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Article
INJECTION OF BOILING HYPERTONIC SALINE IN THE TREATMENT OF CUTANEOUS HAEMANGIOMA

Author: Zuhair F Fathallah
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2016 Volume: 22 Issue: 2 Pages: 31-37
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract This study deals with a new way for the treatment of cutaneous haemangiomas in children and adults by using a boiling hypertonic saline, the material used is safe and nontoxic even if absorbed. A total of 309 patients with 354 haemangiomas were studied. The sample consisted of 233 females and 76 males ranging in age from 2 months to 50 years. Patients were divided into three groups; Group I: observation, Group II: excision and reconstruction, Group III: injection & excision. Each patient in group III received 2-4 shots of boiling saline intra-lesional at an interval of 3-4 weeks, to allow time for the post injection swelling to subside and fibrous tissue to mature. The female to male ratio was 3.1:1. The lesion appears within the first weeks after birth in 189 children (61.3%). Among the 309 patients, 288 (81.4%) haemangiomas were located on the head and neck, 39 (11%) on the trunk, 25 (7%) on the extremities, and 2 (0.6) in the perineal area. The three groups are as follows: group I: observation; 161 patients (52%). group II: excision and reconstruction. 42 patients (13.7); group III: injection & excision, 106 patients (34.3%). The presenting symptoms at consultation were parents worry 200 patients (64%), obstruction of orifices 38 (12.3%), ulceration 32 (10.6 percent), bleeding 26 (8.2%), infection 10(3.2%), and pain 3 (0.8percent). The complications after treatment of the 106 patients were; bleeding 3 patients (2.3%), infection 7 (6.8%), skin necrosis 20 (19.3%); the remaining patients 76 (71.6%) tolerate the injection easily and show no effect. The evaluation of patients treated with boiling saline sclerotherapy is based on improvement of volume, color, and texture as follow, poor 10 (9.1%); good 54 (51.1%); and excellent 42 (39.8%). In conclusion, treatment of cutaneous Haemangioma is indicated when there is no sign of involution. Injection sclerotherapy with boiling saline proved to be safe, nontoxic, cheap and effective.


Article
Effectivness of 10% povidone iodine as ascolicidal agent in hydatid cyst surgery in compared with other scolicidal agents

Author: Ali Nayyef Assi علي نايف عيسى
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2013 Volume: 9 Issue: 16 Pages: 181-195
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Hydatid disease or Echinococcal disease, is a parasitic disease that affects both humans and other mammals such as sheep, dogs, rodents and horses.[1] There are three different forms of Echinococcosis found in humans, each of which is caused by the larval stages of different species of the tapeworm of genus Echinococcus[1].This study was done in the AL-Husseinteaching hospital (AL-Nassiyria)during3 years (between 1st January 2004 to december2006) and follow up for5 years,120 patients [70 females and 50 males] ages range between 12years to 56years presented withhydatid cyst in the liver only we concentrate on the hydatid cyst of liver( un complicated cases) confirm the diagnosis by U/S and CTscan ,and after surgery follow upalso by U/S and CTscan for 5 years.Povidone-iodine (PVP-I) is a stable chemical complex of polyvinylpyrrolidone (povidone, PVP) and elemental iodine. It contains from 9.0% to 12.0% available iodine, calculated on a dry basis.[1]To evaluate effectiveness of 10% povidone iodine as ascolicidal agent in liver hydatid cystsurgery in compare with hypertonic salinesolution and alcohol,povidone iodine have a better effect as a scolisidal effect because(1)there'sa lowerrecurrencerate during 5 years post operativlyfollow up (2) there is little post operative complication related to the povidone iodine(3)mild direct effect on the liver cell during six months follow up postoperativelyaccording to the liver function tests results as compare with other scolicidal agents, so we can use povidone iodine10% in surgical operation for hydatid cyst as ascolicidal because it highly effective against the scolices,little intra or post operative effects on the liver cells , cheep and widely available.

دراسه اجريت على 120 مريض خلال 3 سنوات2004 كانون الثاني الى كانون الاول 2006 في مستشفى الحسين التعليمي في الناصريه والمتابعة للمرضى خلال فتره 5 سنوات.هدف الدرسه هو معرفه مدى قوه البوفادين ايودين 10% في قتل طفيليات مرض الاكياس المائية مقارنه بالسائل عالي التركيز (الهايبر تونك) والكحول من خلال حقن كيس الماء الموجود بالكبد ب10 سي سي من البوفادين ايودين 10% او من الهايبر تونك او الكحول لا على التعيين للمرضى اثناء عمليه ازاله الكيس وننتظر لمده 20 دقيقه بعدها تتم عمليه ازاله الكيس بالسحب السوائل وسحب الكيس ثم تتم عمليه المتابعه المتواصله للمريض للتاكد من عوده الاكياس المائية فى الكبد او في الغلاف التجويفي للبطن وكذالك التأكد من مدى تأثيرهذه المواد الثلاثه على خلايا الكبد او وضائف الكبد من خلال فحص وظائف الكبد الدوري لمده ستة شهور.تبين من خلال دراستنا بان مفعول البوفادين ايودين فعال جدا في قتل طفيليات الاكياس المائيةمقارنه بالمادتين الاخريين وله تاثيرات جانبيه قليله على الكبد ووضائفه وله اق نسبه على عوده الاكياس المائيه بالنسبه الى المادتين الاخريتين,لذا ننصح باستخدام البوفادين ايودين 10% كمحلول قاتل لطفيليات الاكياس المائيه اثناء عمليه رفع الاكياس ولأنه ايضا رخيص ومتوفر


