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Article
Myomectomy During Early Pregnancy(Case report)

Author: Dr. Samar D. Sarsam
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2008 Volume: 4 Issue: 2 Pages: 100-102
Publisher: Baghdad University جامعة بغداد

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Abstract

Myoma is a common benign uterine tumor; therefore it is common in pregnancy. One in ten women will have complications related to myoma in pregnancy. Few treatment options are available during pregnancy, conservative treatment with analgesia, reassurance and supportive therapy is almost always adequate but in carefully selected patients, myomectomy has been performed successfully without jeopardizing pregnancy outcome. The usual indications for surgery during pregnancy include torsion of pedunculated uterine myoma and obstructed labor, surgical intervention during pregnancy is occasionally necessary in uncommon cases of intractable pain.
19 years old lady presented with intractable lower abdominal pain during pregnancy. Ultrasound showed fetus of 18 weeks gestation and ovarian cyst. The pain did not respond to rest and sedation, so emergency exploration laparotomy was done; incarcerated intramural uterine myoma was the cause of the pain, it was enucleated successfully through myomectomy and the pregnancy progressed normally.
Keywords: Pregnancy, uterine fibroid, myomectomy.


Article
Study of Lipid Profile in Patients with Uterine Fibroid

Author: Lilyan W. Sersam
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 274-279
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Leiomyomas are the most common gynaecological neoplasms. Despite the major public health impact of leiomyomas, little is known about their cause. As fibroids are hormone-dependent tumours and their development can be promoted by estrogens, an inverse association between hypercholesterolemia and fibroids should be observed as well as direct association between high-density lipoprotein cholesterol (HDL-C) levels and the presence of fibroids.OBJECTIVE:To investigate the lipid profile in patients with uterine fibroids and to compare it with the lipid profile of women without fibroids.METHODS:A case-control study was conducted in the Department of Obstetrics and Gynaecology at Al-Yarmouk Teaching Hospital during the period from May 2008 to May 2009. Participants were one-hundred twenty pre-menopausal women aged between 18 and 45 years who were recruited during their visit to the gynaecological outpatient clinic and were not taking hormonal therapy. Cases consisted of 60 women with uterine fibroids, and controls were 60 women visiting the same gynaecological outpatient clinic for routine reasons. Thorough history and examination was done for each participant. Body Mass Index (BMI) was measured in kg/m2. All patients underwent a baseline ultrasound examination and classified into two groups according to the presence or absence of uterine fibroids. All women where scheduled to undergo blood test at the beginning (2nd -5th day) of their next menstrual cycle. Fasting venous blood glucose and lipid profile were determined in blood samples taken for each patient. Atherogenic index was also calculated.RESULTS:Women with uterine fibroids were found to have significantly higher levels of serum HDL-C compared to the controls (P=0.0001). A significantly lower levels of total serum cholesterol, low-density lipoprotein cholesterol (LDL-C) were also found in women with uterine fibroids compared to the controls (P=0.0001). Atherogenic index was significantly lower in fibroid group compared with controls (P=0.0001). There was a significant positive correlation between largest fibroid volume and HDL-C level (P<0.0001).CONCLUSION:Women with uterine fibroid have lower atherogenic index compared to women without uterine fibroid. Larger volume of fibroid is associated with higher level of HDL-C.


Article
A case of Giant Uterine Fibroid in a Young Woman

Authors: Safa M.Al-Obaidi --- Mohammed Abd-Zaid Akool
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 4 Pages: 588-592
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:The incidence of uterine fibroid tumor increase as women grow older and they may occur in more than 30 percent of women 40 to 60 years of age. Risk factors include nulliparity, obesity, family history, black race, and hypertension.These neoplasms frequently cause abnormal period, pelvic pain, and pressure symptoms. We present a case report of a large leiomyoma in an adult woman


Article
Goserelin versus Norethisterone in the Management of Menorrhagia with Uterine Fibroid

Authors: Yousif Abdul-Raheem --- Jwan N. Sulaiman --- Faris A. Rasheed
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2010 Volume: 19 Issue: 2 Pages: 54-58
Publisher: Baghdad University جامعة بغداد

