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Article
Compliance Issue in Type II Diabetes: Does it Reduce the Prevalence of Cardiovascular Risk Factors?

Author: Yousif Abdul Raheem
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 125-134
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:Type 2 diabetes, which is the most common form of diabetes, has an alarming increasing rate. It is a recognized risk factor for cardiovascular disease (CVD). Non-compliance with healthy life styles, anti-diabetic drugs and diet are the central issues in patient's management as it might synergist other CVD risk factors.OBJECTIVE:The aims of this study were to find out the compliance, prevalence of CVD risk factors, and any association between them in type 2 diabetic patients.METHODS:A cross-sectional design and a convenient sample of 820 diabetic patients were used in conducting this study for the period from the 1st October, 2006 to 31st December, 2008. A Structured questionnaire was used to collect demographic information from the patients. 10 questions were used to determine the patient's compliance. The classic risk factors; obesity, hyperglycemia (HG), hypertension (HT), and hypercholesterolemia (HC), have been studied for each patient and compared with his/her compliance to find any association.RESULTS:The results of this study revealed that there were only 187 out of 820 (22.80%) with good compliance and 297 (36.22%), 336 (40.98%) patients with fair and poor compliance respectively. The prevalence of obesity, over weight, uncontrolled HG, HT (systolic, diastolic or both) and presence of HC in our diabetic patients were 27.32%, 36.83%, 51.95%, 40.73 and 30.37 respectively. Good compliance was associated significantly with normal body weight, controlled HG, absence of HT, and absence of HC.CONCLUSION:The study concluded that less than one third of our diabetic patients had good compliance. CVD risk factors are prevalent among them, and this prevalence is associated significantly with the level of compliance. Understanding the reasons behind these forms of non-compliance is an important key to the successful development of potential program to decrease the CVD risk factors and associated complications


Article
Goserelin versus Norethisterone in the Management of Menorrhagia with Uterine Fibroid

Authors: Yousif Abdul-Raheem --- Jwan N. Sulaiman --- Faris A. Rasheed
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2010 Volume: 19 Issue: 2 Pages: 54-58
Publisher: Baghdad University جامعة بغداد

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Abstract

Menorrhagia is common in patients with uterine fibroids, if operation needs to be delayed for a particular reason, goserelin can be used safely to reduce bleeding and the size of the tumor.The objective is to compare between goserelin acetate and norethisterone on patients with menorrhagia and uterine fibroid. A randomized controlled study conducted in Elwiya maternity teaching hospital, Baghdad from the first of November 2007 to the end of April 2009. 90 patients from the consultant outpatient clinic with menorrhagia and fibroid, and their operations were delayed for medical reason were allocated in two groups, the first group, was given 3.2 mg goserelin acetate subcutaneously monthly for 3 months and the second group was given 5 mg norethisterone orally three times daily during the attack of bleeding and 5 mg once daily, cyclically if no bleeding for 3 months. The fibroid was measured in two dimensions, using convex real-time ultrasound before treatment and three months after treatment. Haemoglobin and the number of pads used were also reported before and after treatment, also the side effects in both groups and the need for operations.The size of fibroid in two dimensions measurement was reduced from 28.24 cm2 ± 6.14 to 12.3 cm2 ± 3.45 in the goserelin group (P=0.0001) versus 26.56 cm2 ± 5.96 to 25.22 cm2 ± 5.01 in the norethisterone group (P= 0.2589). The haemoglobin level was 9.28 gm/100ml ± 2.44 pre-treatment in the goserelin group and 11.2 gm/100ml ± 1.88 post-treatment (P= 0.0001) versus 10.08 gm/100ml ± 2.86, and 10.24 gm/100ml ± 2.46 respectively in the norethisterone group (P= 0.7798). The need for operation was decreased significantly in the goserelin group. Goserelin showed better patient response and reduction in the tumor size than norethisterone in treatment of patients with menorrhagia and uterine fibroids if operation is delayed for medical or other reasons.

