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Article
Abdominal Transperitonial Approach in Management of Vesicovaginal Fistula in Iraqi Patients

Author: Mohammed Jabbar AL-Rubai
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 238-241
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Vesicovaginal fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina In addition to the medical sequel; they often have a profound effect on the patient's emotional well-being and social life. OBJECTIVE: Is to evaluate success of abdominal approach in treating vesicovaginal fistula in Iraqi patients. METHODS: Retrospective comparative study was carried out on fourteen Iraqi patients suffering from vesicoveginal fistula according to inclusion criteria and followed for 3-12 months after tranabdominal repair with omental interposition flap. RESULTS: Twelve (85%) patients have obstetrical causes while two (15%) patients have gynecological causes. Eight (75%) patients aged between 21-30 years while six (43%) patients aged between 31-45 years. Eight (57%) patients are primigravidae. Site of fistula either spratrigonal[seven cases (50%)] or infratrigonal [seven cases (50%)]. Only one of infratrigonal fistula is close to ureteric orifice. Size of fistula either <1cm [seven cases (50%)] or between 1-2 cm [five cases (36%)] or between 2.1-3 cm [two cases (14%)]. Twelvecases (85%) have correct repair. CONCLUSION: The results of suprapubic closure of a vesicovaginal fistula are very good


Article
Desmoid tumors of the abdominal wall:Two cases report

Author: Adel M. Al-Rekabi عادل موسى الركابي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2008 Volume: 4 Issue: 6 Pages: 151-155
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential.We report on two female patients with desmoid tumor of the abdominal wall who underwent primary resection and proline mesh repair. Both patients had a history of an earlier abdominal surgery. Preoperative evaluation included abdominal ultrasound,and computed tomography. The histology in both cases revealed a desmoid tumor.Complete surgical resection and proline mesh repair is the first line management of this tumor entity.

اورام الدسمويد هي اورام بطيئة النمو مع ميل شديد نحو اختراق الانسجة المجاورة ولكنها لا تمتلك اية قوة انتشار.تم تسجيل حالتين من الاصابة بورم الدسمويد وهي لمريضتين سبق وان اجريت لهما عمليات فتح بطن(قيصرية)وكان الورم في كلتا الحالتين في جدار البطن عند الجرح القديم المندمل.اجريت فحوصات الامواج فوق الصوتية والمفراس ثم اجريت لهما عملية رفع الورم من جدار البطن مع رفع كامل للتليفات المصاحبة في الجرح السابق بغية منع الانتشار الموضعي للورم وبعدئذ رتقت الهوة المتخلفة في جدار البطن بشبكة من البرولين الصناعي.اثبثت الفحوصات النسيجية الاصابة بورم الدسمويد.

Keywords

Desmoid --- abdominal wall --- surgery


Article
Relationship between the eating out home and infection with Giardiasis

Author: Atheer Kadhim Ibadi Zeid
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2012 Volume: 2 Issue: 1 Pages: 7-14
Publisher: University of Kufa جامعة الكوفة

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Abstract

Abstract This study carried out in primary health care center of Muslim Ibn Akeel , in al-Kufa town –Al –Najaf Al- ashraf province from 2/1/2010 to 1/1/2011.The study aims to determine the causes of abdominal pain and repeated diarrhoea in adult males only who were eating outdoor, 33 persons of them were diagnosed as an irritable bowel syndrome. The total number of cases was 150 patients. This study had done in a large area with low-income , poor water, food hygiene, swallowing water (such as from a swimming pool, lake, river, pond, or stream) contaminated with sewage or stool from Giardia-infected people or animals and sanitation are common in communities with repeated diarrhea. These factors combine to facilitate the spread of enteropathogen including, precoded questionnaires with demographic details, clinical history, and physical signs were completed. In this study ; 150 samples of stools were collected for routinely general stool examination. The results were showing high rates of G. lamblia 84.7% , followed by motile monilia, motile bacteria, Ent.Histolytica, Enterobious vermicularis, E. coli, , H.nana & others. The study showed that the highest percentage of infected persons occurs in age group of 25-29 years and lowest in 40-44 years, also highest percentage occurs in the persons who were eating three times daily and in summer more than in other seasons.Only 30 patients 20% were with negative stool examination. This study recommended by practice good hygiene in day care centers, retirement homes, and at home to prevent the spread of infection, wash hands frequently with soap and water for at least 15 seconds, avoid contact with the feces of an infected person, when traveling in areas where giardiasis is common, infection with Giardiasis can be prevented by using only bottled water and avoiding consumption of raw fruits , vegetables and do not use untreated water in areas where the parasite might be present, such as lakes, rivers and streams. Boil the water for at least one minute before using it.

