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Article
Management and Outcome of Stroke in a Sample of Children Admitted to Children Welfare Teaching Hospital/Baghdad

Author: Nebal Waill Saadi Al-Dabbas*, Batool Ali Ghalib Yassin**, Ahmed Mahdi Ibrahim***, Waleed Khalid Abbas Ageedi****
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 194-201
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Stroke in children is a serious disorder in which little has been published. Population-based estimates of the annual incidence of childhood stroke (ischemic and haemorrhagic) range from 2•3 to 13•0 per 100 000 children and incidence rates in neonates are closer to 1 per 5000 live births CONCLUSION:To determine clinical presentation, etiologies, diagnostic procedures, treatment options and outcome of children with stroke.METHODS: Descriptive study of patients with stroke admitted to Children Welfare Teaching Hospital/Baghdad from October 2011 to September 2012 was conducted. Cases were classified radiologically into ischemic stroke (IS) and hemorrhagic stroke (HS) and their management modalities were studied.RESULTS: Out of 21 patients; 13 (61.9%) had hemorrhagic and 8 (38.1%) had ischemic stroke. Female:male ratio was 1.3:1. Haemorrhagic stroke was more among males and infants; ischemic stroke was more among females and older children. In 16 (76%) patients, the diagnosis was established after more than 24 hours of onset. Patients with ischemic stroke spend longer time in hospital. Seizure was the commonest clinical feature in both types (17 patients (81%)) followed by altered mental status (16 patients (76.2%)). CT-scan was abnormal in 20 patients and MRI in 11 patients. Complete recovery was noticed in 7 (54%) patients with hemorrhagic type, while 7 (87.5%) patients with ischemic type recovered with sequelae.CONCLUSION: Stroke was more common among female and children younger than 12 months. Seizure and altered mental status were the commonest presentations. A delay in performing neuroimaging was obvious in the current study. Patients with ischemic stroke tend to spend longer time in hospital. Antibiotic were the medication most often used. The majority of children were discharged well. .


Article
THE SIGNIFICANCE OF HYPERGLYCEMIA IN THE FIRST 24 HOURS OF STROKE

Authors: Muhanad A. Kadhim مهند احمد كاظم --- Hasan A. Al-Hamadani حسن عزيز الححمداني --- Munther T. Hamzah منذر طاهر حمزة
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 1 Pages: 88-92
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:The study focused on acute stage of stroke patients and investigated which parameters of glucose in acute phase of stroke are significant in nondiabetic stroke patients.Objective:To evaluate hyperglycaemia in acute phase of stroke.Methods:Cross sectional study was conducted in Al-Imamain Al-Kadhimiyan Medical City in Baghdad city from October 2013 to September 2014. We studied glucose levels and glycosylated haemoglobin in 100 consecutive patients with acute stroke admitted within 24 hours after onset of symptoms.Results:One hundred consecutive patients (65 men and 35 women ) were included in this study, 76 patients with diagnosis of ischemic stroke and 18 of them with diagnosis of intracerebral haemorrhage and 6 patients with transient ischemic attack Hyperglycemia was found in 44 patient. High glycosylated haemoglobin levels were found in 29 patients, 16 patients of them have history of diabetes. The other 13 with elevated glycosylated haemoglobin levels were considered as prediabetes. The remaining 15 patients had normal glycosylated haemoglobin.Conclusion:There is significant relationship between idiopathic hyperglycemia and prediabetes with acute stroke.Keywords:Stroke, diabetes mellitus, hyperglycaemia


Article
Electrocardiographic changes in acute ischemic stroke In Kirkuk : Azadi teaching hospital

Author: Younis Esmaeel Ebraheem
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2016 Volume: 2 Issue: 2 Pages: 216-219
Publisher: Tikrit University جامعة تكريت

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Article
Red distribution width correlated inversely with muscles power in patients with stroke

Authors: Eman Abdul Ghfoor Shakir --- Zainab Nazar Al-Wahab --- Sajid Ibrahim Khadum
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 3 Pages: 52-57
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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patients with stroke. However, the correlation between the RDW and the stroke severity in terms of muscle power grading was not reported. Methods: The retrospective study involves 37 patients with stroke. “The Medical Research Council Scale (MRC) for Muscle Strength” was used for the assessment of the muscle strength. RDW% was calculated by Coulter Counter device. Results: The muscle power grading was significant and inversely (P<0.01, r = -0.604) correlated with RDW% and significant and inversely (P<0.01, r = -0.72) correlated with plasma triglycerides in patients with stroke. Conclusion:These results show an inverse association between muscle power grading in stroke patients with RDW% and plasma triglycerides.


