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Article
Congenital coronary anomalies in Iraqi adult population

Authors: Amjad Rahman Bairam --- Hasan Yousif Al-Najjar --- Hamid Abdul Wahab Al-Amiry
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 2 Pages: 132-138
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:
Background: Geographic variations in the incidence of different congenital coronary
anomalies are well known, but infrequently studied in the Iraqi population.
Recognition of coronary anomalies is important in patients undergoing coronary
arteriogrphy; coronary interventions and cardiac surgery .Variation in the frequency
of primary congenital coronary anomalies may possibly have a genetic background.
Patients and methods: Three thousands adult patients underwent diagnostic
coronary angiography at two cardiac centers in Baghdad between January 2003 to
March 2006. Their angiographic films were reviewed by at least two experts in
coronary angiographic study.
Results: Among 3000 adult patients who underwent diagnostic coronary
angiography, 28(0.93%) patients (16 males, 12 females) had anomalous coronary
artery. The mean age was 46±8 years (range from 28-73 years).Twenty four patients
(85%) had anomalies of origin and distribution, while the remaining four (15%) had
coronary artery fistulae. Abnormal origin of the left circumflex was the most common
anomaly, seen in 17(60%) patients. Coronary artery fistula was seen in four patients;
from the left anterior coronary artery to the pulmonary trunk in two cases and from
the right coronary to the pulmonary trunk in the other cases. Left main stem was
absent in four cases (15%).While abnormal origin of the right coronary artery from
the left circumflex was seen in two cases. Abnormal origin of the right coronary
artery from the pulmonary artery was seen in just one case (3.5%). Atherosclerotic
plaques in the anomalous artery were seen in four cases (15%) much less than overall
case of coronary artery disease in those who underwent coronary angiography (60%).
Conclusion: Isolated congenital coronary anomalies in adult is rare and there does
not appear to be an increased risk for development of atherosclerosis in anomalous
coronary arteries.


Article
THE CATHETERIZATION AND ANGIOGRAPHIC VARIATIONS IN IRAQI PATIENTS WITH TETRALOGY OF FALLOT

Author: Sadiq M. Al-Hamash صادق الهماش
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2005 Volume: 47 Issue: 1 Pages: 28-34
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease and the catheterization and angiography still considered (in most centers) as essential preoperative diagnostic step. This retrospective aimed at evaluating the catheterization and angiographic finding in our Iraqi patients with diagnosis of TOFPatients and methods: The catheterization and angiographic study of200 patients with TOF-' referred to Ibn Al-Bitar Cardiac Center had been reviewed.Results: There were 126 males and 74 females and their ages ranged from 11 months to 37 years. The catheterization data showed that 88% of the patients had equal LV and RV pressure. The evaluation of pulmonary artery pressure showed that all patients had normal pressure. The review of angiographic studies revealed that the perimembraneous VSDs were the most common type (91%> of the patients). 13 patients (6.5%) had coronary anomalies, and the patent ductus arteriosus is the most common associated anomalies.Conclusion: The frequency of doubly committed VSD and single coronary artery were higher than other studies and we showed there was no indication to measure the pulmonary artery pressure during catheterization.

Keywords

TOF --- Catheterization --- Angiography.


Article
Basophil count as predictor to the deep vein thrombosis and the thrombo-embolization

