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Article
Validity of ultrasound examination in the diagnosis of acute appendicitis compared with surgical results

Author: Hazim K. AL-Allaf حازم العلاف
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2007 Volume: 33 Issue: 1&2 Pages: 51-58
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: To assess the validity of ultrasound examination in the diagnosis of acute appendicitis.
Methods: This case series study included 750 patients. From January 2003 to March 2007, patients with suspected acute appendicitis were sent to the radiological section in the AL-Jamhory teaching hospital and my private clinic for sonography.
A distended appendix with a lumen more than 6mm, aperistaltic appendix with appendicolith in its lumen are all signs and criteria for the diagnosis of acute appendicitis.
Result: Of the 750 patients suspected to have acute appendicitis who were examined by sonography, 527 were males and 223 females. 468 patients had true acute appendicitis, and 220 patients were negative for this disease.
Thirty patients showed false positive diagnosis, while 32 patients proved to have false negative results. The overall sensitivity of ultrasound examination to diagnose acute appendicitis was 94%, specificity 88%, accuracy 92%, positive predictive value 93% and negative predictive value was 88%.
Conclusion: sonography must be used as first modality to assess suspected acute appendicitis. It is easy, non invasive, simple and rapid.

الهدف: لتقييم أهمية فحص الموجات فوق الصوتية في تشخيص حالات اشتباه التهاب الزائدة الدودية الحاد.تقييم البحث: دراسة وصفية لحالات مرضية.المشاركون: 750 مريضا مصابون باشتباه التهاب الزائدة الدودية الحاد.مكان إجراء البحث والإطار الزمني: أجريت الدراسة في شعبة الأشعة في م. الجمهوري التعليمي والعيادة الخاصة في الموصل منذ كانون الثاني 2003 وحتى آذار 2007.طرق الدراسة: تم فحص الزائدة الدودية للمرضى وتم اعتماد الصفات التالية كأدلة على الالتهاب الحاد وشملت انتفاخ الزائدة الدودية بحيث يصبح قطر تجويفها أكثر من 6 ملم, فقدان الحركة النبضية للزائدة, وجود جسم غريب داخل التجويف للزائدة مسببا لانسدادها.النتائج:تم دراسة (750) مريضا مصابين باشتباه التهاب الزائدة الدودية. 527 من الذكور و 223من الإناث تبين إصابة 468 مريضا بالتهاب الزائدة الدودية الحاد المثبت بإجراء التداخل الجراحي, بينما كان 220 مريضا سليما من هذا المرض.تم اكتشاف 30 مريضا من الذين شخصهم فحص الموجات الفوق صوتية بان لديهم التهاب الزائدة الدودية بينما الفحص بعد إجراء العملية تبين خطأ ذلك (موجب خاطئ) وكان هناك 32 مريضا لم يتم تشخيصهم من قبل فحص الموجات الفوق صوتية ولديهم المرض (سالب خاطئ).بلغت حساسية فحص الموجات الفوق الصوتية لتشخيص حالات التهاب الزائدة الدودية الحاد 94% والخصوصية 88% ودقة الفحص 92%.الاستنتاج: فحص الموجات فوق الصوتية هو من الفحوصات السهلة الإجراء والسريعة, وغير تداخليه ولهذا يجب إجراءه كفحص أولي في حالات الاشتباه بالتهاب الزائدة الدودية.

Keywords

Ultrasound --- appendicitis


Article
Evaluation of Modified Alvarado Score in the Diagnosis of Acute Appendicitis at Baghdad Teaching Hospital

