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Article
Effect of Maternal Age on the Course and Outcome of

Author: Enas Talib Abdul -Karim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 1 Pages: 19-25
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Delayed childbirth has become a common phenomenon in the developed world as a result of social,educational, and economic factors .OBJECTIVE:To demonstrate the effect of age on the pregnancy course and outcome among young and oldmothers.Subjects &methods:A cross sectional study was conducted at Al-Kadhimia Teaching Hospital. Data was collected by atrained medical students during the period from first of February to April 2010 .Total of 230women were included in the study using a convenient random sample technique, the sample wasdivided into two groups,128 women < 30 years old (group A) and 102 women ≥ 35 years old(group B), and were taken from obstetric department in Al-kadhimiya teaching hospital .Information were directly obtained from the mother herself and filled in a well designedquestionnaire form.RESULTS:The results showed that there was no significant difference between the two groups regarding somesociodemographic characteristics like address, education, occupation, antenatal care. There was asignificant increase in the presence of medical &obstetric complication, parity, history of abortionand No of abortion in the older age group mothers. As to the outcome of pregnancy, twin deliveryand low birth weight babies were significantly higher in older age group mothers. Interestingly,there was no significant difference regarding presence of congenital anomalies in babies of mothersin both groups.CONCLUSION:Mothers ≥35 years old showed higher rate of obstetric complication than young age group ofmothers, while congenital anomalies were higher but not significant among young age group ofmothers (≤30 years old).


Article
“Cytomegalovirus Seroprevelance in Iraqi Pregnant Women”

Authors: Sajed Nader --- Mohammed Ayad**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 303-307
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Cytomegalovirus is the commonest cause of congenital viral infection in the developed and developing countries. It is a symptomatic in 90% of infected females. Forty percent of pregnant females transmit the virus to their fetus. Ten percent of born infants whom gain the virus will get the clinical signs plus its neurological sequelae.OBJECTIVE:To outline the relationship between Cytomegalovirus infection among pregnant women and its influence upon their pregnancy outcome.PATIENTS AND METHODS:A case-control study was carried out was carried out in the teaching laboratories – medical city, Baghdad through a period from June 2010 till March 2011; upon 165 pregnant women whom taken as a patient group. Blood samples were taken from them and Cytomegalovirus-IgM antibodies plus Cytomegalovirus-IgG antibodies levels were measured via Elisa technique in both to evaluate the viral infection if present or not.RESULTS:The usual age whom attended the gynea-obestetric clinics were the age group from 11-19 years old 73 cases (44.24%); Next came the age group from 20-29 years old 66 cases (40.00%), thirdly was the age group from 30-39 years old 20 cases (12.12%), Lastly was the age group from 40-49 years old 6 cases (3.64%). The concentration of CMV-IgG among females whom attended clinics were seropositive in nearly half the included cases 66/165 (40.0%); while the CMV-IgM concentration was within the seronegative limits. Secondly came another group of patients with seronegative limits regarding both the CMV-IgM and CMV-IgG antibodies 56/165 cases (33.94%), next 30/165 cases (18.18%) were seropositive in their results pointing to both CMV-IgM and IgG limits; and this might be a middle point distance between the previous group and the last group were the CMV-IgM was positive and the CMV-IgG concentration was negative 13/165 cases (7.88%).CONCLUSION:Cytomegalovirus-IgG antibodies got important role as a protective agent against gestation abortion, if Cytomegalovirus-IgM antibodies are seropositive alone this is a risky factor to the pregnancy outcome


Article
Outcome of 50 Iraqi Patientswith Acute Lymphoblastic Leukemia Treated by Modified German Multicenter Study Group (GMALL) Protocol

