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Article
Cortical blindness in preeclampsia (case report)

Author: Baheej Y. Mohammed بهيج ياسين محمد
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2005 Volume: 31 Issue: 2 Pages: 97-99
Publisher: Mosul University جامعة الموصل

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Abstract

Bilateral infarction in the distal posterior cerebral arteries produces cortical blindness (blindness with preserved pupillary reaction). The patient is often unaware of the blindness or may even deny it (Anton's syndrome, which is a form of anosognosia due to compromize of the visual association centre)(1,2). Tiny islands of vision may persist, and the patient may report that vision fluctuates as images are captured in the preserved portions(1). Preeclampsia is associated with abnormalities of cerebral circulatory autoregulation, which increase the risk of stroke at near normal blood pressures(3). During focal brain ischemia, a gradation in brain perfusion exists such that a core of tissue is infarcted within minutes but a shell of surrounding tissue is only marginally ischemic. This ischemic penumbra may progress to infarction within minutes to hours(4).

Keywords

Blindness --- preeclampsia


Article
Asymmetric Dimethylarginine (ADMA) level in Serum of Preeclamptic patients

Author: Faisal Gh. Al-Rubaye* MBChB, MSc, PhD د. فيصل غازي الربيعي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 446-448
Publisher: Baghdad University جامعة بغداد

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Summary:Background: Preeclampsia, the de novo occurrence of hypertension and proteinuria after the 20th week of gestation, continues to exert an inordinate toll on mothers and children alike.The idea that asymmetric dimethylarginine (ADMA) accumulation may be a cardiovascular risk factor in patients with preeclampsia was advanced in 2003. Furthermore, High ADMA levels have been associated with alterations in the regulation of cerebral blood flow and neural function, with insulin resistance, thyroid dysfunction, and alterations in bone homeostasis, fertility, and erectile function. Subject and methods: the present study is a cross-sectional case-control study includes measurement of s.ADMA in 60 patients with preeclampsia. The results were compared with 60 apparently healthy pregnant women (as controls). Results: showed a significant increase in serum ADMA in the preeclamptics as compared with the controls this was accompanied by a significant reduction of this parameter with advancing gestational age in normal pregnancy. Conclusion: preeclamptics (in different gestational age groups) experienced vasospasm induced by inhibition of nitric oxide (which consider the natural vasodilator) when compared with healthy pregnant women matched with their age and gestational age; this was supported by the significant high level of s. ADMA, the endogenous inhibitor of NO .Key words: preeclampsia, asymmetricdimethylarginine.


Article
Prevention of preeclampsia using low dose Aspirin: A randomised controlled trial
الوقاية من تسمم الحمل باستخدام جرعة صغيرة من الأسبرين: باختبار عينة عشوائية

Author: Aseel Mosa Jabber اسيل موسى جابر
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2016 Volume: 6 Issue: 1 Pages: 39-44
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

Objectives: To test the effectiveness of aspirin in low doses to prevention PE in high risk . Study design: Prospective randomized controlled double blind trial. Setting: Department of Obstetrics & Gynaecology, Al-Habobi teaching hospital, Thi-qar province/Iraq. Patients and methods: 100 participants at high risk of developing preeclampsia were randomly divided into 2 groups. Group I involved 50 pregnant women who received acetyl salicylic acid 75 mg/ day. Group II included 50 pregnant women who received placebo. Primary outcomes included gestational hypertension and pre-eclampsia. Secondary outcomes included development of eclampsia, HELLP syndrome, placental abruption, IUGR, NICU admission, neonatal complications and congenital anomalies. Results: The incidence of preeclampsia was 22% in the Aspirin group and 44% in the control group (P <0.001). A highly significant difference was found when comparing the two groups regarding gestational age at delivery (37.8±1.9 vs. 33.2±3.2 ), development of PE (22% vs. 44%) particularly early onset (14% vs. 34%) and severe form (8 vs. 22%) and occurrence of HELLP syndrome (4 vs. 16%) respectively (P <0.001) . There was a significant difference between cases and controls regarding the development of gestational hypertension (14% VS. 22%) (P 0.05) .There was a significant improvement of neonates delivered to mothers who received aspirin proved by the presence of significant higher birth weight (2989±815 vs. 2062±976), lower occurrence of IUGR (10% vs. 24%), neonatal ICU admission (34% vs. 78%) and respiratory distress syndrome (20% vs. 60%). Conclusion: the use of low-dose aspirin is of significant importance in reducing the risk of gestational hypertension, pre-eclampsia and IUGR in high risk women.

