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Article
Coronary Artery Ectasia in Ischemic Heart Disease Patients Referred to aTertiary Cardiac Center

Authors: Hilal AL-Saffar --- Hussein Nasser --- Ammar A. AL-Shaibii
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 623-729
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Coronary artery ectasia represents a form of atherosclerotic coronary artery disease seen in 1-5% of patients undergoing coronary angiography.OBJECTIVE:This study was conducted to verify the clinical characteristics and angiographic patterns of patients with coronary artery ectasia (CAE) among ischemic heart disease patients.METHODS:Coronary artery ectasia was identified in 62 patients by using coronary angiography. Patients were divided into 2 groups: Group A, included patients with isolated CAE (CAE and non flow limiting narrowing < 50%). Group B, included 51 patients with coexistence CAE with obstructive coronary artery disease (CAE and >70% narrowing of coronary artery). Then we compared these two groups with a control group (group C) which included patients with obstructive coronary artery disease in absence of CAE.RESULTS:In the study, 122 were analyzed; the mean age of patients was 56.1 ± 9.6 years. There were 99 (81.1%) males and 23 (18.9%) females. There were no significant differences regarding (age, hypertension, smoking, diabetes mellitus, body mass index and family history of ischemic heart disease) among three groups, but there was significant difference regarding gender in which males constituted (54.5%), (90.2%), (78.3%) of patients in group A, group B and group C respectively.There was significant difference in mode of presentation among these groups in which typical ischemic chest pain was found in (27.3%), (72.5%), (83.3%) of patients in group A, group B and group C respectively. Also there was significant difference in the electrocardiographic changes in which the changes were found in (45.5%), (84.4%), (58.6%) of patients in group A, group B and group C respectively.In patients with isolated CAE, right coronary artery was most frequently involved (91%) and by diffuse type of ectasia (50%) while in patients with coexistence of CAE and obstructive coronary artery disease, the left anterior descending artery was most frequently involved (72.5%) and by focal type of ectasia (45%).CONCLUSION:Male gender was more prevalent in patients with obstructive coronary artery disease than patients with isolated CAE. Also typical ischemic and electrocardiographic changes of myocardial ischemia were more prevalent in patients with obstructive coronary artery disease.


Article
Effect of smoking on angiographic findings in Iraqi patients with coronary artery disease
تأثير التدخين على نتائج الفحص القسطاري في المرضى العراقيين المصابين بقصور الشرايين التاجية

Author: Dr.Hussein A. Fakhir Nafakhi
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2012 Volume: 15 Issue: 1 Pages: 79-84
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: There were conflicting results regarding clinical studies of effect of smoking on the coronary angiographic findings, our aim was to study the effect of smoking on angiographic results in Iraqi patients with history of coronary artery disease submitted to routine coronary angiography.Methods: 393 consecutive patients with history of coronary disease submitted to coronary angiography in cardiology center divided into two major groups: smokers group (198 patients) and non smokers group (195 patients) and comparison had been done between two groups in the number of diseased coronary arteries, distribution of obstructive lesion and morphological severityResults: RCA and LMS (58% &57%) were more likely to diseased in smoking group rather than non smoker and the prevalence of two vessel disease(63% Vs 37%)(P= 0.02) and to lesser extent the three vessel disease pattern(53% Vs 47%) was more common in smoking group compared to non smoking group.On the other hand, no significant association was found between smoking and morphological severity of coronary artery disease regarding multiple or total cut lesions (P value > 0.588).Abbreviations:

