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Article
Histopathological changes of decidua and decidualvessels of early pregnancy

Authors: Noel S. Al-Sakkal نوئيل سليمان الصقال --- Rana A. Azooz رنا عاصم عبد الكريم عزوز
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2009 Volume: 35 Issue: 1 Pages: 37-41
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACT
Objective: The histological examination of the decidua can provide a clue in the diagnosis of intrauterine pregnancy. The purpose of this study is to describe the morphologic features observed in the decidual blood vessels of early pregnancy loss cases prior to 20 weeks gestation, and to compare these findings with Arias-Stella reaction and with changes found in endometrial biopsies of non-pregnant women as a control group.
Material and method: A prospective case control study done at the Department of Pathology of Mosul Medical College, Histopathological Laboratories of Al-Khansa and Al-Zahrawi Teaching Hospitals and the gynecological units of Al-Khansa and Al- Batool Teaching Hospitals in Mosul.
The study was conducted on 161 reproductive aged women with different clinical types of abortion admitted for uterine evacuation. The histopathological features in the decidua and decidual vessels of curettage specimens were described, graded and compared with that observed in endometrial biopsies of non pregnant women as a control group.
Results: Out of a total 161 abortion specimens examined,10.6% of cases showed severe degree of obliterative endarteritis involving one or more decidual vessels. This finding was higher than the frequency of Arias-Stella reaction in the same specimens and none of these features were described in the control group .
Conclusion: Obliterative endarteritis of decidual vessels can be used together with other morphological features for the possibility of occurrence of a pregnancy in the absence of chorionic villi, trophoblast and other emberyonic elements.

الخلاصةالهــدف: يمكن للفحص النسيجي للغشاء الساقط أن يؤشر لحدوث الحمل داخل الرحم. تهدف الدراسة إلى وصف التغييرات المظهرية الملاحظة لأوعية الغشاء الساقط في حالات فقدان الحمل المبكر قبل عمر 20 أسبوع ومقارنة النتائج مع تغييرات ارياس- ستيلا ومع التغييرات الملاحظة لخزع بطانة الرحم لنساء غير حوامل كمجموعة مقارنة. الطريقة: دراسة مستقبلية أجريت في فرع علم الأمراض في كلية طب الموصل والمختبرات النسيجية ووحدات النسائية لمستشفيات الخنساء والزهراوي والبتول التعليمية في مدينة الموصل. أجريت الدراسة على 161 امرأة في سن الإخصاب يعانين من حالات إجهاض متنوعة ادخلن لتفريغ الرحم. تم وصف وتصنيف ومقارنة التغيرات النسيجية للغشاء الساقط وأوعيته في عينات تجريف الرحم مع تلك الملاحظة في خزع بطانة الرحم للنساء غير الحوامل كمجموعة مقارنة.النتائـج: من ضمن 161 عينة إجهاض، أظهرت 10,6 % من الحالات درجة شديدة من التهاب بطانة الشريان ألانسدادي والتي شملت واحد أو أكثر من أوعية الغشاء الساقط. وكان تكرارها أكثر من تكرار تغيرات ارياس-ستيلا لنفس العينات بينما لم تشتمل مجموعة المقارنة على أي من تلك الصفات.الاستنتاج: يمكن استخدام التهاب بطانة الشريان ألانسدادي لأوعية الغشاء الساقط مع التغيرات المظهرية الأخرى كمؤشر لحدوث الحمل في حالة عدم وجود الزغابات المشيمية، الطبقة الغاذية والعناصر الجنينية الأخرى.

Keywords

decidua --- pregnancy


Article
“Cytomegalovirus Seroprevelance in Iraqi Pregnant Women”

