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Article
Appendicectomy

Author: Safwan A. Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2002 Volume: 8 Issue: 2 Pages: 331
Publisher: Basrah University جامعة البصرة

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Article
THE CLOSED TECHNIQUE IN THE TREATMEMT OF PILONIDAL SINUS GIVES SUPERIOR RESULTS TO THE CONVENTIONAL OPEN TECHNIQUE; A PROSPECTIVE STUDY

Author: Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 38-42
Publisher: Basrah University جامعة البصرة

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The aim of this study is to compare between excision followed by primary closure as the first type of treatment and excision with laying the tract open, to heal by granulation, as a second type of treatment of pilonidal sinus.Seventy three patients were included in the study. They were divided randomly into two groups, group A and group B, the first group was treated by closed method and the other by open method.Data were collected and analyzed regarding recurrence rate, time needed for full healing, infection rate and duration of hospital stay.Thirty-five patients comprised group A (30 males and 5 females) compared to 38 patients in group B (31 males and 7 females). The mean hospital stay for group A ranged from 3 to 6 days (mean=4.4 days) while for group B it ranged from 1 to 2 days (mean=1.2 days), a difference that is statistically extremely significant (P value <0.00001). The rate of wound infection was similar (2.8%) in both groups (one in 35 patients of group A and one in 38 patients of group B).Primary closure has the advantages of quicker healing time, shorter post operative specialized medical care and less time off work.

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Article
SURGICAL MANAGEMENT OF INCISIONAL HERNIAS; THE CURRENT STANDING

Author: Safwan A. Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 1 Pages: 105-118
Publisher: Basrah University جامعة البصرة

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OPEN MIDLINE INTERNAL SPHINCTEROTOMY (WITH FISSURECTOMY) IN THE TREATMENT OF CHRONIC ANAL FISSURE

Author: Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 2 Pages: 55-58
Publisher: Basrah University جامعة البصرة

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Anal fissure represents one of the most common diseases of the ano-rectum in which there is denuded epithelium of the anal canal overlying internal sphincter. In this study 110 patients underwent posterior midline sphincterotomy as the treatment for their chronic anal fissures. Mean operating time was 5 minutes and no patient stayed at hospital overnight. All patients were followed-up for 6 months. Symptoms were relieved right following surgery. Four patients developed wound infection. Other 4 patients experienced some difficulty in micturition but none had retention. Six patients experienced relative incontinence to flatus for a couple of weeks postoperatively but all of them regained their sphincter control after that. No patient complained of incontinence for feces. There were no serious scarring of the area like keyhole deformities or its variants and none of the patients developed recurrence. Almost all the patients were satisfied with the outcome. We recommend posterior midline internal sphincterotomy as the surgical treatment of choice for chronic anal fissure because it is simple to perform and results in quick relief of pain and rapid healing in almost all cases, with very few complication and negligible recurrence.

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Article
Today’s Wisdom, Tomorrow’s Nonsense!‎

Author: Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 2 Pages: 3-5
Publisher: Basrah University جامعة البصرة

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Article
Diabetic Foot Management; A 10-Year Study.‎

Authors: Issam Merdan --- Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 2 Pages: 38-42
Publisher: Basrah University جامعة البصرة

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The medical records of 324 diabetic patients admitted to Al-Sader Teaching Hospital (Saddam Teaching ‎Hospital previously) with foot lesions between April 1994 and April 2004 were studied retrospectively. ‎Data were collected for various parameters, both personal and medical. The majority of patients were ‎males, over fifty years of age and known diabetics. Peripheral neuropathy was the main predisposing ‎factor while infected ulcer and gangrene of toe / toes were the most common forms of presentation. ‎Wound swabs were positive for bacterial culture in 215 pts. (66.3%), 97.2% of which were polymicrobial. ‎Dibridement was the most common surgical procedure. There were 6 deaths (1.85%) in the study group ‎mainly due to uncontrolled sepsis with concurrent medical illnesses. It is concluded that foot ‎complication is a common problem in elderly Iraqi diabetics, particularly males, peripheral neuropathy is ‎the most common predisposing factor, foot infections are usually poly microbial and that the majority ‎will need some form of surgical intervention that is mostly conservative rather than a major amputation. ‎We suggest a team approach in the care for these patients which can be provided by establishing foot ‎care clinic in large hospital. ‎

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Article
THE CILNICAL AND BACTERIOLOGICAL PROFILE OF ANO-RECTAL ABSCESS IN BASRAH; A PROSPECTIVE STUDY.

Authors: Mahmoud S Al-Haroon --- Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 36-41
Publisher: Basrah University جامعة البصرة

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Introduction norectal abscess is one of the common surgical problems of the anorectal region1-4. It is a suppurative process of the anal canal that originates from infection of an obstructed anal gland5,6. Once infection gains access to the intersphincteric space, it has easy access to the adjacent perirectal spaces7. Men are affected more than women with 3rd and 4th decades of life as the peak age of incidence7,8. In a descending order of frequency; perianal, ischiorectal, sub-mucosal and supralevator are abscess types according to anatomical location7-12. The bacterial profile of an abscess, which is usually a mixed infection involving aerobic and anaerobic microorganisms, is considered as a prognostic factor for recurrent abscess and fistula formation1,5, 7,10,13,14. Diagnosis is made on basis of history and anorectal examination and is usually easy except in case of deep abscess9,15. All cases require urgent incision and drainage4,16.

