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Article
Abdominal Transperitonial Approach in Management of Vesicovaginal Fistula in Iraqi Patients

Author: Mohammed Jabbar AL-Rubai
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 238-241
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Vesicovaginal fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina In addition to the medical sequel; they often have a profound effect on the patient's emotional well-being and social life. OBJECTIVE: Is to evaluate success of abdominal approach in treating vesicovaginal fistula in Iraqi patients. METHODS: Retrospective comparative study was carried out on fourteen Iraqi patients suffering from vesicoveginal fistula according to inclusion criteria and followed for 3-12 months after tranabdominal repair with omental interposition flap. RESULTS: Twelve (85%) patients have obstetrical causes while two (15%) patients have gynecological causes. Eight (75%) patients aged between 21-30 years while six (43%) patients aged between 31-45 years. Eight (57%) patients are primigravidae. Site of fistula either spratrigonal[seven cases (50%)] or infratrigonal [seven cases (50%)]. Only one of infratrigonal fistula is close to ureteric orifice. Size of fistula either <1cm [seven cases (50%)] or between 1-2 cm [five cases (36%)] or between 2.1-3 cm [two cases (14%)]. Twelvecases (85%) have correct repair. CONCLUSION: The results of suprapubic closure of a vesicovaginal fistula are very good


Article
The shear bond strength of an immediate and delay repaired light-cure composite restoration (In vitro study)

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Background: Defects in composite resin restoration whether discovered at the time of placement or associated withold composite resin restoration could be repaired without replacing the entire restoration. This in vitro study wasconducted to determine and compare the shear bond strength of an immediate and delay repaired light curedcomposite restoration.Materials and methods: Eighty acrylic blocks (25x25x15 mm) were constructed from cold cure acrylic resin; each onecontained an acrylic hole (6mm diameter and 3mm depth) that filled with Helioprogress composite resin. The surfacelayer of the composite resin samples was light cured through plastic strip, abraded by finishing discs and rinsed withdeionized distilled water for 15 sec. The eighty specimens were divided randomly into two groups according to thestorage time in deionized distilled water before the repair:Group I: Stored for 15 min. (Immediate repair group)Group II: Stored for 1week. (Delay repair group)Both groups were subdivided into 4 subgroups according to the surface treatment they received:Subgroup 1: No surface treatment (control)Subgroup 2: 37% phosphoric acid etchant (15 sec.)Subgroup 3: Heliobond (light activated for 20 sec.)Subgroup 4: 37% phosphoric acid and Heliobond.Repair was done by using a standardized translucent plastic straw (3mm diameter and 6mm length) and was filledHelioprogress composite resin and light cured for 40 sec. in four directions. All the specimens were stored in deionizeddistilled water for 24 hr. testing was done by the Zwick testing machine by applying shearing force with speciallydesigned chisel-shape rod. Data obtained were statistically analyzed using analysis of variance test and t-test.Results: The results showed very highly significant difference between the similar subgroups in group I vs. group II andthere was non-significant difference between subgroup 1 vs. 2 and between subgroup 3 vs. 4.Conclusion: Delaying the repair procedure for 1 w resulted markedly reduced the bond strength, the surfacetreatment with 37% phosphoric acid slightly reduced the bond strength in the immediate repair while slightlyincreased it in the delay repair, Furthermore, the surface treatment with Heliobond fifth generation bonding agentmarkedly increased the bond strength in both repairs.

Keywords

Repair --- composite --- shear bond


Article
LABORATORY INVESTIGATION OF SHEAR REPAIR OF REINFORCED LIGHTWEIGHT AGGREGATE CONCRETE BEAMS WITH STIRRUPS
الفحوصات المختبرية للقص لاعادة تأهيل العتبات الكونكريتية المسلحة الخفيفة الوزن بوجود تسليح الاتاري

Author: Mu’taz Kadhim Medhlom
Journal: Journal of Engineering and Sustainable Development مجلة الهندسة والتنمية المستدامة ISSN: 25200917 Year: 2015 Volume: 19 Issue: 6 Pages: 30-43
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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:The structural rehabilitation of reinforced lightweight aggregate concrete beams in shear was studied with resin injection. A series of model beams, reinforced in shear, were loaded in the laboratory until failure, repair and again loaded to failure .The variables in the test program were shear span-to-depth ratio 4.0,3.0,2.5,2.0,1.5 and 1.0 ; and shear reinforcement index ,ρvfy= 0.493,0.704 and 0.896 MPa .Experimental failure loads are compared with predictions using ACI 318M-02 code and the modified compression field theory by the program of “Response 2000” .After testing ,the beams failed due to new diagonal cracks .The ratio of ultimate load to crack load varies from 1.5 for a/d >2 to 2.27 for a/d ≤ 2 (deep beams) .Test results indicate the ACI 318M-02 is conservative .

