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Article
Cervical dysplasia: assessment and risk factors among women attending the Maternity Teaching Hospital in Erbil, Kurdistan-Iraq
خلل التنسج العنقي: تقييم وعوامل الخطر لدى النساء اللائي يراجعون مستشفى الولادة التعليمي في أربيل، كوردستان العراق

Authors: Sherzad Ali Ismail --- Lazha Ahmed Talat --- Baran Kamal Barzanjy
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 1 Pages: 286-293
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objective: Cervical cancer is the second most common female cancer in the world. It is the commonest cause of female cancer deaths in South-East Asia and Africa and accounts for 15% of all female cancers in developing countries. the aims of this study was to determine the frequency of abnormal cervical cytology among women underwent Pap smear and assess for the presence of risk factors related to abnormal Pap smear results. Methods: A hospital-based cross sectional study, using a questionnaire and involved 2,146 women at the Maternity Teaching Hospital in Erbil city from January to December 2009. All Pap smears cytological examinations were conducted using Bethesda classification system. Results: Histological reports were found to be normal in 88.4% of women; meanwhile, 248 (11.6%) women had abnormal cytological findings with a mean age of 36.84 years, significantly older than those with normal results (p <0.05). The duration of marriage was also found to be significantly longer among those with abnormal Pap smear (18.34 years versus 15.72 years, (p < 0.05). Conclusion: This study was able to indicate that during reproductive life, the older ages of women and longer duration of marriage were associated with an increased risk of abnormal Pap smear results.


Article
Spondyloepiphysial Dysplasia

Author: Dawood Sadik. Al-Obidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 1 Pages: 96-99
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT :BACKGROUND:A 13 years old girl from north of Iraq, presentedwith gross deformity of her back & difficulty inwalking& then progressive difficulty inbreathing. A thoracic scoliotic deformity with ribhump obvious on her back, it is a case report ofspondyloepiphyseal dysplasis(SED) with primaryinvolvement of the vertebrae & epiphysealcenters all over the body.AIM OF THE STUDY:To present a very rare case of (SED), includingthe deformities& the complications that can bepresented with it.METHOD:Examining & survying a 13 years old Iraqifemale from north of Iraq.RESULTS:A thoracic scoliotic deformity was found&became more obvious on bending foreword, alsorib hump on the right side.Both hips in fixedflexion deformity & limitation of abduction.DISCUSSION:In SEDT the vertebral bodies are malformed&flattened, 1st described by Nilssone(1924).Wynne-Davies& Gormley(1985)estimated the prevalence to be 1 per 100.000 in aScottish population.


Article
P53 Expression in Gastric Dysplasia and carcinoma in Erbil City

Authors: Gayllan Qadir Ali كيلان قادر --- Bayan. A.Al-Badri بيان البدري
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2011 Volume: 53 Issue: 2 Pages: 190-193
Publisher: Baghdad University جامعة بغداد

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Background: Alteration in the expression of p53 tumor-suppressor protein is an event that occurs frequently in human cancer, but the practical implications of this phenomenon are yet to be fully exploited.
Objectives: to determine the value of p53 expression as a marker of tumor aggressiveness and the relationship between p53 over expression and clinico-pathologic variables in gastric adenocarcinoma.
Material & Methods: The expression of p53 was studied immunohisto-chemically in 10 cases with gastric dysplasia and 85 cases with gastric adenocarcinomas using formalin fixed, paraffin-embedded tissue samples. D07 a monoclonal antibody to p53 protein was used for the immunehistochemical analysis. The correlation between p53 expression in gastric dysplasia, gastric adenocarcinoma and clinicopathologic variables were analyzed.
Results: P53 positivity was found in 48.2% of gastric carcinoma cases, and 40% of gastric dysplasia. There was a significant correlation between the rate of p53 over expression and tumor grade (p = 0.015), and also with carcinomas associated with lymph node involvement (p = 0034). There was no significant association between p53 protein expression and histological type (p = 0.171). The association between p53 protein expression and the depth of tumour invasion was found to be statistically insignificant.
Conclusion: The results obtained suggest that P53 protein expression is a useful biomarker for the assessment of gastric adenocarcinoma aggressiveness. The preoperative assessment of p53 expression in gastric carcinomas can be helpful in identifying patients with higher grades and more advanced tumors. P53 immunoreactivity can predict lymph node status in patients with gastric carcinoma.


