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Article
Study of Outcome of Adult Cases Admitted to the Intensive Care Unit (I.C.U) in Baghdad Teaching Hospital

Authors: Abudalrasool Noori Nassr --- Basil Fawzi Jameel --- Qasim Mohammed Sultan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 86-91
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Patients at Intensive care unit (I.C.U) admitted from different hospital departments (Medical, surgical and obstetrics), with different presentations to the I.C.U., some of these cases need sophisticated management and some of them need just monitoring and supportive therapy.OBJECTIVE:To evaluate the cases in the I.C.U regarding the gender, age and smoking status, and to assess their clinical status and to predict their prognosis and outcome.PATIENTS AND METHODS:A cross-sectional study of 50 case from I.C.U of Baghdad Teaching Hospital. The period of patients' admission from first of January 2013 to 31 of December 2013. Patients 18 year of age and above (adults) were included in the study.RESULTS:From 50 case involved in the study, there was 29 (58%) male and 21 (42%) female, among 29 males there was 14 case (48.3%) survived and 15 case (51.7%) Died, while female 11 case (52.4%) survived and 10 cases (47.6%) died. The survival rate lower among smokers; male (25%), while non-smoker male was 64.7%, however the survival rate was higher (100%) for those with hypoxemia without respiratory failure, but patients (especially male cases) who received mechanical ventilation showed very low survival rate (37.5%) compared to those on oxygen therapy with survival rate (72.2%).CONCLUSION:Smoker patients showed lower survival than non- smokers. Patients who received mechanical ventilation showed very low survival rate in comparison with those on oxygen mask therapy.

Keywords

KEYWORDS: I.C.U.


Article
Survey of Pulmonary Embolism Characteristics, A Hospital Based Study

Author: Salman Hachim Al-Nuami *, Basil Fawzi Jameel **, Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 1 Pages: 58-64
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Pulmonary embolism is a common complication of hospitalization and contributes to 5 to 10 percent of deaths in hospitalized patients, making it one of the leading causes of preventable hospital deaths.OBJECTIVE:Is to evaluate patients with pulmonary embolism admitted to Ibn Alnafees Hospital, Baghdad, Iraq.PATIENTS AND METHOD: Cross-sectional study in one year( 2016) , We treated 52 cases of Pulmonary embolism in Ibn Alnafees Hospital in the CCU and we collected their data on admission to the hospital on different age group, gender, sign and symptoms, investigation, predisposing factors, treatments with thrombolytic therapy and the outcome of the patient. Seven patients died after admission, two of them same of day of admission.RESULT: In this study, the surgery was the most common risk factor for pulmonary embolism followed by deep Venus thrombosis. However, there was no obvious risk factor present in 11.5% of cases, and 28.7% of cases had have more than one risk factor. CONCLUSION: The surgery was the most common risk factor for pulmonary embolism followed by deep vein thrombosis. The CT pulmonary angiography is positive in vast majority of cases, so it's useful and effective diagnostic tool for pulmonary embolism.


Article
Relationship Between FEV1& PEF in Patients with Obstructive Airway Diseases

Authors: Muhammed .W.AL.Obaidy --- Kassim Mhamed Sultan* --- Basil Fawzi Jameel ** --- ,Rokan Motasher Fadhil
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 184-190
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Spirometry is the recommended investigation for diagnosis and categorization of the severity of the air flow limitation, however Spirometer is not widely available, while Peak-flow meter is cheap, portable, and easy to operate and maintain, so the PEF is frequently proposed as alternative to FEV1 for this purpose, and widely used in general practice as a surrogate for FEV1 in assessment of airway obstruction diseases.OBJECTIVE:To determine effect of FEV1 & PEF in obstructive airway diseases.PATIENTS AND METHODS:This study was took place between 1st December 2006 and 1st July 2007in Baghdad teaching hospital. A total of 100 patients with history suggestive of obstructive airway diseases (symptoms of cough, wheezes, shortness of breath, and chest tightness), and their pulmonary function test show obstructive pattern (FEV1/FVC <70%) were included. They were (60%) male and (40%) female, and their age ranged from 16 to 82 years.RESULTS:In screening for obstructive airway diseases, there was a significant relationship (P value <0.05) between FEV1% and PEF%, (94%) of patients with obstructive airway disease as assessed byFEV1% (FEV1 %< 80%) had PEF %< 80%.In severity categorization, the PEF% and FEV1% were concordant in only (60%) of patients, with better concordance as severity of obstruction (based on FEV1%) became more. In patients with mild to moderate airway obstruction (FEV1%>40%), PEF% tended to underestimate FEV1%; while in patients with more severe obstruction (FEV1 %< =40%), PEF% tended to overestimate FEV1%. For the entire study population, PEF% underestimated FEV1% by mean of only 0.35%. However, limits of agreement were wide and exceeded-/+ 14.5. In our study 70% of patients had discordance more than 5% apart between PEF% and FEV1%, (which could be considered clinically important error for estimation of severity of airway obstruction), and this discordance more marked in women, short patients, and in patients with mild airway obstruction.CONCLUSION:The PEF% can reliably exclude airway obstruction, when normal value is present. Assumption of parity between PEF% and FEV1% must be avoided especially in categorization of severity of air way obstruction


