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Article
CYSTINURIA IN A GROUP OF CHILDREN IN IRAQ
السستينيوريا لدى مجموعة من الاطفال في العراق

Author: Shatha Hussain Ali شذى حسين علي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2009 Volume: 7 Issue: 2 Pages: 26-34
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Cystinuria is an autosomal recessive defect in reabsorptive transport of Cystine and dibasic amino acids. Increased urinary excretion of Cystine, the least soluble of all amino acids, results in formation of stones.Objectives: we report our experience with management of cystinuria in a group of Iraqi children. Patients and Methods: from 1999 to 2006, all children with cystinuria were evaluated, treated and followed in Al – Kadhimiya Teaching Hospital. Results: Twenty three patients with cystinuria having calculi (16 males, 7 females) were treated. Their age ranged from 10 months to 18 years. Associated hyperuricosuria was recorded in 30.5%, hypercalciuria in 13% and hyperoxaluria in 4.3%. Follow up period ranged from 1 – 88 months.Nine patients were treated with increased oral fluids and alkalis only. D–Penicillamine therapy was given to 13 patients. Side effect to penicillamine was noticed in 4 patients (22.2%). Captopril was given to 4 patients. Extracorporeal shock wave lithotripsy (ESWL) was performed in 8 patients, and 18 patients underwent open surgical procedures. The stone free rate was 55.6% with fluids and alkali alone, 58.3% with D–Penicillamine, 0% with Captopril and 50% with ESWL. Combined treatments were required in 45% of patients. Stone recurrence rate was 70%. Conclusion: Oral fluids and alkali was most successful when used in patients with mild disease. D–Penicillamine and ESWL had nearly equal rate of successful results. Keywords: cystinuria, chlidren, calculi, urolithiasis

خلفية الدراسة : السستينيوريا مرض وراثي بصفة متنحية ناتج عن خلل في امتصاص الاحماض الامينية الثنائية. زيادة افراز السستين في الادرارلانه الاقل ذوبانا يؤدي الى تكوين الحصى. هدف الدراسة: نقدم تجربتنا في معالجة السستينيوريا لدى مجموعة من الاطفال في العراق. طريقة العمل: من 1999 لغاية 2006 , تم تقييم ومعالجة ومتابعة كل الاطفال المصابين بالسستينيوريا في مستشفى الكاظمية التعليمي. النتائــج: كان عدد المرضى المعالجين 23 (16 ذكر, 7 اناث). تراوح معدل العمر من 10 شهور الى 18 سنة . ظهرازدياد أفراز اليورات في 30.5% , أزدياد أفراز الكالسيوم في 13% , وأزدياد افراز الاوكسالات في 4.3% من المرضى. المدى الزمني لمتابعة المرضى 1 – 88 شهر.تسعة مرضى عولجوا بزيادة السوائل والقلويات فقط . تم استعمال عقار البنسلامين في 12 مريض. الاعراض الجانبية للبنسلامين ظهرت لدى 4 مرضى ( 22.2%) . أعطي عقار الكابتوبريل لاربعة مرضى . تم استعمال تفتيت الحصى في 8 مرضى و 18 مريضا أجريت لهم العمليات الجراحية . معدل الخلو من الحصى كان 55.6% مع السوائل والقلويات , 58.3% مع البنسلامين , 0% مع الكابتوبريل و 50% مع التفتيت .وجدت الحاجة للعلاج الائتلافي في 45% من المرضى . كان معدل رجوع الحصى 70% .الاستنتـاج: السوائل والقلويات اكثر نجاحا في حالة استعمالها في الحالات البسيطة. نتائج العلاج الناجح كانت متساوية حين استعمال البنسلامين والتفتيت . مفتاح الكلمات: السستينيوريا, الاطفال, الحصى, حصى المجاري البولية


