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Article
Indication of Adult Tonsillectomy & Postoperative Complication According to Indications
دواعي استئصال اللوزتين عند البالغين والمضاعفات الحاصلة حسب دواعي العملية

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Abstract

Background: Tonsillectomy remains the most common surgical procedure in field of otolaryngology, and it has a wide range of techniques, indications and complications. Aim of the study: To determine the indications of adult tonsillectomy and the postoperative complications in relation to each indication.Patients and methods: A prospective study of 180 adult patients aged 18-70 years underwent tonsillectomy kept under close observation for analysis.Results: In the study, the most common indication of surgery was acute recurrent tonsillitis (74%), upper airway obstruction (11.1%), suspected neoplasm (8.8) and post-quinsy (5.5%) respectively. The incidence of complications varies according to the indication, patients underwent tonsillectomy for acute recurrent tonsillitis had increased incidence of postoperative bleeding and uvular edema, while patients underwent tonsillectomy for upper airway obstruction had increased incidence of prolonged hospitalization and dyspnea.Key words: Tonsillectomy, tonsillitis, adult tonsillectomy

الخلفية: عملية استئصال اللوزتين هي من أكثر العمليات شيوعاً في حقل جراحة الأنف والإذن والحنجرة، وتتعدد طرق إجراء هذه العملية ودواعيها ومضاعفاتها .أهداف الدراسة: تحديد دواعي استئصال اللوزتين عند البالغين وتحديد مضاعفات العملية ونسبتها لكل داع من دواعي العملية.المرضى وطرق العمل : دراسة تتابعيه أجريت ل 180 مريض تراوحت أعمارهم من 18 الى 70 سنه أجريت لهم عمليه استئصال اللوزتين وتمت مراقبتهم بدقه من أجل التحليل البحثي.النتائج : تبين من الدراسة ان أكثر دواعي العملية هو التهاب اللوزتين المتكرر (74%) تليها انسداد المجاري التنفسية العليا نتيجة تضخم اللوزتين (11,1%) تليها أورام اللوزتين (8,8%) ثم خراج اللوزتين (5,5%).نسبة حدوث المضاعفات تعتمد على دواعي العملية، تبين إن المرضى الذين أجريت العملية لهم بداعي التهاب اللوزتين المتكرر ووذمة اللهاة بينما المرضى الذين أجريت العملية لهم بداعي انسداد الملك التنفسي العلوي هم الاكثر عرضه للرقود المطول في المستشفى والضيق التنفسي.


Article
Incidence of Hypertrophied Tonsils in Patients with Chronic Tonsillitis Selected for Tonsillectomy
نسبة حدوث تضخم اللوزتين في المرضى المصابين باللتهاب اللوزتين المزمن و الذين تم اختيارهم لاستئصال اللوزتين

Authors: Ammar Hadi Khammas د.عمار هادي خماس --- Ehab T. Yaseen د. ايهاب طه ياسين --- Jawad A B Thuhaibat د.جواد الذهيبات
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 2 Pages: 96-100
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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AbstractBackground: - The tonsil reaches its maximum size during the childhood, when it is more active, and gradually becomes smaller after puberty and diminishes considerably in size. The appearance of the tonsil, on examination of the throat, may give a misleading estimate of its size. Some tonsils appear to lie very much on the surface of the throat with only a shallow tonsillar fossa; Others are much more deeply buried in a deep tonsillar fossa, depending partly on its size but, probably more importantly, on the degree to which it is imbedded in to the tonsillar fossa. Aim of the study: - To show the proportion of hypertrophied tonsils in patients with chronic tonsillitis selected for tonsillectomy. Patients & Methods: - A Descriptive study was conducted within six months period (June 2005 – December 2005), in the E.N.T. department at Al-Yarmouk Teaching Hospital. A total of 50 patients were examined and a history of chronic sore throat and malodorous breath were recorded. Patients with obstructive sleep apnea, quinsy, recent acute tonsillitis or suspected malignancy were excluded. Tonsil size (Volume) was measured according pillars, and cervical lymphadenopathy was recorded.Results: - Hypertrophied tonsils occurred in (41%) of patients selected for tonsillectomy with chronic tonsillitis.Conclusions: - The clinical size (on inspection) of the tonsils is not always the real size (on Measurement) of them. The size of the tonsils clinically is of less importance as an indication for tonsillectomy. Key Words: - Tonsillitis, Tonsillectomy, Hypertrophied Tonsils

