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Article
Epidemiological Study of Measles in Al- Kadhimiyia Teaching Hospital

Authors: Lamia Abdul Karim --- Ali Kadhim Al-Husainawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 213-222
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Measles is a highly communicable disease caused by the measles virus. The disease ismarked by prodromal fever, conj unctivitis, coryza, cough, and the pathognomonic koplikspots followed by an erythematous maculopapular rash. Infection confers lifelong immunity. OBJECTIVE:Find out the frequency of measles in the hospital admitted cases in chi l dr en ≤ 12year s accor di ng t o t he vaccination and nutritional status,The causes of non-vaccination andthe vaccine efficiency in preventing measles.The incidence of measles in the exclusively breastfed infants.The presenting signs and symptoms, commonest complications, investigations and theoutcome. PATIENTS AND METHODS:A prospective study was performed from the 1st of January to the 1known as rubeola and is marked by prodromalfever, conjunctivitis, coryza, cough, andpathognomonic Koplik spots, followed by anerythematous maculopapular rash on the 3rd to 7day. Infection confers life-long immunity. st of May in the year 2009, inAl-Kadhimiyia Teaching Hospital.The data was collected through a questionnaire askeddirectly to the parents, and all the patients were systemically examined and followed up clinicallyuntil they discharged home or unfortunately died.The collected data was analyzed and adjustedusing the SPSS version 10 statistical programs.RESULTS:The incidence of measles was (44.29 %).Most of cases were living in crowded houses, allpatients had positive history of contact, mostly during a visit to a medical health facility (49.3%).All age groups were affected by measles, mostly in the 1st (27 %) and the nd (19 %) yearsof life.Higher incidence was reported in males (53.5 %).Most of the cases were nonvaccinated(86.25 %) with non-vaccinated mothers as well (85.25 %). Nineteen percent ofthe cases were malnourished. The incidence was lowest in the exclusively breast fed infants (1.5%).Measles mostly presented with fever for ≥ 3 days (100 %), rash (100 %) and conjunctivitis(98.25 %).The commonest complications were pneumonia (62.75 %), diarrhea (40.25 %).The majority of patients who had developed convulsions had normal CSF analysis results (76.7%). CXR reported pneumonic consolidation in (62.75 %) of the patients. Ninety percent of caseswere discharged home and (10 %) died. CONCLUSION:Measles is higher in the crowded places, in infants and toddlers, in males, in the nonvaccinated,and less in the exclusively breast fed infants. It is more severe in themalnourished patients. Vaccination is the most important preventive measure against measles.Measles mostly present with fever, maculopapular rash, and conjunctivitis, with the mostcommon complications are pneumonia, diarrhea, and encephalitis.The disease usually has no or little effect on the blood counts and CSF analyses, and CXRdocument pneumonic consolidation in the majority of cases.Measles is still a serious disease with high fatality rat

Keywords

measles --- epidemiology --- vaccination.


Article
CAUSES OF NEONATAL DEATHS IN AL- KADHIMIYA TEACHING HOSPITAL
أسباب الوفيات ت لحديثي الولادة في مستشفى الكاظمية التعليمي

Author: Lamia Abdul Karim Al- Saady لمياء عبد الكريم السعدي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2007 Volume: 5 Issue: 2 Pages: 44-48
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: neonatal death is the death take place in the first 28 days of life.Although the neonatal mortality has been declining more rapidly than the post neonatal mortality in the recent decades, neonatal mortality continue to account for close to two third of all infants death. Aim: to review the main causes of neonatal death among the neonates admitted to the nursery care unit (NCU) in Al- Kadhimiya Teaching hospital for ten years period. in order to prevent or treat the treatable ones.Patients and Methods: Through a retrospective study, analysis of the medical records of all the admitted neonates to the NCU in Al- Kadhimiya Teaching Hospital during the period between 1995 -2005, the medical information were analyzed to find the important causes of neonatal deaths.Results: the number of admitted cases during this period was 2683 cases and the total numbers of deaths were 982 cases (36.6%). We found that the main causes of death were Respiratory distress syndrome (RDS), neonatal sepsis, birth asphyxia, congenital anomalies, meconium aspiration and infant of diabetic mother.Conclusion: the most important causes of deaths were sepsis, birth asphyxia and congenital anomalies. Prevention of prematurity as a major cause for RDS will lead to a decrease in neonatal mortality and morbidity, and a significant reduction will depend on genetic counseling and prevention of congenital anomalies.Key Words: Neonatal Death, NCU, RDS .