Author: Hussein Aziz Naser
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2018 Volume: 5 Issue: 2 Pages: 95-106
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Basophil is one of the granulocytes leukocytes that has many functions, one of them is the secretion of heparin. The aim study is investigated the correlate the basophilic count with the low endogenous heparin and thrombosis in the deep veins and the thromboembolism. A cross-sectional study conducted at Al Sader Medical City (radiology unit, Doppler unit study and emergency room) during the period from December 2015 to February 2017 included 203 patients with diagnosis of deep vein thrombosis (DVT) by Ultrasonic Doppler study or pulmonary embolism (PE) by CT pulmonary angiography. A group of 205 subjects without evidence of DVT were used as a control. One hundred sixty seven patients (82.3%) had DVT for first time, while 14 (6.9%) had recurrent DVT, and 22 (10.8%) had PE. The total male number has thromboembolism disease 52 but total female number is 151 with a male to female ratio was 1: 2.9. At current study founded the basophil percent and basophil count in patient with thromboembolism disease was decreased than normal value, The mean basophil percent in thromboembolism disease was 0.35% ± 0.28% while mean basophil count is 30 ± 26, It had been significantly found that basophil percent and basophilic cell count had a strong association with thromboembolism. Basophil percent had a sensitivity of 82%, specificity 79.5% and accuracy of 80.8%. The corresponding values of these parameters for the basophil count were 85%, 73.2% and 79.1%. In conclusion; both low basophil percent and the basophilic count are significantly associated with DVT, recurrent DVT and PE.


Article
Clinical and Angiographic Findings in Diabetic Versus Non-Diabetic Iraqi Patients with Ischemic Heart Disease (A Single Center Experience)

Author: Muataz Fawzi Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 339-346
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Diabetes mellitus (DM) is a common, chronic and complex metabolic disorder. Its direct and indirect effects on the vascular system are major causes of morbidity and mortality.OBJECTIVE:To verify the effects of diabetes mellitus on clinical presentation and angiographic findings in diabetic patients with ischemic heart disease as compared to non diabetic patients.PATIENTS AND METHODS:This cross-sectional descriptive study was conducted in the Iraqi Center of Heart Diseases during the period from November 2008 till June 2009. Two-hundred patients with ischemic heart disease (IHD) who were referred to the Iraqi Center for Heart Diseases were randomly included. Clinical history and examination were done; blood tests, electrocardiography and echocardiography were done for all patients. Patients were classified into 2 groups: 68 patients with diabetes mellitus and 132 patients without diabetes mellitus. Coronary angiography was done for all patients and the results were interpreted by two independent interventional cardiologists.RESULTS :There were 145 (72.5 %) males and 55 (27.5 %) females. The mean age of study population was 56.92 ± 3.9 years (56.57 ± 3.2 years for males, 57.91 ± 4.1 years for females).There were no statistically significant differences between diabetic and diabetic patients regarding sex, age, type of clinical presentation, presence of hypertension and family history of coronary heart disease. Diabetic patients were more likely to be smoker (61.7% vs. 48.4%, P = 0.01), to have dyslipidemia (53% vs. 35%, P = 0.03), left ventricular systolic dysfunction (61.7% vs. 48.4%, P = 0.045) left ventricular diastolic dysfunction (92.6% vs. 58.3%, P =0.03), more diseased coronary arteries (38.2% vs. 25.7%, P =0.009), more frequent left main stem involvement (13.2% vs. 3.8%, P =0.008) and more complex coronary lesions (60.2% vs 31.8%, P =0.00002).CONCLUSION:Diabetic mellitus has clear adverse effects on left ventricular systolic and diastolic functions and angiographic findings in patients with ischemic heart disease


Article
Correlation Between Regional Wall Motion Abnormalities via 2-Dimensional Echocardiography, and Coronary Angiographic Findings

Authors: Hassan Salman Al-Gharbawi --- Basil Najeeb Saeed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 630-634
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Ischemic heart disease induce changes in myocardial performance and there are different ways to study this performance as using echocardiography and cornary angiogramOBJECTIVE:Correlate the findings of regional wall motion abnormalities assessed by 2D echocardiography, to the coronary artery lesions detected by coronary angiogram.METHODS:This study included 101 patients who attended the Iraqi Center of Heart Disease between March 2010 and April 2011. In addition to routine investigations, echocardiography and coronary angiography were done to them.Patients were grouped according to segments of regional wall motion abnormalities into 3 groups :group A (segments 1,2,7,8,13,14), group B (segments 3,4,9,10,15), and group C (segments 5,6,11,12,13,16).These groups were correlated according to the score of regional wall motion abnormalities, with each coronary artery lesions detected by coronary angiogram.RESULTS :(47.5%) of patients in group(A) had hypokinesia, Akinesia in (14.9%), and dykinesia in (21.8%), majority of these abnormalities were correlated with LAD lesions (P-value 0.0001).(44.4%) of patients in group(B) had regional wall motion abnormality in form of hypokinesia(35.6%), akinesia(7.9%), and dyskinesia(1%) .There was a strong correlation between group(B) and LCX lesions (P-value=0.0001)(27.8%) of patients in group(C) showed hypokinesia ,(5% ) Akinesia, and (8 % ) dyskinesia ,majority were associated with RCA lesions in form of critical and total occlusions.CONCLUSION:Regional wall motion abnormalities detected by 2D-echocardiography can be correlated with the lesions of the affected coronary vessel, in terms of the site and severity.