أجريت هذه الدراسة في مركز الرعاية الصحية الأولية (مسلم بن عقيل في الكوفة, محافظة النجف الأشرف) للفترة من 2010/02/01 إلى 2011/01/01. كانت الدراسة تهدف إلى تحديد أسباب آلام البطن والإسهال المتكرر في الذكور البالغين الذين كانوا يتناولون الطعام خارج بيوتهم فقط، 33 شخصا منهم مصابون بمتلازمة القولون المتهيج. وكان العدد الإجمالي للحالات 150 مريضا. وقد أظهرت هذه الدراسة التي أجريت في منطقة كبيرة تمتاز بانخفاض الدخل وقلة الإصحاح المائي و الغذائي، إن ابتلاع ا لماء(في المسابح و البحيرات و الأنهر, الراكدة و الجارية) الملوثة بمياه المجاري و فضلات الإنسان و الحيوانات والصرف الصحي و هي من الأمور الشائعة في المجتمعات التي ينتشر فيها الإسهال المتكرر. وكانت هذه العوامل تتضافر لتسهيل انتشار المسببات المرضية المعوية، بما في ذلك استكمال الاستبيانات المطلوبة مع التفاصيل الديموغرافية، والتاريخ السريري، والعلامات الفسيولوجية. تم جمع 150 عينة من براز الأشخاص المصابين لإجراء فحص البراز العام الروتيني. أظهرت هذه الدراسة ارتفاع معدلات الإصابة بالجياريا اللمبلية 84.7%، تليها المونيليا المتحركة، البكتيريا المتحركة، الطفيليات ألحاله للنسيج،الديدان الدبوسية , اشريشية القولونية، الدودة القزمة وغيرها. كما أظهرت نتائج هذه الدراسة أن أعلى نسبة من الأشخاص المصابين تحدث في الفئة العمرية من 25-29 سنة و 40-44 سنة هي ألأدنى، كما أن أعلى نسبة مئوية تحدث في الأشخاص الذين يتناولون ثلاثة مرات يوميا و في الصيف أكثر مما كان عليه في المواسم ألأخرى.فقط 30 شخصا20% كان فحص خروجهم سالبا. توصي هذه الدراسة بممارسات النظافة الجيدة في مراكز الرعاية النهارية، ودور المسنين، والمنزل لمنع انتشار العدوى, غسل الأيدي بشكل متكرر بالماء والصابون لمدة لا تقل عن 15 ثانية, تجنب التماس مع براز الشخص المصاب,كما يمكن الوقاية عند السفر إلى المناطق التي ينتشر بها مرض الجيارديا باستخدام المياه المعبأة في زجاجات فقط، وتجنب استهلاك الفواكه والخضار النيئة.كما يجب عدم استخدم المياه غير المعالجة في المناطق التي قد يكون الطفيلي فيها موجودا ، مثل الأنهار والبحيرات ومجاري المياه. غلي الماء لمدة دقيقة واحدة على الأقل قبل استخدامها.


Article
9- PREVALENCE OF INTERNAL ABDOMINAL ORGANS� INJURIES IN PATIENTS OPERATED UPON AFTER BLUNT ABDOMINAL TRAUMA.

