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Article
Diagnostic Indications for Upper GIT Endoscopy Prospective Study

Authors: Riyadh Zair Alrubaie --- Haydar Talib Almousawi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2451-2454
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Upper GIT endoscopy is considered a safe procedure performed by a doctor, a well-trained subspecialist who uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.Aim: to set a guideline for indications for upper GIT endoscopy in AKadhymiah Teaching Hospital.Materials And Methods: Prospective study of 600 patients presented with upper GIT symptoms and referred for upper GIT endoscopy. Results & Discussion: The results suggest the importance of symptoms indicating upper GIT endoscopy are in the following orders, dysphagia, acidity, melaena, vomiting, haematemesis, heartburn, nausea, epigastric pain and dyspepsia. The highest age incidence with positive endoscopic findings is between 30-40years ,male more than female, (male/female ratio 2/1). Conclusion: The duration of symptoms over 1 month found to be significant indication. There is no relation between smoking, alcohol or drug intake with endoscopic findings in our study

Keywords

GIT endoscopy --- indications --- pain


Article
Evaluate The Cytokine IL-1α as an Inflammatory Indicator against Isolated Fungi From Patients with Abdominal Pain

Author: Zeana Shaker Al-Hindi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 497 -503
Publisher: Babylon University جامعة بابل

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Abstract

Acute abdominal pain generally refers to previously undiagnosed pain that arises suddenly and is of less than 48 hours. Fungal infections are considered as one of the most common causes in gastrointestinal disease, but virtually all fungi have been reported to cause infection in immune competent persons as well. Microbiological study was carried on 94 patients having abdominal pain by taking stool and blood from them. At periods from 9-2013 to 2-2014 in General Teaching Hilla Hospital..This study is done to determine the pathogenesis of fungi and the type of immune statue for abdominal pain caused by fungi by estimating concentrations of IL-1α as an immune marker and immuonoglobulins IgG and IgM . The rate of samples that gave positive results for fungal isolate was 60% , while 40%were negative , also the total number of isolated fungi was 12 genera. Cl.cladosporides have a highest rate of isolated fungi was 39.36%,another fungi also appear in stool samples wereCl.nacrosporum20.2% , Al.alternata 13.82% , Candida spp. 11.7%, Cryptococcus 5.31% ,Penicilum2.12% ,Candida albicanus2.12% ,Aspergillus flavas,Aspergillus fumigates ,Candida trubicalis , Candida crusi and Aurobasidium pull in rate 1.06% for each one. Immunological tests to sera of patients with abdominal disorder refer to significance increasing in the concentration of IL-1α for all patients at different age groups, compared to control and the highest concentration of them in the age group 19-26 years (51.371 ± 1.813pg/ml), The immunological study also included measuring the concentrations of each of the serum immunoglobulin IgG and IgM, the concentrations of highest 329 ±83.007, 1388.5 ± 391.645, mg / dL respectively, for different age groups and no significant difference compared with control for IgG while their present in IgM , This study refers to the role of both cellular and humeral immune response through fungal infection with different fungi.Distribute the fungal infection appear in both sex at female60% and male40% .


Article
Correlation between t-wave Inversion in Lead 3 Electrocardiography and Mitral Valve Prolapse in Patient with Atypical Chest Pain and/or Palpation
الارتباط بين انعكاس الموجةِ T في القسم 3من تخطيط الكهربائي للقلب وهبوط الصمامِ التاجيِ في مرضِى ألمِ الصدرِ الشاذِّ و/ أَو الخفقان

Author: Ali Yahya Abdullah Al- Salami
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2016 Volume: 6 Issue: 3 Pages: 70-75
Publisher: University of Kufa جامعة الكوفة