Authors: Maral F Thabit --- Hani M Al An sari --- Bashar R Kamoona
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 675-683
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Acute appendicitis is one of the most common causes of abdominal surgical emergencies. It is associated with high morbidity and occasionally mortality related to failure of making an early diagnosis. Modified Alvarado Scoring System is a clinical score which aid in the diagnosis of acute appendicitis.OBJECTIVE :To evaluate the overall diagnostic value of Modified Alvarado Scoring System in patients with suspected acute appendicitis and to determine gender differences.Study design and Setting : A prospective study was conducted in the surgical emergency unit of Baghdad Teaching hospital in a period of five months extending from 18th February to 18th July 2011PATIENTS AND METHODS :(100) consecutive patients above the age of (14) years old and of both genders with provisional diagnosis of acute appendicitis were subjected to interview questionnaire covering sociodemographic and clinical characteristics revealing 7 variables based on the Modified Alvarado Scoring System , summation of all scores were calculated for each patient before underwent surgery and all operated appendices were sent for histopathology.RESULTS:The total number of included sample were (100) patients , (57%) were females and (43%) were males , (60%) were in the age group of (15-24) years old , (49%) were admitted to hospital within (6-12) hours after onset of symptoms . (87%) had Modified Alvarado Score of ≥7 (57.5% females, 42.5% males) while (13%) had Modified Alvarado Score of <7 (53.9% females, 46.1% males) . Out of those (87%) patients with Modified Alvarado Score ≥ 7 , (92%) patients had acute appendicitis and (8%) patients had normal appendix on histopathological examination. The negative appendectomy rate for patients with score ≥ 7 was 8.1%. While patients with Modified Alvarado Score < 7 were (13%), only (46.1%) of them had acute appendicitis on histopathological examination giving a negative appendectomy rate of 53.9%. The sensitivity , specificity , accuracy and positive predictive value in males were ( 85.4%) , (0%) ,(81.4%) and (94.6%) respectively while in females were (100%) , (58.3%) , (91.2%) and (90%) respectively .The overall sensitivity , specificity , accuracy , negative appendectomy rate and positive predictive value were (93%) , (50%) , (87%) , (14%) and (91.9%) respectively .CONCLUSION:Modified Alvarado Scoring System is helpful in the diagnosis of acute appendicitis.

Keywords

alvarado --- appendicitis


Article
Abnormal Urinalysis in Acute Appendicitis

Authors: Athraa Kahtan Azez --- Talib Jawad Kazim --- Mukdad Fuaad Abdul_alkareem
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2014 Volume: 7 Issue: 1 Pages: 60-65
Publisher: Diyala University جامعة ديالى

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Abstract

Background: The correlation between urinalysis and appendicitis is still unclear. Urinalysis can be depended may aid diagnose and compare acute perforated and non-perforated appendicitis.Objective: To determine the correlation between routine urinalysis and simple and perforated appendicitis. Methods: The patients (210) analyzed prospectively with clinically suspected acute appendicitis that underwent urinalysis followed by appendectomy at Baquba Teaching Hospital, during the period from August 2013 to March 2014. Urine test strip analysis was used.Results: Patients with acute appendicitis had a higher percentage of positive urine ketone bodies, higher specific gravity, and lower urine pH than patients with normal appendices. Such and other parameters and such data were much higher in patients with perforated appendix. Conclusion: Routine urinalysis may show differences in findings between simple and perforated appendicitis. Clinically, we believe these urine parameters may aid clinicians in decision making for patients with suspected appendicitis.


Article
IS PEDIATRIC APPENDICITIS SCORE SUFFICIENT TO MAKE THE DIAGNOSIS OF ACUTE APPENDICITIS AMONG CHILDREN?

Authors: Ali F Abdullah علي فاروق عبد الله --- Firas M Katoof فراس مجيد --- Basim Sh Ahmed باسم شهاب احمد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 2 Pages: 195-199
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Children with acute abdominal pain represent most of the admitted cases to the pediatric surgical department, one third of these cases are acute appendicitis. Early diagnosis of “no appendicitis” or “appendicitis” on the basis of pediatric appendicitis score could potentially save emergency department's time and resource use and could avoid time cost and risks for further evaluation.Objective:Evaluation of Samuel scoring system in diagnosing children with acute appendicitis and their need for surgery.Methods:One hundred and twelve patients aged between 5 to 15 years who presented with abdominal pain suggestive of acute appendicitis were studied. A complete data from patients were analyzed by using Samuel score. The clinical findings used by previously mentioned scoring system were analyzed to determine reliability of pediatric appendicitis score (PAS). The Final diagnosis was determined by histopathological report for patients' undergone appendicectomy.Results:The mean (median, SD) score for children with acute appendicitis and non-acute appendicitis were 4.9 (5, 1.8) and 4.6 (5, 1.7) respectively. No variable (of the known signs and symptoms regarded as pathognomonic for acute appendicitis) shows a significant value in the diagnosis of acute appendicitis. A PAS of ≥ 4 had a sensitivity, specificity, Positive predictive value (PPV), and Negative predictive value (NPV) of 0.78, 0.27, 0.87, and 0.16 respectively.Conclusion:The diagnosis of acute appendicitis and the need for surgery is still a matter of clinical judgment which can be built with practice, and although the PAS could provide useful diagnostic information in children with suspected acute appendicitis, it cannot be used as sole method for determining the need for surgery.Key words:Pediatric Appendicitis Score (PAS), acute appendicitis, appendicectomy.


