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Article
Oral manifestation of leukemic children under chemotherapy
الإعراض الفموية لأطفال سرطان الدم تحت العلاج الكيميائي

Authors: Wafaa M. Atoof --- Dunia W. Sabea --- Sajid M.Hameed
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 2 Pages: 65-74
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: The term leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). When a child has leukemia, large numbers of abnormal white blood cells are produced in the bone marrow. These abnormal white cells crowd the bone marrow and flood the bloodstream, but they cannot perform their proper role of protecting the body against disease because they are defective. Most of the children with cancer will be at risk for significant pain at some time during the course of illness. Objective: To assess the oral manifestation in children with leukemia under chemotherapy treatment and its relation to the duration of patient's hospitalization.Patients and methods: One hundred twenty seven patients diagnosed Acute Lymphocytic Leukemia (ALL),collected from Children Welfare Teaching Hospital /Medical City, Central Child Teaching Hospital/Baghdad (hematology & oncology unit) from 25th January 2009 to 25th January 2010, the questionnaire including demographic & clinical information, main oral manifestations. Results: Patients samples ranged in age from (5 – 16) years, only 55 patients (43%) were aged from (8-10) years; 75patients (58.5%) were males;40 patients (31%) were living in south of Iraq. Swollen&palpable lymph node were the main chief complaints in 40 patients (31%); duration of disease is Less than 6 months, in 65 patients (51%); patients who stay in hospital more than 15 days were 90(70.8%); patients who their diagnosis were based on core biopsy & bone marrow biopsy were the most diagnostic methods in 40 (31%); in about half of the patients hematological tests showed that Thrombocytopenia &leucocytosis, elevated in erythrocytes sedimentation rate and anemia. Main oral manifestations presented were: ulceration gentle pressure, spontaneous bleeding, dry mouth, ulcerated/with or without bleeding of lips, laryngeal pain, unable to swallow and difficult/painful speech and mucositis.Conclusions: In this study we can conclude that the main oral manifestations in patient with leukemia were ulceration after gentle pressure; spontaneous bleeding; dry mouth; ulcerated/with or without bleeding of lips, laryngeal pain; unable to swallow and difficult/painful speech, and the duration of hospitalizations were related to the manifestations of patients and their chief complaints; diagnostic procedure and their therapy.Recommendation: the oral manifestations of patient with leukemia are focusing on them through a palliative measures such as the treatment of pain, and nutritional support and maintenance of good oral hygiene.

خلفية البحث : يشير المصطلح إلى اللوكيميا سرطان خلايا الدم البيضاء (وتسمى أيضا الكريات البيض أو الكريات البيضاء ). عندما يكون الطفل مصاب بسرطان الدم، يتم إنتاج أعداد كبيرة من خلايا الدم البيضاء غير الطبيعية في نخاع العظام. هذه الخلايا غير طبيعية تنتج بكثرة من نخاع العظم ، لكنها لا يمكن أن تؤدي دورها الصحيح تجاه حماية الجسم ضد المرض لأنهم معيبة. ومعظم الأطفال المصابين بالسرطان تكون في خطر الألم الشديد في وقت أثناء المرض.الهدف: تقييم حالة الفم في الأطفال الذين يعانون من سرطان الدم تحت العلاج الكيماوي وعلاقته مدة الاستشفاء المريض.المنهجية : مائة وسبعة وعشرون مريض مشخص بسرطان الدم الليمفاوي الحاد ( ALL)، تم جمعها من مستشفى حماية الأطفال / مدينة الطب،ومستشفى الطفل المركزي التعليمي / بغداد (وحدة أمراض الدم و الأورام) من 25 يناير 2009 إلى 25 يناير 2010، على الاستبيان بما في ذلك المعلومات الديموغرافية و السريرية والمظاهر الفموية الرئيسي.النتائج: تراوحت عينات المرضى أعمارهم بين ( 5-16 ) سنة، و الذين تتراوح أعمارهم بين 55 مريضا فقط ( 43 ٪ ) من ( 8-10 ) سنوات، وكانت 75 مريضا 58.5) ٪) من الذكور و 40 مريضا ( 31 ٪ ) كانوا يعيشون في جنوب العراق . واهم الشكوى كانت تورم العقد الليمفاوية في 40 مريضا ( 31 ٪ )؛ مدة المرض هو أقل من 6 أشهر في 65 مريضا ( 51 ٪ ) ؛ المرضى الذين يبقون في المستشفى أكثر من 15 يوما كانت 90 مريضا ( 70.8 ٪ ) ؛ المرضى الذي استندت التشخيص على الخزعة الأساسية و خزعة نخاع العظم كانت أكثر الوسائل التشخيصية 40 مريضا ( 31 ٪ )، في حوالي نصف المرضى أظهرت اختبارات الدم نقص في الصفيحات والكريات الدم البيضاء وارتفاع في كريات الدم الحمراء ومعدل الترسيب و فقر الدم. ومن أهم الأعراض الفموية هي: جفاف الفم ؛والتهاب الغشاء الفموي, تقرح / مع أو بدون نزيف من الشفتين ؛ تقرح مع ضغط خفيف، ألم الحنجرة وصعبة البلع والتكلم.الاستنتاجات: في هذه الدراسة يمكننا أن نستنتج أن الأعراض الفموية الرئيسية لمريض سرطان الدم هو تقرح مع ضغط خفيف؛ جفاف الفم والتهاب الغشاء الفموي؛ تقرح / مع أو بدون نزيف الشفتين، وألم الحنجرة و غير قادر على البلع والتكلم، ومدة الاستشفاء كانت مرتبطة بحالات المرضى مع الشكوى الرئيسية .التوصيات: أوصى الباحثين أن اعرض الفم للمصابين بسرطان الدم يتم التركيز عليه ممن خلال إجراء التدابير الملطفة مثل علاج الألم، و الدعم الغذائي ومتابعة صحة الفم بشكل دوري.


