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Alkaptonuria, a rare inherited disorder: a case report and review of literature
بيلة آلكابتونية، وهو اضطراب وراثي نادر: تقرير حالة ومراجعة الأدبيات

Author: Khalid A. AL-Dabbagh
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2008 Volume: 2 Issue: 142 Pages: 16-22
Publisher: Tikrit University جامعة تكريت

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Abstract

A 70 year old male patient from Erbil city, Iraq, complaining of gradually increasing pain and stiffness in the lower back over the last 50 years. He consulted many doctors and was misdiagnosed as having (prolapsed disc, Ankylosing spondylitis, Osteoarthritis). He was put on analgesics, anti-inflammatory drugs, hard bed .It gave him some relief but the pain and stiffness recurred again over a large area of the spine on stopping the treatment. For the past 20 years, the patient had pain in his hip joints too. There was no history of fever, trauma, oral ulcers, acute abdominal pain, dysuria or recurrent diarrhea. The urine had normal color when voided but the patient has also had brownish black staining of underwear since childhood

وذكر المريض 70 سنة من العمر من مدينة أربيل، العراق، تشكو من ألم متزايد تدريجيا وتصلب في أسفل الظهر على مدى السنوات ال 50 الماضية. استشارته العديد من الأطباء وكانت تشخص خطأ على أنها (القرص هابط، التهاب الفقار اللاصق، هشاشة العظام). تم وضعه على المسكنات، والعقاقير المضادة للالتهابات، والسرير الثابت. واعطاه بعض الراحة ولكن الألم والتصلب تكررت مرة أخرى على مساحة واسعة في العمود الفقري على وقف العلاج. على مدى السنوات ال 20 الماضية، وكان المريض ألم في المفاصل وركه جدا. لم يكن هناك تاريخ من الحمى، والصدمات النفسية، وتقرحات الفم وآلام البطن الحادة، وعسر البول أو إسهال متكرر. كان لون البول طبيعي عندما يفرغ ولكن المريض كما كان أسود اللون البني تلطيخ الملابس الداخلية منذ الطفولة


Article
Prevalence and characteristics of eye involvement in patients with rheumatoid arthritis
انتشار وخصائص اصابة العين عند المرضى الذين يعانون من التهاب المفاصل الروماتويدي

Authors: Khalid A. Al-Dabbagh --- Ruba Abbas Fadhil
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 2 Pages: 1708-1714
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Rheumatoid arthritis is a systemic inflammatory disease. Ocular manifestations involved with rheumatoid arthritis are keratoconjunctivitis sicca, episcleritis, scleritis, anterior and posterior uveitis, dry eyes and ulcerative keratitis. This study aimed to detect the prevalence of ocular manifestations in rheumatoid arthritis patients, find out the relation between the effects of disease modifying anti-rheumatic drugs, biological agents and ocular complications in rheumatoid arthritis patients and explore role of anti-cyclic citrullinated peptide antibodies.Methods: This is a cross-sectional clinical study of 60 rheumatoid arthritis patients who have attended Rizgary Teaching Hospital in Erbil. A data information about symptoms of ocular manifestations and history of ocular complications before starting disease modifying anti-rheumatic drugs and/or biological agents were taken. Musculoskeletal examination, serum Anti-CCP antibodies test were done. Ocular examination by ophthalmologist was done.Results: This study was conducted from April to November 2015 and involved 60 patients; 55 females and five males with a mean± SD age of 46 ± 11.46 years. Thirty nine (65%) patients had ocular manifestations of rheumatoid arthritis. The most frequent manifestation was dry eyes 30 (50.0%). There was no relation between severity of the rheumatoid arthritis disease and ocular manifestation (P = 0.529). There was a relationship between the Anti-CCP antibodies titer and presence of ocular manifestations in rheumatoid arthritis patients (P = 0.006). There were no curable effects of the disease modifying anti-rheumatic drugs, biological agents on ocular manifestations in rheumatoid arthritis patients (P = 0.787).Conclusion: Dry eye was the most common ocular manifestation, anti-CCP antibodies are a sensitive marker for ocular manifestations. Disease modifying anti-rheumatic drugs and biological therapies provide no significant efficacy in treatment or prevent the occurrence of ocular manifestations in rheumatoid arthritis patients.