Article
Outcome of Neonatal Jaundice In ABO Incompatible Pregnancies

Authors: Shatha Hussain Ali --- Kamal Ismail Mashallah --- lamia Abdul Karrim
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 680-687
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Blood group mismatch between the mother and newborn carries substantial risk for neonatal jaundice OBJECTIVE: To study the outcome of neonatal jaundice due to ABO hemolytic disease of the newborn (ABO HDN) and study the relation of epidemiological risk factors and laboratory findings with it´s severity. PATIENTS AND METHODS: In this prospective study, 64 neonates with neonatal jaundice associated with ABO incompatibility were studies. Cases of ABO HDN were diagnosed as those with anemia, reticulocytosis and spherocytes or polychromasia on blood film with or without positive direct Coombs test. Severity of jaundice was regarded according to the type of treatment (phototherapy or exchange transfusion).RESULTS: Forty two patients (65.6%) were males, 46 patients (71.9%) were full term infants, 6 patients (9.4%) had family history of neonatal jaundice treated by exchange transfusion.Only 9 patients (14.1%) presented with TSB level ≥ 20 mg/dl, 8 patients (12.2% ) had PCV level < 45%, 8 patient (12.5%) had reticulocyte count ≥ 5%. Direct Coombs test was negative in all the patients. Twelve patients (18.8%) had abnormal blood film findings . Eight cases (12.5%) had the features of ABO HDN and represented 2.9% from the total admitted cases of neonatal jaundice.Full term babies, positive family history of exchange transfusion, abnormal blood film findings and reticulocyte count were found as significant risk factors for the severity of the jaundice, while gender, body weight, blood group, mode of delivery and parity of the mothers had no significant effect on the severity of the jaundice.CONCLUSION: Not all the cases of ABO incompatibility developed ABO HDN, so laboratory confirmation is required.


Article
Outcome of Vascular Access in Pediatric Haemodialysis of Baghdad Hospitals

Authors: Shatha Hussain Ali --- Ali Sadiq Hassan --- Alaa Kassar Salih
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 435 -444
Publisher: Babylon University جامعة بابل

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Abstract

Vascular access is the ability to enter the vascular system. Three types of vascular access are used: arteriovenous fistula (AVF), arteriovenous grafts (AVG) and central venous catheters (CVC) as permanent or temporary. The Aims of this study are to study the number of each type of vascular accesses,correlationwith some demographic data,complications, survival time and correlation with dialysis adequacy.This is retrospective study based on 55 pediatric patients with CRF receiving maintenance HD in four pediatric HD centers in Baghdad from 1stMarch 2013 till end of March 2014. As for Central venous catheters (CVC), we investigated: number of catheters inserted, insertion site; survival time and; and complications.As for arteriovenous fistula (AVF), we investigated: the number of failed and patent AVF, survival time and the complications.Adequacy of dialysis (Kt/V and URR) was calculated.There was 172 HD vascular accesses in 55 patients; 38 (69.1%) were males and 17 (30.9%) were females. Mean age was 11.9 years.TDL was the commonest VA among patients below 20 Kg (40%), while PDL was commonest among patients with 20 – 30 Kg and above 30 Kg body weight (41.2%) and (47.8%) respectively. For 120 patients (69.8%) temporary dual lumen (TDL) were inserted, and for 27 patients (15.7%) AVF, and for 25 (14.5%) permanent tunneled dual lumen (PDL).Majority of TDL were inserted in right internal jugular veins in 42.98%, and left internal jugular veins in 35.54%. Infection and thrombosis are commonest complications observed in both dual lumen (41.9%, 27.9%),) and AVF (33.3%, 30.1%). Six out of 27 AVF failed to mature (22.2%), Survival time of AVF was 456.3±80.1 days which is more than that of PDL (187.2±36.3 days) and TDL (132.3±1.13 days).Adequate dialysis was seen in 50% of patients dialyzed by AVF, in 26.7% with PDL and in 23.3% with TDL.CVC are the main type of VA used. Infection and thrombosis are the most common complication. AVF provide longer survival time than CVC.


Article
Spectrum of Congenital Anomalies of the Kidney and Urinary Tract in Children

Author: Shatha Hussain Ali*, Ahmed Zuhair Jaffar**, Ali Sadi Salih***, Qahtan Mohammed Ali****
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 291-296
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Congenital anomalies of the kidney and urinary tract comprise a wide range of structural malformations that result from defects in the morphogenesis of the kidney and/or urinary tract OBJECTIVE :Study the types of renal anomalies. Study their clinical presentations, age of presentation, way of diagnosis, and complications.PATIENTS AND METHODS: A descriptive study was conducted from 1st January 2015 till 1st January 2016. Patients were collected from 4 pediatric nephrology centers. Data included: age of diagnosis, type of renal anomaly, radiological methods of diagnosis, clinical presentation and associated complications, family history of congenital anomalies and consanguinity.Thorough physical examination was done to all children. Investigations send were Blood urea, Serum creatinine , urinalysis, urine culture, imaging study were documented.RESULTS:In this study 160 patients were included. Males were more affected than females 1.54:1. Most of the patients diagnosed at >1- ≤ 5 age group, 78 patients (48.8%). Most of the patients had negative family history, 124 (77.5%), and most of their parents were not consanguine (58.1%). Vesicoureteral reflux (VUR) was the commonest anomaly detected in 67 patients (41.9%), followed by Renal agenesis in 24 patients (15.0%). Abdominal Ultrasound was the commonest radiological method used for diagnosis in 152patients (95.0%), followed by voiding cystourethrogram (VCUG) in 80 patients (50.0%). Urinary symptoms were most common presentation in 93patients (58.1%). A higher complication was UTI (62.5%).CONCLUSION: The commonest renal anomaly was VUR, followed by Renal agenesis, then PUJ, These renal anomalies were mostly diagnosed at >1-≤ 5 age group. Males exceeded the number of females, and the majority of patients were diagnosed initially by ultrasoundMost common presentation was urinary symptoms. The most prominent complication was UTI.


