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Article
Study of growth retardation among patients with thalassemia major: correlation to iron overload

Author: Hulal Saleh Sahib
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2018 Volume: 5 Issue: 2 Pages: 77-85
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Thalassemia is an autosomal recessive blood disorder which has a life-long implication in both patients and their families. This study was performed at Al-Diwaniya maternity and children teaching hospital from the 1st of October 2016 to the 1st of January 2017. The total number of patients involved in our study were one-hundred three, all of them were diagnosed with ß – thalassemia major, were subjected to frequent blood transfusion and were on chelating agent. Both patients groups were evaluated with full history (age, gender, time of diagnosis, the rate of transfusion per year, the type and dose of the chelating agent), and were examined for their weight, height and BMI, serum ferritin was also performed for all of them. There was a significant difference in mean age and height of patients on desferal and those on exjade. The rate of transfusion was significantly greater in the group of patients treated with desferal. Serum ferritin was significantly higher in patients treated with desferal than patients treated with exjade. There was a significant correlation between gender of patients and serum ferritin in the group of patients treated with desferal, also there was a significant negative correlation between the dose of the drug and serum ferritin in those treated with exjade.


Article
Growth Pattern and Sexual Maturation Rate in β-Thalassemia Major Patients from Thalassemia Center Erbil

Authors: Nazar Baker --- Abdulkader Alnakashabandi --- Azhar H. Alsaqy --- Abbas Alrabaty
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 40-44
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Thalassemia is genetic disorder in globin chain production, or it refers to a group of blood disease characterized by decrease synthesis of one of two types of poly peptide chain ( α or ß ) that form a normal adult human hemoglobin molecule ( Hb A- α2 ß2 ) resulting in decrease filling of red cell with hemoglobin and anemia .Growth retardation can occur as a complication of thalassemia as early as the 1st or 2nd year of life but these abnormalities are more prominent after the 6 – 8 years of life . OBJECTIVE: The main objective of the present study was to evaluate the relationship of growth failure and sexual maturity rate (SMR) in children with β-thalassemia major in comparison with controls. MATERIAL AND METHOD : In this case-control study, the growth parameters ( height ,weight ,and sexual maturation ) and S.ferritin of 38 patients aged 8-16 years (24 males 14 females) with β-thalassemia major who were attending thalassemia center in Erbil city Iraqi Kurdistan were compared with those of 38 healthy controls of the same age and gender. RESULTS: Underweight and short stature were found in 23 (61%), 30(79%) of patient group and 3(8%), 3(8%) of control group, the mean age of menarche for female patients was 12.31±2.3 and for control female 11.12±1.31years, The SMR were delayed in 37(97.5%) of patients and in 2 (5.5%) of controls. the level of serum ferritin had no significant relationship with delayed SMR. CONCLUSION: Growth failure (underweight and short stature) and delay SMR significantly occur in thalassemia patients compared to controls, and such growth retardation was more likely to occur after 10 years of duration of the disease


Article
Study of Physical Growth Pattern in Thalassemic Children And Adolescent in Hawler Thlassemia Center /Erbil City
دراسة النمو الجسمي للأطفال والمراهقين المصابين بالثلاسسيميا في مركز الثلاسيميا في هولير/اربيل

Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 2 Pages: 160-166
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background :Thalassaemia is one of the most common genetic blood disorders in the world. Growth impairment is a common observable complication and usually found a growth retardation in those patientsObjectives: The study aimed to identify the Physical growth pattern of Thalassemic( case group) with healthy school( control group) children and adolescents in Erbil city.Methods: A study was carried out at Hawler Thalassemia Center in Erbil City during the period from the 1-2-2012- to 30-9-2012 . Fifty Thalassemic children( case group) from Hawler Thalassemia Center in Erbil City and two hundred healthy school( control group) children and adolescents were selected . A questionnaire was designed that composed of two parts to deal with physical growth pattern the data were collected by searchers to interviewed the participants in Hawler Thalassemic Center and secondary schools, for children and adolescents in Erbil city and the data were the analysis by using the (SPSS, 17 ),Results: The results found that the range of age in the study sample was between 8-11 years old ,which present in healthy school children and adolescents ( control group ) ( 46.5%), while in Thalassemic children( study group ) was ( 52.0%),the highest percentage of gender in both groups were male ( 65.5% , 58.0%) respectively revealed that there was significant differences incomparative physical growth pattern between Thalassemic and healthy children and adolescentsConclusion : The study conclude that Thalassemic children (Case group) regarding the age they have high mean score than control group (healthy child) in (sitting and standing ) height , weight and nutritional status as BMI in all age groups. Recommendation: The study recommended that Thalassemia was a important health problem in pediatric and plans need to set up to reduce the number of cases born by development of population screening programmer and awareness creating.

