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Article
Making Use of High Index of Suspicion in Diagnosing Intra‑abdominal Abscess

Author: Kadhim Ch. Hasan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 1 Pages: 99-101
Publisher: Babylon University جامعة بابل

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Abstract

More than 80% of intra-abdominal abscesses occur in the postoperative period and the majority after pancreatico- biliary or colorectal surgery.Over 30% of abscesses are associated with clear evidence of anastomotic leak. There are no reliable signs or symptoms of intra-abdominalabscess. Huge abscesses containing more than 1 L of pus may occur without any significant physical finding. This case report describes apatient with generalized abdomen pain and abdominal distension after 2 weeks of headache and fever. After undergoing laparotomy for dealingwith perforated typhoid ulcer of the ileum and 2nd operation for bowel leakage ,the patient health two weeks later was fair, but unexplainedtiredness while leukocytosis was the only finding which encouraged 3rd operation during which intraabdominal abscesses were found andCorrugated drain was left. We may conclude that unexplained postoperative leukocytosis indicate hidden sepsis. Placing Intraabdominalcorrugated drain may be invaluable in preventing recollection.


Article
Anorectal Abscesses Bacteriology and the Antibiotics Susceptibility Testing

Authors: Maha K. Ali --- Hussein A. Al- Aljasmawy;
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 710-715
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Anorectal abscesses are a common surgical problem, and themost common disease of the anorectum.Objectives: to identify the microorganisms commonly causing the anorectalabscess and the drugs of chioce for treating these infections.Materials and Methods: the patients who were admitted in Hilla Teaching GeneralHospital during a period of one year from December 2001 to December 2002 wereprospectively studied. The aspirated pus was cultivated aerobically and the isolatedmicroorganisms were tested for their sensitivity to commonly prescribed antibiotics.Results: fifty two patients 42 males and 10 females were studied. The most frequentlyisolated micro-organisms were Proteus vulgaris (30.76%), Esch.Coli (13.46%) andKlbesiella spp. (9.61%). The sensitivity pattern was that the cephalosporin's andaminoglycosides (Gentamycin) were the most potent antibacterial against Proteus andStaph aureus.Conclusion: Anorectal abscesses are most commonly caused by Proteus vulgaris andStaph aureus which mainly respond to cephalexin and gentamycin.


Article
Feasibility of percutaneous needle aspiration for the treatment of breast abscesses
جدوى استعمال السحب بالإبرة لمعالجة خراجات الثدي

Author: Karam K. Younis كرم كمال يونس
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 1 Pages: 65-69
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To assess the feasibility and effectiveness of percutaneous needle aspiration under local anesthesia for the treatment of acute breast abscesses in the outpatient breast clinic.Design: A retrospective study of forty three female patients with acute breast abscesses.Setting: Breast clinic in Al Jamhoory teaching hospital in Mosul between February 2004 to February 2007. Methods: Forty three patients with acute breast abscesses were studied. Special enquiries were made regarding lactation, symptomatology and sites of abscesses. All patients had preliminary breast ultrasound (U/S) examination. In the breast clinic, percutaneous needle aspiration of pus under local anesthesia was done followed by systemic antibiotic therapy. Repeated aspiration was carried out later when deemed necessary and follow up by (U/S) was conducted.Results: Forty three patients aged between 16-75 years (mean 37 years) having a provisional diagnosis of acute breast abscesses. All patients presented with a palpable tender mass, of which 4 patients had retro-areolar abscesses. All patients had (U/S) of breast. Five patients were found on breast U/S to have inflammation without evidence of focal pus and they only required antibiotics. Four patients refused aspiration and underwent primary incision and drainage under general anesthesia (GA), while in two patients the abscesses were pointing and opened spontaneously before intervention, and they settled with wound toilet and antibiotics alone. The remaining thirty two patients had their abscesses aspirated, and the treatment was successful in twenty nine patients (91%) with no complications or recurrence. The treatment failed in three patients who required subsequent incision and drainage.Conclusions: Percutaneous needle aspiration of acute small unilocular breast abscesses after prior breast (U/S) followed by systemic broad spectrum antibiotics is successful, when the abscesses are completely drained. The use of this modality of the treatment has still not found wide application in our locality. This study is an attempt to recommend its use wherever facilities exist for its feasibility, low cost, no interruption with lactation and better cosmesis, though incision and drainage still may be necessary for definitive treatment for large or multilocular abscesses.Keywords: Breast, abscess, aspiration.

