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Article
Diagnostic Value of C - Reactive Protein and Other Hematological Parameters in Neonatal Sepsis

Authors: Hafadh Jaleel Hussein --- Yusra Fayyadh Alwan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 370-375
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:There have been many attempts to develop screening tests or scoring systems that can identify infected infants at the time of initial assessment, sparing others from invasive diagnostic procedures, intravenous antibiotics therapy, mother-infant separation and parental anxiety.OBJECTIVE:Is to analyze hematological parameters and C - reactive protein so as to evaluate their diagnostic value in neonatal sepsis.PATIENTS AND METHODS:A cross-sectional study was performed in the neonatal care unit (N.C.U) at the Central Teaching Hospital for Pediatrics and Al-Habibiya Maternity and Children Teaching Hospital during a period from the first of June 2005 to the first of January2006One hundred neonates having clinical features of sepsis and 100 normal asymptomatic neonates were evaluated with a set of investigations including C-reactive protein(CRP), White Blood cellsCount(WBC), Absolute Neutrophil count (ANC), Platelets count (thrombocytopenia), Immature to Total neutrophil ratio (I/T ratio) and Erythrocyte Sedimentation Rate (ESR) to diagnose neonatal sepsis.RESULTS:C-reactive protein (CRP) was positive in (82.4%) of group-A and (81.8%) of group-B and had a specificity of 93.0%. ANC was the second most sensitive test having sensitivity of 61.8% for group-A and 48.5% for group-B and specificity of 86.0%.The sensitivities of platelets count (thrombocytopenia), WBC, I/T ratio and ESR for group-A were: 55.9%, 29.4%, 17.6% and 26.5% respectively, with specificities of 91.0%,89.0%, 92.0% and 81.0% respectively. While group-B had sensitivities of 42.0%, 33.3%,15.2% and 22.7% respectively with specificities of 91.0%, 89.0%, 92.0% and 81.0%respective ly.CONCLUSION:The implementation of CRP and other hematological parameters (ANC, Platelets count and WBCs) are useful in early detection of neonatal sepsis and diagnosis of neonatal sepsis in those who have false negative blood cultures


Article
A retrospective Study of Testicular Relapse in Acute Lymphoblastic Leukemia

Authors: Ali Jameel Ahmed --- Hafadh Jaleel Hussein --- Yusra Fayyadh Alwan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 4 Pages: 511-518
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Testicular relapse in ALL usually appear as painless testicular enlargement mostly unilateral. Diagnosed by wedge biopsy. The testis is a frequent site of relapse.OBJECTIVE:To find out the incidence of testicular relapse in ALL, time of diagnosis of testicular relapse, age group more commonly associated with testicular relapse, the association of testicular relapse with other relapses (medullary or extra-medullary), and prognosis of patients with testicular relapse.PATIENTS AND METHODS:Aretrospective study in the central teaching hospital of children in Baghdad- unit of hematology and oncology, during January 2000 – December 2006.Two hundred-four males were studied retrospectively. Informations were obtained from patients' files.RESULTS:The incidence of testicular relapse was in 18 patients represented (8.8%) of total cases of boys with ALL below 15 years. Relapse is mainly unilateral in 15 patients (83.3%) and mostly in the right side in 11 patients (61.1%) of total cases with testicular relapse.There is no significant statistical incidence of relapse with the age of patient represented by 2 cases (6.2%) from (0-2 years), 11 cases (8.2%) from (2-10 years), and 5 cases (13%) more than (10 years). Time of diagnosis of relapse was mainly during the oral maintenance therapy (13) patients (72.5%). Testicular relapse was isolated in 8 patients (44%) and combined with other relapses in 10 patients (56%) of them 7 patients (39%) with bone marrow relapse and 3 patients (17%) with CNS relapse.The outcome of patients with testicular relapse was better after discontinuation of chemotherapy “after three years of treatment” (2 cases diagnosed with relapse both of them still alive) represented (100%), while during the maintenance therapy of 13 patients, 6 (46.2%) of them still alive, 6 patients (46.2%) of them died, and 1 patient (7.6%) with no report, while induction chemotherapy 2 cases 1 (50%) alive and 1 (50%) died). Patients with isolated testicular relapse had better outcome represented by 6 patients (75%) still alive and 2 patients (25%) died, patients with combined relapse had worse outcome, represented by 3 patients (30%) alive, 5 patients (50%) died, and 2 patients (20%) with no report.Incidence of testicular relapse significantly decreased after the introduction of more intensive chemotherapy in Jan 2004 from 9.8% to 3.1%.CONCLUSION:Incidence of testicular relapse decrease with introduction of intensive chemotherapy and had higher incidence during the maintenance therapy, associated with increased incidence with other medullary and extra-medullary relapses, and has better prognosis when it is late and isolated than for early and combined relapse


