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Article
Oral and Rectal Sedation with Diazepam for Uncooperative Child during Dental Procedure

Authors: Tahani A Al-Sandook --- Ziad H Delemi --- Baydaa A Al-Rawi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2012 Volume: 12 Issue: 2 Pages: 321-328
Publisher: Mosul University جامعة الموصل

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Aims: To identify the clinical picture and the association between dry socket and severe postoperativedevelopment with one of the systemic risk factors (typhoid fever). Materials and Methods: Twentyadult (both sexes) patients attended dental clinic searching for different dental treatments were studied.The clinical picture of 6 months period study was evaluated by completing two case sheet forms. Theywere diagnosed having dry sockets and severe postoperative pain. Blood samples were taken for bacteriological,serological and hematological study to diagnose typhoid fever. These tests included WAT,WFT, WBCs and blood culture. Results: Significant correlation existed between postoperative painand typhoid fever examined by BC and the highest percentage was with dry socket (61.5%) followedby WFT (57.1%(, WAT (44.4%) using two tests for diagnosis showed that WFT and BC gave 97.9%positive for dry socket and Kappa test was 88%, while WAT and WBCs or WFT and WAT gave theleast non significant correlation. Conclusion: There was a strong correlation between dry socket andtyphoid fever and the most sensitive tests for diagnosis was BC followed by WFT, WBCs and WAT


Article
Evaluation of nurses’ knowledge toward pain management of leukemic child under chemotherapy

Authors: Zaid W. Ahjil --- Eqbal G. Maala
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2012 Volume: 25 Issue: 3 Pages: 50-57
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective(s): To evaluate nurses' knowledge toward pain management of leukemic child in oncology wards how were receiving chemotherapy.Methodology: A descriptive study was conducted in two hospitals on (40) nurses, who provided care for the children with leukemia in oncology wards (2) hospitals (Children Welfare Teaching Hospital and Child’s Central Teaching Hospital) in Baghdad city from October 2010 up to the 27th of October 2011 for the purpose of evaluating their knowledge towards pain management for leukemic child. A purposive "non-probability sample" was selected that consisted of (40) nurse who are working in oncology wards. A questionnaire format was used which consist of (2) parts, the first part includes demographic information of the sample and the second part consists of structured Items concerning nurses' knowledge toward pain management for leukemic child which includes (3) main sections and comprised of (89) Items. Reliability and validity of questionnaire was estimated through a pilot study and a panel of expert. The data were analyzed by using descriptive statistical measures which included frequencies, percentages, and standard deviation, as well as the use of inferential statistical measures which include the chi- square test.Results: The results revealed inadequate nurse's knowledge about pain management for leukemic child under chemotherapy, two third (75 %) of the sample has poor knowledge toward pharmacological and non pharmacological pain management methods.Recommendations: Based on the results of research, the study recommends initiating training courses in pain management and developing pain assessment tools for assessing child's pain and evaluating the level of pain management procedures

الهـدف: تقويم معارف الممرضين العاملين في ردهات أمراض الدم والأورام باتجاه إدارة الألم للأطفال المصابين بابيضاض الدم وتحت العلاج الكيماوي.المنهجيّـة: دراسة وصفية شملت (40) من الممرضين العاملين في ردهات أمراض الدم في اثنان من مستشفيات الأطفال في بغداد (مستشفى حماية الأطفال التعليمي، مستشفى الطفل المركزي التعليمي) للمُدّة من 1 تشرين الأول 2010 ولغاية 1 تشرين الأول 2011 لغرض تقويم معارف الممرضين تجاه تدابير الألم للأطفال المصابين بابيضاض الدم وتحت العلاج الكيماوي. اختيرت العيّنة الغرضيّة "غير احتمالية" من (40) من الممرضين العاملين في ردهات أمراض الدم. استعملت استبانة مصممة من جزئين؛ الجزء الأول يتضمن المعلومات الديموغرافية للعيّنة والجزء الثاني يتضمن فقرات تتعلق بمعارف الممرضين تجاه تدبير الألم لأطفال إبيضاض الدم والذي يتكوّن من (3) أجزاء موزعة على(89) فقرة. تمّ تحديد ثبات ومصداقية الاستمارة من خلال إجراء دراسة استدلالية. تمّ تحليل بيانات الدراسة بإستعمال الإحصاء الوصفي الذي تضمّن (التكرارات، النسب المئوية، والإنحراف المعياري)؛ فضلاً عن إستعمال الإحصاء الإستنتاجي الذي شمل معامل الارتباط مربع كاي.النتائـج: بيّنت نتائج الدراسة عدم كفاية معارف الممرضين تجاه تدبير الألم لأطفال إبيضاض الدم تحت العلاج الكيماوي، ثلثي العينة (75%) لديهم ضعف في أسالسب تدبير الألم الدوائية وغير الدوائية. التوصيـات: بناءاً على نتائج البحث، أوصت الدراسة بإجراء دورات تدريبية في مجال تدبير الألم للأطفال تحت العلاج الكيماوي؛ فضلاً عن تصميم كتيب مصغر خاص لغرض تقييم الألم عند الأطفال المصابين بابيضاض الدم.