الخلاصةالهدف: إن الطريقة المتبعة حاليا لعلاج خراج الثدي هي عن طريق بزله جراحيا. إن الهدف من هذه الدراسة هو دراسة جدوى إستعمال طريقة تحفظية لعلاج خراج الثدي بعد فحص الثدي بالأمواج فوق الصوتية حبث يسحب القيح عن طريق الإبرة، وتستعمل الصادات بعد ذلك وقد يعاد سحب القيح من الخراج لأكثر من مرة إن إستدعت الحاجة لذلك.التصميم: تم دراسة 43 مريضة يشكين من خراج الثدي.المكان والزمان: تمت الدراسة في عيادة أمراض الثدي في المستشفى الجمهوري التعليمي بالموصل في الفترة بين شباط 2004 إلى شباط 2007. المرضى والطريقة: تم دراسة سجلات 43 مريضة يشكين من خراج الثدي معدل أعمارهن 37 سنة. وتم السؤال عن الأعراض، حالة الرضاعة وموقع الخراج. تم فحص الثدي المصاب لدى جميع المريضات بجهاز الفحص بالأمواج فوق الصوتية وبعد تعيين الموقع والحجم تم سحب القيح من الخراج تحت التخدير الموضعي وإستعمال الصادات بعد ذلك. أعيد السحب بالإبرة في بعض الحالات التي إحتاجت سحب لأكثر من مرة وإستعمل السونار لغرض المتابعة.النتائج: كان عدد المريضات المصابات بخراج الثدي 43 حالة تراوحت أعمارهن بين 16-75 سنة، وبمعدل 37 سنة. كانت العلامات السريرية لدى كافة المصابات على شكل عقدة محسوسة، منها 4 حالات كانت العقدة خلف الحلمة. أجري فحص الأمواج فوق الصوتية الخاص بالثدي على كافة المريضات حيث تبين لدى 5 مريضات وجود أخماج فقط بدون وجود قيح او خراج، وعولجت هذه الفئة بالصادات. تم بزل الخراج بإستعمال الإبرة لـ 32 مريضة، وقد شفيت 17 حالة بدون جراحة ولمرة واحدة، بينما إحتاجت 5 مريضات لبزل بالإبرة لمرتين و7 مريضات لأكثر من مرتين، بينما فشلت الطريقة في 3 حالات وإحتاجت الى بزل جراحي. أربع مريضات رفضن علاج البزل بالإبرة منذ البداية وتم علاجهن ببزل الخراج جراحيا تحت التخدير العام. كان الخراج لدى مريضتين سطحي ومفتوح تلقائيا قبل أي تداخل جراحي وقد عولجتا بالصادات فقط. الاستنتاج: إن الطريقة التحفظية المتبعة في هذه الدراسة لعلاج 43 مريضة مصابة بخراج الثدي بعد التشخيص بفحص الأمواج الصوتية الخاص بالثدي هي إستعمال الإبرة لسحب القيح من الخراج ومن ثم إستعمال الصادات بعد ذلك، حيث تمت هذه الطريقة بنجاح وخاصة عند بزل الخراج بالكامل، ولو أن هذه الطريقة لم تلقى تقبل كبير لحد الان، لذا فالدراسة الحالية هي محاولة لجعل استعمالها مقبولا عند وجود الإمكانات لذلك علما ان البزل الجراحي لايزال هو الطريقة الشائعة والمتبعة خاصة عند بزل الخراجات الكبيرة او المزمنة.

Keywords

Breast --- abscess --- aspiration


Article
Mustansiriya Medical Journal Volume 12 Issue 2 December 2013 | 34

Author: Haqqi I. Razzouki
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 2 Pages: 34-39
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Despite the improvement in health care in general and antiseptic techniques in particular, cases of gluteal abscess following intra-muscular injections are still encountered. Although this condition is not considered a serious illness, still it causes complications and exerts a pressure on health resources. Objectives: To determine the factors responsible for the development of gluteal abscesses and to suggest measures to avoid this problem and to study the methods used in management. Methods: This is a prospective analytic study in which all patients admitted to the surgical ward with gluteal abscess over a six months period were included. Detailed demographic, clinical and investigative data were recorded. Predisposing factors and co-morbid conditions were documented, also, the persons who did the injection, the types of drugs used and other factors related to the process of injection were studied. The contribution of the human, technical and pharmacological elements were analysed. The methods used in management, early post-operative complications and the final outcome were recorded. Results: Forty-two patients were included in the study; of those, 30 were females (75%) and the mean age was 35 years. Eighteen were diabetic (42.8%) and 16 (38.04%) were over-weight. Thirty-eight patients (90.47%) had history of preceding intra-muscular injections. Most of the drugs used were antibiotics, mainly Cefotaxime used in 14 patients (33.33%). There was also 8 instances related to Diclofenac injection (19.04%) and 4 related to iron preparation (9.5%). There were 8 instances of mixed injections using more than one drug (19.04%). Twenty-eight episodes were related to under-trained personnel (66.67%); 20 female nurses (47.62%) and 8 male nurses (19%). Forty patients presented mainly as local pain(97%) and 36 patient as visible swelling(90%). The main method of diagnosis was clinical. All patients were treated surgically mostly using general anaesthesia (95%) and frank pus obtained in 34 patients(80.95%). The most common organisms obtained on culture were coagulase-positive staph.aureus and proteus. Conclusions: Gluteal abscess disease is still common despite advances in anti-septic techniques. Most of the cases are due to the lack of experience and improper training of para-medical personnel. This condition is seen more with certain types of drugs and in immune-compromised patients like diabetics.