ألهدف: لاختبار فعالية الأسبرين بجرعات منخفضة لمنع PE تحت عوامل خطورة عالية. طرائق ألعمل: اجريت الدراسة في قسم التوليد وألامراض النسائية في مستشفى الحبوبي التعليمي في محافظة ذي قار/ العراق. شملت الدراسة 100 مشاركة في خطر كبير من تسمم الحمل تم تقسيمهن عشوائيا إلى مجموعتين. المجموعة الأولى من 50 امرأة حامل حصلوا على أسيتيل الساليسيليك بجرعة 75 ملغ / يوم. تضمنت المجموعة الثانية 50 امرأة من النساء الحوامل الذين تلقوا العلاج الوهمي. وشملت النتائج الأولية ارتفاع ضغط الدم الحملي وتسمم الحمل. وشملت النتائج الثانوية تطور تسمم ألحمل متلازمة هيلب، انفصال المشيمة ألباكر تأخر النمو داخل ألرحم وقبول نيكو , مضاعفات حديثي الولادة والتشوهات الخلقية. ألنتائج: كان معدل حدوث تسمم الحمل 22٪ في مجموعة الأسبرين و 44٪ في المجموعة الضابطة تحت مستوى احتمالية (P <0.001). تم الحصول على فرق معنوي كبير للغاية عند المقارنة بين المجموعتين فيما يتعلق بعمر الحمل عند الولادة (37.8 ± 1.9 مقابل 33.2 ± 3.2)، وتطور PE (22٪ مقابل 44٪) ولادة مبكرة وخاصة (14٪ مقابل 34٪) و شكل حاد (8 مقابل 22٪) وحدوث متلازمة هيلب (4 مقابل 16٪) على التوالي (P <0.001). كان هناك فرق معنوي بين الحالات السريرية ومجموعة السيطرة فيما يتعلق بتطور وارتفاع ضغط الدم الحملي (14٪ مقابل 22٪) (P 0.05) كما حدث تحسنا كبيرا لحديثي الولادة الذين ولدوا للأمهات اللاتي حصلن على الأسبرين من خلال زيادة اوزان المواليد عند الولادة مقارنة بالمجموعة الاخرى (2989 ± 815 مقابل 2062 ± 976) مع قلة حدوث حالات تأخر النمو داخل الرحم (10٪ مقابل 24٪)، و دخول حديثي الولادة الى وحدة العناية المركزة (34٪ مقابل 78٪) ومتلازمة الضائقة التنفسية (20٪ مقابل 60٪) . ألاستنتاج: استخدام جرعة منخفضة من الاسبرين له أهمية كبيرة في الحد من مخاطر ارتفاع ضغط الدم الحملي، تسمم الحمل وتأخر النمو داخل الرحم عند النساء اللاتي يتعرضن الى مخاطر عالية لتطور هذه الحالات.

Keywords

Preeclampsia --- Aspirin


Article
Electron Microscopic Study of the Effects of Preeclampsia on the Placental Endothelial Cells Ultra Structures during Pregnancy

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Abstract

Background: Preeclampsia occurs in 3-5% of pregnancies and is a major cause (12-20 %) of maternal mortality in developed countries. It is the leading cause of preterm birth and intra-uterine growth restrictions (IUGR). Objective: The study was designed to determine and demonstrate the ultra structural changes of endothelial cells in placenta of women suffering from hypertensive disease. Patients & Methods: Placental samples were obtained from two groups of pregnant women groups (preeclamptic and normal pregnant women). The specimens were fixed in 2.5% gluteraldehyde and preceded for electron microscopic examination. Results: Placenta of women with preeclampsia has shown marked degenerative changes in both endothelial and trophoblastic cells. These changes were represented by precipitation of fibrin with the accumulation of platelets in capillary lumen. Abundance of collagen fibers precipitate in the apical region of both endothelial cells and trophoblasts, with thickening of endothelial basement membrane.Conclusion: All histological changes or lesions obstruct the continuous conduction from maternal surface of the trophoblasts through fetal capillary endothelium causing endothelial dysfunction.


