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Article
Knowledge transfer and exchange among academic researchers of Hawler Medical University
نقل المعرفة والتبادل بين الباحثين الأكاديميين في جامعة هولير الطبية

Authors: Namir G. Al-Tawil --- Sherzad Shabu
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 3 Pages: 377-384
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Knowledge transfer and exchange is a dynamic and complex process which comprises the creation of knowledge and its application to improve health, provide more effective health services and products, and will strengthen the overall healthcare system. This study aimed to understand the current context of knowledge transfer and exchange and identify the main barriers and facilitators for enhancing that from the perspective of university academics.Methods: This cross-sectional survey was carried out between February to September 2015 on 160 academic researchers of the four colleges of Hawler Medical University; Medicine, Dentistry, Pharmacy, and Nursing. A self-administered questionnaire was used for this purpose. Likert scale was used to rate participants answers and SPSS for assessing the level of association between different variables.Results: The study revealed that the mean ± standard deviation time academic researchers used for conducting different activities of knowledge transfer and exchange was 9.39 ± 14.08 and that around 43% of the participants stated that they use less than 5% of their time for knowledge transfer and exchange activities. There was no significant statistical association between knowledge transfer and exchange percentage time used by academic researchers from one side and research areas and different colleges from another side.Conclusion: There is an obvious shortfall from the side of academic researchers in transferring or exchanging the knowledge they acquire from their health research to their target audience. There is a lack of investment from the side of academic researchers in health policy and system research.


Article
Association between Socio-demographic Factorsand Pulmonary Tuberculosis in Erbil

Authors: Namir G. Al. Tawil --- Badia M. Najib --- Ibrahim H. Mustafa
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2011 Volume: 1 Issue: 1 Pages: 85-92
Publisher: University of Kufa جامعة الكوفة

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Abstract


ABSTRACT
¬¬¬¬¬¬¬¬¬¬Background and objectives: Tuberculosis (TB) is the most common infectious disease in the world today; tuberculosis is a major cause of illness and death worldwide, especially in Asia and Africa. Globally, 9.2 million new cases and 1.7 million deaths from tuberculosis occurred in 2006.
The main objective of this study was to study the association between socio demographic characteristics and pulmonary tuberculosis.
Methods: A case-control study was carried out in Erbil city during the period May 10, to December 8, 2009. A convenient sample of 103 cases of TB attending the Consultation Clinic for Chest and Respiratory Diseases was included in the study. A sex and age matched, 103 patients were included in the study as a control group. The control group was taken from the Medical Wards of both Rizgary and Hawler Teaching Hospitals who were free from chest infections and lung cancer. Cases and controls were interviewed using a questionnaire designed by the researchers.
Results: More than half (53.4%) of the cases were of low socioeconomic status compared with 25% among the controls. No significant association was detected between marital status and TB.
Conclusion: TB was found to be associated with low socioeconomic status.
Key words: pulmonary tuberculosis, socio-demographic characteristics, socioeconomic status.

Keywords


Article
Anti-mullerian hormone and antral follicle count in polycystic ovary syndrome and non-polycystic ovary syndrome women
مضاد هرمون موليرين و عد جريب الغارات في متلازمة المبيض المتعدد الاكياس ومتلازمة المبيض غير المتعدد الاكياس

Authors: Jwan J. Namik --- Shahla K. Alalaf --- Namir G. Al Tawil
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 3 Pages: 292-299
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Although the ultimate pathogenesis of polycystic ovary syndrome remains obscure, the distinctive feature is the failure of follicular maturation resulting in an ovulation and accumulation of preantral and small antral follicles which contribute significantly to the production of the anti-mullerian hormone. This study aimed to compare anti-mullerian hormone concentration and antral follicle count in polycystic ovary syndrome and non-polycystic ovary syndrome women regarding clinical, hormonal and ultrasound parameter in both groups.Methods: A cross-sectional study with comparison group study was conducted in the fertility and gynecology outpatient clinic in the Maternity Teaching Hospital, Erbil, Kurdistan region, Iraq from April 1st, 2015, to December 31st, 2015. The study involved a total of 100 infertile women aged 18 - 39 years; 50 polycystic ovary syndrome women based on the Rotterdam criteria and 50 infertile non-polycystic ovary syndrome selected as a comparison group. Anti-mullerian hormone and antral follicle count in both groups were compared.Results: A strong, inverse and significant correlation was found between anti-mullerian hormone and age in each of the two study groups. A weak correlation was detected between anti-mullerian hormone with body mass index, luteinizing hormone, follicular stimulating hormone, and total testosterone, in each of the two study groups. A significant inverse correlation was detected between anti-mullerian hormone and luteinizing hormone/follicular stimulating hormone ratio in the non-polycystic ovary syndrome group (P <0.001). There was a statistically strong, significant and positive correlation between anti-mullerian hormone and antral follicle count in each of the study groups.Conclusion: Anti-mullerian hormone and antral follicle count are higher in polycystic ovary syndrome group than in non-polycystic ovary syndrome group. Elevated levels of the anti-mullerian hormone were associated and related to increased number of follicles in women with polycystic ovary syndrome.


