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Article
Cataract surgery rate in Mosul city

Author: Amer Y. Rajab عامر يحيى رجب
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2008 Volume: 34 Issue: 1 Pages: 76-80
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: To compare the number of cataract surgery rate in Mosul to other part of the world and determine the factors that influence this rate.
Methods: case series study from public and private hospitals in Mosul, on patients who had cataract operations during 2001.
Results: Cataract surgery rate was 1098 per 1 million. Only 15.2% were associated with intraocular lens implant.
Conclusion: Cataract surgery rate in Mosul was the same as in other Middle East Countries, but was very low compared to developed countries.

الهدف: لمعرفة عدد عمليات الساد التي تجرى في محافظة نينوى خلال عام واحد والعوامل المؤثرة عليها التصميم: دراسة الحالات المتتالية.مكان إجراء الدراسة والإطار الزمني لها: جميع مستشفيات محافظة نينوى الرسمية والخاصة خلال عام 2001.المشاركون: جميع المرضى الذين أجريت لهم عملية رفع الساد في عام 2001 .النتيجة: تبين أن عدد العمليات التي أجريت في محافظة نينوى خلال عام 2001 هي 1098 لكل مليون نسمة.الاستنتاج: هذا العدد من العمليات يشبه ما يجرى في بلدان شرق البحر الأبيض المتوسط ولكنه قليل بالنسبة لما يجرى في الدول المتقدمة.

Keywords

Cataract


Article
Comparison of two ophthalmic viscosurgical devices used in Phaecoemulsification

Authors: Muna M. Ahmed منى منير احمد --- Azzam A. Ahmed عزام عبد القادر احمد
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2012 Volume: 38 Issue: 2 Pages: 16-22
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To compare the effect of two ophthalmic viscosurgical devices OVDs (DisCoVisc, Alcon, Fort Worth, Taxes), and (Appavisc, Appassamy ocular devices PVT. LTD.), that currently used in Phaecoemulsification cataract surgery and assess the outcome of these substances on the intraocular pressure (IOP), corneal thickness, endothelial cell counts, corneal clarity and initial visual acuity.Patients and methods: This is a prospective, randomized case series study to compare between two kinds of OVDs used currently in Phaecoemulsification cataract surgery on 40 patients with age range from 55-65 years in the period from June 2009-June 2010, at Al-Jumhory Teaching Hospital, Mosul. Standard procedure was implemented with intraocular lens implantation (IOL). Patients were followed up for three months with particular attention to the first six hours to one day to assess the outcome of surgery in terms of intraocular pressure (IOP), corneal thickness, endothelial cell counts, corneal clarity and visual acuity.Results: The study enrolled 46 patients, and 40 patients completed the study. There was improvement of visual acuity in all patients. No significant difference in the IOP between the two groups in the first 6 hours to 1 day post operatively (17.90±2.53) (18.60±2.21), (P=0.26) and (17.90±2.36) (18.55±2.06), (P=0.941) for Appavisc and DisCoVisc related groups respectively. Also there was no difference with regard to both corneal thickness per-operatively and on day one post-operatively and endothelial cell counts (576.5±44.04) (576.0±50.2) (P=0.974), (665.5±141.9) (670.6±117.1) (P=0.902) and (2311.73±288) (2359.78±383.2) (P=0.657), (2021.2±201) (2035.05 ± 377) (P=0.886) for Appavisc and DisCoVisc related groups respectively. In Appavisc related group; four patients had posterior capsular rupture (PCR) and two patients develop grade III corneal edema. In DisCoVisc related group; two patients had PCR and no significant corneal edema. A formal dry vitrectomy done for those developing PCR with successful IOL implantation, and for those developing corneal edema; a frequent instillation of topical corticosteroid was prescribed with improvement of their vision after two weeks post operatively. Initial visual acuity was better for DisCoVisc related group (0.74±0.21) than for Appavisc related group (0.52±0.29), (P=0.01). Conclusion: Both viscoelastics used had no significant effect on the IOP in the first six hours and first post-operative day, as well as pachymetry and endothelial cell counts both preoperatively and on day one post-operatively, however DisCoVisc was superior to Appavisc regarding corneal clarity and hence visual acuity.