Article
Oral Findings in Rheumatoid Arthritis Patients

Author: Ali Mihsen Hussein Al-yassiri
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1584-1590
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Rheumatoid arthritis affects women more than men 3:1. Rheumatoidarthritis can start at any age but most commonly occurs in the 30 – 50 age groups.Rheumatoid arthritis also has oral, occular manifestations, dryness, swelling ofsalivary glands, xerostomia, oral and mucosal ulcerations. The aims of this study were todetermine the oral manifestations in newly and old (previously) diagnosed Rheumatoidarthritis patients and compare it with healthy controls (without systemic diseases) and finallyto find the accurate prevalence of these manifestations in rheumatoid arthritis patients.Materials and methods: Seventy two (72) subjects were incorporated in this study, theywere divided into 2 groups, Rheumatoid arthritis patients group: fifty – two (52) patients withrheumatoid arthritis, they were (11) males and (41) females, Seventeen newly diagnosedrheumatoid arthritis untreated patients. Thirty five rheumatoid arthritis patients were onmethotrexate treatment. All rheumatoid arthritis patients were without any other systemicdisease. Healthy control group: - twenty healthy control subjects with no signs and symptomsof any systemic disease. They were sex and age matched to rheumatoid arthritis patients.Results: The results revealed that the main oral manifestations of Rheumatoid arthritispatients were angular cheilitis, candidial infection, tempromandibular joint disorder, oralulceration, and xerostomia. In old diagnosed rheumatoid arthritis patients, the percentages oforal ulcerations, tempromanbdibular joints, and xerostomia was significantly higher than innewly diagnosed rheumatoid arthritis patients. While the percentage of angular chilitis andcandidial infections in newly diagnosed rheumatoid arthritis patients was significantly higherthan in old (previously) diagnosed patients.Conclusion: Rheumatoid arthritis is a chronic disease in which Saliva is a goodrecommended sample for evaluation and estimation of the severity of disease as well astreatment follow up. Oral ulceration and xerostomia are the most prominent oralmanifestations coincide with the progress of the disease and treatment.


Article
The Effect of Carrageenan on Lymphoma Patients under Chemotherapy (A case series study)

Authors: Israa A. Al-Mamory --- Fawaz D. Al-Aswad
Journal: Journal of Oral and Dental Research مجلة طب الفم والاسنان ISSN: 23106417 Year: 2017 Volume: 4 Issue: 2 Pages: 158-168
Publisher: Iraqi Association for Oral Research الجمعية العراقية لبحوث طب الفم

