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Article
Cardiovascular Autonomic Nervous System Dysfunction in Iraqi Systemic Lupus Erythematosus Patients

Author: Ziad Shafeek Al-Rawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 221-225
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:OBJECTIVE:To assess the incidence, and pattern of autonomic dysfunction in Iraqi systemic lupus erythematosus (SLE) patients and its possible association to patient’s age, duration of disease, SLE activity, drugs used &autonomic nervous system symptoms.PATIENTS AND METHODS:Fifty Iraqi SLE patients and 50 healthy controls were included in this study. Full history was taken and complete clinical examination was done for all individuals in both groups. Disease characteristics [age, sex, duration, SLE disease activity index (SLEDAI), drugs used, and autonomic nervous system symptoms] were also documented. Laboratory analysis included complete blood count, general urine examination, and anti-double stranded deoxyribonucleic acid. Individuals in both groups were assessed for autonomic dysfunction using 5 non-invasive tests: heart rate response to Valsalva maneuver, heart rate response to deep breathing, and heart rate response to immediate standing (30:15 ratios), systolic blood pressure response to standing and diastolic blood pressure response to sustained handgrip. Autonomic dysfunction was categorized as normal, parasympathetic, sympathetic, and mixed pattern according to criteria proposed by Ewing.RESULTS:Forty three (86%) Iraqi SLE patients have autonomic dysfunction compared with 0 % of controls (p=0.00000000001) and the most common autonomic function pattern was the mixed pattern 28(56%) patients. There was no statistical significant association between autonomic function pattern and age group of patients (p=0.536). Also no statistical significant association were observed between autonomic dysfunction; and age, sex, disease duration, disease activity (SLEDAI),autonomic nervous system symptoms or drugs used (chloroquine, prednisolon, azathioprine) (p=0.434, p=0.213, p=0.405, p=0.450, p=0.069, p=0.935, p=0.204, p=0.443 respectively).CONCLUSION:The incidence of autonomic dysfunction in Iraqi SLE patients using non-invasive tests is high (86%) and the most common pattern was the mixed pattern (56%). Also there was no statistical significant association observed between autonomic dysfunction and age, sex, duration, SLE disease activity index (SLEDAI), drugs used, and autonomic nervous system symptoms.


Article
Influence of Sodium and Potassium Levels by Thyroid Hormones Disorder in Sera of Female Patients with Cardiovascular Diseases

Authors: Fatin F. Alkazaz --- Sura A.Alemami --- Mushtak abd hinadi Al taai
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2012 Volume: 15 Issue: 2 Pages: 29-34
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Dysregulation of sodium and potassium has a characteristic role in the development of various cardiovascular disease. In the present study it sought to explore the sodium and potassium influenced by thyroid hormone disorders in sera of patients with cardiovascular disease. The study population consisted of 51 female patients with cardiovascular disease in combination with thyroid dysfunction. Thyroid function disorders were found to have hypothyroidism in 47%of patients and hyperthyroidism in 53%of patients. A significant increase in sodium and potassium concentrations were found in both patient groups. A positive significant correlation was observed between Na concentration and T4 level in sera of patients with hyperthyroidism while a significant negative correlation was found between Na concentration and TSH level in sera of patients with hypothyroidism.

إن عدم انتظام مستوى الصوديوم والبوتاسيوم في الدم له دور مميز في تطور عدد من الأمراض القلبية الوعائية, ولغرض إيضاح تأثر مستويات الصوديوم والبوتاسيوم بالتغيرات الهرمونية للدرقية في مصول دم المصابات بمرض القلب الوعائي, تم قياس مستوى هرمونات الدرقية (HSΤ,4Τ,3Τ) و تركيز الصوديوم والبوتاسيوم في مصول دم المصابات بمرض القلب الوعائي حيث تضمنت الدراسة الحالية جمع 51 عينة من المصابات بمرض القلب الوعائي ولديهن اضطرابات في هرمونات الدرقية ,وقد تبين ظهور قصور الدرقية في 47% من المرضى وفرط الدرقية في 53% من المرضى. أيضا توصلت الدراسة إلى وجود ارتفاع معنوي في مستويات الصوديوم والبوتاسيوم في مصول دم كلا المجموعتين مع وجود علاقة ايجابية معنوية بين مستوى 4Τ و الصوديوم في مصول دم المصابات بأمراض القلب الوعائي اللاتي لديهن فرط الدرقية في حين لوحظ أن العلاقة بين مستوى الصوديوم وTSH في مصول دم المصابات بأمراض القلب الوعائي اللاتي لديهن قصور الدرقية كانت سالبةمعنوية.


