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Article
A Comparison of Hysterosalpingography and Laparoscopy in the Investigation of Infertility

Authors: Zainab Baker --- Fouad Hamad Al-Dahhan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2002 Volume: 8 Issue: 2 Pages: 292
Publisher: Basrah University جامعة البصرة

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Abstract

A comparative study of hysterosalpingography (HSG) and laparoscopy in the Investigation of infertility is presented. Laparoscopy with permeability testing was performed in 68 patients previously investigated by HSG. Complete history of factors that may predispose to tubal occlusion was obtained. Patients with problems of ovulatory failure or poor semen analysis that may contribute to their infertility were excluded. There was agreement between the two techniques in 19 (27.9%) of cases where both tubes were patent i.e. all the cases that identified to be patent in HSG, were patent in laparoscopy. Similarly, agreement between the two techniques in terms of bilateral blockage (26.4%), right tubal blockage in only (5.8%), and the left tubal blockage, there was (4.4%) agreement between two techniques. The overall agreement between the two methods was (64.5%) of cases. However, the diagnostic accuracy of the two methods differed significantly. It would appear that laparoscopic hydrotubation, despite its invasive nature has an edge in diagnostic accuracy when compared with HSG. It would be advantageous to subject patients in whom HSG has shown tubal blockage to laparoscopy or any of the newer techniques of hysteroscopy or sonographic hydrotubation

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Article
THE ROLE OF METFORMIN IN INDUCTION OF OVULATION IN OBESE INFERTILE PATIENTS WITH POLYCYSTIC OVARY SYNDROME

Authors: Huda Moosa Omran --- Fouad Hamad Al-Dahhan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 93-97
Publisher: Basrah University جامعة البصرة

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Abstract

AbstractThis study aimed to find the effective method of induction of ovulation; in obese infertile patients with polycystic ovary syndrome. It is a prospective case-control study done at Infertility clinic of Basra Maternity and Child hospital.Sixty obese, hirsute infertile patients for more than two years; with ultrasound findings of polycystic ovary syndrome, subjected to the following investigations: Serum LH, FSH, Testosterone, Prolactin &fasting blood sugar. All investigations were carried on early follicular phase of the cycle. Patients were divided randomly into two groups: Group A and group B. All patients received clomiphene citrate 50-150mg for five consecutive days beginning on day 5 of the cycle. The patients with group B also received 500mg of Metformin tablet three times daily for 6 months. Ovulation- which assessed by transvaginal folliculometry, and ovarian artery Doppler velocimetry; triggered with hCG when one or more follicle measuring ≥ 18 mm in diameter, and blood flow indices of the active ovary; showing the dominant follicles were good; on ultrasonic examination. Ovulation response and pregnancy rate were assessed in both groups.Results obtained from this study pointed out the beneficial effect of Metformin on ovulation induction in obese hirsute women with PCOS.It is concluded that PCOS remains an enigmatic disease. Once considered relatively benign, PCOS is implicated in medical disorders related to hyperinsulinism and hyperandrogenemia. Restoring fertility and treating abnormal hair growth remain important considerations in the physical and psychological health of reproductive-age women. Metformin has shown great promise in the treatment of insulin-resistant PCOS, but whether it would benefit all women who have PCOS remains unclear. Weight loss is the most important primary recommendation that can be made in the treatment of PCOS.