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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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
EVALUATION OF MEDIAL APPROACH (LUDLLOF) FOR OPEN REDUCTION OF DEVELOPMENTAL DYSPLASIA OF THE HIP IN CHILDREN

Authors: Haider R Majeed --- Ali A Ahmed Al-Iedan --- Haider Abdulshareef Abdulsahib
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2014 Volume: 20 Issue: 2 Pages: 61-68
Publisher: Basrah University جامعة البصرة

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Abstract

Developmental dysplasia of the hip is a challenging surgical problem, there are many controversies regarding its management. Open reduction via medial approach is one of its treatment options, which needs further work to evaluate its role in management of Developmental dysplasia of hip. In this study, we tried to put an answer whether the medial incision of open reduction of developmental dysplasia of the hip is valuable in terms of stability, avascular necrosis, effect of age and the need for further procedures. Out of the ninety Children with DDH received within two years, twenty five of them needed open reduction through Ludloff’s approach; they were subjected to full assessment including detailed history and clinical examination in addition to radiographic evaluation. The remaining sixty five patients underwent closed reduction and hip spica cast application. Regarding those patients treated by open reduction, seven were males while eighteen were females, sixteen of them are below one year of age, trials of closed reduction under general anesthesia with arthrographs taken during the procedure to obtain the optimal range of hip movement with no benefit, so they were operated upon through the medial (Ludloff) approach. We found that this approach have more easy access to the hip joint, no need for blood transfusion and shorter time (20-30) minutes for each hip in relation to other approaches in the same age group. Serial follow up clinically and radiographically was performed to all patients. Postoperative complications included six hips with avascular necrosis of femoral head according to Kalmachi and MacEwan classification. No redislocation and infection was recorded. In conclusion, this method provides a stable and concentrically reduced hip.


Article
MULTILINEAGE DYSPLASIA IN IRAQI KURDS WITH ACUTE MYELOID LEUKEMIA: A RETROSPECTIVE STUDY ON 105 PATIENTS
خلل التنسج المتعدد في الكورد العراقيين المصابين بسرطان الدم النخاعي الحاد: دراسة أسترجاعية على 105 مريض

Authors: AMEER I. A. BADI --- NASIR A. S. AL-ALLAWI, --- KHAMLEEN M. HASAN
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2017 Volume: 11 Issue: 2 Pages: 1-10
Publisher: University of Dohuk جامعة دهوك

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Background: Acute Myeloid leukemia (AML) with multilineage dysplasia (MLD) is an important subcategory of acute myeloid leukemia, which has been reported to have prognostic importance. No studies have addressed this category of AML in Iraq Kurds, so this study was initiated. Subject and Methods: A total of 105 patients diagnosed as Acute Myeloid leukemia over 10 years were reassessed. They have a median age of 40 and a male: female ratio of 1.02:1. The reassessment included re-evaluation of their clinical and hematological records, as well as re-evaluation of their peripheral blood and marrow smears for multilineage dysplasia. The study also included assessing any correlations between various clinical and hematological parameters and the presence of MLD.Results: Multilineage dysplasia was documented in 35.3% of cases. The dysplasia was bilineage in 23.8% and trilineage in 11.4%. The most frequent dysplastic changes were hypogranular granulocytes, pseudo-pelger-hüet anomely, and mono-lobated megakaryocytes, seen in 46.6%, 29.5% and 20.9% respectively. The dysplasia was encountered in most frequently in M5 and M6 morphological subtypes, while it was absent in the M3 subtype, a finding which was significant (p =0.001). When the latter subtype was excluded from evaluation, it was found that patients with MLD were less likely to have organomegaly, more likely to have leukopenia, platelets < 20x109 /l, blast <20% in peripheral blood or <60% in bone marrow than those with no MLD, although none was significant.Conclusions: Multilineage dysplasia is frequently encountered in Iraqi Kurds with AML and seen in all morphological subtypes except M3, and its presence needs to be documented in bone marrow reports on new AML cases. Further prospective studies preferably including cytogenetics to evaluate outcome in AML-MLD versus AML without it, needs to be initiated.