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Abstract

Background There are three types of carrageenan available (iota, kappa, and lambda) which differ in composition and degree of sulfation in polymeric structure. A malignant lymphocytes that accumulate in lymph nodes causes a group of diseases called Lymphomas causing the characteristics lymphadenopathy. These may pelt over into the blood or infltrate organs outside the lymphoid tissue. They are Hodgkin›s lymphoma and non–Hodgkin›s lymphoma and this is based on the histologic presence of Reed-Sternberg cells in Hodgkin›s lymphoma. Objectives The present study designated to determine the oral manifestations after application of carrageenan in patients with Hodgkin›s& Non-Hodgkin›s lymphoma receiving chemotherapy and to determine the effect of topical carrageenan on the levels of salivary immunoglobulin A, interleuekin-6 and tumor necrosis factor-α in Hodgkin›s & non-Hodgkin›s lymphoma patients. Results The oral manifestations was in Non-Hodgkin›s lymphoma patients (64%) and in Hodgkin›s lymphoma patients (36%) taste alteration, followed by burning mouth syndrome, dry mouth and lastly candidiasis with signifcant differences after application of carrageenan p>0.05.The levels of salivary immunoglobulin A, interleuekin-6 and tumor necrosis factor-α were slightly decreased but not signifcantly differences after carrageenan application. Conclusions The carrageenan effects on oral lesion may allow the use of Κ –carrageenan as a base or primary compound in dental practice besides the other compounds like chlorhexidine. The salivary immunological markers level slightly decreased in lymphoma patients after receiving carrageenan which indicate that there is no absorption from oral mucosa.


Article
Oral manifestations, oral health status and saliva composition changes in a sample of Iraqi systemic lupus erythematosus patients

Authors: Noor S. Mohammed نور محمد --- Taghreed F. Zaidan تغريد زيدان
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 2 Pages: 65-69
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with significantmorbidity and mortality. Sicca symptoms are frequent in SLE which may be related to concomitant occurrence ofSjögren's syndrome (SS). The aims of study were to determine prevalence of oral manifestations andtempromandibular joint disorders, and to find a correlation between the changes in saliva flow rate, pH andcomposition with the incidence of dental caries in SLE patients.Subjects, materials and methods: One hundred and two individuals were enrolled in this study; 52 of them were SLEpatients; and 50 were healthy control individuals matched in age and gender. The assessment of dental status wasmade according to the decay missing filling teeth (DMFT) index; the gingival inflammation was assessed using thecriteria of gingival index; Clinical pocket depth was measured with periodontal probe type William, and wholeunstimulated saliva samples have been collected from each subject for biochemical analysis. Also, salivary flow rateand pH were measured. After centrifugation, the supernatant of saliva was aspirated for biochemical analysis.Results: Oral ulceration was the most prominent orofacial manifestations of SLE patients followed byTempromandibular joint (TMJ) disorders and facial skin rash then oral vesicles& bullae, oral lichen planus and finallyoral petechiae & purpura. Salivary flow rate and salivary pH were significantly lower in SLE patients than in the controlsubjects. Oral hygiene index (DMFT index, gingival index, Clinical pocket depth) were significantly higher in SLEpatients than in the control subjects .Salivary calcium, sodium, chloride, and total protein were significantly higheramong SLE patients than in the control subjects. While salivary potassium and inorganic phosphorus were significantlylower among SLE patients than in the control subjects. In addition, there was a highly significant positive linearcorrelation between age of SLE patients and DMFT, and between age and clinical pocket depth; and a highlysignificant negative linear correlation between salivary flow rate and salivary calcium in SLE patients. Also there washighly significant positive linear correlation between DMFT and salivary calcium, and between DMFT and salivarychloride.Conclusions: Oral manifestations are common in Iraqi SLE patients. Changes in salivary flow rate, pH, salivarycomposition, and increased dental caries may serve as potential markers of the extent of autoimmune mediatedsalivary gland dysfunction which is similar to Sjogren’s syndrome


Article
Oral manifestations, microbial study and salivary IgA study in lymphoma patients receiving chemotherapy

Authors: Hamza W. Ahmed Al-kuhla حمزة احمد الكحلة --- Fawaz D. Al-Aswad فواز الاسود
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 1 Pages: 39-44
Publisher: Baghdad University جامعة بغداد