خلفية الدراسة : على الرغم من الانخفاض الحاصل في الوفيات لحديثي الولادة في العقود المتأخرة عن الوفيات للأطفال الذين تجاوزوا سن حديثي الولادة ولكن الوفيات لحدثي الولادة لا زالت تشكل تقريبا ثلثي الوفيات لدى صغار الأطفال.الهدف : لإيجاد أهم الأسباب المؤدية إلى الوفاة لدى جميع حديثي الولادة اللذين ادخلوا إلى ردهة العناية المركزة لحديثي الولادة في مستشفى الكاظمية التعليمي وذلك لمنع والوقاية ومعالجة ما يمكن من هذه الأسباب.طريقة العمل: لقد تمت مراجعة السجلات الطبية لكل المرضى اللذين ادخلوا إلى ردهة حديثي ا لولادة في مستشفى الكاظمية التعليمي للفترة الزمنية بين 1995-2005 لايجا أهم الأسباب المؤدية إلى الوفاة خلال هذه الفترة.النتائج: كانت النتائج إن عدد المرضى الداخلين الى ردهة حدثي الولادة هو 2683مريض ولمختلف التشخيصات وكان عدد الوفيات لجميع الأسباب هو 982حالة مرضية . إن أهم أسباب الوفاة لدى المرضى الراقدين هو وحسب ما هو مسجل في السجلات الطبية للمرضى كالأتي :طفل خديج مع متلازمة عسر التنفس ,تسمم الدم الجرثومي,الاختناق الولادي , التشوهات الخلقية , استنشاق العق , والطفل لأم مصابة بداء السكر .الاستنتاج: إن من أهم العوامل التي تؤدي الى انخفاض الوفيات لدى حديثي الولادة هو محاولة منع حدوث الولادات المسبقة ومعالجة الأطفال الخدج وقليلي الوزن سوف يؤدي الى انخفاض في نسبة الوفيات بشكل كبير كذلك الأمراض الوراثية والتشوهات الخلقية ومعالجة ما يمكن معالجته منها ومحاولة منع حدوثها.مفتاح الكلمات: الوفيات لحديثي الولادة ,ردهة العناية المركزة لحديثي الولادة, متلازمة عسر التنفس.


Article
Risk Factors and Common Causes of Death Due to Measles in AL-Kadhimiyia Teaching Hospital.2009

Authors: Lamia Abdul Karim --- Abdul-KaremJasemAlbahadle --- Ali Kadhim Al-Husainawi*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 32-39
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Remains a common disease in many parts of the world. According to the World Health Organization (WHO), more than 20 million people worldwide are affected by measles each year. It is the leading cause of vaccine-preventable deaths among young children.OBJECTIVE:To find out the epidemiological criteria of died patients because of measles& the main causes of death.PATIENTS AND METHODS:Prospective study carried out in the pediatric ward of Al-Kadmyia Teaching Hospital between the 1st of January to the 1st of May 2009,the total number of measles cases admitted were 894 , the number of died cases in the same period due to measles were 52 case , the age of the studied sample (1month- 10 years).The data collected through a data sheet asked to the parents of the patient including the age ,sex, body weight, feeding history, history of contact, vaccination history , maternal vaccination status and her educational level.All the patients examined systematically and investigated and followed up till discharged or unfortunately diedRESULTS:The age of the died cases mostly in the 1st2years(27 case), there is male(31) , female(21) died cases.The mortality occur more in under weight cases27 , the died cases were either on mixed feeding 17cases, bottle feeding 10, solid feeding 25 cases.All the died cases had history of contact with measles., there were 49 cases non-vaccinated, the vaccination status of the mothers were 38 mother were not vaccinated. The educational level of the mothers were 29 illitrate,15 primary and 8 secondary school.The most common causes of death :16 encephalitis, 36 pneumonia.CONCLUSION:The death occurs more in infants and toddlers than in other age groups, more in males,underweight, and the non-vaccinated than in the vaccinated patients.Death is more common among children belong to non-vaccinated, illiterate mothers.Pneumonia is the most frequent complication of measles and encephalitis is the most lethal complication.


Article
The Effect of Weight and Gestational age on Neonatal Mortality
تأثير الوزن والعمر على الوفيات لحديثي الولادة

Authors: Lamia Abdul Karim لمياء عبد الكريم --- Sabeeha Al-Mafraji. صبيحه
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 4 Pages: 286-290
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: neonatal mortality has progressively declined in recent decades, this depend primarily on preventing the low birth weight infants, prenatal diagnosing and early treatment of diseases that result from factors during gestation and delivery.Patients & methods: retrospective study was done in the nursery unit at Al- Kadhimia Teaching Hospital to study the risk factors of neonatal mortality; we study the birth weight, the gestation age and sex as risk factors during the period 1997-2000.Results: The total no. of admission to NCU (Nursery care unit) was 1264 newborn baby, the no. of death was 402 cases, and most of these cases 341 were below 2.500 kg. The higher mortality occurs in newborn with gestation age 28- 32 weeks mostly among males in all gestational age and birth weight.Conclusion: birth weight and gestational age consider the major determinants of neonatal death, the lower the birth weight and gestational age the higher the mortality.