الهدف من هذا البحث هو دراسة تأثير التدخين على نتائج قسطرة الشرايين التاجية للمرضى العراقيين المصابين بقصور الشرايين التاجية حيث تم اختيار عينة متكونة من 393 مريض مصابين بقصور الشرايين التاجية ممن خضعوا للفحص القسطاري في مركز القسطرة في مستشفى الصدر التعليمي للفترة من 2008 ولغاية نهاية عام 2010 حيث تم تقسيمهم الى مجموعتين ,المجموعة الاولى هم المرضى المدخنين وعددهم198 والمجموعة الثانية هم المرضى غير المدخنين وعددهم 195نتائج البحث اظهرت ان المدخنين لديهم نسبة الاصابة في الشريان التاجي الايمن وكذلك نسبة حدوث الاصابة في شريانيين تاجين مجتمعين والى حد اقل 3 شرايين مجتمعة هي اكثر من غير المدخنين في حين لايوجد اختلاف احصائي مهم بين المدخنين وغير المدخنين في قوة او شدة الاصابة للشرايين التاجية في الفحص القسطاري


Article
Stenting of Unprotected Left Main Coronary Artery Stenoses: Immediate and six months Outcomes
وضع دعامة لتضيق الشريان التاجي الرئيسي الأيسر : النتائج الفورية وبعد ستة أشهر

Authors: Hikmat Al-Shaarbaf --- Ali Jabbar Al-Ibrahemi --- Khalid I. Amber
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 3 Pages: 65-71
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Revascularization with coronary bypass grafting (CABG) has been the gold standard therapy forleft main coronary artery ( LMCA) stenosis. Improvements in angioplasty and coronary stent techniques and equipment warrant a reappraisal of angioplasty in LMCA stenosis.Objectives: To assess in-hospital and six-month clinical outcomes after stenting of unprotected left main coronary artery (LMCA) stenosis.Methods:Prospective study in a tertiary center of interventional cardiology and cardiac surgery for64 patients with unprotected LMCA stenoseswho were treated with bare-metal stents and underwent angiographic follow-up at 3 and months following the intervention.Results: The procedural success rate was 100% with no episodes of acute orsubacute stent thrombosis. in-stent restenosis rate was 15.6% and 15.9% in the first 3 and 6 months respectively. Six month mortality was nil. Conclusion: Stenting of unprotected LMCA stenosis deserves to be considered a safe and effective alternative to CABG in carefully selected patientsRecommendation: Larger series should clarify whether unprotected LMCA stenting has the same favourable results as CABG .

الخلفية: تعتبر إعادة الوعائية بواسطة زراعة الشرايين القاعدة الذهبية لعلاج تضيق الشريان التاجي الرئيسي الأيسر. إن تحسن وتطور التداخل القسطاري باستعمال الدعامات يستدعي إعادة تقييم هذه الطريقة في العلاجالهدف: لتقييم النتائج الفورية وبعد مضي ستة أشهر لوضع دعامة لتضيق الشريان التاجي الرئيسي الأيسر غير المحميالمنهجية: دراسة مستقبلية في مركز ثلاثي للتداخل القسطاري وجراحة القلب حيث تم علاج 64 مريضاُ يعانون من تضيق الشريان التاجي الرئيسي الأيسر غير المحمي بواسطة الدعامات المعدنية المجردة، وتم إجراء المتابعة بواسطة التصوير الوعائي (قسطرة الشرايين التاجية) بعد مضي 3 و 6 أشهر من إجراء التداخل.النتائج: كانت نسبة نجاح إجراء التداخل 100% مع عدم حدوث حالات تخثر داخل الدعامة الحاد و شبه الحاد. وظهر ان نسبة رجوع التضيق داخل الدعامة 15.6% و 15.9% في غضون الثلاثة والستة أشهر الأولى على التوالي ولم تحصل حالات وفاة خلال هذه المدة.الاستنتاج: ان وضع دعامة لتضيق الشريان التاجي الرئيسي الأيسر يستحق أن يعتبر بديلاً أميناً وفعالاً لزراعة الشرايين لدى بعض المرضى الذين يتم اختيارهم بعناية.التوصيات: سلسله اكبر من الدراسات يجب ان توضح فيما اذا كان وضع دعامه لتضيق الشريان التاجي الرئيسي الايسر له نفس النتائج الإيجابية لزراعة الشرايين التاجية.


