antinociceptive effect of different doses of melatonin administered i.p. to mice, and then, to find the dose- response line of melatonin in mice as analgesic agent.Methods: The dose response effect of melatonin (10, 50, and 100mg/kg) were assessed against control using tail flick test in mice as a model of nociceptive pain. In this model, all doses of melatonin 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 melatonin.Results: Administration of melatonin i.p. to mice significantly P ≤ 0.05 increase tail flick latency in melatonin treated groups after 30 min and 60 min compared to baseline values; while after 120 min, administration of melatonin produce significant and dose dependent antinociceptive effect following its i.p. administration. The percentage increase in tail flick latency produced by i.p. administration of melatonin doses of 10, 50, and 100 mg/kg were 86.59%, 156.05% and 169.19% respectively when compared to baseline values.Conclusions: The present study showed that melatonin produces analgesic effect in a dose dependent manner in mice, further studies are required to know the exact mechanism by which melatonin exerts this analgesic effect.Keywords: melatonin, analgesia, pain

Keywords

melatonin --- analgesia --- pain


Article
Pain intensity and control with fixed orthodontic appliance therapy (A clinical comparative study on Iraqi sample)

Author: Hayder Fadhil Saloom حيدر فاضل سلوم
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 3 Pages: 122-128
Publisher: Baghdad University جامعة بغداد

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Background: The purpose of this prospective, randomized clinical trial was to investigate the level and intensity ofpatients` pain and discomfort, and to compare between the use of Bite Wafer and Paracetamol in reducing painand discomfort associated with initial orthodontic tooth movement in both adolescents and adults.Sample: 110 subjects with two age groups, 52 adolescents with age range from 12 to less than 18 years and 58 adultswith age range 18-24 years, successfully completing the study. For each subject fixed orthodontic appliance (Roth0.022) was bonded and round 0.014 NiTi arch wire was ligated with elastic ligature. The subjects in the Bite Wafergroup were instructed to chew on it whenever they feel pain for the next 7 days, and document the time andeffectiveness of it in the questionnaire. The Paracetamol group subjects instructed to use Paracetamol 500mg torelive pain and record times and effectiveness of its use in questionnaire.Results: The peak of pain was occurred in the first day and declined gradually till totally disappeared at the sixth dayafter initial arch wire placement. A marked reduction of pain intensity was noticed in both adolescents and adultsgroups, using Bite Wafer, from the first to the sixth day which is much higher than Paracetamol group especially inadolescents. No gender differences (P>0.05) was noticed in this study.Conclusion: Although both Bite Wafer and Paracetamol reduced pain gradually, Bite Wafer reduced pain moreobviously and safely in comparison to Paracetamol especially in adolescents

Keywords

pain --- Wafer --- orthodontic


Article
A clinical comparison between maxillary and mandibular posterior teeth using local anesthesia and normal saline by the periodontal ligament injection (An in vivo study)

Authors: Majidah K.W. AL-Hashimi ماجدة الهاشمي --- Raad S. Al-Doori رعد الدوري
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 1 Pages: 18-23
Publisher: Baghdad University جامعة بغداد