الخلاصةالهدف من الدراسة: لمقارنة نوعين من السوائل الثقيلة (DisCoVisc and Appavisc)وملاحظة مدى تأثيرهما على ارتفاع ضغط العين بعد 6 ساعات ويوم واحد من إجراء عملية إزالة الساد بالأمواج فوق الصوتية (Phaecoemulsification) وملاحظة تأثير هذه المواد على صفاء القرنية وحدة الأبصار.التصميم: دراسة مقطعية. العينات: تم توزيع المرضى بشكل عشوائي إلى مجموعتين من عشرين مريض لكل مجموعة، و تم إجراء عمليات رفع الساد في مستشفى الجمهوري التعليمي، وقد امتدت الدراسة للفترة بين 162009 و لغاية 3062010، حيث تراوحت أعمار المرضى بين 55-65 سنة ومعدل أعمار المرضى كان 60 سنة وتم استخدام اختبار tللعينتين المستقلتين واختبار t للعينتين المرتبطين باستخدام البرنامج الإحصائي11 SPSS versionفي التحليل الإحصائي. النتائج: لا يوجد هناك اختلاف معنوي في ضغط العين خلال الست ساعات الأولى للمرضى الذين استخدموا مادة (Appavisc) (17.9±2.53) مقارنة بالمرضى الذين استخدموا مادة (DisCoVisc) (17.9±2.36) وكذلك بعد يوم واحد (18.6±2.21) (18.55±2.06) على التوالي بينما كان هناك فرق ملحوظ في حدة الإبصار لمادة (DisCoVisc) كانت نتائجها أعلى من مادة (Appavisc) (0.74±0.21) (0.52±0.29)، (P =0.01). هناك اختلافات معنوية في صفاء القرنية بن المادتين حيث إن صفاء القرنية من الدرجة الأولى كان 75% في مادة (DisCoVisc) مقارنة بـ 30% في مادة ((Appavisc، (P=0.01).الاستنتاج: لا يوجد فرق بين مادتي (DisCoVisc) و (Appavisc)في ارتفاع ضغط العين، وسماكة القرنية وعدد الخلايا المبطنة للسطح الداخلي للقرنية علما أن صفاء القرنية وحدة الإبصار كانت نتائجها أفضل عند استخدام مادة (DisCoVisc).


Article
EFFECT OF NIMODIPINE (0.5%) EYE DROPS AGAINST SELENTIE-INDUCED CATARACT IN RABBITS

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Abstract

Background:Increase Ca2+‏ level in human lenses found to play a main role in the opacification development.Objective:To investigate the protective effects of nimodipine (0.5%) eye drops against selenite-induced cataract in rabbits.Methods:Twenty-four adult rabbits with body weight in a range of (1.5-2 kg) with no signs of ocular inflammation were divided into three groups (apparently normal group, cataract group, nimodipine (0.5%) eye drops group). Cataract induction was done by a single intravitreal injection of sodium selenite solution in right eye. Lens opacity, pupil diameter, intraocular pressure, pupillary response to light, corneal sensation, conjunctival redness, malondialdehyde (MDA) and reduced glutathione (GSH) levels in aqueous humor and histopathological study of lens were evaluated. Apparently, normal group received distilled water.Results: Nimodipine (0.5%) eye drops resulted in prevention of cataract development, there was no change in pupil diameter, positive pupillary response to light, positive corneal sensation, no conjunctival redness, decreased MDA and increased of GSH levels. Longitudinal lens section showed homogenous appearance and it looked like normal in its feature.Conclusions: Nimodipine (0.5%) eye drops had prophylactic effect against selenite-induced cataract in rabbits.Key words:Cataract, nimodipine, selenite.