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Background: Lymphoma is a general term that includes 40 different sub-types of the disease. These can be dividedinto two main types: Hodgkin Lymphoma and Non-Hodgkin lymphoma. Lymphomas are a cancer of white cellsproduced by the bone marrow and matured in the lymphatic system. The cancer may originate in the lymph glandsor organs such as the liver, spleen, bowel or bone marrow. The aims were to determine the prevalence of oralmanifestations in lymphoma patients, isolate and identify different microorganism (aerobic, anaerobic and fungi),from oral micro flora from lymphoma patients under chemotherapy and detect the level of salivary IgA incomparison with healthy control.Subjects, materials and methods: The study included 52 lymphoma patients (17 Hodgkin’s and 35 Non Hodgkin’s) ofboth sexes (27 male and 25 female) those patients were matched in age and sex with 15 healthy control subjects.Results: The most frequent oral manifestations in the lymphoma patients in this study was taste alteration (52.2%),burning mouth sensation (37.3%), dry mouth (37.3%), halitosis (16.4%) and (7.5%) white coated tongue respectively.Various species of bacteria were isolated; the main bacteria isolated were streptococcus viridians, Neisseria,Staphylococcus aureus, Staphylococcus albus, Pseudomonas, Actinomyces, Lactobacillus, Klebsiella, andEscherichia-coli and anaerobic bacteria such as Peptostreptococcus and Bacillus. Fungi such as Candida albicanswere also identified. Level of Salivary IgA was significantly decreased in lymphoma patients under treatment incomparison to healthy control.Conclusions: The finding of this study shows obvious differences in the prevalence of micro-organisms betweenlymphoma patients and healthy control. The most frequent oral manifestations in lymphoma patients were tastealterations, xerostomia, and burning mouth sensation.A significant decreased in level of salivary IgA was noticed in all lymphoma patients.It is highly recommended that all patients to have thorough dental examination before starting treatment


Article
Oral manifestations, biochemical, and IL-6 analysis of saliva in major depressive disorder patients under treatment

Authors: Omar F. Fawzi عمر فوزي --- Fawaz D. Al-Aswad فواز الاسود
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 2 Pages: 89-93
Publisher: Baghdad University جامعة بغداد

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Background: Major depressive disorder (MDD) is mental disorder characterized by an all-encompassing low moodaccompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The aims of thestudy: were to determine the prevalence of oral manifestation among patients with major depressive disorderreceiving antidepressant drugs, and detect alkaline phosphatase (ALP), Total Salivary proteins (TSP), and Interleukin-6(IL-6) in relation to MDD patients under treatment and to compare with healthy controls.Materials and method: (50) MDD patients; between the ages of 20 years and 60 years.The depression patients aredivided into (25) patients under treatment with fluoxetine (Prozac), and (25) patients under treatment withimipramine (Tofranil).The depression patients are diagnosed according to Hamilton depression scale used in thedepartment of psychiatry in Al-Yarmouk Teaching Hospital by a psychiatric specialist.Results: The most frequent oral manifestations in the patients with MDD, in this study were burning mouth syndrome(72%), and dry mouth (70%), while metallic taste (48%) was fairly frequent, males more effected than females.Burningmouth syndrome, and metallic taste were more frequent in patients with Prozac treatment, while dry mouth wasmore frequent in patients with Tofranil treatment. increased levels of IL-6, TSP, and ALP in MDD patients receivingtreatment as compared to healthy controlConclusion: frequent oral examination of patients with MDD is mandatory, and these patients should be a majorconcern in dental practice


Article
Oral Manifestations, Biochemical, and IL-6 Analysis of Saliva in Epileptic Patients under Treatment

Authors: * Dr. Omar Faridh Fawzi, B.D.S. M.Sc. ** د. عمر فوزي --- Dr. Fawaz Dawood Al-Aswad, B.D.S.,M.Sc.,Ph.D. د. فواز داود
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2013 Volume: 10 Issue: 1 Pages: 105-116
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: From the ancient Greek (epilepsia). Seizure is common and diverse setof chronic neurological disorders characterized by seizures.Patients and Methods: The sample population comprised 10 epilepsy patients and 10persons with no history of systemic disease, oral manifestation was recorded aswell as saliva samples were taken. The IL-6, alkaline phosphatase and totalsalivary proteins had been measured.Results: The most frequent oral manifestation was gingival hyperplasia 85.7%, anddry mouth 75%, increased level of IL-6 and total salivary proteins in epilepsypatients receiving treatment, when comparing the level of alkaline phosphatase,slightly decreased in study group, with no statistical significance.Conclusion: In addition to the systemic effects of antiepileptic medication, and oraleffects, including saliva composition and oral manifestation was recorded also.Therefore epileptic patients are at an increased risk of developing dry mouth,gingival hyperplasia, and alteration in saliva composition compared with healthsubjects.