Article
A Statistical Radiological Analysis in Patients with Sputum Smear Positive Pulmonary Tuberculosis

Authors: Waleed Latif Hussein --- Basil Fawzi Jameel --- Muhammed .W.AL.Obaidy --- Adnan M. AL,Jubouri
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 148-157
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:Tuberculosis (TB) a multi-systemic disease with various presentations and manifestations; is due to infection with the acid fast bacillus mycobacterium. Disease occurs in only (10%) of infected individuals, it is associated with overcrowding and immune-compromised statesOBJECTIVE:To identity the main findings in plain chest X-ray and CT-scan of the chest of pulmonary tuberculosis patients with sputum smear positive in relation to certain factors and clinical conditions including : gender, age , smoking , alcohol- consumption , co-morbid diseases e.g. diabetes mellitus and steroid medication for more than 4 weeks .PATIENT AND METHOD:Across sectional study of randomly collected (100) patients all were new cases of pulmonary tuberculosis disease with sputum smear positive, A plain chest radiography was done to all of them , and a randomly chosen (30) patients (out of the same sample of the study) were examined also by ( high resolution CT-scan ) of the chest to compare the radiological findings.The sample of patients collected consisted of (68)males and (32) females , aged between (12 -82) years.The study was done in the specialized chest and respiratory diseases center in Baghdad during the period from first of March 2012 ,to the end of August 2012.RESULTS:100patients with sputum smear positive – pulmonary tuberculosis disease were collected, 68 patients (68%) were males and 32 patients (32%) females. From our study97 patients(97%)of total number presented with positive radiological findings whether by plain chest X-ray and /or CT-scan of chest, And 3 patients(3%) of the sample studied were with normal both plain chest X-ray and CT-scan of chest.The radiological findings of all of the patients studied were as :Infiltrative lesion48 patients( 48% )Cavitary lesion(: 37%)Consolidation ( 32%)Pleural effusion (17%)Miliary shadowing( 1%)Clear radiological was found that 28 patients (28%) had radiological abnormalities in the right side of the chest and 25 patients were with left sided radiographic abnormality, while bilateral chest radiological finding had been shown in44 patients (44%).CONCLUSION:The CT- scan of chest is more sensitive than plain chest X-ray for evaluation of abnormal or obscured radiological findings. There is no specific pattern for radiological finding in the chestthe direct sputum examination is remained the 'gold standard' for the diagnosis of pulmonary tuberculosis.


Article
Clinical Evaluation of Overnight Oximetry Monitoring of High Risk Patients for Obstructive Sleep Apnea

Author: Qasim M Sultan*,Mustafa Nema**, Basil Fawzi Jameel ***, Mohammed Shakir Hasan ****
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 3 Pages: 372-378
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Obstructive sleep apnea (OSA) is a condition of sleep related pharyngeal collapse, in which recurrent episodes of upper airway occlusion occur during sleep causing diminution (hypopnea) or cessation of airflow (apnea) in the pharynx provoking arousals and sleep fragmentation, resulting in daytime sleepiness.Oximetry alone is very valuable tool in the diagnosis and management of OSA, it can identify most cases allowing referral for continuous positive airway pressure (CPAP) treatment.OBJECTIVE:To evaluate the overnight oximetry monitoring as a swift and accessible PATIENTS AND METHOD: Cross sectional study of 20 patients, 12 males and 8 females with high probability of OSA, attended to respiratory clinic in Baghdad teaching hospital suffering from excessive daytime sleepiness, they were clinically evaluated plus using overnight oximetry as an objective testing method.RESULTS: The study sample was 20 patients, 12 males (60%), 8 females (40%), mean age 48 years, mean BMI 45.6 Kg/m2, female mean BMI 53.1 Kg/m2, male mean BMI 37 Kg/m2, and mean basal Po2 saturation 89.6 %.Desaturation index (DI) show significant correlation with AHI, BMI, and gender, while no significant correlation with age. AHI show significant correlation with baseline SPO 2 and gender, and no correlation with BMI and age.CONCLUSION: Desaturation index assessed by nocturnal pulse oximetry maintain its utility as a screening method in the recognition of obstructive sleep apnea in obese patients with high clinical pretest suspicion. DI when combined with appropriate clinical evaluation could be used as an initial diagnostic test for OSA. .