: المنشأت الخرسانية المسلحة الخفيفة الوزن المهدمة بأجهادات القص تم دراسة أعادة التأهيل بواسطة أستخدام طريقة الحقن .عدة مجاميعمن العتبات المسلحة بالقص تم تحميلها بالمختبر لغاية الفشل ثم تم تصليحها وتحميلها للفشل .تم دراسة المتغيرات التالية : نسبة فضاء القص الىالعمق 1.0,1.5,2.0,2.5,3.0,4.0 وكذلك دليل تسليح القص وكانت القيم MPa 0.493 , 0.704 , 0.896 تم مقارنة النتائج المختبريةمع قيم معادلة الكود الامريكي وبرنامج (Response 2000) بعد أجراء الفحوصات تبين أن العتبات تفشل بتشقق قطري جديد وأن نسبة الحملألاقصى الى حمل التشقق يتغير من 1.5 عندما a/d >2 الى القيمة 2.27 عندما a/d ≤2 للعتبات العميقة . النتائج تبين ان القيم المستخرجة مناستخدام طريقة ACI 318M-02 هي اكثر دقة


Article
Splenic Injuries atAl-Kadhimiya Teaching Hospital

Authors: Nahidh A. Abdulshaheed ناهد عداي عبد الشهيد --- Anees K. Nile انيس نايل --- Hikmat A. Hatam حكمت حاتم
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2009 Volume: 5 Issue: 1 Pages: 83-90
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The spleen is the most common solid organ injured in patients who had sustained abdominal trauma. Such injuries to the spleen represent approximately one quarter of all blunt injuries of the abdominal viscera.Due to its remarkable vasculature and its fragile structure, splenic rupture is the most widespread cause of intra-abdominal hemorrhage.Objective: To assess the magnitude of splenic injury, the management of splenic injury, and to evaluate the postoperative complications.Methods: A prospective study of 57 cases of splenicinjury was performed in Al-Kadhimiya TeachingHospital during the period between the 1st of October2004 and the 1st of October 2006. Statistical analysiswas then performed to identify the causes, managementand postoperative complications. Splenic injuries weregraded into 5 grades.Results: The highest incidence of splenic injury was recorded in age group s31-40 year. Penetrating injury was much more common than blunt trauma (73.68% versus 26.31%).Fifty patients (87 %) were diagnosed by exploratory laparotomy, ultrasonography in 5 patients (8.77 %), CT scan was positive in 2 patients (3.5 %). Associated injuries were recorded in 41 patients 71.92%. Pulmonary complications were the most frequent complications (18 patients, 31.57 %).Conclusion: Splenic injuries are common surgical problems in Al-Kadhimiya Teaching Hospital. Still there are many difficulties in establishing the diagnosis of the splenic injury with shortage in the new diagnostic modalities especially (CT -Scan, MR1 and even U/S scan) in the emergency situations.In spite of the dangerous post-operative complications of splenectomy, it is still the most commonly performed surgical procedure in cases of splenic injury.

Keywords

Spleen --- Splenic Injury --- Splenectomy --- Repair


Article
Shoelace Darn Repair of Abdominal Incisional Hernias

Author: Talib A. Majid
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 198-202
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Abdominal incisional hernias are a common condition in practice. Numerous surgical procedures have been used to repair them with different results.OBJECTIVE:This study aims to find the place of shoelace darn in the repair of incisional hernias.METHOD:One hundred patients with abdominal incisional hernias have been managed by a shoelace darn repair., The details of the operative technique have been described.RESULTS:shoelace darn repair was an easy procedure associated with some complications, and followed by recurrence in 4 patients. The age, sex, clinical presentation, the type of previous surgery, the type of incisional hernia, the body built of the patients were discussed .CONCLUSION:Shoelace darn repair have got a good place in managing abdominal incisional hernias


Article
Tension –Free Inguinal Hernia Repair Comparing 'Mesh' with 'Darn' A Prospective Randomized Clinical Trial