Article
Evaluation of Pediatric Appendicitis Score in Predicting Appendicitis

Author: Maha A.Lattuf AL-Rudaini* , Kawthar Fakhri Khalaf Al-Bayati**, Zaidoon Moayad Younis Altaee***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 255-260
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: The diagnosis of acute appendicitis carries significant difficulties, particularly in very young ages on which the history and physical examination are difficult. The clinical challenge is to diagnose appendicitis early enough to prevent perforation, while minimizing the number of negative appendicitis that are performed. The diagnosis of acute appendicitis is primarily clinical and the clinical scoring systems have been investigated as alternatives or adjuncts to diagnostic imaging. OBJECTIVE: Is to establish the accuracy and applicability of using pediatric appendicitis scoring system (PAS) in evaluating acute appendicitis in pediatric age group.METHODS: A prospective cohort study was conducted in Al-Khansaa Teaching Hospital and Children Welfare Teaching Hospital, from January 2014 till November 2015. The study includes 143 patients aged from (3-13) years old referred from pediatric emergency unit or outpatient clinic with suspicion of acute appendicitis. All the obtained data were analyzed using pediatric appendicitis score (PAS) system which classifies the patients into 3 groups: Group (1): Patients with scoring (1-3) includes 38 patients, Group (2): Patients with scoring (4-6) includes 20 patients, while Group (3): Patients with scoring (7-10) includes 85 patients. Surgery was done to all patients of group 3 and thirteen patients of group 2. All removed appendices were sent for histopathological study.RESULTS: The median age of the 98 operated on patients was (8.9 years ± 2.6). The histopathological results of appendicitis were confirmed in 89 patients underwent surgery (five patients of group 2 and 84 patients of group 3), while negative histopathological result of appendicitis is seen in nine (9.2%) patients. There is significant association of positive histopathological findings with high PAS (≥7) scoring (p<0.0001). The 8 parameters of PAS system shows accuracy as following: the right lower quadrant tenderness, anorexia and hop tenderness shows accuracy of 90.8%, 87.8% and 86.7% respectively, while leukocytosis, fever and nausea/vomiting shows accuracy of 83.7%, 80.6% and 63.3% respectively. Migration of pain and PMN neutrophilia shows the lowest accuracy rate. The sensitivity of PAS system was 94.4%, the specificity was 88.9%, the PPV was 98.8%, the NPV was 61.5% with overall accuracy of PAS system was 93.9%.CONCLUSION: PAS system is easy, simple and useful tool in pre-operative diagnosis of acute appendicitis and can be used by pediatricians to reduce the number of admission to the hospital. Patients with scores of ≥ 7 show high probability of appendicitis and early operation is indicated, while patients with score of ≤3 rule out this disease. The CT scan and diagnostic laparoscopy is advocated for patients with score of (4-6).


Article
Do Antibiotics have a Role in the Conservative Management of Appendix Mass?

