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Article
Analytic Study Of Congenital Malformations In Four

Author: Numan Nafie Hameed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 32-36
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Congenital malformations are responsible for a considerable proportion ofperinatal, neonatal and infant mortality in many Eastern Mediterranean countries. So this studyaims to find out the incidence, types and probable risk factors of these malformations in Baghdad.Patients and methods: one hundred cases of congenital malformations were studied out of 8090neonates born in 4 hospitals in Baghdad province over 5 months in 2002 (preterm, term) .Theincidence , types and risk factors were analysed .Results: the incidence of congenital malformations was 12.36/ 1000 live births, with the centralnervous system malformations being the commonest. There is increased risk in consanguinousmarriages 27 (27%), mothers not attending antenatal care 25 (25%), mothers of low gravidity 60(60%), and mothers not taking folic acid during pregnancy (86.7%).Conclusion: Consanguineous marriages and mothers not taking folic acid during pregnancy areimportant risk factors for the occurrence of congenital malformations .So I recommend geneticcounseling especially for consanguineous marriages, and giving all pregnant women folic acidbefore and during pregnancy. A multicentre study will give more broad idea about the incidence ,types ,and risk factors in our country


Article
Respiratory Distress in Full Term Newborns

Author: Numan Nafie Hameed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 233-239
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Respiratory distress (RD) is among the most common symptom complexes seen in the newborn infant. It may result from both non-cardiopulmonary and cardiopulmonary causes.OBJECTIVES:This study Aimed to assess some possible risk factors, types, and short term out come of RD in full term newborns.PATIENTS AND METHODS:A case control study extending along a 6 months period from 1st of October 2006 to 31st of march 2007, during which a 50 full term newborns with RD, who were admitted to the NICU of Baghdad Teaching Hospital in Medical City-Baghdad, and enrolled with another 50 full term newborns without RD delivered in the same period, in the same place.For studied groups (cases and controls), a full prenatal and natal history, and complete physical examination were done, including Down's score evaluation of RD. For each patient in the studied group, CXR, CBP, CRP, Bl.C/S were under taken, close observation and out come were recorded.RESULTS:The risk factors that emerged as being significant includes: history of maternal smoking, caesarian section delivery and male sex .The elective caesarian delivery was highly significant risk factor for RD in full term newborns. The percentage of RD in full term newborns to the total live births at that period was (2.16%), TTN was the commonest cause (1.68%), followed by HMD (0.25%), MAS (0.086%), CHD (0.086%) and then C. P (0.001%).CONCLUSION:That RD in full term newborns is still an important problem in this NICU, especially due to TTN and following elective CS. These prompt us to recommend the reduction of these risk factors especially elective CS to decrease the percentage of RD in full term newborn babies


Article
Respiratory Distress Syndrome in Neonatal Care Units in Medical City

Author: Numan Nafie Hameed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 4 Pages: 378-385
Publisher: Baghdad University جامعة بغداد

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Abstract

Introduction: Neonatal Respiratory distress syndrome (RDS) remains one of the major cause's neonatal morbidity and mortality despite advances in perinatal care especially in developed countries. Objectives: The aims of this study were to find out me risk factors of mothers and newborns (NB) which increase the incidence, morbidity, and mortality of RDS. Patients & Methods: A prospective descriptive cross-sectional study was conducted on 100 live NR infants born at neonatal care units in Baghdad hospital & private nursing home (medical city complex) / Baghdad in the period from the first of March to the end of June 2006. They were presented with RDS, which was diagnosed clinically and radio-graphically. The study includes preterm and mil term N8 with all birth weights. Results: In tins study, there was an increase in the incidence of RDS in preterm NBs 3.5 times more than in mil term, and 2.0 times more in small for gestational age (SGA) than in appropriate for gestational age (AGA). It was found that the risk of death from RDS with air leak was 11 times more than those without air leak, and from RDS with pneumonia 4.0 times more than those without pneumonia. The risk of death among NB delivered by elective Caesarian section (C/S) was 2.4 times more than those born by emergency C/S. and 5.1 times more in NB of diabetic mothers than those without diabetes. Conclusions: We conclude that prematurity and SGA are risk factors for the development of RDS, and air leak and pneumonia are most important complications that increase the risk of death from RDS. So we recommend a proper and regular antenatal care and. management of high risk pregnancies to avoid premature delivery and SGA, and proper respiratory care of NB to decrease the complications of RDS especially air leak and pneumonia to decrease the risk of death.


