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Article
Study of visceral leishmaniasis (kala-azar) in children of Iraq

Author: Sadiq M. Al-Hamash
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 2 Pages: 15-19
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Leishmaniasis is a parasitic disease caused by a Leishmaniaspecies, transmitted to humans through bites of female sand fly and isendemic in Iraq.Aims: To study the epidemiological, clinical, diagnostic and therapeuticaspects of visceral leishmaniasis in Iraqi children.Patients and Methods: This was a retrospective study done on patientswith Kala-azar admitted to Welfare Child Hospital-Medical City fromOctober 2004 to September 2005. The diagnosis was based onserological test and/or bone marrow exam. For each patient thefollowing data were reviewed: age, sex, time of admission, signs,symptoms, laboratory investigations and treatments.Results: A total of 50 visceral leishmaniasis cases were included. Allpatients were in the age range 0-10 years. Most cases occur in winter70%. Fever was recorded in 100%, splenomegaly in 92%, hepatomegaly in80%, and pallor in 70% of cases. Concomitant conditions were frequent:34% of cases had cough; jaundice was present in 26%; diarrhea in 18%;vomiting in 12% whereas lymphadenopathy was present only in 1% ofcases. Sodium stibogluconate (pentostam) was most often prescribedmedication (86% of cases) while miltefosine was less prescribed (14% ofcases).Conclusions: in Iraq, kala-azar should be suspected in any patient withprolonged fever and/or hepatosplenomegaly with pancytopeniawhereas in case of presence of lymphadenopathy the kala-azar would bethe last possible differential diagnosis. Also Pentostam remains the mostcommon prescribed medication for kala-azar in our country.


Article
THE CATHETERIZATION AND ANGIOGRAPHIC VARIATIONS IN IRAQI PATIENTS WITH TETRALOGY OF FALLOT

Author: Sadiq M. Al-Hamash صادق الهماش
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2005 Volume: 47 Issue: 1 Pages: 28-34
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease and the catheterization and angiography still considered (in most centers) as essential preoperative diagnostic step. This retrospective aimed at evaluating the catheterization and angiographic finding in our Iraqi patients with diagnosis of TOFPatients and methods: The catheterization and angiographic study of200 patients with TOF-' referred to Ibn Al-Bitar Cardiac Center had been reviewed.Results: There were 126 males and 74 females and their ages ranged from 11 months to 37 years. The catheterization data showed that 88% of the patients had equal LV and RV pressure. The evaluation of pulmonary artery pressure showed that all patients had normal pressure. The review of angiographic studies revealed that the perimembraneous VSDs were the most common type (91%> of the patients). 13 patients (6.5%) had coronary anomalies, and the patent ductus arteriosus is the most common associated anomalies.Conclusion: The frequency of doubly committed VSD and single coronary artery were higher than other studies and we showed there was no indication to measure the pulmonary artery pressure during catheterization.

Keywords

TOF --- Catheterization --- Angiography.


Article
Electro Cardiographic Features of PtientsWith Tetralogy of Fallot

Authors: Dhia’a Hassan --- Fadhil Al-Rubaiy --- Sadiq M. Al-Hamash
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 19-22
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: For many decades, the ECG was the workhorse of non-invasive cardiac test and today although other techniques provide more details about the structural anomalies in congenital heart diseases, ECG is likely to be part of clinical evaluation of patients with such diseases because it is inexpensive, easy to perform and in certain situations may be both sensitive and specific.
Objective: this study carried out to identify the pattern of ECG study in patients with TOF.
Methods: this is a retrospective study of 200 patients with TOF, referred to Ibn Al-Bitar cardiac center from April 1993 to May 1999. The diagnosis of TOF established by echocrdiographic, catheterization and angiographic study. For each patient, the ECG tracing had been analyzed for rhythm, p-wave, P-R interval, QRS axis, duration and T-wave in V1 and any chamber enlargement.
Results: The ECG analysis revealed that all patients had sinus rhythm, normal P-R interval and normal p-wave duration and amplitude, and normal QRS duration. All studied patients had one criteria of RVH and 95% of them had two or more of such criteria.
Conclusion: we found that in the absence of RVH criteria, the diagnosis of TOF is unlikely and the present of northwest axis should indicate canal type VSD.
Key words: ECG, TOF, congenital heart disease

Keywords

ECG --- TOF --- congenital heart disease


Article
Clinical Features Of Iraqi Patients WithTetralogy Of Fallot

Authors: Muthana H. Al-Quraishi --- Zuhair Al-Nasiry --- Sadiq M. Al-Hamash
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 4 Pages: 374-377
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Tetralogy of Fallot is the most common cyanotic congenital heart disease which represents about 8-10% of all congenital heart diseases. It is characterized by four morphological features, large malalignment ventricular septal defect, Pulmonary stenosis, Overriding of aorta, and Right ventricular hypertrophy. The infant with TOF does well for the first few months of life with minimal or no cyanosis. The cyanosis begins to increase with secondary slow increase in polycythemia as well. Hypercyanotic spells are the most common complicating features of TOF
Patients and methods: This is a retrospective study of 200 patients with Tetralogy of Fallot (TOF) referred to Ibn Al-Bitar Center for Cardiac surgery from April 1993 to May 1999. The diagnosis was established by echocardiography, catheterization and angiographic study. For each patient, clinical history, physical examination, O2 saturation and hematocrit level had been reviewed.
Results: The patients' ages ranged from 11 months to 37 years. The weight of 42 patients (22%) and the height of 38 patients (20.5%) were below 3rd centile. There were 60 patients (30%) were polycythemic (hematocrit above 65%). Only 7 patients (14%) had low cyanosis (pink TOF) and one third of the patients had history of hypercyanotic spells. The CNS complications were the most common complications.
Conclusions: The study revealed that most of our patients had been delayed in their presentation for proper medical and surgical management. The study showed that most of TOF patients had normal growth pattern and the most important factor affecting the growth was the level of oxygen desaturation and we found high incidence of both infective endocarditis and CNS complications.

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