Author: Dhafir Dawood Sulieman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 3 Pages: 226-230
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Management of acute appendicitis is strictly surgical but acute appendicitis presented as appendix mass could be treated in different ways including using antibiotic treatment regime but these options remains controversial. The aim of this study was to evaluate the role of antibiotic in the conservative management of appendix mass.METHODS:The medical records of 1051 patients diagnosed as acute appendicitis at two different teaching hospitals in in Yemen, have been reviewed for the purpose of this study. 516 cases collected from Kuwait University Hospital,(K.U.H.) Sanu'a (between Jan 2005 to Dec 2007 ) and 535 cases collected from Ibn Sina Teaching Hospital ,(ISTH). Mukalla, (between Jan 2007 to Dec 2007). It has been found that 893 cases had urgent operation, and 98 patients diagnosed as suspected non obstructive acute appendicitis and got recovered completely with conservative treatment. On the other hand 60 cases, (5.7%), presented with appendix mass, and have been treated conservatively by distributing them randomly into two selected groups, group A treated with rest + antibiotic, group B treated with rest only and results analyzed prospectivelyRESULTS:The 35 appendix mass cases treated at K.U.H, represent (7.5%) ,cases distributed as Group A, had an average hospital stay of Sdays ( ranging from3-7), while group B, had stayed an average of 6.5 days (ranging from3-ll). 25 appendix, mass casesrepresent 5.1% at I.S.T.H. Group A. had an average hospital stay of 5.5 days(3-8) ,while group B, had an average of 8 days (3-20). the proportion of appendix mass presented with pyrexia in both groups were 41.6%.Complications: two cases reported at I.S.T.H with signs &symptoms of recurrent sub acute appendicitis and palpable residual appendix mass, both from group A, refused operation and were treated conservatively with the same regime (antibiotics+ rest) signs and symptoms subsided in few days & discharged. Other complications such as abscess formation or spreading peritonitis were absent.Interval appendicectomy; all patients were advised to come back in 6 weeks for elective appendicectomy. 6 cases reported at K.U.H, and only 2 at I.S.T.H. All were free from signs & symptoms and they had operationCONCLUSION:Conservative treatment for appendix mass is effective and safe, antibiotic, might shorten the resolution time but not essential. Complications is only 3% and represented by recurrent sub acute appendicitis, which responded to conservative treatment. Interval appendicectomy is probably unnecessary and should be reserved for cases with recurrent of signs and symptoms only


Article
Effect of histological parameters of appendicitis and related with age and sex
د ا رسة نسجیة لالتهاب ال ا زئدة الدودیة وعلاقتها بالجنس والعمر

Author: Samiea Mojbel Hamad سمیعة مجبل حمد
Journal: Journal of university of Anbar for Pure science مجلة جامعة الانبار للعلوم الصرفة ISSN: ISSN: 19918941 Year: 2011 Volume: 5 Issue: 1 Pages: 13-16
Publisher: University of Anbar جامعة الانبار

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Abstract

Acute appendicitis is the most common acute surgical condition of the abdomen. The mostimportant step for appendicitis is the obstruction the eppeniceal lumen. Our study was aimed to studythe histological parameter associated with appendicitis. This study was included 55 of appendixspecimens, which were resects. These samples were collected from teaching Ramadi hospital. Grossexamination for diameter of lumen and thickness of mucosa was performed and then the samples werefixed in 10℅ formalin for histological examination. The relation of age and sex with appendicitis wasstudied in this work. This study was recorded increase in thickness of mucosa(Mean=1.4mm) anddecrease in diameter of lumen(Mean=1mm). increase incidence of appendicitis between males andfemales(50.9/49%).The age of the patients ranged from (8-45)years with mean (21.4).Histologicalstudy was revealed increase infiltration of white blood cell within muscularis mucosa. Congestion,destruction of mucosa, hyperplasia of lymph nodules, obstruction of lumen with found some of warmsuch as Enterobious vermicularis within lumen. From these results we found the ratio of incidence ofappendicitis increase in males than females and ensured that by increase the histological parametersand pathological changes compare with normal

الخلاصةتضمنت الد ا رسة جمع عینات ال ا زئدة الدودیة التي تم استئصالها من ٥٥ مریض دخلوا مستشفى الرمادي التعلیمي تت ا روح اعمارهم٤٩ )% ، تم قیاس قطر العینات وسمك الجدار عیانیا ثم - ٤٥ ) سنة بمعدل ٢١.٤ وكانت نسبة الذكور الى الاناث( ٥٠.٩ - بین( ٨حفظت العینات في محلول ١٠ % فورمالین ، بعدها تم تحضیر المقاطع النسجیة وصبغت بالایوسین والهیماتوكسلین . اظهر الفحصالمجهري تضیق في قطر العضو مع زیادة في سمك الجدار العضلي الداخلي و تهتك في الطبقة الظهاریة كما تبین تضخم وزیادة فيقطر العقیدات اللمفاویة بالاضافة الى تجمع كریات الدم البیض ضمن النسیج العضلي الداخلي وظهور اكیاس لبعض الدیدان فيالفسحة الداخلیة لل ا زئدة الدودیة وتعزى هذه التغی ا رت الى اصابات بكتیریة او فایروسیة او طفیلیة وبعض الاحیان تعزى الى السلوكالغذائي الخاطئ. ویعود قلة حدوث الالتهاب عند النساء الى الاختلاف الفسلجي وتأثیر بعض الهرمونات خاصة في فترة الحمل، كمایلاحظ غالبا ازدیاد حدوث الاصابة في الم ا رحل الاولیة (في عمر الم ا رهقة)لان الجسم یكون في م ا رحل النمو السریع وتط أ ر علیه تغی ا رتفسلجیة كثیرة

