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Article
Results of Kidney Biopsies among Adult Iraqi Patients in a Single Center

Authors: Nawar S.Jameel نوار جميل --- Mohammad Abdul Mahdi محمد عبد المهدي --- Ali Jasim H. Al-Saedi علي جاسم الساعدي
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 1 Pages: 82-84
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/IraqMaterial and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).Results: Primary glomerulonephritis (GN) was seen in 102 of 120 patients (85%), focal segmental glomerulosclerosis, and membranous nephropathy were the most common histological diagnosis (33.3% and 21.5% respectively).Conclusion: The study further emphasize the need for national GN registry and long term follow up, to recognize the common pattern of GN, their natural history, the appropriate line of management, and to try to halt their progression to end stage renal disease (ESRD).Key Words: Iraq, Glomerulonephritis, Renal Biopsy.


Article
Inconclusive Urinary Bladder Biopsy; Facts and Lessons

Author: Ausama Saadi Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 4 Pages: 303-306
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:To review the pathologic analysis of urinary bladder biopsies and study the frequency and causes of inconclusive biopsies among Iraqi patients.METHODS:This is a retrospective study in which 933 patients underwent 1047 urinary bladder biopsy procedures during endoscopic evaluation, or transurethral resection of a known bladder cancer in Surgical Specialties Hospital, Baghdad, Iraq between June 2000 and June 2007. Pathologic records of patients were reviewed.RESULTS:In 933 patients aged 2-100 years with a mean age of 56.87±14.3 years who underwent 1047 urinary bladder biopsy procedures, pathologic review showed bladder cancer in 655 (62.56%) biopsies, no overt malignancy in 340 (32.47%) biopsies, no pathological diagnosis could be made in 43 (4.11%) biopsies, and normal biopsy in 9 (0.86%) biopsies. In 238 bladder cancer biopsies, pathologic analysis of muscle invasion was not carried out due to their lack of muscular tissue.CONCLUSION:Urinary bladder biopsy is one of the most common biopsies in urology practice. Every effort is made to prevent technical defects of taking and processing such biopsies, to optimize pathologic analysis and surgical management.

Keywords

Bladder biopsy --- Cystoscopy


Article
AGE AND BIOPSY AS PREDICTIVE FACTORS IN THE MANAGEMENT OF ORAL SQUAMOUS CELL CARCINOMA….80

Author: Ali Abbas Alshawi
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 1 Pages: 80-87
Publisher: Basrah University جامعة البصرة

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Abstract

Keywords

BIOPSY --- SQUAMOUS --- CELL --- CARCINOMA


Article
TROCARIZATION FOR DIAGNOSIS OF SARCOCYSTOSIS IN SHEEP
استخدام تقنية البزل قي تشخيص داء الحويصلات الصنويرية في الضان

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Abstract

Trocarization was used for diagnosis of sheep sarcocystosis for the first time with current study by using human biopsy needle. The obtained samplesexposed to recommended sarcocystosis diagnosis techniques ( Trichinoscopy,Post trichinoscopy drop examination , Peptic digestion method and histopathlogical method ) .Out of eleven biopsy samples ( taken from the oblique muscles of the left flank )Trichinoscopy was the less sensitive ( 7/11 ) , Post trichinoscopy drop examination ( 9/11 and lately the most efficient methods which are Peptic digestion ( 11/11) and histopathological method (3/3 ).The biopsy technique showed to be suitable for sarcocystosis diagnosis insheep without any effects on the live of the animals which make it the preferablemethod for advance researchs.

تم استخدام تقنية البزل لتشخيص داء الحويصلات الصنوبرية بالضان اعتمادا على الخزعة التي تم الحصول عليها بتطبيق التقنية بوساطة ابرة الخزعة البشرية وذلك لاول مرة من خلال هذه الدراسة.ان الخزع المفحوصة باستخدام تقنيات تشخيصية خاصة بداء الحويصلات الصنوبرية( فحص منظار الشعرياتو فحص القطرة ما بعد منظار الشعريات وفحص الهضم بمحلول الببسين واخيرا الفحص النسيجي)تفاوتت في دقتها التشخيصية اذ كان منظار الشعريات اقلها حساسية ( 7/11 ) ثم فحص القطرة ( 9/11 ) فيما كانتا طريقتي الهضم بمحلول الببسين ( 11/11 ) و الفحص النسيجي (3/ 11 )هما الادق . اظهرت الدراسة ان تقنية الخزعة بوساطة البزل ملائمة لتشخيص داء الحويصلات الصنوبرية في الضان مع عدم التاثير على صحة الحيوان وهذا يجعلها ملائمة لاجراء الابحاث المتقدمة.