Article
Serum status of selenium and chromium in patients with cardiovascular diseases and controls in Iraq.

Author: Kassim M. Al Doori
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 428-430
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The importance of essential trace elements plays a major role in medicine mainly cardiovascular diseases.Methods: The study involved 305 patients with either myocardial infarction ( MI ) , angina pectoris ( AP ) or hypertension ( HT ) for evaluation of these trace elements level ( Se & Cr ) as compared with 100 control subjects in Ibin Al Bitar hospital for cardiac surgery between July 2003 and May 2005 by using Atomic Absorption Spectrophotometer ( AAS ) done in the laboratories of ministry of Sciences and Technology in Baghdad.Result: The total numbers of patients enrolled in this study were 305 patients, Ml contributes to 70 patients, 55 male and 25 female with mean age of 60 ± 20 and 58 ± 19 years respectively. Unstable angina contribute to 105 patient in which 70 of them were male with mean age of 63 ± 20 years and 35 female with mean age of 60 ± 19 years and 120 hypertensive patient in which male contribute to 90 with mean age of 64 ± 19 years and the other 30 were female with mean age of 48 ± 13 years, those 305 patients were compared with 100 normotensive control subject in which 65 of them were male with mean age of 56 ± 20 years and the remaining 35 were female with mean age of 46 ± 13 years. The analysis of results show that the level of Se and Cr were significantly lower in both sexes in patient with MI, AP and HT as compared with control, and the concentrations of Se were even much lower in acute MI as compared with AP. Conclusion: The concentrations of trace elements Se and Cr were significantly lower in patients having MI, AP and HT as compared with controlled normotensive persons, besides the concentration of Se was much lower in MI as compared with cases of AP.


Article
Cardiovascular Manifestations of Primary Hypothyroidism

Authors: Ahmed Shaker Al-Zaidi --- Adil S .Abdul-Ghafour --- Abdulla J Minshed Al-Farttoosi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 113-119
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Primary hypothyroidism accounts for 90 to 95 %of all cases of hypothyroidism. Thyroid hormone deficiency increases systemic vascular resistance, decreases contractility and slow the heart rate .OBJECTIVE: To investigate cardiac changes in primary hypothyroidism.METHODS:In this prospective study 36 patients with untreated primary hypothyroidism were compared with 30 healthy persons. Cardiovascular evaluation of all subjects had been made both clinically and by the following studies :Chest X-Ray, electrocardiography, serum lipid and Echocardiography.RESULTS::The main cardiac manifestations of hypothyroidism were: Easy fatigability( 88.9 %(, exertional dyspnea )75%o),obesity or gaining weight( 66.7 %(, sinus bradycardia ) 47.2 %(and peripheral edema(11.1 %(Electrocardiography showed sinus bradycardia in( 47%( low QRS voltage in )33.3%( , flat or inverted T wave(27.8%), prolonged QT interval )19.5%), first degree heart block in( 19.5 %(.Echocardiography showed the following :a decrease in global systolic function, asymmetric sepalhypertrophy in )91.6%) Pericardial effusion in )38.8%).Low QRS voltage was found to be related to thyroxin level and age of the patient .No correlation was found between heart rate and thyroxin level.CONCLUSION:Primary hypothyroidism accompanied by significant changes in cardiovascular system which may explain the development of premature coronary artery disease in these patients.


Article
Compliance Issue in Type II Diabetes: Does it Reduce the Prevalence of Cardiovascular Risk Factors?

Author: Yousif Abdul Raheem
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 125-134
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:Type 2 diabetes, which is the most common form of diabetes, has an alarming increasing rate. It is a recognized risk factor for cardiovascular disease (CVD). Non-compliance with healthy life styles, anti-diabetic drugs and diet are the central issues in patient's management as it might synergist other CVD risk factors.OBJECTIVE:The aims of this study were to find out the compliance, prevalence of CVD risk factors, and any association between them in type 2 diabetic patients.METHODS:A cross-sectional design and a convenient sample of 820 diabetic patients were used in conducting this study for the period from the 1st October, 2006 to 31st December, 2008. A Structured questionnaire was used to collect demographic information from the patients. 10 questions were used to determine the patient's compliance. The classic risk factors; obesity, hyperglycemia (HG), hypertension (HT), and hypercholesterolemia (HC), have been studied for each patient and compared with his/her compliance to find any association.RESULTS:The results of this study revealed that there were only 187 out of 820 (22.80%) with good compliance and 297 (36.22%), 336 (40.98%) patients with fair and poor compliance respectively. The prevalence of obesity, over weight, uncontrolled HG, HT (systolic, diastolic or both) and presence of HC in our diabetic patients were 27.32%, 36.83%, 51.95%, 40.73 and 30.37 respectively. Good compliance was associated significantly with normal body weight, controlled HG, absence of HT, and absence of HC.CONCLUSION:The study concluded that less than one third of our diabetic patients had good compliance. CVD risk factors are prevalent among them, and this prevalence is associated significantly with the level of compliance. Understanding the reasons behind these forms of non-compliance is an important key to the successful development of potential program to decrease the CVD risk factors and associated complications