Article
Ankle/Arm Pressure Index in Coronary Patients Referred for Coronary Angiography
تقييم معامل الضغط لشرياني الكاحل و العضد لمرضى الأزمات القلبية المحالين للفحوص القسطارية

Author: Saad Eldin Majeed سعد الدين مجيد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2005 Volume: 18 Issue: 4 Pages: 283-290
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:A cohort study was conducted to assess Ankle/Arm index (A.A.I.) in 136 coronary patients (84 male, 52 female). Round two thirds of the tested subjects had abnormal A.A.I.; aging and male gender negatively influenced the index values. Low pressure indices were reflecting the combined effect of many risk factors and were putting related subjects at higher risk for acute coronary events and post-ischemic complications due to more wide spread and characteristically more complex lesions. The test is simple and cheap, it can be included in routine bedside clinical examination for a better risk stratification of cardiovascular diseases.

الملخص:في دراسة أجريت لتقييم معامل الضغط لشرياني الكاحل و العضد للمرضى المحالين للفحوص القسطارية من المصابين بالأزمات القلبية تأثرت معدلاته سلباً لدى المسنين و الذكور من المرضى قيد البحث. و عكست المعدلات المتدنية للمعامل المذكور التأثير المساعد المشترك لعوامل الخطورة المسببة لتصلب الشرايين و أرجحية التعرض للأزمات القلبية الحادة. يفيد هذا الفحص البسيط و الزهيد الثمن و الذي يمكن إجراءه بشكل نمطي في فرز الأشخاص الأكثر عرضة للأصابة بالنوبة القلبية و إتخاذ إجراءات وقائية تحد من فرص التعرض للمرض.


Article
Assessment of some risk factors for angiographically defined coronary artery disease in the Erbil Cardiac Center
تقييم بعض عوامل الخطر لمرض الشريان التاجي المحدد في تصوير القلب في مركز أربيل للقلب

Authors: Mothafar A. Barzani --- Mariwan H. Saka
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 2 Pages: 949-956
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: There are many modifiable risk factors that are closely associated with coronary artery disease. The aim of this study was to assess the association between some coronary risk factors and the angiographically documented coronary artery disease.Methods: This descriptive cross-sectional study was based on review of hospital records of 310 consecutive patients who underwent coronary angiography in Erbil Cardiac Center. A questionnaire was used to record patient’s demographic profile, coronary risk factors and the severity of stenosis in percentage.Results: Of the 310 patients, 69.4% had evidence of coronary artery disease on coronary angiography. Male gender, age, diabetes, and smoking habit were strongly associated with angiographically documented coronary artery disease, while the association of hypertension and family history were not statistically significant. Only male gender was strongly associated with severity of coronary artery disease.Conclusion: The angiographic extent of coronary artery disease was found to have the strongest positive correlation with male gender and the weakest with hypertension. The most important predictive factors for coronary artery disease positivity were age, diabetes and smoking status. Hypertension and family history of premature coronary artery disease did not prove to be either a significant predictor of coronary artery disease at coronary angiography or an important determinant of coronary artery disease severity.