خلفية البحث : ثلاسيميا من أكثر الأمراض الوراثية شيوعا في العالم ومن المضاعفات التي تلاحظ المصابين هو ضعف النمو البدني لدى ألاطفال المصابين بالثلاسيمياالهدف : تهدف الدراسة للتعرف على نمط النمو البدني( الجسمي) لدى الأطفال المصابين بالثلاسيميا ومقارنتها بالأصحاء من طلبة المدارس الثانوية لمدينة اربيلالمنهجية :أجريت دراسة في مركزهولير للثلاسيميا للفترة من 2012-2-30 الى 2012-9-2012اختيرت عينة من خمسون طفل مصاب بالثلاسيميا ومائتان طالب سليم معافى من طلاب المدارس الثانوية لمدينة اربيل تم تصميم استمارة استبيان تتضمن جزئين لجمع البيانات من خلال استخدام أداة الاستبيان باعتماد تقنيات المقابلة المباشرة كوسيلة لجمع البيانات وقد تم تحليل البيانات عن طريق برنامج SPSS الإصدار 17. ألنتائج :اظهرت النتائج بوجود فرق في أنماط النمو البدني( الجسمي) لدي الأطفال المصابين بالثلاسيميا ومقارنتها بالأطفال الأصحاء من طلبة المدارس الاستنتاجات : بينت نتائج الدراسة فيما يخص العمر وعلاقته بالطول بوجد وسط حسابي عالي لدى طلبة المدارس عند الوقوف والجلوس وكذلك عند الوزن والكتلة العضلية لجميع الفئات العمرية عند مقارنتها الأطفال المصابين بالثلاسيمياالتوصيات : . اوصت الدراسة بان مرض الثلاسيميا احدى المشاكل الصحية لدى الاطفال فان التخطيط الصحي لغرض تقليل نسبة حالات الاصابة وبرامج التحري عن المرض اضافة الى التوعية الصحية للأفراد المجتمع


Article
Study the causes of growth retardation in pure breed imported calves after theileriosis in Abu-Shaeer cattle Farm /Diyala province
دراسة أسباب تأخر نمو العجول المستوردة نقية السلالات بعد الأصابة بمرض الثليريوسزTheileriosis في محطة أبقار أبو شعير-- محافظة ديالى

Authors: Gh.H. Jameel غسان حمدان جميل --- H. M. Majeed حميد محمود مجيد --- O. J. katwan عمر جاسم كطوان
Journal: Al-Qadisiyah Journal of Veterinary Medicine Sciences مجلة القادسية لعلوم الطب البيطري ISSN: 18185746 23134429 Year: 2013 Volume: 12 Issue: 2 Pages: 93-100
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

The aim of this study is investigated the causes of retardation in growth of purebred calves infected by Theileria annulata.Blood samples of infected group (treatment group) were taken once, and blood samples of the control group (clinically healthy) were taken also .Serum separation was done to two groups to determinate some blood factors levels as ferritin ,phosphorus ,glucose ,growth hormone ,total T3 and total T4.It was detected that mean values of serum Ferritin was significantly higher than the values of the control group and healthy animals.No significant effect of the infection on the phosphorus and T3 levels ,While there were significant depression in serum levels of glucose ,growth hormone and T4.

تهدف الدراسة الى التقصي عن أسباب تأخر نمو ألعجول نقية السلالات المصابة بمرض الثليريوسز.تم أخذ عينات من دم العجول المصابة مرة واحدة . كما أخذت عينات دم من عجول مجموعة السيطرة التي تبدو سليمة سريريآ. تم فصل السيرم لكلا المجموعتين لتحديد مستويات بعض عناصر الدم مثل Growth hormone, Glucose, Phosphorus, Ferritin T4,T3 , .كانت مستويات Ferritin في مجموعة العلاج مرتفعة معنويآ عن مستوياتها في مجموعة السيطرة وأعلى مما في الحيوانات السليمة.كما لم يلاحظ أي تأثير معنوي للخمج على مستويات الفسفور وT3، بينما هناك أنخفاض معنوي في مستويات الكلوكوز وهرمون النمو وT4.