Article
Patients' awareness about Cardiovascular Disease and the Causes of Coronary Artery Disease

Author: Ahmed A. Hussein Al Jumaily
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2012 Volume: 25 Issue: 1 Pages: 79-88
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: This study aims to assess the awareness of patients suffering from cardiovascular diseases.Methodology: A descriptive design was applied in this study. A purposive sample consisted of (100) patients with cardiovascular disease in the Mosul's hospitals were interviewed to achieve study objectives. A questionnaire was used for data collection after tested for validity and reliability by pilot study.Results: The study results showed the mean of patients awareness are (1.78) cut point of (3) and the majority of patients84% were aged more than 50 years or above. Slightly increase proportion of male more than females. Most of them are married81%, retired, smokers, and a period of developing the disease are less than one year47%. Recommendations: the study recommended the need for targeted education regarding risk factors, especially those who are treated for hypertension and diabetes mellitus.

الهدف: تهدف هذه الدراسة لتقييم مدى وعي المرضى الذين يعانون من أمراض القلب والأوعية الدموية.المنهجية: تم تطبيق تصميم وصفي في هذه الدراسة. وأجريت مقابلات مع عينة غرضية تتألف من (100) المرضى من الذين يعانون من أمراض القلب والأوعية الدموية في مستشفيات الموصل لتحقيق أهداف الدراسة. تم استخدام استبيان لجمع البيانات بعد اختباره للصدق والثبات بدراسة التجريبية.النتائج: أظهرت نتائج الدراسة أن ان معدل وعي المرضى (1.78) من نقطة قطع (3) وان غالبية المرضى84 %كانت أعمارهم أكثر من 50 سنة ،الذكور أكثر قليلا من الإناث .نسبة الحالة الزواجية 81% للمتزوجين، كذلك المتقاعدون والمدخنون كانت نسبتهم أكثر من غيرهم،فترة ألإصابة بالمرض كانت اقل من سنة ،كذلك اظهرت الدراسة فروق ذات دلالة نوعية حول وعي المرضى الذين كانت مدة الإصابة لديهم اقل من سنة واحدة47%.التوصيات: أوصت الدراسة على ضرورة التعليم المستهدف بشأن عوامل الخطر، وخصوصا بين الأشخاص الذين يعالجون من عوامل الخطر المعروفة مثل مرض ارتفاع ضغط الدم ومرض السكري.


Article
Assessment of the Nurse’s Role Regarding drug Administration of Cardiovascular Patients
تقييم دور الكادر التمريضي حول اعطاء الادوية للمرضى المصابين بأمراض القلب و الاوعية الدموية

Authors: Ronak N. Hussain --- Yousif M. Younis
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2014 Volume: 27 Issue: 1 Pages: 32-37
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: The aim of the study was, to assess the nurse's role regarding cardiovascular drug administration in Erbil city. Methodology: A descriptive survey was conducted in Hawler teaching and Rizgari teaching Hospitals. The number of samples is 50 nurses; the period of the study was started from 15th of November 2008 up to the end of March 2009. A questionnaire was developed by investigators based on extensive review of available studies and literatures. Data were collected through application of observational check list consist of two part, part one was demographic sheet and part two about nurse’s responsibility regarding medication administration which include (before, during, after drug administration). Data were analyzed through the application of descriptive statistical analysis such as (frequency, percentages and grand mean of scores).Results: Results showed that (72%) of nurses were within age group of (31-40) years, (66%) of them were married, and (64%) of them were institute graduated. The study showed that nurses' practices were inadequate with low grand mean of score in most items regarding assessment of patients before, during and after drug administration.Recommendations: Increase nursing staff awareness about cardio vascular drug administration through performs training on cardiac medication administration, follow up nurses' practice during drug administration and follow up the five rights of cardiac drug administration.

