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Article
Nurse’s Knowledge and Attitudes toward Cancer Pain Management at Baghdad Hospitals
معارف واتجاهات الممرضين تجاه تخفيف الم السرطان في مستشفيات بغداد

Authors: Faisal Younus Sameen --- Wafaa M. Attoof Al-Attar
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 3 Pages: 134-143
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives: The present study aims to assess Nurse’s Knowledge and Attitudes toward Cancer Pain Management at Baghdad Hospitals.Methodology: Descriptive study was conducted during the period from December 29th 2014 to July 1st 2015. The sample was selected purposive (non probability) of 95 nurses from Al –Amal National Hospital for Cancer Management and Baghdad Teaching Hospital. The study instrument consisted of two major parts constructed for the purpose of the study (socio-demographic characteristic and Knowledge and Attitudes Survey Regarding Pain (KASRP).Reliability of the questionnaire form was determined through a pilot study while the content validity of the questionnaire was determined through a panel of experts; and collected data from 30th of March to 10th of May2015. The data were analyzed by used descriptive statistics (frequencies, percentages, mean, S.D), inferential statistical analysis (correlation coefficient and chi- square test,).Results: Results of the study showed that, the knowledge and attitudes towards pain management were poor. The correct answer rate for the entire scale, on average, was 37.4%, ranging from (9.5% to 82.1%), And found that (7.4%) of nurses score were more than 50%, and (92.6 %) of nurses score were less than 50% level, In socio-demographic characteristics has no significant relationship with knowledge and attitudes, about cancer pain management, while training session in cancer pain management out Iraq has found significant differences at (P value < 0.05).Conclusion: The study concluded that, the knowledge and attitudes of nurses in oncology units towards the toward cancer pain management is unaccepted to the importance of the patient’s disease.Recommendation: The researcher recommends the establishment of regular courses for nurses about pain control and conduct studies on the impact of cancer pain treatments for the long term and activating pain measurement chart.

هدف الدراسة: تهدف الدراسة الحالية الى تقييم معارف واتجاهات الممرضين تجاه تخفيف الم السرطان في مستشفيات بغداد.المنهجية: أجريت الدراسة الوصفية للمدة من 29 من كانون الاول 2014 إلى الأول من تموز 2015. وتم اختيار عينة غرضية غير احتمالية ل 95 ممرض وممرضة من مستشفى الامل الوطني لمعالجة السرطان و مستشفى بغداد التعليمي. يتكون الاستبيان من جزئين ( الصفات الديموغرافية و المعارف واتجاهات الممرضين تجاه تخفيف الم السرطان ) وتم تحديد صدق الأداة من خلال عرضها على (17) خبيرا من ذوي الاختصاص ومن ثم تطبيق (الاختبار- واعادة الاختبار) لتحديد ثبات الاستمارة من خلال حساب معامل الارتباط بيرسن (0.79 ) .جمعت العينة من 30 اذار ولغاية 10 ايار2015 .تم تحليل البيانات من خلال الاحصاء الوصفي (التكرارات ،النسبة ألمئوية، والوسط والانحراف المعياري)والإحصاء ألاستنتاجي (معامل الارتباط واختبار مربع كاي ). النتائج: اظهرت نتائج الدراسة أن معارف واتجاهات الممرضين في وحدات الأورام تجاه معالجة الألم كانت ضعيفه وان معدل الاجابات الصحيحة 37.4٪، والتي تراوحت اجاباتهم مابين ( 9.5٪ إلى 82.1٪) ووجدت ان (7.4٪) من درجات الممرضين كانت اكثر من 50٪، و (92.6 ٪) درجاتهم أقل من 50٪، و عدم وجود فروقات بين الصفات الديموغرافية ومعارف الممرضين واتجاهاتهم حول معالجة الألم سرطان، بينما وجدت فروقات ذات دلالة معنوية بين الدورات التدريبية في معالجة الم السرطان خارج العراق بمستوى معنویة (0.05)الاستنتاج: استنتجت الدراسة بان معارف واتجاهات الممرضين في وحدات الأورام تجاه معالجة الم السرطان بمستوى غير مقبول بالنسبة لاهمية المرض للمريض.التوصيات: يوصي الباحث اقامة دورات ومحاضرات منتظمة للممرضين حول السيطرة على الألم و إجراء دراسات حول تأثير علاجات الم السرطان للمدى البعيد وتفعيل استمارة قياس الألم.

