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Article
Excessive crying in infancy; value of the history and physical examination

Author: Ali Abdul-Razak Obed علي عبد الرزاق عبيد
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 2 Pages: 69-73
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Excessive crying in early infancy is a common condition that causes a great deal of concern to the parents and physician. Objective: The aim of this study is to find the underlying etiology of excessive crying in infancy and to determine how the history, physical examination, and laboratory investigations contribute to the final diagnosis. Method: A prospective study done on 150 afebrile infants less than 4 months of age visited Al-Elwia hospital for children complaining of excessive crying of more than two hours.The study done over a one year period from the first of January 2009 to the end of December 2009.All febrile infants and those with acute illness preceding the onset of crying were excluded from the study. Results: Of 150 afebrile infants with excessive crying 95 cases (63.3%) diagnosed as having idiopathic colic, 55 cases (36.7%) have a secondary underlying disorder.The most common associated disorders include constipation, 12 cases (8%), gastro-esophageal reflux in 9 cases (6%), and feeding problems in 9 cases (6%).Urinary tract infection was the most common underlying serious etiology found in 4 cases (2.7%).History and physical examination contribute to the final diagnosis in 85% of cases. Conclusion: Accurate diagnosis of infants with colic or excessive crying requires a thorough history and physical examination to exclude underlying etiology.Screening laboratory tests apart from urine analysis and culture is of little help.

Keywords

infant --- colic --- excessive crying.


Article
EARLY PRESENTATION OF BILATERAL MORGAGNI HERNIA IN AN INFANT. CASE REPORT

Author: Ahmed Z Zain احمد ازبار زين
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 3 Pages: 299-301
Publisher: Al-Nahrain University جامعة النهرين

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In this report, a rare case of bilateral Morgagni hernia is enlightened in a 7-month old infant weighing 6.5 kg, presented with shortness of breath and fever for 5 days duration. There was a history of the same attack at 2 and 5 months of age and treated as a chest infection. He was admitted to pediatrics emergency unit for investigations and treatment. Plain chest radiography revealed retrosternal bowel herniation and Barrium-enema revealed bilateral big Morgagni hernia .Reduction of herniated contents (transverse colon and omentum) done with repairing of bilateral big Morgagni hernia through transabdominal approach. This case is a very rare and interesting one, because of an early bilateral presentation, and the fact that it occurred in a male infant.


Article
Exclusive Breast Feeding Incidence in the First Six Months of Life and Its Associated Factors

Authors: Hussein Fadhil Musa Aljawadi --- Esraa Abd Al-Muhsen Ali --- Hassan Abd-Alhadi Altimimi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 3 Pages: 62-70
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Healthy nutrition is especially important during the first 6 months of life being the period of exceptionally accelerated growth and high nutrient requirements. The global nutrition target number 5 for 2025 by World Health Organization is to elevate the rate of exclusive breastfeeding in the 1st six months up to 50 percent.Aim of study: to determine the exclusive breastfeeding rate and associated risk factors for the first six months of life in Misan, South East of Iraq.Subjects and Methods: A cross-sectional study with analytical elements. It was conducted in Al-Sader Teaching Hospital during the period from 1st of September 2016 to 1st of March 2017 among randomly selected 500 mothers having infants aged between 7-12months.Results: Exclusive breastfeeding rate was 45.6% and there was a significant association with some factors like residence, previous breastfeeding, maternal health status, education level, employment, the number of babies at delivery and birth order in which the P values were 0.009, 0.0008, 0.0005, 0.033, 0.038, 0.05 and 0.03 respectively.Conclusion: Exclusive breastfeeding rate in Misan was low and it was less than the target of World Health Organization.

Keywords

breastfeeding --- infant --- exclusive --- Misan.


Article
Infant Mortality Rate from 2007-2009 in Falluja City, Western Iraq
معدل وفيات الأطفال الرضع من العام 2007 الى 2009 في مدينة الفلوجة ,غرب العراق

