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Article
salivary glands tumors in al- najaf

Author: Ali M. Al-saiegh علي السقة
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2005 Volume: 47 Issue: 4 Pages: 330-334
Publisher: Baghdad University جامعة بغداد

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Article
Incisional local anesthesia for pain control after abdominal surgery

Authors: Emad A.M.Al-Janabi --- Ali M. Al-Saiegh --- Raad S. Al-Saffar
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2008 Volume: 5 Issue: 3-4 Pages: 522-531
Publisher: Babylon University جامعة بابل

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Abstract

Bach ground:-The optimizing of postoperative pain control is an important aspect in perioperative patient care the use of inscional local anaesthesia in post operative pain control after abdominal operations was proved effective method of analgesia Aim:-to evaluate the efficacy of postoperative incisional infusion of local anaesthesia (bupivicain) in reduction of postoperative pain in abdominal surgical wounds as well as the need for systemic analgesia and possible side effects of local anaesthesia. Patients and method:- aprospective randomized placebo controlled clinical trial on 80 patients (39 male 41 female) between 13 –54 years old of different abdominal operations, admitted to El- furat hospital in kufa city from December 2005 to October 2006.The patients were divided in tow groups, intervention group 40 patients and placebo group: 40 patients. The study involve the use of incisional intermittent injection of local anesthesia bupivacaine 0.25% via thin subfascial catheter ( B/BRAUN Melsungen AG), in intervention group , for relieve of postoperative pain and assess need for systemic analgesia ( especially opiate) as compared to placebo group in which we inject normal saline via the incisional catheter. Result:-The study had been discusses age, sex distribution, types of incision, pain assessment by visual analogue score, the need for systemic analgesia & complications of local anesthesia. The mean visual analogue score of pain was measured in 1st 6th, 12th , 18th , 24th hours after surgery in every patient in both groups were significantly decreased in bupivacaine group in comparism to normal saline group P<0.005. There is significant decrease for systemic analgesia requirements after operation in intervention group as compared with placebo group (P<0.05). There is only one minor complication (seroma or wound infection) was reported in each group (2.5%). Conculsion:-Study concludes the effectiveness of incisional bupivacaine intermittent injection in relieve of postoperative pain and decrease need for systemic analgesia. Key words: incisional local anesthesia, abdominal surgery.

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Article
Acute Abdomen in Elderly Patients

Authors: Kabil S. Al-Jubori --- Raad S.AI-Safar --- Ali M. Al-Saiegh
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2006 Volume: 3 Issue: 3-4 Pages: 220-229
Publisher: Babylon University جامعة بابل

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It has been estimated that 50% of persons who reach the sixth and seventh decades of life will require surgery befor they die . At the time being more elderly peopele are undergoing surgery and are more likely to be admitted as emergency cases than young, this study was done to evaluate the real situation of this problem in our society & our surgical practice. A prospective study was done on 109 patients (61 male and 48 female ) above the age of 60 year, admitted to the emergency unit and surgical wards of Najaf hospitals, complaining from acute abdomen , for one year period Feb. 2004 to Feb. 2005, The study discuss different aspects such as : age, sex distribution, causes, percentage of operative to conservative management, hospital stay, complications and mortality rate. The mean age was 67.4 years , the largest admission was for age group 60-70(68 %), 81 patients (74.3%) were treated operatively , other 28 patients (25.7%) were treated conservatively. The most common causes of acute abdomen were intestinal obstruction (30%), liver and gall bladder diseases (24.7%) , followed by urinary system disorders (19%) , then peptic ulcer (8.25%) , appendicular disorders (7.3%) , gyenecological diseases (3.6%), pancreatic disorders (3.6%) and other less frequent disorders represent (2.7%). The most common post operative complication was chest infection (38.3%), ileus (28.4%), wound infection (19.7%) and thrombophlebitis (16%), mortality rate was (5.5%). From the present study we concluded that age alone is not acontraindication to surgery, and proper management of associated medical illness is mandatory as they may be more important causes of death than the surgical disease itself, mortality may be decreased by avoiding delay of admission and proper timing & decision of surgical intervension.