Keywords

Pain --- Knowledge --- Attitude --- Nurses


Article
EFFICACY OF PREEMPTIVE PREINCISIONAL USE OF KETAMINE ON POSTOPERATIVE PAIN RELIEF FOLLOWING APPENDECTOMY

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 1 Pages: 18-23
Publisher: Basrah University جامعة البصرة

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Abstract

Pain, which is often inadequately treated, accompanies the surgical procedures may persist long after tissue healing. Preemptive analgesia, involves the introduction of an analgesic regimen before the onset of noxious stimuli. Previous studies have suggested that ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, provides a preemptive analgesic effect. In literature, its use is controversial; for this reason the aim of our research is to evaluate whether the preemptive use of ketamine decreases postoperative pain in patients undergoing appendectomy. In double-blind, randomized clinical trial, 100 patients underwent appendectomy for acute appendicitis were studied. Patients were randomly assigned into two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In control group the same volume of normal saline was injected. Pain intensity was assessed at time 0 (the time of complete consciousness), 4, 12, 24 hours postoperatively using the visual analogue scale (VAS). One hundred patients (50 for both groups) were enrolled. For all the evaluated times, the VAS score was significantly lower (p value <0.05) in the ketamine group compared to the control group. There was a highly significant difference between the groups regarding the interval time of analgesic need. The total dose of tramadol in the first 24 hours was 2.42±0.70mg/kg in ketamine group and 3.86±0.35mg/kg in control group (p=0.009). The occurrence of nausea and vomiting in ketamine group was less than in control group. Three patients experienced brief nondisturbing hallucination in the recovery room in ketamine group. No other drug side effects in ketamine group were noticed. In conclusion, low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.


Article
Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint

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Abstract

Background: Temporomandibular joint disorders refer to a group of heterogeneous pain and dysfunction conditionsinvolving the masticatory system, reducing life quality of the sufferers. Arthrocentesis is simple and less invasivesurgical procedure for the treatment of internal derangement than arthroscopy and better than other conservativeprocedures such as drugs, occlusal appliances and physiotherapy. The aim of the study was to evaluate the effectof arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibularjoint for the restoration of its function, reducing pain and preventing further deterioration of the temporomandibularjoint dysfunction.Materials and methods: This study was performed in Al-Sheed Ghazi Al-Hariri Hospital, Department of Oral andMaxillofacial Surgery, from November 2012 to October 2013, included 60 patients, aged 18 to 45 years withsymptoms of temporomandibular joint pain, clicking during function and limited mouth opening.Temporomandibular joint internal derangement was assessed with clinical examination and confirmed withcomputed tomography scan. Arthrocentesis was done with insertion of two 18 gauge needles in the upper jointcompartment, lavaged with ringer’s lactate solution and at the end of the procedure 1ml of hyaluronic acid wasinjected. Intensity of temporomandibular joint pain was assessed using visual analog scale, maximum mouth openingwas assessed with ruler scale and joint clicking was assessed clinically by stethoscope and manual palpation. All theparameters were measured before the procedure then 1 and 3 months later.Results: During 4 months follow-up, clinical examination and comparison of the results showed reduction in pain withsuccess rate 95%, improvement in mouth opening with success rate 100% and clicking disappeared in 95% ofpatients.Conclusion: The technique of arthrocentesis using Sodium Hyaluronate injection, used in patients who presented withinternal derangement, showed therapeutic benefits, simplicity, safety, patients acceptance of the technique andlack of significant side effects and complications.