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Background: Local anesthesia is the primary method used in dentistry to control patients’ pain. However, even in thepresence of adequate soft tissue anesthesia, there may be incomplete pulpal anesthesia. This is particularly true inthe mandible where obtaining profound pulpal anesthesia may be difficult. The periodontal ligament injection hasreceived much attention in the dental literatures. lntraligamentary anesthesia has been advocated as a primary anda supplemental injection technique. The purpose of this study is to evaluate, with electrical pulp tester, the anestheticefficacy of the periodontal ligament injection using 2% Lidocaine with 1:80000 epinephrine and normal saline in fortyvolunteers. The success rate was defined as no patient’s response to the maximum output of an electrical pulptester. Also pain rating during initial needle penetration and injection of solution were compared.Material and method: Forty adult volunteers participated in this study. The subjects were divided into four groups (10subjects each): Group Ia: each subject received a periodontal ligament injection in mandibular first premolar andfirst molar right or left side with Lidocaine injection and pulp tested each minute by EPT and Ethyl chloride. Group 1b:each subject received a periodontal ligament injection in mandibular first premolar and first molar right or left sidewith normal saline injection and pulp tested each minute by EPT and Ethyl chloride. Group IIa: each subject receiveda periodontal ligament injection in maxillary first premolar and first molar right or left side with Lidocaine injection andpulp tested each minute by EPT and Ethyl chloride. Group IIb: each subject received a periodontal ligamentinjection in maxillary first premolar and first molar right or left side with normal saline injection and pulp tested eachminute by EPT and Ethyl chloride.Results: The results showed that the duration of profound pulpal anesthesia, using 2% Lidocaine with 1:80000epinephrine, was 10 minutes and injection of anesthetic solution and normal saline in clinically healthy teeth wereonly mildly discomforting. The periodontal ligament injection using normal saline was not effective in producinganesthesia. A conclusion was drawn from the study that the periodontal ligament injection can be used effectively,as a primary injection technique, to anesthetize mandibular posterior teeth especially the first molars

Keywords

Pain --- PDL --- local anesthesia


Article
Etiology of the oral burning pain and its relationship to sex, age and anatomical sites (Clinical study among a sample of Iraqi patients in Baghdad)

Author: Sabah M. Dhamad صباح ضمد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 2 Pages: 70-77
Publisher: Baghdad University جامعة بغداد

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Background: The studies about oral burning pain are few in Iraq in spite of this disease is a significant commonamong numbers of Iraqi patients, so more information were required in order to avoid its effect and occurrence. Theaim of the current study is to determine the actual causes for the disease by examining a sample of Iraqi patients inBaghdad, in order to evaluate its relationship to the age, sex and the anatomical sites.Subjects and methods: Sixty patients were selected from two hospitals, several specialized dental clinics and publicmedical clinic, in east of Baghdad (Sadder, Jamella and Baladeyate cities). Nineteen patients were excludedbecause they could not continue in this study. The remaining forty one patients, 23 female patients, their agesranged between 25 – 60 years, while the male patients were 18, their ages ranged between 20 – 60 years. Theduration of symptoms of burning inside the oral cavity ranged from 6 months to 3 years . Each patient in this studywas examined clinically to detect any oral lesion may have direct cause for the disease , also patients were askedabout the types of drugs intake , in addition to their psychological conditions . The medical and dental histories weretaken from all examined patients, also all medical and dental reports of the patients were determined. Few results ofdifferent investigations of the examined patients were replaced by new ones, and the others were taken inconsideration for obtaining results for this study. Fasting blood sugar, thyroid function test, histopathologicalexamination and others were examples for such investigations which had been done. The most important finding inthis current study that the cause of oral burning pain in the examined Iraqi sample was mainly multi factorial causesand a few cases were caused by single etiology.Results: This study revealed that the most common causes of the oral burning pain in this Iraqi sample was , hormonalchanges , bad psychological conditions , the side effects of some drugs intake , chronic gastritis in addition to otherfactors. The most anatomical site affected inside the oral cavity was the dorsal portion of the tongue.Conclusion: One conclusion for the current study in some examined cases was found that a hiding cause may play arole in oral burning pain occurrence beside other factors. This study appeared that female patients over 50 yearswere more susceptible to this disease than male patients; also older age groups for both sexes were mostly affected


Article
The Ability of Microscopic Hematuria to Predict the Presence of Urolithiasis in Patients with Acute Flank Pain: An Iraqi Experience
اختبار قدرة العثور على الدم مجهريأً في فحص البول كمؤشر للتنبؤ بوجود حصى المسالك البولية: دراسة عراقية

