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Article
Povidone Iodine and Hypertonic Saline Induced Sclerosing Cholangitis in Hepatic Hydatid Cysts Surgery

Author: Abdulrazzak Kalaf Hassan
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2680-2686
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Surgery is the treatment of choice for hepatic hydatid disease but surgical treatment carry the risk of recurrence if we do not use a proper scolicidal agent and may convert patient with solitary hepatic hydatid cyst to patient with many incurable cysts. The ideal scolicidal agent should kill vital scolices, and not have local or systemic adverse effect, and not toxic to bile duct. Yet, there is no ideal scolicidal agent involving such effects. One of the important serious complications after instillation of scolicidal agents is sclerosing cholangitis.Aim: to assess the risk and severity of povidone iodine and hypertonic saline induced sclerosing cholangitis in guinea pigs.Materials and methods: In this study we used twenty guinea pigs which were divided into two equal groups. In the first group 0.3 ml10% povidone iodine was injected to the biliary tree after clamping then released after five minutes and second group, 0.3 ml 20% hypertonic saline was used.Four months later on the pig was euthanized by ether and three biopsies taken from the liver and sent for histopathological examination. Afterwards, the liver, gall bladder, the common bile duct and the duodenum were excised in one piece and immediately transferred for cholangiography. Two X-ray films were taken for each specimen in lateral and antero-posterior view after contrast material injection. Results: in povidone iodine group 8 animals (80%) had sclerosing cholangitis while in hypertonic saline group only 2 animals (20%) had sclerosing cholangitis. This difference between the two groups was statistically significant. Conclusions: Usage of 10% povidone iodine as a protoscolicidal agent carry high risk of sclerosing cholangitis.


Article
The Effect of Hypertonic Saline in Treatment of Moderate Bronchiolitis in Children

Author: Alaa Jumaah Nasrawi علاء جمعة النصراوي
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2017 Volume: 17 Issue: 1 Pages: 77-91
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Airway oedema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline (HS) solution may reduce these pathological changes and decrease airway obstruction.Aim: To assess the effects of nebulized hypertonic (3%) saline solution in infants with acute viral Bronchiolitis of moderate severity.Methods: This study was conducted in Al Zahraa teaching hospital for maternity and pediatric in the period between December 2013 till November 2014 at which 165 patients with acute viral bronchiolitis were included. The inclusion criteria were; Infants aged ≤18 months presented with a prodromal history consistent with viral upper respiratory tract infection followed by wheezing and/or crackles on auscultation. Patients were excluded from the study if they have the following criteria: born at ≤ 34 weeks’ gestation, previous history of wheezing, steroid use within 48 hours of presentation, history of apnea within 24 hours before presentation, oxygen saturation ≤85% on room air at the time of recruitment, history of a diagnosis of chronic lung disease,congenital heart disease, or immunodeficiency, consolidation or atelectasis on a chest X-Ray and infants with bronchiolitis severity score <4 or > 8. Result: We found that nebulized 3% HS decreases bronchiolitis severity score after 12h of treatment and its effect subsided after more than 48 h. In regard to hospital stay, the study shows a decrease in mean of hospital stay length from 42.2 to 36.3 h. Conclusion: Nebulization with 3% hypertonic saline is safe, can be widely generalized, and may be superior to current treatment for early outpatient treatment of bronchiolitis.Recommendation: Planning for a multicenter trial to explore the clinical benefit of this therapy with a large sample size is essential.

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