Author: Alaa Fadhil Alwan
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 2 Pages: 45-51
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background and aim: Acute lymphoblastic leukemia (ALL) is a lymphoidmalignancy, which arises from bone marrow,appearing in marrow, blood circulation and otherorgans. Treatment outcome have significantly improved since the adaptation of intensification and risk adapted therapy-based on identified prognostic markers. Treatment programs in adult ALL have evolved from the successful strategies employed in pediatric ALL and incorporate multiple active agents into complex regimens. The goal of these doses intensive regimens is rapid cytoreduction with restoration of normal hematopoiesis, The aim of the study was to assess the efficacy of a modified German multicenter study group for Acute Lymphoblastic leukemia (GMALL) protocol in adult acute lymphoblastic leukemia (ALL( in respect to disease free survival (DFS) and overall survival(OS) and to determine the prognostic factors affecting this outcome. Patients and method: A prospective study conducted in the hematology unit in Baghdad Teaching Hospital on 50 patients with newly diagnosed (ALL) between January 2006 to January 2008.A written informed consent were obtained from all patients. All patients were undergone full clinical examination with full laboratory investigations. The diagnosis based on morphology and cytochemical stains (periodic acid-Schiff, Sudan Black) of bone marrow examination. In Modified GMALL, induction phase consist of 2 phases, phase 1 induction was given over 5 weeks with weekly vincristine (VCR), Doxorubicin(DOX), and continuous oral prednisolone(RDN), Phase II induction consisted of 3 doses of weekly cyclophosphamide(CYCLO) alternating with 3 doses of weekly cytosine arabinoside (ARA-C) combined with CNS directed therapy using intrathecal Methotrexate (MTX) with daily 6-mercaptopurine(6-MP) followed by cranial irradiation. Consolidation consisted of weekly VCR and two courses of 5 days Ara-C and Etoposide (ETOP) with dexamethasone (DEXA) over a period of 4 weeks and maintenance therapy of daily 6-MP tablets and weekly MTX tablets. Results: The study included 50 patients with median age of (28.5 years), ranged from 16-71 years. Thirty-one patients (62%) were males, while 19 patients (38%) were females. All patients received modified GMALL protocol; forty-two patients (84%) achieved complete remission (CR). The DFS and median OS were 8.5 months, 10 months respectively. The median OS at 1 year was 54%. Deaths occurred in 19 patients (38%). Infection was the main cause of death.In univariate study analysis, age less than 30 years, absence of hepatomegaly and lymphadenopathy, and peripheral blast percent less than 50% were associated with better OS while presence of lymphadenopathy was considered poor prognostic factors and associated with low CR rate, short DFS, and OS. Conclusion: The modified GMALL protocol produced good induction remission rate but with lower survival rate in comparison to other intensive adult protocols. This study also showed that there are certain bad prognostic factors such as age more than 30 years, hepatomegaly and lymphadenopathy which adversely affect the outcome


Article
EVALUATION OF LEPTIN IN SERA AND FOLLICULAR FLUIDS OF INFERTILE WOMEN UNDERGOING INTRA-CYTOPLASMIC SPERM INJECTION AND THEIR EFFECTS ON PREGNANCY OUTCOME

Authors: Menal F. Farhood منال فاضل فرهود --- Farqad B. Hamdan فرقد بدر حمدان --- Anam R. Al-Salihi انعم رشيد الصالحي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 2 Pages: 146-152
Publisher: Al-Nahrain University جامعة النهرين

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Background: Leptin may serve as the critical link between the body’s adipose tissue and the hypothalamo-pituitary axis, thus it is considered a possible link between nutrition and reproduction.Objective:To evaluate leptin in the serum and follicular fluid and its effect on fertilization rate and pregnancy outcome in infertile female patients undergo intra-cytoplasmic sperm injection cycle.Methods:Seventy four infertile women who agreed to participate in the study were selected randomly from those attending the Fertility Centre in Al-Sader Teaching Hospital, Holly Najaf. Hormonal analysis was done for serum and follicular fluid leptin hormone at the day of ovum pickup.Result:Serum and follicular fluid leptin hormone levels were increased above its normal cutoff level according to the kit used. There was a relationship between the fertilization rate and leptin in serum and follicular fluid. Fertilization rate was significantly (p = 0.049) different depending on the serum leptin level while it has nothing to do with follicular fluid leptin hormone. On the other hand, follicular fluid leptin significantly (p = 0.04) affect pregnancy outcome.Conclusion: Leptin provides possible impact on oocyte and/or embryo quality leading to impaired endometrial bed preparation that may be involved in pregnancy failure.Keywords: Leptin, ferilization rate, pregnancy outcome.


Article
Pregnancy outcome in women with subchorionic haemorrhage detected in first and second trimester of pregnancy
نتائج الحمل في النساء المصابات بنزيف تحت الغشاء المخاطي في الثلث الأول والثاني من الحمل