Article
H. Pylori Infection in Iraqi patients with ischemic heart diseases

Authors: Basil. N. Saeed ايمان العبيدي --- Eman Sh. AL-Obeidy
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 1 Pages: 29-31
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Cardiovascular diseases are among the most common cause of death in Developed countries. In addition to traditional risk factors for cardiovascular disease, nowadays, accumulating evidence indicates that a variety of infectious agents may contribute to pathogenesis of ischemic heart disease.Patients and methods: 125 patients (25 females and 100 males) attending the department of cardiology, Baghdad, teaching hospital over the period December 2008- June 2009were enrolled. Their age range between (39-75 years) compared with 50 healthy individuation (Age & sex matched).The sera were tested for H. pylori antibodies using enzyme linked immunosorbent assay (ELISA).Results: 80% of patients showed the anti-H. Pylori IgGs (P < 0.05). But there were no significant association between risk factors & H. pylori infection (P > 0.05).Conclusions: These findings raise the possibility that exposure to H. pylori may lead to increased risk of coronary artery disease independent of other risk factors.Keywords: coronary artery disease, Helicobacter pylori, RAO


Article
Status of Some Trace Elementsin Idiopathic and Ischemic Cardiomyopathy and Coronary Artery Disease: Echocardiographic Correlation

Authors: Waleed K. Hussein --- Ali Y. Majid --- Basil O. Saleh
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 331-335
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:The most principal mechanisms of cardiomyopathies are;high preload and afterload and low myocardial contractility, imbalance of trace elements may cause myocardial metabolic dysfunction and may have a role in aetiology of cardiomyopathy, particulary in IDC. Trace elements are being increasingly recognized as essential mediators of the development and progression of heart diseases.
Methods: Study design Multi case-control study and single center estimation of trace elements concentrations in a number of volunteer settings this study was conducted in the Department of Cardiology, Ibn Albitar Hospital, and in the Physiological Chemistry Department of the College of Medicine, Baghdad University, from June 2005 to July 2006. Subjects Twenty-five patients with IDC, 15 patients with ICM, 16 patients with coronary artery disease(CAD) who have normal LV function, and seventeen healthy individuals as controls were included in this study. Investigations included serum estimation of zinc (Zn), copper (Cu), and magnesium (Mg) concentrations in these groups of patients and controls.
Results: The mean (±SD) value of serum zinc was significantly decreased in CAD patients compared with controls (P< 0.003). Serum Cu values (mean±SD) were significantly higher in IDC, ICM and CAD groups than in controls (P< 0.0001, P< 0.002, and P< 0.007, respectively). Serum Mg (mean±SD) value was significantly decreased in ICM patients compared to controls (P<0.007). Furthermore, there was a significant positive correlation between serum Mg levels and the values of LVEF % in IDC patients (r=0.522, P< 0.007).
Conclusion: This study confirmed that heart failure (IDC and ICM) and CAD are associated with serum trace elements (Zn, C u, and Mg) abnormalities.


Article
Coronary angiographic findings in patients with chest pain and rightbundle branch block

Authors: Mohammed H. Al Myahi --- Kassim M. J. Al Doori*, --- Ihssan A. Abid
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 282-285
Publisher: Baghdad University جامعة بغداد

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Abstract

Back ground : Coronary artery diseases are not uncommon in the presence of right bundle
branch block .
Aim : The aim of this study is to assess the findings of coronary angiography in patients with
chest pain and right bundle branch block.
Methods : The study involved review of case sheets and coronary angiography of one
hundred patients, who underwent coronary angiography due to chest pain suspected to have
coronary artery diseases (CAD) , fifty patients of them had right bundle branch block (RBBB) ,
the other fifty did not have RBBB , those 100 patients were presented to Ibin Al Bitar hospital
for cardiac surgery from January 2004 to June 2006.
History, clinical examinations, electrocardiogram (ECG) , ECG exercise tests (EET)
echocardiogram (ECHO) and coronary angiography had been performed.
Results : Mean age of patients was 53± 10.6 years, 84% were male , hypertension, diabetes
mellitus, and smoking as risk factors were present as 30%, 32% and 48% respectively. 58% of
patients presented with chronic stable angina (CSA) while 42% with acute coronary syndrome
(ACS), ECHO showed that left ventricular dysfunction (LVD) was present in 34%, EET was
positive in 11 of the 23 patients (47.8%) who were able to perform EET. Normal coronary
angiography found in 20% of patients and there were no significant difference in coronary
angiographic findings between patients with and without RBBB.
Conclusion : RBBB of indeterminate age has no significant impact on clinical and
haemodynamic characteristics of CAD patients and it may be incidental finding.


