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Article
Frequency of Gastroesophageal Reflux Disease In Al-Kindy Teaching Hospital

Author: *Riyadh Mohamad Hasan
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 2 Pages: 115-119
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Gastroesophageal reflux disease (GERD) is considered to be a common and chronic gastrointestinal disease. Objectives: To determine the frequency of GERD, erosive esophagitis and non-erosive reflux disease (NERD) among patients in discrete area in Baghdad.Type of the study: A cross-sectional studyMethods: 1100 patients referred to gastroscope unit in Al-Kindy Teaching Hospital from January 2013 to January 2015. They were undergoing upper gastrointestinal endoscopy . The information on patient’s data were collected using a questionnaire. Body mass index and waist circumference were measured. Results: According to gastroscope findings, they were classified into three groups: Group I was symptomatic patients with gastroscope findings of GERD that constitutes (40.90%) and the second group (GroupII) was symptomatic patients with non erosive reflux disease (NERD) that represents (13.90%) and the last group was Group III that comprised patients with normal esophagus and with other gastroscpe findings (45.18%). Conclusions: GERD constitutes the highest percentage (40.9%) and GERD grade II constitutes the highest percentage (51.11%) of GERD grads


Article
Manifestation and response of Laryngopharygeal reflux to treatment in Kurdistan -IRAQ

Author: Said Mustafa Said سعد مصطفى سيد
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2010 Volume: 6 Issue: 1 Pages: 118-126
Publisher: Baghdad University جامعة بغداد

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Abstract

BACKGROUND: In 1972 complete description of the inflammation of posterior third of the vocal cords was done, with barium swallow confirming Gastro Esophageal Disease [CRED] & subsequent successful symptomatic treatment with antacid. The possible association between GERD & chronic laryngitis was initially known as acid laryngitis .2OBJECTIVE: To record the common presentation symptoms of laryngopharyngeal reflux LPR in Kurdistan- Iraq. To study the significance of fibro optic laryngoscope in diagnosis and improvement of laryngopharyngeal reflux [LPR] and to evaluate the effect of medical therapy on these nonspecific symptoms and Laryngoscopic finding.METHODS: A prospective study was conducted over a two year period at Rizgary teaching hospital, Kurdistan/lraq; on 132 patients who presented primarily with Laryngopharyngeal symptoms .They were evaluated using special questionnaire for recording these symptoms: persistent chronic cough, globus sensation, throat clearing, voice change, regurgitation, heartburn, symptoms of peptic ulcer disease, and any other non specific respiratory symptom. These symptom and Laryngoscopic findings pre and post anti-reflux therapy were recorded. Esophagogastro - duodenoscopy findings were also recorded but only on presentation. RESULTS: A total of 132 patients were evaluated over a two year period .Respiratory symptoms at presentation were persistent irritative cough [92%], itchy throat [85%], globus pharynges [83%], and cricopharngeal spasm [57%]. Endoscope findings revealed gastroduodenitis in 5%, non specific gastritis in 9%, duodenal ulcer in 2%, and normal findings in 62.7%, while Laryngoscopic finding were mainly posterior commissure injection 82%, vocal cord edema 74%, laryngeal erythema 77% and subglottic edema 24%. Patients were treated medically with antacids, H2 antagonists, proton pump inhibitors and were followed up and reexamined by laryngoscope; all data about improvement in symptom and in the laryngeal sign by Laryngoscopic findings were collected following anti-reflux therapy and showed significant improvement in both ,all were analyzed in special figures and tables.CONCLUSION: Reflux laryngitis and LPR should be a differential diagnosis in patient with pharyngeal and laryngeal symptoms not associated with upper respiratory disease in the presence or absence of GERD or peptic ulcer symptom, dyspepsia, regurgitation. The management should be multidisciplinary. Laryngoscopic finding were of value in the diagnosis of the changes in laryngeal mucosa pre and post medical treatment by Proton Pump Inhibitors empirical therapy.


Article
Gastroesophageal Reflux Disease: Clinical And Endoscopic Correlates
مرض الانعكاس المعدي المريئي – دراسة العلاقة بين الأمراض السريرية والعلامات الناظورية

Author: Dr.Sadiq Jarallah Yaseen د. صادق جارالله ياسين
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2010 Volume: 4 Issue: 2 Pages: 21-28
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACTThis prospective study considered 146 patients attended the endoscopy units in Baghdad Teaching Hospital and the Gastroenterology and Hepatology Teaching Hospital in the Medical City in Baghdad from August 2000 till August 2001.They were diagnosed as sufferers of gastroesophageal reflux disease (GERD). The study tried to differentiate on base of the clinical presentation between patients with GERD who have endoscopic peptic esophagitis and those who are free from this complication. It was found that dysphagia has a statistically significant association with peptic esophagitis while age, male gender, heartburn, noncardiac chest pain, smoking and alcoholism have no significance for the intended differentiation despite the observation that, aging, male gender and smoking were determinants of higher grades of peptic esophagitis in case they are present.