Article
The relationship between Coronary Angiography and Class of Angina
العلاقة بين تلوين الشرايين ألتاجيه ودرجه الذبحة الصدرية

Author: Abdul-Kareem Al Shimary د عبد الكريم الشمري
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 3 Pages: 181-185
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Coronary heart disease is the most common form of heart disease and the single most important cause of death worldwide. Coronary arteriography provides detailed anatomical information about the extent and nature of coronary artery disease. A system of grading the severity of angina pectoris proposed by the Canadian Cardiovascular Society has gained widespread acceptance.Aim of the study: To study the relationship between coronary angiography and class of angina in patients with coronary heart disease. Methods: Seventy three patients with chest pain underwent coronary angiography in Iraqi Heart Center, for the period extended between July and December 2003. 68.6% were males, 31.4% were females, and the age was between 30-80 years. Coronary angiography was done through the right or left femoral arteries under local anesthesia. Class of angina depends on Canadian Cardiovascular Society classification.Results: Of the seventy three patients who underwent coronary angiography, 35.6% had angina class II, 30.1% had angina class III, while the rest had angina class IV. Of these patients, 48.0% had single vessel disease, 30.0% had two vessels disease, and 22.0% had three vessels disease.Conclusion: There is generally little relation between coronary artery disease and the CCS classification of effort angina. Presence or absence of angina rather than the Canadian Cardiovascular Society classification should indicate the need for coronary angiography.Key words; Coronary artery diseases, angiography, angina class

ألمقدمه: يعتبر قصور الشرايين التاجية واحد من أكثر أمراض القلب شيوعا واهم الأسباب المؤدية إلى الوفاة في أنحاء العالم. ويقدم فحص تلوين الشرايين التاجية معلومات مفصله عن درجة وطبيعة إصابة الشرايين. ويقوم التصنيف المعتمد على جمعية أطباء القلب الكندية إلى تقسيم شدة الإصابة إلى أربعة أصناف.طريقه العمل: ثلاثة وسبعون مريضا مصابون بالذبحة الصدرية اجري لهم فحص تلوين الشرايين التاجية في المركز العراقي لأمراض القلب/مدينة الطب لفترة من تموز – كانون الأول عام 2003. 68.6% من الرجال و 31.4% من النساء وتتراوح أعمارهم بين 30 – 80 عاما. وتم الفحص من خلال الشريان الفخذي الأيمن أو الأيسر وتحت التخدير الموضعي. وتم تصنيف درجة وشدة الذبحة الصدرية بالاعتماد على تصنيف جمعية أطباء القلب الكندية من 1 – 4.النتائج: من مجموع المرضى هناك 35.6% لديهم ذبحة صدرية من الدرجة الثانية، 30.1% من الدرجة الثالثة، والباقين من الدرجة الرابعة: من هؤلاء 48% لديهم شريان واحد مصاب، 30% لديهم شريانين مصابين، و 22% لديهم إصابة بثلاثة شرايين.الاستنتاج: هنالك علاقة ضعيفة بين شدة درجة الذبحة الصدرية وعدد الشرايين المصابة بالتضييق، ولذلك يجب اعتماد وجود أو عدم وجود الذبحة الصدرية كمقياس للحاجة الى تلوين الشرايين بدلا من الاعتماد على التصنيف الكندي.


Article
Troponin Positive Acute Coronary Syndrome with and without Significant Stenosis on Coronary Angiography

