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Article
OSCE, THINGS TO BE SAID ………………………4

Author: Mazin A Abdulla
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 1 Pages: 4-6
Publisher: Basrah University جامعة البصرة

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STUDENT'S PERCEPTION OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) IN SURGERY AT BASRAH COLLEGE OF MEDICINE

Author: Mazin A Abdulla
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2012 Volume: 18 Issue: 2 Pages: 21-25
Publisher: Basrah University جامعة البصرة

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STUDENT'S PERCEPTION OF OBJECTIVESTRUCTURED CLINICAL EXAMINATION (OSCE) INSURGERY AT BASRAH COLLEGE OF MEDICINEMazin A AbdullaMB,ChB, CABS, Lecturer & Consultant Surgeon, Dept. of Surgery, Basrah College of Medicine, Basrah-IRAQ.AbstractThe assessment method of OSCE gains popularity in most medical schools globally. TheDepartment of Surgery in Basrah Medical College introduces this assessment format since2010. The main objective of this study is to evaluate student's perception about preference ofthis test and acceptability of standardized patients.A survey of successive batches of medical students (3 batches of six year and 4 batches offourth year), who had been examined with Objective Structured Clinical Examination, wasconducted using a self-administered questionnaire. Data were analyzed. The study wasconducted in the academic year 2011-2012.Two hundred and twenty one students completed the questionnaire, 100 students in the 6thyear and 121 students in the 4th year. Eighty nine (40.3%) of the all respondents reported thatOSCE was an easier examination than the traditional one and 106(48%) perceived that theduration of station was adequate. Moreover, 141(63.8%) preferred to have the traditionalexamination in addition to the OSCE. There was clear difference in opinion regarding the use ofstandardized patients (PSs) between 4th year students as 79(65.3%) dislike it while 58(58%) inthe 6th year students accept the use of such patients.In conclusion, the overall student's evaluation of OSCE was encouraging, as the majority ofparticipated students preferred this examination and at the same time they want to keep thetraditional one. The benefit of this survey can be gained if timely feedback is offered on theperformance of the candidates after applying the standards of OSCE.

Keywords

OSCE --- Examination


Article
ACUTE APPENDICITIS, A QUALITY OF CARE STUDY IN BASRAH GENERAL HOSPITAL

Authors: Ahmed Abdul-Razak Essa --- Mazin A Abdulla
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 2 Pages: 14-18
Publisher: Basrah University جامعة البصرة

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Abstract

This study is designed to evaluate the parameters that indicate the quality of care in acute appendicitis. It is a prospective study in Basrah General Hospital. One hundred ten patients underwent appendectomy in the period between March and July 2010, were studied according to a data collection sheet. The mean duration of symptoms was 29.2 hours and 10% of patients visited the hospital twice. Decision to operate depending on clinical diagnosis alone done in 14.54% of patients while blood cell count was the most frequent investigation done in 78.18% of the patients. The mean waiting period was 6.6 hours. All patients received antibiotics postoperatively while antibiotic prophylaxis used in 74.5%. Rate of perforation of appendix was 12.7%. Histopathological examination of the removed appendix done in 7.27%. The mean hospital stay was 44.02 hours with 20% of patients developed post operative complications. Most of our patients were satisfied with hospital services, facilities and staff behavior. In conclusion, non-utilization of investigations in some patients, long waiting period, high complication rate and extended usage of antibiotics are aspects among others which need to deal with by conducting hospital audits.

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Article
10- SPILLED GALL STONES DURING LAPAROSCOPIC CHOLECYSTECTOMY : A PROSPECTIVE STUDY

Authors: Mushtaq Ch. Abu-Alhail --- Mazin A Abdulla --- Jasim D Saud
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 65
Publisher: Basrah University جامعة البصرة

