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Article
Using Single Dose Systemic Dexamethasone Pre Operatively for Postoperative Pain as Part of Multimodal Analgesia in Laparoscopic Cholecystectomy

Author: Hassan Sarhan Haider ,Bashar taha Enad , Mohammad Shakoor Mugheer
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 2 Pages: 183-187
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Pain after laparoscopy occurs for various reasons and a range of treatment have been suggested for the reduction in pain. There are reports that local anesthesia infiltration, removal of remaining carbon dioxide, administration of anti-inflammatory analgesia before surgery and dexamethasone are effective in post operative pain management. Recently multimodal analgesia methods, where a combination of the above methods are used, are recommended for their effectiveness.METHOD: Eighty patients aged 20-60 years; ASA class 1 &2;undergoing laparoscopic cholecystectomy under general anesthesia were studied and divided into two groups: Group S(n = 40) received dexamethasone 8 mg before induction ; Group N received 2ml normal saline before induction. We measure the degree of pain of both groups with VAS at 1,3,6&24 hours after surgery.RESULTS: VAS score of Group S were lower than that of Group N during 24 hours after laparoscopic cholecystectomy and analgesia consumption of Group S were lower than that of Group N.CONCLUSION: A single dose of dexamethasone (8mg) intravenously given before induction was effective in reducing postoperative pain after laparoscopic cholecystectomy with multimodal analgesia..


Article
Pain Perception to Orthodontic Tooth Movement during Menstrual Cycle: A Clinical Study

Author: Munad J. AL_Duliamy
Journal: Tikrit Journal for Dental Sciences مجلة تكريت لعلوم طب الاسنان ISSN: 20731213 Year: 2018 Volume: 6 Issue: 1 Pages: 33-37
Publisher: Tikrit University جامعة تكريت

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Abstract

Pain during orthodontic treatment is inevitable side effect. Therefore, it is the responsibility of the orthodontist to alleviate this pain as possible. Menstrual cycle is often a painful event to female. Female is the most of orthodontic patient. Hence, study the pain perception of female to orthodontic treatment during menstrual cycle is essential. Aim: the aim of the present study is to asses, if there is change in pain perception to orthodontic tooth movement during menstrual cycle. Seventeen healthy female with regular menstrual cycle intended to receive orthodontic treatment with fixed appliances were participated in the study. Elastomeric separators were placed mesial and distal to maxillary and mandibular first molars during the menstrual and postmenstrual period respectively. Visual analog scale (VAS) was used to assess pain perception at 4 hours, 24 hours, 2nd, 3rd, 4th and 5th days after the separators were placed. Data of VAS scores were statistically analyzed. There were statistically significant increase in the pain perception level after the insertion of separators during menstrual cycle period and decrease during postmenstrual period. During menstrual cycle, female experienced higher pain perception to orthodontic tooth movement. Hence, it is better to postpone orthodontic visits for female patients to postmenstrual period.


Article
Low Back Pain and Obesity (Review Article)

Author: Mohammed Sh. Al- Edanni
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2018 Volume: 14 Issue: 2 Pages: 1-6
Publisher: Baghdad University جامعة بغداد

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Abstract

Low back pain a major causes of morbidity throughout the world and it is a most debilitating condition ,and can lead to decreased physical function ,compromised quality of life, and psychological distress. Obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific LBP. However, the relationship between obesity and LBP remain to date unsupported by objective measurements of mechanical behavior of spine and it is morphology in obese subjects.