Keywords

Cataract --- nimodipine --- selenite


Article
Association of intraocular pressure with cataract surgery
رابطة الضغط داخل العين مع جراحة الساد

Authors: Eman Hussein Alwan --- Ahmed Kareem Joma --- Ahmed Ismail Abdulgani --- Zed Janan Petris
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 2 Pages: 1310-1315
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Cataract and glaucoma are common co-morbidities and are the first and the second leading causes of blindness worldwide. There are many reasons to consider cataract extraction in individuals with cataract. These individuals derive great visual benefit from the increased acuity and improved contrast sensitivity provided by a clear artificial lens. An improvement in vision allows for more accurate visual field monitoring, and a clear optical pathway enhances the quality and reproducibility of optic nerve imaging. This study aimed to determine the association between intraocular pressure with cataract surgery in human eyes by monitoring changes in intraocular pressure in patients who underwent cataract surgery at Hawler Teaching Hospital at Erbil. Methods: This cross-sectional study was conducted on 71 subjects that underwent cataract surgery at Hawler Teaching Hospital at Erbil city from April 2013 to April 2014. Full ophthalmic examination including intraocular pressure measurement was done to every participant before cataract surgery, one week and one month after surgery.Results: Paired samples t-test showed highly significance difference (P <0.001) between mean intraocular pressure measurements before, one week and one month after cataract surgery. The average decrease in postoperative intraocular pressure from preoperative intraocular pressure during one month was 2.02mm Hg (12.39%).Conclusion: Cataract surgery reduces intraocular pressure and can be considered as an effective way to manage patients with a concurrence of glaucoma and cataracts.


Article
Prevalence and Risk Factors for Eye Problems among 20-65Years Old Iraqi Diabetics Patients

Authors: May Abdul hameed Ali --- Yousif Abdul Rahim --- Baqir Kareem abed *
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 2 Pages: 166-174
Publisher: Baghdad University جامعة بغداد

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Abstract


Summary:
Background: Diabetes is a chronic illness that requires continuing medical care to
prevent acute complications and to reduce the risk of long-term complication. Eye
diseases are the most feared complication of diabetes. The main disorders include
diabetic retinopathy, cataracts and glaucoma. Early detection of these conditions is
important to avoid risk of vision affection or even blindness.
Objectives: This study aimed to assess the prevalence and risk factors for eye
problems among 20-65 years old diabetics' patients.
Methods: We studied 2540 diabetic patients selected from the Specialized Center for
Endocrinology & Diabetes and the National Center for Treatment & Research of
Diabetes in Al-Mustanseria Collage of Medicine from the 1st
of January, 2004 to the
31st
of December, 2005. Structured questionnaires, full ophalmological examination
were used to determine the prevalence of eye problems with their risk factors.
Results: It was found that the prevalence of eye complications in the study sample
was 45.4%, 30.2%, 14.6 and 3%, for reduction in visual acuity, retinopathy, cataract
and glaucoma respectively. These ocular manifestations are common and cause a
significant deterioration in the vision. Age, family history, duration of diabetic
disease, smoking, and presence of chronic diseases (hypertension&or ischemic heart
disease), were found to be the main risk factors for the above complications which in
turn lead to reduction in the visual acuity in diabetic patients.
Conclusions: These ocular manifestations are common in diabetic patients and cause
a significant deterioration in the vision. Regular ophthalmology, including slit-lamp
examination, fundus examination and regular measurement of the intraocular
pressure, are necessary for the early detection and management of potential
complications.