Article
Risk Factors for Recurrent Febrile Convulsions in Children
عوامل الخطورة للاختلاجات الحرارية المتكررة عند الاطفال

Author: Yusra Fayyadh Alwan (FIBMS) a *Hafadh Jaleel Hussein (FIBMS) د. يسرى فياض علوان
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2013 Volume: 9 Issue: 2 Pages: 14-16
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Febrile convulsions are the most frequent type of seizures in children under 6 years of age. Significant percentage of these children will later suffer from recurrence of febrile convulsion.Objectives: To identify the main risk factors for recurrent febrile convulsions in children.Methods: we carried out a case control study involving 89 children those who experienced first attack of febrile convulsions and 92 children with recurrent attack of febrile convulsions. The study was conducted in Central Children Teaching Hospital, Baghdad during the period 2006- 2007. Results: Compared to children with first attack of febrile convulsion, children with recurrent seizures were younger at onset (4- 12m) (67% vs. 44%), mainly male (70% vs. 51%) and had more often family history (first degree relative) history of epilepsy, low degree of temperature (45% vs. 23%) and frequent febrile illnesses (83% vs. 50%). second degree family history of febrile convulsion and onset of febrile convulsion in relation to onset of fever and type of convulsion (simple vs. complex) were not significant risk factors.Conclusions: Awareness of these risk factors should lead pediatricians to suggest administration of short course of diazepam at onset of each febrile illness to prevent recurrent febrile convulsions. Also, public education on recurrent febrile convulsions is needed.

الخلاصةالاختلاجات الحرارية هي أكثر أنواع الاختلاجات في الأطفال الذين تقل أعمارهم عن6 سنوات. هدفنا من هذه الدراسة هو بيان العوامل الرئيسية التي تلعب دورا" في تكرار الاختلاجات الحرارية. أجريت هذه الدراسة الاستطلاعية في مستشفى الطفل المركزي في بغداد للفترة من الأول من كانون الثاني 2006 لغاية كانون الثاني 2007 . ضمت الدراسة 181 طفلا" يعاني من اختلاجات حرارية أعمارهم تتراوح ما بين 4 اشهر إلى 6 سنوات، 92 طفل يعاني من اختلاجات حرارية متكررة ( 2 أو أكثر ) و 89 طفل يعاني من اختلاج حراري واحد فقط ( العينة المقارنة ) . تم اعتماد عوامل الخطورة التالية: العمر الحالي للمريض والعمر الذي بدأ به أول اختلاج حراري ، الجنس ، عدد مرات الاختلاجات الحرارية ، وجود تاريخ عائلي ( قرابة من الدرجة الأولى أو الثانية ) للاختلاجات الحرارية أو الصرع، نوع الاختلاج الحراري بسيط أو معقد، درجة الحرارة والوقت الفاصل بين ارتفاع الحرارة وحدوث الاختلاج، عدد مرات حدوث الإمراض المصاحبة بارتفاع درجة الحرارة خلال السنة.الاستنتاج :العوامل التي تؤدي الى زيادة خطر تكرار الاختلاجات الحرارية هي :عمر الطفل اقل من 12 شهر عند حدوث أول اختلاج حراري, جنس الطفل الذكور أكثر من الإناث, وجود تاريخ عائلي للاختلاجات الحرارية, درجة حرارة الطفل عند حدوث الاختلاج الحراري ( اقل من 39 ), تكرار حدوث الإمراض المصاحبة بارتفاع درجة الحرارة خلال السنة, وجود تاريخ عائلي للصرع. بينما وجود اختلاجات حرارية في الأقرباء من الدرجة الثانية في تاريخ العائلة والوقت الفاصل بين ارتفاع درجة الحرارة وحدوث الاختلاج الحراري تعتبر عوامل غير مهمة.