Article
Perception of Pain by a Sample of Patients Undergoing Orthodontic Treatment in Sulaimani City

Authors: Idriss Q. Abdul --- Tara A. Rasheed
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2018 Volume: 18 Issue: 30 Pages: 48-58
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: Orthodontic treatment is known as a painful procedure among patients. They feel varying degrees of pain during orthodontic treatment from the stage of initial examination till the end of the treatment. The aims of this study are to explore pain experience among patients undergoing orthodontic treatment with the fixed appliances by comparing two different arch wires sizes. Materials and Methods: The study group consisted of 60 patients (26 males, 34 females) with a mean age of 17.6 years and 20.5 years consequently. Insertion of either 0.014 or 0.016-inch wire was by random selection of patients. Patients were asked to fill out a series of questionnaires for five consecutive days after the insertion of orthodontic initial arch wire, and after the arch wire activation for 4 hours, 6 hours, 24 hours, and till 5 days. The intensity (weak, mild, moderate, severe, and intensive) of the pain symptoms in connection with ten items (Biting on a hard/soft food, sensitive to hot or cold food/drink, mastication of food, fitting anterior and fitting posterior teeth together, cheeks, lips, and tongue pain) have been evaluated. Results: No significant differences were found between age groups, and between the two arch wire groups. Pain perception was more significant in females than in males and the pain perceived at the anterior teeth was greater than posterior teeth. Pain percentage level increased gradually till reaching the peak within 24 hours after the insertion of arch wire and retained the same level in the 2nd day, then decreased till the 5th day. Perceptions of pain by fitting anterior teeth were exactly the same within the period of the first few hours in both arch wire groups, and decreased over the following hours. Conclusion: No age discrimination was found for perception of pain in the two different arch wire groups, with no significant correlation for the time with initial pain that perceived after the insertion of two different initial arch wire sizes then the intensity of pain reduced over the time. Pain was perceived as being greater at the anterior than the posterior teeth and females experienced more pain than males.


Article
Prevalence of computer vision syndrome in Erbil
انتشار متلازمة رؤية الكمبيوتر في أربيل

Authors: Eman Hussein Alwan --- Dler Jalal Ahmed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 1 Pages: 115-119
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Nearly all colleges, universities and homes today are regularly using video display terminals, such as computer, iPad, mobile, and TV. Very little research has been carried out on Kurdish users to reveal the effect of video display terminals on the eye and vision. This study aimed to evaluate the prevalence of computer vision syndrome among computer users. Methods: A hospital based cross-sectional study was conducted in the Ophthalmology Department of Rizgary and Erbil teaching hospitals in Erbil city. Those used computers in the months preceding the date of this study were included in the study.Results: Among 173 participants aged between 8 to 48 years (mean age of 23.28±6.6 years), the prevalence of computer vision syndrome found to be 89.65%. The most disturbing symptom was eye irritation (79.8%), followed by blurred vision(75.7%). Participants who were using visual display terminals for more than six hours per day were at higher risk of developing nearly all symptoms of computer vision syndrome. Significant correlation was found between time-consuming on computer and symptoms such as headache (P <0.001), redness (P <0.001), eye irritation (P <0.001), blurred vision (P <0.001) and neck pain (P <0.001).Conclusion: The present study demonstrates that more than three-fourths of the participants had one of the symptoms of computer vision syndrome while working on visual display terminals.


Article
Role of Encouraging Words in Reducing Anxiety and Pain During Tooth Extraction

Authors: Abdurrahman A .Al-Samman --- Omar S. Al-Nuaime --- Omar J.B Mohamedtaib
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2018 Volume: 18 Issue: 30 Pages: 73-82
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: The present study tests the effect of preoperative encouraging words provided by dental clinician onthe levels of anxiety and pain experienced by patients after tooth extraction. Materials and methods:Patients were randomly assigned to the intervention and the control group. Intervention subjects had preoperative ten minutes appointment with operating oral surgeon. This appointment identify the sources ofanxiety, and participants given individualized encouragement according to their needs. Control subjectsreceived reassurance immediately before surgery. All patients completed several questionnaires coveringmeasures of anxiety and pain. Results: Discussion with patients along with encouragement highly affectspatients’ levels of anxiety and pain after tooth extraction. Conclusions: Dental clinicians should considerthe practice of encouraging patients shortly before tooth extraction.