الهدف : الهدف من الدراسة هو تقييم دور الكادر التمريضي حول اعطاء الادوية للمرضى المصابين بأمراض القلب و الاوعية الدموية. المنهجية: دراسة وصفية اجريت في مستشفى اربيل و رزكاري التعليميين مابين 15-9-2008 الى 30-3-2009 , و كانت بعنوان تقييم دور الكادرالتمريضي حول اعطاء الادوية للمرضى المصابين بامراض القلب و الاوعية الدموية في وحدة انعلش القلب. اجريت الدراسة على (50) عينة غير احتمالية من الكوادرالتمريضية النتائج : اشارت نتائج الدراسة بان ( 72%) من لكوادرالتمريضية يتراوح اعمارهم بين (31-40) سنوات, و (66%) منهم كانوا متزوجين, و (64%) كانوا من خريجي المعاهد. و اظهرت ايضا بان الممارسات التمريضية حول اعطاء الادوية لمرضى القلب و الاوعية الدموية كانت غير مرضية اضافة الى نقص فى تقيم المريض قبل و اثناء و بعد اعطاء الادوية في كلا المستشفيين بنفس المستوى من خلال نتائج التحليل الاحصائي (الوسط الاجمالي ).التوصيات: زيادة توعية الكوادر التمريضية من خلال فتح الدورات التدريبة لهم حول كيفية اعطاء الادوية للمرضى المصابين بأمراض القلب و الاوعية الدموية ايضا متابعة الممريضات حول تنفيذ حقوق خمسة من خلال اعطاء الادوية للمرضى .

Keywords

Nurse --- Cardiovascular --- Medication


Article
Cardiovasular Manifestations of Primary Hypothyroidism

Author: Sabah M. Zangana
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 2 Pages: 446-454
Publisher: Babylon University جامعة بابل

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Abstract

Hypothyroid patients are liable for cardiovascular complications, especially arrhythmias hypertension, ventricular dysfunction ischemic heart disease, and pericardial effusion. To detect the above-mentioned cardiovascular manifestations in hypothyroid patients before and after treatment. 92 cases of hypothyroidism, )Collected within 25 years) diagnosed by hormonal assay were studied for their cardiovascular manifestations, clinically, by ECG, chest X-ray, echocardiography and sometimes exercise ECG at time of diagnosis (from 1988-2002 ) and followed for the first 10 years from the starting point of the treatment.Among 92 hypothyroid patients studied, cardiovascular manifestations were not high before treatment, while after treatment and during the first 10 years of follow-up, no relevant cardiovascular disease could be detected.Although hypothyroid patients are liable for cardiovascular complications, in this study cardiovascular manifestations are not common in hypothyroid patients neither before nor after the treatment.


Article
Serum uric acid in smokers

Authors: Bassam E Hanna بسام --- Luma M Tohala لمى توحلة --- Jamal M Hamed جمال
Journal: Iraqi Journal of Pharmacy المجلة العراقية للصيدلة ISSN: 16802594 Year: 2010 Volume: 9 & 10 Issue: 1 Pages: 36-43
Publisher: Mosul University جامعة الموصل

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Abstract

Objectives: To demonstrate the possible effect of smoking on serum uric acid level. Methods: The study was conducted during the period from March to June 2008 in Mosul city as a case control study. Participants: Subjects enrolled in this study were divided into two groups; nonsmokers and smokers composed of 47 and 40 apparently healthy male volunteers respectively with the same dietary habit, no pastmedical history of diabetes mellitus , hyperuricemia and gout , renal, lung or heart diseases or drug history affecting uric acid level. Smoker group is subdivided into heavy , moderate and mild smokers. Fasting blood and random urine samples were obtained from both groups for measurement of uric acid and creatinine. Calculation of both urine uric acid/urine creatinine ratio and fraction excretion of uric acid were done.Results: No significant differences in the age , serum creatinine , spot urine uric acid/urine creatinine ratio and fraction excretion of uric acid between two groups where as serum uric acid was significantly lower in smokers. In smokers there are significant negative correlations of the average number of cigarette smoked/day and the duration of smoking with serum uric acid level. Heavy , moderate and mild smokers showed no significant differences in the age , urine uric acid/urine creatinine ratio , fraction excretion of uric acid , serum creatinine and serum uric acid except a significant lower serum uric acid value in the heavy smoker compared with moderate and mild smokers .Conclusion: The significant low serum uric acid level in smokers is due to the reduction of endogenous production as a result of chronic exposure to cigarette smoke that is a significant source of oxidative stress and as this reduction is proportionate with the duration and number of cigarette smoked/day and as low uric acid predispose to cardiovascular diseases as proved by other studies, therefore, its recommended for smokers to stop or reduce smoking with the use of serum uric acid as a routine test for follow-up as it is inexpensive , simple to reflect antioxidant level.