Article
Prophylactic Effects of Melatonin in Lead Induced Toxicity in Rats

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Abstract

Exposure to lead results in significant accumulation in most of vital organs, and free radical damage has been proposed as a cause of lead-inducedtissue damage where oxidative stress is a likely molecular mechanism. This study is designed to evaluate therapeutic effects melatonin in lead-inducedorgans toxicity in rats. Evaluation of melatonin in this respect was conducted in a rat model of lead-induced toxicity. All test groups here were challenged with subcutaneousinjections of 100mg/kg lead acetate daily for one month. Melatonin in a dose of 20 mg/kg was administered intraperotoneal as adjunct treatment with leadacetate. The changes in total body weight, weight of major organs (brain, liver and kidney), oxidative stress parameters, hemoglobin content, liver and renal functions, and histological appearance of the studied organs were evaluated and compared with that of negative and positive controls. In addition, melatonin has the ability to reverse the damage induced by lead in many organs and tissues through the reduction of MDA levels in RBCs, brain, liver and kidney; and the increase in GSH levels in all studied organs; in addition to the improvement in the indices of the functions of the organs studied.These findings demonstrate that melatonin capable of preventing damage of rat tissues caused by successive doses of lead acetate, and also demonstratethat these animals had restored their organ functions due to treatment with melatonin.

الخلاصة:یؤدي التعرض الى الرصاص الى تجمع كمیات كبیرة منه في معظم الاعضاء الحیویة للجسمولقد تم افتراض نظریة الضرر الذي تسببه الجذور الحرة كسبب وراء تلف الانسجة نتیجة التعرضللرصاص حیث تكون حالة فرط الأكسدة هي المیكانیكیة المتوقعه لمثل هذا التأثیر.تم تصمیم هذه الدراسة لتقییم التأثیر الوقائي للمیلاتونین في حالات تسمم الأعضاء المستحثةبواسطة الرصاص في الجرذان. تم تقییم تأثیر المیلاتونین بهذا الخصوص على نموذج للتسمم الناتج منالتعرض للرصاص في الجرذان. تم تعریض مجامیع الحیوانات التي تمت دراستها الى جرعة یومیةمقدارها 100 ملغم /كغم من مادة خلات الرصاص تحت الجلد لمدة شهر واحد.تم أستخدام 20 ملغم /كغم من مادة المیلاتونین عن طریق البریتون اما كعلاج مصاحب للتعرضللرصاص(وقائي).تمت متابعة التغیرات الحاصلة في وزن جسم الحیوان، أوزان الأعضاء الحیویة الرئیسیة مثلالدماغ والكبد والكلیة، معاییر فرط الأكسدة، محتوى الدم من الهیموغلوبین، فعالیة الكبد والكلیتین أضافةألى التغییرات النسیجیة التي طرأت على الأعضاء التي تمت دراستها مقارنة مع المجموعة القیاسیة(السلبیة أوالایجابیة). أظهرت النتائج بأن المیلاتونین یقي جسم الجرذان ضد الضررالذي تسببه عملیةالتأكسد المفرط نتیجة التعرض الى الرصاص من خلال تقلیل مستویات المالوندیالدیهاید في الكریات الدمالحمراء، الدماغ، الكبد والكلیة أضافة الى زیادة مستویات الكلوتوثایون في الأعضاء والأنسجة التي تمتدراستها؛ بالأضافة الى تحسن وظائف الأعضاء التي تمت دراستها ؛ بالأضافة الى تحسن وظائفالأعضاء التي تمت دراستها .یمكن الأستنتاج من هذه النتائج أن المیلاتونین له القابلیة على منع الضرر النسیجي نتیجةللتعرض الى جرع متعاقبة من خلات الرصاص وأن الحیوانات المختبریة لها القدرة على أستعادة فعالیةأعضاءها الحیویة نتیجة للعلاج بالمیلاتونین بعد التعرض للرصاص.Abstract

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