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Article
Primary Percutaneous Coronary Intervention in Acute ST Elevation Myocardial Infarction: A Single Centre Experience

Authors: Ahmed Hussein AL- Mayali --- Mushtaq T. Al-Hassnawi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 2 Pages: 3978-3987
Publisher: Kerbala University جامعة كربلاء

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Abstract

background Early revascularization is critically important in the management of patients presenting with acute myocardial infarction.Aim To assess the benefit of early primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction.Methods This study include 51 patients with acute STEMI they were selected from those who were admitted to the coronary care unit of Karbala cardiac center in Karbala-Iraq during a period between January 2017 and February 2018. Detailed history and thorough physical examination was done. Investigations done for each patient in form of ECG, cardiac troponin, blood urea, serum creatinine, and complete blood picture.Results & discussion percutaneous coronary intervention only, using one stent, two stent, three stent, aspiration catheter, CABG & medical treatment, 7 (13.7%),25(49%), 8(15.6%), none , 4(7.8%), 4(7.8%), 4(7.8%), 3(5.8%) respectively).Infarct related artery, LAD, LCX, RCA & LMS (30(58.8%), 4(7.8%), 6(11.7%), 2(3,9%) respectively, and the number of diseased vessels , single vessel, two vessels, three vessels & LMS which was (20(39.2%), 13(25.4%), 14(27.4%) respectively.Inhospital outcome, which include the following:- favorable outcome, period of hospitalization, access site bleeding, contrast induced nephropathy, death, respectively. Which were (96%, ˂ 1day 38(74.5%), ˃1day 13(25.5), 3.9%, 5.8%, 3.9% respectively)Conclusion in case of ST elevation myocardial infarction, left anterior descending artery is most culprit vessel to be involved, one quarter of patient needs one stent & carry favorable out comes in form of less complications and also decrease the period of hospitalization.

Keywords

primary PCI --- acute MI


Article
Incidence and in-hospital complications of acute mitral regurgitation in the early phase of acute myocardial infarction in Erbil teaching hospital
نسبة ومضاعفات في المستشفى من قلس التاجي الحاد في المرحلة المبكرة من احتشاء عضلة القلب الحاد في مستشفى أربيل التعليمي

Authors: Abdulkareem A. Al-Othman --- Firaz Muhammad Mawlood
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2012 Volume: 16 Issue: 2 Pages: 84-89
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Acute mitral regurgitation is one of the mechanical complications of acute myocardial infarction. The aim of the study was to detect the incidence of ischemic mitral regurgitation and its effect on in-hospital complications in early phase of acute myocardial infarction.Method: The study sample consisted of 100 patients with first attack of acute myocardial infarction admitted to Coronary Care Unit in Erbil Teaching Hospital from October 2009 to May 2010.The patients categorized into: group-I which represent those without mitral regurgitation; group-II represent those with mitral regurgitation and the latter categorized patients with mild mitral regurgitation (group-IIA) and those with moderate-severe mitral regurgitation (group-IIB).Results: The incidence of acute mitral regurgitation among patients with acute myocardial infarction was 33%. Fourteen patient (42.42%) had mild and 19 (57.58%) had moderate-severe mitral regurgitation. Group-II patients were older (mean age: 65.4±10.76 years) than group-I (mean age 56±11), p value=0.01. Left ventricular systolic dysfunction among group-IIA, 9 patients (64.28%) and group-IIB, 16 patients (84.21%) were higher than group-I, 12 patients (17.91%), p=<0.001.Conclusion: Acute mitral regurgitation is common in early phase of acute myocardial infarction and it is strongly associated with left ventricular systolic dysfunction.