Article
Outcome of Nasal Septalheamatoma / Abscess

Author: Adil Hadi Salih Al-Azzawi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 3 Pages: 593 -595
Publisher: Babylon University جامعة بابل

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Abstract

Septalheamatoma and abscess are infrequent conditions, but can result in a serious complications if not dealt with at a proper time.To study the outcome of nasal septalheamatoma and abscess in relation to the time of diagnosis and drainage.Forty three patients were prospectively studied, the time of diagnosis, drainage and outcome were sequentially evaluated.Forty three patients (31 males and 12 females), age range 3-20 years (mean age 8 years) were included. Surgical interference (drainage with anterior package and insertion of drain) was performed in all patients.A delay in diagnosis and surgical drainage is the main cause of subsequent complication.

Keywords

heamatoma --- abscess --- deformity


Article
Presence of Entamoebagingivalis in dental patients

Authors: Wssam M AL-SAEED --- Hind J MAHMOOD
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2001 Volume: 1 Issue: 1 Pages: 65-68
Publisher: Mosul University جامعة الموصل

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Abstract

This study has been carried out to investigate the presence of E. gingivalis in dental patients in Mosul. Soa total of 115 patients with different oral pathological conditions (dental caries, periodontitis, gingivitis & abscess) were examined. The result revealed 52 (45.2%) were positive for the presence of Entamoebagingivalis. In addition 55 healthy individuals with good oral hygiene were also examined as control group, 3 of them (5.4%) were seen positive for the presence of parasite. Examination Was carried out by direct wet smear method.Results shows the highest incidence (53.3%) of this parasite was found in patients with dental caries, they were 24 out of 45, while the lowest incidence (26%) Was found in patients with tooth extraction, they were 4 out of 15. The present of this parasite was (46.7%) in males and (43.3%) in females, the percentage are approximately similar in both sexes


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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Abstract

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
Splenic abscess: A rare presentation

Author: Dr. Najeeb S. Jabbo
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 1 Pages: 65-67
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Splenic abscess is a rare entity with a wide variability of causative pathogens Its reported mortality rate is still high, up to 47%, and can potentially reach 100% among patients who do not receive antibiotic treatment. The timely and widespread use of imaging methods (eg, computed tomography [CT] scanning, ultrasonography) facilitates early diagnosis and guides treatment, thus improving the prognosis. We are reporting a 42-year-male patient presented with an abscess in the spleen. The etiology was due to typhoid fever. It was diagnosed by CT-scan and treated by splenectomy. A review of the modalities of treatment is discussed


Article
Pediatric brainstem abscess: a case-based review

Author: Hassen Hadi Almuhammed* حسن هادي المحمد
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2016 Volume: 34 Issue: 1 Pages: 50-55
Publisher: Basrah University جامعة البصرة

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Abstract

Solitary brainstem abscess is uncommon condition with high mortality and morbidity. The diagnosis require high index of suspicion and appropriate imaging. It can be managed by medical treatment alone, stereotactic aspiration of the purulent material, or by surgical drainage along with medical therapy. Here, I present a case of a child with large solitary brainstem abscess involving the pons and the medulla oblongata without systemic infection or systemic predisposing factors. The patient managed by mean of microsurgical drainage and antibiotic therapy. The literatures on brainstem abscess was reviewed and an over view of the literature is presented. This case-based review of brainstem abscess reinforce the conclusion that early diagnosis and proper management with microsurgical drainage and maximal medical therapy may result in a good prognosis.


Article
A study of 74 cases of brain Abscess

Author: Ali. K. AL-Shalchy
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 438-439
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Brain abscess is collection of pus in the brain parrynchima surrounded by a true capsule. Usually diagnosed by CT & MRI, & treated surgically by drainage by burr hole, or excision.Objective: evaluate our work with brain abscess.Patient& method: 74 Patients collected in the specialized surgical hospital neuro-surgical department, from Jan. 1995 till Jan. 2005 treated surgically, all cases fully evaluated clinically & radiologically & then evaluation of the surgical procedure.Results: there is a slight male predominance & prevalence more in the 1st 2decades of life mostly in children with cong. heart disease, headache was the most common presenting feature, with other signs of infection diagnosis was mostly by CT scan, all cases were managed surgically & the out come is compared other studies.Conclusion: Brain abscess a relatively common disease, each case should be managed individually & depending on surgeon experience.

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