Article
ACUTE ABDOMEN in PREGNANCY: AETIOLOGY & ‎OUTCOME in BASRAH

Authors: Fouad Hamad Al-Dahhan, #‎ --- Ehab A. Hassan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2004 Volume: 10 Issue: 2 Pages: 92-98
Publisher: Basrah University جامعة البصرة

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Abstract

This is a prospective study conducted in all major hospitals in Basrah (Basrah Maternity & Child ‎Hospital, Basrah Teaching hospital and Basra General hospital) to prove that ‘acute abdomen in ‎pregnancy’ is common and that the effect of delayed diagnosis can have serious implication on both ‎maternal and fetal outcome. Two hundred and fourteen pregnant females were included. Their age ranged ‎from 16-42 years (mean age was 27 years). Operations were performed whenever indicated by a registrar ‎or consultant gynecologist. Abruption placenta was the causative factor in 33.17% of cases, ectopic ‎gestation in 24.7%, acute appendicitis in 11.21% and the remaining 30.9% resulted from miscellaneous ‎conditions. Most of the patients (94.39%) presented within the first twenty-four hours of their initial ‎complaint. Delayed diagnoses were made in 12 with 50% maternal mortality and 100% perinatal mortality. ‎One hundred and sixty nine patients (78.97%) underwent emergency operations, while forty-five patients ‎‎(21.02%) were treated conservatively. Various complications were encountered; the most common was ‎wound infection (19.8%).‎

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Article
Lipid Profile and Menopausal Status

Authors: Ahlam Disher --- Lamia M. Al - Naama --- Fouad Hamad Al - Dahhan
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2008 Volume: 4 Issue: 2 Pages: 8-12
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Dyslipidemia is a major cause of cardiovascular disease, which in turn, is the most common cause of female morbidity and mortality. Postmenopausal women (natural and surgical) are at higher risk of developing cardiovascular disease, especially coronary artery atherosclerosis.
Objective: To observe the relationship between blood lipids: total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), triglycerides (TGs), and very low density lipoprotein- cholesterol (VLDL-C), LDL-C/ HDL-C ratio (atherogenic index) and menopausal status, and to determine the co-factors that may explain this relationship
Methods: A prospective, cross-sectional study, which includes 279 women, age range from 35-55 years agreed to participate in this study. They were divided into 4 groups according to their menopausal status. These were pre-, peri post- natural and surgical post- menopausal. Data were collected from participants in a pre-coded questionnaire and an overnight fasting blood sample was collected for biochemical analysis.
Results: Postmenopausal women had higher levels of lipids than pre or peri-menopausal. TC concentration and LDL-cholesterol levels were higher in natural and surgical menopause than in pre and pri-menopausal women (p<0.01 and p<0.05 respectively). While LDL/HDL-C ratio (atherogenic index) were higher in the surgical postmenopausal women than in pre-menopausal group (p<0.05). No significant inter-group differences were found in HDL-C. Triglycerides, and VLDL levels were higher in surgical menopause group than in both pre- and peri-menopause groups (p<0.05). No significant differences were demonstrated in pre-, peri-, and natural menopausal women with regard to triglyceride and VLDL levels and LDL/HDL-C ratio.
Conclusion: Dyslipidemia is more frequent among women with natural and surgical menopause groups than in the other groups. This makes those women more susceptible to CVD. Certain co factors appear to have direct associations with lipid levels in each group and those were discussed.
KeyWords: Menapause, Lipid profile

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menapause --- lipid profile


Article
LOW-LYING PLACENTA IN BASRA: FETOMATERNAL OUTCOME
ارتكاز المشيمة المعيب العواقب لدى الأم والطفل

Author: Fouad Hamad AL-Dahhan أ.م.د. فؤاد حمد الدهان
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2006 Volume: 24 Issue: 1&2 Pages: 13-18
Publisher: Basrah University جامعة البصرة