Keywords

Acute MI --- MR


Article
Factor XII level in patients with acute Myocardial Infarction
مستوى العامل الثاني عشر عند مرضى احتشاء العضلة القلبية الحاد

Author: Aladdin Mudhafar Zubair Al-Qasim د.علاء الدين مظفر زبير القاسم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 1 Pages: 25-29
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients in industrialized countries. Factor XII is one of the contact activation factors. Hageman factor (FXII) activates coagulation through the intrinsic pathway. It concurrently activates the fibrinolytic system. This mechanism exists to limit clotting by cleaving fibrin, thereby solubilizing the fibrin clot.Aims of the study: To study the level of intrinsic coagulation factor (FXII: C) in patients with acute myocardial infarction.Subjects, Materials and Methods: Thirty patients were included in this study (9 female, 21 male) that were just admitted to the Coronary Care Unit in Al-Yermouk Teaching Hospital and diagnosed as having acute myocardial infarction. Blood samples were taken from these patients. Their age range is 48-68 years. Thirty healthy subjects (9 female, 21 male) age and sex matched with the patients were included as a control group. FXII: C activity was assayed for both patients and control groups. Statistical Methods: The student T-test and correlation study were used for statistical tests. Results Mean FXII: C (71.03±11.46) is significantly (P value <0.001) lower in acute myocardial infarction group than control group (119.00%±8.52). Conclusion FXII: C level was significantly lower in patients with acute myocardial infarction than control group.Key words: acute MI, factor XII assay

خلفية البحث: يعد إحتشاء عضلة القلب الحاد من الحالات المشخصة الشائعة لدى المرضى الراقدين في المستشفيات. لقد لوحظت زيادة في العلامات الخثرية في حالة إحتشاء عضلة القلب الحاد مما يدل على تنشيط جهاز التخثر لدى هؤلاء المرضى.الهدف من الدراسة: قياس مستوى العامل الثاني عشر عند مرضى إحتشاء عضلة القلب الحاد.العينات وطرق العمل:أجريت هذه الدراسة في مستشفى اليرموك التعليمي للفترة مابين تشرين الاول 2008 وآذار 2009 وخلال هذه الفترة جمعت ثلاثون حالة من المرضى المصابين بإحتشاء عضلة القلب الحاد في وحدة إنعاش القلب وسحبت عينات دم من هؤلاء المرضى وفحصت في مختبرات المستشفى المذكورة أعلاه وقد تضمنت الفحوصات المجراة قياس مستوى عامل التخثر الثاني عشر في بلازما الدم.سحبت عينات دم لعشرين من الاشخاص الاصحاء بأعمار وأجناس متوافقة مع المرضى كمجموعة سيطرة لأغراض المقارنة وأجريت عليها نفس الفحوصات المختبرية المجراة على عينات دم المرضى.النتائج:ان هناك نقصان ملحوظ (P value 0.0001) في نسبة عامل التخثرالثاني شر(71.03±11.46) لدى مرضى احتشاء عضلة القلب الحاد وبين المجموعة السيطرة(119.00%±8.52).

Keywords

acute MI --- factor XII assay


Article
Study of Chromosomal Aberrations and Micronucleus Formation in Some Iraqi Patients infected with Acute Myeloid Leukemia (AML)
دراسة التشوهات الكروموسومية وتكوين النويات الدقيقة عند بعض المرضى العراقيين المصابين بإبيضاض الدم النخاعي الحاد

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Abstract

The effect of acute myeloid leukemia (AML) was studied on some cytogenetic parameters occur in lymphocyte in three cases; before, during and after chemotherapy treatment. The study involved 47 AML Iraqi patients their ages ranged between 2.5-81 years including 20 females and 27 males. Results were compared with 26 healthy individuals and summarized as follows: 1- AML was the most common leukemia in adults as compared with children. It was found that 46.8% AML patient ages were less than 15 years; 90.15% at 30-16 years; 40.9% at individuals at 31-45 years, the percentage increased to 90.5% in those who are over 45%. 2- AML was more common in males than females recording 57.5% and 42.5% respectively; representing 1.35:1.00 male:female ratio. 3- Two cases representing 5.3 of the studied sample exhibited dioploidy after examination under light microscope. The highest mitotic index was 7.498% and occurred in patients before taking therapy compared to 6.784% during therepy and 7.000% after therapy. 4- Micronucleus mean values recorded 0.033, 0.020 and 0.036 MN/1000 cells for AML patients before, during and after therapy respectively, when compared with the control which recorded 0.002 MN/1000cells. Nuclear division index (NDI) means before, during and after therapy of AML patients were 1.658, 1.000 and 1.424 respectively compared with control which recorded 1.282.