الخلفية والأهداف: سرطان الدم النخاع النقياني الحاد ذو النمو الشاذ المتعدد الطبقات هو فئة فرعية هامة من سرطان الدم النقياني الحاد، وقد تم تسجيله لأهميته كنذير تكهني. لم تتم أي دراسة من هذا القبيل عن هذه الفئة في إقليم كردستان، لذا بدأت هذه الدراسة. طرق البحث: تم إعادة تقييم ما مجموعه 105 مريضا تم تشخيصهم على أنها سرطان الدم النقياني الحاد على مدى 10 سنوات. ويبلغ متوسط العمر 40 سنة، ونسبة الذكور: الإناث 1.02: 1. وشمل تقييم السجلات السريرية والدموية إعادة تقييم فحوصات الدم المحيطي ومسحات النخاع للبحث عن النمو الشاذ المتعدد الطبقات. وشملت الدراسة مقارنة الارتباطات بين اختلاف المعايير السريرية والدموية مع وجود النمو الشاذ المتعدد الطبقات. النتائج: تم توثيق النمو الشاذ المتعدد الطبقات في 35.3٪ من الحالات. وكان خلل النمو الشاذ الثنائي في 23.8٪ و الثلاثي في 11.4٪. كانت التغيرات المتضرره المتكررة هي الخلايا المحببة قليلة الفصوص، شذوذ بلكر هيو الكاذب ، و النَّوَّاء أحادي الفصوص، وجدت في 46.6٪، 29.5٪ و 20.9٪ على التوالي. وقد وجد النمو الشاذ في معظم الأنواع الفرعية ولكن على الأرجح في M5 و M6 ، في حين كان مفقودا في النوع الفرعي .M3 حيث كانت النتيجة كانت احصائيا كبيرة 0.001). (P =. عندما تم استبعاد النوع الفرعي الأخير من التقييم، وجد أن المرضى الذين يعانون من النمو الشاذ المتعدد الطبقات كانوا أقل احتمالا أن يكن لديهم تضخم عضوي، ولكن من المرجح أن يكون لديهم نقص الكريات البيض، الصفائح الدموية اقل من /20x109لتر، خلايا النخاع الاولية اقل من 20٪ في الدم المحيطي أو <60٪ في نخاع العظم مقارنة مع أولئك الذين ليس لديهم النمو الشاذ المتعدد الطبقات.الاستنتاجات: أن نسبة عالية من حالات سرطان الدم النفياني الحاد في دهوك تشهد وجود نمو شاذ متعدد الطبفات و يشمل هذا جميع الاصناف الشكلية باستثناء M3 . ويتعين توثيق وجود النمو الشاذ المتعدد الطبقات في تقارير سرطان الدم النقياني الحاد، ومن الأفضل أن تشمل الدراسات المرتقبة فحوص الوراثة الخلوية لتقييم نتائج هذا السرطان الحاد ذو النمو الشاذ المتعدد الطبقات مقابل نتائج سرطان الدم الحاد بدون هذا النمو.

Keywords

AML --- Multilineage Dysplasia --- Kurds --- Iraq.


Article
Ultrasonographic Findings in Developmental Dysplasia of the Hip in Infants