ملخص البحث:اجريت هذه الدراسه على 146 مريضا من مراجعي وحدات تنظير الجهاز الهضمي في مستشفى بغداد التعليمي ومستشفى امراض الجهاز الهضمي والكبد التعليمي في مدينة الطب في بغداد خلال الفترة من بداية شهر اب سنة 2000 وحتى نهاية شهر اب سنة 2001 وكانوا يعانون من اعراض الانعكاس المعدي المرئي. هدفت الدراسة الى محاولة التفريق بالاعتماد على الاعراض السريرية بين المصابين من بين المرضى المذكورين بالتهاب المريء الحمضي الرجوعي المحسوس ناظوريا وبين المرضى غير المصابين به. وتبين من خلال هذه الدراسة ان شكوى صعوبة البلع ذات دلاله احصائيه مهمه تشير الى التهاب المريء الحمضي الرجوعي في حين لم تكن هناك علاقات احصائية مهمه تربط بين الاصابه بهذا الالتهاب مع عمر المريض وجنسه وشكوى حرقة الفؤاد والام الصدر غير القلبيه والتدخين اوتعاطي الكحول. ولكن تبين ان تقدم سن المريض والجنس الذكري والتدخين جميعها عوامل محدده لدرجات اعلى من الالتهاب الحمضي للمريء في حال وجوده.


Article
Spirometric evaluation of gastroesophageal reflux disease (gerd) associated cough and asthma
تقييم وظائف الرئة لمرضى الجزر المعدي المريئي المترافق مع السعال والربو

Authors: Shaimaa A. H. Jassim شيماء عبد الهادي --- Afraa M. AL-Ameen عفراء محمد --- Amjad F. Ahmad امجد فوزي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 4 Pages: 422-425
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Gastroesophageal reflux disease can lead to esophageal complications, including esophagitis, ulceration, stricture, hemorrhage, and Barrett's esophagus. However, the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research.Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index (BMI), disease duration, presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects (90) of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five (55) GERD associated cough and asthma subjects served as test group while the remaining (35) served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul.Results: Spirometric data of the control group were within the normal predicted range (80-120%) thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas, the measured spirometric parameters (forced vital capacity (FVC), forced expiratory volume in 1 second ratio (FEV1%), peak expiratory flow (PEF), and forced mid expiratory flow(FMF) are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition, neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects, unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease.Key words: Gastroesophageal Reflux Disease, chronic cough, asthma.

الخلفية :إن الجزر المعدي المريئي قد يؤدي إلى مضاعفات في المرئ مثل الالتهاب , تقرحات ,تضيق ونزف المرئ وممكن أن تمتد ھﺬه المشاكل إلى أجزاء خارج المرئ وقد تكون سببا في السعال المزمن والربو القصبي .الأهداف :تقييم صورة وظائف الرئة في مرضى الجزر المعدي المريئي المرتبط بالسعال والربو القصبي وعلاقتها مع مؤشر كتلة الجسم , مدة المرض ووجود أو غياب الأعراض مع نتيجة فحص التنظير الداخلي .الاشخاص وطريقة العمل :تم اختيار تصميم دراسة المقطع العرضي الوصفي واجريت الدراسة في مستشفى ابن سينا التعليمي في الموصل . شملت الدراسة تسعون شخصا تتراوح اعمارهم بين (19- 65 سنة) من كلا الجنسين 35 شخصا كعينة ضابطة و55 مريضا يعانون من الجزر المعدي المريئي والسعال والربو وبعد أخذ جميع المعلومات اجري فحص وظائف الرئة لجميع المشمولين بالدراسة ثم اجري للمرضى ناظور المعدة .النتائج:أظهرت نتائج وظائف الرئة للعينة الضابطة أنها ضمن المدى الطبيعي (80-120%)مما يؤكد عدم وجود أي مرض في الرئة بينما كانت نتائج وظائف الرئة (FVC و ( FMF, PEF,FEV1% للمرضى منخفضة معنويا مع وجود تحدد واضح في وظائف الرئة لدى المرضى ذوو كتلة الجسم العالية .و وجود نمط انسدادي في وظائف الرئة لدى المرضى اللذين كان فحص الناظور موجب بالمقارنة مع المرضى اللذين كان فحص ناظور المعدة لهم سالب. الاستنتاج: إن وظائف الرئة لمرضى الجزر المعدي المريئي ذوو نتيجة ناظور معدة موجبة أظهرت نمط انسدادي بغض النظر عن وجود أو غياب اعراض المرض أو مع مدة المرض .انخفاض قيم وظائف الرئة للمرضى اللذين كانوا يعانون من الجزر المعدى لفترة اطول من ثلاثة اشهر عند مقارنتهم مع المرضى اللذين كانت فترة مرضهم اقل. مفتاح الدلالة:الجزر(الاسترجاع) المعدي المريئي ,السعال المزمن ,الربو.