Article
Evaluation the levels of Plasma Interleukins (IL-8, IFN-م, IL-10) in Preeclamptic Pregnancies
تقييم مستوى الحركيات الخلوية في بلازما النساء ذوات مقدمة الارتعاج

Authors: Abbass M.Rahmah عباس مهدي رحمة --- Amna N.Jassim آمنة نصيف جاسم --- Suaad A. Brakhas سعاد الماس براخاس
Journal: Baghdad Science Journal مجلة بغداد للعلوم ISSN: 20788665 24117986 Year: 2011 Volume: 8 Issue: 4 Pages: 918-925
Publisher: Baghdad University جامعة بغداد

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Abstract

This study is to evaluate plasma levels of several cytokines in preeclamptic pregnancies compared to those of healthy pregnancies.Ninety pregnant women with preeclampsia (37 mild & 53 severe) and thirty healthy pregnant women were enrolled in the study. Blood samples were taken and plasma levels of IL-8, IL-10, and IFN-γ were measured by enzyme-linked immunosorbent assay (ELISA).Preeclamptic women and their severe cases but not mild cases had significantly (P<0.05) increased levels of plasma IL-8, and IFN-γ as compared with healthy pregnancies. By contrast, plasma levels of IL-10 was significantly (P<0.05) increased in healthy pregnant women as compared to all groups of preeclampsia. Preeclampsia is associated with an imbalance between pro-inflammatory cytokines (IL-8, IFN-γ) and anti-inflammatory cytokines (IL-10), and these support our suggestion of altered immune response in preeclampsia.

تضمنت هذه الدراسة تقييم مستويات كل من الحركيات الخلوية γ IL-8, IL-10, IFN- في بلازما النساء العراقيات المصابات بمقدمة الارتعاج, شملت هذه الدراسة 120 امراة حامل قسمت الى اربعة مجاميع:المجموعة الاولى : مجموعة النساء ذوات مقدمة الارتعاج المعتدل (37) المجموعة الثانية : مجموعة النساء ذوات مقدمة الارتعاج الشديد (53) المجموعة الثالثة : مجموعة النساء ذوات مقدمة الارتعاج الكلي (90)المجموعة الرابعة : مجموعة النساءالسليمات كسيطرة (30) اظهرت نتائج الدراسة الحالية ارتفاع معنوي (P<0.05) في مستوى الحركيات الخلوية IL-8,IFN-γ في البلازما في المجموعة الثانية والثالثة مقارنة بالمجموعة الاولى و الرابعة وكذلك ارتفعت معنويا (P<0.05) مستوى IL-10 في بلازما النساء الحوامل السليمات (مجموعة السيطرة) مقارنة بمجاميع المرضى الثلاث .نستنتج من خلال الدراسة الحالية اختلاف في مستوى الحركيات الخلوية في بلازما النساء المصابات بمقدمة الارتعاج الشديد مما يؤكد الاختلاف في الاستجابة المناعية لهؤلاء النساء.


Article
Plasma level of atrial natriuretic peptide during normal pregnancy and preeclampsia

Author: Abdul-Aziz A. Aziz عبد العزيز احمد عزيز
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2005 Volume: 31 Issue: 1 Pages: 1-5
Publisher: Mosul University جامعة الموصل

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Abstract

objective: To assess plasma atrial natriuretic peptide (ANP) level in pregnant and
preeclamptic women, and to evaluate the role of this hormone in the defense mechanism
against body fluids and electrolytes disorders encountered under such physiological
and pathophysiological conditions.
Design: A case- series study.
Setting: Al - Batool Teaching Hospital for Gynecology and Obstetrics, Mosul, during the period from December 2003 to September 2004.
Participants: Twenty five women with normal pregnancy (group I ), 25 pregnant women with
preeclampsia (group ll ) and 25 healthy non pregnant women (control group) were included in this study.
Methods: Plasma ANP, serum creatinine, urea, sodium and potassium were measured in all
groups. unpaired -t-test was used to examine the difference in the mean of the studied
parameters between different groups. Pearson correlation was used to assess the relation
between different parameters within each group.
Results: The mean of plasma ANP level was significantly higher in group I (p<0.05) and group
ll (p<0.0001) than that in the control group. Furthermore, the plasma ANP level was
significantly higher in group ll (p<0,0001) than that in group l. The mean of serum creatinine
and serum urea were significantly higher in group ll than that in group l (p<0.005 and p<0.0001) and control group (p<0.0001 and p<0.0001).
Conclusion: The results of this study indicate that plasma ANP level significantly increases
during pregnancy especially among those who develop preeclampsia. Since ANP plays an
important role in the maintenance of body fluids and electrolytes homeostasis and blood
pressure regulation, estimation of plasma ANP level may be of value in better understanding
and management of pathophysiological conditions that challenge the body homeostatic
mechanisms during pregnancy.
Key words: Atrial natriuretic peptide, preeclampsia.