أهداف البحث: لعَرْض التأثيرِ المحتملِ للتدخين على مستوى الحامض البوليِ في مصل الدم.الطرق:-أجريت الدراسة في الفترةِ مِنْ آذار ولغاية حزيران من عام 2008 في مدينه الموصل بطريقة مقارنة الحالات ألمرضيه مع ألمجموعة الضابطة.المشاركون: قسم المشاركون في البحث إلى مجموعتين: غير مدخنين ومدخنين تتكون من 47 و 40 على التوالي مِن الذكور المتبرعين الأصحاء بنفس النمط الغذائي وبدون تاريخ مرضي سابق لداء السكري, ارتفاع مستوى الحامض البولي أو داء الملوك, أمراض الكلى, الرئة أو القلب أو تاريخ دوائي يوثر على مستوى الحامضِ البوليِ. مجموعة المدخنين قسمت بدورها إلى شديدي , معتدلي و لطيفي التدخين . من كلتا المجموعتين تم استحصال عينات دم في حالة الصوم وعينات عشوائية للإدرار لقياس تركيز الحامض البولي والكرياتنين . تم حساب نسبة الحامض البولي /الكرياتينين في الإدرار وطرحِ كسرِ الحامضِ البولي . النَتائِج: عدم وجود اختلافات معنوية في العُمر , كرياتينين مصل الدم, نسبة الحامض البولي /الكرياتينين في الإدرار وطرحِ كسرِ الحامضِ البولي بين المجموعتينِ بينما هنالك انخفاضا معنويا في تركيز الحامض البوليِ في مصل الدم في المدخنين. في المدخنين هنالك ارتباط سلبي معنوي بين العدد المتوسط للسجائر المدخنة / يوم ومدّة التدخين وبين تركيز الحامض البوليِ في مصل الدم. أظهر شديدي , معتدلي و لطيفي التدخين عدم وجود اختلافات معنوية في العُمر , نسبه الحامض البولي /الكرياتينين في الإدرار, طرحِ كسرِ الحامضِ البولي , كرياتينين مصل الدم و تركيز الحامض البوليِ في مصل الدم باستثناء وجود انخفاضا معنويا في تركيز الحامض البوليِ في مصل الدم لشديدي التدخين مقارنة بمعتدلي و لطيفي التدخين. الاستنتاجات :- إن سبب المستوى المنخفض للحامض البوليِ في مصل الدم في المدخنين يعود لانخفاض الإنتاجِ الذاتيِ كنتيجة للتعرّضِ المُزمنِ إلى دخانِ السيجارةِ الذي هو مصدرُ هامُّ لإجهاد الاكسدة ولكون هذا الانخفاض متكافئُ مع مدة وعدد السيكائر باليوم و يُهيّئُ للإصابة بأمراض الأوعية القلبيةِ كما أثبتته الدراسات الأخرى، لذا ما يوصّى به للمدخنين للتَوَقُّف أَو تَخفيض التدخين وإستعمالِ قياسِ الحامض البولي لمصل الدم كاختبار روتيني للمتابعة كونه بسيط و رخيص لعَكْس مستوى مانعِ التأكسد.


Article
•Evaluation of Serum Cystatin C in Iraqi Cardiovascular Patients

Author: Shaimaa S. Mutlak
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2011 Volume: 4 no 2 Issue: 10 Pages: 1063-1066
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Cystatin C has been reported to be a potent predictor of increased cardiovascular disease mortality. Serum Cystatin C may have a stronger association with mortality and cardiovascular disease than serum Creatinine in patients with normal or mildly reduced kidney function.Objectives: The aim of this study to1- Determine the prognostic value of cystatin C in patients with cardiovascular disease (CVD) and compare the observed value with that obtained for healthy controls.2- Study the correlation between serum cystatin C and creatinine in cardiovascular disease patients.Patients and Methods: The prospective study included thirty (30) patients admitted to hospital with cardiovascular disease (CVD) slected from Baghdad teaching hospital and twenty-one (21) healthy individuals were included in this study. Fasting serum cystatin C and creatinine were measured in all patients and controls.Results and Discussion: A significant increased in the level of serum cystatin C concentration was observed in patients with (CVD) as compared with the control group.Conclusion: Cystatin C is a prognostic biomarker of CVD. A graded association exists between higher serum Cystatin C and increased CVD prevalence in patients without chronic kidney disease (CKD).

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