Article
Comparison of the Onset of Diclofenac Potassium Sachet(Voltfast) and EntericCoated Diclofenac Potassium(Cataflam) in Treatment of Pain Following Tooth Extraction

Author: Dirar A. Al-juma`a
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2015 Volume: 15 Issue: 26 Pages: 369-373
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: This study was undertaken to compare the analgesic onset of voltfast and diclofenac potassium in patients after extraction of teeth. Materials and methods: One hundred fifty patients were enrolled in this study and randomly divided into two groups. Group 1 received sachets of oral diclofenac potassium (Voltfast) and group 2 received entric coated of diclofenac sodium (Cataflam) after extraction of teeth. The patients reported their pain relief in a questionnaire after the tooth extraction. The patient was instructed to take the drug as prescribed as the effect of local anesthesia begin to wear off and pain start. To evaluate the onset of the two drugs, the patients were asked to report if they had any problem using the drug. Results: seventy five patients received voltfast and cataflam seventy five patients received for relief of pain. The pain relief in both groups was efficient with statistically significant difference between the two groups. Conclusions: Oral diclofenac is an effective treatment for moderate to severe postoperative pain. Significantly more participants experienced a faster onset of pain relief with voltfast than with cataflam.


Article
Hiplabral Tear Management In Athletics

Author: Mohammed Elmajee
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 3 Pages: I-IX
Publisher: Babylon University جامعة بابل

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Abstract

Objectives•To review the most up-to-date evidence-based literature in managing patients with labral tear, particularly athletic population•To appraise the current understanding about labral tear management•To suggest some future recommendations and formulate new research questions


Article
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia

Author: Ahmed L. Al-Shamari M.B.ch.B, FIBMS (ORTHO)*
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2015 Volume: 11 Issue: 1 Pages: 45-48
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild systemic diseases) of ASA (American society of anesthetists) undergoing elective orthopaedic surgeries were randomly assigned in two groups and (both of them have general anesthesia); Group A (10patients) received local infiltration of 0.5% bupivacaine before closure of surgical wounds and group B (10 patients) received local infiltration of 0.9% of normal saline. We use uniform technique of anesthesia in both at rest and on passive mobilization by nurses and residents groups. Visual analogue pain scale scores were assessedblinded to analgesic treatment and we check the needs for analgesic drugs post-operative in both groups.Results: Group A showed a significant reduction inpostoperative pain at rest and on mobilization afterinfiltration of 0.5% bupivacaine with short hospital stay andonly 3 patients need for post-operative analgesia ,while allpatients in group B require at least single dose of analgesialike pethidine or non-steroidal anti-inflammatory drugs.Conclusion: The use of 0.5% Bupivacaine by wound infiltration is effective for post-operative pain relief, as it reduces the requirements for additional post-operative analgesia after total hip and knee replacements.


Article
Prosthodontic Appliance Wearing and Its Relationship to Oral Pain Sensation, Fungal Infection and Measures for Management
تأثير استعمال اجهزة الاسنان التعويضية داخل الفم وعلاقتها بتكوين الم تحسس في الفم وظهور الالتهابات الفطرية وكيفية معالجتهما

Author: Amena Jassim Lafta أمينة جاسم لفتة
Journal: Al-Rafidain University College For Sciences مجلة كلية الرافدين الجامعة للعلوم ISSN: 16816870 Year: 2015 Issue: 36 Pages: 326-336
Publisher: Rafidain University College كلية الرافدين الجامعة

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Abstract

Back ground: Many Iraqi dentures wearer suffered from oral pain sensation and candidiasis, so this study is important to prevent, decrease and manage the symptoms of these diseases, therefore the current study aimed to evaluate the relationship between the denture wearing, oral pain sensation and candidiasis caused by dentures and how it was managed. Subjects and methods: Twenty patients (12males and 8 females) were selected from Hospitals and special private dental clinics in Baghdad as studied sample, all of them wore badly constructed partial or complete denture. Patient's ages ranged between 40-65 years. Similar control group was choosen with the same number of males and females and nearly similar age group, all of them did not wear any dental appliances.Medical and dental history were taken from all the participants in the current study, also clinical examination and laboratory investigations were done to evaluate the badly constructed dental appliances in feeling oral pain sensation and developing candidiasis.Results: The study revealed that people who constructed bad dental appliances were more to be affected with oral pain sensation and candidiasis than others, especially with woman after 45 years or around the menopausal period or subjects with bad oral hygiene and that may lead to discomfortable oral mucosal sensation.Conclusion: The recent study showed that people with continuous wearing of dental appliances are more commonly effected with candidiasis and oral pain sensation, the laboratory investigations revealed that candida albicans was the most common type that causes candidiasis, also many local and systemic factors may share in the occurance of these diseases. Two types of drugs were used to treat the candidiasis, that means the patients in the study ground when they were treaded, some of them removed the dentures from their months during the period of treatment, those developed improvement than others.