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Abstract

Back ground: Mitral valve prolapse (MVP) is disease present in 2- 3% of the general population.Mitral valve prolapse may be found with mitral regurgitation, bacterial endocarditis, congestive heart failure, and even sudden death. Mitral valve prolapse may be refer to as syndrome that present with symptoms palpitation or any other physical finding. The diagnosis of MVP can be confirmed by echocardiographyObjectives: We aimed from this study to test the possible use of electrocardiography as primary survey tool to diagnose patient with mitral valve prolapse.Methodology: In this cross sectional study, we involve 75 patients with palpation and atypical chest pain. All these persons had been selected from those patients visit the internal medicine consult department and echocardiography unit in Al-Sadr medical city from January 2013 to January 2016. For all patient's data collected about age, sex, blood pressure, laboratory finding of lipid profile, electrocardiography and echocardiography.Results: During period of this study which extends over 2 years, 75 patients of MVP enrolled in this screening research. Statistical analysis shows that sensitivity of electrocardiography as screening tool for diagnosis of MVP in a patient with atypical chest pain = 98.41, were its specificity = 90.9, positive predictive value = 98.41, negative predictive value = 90.9 so that as shown electrocardiography are highly specific and sensitive and this can use to diagnose MVP as it sensitive or exclude diagnosis of MVP as it specific.Conclusion:1.we found that T-wave inversion in lead 3 of ECG is unique change in ECG for mitral valve prolapse2.we found that T-wave inversion in lead 3 of ECG highly reliable tool in make diagnosis of mitral valve prolapse as it sensitive test3.we found this tool highly specific so can safely exclude diagnosis of mitral valve prolapse if test negative Recommendation: We recommend use T-wave inversion in lead 3 of ECG as screening tool for mitral valve prolapse, as this change in ECG sensitive and specific.

خلفية البحث: يعد هبوط الصمامِ التاجيِ مرضُ موجود في 2- 3 % من عامةِ السكان, إن هبوط الصمامِ التاجيِ قَدْ يُوْجَدُ بالتقئِ التاجيِ، التهاب شغافي جرثومي، عجز قلب ازدحامي، و حتى الموت المفاجئ ,ان هبوط الصمامِ التاجيِ قَدْ يُشارُ إليه كمتلازمة مرضية يعاني المريض من أعراض كالخفقانِ أَو أيّ إيجاد طبيعي آخر , وان تشخيص هبوط الصمامِ التاجيِ يُمْكِنُ أَنْ يُؤكّدَ مِن قِبل إيكو القلب.الهدف: هدّف الدراسةِ هو لاختبار الاستعمال المحتملِ للتخطيط الكهربائي للقلب كأداة مسحِ أساسيةِ لتَشخيص مرضى هبوطِ الصمامِ التاجيِ.المنهجية: تتضمن هذه الدراسةِ المسحية ، 75 مريضَ مَع الخفقانِ أو ألم صدرِ شاذِّ, كُلّ هؤلاء الأشخاصِ كَانوا قَدْ اختيروا مِنْ أولئك المرضى الذين يَزُورونَ استشارية الطبّ الباطني ووحدةَ إيكو القلب في مدينةِ الصدر الطبية خلال الفترة من يناير/ كانون الثّاني 2013 إلى يناير/ كانون الثّاني 2016. لكُلّ مريضِ جَمعتْ البيانات حول العُمرِ,الجنس ، ضغط الدمّ, النتائج المختبريةِ لمستوى الدهن في الدم ,التخطيط الكهربائي للقلب و إيكو القلب, تم تحليل البيانات والنتائج باستخدام الوسائل الإحصائية spss النسخة العشرون .النتائج:خلال فترةِ الدراسةِ التي امتدت على مدار سنتين، 75مِنْ مرضى هبوط الصمامِ التاجيِ سجّلَ في هذا البحثِ المسحي.اظهر التحليلُ الإحصائيُ بان حسّاسيةِ التخطيط الكهربائي للقلب كفحص تشخيصِي لهبوط الصمامِ التاجيِ في مريض ألمِ الصدرِ الشاذِّ = 98.41، بينما كَانتْ الخصوصية = 90.9، القيمة التنبؤية الإيجابية = 98.41، وكانت القيمة التنبؤية السلبية = 90.9 لذلك فأن التخطيط الكهربائي للقلب عالي الخصوصية والحسّاسية ولهذا يُمْكِنُ أَنْ يَستعملَ لتَشخيص هبوط الصمامِ التاجيِ لحسّاسيته أَو يَستثنى تشخيصَ هبوط الصمامِ التاجيِ لخصوصيته.الاستنتاج: نستنتج من الدراسة ما يلي: 1.وَجدنَا ان انعكاس الموجةِ T في القسم 3 من التخطيط الكهربائي للقلب يعتبر تغييراُ فريدُا في التخطيط الكهربائي للقلب لهبوطِ الصمامِ التاجيِ.2.وَجدنَا ان انعكاس الموجةِ T في القسم 3 من التخطيط الكهربائي للقلب أداة موثوقة جداً في تشخيصِ هبوطِ الصمامِ التاجيِ كونه اختبار حسّاس.3.وَجدنَا هذه الأداةِ خاصة جداً لذا يُمْكِنُ أَنْ يستثنى تشخيصَ هبوطِ الصمامِ التاجيِ بسلامة إذا كان الاختبار سلبيِ.التوصيات: نوصي باستخدام انعكاس الموجةِ T في القسم 3من التخطيط الكهربائي للقلب كأداة مسح لغرض تشخيصَ هبوطِ الصمامِ التاجيِ كون هذا التخطيط الكهربائي للقلب ذو حساسية وخصوصية عالية.