الملخص:-الخلفية:- اثناء فترة الطفولة تصل اللوزتان اقصى حجمهما حيث تكونان أكثر فعالية و بعد فترة البلوغ يبدأ حجمهما بالتضاؤل تدريجيا و بشكل ملحوظ . أن مظهر اللوزتين قد يعطي انطباعا خاطئا عن حجميهما الحقيقي عند معاينة و فحص البلعوم فبعضها تكون سطحية مع ضحالة حفرة اللوزة بينما بعضها الآخر قد تكون أكثر عمقا. يعود السبب في ذلك الى حجم اللوزة و درجة انغمارها في حفرتها. من وجهة النظر السريرية يعتقد ان سبب تضخم اللوزتين هو عملية فسيولوجية تشير الى تكاثر الخلايا اللمفاوية ( صنف ب ) بينما اضمحلال و انحسار اللوزتين يؤشر اضمحلال فعالية الخلايا المفاوية و بالتالي وهن العمليات المناعية . هدف الدراسة:- لبيان حدوث تضخم اللوزتين عند المرضى المصابين بالتهاب اللوزتين المزمن و الذين تم اجراء عملية استئصال اللوزتين لهم .المرضى و طرق العمل:- تم اجراء هذه الدراسة الوصفية خلال فترة ستة اشهر في مستشفى اليرموك التعليمي قسم الانف و الاذن و الحنجرة . وقد صممت لتحديد العلامات السريرية المهمة للمرضى المصابين بالتهاب اللوزتين المزمن . تم فحص 50 مريضا ادخلوا الى المستشفى لغرض استئصال اللوزتين بسسبب اصابتهم بالتهاب اللوزتين المزمن و تم تثبيت تاريخهم المرضي . استثني من هذه الدراسة المرضى المصابين بانقطاع النفس اثناء النوم ( البهر ) و خراج اللوزة و التهاب اللوزتين الحاد و حالات الاشتباه بالاورام السرطانية . تم تدوين تضخم الغدد اللمفاوية العنقية و احتقان العماد الامامي لللوزة و نفايات الخبايا اللوزية . واعتمادا على قاعدة ارخميدس و باستخدام انبوب زجاجي مدرج تم قياس حجم اللوزة . النتائج:- تبين حدوث تضخم اللوزتين في 41% من المرضى المصابين بالتهاب اللوزتين المزمن المشمولين بهذه الدراسة .الاستنتاجات:- أن حدوث تليف اللوزتين و عدم فعاليتهما يعزز دور العلاج الجراحي في حالة التهاب اللوزتين المزمن . حجم اللوزة التخميني ( عند المعاينة السريرية ) ليس هو بالضرورة حجمها الحقيقي دائما ويعزى ذلك الى :-1- الحجم النسبي لللوزة و البلعوم 2- درجة انغمار اللوزة في الحفرة اللوزية.


Article
Study of the Relationship Between Blood Group and Group A Beta -Hemolytic Streptococci Isolated from Patients with Tonsillitis
دراسة العلاقة بين فصائل الدم ومجاميع بكتريا المسيحيات العنقودية المحللة للدم نوع بيتا لمرضى التهاب اللوزتين

Author: Rana Talib Al-Ani رنا طالب العاني
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2016 Volume: 57 Issue: 2A Pages: 855-861
Publisher: Baghdad University جامعة بغداد

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Abstract

The aim of this study is the relationship between blood group and group A Beta-Hemolytic Streptococci, Ninety patients with tonsillitis were included in this Study from both genders and different age group for blood group study. They were attended at Ramadi Teaching Hospital during the period extended from January 2011 to June 2011. Their ages range from 3-35years.The control group included 20apparently healthy persons, while patient divided into, chronic and recurrent acute tonsillitis. Diagnostic tools were Bacteriological methods (Bacitracin method to identify and count Streptococcus pyogenes group A beta hemolytic streptococci (GABHS ).Results of blood grouping showed a reduced frequency of blood group AB- with tonsillitis and increased frequency of blood group O + with tonsillitis.