Author: Kamal Ahmad Saeed
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 42-47
Publisher: Basrah University جامعة البصرة

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Abstract

Blunt abdominal trauma may result in multiple severe injuries which make the abdomen difficultto assess and easy to overlook. Unrecognized intra-abdominal injury is a significant cause ofpreventable death in blunt trauma. This study aimed to find the frequency and features oflapratomy findings for different internal abdominal organs� injuries in patients subjected to bluntabdominal injury. A total of 450 patients subjected to blunt abdominal trauma were admitted tothe emergency surgical department of Sulaimania Surgical Teaching Hospital following, 140 ofthem were decided to undergo exploratory laparotomy depending on their clinical and imagingfindings that suggesting a visceral injury. Thirty one percent of the patients who subjected toblunt abdominal trauma need exploratory laparotomy, 80.7% of them were male, and 67.9%were young. The predominant causative factor of blunt abdominal trauma was the motor vehicleaccidents. Spleen and liver were the frequent injured solid organs. Almost all of the patients hadpositive laparotomy results. Traumatic head and neck injuries were the most commonassociated non abdominal injuries. Morality rate was only 5% while complication rate was only7%. It is concluded that males at young active productive age are the main persons suffer fromblunt abdominal trauma. This has an important economic impact on the productivity of thecommunity. Spleen injury being the most commonly intra abdominal solid injured organ followedby liver, other visceral structures are uncommonly involved.j1


Article
Evaluation use of Ultrasound guided Transverses Abdominal Plane Block and Paracetamol for Post-operative Analgesia in Appendectom Patients
تقنية كبح العضله البطنية المستعرضه باستخدام موجات فوق الصوتيه بالمقارنة مع الباراستامول لضمان التسكين بعد عملية استئصال الزائدة الدودي

Author: layla khalil ليلى خليل
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2017 Volume: 30 Issue: 2 Pages: 83-87
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: A lot of pain relieve techniques were use postoperatively the transverses abdominal plan block is new regional anesthesia technique and paracetamol infusion one of these.Objectives: the aim of this study to evaluate the effectiveness of the two methods in patients undergoes appendectomy.Methods: Non- randomized clinical trial, started in the 1stfeb 2016 to 1st Feb. 2017 at Al-Jarah hospital Iraq –Baghdad, A 180 patients ASA I, undergone appendectomy. Age matched, 80 Patients were on ultrasound guided transverses abdominis plane block and 100 toke paracetamol .after wound closure 20 ml of 0.5% bupivacaine was infiltrated in to transverses abdominis neuro facial plan by posterior approach. 1000 mg of paracetamol (parol) were administered after induction of anesthesia as infusion in 20 min and pain score was assessed in postoperative period in 0 hr, 1 hr, 2hr, 3hr, 4hr by numerical rating scale (NRS) and visual analogue scale (VAS).Results: Transverses abdominal plane block (TAP) under ultrasound guidance had significantly lower postoperative pain score according NRS and VAS in comparison to paracetamol (P-value less than 0.001) at 4hr post-operative after appendectomy.Conclusion: Ultrasound-guided transverses abdominis plane block was easy, safe, reliable and effective analgesic postoperative appendectomy than paracetamol.


Article
Evaluation of Focused Abdominal Sonography for Trauma (FAST) in Baghdad Teaching Hospital

Authors: Raed J .Wiwit --- Saad Abdulla Ibrahim Sarsam --- Salah M.Tajer
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 4 Pages: 393-397
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Focused Abdominal Sonography for Trauma (FAST) is widely applied in the initial management of trauma patients, Being non invasive, repeatable and without risk of irradiation, make it attractive tool in evaluation of trauma patients.OBJECTIVE:Evaluation FAST sensitivity and specificity in detection of hemoperitoneum in abdominal trauma victims .METHODS:Prospective study conducted in the emergency department of Baghdad teaching hospital for one year period .The FAST done by a general surgeon or emergency physician during the secondary survey of blunt and penetrating abdominal trauma victims with equivocal clinical findings.RESULTS:Ninety three (93) patients included in the study, with over all sensitivity of FAST was 80.9 % and specificity 95.8 %. In blunt abdominal trauma the sensitivity was 92.3 % and specificity was 96 % while in penetrating abdominal trauma the sensitivity was only 62.5 % and specificity 95.2 %.CONCLUSION:FAST is highly sensitive and specific in detection of hemoperitoneum after blunt abdominal trauma ,but its lower sensitivity in penetrating abdominal injury require modification in the protocols like repetition of the scan or application of extra views. Its high specificity make it suitable as "rule in" test in both blunt and penetrating abdominal injury.