Article
Neonatal Deaths in Neonatal Care Unit and Surgical Ward of Children Welfare Teaching Hospital – Medical City - Baghdad (2005-2009)

Authors: Ataa Jabir Hasan --- Numan Nafie Hameed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 293-299
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Neonatal deaths in Iraq account for more than half of under-five children deaths. The rates vary according to causative factors in each area of the world.OBJECTIVE:To have an idea about death rates and major causes of neonatal death in Children Welfare Teaching Hospital(CWTH), Medical City ,Baghdad .PATIENTS & METHODS:The medical records of 1074 neonatal deaths in Neonatal Care Unit(NCU)& surgical unit from 2005-2009 in Children Welfare Teaching Hospital, Baghdad , were studied retrospectively, especially for the cause of death as registered in the files.RESULTS:Neonatal deaths relative to admission (15.1%) distributed between Neonatal Care Unit & surgical ward into (11.38%) & (25.5%) respectively. Of 1074 total neonatal deaths, males were 653 (60.8%), 421 (39.2%) were females. Male to female ratio was 1:6. Major causes of death were: congenital anomalies (53.2%), respiratory problems (20%) & neonatal infections (14%).CONCLUSION:The results of this study indicate that neonatal death rates are still high, with congenital anomalies being the most common . More researches are needed to know the causes and the need for improvement in neonatal care services


Article
Early Neonatal Indirect Hyperbilirubinemia in Full Term Newborns and Types of Feeding

Authors: Farah Kadem Na’ma --- Numan Nafie Hameed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 174-180
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Neonatal jaundice remains the most common and, perhaps, the most controversial problem in full-term newborns during the immediate postnatal period.OBJECTIVE:To evaluate the relationship between types of feeding and neonatal indirect hyperbilirubinemia in full term neonates in the first week of life.METHODS:In the period from the first of January 2008 to the first of August 2008, populations of 140 full term newborns admitted to the neonatal care unit in Children Welfare teaching Hospital in Medical City-Baghdad were studied. A serum bilirubin level >12.9 mg/dL was considered significant.RESULTS:Of the population studied, most newborns received supplementary feeding 73 (52.1%), followed by breast feeding 50(35.7%), while only 10(7.1%) and 7(5.0%) were on mixed and formula feeding, respectively. Ninety (64.3%) of the jaundiced neonates were males and 50(35.7%) were females with a male to female ratio of (1.8:1).CONCLUSION:This study revealed that, no significant association could be found between different types of feeding and indirect hyperbilirubinemia in full term newborns. Besides, giving water, dextrose water or formula with breastfeeding will adversely affect the volume of milk transferred to the baby and the volume of milk produced by the mother


Article
Assessment of Knowledge of Pediatric Resident Doctors About Neonatal Pain

Authors: Numan Nafie Hameed --- Bassam H. Sweedan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 4 Pages: 443-452
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Infants including newborn babies, experience pain similarly and probably more intensely than older children and adult. They are also at risk of adverse long term effects on behavior and development, through inadequate attention towards pain relief in early life. However, the issue of analgesia in young babies has been largely neglected in most clinical setting, despite subjecting them to painful diagnostic and therapeutic procedures.OBJECTIVE:To assess the knowledge of resident doctors regarding neonatal pain and to compare this with best evidence-based medicine.SUBJECTS & METHODS:A survey study questionnaires was distributed to pediatric resident doctors (PRD) in three training hospital centers in Baghdad (A- Al-Kademia teaching Hospital, B- Child central teaching hospital, and C- Children Welfare teaching hospital/ medical city) during the period from first of February to first of May, 2010. The questions were about the doctors` knowledge in treatment of pain in neonates, specifically regarding the perception and the effects of pain, pain assessment tools, and the safety and efficacy of treatments for both procedural and long-term pain.RESULTS:This study included 101 PRD, 29 were females and 72 were males. Doctors generally knew about efficacy of skin to skin contact and massage , breast feeding and oral sucrose during short term procedures, benefit and risk of use of morphine and midazolam, but less agreed that sedation does not necessarily provide adequate pain relief into neonates. Doctors were supporting use of topical anesthetic agents but not supporting the benefit of treating long term pain with opioid analgesic outweigh the risk of neonates. About half of PRD knew the difference in long term effect between neonates and older children. Pain assessment tools were not perceived to be reliable ,valid or routinely used.CONCLUSION:The knowledge of resident doctors regarding neonatal pain was inadequate when compared with developed countries studies and evidence based medicine, so we recommend to increased the educational programs and training on neonatal pain management