Author: Haider Qasim Hamood
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 2 Pages: 124-132
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Ultrasound (U/S) is valuable modality for evaluating the hip in infants because it enables direct imaging of the cartilaginous portion of the hip that cannot be seen on plain radiographs. Furthermore, U/S examination enables dynamic study of the hip with stress maneuvering. U/S is the preferred imaging modality which used to study the hip disorders like developmental dysplasia of hip ( DDH ), because it is sensitive indicator of malposition, instability and lack of acetabular development. U/S accomplishes all of these without exposing the infant to ionizing radiation, not expensive, non-invasive and available.OBJECTIVE:The aim of our study is to determine the effectiveness and sensitivity of ultrasound examination of neonates to confirm the early clinical diagnosis of developmental dysplasia of hip ( DDH ) especially in the high risk groups of neonates and young infants.METHODS:We conducted a retrospective review of ultrasonographic imaging in 60 neonates and young infants ( 36 females and 24 males ; age range, 1-9 months, median age , 4 months). U/S examination of the hip joint were evaluated for, percent bony coverage (PBC), which indicates the percentage of the femoral head that covered by the bony acetabulum, normally, 50% or over of the femoral head should be covered by bony acetabulum. And evaluated for Graf angles, alpha angle which defines the bony acetabulum and normally it is more than 60 degree and beta angle which indicates the cartilaginous development and it is normally less than 55 degree. Also evaluate the femoral head flattening which usually associated with delayed ossification , shortening and anteverting of the femoral neck .RESULT:DDH is more common in the female patients ( F:M = 3:1 ). Instability and dislocation is usually unilateral, this is seen in 30 patients (50%), (unilateral :bilateral = 3:1). Left hip is more commonly affected, this is seen in 24 patients(40%),( L:R = 4:1 ). Children born by caesarian section are more likely to have associated instability or dislocation of the hip, 10 patients(25%). First born baby are more affected, 4 patients(10%) and usually these children are more likely to have been breech presentation during their gestation, 14 patients (35%). Family history of DDH is seen in 6 patients(15%).CONCLUSION:The U/S is the preferred modality for evaluating the hip in infants who are younger than 6 months. U/S of infant's hip can be used in the diagnosis of DDH and also in monitoring of treatment or follow-up the improvement in the acetabular maturity and morphology, as well as the location of femoral head can be documented to assist in the guidance of therapy plan.


Article
Bladder Mucosal Pathological Changes Accompany High Grade and Squamous Cell Bladder Tumors

Author: Jassim Mohammad Alkhazraji
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 536-541
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Carcinoma of the bladder is the second most common cancer in Iraq. The status of the bladderurothelium other than the principal lesions can provide distinct diagnostic information with regard totreatment response and outcome. Positive mucosal biopsy results are a significant indicator ofintravesical recurrence. Currently, in our urological practice, the importance of performing this step incystoscopy is relatively underestimated.OBJECTIVE:The objective of this study is to carry out a histological assessment of 'extra-tumor' bladder mucosa fordysplasia, and correlate the resulting findings of dysplasia with the grade, the type, and the macroscopicappearance of the tumor.MATERIALS AND METHODS:A total of 350 biopsies were taken by cystoscopy from 68 patients admitted with bladder tumors, eitherby cold-cupped biopsy forceps or resectoscope as part of TUR of the tumor. Normal-looking mucosa ofthe bladder was included in each patient's biopsy in a four quadrant way. All biopsies were examinedby the same histopathologist. All patients were managed according to their presentation, cystoscopicand histopathological findings.RESULTS:Statistical analysis showed that the highest significant difference was obtained in patients with tumorgrade, low against high grade (p<0.005). However, a noticeable difference was found in the other twocomparison groups, namely, the type, transitional against squamous and the macroscopic appearance,papillary against solid (p<0.05).CONCLUSION:The high grade, solid tumors and squamous cell carcinoma are associated with general bladder mucosaldysplastic changes which may exclude the bladder preserving procedures as an option of surgicaltreatment. In Iraq, more extensive studies are necessary to come out with appropriate guidelines for abetter treatment and outcome of bladder carcinoma which is a major health problem


Article
Bladder Mucosal Pathological Changes Accompany High Grade and Squamous Cell Bladder Tumors

Author: Jassim Mohammad Alkhazraji
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 536-541
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Carcinoma of the bladder is the second most common cancer in Iraq. The status of the bladderurothelium other than the principal lesions can provide distinct diagnostic information with regard totreatment response and outcome. Positive mucosal biopsy results are a significant indicator ofintravesical recurrence. Currently, in our urological practice, the importance of performing this step incystoscopy is relatively underestimated.OBJECTIVE:The objective of this study is to carry out a histological assessment of 'extra-tumor' bladder mucosa fordysplasia, and correlate the resulting findings of dysplasia with the grade, the type, and the macroscopicappearance of the tumor.MATERIALS AND METHODS:A total of 350 biopsies were taken by cystoscopy from 68 patients admitted with bladder tumors, eitherby cold-cupped biopsy forceps or resectoscope as part of TUR of the tumor. Normal-looking mucosa ofthe bladder was included in each patient's biopsy in a four quadrant way. All biopsies were examinedby the same histopathologist. All patients were managed according to their presentation, cystoscopicand histopathological findings.RESULTS:Statistical analysis showed that the highest significant difference was obtained in patients with tumorgrade, low against high grade (p<0.005). However, a noticeable difference was found in the other twocomparison groups, namely, the type, transitional against squamous and the macroscopic appearance,papillary against solid (p<0.05).CONCLUSION:The high grade, solid tumors and squamous cell carcinoma are associated with general bladder mucosaldysplastic changes which may exclude the bladder preserving procedures as an option of surgicaltreatment. In Iraq, more extensive studies are necessary to come out with appropriate guidelines for abetter treatment and outcome of bladder carcinoma which is a major health problem.