دُرس تاثير مرض إبيضاض الدم النخاعي الحاد ( (AMLفي بعض معايير الوراثة الخلوية الحاصلة في كريات الدم البيضاء في ثلاثة حالات للمرضى اشتملت على مرحلة ما قبل العلاج وفي اثناء العلاج وبعد العلاج الكيميائي. شملت الدراسة التشوهات الكروموسومية وتكوين الانوية ايضاً. تكونت عينة الدراسة 47 من المرضى العراقيين المصابين بمرض إبيضاض الدم النخاعي الحاد الذين تراوحت أعمارهم بين 2.5 – 81 سنه إذ تضمنت على 20 انثى و27 ذكر. قورنت النتائج مع عينة مكونه من 26 من الاصحاء ويمكن اختصار النتائج التي تم التوصل اليها وكما يلي: 1- مرض AML أكثر شيوعاً في البالغين مما هو في الاطفال, إذ وجد بان 46.8% من المرضى المصابين هم من أعمار دون 15 سنة, تلتها 90.15% في الاعمار 16-30 سنة وبلغت 40.9% في الاشخاص الذين تراوحت أعمارهم بين 31-45 سنة وارتفعت الى 90.5% في الاعمار التي زادت عن 45 سنة. 2- سجلت الذكور نسبة أكثر من النساء لتسجلا 57.5% و 42.5% على التوالي وبنسبة 1.35ذكور:1.0 اناث. 3- سُجلت حالتين وبما يشكل 5.3% من العينة المدروسة من المرضى ذات خلايا ثنائية المجموعة الكروموسومية (Diploid) بعد فحصها تحت المجهر الضوئي. تحقق أعلى دليل لإنقسام الخلايا (MI) في المرضى قبل تعاطيهم العلاج الذي وصل الى 7.498± 1.7 بينما سجل 6.784±4.5 اثناء العلاج وارتفع الدليل قليلاً ليصل الى 7.00± 2.5 في المرضى بعد تعاطيهم العلاج. 4- سُجلت معدلات قيم للانوية الصغيرة 0.033 ± 0.018 ,0.020 ± 0.00015 و 0.036 ± 0.01 في المرضى قبل واثناء وبعد العلاج على التوالي في الوقت الذي سجلت معاملة المقارنة 0.002 ± 0.00002. وكانت معدلات دليل الانقسام النووي (NDI) قبل واثناء وبعد العلاج 1.658±0.200, 1.000±0.022 و 1.424 ±0.19 على التوالي والتي سجلت إختلافاً معنوياً عن معاملة السيطرة (1.282±0.09).

Keywords

AML --- CA --- MI --- MN --- NDI


Article
Orthostatic Hypotension Predicts The Early Morbidity And Mortality In Patients With Ischemic Heart Disease In Coronary Care Unit