Article
Associated Factors of Low Back Pain in a Sample of Patients Attending Hawler Teaching Hospital/Erbil City A Case Control Group

Authors: Burhan Izzaddin Sabir --- Vian A Naqshbandi
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2018 Volume: 26 Issue: 6 Pages: 45-55
Publisher: Babylon University جامعة بابل

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Abstract

Background and objective: Low back pain (LBP) is an important clinical, social,economic,andpublichealthproblemaffectingthepopulationerraticallyandrandom.Theaim of the study was to determine the factors associated with low back pain among patients attendingphysiotherapydepartmentatHawlerteachinghospitalinErbilCity.Methods: the study was carried out from November 3rd, 2014 to November 3rd 2015.Thestudyinvolvedof100casesdiagnosedwithlowbackpaininthephysiotherapydepart- mentatHawlerteachinghospitalsubjectsincontrolgroupareofthesameageandgender ofthoseintheexperimentgroup,and100participantsasa100ascontrolgroupfreefrom low backpain.Result:Multiplelogisticregressionofriskfactorsoflowbackpainrevealedthatbody massindex7.55,nonusinglumbarsupportinsittingchairduringwork31.81,non-practice exercise 5.58, standing erect 34.836, sitting on a high backrest chair 27.986, sitting on a lowbackrestchair65.167,drinkingwaterperday18.989,emotionalstress14.636timehave riskyeffectonlowbackaffectlowbackpainrespectively.Conclusion: The study concluded that most of the participants in the study were employers and they perform different types of positions such as bending, squatting and sittingduringworktime,therewerestatisticalsignificantassociationbetweenbodymass index,liftingheavyobjects,drivingandemotionalstresswithdevelopmentoflowbackpain.

الخلفية والهدف:آلام أسفل الظهر هو مشكلة سريرية, اجتماعية واقتصادية هامة وهو بالتأكيد مشكلة صحية عامة تؤثر على الانسان بطريقة متقطعة وبشكل عشوائي. الهدف من هذه الدراسة هو تحديد العوامل المرتبطة بآلام أسفل الظهر بين المرضى الذين يراجعون قسم العلاج الطبيعي في مستشفى هوليرالتعليمي في مدينة أربيل بهدف العلاج. الطريقة والمنهاج: أجريت الدراسة واستمرت لعام كامل بدءا من ال 3 من شهر تشرين الثاني 2014 إلى ال 3 من شهر تشرين الثاني من 2015. وشملت الدراسة 100 حالة تم تشخيصها بآلام أسفل الظهر في قسم العلاج الطبيعي في مستشفى هوليرالتعليمي مع عدد مماثل من الاشخاص الاصحاء لا يعانون من نفس المشكلة كمجموعة ضابطة و مراعاة التطابق في العمر والجنس لكلا المجموعتين.النتائج: اظهرت نتائج التحليل الاحصائي للانحدار المنطقي المتعدد للعوامل المرتبطة بالام اسفل الظهر ان مؤشر كتلة الجسم7.55, عدم استخدام دعم المنطقة القطنية في حالة الجلوس31.81, عدم ممارسة الرياضة 5.58, الوقوف بشكل منتصب 34.836, الجلوس على الكرسي بمسند عالي للظهر 27.986, والجلوس على الكرسي بمسند منخفض للظهر 65.167, عدم شرب كمية كافية من الماء يوميا 18.989, التوتر النفسي والعاطفي 14.636 مرة لها تأثير الخطورة على الاصابة بالام اسفل الظهر بشكل متوالي لكل عامل. الاستنتاجات: توصلت الدراسة الى ان معظم المشاركين في البحث هم من الموظفين و اصحاب الاعمال و هم يؤدون اوضاع مختلفة اثناء العمل مثل: الانحناء, جلوس القرفصاء والجلوس اثناء العمل لفترات طويلة. واكد ان هناك ارتباط ذات دلالات احصائية عالية بين مؤشر كتلة الجسم, رفع الاشياء الثقيلة, قيادة السيارات والتوترات العاطفية والنفسية و بين تطور حالات الام اسفل الظهر.