Author: Samira T. Abdulghani, د. سميرة طلفاح عبد الغني
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 1 Pages: 49-51
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Infant mortality is considered one of the most sensitive indicators of the health status of a community. Fallujah lacks accurate information on mortality and related indicators. Reporting of infant deaths is defective. Causes of death in general are grossly misrepresented in death certificates.Objectives: Estimating the IMR in Fallujah city, Al-Anbar governorate, Iraq , during the years 2007, 2008, & 2009.Patients & methods: This is a review of hospital records involving all live births & deaths occurring from the beginning of January 2007 to 31 December 2009. The data were collected from files of patients admitted to the neonatal & children hospital wards during the studied years, from birth & death certificates recorded in the hospital & Fallujah health vital statistics center. Data collected included name, age, sex, residence, place & date of death.Results: The IMR was 75/1000 live births in 2007, 67.4/1000 live births in 2008, & 65.9/1000 live births in 2009. About 83.8% of deaths occur during the neonatal period, & 16.2% in the postneonatal period, the male IMR (89/1000 live births) was higher than female IMR (50.4/1000 live births). The studied dead infants were 52.8% in the rural & 47.2% in the urban areas.Conclusion: IMR didn't show much difference during the 3 studied years this may reflect the fact that there was no much improvement in the social, health economic in addition to the security situation during the studied years.Key words: Infant, mortality rate, Fallujah, Iraq.

الخلاصة: الهدف من هذه الدراسة هو تحديد معدل وفيات الأطفال الرضع للفترة بين بداية عام 2007 وحتى نهاية عام 2009 .ولغرض ذلك تم شمول كافة الولادات الحية والوفيات التي وقعت في مدينة الفلوجة للأعوام الثلاثة ,والتي تم جمع معلوماتها خلال الفترة من 10 شباط الى 20 نيسان 2010 من سجلات المرضى الراقدين في مستشفى الفلوجة ,ومن سجلات الولادات والوفيات في مركز الأحصاء الصحي والحياتي في مدينة الفلوجة.المعلومات الخاصة بالمشمولين تضمنت الأسم , العمر ,محل السكن , مكان وتاريخ الوفاة.معدل وفياة الرضع كانت 75 لكل 1000 ولادة حية عام 2007 , 67.4 لكل 1000 ولادة حية عام 2008 و65,9 لكل 1000 ولادة حية عام 2009. أظهرت النتائج أن 83.8% من الوفيات حدثت في ال 27 يوم الأولى من العمر و16.2% من 28 يوم الى عمر سنة. كما أن معدل الوفيات أعلى قليلا في الريف عنها في المدينة . نستنتج من النتائج أعلاه أنه لا يوجد تغيير كبير في معدل وفيات الرضع من عام 2007 والى نهاية 2009 وذلك يعكس عدم وجود تحسن كبير في الظروف الأجتماعية و المعاشية والصحية والأمنية في المدينة خلال الأعوام الثلاثة.

Keywords

Infant --- mortality rate --- Fallujah --- 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

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
Mortality Rate Among Low Birth Weight Infants in Al- Battool Teaching Hospital , Diyala Province, Iraq

Author: Dawood Salman Hameed Alazzawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 499-503
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:An analytic cross-sectional study through which a review for the records of all patients admitted toneonatal nursery in Al-Battool teaching hospital,Diyala province, Iraq during the first six months of2003 and 2009 were performed.OBJECTIVE:To demnstrate the deterioration of the condition of low birth weight infants.PATIENTS AND METHODS:This study about mortality rate among low birth weight infants who delivered in Al-Battool teachinghospital Diyala governorate including the records of 366 patients admitted during first six months of2003 and compared with records of 558 patients admitted during the same period of 2009. Informationhas been studied extensively for gestational age, birth weight, predisposing factors and mortality.RESULTS:Mortality rate is increased to 30% during 2009, while it was 12% during 2003.Increase percentage of low birth weight infants (28-36wks) during first 6months 2009 (49%), ascompared to first 6 months 2003 (45%).Increase in congenital abnormalities rate (ranging from cleft palate to congenital heart diseases) (42%)on 2009 as compared to (29%) on 2003.Increase number of low birth weight infants to total deliveries at hospital (13.1%) during 2009 ascompared to (11.7%) during 2003.CONCLUSION:High mortality rate, increase percentage of low birth weight infants and increase cases of congenitalabnormalities during 2009, to be studied extensively and thoroughly regarding the environmentalcauses and health services availability.