Authors: Parween Omer Hassen --- Samira S. Shekh Mohammed --- Parez Retha
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 2 Pages: 1035-1040
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Subchorionic hemorrhage is the most common sonographic abnormalities and the most common cause of first trimester miscarriage and mainly associated with vaginal bleeding. The present study was conducted with an aim to find out the effect of subchorionic hemorrhage in first and second trimester of pregnancy outcome.Methods: A case cohort prospective study was designed to investigate 100 patients having a subchorionic hematoma in the presence of singleton live embryo or fetus. The study assessed the association of the volume size of subchorionic hematoma, maternal age and gestational age at time of the diagnosis with adverse pregnancy outcomes.Results: The incidence of miscarriage and preterm delivery was 35% and 21% respectively. The mean (±SD) age of those who aborted was 29.97 ± 7.0 years, slightly higher than the mean age of those who ended with preterm delivery (27.7 ± 5.87 years) and those continued with their pregnancies to viability (28.3 ± 6.2 years). There was a statistically significant association between previous histories of preterm delivery and pregnancy outcome (P =0.015). Miscarriage was significantly high among women with gestational age <12 weeks, while term pregnancy was significantly high among women with gestational age >13 weeks (P <0.001). The estimated volume of the hematoma did not correlate with the outcome of the pregnancy, perhaps it is the presence or absence of a hematoma as a marker of the integrity of placentation and not its size.Conclusion: Subchorionic hematoma in first and second trimester of pregnancy associated with adverse pregnancy outcome (spontaneous miscarriage and preterm delivery.


Article
Prospective comparison of primary wound closure with tissue- adhesive versus suture materials
مقارنة مستقبلية لإغلاق الجرح الأساسي بالمواد اللاصقة مقابل الخيط

Authors: Jalal Hamasalih Fattah --- Rasim Yousif Marbin
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 1 Pages: 859-865
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and Objectives: Nowadays the final outcome of wound closure using tissue adhesives and suture material is making a real competition for better results. Cosmetic outcome is regarded as the first demand for the patients. The aim of this study was to make a comparison between the two closure methods in terms of cosmetic outcome, complication and patients’ satisfaction. Method: A prospective comparative study was conducted at Rizgary Teaching Hospital and West Erbil Emergency Hospital in Erbil city from March 2012 to March 2013. A total of 105 patients were included in the study. The method of closure was selected alternatively between tissue adhesive (octylcyanoacrylate) and suture material. Analysis for cosmetic outcome, complications and patients’ satisfaction were done using the statistical package for the social sciences (version 19). Results: The complications were 25% (13 patients) in the tissue adhesive group and 18% (9 patients) in the sutured group. Of the 44 patients in the tissue adhesive group, 86.4% (38 patients) were satisfied; while of the 61 patients in the sutured group, 88% (54 patients) were satisfied with the end result. Excellent cosmetic outcome achieved in 77.3% in the tissue adhesive group and 80.3% in the sutured group. Conclusion: Tissue adhesive (octylcyanoacrylate) is effective and reliable in primary skin closure, yielding similar cosmetic results to standard suturing method. Tissue adhesive is faster and offers several practical advantages over suture repair.


Article
Treatment outcome of 100 chronic myeloid leukemia patients using nilotinib as the 2nd line therapy

Authors: Yaseen M. Taher --- Ali M. Almothaffar --- Bassam Francis Matti --- Alaa Fadhil Alwan
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2018 Volume: 7 Issue: 2 Pages: 67-71
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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BACKGROUND: Nilotinib is a potent and selective BCR‑ABL inhibitor approved for use in patientswith newly diagnosed chronic myeloid leukemia (CML) in chronic phase (CML‑CP) and in patientswith CML‑CP and accelerated phase (CML‑AP) who are resistant to or intolerant of imatinib. Patientswith imatinib‑resistant CML, nilotinib treatment resulted in a significant proportion of patients achievinghematologic and cytogenetic responses in all phases of CML.OBJECTIVES: The aim of the present study was to assess the treatment outcomes in term of themolecular response rate of CML patients using Nilotinib as the second‑line therapy after failure ofimatinib therapy.PATIENTS AND METHODS: A prospective study conducted between December 2014 and December2016 in Baghdad Teaching Hospital and National Centre of hematology. A total of 100 patients,who were on nilotinib therapy as the second‑line therapy, were enrolled in this study. The molecularresponse was assessed using real‑time quantitative polymerase chain reaction (RQ‑PCR). Majormolecular response (MMR) was defined as the BCR‑ABL1 of <0.1% by RQ‑PCR.RESULTS: The median age was 39 years, 59 were female and 41 were male. Fifty‑three patientswere classified as high‑risk group, and 47 patients were as low risk. The BCR‑ABL transcription levelhad a significant reduction from baseline at 3 months (P = 0.035) and the reduction from 3 monthsto 6 months was also statistically significant (P < 0.001). Comparing the patients who achievedMMR versus NO MMR, there was a significant association between low European Treatment andOutcome Study score and achieving MMR. An estimated 24 months overall survival (OS) is 95%.CONCLUSION: This study concluded that nilotinib is an effective therapeutic option for patientswith CML‑CP‑resistant to imatinib therapy. Nilotinib treatment resulted in a high‑OS rate and waswell tolerated.