Article
Comparative lipid profile study between ischemic and hemorrhagic stroke

Author: Dr. Younis Esmaeel Ebraheem
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2016 Volume: 21 Issue: 1 Pages: 20-26
Publisher: Tikrit University جامعة تكريت

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Article
SERUM HDL IN PATIENTS WITH ISCHEMIC STROKE - A CASE CONTROL STUDY

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Background:Elevated high-density lipoprotein cholesterol (HDL-C) levels have been shown to be protective against cardiovascular disease. However, the association of specific lipoprotein classes and ischemic stroke has not been well defined.Objectives:To evaluate the association between HDL-C and ischemic stroke in men and women, and to compare the results with a control sample of the same age group.Methods:A hospital based case-control study was done comparing serum HDL-C levels in 48 ischemic stroke patients to 50 controls recruited from Al-Imamain Al-Kadhemain Medical City, all patients and control had negative past medical history, negative history for smoking and alcohol. Serum lipid profile was determined in all of them.Results :This study showed that regarding the serum HDL-C levels, 41 (85.4%) patients were found to have low levels (less than 40 mg/dl) while among the control group, only 19 (38%) have shown low serum HDL-C level.Conclusion:The study showed that there is a significant association between the low level of serum HDL-C cholesterol and the risk of ischemic stroke in this population.Keywords: cholesterol, lipoproteins, HDL-cholesterol, ischemic stroke


Article
HYPONATREMIA IN A GROUP OF IRAQI PATIENTS WITH STROKE

Author: Abdul-Kareem K. Al-Khazraji عبد الكريم كاظم الخزرجي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 2 Pages: 191-196
Publisher: Al-Nahrain University جامعة النهرين

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Background: Hyponatremia is a common electrolyte disorder encountered in patients of stroke, which is usually either due to inappropriate secretion of antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). Making an accurate diagnosis is important because the treatment of each condition is quite different. Objectives:We conducted this study to determine the incidence and etiology of hyponatremia in patients of stroke.Methods:A cross sectional study of 100 patients diagnosed to have stroke (50 ischemic, 50 hemorrhagic) based on clinical history, examination and brain images. Patients were evaluated for hyponatremia (serum sodium < 135 mmol/L) during the second week of their admission. Results:Out of 100 patients, 17 patients had hyponatremia, all Patients with serum sodium level in hyponatremic range were limited to patients with hemorrhagic stroke, while no patients with ischemic stroke had a low serum sodium level, this difference was significantly different, P-value was < 0.001.Conclusion:Incidence of hyponatremia in our study population was 17%, all Patients with hyponatremia were limited to patients with hemorrhagic stroke, in patients of hyponatremia; 82% were having SIADH and 18% were having CSWS.Keywords: Hyponatremia, ischemic stroke, hemorrhagic stroke, syndrome of inappropriate antidiuretic hormone, cerebral salt wasting syndrome.


Article
C-Reactive Protein Profile Among Acute Stroke Patients

Authors: Hayder Kadhum Hassoun --- Husain Salih Abass --- Taki Tiraihi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 7-12
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND:C-reactive protein (CRP) is an inflammation marker, which has been implicated in stroke severity, response to stroke, or a mixture of both. OBJECTIVE:This study has been conducted in order to clarify early CRP essay in relation to the type of acute stroke (ischemic and hemorrhagic), onset duration, severity, stroke disability and carotid stenosis. METHODS: A cross sectional randomized study included 50 patients with stroke (23 male and 27 females: mean age 54.7 + 10.3 years). They were classified into having ischemic or hemorrhagic strokes, deficit in less or more than 12hrs (within 24 hrs), large or small size infarction, severe or non-severe disability and severe or non-severe carotid stenosis. RESULTS:There is more significant association of C-reactive protein with the ischemic (82.4%) than the hemorrhagic types (56.3%).There is significant association of CRP positivity in relation to the late onset duration of the deficit (> 12 hrs: 85.2%) in comparison to the early onset (≤ 12hrs: 60.9%). C-reactive protein level showed statistically significant association with the size of infarction (CRP is positive in 91.3% of the large size versus 63.6% of the small size). There is significant association of CRP level in relation to carotid stenosis (68.8% in severe stenosis versus 31.2% in non-severe ones). The short-term disability was significantly associated with CRP level (CRP is positive in 83.8% with severe disability versus 57.8% with the non-severe one). CONCLUSION: High CRP level at the admission of the acute stroke patient is more associated with the ischemic type, the late onset, the large size infarction, severe disability and severe carotid stenosis.