Article
PREDICTORS OF HYPOXEMIA IN BRONCHIOLITIS IN ASAMPLE OF IRAQI INFANTS

Authors: Cawes Omar Hamad --- Muhi K. AL-Janabi --- Numan Nafie Hameed
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 2 Pages: 145-153
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Bronchiolitis is the first episode of wheezing associated with low grade
fever, rhinitis, tachypnea, and increasing respiratory effort in a previously healthy
infant during the winter months, and it is the most common lower respiratory tract
infection in infancy.
Objectives: This study is designed to analyze the clinical signs and symptoms alone
or as combinations as possible predictors of severe hypoxemia in infants with
bronchiolitis.
Patients and methods: This is a prospective study, which was carried out on 96
infants with a mean age of 7.74 ،ہ3.72 months who were admitted to Children
Welfare Teaching Hospital in Medical City-Baghdad with bronchiolitis during the
period from 1st
October 2006 to the 15th
March 2007. They are divided into two
groups: group one 46 cases (oxygen saturation (SaO2<90) and group two, 50 cases
(SaO2،ف90).Complete history taken from care taker and full examination done for each
patient. A portable oximeter was used to measure oxygen saturation.
Results: Forty nine (51%) of patients were males and 47 were females (49%), with
male to female ratio of 1.04:1. The mean age was (7.745،ہ3.7) months. The mean
oxygen saturation was (90%), with a median of (84.7%) and a range of (76%-89%) in
group one (SaO2<90), while it was (95.32%) with a range of (90%-99%) in group two
(SaO2،ف90).
Conclusions: Reduced ability to feed, sleep disturbances, hypotonia and clinical
signs as suprasternal retractions, continuous nasal flaring, tachypnea, grunting, head
nodding and cyanosis appeared to be statistically highly significant in this study as
predictors of severe hypoxemia. Combinations of signs and symptoms that showed
statistically significant association with severe hypoxemia were: grunting or head
nodding, cyanosis or head nodding, tachypnea or sleep disturbance, tachypnea or
suprasternal retractions, and tachypnea or head nodding (p.value <0.0001) for all
mentioned combinations, So we recommend to use these combinations of signs and
symptoms as significant predictors of severe hypoxemia especially when pulse
oximetry is not available.


