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Article
INCIDENCE OF COMPLICATIONS IN POST-OPERATIVE THYROIDECTOMY
مدى حدوث مضاعفات جراحة الغدة الدرقية بعد العملية الجراحية

Author: Amel Baqer Mohammed
Journal: AL-TAQANI مجلة التقني ISSN: 1818653X Year: 2012 Volume: 25 Issue: 2 Pages: 123-128
Publisher: Foundation of technical education هيئة التعليم التقني

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Abstract

1-Back ground:The study and follow up of postoperative thyroidectomy patient is important in evaluation of postoperative complications.2-Objectives: to determine the incidence of postoperative complications of thyroid surgery.Methods: sixty- six patients with thyroid diseases were admitted to surgical unit, Medical city- teaching center in the period from 1- Oct. 2001 to 1- Oct. 2002. All patients were examined clinically, biochemically. Nuclear scanning, ultrasonography, computed tomography CT were used selectively (depending upon the needs of cases). After operation a careful follow up was done for three days to determine the presence of complications.Result:the incidence of complications in this study was Tetany six cases (four cases were toxic).Hematoma three cases (all were toxic).Stridor three cases (allwere toxic).Recurrent laryngeal nerve injury twocases (both of them are bilateral and transient in one case goitre was toxic). The mortality rate was zero.Conclusion:mortality rate following thyroidectomy is zero. The morbidity rate is about 21% in this study, there are four major complications of thyroid surgery- Titany, wound haematoma, recurrent laryngeal nerve injuryand hypoparathyroidism. Sonorography, computed tomography CT scan are helpful in some cases such as retrosternal goitere, when a posterior or accessory nodule is suspected.

أجريت هذه الدراسة لتوضيح مدى حدوث مضاعفات الغدة الدرقية بعد الاجراءات الجراحية حيث تمت الدراسة في مستشفى مدينة الطب التعليمي- الوحدة الجراحية للفترة من الأول من تشرين أول 2001 الى تشرين أول 2002 حيث تم إدخال 66 مريض للمستشفى جميعهم مصابين بمختلف أمراض الغدة الدرقية. تم اجراء الفحوصات السريرية والمختبرية لجميع المرضى, وتم اختيار بعض الحالات للفحص بالاشعة السينية والمسح الضوئي باليود المشع وفحوصات الانف والأذن والحنجرة. كما تم الفحص بالموجات فوق الصوتية و المفراس لبعض الحالات.بعد إجرائهم العملية تمت متابعتهم بعناية سريريالمدة ثلاثة ايام لمعرفة المضاعفات الجراحية بعد العملية واتضح ان هذه المضاعفات رغم انها قليلة الحدوث الا انها خطيرة في بعض الأحيان.هذه المضاعفات تشمل ست حالات تكززو ثلاث حالات تجمع دموي و ثلاث حالاتصرير في الصوت وحالتين اصابة العصب الحنجري الراجع.لم تحدث حالة وفاة في هذه المجموعة.


Article
The short – term nephropathological complications in experimentally induced diabetes mellitus in female domestic rabbits*

Author: Hassan Kh. Ulaiwi Al-Karagoly,Kassim Fawzi AbdulKareem,
Journal: Journal of Education for Pure Science مجلة التربية للعلوم الصرفة ISSN: 20736592 Year: 2012 Volume: 2 Issue: 1 Pages: 268-277
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

This study was designed to assess the pathological changes in kidneys after twenty days from induction of diabetes mellitus in female rabbits.Sixteen female rabbits were used in this experiment and divided into two equal groups: diabetic group (Df) and control group (Cf). Animals were housed in cages under 12/12 h light/dark cycle at 25±2 °C& 60% relative humidity with standard granulated food & water available ad libitium. The animals were left one month for adaptation. Diabetes mellitus was induced by i.v injection of alloxan monohydrate at dose rate 100 mg/kg dissolved in 1 ml of normal saline, while the control group was injected with 1 ml of normal saline. Blood was collected after three days to check fasting serum glucose. The procedure of alloxan injection and blood collection were made on empty stomach. The laboratory tests including serum glucose estimation at days (0, 3, 10 and 20) days. After taking blood samples four rabbits were sacrificed by decapitation. The kidneys were removed for histopathological study by using H/E stains. We found the following results according to the periods of the experiments: Serum glucose level was elevated, by checking after 3 days of injection of alloxan, and still elevated to the end of the experiment. The histopathological results after 10 days of induction of diabetes revealed that there were edema, hypertrophy and hypercellularity of glomeruli without any cast or inflammation, while there were necrosis as well as glomerular swelling after 20 days of induction of diabetes.