Authors: Sajed Nader --- Mohammed Ayad**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 303-307
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Cytomegalovirus is the commonest cause of congenital viral infection in the developed and developing countries. It is a symptomatic in 90% of infected females. Forty percent of pregnant females transmit the virus to their fetus. Ten percent of born infants whom gain the virus will get the clinical signs plus its neurological sequelae.OBJECTIVE:To outline the relationship between Cytomegalovirus infection among pregnant women and its influence upon their pregnancy outcome.PATIENTS AND METHODS:A case-control study was carried out was carried out in the teaching laboratories – medical city, Baghdad through a period from June 2010 till March 2011; upon 165 pregnant women whom taken as a patient group. Blood samples were taken from them and Cytomegalovirus-IgM antibodies plus Cytomegalovirus-IgG antibodies levels were measured via Elisa technique in both to evaluate the viral infection if present or not.RESULTS:The usual age whom attended the gynea-obestetric clinics were the age group from 11-19 years old 73 cases (44.24%); Next came the age group from 20-29 years old 66 cases (40.00%), thirdly was the age group from 30-39 years old 20 cases (12.12%), Lastly was the age group from 40-49 years old 6 cases (3.64%). The concentration of CMV-IgG among females whom attended clinics were seropositive in nearly half the included cases 66/165 (40.0%); while the CMV-IgM concentration was within the seronegative limits. Secondly came another group of patients with seronegative limits regarding both the CMV-IgM and CMV-IgG antibodies 56/165 cases (33.94%), next 30/165 cases (18.18%) were seropositive in their results pointing to both CMV-IgM and IgG limits; and this might be a middle point distance between the previous group and the last group were the CMV-IgM was positive and the CMV-IgG concentration was negative 13/165 cases (7.88%).CONCLUSION:Cytomegalovirus-IgG antibodies got important role as a protective agent against gestation abortion, if Cytomegalovirus-IgM antibodies are seropositive alone this is a risky factor to the pregnancy outcome


Article
Ectopic pregnancy, A Prospective Study In Al-Batool Teaching Hospital In Mosul – Iraq

Author: Ghada Al-Daheen
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 63-69
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ectopic pregnancy (EP) is the implantation of pregnancy at an extra uterine site. EP accounts for approximately 2 % of reported pregnancy. The largest risk factors are upper genital tract infection due to sexually transmitted diseases (STDs), as well as other risk factors as smoking, the use of intrauterine device, previous tubal or pelvic surgery, history of infertility, and the risk of age and parity. It is difficult to diagnose EP clinically. However diagnostic aids like B-hCG assessment and ultrasound scan has proved to be of great help. The treatment trends for ectopic pregnancy have changed to more conservative procedures like salpingostomy, segmental resection and fimbrial expression.
Methods: From September 2000 to September 2002, a prospective study was conducted to forty patients who were admitted at Al-Batool teaching hospital, as proven or suspected cases of ectopic pregnancy.
Complete assessment of the patients through detailed history and clinical examination was carried out, and accordingly patients were classified into unstable and stable groups.
The investigations has included pregnancy test (PT), ultrasound scan (USS), and laparoscopy.
The operative procedures were either salpingectomy, or conservative surgery in the form of salpingostomy and milking of the tubes.
Histopathological examination confirmed EP in all surgically treated patients.
Results: Forty cases of ectopic pregnancies were collected. 67.5 % were in the age group 26 – 35 year.
Women with higher parity had the highest percent with EP (37.5 %).
Twenty - seven cases (67.5 %) were clinically unstable.
USS was performed for twenty – six (65 %) patients with positive results in all, where twenty – one patients (80.76 %) had an adnexial mass.
Diagnostic laparoscopy was carried out in four cases (10 %) only.
Among the forty cases of EP the findings at laparotomy were as follows:
Tubal abortion was evident in four cases ( 10 % ). Intact ampullary pregnancy in fourteen patients (35 % ), two isthmic gestations (5 %), two ovarian pregnancies ( 5 %) , and one corneal pregnancy( 2.5 %). In seventeen cases (42.5 %) there was ruptured ectopic pregnancy. There was accompanying ovarian cysts in five patients (12.5 %),
The operative procedures included: Salpingectomy in thirty one patients ( 77.5 % ) , salpingostomy in two cases ( 5 % ), milking of the tube in four cases ( 10% ), and conservative removal of the products of conception from the ovarian tissue with adequate haemostasis in the two cases of ovarian pregnancy ( 5 % ).
The route of exploration and management was through opened laparotomy in all. Two cases that were treated through laparoscopy.
Conclusion: Early diagnosis of cases of ectopic pregnancy would reduce the morbidity and even the mortality of ectopic pregnancy. It allows more conservative form of treatment to be applied, and thus giving a better chance for the patient to preserve fertility.
Key word: Ectopic pregnancy, tubal pregnancy, risk factors in ectopic pregnancy