Article
Mortality Rate Among Low Birth Weight Infants in Al- Battool Teaching Hospital , Diyala Province, Iraq

Author: Dawood Salman Hameed Alazzawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 499-503
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:An analytic cross-sectional study through which a review for the records of all patients admitted toneonatal nursery in Al-Battool teaching hospital,Diyala province, Iraq during the first six months of2003 and 2009 were performed.OBJECTIVE:To demnstrate the deterioration of the condition of low birth weight infants.PATIENTS AND METHODS:This study about mortality rate among low birth weight infants who delivered in Al-Battool teachinghospital Diyala governorate including the records of 366 patients admitted during first six months of2003 and compared with records of 558 patients admitted during the same period of 2009. Informationhas been studied extensively for gestational age, birth weight, predisposing factors and mortality.RESULTS:Mortality rate is increased to 30% during 2009, while it was 12% during 2003.Increase percentage of low birth weight infants (28-36wks) during first 6months 2009 (49%), ascompared to first 6 months 2003 (45%).Increase in congenital abnormalities rate (ranging from cleft palate to congenital heart diseases) (42%)on 2009 as compared to (29%) on 2003.Increase number of low birth weight infants to total deliveries at hospital (13.1%) during 2009 ascompared to (11.7%) during 2003.CONCLUSION:High mortality rate, increase percentage of low birth weight infants and increase cases of congenitalabnormalities during 2009, to be studied extensively and thoroughly regarding the environmentalcauses and health services availability.


Article
12.GOMCO CLAMP CIRCUMCISION IN NEONATES AND INFANTS: A PRELIMINARY EXPERIENCE IN IRAQ

Author: Ali E. Joda علي عكاب جوده
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 2 Pages: 188-197
Publisher: Al-Nahrain University جامعة النهرين

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Background: Circumcision and its complications are one of the most common cases that pediatric surgeons facing in their practice. There are many techniques that have been described to perform it either by the free hand operative methods or with the use of special devices.Objective: To evaluate the results of using Gomco clamp for circumcision as a preliminary experience in Iraq.Methods: A total of 120 babies were subjected to circumcision by this device during the period from April 2014 - November 2015; their age ranges from 7 days - 11 months and they were divided into 3 groups: neonates, infants 1-3 months, infants 4-11 month. By using three different sizes of the clamp, the procedure was performed under local anesthesia in the majority of cases in a form of subcutaneous ring block with aid of sedatives while general anesthesia was given to those cases of coincidental circumcision with other operations. The outcomes of the procedure were assessed after one-month period of follow up.Results: 12.5% of cases were neonates; the average duration of the procedure was 20 minutes. A total complication rate of 9.16% was recorded (11 cases out of 120. The lowest rate of complication (6.6%) was seen in neonates, while the group of infants older than 4 months had the highest complication rate (10%). The most frequent complication recorded was bleeding (36.3% of all complication rate) followed by excess skin, infection, meatitis, epidermal inclusion cyst, no other complications were recorded.Conclusion: Circumcision by Gomco clamp is a safe and simple method with good functional and cosmetic results if performed during neonatal period and early infancy. Choosing the suitable size of the clamp, adequate training and good postoperative care will minimize most of the complications.Keywords: Circumcision, Gomco clamp, neonate, infant, complications.Citation: Ali E. Joda. Gomco clamp circumcision in neonates and infants: a preliminary experience in Iraq. Iraqi JMS. 2017; Vol. 15(2): 188-197. doi: 10.22578/IJMS.15.2.12


Article
The Impact of Mother-Infant Bonding on Periodontal Health Status in the Postpartum Period

Authors: Rula Nabeel Issa رولا نبيل عيسى --- Ban Sahib Diab بان صاحب ذياب
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2018 Volume: 30 Issue: 1 Pages: 76-79
Publisher: Baghdad University جامعة بغداد

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Background: Mother-infant bonding is an important psychological step postpartum and disturbed relationship may carry dramatic consequences as a psychological disorder which may affect the periodontal health of the mother. The aim of the present study was to assess the effect of the postpartum Mother-infant bonding on their periodontal condition.Materials and Methods: Mothers in the postpartum period with age range 20-35 years were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed by measuring probing pocket depth and clinical attachment level.Results: The mean values of both probing pocket depth (PPD) and clinical attachment loss (CAL) were higher among disordered mothers than mothers with normal bonding relationship. The mean percentage of PPD according to different thresholds of severity and CAL (1-2 mm) was higher among the disordered mothers.Conclusion: Mother-infant bonding disorder could influence the periodontal health status of the mother


Article
Infants of diabetic mothers: an Iraqi Teaching Hospital experience
الرضع من أمهات مصابات بالسكري : تجربة مستشفى تعليمي عراقي

Author: Numan N. Hameed نعمان نافع حميد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 3 Pages: 254-256
Publisher: Baghdad University جامعة بغداد