العديد من العراقيين الذين يستعملون اطخم الاسنان يعانون من اعراض مرض تحسس الفم والالتهابات الفطرية لذا فان هذه الدراسة مهمة لمنع او تقليل او معالجة اعراض مرض تحسس الفم والالتهابات الفطرية لذا فان الدراسة الحالية تهدف الى توضيح مدى العلاقة بين استعمال اطخم الاسنان من جهة وظهور اعراض تحسس الم الفم مع الالتهابات الفطرية من جهة اخرى وكيفية التعامل مع هذه الحالات.عشرون شخصا بواقع (12) شخص من الذكور و (8) من الاناث تم اختيارهم من المستشفيات وعيادات طب الاسنان الخاصة في بغداد وتم اعتمادهم كنموذج دراسي وجميعهم يستعملون اطخم اسنان كاملة اوجزئية ليست جيدة داخل فم هؤلاء الاشخاص. اعمار هؤلاء الاشخاص تتراوح بين (40-65) سنة وتم اختيار مجموعة ثانية اخرى كمجموعة ظبط جميعهم ليسوا من مستعملي اطخم الاسنان وبنفس العدد والترتيب واعمار مقاربة للمجموعة الاولى. ثم التاريخ المرضي فيما يخص الحالة العامة وصحة الاسنان لكلا المجموعتين كذلك فحوصات سريرية واخرى مختبرية قد عملت لكلا المجموعتين لتقييم تاثير اطقم الاسنان على ظهور اعراض التحسس والالتهابات الفطرية اظهرت هذه الدراسة بان الاشخاص من ذوي اطخم الاسنان غير الجيدة في المجموعة الاولى (النموذج الدراسي) هم اكثر عرضه للاصابة باعراض تحسس الفم والالتهابات الفطرية عند النساء بعد سن 45 سنة او الاشخاص غير المعنيين بنظافة الفم في حين ان المجموعة الاخرى المقارنة لاتعاني من هذه الامراض كذلك تشير الفحوصات المختبرية الى ان اشهر انواع الفطريات الذي تسبب الالتهابات الفطرية هي من نوع (Candida albicans) كذلك تشير هذه الدراسة الى ان هناك اسباب محدودة او محددة عامة قد تشارك في وجود وتكوين اعراض تحسس الفم من الالتهابات الفطرية. ثم استعمال نوعين من الادوية لمعالجة الفطريات في هذا البحث.


Article
Chronic Dyspepsia in Iraqi Patients: Types, Causes and Common Presentations

Author: Ali Nasir Sattar
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 2 Pages: 2282-2286
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Dyspepsia is a common problem in the outpatient clinic. The clinical presentation is variable, and often chronic.Aims: is to find the proportions of organic and functional dyspepsia, the causes of organic dyspepsia, and the most common presentation of each type of dyspepsia.Methodology: From January 2013 to July 2014, the types, causes, and common presentations of chronic dyspepsia were studied clinically and endoscopically in 116 patients (Male=68, Female=48) at the outpatient clinic in Al-Hindeya general hospital.Results: During the 16 months study period, 62 patients had organic dyspepsia and 54 patients had functional dyspepsia. Men reported organic dyspepsia (67.4%) more often than women (32.6%), while functional dyspepsia was more common in females (52%). Out of 62 patients with organic dyspepsia, 38 had peptic ulcer disease, 12 had reflux esophagitis, 2 had hiatus hernia, and 10 had gallstones. There was a statistically significant relation between heartburn, epigastric pain and organic dyspepsia, while the relation between altered bowel motion, abdominal distention and functional dyspepsia was highly significant.Conclusions: Peptic ulcer disease, reflux esophagitis, gallstones, and hiatus hernia are the most common causes of organic dyspepsia. Heartburn and epigastric pain are significant predictors to organic dyspepsia, while abdominal distention and altered bowel motion are highly significant predictors of functional dyspepsia.Keywords: Dyspepsia, organic, functional, heartburn, epigastric pain, abdominal distention, and altered bowel motion.