Author: dr. Safaa Ali Khudhair د. صفاء علي خضير
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2009 Volume: 3 Issue: 1 Pages: 33-39
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACTBackground: The mechanism by which the orthostatic hypotension and cardiac autonomic neuropathy increase cardiovascular morbidity and mortality remain to be settled. Some studies found exercise intolerance in patients with cardiac autonomic neuropathy with a reduced response in heart rate and blood pressure and decreased cardiac output during exercise. An association between cardiac autonomic neuropathy and QT prolongation has been shown.Objective: To asses the role of the orthostatic hypotension in the development of the early cardiovascular complications in the patients of the coronary care unit.Patients and method: In this a prospective observational follow up study, (50) patients with ischemic heart diseases were included. Blood pressure was measured with the standard mercury sphygmomanometer, the measurement in supine position was taken after at least 15 minutes of rest and the measurement in standing position was taken at the third minutes of standing, the orthostatic hypotension is said to be present when there was a sustained drop in systolic (≥ 20 mmHg) or diastolic (≥ 10 mmHg) blood pressure at the third minute of standing up.Results: Out of twenty two patients with orthostatic hypotension fifteen patients developed cardiovascular complications and out of twenty eight patients without orthostatic hypotension five patients developed cardiovascular complications, this association is statistically significant Conclusion: Orthostatic hypotension can be used as a prognostic marker for the development of early adverse outcomes in patients with acute coronary syndrome, thus it can be useful tool to screen the high risk patients in the coronary care unit.


Article
Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in Ibn Alnafees Hospital, Baghdad

Authors: Majid Abdul Muhsin Falih --- Alaa AbdulHussein Allawi --- Raed Sabri Al Abboodi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 310-312
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUD:Primary percutaneous coronary intervention (PCI) provides outcomes superior to fibrinolytic therapy in acute myocardial infarction (AMI), but no registry or study in Iraq has demonstrated its use in hospital.OBJECTIVE: To evaluate using of primary PCI for acute MI in Ibn Alnafees hospital –Baghdad.METHODS: Patients between 2010 and march 2013 having symptom onset within 12 hours and either ST-segment elevation of - 1 mm in - 2 contiguous leads or presumed new left bundle branch block (LBBB) in electrocardiogram (ECG) who were treated with primary PCI were included in this study. Two patient had cardiogenic shock treated within 16 hours.RESULTS:A total of 76 patient included in this study having primary PCI for acute MI. successful result reported in 71 of cases, while death reported in 2 cases, slow flow in 2 cases, no re flow in one case and stent thrombus formation in one case. No need for urgent or elective CABG.CONCLUSION: Primary PCI for patients with AMI having ST-elevation or new LBBB is a safe and effective strategy


Article
The study of chromosomal aberrations in mice infested with radiated and non-radiated protoscolices of Echinococcus granulosus .
دراسة التشوهات الكروموسومية في الفئران المصابة المشعةمع وغير المشعة بالطور المعدى للمحببه الشوكيه.

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The mitotic index (MI) and the chromosomal aberration in cells have been studied in white bulb mice subjected to radiated and non-radiated protosolices of E. granulosis . In this experimental infestation , gamma ray of 81.58416 × 103 wave length have been used. The protoscolices were subjected to a high degree of 25 Gy and low degree of 5 Gy. The results revealed no significant variation in both MI and chromosomal aberration were found in bone marrow cells of infested mice in comparison to control.

تم خلال هذا البحث ايجاد معامل الانقسام الخلوي MI ودراسة التغيرات الكروموسومية في خلايا نقي العظم لفئران بيضاء حقنت برؤيسات وأكياس لطفيلي المشوكات الحبيبية مشععة بدرجة 5 كري و 25 كري باشعة كاما ذات طول موجي 81,55416×103 . وأظهرت النتائج وجود فرق بسيط في معامل الانقسام الخلوي لحيوانات التجربة المحقونة بالرؤيسات والأكياس المشععة مقارنة بنفس النوع من الخلايا في حيوانات السيطرة الموجبة والسالبة ، كما ظهرت تغيرات كروموسومية بسيطة ، لذلك ليس هنالك تأثير للرؤيسات المشععة على كروموسومات المعاملات.