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Abstract

Menorrhagia is common in patients with uterine fibroids, if operation needs to be delayed for a particular reason, goserelin can be used safely to reduce bleeding and the size of the tumor.The objective is to compare between goserelin acetate and norethisterone on patients with menorrhagia and uterine fibroid. A randomized controlled study conducted in Elwiya maternity teaching hospital, Baghdad from the first of November 2007 to the end of April 2009. 90 patients from the consultant outpatient clinic with menorrhagia and fibroid, and their operations were delayed for medical reason were allocated in two groups, the first group, was given 3.2 mg goserelin acetate subcutaneously monthly for 3 months and the second group was given 5 mg norethisterone orally three times daily during the attack of bleeding and 5 mg once daily, cyclically if no bleeding for 3 months. The fibroid was measured in two dimensions, using convex real-time ultrasound before treatment and three months after treatment. Haemoglobin and the number of pads used were also reported before and after treatment, also the side effects in both groups and the need for operations.The size of fibroid in two dimensions measurement was reduced from 28.24 cm2 ± 6.14 to 12.3 cm2 ± 3.45 in the goserelin group (P=0.0001) versus 26.56 cm2 ± 5.96 to 25.22 cm2 ± 5.01 in the norethisterone group (P= 0.2589). The haemoglobin level was 9.28 gm/100ml ± 2.44 pre-treatment in the goserelin group and 11.2 gm/100ml ± 1.88 post-treatment (P= 0.0001) versus 10.08 gm/100ml ± 2.86, and 10.24 gm/100ml ± 2.46 respectively in the norethisterone group (P= 0.7798). The need for operation was decreased significantly in the goserelin group. Goserelin showed better patient response and reduction in the tumor size than norethisterone in treatment of patients with menorrhagia and uterine fibroids if operation is delayed for medical or other reasons.

إن دواء كوزرلين ( Goserlin ) يظهر نتائج أفضل من دواء ( نوراثي ستيرون ) Norethisterone في معالجة وتقليص حجم العقد الليفية في الرحم و خاصة عند المريضات اللواتي يعانين من نزف شديد أثناء الدورة الشهرية أو هناك أسباب طبية تؤدي إلى تأجيل عملية رفع العقد الليفية جراحياً . ووجد أن إعطاء دواء ( الكوزرلين ) ) Goserlin ) لمدة 3 أشهر فعال في معالجة المريضات اللواتي يعانين من نزف شديد أثناء الدورة الشهرية بسبب وجود عقد ليفية على الرحم إذ وجد انه يقلل من شدة النزف ويرفع من نسبة الهيموكلوبين بالدم مما يقلل الحاجة إلى إعطاء دم أو اللجوء إلى التداخل الجراحي مع وجود إعراض جانبية طفيفة .


Article
A comparative study of premenopausal women with fibroids and Lipid profile

Author: Huda Hussam, Zainab M. Zwain
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2016 Volume: 2 Issue: 2 Pages: 67-77
Publisher: Tikrit University جامعة تكريت

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Abstract


Article
The Relationship between the Presence of Uterine Fibroid and Symptoms in Women 20-40 Years Old

Authors: Muna Kasim Mahmood --- Zena Mahdi Abd Ali
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1793-1796
Publisher: Kerbala University جامعة كربلاء

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Abstract

Abstractbackground: we examined the prevalence of uterine fibroid and menstrual cycle characteristics in a population of non-care-seeking women.Methods: this is a cross- sectional study involves 175 women who were not lactating or using contraception and their age between 20-40. After taking history transvaginal ultrasound done to these female. We examined the association between menstrual cycle characteristic and the presence of uterine fibroid.Results & discussion: uterine leiomyomata were detected in 31 women (17.71%). The presence of uterine leiomypma was not significantly related to amount of blood loss with menstrual cycle, regularity of the cycle, dysmenorrheo or deep pelvic pain.Conclusion: in this population of non-care seeking women, menstrual cycle abnormalities are not related to the presence of uterine leiomyoma.Keywords: Uterine Fibroid, Menstrual cycle, uterine, Leiomypma


Article
Isolation and Partial Purifiction of Arginase from Sera of Women with Uterine Fibroids
فصل وتنقية جزئية لأنزيم الأرجينيز من أمصال النساء المصابات بتليف الرحم

Author: Taghreed U. Mohammd تغريد علوم محمد
Journal: Ibn Al-Haitham Journal For Pure And Applied Science مجلة ابن الهيثم للعلوم الصرفة والتطبيقية ISSN: P16094042/ E25213407 Year: 2015 Volume: 28 Issue: 2 Pages: 116-125
Publisher: Baghdad University جامعة بغداد

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Abstract

The first aim of the present study was performed to assay the activity of arginase in sera of women with uterine fibroid.. This study consisted of(50) women with uterine fibroid as patient's group and (30) healthy women as control group. The age ranged between (30-55) years for the two groups. The results showed that highly significant increas (P< 0.0001) in the arginase activity in sera of women with uterine fibroid (7.99± 0.23) I.U/L is found when compared with healthy group (0.52±0.02) I.U/L.The second aim was performed to isolate arginase from sera of women with uterine fibroids. The purification is done by addition of ammonium sulfate, dialysis, gel filtration chromatography by using sephadex G-50 and ion exchange chromatography by using DEAE cellulose A-50. The results showed a single band for isoenzymes following steps by using sodium dodecyl sulfate- polyacryl amide gel electrophoresis (SDS-PAGE) .