Authors: Ali M.Al-Saiegh --- Raad S. Al-Saffar --- Haider T. Al-Khassaki***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 220-227
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Lichtenstein tension free hernioplasty(mesh repair) and Moloney darn repair are commonly practiced repairs for inguinal hernias with acceptably low recurrence rates. Mesh repair is considered more recent than darn repair and both of them are tension free.OBJECTIVE:To compare the number of postoperative complications and early recurrence between Mesh repair and Darn repair, for inguinal hernia.PATIENTS AND METHODS:The study was conducted at Department of Surgery, Al-Sadur teaching hospital in An-Najaf from 1st august 2007 to 1st august 2008 . A total of 104 patients were selected. 51 patients were treated with Lichtenstein tension free hernioplasty (Group A) and 53 with Darn repair (Group B). Cases were followed up for three months to one year. The study design was quasi experimental.RESULT:The male to female ratio was 51:1. The mean hospital stay was 37.18 hours in group A and 47.17 hours in group B. there was statistically significant difference between the groups ( p< 0.05).The mean operative time was 44.7 minutes in group A and 50.9 minutes in group B. There was statistically significant difference between the groups ( p< 0.05). the The total number of postoperative complications was reported in 36 patients, 15 ( 29.42%) complications occurring in group A and 21( 39.62%) in group B. Scrotal swelling was the most common complication followed by urinary retention and wound infection in both study groups. Postoperative complications like scrotal swelling ( 11.77% vs. 16.98%), haematoma ( 5.88% vs. 3.77%), urinary retention (5.88% vs. 9.43%), wound infection ( 1.96 vs. 7.55%) and scar pain ( 3.92% vs. 1.89%) were unsignificantly low in Lichtenstein tension free hernioplasty as compared to Darn repair (P > 0.05). There were no recurrences noted till date in any of the two groups under study.CONCLUSIONOpen inguinal hernia repair with a nylon darn was equivalent to polypropylene mesh with respect to early measures of postoperative outcome and recurrence at 1 year. The mesh was superior to darn in operative time and hospital stay

Keywords

inguinal hernia --- mesh --- darn --- repair.


Article
3- OUTCOME OF LARGE INCISIONAL HERNIA REPAIR WITH POLYPROPYLENE MESH

Authors: Safwan A Taha --- Mazin H Alhawaz --- Nezar A Almahfooz --- Sadiq Galib Kadum
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 8-19
Publisher: Basrah University جامعة البصرة

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Incision hernia remains a frequent complication of abdominal surgeries with a reportedincidence of (2-20%). Repair of large incision hernia is a difficult surgical problem with short andlong term complications, severity of these complications are related in part to the type ofoperative technique adopted.The aim of this study is to evaluate the outcome of repair of large incision hernia with the (onlaytension free) mesh technique.This is a retrospective study includes 46 patients who underwent mesh repair for large incisionhernia during the period from January 1997 to December 2004. The operations were done bythe same surgeon and by the same procedure (i.e; onlay tension free polypropylene mesh withtwo points fixation). Data regarding relevant patients with big ventral incision hernia with (onlaymeshrepair) in Basrah teaching hospital and private hospital were revised. The presentingcondition, hernia description, associated systemic and local factors, procedure of repair andfollow up duration were all taken in consideration. Possible complications like; hematoma,seroma, wound infection, intestinal obstruction and enterocutaneous fistula were recorded anddiscussed once they occurred. The follow up period ranged from 4 to 21 months.Forty six patients were included in the study: 20 females and 26 males with median age of 50.5year (range 35-68 year). Eleven patients (23.91%) were overweight and had body mass index"BMI" equal to more than 30, four patients (8.69%) had controlled diabetes mellitus, five(10.86%) had controlled hypertension and two (4.34%) suffered from chronic obstructive air waydisease, there were eleven smokers (23.91%). Sixteen patients made regular visits thatextended up to 12 months, 12 patients made regular visits up to 6 months, one made regularvisits up to 18 month mainly due to partial intestinal obstruction., one patient was followed-up to17 month because of multiple wound sinuses while 8 patients made irregular visits up to 21month due to causes other than the hernia, eight patients lost from follow-up after 4 months.The original operation was bowel related in 18 cases, gynecological in twelve,hepatopancreatobiliary in 10, repair of paraumbalical hernia in six patients. The old incisionswere long midline in 23 cases, paramedian in 17 and transverse in six patients. The mainpostoperative complications were seroma formation (13.04 %), wound haematoma (6.52 %),wound infection (4.34 %). no recurrence of hernia and no enterocutanous fistula were reportedduring our follow-up period.In conclusion, tension free onlay mesh repair is a feasible operative procedure for repair of largeincision hernia with no significant major morbidity.


Article
Transverse strength measurements of repaired acrylic resin modified with different surface treatments

Author: Dr. Firas Abd Kati Al-Shammari, Assisst. Lecturer د. فراس الشمري
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2014 Volume: 11 Issue: 1 Pages: 88-95
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Aim: the purpose of this study was to evaluate the effect of chemical and mechanicalsurface treatments on repaired acrylic resin in terms of transverse strength.Materials and methods: seventy acrylic specimens were fabricated and divided into7 groups according to kind of reinforcement materials. Thesespecimenswere cut inthe mid and a space of 3 mm was created. The repair was done with varioussurface treatments and specimenswere then subjected to loads till fracture. Datawere analysed and compared via ANOVA and Tukey tests.Results: the transverse strength of repaired acrylic resin had been influenced by thetype of surface treatment used.The repaired samples withglass fibers,stainless steelwire and monomerimproved significantly the bond strength than untreated group(P<0.05).Statistically, there were significant differences between control groupand repaired groups (P<0.05); and among all repaired groups (P<0.05) withexception no significant differencesbetween fiber and monomer, and wire andmonomer groups (P > 0.05).Conclusion:A combination of chemical and mechanical treatments has a significanteffect on transverse strengths. The repaired joints with monomer, wire, or glassfibers had significantly improved the strength of repaired acrylic resin.