Keywords

Histology --- appendicitis --- sex --- age


Article
ULTRASONOGRAPHY FOR SUSPECTED ACUTE APPENDICITIS (RADIOPATHOLOGICAL STUDY)
دور الأمواج الفوق الصوتية في تشخيص التهاب الزائدة الدودية الحاد

Author: Maha shakir hassan مها شاكر حسن
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2010 Volume: 4 Issue: 3 Pages: 1-10
Publisher: Thi-Qar University جامعة ذي قار

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SUMMARYBackground: Acute appendicitis is one of the commonest surgical emergencies. Simple appendicitis can progress to perforation, which is associated with a much higher morbidity and mortality, and surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain.1in this study we asses the role of ultrasonography in adition to clinical and laboratory data to reach the final diagnosis of acute appendicitis.Patients and methods: in this combined retrospective and prospective study to 75 patients who referred to surgical service. A complete clinical history, physical examination, WBC count, neutrophils count, and ultrasonography. A histopathological correlation done for 57 cases undergo surgical operation.Results: for 57 cases of acute appendicitis most patients was between 11-30 years old ( 59.65), male: female ratio was 1: 1.5, most common symptoms was abdominal pain present in all cases. The sensitivity of ultrasonographic examination was 94.7%, specificity was 88.9% and accuracy was 93.3%. leukocytes count was ≥ 10x109 in 43 (75.43%) of acute appendicitis cases, and the neutrophil count ≥ 75% in 34 (59.64%) of acute appendicitis ccases.Conclusion: ultrasonography is an accurate procedure that leads to prompt diagnosis and early treatment of many cases of appendicitis.

الخلاصةالتهاب الزائدة الدودية الحاد واحدة من أكثر الحالات الجراحية شيوعا,التهاب الزائدة الدودية البسيط قد ينتهي بتمزق الزائدة الدودية المصحوبة بزيادة نسبة المعانات للمريض والتي قد تؤدي للوفاة, لذلك فان الجراحين يقومون بإزالتها عندما يكون التشخيص محتمل متجنبين الانتظار لحين التأكد من التشخيص.في هذه الدراسة نحن نقيم أهمية الأمواج الفوق الصوتية في تشخيص الالتهاب بالإضافة إلى المعلومات التي نحصل عليها من أعراض المرض,و فحص المريض, و النتائج المختبرية, ومقارنتها بالتحليلات النسيجية.من خلال دراسة 75 حالة 57 خضعوا للجراحة, وقد استنتجنا ان للفحص بالأمواج فوق الصوتية أهمية كبيرة للمساعدة في التشخيص, وان حساسية الفحص كانت 94,7%,وخصوصيته كانت 88,9%,و دقته كانت 93,3%.


Article
EARLY APPENDECTOMY DURING PREGNANCY
استئصال الزائده الدوديه المبكر عند الحوامل

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ABSTRACTBackground: Appendectomy for presumed acute appendicitis is the most common surgical emergency during pregnancy, acute appendicitis occurs at the same rate in pregnant and non pregnant women, but pregnant women have a higher rate of perforation. Patients &methods: This prospective study done 42 pregnant women between age 20 to 41 years all of them were complained from signs and symptoms of acute appendicitis arrived ER of Al Hussain teaching hospital in AL Nassyria during period 2010 either came directly or referred from gynecologist ,they underwent appendectomy early after diagnosis .Results: Most of patients succeeded pregnancy 38 patients (90.4%) { in spite of 3 patient (7%) have threatened abortion anther 3 patients have preterm uterine contraction but they continue of pregnancy successively},only 4 patient (9.5%) end with abortion.Most of women [21patients (50%)] complained from acute appendicitis during second trimester .Most of patients who did not delay operation till 48 hours can pass pregnancy successfly with some problems , while who delayed more liable to abortion [4 of 10 patient (40%)] . Aim: reduce fetal loss after appendectomy during pregnancy. Conclusion: we advices early operation in pregnancy with out delay, no place for conservative management in acute appendicitis .