Article
MRI Finding of Cartilaginous Endplates Herniation of Lumbar Spine in Patient with Low Back Pain

Author: Mohammed Abd Kadhim* , Mansour Eidan Dawood Al – Zubaidi**, Firas Mahmood Yaqub
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 4 Pages: 328-334
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Magnetic resonance imaging (MRI) provides a noninvasive assessment of the lumbar spine. Little isthought about the MRI characteristics of cartilaginous endplate (CEP) and CEP herniation on theground that their normal thickness is only 0.6mm, making it hard to perceive at routine MRIexaminationsOBJECTIVE :To study the reliable magnetic resonance imaging findings suggested cartilage endplate herniation inlumbar spine.PATIENTS AND METHODS:This prospective study was conducted on 46 patients with low back pain in the MRI unit of Al-Imamein Alkadhmein Medical City, Baghdad, Iraq between September, 2016 and August 2017.Inclusion criteria: adult patients with lumbar disc herniation proved by MRI with surgical prove ofcartilage end plates herniation. Exclusion criteria include: patients with previous back surgery,history of spinal tumor and the general contraindications to MRI. Sagittal and axial T1-weightedspino-echo image and sagittal and axial T2 weighted spine echo images were obtained. Statisticalanalysis using SPSS version 23, the level of significance (p value) was set as ≤ 0.05.RESULT:Forty six patients with low back pain were included in this study, the mean age of 44±9 years, 26patients were females and 20 patients were males.The CEP herniation was detected by MRI among52.2% of patients with back pain. There was a highly significant association between CEP andincreased age of the patients, back pain radiated to both limbs, L4-5 defect site, modic changes andlumbar posterior marginal nodes (p value 0.01, 0.004, 0.02, 0.03 and <0.001 respectively). Nosignificant differences between patients with CEP herniation and those without CEP herniationregarding posterior osteophytes, dorsal vertebral cornal defect, heterogeneous signal intensity andposterior corner and mid endplate irregularities. There was a highly significant association betweenlumbar posterior marginal nodes and CEP herniation (p<0.001).CONCLUSION:CEP herniation is more prevalent among advanced age and at lower lumbar level. The most commonMRI signs related to CEP herniation were modic changes in mid endplate and lumbar posteriormarginal nodes..


Article
The Effectiveness of Calcaneal Drilling for Treatment of Resistance Cases of Plantar Heel Pain
فعالية التثقيب الحفري لعلاج الحالات المقاومة لألم بطانة الكعب الأخمصي

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Abstract

Background: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders.Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome.Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and Al-Wassity Hospitals. Result: Drilling of the calcaneum is a simple procedure achieving 70.6% cure in resistant ases with few complications provided good patient selection was done.Conclusion: Abnormalities in the intraosseous pressure within the calcaneum are a possible cause of plantar heel pain in some patients who failed to respond to conservative treatment

الخلفية: ألم الكعب الأخمصي هو متلازمة سريريه تتميز بألم بطانة الكعب الأخمصي الذي يكون الأسوأ في الصباح ويتحسن بعد الخطوات القليلة الأولى في اليوم وهي شكوى قد تكون ناجمة عن مجموعة واسعة من الاضطرابات العظمية الأنسجة الرخوة. الهدف: لتقييم فعالية عملية التثقيب الحفري لعظم العقب لمعالجه متلازمة الكعب الأخمصي.طرق العمل: خلال الفترة من تشرين الاول 2012 إلى آب 2016، تم تسجيل 17 مريضا (17 كعب) في دراسة سريريه في وحدة تقويم العظام في مستشفى الشيخ زايد و مستشفى الواسطي ومستشفى الكندي التعليمي. النتائج :التثقيب الحفري لعظم العقب لمعالجه متلازمة الكعب الأخمصي هو إجراء بسيط تم تحقيق نتائج جيده لعلاج الحالات المقاومة 70.6٪ مع عدد قليل من المضاعفات اذا تم اختيار المريض بصوره جيدة. الاستنتاج:تشوهات في الضغط داخل العظم العقبي هي سبب محتمل لآلام الكعب الأخمصي في بعض المرضى الذين فشلوا في الاستجابة للعلاج التحفظي