Authors: Mohammed Hilal AL-Ali --- Hassan A. Farhan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 237-243
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Occasionally, coronary arteries without significant stenosis are observed during invasive treatment of acute coronary syndrome (ACS). OBJECTIVE: The aim was to study the frequency and to determine the most predictive factors of Troponin positive ACS without significant Stenosis on angiography.METHODS:The study involved one hundred twenty four patients admitted with Troponin positive ACS who underwent cardiac catheterization during hospitalization. The primary end-point was the estimation of coronary arteries without significant stenosis, and the secondary end-point was analysis of the most predisposing factors. In evaluating the primary end-point, the patients were divided into two groups according to the presence of ST elevation myocardial infarction (STEMI) or not. Also the patient who has no significant coronary artery Stenosis (< 50%) was subdivided to two groups:a- Myocardial Infarction with No critical lesion in Coronary angiogram (MINC)b-Normal coronary angiogramRESULTS: Overall, 20 patients (16%) had coronary arteries without significant lesions, from which 8 patients (6.4%) had MINC and 12 patients (9.6%) had normal coronary angiogram. The predictors were: female sex (P=0.008), age <45 years (P=0.001), and the absence of: diabetes (P=<0.001), hypertension (P=0.005) and absence of ST-segment elevation (P=0.001). Furthermore absence of regional wall motion abnormality (RWMA) is considered as another predictors for non-significant coronary artery lesion (P=0.008). Also the angiographic analysis of all lesions revealed that single vessels CAD are the commonest finding in Group I patients (P= 0.02). We further analyzed a suspicious angiographic lesions by using QCA {18 lesions (14.5%)} and FFR {6 lesions (4.8%)} technique.CONCLUSION: Overall, patients with Troponin positive ACS had non- significant coronary artery Stenosis on angiography, and female sex, age <45 years and the absence of diabetes, hypertension, ST- segment elevation or RWMA were all associated with coronary angiography showing no significant stenosis.


Article
Angiographic anatomical variation of origin of left circumflex coronary artery in Basrah
التصوير الوعائي للتباين التشريحي لمنشأ الشريان التاجي المنعطف الأيسر في البصرة

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Abstract

Background: The left circumflex coronary artery normally originated from left coronary artery , however, this artery may change its origin either from left aortic sinus or from right aortic sinus. This knowledgement may help in understanding some of ischemic heart diseases and its consequences on cardiac surgery. Objective: To know the incidence of anatomical variations of left circumflex coronary artery origin among people in Basrah.Patients and Method: Prospective study of the coronary angiography carried out in cardiac catheterization center at Al-Sader Teaching Hospital during period from 5th of October 2012 to end of June 2013. A sample of 315 patients was recruited with normal coronary angiography. Results: In the present study the left circumflex artery was variable in its origin, the left circumflex artery originated from the left coronary artery in 97.1%, originated from the left aortic sinus in 1.9% and in 1% of the sample it originated from right aortic sinus. Conclusions: Recognition of the origin of left circumflex coronary artery and its anatomical variations before cardiac surgery is important to prevent myocardial infarction and death. Special surgical consideration must perform in valvular replacement in patient with variation of origin of left circumflex coronary artery.

الخلفية: الشريان التاجي المنعطف الأيسر ينشا عادة من الشريان التاجي الأيسر، ومع ذلك، هذا الشريان قد يتغير منشأه أما من الجيب الابهري الأيسر أو من الجيب الابهري الأيمن وان هذه المعرفة قد تساعد على فهم بعض من أمراض القلب الاقفاري وعواقبه في جراحة القلب. الهدف: الهدف من هذه الدراسة معرفة حدوث اختلافات تشريحية من منشأ الشريان التاجي المنعطف الأيسر بين سكان البصرة.طريقة أجراء البحث والمرضى: أجريت دراسة استطلاعية لتصوير الشرايين التاجية في مركز قسطرة القلب في مستشفى الصدر التعليمي خلال الفترة من الخامس من تشرين الأول 2012 و حتى نهاية حزيران 2013 وقد أجريت على 315 مريض ذوي شرايين تاجية سليمة.النتائج: في هذه الدراسة كان الشريان المنعطف الأيسر متغير المنشأ، حيث ينشا الشريان المنعطف الأيسر من الشريان التاجي الأيسر في 97.1٪ و ينشا من الجيب الابهري الأيسر في19% و في 1% ينشا من الجيب الابهري الأيمن.الاستنتاجات: أن من الأجدر أدراك الاختلافات في منشأ الشريان التاجي المنعطف الأيسر وذلك للوقاية من احتشاء عضلة القلب والموت و خصوصا في عمليات القلب المفتوح. ويجب الأخذ بالاعتبار إجراء دراسة جراحية خاصة في استبدال صمامات القلب لهولاء المرضى

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