Article
Growth Retardation in β-Thalassemia Major

Authors: Qais Abdullah Ali Al-Salehe --- Mohammed Shaker Al-Awady --- Shaima Khidar Abbass
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 267-273
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Thalassemia is an inherited autosomal recessive blood disease caused by genetic defects result in reduced rate of synthesis of one of the globin chains that make up hemoglobin. The combination of transfusion and chelating therapy has dramatically extended the life expectancy of thalassemic patients. OBJECTIVE: The objective of this study is to determine the factors associated with short stature in thalassemic patients and main endocrine complications. PATIENTS AND METHODS: A case-control study was performed prospectively in Ibn-Al Balady hospital in (Al- Sader city-Baghdad- Rasafa) for the period extended from the 1st of January to 31st of May (2013). Data were collected from 181 thalassemic patients, their ages were 10 to 20 years old being attended the hospital for regular follow up and blood transfusion. The control in this research work was one of the patients' relatives with the same age after thalassemia was ruled out in the control. Data collected in this study included: age, sex, height and weight were assessed by the National Center of Health statistics (NCHS) growth curves , history of splenectomy, times of blood transfusion , hepatitis infection, type of chelating agent. Serum ferritin, hormones level, fasting and random blood sugar and serum calcium were estimated. RESULT: It was founded that 79% of the β-thalassemic patients had short stature (their height equal or less than5rd percentile) with significant relation with high serum ferritin (P-value=0.006). Delayed puberty was the commonest endocrine complication in thalassemic patients (83.9%). CONCLUSION: High serum ferritin is associated with growth retardation and many endocrine complications . Aggressive iron-chelating therapy and regular measurement of hormones concentration are necessary for thalassemic patients mainly during puberty to avoid growth retardation.


Article
The correlation between serum levels of soluble platelet -selectin in preeclampsia with & without intrauterine growth retardation versus normal pregnancy

Authors: EsraaH. AL-Maini اسراء حمدي --- Sarah I. Ali ساره اسماعيل
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2017 Volume: 59 Issue: 1 Pages: 36-41
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: preeclampsia is characterized by endothelial dysfunction with vasoconstriction due to cell adhesion molecules or mediators released by defective placentation. Soluble platelet selectin, one of the cell adhesion molecules, is elevated in many inflammatory conditions including preeclampsia.Objective: To investigate if soluble platelet-selectin levels can be used as a marker for adverse outcomes in pregnancy complicated with sever preeclampsiaPatients and methods:This study involved 115 pregnant women in their third trimester of pregnancy; divided into Group A: involves 25 pregnant women with preeclampsia complicated by intrauterine growth restriction.Group B: involves 35 pregnant women with preeclampsia without intrauterine growth restriction.Control group: involve 55 pregnant women with normal blood pressure and normal fetal growth .The data were conducted from patients by special questionnaire, this involve name, age, parity, examination included vital signs, abdominal, obstetrical examination and investigations including :Liver function test, Renal function test, Complete blood picture and maternal serum levels of soluble platelet selectin was measured by enzyme-linked immunosorbent assay ,albumin in urine and serial obstetrical ultrasound scan to confirm the diagnosis of intrauterine growth retardation and Doppler study to determine fetuses at risk .Results: this study revealed a significantly higher concentration of soluble platelet selectin levels in serumofpreeclamptic women with and without intrauterine growth retardation versus normotensive and normal fetal growth. The maternal serum levels of sP-selectin in preeclampsia without intrauterine growth restriction were significantly higher than preeclampsia complicated by intrauterine growth restriction .Sensitivity was 91.7% and specificity 100% at cut off value 6.975 ng/ml of maternal soluble platelet _selectin for prediction of adverse pregnancy outcome .Conclusion: soluble platelet -selectin levels have a positive significant correlation with the severity of preeclampsia, so it can beconsidered as a marker for its severity and can be used as a predictor for adverse outcomes as itsnegatively correlated with these complicationsKeywords:soluble platelet-selectin ,preeclampsia with & without intrauterine growth retardation versus normotensive pregnancy .


Article
Causes of short stature in Iraqi hospital based study patients
أسباب قصر القامة عند المرضى المحالين الى أستشارية امراض الغدد الصم في مستشفى حماية الأطفال/مدينة الطب

Authors: Munib A. AlZubaidi د. منيب احمد كاظم --- Maher M. Saleh د. ماهر مهدي صالح --- Zahraa M. Jawad د. زهراء مهدي جواد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2017 Volume: 59 Issue: 3 Pages: 221-225
Publisher: Baghdad University جامعة بغداد