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Article
ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRIC MALIGNANCY …51

Authors: HASHIM S KHAYAT --- SAFWAN A TAHA
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 2 Pages: 51-56
Publisher: Basrah University جامعة البصرة

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ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRICMALIGNANCY.Hashim S Khayat# & Safwan A Taha**CABS. Professor, Dept. of Surgery, University of Basrah, College of Medicine; #FRCS Ed. Consultant Surgeon and Chairman, Basrah General Hospital, Basrah; IRAQ.AbstractOut of 62 patients who underwent total gastrectomy for gastric malignancy, 40 patients had roux-en-y esophagojejunostomy. Their age ranged from 32 to 70 years. Seventeen patients were less than 60 years old and 27 were older. There were 23 males and 17 females. Operations were done through thoraco-abdominal incisions in 28 patients and upper midline incisions in 12. The anastomoses, on the other hand, were hand sewn in 34 patients and stapled in the other 6. The procedure included splenectomy in 37 patients, distal pancreatectomy in 6 and transverse colectomy in 2 patients. Postoperative complications included chest infection (8 patients), wound infection (7 patients) and anastomotic leak (1 patient). Eleven patients died postoperatively, the leading cause being pulmonary embolism, respiratory failure and over-whelming sepsis. Out of our surviving patients, 4 (10%) are still alive 5 years or more after surgery and are enjoying good health. Our results are well within the international figures although we think that the outlook could have improved had we gained access to certain facilities like hyperalimentation, chest physiotherapy units and measures that could prevent deep venous thrombosis. Roux-en-y esophagojejunostomy is a safe method to restore the continuity of the alimentary tract after gastrectomy. It requires less time than “pouch-forming” procedures, has less incidence of anastomotic leakage, produces acceptable morbidity and mortality, gives good nutritional value and does not require the special expertise needed to perform the “pouch-forming” procedures.

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Article
Combination Medical Therapy ( -Blockade and Androgen Suppression) in the Treatment of Benign Prostatic Hyperplasia

Authors: Safwan A. Taha --- Ziad Al-Naieb --- Mortadha M Saleh
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2002 Volume: 8 Issue: 2 Pages: 204
Publisher: Basrah University جامعة البصرة

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This is a prospective study designed to compare the outcome of two different lines of medical therapy for Benign Prostatic Hyperplasia (BPH), namely:  blockers alone versus  blockers and androgen suppressors in combination. One hundred patients were included in the study, which was conducted during the period from September 1998 to March 2001. Detailed history was taken with thorough physical examination and investigations. Patients also underwent ultrasonography and intravenous urography to assess the upper tract function and postvoiding residual volume. The American Uorological Association (AUA) Symptom Score, urinary flow rate and the volume of residual urine were assessed in all patients and were used for comparison. The patients were randomized into two equal groups, each consisting of 50 patients. Those in group I were given Doxazosin (4 mg/day) alone while those in group II were given a combination of Doxazosin (4 mg/day) and Finasteride (5 mg/day). It is concluded that the results obtained with combination therapy are more promising and significantly better than those obtained with a single agent. All the parameters of comparison, i.e. the AUA score, urinary flow rate and volume of residual urine, improve with both methods but to a much greater extent in group II, the combination therapy group.

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Article
4- CAUSES AND INCIDENCE OF LAPAROSCOPIC CHOLECYSTECTOMY CONVERSION

Authors: Adnan Y Abdulwahab --- Safwan A Taha --- Salam T Mutlak
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 20-24
Publisher: Basrah University جامعة البصرة

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Four hundred cases of laparoscopic cholecystectomy candidates wereprospectively followed at the time of surgery by obtaining a data sheet for thepatient’s age, sex, time from the introduction of ports till decision of conversionand the cause of conversion if present in two years (2006 & 2007) period.From 400 laparoscopic cholecystectomy, 20 conversions were obtained and thecauses were; wide cystic duct, empyema of the gall bladder, severe obesity, livertumor, abnormal position of gall bladder, vascular variation and dense adhesionswith disturbed anatomy. The percentage of conversion was 5%. Eight conversioncases were males from the total 45 male patients underwent laparoscopiccholecystectomy. Twelve cases were females out of 355 female patientsunderwent laparoscopic cholecystectomy. The percentage of conversion for malepatients was 17.7% while in female patients was 3.3%. Our results showed thatthe conversion rate in this study was 5% and the most common cause forconversion is dense adhesions. No biliary duct injury or severe bleeding thatneed conversion is found in this study and the rate for conversion is higher inmale patients.

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