Article
Perinatal out come of Breech Presentation in the Presentation in the Pretext Mode of Delivery

Author: Abdulrazak H. Alnakash
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 70-75
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: To choose the best mode of delivery for term, frank or complete, breech presentation through studying the perinatal outcome of each mode of delivery decided when managing a group of pregnant ladies presented with breech delivery in our centre.
Methods: One hundred and fifty pregnant ladies presented at term with singleton, frank or complete, breech presentation for delivery in our centre during the period from May 2004 to August 2005.
Mode of delivery, parity, gestational age, maternal age, maternal medical illness, and birth weight where the variables that have been tested in each delivery included in the study to verify their relationship to perinatal outcome.
Results: No significant relationship is found between the occurrence of adverse perinatal outcome and the variables. However, mode of delivery was the major determinant of the perinatal outcome.
of the 150 pregnant ladies, 46 were delivered vaginally, 32 had elective caesarean section, and the remaining 54 pregnant, had undergone an emergency caesarean section because they were presented with labour. Thirteen (8.6 %) babies were adversely affected by the process of delivery, 9 (5%) of them were delivered by vaginal route, 3 (2 %) delivered by emergency caesarean section and one (0.6%) by elective caesarean section.
Conclusion: Elective caesarean section is regarded the safest way of delivery for those with term, frank or complete, breech presentation.
Key Words: Breech, Perinatal outcome, Cesarean Section (CS).


Article
PITUITARY ADENOMA: RETROSPECTIVE STUDY AND ANALYSIS OF FACTORS THAT AFFECT THE OUTCOME OF SURGICAL TREATMENT
دراسة سريرية, و تحليل للعوامل المؤثرة في نتائج العلاج الجراحي لأورام الغدة النخامية

Authors: Samir H. Abood سمير حسن عبود --- Sarmad A. Ibraheem سرمد عزيز ابراهيم --- Abdul-Amir Jasim عبدالامير جاسم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2005 Volume: 4 Issue: 2 Pages: 197-209
Publisher: Al-Nahrain University جامعة النهرين

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Background: Pituitary adenomas are benign epithelial tumors, representing about 10% of intracranial tumors. They present as visual or hormonal disturbances or both. Attention to details in the treatment of theses benign tumors can’t be overemphasized in order to achieve best results. Objective: The aim of this work is to review the clinical and radiological features of these relatively common tumors, and identify factors that affect the outcome of surgical treatment and recurrence.Methods: This study was carried out retrospectively by reviewing the medical records of all patients with pituitary adenomas treated in the period of four years, and collecting clinical, radiological, laboratory, and surgical data. Follow up of 1-4 years was obtained on all patients. Results: There were 55 patients (31 male and 24 female) the median age was 37 year. The main presenting symptoms were visual deterioration in 49%, symptoms of endocrine disturbance in 35.3%, headache in14.5%, behavioural changes in 1.8% and seizure in 1.8%. The most common hormonal disturbance was hyperprolactinemia (32.7%). Lateral skull x-ray showed grade III sellar enlargement with erosion of the dorsum sellae in 87.2%. Brain CT scan showed isodense mass in 76% of cases, with suprasellar extension in 82.6% and contrast enhancement in 85.7%. The operative approaches were right subfrontal craniotomy in 83.6% and tarns-sphenoidal (sub labial) approach in 16.3%. Intracapsular (subtotal) removal was achieved in 70.9%, while capsular (total) removal was achieved in 29.1%. Tumour recurred in 3 patients; two of them had postoperative radiotherapy and all had originally aggressive tumors.. There were 2 cases of post radiation glioma.Conclusion: The results of the study were similar to those published. Pituitary adenoma is usually benign relatively avascular soft in consistency with characteristic clinical and radiological features. Unless associated with advanced optic atrophy with visual loss there is dramatic improvement of optic nerve function following surgery. Transient diabetes insipidus is the commonest postoperative complication mainly following trans-sphenoidal approach. The only factor that enhances recurrence is tumour aggressiveness. Postoperative radiotherapy is only indicated for aggressive invasive pituitary adenoma.Key words: Pituitary, Adenoma, Outcome.