Article
DIAGNOSIS OF THYROID NODULES USING FNA
تشخيص عقد الغدة الدرقية عن طريق الرشف الخلوي بالإبر الدقيقة دراسة تطلعية تحليلية

Author: Ali Swailem
Journal: journal of kerbala university مجلة جامعة كربلاء ISSN: 18130410 Year: 2013 Volume: 11 Issue: 4 Pages: 302-310
Publisher: Kerbala University جامعة كربلاء

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Abstract

BACKGROUND :- Thyroid gland differs from other endocrinal organs in it s heaviness and early working in embryonic period (1).The main reason for intense interest of thyroid research is the outbreak of thyroid cancer after disaster of Chernobel nuclear energy plant leaks in 1986(2). Most common clinical findings in the thyroid gland is different pictures of neck swellings which defined as Any disorders of growth of thyroid cells changes into a swelling in thyroid. Nodule—means knot or knob. Benign nodules can be caused by1-Adenomas 2-Colloid nodules 3-Cysts 4-Infectious nodules5-Lymphocytic nodules 6-Hyperplastic nodules. 7-Thyroiditis .8-Congenital anomalies.Malignant nodules are classified as 1-Differentiated tumors a-Papillary adenocarcinoma b-Follicular adenocarcinoma2-Medullary carcinoma3-Undifferentiated tumors like : anaplastic 4-Others :- a-Lymphoma b-sarcoma c-squamous cell carcino ma d-Metastatic tumors. (3)FNAC plays an important role in diagnosis of thyroid nodules.AIMS OF STUDY:- To test suitability of fine needle aspiration cytology & avoid morbidity and complications of unwise thyroid operative decisions. PATIENTS MATERIALS& METHODS:- This study was carried out in Al-Hussein Teaching Hospital in Karbala city during the period from 1st January 2011 to 31st December 2012=2years. ( 120 ) patients were included in this study; designed as a prospective study.RESULTS :-The results studied were compared with pathological and importance of FNAC was tested byfinding of Sensitivity(83.3%),Specificity(95.3)PositivePredictiveValue=PPV(78.1%) and Negative Predictive Value=NPV(48.6%)Accuracy ratio=95% . Out of 120 patients FNAC showed 98 patients as benign and 22 patients as malignant while pathological examination revealed 96 patients had benign and 24 patients had malignant lesions . FNAC was able to correctly diagnose (94/98) as benign lesions while (4/98) cases of benign lesions appeared to be malignant on pathological examination (False negative) . Out of (24) cases which appeared to be malignant on pathological examination. FNAC confirmed 22 cases while (2/24) benign lesion was misdiagnosed as malignant (False positive). Conclusions:- This study showed a sensitivity of( 83.3 )%, specificity( 95.3%)and accuracy ratio=95% of FNAC in diagnosis of thyroid cancer in thyroid swelling lesions.