إن دواء كوزرلين ( Goserlin ) يظهر نتائج أفضل من دواء ( نوراثي ستيرون ) Norethisterone في معالجة وتقليص حجم العقد الليفية في الرحم و خاصة عند المريضات اللواتي يعانين من نزف شديد أثناء الدورة الشهرية أو هناك أسباب طبية تؤدي إلى تأجيل عملية رفع العقد الليفية جراحياً . ووجد أن إعطاء دواء ( الكوزرلين ) ) Goserlin ) لمدة 3 أشهر فعال في معالجة المريضات اللواتي يعانين من نزف شديد أثناء الدورة الشهرية بسبب وجود عقد ليفية على الرحم إذ وجد انه يقلل من شدة النزف ويرفع من نسبة الهيموكلوبين بالدم مما يقلل الحاجة إلى إعطاء دم أو اللجوء إلى التداخل الجراحي مع وجود إعراض جانبية طفيفة .


Article
Presentation and Management Outcome of Eclampsia at AlElwiya Teaching Hospital

Authors: Samar Sarsam, Thikra madlol --- Yousif Abdul Raheem, Inteasar Twaigery
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 277-281
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Eclampsia is a life-threatening complication of pregnancy for both the baby and the mother. Research isunderway to understand this complex condition and to improve the treatments that are currently used tocontrol it as it is a preventable complication of pre-eclampsia.OBJECTIVE: The study reviews the cases of eclampsia managed at Elwiya teaching Hospital with respect toincidence, management, maternal and perinatal outcome. METHODS: This prospective observational study was carried out in the department of Obstetrics and Gynaecologyat Elwiya Teaching Hospital – Baghdad-Iraq. Fifty two cases of eclamptic fits were dealt with from the1st of January till the 31st of December 2008. Pregnant patients with other convulsive disorders andmore than 7 days postpartum were excluded from the study. All the patients included were evaluated bydetailed history (taken from the attendants). Management was according to basic protocol foreclampsia; stabilization of patients, anticonvulsive therapy Magnesium sulfate, phenytoin and/ordiazepam and early delivery. A team of specialists and trained nurses were needed in the intensive careunit to deal with eclamptic mothers.RESULTS: During the year 2008, total number of deliveries from the 1INTRODUCTION: Eclampsia is one of the fatal complications of preeclampsiawhich is a multisystem disorder; itpresents a challenge to obstetricians and otherphysicians. Eclampsia is defined as seizure activityunrelated to other cerebral conditions in a pregnantwoman with pre-eclampsia. The condition wasknown to the ancient Greeks, who named it eclampsia. It has been prevalent since the time ofHippocrates; it remains an important cause ofmaternal mortality throughout the world,accounting for about 50000 deaths worldwide.Department of Obstetrics and Gynecology atElwiya Teaching Hospital – Baghdad . (1)st of January till the 31An eclamptic seizure occurs in 0.5% of mildly preeclampticpregnancies and 2% of severe preeclamptics.(2) st of December was12154, of these patients 52 presented with eclamptic fit with incidence rate of 4.28 per 1000 deliveries.The distribution of cases regarding the seasons was more in winter. 35 patients (67.31%) had poorantenatal care, 17 (32.69%) had good antenatal care. Four patients had history of eclampsia in theirprevious pregnancies. All the patients gave history of imminent eclampsia; two of them had blindnessalso; albumin in urine was negative in two cases only. Serious maternal complications occurred in28(53.84%) cases. Eight of the neonates died due to severe RDS.CONCLUSION: Eclampsia is still present and common in our locality; we need better antenatal care to predict pregnantladies liable to develop eclamptic fit in order to decrease the incidence of eclampsia complicatingpregnanc


Article
The Necessity of Teaching Diabetic Patients the

Author: *Khalid Ibrahim Al- Lehibi FRCP (Edin),**Yousif Abdul Raheem FICMS/CM ***Ibtisam Shilbah Hussein
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 136-144
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5% and the last group showed the best benefit of teaching them the correct way of injection when compared with first group (P= 0.0001). Also patient with age 20-40years showed the best results (P=0.0001), while the poorest results were observed in those aged 40 years and above.Conclusion: Teaching patients the right injection technique is important to achieve good glycemic control in those who already had poor one.Keywords: glycemic control, A1 c, injection technique.