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Background: Despite significantly increased input from multidisciplinary teams during antenatal period, pregnancy outcome from women with type 1, type 2 and gestational diabetes mellitus (DM) remain substantially worse than that of general obstetric population. In Iraq, the true magnitude of infant of diabetic mother (IDM) is not well known as health system has been badly eroded over the period of gulf wars and sanctions.Objectives: to through a light on IDM in the maternity ward and neonatal care unit (NCU) of Baghdad Teaching Hospital, Medical city complex, Baghdad. Patients & Methods: A total of 120 IDM admitted to the maternity ward and (NCU) of Baghdad Teaching Hospital, Medical city complex, Baghdad, Iraq, were included in this descriptive study during the period 1st Jan. 2006 to 1st Jan. 2009. A questionnaire was filled for each neonate, which included maternal and neonatal information. Results were presented in frequencies. Multiple logistic regression was done to identify factors associated with death of IDM.Results: Gestational diabetes was the common type (60.8%), cesarean section was a common mode of delivery (81.7%) and (84.2%) of mothers got antenatal care visits. Regarding the neonates, prematurity was observed in (26.7%), macrosomia in (26.7%), hypoglycemia in (56.8%), hyperbilirubinaemia in (26.1%),congenital anomalies in (12.5%) and Sepsis in (11.4%) of the neonates. Mode of delivery and prematurity significantly affect the death of neonates (p = 0.036 and 0.0008), while parity, type of DM, and birth weight were not significantly affecting the outcome of IDM.Conclusions: High rates of hypoglycemia , Hyperbilirubinemia, prematurity, congenital anomalies and macrosomia were reported. The mode of delivery and prematurity significantly affect the death of IDM. Better perinatal care of mothers and their IDM with tighter preconceptual glycemic control is likely to reduce the prevalence of reported complications and death and improve the outcome for IDM.

الخلاصة:الخلفية : على الرغم من إدخال زيادة كبيرة من الفرق المتعددة التخصصات خلال الفترة السابقة للولادة ،فان نتيجة الحمل من النساء مع نوع 1 ،و نوع 2 داء السكري و السكري أثناء الحمل لا تزال أسوأ بكثير من عدد الولادات العامة. وفي العراق ، فإن الحجم الحقيقي لوفيات الرضع من الأمهات المصابات بالسكري (IDM) ليست معروفة جيدا لان النظام الصحي تآكل بشدة خلال فترة حرب الخليج والعقوبات.الأهداف : لتسليط الضوء على IDM في جناح الأمومة و وحدة الرعاية لحديثي الولادة (NCU) في مستشفى بغداد التعليمي ، مدينة الطب ، بغداد.المرضى والطرق: شملت هذه الدراسة ما مجموعه 120 IDM ادخل إلى جناح الولادة وNCU في مستشفى بغداد التعليمي ، مدينة الطب ، بغداد ، العراق . وأجريت هذه الدراسة الوصفية خلال الفترة من 1 يناير 2006 إلى 1 يناير 2009 :. وقد شغل الاستبيان كل وليد ، والتي اشتملت على معلومات الأمهات والأطفال حديثي الولادة. وعرضت النتائج في الترددات. وقد اجري الانحدار اللوجستي المتعدد لتحديد العوامل المرتبطة بوفاة IDM.النتائج: لقد كان السكري الحملي أكثر الأنواع شيوعا (60.8 ٪) ، و العملية القيصرية كانت أكثر أنواع طرق الولادة شيوعا(81.7 ٪) و (84.2 ٪) من الأمهات قامت بزيارات الرعاية قبل الولادة .فيما يتعلق الولدان ، لوحظ الخداج في (26.7 ٪) ، العملقة في (26.7 ٪) ، نقص السكر في الدم في (56.8 ٪) ، اليرقان الولادي في (26.1 ٪) ، التشوهات الخلقية في (12.5 ٪) والإنتان في (11.4 ٪) من الولدان. وكانت طريقة الولادة والخداج تؤثر تأثيرا كبيرا على وفاة حديثي الولادة (P = 0.036 و 0.0008) ، بينما الولادات المتكررة للأمهات ، ونوع السكري، و الوزن عند الولادة لم تؤثر بشكل كبير على نتائج IDM.الاستنتاجات :لقد وجدت معدلات عالية من نقص السكر في الدم ، فرط بيليروبين الدم والخداج ، التشوهات الخلقية والعملقة .إن نوع الولادة والخداج قد اثر تأثيرا كبيرا على وفاة IDM. و إن تحسين الرعاية ما حول الولادة للأمهات وIDM مع تشديد الرقابة حول نسبة السكر في الدم من المرجح أن تحد من انتشار المضاعفات و الوفيات المبلغ عنها وتحسين النتائج لIDM.

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