هدفت الدراسة الحالية أولا إلى قياس فعالية أنزيم الأرجينيز من امصال النساء المصابات بتليف الرحم. تضمنت هذه الدراسة (50) امرأة من المصابات بتليف الرحم و (30) امرأة سليمة بوصفهم مجموعة مقارنة، تراوحت أعمارهن بين (30-55) سنة في المجموعتين. بينت النتائج وجود ارتفاع معنوي 0.0001)>P)في فعالية أنزيم الأرجينيز في النساء المصابات بتليف الرحم (0.23±7.99) وحدة عالمية/لتر، بينما كانت معدل فعاليته (0.02±0.52) وحدة عالمية/لتر في الأصحاء.اما الهدف الثاني هو فصل وتنقية متناظرات انزيم الارجينيز من امصال النساء المصابات بتليف الرحم من خلال الترسيب بكبريتات الامونيوم والديلزة وبأستعمال تقنية كروموتوغرافيا الترشيح الهلاميsephadex G-50 وكروموتوغرافيا التبادل الأيوني DEAE cellulose-50 تم فصل أربع متناظرات أنزيمية تختلف في درجة تنقيتها. وعند استعمال طريقة الفصل بالترحيل الكهربائي على هلام SDS-PAGA بتركيز10% وبأستعمال صبغة Coomassie blue R250 ظهرت حزمة منفردة لكل متناظر.


Article
Role of Diffusion Weighted Imaging (DWI) of MRI Study in Differentiation Between Adenomyosis and Fibroids of the Uterus in Al-Hilla Teaching Hospital

Authors: Kassim Amir Hadi Taj-Aldean --- Shaimaa Jassim Bader
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 606 -615
Publisher: Babylon University جامعة بابل

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Abstract

The uterine fibroid is most common solid uterine tumour , it is single or multiple benign neoplasm and present in 20-40% of women in productive age. There are several factors that are attributed to underlie the incidence and development of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on pelvic pressure symptoms or the woman’s menstrual cycle .Adenomyosis of the uterus is benign uterine pathology. It is thought by many to be on the spectrum of endometriosis, with ectopic endometrial glandular tissue in the myometrium. Adenomyosis may present with dysmenorrhea and menorrhagia. Ultrasound and MRI are imaging modalities that may show characteristic findings. Diffusion weighted image in MRI has been applied to evaluate the intracranial lesion ,but technical advancement make it possible to use in extra cranial sites. The aim of this study was to assess the differences, if any, in the apparent diffusion coefficient (ADC) values of adenomyosis and fibroids. Methods and Material Total patient of sample study 56 ,Patients (n= 25) diagnosed by ultrasound as uterine fibroids and (n=31) as adenomyosis, who underwent pelvic MR imaging with DWI, were included in this cross section study. DWI was achieved with using a 1.5 T scanner , different b factors of ( 0, 400, and 600 s/mm) and ADC region of interest(ROI) size were located over an area of Adenomyosis, a fibroid and unaffected normal myometrium all results are correlate with histopathological result which was considered as gold standard diagnostic methods. Results using Student’s t test to compare the ADC values of adenomyosis and fibroids. The standard deviation and the mean of the ADC values were as follows: adenomyosis 0.75 ± 0.30, fibroid 0.63 ± 0.29 and myometrium 1.39 ± 0.36. Statically, there was significant difference between the ADC values of normal myometrium and adenomyosis (p < 0.0001), normal myometrium and fibroids (p < 0.0001), and fibroids and adenomyosis (p < 0.001). Conclusion The present study display that ADC values have the possible to quantitatively and significantly differentiate between Adenomyosis and fibroids.

Keywords

Adenomyosis --- fibroid --- ADC value --- leiomyoma --- myoma --- MRI.