Article
Validity and Reliability of Full Cup Test in Pain Evaluation after Dental Surgery: A Comparison with Four Pain-Rating Scales in a Sample of Iraqi Patients

Authors: Huda A. Othman --- Omar S. Al-Nuaime --- Abdurrahman A. Al-Samman
Journal: Journal of Oral and Dental Research مجلة طب الفم والاسنان ISSN: 23106417 Year: 2016 Volume: 3 Issue: 1 Pages: 2-7
Publisher: Iraqi Association for Oral Research الجمعية العراقية لبحوث طب الفم

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Abstract

Objectives: Pain assessment by clinicians can be difficult as it is subjective and depends on the patient›s self-report.The aims of this study were to evaluate the validity and reliability of a pain-rating scale; the full cup test (FCT), and tocompare its performance to other scales in assessing pain following dental surgery. The ease of using these pain scaleswere compared.Study design: Forty-three patients who have had different dental surgeries were included. All patients asked to completefive pain scales: Faces pain scale, numeric rating scale, visual analog scale, verbal rating scale, and FCT for sevenconsecutive days starting on the day of the surgery. The analysis of variance (One-way ANOVA test), correlation betweendifferent scales (Pearson correlation), and reliability (Cronbach alpha) of FCT were evaluated.Results: The scales correlated highly with each other (P < 0.001). The FCT was highly reliable (Cronbach›s Alpha=.970) and was found to be the easiest scale to use.Conclusion: The FCT is valid, reliable and relatively easy to use pain scale in this group of patients. It can be used toassess pain intensity interchangeably with other pain rating scales.


Article
Incidence and severity of pain following the usage of three different root canal instrumentation systems

Authors: Jamal A. Mehdi --- Ahmad H. Oubaid
Journal: Journal of Oral and Dental Research مجلة طب الفم والاسنان ISSN: 23106417 Year: 2016 Volume: 3 Issue: 1 Pages: 20-27
Publisher: Iraqi Association for Oral Research الجمعية العراقية لبحوث طب الفم

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Abstract

Introduction: Post-Operative pain is one of the most common issue that might happened during and after endodontictreatment, this prospective randomized clinical trial evaluated the incidence and severity of Post-Operative painfollowing root canal instrumentation using ProTaper Universal System, ProTaper Next system and WaveOne system.Methods: Ninety patients with asymptomatic irreversible pulpitis on their permanent molar teeth selected and distributed randomly into three different groups of 30 patients each, to have access opening and instrumentation at same visit, those patients were fitted with inclusive criteria that we put for this study. Group 1 instrumented with ProTaper system, Group 2 instrumented with ProTaper Next system and Group 3 instrumented with WaveOne system, all systems strictly followed manufacturing instruction. The assessment of Post-Operative pain carried out at day 1, 2, 3 and 7, using Verbal Rating Scale (4-point scale). Verbal Rating Scale pain score compared and analyzed using Chi-Square test. Result: total score for Verbal Rating scale (scores recorded for 4 days) showed significant difference among the groups (P < 0.05), there was a significant difference between ProTaper Next group and the other two group (ProTaper group and WaveOne group) (P < 0.05), while there was Non-significant difference between ProTaper System and WaveOne System (P ≥ 0.05). Conclusion: ProTaper next system caused the lowest incidence and severity of Post-Operative pain, WaveOne system caused the highest incidence and severity of Post-Operative pain.