Article
The Necessity of Teaching Diabetic Patients the Correct way of Insulin Administration: A Clinical Trial to Improve Glycemic Control

Author: *Khalid Ibrahim Al- Lehibi FRCP (Edin),**Yousif Abdul Raheem FICMS/CM ***Ibtisam Shilbah Hussein
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 2 Pages: 137-146
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5% and the last group showed the best benefit of teaching them the correct way of injection when compared with first group (P= 0.0001). Also patient with age 20-40years showed the best results (P=0.0001), while the poorest results were observed in those aged 40 years and above. Conclusion: Teaching patients the right injection technique is important to achieve good glycemic control in those who already had poor one. Keywords: glycemic control, A1 c, injection technique.


Article
Quality of Life among People Survived from Terroristic Explosions: A Retrospective Cohort Study

Author: aMohammed DJassamFIBMS(Psych.) bAhmed Abed Marzook (MSc COMM MED) Yousif Abdul raheem FICMs/CM
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 1 Pages: 56-61
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Increasing interest in quality of life (QoL) is the new approach for understanding and improvement of health care. Although there are many studies about quality of life, there is deficiency of data about quality of life of peoples survived from terroristic explosions.Objectives: To study the QoL for peoples survived from terroristic explosions and compare it with that of a controlled people. Methods: This study was conducted between, 1st of July till 31st of December 2013. The sample of this study was collected from peoples attending the outpatient clinics in four primary health care centers, Baghdad city (2 from Rusafa and 2 from Karkh). 183 individuals proved to be exposed to terroristic explosion and 199 individual not exposed to such event were recruited and Arabic version of the World Health Organization (WHO) self-reporting questionnaire (WHO-QoL-BRIEF) was used to assess the QoL.Results: This study revealed that peoples exposed to event of terroristic explosion show a serious defect in all domains of QoL (physical, psychological, social and environmental) as compared with that for non exposed peoples to such accidents in the same areas of the study.Conclusions: This study showed that peoples survived from terroristic explosions have a low QoL indicators as compared with those not exposed to such trauma .


Article
Evaluation the Effectiveness of Impregnated Net in Reducing Leishmaniasis Incidence: Diala-Iraq

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Background: Leishmaniasis is important public health problem owing to its impact on morbidity and mortality and difficulties in application of effective control measures.Objective: The aim of the study is to evaluate the using of impregnate bed nets in the control of leishmaniasis. Methods: The study was conducted throughout the years 2004 and 2005, in Diala Governorate (about 60km north-east Baghdad). This is the first study in Iraq for evaluation of the impregnated bed net in control of leishmaniasis. Two villages were selected to achieve this aim. The nets were distributed for the first village to be used by their population. The second village was served as control. Results: The results revealed that there was a significant decline in the incidence of cutaneous leishmaniasis from 19.23 per 1000 (before net distribution) to 3.34 per 1000 (after net distribution). On other hand, there was no significant difference in the incidence in the second village (control) as it was 13.42 to 12.46 per 1000.Conclusions: Impregnated bed net is effective in the reduction of leishmaniasis incidence when used properly as a control measures.


Article
Orthodontic Treatment and Temporomandibular Joint Condylar Position Relationship with Disk Displacement (Magnetic Resonance Imaging Study)

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Temporomandibular joint (TMJ) is a complex synovial articulation between the mandibular condyle and the glenoid fossa of temporal bone. The question of whether a relationship exists between orthodontic treatment, abnormal condyle and disk position, and temporomandibular disorders has been investigated for many years. Despite the abundance of studies, the question continues to trouble orthodontists.This study conducted to assess the relationship between orthodontic treatments, abnormal condyle and disk position, with temporomandibular disorders, and to study the disk- condyle relationship in term of presence or absence of anterior disk displacement. By mean of Magnetic Resonance Imaging a cross sectional investigation for the condyles of temporomandibular joints (TMJs) and disk position was conducted to 50 TMJs of 25 patients between 19-30 years of age who had undergone orthodontic treatment (by upper and lower fixed orthodontic appliances with extraction of maxillary first premolar only for treatment of class II division 1 malocclusion), and 50 TMJs of 25 patients who had not yet received orthodontic treatment from the same class and matched age group.The results of this study showed that 30% of pre-treatment group have anterior disk displacement in comparison to 26.0% of the post treatment group. The condyle position is more concentric in post treatment group than pre-treatment, and the position of the disk is not affected by orthodontic treatment. This conclude that condyle position of the TMJ may be affected by orthodontic treatment, but the disk position is not.

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