Article
Effect of maternal age on the ovarian reserve markers, and pregnancy outcome in a sample of Kurdish women in Erbil city
تأثير عمر الأم على علامات احتياطي المبيض ونتائج الحمل لدى عينة من النساء الكورديات في مدينة أربيل

Authors: Namir G. Al-Tawil --- Shahla K. Alalaf --- Manar J. Hussein
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 1 Pages: 8-16
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The ovary has a biological age that does not always correspond to the chronological age; this may be of great importance for the evaluation of women reproductive outcome. This study aimed to determine the effect of maternal age on the pregnancy rate, and the ovarian reserve markers (antimullerian hormone, follicular stimulating hormone, and antral follicular count).Methods: A cross-sectional study was conducted in the in vitro fertilization center at the Maternity Teaching Hospital located in Erbil city, from January 1, 2015, to January 31, 2016. A convenience sample of 300 infertile women of different age groups was included in the study. Transvaginal ultrasound was conducted to determine antral follicular count, and blood test was done for determination of serum antimullerian hormone and follicular stimulating hormone. The study sample was divided into four age groups. Chi square test, ANOVA test, Pearson correlation, and logistic regression were used to determine the associations.Results: The biochemical pregnancy rate of the study population was 37% and the clinical pregnancy rate was 32%. The most common type of infertility among the studied sample was primary infertility (74%). Results showed a strong inverse significant correlation between antimullerian hormone and antral follicular count with age, but there was no statistically significant association between maternal age and serum follicular stimulating hormone.Conclusion: Maternal age is a significant factor that can affect ovarian reserve and causes ovarian aging. The pregnancy rate decreases with advanced maternal age.


Article
Association between life-style factors and pulmonary tuberculosis in Erbil
العلاقة بين عوامل نمط الحياة والسل الرئوي في أربيل

Authors: Namir G. Al. Tawil --- Badia M. Najib --- Ibrahim H. Mustafa
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2011 Volume: 15 Issue: 3 Pages: 6-11
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: The majority of individuals in a population do not develop tuberculosis, due either to lack of exposure or due to individual characteristics that limit development of the disease after exposure. Evidences suggested that there is an association between lifestyle variables and tuberculosis. The main objective of this study was to study the association between lifestyle characteristics and pulmonary tuberculosis.Methods: A case-control study was carried out in Erbil city during the period May 10, to December 28, 2009. A convenient sample of 150 cases of TB attending the Consultation Clinic for Chest and Respiratory Diseases was included in the study. A sex and age matched, 150 patients were included in the study as a control group. The control group was taken from patient of the Medical Wards of both Rizgary and Hawler Teaching Hospitals who were free from chest infections and lung cancer. Cases and controls were interviewed using a questionnaire designed by the researchers.Results: Around one quarter (24%) of the cases were smokers compared with 14.7 % among the controls. Significant difference of nutritional status between both groups was detected. Controls eat more food and of better quality than cases. No significant association between alcohol drinking, practicing of sports/ exercise and TB was detected.Conclusion: TB was found to be associated with low nutritional status and smoking.


Article
Association between Ramadan Fasting and cerebrovascular diseases
العلاقة بين صيام رمضان والأمراض الدماغية

Authors: Namir G. Al-Tawil --- Srood N Jarjees --- Mutaz Fadhil Hummadi --- Abdullah Faky Yazdeen --- et al.
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 3 Pages: 1853-1858
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Cerebrovascular diseases are attacks of sudden neurological deficits (motor, sensory or cerebellar). There are a lot of risk factors for stroke like age, diabetes, hypertension, smoking, hyperlipidemia, cardiac diseases and others. This study aimed to show if there is increasing rate of cerebrovascular events during Ramadan in relation to fasting in our city during the summer season.Methods: This case-control study was carried out in Rizgary Teaching Hospital, Erbil- Iraq from 1st of August to 30th of August 2011. Patients were included in this study if they were middle aged and elderly patients having clinical and radiological features of stroke, another group of in-patients was selected as a control group. Chi square test and logistic regression analyses were used to show the association between stroke and fasting.Results: A sample of 60 patients and 60 control cases were included in this study. Fasting was significant risk factor for stroke in our studied sample, 66.7% of the cases were fasting compared with 40% of the control group (P = 0.03). Hyperlipidemia and history of ischemic heart disease found also to be associated with stroke (P = 0.017 and 0.011, respectively). Logistic regression analysis showed that only fasting and hypercholesterolemia were independent risks factors in causing stroke in our studied sample.Conclusion: In Erbil, where the summer is too hot and the daytime (fasting hours) is long, fasting during Ramadan was found to be an independent risk factor for stroke, and specifically ischemic stroke.