Author: Jassim M. Al-Khazraji جاسم محمد كريم الخزرجي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 2 Pages: 148-152
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Iraq is a country with high prevalence of urinary stones since the dawn of civilization. Flank pain is a common complaint encountered in emergency rooms and outpatients clinics in which diagnosis can overlap due to the poor localization of pain by the patient. There is an anecdotal belief that anyone with flank pain must have a 'kidney stone'. General urine examination (GUE) is the primary screening test done for almost all patients presenting with acute loin pain. The interpretation of the results of urinalysis is usually done by the requesting doctor, hence building a decision whether a urinary stone is present or not. The finding of microscopic hematuria largely contributes to this decision and may or may not preclude the need for further investigations to confirm or exclude the presence of urinary stones as a cause of pain.Purpose: To test the ability of the microscopic hematuria in predicting the presence or absence of urolithiasis in patients presenting with acute flank pain using ultrasound, KUB, intravenous urogram (IVU) and to a less extent computerized tomography (CT) scan as gold standards.Materials and Methods: A randomized prospective study was performed in the Urology Consult Clinic of Al-Karama Teaching Hospital on 64 patients presenting with acute loin pain between January 2008 and December 2009. Each patient had a urinalysis within few hours of onset of pain as primary screening test, to look for microscopic hematuria. To confirm or exclude presence of stones, all patients were subjected to ultrasonic examination in the radiology department; some patients have KUB in addition. In cases of uninformative results, IVU or CT scan study were done in the hospital or requested in an outside radiological unit of another hospital or a private clinic. The results were recorded and interpreted to test for a correlation of microscopic hematuria and presence of urinary stones. Each patient was managed according to his individual condition. Results: Sensitivity and specificity of microscopic hematuria were 51.61% and 54.55% respectively. The positive predictive value and negative predictive value for hematuria as a predictor for stone disease was 63.64% and 38.71% respectively. Overall accuracy of microscopic hematuria was 51.56%.Conclusion: Hematuria is not found to be a sensitive or a specific marker in predicting urinary stones for patients with acute flank pain in current urological practice. Initial diagnosis of renal or ureteric stones should be made by an accurate history and by the results of urinalysis for hematuria. IVU is still a key-role player in establishment of diagnosis especially, ureteric stones. CT scan is now being introduced as an accurate tool with unrivalled superiority.Keywords: Urolithiasis, microscopic hematuria, acute loin pain, Iraq.