Article
Trace Elements Levels and Oral Manifestations in Type 2 Diabetic Patients

Author: Huda Shakir Ahmed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 2 Pages: 161-164
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Diabetes mellitus (DM) has been shown to be associated with oral manifestations and abnormalities in the metabolism of micronutrients, especially copper, zinc, and magnesium. OBJECTIVE: To study the oral manifestations in type 2 diabetic patients and to estimate trace elements levels such as copper (Cu), zinc (Zn), and magnesium (Mg) in those patients comparing to control group. PATIENTS AND METHODS: A total of 30 diabetic patients were studied for their oral manifestations and trace elements levels including serum copper, zinc, and magnesium; their age range was (40-55) years and compared with 30 healthy controls. RESULTS: There was a significant decrease in serum Cu, Zn, and Mg in DM patients as compared with their controls, (P < 0.05). Also, several oral complications are seen among diabetics. CONCLUSION: It can be concluded that several oral complications are seen in diabetic patients. The deficiency of some essential trace metals such as Cu, Zn, and Mg may play a role in the development of diabetes.


Article
Oral manifestations, microbial study and salivary IgA study in asthmatic patients receiving prednisolone

Authors: Mushtaq T. Ibraheem مشتاق ابراهيم --- Fawaz D. Al-Aswad فواز الاسود
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2014 Volume: 26 Issue: 2 Pages: 87-93
Publisher: Baghdad University جامعة بغداد

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Background: Asthma is a disease of the airways characterized by chronic inflammation associated with airwayhyper-responsiveness and airway wall remodeling.Aims of the study: The aims of this study was to determine the prevalence of oral manifestations , identify differentmicroorganism from oral micro flora and determination of salivary IgA and salivary flow rate in asthmatic patientstaking different dose of Prednisolone in comparison with control group.Subjects, materials and methods: The study included 17 patients under treatment with Prednisolone (10-20 mg),15patients take (20-30 mg) of Prednisolone and other 18 patients take (30 – 40mg) of Prednisolone, and 25 healthycontrol group (10 male and 15 female).Results : The most frequent oral manifestations in asthmatic patients on Prednisolone was burning mouth syndrome,then dry mouth, tooth erosion and white coated tongue and decreased in salivary flow rate. High prevalence ofStaphylococcus aureus , Staphylococcus epidermidis , streptococcus Viridians and Candida albicans in patients withasthma and difference in oral microbial isolation between asthmatic patients take different dose of Prednisoloneand healthy control.The level of salivary IgA in asthmatic patients treated with Prednisolone less than healthy control.Conclusions: The findings of this study show an obvious difference in the prevalence of oral manifestation and somemicro-organisms between patients with asthma and healthy control. Decrease of IgA and salivary flow rate inpatients with asthma as compared to healthy control


Article
Assessment of oral manifestations of patients with renal failure undergoing hemodialysis by serum and salivary biomarkers

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Background: Renal failure refers to a condition where the kidneys lose their normalfunctionality. Patients with end stage renal disease (ESRD) have to undergohemodialysis (HD), With impaired renal function, a decreased glomerularfiltration rate (GFR), and the accumulation and retention of various products ofrenal failure, the oral cavity may show a variety of changes as the body progressesthrough an azotemic to a uremic state. The general dentist should be able torecognize these oral symptoms as part of the patient’s systemic disease and not asan isolated occurrence.Aims of the study: To evaluate the biochemical properties of the saliva andAssessment of oral manifestations in patients with chronic renal failureundergoing hemodialysis.Patients and methods: Spectrophotometer was used for measuring serum andsalivary calcium, phosphorous, urea and creatinine in thirty three hemodialysispatients and twenty two control healthy subjects . Salivary PH, Gingival indexand salivary buffering capacity was also recorded.Results and discussion: All serum and salivary biomarkers (calcium, phosphorous,urea and creatinine) were significantly changed in hemodialysis patients (calciumdecreased while the others increased).Also salivary PH and buffering capacitywere significantly increased in hemodialysis patients. Gingival index alsoincreased, and the oral manifestations that was recorded include: dry mouth(n=21), uremic odor (n=20) , bad taste (n=17) , burning sensation (n=14) , coatedtongue (n=10) ,pale mucosa ( n=5) petechia (n=3), fissured tongue (n=3).Conclusions: there was differences in salivary parameters between hemodialysispatients and control group and the salivary variables was correlated too serumvariables , many oral manifestations found to be in hemodialysis patients.

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