أجريت هذه الدراسة لتقييم التغييرات المرضية التي تظهر في الكلى بعد عشرين يوماً من إحداث الإصابة بداء السكّري. استعملت في هذه التجربة ستة عشر أرنباً أنثى وقسمت إلى مجموعتين متساويتين:المجموعة المستحث بها داء السكر تجريبياً التي تضمّنت (8) أرانب ورمز إليها ( (Df ،ومجموعة السيطرة التي تضمّنت (8) أرانب ورمز إليها (Cf). ربيت حيوانات الدراسة في أقفاص ذات أبعاد قياسيه وفي ظروف جيده من أضاءه ودرجة حرارة ورطوبة نسبية وكان الغذاء والماء متوفرين طول فترة الدراسة. تركت الحيوانات شهراً واحداً للتكيّف. تم استحداث داء السكر عن طريق الحقن الوريدي لمادة الالوكسان و بجرعة 100 ملغم / كيلوغرام كانت قد أذيبت في مللتر واحد من الملح الطبيعي الفسلجي، بينما حقنت مجموعة السيطرة بمللتر واحد من الملح الفسلجي فقط. جمع الدم من الحيوانات بعد ثلاثة أيامٍ من حقن مادة الالوكسان لغرض تقييم مستوى سكر المصل وقد أجريت عملية حقن مادة الالوكسان ومن ثم عملية سحب الدم بعد تجويع الحيوانات عدة ساعات في الفترات (3 و10 و20) يوماً بعد الحقن. بعد أخذ عينات الدمّ تمت التضحية بأربعة أرانب وأخذت منها الكلى لغرض عمل التقطيع النسيجي باستعمال صبغات الهيماتوكسلين والايوسين ،وقد أظهرت الدراسة النتائج الاتيه طبقا لفترات التجربة: اظهر مستوى سكر مصل الدم ارتفاع بعد الأيام الثلاثة الأولى من استحداث داء السكّري في المجموعة المعاملة. وقد لوحظ على الحيوانات المصابة العلامات السريرية المميزة للمرض والتي تضمنت العطش وكثرة التبول وكثرة الأكل. كما أوضحت نتائج الفحص النسيجي المرضي وجود وذمة، تضخّم كبيبي في الكلية وبدون ارتشاح للخلايا الالتهابية بعد عشرة أيام من استحداث داء السكر، وورم كبيبي ونخر وتضخم مع وذمة بع عشرين يوماً من الاستحداث التجريبي لداء السكر. *البحث مستل من أطروحة الماجستير للباحث الأول


Article
Early complications after tracheastomy

Author: Laith Ali Mahmood (F.I.B.M.S.) *, Ahmed Athab AL-Zubaidi(F.I.B.M.S.) **
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2012 Volume: 15 Issue: 1 Pages: 139-146
Publisher: University of Kufa جامعة الكوفة

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Abstract

Having a tracheostomy is considered to be a safe and straightforward procedure, but as with many surgical procedures it does carry a risk of complications.Aim: To evaluate tracheostomy early complications at Medical City Complex, Baghdad. Patients and methods: A prospective study of (125) consecutive tracheostomies that were performed during one year period from May 2006 through May 2007 in Medical City, Baghdad.Results: Ninety three patients (74.4%) were males. Thirty seven patients (29.6%) were in their third decade. Complications developed in fifty three patients (42.4%); wound infection was the commonest in twenty three patients (43.4%), followed by subcutaneous emphysema in fourteen patients (26.4%) and haemorrhage in ten patients (18.8%). One tracheostomy related death was encountered (0.8% of the total no. of patients). The complication rate was significantly higher in urgent tracheostomies (50.6%) than elective procedures (26.1%) and in those performed with local anaesthesia (48.3%) compared to (25%) under general anaesthesia.Conclusions: Most of early complications were due to the urgency of the procedure and inadequate postoperative nursing care. Wound infection was the commonest complications.

