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Article
The Evaluation of Use Tenodermodesis Procedure with Fixation of Distal Interphalangeal Joint in Extension Position by Kirschner Wire in Management of Delayed Mallet Finger

Author: Ahmed Miri Saadoon
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2013 Volume: 10 Issue: 3 Pages: 647-655
Publisher: Babylon University جامعة بابل

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Abstract

Objective :To evaluate the validity of tenodermodesis with fixation of distal interphalangeal (DIP) joint in extension position by kirschner wire(k. wire) in management of delayed cases of mallet finger .Methods: This study was conducted on 30 patients in Al-Diwanyia teaching hospital who were complaining from dropping of distal phalanx (mallet finger) and presented after 10 days from the time of injury ,they underwent surgery by tenodermodesis procedure and fixation of DIP joint in extension position by k. wire .The time of study was between 2008 and 2010 and followed up for a period for 1 year. The patients were evaluated according : Sex and age, wether the injured hand was right or left ,the finger that commonly injured, average delay before presentation ,type of trauma, extensor lag at presentation and radiograph :x-ray AP and lateral views for injured finger to see If there is bone avulsion or volar subluxation of distal phalanx .We excluded the open injuries with soft tissue loss and injuries associated with fractures greater than one third of articular surface from the study.Conclusion: We conclude that delayed cases of mallet fingers can be managed with tenodermodesis procedure with fixation of DIP joint in extension position by k. wire with no joint problems like( stiffness or deviation),accepted flexion ability ,negligible extension lag and good patients satisfaction at 1 years follow up.

هذه الدراسة هي دراسة تقويمية لمرضى مصابون باصبع (مالت) ) اي سقوط السلامية الاخيرة من اصابع اليد نتيجة لشدة خارجية .اجريت هذه الدراسة في مستشفى الديوانية التعليمي للفترة ما بين شباط/2008 وكانون الاول/2011 شملت ثلاثون مريضا20 ذكر و 10 انثى ، اعمارهم تتراوح ما بين 15 و40 سنة.تم علاج المرضى باستخدام عملية جراحية تدعى(tenodermodesis )اي خياطة الوتر الباسط لطرف الاصبع سوية مع الجلد مع تثبيت المفصل مابين السلامية البعيدة والوسطى ب كيسنر واير(كي واير).تم الاستنتاج بان استخدام هذه الطريقة مقارنة بطرق جراحية وغير جراحية اخرى افضل وذلك بسبب قلة حدوث المضاعفات التي تحصل في مثل هذا النوع من الاصابات مثل تصلب المفصل او انحراف عظام المفصل كذلك شاهدنا قدرة مقبولة على عمل حركة الانقباض مع فقدان جزء قليل جدا من القدرة الكاملة على الابساط في المفصل م ابين السلامية البعيدة والوسطى.

Keywords

mallet --- k.wire --- delayed


Article
Developmental Hip Dysplasia and Delayed Walking
تأخر المشي عند الأطفال المصابين بداء الحثل الولادي

Author: Husham A. S. Alkattan د. هشام الكطان
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 1 Pages: 44-48
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Most children are able to walk alone by 11 to 15 months but the rate of development is very variable. Some children will fall outside the expected range and yet still be fine in the end. Walking is considered to be delayed if it has not been achieved by 18 months. Delay in walking may be simply variation of normal. Other common causes include, (1) Delay in motor maturation, (2) Abnormalities in muscle tone and power, (3) Environmental factors.Aim: To determine the Odds’ ratio (OR) of the risk factors. To demonstrate differences between cases of DDH and their controls in respect to walking state. Study design: Case control study in outpatient of Al-Jumhorei teaching hospital. Consisted of 754 (377 cases of DDH, 377 controls), have been examined (295 males and 459 females), ages varies between 12 -208 months average (around 15.06 monthsStudy period: 1st Jan 2010-1st Jan 2011.Methodology: The sample of control was selected according to the method of individual matching, (MacMahon and Pugh, 1970; Gordis, 1996). For each patient with DDH one control was chosen.Results: Reveals that DDH is not a risk factor for delayed walking, moreover it has been found that it is a protective factor, Odd ratio (0.293) with highly significant association , P <0.002.Conclusion: DDH had no effect on delayed walking.Key word: Developmental hip dysplasia, Delayed walking.