Keywords

Ramadan --- Fasting --- Stroke --- Summer season


Article
Evidence-based health policymaking in Iraqi Kurdistan: Facilitators and barriers from the perspectives of policymakers and advisors
صنع السياسات الصحية القائمة على الأدلة في كوردستان العراق: الميسرون والحواجز من وجهة نظر صناع السياسات والمستشارين

Authors: Rod Sheaff --- Michael P. Fuller --- Namir G. Al-Tawil --- Sherzad Shabu
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 3 Pages: 1075-1083
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Evidence from research is underutilized in policy and practice in the majority of developing countries including Iraq. This aim of this study was to assess the role of research in health policy making in Iraqi Kurdistan context and identify the main barriers and facilitators for enhancing such role. Methods: This cross-sectional survey was carried out between November 2013 and March 2014 in the three governorates of the Iraqi Kurdistan Region, Erbil, Duhok and Sulaimaniyah. The study participants included 10 key health informants and three health advisors. Two types of combined questionnaires for health policy makers and health advisors were used for data collection.Results: Conferences and seminars were the main sources of scientific evidences identified by health policymakers (80%), followed by consultants (70%). Different jargons/discourse was the main obstacle in consulting researchers (90%), followed by lack of tradition in collaborating (70%). Collection of specialists/advisors, followed by professional associations, scientific committees and international organizations/UN agencies were the main groups identified by health advisors to build bridges between the scientific community and policymakers.Conclusion: Policymakers very rarely consult researchers directly in their decision making. There is poor networking among researchers, policy-makers, practitioners and representatives from civil society which has its negative impact on evidence-based policymaking. There is obviously a lack of any sort of program of funded research that can inform policymaking.

Keywords

Health policy --- Kurdistan region --- Erbil --- Iraq


Article
Nurses’ attitude toward the care of dying cases in the cardiac center in Erbil city
موقف الممرضات من رعاية الحالات المميتة في مركز القلب في مدينة أربيل

Authors: Namir G. Al-Tawil --- Vian A. Naqshbandi --- Nazar Ali Sheren --- Salih A. Abdulla
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 2 Pages: 763-768
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Nurses play a key role in providing care at the end of life; death is inevitable that affect every human being. Nurses are present at both the beginning and the end of life and play a key role in caring for dying patients. The aim of this study was to assess the attitudes of critical care nurses toward care of the dying as well as assessing the relationship between demographical components and attitudes toward care of the dying.Methods: A cross-sectional study was carried out in the cardiac center of Erbil city, Iraqi Kurdistan region, during the period from 2nd February to 4th of March, 2013. A convenience method of sampling was used to collect 40 nurses working in that center. The mean age(±SD) of nurses were 27.87 (±2.92, range=35-24). Each nurse was asked to complete the Frommelt Attitudes toward Care of the Dying Scale (FATCOD) and demographics questionnaire designed and copyrighted by Katherine Frommlet in 1988.Results: The study indicated that there was positive attitude among study samples. Results showed that no significant relationship between attitudes score with gender, nurse education, and duration of service, while there was significant association between high attitudes score with older ages (P = 0.003).Conclusion: The nurse's attitudes toward dealing with dying cases were positive in the majority of related items, and there were no associations between gender, duration of experience, and level of education and their attitude, while it was found a significant association between ages and attitudes towards care of the dying.


Article
Effects of Ramadan fasting on body weight and metabolic profile
آثار صيام رمضان على وزن الجسم و الشاكلة الاستقلابية