ألخلاصه دراسه مستقبليه أجريت على 42 من النساء الحوامل بفترات متباينة من الحمل تتراوح اعمارهن بين 20 الى 42 عاما دخلن طوارئ مستشفى الحسين التعليمي في الناصريه خلال عام 2010 جميعهن أصبن بالتهاب الزائده الدوديه إثناء حملهن ( الكثير منهن مرسلات من قبل طبيبات نسائيه) وقد تم تشخيصها سريريا مع مساعده بعض الفحوصات المتوفره ثم أجرينا عمليه استئصال الزائده الدودبه بعد وصولهن الطوارئ بفترة وجيزة فكانت النتائج كالاتي :- 1- كان معظم النساء 38 أمراءه( 4،90 %) قد أكملن حملهن بسلام بالرغم من 3 نساء(7%) أصبن بإجهاض مهدد و 3 أخريات (7%) بألم قوي بسبب تقلصات رحميه مبكرة) لكنهن أكملن حملهن بسلام فقط أربعه مريضات (6،9 %) انتهى حملهن بالإجهاض 2-أكثر حالات الزائدة الدودية تحدث خلال الأشهر الثلاثة الوسطى21 مريضه 50% 3- وجد نا المريضات اللواتي يتأخرن بأجراء العملية ل 72 ساعة او أكثر هن اكثر عرضه للاجهاض من غيرهن ( 4 مريضات من اصل 10 ) او من مشاكل الحمل الأخرى مثل الإجهاض المهدد او التقلصات ألرحميهلذا ننصح بأجراء عمليه الزائدة الدودية اثتاء الحمل بعد تشخيصها سريريا وبعض الفحوصات المتوفرة بأقرب وقت ممكن لتفادي تلك المشاكل


Article
Parasitic Cause of Acute Appendicitis In Najaf
المسببات الطفيلية لالتهاب الزائدة الدودية الحاد في النجف

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Abstract

Background & objectives : Acute appendicitis is the most common acute surgical condition of the abdomen .In spite of many researches & studies that had been performed on the acute appendicitis in general, very limited works talking about the role of the parasites in the causation of acute appendicitis This study was performed to investigate the preformed to investigate the prevalence rate of intestinal parasites in appendices of patients with clinically diagnosed acute appendicitis who arrived to Al-Najaf city hospitals .Patients & methods : Prospective study included 500 patients from both sexes were done .from August 2001 to July 2002 .Excised appendices were examined macroscopically and microscopically for detection of parasitic infections . Examination of tissue digests was conducted for 80 specimens by using acidic pepsin solutions to determine the efficiency of different diagnostic methods of detecting parasitic infestations in appendix .Results : There were 318 males & 182 femals ,their ages ranging from 5 to 49 years .The total infection rate of appendices with intestinal parasites was 16.2 % (11.4% with heliminth and 4.8 % with protozoa). The prevalence of E.histolytica ; G. lamblia ; E.vermicular; A.lumbricoides ; H.nana and T.trichiura was 2.4 % ; 2.0% ; 10.0% ; 0.6% ; 0.6% and 0.2% respectively .H.nana and G.lamblia were isolated from the appendix for the first time in Iraq. The incidence of sigle parasitic infection was 85.18% against 14.81% for double infections, which was between E.vermicularis & E.histolytica (7.4%) while the lowest relationship was between E.vermicularis with T.trichiura and E.vermicularis with A.lumbricoides (102%) .Conclusion: Parasitic infection has a sensible role in the etiopathology of acute appendicitis in addition to its considerable affection on the human health in our people that require an intensive work to manage this problem .

شملت الدراسة فحص 500 مريض مصابون بالتهاب الزائدة الدودية الحاد . فحصت الزوائد المزالة بعد العمليات الجراحية مجهريا وعيانيا لتحديد الإصابات الطفيلية . بلغ عدد المرضى الرجال 318 والمرضى النساء 182واللذين تراوحت أعمارهم من 5 إلى 49 سنة . بلغت النسبة الكلية للإصابة بالطفيليات 16.2% منها 11.4% ديدان و 4.8% أو إلي طبية . كانت نسبة الإصابة بطفيليات الاميبا الحالة للنسيج ، الجارديا، الدودة الدبوسية ، الصفر الخراطيني ، الدودة القزمة والدودة السوطية هي 0.6% , 10% , 2% , 2.4% , 0.6% , 0.2% على التوالي . إصابة الزوائد الدودية بالدودة القزحة والجارديا سجلت لأول مرة في العراق .

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