Article
In vitro effects of hypertonic saline solution on whole blood clotting

Author: Mohammed Shnain Ali;
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1568-1572
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: hypertonic saline solution is frequently used to in the management ofhemorrhagic shock.Objective: To determine the effects of hypertonic (7%) saline solution on wholeblood coagulation (clotting) in vitro.Patients and methods: Ten healthy volunteers (5 males and 5 females with age range of 28-44 years) with no previous medical history of bleeding tendency and no medical history ofdrug intake were studied after their consent. Hypertonic (7%) saline was preparedimmediately before use. For each patient, 4 ml of venous blood sample was obtained andinvestigated as follows:Undiluted 450 µl of whole blood for baseline coagulation tests [prothrmbin Time (PT),activated partial thromboplastin time (APTT) and thrombin time (TT)]. After that, the sameabove tests were done after dilutions of whole blood (i.e whole blood replacement byhypertonic saline and isotonic saline for each dilution). An Isotonic (0.9%) saline dilutionserves as control. Blood volume replacements at 2.5%, 5%, 7.5% and 10% were done andstudied.Results: The baseline coagulation tests (PT, APTT, and TT) were normal for all 10 (100%)of subjects. At 2.5% and 5% of blood volume replacement PT, APTT and TT were slightlyprolonged, but showed no statistically significant difference between hypertonic (7%) salineand the control (isotonic saline) while PT, APTT and TT were prolonged in hypertonic (7%)saline with statistically significant difference (p<0.05) from isotonic (0.9%) saline at 7.5%and 10% of whole blood volume replacement in 10, (100%) of subjects.Conclusion: The study showed that hypertonic (7%) saline disturbs coagulation in vitro whenit replaces 7.5% or 10% of whole blood volume.


Article
Povidone Iodine and Hypertonic Saline Induced Sclerosing Cholangitis in Hepatic Hydatid Cysts Surgery

Author: Abdulrazzak Kalaf Hassan
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2680-2686
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Surgery is the treatment of choice for hepatic hydatid disease but surgical treatment carry the risk of recurrence if we do not use a proper scolicidal agent and may convert patient with solitary hepatic hydatid cyst to patient with many incurable cysts. The ideal scolicidal agent should kill vital scolices, and not have local or systemic adverse effect, and not toxic to bile duct. Yet, there is no ideal scolicidal agent involving such effects. One of the important serious complications after instillation of scolicidal agents is sclerosing cholangitis.Aim: to assess the risk and severity of povidone iodine and hypertonic saline induced sclerosing cholangitis in guinea pigs.Materials and methods: In this study we used twenty guinea pigs which were divided into two equal groups. In the first group 0.3 ml10% povidone iodine was injected to the biliary tree after clamping then released after five minutes and second group, 0.3 ml 20% hypertonic saline was used.Four months later on the pig was euthanized by ether and three biopsies taken from the liver and sent for histopathological examination. Afterwards, the liver, gall bladder, the common bile duct and the duodenum were excised in one piece and immediately transferred for cholangiography. Two X-ray films were taken for each specimen in lateral and antero-posterior view after contrast material injection. Results: in povidone iodine group 8 animals (80%) had sclerosing cholangitis while in hypertonic saline group only 2 animals (20%) had sclerosing cholangitis. This difference between the two groups was statistically significant. Conclusions: Usage of 10% povidone iodine as a protoscolicidal agent carry high risk of sclerosing cholangitis.


Article
The Effect of Hypertonic Saline in Treatment of Moderate Bronchiolitis in Children

Author: Alaa Jumaah Nasrawi علاء جمعة النصراوي
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2017 Volume: 17 Issue: 1 Pages: 77-91
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Airway oedema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline (HS) solution may reduce these pathological changes and decrease airway obstruction.Aim: To assess the effects of nebulized hypertonic (3%) saline solution in infants with acute viral Bronchiolitis of moderate severity.Methods: This study was conducted in Al Zahraa teaching hospital for maternity and pediatric in the period between December 2013 till November 2014 at which 165 patients with acute viral bronchiolitis were included. The inclusion criteria were; Infants aged ≤18 months presented with a prodromal history consistent with viral upper respiratory tract infection followed by wheezing and/or crackles on auscultation. Patients were excluded from the study if they have the following criteria: born at ≤ 34 weeks’ gestation, previous history of wheezing, steroid use within 48 hours of presentation, history of apnea within 24 hours before presentation, oxygen saturation ≤85% on room air at the time of recruitment, history of a diagnosis of chronic lung disease,congenital heart disease, or immunodeficiency, consolidation or atelectasis on a chest X-Ray and infants with bronchiolitis severity score <4 or > 8. Result: We found that nebulized 3% HS decreases bronchiolitis severity score after 12h of treatment and its effect subsided after more than 48 h. In regard to hospital stay, the study shows a decrease in mean of hospital stay length from 42.2 to 36.3 h. Conclusion: Nebulization with 3% hypertonic saline is safe, can be widely generalized, and may be superior to current treatment for early outpatient treatment of bronchiolitis.Recommendation: Planning for a multicenter trial to explore the clinical benefit of this therapy with a large sample size is essential.

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