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DOES POST-LAPAROSCOPIC CHOLECYSTECTOMY INTRA-ABDOMINAL DRAIN REDUCES POSTOPERATIVE SHOULDER PAIN?

Authors: Ahmed H. Ismael احمد حقي اسماعيل --- Anees K. Nile انيس خليل نايل --- Hassan A. Hassan حسن احمد حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 1 Pages: 4-10
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: In the context of the much-heralded advantages of laparoscopic surgery, it can be easy to overlook post-laparoscopy pain as a serious problem, yet as many as 80% of patients will require opioid analgesia. It is generally accepted that pain after laparoscopy is multifactorial, and the surgeon is in a unique position to influence many of the putative causes by relatively minor changes in technique.Objective: To determine whether a drain placed in the peritoneal cavity during laparoscopy is both clinical and cost-effective method of reducing postoperative shoulder pain.Methods: One hundred female patients were having laparoscopic cholecystectomy were divided into two groups, a control group (50 patients) where no intra-peritoneal drain was inserted and second group (50 patients) in which the patients had intra-peritoneal gas drain sited in the subhepatic area. Patients' age, weight, height, operative time, total amount of CO2 and amount of analgesia used were recorded for each patient in both groups. Shoulder pain was assessed using visual analogue score (VAS) from 1-5 scale at 4, 8, 24 & 48 hours postoperatively, where as abdominal pain was assessed at 48 hour post-operatively. pH of the abdominal fluid was assessed in the second group of patients by using pH meter 48 hours postoperatively. ResultsShoulder pain may occur in many of patients of the control group more frequent than those of the second group, where as postoperative abdominal pain was found to be greater in patients with subhepatic drain after laparoscopic cholecystectomy.Conclusion: Low-cost drain decreased the frequency of shoulder pain and reduced the need for analgesia, but increases the abdominal pain; however it is less cost-effective than simple oral analgesia after laparoscopy.Keywords: laparoscopic cholecystectomy, intra-abdominal drain, shoulder pain


Article
OPEN VERSUS CLOSED METHODS IN TREATMENT OF PILONIDAL SINUS DISEASE

Authors: Ali A Ali علي عزيز علي --- Basher A Abdul-Hassan بشار عباس عبد الحسن --- Anees K. Nile انيس خليل نايل
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 2 Pages: 114-119
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Pilonidal sinus disease can be managed surgically either by excision & primary closure, or by excision and leaving the wound to heal by secondary intention. This study is designed to show the difference between these two methods.Objective: To assess the difference between excision and primary closure versus excision and healing by secondary intention in treatment of pilonidal sinus disease.Methods: Between January 2005 and January 2009, 60 median aged patients with Pilonidal sinus disease were studied in Al-Kadhimiya Teaching Hospital, Baghdad, Iraq; 30 cases were operated by excision and primary closure (group І); the remaining 30 cases were operated by excision and healing by secondary intention, without closure (group II). The principle outcome measures recorded were duration of hospital stay, operative time, duration of complete healing, wound infection and recurrence rate. Satisfaction and comfort of patient was monitored by using visual analogue scale during first five days post-operatively. Data were statistically analyzed by using SPSS & Chi square.Results: A total of 60 patients were divided into 2 groups, 30 patients operated by using primary closure (group I), and 30 patients operated without closure (group II). Age range of patients was from (16 - 37 yrs). Duration of hospital stay and duration of complete healing was longer in patients of group II than those of group I (p ≤ 0.001). Operative time in group I is more than that in group II (p ≤ 0.001). Pain scores were lower in group I than group II (p = 0.004). The frequency of wound infection and recurrence rate after one year follow up were more in group I than group II, this was statistically of little significance.Conclusions: Excision and primary closure is recommended as a preferred procedure in the management of chronic sacral PNS disease. It has the advantages of short hospital stay, early wound healing, rapid return to work.Key words:pilonidal sinus, primary closure, secondary intention


Article
12.THE LEVEL OF 27-HYDROXYCHOLESTEROL AND OXYSTEROL 7 α-HYDROXYLASE (CYP7B1) IN TISSUES OF WOMEN WITH BREAST TUMORS