Article
Low Level Laser Irradiation Effects on Joint Movements

Authors: Ziad T. Al-Dahan زياد طارق الدهان --- Ali S. Mahmood علي شكر محمود --- Ghassan H. Farhan غسان حامد فرحان
Journal: AL-NAHRAIN JOURNAL FOR ENGINEERING SCIENCES مجلة النهرين للعلوم الهندسية ISSN: 25219154 / eISSN 25219162 Year: 2016 Volume: 19 Issue: 2 Pages: 407-411
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This study tried to show an approach for joints process healing based on using of low level laser therapy (LLLT), in order to enhance the healing rate. The effect is not thermal, but rather related to photochemical reactions in the cells. This study included 26 patients with low back pain (LBP) in range of 20-50 years old were randomly divided to the laser treatment group and laser placebo group (control group). Both of two groups were treated twice weekly for 6 weeks. The treated group exposed group to pulse infrared with diode laser (BEAM 3K00) with 904nm wavelength and 230mJ (energy) for one point, and was irradiated on the vertebral column. The same process was performed on control group but with off laser. The laser placebo group did not complete their treatment because there was no improvement or decrease pain. The treated group divided into three subgroups according to the treatment period: the first showed improvement and decrease pain where dispersed to (4) in end of the three-week treatment, and (4) in a five-week treatment, and (5) valuable six weeks treatment. Visual analogue scale (VAS), Schober test and Roland Disability Questionnaire (RDQ) were used in the clinical and functional evaluations pre and post therapeutic periods. Significant improvements were noted in all groups with respect to all outcome parameters, in comparison to placebo laser group. Efficacies of treatment were evaluated using pain relief between treated groups by the statistical significance of the differences between the three feature sets for the LBP was tested with a Bonferroni corrected analysis of variance (ANOVA) test with a significance level of 0.05. Statistically significant differences were found in all outcomes measured (p<0.05).

تظهر هذه الدراسة عملية علاج المفاصل باستخدام الليزر واطئ المستوى يكون تأثير الليزر غير حراري لكن من التفاعلات الكيميائية الضوئية في الخلايا ويكون العلاج بدون تدخل جراحي.استخدم 26 مريض مصابون بألم أسفل الظهر بعمر مابين 20-50 سنه قسمت بشكل عشوائي إلى مجموعة عولجت بالليزر ومجموعة بعلاج ليزر مموه .كلا المجموعتين تم معالجتها مرتين بالأسبوع ولمدة ستة أسابيع. في هذا العمل تم استخدام الدايود الليزري ذو الأشعة النبضية بطول موجي 904 نانو متر على مجموعة الليزر.أما مجموعة الليزر المموه فقد تم إطفاء جهاز الليزر أثناء المعالجة .طبق الليزر على أجسام الفقرات المصابة .وبعد المباشرة بالعلاج في كلا المجموعتين لم تكمل العلاج مجموعة الليزر المموه وذلك لكونهم لم يشعروا بتحسن أو انخفاض بمستوى الألم أما مجموعة العلاج بالليزر فقد انقسموا إلى ثلاثة مجموعات حسب فترة العلاج وذلك لشعورهم بالتحسن وانخفاض مستوى الألم لديهم .استخدمت ثلاث متغيرات للتقييم هي (مقياس مستوى الألم , واستبيان العجز رولاند, واختبار شوبر).لوحظت تحسينات في مجموعات الليزر بكل المتغيرات ماعدا مجموعة الليزر المموه وقد تم استخدام التحليلات الإحصائية لمعرفة أهمية التحسن (الكفاءة)بين المجموعات التي عولجت بالليزر واستخدم لذلك اختبار بونفيروني في برنامج الماتلاب مع مستوى أهميه 0.05.من النتائج وجدنا فروق ذات دلالة إحصائية في جميع نتائج المتغيرات (P<0.05).