الملخص:المقدمة: شهدت العقود الماضية انخفاض في وفيات حديثي الولادة وهذا نتيجة التحوط من الولادة المبكرة ومنع وتشخيص وعلاج الأمراض التي تنتج من العوامل المسببة خلال فترة الحمل والولادة .المرضى وطريقة العمل : تمت دراسة راجعة للأطفال حديثي الولادة في مستشفى الكاظمية التعليمي ودراسة العوامل ذات الخطورة لحدوث الوفاة عند الأطفال حديثي الولادة بدراسة الوزن والعمر بالأسابيع والجنس للفترة بين 1997-2000.النتائج: عدد الدخول في وحدة حديثي الولادة كان 1264حالة وكان عدد الوفيات 402حالة .أكثر هذه الحالات 341كان دون ال 2500غرام والأطفال دون ال1500غرام هم الأكثر خطورة و أعلى مستوى للوفيات للأعمار 28-32 أسبوع . اكثر هذه الوفيات كانت بين الذكور لكل الأعمار والأوزان .الاستنتاج: الوزن والعمر تعتبر من العوامل الرئيسية المحددة للوفاة وكلما نقص الوزن والعمر زادت نسبة الوفيات.


Article
The Value of C- Reactive Protein in Neonatal Sepsis
قيمة البروتين التفاعلي ( CRP ) C في التسمم ألوليدي

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Abstract

Abstract:Background: Neonatal sepsis occur 1-8 per 1000 live birth. It is mandatory to have a high index of suspicion for the possibility of sepsis since the signs and symptoms are non specific. (C-Reactive Protein) CRP an acute phase protein used as a screening test for inflammation and disease activity and diagnostic adjuvant. Objective: To evaluate the importance of CRP in the diagnosis of neonatal sepsis, sensitivity, specificity and the predictive value of it.Patients &methods: One hundred neonates with suspected sepsis were admitted to the Central Teaching Hospital for Children / Baghdad, between 1st of April and 1st of October 2005, were selected for diagnosis of sepsis by CRP and blood culture. The clinical presentations of these neonates were studied to find the most common signs and symptoms.Results: there were 76% of total cases with positive CRP . 53% of cases had positive blood culture and CRP, and the sensitivity was 96.36%, specificity was 48.8% and the negative predictive value was 91.6% and the positive predictive value was 69.7% Conclusions: CRP show high sensitivity and negative predictivevalue which are helpful in the diagnosis of sepsis. A singlenormal value cant exclude infection and serial measurements will enhance the sensitivity of the test. CRP is not recommended as a sole indicator of neonatal sepsis but may be one of a septic work up.

الملخص:الخلفية: التسمّم ألوليدي يَحْدثُ 8-1 لكلّ 1000 مولود حيِّ. وانه من الضروري أَنْ يَكُونَ هناك نسبة عالية مِنْ الشكِّ لإمكانيةِ التسمّمِ لأن الإشاراتِ والأعراضِ غير محدّدة. البروتين التفاعلي C هو بروتين المرحلة الحادّةِ يستعمل كاختبار فحص لنشاطِ المرضَ والالتهاب وللتشخيصَ. الهدف: لتقييم أهمية البروتين التفاعلي C في تشخيص التسمم ألوليدي وكذلك لتقييم أهمية درجة الحساسية , الخصوصية والقيمة المتوقعة للبروتين التفاعلي C.المرضى والطرق: مئة طفل حديثي الولادة يفترض لديهم تسمم الدم ادخلوا م. الطفل المركزي التعليمي للأطفال / بغداد للفترة بين أولِ مِنْ أبريل/نيسانِ حتى أولِ مِنْ أكتوبر/تشرين الأولِ 2005 , وأكد التشخيص بواسطة البروتين التفاعلي C و زرع الدم. وقد درست العروض السريرية لإيجاد الإشاراتِ والأعراضِ الأكثر شيوعاً. النتائج: من مجموع الحالات %76 لديهم نتائج ايجابية للبروتين التفاعلي C فقط , %53 لديهم نتائج ايجابية لزرع الدم و البروتين التفاعلي C . درجة الحساسية كانت % 96.36 ودرجة الخصوصية كانت % 48.8 أما النتائج السلبية للقيمة المتوقعة فهي % 91.6 والنتائج الايجابية للقيمة المتوقعة % 69.7 .الاستنتاجات: البروتين التفاعلي C اظهر درجة حساسية و قيمة سلبية متوقعة عالية , وهذان مهمان في تشخيص التسمم في حديثي الولادة. قراءة واحدة طبيعية للبروتين التفاعلي C لا تنفي تشخيص المرض , بينما عدد من القراءات قد يزيد من حساسية هذا الاختبار. البروتين التفاعلي C لَيسَ مؤشر وحيد للتسمّمِ ألوليدي لكن قَدْ يَكُون جزء من عمل متكامل .

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