تعتبر عملية تفويه الرغامي من العمليات الأمنة , ولكنها تحمل كأي عملية جراحية أخرى خطورة حصول المظاعفات.الهدف من الدراسة: تقييم المظاعفات المبكرة الحاصلة بعد عمليات تفويه الرغامي التي أجريت في مستشفيات مجمع مدينة الطب في بغداد .المرضى والطرق: دراسة منظورة ل (125) عملية تفويه رغامي متتابعة أجريت خلال فترة عام واحد من أيار 2006 وحتى أيار 2007 في مستشفيات مجمع مدينة الطب في بغدادالنتائج:33 مريضا(74,4%) كانوا ذكورا. 37 مريضا( 29,6%) من مرضى هذه الدراسة كانوا في العقد الثالث من العمر. حصلت المضاعفات عند 53 مريضا(42,4%).ألتهاب الجرح الجرثومي كانت الأكثر شيوعا وحدثت في 23 مريضا 43,4%),تبعها النفاخ تحت الجلد في 14 مريضا(26,2%) والنزف في عشرة مرضى(18,8%).سجلت حالة وفاة واحدة متعلقة بعملية تفويه الرغامي(0,8%).معدل المظاعفات كان مرتفعا بصورة ملحوظة في حالة العمليات الطارئة(50,6%) عن ماهو عليه في العمليات الباردة(26,1%) , وفي العمليات التي أجريت تحت التخدير الموضعي (48,3%) مقارنة بتلك المجراة تحت التخدير العام (25%).الأستنتاجات: أغلب المضاعفات المبكرة لعملية تفويه الرغامي كانت عائدة الى الطبيعة الطارئة للعملية والعناية التمريضية غير المناسبة بعد العملية. ألتهابات الجروح الجرثومية كانت هي الأكثر شيوعا بين هذه المظاعفات


Article
Postoperative Urological Complications of Renal Transplantation; Al Karama Hospital Experience

Authors: Yousuf M. Alhallaq --- Shawqi Ghazala --- Mohammad Batal --- Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 4 Pages: 384-486
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Studying early post kidney transplant urological complication will provide a feed back evaluation for the surgical technique used and the way of complication management.OBJECTIVES:To study the postoperative urological complications and their management in the first 6 months following renal transplantation.METHODS:This is a retrospective study in which 123 patients with end stage renal disease (ESRD) underwent renal transplantation from January 2001 to October 2004 in Al Karama teaching hospital, Baghdad – Iraq. All the transplanted kidneys were from living donors. Direct matching between the serum of recipient and lymphocytes of the donor was negative. Extravesical ureteroneosystostomy was carried out using a stent across the anastomotic site. Postoperatively recipients were followed for 6 months by clinical and regular laboratory tests. Ultrasound and color Doppler examinations were performed when there was any evidence of decreased urinary output, allograft dysfunction, or clinical suspicion of rejection.RESULTS:In 123 patients aged 5 – 59 years with a mean age of 34 years, renal transplantation was carried out. Postoperative urological complications within the first 6 months were reported in 12 (9.75%) patients including urinary leakage in 6 (4.8%), ureteral obstruction in 3 (2.4%), and lymphocele in 3 (2.4%) patients.CONCLUSION:Major urological complications after renal transplantation contribute to patient morbidity and compromise graft function. Early diagnosis and treatment will avoid loss of the graft.


Article
Ureteral Stent Forgotten for 10 Years; A Challenge When Choices are Limited

Author: Ausama Saadi Abdul muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 95-99
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Article
Thyroid Surgery with Drain Versus without Drain

Authors: Ammar Noori Muhammed --- Wassem Ahmed AL-Kateb --- Ramez AL-Mukhtar --- Tharwat Idrees Sulaiman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 343-348
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The nature and indications for thyroid surgery vary and a perceived risk of postoperative complications such as seroma , haematoma , wound infection and haemorrhage post-surgery is one reason why wound drains are frequently inserted. They are generally used as a matter of the surgeon’s habit or preference more than a matter of proven benefit in the patient’s postoperative period.OBJECTIVE:To evaluate the differences in outcome and complications following thyroid surgery whether draining the wound or not .PATIENTS AND METHODS:One hundred forty five patients with different thyroid diseases requiring surgical intervention presenting to the first surgical unit in Baghdad teaching hospital between the first of October 2007 to the 31th of December 2009(27 months period) were enrolled. Patients were divided into two groups : those who had their wounds drained postoperatively ; (the drain group DG) and those who had their wounds closed without drain ; (the non drain group NG).RESULTS:Seroma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Small haematoma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Large haematoma occurred only in one patients (1%) in the DG, and it didn't occur in the NG. Wound infection occurs only in two patients (2%) in the DG, and in one patient (2.2%) in the NG. The mean of in-hospital stay was 2.07 days in the DG, and 1.06 days in the NG.CONCLUSION:The use of drain showed no effect on the prevention of wound infection , seroma , haematoma formation or the need for re-exploration, indeed the use of drain had lengthened the in hospital stay .So the Routine use of drains after thyroid surgery might be therefore not necessary, if not detrimental.