Keywords

Background: Gastroesophageal reflux disease can lead to esophageal complications --- including esophagitis --- ulceration --- stricture --- hemorrhage --- and Barrett's esophagus. However --- the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research. Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index --- BMI --- disease duration --- presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects --- 90 of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five --- 55 GERD associated cough and asthma subjects served as test group while the remaining --- 35 served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul. Results: Spirometric data of the control group were within the normal predicted range --- 80-120% thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas --- the measured spirometric parameters --- forced vital capacity --- FVC --- forced expiratory volume in 1 second ratio --- FEV1% --- peak expiratory flow --- PEF --- and forced mid expiratory flow --- FMF are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition --- neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects --- unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease. Key words: Gastroesophageal Reflux Disease --- chronic cough --- asthma. --- الجزرالاسترجاع --- المعدي المريئي --- السعال المزمن --- الربو.


Article
Correlation Between Helicobacter Pylori Infection and Severity of Asthma
العلاقة بین الإصابة بالملویات البوابیة وشدة الربو القصبي

Authors: Sadiq J. Ali Almuhana --- Ammar Jabbar Majeed --- Abdul-Razzaq Hassan Alkaaby --- Sabah Ali Jaber Alhelu
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 2 Pages: 130-137
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Microbial exposures have been suggested to confer protection from allergic disorders, and reduced exposures to gastrointestinal microbes have been proposed as an explanation for the increase in asthma severity and prevalence. Since the general prevalence of Helicobacter pylori has been decreasing, we hypothesized that H. pylori serostatus may be inversely related to the severity of asthma. Objective: The aim of this study is to find whether infection with H.pylori reduces the probability of development of severe asthma in patients with persistent asthma.Patients and methods: In this study fifty patients with persistent asthma includes 19 males and 31 females their ages range from (17 – 66) years For all those patients, full history and complete physical examination have been done, then after, the patients subjected to pulmonary function test. After that, two milliliters sample of venous blood have been drawn, then, the sample centrifuged and sent to assess for H.pylori infection serology. Data was analyzed by using SPSS.Results: There is significant association between severity of asthma and result of H.pylori so with increase severity of asthma there is decrease in percentage of positive H.pylori serology. And there is no statistical significant are noted between patients sex or age and results of H.pylori infection test. Conclusion: There is significant inverse association between severity of asthma and result of H.pylori infection serology. This association not affected by ages and sex of patients.Recommendations: Since the exact mechanism by which H.pylori affect asthma is not clear, there is need for further studies to explore it.

خلفية الدراسة: طالما كان يعتقد إن الإصابات الجرثومية توفر حماية من إمراض الحساسية,وقلة التعرض للجراثيم المعوية أعطت تفسير لزيادة انتشار الربو وزيادة شدته,ولذلك بما إن الانتشار العام للإصابة بالملويات البوابية بدأ بالانحسار, لذلك وجدنا أن نتيجة الفحص المناعي للإصابة بالملويات البوابية تتناسب عكسيا مع شدة الإصابة بالربو المزمن.الهدف :الهدف من هذه الدراسة هو تحديد هل أن الإصابة السابقة بالملويات البوابية تقلل من احتمالية حدوث حالة الربو الشديد عند مرضى الربو المزمن.المنهجية : شارك في هذه الدراسة خمسون مريض مصابون بالربو المزمن , يتكونون من 19 ذكر و31 أنثى تتراوح أعمارهم بين 17 و 66 سنة , من كل هؤلاء المرضى تم اخذ تاريخ مرضي شامل وخضعوا لفحص سريري كامل, بعد ذلك اجري لهم فحص وظائف الرئة , من ثم سحب من كل مريض عينة بمقدار 2 مليليتر من الدم الوريدي,من ثم تم إجراء الطرد المركزي للعينة وأرسلت لغرض إجراء فحص الملويات البوابية المناعي.النتائج: تم إيجاد علاقة إحصائية معتبرة بين شدة الربو والنتائج الموجبة لفحص الملويات البوابية المناعي ,حيث كلما زادت شدة الربو كلما قلت نسبة النتائج الموجبة للفحص المناعي,كذلك تم إثبات عدم وجود علاقة إحصائية معتبرة تربط أعمار المرضى أو أجناسهم بنتائج الفحص المناعي.الاستنتاج : هناك علاقة عكسية بين شدة الربو القصبي ونتائج فحص الملويات البوابية المناعي.التوصيات: نظرا لعدم وضوح العلاقة المباشرة بين الملويات البوابية والربو القصبي نوصي بالمزيد من الدراسات لاكتشاف تلك العلاقة .

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