Article
TRANSLIMBAL INTRAOCULAR ENDOILLUMINATION DURING CATARACT SURGERY

Authors: Fareed Warid --- Maha Elshafei
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 37-42
Publisher: Basrah University جامعة البصرة

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Abstract

TRANSLIMBAL INTRAOCULAR ENDOILLUMINATION DURING CATARACT SURGERY Fareed Warid* and Maha Elshafei@*MB,ChB, CABO, FRCS-Ed, Consultant Ophthalmologist, Department of Ophthalmology, College of Medicine, Basrah University, Basrah, IRAQ. @MD, FRCSI, Senior Consultant Ophthalmologist, Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.Abstract The aim of this study is to describe a technique for intraoperative examination of macula and posterior capsule during phacoemulsification surgery in eyes with dense cataract. This work was done in Ophthalmology Department, Hamad Medical Corporation, Doha-Qatar on 36 patients (42 Eyes) with dense cataract and obscured fundus view. No data were recorded for macular status, and preoperative macular assessment was not conclusive by Ophthalmoscopy, B-Scan Ultrasound, and Optical Coherence Tomography (OCT). All patients were consented for cataract surgery plus additional vitreoretinal surgical procedure if indicated. Fundus examination done during phacoemulsification by translimbal insertion of endo-light probe after Irrigation/Aspiration step prior to lens implantation, capsular-bag expanded by viscoelastic to accommodate probe insert. Posterior capsule status checked by Endolight using microscope lens system only, macula checked by endolight with a vitreoretinal viewing lens system. Forty-two eyes (25 right and 17 left), (27 males, 15 females) in 39 patients were studied. The mean age was 59 years (47-78 years). Fourteen patients (18 eyes) were diabetics. Preoperative Visual Acuity of ≤6/60 was recorded in all patients. Cataract Density was graded by fundus visualization and in all cases, only shadow of optic disc and/or major vessels could be seen. Concurrent intravitreal injections was done in eight eyes (19%): seven of them were having Diabetic Macular Edema, and one has hemorrhagic Choroidal Neovascular Membrane (CNVM) due to age related macular degeneration. No complication was recorded in relation to Endoillumination. Posterior Capsule visualization was improved significantly and intracapsular lens implantation was done in all cases In conclusion, translimbal endo-illumination technique improved view to both Macula and posterior capsule during phacoemulsification with subsequent early surgical decision according to endolight findings. No extra incision required. Key words: Surgery, Cataract, Translimbal, Endo-illumination, Phacoemulsification.


Article
Blood Glucose Control, Ophthalmology Referral & Microalbuminuria In Patients With Insulin Dependent (Type 1) Diabetes Mellitus
السيطرة على سكر الدم مع التقييم فحص العين والالبومين في الادرار لدى المرضى المصابين بالسكري النوع الاول

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Abstract

Abstract:Objective: To review the blood glucose level, duration of illness, referral for ophthalmologic assessment & microalbuminuria among patients with insulin dependent (type 1) diabetes mellitus.methods: A retrospective review of randomly chosen medical records for 100 patients with type 1 insulin dependent diabetes mellitus was done in national diabetic center (NDC) of AL-Mustansiriya University from the 1st March 1999 to the 1st March 2004. Review for age, sex, duration of illness FBG, HbA1C, Micral test, blood pressure, and blood urea & creatinine levels, also review of the patient's files for ophthalmologic referral.Results: Insulin dependent (type 1) diabetes mellitus were more in female with peak incidence between10-14 yr of age. FBG > 10 mmol/ l in 57%, 38% having the disease ≤ 5 yrs of which 52.6% were referred to ophthalmologist, 10% who had diabetes for 7-17yrs developed cataract & no one had retinopathy. 36% were having HbA1C more than 8%. Micral test were (+ve) in 23.5% of patients, none of them had developed renal failure. 44.5% developed diastolic blood pressure between 90-100 mmHg and the mount of microalbuminuria was directly related to elevation of HbA1C.Conclusion: Better control of blood glucose and shared care with ophthalmologists are important steps to improve the quality of care provided to diabetic patients. .Key words: Insulin dependent diabetes mellitus, diabetic nephropathy, diabetic cataract.