إن الهدف من هذه الدراسة هو العلاقة بين مجاميع الدم وبكتريا المسيحيات العنقودية,حيث تم دراسة 90 مريض يعانون من التهاب اللوزتين حيث تضمنت الدراسة لكلا الجنسين ولمختلف الأعمار وعلاقتها بفصيلة الدم .المرضى كانوا را قدين في مستشفى الرمادي التعليمي ضمن فترة كانون الثاني الى حزيران 2011 .و لأعمار اختلفت من 3-35 سنة .عينات السيطرة تضمنت 20شخصا أصحاء ظاهريا، تم تقسيم المرضى إلى مجموعتين التهاب اللوزتين المزمن والحاد المتكرر، تضمن التشخيص الطريقة البكتيرية لتشخيص (GABHS) ،النتائج لمجاميع الدم أظهرت انخفاض مجموعة لدم AB- مع التهاب اللوزتين وزيادة مجموعة الدم O+ مع التهاب اللوزتين.

Keywords

GABHS --- tonsillitis --- blood group


Article
Bacteriological and Immunological Study of Patients with Tonsillitis in Hila City

Author: Zainab Nasser Nabat , Bareq A. ALateef , Intisar Marzoog Hussain
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2019 Volume: 18 Issue: 2 Pages: 252-260
Publisher: Baghdad University جامعة بغداد

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Abstract

The current study was conducted to investigate the bacterial causes of tonsil infection which including chronic and acute tonsillitis. Two hundred twelve swabs were collected from the infected people with Tonsillitis in addition to 90 blood sample of people who reviewed Al-Hilla teaching hospital and Al-Noor hospital for children from October 2013 to April 2014 and 100 blood control. Culture investigations showed 197 positive bacterial growths. The bacterial growth include 147 Gram positive and 75 isolates Gram negative isolates, Gram-positive include Streptococcus pyogens (20.2%), Staphylococcus aureus (19.3%), Streptococcus pneumoniae (15.3%) and Streptococcus viridans (11. 2%). Streptococcus pyogens show high percentage of isolate 20.2% while S. viridians show low percentage isolate (11.2%). While Gram negative include, H. influenzae (17.1%), K. pneumoniae (8.1%), P. aeruginosae (2.03),E .coli (3.6%). H. influenzae show high percentage of isolate (17.1%) while E. coli shows low percentage of isolates (3.6%). The concentration of cytokines was revealed in this study IL-17 showed increased at in concentration especially in age group 1-10 years and reached 55.25 pg/ml compared to control group. The Heat shock protein (HSP-27) showed increase in their concentrations in tonsillitis patient than in controls particularly at age group 21-30 years which reached 22.25 pg/ml.

Keywords

Tonsillitis --- IL-17 --- HSP27.


Article
Peritonsillar abscess (Quinsy) : Cross sectional study in Al-Yarmouk teaching hospital

Authors: Ammar Hadi Khammas --- Mohammed Radef Dawood
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 1 Pages: 49-52
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Aims: To find the demographic distribution, by analyzing the data such as age, gender, residence, chief complaint, pharyngotonsillar bulge and seasonal distribution, among Iraqi patients. Patients and Methods: Cross-sectional study of 42 patients attending outpatient ENT department in Al-Yramouk Teaching Hospital with suspected peritonsillar abscess, for one year period, only 3o patients diagnosed as having peritonsillar abscess, confirmed by positive needle aspiration, were included and analyzed for most common affected age ,gender, chief complaint , residence , pharyngotonsillar bulge and seasonal distribution, while the remaining 12 patients having only peritonsillar cellulitis confirmed by negative needle aspiration, so excluded from the current study. Results: The most common age group affected were 16-24 years ( 40%), the most common gender was male (male to female ratio 1,5:1), the most common chief complaint is trismus (77%), the most common months of presentation was November and December of the year (13 and 20 % respectively) and the most common degree of pharyngotonsillar bulge was moderate (63%) .The most common residence was urban (70%). Conclusions: The most common age group is young adult male, trismus is main chief complaint, and the commonest degree of pharyngotonsillar bulge is moderate.


Article
Comparative study of the Antibody Responses to Streptococcus pyogenes between school Children carriers and patients with Tonsillitis
دراسة مقارنة لاستجابة الاجسام المضادة ضد بكتريا المكورات المسبحية (Streptococcus pyogenes) بين اطفال المدارس الحاملين للبكتريا المصابين بالتهاب اللوزتين.