Authors: Zahraa K. Mohammed زهراء كاظم محمد --- Hassan H. AL-Saeed حسن حسين العبد --- Anees K. Nile انيس خليل نايل
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 2 Pages: 201-206
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:In Iraq, breast cancer is the commonest type of malignancy in females. The disease is a genetically and clinically heterogeneous. The cholesterol metabolite 27-Hydroxycholesterol (27HC), a primary metabolite of cholesterol and an estrogen receptor (ER) and Liver X receptor (LXR) ligand, increases ER-positive breast cancer. 27-hydroxycholesterol (27HC) is metabolized by oxysterol 7α-hydroxylase (CYP7B1), CYP7B1 expression has been decreased in ER-positive tumors compared with normal breast tissues.Objective:To study and investigate the possible association of clinic-pathological parameters 27HC and CYP7B1 level in sera of women with benign and malignant breast tumors and in control group by ELISA technique and Investigate the possible relationships of 27HC with CYP7B1.Methods:This case control study was conducted on sixty patients with breast diseases were divided into three group, group I contained twenty patients with benign breast diseases, group II consisted of twenty premenopausal patients with breast cancer. Group III comprised twenty postmenopausal patients with breast cancer with the mean age and standard deviation (25.25±7.87, 38.65±6.28, 58.5±7.02 years). 27HC and CYP7B1 were measured in tissues by instrument ELISA technique.Results:The tissue homogenates of women with premenopausal and postmenopausal breast cancer groups showed a significant elevation of 27HC in comparison with benign (p> 0.001), whereas there is no significant difference observed between both breast cancer groups (p= 0.542). The tissue homogenates of women with premenopausal and postmenopausal breast cancer groups showed a significant decrease of CYP7B1 concentration in comparison with benign (p= 0.003) and (p= 0.001), whereas there is no significant difference observed between both breast cancer groups (p= 0.868).Conclusion:A higher incidence of 27HC and a lower incidence CYP7B1 were obtained in malignant than benign breast tumor tissues with positive estrogen receptors. These indicate that the levels of 27HC and CYP7B1 in breast tumor tissues may be used as new biochemical markers for breast tumor prognosis.Keywords:27-Hydoxycholesterol, CYP7B1, breast cancer, estrogen receptorCitation:Mohammed ZK, AL-Saeed HH, Nile AK. The level of 27-hydroxycholesterol and oxysterol 7α-hydroxylase (CYP7B1) in tissues of women with breast tumors. Iraqi JMS. 2018; 16(2): 201-206. doi: 10.22578/IJMS.16.2.12


Article
THE INCIDENCE OF BREAST CANCER IN EXAMINED BIOPSIES OF BREAST MASSES IN AL-HUSSAIN TEACHING HOSPITAL IN KERBALA

Authors: Akram F.M. Ali اكرام فؤاد محمد علي --- Anees K. Nile انيس خليل نايل --- Fatin H.A. Al-Wajidi فاتن جاسم علي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2015 Volume: 13 Issue: 1 Pages: 97-102
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Breast cancer is the most common type of malignancy among females worldwide. Breast cancer is the second most commonly diagnosed cancer in women under 35 years with the most common hitological type being infiltrative ductal carcinoma.Objective:To determine the incidence of breast cancer in excised breast biopsy specimen in Al-Hussain Teaching Hospital in Kerbala governorate as well as determining the most prevalent histopathological type, pathological stage and grade at time of diagnosis.Methods:It was a statistical study in which a total of 200 excised biopsy and mastectomy specimens where enrolled in the study, biopsy processing and slide preparation from paraffin blocks was processed in the pathology laboratory in Al-Hussain teaching hospital in Kerbala from January 2011 – January 2012.Results:Out of 200 cases who were initially enrolled in the study, 140 (70%) were benign, and 60 (30%) were malignant. The highest incidence of breast cancer was found among 40-49 years age and ductal carcinoma is the most common histological type.Conclusions:Breast cancer accounts for about 30% from all excused biopsy materials in Al-Hussain Teaching Hospital in Kerbala. This study highlights some of the features of breast cancer seen in this region; younger age, intermediate stage at presentation, and higher incidence in housewives. In contrast to data from the West, where more than half of breast cancer patients are above 50 years of age and higher incidence among high socioeconomic group.Key words:Breast cancer, lesions, histopathology, incidence, percent.

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