Article
Approximate Solution for Linear Time- Delayed Improper Integral Equation Using Orthogonal Polynomials
الحل التقریبي للمعادلات التكاملیة المعتلة الخطیة ذات زمن متباطئ باستخدام متعددات الحدود المتعامدة

Author: Hayat Adel Ali
Journal: Engineering and Technology Journal مجلة الهندسة والتكنولوجيا ISSN: 16816900 24120758 Year: 2012 Volume: 30 Issue: 1 Pages: 167-174
Publisher: University of Technology الجامعة التكنولوجية

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Abstract

In this paper we adopt the collocation method based on orthogonal polynomials(Laguerre, Hermite) to solve linear time delayed improper integral equationapproximately. Some examples are given to illustrate the high accuracy and theefficiency of the proposed numerical techniques.

(Laguerre, في ھذا البحث تم تبني طریقة التجمیع بالاعتماد على متعددات الحدود المتعامدةكأساس لحل المعادلات التكاملیة المعتلة الخطیة ذات زمن متباطئ تقریبیا. بعض الأمثلة Hermite)أعطیت لبیان الدقة العالیة والكفاءة للتقنیة العددیة المقترحة.


Article
Demographic and clinical characteristic of Cerebral Palsy Among Children in Diyala Province – Iraq

Author: Dawood Salman Hameed Al-Azzawi داود سلمان حميد العزاوي
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2012 Volume: 2 Issue: 1 Pages: 72-78
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Cerebral palsy (CP) is defined as non-progressive disorder of movement and posture due to brain insult or injury occurring in the period of early brain growth (generally under three years of age).Objectives: This is a descriptive study of the demographic and clinical characteristics of cerebral palsy in Diyala province – Iraq is to put the light on this upsetting neurological disorder.Patients and Methods: This study is carried out among children who were referred from the primary health care centers to the reference consultation clinic at Al-battool Maternity and Children teaching hospital in Baquba, the center of Diyala governorate from the first of May 2008 till 30th of April 2011.The following data were studied, the presenting compliant, patients age and sex distribution, mode of delivery, age of presentation, number of full-term and pre-term, the condition at birth and birth asphyxia, types of CP and associated medical abnormalities.Results: The total number of patients were 82, males were affected more than females, the ratio is (1.4:1) (male 48 =58.5% and female34=41.5%).The most common first presenting complaints were the delayed milestones (50%). Most of the patient presented between the age of (7-12) months (48.8%). Spastic CP was the most common type (57.3%), among the other types of spastic CP are spastic quadriplegia (45.1%). Most of the patients are product of vaginal delivery (61%).Most of the patients came to parents who had consanguineous marriage (58%).Conclusions: The study explain that the high prevalence of spastic quadriplegia which is the most common type of CP encountered in the clinical practice is due to the high prevalence of birth asphyxia.Recommendations:1- To prevent the treatable causes of CP e.g. asphyxia and kernicterus, through initiation of centers for early detection of childhood disability.2- Establish special centers to look after CP patients specially those need orthopedic surgery and physiotherapy and so on.


Article
Bone marrow injection in patients with delayed union and non-union of long bone fractures

Author: Firas T. Ismaeel
Journal: Diyala Journal For Pure Science مجلة ديالى للعلوم الصرفة ISSN: 83732222 25189255 Year: 2010 Volume: 6 Issue: 3 Pages: 360-366
Publisher: Diyala University جامعة ديالى

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Abstract

Background: In the process of bone formation and healing of fractures, the bone marrow as a source of osteoprogenitor cellswhich are the most important factor in this process . The aim of this study is to show the effect of bone marrow injection in management of delayed union and non-union.Patients and methods: Twenty one patients with delayed union and non union were treated by bone marrow injection. Most of cases have compound fractures of the long bones. The bone marrow were aspirated from the anterior or posterior iliac crests and then injected percutaneously into the fracture site.Results: Full union was achieved in 15 cases, while failed in the others. The mean time for union was 20 weeks; no major complications were seen during or after the procedure.Conclusion: The usage of bone marrow injection in the treatment of delayed union and non-union is a safe, easy and a minimally invasive procedure, compared to usual open bone graft especially for cases with high risk of anesthesia or risk of infection.