الملخص: الهدف:لمراجعة مستوى السكر في الدم, مدة المرض, الإرسال لتقيم فحص العين و فحص الألبومين في الإدرار بين المرضى المصابين بالسكري المعتمد على استعمال الأنسولين. المرضى والوسائل: دراسة بحثية عشوائية للتسجيلات الطبية لمائة طفل يراجعون المركز الوطني للسكري في مستشفى اليرموك التعليمي للفترة من الأول اذار1999 إلى الأول آذار 2004 . المراجعة شملت العمر, الجنس, مدة الإصابة بالسكري, مستوى السكر بالدم بعد الصيام, فحص السكر التراكمي, فحص مايكرل, ضغط الدم الانبساطي,فحص اليوريا و الكرياتنين بالدم وكذالك مراجعة الإرسال إلى الفحص الدوري للعين.النتائج: داء السكري المعتمد على استعمال الأنسولين أكثر شيوعا في الإناث( 53 %) وأكثر شيوعا في الأعمار (10 – 14). (57%) لديهم مستوى السكر بالدم بعد الصيام أكثر من 10 ملي مول/ لتر( غير مسيطر علية), (38%) مضى 5 سنوات أو أكثر على إصابتهم بالسكري منهم (52,6%) أرسلوا إلى أخصائي العيون, (10%) من الذين أرسلوا كان لديهم العدسة الكدرة وتتراوح مدة السكري عندهم من 7-17سنة, لا يوجد احد من هؤلاء لدية اعتلال الشبكية. (36%) لديهم فحص السكر التراكمي أكثر من (8%) (غير مسيطر علية). فحص مايكرل موجب في (23,5%) من المرضى, (44,5%) كان ضغطهم الانبساطي من 90-100 ملم زئبقي, وكمية الألبومين بالإدرار تتناسب تناسب مباشر مع ارتفاع فحص السكر التراكمي.الاستنتاج: العدسة الكدرة, الألبومين في الإدرار, ارتفاع ضغط الدم الانبساطي بداء السكر المعتمد على استعمال الأنسولين يتناسب تناسب مباشر مع عدم السيطرة. ولم يصب احد منهم بعجز الكلية المتكامل.


Article
Eye Complications in Children and Adolescent with Type 1 Diabetes Mellitus

Authors: Rajaa Mohsin Shadhan --- Munib Ahmed Alzubaidi --- Najah Kadhim Alquraishy
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 132-139
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Diabetes mellitus is characterized by hyperglycemia and glycosuria and is an end point of a few disease processes. The most common type occurring in childhood is type 1 DM, which is accompanied by chronic and dangerous micro vascular changes affecting most body systems, especially the eye, leading to cataract and diabetic retinopathy. Diabetic retinopathy without appropriate management is emerging as one of the leading causes of blindness. Therefore, it is necessary to identify relevant risk factors, improve the early diagnosis and management of diabetic retinopathy to reduce the risk of blindness.OBJECTIVE: To estimate the presence of eye complications (cataract and retinopathy) among children and adolescent with type1 diabetes mellitus and to study the effect of various factors on their occurrence.PATIENTS AND METHODS:This study was carried out over nine months period(from first of May till the end of January) at Children Welfare Teaching hospital/Medical City .It included 150 children who had type1diabetes mellitus for at least 4 years in children with pre pubertal onset of diabetes and two years in children with pubertal onset .History was taken, physical examination and investigations were done, then ophthalmological examination looking for eye complications (cataract or retinopathy) performed by ophthalmologist. Statistical analysis done using T test, Chi square, P value <0.05 regarded as statistically significant RESULTS: This study included 150 patients with type 1 diabetes mellitus, their age ranges from 4.5 - 19 years, with duration ranges from 2-18 years. Female to male ratio was 1.8:1.Out of 150 diabetic patients, 24/150 (16%) had eye complications, 9 (6%) of them had retinopathy while other 15 (10%) had cataract .The age of all patients who had eye complication was >10 years which is highly significant (P value: 0.009) and the incidence of eye complications increases with increasing duration of diabetes (p value 0.04). Twenty two (14.7%) female and two (1.3 %) male had eye complications, which is highly significant (P value: 0.002). HbA1c >10 in 17/24 (70.8%) patients with eye complications. there were significant association between the presence of eye complications and macroalbuminuria (p value: 0.02), and limited joint mobility (p value: 0.001) .out of 24 patients with eye complications, 16 (66.6%) patients had short stature and 7(4.7%) patients had celiac disease.CONCLUSION and recommendations:The incidence of eye complications (cataract and diabetic retinopathy) increases with increasing age and duration of diabetes and it is more common in female and it is associated with the presence of other chronic complications (LJM, nephropathy and short stature).So screening all patients with type 1 DM according to the guidelines is required for early detection and treatment of eye complications using new methods like fundal photography.