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Abstract

Jasim D Saud#, Mazin A Abdulla@ & Mushtaq Ch. Abu-Alhail**#MBChB, CABS, Specialist Surgeon, Basrah General Hospital, Basrah, Iraq. @MBChB, CABS,Consultant Surgeon, Department of Surgery, College of Medicine, University of Basrah, Basrah, Iraq.ABSTRACTThis study assesses the impact of spilled gall stones during laparoscopic cholecystectomy (LC)and it's clinically significant complications resulting from stones left in the peritoneum.This is a prospective analysis of laparoscopic cholecystectomies performed at The SurgicalUnit in Basrah General Hospital from 1st January 2006 to 31st December 2010. There were 678patients in the study who underwent LC. The inclusion criteria for LC were: patients of all agesand both genders, symptomatic gallstone disease, recurrent attack while waiting for interval LC,normal values of blood complete picture & liver function tests and ultrasound examination ofabdomen demonstrating gallstone disease.There were 73 cases of gallbladder perforation, i.e. a frequency of 10.7%. In 34 of thesepatients gallstones spillage also occurred in a frequency of 5%. An effort was made in eachcase to remove the spilled stones laparoscopically but in 25 patients unretrieved stones wereleft (frequency of 3.6%). Eight patients (1.17%) developed complications, one patient developedileus which was thought to be the result of irritation from a gallstone that had been shown on USexamination. The free fluid in the Douglas pouch resolved with medical management. Twopatients developed sub-hepatic abscess, presenting with right hypochondrial & shoulder tip painand fever post operatively; which confirmed by abdominal sonograph, one patient respondedwell to medical treatment while the other one required ultrasound guided drainage and broadspectrumantibiotics. Three patients developed epigastric port site infection; two were treatedsuccessfully by daily wound care and appropriate antibiotics after culture and sensitivity. Onedeveloped persistent epigastric sinus, and a gallstone was retrieved on exploration. Twopatients developed sub-hepatic and right sub-phrenic abscess respectively in the seventh postoperative day and required open drainage. There was no mortality and long-term morbidity.In conclusion, complications arising from spillage of gall stones during laparoscopiccholecystectomy are rare. They can present months after the cholecystectomy with septiccomplications. The patients should be informed preoperatively that spillage of bile andgallstones are possible. The surgeon should take utmost care to prevent spillage of stones andattempt to remove all visible stones at the time of surgery. If spillage occurred it should berecorded clearly in the operative notes and such patients should be kept under close follow upto aid in the early diagnosis of later complications. There is no indication for routine conversionto open surgery.


Article
THE ADVANTAGE OF ACUTE INFLAMMATORY MARKERS IN DIAGNOSIS OF ACUTE APPENDICITIS

Authors: Mazin H Al-Hawaz --- Mazin A Abdulla --- Hyder Dakhel Ali
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 2 Pages: 8-13
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract Acute appendicitis is the most common cause of emergency abdominal surgery with an estimated lifetime prevalence of 7%–8%. Despite advances in diagnosis and treatment, it is still associated with morbidity (10%) and mortality (1%–5%). This study was designed to investigate the results of WBC count, platelet distribution width and C-reactive protein values based on the pathology results in patients undergoing appendectomy with an early diagnosis of acute appendicitis. This prospective cross sectional study was carried out in Basrah Teaching Hospital from the period 1st of September 2015 to 1st of June 2017, a total of 154 consecutive patients were enrolled in the study. All patients were admitted to the emergency department with history suggestive of acute appendicitis, blood tests were done for inflammatory markers in form of WBC, CRP and PDW, a period of 24 hours prior to surgery was accepted, histopathological data were used to assess inflammation of the appendix. The majority of patients were males 61% while females were 39%, with age range between 14-46 years (mean 24.28 years). There was a correlation between WBC count and acute appendicitis(P value=0.004), with sensitivity range (53%-69%) and specificity range (25-89%), while positive predictive value (PPV) and negative predictive value (NPV) were 96% and 8% respectively. A significant correlation found between CRP and acute appendicitis (p value less than 0.0001) with sensitivity range (71%-85%), while specificity was (10%-74%) and PPV, NPV were 95% and 9% respectively. Regarding PDW, no correlation was found with acute appendicitis (p value=0.296) with sensitivity range (6%-16%) while specificity (17%-82%), PPV 78%, NPV 2%. There was significant correlation between inflammatory markers (WBC, CRP, PDW) and complication with a p value=0.0001, ruptured appendix and peri-appendicular abscess were the most common complications recorded, only 8(5.2%) patients had normal appendix after histopathological examination. In conclusion, acute inflammatory markers play an important role in diagnosis of acute appendicitis along with history and physical examination.

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