Authors: Fadwa .E. Abd Al-Kareem فدوى عماد عبد الكريم --- Aruba .KH. Abbas عروبة خالد عباس --- Median .A. Hussein مدين علي حسين
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2014 Volume: 55 Issue: 2 Pages: 403-410
Publisher: Baghdad University جامعة بغداد

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Abstract

This study is designed to evaluate the immune status of patients and schoolchildren with respect to Streptococcus pyogenes. A prospective study was conducted to investigate antibody against GAS in children patients and asymptomatic healthy carriers in serum samples with tonsillitis and compare antibody response (ASO) between patients and healthy carriers with tonsillitis. Tonsillar swabs were obtained to detect the presence of GAS and blood samples were collected to determine elevated ASO titer in serum. A total of 376 sample patients and asymptomatic healthy carriers were included in this study, 142 (37.7%) samples are GABHS positive, included 80 (56.3%) patients and 62 (43.6%) asymptomatic healthy carriers. The finding of a significant relationship between ASO positive and GABHS carriage and patients indicated that ASOT measurement might be used together with throat culture to identify GABHS carriers and GABHS patients. The value of ASOT varies with the age of the subject, and the most pronounced differences are between the values of preschool age children and school age children. The upper limits of normal values for these groups were as follows: preschool age (100) and school age (170). Recently infected children showed raised ASO antibody titer than the carrier. But this study present elevated of ASOT in asymptomatic healthy carriers indicated recent infection or past infection then this children recovery from disease but remain record titer of antibody.

تم تصميم هذه الدراسة لتقييم الحالة المناعية للمرضى وأطفال المدارس فيما يتعلق ببكترياالعقدية المقيحة. وقد أجريت دراسة للتحقيق من الأجسام المضادة ضد بكتريا المكورات المسبحية المجموعة (أ) في الأطفال المرضى والحاملين للبكتريا في عينات مصل الدم مع التهاب اللوزتين ومقارنة بين استجابة الأجسام المضادة (ASO) بين المرضى والحاملين الصحيين مع التهاب اللوزتين. تم الحصول على مسحات من اللوزتين للكشف عن وجود GABHS وعينات الدم تم جمعها لتحديد ارتفاع ASO عيار في مصل الدم. عينة الدراسة تتضمن 376 عينة من المرضى والحاملين للبكتريا صحيين في هذه الدراسة، 142 (37.7٪) كانت ايجابية GABHS ، وشملت 80 (56.3٪) من المرضى و 62 (43.6٪) حاملين للبكتريا غير عرضيين والباقي من العينة هم سلبية للبكتريا. أشارت النتائج وجود علاقة ذات دلالة إحصائية بين ASO و.GABHS وأن قياس ASOT يمكن استخدامها مع زراعة مسحة اللوزتين لتحديد الحاملين GABHS من المرضىGABHS. قيمة ASOT يختلف مع عمر الاطفال، والاختلافات أكثر وضوحا ما بين القيم من الأطفال في سن ما قبل المدرسة والأطفال في سن المدرسة. وكانت الحدود العليا من القيم العادية لهذه المجموعات كما يلي: سن ما قبل المدرسة (100) وسن المدرسة (170). أظهرت الاصابات المتكررة من الاطفال ارتفاع ASO عيار الأضداد في المصابين عن الحاملين. ولكن في هذه الدراسة الحالية ارتفاع ASOT في الحاملين للبكتريا نتيجة عدوى أخيرة أو عدوى في الماضي ثم شفاء الأطفال من المرض ولكن تبقى عيارة من الأجسام المضادة مسجلة.


Article
Familial tendency of tonsillitis in patients undergoing tonsillectomy surgery

Author: Saman Fadhil Jamal سامان فاضل جمال
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2015 Volume: 20 Issue: 2 Pages: 29-35
Publisher: Tikrit University جامعة تكريت

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Article
Dental caries in relation to oral infections and feeding types among children aged 2-5 years

Author: Aseel H. M.J. Al-Assadi اسيل الاسدي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 2 Pages: 104-108
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Dental caries is an infectious and transmissible disease that still represents as a significant public healthproblems in many countries. The aim of this study was to investigate the relation between dental caries and oralinfections (tonsillitis and candidiasis) as well as the relation to feeding type.Material and methods: The study sample composed of 22 healthy children aged 2-5 years with full set of primarydentition and had dental caries. The control group composed of 22 caries free children matching the study group inage and gender. An information sheet from the parents was done to all children concerning general health, feedinghabits and frequency of oral infections (tonsillitis and oral thrush) during the last year. Children were examinedclinically using dmft index, oral microorganisms was sampled and cultured aerobically using blood agar, MacConkeyagar, chocolate agar and sabauraud,s dextrose agar.Results: Children with dental caries were mostly bottle fed and showed higher frequency of continuous oralinfections. Regarding dental caries there were highly significant relations between caries activity and method offeeding and types of microorganisms found in the oral cavity , also a highly significant relation was found betweenmethod of feeding and frequency of oral infections. Children with dental caries had more types of oralmicroorganisms compared to caries free children Candida, Strep.pyogenes, Strep. viridans, Strep.faecalis,Strep.pneumonia, Staph.aureus, E.coli, Enterobacter ,Acinetobacter and Pseudomonas were found in highfrequency among caries active children.Conclusion: Types of microorganisms found in the oral cavity was affected by dental caries which in turn affectfrequency of infections. Breast feeding was predominant among caries free children and associated with lower ratesof oral infections compared with bottle feeding so public should informed about its long term effect on the generalhealth