Article
Evaluation of the Analgesic Effect of Four Intra-Articular Ozone Injections in Knee Osteoarthritis

Author: Iyad Abbas Salman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 211-214
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Knee osteoarthritis (OA) is a degenerative disease of the knee joint. There is no cure for the disease, but some treatments attempt to slow disease progress.Intraarticular ozone injection is increasingly being applied. In knee osteoarthritis it represents a complementary treatment method which provides pain relief, decongestion, subsidence of bruises (hematomas), a reduction in temperature and an improvement in motility.OBJECTIVE: To evaluate the analgesic effect of 4 subsequent intra-articular ozone-oxygen injections in knee joint osteoarthritis. PATIENTS AND METHODS:It was a prospective, randomized clinical study, done on 30 knee joints, all patient were with history of OA of knee joint & suffering from long standing pain & they have long history of medical therapy. After taking patient consent, 5 weekly sessions of intra-articular 5 ml (25 μg/ml ) ozone injections were done under complete aseptic technique. Numerical Analog Pain score has been assessed and recorded before each session.RESULTS: It was found that there was highly significant difference between each 2 subsequent sessions and the p-value was below 0.01 in all times.CONCLUSION: Subsequent Intra-articular ozone injection had significant analgesic effect in knee joint osteoarthritis


Article
Chronic Pelvic pain of myofascial origin in a 53 year old patient

Authors: Patricia McWalter --- Tarfah Al-Muammar --- Kevin Hafez
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2016 Volume: 29 Issue: 4 Pages: 236-239
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Chronic pelvic pain in women has a multifactorial etiology but pelvic musculoskeletal dysfunction is not routinely evaluated as a cause by gynaecologists. There is no gold standard diagnostic test for pelvic musculoskeletal problems. Our patient presented to a gynaecologist because of chronic pelvic pain. However no gynaecological cause was found for her symptoms. This patient enjoyed sport particularly horse riding. Imaging revealed osteitis pubis and an osteophyte of the sacro-ilium. It has been recognised in athletes that there can be an association between stress injuries to the pubic symphysis and degenerative changes at the sacro-ilium. This case demonstrates the importance of thinking of a myofascial cause for chronic pelvic pain.


Article
Analysis of brainstem activitywith fMRI during low-level of pain- a feasibility study with innocuous cold stimuli
تحليل فعاليه جذع الدماغ مع الرنين المغاطيسي الوظيفي خلال مستوى واطيء من الالم- دراسة قدرة التفعيل مع محفز بارد غيرمؤذي

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Abstract

Background: In functional magnetic resonance imaging (fMRI) studies, there are limitedpublished data on the functional map of the human brainstem.Objective: To assess the feasibility and to map the neural activity in the human brainstem with Fmri by equal intensity by low-level of thermal stimuli on the peripheral sensors of the skin.Patients and Methods: Functional magnetic resonance imaging studies of the brainstem were carried out on 6healthyindividuals in a 3T MRI machine. A noxious thermal stimulus was applied on the peripheral sensitisation nerves on the arm. Functional magnetic resonance imaging data spanned from the brainstem location by a 32-head channel and analyzed using a fixed-effects General Linear Model to discriminate signal intensity changes from physiological motion. The results were normalised and combined to show the activity at each location on a voxel-by-voxel basis. Areas of physiological activity were recognized with comparison to the number of atlases.Results: Noxious and innocuous related activation clusters were approved in this applied method. There were considerable activity in the midbrain, pons, medulla and reticular formation. The results of this pilot study are similar and in some anatomical regions even better with head coils than obtained with previous functional magnetic resonance imaging spinal coil studies. We obtained evidence of localization of the following nuclei by using this method, as follows: major activities in the inferior anterior parts of pons and the junction with medulla includes the (olive and pyramids),superior cerebella pundicle, rostral portion of medulla (RMV), Broadmann areas [5,2] touch and temperature sensation areas with the innocuous stimuli; activation in the left side of the medulla the (olive and pyramids), the left side of pons, the left side of midbrain, Broadmann area [5,7] pain and temperature sensation areas with noxious stimuli.Conclusion: This pilot study provides useful evidence flow-painful and innocuous information transmitted between the peripheral nervous system and the central nervous system in healthy participants. It also demonstrates how peripheral sensitisation induces physiological changes in the brainstem correlates with noxious and innocuous thermal transmission.