تمهيد: إن مرض حصى المسالك البولية معروف في العراق منذ فجر الحضارة. يعتبر الم الخاصرة الحاد من الحالات الشائعة التي يواجهها الطبيب في ردهات الطوارئ والعيادات الخارجية وهو يمكن إن يتداخل فيه التشخيص نتيجة عدم قدرة المريض على التحديد الدقيق لمكان الألم. هنالك اعتقاد شائع بين الناس أن كل من يعاني من ألم الخاصرة لديه حصى في الكلى. ويُجرى فحص البول العام كإجراء مسح أولي لكافة المرضى الذين يعانون من ألم الخاصرة الحاد. تتم القراءة الأولية وتفسير نتائج الفحص من قبل الطبيب الذي يستقبل المريض وبناء عليه يقوم ببناء قرار فيما إذا كانت الحالة ناتجة من حصى المسالك البولية أم لا. يسهم العثور على الدم مجهرياً في فحص البول إلى حد كبير في بناء هذا القرار، وقد يحول دون الحاجة إلى إجراء مزيد من الفحوص الشعاعية لتأكيد أو استبعاد وجود الحصى البولية كسبب للألم.الأهداف: لاختبار هل أن العثور على الدم مجهرياً في فحص البول لهؤلاء المرضى، هو مؤشر قادر على التنبؤ بوجود حصى المجاري البولية أم لا، وذلك باستخدام الفحوصات الشعاعية كالسونار وأفلام الأشعة العادية والملونة والمفراس، كثوابت مرجعية موثوقة المصداقية.المواد والطرق: أجريت دراسة مستقبلية في العيادة الاستشارية البولية لمستشفى الكرامة التعليمي، على 64 مريضاً يعانون من ألم الخاصرة الحاد للفترة مابين كانون الثاني (يناير) من عام 2008 الى كانون الأول (ديسمبر) من عام 2009. إذ أجري تحليل البول العام لكل من هؤلاء المرضى خلال الساعات الأولى بعد مراجعتهم أو إحالتهم من شعبة الطوارئ أو الإختصاصات الاستشارية الأخرى، كفحص أولي لفرز وجود الدم مجهرياً في البول من عدمه. ولغرض تأكيد أو استبعاد وجود الحصى البولية لديهم كمسبب للالم، تمت أحالتهم إلى شعبة الأشعة لأخذ سونار البطن والحوض، ولبعض منهم، أخذت أشعة الكلية والحالب والمثانة (KUB) العادية. وفي حالة النتائج المبهمة للسونار او الأشعة، أُحيل المرضى لأخذ الأشعة الملونة أو المفراس داخل المستشفى أو خارجها. تم تسجيل النتائج وتحليلها إحصائيا ًلاختبار العلاقة بين وجود الدم مجهرياً من جهة والحصى البولية من جهة أخرى. وقد تم علاج كل مريض وفقا لحالته.النتائج: ظَهَرَ بالتحليل الاحصائي أنَّ وجود الدم في البول مجهرياً كمؤشر للدلالة على وجود الحصى البولية حسَاس بنسبة 51,61% وله صفة الخصوصية بنسبة 54,55%. وكانت القيمة التنبؤية الأيجابية له 63,64% فيما بلغت القيمة التنبؤية السلبية 38,71% وبلغ مؤشرالدقة العامة 51,56%.الاستنتاج: إن العثور على الدم في البول مجهرياً هو مؤشر ضعيف الحساسية و ليست له صفة الخصوصية للدلالة على الحصى في الممارسة البولية الجراحية لدى المرضى الذين يعانون من ألم الخاصرة الحاد. أذ يجب الاعتماد على السؤال الدقيق للمريض عن حالته مع ربطه بالعثور على الدم مجهرياً من عدمه في نتيجة فحص البول، من اجل الوصول الى تشخيص أولي لمكان الحصى، سواء في الكلى أو الحالب. مازال للاشعة الملونة الدور الأساسي في الوصول الى التشخيص، وخاصة لحصى الحالب. فيما يتم تدريجياً إدخال المفراس في المستشفيات باعتباره اداة تشخيص أولية دقيقة ذات قدرة لاتضاهى.


Article
Assessment of Knowledge of Pediatric Resident Doctors About Neonatal Pain

Authors: Numan Nafie Hameed --- Bassam H. Sweedan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 4 Pages: 443-452
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Infants including newborn babies, experience pain similarly and probably more intensely than older children and adult. They are also at risk of adverse long term effects on behavior and development, through inadequate attention towards pain relief in early life. However, the issue of analgesia in young babies has been largely neglected in most clinical setting, despite subjecting them to painful diagnostic and therapeutic procedures.OBJECTIVE:To assess the knowledge of resident doctors regarding neonatal pain and to compare this with best evidence-based medicine.SUBJECTS & METHODS:A survey study questionnaires was distributed to pediatric resident doctors (PRD) in three training hospital centers in Baghdad (A- Al-Kademia teaching Hospital, B- Child central teaching hospital, and C- Children Welfare teaching hospital/ medical city) during the period from first of February to first of May, 2010. The questions were about the doctors` knowledge in treatment of pain in neonates, specifically regarding the perception and the effects of pain, pain assessment tools, and the safety and efficacy of treatments for both procedural and long-term pain.RESULTS:This study included 101 PRD, 29 were females and 72 were males. Doctors generally knew about efficacy of skin to skin contact and massage , breast feeding and oral sucrose during short term procedures, benefit and risk of use of morphine and midazolam, but less agreed that sedation does not necessarily provide adequate pain relief into neonates. Doctors were supporting use of topical anesthetic agents but not supporting the benefit of treating long term pain with opioid analgesic outweigh the risk of neonates. About half of PRD knew the difference in long term effect between neonates and older children. Pain assessment tools were not perceived to be reliable ,valid or routinely used.CONCLUSION:The knowledge of resident doctors regarding neonatal pain was inadequate when compared with developed countries studies and evidence based medicine, so we recommend to increased the educational programs and training on neonatal pain management

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