Article
Complications of laparoscopic cholecystectomy

Author: Tariq E. Al-aubaidi MBChB, FICMS د. طارق ابراهيم العبيدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 357-360
Publisher: Baghdad University جامعة بغداد

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Summary:Background: cholecystectomy is one of the most frequently performed operations. Open cholecystectomy has been the gold standard for over 100 years .laparoscopic cholecystectomy was introduced in 1980s.Patient and methods: Two hundred patients admitted to first surgical unit in Baghdad teaching hospital from first May 2007- first May 2009 with gall stone disease both symptomatic and asymptomatic, of both genders and any age were evaluated by history, examination and investigations and data was collected.Results: Two hundred patients underwent LC in the study period. 181(90.5%)were females and 19(9.5%)were males. The most common age group was between 21-40 years (55%), bleeding was the commonest complication, occurring from trocar site in 11(5.5%) cases, vascular injury in Calot's triangle in 9(4.5%) cases and liver bed in 23(11.5%) cases. Spilled gall stones occurred in 32(16%) cases, biliary leak in 7(3.5%) cases including common bile duct injury in one case. Port site infection was seen in 11(5.5%). There was no bowel injury or port site hernia and there was no mortality. Conclusion: LC is a safe and effective procedure in almost all patients with cholelithiasis. Good training and dealing with the complications makes this procedure with good results and less complication.Keywords: laparoscopy, cholecystectomy, complications.


Article
Awareness Regarding Diabetes Mellitus and Its' Complications in Type 2 Diabetic Patients
الوعي عن داء السكري ومضاعفاته لدى مرضى النوع الثاني من داء السكر .

Author: Maral F Thabit (FICMS)
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2013 Volume: 9 Issue: 2 Pages: 25-28
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Various studies conducted in many parts of the world suggest that there is lack of public awareness and knowledge of various aspects related to diabetes. With proper education, awareness, earlier detection and better care, many complications and co-morbidities can be reduced in diabetic population.Objectives: to evaluate the level of awareness of diabetes mellitus type 2 patients regarding their disease and its' complications.Methods: Cross – sectional survey was conducted during November and December 2011, in the Medical centers of Al Baladiat, Mustansyria and Zuafranya, including 145 type 2 diabetic patients (58.6 % males, 41.4% females) who were subjected to self–structured questionnaires regarding different aspects of the disease Results: Medical staff was the main source of information in 75% of patients, poor proportion of correct responses (25.5%) regarding disease etiology, symptomatology of feeling hungry (42.7%), generalized weakness (33.1%) also (44.8% & 30.1%) knew about the target blood sugar and blood pressure respectively. The proportions of correct responses regarding disease complications were not acceptable especially for myocardial infarction (18.6%), also poor daily blood sugar monitoring (11.03%). The knowledge of patients regarding management of disease by life style modifications was poor regarding physical exercise (40.6%) and weight reduction (40%) and (46.8%) of patients knew their drugs name , doses and side effects.Conclusions: Generally, poor awareness of patients regarding diabetes mellitus and its complications.

