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Article
GIANT FIBROADENOMA; CASE REPORT AND REVIEW OF LITERATURE

Author: Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 16
Publisher: Basrah University جامعة البصرة

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Abstract

IntroductionFor a variety of reasons, giant breast tumors continue to pose a challenge in diagnosis and management. These tumors are poorly understood because of their rarity and unpredictable behavior. Their rapid growth, associated with skin congestion and ulceration, and tendency to recur, gives rise to a suspicion of malignancy1,2. In addition, owing to the varied histological features seen in these tumors, there have been widely varying interpretations and diagnoses by pathologists3. This has led to inappropriate, and at times unnecessarily radical, surgical therapy. In the 1950s, breasts were amputated for this relatively non-threatening condition4. However, the present trend is towards more conservative management. In order to ensure proper surgical management, an under-standing of the natural history of the disease and its biologic behavior is essential. Bas J Surg, March, 12 2006

Keywords

GIANT --- FIBROADENOMA


Article
BARIATRIC SURGERY; RISK AND BENEFIT

Author: ISSAM MERDAN
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 2 Pages: 4-18
Publisher: Basrah University جامعة البصرة

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Abstract

Obese patients loss more weight with bariatric surgery than with medical weight loss treatment. ‎The laparoscopic Roux-en-Y gastric bypass procedure results in more short term weight loss ‎than laparoscopic adjustable gastric banding, but the latter has fewer postoperative ‎complication and lower mortality rate; long term comparative data are currently lacking. The ‎decision regarding which procedure to perform should be based on individual patient and ‎surgeon factors.‎Early complications of gastric bypass surgery are bleeding, anastomotic leak, wound infection, ‎thromboembolism, and anastomotic stricture. Longer term complication scan include marginal ‎ulcers, bowel obstruction, gallstones, and nutritional deficiencies.‎Complication of adjustable gastric banding includes prolapsed and erosion. Patient typically ‎loses more than 50% of their excess weight after bariatric surgery. Obesity related diseases ‎markedly improve after bariatric surgery, reducing cardiovascular risk and improving life ‎expectancy. Patient undergoing bariatric surgery must commit to a program of lifestyle ‎changes, diet, vitamin supplementation, and follow-up.‎

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Article
PENILE SQUAMOUS CELL CARCINOMA, CASE REPORT AND REVIEW OF LITERATURES

Author: Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 1 Pages: 1-4
Publisher: Basrah University جامعة البصرة

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Abstract

Penile tumors represent a difficult diagnostic and therapeutic issue to solve, mainly because of their psychological implications. The diagnosis may be delayed because many patients tend to disregard early asymptomatic lesions. Circumcision soon after birth confers almost complete immunity against carcinoma of the penis. Later circumcision does not seem to have the same effect, and Moslems circumcised between the ages of 4 and 9 years are still liable to the disease1.

Keywords


Article
LAPAROSCOPIC ENTRY: A REVIEW OF TECHNIQUES, TECHNOLOGIES, AND COMPLICATIONS

Author: Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2013 Volume: 19 Issue: 1 Pages: 10-23
Publisher: Basrah University جامعة البصرة

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Abstract

Laparoscopy (Gr: Laparo-abdomen, scopein-to examine) is the art of examining the abdominal cavity and its contents. It requires insertion of a cannula through the abdomi¬nal wall, distention of the abdominal cavity with gas or air (pneumoperitoneum), and visualization and examination of the abdomen’s contents with an illuminated telescope. With the advent of videocameras and other ancillary instruments, laparoscopy rapidly advanced from a being a diagnostic procedure to one used in fallopian tubal occlusion for sterilization and eventually in the performance of numerous sur¬gical procedures in all surgical disciplines for a variety of indications.

Keywords

laparoscopy --- techniques


Article
ORBERATM INTRAGASTRIC BALLOON SYSTEM

Author: Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 2 Pages: 3-6
Publisher: Basrah University جامعة البصرة

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Abstract

Current ConceptORBERATM INTRAGASTRIC BALLOON SYSTEM ……………………………………………..3Issam Merdan


Article
GASTRO-JEJUNAL FISTULA DUE TO MAGNET FOREIGN BODY, A CASE REPORT

Author: Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 1 Pages: 85-87
Publisher: Basrah University جامعة البصرة

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Abstract

GASTRO-JEJUNAL FISTULA DUE TO MAGNET FOREIGN BODY, A CASE REPORTIssam MerdanMB,ChB, FICMS, CABS, Professor of Surgery, Dept. of Surgery, Basrah Collage of Medicine. Consultant Surgeon, Al-Sader Teaching Hospital, Basrah, IRAQ.