Article
Assessment of anesthetic efficacy of 4%articaine and 2%Lidocaine during implant pilot hole preparation in the mandibular posterior region infiltration

Author: Dr. Jabbar J. Kareem (Lecturer).* د. جبار جاسم كريم
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2012 Volume: 9 Issue: 1 Pages: 64-69
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Aim.The aim of this study was to evaluate and compare the anesthetic efficacy of 4%articaine and 2% lidocaine (both with 1:100,000 epinepherine) for buccal andlingual infiltration in patients need implant placement.Materials and methods.Forty patients have edentulus regions posterier to mentalforamen were divided into 4 study groups and received buccal and lingualinfiltration of either 4% articaine or 2% lidocaine. Surgical procedure was begun5 minutes after solution deposition. Success was defined as no or milddiscomfort (VAS recordings) during during pilot hole drill.Results.The success rate for mandibular infiltration to produce anesthesia usingarticaine was 100% in premolar and molar area for the articaine solution andsuccess rate was 80% in preamolar and 30% in molar area. There was highsignificant difference between the articaine and lidocaine solutions (ANOVA P< 0.001).Conclusion. The efficacy of 4% articaine was superior to 2% lidocaine formandibular posterior regoin.


Article
Effects of low-energy laser in the treatment of myofascial pain dysfunction syndrome of the temporo-mandibular joint

Author: Ali H. Abbas علي عباس
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 3 Pages: 82-86
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The aim of this study to evaluate the effectiveness of low-energy 904nm gallium-arsenide laser therapyin myofascial pain dysfunction syndrome of the temporo-mandibular joint.Materials and methods: Twenty six patients included in this study who complain from myofascial pain dysfunctionsyndrome of the temporo-mandibular joints. The patients were randomly divided into two groups. Group 1 consistedof 13 patients who received non steroidal anti inflammatory drug and muscle relaxant for three weeks, and group 2consisted of 13 patients who received low-energy laser for three weeks.Results: The study reveals significant early improvement in laser group in reducing pain severity and muscletenderness from first week up to the end of the observation period.Conclusion: Low-energy laser had an effect at the trigger points and significantly reducing the pain and muscletenderness


Article
Evaluation of topical versus systemic medications in the treatment of neuropathic orofacial pain A prospective study

Author: Ihsan A. Kumail احسان كميل
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 1 Pages: 53-59
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Neuropathic orofacial pain is a multifactorial condition and mainly treated by systemic anticonvulsantand antidepressant medications which result in unpleasant side effects and may contradict or interact with othermedications especially in elderly. This study demonstrates preparation of alternative topical treatment andevaluation of its efficacy versus systemic treatment in respect to period taken for pain reduction and side effects.Sample and Method: A prospective study was conducted on systemically healthy 41 patients treated forneuropathic orofacial pain attended the Oral Medicine Clinic/ Dentistry College/ Mustansiria University and privateclinic. Patients were divided into 2 groups of almost similar ages, genders and pain severities. Microemulsive gel wasprepared to carry specific concentrations of active agents by transdermal permeative vehicle to the affected sites.The first group received topical medications only (n = 21), while the second group was treated with systemicmedications only (n = 20). The intensity of pain was recorded for each on a Visual Analog Scale (from 0= no pain to10= intolerable pain) at diagnosis, and at 4 successive weeks after initiation of treatment. Reduction in pain severitywas considered only if it equals 30% or more. The two methods of treatment were evaluated according to the periodrequired for 30% pain reduction and side effect(s) caused by each type of treatment.Results: After initiation of treatment, 81% of patients (no= 17) on topical treatment showed 30% reduction inneuropathic orofacial pain levels (which is considered a good response) within 2 weeks, the rest 4 patients (19%)reached 30% pain reduction within the third week. In systemic group, 50% of patients (no= 10) showed 30% painreduction within 2 weeks, 4 patients (20%) showed 30% reduction in the third week and 6 patients (30%) of the samegroup did not experienced 30% pain reduction until the fourth week. Ten patients of systemic group experiencedside effects, while patients on topical treatment did not complain of any side effect along term of treatment.Conclusion: Topical medication as a single treatment is more efficient in reduction of neuropathic orofacial painwithin shorter period and no side effects than systemic medications. Younger patients (≤ 40 years) responded totreatment better than elderly in both groups