Article
Detection the level of YKL-40 biochemical marker and vitamin D level in sera of Iraqi Uterine cancer females' patients
الكشف عن مستوى مادة (YKL-40) الكيموحياتية ومستوى الفيتامين دال عند الإناث العراقيات المصابات بسرطان الرحم

Authors: Walaa E. Jasm --- Amal R. Farhan --- Wasan T. Abed, MsC
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2013 Volume: 26 Issue: 2 Pages: 1-8
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: Detection the level of YKL-40 biochemical marker and vitamin D level in sera of Iraqi uterine cancer females' patients.Methodology: This study included 90 female volunteers, 30 of them were healthy volunteers who were considered as a control group, while sixty serum samples were collected from women patients suffering from uterine tumors (30 malignant and 30 fibroid benign tumors), benign cases were considered as a disease control group for malignant tumors. The average age of those females was 30-75 years, which matched the control group. All the samples were collected from Azady hospital in Kirkuk and the gynecologic department at Medical City in Baghdad during October /2012 to May /2013. All the serum samples were undergone biochemical estimation for the levels of YKL-40, and 25 (OH) vitamin D using ELISA technique, and BMI data were collected. Results: Estimation of YKL-40 levels showed that there were 28 No. (93.33%) of EC patients had high level of YKL-40, while 26 no. (86.67%) of fibroid (benign tumor) patients had low level, and 15(50.00 %) of healthy control had low. There was a significant difference found in YKL-40 level in EC patients when compared with the fibroid (benign tumor) patients and healthy control (Pvalue= 0.0001), (Pvalue= 0.0001) respectively. The highest percent of women with EC and the women with fibroid (benign tumor) had deficiency of 25 (OH) vitamin D levels (66.67%). While the highest percent of healthy control had sufficiency of 25(OH) vitamin D level (56.67%). statistically there was significant difference among study groups (p=0.0001). Were as no significant difference between EC patients and fibroid (benign tumor) patients (P-value =0.822).Recommendations: Comparing between the ykl-40 marker and other tumor marker diagnostic levels in the detection of uterine tumors. For further studies, we recommended study the diagnostic levels of ykl-40 marker and its correlation with other body tumors. It is recommended to do estimation of vitamin D levels with more advanced method and correlation of its with disease.

المستخلص: الكيموحياتية ومستوى الفيتامين دال عند الإناث العراقيات المصابات بسرطان الرحم. YKL-40الهدف: الكشف عن مستوى مادةالمنهجية: وشملت الدراسة ۹۰ متطوعة، كان ۳۰منهم متطوعين غير مصابات اعتبرن كمجموعة ضابطة، في حين تم جمع عينات مصل من ستين مريضة من النساء اللواتي يعانين من أورام الرحم (۳۰منها من الأورام الرحمية الخبيثة و۳۰ منهن للورم الليفي الذي هو من الأورام الرحمية الحميدة)،حيث اعتبرت مجموعة الأورام الحميدة كمجموعة ضابطة للمرض. كان متوسط عمر هؤلاء الإناث ۳۰-٧٥سنة، والذي يقابل المجموعة الضابطة. تم جمع جميع العينات المذكورة أعلاه من مستشفى أزادي التعليمي في كركوك والقسم الخاص بأمراض النساء في المدينة الطبية في بغداد خلال شهر أكتوبر / ٢۰١٢ إلى مارس .وقد خضعت جميع العينات المصل لتقدير مستويات YKL-40 الكيموحياتية، و25 (OH) vitamin D فيتامين باستخدام تقنية ,ELISA,كما جمعت بيانات الوزن والطول. وتمت مقارنة نتائج عينات المرضى مع البيانات المناظرة لها من المجموعة الضابطة وثم تم تحليلها إحصائيا. النتائج: تقدير مستويات YKL-40 في مصل الدم أن هناك ۲٨ مريضة (٣٣.٩۳٪) من مرضى سرطان بطانة الرحم كان عندهم مستوى عال من YKL-40بالمصل، في حين أن ۲٦ مريضة (٦۷.٨٦٪) من مرضى الورم الليفي (ورم حميد) وجد عندهم انخفاض مستوى YKL-40 بالمصل، و١٥امرأة (۰۰.٥۰٪) من الأصحاء كان عندهم المستوى منخفض من YKL-40 بالمصل. وظهر هناك فرق كبير في مستوى مادة YKL-40 في مرضى سرطان بطانة الرحم بالمقارنة مع مرضى الورم الليفي (ورم حميد) والأصحاء (۰٫۰۰۰١p= ، ۰٫۰۰۰١p=) على التوالي. كان أعلى نسبة من النساء ذوات سرطان بطانة الرحم والنساء ذوات الورم الليفي (ورم حميد)عندهم نقص في مستوى ٢٥هيدروكسي الفيتامين (د) (٦۷.٦٦٪). في حين أن أعلى نسبة من النساء الأصحاء لديهم مستوى الاكتفاء من٢٥هيدروكسي الفيتامين (د) (٦۷.٥٦٪). إحصائيا كان هناك فرق كبير بين مجموعات الدراسة (۰٫۰۰۰١p=) ، بينما لا يوجد فرق كبير بين مرضى سرطان بطانة الرحم والورم الليفي (ورم حميد) (۰٫٨٢٢P=).التوصيات: أوصت الدراسة إلى المقارنة بين مادة ykl-40 الكيموحياتية ومواد أخرى في الكشف عن أورام الرحم.دراسة المستوى التشخيصي لهذه المادة وعلاقتها بأورام أخرى في الجسم. أوصت أيضا بقياس مستوى الفيتامين دال مع طرق أخرى احدث وملاحظة علاقته مع المرض.