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Article
Tension –Free Inguinal Hernia Repair Comparing 'Mesh' with 'Darn' A Prospective Randomized Clinical Trial

Authors: Ali M.Al-Saiegh --- Raad S. Al-Saffar --- Haider T. Al-Khassaki***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 220-227
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Lichtenstein tension free hernioplasty(mesh repair) and Moloney darn repair are commonly practiced repairs for inguinal hernias with acceptably low recurrence rates. Mesh repair is considered more recent than darn repair and both of them are tension free.OBJECTIVE:To compare the number of postoperative complications and early recurrence between Mesh repair and Darn repair, for inguinal hernia.PATIENTS AND METHODS:The study was conducted at Department of Surgery, Al-Sadur teaching hospital in An-Najaf from 1st august 2007 to 1st august 2008 . A total of 104 patients were selected. 51 patients were treated with Lichtenstein tension free hernioplasty (Group A) and 53 with Darn repair (Group B). Cases were followed up for three months to one year. The study design was quasi experimental.RESULT:The male to female ratio was 51:1. The mean hospital stay was 37.18 hours in group A and 47.17 hours in group B. there was statistically significant difference between the groups ( p< 0.05).The mean operative time was 44.7 minutes in group A and 50.9 minutes in group B. There was statistically significant difference between the groups ( p< 0.05). the The total number of postoperative complications was reported in 36 patients, 15 ( 29.42%) complications occurring in group A and 21( 39.62%) in group B. Scrotal swelling was the most common complication followed by urinary retention and wound infection in both study groups. Postoperative complications like scrotal swelling ( 11.77% vs. 16.98%), haematoma ( 5.88% vs. 3.77%), urinary retention (5.88% vs. 9.43%), wound infection ( 1.96 vs. 7.55%) and scar pain ( 3.92% vs. 1.89%) were unsignificantly low in Lichtenstein tension free hernioplasty as compared to Darn repair (P > 0.05). There were no recurrences noted till date in any of the two groups under study.CONCLUSIONOpen inguinal hernia repair with a nylon darn was equivalent to polypropylene mesh with respect to early measures of postoperative outcome and recurrence at 1 year. The mesh was superior to darn in operative time and hospital stay

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inguinal hernia --- mesh --- darn --- repair.


Article
Post-Surgical Loco Regional Recurrence Of Breast

Author: Ali M. Al-saiegh * M.B.CH.B. D.S F.I.C.M.S. علي السقة
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 2 Pages: 193-198
Publisher: Baghdad University جامعة بغداد

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SummaryBackground : From the standpoint of mortality &morbidity, cancer is by far the most important clinical problem that concerns the breast today .The age adjusted incidence of new cases has been increasing steadily with increase in the incidence among the Iraqi women during the last few years .Materials &method : A prospective study was arranged to assess the occurrence of post-surgical loco-regional recurrence of breast carcinoma in the Iraqi female patients , a total number of 91 female patients were assessed during period from Dec.2000 to Dec.2002, the median period of follow up was two years .Result : Loco-regional recurrence developed in 20 patients (22%). Chest wall and axilla were the main sites of loco-regional recurrence seen in 12 (60%) and 6 (30%) patients respectively. Significant association were found regarding the duration between first complaint and surgical management (latency period), the size of primary tumour , the number of lymph nodes involved , staging , histopathology & grading of primary tumour .While the association between the rate of loco-regional recurrence and age ,education level ,socioeconomic status ,contraception history, marital state , lactation state , family history , parity , type of adjuvant therapy, type of surgery were in-significant .Conclusion: Carcinoma of the breast affecting Iraqi females at younger ages in a high & increasing rate than other studies with a higher Loco-regional recurrence rate. Significant association were found regarding latency period, staging, histopathology & grading of primary tumour .Aims Of Study:1.To assess the incidence of post operative loco regional recurrence of breast carcinoma in Iraqi female patients.2.To determine the significance of certain variables that may affect the loco regional recurrence rate .Keywords : breast cancer , locoregional , recurrence

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