Article
Synergistic effect of diabetic type II with risk factors on the incidence of cataract eyes lens and opacity

Author: Salah Abd- Al kader Omran
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2018 Volume: 5 Issue: 2 Pages: 86-96
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

We conducted a scientific study for one year at the Specialized Center for Diabetes (Iraq – Samawa) on the rate of increase of white cataract (eye water). Patients were 280 diabetic / type II of aged ≥ 40 years with reduce the development of disease and collected randomly, included women and men. The files of patients were reviewed and the nature of the process the disease of high risk of obesity, high blood pressure, heart disease, high urea, creatinine, and COPD, were involved in this scientific study for a full year at the specialized center for diabetes (Iraq- samawa). Patients were divided to four groups (4 codes); the first is the patient pre – diabetes (30) patient and the second were diabetic (130) patient and the third chronic diabetes (98) patient and the fourth (22) patient under control there is no diabetes. Work was accomplished by the help of the ophthalmologist in diagnosis, transfer and follow-up before injury cataract and after injury cataract and necessary surgery for the two patients We have the main goal of preparing the patient for follow-up and medical treatment by controlling blood sugar and the various risk factors that threaten the life of the patient and during the work). The medications; Metaformin, Daonil, Amyral, Novenorm, Statin, Asprin, Saxaglaptin were used in this study. All precautions to maintain the health of the patients and improve the living, also reducing the rate of diabetes and cataracts eye clearly and according to the census. The age after 65 years were the most vulnerable to cataracts and females (9 -16%) are more likely than men (6% -11%) to have cataracts, as conclusion; the irregular diabetes is a risk factor of cataracts with the cooperation of other factors like age.


Article
EVALUATION OF THE EFFECT OF OCULOCARDIAC REFLEX ON THE HEART RATE IN NON-ATROPINIZED PATIENTS DURING CATARACT SURGERY UNDER LOCAL ANAESTHESIA

Authors: Salam N Asfar --- Jasim M Salman --- Salsabel Shakir Mahmood
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 2 Pages: 41-45
Publisher: Basrah University جامعة البصرة

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Abstract

Oculocardiac reflex (OCR) is an event seen during the cataract operation revealed as bradycardia. The situation is triggered by pulling or stitching of external ocular muscles. Anesthesiologists used atropine for controlling this reflex if ensues. This study aimed to estimate the incidence of the oculocardiac reflex during cataract surgery under local anesthesia (LA) and to assess the need for atropine to avoid this event. This study included eighty patients aged 45-80 years with class I or II ASA physical status listed for elective cataract extraction and intraocular lens (IOL) implantation under peribulbar block. The past medical history, drugs history, investigations and baseline vital signs were all observed and recorded. The observer continuously monitors heart rate readings. Oxygen was given to all patients through nasal cannula while spontaneously breathing. The results showed a significant drop in the heart rate following superior rectus muscle grasp and stitching (5.69%). This finding was observed following sedation (6.19%) and after removing of the stitch (6.22%), which indicates triggering of OCR. This slowing in heart rate did not require the use of atropine as bradycardia did not reach a serious level. In conclusion, the alterations in heart rate during cataract surgery observed mainly at handling of the extra-ocular muscles and following sedation. Atropine is not essential as a routine premedication in cataract surgery, particularly in geriatric populations in order to avoid the major side effects of atropine such as: tachyarrhythmias, central nervous system toxicity and urine retention, however, it should be accessible for administration if bradycardia ensues.

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