Article
Histopathological findings in hysteroctomized sample of women with abnormal uterine bleeding attending Al- Batool Maternity Teaching Hospital-Baquba-Iraq
نتائج الفحص النسيجي في عينات الرحم المستأصل للنساء اللواتي يعانين من نزف الرحم الغير طبيعي والمراجعات لمستشفى البتول التعليمي للنساء والولادة- بعقوبة- العراق

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Abstract

Background: Abnormal uterine bleeding considered as one of the most common and challenging problems presenting to the gynecologist; it is responsible for a lot of outpatient gynecologic visits.Objective: To identify histopathological pattern in hysteroctomized sample of women with abnormal uterine bleeding .Patients and Methods: Descriptive study was carried out in the Department of Obstetrics and Gynecology in Al-Batool Teaching Hospital in Baquba City, during the period from 15th July 2015 to 14th December 2015. A total of thirty three women presenting with abnormal uterine bleeding who was admitted for total abdominal hysterectomy during the study period. Prepared paper of questionnaire used for patient including full history and examination. Specimens of uterus and adnexa after hysterectomy were sent for histopathalogical study by specialist histopathologist.Results: In this study highest percentage of abnormal uterine bleeding was with age group 46-55years (51.51%), and the lowest percentage with age group 76-85years (3.03%). grandmultiparous had higher percentage (60.61%) while low parity had lowest percentage (9.09%). Fibroid was the most common histopathological findings (42.42%) and the lowest percentage with secretary bleeding (3.03%). The histopathological findings varied with age and parity in hysterectomized specimens and samples.Conclusion: Fibroid constitute the majority of cases that attend our hospital for hysterectomy followed by proliferative endometrium so all patient with abnormal uterine bleeding should be evaluated for underlying structural causes.

خلفية الدراسة: نزف الرحم غير الطبيعي يعد واحدة من أكثر المشاكل شيوعا وتحديا بالنسبة لطبيب النسائية وهي السبب الرئيس عن الكثير من زيارات المرضى لعيادات النسائية .الهدف من الدراسة: تحديد نمط الأنسجة في عينات الرحم المستأصل للنساء اللواتي يعانين من نزف الرحم غير الطبيعي. المرضى وطرائق العمل: أجريت دراسة وصفية في قسم التوليد وأمراض النساء في مستشفى البتول التعليمي في مدينة بعقوبة ، خلال الفترة من 15 تموز 2015 الى 14 كانون الاول 2015 . انظم للدراسة مجموعه متكونة من ثلاثة وثلاثين من النساء اللواتي يعانين من نزف الرحم غير الطبيعي واللواتي ادخلن لأستئصال الرحم. أعدت ورقة الاستبيان لكل مريضة اذ شملت التاريخ المرضي والفحص الكامل.بعد استئصال الرحم وملحقاته ارسلت العينات الى الفحص النسيجي ليتم فحصها بواسطة اخصائي الانسجة .النتائج: أعلى نسبة من نزف الرحم غير الطبيعي كانت مع الفئة العمرية 46-55 سنة (51.51%) بينما اقل نسبة كانت مع الفئة العمرية 76-85 سنة (3.04%), النساء متعددات الولادة كانت لديهن اعلى نسبة من النزف الرحمي غير الطبيعي (60.61%) بينما النساء ذوات الولادات القليلة كانت لديهن اقل نسبة (9.09%). الورم الليفي كانت اكثر نتائج الفحص النسيجي شيوعا في العينات (42.42%) بينما اقل نسبة مئوية كانت مع بطانة الرحم الافرازية ( 3.03%). نتائج الفحص النسيجي تباينت مع التقدم في السن وازدياد عدد الولادات.الاستنتاجات : الورم الليفي يشكل غالبية الحالات التي تحضر إلى المستشفى لاستئصال الرحم تليها بطانة الرحم التكاثرية لذلك يجب أن يتم تقييم كل مريضة تعاني من نزف الرحم غير الطبيعي لمعرفة الأسباب الكامنة ورائها.

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