Article
Effect of Administration of Crystalloid IV Fluids Preoperatively on Postoperative Pain
تأثير اعطاء محاليل وريدية جزيئية قبل العملية على شدة الألم بعد العملية

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Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, socio-cultural and behavioral factors. Postoperative pain is the commonest reason for delayed discharge and unanticipated hospital admission after ambulatory surgery. Our Objective is to test the hypothesis that administration of 2 ml/kg/hr preoperative IV fluids may attenuates postoperative pain.The study was carried out in the Baghdad Teaching Hospital, Al-Yarmok Teaching Hospital and Al-Karama Teaching Hospital from 12 May till 17 June 2009. The total number of patients was 120 (35 males and 85 females) with their age ranged between 10-90 years. The patients were divided into two groups according to administration of preoperative IV fluids, group A (65 patients) did not receive IV fluids and group B (55 patients) received IV fluids preoperatively. Regarding group A, the pain scale was ≤ 5 in 15.3% of patients, and it was >5 in 84.7% of patients and these results obtained within 0-5 hours after awaking from anesthesia. Whereas in group B, the pain scale was ≤5 in 29.09% of patients and was >5 in 70.9% of patients. We have demonstrated that the preoperative administration of 2ml/kg/hr IV fluids (crystalloid) to patients who had fasted from fluids decreased the severity of postoperative pain, and the need for postoperative analgesia. We report for the first time that administration of large volume preoperative IV fluids significantly reduce the incidence and severity of pain in patients at high risk for pain.

الألم تجربةُ حسّيةُ وعاطفيةُ التي تُتأثّرُ بالعواملِ السلوكيةِ والثقافيةِ والاجتماعية والإدراكيةِ والعاطفيةِ والحسّيةِ والفسلجيةِ .الألم ما بعد الجراحة المسببُ المشتركُ للإطلاقِ المتأخرِ ودخولِ المستشفى الغير متوقّعِ بعد الجراحةِ المتنقلةِ.هدفنا كان لاختبار الفرضيةِ التي تفيد بأن اعطاء سوائل وريديةِ (بمقدار 2ملكغمساعة) قبل الجراحةِ قَدْ تُخفّفُ ألمَ ما بعد الجراحةَ. الدراسة نُفّذتْ في مستشفى بغداد التعليمي، مستشفى اليرموك التعليمي، ومستشفى الكرامة التعليمي مِنْ 12 حتى 17 يونيو/حزيرانِ 2009. العدد الكليّ للمرضى كَان 120 (35 ذكر و85 أنثى) بأعمار تَراوحتْ بين 10-90 سَنَة. المرضى قُسّموا إلى مجموعتين المجموعةِ الف (65 مريض) لَمْ تُستلمْ آي محاليل وريدية والمجموعة باء (55) استلموا سوائل وريدية قبل الجراحة.بخصوص المجموعة الف ، مِقياس الألمَ كَانَ< 5 في 3 . 15 % مِنْ المرضى، وكَانَ> 5 في 84.7 % مِنْ المرضى وهذه النَتائِج تم الحصول عليها خلال 0 -5 ساعات بعد الصَحوة مِنْ التخديرِ بينما في المجموعة باء ، مِقياس الألمَ كَانَ< 5 في 29.09 % مِنْ المرضى وكَانَ> 5 في 70.9 % مِنْ مرضى بَيّنَّا بأنَّ تقديم سوائل وريدية بكميات كبيرة ما قبل الجراحة للمرضى الذين عانوا من نقص بالسوائل قد قلل من شدَّةَ الألمِ ما بعد الجراحةِ، والحاجة لمسكنات الألم ما بعد الجراحةِ.نَذْكرُ للمرة الأولى بأنّ تقديم سوائل وريديةِ (بمقدار 2ملكغمساعة) ما قبل الجراحةِ تُخفّضُ بشكل ملحوظ حدوث الألم وشدَّةَ الألمِ في المرضى المعرضين للخطرِ العاليِ للألمِ.