Article
Risk Factors of Small for Gestational Age Newborn Babies

Authors: Numan Nafie Hameed --- Munib Ahmed ALZubaidi --- Sajjad H.Kadhim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 1 Pages: 54-60
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The most common definition of Small for gestational age (SGA) newborns refers to a birth weight below the 10th percentile for gestational age. Intrauterine growth retardation(IUGR) may be caused by maternal, placental, or fetal factors. However, no underlying etiology can be identified in at least 40 % of SGA infants.OBJECTIVE:To evaluate the risk factors of SGA births in a sample of Iraqi term newborns.PATIENTS& METHODS:A case control study extended over eight months from Dec. first 2007 to July 31st, 2008 . In this study, 100 SGA newborns &100 control newborns evaluated within the first day of life.This study was performed in delivery rooms &neonatal special care birth unit in Baghdad Teaching Hospital in Medical City . Data were collected by direct interview of the mothers. Data included different variables related to mothers & neonates.RESULTS:There was a significant relationship between SGA births & maternal urinary tract infections (OR=5.231, P<0.0001) & with antepartum hemorrhage (8.6 time risk ,0R=8.609, P=0.0349).The majority of SGA newborns(15%) occurred in multiple pregnancies (OR=17.471, P=0.0003). SGA newborns were more common among non employed mothers (OR=2.100, P=0.0355).Also SGA newborns had significant relationships with mothers not attended antenatal care (OR=3.648, P=0.0001),those with maternal history of SGA births (OR=15.474, P<0.0001) , those mothers with anemia (OR=5.532, P<0.0001) & lastly with mothers suffering from hypertension (OR=8.877, P<0.0001).CONCLUSION:There was significant relationship between SGA births and :Multiple pregnancies& maternal history of SGA births, mothers suffering from hypertension& maternal history of APH and maternal anemia& UTI, mother not attended antenatal clinic & with no employment.


Article
Demographic and Clinical Presentations of Pediatric Hydrocephalus in Medical City

Authors: Mahjoob N. Al Naddawi --- Numan Nafie Hameed --- ,Amal A. Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 139-144
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Hydrocephalus is distension of the ventricular system of the brain related to inadequate passage of cerebrospinal fluid from its points of production within the ventricular system to its points of absorption into the systemic circulation.OBJECTIVE:To study the demographic and clinical presentations of pediatric hydrocephalus in medical city complex , Baghdad.PATIENTS AND METHODS:This is a prospective study ,which was carried out on 100 children with a mean age+- standard deviation ( 24.3 +/- 16.06 )months and median 16 months, who were admitted to Children Welfare Teaching Hospital & neurosurgical department ( Surgical Specialties Hospital) / Medical City complex, Baghdad in the period from April first 2009 to October first 2009. A specially designed questionnaires were used to aid the investigators in performing a family interview. General and neurological examinations, and investigations including neuroimaging studies were done.RESULTS:Of 100 patients,(62%)were males and (38%) were females, with male to female ratio of 1.6:1. Family history of congenital anomaly was positive in (26%) of patients, while hydrocephalus was positive in (14%). Seventy-Two percent of patients had congenital hydrocephalus. Eighty–Seven percent of patients were full term. Fifty-Seven percent of patients were products of NVD ,while (43%) were products of CS,(2%) of them were emergency CS& (41%) were elective. The macrocephaly was diagnosed or noted at birth in (32%)of patients. The study showed that U/S finding of hydrocephalus was positive in (49%).CONCLUSION:The majority of the patients had congenital hydrocephalus, but there was delay in the diagnosis of macrocephaly. Prenatal ultrasound diagnosis yield was low in this study. Family history of hydrocephalus and other neural tube defect was important to be elicited


Article
Long Term Complications of Type 1 Diabetes Mellitus in Children and Young Adults

Authors: Munib Ahmed Alzubaidi --- Esraa Majid Mutashar --- Numan Nafie Hameed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 1 Pages: 21-24
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Diabetes mellitus is a common chronic metabolic syndrome characterized by impaired metabolism of glucose; morbidity and mortality come from acute metabolic derangement and from long term complications that affect small and large vessels.OBJECTIVE:The assessment of the long term complications of diabetes mellitus in children and young adultsPATIENTS AND METHODS:The study included 150 patients with type1 diabetes mellitus attending the diabetic clinic of Children Welfare Teaching Hospital who were assessed for the presence of long term complications of diabetes mellitus.RESULTS:The total number of the sample was 150 patients with male to female ratio of 1:1.2 with median age of 12.2 years.Long term complications occurred in 26.7% of patients; (75%) of them had diabetes for more than 5 years. These complications include eye complications (retinopathy and cataract) 12.6%, Renal complications (albuminuria, oedema, and hypertension) 10.6%, peripheral neuropathy 4.6%, limited joint mobility 6.6%, and short stature 17.3%.CONCLUSION:Long term complications were found in significant number of patients with type I diabetes mellitus which can occur in children with short duration of diabetes, and their frequency increases significantly with increasing duration of diabetes.

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