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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Abstract

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
PORT SITE INFILTRATION OF LOCAL ANESTHETIC IN REDUCTION LAPAROSCOPIC CHOLECYSTECTOMY

Authors: Ali Kadhim Nazir --- Issam Merdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 2 Pages: 17-22
Publisher: Basrah University جامعة البصرة

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Abstract

PORT SITE INFILTRATION OF LOCAL ANESTHETIC IN REDUCTION LAPAROSCOPIC CHOLECYSTECTOMYAli Kadhim Nazir & Issam Merdan*MB,ChB, FICMS General Surgeon, Al-Sadder Teaching Hospital, Basrah, Iraq.Professor of Surgery, Department of Surgery, Basrah College of Medicine, Basrah University, Iraq.Abstract Laparoscopic cholecystectomy has become a standard technique for gallbladder surgery of symptomatic cholelithiasis. However, pain is the dominant complaint after this surgical procedure.This study aimed to evaluate the efficacy of long acting local anesthetic (Bupivacaine), infiltrated at port sites in amelioration of pain following laparoscopic cholecystectomy. Seventy two patients underwent elective laparoscopic cholecystectomy enrolled in this study, patients were divided into treatment and control groups of 36 patients each. Following removal ofthe gallbladder, treatment group received 20 ml of 0.25% Bupivacaine in divided doses at the trocar sites, unlike control group which receive no treatment. The evaluation of postoperative painwas done at fixed time intervals by McGill Pain Questionnaire, and the dosage of narcotic analgesic Tramadol, was also recorded. Mean pain scores at 6 hours postoperatively in treatment group was less than that of the control group (4.5 and 7.6) respectively with (p<0.05). Pain scores at 12 and 24 hours postoperatively didnot differ between the two study groups (p>0.05). The mean total narcotic analgesic dose used during the first 24 hours postoperatively was less in the treatment group compared to the controlgroup (92 mg and 158 mg) respectively with (p<0.05). The localization of pain during the first 24 hours postoperatively was 58% incisional, 36% intra-abdominal, and shoulder tip pain 6%. In conclusion, postoperative infiltration of long lasting local anesthetic (Bupivacaine) into the port sites of laparoscopic cholecystectomy may be desirable. This is simple, inexpensive, and effectivetechnique to minimize early postoperative pain which can be practiced for elective laparoscopic cholecystectomy.


Article
HETEROTOPIC OSSIFICATION OF THE ABDOMINAL WALL

Authors: Issam Merdan --- Haider M Mahmood
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 1 Pages: 98-100
Publisher: Basrah University جامعة البصرة

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Abstract

Heterotopic ossification is a rare and benign condition which occurs when bone develops in tissues that do not normally ossify. We report a 53-year-old man who underwent laparotomy for recurrent pyloric obstruction. A segment of abnormal hard tissue was found in the abdominal wall and so was excised. Histopathology revealed metaplastic bone deposition. Heterotopic ossification may occur at various sites and is a recognized but infrequent sequela of abdominal surgery. This case highlights clinical, aetiological and histopathological features of this rare finding.


Article
GYNAECOLOGICAL DISORDERS THAT MIMICS ACUTE SURGICAL CONDITIONS: A STUDY ON 588 FEMALE PATIENTS WITH THE PRESUMPTIVE DIAGNOSIS OF ACUTE APPENDICITIS
الاعتلالات النسائية المشابه للحالات الجراحية الحادة:دراسة تشمل 588 مريضة مشخصة مبدئيا" بالتهاب الزائدة الدودية الحاد

Author: Issam Merdan م.د.عصام مردان
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2006 Volume: 24 Issue: 1&2 Pages: 6-8
Publisher: Basrah University جامعة البصرة

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Abstract

ABSTRACTObjective: In surgical practice, the surgeon may face several gynaecological disorders that can present asan acute abdomen, more specifically acute appendicitis. Some of these disorders may not need surgicalinterference. The objective of this study was to investigate the incidental findings of gynaecologicaldisorders in a routine surgical practice in a major hospital in Basrah (Iraq) and to determine theincidence, types and features of these diseases that differentiate them from surgical diseases in order toavoid unnecessary surgical procedures.Patients and Methods: This study was conducted from January 2000 to 2004 in Al-Sadir TeachingHospital in Basrah, it included 588 female patients of different age groups who were admitted to thehospital with presumptive diagnosis of acute appendicitis.Results: Intra operative diagnosis of acute appendicitis was confirmed in 65.3% while normal appendiceswere found in 6.9%. Gynecological disorders were found in 24.3%, of these disorders, the most commonwas ruptured ovarian cysts. Age group mostly affected was between 21 and 30 years.Conclusion: Female patients especially in child bearing age who present clinically as acute abdomen oracute appendicitis needs proper in hospital observation and repeated clinical examination together withthe use of ultrasound in order to exclude gynaecological disorders that didn't need surgical interference.

تمت دراسة 588 مريضة مشخصة مبدئيا" بألتهاب الزائدة الدودية الحاد وبأعمار مختلفة للفترة من (2000-2004) في مستشفى الصدر التعليمي/البصرة وقد أظهرت نتيجة الدراسة بأن 65,3% فقط كانوا مصابين فعليا" بالتهاب الزائدة الدودية الحاد. وكانت نسبة الاعتلالات النسائية 24,3% وكان الاعتلال الأكثر حدوثا" هو أنفتاق كيس المبيض. نستخلص من هذه الدراسة بأن الإناث في عمر الحمل واللواتي يظهرن علامات التهاب الزائدة الدودية الحاد أو الآم البطن الحاد بحاجة إلى مراقبة مع إعادة الفحص في المستشفى إضافة إلى استعمال جهاز السونار لغرض استبعاد الاعتلالات النسائية التي لايحتاج الى تداخل جراحي.

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