Article
Assessment of tempromandibular joint space and condylar position in patients with myofacial pain dysfunction syndromes by using cone beam computed tomography
تقييم مساحة المفصل tempromandibular والموقف اللولبي في المرضى الذين يعانون من متلازمات ضعف الألم الليفي العضلي باستخدام التصوير المقطعي المحوسب شعاع

Authors: Sangar Hamid Ali --- Sarkawt Hamad Ali --- Katayon Nathm Kurshid --- Hassan Ali Mahmood
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 1 Pages: 929-934
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objectives: Joint space assessment and condylar relation in the glenoid fossa is considered as integral component of the clinical assessment of the patient with tempromandibular joint disorder. Any variant from normal tempromandibular joint may affect the diagnosis and management of the case. Methods: Thirty patients with unilateral myofacial pain dysfunction syndrome were included in this study (14 male and 16 female). Joint space analysis was performed by cone beam computed tomography for all patients. Analysis of data for joint spaces (anterior, middle, posterior, medial and lateral) was performed by using t-test. Results: The joint spaces and condyle positions in anterior, superior and posterior regions showed less joint space and statistically significant difference (P <0.05) from same joint space of normal side. No statistically significant differences were found in space value between middle and lateral condylar space of the diseased side and normal side of the patient. The joint spaces in normal sides were between 2 to 3.2 mm. Age and gender variations showed no statistical differences. Conclusion: The use of cone beam computed tomography for examination of tempromandibular joint space in patients with myofacial pain dysfunction syndrome give a good diagnostic criteria for affected side.


Article
The Effects of Topical Ketamine Gel on Saliva and Serum Level of Interlukin-6 in Patients with Recurrent Aphthous Ulceration

Authors: Ghada A. Taqa --- Ahmed A. Mohammad --- Abbas F. AL-Taee
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2015 Volume: 15 Issue: 26 Pages: 387-392
Publisher: Mosul University جامعة الموصل

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Aims: To evaluate the effect of topical application of ketamine gel )0.5%( and gel alone)without ketamine( on salivary and serum level of human interlukin-6)IL-6 (in patient with recurrent aphthous ulceration )RAU( and compare the results with control group having no RAU. Materials and methods: The investigation was carried out on)36( subjects with mean ± SD ages )25.11±6.31(years and different sex )20 males,16 females(. These subjects were divided into three groups. Group1: The study group consisted of )12(patients having minor RAU received topical ketamine gel )0.5%( applied on the lesion. Group2: The placebo group consisted of )12(patients having minor RAU received topical gel alone. Group3: The control group consisted of )12( healthy subjects having no RAU.Peripheral venous blood and saliva samples were collected from all subjects before treatment, and four days after treatment from group1and group2 only, to assess the levels of serum and salivary )IL-6( by Enzyme Linked Immuno Sorbent Assays )ELISA( method. Patients were subjectively assessed for the intensity of pain which was recorded pre and four days post treatment in group1 and 2 by using Verbal Pain Scale )VPS(. Data were analyzed using paired t-test, One way ANOVA and Willcoxon Signed Ranks test. Results: The results showed that the mean of serum IL-6 concentrations were high in the study and placebo groups )18.49±5.4pg/ml( and )18.97± 7,47 pg/ml( respectively before treatment comparing with mean of serum IL-6 concentration of control group )9.63±2.77pg/ml(, and the mean of salivary IL-6 concentrations were high in the study and placebo groups )63.03±47.28pg/ml( and )62.25±45.14pg/ml( respectively before treatment comparing with mean of saliva IL-6 concentration of control group )13.1±5.08pg/ml(.

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