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Open Access Esophagogastroduodenoscopy

Authors: Tawfiq J. Al Marzook --- Zuhair B. Kamal --- Riyadh M. Hassan
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 268-271
Publisher: Baghdad University جامعة بغداد


Background: Open access gastroduodenoscopy allows general practitioners to request gastroduodenos-copy without prior referral to a specialist. Endoscopy of the upper gastrointestinal tract in experienced hands has definite advantages over conventional barium-meal examination.
Patients and Methods: A total of 266 patients who were referred directly from general practitioner or a specialist attending for esophagogastroduodenoscopy (EGD) to the Endoscopy Unit At Al-Kindi Teach-ing Hospital from September- 2008 to Feb-2010 as an open access policy. Six inclusion criteria were used to include patients in our study group , while 136 patients had underwent EGD were referred from outpatient clinics of the hospital by specialist after screening and filtration were included in the study. Data were obtained from patients include chief complaint and duration and full history of present illness with special emphasis on age, gender, symptoms (abdominal pain, vomiting, loss of weight or appetite, hematemesis, melena, dysphagia), and history of present medications. EGD was done for all patients with gastroscope Pentax EG-2985K2.8.
Results: Two hundred sixty six patients were included in the study and underwent EGD . One hundred thirty EGDs were done in this study as an open access EGD policy while 136 EGD were done for patients who were referred from outpatient clinics of the hospital. In open access EGD policy, 66.15% of patients were males and 33.85% patients were females. The most commonly affected age group which showed abnormal endoscopic findings were in the second decade of life (20-29 years) 22.31% of cases; the chief complaint was epigastric pain in 87.69% of patients. Normal EGD was found in 23.07% of patients while pathological lesions were seen in 76.93% of patients.
Gastro esophageal reflux disease (GERD) was the most common condition encountered by EGD (33.08%). While 136 patients referred from outpatient clinics of the hospital underwent EGD, 68.38% of patients were males and 31.62% of patients were females, most of the patients were in the third decade of life (28.67%), normal EGD was found in 44.12% of patients. Chronic active DU and GERD were the most common diagnoses 12.5%, 11.76% respectively.
Conclusions: The clinical assessment and the strict application of the six inclusion criteria in open ac-cess EGD policy increase the yield of diagnosis of pathological lesions and decrease the number of un-necessary EGDs in our study.


Gasteroscopy --- gastritis --- endoscope

Gynecomastia Treatment Should it be Individualized? A Prospective Study

Authors: Riyadh M Hassan --- ,Zuhair B Kama --- Wisam Abdul lateef Hussein*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 394-402
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND :Gynecomastia is a benign enlargement of the male breast.OBJECTIVE:Was to analyze a 3 year period of gynecomastia patients in Al-Kindy Teaching Hospital and the surgical approach used and its outcome.PATIENTS AND METHODS:A prospective study of patients consulting Al-Kindy Teaching Hospital because of gynecomastia between October 2007and August 2010 was done. Data were analyzed for etiology, grade of gynecomastia, surgical technique, complications, and histological results.RESULTS:A total of 64 patients with 86 operations were included. Techniques included subcutaneous mastectomy alone, or subcutaneous mastectomy with wise pattern "inverted T incision". Atypical histological findings were found in 3.12% of the patients (papilloma, fibrolipoma). Surgical revision among all patients was 7%. Body mass index higher than 25kg/m2 was found as significant risk factors for complications (p.043), and that higher grades of gynecomastia (grade IIb and III )had higher statistical incidence of complications p= 0.01CONCLUSION:The treatment of gynecomastia requires an individualized approach. Caution must be taken in high BMI and higher grades, which are associated with increased complication rates. Histological tissue diagnosis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology.

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