Article
Serum Concentration of Vitamin D in Preeclampsia

Author: Faisal Gh. Al-Rubaye
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 220-223
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Preeclampsia, the de novo occurrence of hypertension and proteinuria after the 20th week of gestation, continues to exert an inordinate toll on mothers and children alike. Vitamin D, on the other hand, has direct influence on molecular pathways proposed to be important in the pathogenesis of preeclampsia, yet the vitamin D-preeclampsia relation has not been studied.OBJECTIVE:To assess the vitamin D status of preeclamptic women in different gestational period with respect to normal pregnancy.PATIENT AND METHODS: the present study is a cross-sectional case-control study (2008-2009) At Al-Kadhimiya Teaching Hospital. Includes measurement of serum vitamin D3 in 60 patients with preeclampsia who were classified into two groups according to the gestational age:o Preeclamptics in the second trimester G1: (n=30).o Preeclamptics in the third trimester G2: (n=30,).The results were compared with 60 apparently healthy pregnant women (as controls). They were classified according to the gestational age into two groups:o Pregnants in the second trimester G3: (n=30).o Pregnants in the third trimester G4: (n=30).RESULTS:Showed a significant decrease in serum vitamin D3 in the preeclamptics as compared with the controls (p < 0.001)this was accompanied by a significant reduction of this parameter with advancing gestational age in both preeclamptic and healthy pregnents.CONCLUSION:Preeclamptics (in different gestational age groups) experienced hypovitaminosis D when compared with healthy pregnant women matched with their age and gestational age; this can be explained partly by the reduction of insulin–like growth factor which has a stimulatory effects on vitamin D3 and partly explained on genetic defects affecting fetoplacental unit.The above results were supported by the significant low level of s. vitamin D3; which call for the need for vitamin D supplementation in pregnancy.

Keywords

preeclampsia --- vitamin D.


Article
SERUM LEPTIN LEVEL IN SEVERE PREECLAMPSIA

Authors: Maad M Shalal معد مهدي شلال --- Anwar N Al Bassam انوار نوري البصام --- Isra T Hassan اسراء طالب حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 2 Pages: 144-147
Publisher: Al-Nahrain University جامعة النهرين

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Background:Preeclampsia is a major cause of maternal morbidity and mortality with unknown aetiology. Placental hypoperfusion and diffuse endothelial cell injury are considered the central pathological process. Many adipocyte hormones like leptin play an important role in the inflammatory and atherosclerotic process and may be used as a marker for preeclampsia.Objective:To find the role of serum leptin measurement in pregnant women as a marker of preeclampsia.Methods:Seventy six primigravida women in their 3rd trimester of pregnancy were studied; 44 of them with severe preeclampsia, while the other 32 women with normal blood pressure without any history of previous diseases. Blood samples were taken for serum leptin, uric acid and creatinine levels, urine samples were collected for albumin. Serum leptin level was measured by ELISA kits.Result:Serum leptin and uric acid levels but not the creatinine was different in eclamptic group than control group. Mean age, height and weight were not different between the two groups. The systolic and diastolic blood pressures were also different between the two groups. 26 cases (59.1%) had proteinuria of 3+ albumin and 18 cases (40.9%) with 4+.Conclusion:Elevated serum leptin level can be used as a marker in the assessment of preeclampsia.Key words:Primigravida, preeclampsia, serum lipten.


Article
Risk Factor Of Preeclampsia In Najaf Governorate
عوامل الخطورة قبل الارتعاج في محافظة النجف

Authors: Dhaferah Jaafar Abd-Ali --- Majid khadum Hussein --- Zahraa Sami Razzaq
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 2 Pages: 13-19
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objective :It aim to study some of the risk factors and a association Preeclampsia Methodology :The present study was carried out in the Department of at Azzahra Teaching hospital in najaf governorate period from December 2012 to March 2013. Sixty preeclampsia pregnant women and forty healthy pregnant women as control group .Results:The results present study of preeclampsia in showed a significant increase (P ≤ 0.01) in patients (42%) in group age (25-34) years when compared with the other group. where the results found a significant ( P <0.01) percentage (77.5%) of Preeclampsia occurred in group (33-39) weeks.and in the patients with previous history for Preeclampsia significant( P<0.001) with compared healthy pregnant , pregnant with preeclampsia had familial history significant 0.01% percentage 62% and significant( P<0.01) percentage 33% of them had had no children where 8% of pregnant with preeclampsia had diabetes mellitus. Conclusion: Maternal age and Gestational age affect in pathogenesis of preeclampsia ,previous history & family history and parity as important determent risk factor of preeclampsia . Recommendation Risk factor of PE adopted in this study should be considered in counseling pregnant woman regarding PE and should aid in early detection of the abnormal signs and symptoms of PE in particular, responsible for the perinatal mortality and maternal morbidity and mortality.