Article
Delayed puberty in Female with Type 1 Diabetes Mellitus
تأخر البلوغ عند الإناث المصابات بداء السكري نمط واحد

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Abstract

Abstract:Objective: To assess the growth and maturation of female with type 1 D.M.Patients & Method: Eighty one type I diabetic females aged 9-18 years & a matched control group were studied in term of height, weight in addition to assessment of sexual maturation rate of breast, pubic hair and menarche.Results: The study revealed that there is retardation in weight & height among diabetic patients. Also there was a significant statistical difference between diabetic patients & controls for all the studied variables.Conclusion: Derangement of metabolic control leads to growth retardation. Diabetic who are maintained in good control can mature at normal rates.Key words: Delayed puberty, female type 1 diabetes mellitus

الملخص:دراسة أجريت لقياس تأخر النمو والبلوغ بين الفتيات المصابات بمرض السكري نمط (1).طريقة البحث:ـ شملت الدراسة (81) مريضة مصابة بداء السكري نمط (1) تتراوح اعمارهن ما بين 9-18 سنة وكذلك عينة ضابطة مماثلة.وقد جرت دراسة معدل الطول والوزن بالإضافة إلى تقييم معدل النضج الجنسي للثدي والشعر في أسفل البطن وتاريخ بداية الحيض.النتائج:ـ بينت الدراسة أن هناك تأخر في نمو بين المريضات بالنسبة للوزن والطول. كما وجدت فروقات معنوية بين معدلات النمو والنضوج بين المريضات والعينة الضابطة وفي كل المتغيرات المدروسة.الاستنتاج :إن الخلل في السيطرة على مقياس الأيض يؤدي إلى تأخر في النمو . وكلما تمت السيطرة بصورة جيدة على المرض فيمكن أن يكون معدل النمو والبلوغ مقارباً للمعدلات الطبيعية.


Article
Delayed Management in Acute Abdomen: causes and consequences
إرجاء التدابير العلاجية في حالات البطن الحادة: الاسباب والنتائج

Authors: Haqqi I. Razzouki حقي اسماعيل رزوقي --- Amer H. Salman عامر حسن سلمان
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2013 Volume: 26 Issue: 1 Pages: 78-84
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

ABSTRACT:Background: Acute abdomen is a serious life-threatening condition which needs prompt diagnosis and management. However, in many situations, there is a delay in management which may affect the clinical outcome and worsen the prognosis.Objectives: To determine the causes of delay in diagnosis and treatment in acute abdomen and to study the effects on prognosis.Patients and Methods: A prospective case-series study done in Al-Yarmouk teaching hospital, surgical department over a six months period from 1st of April 2011 to the 1st of October 2011.Ninety five Patients presented with acute abdomen were divided into two groups according to the duration of their symptoms. Thirty five patients who presented after 24 hours were considered delayed and 60 patients who presented before 24 hours were considered as controlled group. Both groups were followed closely and the operative findings, Post-operative complications and the final clinical outcome were documented.Results: There were 35 patients with delayed acute abdomen. The delay was due to the patient or his family in 19 (54.2%) cases and due to medical factors in 11(31.4%) patients. The most common operative finding was perforated duodenal ulcer 5 (14.2%) patients and perforated appendix 5 (14.2%) patients. Thirty (85.7%) patients developed post-operative complications mainly prolonged paralytic ileus, peritonitis and early surgical site infection. The total post operative complications were 25 (71.4%) patients and full recovery was 5 (14.3%).There were 5(14.3%) deaths due to septic shock or cardiovascular complications. Sixty patients presented within 24 hours and considered as controlled group, The most common operative finding was perforated duodenal ulcer 30 (50%) patients, and obstructed or strangulated hernia was 15 (25%) patients, the total post operative complications in this group was (25%) P-value 0.006 (significant), full recovery was found in 42 (66.6%) patients P-value 0.0007(significant), there was no deathConclusions: Although many factors causing delay management in cases of acute abdomen are mainly related to the patient, there were a significant number of cases in which the attending doctor was responsible for the delay. There was a definite relationship between the delay in diagnosis and management and the incidence of complications and Death. Keywords: Acute Abdomen; Delayed treatment; causes, consequences