Article
Acute Abdomen in Al-Kindy Teaching Hospital

Author: Dr. Mohammed salih A. Ali M.B.Ch.B. C.A.B.S.
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 46-53
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective; Is to study and analysis the pattern of the non-traumatic acute abdomen cases that received by causality department of Al-Kindy Teaching Hospital in one year and to see the causes of acute abdomen and to compare it to other studies.Method: This prospective study was done for all cases of non-traumatic acute abdomen (370 patients) which were admitted to the causality department of Al-kindy Teaching Hospital from 1 march 2010 to 28 February 2011, clinical history and physical examination and resuscitation were done for all patients. WBC, GUE, plain abdomen were also done for all patients, and US was done for highly indicated cases, surgical operations done for patients indicated and reminder treated conservatively.Result;370 patients received in the causality department, the ratio of male to female is 1.23:1.Common age group involved is 11-20years (34%), followed by age group 21-30 years ( 28%), it occur least at old age group ≥ 60years (1.6%) . 45.5% patients presented after 24 hours from onset of pain.60.37% of patients have generalized abdominal pain and 60% of patients complain of vomiting. And only 57% of patients have WBC more than 10x109/L.Clinical preoperative diagnosis was acute appendicitis in 68.6% of patients, perforated viscous in 12.6%, acute cholcystitis 3.78%, peritonitis without clear cause 2.7%, renal disease 4.32%, non-specific disease group 5.9%, and 8 patients as case of intestinal obstruction.The final result was suppurative acute appendicitis 54.6%, Ruptured appendix 5.94%, Perforated DU 8.64%, perforated typhoid 5.67%, UTI 4.32% and non specific infection 10.8%The post operative complications not differ from other centers.Conclusion : The non-traumatic acute abdomen is one of the most common surgical condition, and acute appendix is the most common cause of acute abdomen and most of patient presented after 24hours after onset of symptom.Key worlds; - non-traumatic acute abdomen, -acute abdomen, - abdominal pain analysis.


Article
Efficiency of Nursing management Toward Pain

Author: Rajha A. H. Hamza
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2012 Volume: 2 Issue: 3 Pages: 9-14
Publisher: University of Kufa جامعة الكوفة

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Objectives: The study aimed to identify the efficiency of nursing managementtoward patients' pain. And to find out the association between the nursing knowledgeconcerning pain management and nurses characteristics. Methodology: A descriptivestudy is carried out at AL-Najaf teaching hospitals which include, AL-sadder medicalcity, AL-Hakeem hospital, AL-Zahra hospital, AL-Forat hospital, from the period of11/11 /2011 to 28/3/2012. A probably (random sample) of (83) nurses those who arework in the above hospitals. The data are collected through the use constructedquestionnaire, which consists of two parts, demographic characteristic sheet thatconsists of (6) items, which included gender, age, level of education, years ofexperience and hospital, place of work in the hospital. And the second part of thequestionnaire was consists of (16) question concerning nursing management regardingpain management and by means of direct interview technique with nurses who wereindividually interviewed in the hospitals. Results: The finding of the present studyindicate that a significant association between nursing knowledge concerning painmanagement and gender and the result shows no other association occurs between thenursing management and other nursing characteristic in this results. And the majorityof nurses have moderate level in knowledge about pain management.Recommendation: Conduct education programs for nurses who have no experience inassessing and managing of pain and to increase the teaching hours about painmanagement in the curriculum in nursing colleges and institutes including both theoryand practice. Also to Provide posters, pamphlets, and booklets in the hospitals toimprove their knowledge.