Article
Periodontal status during pregnancy

Author: Bacima G. Ali باسمة علي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2005 Volume: 17 Issue: 2 Pages: 64-68
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The purpose of the present research was to determine the prevalence and severity of gingival inflammation at different periods of gestation and the prevalence of pregnancy tumor, since the hormonal changes have been implicated complicating factors for periodontal disease.Method: Fifty women were examined; seventeen women from first trimester, twenty at second trimester and thirteenth at third trimester.Results: It was revealed that a high prevalence of periodontal disease increased with advanced stages of pregnancy. The percentage of pregnancy tumor was 6% from the total sample and only in 2nd and 3rd trimester groups.Conclusion: Local treatment in a preventive oral hygiene program from early pregnancy is very important to prevent further progression of any inflammation


Article
Maternal risk in teenage pregnancies

Author: Anwar N. Al-Bassam انوار نوري البصام
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2014 Volume: 10 Issue: 17 Pages: 214-223
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: Early marriage and confinement are contributing factors to high maternal mortality and morbidity.Objective: To identify the maternal complications of teenage pregnancy.Patients and Methods: A hospital based cohort study was undertaken among pregnant ladies admitted to Baghdad teaching hospital. The study group comprised of teenage mothers between 15-19 years old and a control group of mothers between 20-24 years old in their first pregnancy. Data included socio-demographic characteristics, ANC, medical and obstetrical complications, mode of delivery .Results:. The study group include 228 primigravida aged between (15-19)years and the control group composed of 272primigravida aged between (20-24)years.There is statistically significant difference between the two groups in educational level (p=0.0001), antenatal care (p=0.0001) , anemia (p=0.0001), hypertensive disorders [ OR-95%CI=10.96 (4.15-35.51) *], elective cesarean section[ OR-95%CI=2.13(1.2-3.85)*] Conclusion: The study shows that poor educational level ,poor ANC , medical problems complicating pregnancy ,operative deliveries are higher in teenagers.

خلفية الدراسة: الزواج المبكر والولادة هي عوامل مساهمة لسقم وموت الامهدف الدراسة : تقييم ضخامة مشكلة الحمل في سن المراهقة ومضاعفاته وحصيلته.المرضى والطرق: أجريت دراسة وصفية في مستشفى بغداد التعليمي,تضمنت الدراسة مجموعة النساء الحوامل في سن يافعة (15-19) سنة ,رمزن بالمجموعة المعرضة , ومجموعة النساء الحوامل اللواتي بلغ أعمارهن بين(20-24) سنة, رمزن بالمجموعة المقارنة في حملهن الاول الولادة أو بسبب مضاعفات الحمل .المعلومات التي جمعت تضمنت المواصفات الاجتماعية,المستوى التعليمي,العناية الصحية ,مضاعفات الحمل ,طريقة الولادة النتائج: المجموعة المعرضةاشتملت 228 حامل بكربين سن (15-19)سنة, والمجموعة المقارنة اشتملت 272حامل بكربين سن(20-24)سنة.هناك فرق إحصائي مهم بين المجموعتين في المستوى التعليمي(بقيمة بي =0.0001),العناية الصحية(بي 0.0001), فقر الدم(بي =0.0001) ,ارتفاع ضغط الدم أثناء الحمل(نسبة اود=10.96),العمليات القيصرية الباردة(نسبة اود=2.13),ألاستنتاج: الدراسة أظهرت أن ضعف المستوى التعليمي,ضعف العناية الصحية, المشاكل الطبية المعقدة للحمل,الولادات بعملية, كانت أكثر عند المراهقات


Article
Salivary magnesium during pregnancy and laborand its relation to gingivitis

Author: Wesal A. Al-Obaidi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 4 Pages: 387-390
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Changes in the level of salivary magnesium could be of great clinical interest not only because of its relation with oral health but also with the physiological alteration occurring during pregnancy. The aim of this study was to investigate the effect of pregnancy on the salivary magnesium level and their relations to gingivitis.Materials and methods: Salivary samples were taken from 24 pregnant women, 17 non pregnant and 14 lactating women. Flow rate was calculated. The supernatant salivary samples were assayed using atomic absorption spectrophotometer. Gingival Index was applied for the assessment of gingival inflammation.
Results: Salivary magnesium concentration was significantly the lowest mean value during pregnancy, with decrease in concentration in the third trimester followed by a marked increase after labor reaching the normal level. Pregnant women had a significantly highest Gingival Index mean than other control groups. Very weak correlations were found between flow rate and (pregnancy and salivary magnesium). A positive correlation was recorded between gingivitis and pregnancy and a negative correlation between gingivitis and salivary magnesium. However, statistically all correlations were not significant.
Conclusion: The salivary magnesium is influenced by female sex hormone during pregnancy. Analysis of saliva may be applicable as an investigation means of the physiological alterations that occur during and after pregnancy.