Article
Upper Abdominal Complaints Compound Diagnoses.

Author: Mohamad Theyab Al-mishhadani محمد ذياب المشهداني
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2011 Volume: 1 Issue: 2 Pages: 26-32
Publisher: Diyala University جامعة ديالى

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Abstract

Back ground: Upper abdominal complaints include a variety of symptoms that make the patients seeking the medical advice.Error in diagnosis leads to unnecessary admission to hospital, delay in treatment and possible increasing in mortality rate.Objectives of study: To show that this group of patients may have more than one diagnosis. Detect the symptoms which are associated with high incidence of compound diagnosis.Patients and method: One Hundred patients who are with different upper abdominal complaints collected randomly from the patients who referred to surgical clinic in Alkufa teaching hospital , All of them submitted to U/S and OGD examination in the period from the first of NOV. 1996 through JUN.1997.Result: Ten patients which represent 10%of the sample had more than one diagnosis and the most of them were complaining from dyspepsia as primary symptoms or as an associated symptom.Conclusion: Many patients who presented with upper abdominal complaint may had more than one pathology, and usually one of these pathologies was the main cause of the symptom.Correct preoperative diagnosis is essential to avoid unnecessary operation and to decrease the morbidity and mortality associated with missed diagnosis or over treatment.Recommendations: We recommend a combined OGD &US examination in this group of patients especially in those with dyspepsia.


Article
Random Abdominal Flaps for Reconstruction of Upper Limb War Injuries: A Good Option for a Bad Time

Author: Harith Abdul Jabbar Al Ani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 2 Pages: 165-171
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Soft tissue war injuries of the upper limb are usually extensive and multiple . Plastic surgeons facethe challenge of reconstructing these injuries in patients who are multiply injured ,and in a time whenfacilities for free flap surgery are not available.OBJECTIVE:To demonstrate the efficacy of random abdominal flaps in reconstructing soft tissue defects of theupper limb.METHODS:From May 2003 to September 2005, 55 war injury patients with deep soft tissue loss in the upperlimb were managed by random abdominal flaps of different shapes and directions, 13 of them hadother soft tissue injuries affecting other areas in the body. The surgeries were done in busy generalhospitals during war where time, personnel and facilities are limited.RESULTS:In 53 patients, the flaps had completely survived without complications, 2 flaps developed partial tipnecrosis and healed later by secondary intention. Donor areas were covered by split thickness skingrafts in 52 cases, and directly closed in 3 cases. The largest flap dimension was 18 cm length and 15cm width. The main disadvantages of the flap are donor site scar, bulk of the flap, and the need for asecond stage for flap separation.CONCLUSION:Random abdominal flaps are easy, safe, versatile and operative time saving option for coverage ofupper limb injuries. It can be designed in any direction to cover different soft tissue defects. Theseflaps still continue to be an excellent alternative for free tissue transfers during war time.