اعراضها تدهور النظر أو اختلال افراز الهورمونات، او كليهما. للحصول على افضل النتائج في علاج هذه الاورام الحميدة يجب الاهتمام بالتفاصيل المميزة لها.هدف الدراسة: مراجعة الخواص السريرية والشعاعية لهذه الاورام, والتعرف على العوامل المؤثرة في نتائج العلاج الجراحي.طريقة البحث: دراسه رجعية للمرضى المصابين بورم النخامية خلال فترة اربعة اعوام، من خلال مراجعة طبلاتهم و متابعة حالتهم لفترة 1-4 اعوام. النتائج: عدد المرضى 55 (31 ذكر 24 انثى) متوسط الاعمار كان 37 سنة، الاعرا ض الابتدائية كانت تدهور النظر 49%، اعراض اختلال الهورمونات 35.5%،الصداع 14.5%، اضطراب التصرف 1.8% و الصرع في 1.8% من الحالات. ألاضطراب الهورموني الرئيسي كان زيادة افراز هورمون الحليب 32.7%. اشعة الجمجمة الجانبية اظهرت توسع من الدرجة (3) في السرج التركي مع تنخر في 87.2% من الحالات. مفراس الدماغ اظهر وجود كتلة مساوية الكثافة في 76% من الحالات مع وجود امتداد الى ما فوق السرج التركي في 82.6% و تظهير بالصبغة في 85.7% من الحالات. عولج 46 مريضا جراحيا بفتح الجمجمة (83.6%)، و 9 مرضى عن طريق الانف (16.3%). استؤصل الورم من داخل الكبسولة ( شبه تام) في 70.9% من الحالات و استؤصل الورم بصورة تامة في 29.1% من الحالات. توفي (3) مرضى و رجع الورم لدى ثلاثة اخرين كانت اورامهم عنيفة، و قد عولج اثنان منهم بالاشعة العميقة. أثنان من اللذين عولجو بالاشعة العميقة اصيبو باورام في الدماغ.الاستنتاج: نتائج البحث كانت متوافقة مع البحوث المنشورة في الموضوع. أورام الغدة النخامية حميدة في معظم الحالات منخفضة الدموية و لينة، ذات صفات سريرية و شعاعية مميزة. في ما عدا الحالات المتقدمة من ضمور العصب البصري و فقدان البصر، كان هناك تحسن ممتاز في النظر بعد العملية. السكر الكاذب المؤقت كان ابرز المضاعفات بعد العمليات من الانف. العامل الوحيد المؤثر في رجوع المرض هو طبيعة الورم العنيفة. العلاج بالاشعة العميقة يتوجب فقط في الاورام العنبفة. مفتاح الكلمات: الغده، النخاميه، نتائج العلاج


Article
Rupture of the Corpus Cavernosum: Outcome of Surgical Management
تمزق الجسم ألكهفي للقضيب: حصيلة المعالجة الجراحية

Author: Ala'a Al-Deen Al-Dabbagh د. علاء الدين الدباغ
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 1 Pages: 55-58
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractObjective: The aim of this study is to present our experience in the management of patients with penile fracture by immediate surgical repair. Patients & methods: A total of 14 men with fractured penis had been evaluated and treated from January 1994 to February 2003. Their age ranged from 20-35 years with a mean age of 25 years. All were managed by immediate surgical exploration with evacuation of the hematoma and repair of the lacerations.Results: Our operative and post operative plan resulted in a brief hospital stay, very few complications and good to excellent results in 12 (86 %) of cases with preservation of normal penile erection, normal marital relations and no penile deformity. Conclusion: These results compare favorably to operative management reported by most studies. Therefore, early surgical repair of the rupture is advocated. Key words: Corpora rupture, penile fracture, Treatment, Outcome.

الملخص:الغرض من الدراسة:إبداء الخبرة في علاج الحالات التي يتعرض فيها القضيب للكسر بالمعالجة الجراحية الآنية. المرضى وطرق العلاج:أجريت الدراسة على (14) مريض مصاب بكسر في قضيبه, تراوحت أعمارهم مابين (20-35 عام ) بمتوسط عمر ( 25 عام ) خلال الفترة من كانون الثاني 1994 إلى شباط 2003 تمت معالجة جميع المرضى آنيا بالتداخل الجراحي لتفريغ الورم الدموي وإصلاح التمزق الحاصل في الجسم ألكهفي للقضيب0 النتائج: أفضت هذه الدراسة إلى حصولنا على نتائج فائقة وجيدة في12( 86 %) من الحالات بتمكين المريض من الاحتفاظ بنعوض طبيعي بدون تشوه والقدرة على المعاشرة الزوجية السوية, إضافة إلى تميز خطتنا العلاجية هذه بقلة المضاعفات وقصر فترة الرقود بالمستشفى. الاستنتاج: أثبتت هذه الدراسة من خلال توافق نتائجها مع نتائج معظم الدراسات الأخرى , أن العلاج الجراحي المبكر لحالات تمزق الجسم ألكهفي للقضيب هو العلاج الأمثل.

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