Article
Effect of casein phosphopeptide-amorphous calcium phosphate on surface roughness of a silorane-based and methacrylate-based composite resin (In vitro comparative study)

Author: Baydaa Hussein بيداء حسين
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 3 Pages: 106-112
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: When using a fluoridated agent for caries-preventive intervention, the clinician should be careful not toallow the agent to come into contact with the composite restorations since topically applied fluorides were found toinduce adverse effects on the morphologic characteristics and composition of composite restorations. A newremineralizing agent "MI Paste" and its fluoridated form "MI Paste Plus" based on Recaldent technology (CPP-ACP)were developed. This study was conducted with the aim of assessing the effect of these new remineralizing agentson surface roughness of two types of composite resin materials.Materials and Method: Cylindrical specimens 12mm in diameter and 2mm in height were prepared from two types ofcomposite resin materials: Filtek™ P90 (a silorane-based composite material) and Filtek™ Z350 XT (a methacrylatebasednanofill composite material). Each specimen was cured against a celluloid strip in a specially designedcylindrical mold using a QTH light curing unit for 40 seconds. Forty specimens were prepared for each compositetype and subdivided into four subgroups of ten specimens each: Subgroup 1: without treatment, dry-stored in anincubator at 37ïC for one week (control subgroup), Subgroup 2: without treatment, stored in deionized water in anincubator at 37ïC for one week, Subgroup 3: treated with MI Paste once daily for one week, and Subgroup 4:treated with MI Paste Plus once daily for one week. Surface roughness of the specimens was obtained with a surfaceprofile testing machine, which used the roughness average (Ra) to assess surface changes. Several measurementswere taken for each specimen and the mean value of these measurements on one specimen was regarded as theRa of that specimen. The mean Ra value of each subgroup was then calculated.Results: The results of this study showed statistically non-significant differences among the different subgroups ofFiltek™ P90 composite resin material. Concerning Filtek™ Z350 XT composite resin material, the results showed astatistically highly significant difference in surface roughness between the subgroup stored in deionized water andthe control one, with statistically non-significant difference between the subgroups treated with MI Paste and MIPaste Plus and the control subgroup. Comparison of significance between the corresponding subgroups of bothcomposite types revealed statistically non-significant differences except for subgroup 2 which showed a statisticallysignificant higher surface roughness in Filtek™ Z350 XT than Filtek™ P90.Conclusions: The daily application of the MI Paste and MI Paste Plus for one week had non significant effect onsurface roughness of the silorane-based composite resin material Filtek™ P90. On the other hand, the application ofthese agents caused surface smoothening of the nanofilled methacrylate-based composite resin material Filtek™Z350 XT.


Article
The Role of Circulating Immune Complexes in the Pathogenesis of the Ischemic Heart Disease

Author: Suha AL-Fakhar
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 4 Pages: 406-410
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Circulating immune complexes (CICs) were found to have an effect on the pathogenesis and prognosis of ischemic heart disease (IHD).METHODS:A total of 24 patients, 13 as a patient group with IHD (10 males and 3 females), and 11 healthy control group (6males and 5 females), for all the level of CICs was detected by platelets aggregation test (1).RESULTS:The results showed that all patients with IHD had positive platelets test, while only 4control group had a positive results.CONCLUSION:This study showed that there was significant raise in the level of CICs in the IHD and it might play a role in it’s development.


Article
Post-traumatic Stress Disorders amongpatients with Myocardial Infarction in Mosul city
كرب ما بعد الصدمة لدى المرضى المصابين باحتشاء العضلة القلبية في مدينة الموصل

Authors: Radhwan. H. Ibrahim --- Zeyad.T.al-Noimi --- Eman salem
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2013 Volume: 3 Issue: 1 Pages: 142-148
Publisher: University of Kufa جامعة الكوفة

