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Article
Necrotizing fasciitis: The role of early wide surgical

Author: Najeeb S. Jabbo
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2014 Volume: 13 Issue: 2 Pages: 18-23
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Necrotizing fasciitis is a rare, progressive serious bacterialinfection of skin, subcutaneous tissue and fascia. It frequently affects theperineum and genital areas in which local redness and edema progressrapidly to necrosis and hemorrhagic bullae. Because of this rapidprogression, it is important to diagnose and treat necrotizing fasciitisquickly.Aims: To evaluate the role of early wide surgical debridement and diversioncolostomy in improving the prognosis.Methods: A case series study was done at Al‐ Yarmouk teaching hospital,involving all patients diagnosed with NF and treated by the authors for athree‐year period. Those patients were assessed clinically on admission andfollowed closely. All relevant demographic, clinical, biochemical andradiological data were documented. The methods of treatment with specialemphasis on surgical debridement were recorded. The clinical outcome,morbidity and mortality were recorded.Results: Seventeen cases were included, 11(64.7%) male and 6(35.3 %)female. The mean age was 51+‐7 years and 64.7% were diabetics. The primarysites affected were the perineum and scrotum, seen in 7 cases (41.1%). Themain presentation was excessive local pain, seen in 15cases (88.2%) and 15patients had initial constitutional symptoms (88.2%). Blood cultures andculture of debrided material revealed mainly group A streptococci andproteus. Early wide debridement was done in 9 cases (52.9%) and thosepatients had earlier healing and shorter stay in hospital (mean stay 20 days).Initial local debridement was done in 6cases (35.2%) and the mean durationof stay in hospital was 40 days. Diversion colostomy was done for 3 patients(29.4%) and all had early healing without mortality. There were 3 deaths(17.7%), two of them had initial local debridement.Conclusions: Early wide surgical debridement is essential and improveshealing, shortens hospital stay and decreases mortality. Diversioncolostomy is helpful in some cases but needs further evaluation.


Article
The role of arthroscopic lavage and debridement in the treatment of osteoarthritis of the knee

Authors: Abdul Jabbar R Abed --- Ammar S Maulood
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2016 Volume: 29 Issue: 3 Pages: 178-183
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Osteoarthritis of the knee joint is a common orthopaedic problem. Many patients presented as having failure of conservative treatment. The knee is the joint in which scope has itˊs greatest application; it had allowed evaluation of the effectiveness of other tools. Several reports have indicated that debridement decreased symptoms in most patients; this decrease could be attributed to decreasing the stimulus for pain in the joint.Objectives: To evaluate the role of arthroscopic debridement and lavage in the treatment of osteoarthritis of the knee joint and to identify which factors can predict good surgical outcome.Patient and Method: A prospective study conducted by selecting 33 patients with osteoarthritis of the knee according to certain inclusion criteria. All of them had a failure of conservative treatment for at least 6 months. We did arthroscopic lavage and debridement to all of the patients and the results were recorded accordingly. Results: the age range of the patients was between 30-83 years (mean ±SD) (55.4±12.8), 23 females and 10 males, Evaluation of the patients was done 1 month and 6 months after surgery. Good to excellent results were achieved in 81.8% of the patients after 1 month of surgery and 66.7% after 6 months of surgery. Better results were achieved in patients with short duration of symptoms, mild-moderate radiological and arthroscopic changes, normal alignment of the limb, young age groups, positive mechanical symptoms, unicompartmental disease, and unilateral arthritis.Conclusions: Arthroscopic debridement and lavage of the knee is a simple and effective treatment option for treatment of knees with osteoarthritis. It can be used to delay more definitive surgery


Article
Fournier's Gangrene: Case Series Study, in Baghdad
غنغرينيا فورنييردراسة حالات متعددة في بغداد

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Abstract

Objective: The aim of this study was to determine the efficiency of urgent surgical treatment of Fournier's gangrene and how it prevented and reduced greatly the disease morbidity and mortality.Methods: The study was carried out on 11 cases of genital and perineal gangrene presented between January 2005 and December 2007. At diagnosis, treatment of all patients was initiated with broad spectrum antibiotics and urgent surgical debridement of all obviously necrotic and doubtfully viable tissues.Results: Escherichia coli and Staphylococcus aureus were the most frequently isolated organisms in tissue cultures. An average of 2.6 operations was required per patient. The average hospital stay was 14.3 days. The mortality rate was 18.1% due to system failure.Conclusion: Fournier's gangrene is a urologic emergency associated with high morbidity and mortality. Operative debridement remains the definitive treatment that should be performed early to ensure the best possible out come.Keywords: Fournier's gangrene, Debridement, Penis, Scrotum.