Article
Trend of deaths due to circulatory system in Erbil City between 2007 to 2011
نمط مسببات الوفاة نتيجة جهاز الدوران في مدينة اربيل بين 2007-2011

Authors: Haitham I. Bahoo Al – Banna** MBChB, FICMS هيثم عيسى بحو البنا --- Aso H. Zangana* MBChB, MSc ئاسو حميد زنكنة
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2016 Volume: 58 Issue: 4 Pages: 361-365
Publisher: Baghdad University جامعة بغداد

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Background: Circulatory diseases are one of the leading causes of death in the world which continue to rise despite preventive measures.Objective: To determine gender, age and cause specific trends of mortality due to circulatory diseases between 2007 and 2011 in Erbil city.Methods: A review of registered death records from disease of circulatory system was performed at the statistical unit in Directorate of Health in Erbil city. No special codes for the cause of death were available on death certificate. Statistical analysis was done using SPSS version 19Results: Diseases of circulatory system was responsible for 25.5% of total deaths during the study period. Highest rates were recorded at 2011 with 74 deaths per100000 population. After 2009, circulatory mortality increased sharply to be the first cause of death till 2011, Stroke, Ischemic heart diseases (IHD), cardiac arrest and heart failure were the main cause of deaths. Most of deaths occur in age group of 65-74 years. Ischemic heart diseases was the main cause of death in male (31.5%) while stroke in female (34.5%) which were statistically significantConclusion: Circulatory mortality was the second leading cause of death in Erbil city till the year 2009 where it started to increase to be the first cause till 2011. Future preventive public health strategies for circulatory diseases prevention are mandatory.

ألمقدمة:أمراض جهاز الدوران او الدورة الدموية هي واحدة من المسببات الرئيسية للوفاة على الرغم من الاجراءات الوقائيةألاهداف: لتقيم نمط وفيات جهاز الدوران من حيث العمر والجنس والمسبب للوفاة في مدينة اربيل للقترة من 2007-2011ألطريقة: تم استعراض سجلات الوفاة المسجلة في قسم الاحصاء قي دائرة صحة اربيل ولم تحتوي شهادات الوفاة على نمط موحد لتسجيل الوفيات .تم اجراء التحليل الاحصائي باستخدام برنامج (SPSS) أصدار (19)النتائج:أمراض جهاز الدوران سجلت نسبة (% 25.5 ) من كافة الوفيات خلال فترة الدراسة. أعلى نسبة سجلت كانت في عام 2011 ( 74 حالة وفاة لكل 100000 شخص). بعد عام 2009 سجلت زبادة كبيرة في عدد حالات الوفاة نتيجة جهاز الدوران واستمرت الى عام 2011 ليكون المسبب الرئيسي للوفاة. السكتة الدماغية,عدم كفاية الشرايين التاجية,توقف القلب وعجز القلب كانت الاسباب الرئيسية للوفاة في الاعمار العمرية بين 65-74 .امراض السكتة الدماغية اكثر في الاناث (34.5%) وعدم كفاية الشرايين التاجية بالنسبة للذكور(31.5% ) وكلاهما يعتد بهما احصائيأألخلاصة: أظهرت الدراسة أن أمراض جهاز الدوران هي المسبب الثاني للوفاة في اربيل لفترة الدراسة ولكن بعد عام 2009 حصلت زيادة حادة في وفيات جهاز الدوران ليصبح المسبب الاول في عام 2011 . يجب وضع ستراتيجيات الوقاية ضد امراض جهاز الدوران في الصحة العامة

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