هدف الدراسة :- تقييم درجة الوعي عن داء السكري ومضاعفاته لدى مرضى النوع الثاني من داء السكر . المنهجية : - انجزت دراسة بمسح مقطعي خلال شهر تشرين الثاني ، وكانون الاول 2011 في العيادة الطبية الشعبية في حي البلديات ، المستنصرية ، الزعفرانية . شملت الدراسة 145 مريض مصاب بالنوع الثاني من داء السكري (58.6% ذكور ، 41.3% اناث ) ، تم عرض عليهم اسئلة لغرض الاجابة عليها من قبلهم حول نواحي مختلفة من المرض. النتائج :- الكادر الطبي كان المصدر الرئيسي لمعلومات 75% من المرضى ، كانت النسبة المئوية للاستجابات الصحيحة ضعيفاً (25.5%) حول مسبب المرض، اعراض المرض المتمثلة في الشعور بالجوع (42.7%) ، الضعف العام (32.1%) كذلك (44.8 % ، 30.1% ) ابدوا معرفتهم بالقياس المثالي لنسبة السكر وضغط الدم على التوالي . كانت نسبة الاستجابة الصحيحة حول مضاعفات المرض غير مرضياً خصوصاً الجلطة القلبية (18.6%) ، كذلك قياس نسبة السكر في الدم يومياً (11.03%) ، كانت معرفة المرض بالنسبة الى علاج المرض بتغيير انماط الحياة ضعيفاً حول ممارسة الرياضة (40.6%) وتخفيف الوزن (40%) وكذلك (46.8%) من المرضى ابدوا معرفتهم باسماء ادويتهم ، جرعها والتاثيرات الجانبية . الاستنتاجات : بصورة عامة ، كانت درجة الوعي لدى مرضى داء السكري ضعيفاً حول المرض ومضاعفاته .


Article
Complications of Endoscopic Sinus Surgery

Authors: Alaa Mtashar Al-Mansoury --- Yaseen Adeeb Al-Dori --- Bahaa Mohsen Al-Anbary
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 2 Pages: 421-427
Publisher: Babylon University جامعة بابل

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Abstract

Endoscopic sinus surgery (ESS) is obtained to restore paranasal sinus function which usually will lead to reestablishing the physiologic pattern of ventilation and muco-ciliary clearance.To evaluate the complication of endoscopic sinus surgery (ESS) after management of different sinonasal diseases and how to deal with these complications ninety patients with different sinonasal diseases who were underwent functional endoscopic sinus surgery were seen and evaluated in department of otolaryngology.They had been submitted to clinical and endoscopic examination of the nose.All patients had a coronal and axial CTscan preoperatively, and all procedures were performed under general anesthesia. The extent of surgery was mainly decided depending on the findings in pre-operative CT scan of paranasal sinuses.The main presenting symptoms of patients were nasal obstruction (71.1%), anterior nasal discharge (65.5%), facial pain (63.3%), headache (55.5%), postnasal drip (50%) & hyposmia/anosmia (31.1%). Most of the patients have got partial or complete symptomatic relief. The minor complications of endoscopic sinus surgery occurred in 18 cases (19.97%) which include adhesions (11.1%), minor epistaxis (5.55%), periorbital ecchymosis (2.22%) & infection (1.1%). Major complications occurred in 6 cases (4.27%) which was Major epistaxis (2.22%), CSF leakage (2.22%), Meningitis (1.1%) Pneumocephalus (1.1%).It was concluded that endoscopic sinus surgery (ESS) is an efficient method for treating different sinonasal diseases and can be performed with success rate to alleviate symptoms with less morbidity especially when there is good clinical and preoperative CT scan assessment with endoscopic sinus surgery training courses and proper hypotensive anaesthesia and good postoperative care.


Article
LESSONS TO BE LEARNED LESSONS TO BE AVOIDED IN THE FUTURE

Author: Thamer A Hamdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 1 Pages: 1-2
Publisher: Basrah University جامعة البصرة

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LESSONS TO BE LEARNED LESSONS TO BE AVOIDED IN THE FUTURE Thamer A Hamdan MB,ChB, FRCS, FICS, FACS, Professor of Orthopedic Surgery, Chancellor of Basrah University, Basrah, IRAQ. It is a well-known fact that lucky is the one whose mistakes can be counted. There is not a single surgeon who has not had complications of one type or another. Those who deny complications either have not done enough surgery or not telling the truth. I Surgeons may have complications in spite of good judgment and proper execution of surgical procedures. Simply speaking, complications should be the pillars for future rectification of personal and colleague’s careers. It is a shame when surgeons discover at time of surgery, that something was missed prior to putting the knife on the patient’s body. Certainly, this situation is embarrassing or even perplexing for the surgeon, because he may feel, he do not know how to behave when he faces a surprise. It is really painful when he feels he is guilty by the sin of omission or commission. At the same time, we should admit that we have faced some unexpected findings at the time of surgery. However, we may not be blamed because this was not due to lack of proper pre-operative evaluation but because of similarities of clinical manifestations or due to masking of the cardinal clinical features. One of the best example is emergency operation for acute appendicitis, while the operative findings are suggestive of ovarian cys

Keywords

mistakes --- complications --- lessons

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