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Abstract

ABSTRACTObjective: To study the maternal and foetal complications of low-lying placenta at the main referralhospital in Basrah.Methods: This is a case control study of 598 pregnant women attended the ultrasound department atBasra Maternity & Child Hospital, from December 1998 to June 2000; 182 cases with low-lying placentaand 416 control.Results: When the low-lying placenta compared with the control group, there is a significant increase inthe incidence of obstetrical & neonatal complications. These include abortion, preterm labour, abnormallie, and presentation, caesarean section, postpartum haemorrhage and caesarean hysterectomy.Neonatal complications include preterm babies, babies with low birth weight and Apgar score. Perinataldeaths mainly caused by Respiratory Distress Syndrome constitute 6.9%. Type I & II praevia carries alower risk of antenatal, postnatal, & foetal complications than type III & IV. There was no maternaldeath among the study group.Conclusion: Low lying placenta, especially major degree, have a high incidence of obstetricalcomplications, the most important of which are preterm labour and massive ante-partum andpostpartum haemorrhage. There is increased incidence of neonatal complications, mainly prematurity,small for gestational age and perinatal deaths. There was no relation noted between placenta praeviaand congenital anomalies of the newborns.

هدف الدراسة: دراسة حول العواقب والاختلاطات الناجمة عن وضع المشيمة المعيب في البصرة . طريقة الدراسة: دراسة تتكون من (598) حالة اجري لهم الفحص بواسطة الموجات الفوق الصوتية في مستشفى البصرة للولادة. منهم (182) مجموعة الدراسة "وضع المشيمة المعيب". و (416) مريضة مجموعة السيطرة "وضع المشيمة الطبيعي". النتائج: عندما قورنت مجموعة الدراسة بمجموعة السيطرة تبين وجود فروقات واضحة في نسب حدوث المضاعفات منها الإسقاط، الولادات المبكرة، الوضع الغير سوي للجنين تسبب العمليات القيصرية. النزف بعد الولادة ، واستئصال الرحم في مجموعة الدراسة. كان وزن الأطفال اقل والوفيات للأطفال حول الولادة أكثر، وذلك غالبا" بسبب الولادة المبكرة حيث كان السبب المباشر متلازمة عسر التنفس الولادي (9ر6%). ولم تحدث وفاة بين الأمهات في مجموعة الدراسة كانت المضاعفات أكثر في النمط II وIII منها في النمط I وII . الخلاصة: النمط III وIV مصحوب بزيادة في العواقب كالولادة المبكرة والنزف الشديد إثناء الحمل وبعده. كما أن هناك زيادة في المضاعفات لدى الأطفال منها الولادة المبكرة. والأوزان القليلة بالنسبة لفترة الحمل والوفيات حول الولادة. لم تشاهد علاقة بين ارتكاز المشيمة المعيب وبين تشوهات جنينية أو صغر حجم الجنين.

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Article
A COMPARISON OF FOUR METHODS OF RIPENING THE ‎UNFAVORABLE CERVIX

Authors: Fouad Hamad Al-Dahhan --- Ali Falih Al-Asadi
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 2 Pages: 55-63
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to compare the efficacy of four clinical methods used for ripening unfavorable cervix in ‎Basra Maternity Hospital. ‎‎ A prospective study was conducted to compare four methods of ripening the unfavourable cervix : ‎Foley's catheter with extraamniotic saline infusion, Foley's catheter alone, Oxytocin, and Sweeping of ‎membranes.‎‎ The clinical trial involved a total of (121) pregnant women (47 primigravidae and 74 multiparae).‎The success rates in achieving cervical ripening were (100%, 84.6%, 75%, and 54.5% for primigravidae) ‎and (100%, 91.3%, 88.8%, and 64.7% for multiparae) for method I-IV respectively. Post-ripening ‎Bishop's score was 6.9, 5.6, 4.6 and 4.1 for primigravidae &7.3, 6.05, 5.6 and 4.4 for multiparae, for ‎method I-IV respectively.‎‎ The mean priming time was shortest in method-I (6.1 in primigravidae and 5.7 in multiparae) and longest ‎in method-IV (21.6 in primigravidae and 17.8 in multiparae). The induction delivery internal was longer as ‎we move from method-I toward IV. The caesarean section rate was highest in method-III and the lowest ‎rate was in method-I. In conclusion, Foley's catheter with extraamniotic saline infusion was found to be ‎the best method in comparison to the other three methods as it was safe, rapid, effective, inexpensive ‎and requires little training for application

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