Article
Focused Abdominal Sonography for Trauma (Fast) At the Emergency Department of Kirkuk General Hospital

Author: Saad M. Attash* , Khalid A. Al-Dabbagh**, Mohammed A. Younus***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 2 Pages: 188-192
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Blunt abdominal trauma (BAT) is a diagnostic challenge. The introduction of bedside ultrasound provides another diagnostic tool for the emergency physician (EP) to detect intra-abdominal injuries.OBJECTIVE:To assess the benefits of FAST in the evaluation of patients with blunt abdominal trauma in the emergency department of Kirkuk General Hospital in Kirkuk.PATIENTS AND METHODS:This was a prospective study including100 consecutive cases of blunt abdominal trauma in the emergency department of Kirkuk General Hospital in Kirkuk. The results of FAST scans were analyzed and compared with operative findings, diagnostic laparoscopy and CT scanning when the FAST was positive or followed by a period of clinical observation when the FAST was negative. Descriptive statistics, sensitivity, specificity, and predictive values were calculated.RESULTS :There was a 100 consecutive blunt abdominal trauma cases during 9 months period, and FAST scans were performed in these cases. The sensitivity and specificity were 92% and 93.3%, respectively. The negative predictive value was 0.97, while the overall accuracy was 93%.CONCLUSION:The high specificity of FAST (93.3%) makes it a good ‘rule in’ tool for BAT patients. The high negative predictive value also makes the FAST scan a useful screening tool. However, ultrasound examination is operator dependent, and FAST scan has its own limitations. .


Article
The application of laparoscopy in abdominal trauma at Al-Jumhoori Teaching Hospital in Mosul

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Abstract

Objective: To evaluate laparoscopy as a diagnostic and therapeutic method in selected cases in abdominal trauma, and its value in avoiding unnecessary laparotomies at Al-Jumhoori Teaching Hospital in Mosul, Iraq. Patients and methods: From October 2009 to October 2011, sixty hemodynamically stable patients who were admitted with abdominal trauma (48 blunt, and 12 penetrating injuries), were submitted to diagnostic laparoscopy (DL) in the operating theatre of the Emergency Department of Al-Jumhoori Teaching Hospital in Mosul. Data collected and analyzed. Results: Negative and non therapeutic laparotomies were avoided in 38 patients (63.3%), and laparoscopic intervention was done in 4 patients (17.4%). The mean hospital stay of the (DL) negative patients was 2.1 days, and for the (DL) positive patients with laparoscopic intervention was 2.4 days, while of the patients with therapeutic laparotomy was 5.7 days. All the patients were discharged with no reported complication and no deaths were reported.Conclusion: Laparoscopy can be performed safely and effectively in hemodynamically stable patients with abdominal trauma. The most important advantages are reduction of the negative and non therapeutic laparotomy rate and shortening of hospitalization. Keywords: Blunt abdominal trauma, penetrating abdominal trauma, diagnostic laparoscopy.

الخلاصةالهدف: لمعرفة مدى فعالية منظار البطن كأداة تشخيصية في حالات إصابات البطن وإمكانية استخدامه في التعامل مع بعض هذه الإصابات.المرضى والأساليب: من تشرين الاول 2009 ولغاية تشرين الأول 2011 أجري منظار البطن التشخيصي لستين مصابا بإصابات البطن المختلفة (48 إصابات البطن الكليلة و12 إصابات البطن النافذة). تم إجراء المنظار في صالة عمليات الطوارئ في المستشفى الجمهوري التعليمي في الموصل.النتائج: تم تجنب عمليات استكشاف البطن غير الضرورية وغير العلاجية في 38 مريضا (63.3%) وتم التعامل مع 4 حالات منظارياً (17.3%) وكانت مدة رقود المرضى الذين كان منظار البطن التشخيصي لهم سلبيا (2.1) يوم والمرضى الذين كان منظار البطن التشخيصي لهم ايجابيا وتم التعامل مع إصاباتهم منظارياً (2.4) يوم، في حين كانت مدة رقود المرضى الذين أجريت لهم عمليات فتح البطن العلاجية (5.7) يوم. وقد غادر كل المصابين المستشفى بدون تسجيل أي مضاعفات ولم يتم تسجيل أي وفاة بين المصابين.الخلاصة: يمكن إجراء منظار البطن التشخيصي للمرضى المصابين بإصابات البطن بصورة أمينة وفعالة. أهم الفوائد من استخدام منظار البطن التشخيصي هي التقليل من عمليات فتح البطن الاستكشافية غير ضرورية والتقليل من فترة رقود المرضى في المستشفى.

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