عقدة الغدة الدرقية حالة سريريه شائعة قد تصل إلى 50%عند كبار السن معظم هذه الحالات حميدة . معظم هذه الحالات حميدة حيث أن سرطان الغدة الدرقية يمثل حالة سريريه غير شائعة الحصول . أذا كانت إفرازات الغدة الدرقية طبيعية فان استخدام خزعة الرشف الخلوي بالإبر الدقيقة يوفر معلومات مباشرة حول نوعية الوضع الخلوي لعقدة الغدة الدرقية المنفردة. أهداف هده الدراسة هي لتقييم دقة طريقة الرشف الخلوي في تشخيص العقدة المنفردة للغدة الدرقية وتجنب العمليات الجراحية غير الضرورية للغدة الدرقية. هده الدراسة أجريت على 120 مريضا في قسم الجراحة في مستشفى الحسين (ع) التعليمي في كربلاء المقدسة للفترة من 1/1/2010 لغاية 31/12/2011 وهي دراسة تطلعية تحليلية. وهي أول دراسة من نوعها في العراق. نتائج هذه الدراسة قورنت مع الفحص النسيجي كما إن كفاءة الفحص الخلوي بالرشف بالإبر الدقيقة قد قيست بالحساسية – النوعية ألآحصائية كما تم قياس القيمة التوقعية الايجابية والسلبية. من 120 مريضا اظهر الفحص الخلوي98 حالة حميدة 22 حالة سرطانية بينما الفحص النسيج اظهر96 حالة حميدة و24 حالة سرطانية . الفحص الخلوي كان قادرا على التقاط94 حالة حميدة بينما هناك 4حالات حميدات (بالفحص الخلوي بالرشف بالإبر الدقيقة) بينما اثبت الفحص النسيجي أنها خبيثة وهذا يسمى (السلبية الكاذبة) 0 من 24مجموع حالة شخصت نسيجيا على كونها خبيثة تم تشخيص 22 حالة بالفحص الخلوي (مطابق للفحص النسيجي ) بينما تم الاشتباه بحالتين حميدتان على أنهما سرطان بينما اثبت الفحص النسيجي أنهما حميدتان وهدا يسمى (الايجابية الكاذبة)0 نتائج تحليل هده الدراسة يظهر الحساسية = 33, 8%والنوعية =95,3% استنتجت هده الدراسة أن الفحص الخلوي للرشف بالإبر الدقيقة مفيدة جدا في تشخيص السرطان في عقد للغدة الدرقية.

Keywords

FNAC --- Biopsy --- Thyroid nodules .


Article
1.Editorial: LIQUID BIOPSY- A NEW PROSPECT

Author: Ahmed K. Mahdi احمد خيرالله مهدي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 4 Pages: 353-356
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Tissue biopsy has been the mainstay in tumor diagnosis for centuries. But due to its invasiveness and the heterogeneity of tumors there was a need for an alternative or adjuvant techniques to diagnose and assess tumors. Liquid biopsy is emerging as a new technique that will open the way for the diagnosis, tumor characterization, assess disease prognosis and individualize treatment options in cancer patients.Keywords: Biopsy, CTC, ctDNACitation: Mahdi AK. Liquid biopsy - A new prospect. Iraqi JMS. 2018; 16(4): 353-356. doi: 10.22578/IJMS.16.4.1

Keywords

Biopsy --- CTC --- ctDNA


Article
Blind Percutaneous Needle Liver Biopsy: Still the Gold Standard Method in Diagnosing Chronic Liver Diseases

Authors: Dr. Mohammad A. Shaikhani --- Dr. Sabah M. Zangana
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.6, 7 Issue: 4 Pages: 397-402
Publisher: Kerbala University جامعة كربلاء

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Abstract

ercutaneous liver biopsies were done for 55 patients in 2 central hospitals in Kirkuk &Sulaimaneyah in Iraq. The patients were 40 males & 15 females. The clinical conditionsfor which liver biopsies were indicated included liver cirrhosis, chronic hepatitis, livertumors, undiagnosed hepatomegaly, fatty liver & pyrexia of unknown origin (PUO).Thediagnostic accuracy in reaching the final diagnosis of chronic liver disease was more than 50% incases of cirrhosis & 100% in the other causes, although the number of those cases were small todraw accurate conclusions. The complications included only a minor complication in only onecase, without major complications or deaths.


Article
Paraffin embedded marrow clot sections as an adjuvant procedure in the diagnosis of bone marrow diseases.
فحص المقاطع النسجية لخثرة نخاع العظم كطريقه مساعده لتشخيص امراض نخاع العظم

Author: Jasim M. A. Al-Diab جاسم محمد الذياب
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2016 Volume: 34 Issue: 1 Pages: 15-19
Publisher: Basrah University جامعة البصرة