الهدف: تهدف الدراسة الحالية الى ربط بعض عوامل الخطورة مع الإصابة بقبل الارتعاج المنهجية : اجريت الدراسة الحالية في مستشفى الزهراء التعليمي في محافظة النجف من كانون الأول 2012 ولغاية آذار 2013 وتضمنت الدراسة ستين امراءة حامل مصابة بقبل الارتعاج مع اربعين حامل كمجموعة سيطرة وقد حللت النتائج إحصائيا باستخدام برنامج SPSS وقد استخدمت النسب المئوية وفحص الطالب T –test النتائج :بينت نتائج الدراسة الحالية زيادة معنوية (P≤0.01) في النساء المصابات بقبل الارتعاج (42%) في الفئة العمرية ( 25-34) سنة عند مقارنتها مع الفئتين العمريتين الأخريتين, بينما اوضحت النتائج ان هناك زيادة معنوية (P<0.01) للنسبة مئوية للإصابة بقبل الارتعاج (77.5%) في عمر الحمل ( 33-39) أسبوعاً و ان الإصابة السابقة لدى الحامل لها زيادة معنوية( P<0.001) بالمقارنة مع الحوامل السليمات في حين اظهر التاريخ العائلي لقبل الارتعاج أهمية معنوية P<0.01) ) وقد وجدت النتائج ان المصابات اللاتي لديهن تاريخ عائلي للإصابة لهن فرق معنوي(( P<0.01 للنسبة 62 %, اما الحوامل المصابات في الحمل الاول ) ليس لديهن اولاد( فقد اظهرت زيادة معنوية( P<0.01 ) للنسبة 33% من العينة الكلية في حين لم تكن هناك أهمية معنوية لتأثير السكر في الإصابة بقبل الارتعاج فقد شكلت المصابات بقبل الارتعاج والسكري بنسبة (8% الاستنتاجات: إن عمر الحامل وعمر حملها يؤثران في الإصابة بقبل الارتعاج, وان الإصابة السابقة لقبل الارتعاج والتاريخ العائلي وانعدام الولادات السابقة تعد مهمة لتحديد عوامل الخطورة للإصابة بقبل الارتعاج.التوصيات: وينبغي النظر الى عوامل الخطر لما قبل الارتعاج التي اعتمدت في هذه الدراسة الى تقديم الاستشارة للمرأة الحامل ويجب أن تساعد في الكشف المبكر عن علامات وأعراض غير طبيعية لقبل الارتعاج على وجه الخصوص إنها مسؤولة عن وفيات قبل الولادة والوفيات النفاسية.

Keywords

preeclampsia --- risk factors


Article
Assessment of Plasma FXII:C in pregnant women with severe preeclampsia

Authors: Alaa F.Alwan --- Alauldeen M. Zubair --- Shaymaa W. Salman
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 79-84
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background:Preeclampsia is a complication of pregnancy constituting a major cause of both maternal and fetal morbidity and mortality. Pregnancy is a hypercoagulable state with changes in procoagulant, anticoagulant, and fibrinolytic systems. In preeclampsia, there is a shift in the haemostatic balance towards a pro-thrombotic state, together with changes in endothelial function. It is a state of enhanced coagulation as evidenced by an increased amount of clotting factors in maternal circulation.Aim of the study:•To study the changes in FXII:C activity in pregnant women suffering from severe preeclampsia, and compared with healthy normotensive pregnant women.•To correlate its level with the severity of preeclampsia.Patients and Methods: Thirty five pregnant women in the third trimester of pregnancy with severe preeclampsia were collected from the Department of Obstetrics and Gynaecology in AL-Yarmouk Teaching Hospital from July to October 2010. Their age range is 18-41 years. The criteria for severe preeclampsia included sustained blood pressure of 160/110 mmHg or higher with persistent proteinuria of 2+ or greater on urine dipstick. A total of thirty five healthy pregnant women who were not in labour, their age and gestational age matched with the patients and normotensive throughout gestation were included as a control group. Blood samples were taken from both groups. Four ml of citrated plasma was isolated for PTT, and FXII:C assay [by parallel line bioassay of coagulation factors].Results: There was significant difference in mean PTT between patients with severe preeclampsia (27.17±4.11) and control group (31.40±4.53). (P value < 0.0001).There was significant difference in mean FXII:C between patients with severe preeclampsia (173.29±8.82) and control group (131.85±9.78). (P value < 0.0001).Conclusions: Factor XII:C was significantly increased in patients with severe preeclampsia than control group and show significant direct linear correlation with the severity of preeclampsia. Activated Partial Thromboplastin Time was significantly shorter in patients with severe preeclampsia than control group.

Keywords

factor XII --- preeclampsia

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