Article
Social Backgrounds for Mothers Having Infants and Children with Developmental Dysplasia of Hip
الخلفية الاجتماعية للأمهات اللاتي لديهن أطفال مصابين بالخلع الولادي لمفصل الحوض

Author: Hisham A. Al-Kattan د.هشام القطان
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 1 Pages: 18-23
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Developmental dysplasia of the hip (DDH) embraces conditions of varying severity. Early identification of affected infants is important for optimal outcome. The incidence of DDH is variable and depends on many factors. Approximately one in 1 000 children is born with a dislocated hip, and 10 in 1 000 may have hip subluxation. Factors contributing to DDH include breech presentation, female sex, positive family history, firstborn status, and oligohydramnios. Intrauterine position, sex, race, and positive family history are the most important risk factors. These factors have been meticulously globally studied by many researchers, this study aimed at exploring the effect of social backgrounds for mothers having babies with DDH. Aim: To examine the impact of different socio-economic and medical characteristics for women and the subsequent occurrence of developmental dysplasia of hip among their children. Study design: Case-control study, where 43 women with DDH babies, were allocated as cases. Another 91 women who have not had babies with DDH were considered as controls. Study period: 1st. February 2007 to 1st. December 2007.Data collection tools: Including, assessment of socio-economic features such as personal characteristics, life events and social context. In addition, previous history of oral contraceptive usage and the presence of one or more of chronic non-communicable diseases were also gained. Results: Regarding Personal Characteristics; positive family history was found to be significantly associated with the development of DDH (P=0.001), while sedentary life styles were found to be significantly negatively associated with the occurrence of DDH (P=0.022). According to Life Events; stress, in this work appeared to be significantly associated with the development of DDH (P= 0.017), while social discontinuities and geographical mobility, both showed negative significant association with DDH. Regarding Social Context, both social disintegration and urbanization appeared to be significantly (P=0.032, P=0.023 respectively), negatively associated with the occurrence of DDH. According to Other Variables, the previous history for use of oral contraceptives showed significant (P=0.018) negative association with DDH, while obesity in women appeared to be positively associated with the occurrence of DDH among their children. Conclusion: Women with positive family history stress and obesity appeared to be at significant risk to have children with DDH. While, women with sedentary life, social discontinuities, geographical mobility, social disintegration, urbanization and previous usage of oral contraceptives appeared significantly protected from having children with DDH.Key words: Social, Backgrounds, Mother, Developmental Dysplasia of Hip

الملخص:الهدف: لدراسة تأثير مختلف العوامل الطبية و الاجتماعية للنساء اللاتي لديهن أطفال مصابين بالخلع الولادي لمفصل الحوض.تصميم الدراسة: دراسة العينة و الشاهد.وقت الدراسة: من الفاتح لشباط عام 2007 إلى الفاتح من كانون الأول لعام 2007.الاستنتاج: النساء اللاتي لديهن تاريخ عائلة ايجابي لمرض خلع مفصل الحوض الولادي مع الإجهاد و السمنة وجدن أنهن يحملن خطر هام و معنوي في حدوث هذا المرض عند أولادهن. بينما النساء ذوي الحياة الكسولة, عدم التواصل الاجتماعي, الحركة الجغرافية, المشاكل الاجتماعية, التمدن واللاتي كن قد استعملن حبوب موانع الحمل هن في حالة حماية معنوية عالية من حدوث مرض خلع مفصل الحوض الولادي عند أولادهن.

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