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Abstract

Objectives: This study was conducted to evaluate the role of histopathological examination of paraffin embedded marrow clot sections in the diagnosis of different neoplastic and non-neoplastic marrow diseases, and whether these sections can replace the need for performing bone marrow trephine biopsy.Methods: Patients included in the study are those with clinical manifestations of hematological disorders who were subjected to peripheral blood examination, marrow aspirate cytology with complimentary bone marrow trephine and marrow clot biopsy. Along with marrow aspiration, the blood left behind after preparing marrow smears, was used to prepare paraffin embedded histological clot sections. The results for 114 patients were analyzed simultaneously for their concordance to highlight the usefulness of marrow clot sections in the diagnosis of different diseases affecting the bone marrow. Immunohistochemical stains were used whenever indicated to obtain additional diagnostic information. Results: Marrow clot sections were diagnostic and concordant with the complete blood count, marrow aspirates and trephines in 63% of the cases. While trephines were unconvincing in another 15.7% of the cases, the clot sections were diagnostic. In 1.7% of the cases, the clot sections and trephines were diagnostic while marrow aspirates were inconclusive, thus in 81% of the cases, marrow clot sections provided the diagnosis and replacing the need for performing trephine biopsy. However, trephine biopsy is still considered necessary in 19 % of the cases in whom the clot sections are of poor quality and unconvincing Conclusion: In most of the cases clot sections can replace the need for trephine biopsy, but trephine biopsy is still required in other cases. The clot sections are useful as an adjuvant procedure to increase the diagnostic yield in marrow studies. Because it is difficult to expect which patients will be diagnosed by clot sections and which will need trephine biopsy, it is advisable to perform both trephine and clot biopsy together with the marrow aspirates.

أهداف البحث: أجريت هذه الدراسة لتقييم دور فحص المقاطع النسيجية لخثرة نخاع العظم في تشخيص مختلف امراض النخاع الورمية وغير الورميه، وما إذا كانت هذه المقاطع النسجية يمكن أن تغني عن الحاجة لإجراء خزعة نخاع العظم. طريقة العمل: المرضى المشمولين في هذه الدراسة هم اللذين يعانون من اختلالات دموية والذين اجريت لهم فحوصات الدم المحيطي والفحص الخلوي لسحب خلايا النخاع مع خزعة نخاع العظم وخزعة خثرة النخاع. بعد سحب النخاع وتحضير مسحات الفحص الخلوي للنخاع تتم الاستفادة من الدم المتبقي لتحضير مقاطع نسيجية من خثرة الدم. تم تحليل نتائج 114 مريض في وقت واحد لتطابقها مع بعضها وصولا للتشخيص النهائي وذلك لتسليط الضوء على فائدة فحص المقاطع النسيجية لخثرة النخاع في تشخيص الأمراض المختلفة التي تصيب نخاع العظم. كما استخدمت الاصباغ المناعية النسيجية حسب الحاجه للحصول على معلومات تشخيصية إضافية.النتائج: كانت نتائج فحوصات المقاطع النسيجية لخثرة نخاع العظم مشخصة ومتطابقة مع تعداد الدم الكامل والفحص الخلوي لسحب خلايا النخاع وكذلك مع خزعة نخاع العظم في 63٪ من الحالات. في حين كانت خزعة نخاع العظم غير مقنعة في 15.7٪ من الحالات كانت المقاطع النسيجية لخثرة النخاع مشخصة. وفي 1.7٪ من الحالات، كانت المقاطع النسيجية لخثرة النخاع وخزعة نخاع العظم مشخصة بينما كانت مسحات الفحص الخلوي للنخاع غير حاسمة .وهكذا فانه في 81٪ من الحالات، كانت المقاطع النسيجية لخثرة النخاع تشخيصيه مع امكانية الاستغناء عن الحاجة لأداء خزعة نخاع العظم. ومع ذلك فأن خزعة نخاع العظم كانت ضرورية للتشخيص في 19٪ من الحالات التي تكون فيها المقاطع النسجية لخثرة النخاع ذات نوعية رديئة وغير مقنعة.الاستنتاج: في معظم الحالات يمكن للمقاطع النسيجية لخثرة النخاع ان تحل محل خزعة نخاع العظم، ولكن ما زالت هناك حاجة لعمل خزعة نخاع العظم في حالات أخرى. تعتبر المقاطع النسيجية لخثرة النخاع مفيدة كإجراء مساعد لزيادة الغلة التشخيصية في فحوصات نخاع العظم وبما أنه من الصعب أن نتوقع أي من المرضى سيتم تشخيصهم عن طريق المقاطع النسيجية لخثرة النخاع وأيهم سيحتاج الى خزعة نخاع العظم، فإنه من المستحسن عمل خزعة نخاع العظم وخزعة خثرة النخاع جنبا إلى جنب مع الفحص الخلوي لسحب خلايا النخاع


Article
Diagnostic Value of Cytology and Colposcopy in Patients withAbnormal Cervical Pap Smears