الهدف: كان الهدف من هذه الدراسة هو التعرف على مدى فعالية العلاج الجراحي المستعجل لغنغرينا فورنيير و جسامة قدرته على ردع و تقليل و بالة وفنائية المرض.الطرق: اجريت الدراسة على 11 حالة مرضية مصابة بغنغرينا اعضاء التناسل و العجان خلال الفترة من كانون الثاني 2005 و حتى كانون الأول 2007.حال تشخيص المرض تمت معالجة جميع المرضى بالمضادات الحيوية ذات الطيف الواسع مع التداخل الجراحي الآني لنزع كافة الأنسجةالمتنخرة و المتعفنة.النتائج: اظهرت نتائج الدراسة ان الشريشيات القولونية و المكورة العنقودية البرتقالية هي الكائنات الأغلب تكراراً في الزرع النسيجي.كما لوحظ ان معدل عدد العمليات الجراحية التي اجريت لكل مريض هو 2,6عملية بينما كان متوسط فترة الرقود في المستشفى 14,3 يوماً , و وجد ان نسبة الوفيات عند المرضى كانت 18,1 % و هي ناتجة عن قصور بعض اجهزة الجسم. الخاتمة: غنغرينا فورنيير تعد من الحالات الطارئة المصحوبة بارتفاع نسبة المراضة و الموت وان علاجها الجازم هو نَضْر الجروح المبكر الذي يمكن ان يؤمن افضل النتائج.


Article
Evidence for feasibility of aluminum potassium sulfate (alum) solution as a root canal irrigant

Author: Bestoon M. Faraj بستون فرج
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 1 Pages: 1-5
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The purpose of this study was to evaluate, in vitro, the antimicrobial activity and cleaning efficiency ofthe aluminum potassium sulfate (alum) solution.Materials and methods: The antibacterial action of alum solution (1 mg /mL, at pH 3.6) against bacterial isolatesfound in infected root canals, including facultative anaerobic microorganisms (Escherichia coli , Staphylococcusaureus and Klebsiella sp.), and aerobic species (Pseudomonus aerogenosa ) ,using agar well diffusion test. Theinvestigation of the debridement and smear layer removing efficiency, on the cervical, middle and apical thirds ofroot canals of freshly extracted human single-rooted teeth were done by a scanning electron microscopy study.Results: Alum solution were able to demonstrate antibacterial activity against all the bacteria tested, and producedinhibitions zones of 27, 25, 24 and 22 mm against Staphylococcus aureus, Pseudomonus aerogenosa ,Escherichiacoli, and Klebsiella sp. respectively. Alum solution was effective in removing the debris and smear layer. Removal ofthe smear layer and other debris was more effective in the coronal and middle third than in the apical third.Conclusion: The findings of this study suggested that alum solution has potential for use as an endodontic irrigant,during chemomechanical root canal preparation


Article
Comparative Clinical Study of The Use of Coralline Calcium Carbonate as a Graft Material and Open Flap Debridement Alone for Treatment of Human Periodontal Infrabony Pockets

Author: Zainab Muhi Hameed Al- Fatlawi
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2013 Volume: 21 Issue: 5 Pages: 1862-1872
Publisher: Babylon University جامعة بابل

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Abstract

The purpose of this study was to evaluate the clinical response to coralline calcium carbonate(CalCarb) bone replacement graft material in human infrabony periodontal pocket,and compares to open flap debridement . Twenty two patients completed the study with clinical data collected at baseline and after 6 months post-treatment. (14 males, 8 females; average age 42.77 ± 10.27, range 27 to 58 years) (11) patients received CalCarb grafts and(11) patients received open flap debridement(OFD) alone in randomly selected patient as part of their planned infrabony pocket defect correction surgery.Parameters measured in this study (clinical probing,depth, gingival recession, clinical attachment level). Statistical analysis for data with the use of a statistical software program at base line and after 6 months,the mean value of postsurgical pocket depth parameter for patients treated with CalCarb was highly significant difference higher than presurgical mean value for the same parameter,these results consist with other many studies (19-24) . For the mean values for the reduction of pocket depth(3.76±1.68) and gaining of clinical attachment level(3.5±0.71) were higher in patients treated with CalCarb , than those treated wih OFD nly[(3.3±0.79) (2.97±0.45) ] respectively.Natural coralline porous calcium carbonate appears to be a clinically useful graft material .