Article
Candida Vulvovaginitis in pregnancy

Authors: Sawsan A. Hussien --- Eman E. Yousif
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 185-187
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Vulvovaginal candiddiasis is an opportunistic mucosal infection caused by Candida albicans that affects large number of otherwise healthy women of child bearing age. Acute episodes often occur during pregnancy.Patients and methods: This study was done on 50 pregnant women with Candida vulvovagnitis who were diagnosed by direct microscopic examination, culture technique, germ tube production, chlamydospore, and Api 20 candida system, at Baghdad Teaching Hospital in the period between October 2008 to February 2009.
Results: The study group included 50 pregnant women with Candida vulvovaginitis . The percentage of pregnant women with Candida albicans infection who their age is higher than 30 years old is 100 %( 23cases), while the percentage is high as 100 % (36cases) in pregnant women whom their gestational age more than 37 week gestation. On the other hand the percentage of pregnant women who have children more than 3 (100%) (12cases). Candida albicans was occurred more frequently when pregnant women suffered from diabetes mellitus 100 %( 14cases). Conclusion: Direct relationship was detected between the percentage of infection and the age of the mother, gestational age, parity, and the presence of diabetes mellitus, the higher the age of the mother, gestational age, parity, and the presence of diabetes mellitus, the higher percentage of infection with Candida albicans during pregnancy.

Keywords

Candida --- vulvovaginitis --- pregnancy.


Article
Myomectomy During Early Pregnancy(Case report)

Author: Dr. Samar D. Sarsam
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2008 Volume: 4 Issue: 2 Pages: 100-102
Publisher: Baghdad University جامعة بغداد

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Abstract

Myoma is a common benign uterine tumor; therefore it is common in pregnancy. One in ten women will have complications related to myoma in pregnancy. Few treatment options are available during pregnancy, conservative treatment with analgesia, reassurance and supportive therapy is almost always adequate but in carefully selected patients, myomectomy has been performed successfully without jeopardizing pregnancy outcome. The usual indications for surgery during pregnancy include torsion of pedunculated uterine myoma and obstructed labor, surgical intervention during pregnancy is occasionally necessary in uncommon cases of intractable pain.
19 years old lady presented with intractable lower abdominal pain during pregnancy. Ultrasound showed fetus of 18 weeks gestation and ovarian cyst. The pain did not respond to rest and sedation, so emergency exploration laparotomy was done; incarcerated intramural uterine myoma was the cause of the pain, it was enucleated successfully through myomectomy and the pregnancy progressed normally.
Keywords: Pregnancy, uterine fibroid, myomectomy.


Article
Effect of Serum Zinc Concentration Amongst Pregnant Women in Mosul
تأثير تركيز الخارصين على نساء الموصل الحوامل

Authors: Wael Abd-Alkader وائل عبد القادر --- Luma M. Tohala لمى معتصم توحلة --- Bassam E. Hanna بسام ادور حنا
Journal: Rafidain journal of science مجلة علوم الرافدين ISSN: 16089391 Year: 2011 Volume: 22 Issue: 4E Pages: 51-61
Publisher: Mosul University جامعة الموصل

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Abstract

The study was conducted in Mosul during the period from february to april 2009 including non-married and pregnant group composed of 35 and 105 apparently healthy women respectively, pregnant group were subdivided equally according to their trimester into three subgroups, women in second and third trimester are having ferrous sulphate in their ingestion. Serum zinc measurement were done for these groups of women. The results showed that serum zinc concentration start to reduce significantly during second trimester continue to decline in third trimester in comparison with non-married group. Therefore, it is recommended to measure serum zinc during pregnancy with use of optimal dose of zinc supplemental therapy.