Authors: Namir G. Al-Tawil --- Bashdar M. Hussen --- Saleem S. Qader --- Halgurd F. Ahmed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 3 Pages: 816-821
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Fasting during the Ramadan month is a religious duty and it is obligatory for all healthy adult Muslims. The aim of this study was to investigate the effects of fasting during Ramadan in different times and place on body weight, blood sugar, serum lipids and blood pressure.Methods: Fifty three healthy adult fasting volunteers were included in the study. Peripheral venous blood samples were taken three days before Ramadan, at the end of the first week, and at the end of the fourth week of fasting. The last blood sample was taken one week after the end of Ramadan. Serum total cholesterol, HDL and LDL, triglycerides and glucose were measured. Vital signs and body mass index were taken by one of the researchers.Results: Thirty three (62.3%) volunteers were males, 93.4% were below 40 years of age. Weight changed significantly during Ramadan. Mean systolic blood pressure decreased by 11 mmHg while diastolic blood pressure decreased by 9 mmHg (P <0.001). Fasting blood sugar decreased by 14.96 mg/dl (P <0.001). Plasma lipids; cholesterol decreased by 19.3 mg/dl (P <0.027), LDL by 23 mg/dl (P <0.001), triglyceride by 44 mg/dl (P <0.003) but the HDL increased by 5.4 mg/dl (P <0.002) during Ramadan fasting. Before Ramadan, 19% of participants had abnormal serum cholesterol and 37% had abnormal LDL level, while after Ramadan all had normal lipid levels (P <0.001). The proportion of participants with abnormal HDL decreased from 94% before Ramadan to 50% after Ramadan (P <0.001).Conclusion: Ramadan affects the body physiology and lowers the weight, serum lipids, blood pressure and blood glucose levels.

Keywords

Ramadan --- Fasting --- Lipid profile


Article
Role of Cardiac Troponin I Level in Predicting in Hospital Outcomes in Patients with ST-segment Elevation Myocardial Infarction in Erbil-Iraq
دور مستوى تروبونين القلب نوع (I) في التنبؤ بالنتائج داخل المستشفى للمرضى الذين يعانون من احتشاء عضلة القلب)ارتفاع شريحةST) في مدينة أربيل- العراق

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Background: The correlation of cardiac troponin I with early in-hospital outcomes in acute myocardial infarction is not well established.Objective: To assess the role of troponin I in predicting in-hospital outcomes and early left ventricular systolic dysfunction in patients with ST-segment elevation myocardial infarction.Patients and Methods: A prospective study which consist of 116 patients (74 were males and 42 were females), with ST-segment elevation myocardial infarction who had been admitted to the Coronary Care Unit from March 2015 to September 2015 were enrolled. Patients were divided according to the level of troponin I on admission into 3 groups (low, medium and high elevation). Results: The mean age (+ SD) of the patients was 60+11.4 years. The troponin level of 66.2% of males was high compared with 52.4% of females (p=0.002). The incidence of acute pulmonary edema (21.1%), cardiogenic shock (7%) and early left ventricular systolic dysfunction (49.3%) was significantly higher among patients with high troponin level compared with (0%, 0% and 16%, respectively) among patients with low troponin level. All deaths and cardiac arrest were of high troponin level.Conclusion: High admission troponin I in ST-segment elevation myocardial infarction permits early identification of patients at increased risk of major cardiac complications and death.

خلفية الدراسة: العلاقة بين تروبونين القلب نوع (I) مع الحصيلة الأولية (في المستشفى) لمرضى احتشاء العضلة القلبية الحاد ليست مؤكدة.اهداف الدراسة: لتقييم دور تروبونين القلب نوع (I) في التنبؤ بنتائج الاولية في المستشفى والخلل البطيني الأيسر الانقباضي في المرضى الذين يعانون من احتشاء عضلة القلب - شريحة ارتفاع STالمسمى (ستيمي).المرضى والطرائق : دراسة مستقبلية تم من خلالها تقييم و قبول 116 مريضا (74 من الذكور و 42 من الإناث)، يعانون من احتشاء العضلة القلبية ( نوع ستيمي) الذين تم قبولهم في وحدة الرعاية التاجية المركزة من اذار 2015 إلى ايلول 2015 . اذ تم تقسيم المرضى وفقا لمستوى التروبونين ( I ) الى 3 مجموعات, منخفضة , متوسطة ومرتفع.النتائج: كان متوسط العمر للمرضى 60 + 11.4 سنة. وكان مستوى التروبونين مرتفع في 66.2٪ من الذكور مقارنة مع 52.4٪ من الإناث .كانت نسبة الوذمة الرئوية الحادة (21.1٪)، والصدمة القلبية (7٪)، والخلل البطيني الأيسر الانقباضي (49.3٪) أعلى بكثير بين المرضى الذين يعانون من ارتفاع مستوى التروبونين مقارنة مع (0٪، 0٪ و 16٪ على التوالي) بين المرضى الذين يعانون من انخفاض مستوى التروبونين. وكانت جميع الوفيات والسكتة القلبية عالية في المرضى الذين لديهم مستوى التروبونين مرتفع.الاستنتاجات: ارتفاع تروبونين القلب نوع (I) في مرضى( ستيمي ) عند دخولهم المستشفى يسمح للتشخيص المبكر للمرضى الذين لديهم خطر متزايد من مضاعفات القلب الرئيسية والموت.

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