Article
The Effect of Combined Administration of Fish Oil with Garlic to Lower Cholesterol in Hypercholesterolemic Subjects (Comparative Study)

Authors: Hnoosh, L. J. --- Abdil Razzak, A.*
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2007 Volume: 1 no.3 Issue: 2 Pages: 217-224
Publisher: Kerbala University جامعة كربلاء

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background: Garlic and its preparations have been widely recognized as agents for prevention andtreatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia,thrombosis, hypertension and diabetes.Elevated total cholesterol, especially low-density lipoprotein has been documented as the leading riskfactor for the coronary artery disease. Studies with fish oil supplementation alone have shown an increasein low-density lipoprotein, thereby enhancing the risk associated with incidence of coronary artery diseasein hypercholesterolemic subjects. In view of this, the effect of a combined supplementation of fish oil withgarlic pearls on the serum lipid profile of hypercholesterolemic subjects was studied.Methods and Results: We administered 600 mg of fish oil with 500 mg of garlic pearls (garlic oil) perday to 16 hypercholesterolemic subjects with a total cholesterol above 220 mg/dl for 60 days. The effectof this combined supplementation was compared with group that administered 500mg garlic only per dayto 16 hypercholesterolemic subjects with a total cholesterol above 220 mg/dl for 60 days also while thecomparison done with garlic group(16 hypercholesterolemic subjects) that take only garlic and with acontrol group (16 hypercholesterolemic subjects) without any supplementation. Significant reductionswere seen in all the lipid parameters (except high-density lipoprotein which was increased) in the testgroups after 60 days compared to that of the control group. The total cholesterol, low-density lipoprotein,serum triglyceride, very low-density lipoprotein, and the total cholesterol: high-density lipoprotein ratioreduced significantly.


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

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

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

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


Article
The Study of Association Between Toxoplasma gondii Infection with Ischemic Heart Diseases

Authors: Tariq.Q.Tallab --- Jabbar R. Al-Autabbi --- Dhiaa.k.Al-Umer
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 4 Pages: 557-561
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Coronary artery disease (CAD) is the main cause of mortality in industrial and developing countries. New risk factors including infections are under investigation as potential factors. One of these infectious agents is Toxoplasma gondii, few data have been published on the association of atherosclerosis (the usual cause of ischemic heart disease) and Toxoplasma gondii infection. The OBJECTIVE:Was to investigate potential role of T.gondii infection as a risk factor for coronary atherosclerosis in ischemic heart disease patients and the correlation between T.gondii with other cardiovascular risk factorsPATIENTS AND METHODS:This study was conducted on (58) patients with Ischemic Heart Diseases attended cardiac care unite in Al-Hussein teaching hospital in Nasseriya city, southern Iraq and 32 healthy controls ,all are free from clinically evident disease were attending the blood bank in Nasseriya city between November 2010 to the end of August 2011. the sera of the patients and control groups were tested for T.gondii antibodies using Enzyme-Linked Immunosorbent Assay (ELISA) technique. The obtained data was analyzed and the results were tabulated.RESULTS: 22(37.9 %) in the case group and 11(34.4 %) in the control group were seropositive for T.gondii antibodies, odds ratio (OR) 1.167 . P= 0.915 . And there were no association between risk factors and Toxoplasma gondii infection, (Table 2, 5). ( Figure 1).CONCLUSION: This study shows that there is no association between Toxoplasma gondii infection and ischemic heart disease


Article
Assessment of early and late complication post coronary artery graft by – pass surgery CABG
تقييم المضاعفات المبكرة والمتاخرة بعد عملية ترقيع الشرايين التاجية