Article
Ultrasound Guided Percutaneous Drainage of Intra-Abdominal Abscesses and Fluid Collections

Authors: Nawar Abdul Munim --- Ali Zamil Mushettet --- Talib A.Majid --- Balsam Salim Atto
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 367-373
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND :Percutaneous image-guided drainage is the first-line treatment for infected or symptomatic fluid collections in the abdomen and pelvis, in the absence of indications for immediate surgery and considered potentially a life saving therapeutic surgical procedure in high risk patients .OBJECTIVE:To evaluate the efficacy of US-guided percutaneous drainage in treating intra-abdominal abscesses and fluid collectionsPATIENTS & METHOD :Patients with intra-abdominal collections underwent percutaneous drainage under ultrasound (US) guide were studied prospectively in the Gastro-enterology and hepatology hospital in baghdad from April 2008-Sept 2009. The procedure done under local anesthesia & aseptic technique, needle access obtained before placing the catheter .Peritoneal Dialyses catheter was used in our study.RESULTS :There were 43 patients (29 females and 14 males ), Age ranging 8-67 years. The collections diagnosed basically on US in 33 patients ( 76.7% ) & US and CT-scanning needed in 10 (23.3%). These collections were post-operative in 36 patients (83.7%) and primary (spontaneous) in 7 (16.3%)The post-operative cases were as follow:18 patients (50 % ) operated on for gall bladder diseases, 6 (16.7 %) for abdominal trauma ,4 ( 11% ) for acute abdomen , 4 ( 11% )for Hydatid cyst, 2 (5.6 %) colonic surgery and one patient (2.8 %) operated on for acute appendicitis and one (2.8%) after ERCP. Twenty three (53.5 %) of the collections were single & 20 (46.5%) were multiple. The single collections were located as: Right Hypochondrial(Right subphrenic,Subhepatic and Hepatic) in 15 patients (65.2 %), Epigastric in 4(17.4 %),2 of them were pancreatic, Pelvic in 3 (13 % ) , and paracolic in one patient ( 4.4 % ). Six patients(14 %) have hepatic collections, 4 of which were following Hydatid Cyst Surgery, the remainder were Pyogenic hepatic abscesses. Material drained was Bile in 24 patients ( 56 %),Pus in 17(39.5 %) & blood and urine in one patient (2.25 %) for both, Fourteen patients (32.6%) underwent more than single drainage procedure, nine of them (64.3 % ) twice , three (21.4 %) three times& two (14.3% )more than 3 re-interventions.The operations has been avoided in 26 patients (60.5 %) but was not avoidable in 17 ( 39.5% ), because of the ultimate need of the condition for operation in 15 patients (88 % )and failure of drainage in 2 patients ( 4.7 %)CONCLUSION:US guided drainage is an efficacious therapy for intra-abdominal collections and have become the treatment of choice for a wide variety of collections. It helps to obviate or delay a major surgery.


Article
NON-OBSTETRIC /GYNAECOLOGIC ABDOMINAL SURGERY DURING PREGNANCY

Author: Majeed H AlwanF
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 20-31
Publisher: Basrah University جامعة البصرة

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Abstract

Pregnancy is the only physiologic condition that is treated in the hospital environment. All other medical conditions that are treated in such a setting are pathologic. When a pregnant patient develops a pathologic condition that requires surgical intervention, it is imperative to remember that the lives of two individuals are involved, the mother and the foetus. In such settings it is essential that the treating surgeon understand the physiologic states of these two individuals as an interdependent symbiotic relationship. Not only must appropriate maternal care be rendered, prevention of foetal complications is also desirable.Changing physiology and anatomical landmarks frequently cause confusion and delay in dealing with surgical problems in the pregnant patient. Both symptoms and signs could be modified, contributing to delay in seeking medical attention, timely referral for surgical evaluation, or the initiation of appropriate diagnostic procedures.Surgery during pregnancy is an uncommon event, but one that creates a great deal of anxiety for both patients and medical practitioners. Delays in diagnosis and definitive treatment represent the most significant risk for untoward outcome in both the mother and the foetus.Laparoscopic surgery has rapidly and widely spread in the management of wide abdominal conditions, which resulted in several significant benefits to the non-gravid patients. Pregnant patients and their foetuses could drive the same benefits from minimally invasive surgery, which are received by the non-gravidas. However, due to the several physiological and anatomical factors encountered during pregnancy many issues need to be thought about and dealt with.Optimal surgical treatment of the pregnant patient will be realized when there is collaboration between the various subspecialties involved in her care.

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