خلفية البحث: ان حالات البطن الحاد تكون في اغلب الاحيان شديدة مع خطر الموت و تحتاج الى تشخيص سريع و تداخل عاجل . هناك في حالات عديدة تاءخير في المعالجة مما يؤثر على النتائج السريرية و يؤدي الى تدهور في التكهناهداف البحث: لتحديد اسباب التاخير في التشخيص و المعالجة لحالات البطن الحاد و لدراسة المضاعفات المترتبة على هذا التأخير ومدى تأثيرها على التكهنات.المرضى و طرق البحث: دراسة مستقبلية شملت المرضى المصابين بالبطن الحاد الداخلين الى قسم الجراحة في مستشفى اليرموك التعليمي لمدة ستة اشهر. تم تقسيم المرضى الى مجموعتين حسب الفترة ما بين ظهور الاعراض و وصولهم المستشفى واعتبرت الحالات الواصلة بعد 24 ساعة متأخرة0 لاغراض البحث تم متابعة المجموعتين تفصيليا وتوثيق مشاهدات العمليات الجراحية والمضاعفات بعد العمليات و النتائج السريرية.النتائـــــــــج: كانت هناك 35 حالة بطن حاد متأخرة .كانت العوامل المتعلقة بالمريض او عائلته هي سبب التأخير في 19 مريضا و العوامل المتعلقة بالكادر الطبي هي السبب في 11 مريضا.الحالات الاكثر حدوثا هي انثقاب قرحة الاثني عشري و انثقاب الزائدة الدودية.حدثت مضاعفا ت بعد العملية في 30 مريضا اكثرها شيوعا شلل الامعاء المطول و التهاب غشاء البريتون و التهاب جرح العملية. وحدوث خمس وفيات بسبب الصدمة الجرثومية او اختلاطات متعلقة بالقلب و جهاز الدوران .الاستنتاجات: ان العوامل المتعلقة بمعالجة حالات البطن الحادة المتأخره تعود اساسا الى المريض و عائلته الا ان هناك حالات كثيرة يعود السبب للكادر الطبي و لاسباب متعددة. هناك علاقة مؤكدة بين التدابير العلاجية في حالات البطن الحاد المتأخرة و بين زيادة الاختلاطات بعد العملية و كذلك زيادة وقوع الوفيات مقارنة بالحالات التي تم علاجها مبكرا.


Article
Early and delayed laparoscopic cholecystectomy in patients with acute cholecystitis

Author: Tariq E.Alaubaidi طارق العبيدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 1 Pages: 40-43
Publisher: Baghdad University جامعة بغداد

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Article
Effect of early laparoscopic Cholecystectomy in Acute Cholecystitis

Author: Abdulhameed J. Ali*, Arkan A. AL-Ogali**, Hala I. Salih**, Abdalrahman H. Turfa
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 2 Pages: 41-44
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Laparoscopic cholecystectomy (LC) has become the treatment of choice for elective cholecystectomy.Objectives: To evaluate the safety and feasibility of early LC for AC and to compare the results with delayed LC.Methods: A prospective study done from April 2011 to October 2013, 88 patients with diagnosis of AC were divided randomly into two groups according to the mode of treatment; (early group n=40) treated by early LC within first 72 hours or (delayed group, n=48) initial conservative treatment for 4-6 weeks, followed by delayed LC.Results: There was no difference between the two groups (early & delayed LC), operating time (early 80min, delayed70min), conversion rate (early 7.5%, delayed 6.25%),postoperative complications (early 20%, delayed 14.58%),However, the early group had shorter mean hospital stay(early 2.5 days, delay 5 days).Conclusion: early laparoscopic cholecystectomy appears to be reliable, safe, and cost effective treatment modality for acute cholecystitis, offering the additional benefits of a shorter hospital stay.Keywords: Acute cholecystitis, early LC, delayed LC.


Article
Causes and Prevention of Missing a Diagnosis and Late Management of Acute Appendicitis

Authors: Ali Abdulhaleem Kadhim --- Mohend Abbas Noori Al-Shalah --- Adnan Mohammad Kamil
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 370 -377
Publisher: Babylon University جامعة بابل

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A delay in diagnosis and late management of appendicitis with appendectomy is still high with subsequent some serious sequelae. This study is to identify and prevent a causes of delay in diagnosis of appendicitis. Aprospective cross section study includes 308 appendectomies performed in a Hilla teaching hospital from January 2013 to July 2015 by same surgical team; 143 (46%) male and 165 (54%) female. Delayed diagnoses was considered when the duration of pain was more than 48 hours, or operative finding show obvious features of delay, like perforation, gangrenous appendix, abscess collection or mass formation. Average duration of symptoms for delayed patients was 96 hours and for early diagnosed was 29 hours, Reasons fordelay were sought and divided into two groups; the first is patient behavioral reason, and the second is medical assessment reason. Twenty one percent of appendectomised patients show delayed management despite more than 48 hours abdominal pain (3-10 days, average 4 days), 69%of them was male, and, 31% female. Average duration of hospitalization in a delayed cases was 3.5 days, while average duration of admission for early treated cases was 1.3 day. Mortality rate was zero. As a reason for delay in diagnosis; patient assessment was the main reason for delay diagnosis (44 patients, 68%); while patient behavior cause was 32% (21 patients). The patient assessment is the main cause of delay in diagnosis and should be improved by examining patients with abdominal pain by expert surgical team considering atypical presentation with proper follow up and investigations.Quality improving program is advised to reduce missed diagnosis of appendicitis.

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