Authors: Nada A Alwan --- Raji H Al-Hadithi --- Nada S Al-Rubai’ee
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2006 Volume: 3 Issue: 1 Pages: 56-62
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: An optimal cancer detection system
for preclinical cervical lesions should combine a
cytological examination with a colposcopic follow-up
examination. Detection at early pre-invasive stage
provides an opportunity for treatment to prevent
progression to invasive cancer.
Objective: The present study aimed at evaluation
of cytology, colposcopy, and combined cytology and
colposcopy in predicting histopathological diagnosis
of cervical intraepithelial neoplasia/squamous
intraepithelial lesion (CIN/SIL) or other neoplastic
changes in patients with abnormal cervical
cytological findings.
Methods: This prospective study was conducted in
the Cyto-colposcopy Unit of Teaching Laboratories
and Outpatient Department of Medical City Teaching
Hospital over a period of one year (Sep. 2001- Sep.
2002). Eighty-one married females were included in
the study. A cervical smear was taken followed by a
colposcopic examination of the cervix and then a
punch biopsy was taken from the suspected lesions
for histopathological study. Estimation and evaluation
of the validity parameters of cytology, colposcopy,
and combined cytology and colposcopy were
performed using different cutoff points by special
statistical analysis.
Results: Sensitivity, specificity and accuracy of
cytology in the diagnosis of CIN/SIL were 73%,
93.2% and 84.0% respectively.
The False–negative rate was 27%. Sensitivity,
specificity and accuracy of colposcopy in the
diagnosis of CIN were 83.3%, 58.5% and 70.1%
respectively choosing doubtful findings as a cut-off
point. The combination of cytology and colposcopy
gave the following results: sensitivity, specificity and
accuracy were 94.6%, 61.4% and 76.5% respectively;
the negative predictive value (NPV) was 93.1%.
When suspicious colposcopic findings were chosen as
the cut-off point, the specificity and the positive
predictive value (PPV) were higher at the expense of
sensitivity and NPV
Conclusion: The conventional Pap smear, a
valuable tool in the evaluation of patients with
abnormal cervical cytology, was found to be of
relatively low sensitivity in predicting CIN/SIL.
Colposcopy is a valuable tool too. However, the
validity parameters showed variable figures
depending on the different cut-off points applied for
the diagnosis of CIN/SIL. The ideal cut-off point was
when doubtful and higher-grade colposcopic lesions
are considered positive. The combination of cytology
and colposcopy resulted in an increased sensitivity
and NPV. The specificity could be further increased
or improved when the threshold was set to distinguish
higher-grade lesions (suspicious lesions) from lesser
abnormalities.
Key words: Colposcopy, Abnormal Pap smears,
Biopsy


Article
Pediatric Glomerular Diseases (Review of histopathological subtypes)

Authors: Nariman F.A. Azat نرمان فهمي --- Numan N. hameed نعمان نافع --- Onss A. Sahib انس احمد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 1 Pages: 1-3
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Glomerular injury can be caused by immunologic, infectious, toxic, metabolic and heamodynamic factors. The glomerular response to injury determines the pathology, which can be observed in renal biopsy. The purpose of this study was to analyze different histopathological subtypes of primary and secondary glomerular diseases in children.Patients and methods: A retrospective study was done on 100 renal biopsy cases in children welfare teaching hospital between December 2003 and December 2007. Ultrasonically guided biopsies were taken and only light microscopy was used to examine the specimens.Results: The study group included 100 cases with renal diseases, 83 (83%) cases of which having primary glomerular disease, the remainder 17 (17%) cases represented secondary glomerular disease. The patients age ranged between (1month-15 years).The frequency of the different entities of primary glomerular disease was: focal segmental glomerulosclerosis (FSGS %) 27 (27%), Minimal change disease22 (22%), Mesangioproliferative glomerulonephritis21 (21%), Mesangiocapillary Glomerulonephritis7(7%) and congenital nephrotic syndrome 6 (6%).patients with secondary glomerular diseases: 14 (14%) patients had Systemic Lupus Erythromatosis(SLE), 2(2%) Henoch-Schonlein Purpura and 1(1%) Amyloidosis . Conclusion: The results of this study were comparable to other studies, with Focal segmental glomerulonephritis being the most common primary glomerular diseases and systemic lupus erythromatosis being the most common secondary glomerular diseases in children. Further study on a much larger scale with the utilization of immunoflourescent and electron microscopy with full serology and infectious screening is needed to provide deeper understanding of these different diseases. Keywords: Glomerular diseases, renal biopsy, Children

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