الهدف من هدة الدراسة هو لتقييم القياسات السريريةالناتجة عن استخدام الطعم العظمي(كورالين كالسيوم كاربونيت)المستخرج من نبات الشعب المرجانية البحرية استخدامة لعلاج ازدياد عمق الجيب اللثوي وذوبان العظم الموضعي و مقارنة هدة النتائج مع نفس القياسات ولكن باستخدام التجريف الجراحي.العينة تكونت من 22 شخص .التحليل الاحصائي للقراءة الاولى و القراءة الثانية بعد ستة اشهر اوضحت انتائج ان نقصان عمق الجيب اللثوي و احتساب مستوى الاربطة اكبر بكثير عند استخدام الطعم العظمي المرجاني مقارنة بالتجريف الجراحي .


Article
Hiplabral Tear Management In Athletics

Author: Mohammed Elmajee
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 3 Pages: I-IX
Publisher: Babylon University جامعة بابل

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Abstract

Objectives•To review the most up-to-date evidence-based literature in managing patients with labral tear, particularly athletic population•To appraise the current understanding about labral tear management•To suggest some future recommendations and formulate new research questions


Article
The Urgency of surgical debridement in the management of wounds with open fractures
العجلة في التنظير الجراحي لعلاج الجروح مع الكسور المفتوحة

Authors: Issam Al-Azzawi د. عصام العزاوي --- Ghaith Y. Qasem د. غيث ياسين قاسم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2015 Volume: 28 Issue: 2 Pages: 81-84
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Others have reported that a delay in surgical management of open fractures does not significantly increase infection rates.Background: Best practices suggest urgent debridement of the wound and stabilization of the fracture using a range of techniques. Objectives: To compare the result of early wound debridement within six hours and those after six hours. Patients & Methods: A prospective study carried out in Al-Yarmouk Teaching Hospital for period March, 2008-March, 2010 on 248 patients with open fractures admitted to orthopedic emergency unit. The data were collected by the researchers through direct interview and filling a prepared questionnaire. Follow-up continued until radiological union had occurred or none-union was confirmed and infection was diagnosed by infection sign and culture. Results: Mean age of the patients in this study was 31 years. The commonest mechanism of injury was a blast and bullets injury (56%) followed by road traffic accidents (44%) number of males was 239 and females were 9. The results were analyzed and no statistically significant difference could be demonstrated between the two groups (p=value 0.6).Conclusions & Recommendations: No effect of early debridement on infection rate of open fractures. Arbitrary time figures including 6 hours rule should be re-evaluated

مقدمة : تشير أفضل التطبيقات الجراحية الى ضرورة التنضير والتنظيف العاجل للجرح وتثبيت الكسر باستخدام مجموعة من التقنيات. بعض الباحثين ذكروا ان التأخير في التنضير الجراحي للكسور المفتوحة لا يزيد بشكل كبير معدلات الإصابة بالخمج. الهدف من الدراسة : المقارنة تنضير الجرح المبكر في غضون ست ساعات، والتنضير بعد ست ساعات. منهجية البحث : دراسة استطلاعية في مستشفى اليرموك التعليمي للفترة مارس 2008 إلى مارس 2010 على 248 من مرضى الكسور المفتوحة ادخلوا الى وحدة طوارئ العظام. تم جمع البيانات من قبل الباحثين من خلال المقابلة المباشرة وملء الاستبيان المعد مسبقا. المتابعة استمرت حتى التئام العظام المشخص بالاشعة وتم تشخيص العدوى عن طريق علامة العدوى والزرع الجرثومي. النتائج : كان متوسط عمر المرضى في هذه الدراسة 31 عاما. كانت أشيع آلية للإصابة هي الانفجار وإصابة الرصاص (56٪) تليها حوادث المرور على الطرق (44٪) وكان عدد الذكور 239 والإناث كن 9. لم يكن هناك ارتباط ذو دلالة احصائية بين التعجل في التنضير الجراحي وإصابة الجروح المفتوحة بالخمج (p=0.1).

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