Article
Bacteriological, Serological and Histopathological Study on Tonsillectomy Specimens

Authors: Haitham Abdul-Malik Alnori --- Kawkab Adris Mahmod --- Ali A. Muttalib Mohammed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 2 Pages: 219-225
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Tonsillitis is one of the commonest infectious disease occurring in the young age group. Tonsillectomy is generally indicated when there are frequent attacks of acute tonsillitis, usually six attacks or more per year for two successive years. Other indications of tonsillectomy include obstructive sleep apnea, quinsy ( usually after the second attack of quinsy) and suspicion of malignancyOBJECTIVE: The aim of the present study is to: i) identify the types of bacteria in the tonsil core and to study the sensitivity of bacterial isolates to some antibiotics. ii) estimate serum concentration of Antistreptolysin O (ASO), C-Reactive Protein (CRP) and Epstein Barr Virus (EBV) serology in patients subjected to tonsillectomy compared to control group. iii) study the histopathological changes of routine tonsillectomy specimens.METHODS: This case series included hundred patients who underwent tonsillectomy at Al-jamhori Teaching Hospital from January 2010 to July 2012. The main indication for surgery was recurrent attacks of tonsillitis for two or more successive years. Core of the tonsil was studied regarding bacteriology and sensitivity of the cultured bacteria to some antibiotics. At the same time blood sample was obtained and analyzed for ASO, EBV and CRP. Finally the removed tonsils were sent for histological examination.RESULTS: The mean age of our patients was 10.32 years with a range of 3-35 years. The study included 60 males (60%) and 40 females (40%) with a ratio of 1.5 :1. Group A beta hemolytic Streptococcus pyogenes was the commonest isolate from tonsil core (21.4%) and was most sensitive to azithromycin. Serological tests for ASO, CRP and EBV were positive in 24%, 22% and 20% compared to 22%, 8% and 10% in control group respectively. CRP was significantly higher among patients than control group. Histological examination revealed chronic non-specific tonsillitis with reactive lymphoid hyperplasia.CONCLUSION: The resistance of many bacteria to penicillin and amoxicillin, and the high percentage of beta-lactamase secreting microbes in recurrent tonsillitis mandate the need to consider a combination of amoxicillin and clavulanic acid or second generation cephalosporin. ASO titer is not an accepted indication for tonsillectomy.


Article
Facts about chronic tonsillitis: a pathological study

Author: Raid M. S. AL-Ani
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2016 Volume: 3 Issue: 1 Pages: 1-5
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Although tonsillectomy was the commonest procedure performed by otolaryngologists, there is no consensus among them to send the excised tonsils for histopathological study. The objective of this study is to determine the unique histopathological features of chronically infected tonsils and to evaluate the necessity for routine histopathological examination of excised tonsillar tissues. This prospective study was conducted in Al-Ramadi Teaching Hospital/ENT Department and Pathology and Forensic Medicine Department in Anbar Medical College, Iraq. Hundred adult patients with chronic tonsillitis were subjected to histopathological examination during the period from 1 January 2012 to 31 December 2012. The histopathological results showed features of chronicity in form of hyperplasia 200(100%), fibrosis 144(72%), surface ulceration 112(56%), crypt abscess 80(40%), bacterial colonies 48(24%), focal suppuration 16(8%) and focal necrosis 8(4%). No malignant or granulomatous changes were found in the examined tissues. In conclusion, there is a strong correlation between the clinical and pathological findings of patient with chronic tonsillitis. Granulomatous or malignant lesions were not recorded. This study support previous studies which reported that routine histopathological examination of the removed tonsils is not recommended unless suspicious findings like weight loss, history of cancer, neck mass, asymmetry of the tonsils and fungating or ulcerative tonsillar mass.

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