الھدف:تھدف ھذه الدراسة إلى معرفة كفاءة العنایة التمریضیة المقدمة للمرضى الذین یعانون من الألم، ولمعرفةوجود علاقة بین العنایة التمریضیة المقدمة للمریض الذي یعاني الألم والمعلومات الدیموغرافیة عن الممرضینوالممرضات. إجراءات البحث: دراسة وصفیة كمیة أجریت في مستشفیات محافظة النجف الاشرف : مدینة2012 . تم /4/28 -2011/11/ الصدر الطبیة، مستشفى الحكیم، مستشفى الزھراء، ومستشفى الفرات للفترة من 11جمع عینة عشوائیة مؤلفة من 83 ممرض وممرضة. تم وضع استمارة استبیانیھ لھذا الغرض مؤلفة من جزئینالأول یحتوي على المعلومات الدیموغرافیة ومؤلفة من العمر والجنس والمستوى العلمي وسنین الخدمةوالمستشفى التي یعمل بھا . ومكان العمل في المستشفى. أما الجزء الثاني فیحتوي على ( 16 ) سؤال تخص العنایةالتمریضیة للمرضى الذین یعانون من الألم تم جمع المعلومات بطریقة المقابلة الشخصیة للممرضین والممرضات.النتائج: أظھرت النتائج وجود علاقة قویة بین مستوى العنایة التمریضیة والجنس اما باقي العلاقات فكانتضعیفة. وإن غالبیة الأشخاص ضمن العینة لدیھم مستوى متوسط من المعرفة بالعنایة التمریضیة. التوصیات:تحضیر برنامج تثقیفي للممرضین والممرضات الذین لدیھم خبرة قلیلة في تقییم والعنایة بالألم. وبزیادة عددالساعات الدراسة العملیة والنظریة في المناھج اللازمة لتدریس العنایة بالألم لطلبة كلیات التمریض. وتوفیركتیبات ونشرات ومطبوعات التي تساعد على تزوید المریض والممرضة بالمعلومات اللازمة لھذا الغرض


Article
The Incidence of Pain after Root Canal Treatment Using Different Irrigation Methods

Author: Iman M. Al-Zaka ايمان محمد الزقة
Journal: Tikrit Journal for Dental Sciences مجلة تكريت لعلوم طب الاسنان ISSN: 20731213 Year: 2012 Volume: 1 Issue: 2 Pages: 38-43
Publisher: Tikrit University جامعة تكريت

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Abstract

The aim of this study was to compare the postoperative level of pain after root canal therapy using different irrigation protocol. Materials and method: in a clinical trial, 90 asymptomatic single-rooted teeth were treated endodontically with different irrigation techniques. The teeth were randomly assigned into three groups. In group I(n = 30), procedures were performed using an endodontic irrigating syringe (Vista, Appli-vac). The group II (n = 30) used an irrigation device based on subsonic system Endoactivator (Dentsply Tulsa Dental Specialist). In group III (n = 30) used Safety Irrigator (Vista Dental Products, WI). Pain levels were assessed by an analog scale questionnaire after 4, 24, and 48 hours. Results: during the all time intervals after treatment, the pain experience with group III was significantly lower than the other methods. In conclusion, an irrigation/evacuation system Safety Irrigator resulted in significantly less postoperative pain than subsonic Endoactivator and conventional needle irrigation.


Article
A Comparative Study of Laparoscopic Versus Open Appendectomy

Author: Basher A. Abdul- Hassan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 233-237
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Laparoscopic appendectomy has gained popularity in recent years and has become one of the most widely performed procedures. However, it is not the universal gold standard as laparoscopic cholecystectomy for acute cholecystitis. This is, perhaps, due to the emergency nature of disease often operated by junior staff in odd hours when laparoscopic equipment, trained staff and supervision may not be availableOBJECTIVE:To compare the results of open with laparoscopic appendectomy in terms of postoperative pain, rate of wound infection and hospital stay.PATIENTS & METHODS:This study was conducted in Al- Kadhmyia teaching hospital, over a period of six months from the 1st of October 2009 to the 1st of April 2010. Patients undergoing surgery for acute appendicitis were randomly assigned into one of the two groups (A or B) after obtaining written and informed consent. In Group-A patients underwent open appendectomy and in Group B laparoscopic appendectomy was performed. Post operatively pain chart, days of hospital stay and wound infection was recorded.RESULT:Sixty patients (38 male, 22 female), with clinical diagnosis of acute appendicitis based on Alvarado score of six and above, were included in the study. They were randomized into 2 groups of A and B with 30 patients in each group. Group-A comprised open appendectomy procedure and Group-B comprised laparoscopic appendectomy. Comparison of postoperative pain by visual analogue scale was significantly low in Group B, compared with Group A, on day 0, 1 and 2. Number of days in Hospital was 4.1±0.8 days in Group A and 1.5±0.06 days in Group B. None of the patients in Group B, while 8 (26.67%) patients in-Group A, developed postoperative wound infection at 1 week follow up.CONCLUSION:Laparoscopic appendectomy is safe and effective. Postoperative pain, hospital stay and wound infection were significantly lower after this mode of surgery

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