Article
The Immediate And Intermediate Results Of Percutaneous Balloon Aortic Valvuloplasty In Patients With Congenital Valvular Aortic Stenosis
النتائج الأولية والمتوسطة المدى لعملية توسيع الصمام الابهري بواسطة البالون القسطاري للمرضى المصابين بتضييق الصمام الابهري الولادي

Author: Hussein A. Alwahab *, Hassan Yousif Al- Najjar**, Husam Thaaban Al-Zuhairi***, Yusra Fayyadh Alwan****
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2017 Volume: 13 Issue: 2 Pages: 54-59
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Aortic valve stenosis results from minor to severe degrees of aortic valve maldevelopment. This stenosis causes mild to severe obstruction of the left ventricular outflow .Objectives : to study the immediate and intermediate results of percutaneous balloon aortic valvuloplasty in patients with congenital valvular aortic stenosis .Type of the study: A prospective study.Methods: The study was done on thirty five patients with congenital valvular aortic stenosis who had percutaneous balloon aortic valvuloplasty in Ibn Al- Bitar Center for Cardiac Surgery from May 2009 to February 2011. Results: Twenty seven patients were male (77.2%) and 8 patients were female (22.8%), male to female ratio 3.5/ 1, . The aortic valve was bicuspid in 18 patients (51.4%) while 17 patients ( 48.6%) had tricuspid aortic valve. Balloon aortic valvuloplasty was successful in 30 patients (85.7%),. Maximum peak instantaneous Doppler pressure gradient across the aortic valve 24 hours postprocedural echocardiography showed reduction which is statistically significant. New aortic regurgitation had occurred in 15 patients ( 42.8%), it was mild in 9 patients ( 25.6%), moderate in 5 patients ( 14.3%) and severe in 1 patient( 2.9%) which is statistically significant. The follow up of 12.57 ± 3.88 ( 3- 22) months after intervention was done for all patients using echocardiography Doppler study, reveal the maximum peak instantaneous Doppler pressure gradient across the aortic valve was raised which is statistically significant. The aortic regurgitation was present in 18 patients (51.4%) , it was mild in 9 patients (25.7%) , moderate in 6 patients (17.1%) and severe in 3 patients ( 8.6%). No mortality had been reported during the procedure or on follow up. Conclusion: Aortic balloon valvuloplasty is safe and effective procedure in the treatment of congenital valvular aortic stenosis but mild aortic regurgitation is the most common immediate complication of aortic balloon dilatation and progressive aortic regurgitation is a major problem during the intermediate follow up.

هدف الدراسة : بيان الفائدة الأولية والمتوسطة المدى لعملية توسيع الصمام الابهري بالبالون بواسطة القسطرة عن طريق الجلد لعلاج تضيق الصمام الابهري الولادي .المرضى وهيكل الدراسة : خمسة وثلاثون مريض مصاب تضيق الصمام الابهري الولادي أجريت لهم عملية توسيع الصمام الابهري بالبالون بواسطة القسطرة عن طريق الجلد في مركز ابن البيطار لجراحة القلب من شهر أيار عام 2009 لغاية شهر شباط عام 2011 .النتائج : وجد أن (27) مريض كانوا ذكورا (77.2%) و (8) كانوا إناثا (22.8%) بنسبة (1:3.5) .الصمام الابهري كان ثنائي الوريقات في (18) مريضا وثلاثي الوريقات في (17) مريضا . عملية توسيع الصمام الابهري بالبالون كانت ناجحة في (30) مريضا (85.7%) .فرق الضغط التقلصي القمي خلال الصمام الابهري بعد عملية توسيع الصمام أظهر انخفاضا وكذلك ضغط البطين الأيسر التقلصي أظهر انخفاضا وكلاهما ذات أهمية إحصائياً . الضغط الآني القمي الأعلى مقاسا بأيكودوبلر خلال الصمام الأبهري 24 ساعة بعد توسيع الصمام اظهر انخفاض في الضغط وهو ذو أهمية إحصائيه .تسريب جديد في الصمام الابهري حدث في (15) مريضا (42.8%) ، وكان بسيطا في (9) مرضى (25.6%) متوسط الشدة في (5) مرضى (14.3%) وشديد في مريض واحد (2.9%) وهي ذات أهمية إحصائيا . خلال متابعة المرضى عن طريق فحص الايكو لفترة 12.57 ± 3.88 (3-22) شهر بعد عملية توسيع الصمام الابهري فرق الضغط الآني القمي الأعلى خلال الصمام الابهري ارتفع وتسريب الصمام الابهري كان موجودا في (18) مريضا (51.4%) وهو بسيط في (9) مرضى (25.7%) ومتوسط الشدة في (6) مرضى (17.1%) وشديد في (3) مرضى (8.6%) . الاستنتاجات : عملية توسيع الصمام الأبهري بالبالون فعاله وأمينة في علاج تضيق الصمام الأبهري الولادي لكن حدوث تسريب بسيط في الصمام الأبهري هو أكثر المضاعفات الأولية لعملية توسيع الصمام وتزايد نسبة تسريب الصمام يشكل أهم المضاعفات خلال المتابعة المتوسطة المدى .

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