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Background:Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any forms of traumatic events including myocardial infarction (MI). PTSD after MI may affect quality of life and cardiovascular outcome.Objective: This study aimed to assess the degree of severity of the core symptoms of depression, anxiety and stress in MI patients,to signify Post-traumatic Stress Disorders among MI patients according to their age, sex and severity,to define the full range of core symptoms of depression and anxiety, meet difficult standards of psychometric adequacy in MI patients.Method:A descriptive study, design was applied in Ibn sena teaching hospital, in Mosul city for period from 14th, May, 2012 to 1st, September, 2012 in order to achieve the objectives of the present study.The study subjects consist of54 patients who were diagnosed with myocardial infarction in Ibn sena teaching hospital, their age ranges between (40-89) years.In the present study Depression, Anxiety and Stress Scale (DASS,1995) was used to diagnose patients with Depression Anxiety and Stress.Results: The severity of Post-traumatic Stress Disorders in MI patients shows that most of patients had moderate stress disorders which constituted 48% while 55%of them had extremely severe anxiety, and on depression scale had moderate and severe.The majority of male had moderate stress disorders which constituted (48.5%), while (69.5%) of female had extremely severe anxiety disorder and the majority of female had server depression.Conclusions:The study highlighted the developmentof PTSD after MI.Anxietydisorders are more severe than depression and stress disorders. Anxiety disorders have the highest percentage and frequency among female.Depression disordershas the highest percentage and frequency and found in age group (50-59).Recommendations:Integration care of patient with myocardial infarction in all spectrums (psychiatry, healthy, socially, and educationally ). Psychiatrists and nurses must be aware of increased prevalence of PTSD after MI and importance of early detection of any suspected case and referral to Psychiatric research unit.

الخلفية :اضطراب كر بما بعد الصدمة هو اضطراب القلق الشديدة التي يمكن أن يظهر بعد التعرض لأي شكل من أشكال الأحداث المؤلمة بما في ذلك احتشاء عضلة القلب.اضطراب كرب ما بعد الصدمةوربما تؤثر على نوعية الحياة وحصيلة القلب والأوعية الدموية.الأهداف: هدفت الدراسة إلى تقييم شدة الأعراض الأساسية للاكتئاب والقلق والإجهاد لدى مرضى أحشاء العضلة القلبية, وللدلالة على اضطراب كرب ما بعد الصدمةبين مرض احتشاء عضلة القلب حسب الجنس, العمر والشدَّة.المنهجية: دراسة وصفية, تم تطبيق التصميم في مستشفى أبن سينا التعليمي في مدينة الموصل للفترةمن 14 أيار،2012الى الاول أيلول، 2012من أجل تحقيق أهداف هذه الدراسة,وتكونت عينة الدراسة من (54) مريض مشخصين كمرض احتشاء العضلة القلبية. وأعمارهم تتراوح بين(40 – 89) سنة.في هذه الدراسة تم استخدام مقياس لتشخيص المرضى الذين يعانون من القلق والاكتئاب والإجهاد (1995).النتائج: أشارت النتائج أن معظم المرض كان لديهم إجهاد متوسطة والتي شكلت (48%) بينما (55%) منهم القلق الشديد للغاية, وكانوا يعانون من كأبة متوسطة .غالبية الذكورِ كَان لديهم اِضطراباتُ الإجهادِ متوسطة والتي شكّلتْ (48.5 %)، بينما (69.5 %) مِنْ الأناث كَانَ لديهما ضطرابات قلق حاد جداً وأغلبيةِ الأناث كَانَ لديهم كآبةُ شديدة.استنتاجات: سلطت هذه الدراسة الضوء على تطور اضطرابات كرب ما بعدالصدمة لدى مرض احتشاء العضلة القلبية. اضطرابات القلق كانت الأكثر شدة من اضطرابات الكأبة والإجهاد. اِضطرابات القلق كانت الأكثر تكرار ونسبة مئويةُ لدى الإناث. اِضطرابات الكآبة كانت الأعلى نسبة والأعلى تكراراوظهرت في الفئة العُمرية (50-59).التوصيات : أوصت الدراسة بتقديم الرعاية الشاملة للمريض احتشاء العضلة القلبية من جميع النواحي(النفسية ,الصحية ,الاجتماعية والتعليمية). الطبيب النفسي والممرض يجب ان يكونوا واعيين لنسب الزيادة الحاصلة لكرب ما بعد الصدمة لدى مرضى احتشاء العضلة القلبية وأهمية التشخيص المبكر وأحاله المرض المشتبه بهم الى وحدة البحوث النفسية.

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