Article
Assessment of Body Mass Index & Nutritional Status in Pulmonary Tuberculosis Patients
تقييم مؤشر كتلة الجسم والحالة الغذائية لدى مرضى التدرن الرئوي

Authors: Azher Abbas Naser د.أزهر عباس ناصر --- Qasm Mohammed Sultan د.قاسم محمد سلطان --- Basil Fawzi Jameel د.باسل فوزي جميل
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 4 Pages: 282-285
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractBackground: Pulmonary tuberculosis (PTB) is a chronic infectious disease which affects nutritional status of the patients. The presence of poor nutritional status in pulmonary tuberculosis patients has been one of the most important determining factors in recommending adjuvant nutrient therapy to prevent oxidative stress and further complication. The aim of the study: This study was designed to assess the nutritional status and body mass index (BMI) of pulmonary tuberculosis patients. Patients and methods: During the period 1st of June 2010 to 30th of May 2011, a case-control study was done on 60 patients with active pulmonary tuberculosis who attending chest and respiratory disease institute in Baghdad, and 60 controls, Levels of total serum protein (TP), S. albumin (ALB.), S. globulin, S. triglyceride (TG), total serum cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and body mass index (BMI) were measured for both groups.Results: The mean levels of TP (59.5 ± 0.8g/dl), ALB (23.4 ± 1.8g/dl), TC (138.7 ± 4.9mg/dl), HDLC (32.2 ± 4.0mg/dl), LDLC (86.5 ± 1.3mg/dl) and TG (62.4 ± 1.3mg/dl) were significantly lower while the level of globulin (36.2 ± 1.2g/dl) was significantly higher in pulmonary tuberculosis patients when compared with controls (TP=81.2 ± 4.5g/dl; ALB= 50.0 ± 4.0g/dl; TC = 213.5 ± 26.8mg/dl; HDLC = 57.4 ± 8.5mg/dl; LDLC = 161.1 ± 28.3mg/dl; TG= 148.5± 37.1mg/dl; globulin = 31.4 ± 1.7g/dl respectively). (P <0.05), The body mass index (16.9 ± 1.1kg/m2) was significantly lower when compared with controls (BMI= 23.5 ± 2.1kg/m2). (P <0.05)Conclusion: There is a significant degree of nutritional depletion and weight loss in PTB patients than in general population, BMI is considered to be a useful technique for assessment of nutritional state of pulmonary tuberculosis patients, The nutritional derangement could call for prompt nutritional intervention in the management of pulmonary tuberculosis patients.Key Words: Assessment Pulmonary Tuberculosis, Body Mass Index, Nutritional State.

الخلاصةالخلفية: التدرن الرئوي مرض معدي مُزمن والذي يُؤثّرُ على الحالة الغذائية للمرضى. وجودالحالة الغذائية السيّئةِ في مرضى التدرنِ الرئوي هو أحد أهم العواملِ الحاسمِة في وصف العلاجِ المساعد والمغذّي لمَنْع إجهادِ الاكسدة والتعقيدات آلاخرى.هدف الدراسةِ: هذه الدراسةِ صُمّمتْ لتَقييم الحالة الغذائية ومعامل كتلةِ جسم لمرضى التدرن الرئوي.طريقة إجراء البحث: خلال الفترةِ من يونيو/حزيرانِ 2010 إلى مايو/مايسِ 2011, اجريت دراسة على 60 مريضِ مصاب بالتدرنِ الرئويِ النشيطِ و60 شخص سليم, وقد قيست مستويات البروتينِ الكليِّ (TP)،الزلال (ِALB ) , الكولوسترول الثلاثي (TG) الكولوستيرول الكليّ (TC)، الكولوستيرول عالي الكثافةِ (HDLC)، الكولوستيرول منخفض الكثافةِ (LDLC)، وكذلك قيس معامل كتلة الجسم (BMI).النَتائِج: كان معدل مستويات البروتين الكلي, الزلال ، الكولوسترول الكلي ,الكولوستيرول عالي الكثافةِ, الكولوستيرول منخفض الكثافةِ, الكولوسترول الثلاثي واطئة جداً بينما مستوى الكلوبيولين كَانَ عالي جداً في مرضى التدرنِ الرئويينِ عندما قورنوا بالاشخاص الاصحاء (على التوالي). (P <0.05)•كان معدل معامل كتلة الجسم عند مرضى التدرن الرئوي (16.9 ± 1.1 كيلوغرام /م 2) واطئ جداً عندما قورن بالاشخاص الاصحاء (BMI = 23.5 ± 2.1 كيلوغرام ).•كان هناك إرتباط مباشر هامّ بين معامل كتلة الجسم وكُلّ من البروتين الكلي، الزلال، الكولوسترول الثلاثي والكولوستيرول منخفض الكثافةِ عند مرضى التدرن الرئوي.•كان هناك إرتباط معكوس هامّ بين معامل كتلة الجسم والكلوبيولين عند مرضى التدرن الرئوي.•ليس هناك إرتباطَ هامَّ بين معامل كتلة الجسم و الكولوستيرول عالي الكثافةِ عند مرضى التدرن الرئوي.الاستنتاج: هناك درجة هامّة مِنْ سوء التغذية وفقدان الوزن في مرضى التدرن الرئوي مقارنة بعموم الناس.يعتبر معامل كتلة الجسم تقنية مفيدة لتقييمِ الحالة الغذائية لمرضى التدرن الوئوي.سوء التغذية يُمْكِنُ أَنْ يَدْعوَ إلى تدخّلِ غذائي عاجلِ في علاج مرضى التدرن الرئويِ.الكلمات الافتتاحية: تقييم, مؤشر كتلة الجسم, مرض التدرن الرئوي.

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