أجريتْ الدراسة في مدينةِ الموصل خلال الفترةِ مِنْ فبراير/شباطِ إلى أبريل/نيسانِ 2009 متضمنة مجموعه من النساء غير المتزوجات والحبالى متكونة من 35 و 105 امرأة على التوالي. مجموعة الحبالى قُسّمتْ بالتساوي طبقاً لثُلثِ الحملِ إلى ثلاث مجاميع فرعيةِ, وان النِساء في الثلثين الثاني والثالث من الحمل كُنَ يتناولن كبريتات الحديدوز وتم قياسُ تركيزِ الخارصينِ لمصل الدم لهذه المجاميع من النساء. دلت النتائج على أن تركيز الخارصينِ لمصلِ الدم بدا بالانخفاض المعنوي أثناء الثُلثِ الثانيِ من الحمل وواصلُ الهُبُوط في الثُلثِ الثالثِ بالمقارنة مع مجموعة غير المتزوجات. لذا يُوصي البحث بقياس الخارصينِ لمصلِ الدم أثناء الحمل و استعمال علاجِ الخارصينِ الداعم بجرعٍ مثاليةِ

Keywords

Zinc --- Pregnancy --- Trimester


Article
Popular health beliefs: Old wives tales about pregnancy and its outcome in Mosul city.

Authors: Asma A. AL-Jawadi اسماء الجوادي --- Nuha Hachim نهى حاجم --- Dhafer B. AL-Youzbaki ظافر بشير اليوزبكي
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2007 Volume: 33 Issue: 1&2 Pages: 42-50
Publisher: Mosul University جامعة الموصل

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Abstract

Background: Searching of popular health beliefs carries many benefits to the whole health process and any physician wants to function effectively in his community must be aware, socially, about these important popular beliefs about health and illness that may manipulate any treatment or preventive health plan. This work was conducted to evaluate the most important popular health beliefs related to pregnancy and its outcome.
Methods: A cross sectional design was used in this work. From the sociological point of view, it is a qualitative research, using a consecutive sample of women attendants at a primary health care centers for the period from. 1st. October 2006 to 1st. February 2007.
Assessment of the popular health beliefs about pregnancy regarding nutrition, hygiene, physical activity, dressing, utilization of medical services during pregnancy, deliveries, breast feeding, and sexual activities throughout the pregnancy was carried out by the use of especially designed questionnaire. All the information were gathered from women more than 40 years old, who have children and living in Mosul city since 30 years.
Results: Most of the participants in this study agreed about the importance of organ and red meats, milk, vegetables and fruits during pregnancy (99%, 97%, 95%, and 94% respectively). A lower proportion agreed about the usefulness of vitamins (63%), iron tablets (61%) and white meats (61%). Sufficient numbers (71%) regarded bathing as a healthy practice during pregnancy as well as tooth brushing (68%) and hand washing (92%). Only 36% went with walking for the pregnant women, 96% were against aerobics and also against running. More than two thirds (77%) supported vaccination, all refused exposure to X-ray and 90% also refused non-prescribed medication. The majority (91%) agreed about the importance of hospital deliveries and three quarters (75%) disagreed about untrained dia as a birth attendant. Fortunately, 83% were agreed about giving the colostrums to the new born directly after delivery. A dangerous proportion (18%) of mothers was assured about the benefits of application ash of dung or dung on the umbilical stump. Breast feeding got support from 84% while, 60% agreed about 3 weeks and more as a rest period after delivery.
Conclusion: Many popular health beliefs regarding pregnancy in Mosul city go in agreement with the scientific health facts and theories that should be reinforced and supported. Moreover, the very hazardous popular health belief that ash of dung or dung may be applied to the umbilical stumps of the newly born babies, still needs an intensive intervention health educational program.

الخلاصة: إن العديد من المعتقدات الطبية الشعبية فيما يخص الحمل في محافظة نينوى تذهب بالموافقة مع الحقائق والنظريات الطبية العلمية والتي يجب ان تقوّى وتدعم. إضافة إلى هذا، هناك معتقد شعبي من ناحية الصحة خطيرا جداً وهو وضع رماد روث أو روث الحيوانات على قاعدة السرّة للأطفال حديثي الولادة. وهذا حقيقة يحتاج إلى برنامج تداخلي صحي وتثقيفي وذلك لإنقاذ حياة الأطفال حديثي الولادة الذين قد يتعرضون لمثل هذا الخطر الجسيم.

Keywords

Health --- pregnancy --- beliefs

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