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Abstract

Backgrounds: Growth is an important objective parameter of general health of the child. Normal growth requires adequate nutrition along with various hormonal stimuli. Short stature is a common cause of referral to pediatric endocrinologists.Objectives: To find the causes of short stature in patients referred to pediatric endocrinology clinic of children welfare teaching hospital, the significance of bone age assessment and the variation of growth hormone level in these patients.Patients and methods: This prospective study was carried out in the endocrine clinic of Children Welfare Teaching Hospital/Medical City over ten months period, included 150 patients. A proper detailed medical history was taken, physical examination performed included growth parameters, and general investigations with bone age, thyroid function test, celiac screening and growth hormone level were done for all patients. Growth hormone stimulation test was done when indicated and phenotype, Karyotyping was done in selected cases.Result: The total number of patients included in this study was150, ranging from ≥ 2 to 16 years old, and the male to female ratio was 1.14:1.The relationship between age and gender is significant(p-value 0.04).The commonest etiology was endocrine causes in 92(61.33%), non-endocrine causes in 34(22.67%) and normal variant in 24(16%) patients. Bone age was delayed in 86(57.33%) and normal in 6(4%) of endocrine cause which is highly significant (p-value< 0.001), and in non-endocrine causes it was delayed in 24(16%) and not delayed in 10(6.67%) patients which is significant (p-value<0.01). Growth hormone level was deficient in 80(53.33%) patients of endocrine causes of short stature which is highly significant (p-value <0.001%), and deficient in 15(10%) patients of non-endocrine causes which is significant (p-value<0.03%).Conclusions: Growth hormone deficiency, familial short stature and constitutional growth delay were the leading causes of short stature in patients referred .Growth hormone deficiency is the commonest cause of short stature in those patients, bone age is a corner stone in evaluating short stature and it gets delayed in some cases with systemic and endocrine causes other than growth hormone deficiency and constitutional growth delay.Keywords: Growth hormone, Growth retardation, bone age, short stature.

الخلفية: يعتبر النمو مقياس مهم من مقاييس الصحة العامة للطفل.وان النمو الطبيعي للطفل يحتاج التغذية كافية بالأضافة الى تحفيز هرمون النمو.قصر القامة من الأسباب العامة لأحالة الطفل الى أستشارية امراض الغدد الصم. الغاية: ايجاد اسباب قصر القامة عند المرضى المحالين الى أستشارية امراض الغدد الصم في مستشفى حماية الأطفال التعليمي واهمية معرفة العمر العظمي وهرمون النمو عند هؤلاء الأطفال.المرضى والطريقة:أن هذه الدراسة المستقبلية أجريت في أستشارية امراض الغدد الصم في مستشفى حماية الأطفال التعليمي التابع لدائرة صحة مدينة الطب خلال فترة عشرة أشهر متضمنة 150 حالة مرضية تم خلالها اخذ التاريخ المرضي بشكل دقيق لجميع الحالات المرضية و الفحص السريري متضمنا مقاييس النمو و أجراء الفحوصات المختبرية العامة و معرفة العمر العظمي , وظائف الغدة الدرقية ,الفحص الخاص بداء الحنطة ,فحص هرمونات النمو مختبريا , علما ان الفحص الكروموسومي أجري لبعض الحالات بشكل أنتقائي .النتائج :أن العدد الأجمالي لهذه الدراسة كان 150 حالة مرضية يتراوح معدل أعمارهم من أكثر من 2 سنة الى 16 سنة . نسبة الذكور للأناث 1.14: 1 الأسباب:كان القصورفي افرازات الغدد الصم في 92 حالة (61.33%) (السبب الأكثر شيوعا),الأسباب اللاغددية 34 حالة (22.67%),الأختلافات الطبيعية 24 حالة (16%). العمر العظمي كانت اختلافاته كالآتي :-في قصور الغدد الصم : متأخرا في 86 حالة (57.33%) طبيعيا في 6 حالات (4%) (( p. Value <0.001في الأسباب اللاغددية : متأخرا في 24 حالة طبيعيا في 10 حالات (6.67%) (p. value <0.01) مستوى هرمون النمو:- منخفضا في 80 حالة (53.33%) من حالات قصور الغدد حيث يعتبر ذات أهمية عالية p. Value <0.001منخفضا في 15 حالة (10%) من حالات الأسباب اللاغددية p. Value< 0.03 طبيعيا في كل حالات الأختلافات الطبيعيةالأستنتاج :نقصان هرمون النمو , قصر القامة الوراثي و تأخر النمو النظامي هي من أهم أسباب قصر القامة عند المرضى المحالين الى أستشارية امراض الغدد الصم في مستشفى حماية الأطفال التعليمي . أن نقصان هرمون النمو هو السبب الأكثر شيوعا ضمن أسباب قصر القامة . أن العمر العظمي يعتبر حجر الزاوية في تقييم قصر القامة وهو متأخر عند المرضى المصابين ببعض الامراض المزمنه و الأمراض العامة و أمراض الغدد الصم أضافة الى انه متأخرعند كل المرضى المصابين بنقصان هرمون النمو و تأخر النمو النظامي . مفتاح الكلمات : تاخر النمو,هرمون النمو, العمر العظمي, , قصر القامة الوراثي

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