Authors: Suad. Jassim --- Sabah Abass Ahmed --- Arkan B. Nagi
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2013 Volume: 3 Issue: 1 Pages: 200-207
Publisher: University of Kufa جامعة الكوفة

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Objective: The study aims to assess the early and late complications that occur in patients with cardiovascular-coronary grafts as well as find a relationship with some demographic specifications for them.Methodology: A descriptive study - analysis conducted to assess the complications early and late that occur in patients with graft artery to coronary heart in the intensive care unit of Hospital Ibn Al-Bitar Teaching Hospital, surgery specialist education in the city of Baghdad for the period from the first of September / 2009 until the twentieth of May / 2010. Chosen sample object-and consisting of (50) sick "after the exit of the process through the (48) hours the first in the intensive care unit phase evaluation of the first and the second phase in the outpatient clinic after discharge from the hospital and when their review periodical for the purpose of screening and follow-up after obtaining official approvals fundamentalist institutions health and to decide when, with patients in advance. Data was collected using the questionnaires and filled through the interview. The data were analyzed using descriptive statistical methods (frequencies and percentages) and inferential statistical analysis (mean and correlation coefficient).Results: The results indicate that most of the sample are male, smokers, people with high blood pressure in addition to the strong relationship between educational level and incidence of complications early for the process of grafting veins coronary heart Kertjav heart muscle, lack of fluids, difficulty breathing, infection of wounds on the chest. Conclusion: The study concluded that the most of the sample are male, smokers, people with high blood pressure in addition to the strong relationship between educational level and incidence of complications early for the process of grafting veins coronary heart. Recommendation: The study recommended an educational program to provide a video or manuals containing instructions to be followed by patients pre and postoperative in order to avoid complications.

الهدف: تهدف الدراسة الى تقييم المضاعفات المبكرة والمتأخـــــــــــرة التـــــــي تحدث عند مرضى ترقيع الشــــــرايين القلبية التاجية وكذلك ايجاد العلاقة مع بعض المواصفات الديموغرافية لهم. المنهجية: دراسة وصفية - تحليلية أجريت لتقييم المضاعفات المبكرة والمتأخرة التي تحدث عند مرضى ترقيع الشرايين القلبية التاجية في وحدة العناية المركزة لمستشفى ابن البيطار التعليمي ومستشفى الجراحات التخصصية التعليمي في مدينة بغداد للفترة من الاول من ايلول / 2009 ولغاية العشرون من مايس /2010. اختيرت عينة غرضية والمتكونة من(50) مريضا" بعد خروجهم من العملية خلال ال (48) ساعة الاولى في وحدة العناية المركزة كمرحلة تقييم اولى والمرحلة الثانية في العيادة الخارجية بعد خروجهم من المستشفى وعند مراجعتهم الدورية لغرض الفحص والمتابعة بعد استحصال الموافقات الرسمية الاصولية من المؤسسات الصحية وتحديد الموعد مع المرضى مسبقا". تم جمع المعلومات بأستخدام الاستمارات الاستبيانية وملؤها عن طريق المقابلة. تم تحليل البيانات بأستخدام الوسائل الاحصائية الوصـــفية ( التكرارات و النسب المئـوية) والتحـــليل الاحصائي الاستنتاجــــي ( الوسط الحسابي ومعامل الارتباط ).النتائج: اشارت النتائج الى ان معظم افراد العينة هم من الذكور ,المدخنين, والمصابين بأرتفاع ضغط الدم بالأضافة الى وجودعلاقة قوية بين المستوى التعليمي وحدوث المضاعفات المبكرة لعملية ترقيع الاوردة التاجية للقلب كأرتجاف عضلة القلب , قلة السوائل , صعوبة التنفس وخمج الجروح عن الصدر.التوصيات: أوصت الدراسة بتقديم برنامج تثقيفي فيديوي او كتيبات تتضمن الأرشادات والتعليمات الواجب اتباعها من قبل المرضى قبل العملية وبعدها لتلافي حدوث المضاعفات.

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