Article
The effect of a training course using swimming (free, back) in the strength of some muscles and lower back pain for ages (35-45) years
أثر منهج تأهيلي باستخدام السباحة (الحرة ، الظهر) في قوة بعض العضلات وآلام أسفل الظهر للأعمار (35-45) سنة

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The researchers pointed to the clear and influential role offered by exercise in general and swimming in particular in the treatment of many diseases and injuries and rehabilitation in most countries of the developed world. The problem of research is the large number of employees with back pain, as this category issue on the use of computer and sitting for long times, lack of mobility, and lack of exercise that lead to muscle weakness around the spine which cause of back pain. However, The study aimed to:1.Preparing a training intervention using (free, back style) swimming in the strength of some muscles and lower back pain for ages (35-45) years.2.Identify the effect of the rehabilitation intervention using free swimming in the strength of some muscles and lower back pain for ages (35-45) years.3.Identify the effect of the rehabilitation intervention of using back-lift in the strength of some muscles and lower back pain for ages (35-45) years.4.Identify the affectivity of using swimming (free, back) in the strength of some muscles and lower back pain for ages (35-45) years.The researchers used the experimental approach .The research population involved the staff of Karbala University patients with chronic low back pain of (26) employees, and therefore the sample was selected in the form of 10 employees and were divided equally into two experimental groups each group of (5).

أشار الباحثان إلى الدور الواضح والمؤثر التي تقدمه ممارسة التمارين الرياضية بشكل عام والسباحة بشكل خاص في علاج الكثير من الأمراض والإصابات وتأهيلها في أغلب دول العالم المتقدمة، أما مشكلة البحث تتلخص في كثرة أعداد الموظفين المصابين بآلام الظهر إذ إن هذه الفئة تقع على عاتقها استخدام الحاسوب لساعات طويلة والجلوس بصورة خاطئة وقلة الحركة وقلة ممارسة النشاط الرياضي التي تؤدي إلى ضعف العضلات المحيطة بالعمود الفقري تكون السبب في حدوث آلام الظهر لذا ارتأى الباحث إلى دراسة هذه المشكلة من خلال وضع منهج تأهيلي باستخدام السباحة الحرة والظهر لتأهيل هذه الاصابة والحد من الآلام المزمنة لأسفل الظهر ومعرفة اي النوعين من السباحة لها الأفضلية في التأهيل. وهدفت الدراسة إلى:1)إعداد منهج تأهيلي باستخدام السباحة (الحرة ، الظهر) في قوة بعض العضلات وآلام أسفل الظهر للأعمار (35-45) سنة.2)التعرف على أثر المنهج التأهيلي باستخدام السباحة الحرة في قوة بعض العضلات وآلام أسفل الظهر للأعمار (35-45) سنة.3)التعرف على أثر المنهج التأهيلي باستخدام سباحة الظهر في قوة بعض العضلات وآلام أسفل الظهر للأعمار (35-45) سنة.4) التعرف على أفضلية التأثير باستخدام السباحة ( الحرة ، الظهر) في قوة بعض العضلات وآلام أسفل الظهر للأعمار (35-45) سنة.استخدم الباحث المنهج التجريبي وحدد مجتمع البحث من موظفي جامعة كربلاء المرضى الذين يعانون من آلام أسفل الظهر المزمن والبالغ عددهم (26) موظف ، وعليه جاء اختيار العينة بالأسلوب القصدي بواقع (10) موظفين وقد تم تقسيمهم بالتساوي إلى مجموعتين تجريبيتين كل مجموعة مكونة من (5) أفراد.

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