خلفية الدراسة: جذع الدماغ واحد من اهم اجزاء الدماغ المسؤلة عن تحوير الالم الغرض من هذا البحث هو لتخمين قدرة تحفيزجذع الدماغ بواسطه مؤثر حراري واطيء المستوى موضوع على الجلد اذا كان قابلا على اعطاء خريطه وظيفيه واضحه للمناطق العصبيه التي سوف تتفعل من بواسطة التصوير بالرنين المغناطيسي الوظيفي مقارنه مع الدراسات المحدودة السابقه التي استخدمت محفزات الم عاليه الشدة.الهدف من الدراسة: لتقييم جدوى ولرسم خريطة النشاط العصبي في الدماغ البشري مع الرنين المغناطيسي الوظيفي من خلال كثافة متساوية على مستوى منخفض من المحفزات الحرارية على أجهزة استشعار الطرفية من الجلد.المرضى والطرائق : المعلمات المعتمدة في هذه الدراسة تضمنت جهاز رنين مغناطيسي وظيفي متقدم مع مجال مغناطيسي ثلاثه تسلا تم نقل المعلومات بواسطه اثنان وثلاثون قناة راسية وتم تحليل المعلومات الالكترونيه اعتمادا على موديل ثابت عام اعتمادا على شدة الاشارة من تغيرات الفسيولوجيه المصاحبه للتجارب. هذه المستويات تم اعادة دمجهن مع الصور الاوليه بمبدا الوحدة الحجميه بالمقارنه على اطالس تشريحيه.النتائج: النتائج اوضحت على ان المحفزات المؤلمه والغير مؤلمة ايضا قادرة على اعطاء خارطه واضحه لبعض مناطق جذع الدماغ كالدماغ الاوسط والجسر والنخاع المستطيل مشابه ذلك لدراسات السابقه مع الالم وبعض النتائج الاخرى كانت افضل حتى في هذه الدراسة الاوليه مع الكويل الراسي كمناطق التشكيل الشبكي و الزيتونه والشبكه النخاعيه والسويقات المخيخيه وحصلناعلى أدلة توطين وتفعيل مناطق نويات التالية باستخدام هذاالأسلوب على النحوالتالي: الأنشطة الرئيسية في الأجزاءالأمامية السفلية للجسروتقاطع مع النخاع والمخيخات والاجزاء المنقاريه من النخاع و السويقه (الزيتونه و الهرم ). مع اشارات بارزه في مناطق برودمان الدماغيه (5 و2) التي تخص مناطق اللمس وبشعور بدرجات الحرارة مع المؤثر الغير مؤلم. اما مع المؤلم فتضمن التنشيط في الجانب الايسر من النخاع (الزيتونه و الهرم ) وعلىالجانبالأيسرللجسرومنالدماغالمتوسط، مع اشارات بارزة في مناطق برودمان الدماغيه (7و5) الخاصه بشعور بدرجات الحرارة مع الالم.الاستنتاجات: هذه الدراسة الاولية تقدم دليلا وتصورا مفيدا لتفاعل نخاع الدماغ مع المحفزاتمؤلمةوغيرمؤلمة التي تنتقلبين الجهازالعصبي المحيطي والجهازالعصبي المركز يلدىا لمشاركين الأصحاء. وهذا يوضح أيضا كيفيه تفاعل مع هذه المؤثرات يؤدي الىتغييرات فسيولوجيه في نخاع الدماغ المسؤل عن تحوير الالم مع ا نتقال الشعور بالحرارة المؤلمة وغيرالمؤلمة.

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