Article
Proline Mesh (Patch And Plug) Repair Of Inguinal Hernia Under General Versus Local Anaesthesia : Early And Long-Term Outcomes

Author: Jawad Kadhim Al-Dhahiry جواد كاظم الظهري
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2014 Volume: 10 Issue: 18 Pages: 71-77
Publisher: Al-Qadisiyah University جامعة القادسية

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Background: There is minimal data regarding the feasibility of Proline (patch and plug) inguinal hernia repair under local anaesthesia and patient acceptability.This study compares outcomes of Proline ( patch and plug) inguinal hernia repair under local anaesthesia versus general anaesthsia . Place and Duration of Study: The study was conducted in Department of Surgery,Al-Karama Teaching Hospital,Medical college/Wasit University,Iraq ,from 1st Faruary 2008 to 30th June 2012 and included 124 male patients. Follow-up period ranged from 6 months to 53 months .Study Design: The study design was a prospective study.Methods: This is a prospective study ,included 124 male patients(female patients were not included in this study ) with inguinal hernias that were repaired with Proline (patch and plug) over a 4.5 year period. The outcome (parameters) measures were, the type of anaesthesia used, early and late postoperative complications, and the patient satisfaction. Results: One hundred twenty four inguinal proline mesh hernioplasties were analyzed. Eighty two hernioplasties were performed under local anaesthesia (group A) and fourty two were performed under general anaesthesia (Group B). Patients with a body mass index >30 were 17 (14%) of group A and 8 (6%) of group B, respectively, (p = 0.7). Day cases were higher in the local-anaesthesia group (75 days vs. 16 days, p = 0.001). Early complications were similar in the two groups. 18 (26%) patients in the local anaesthesia and 6 (19%) in the general anaesthesia developed chronic groin pain (p = 0.6). One recurrence was noted in the local anaesthesia group. Patient satisfaction was high with both anaesthetic techniques. Conclusions: Proline (patch and plug) inguinal hernia repair under local anaesthesia resulted in increased day cases with similar complication rate when compared to general anaesthesia. Both anaesthetic techniques were associated with good outcomes and excellent patient satisfaction.

هنالك معلومات وبيانات قليلة حول جراحة الفتوقات المغبنية باستخدام شبكة البرولين تحت التخدير الموضعي والتخدير العام. تمت الدراسة خلال فترت اربع سنوات ونصف السنة في مستشفى الكرامة التعليمي في مدينة الكوت ,من الاول من شباط 2008 الى الثلاثين من حزيران 2012 واحصيت النتائج من مجموعة التخدير الموضعي وقورنت بمجموعة التخدير العام من حيث المضاعفا ت المبكرة والمتاخرة ونسب رجوع الفتوق, فوجدت النتائج متماثلة من حيث المضاعفات المبكرة والمتاخرة للمجموعتين مع زيادة مهمة بعدد الحالات التي تجرى تحت التخدير الموضعي ويتم اخراج المرضى من المستشفى في نفس اليوم مع موافقة و قبول من قبل المرضى من حيث طرق التخدير .فترة المتابعة تراوحت ستة اشهر – الى-ثلاثة وخمسين شهرا .


Article
Evaluation of Impact and Transverse Strength of Denture Bases Repaired with Nano Reinforced Resin

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Background: Failure of resin bases were a major disadvantage recorded in the constructed dentures. Reinforcements of the repair joint with nano fillers represent an attempt to enhance the strength and durability. The purpose of the research was to estimate the influence of nano fillers reinforcement with (ZrO2 and Al2O3) on impact and transverse strength of denture bases repaired with either cold or hot processing acrylic resin.Materials and methods: A hundred and forty (140) samples were processed with hot cured resin and organized in subgroups depending on the repair materials and condition (without repair (control), repair with hot cure, cold cure, hot and cold cure reinforced with either (5% Zr2O or 0.5% Al2O3). The samples in these subgroups were processed depending on the test applied (impact and transverse strength). The samples were immersed in distalled water for about four weeks at 37°C before testing, after that, the samples prepared for each test were subdivided depending on the selected subgroups of the study. Repairing the samples with cold cure resin was done with the aid of Ivomet; after that the samples incubated for 48 hours in 37°C distilled water. Transverse strength test was done by using INSTRON universal testing machine while the impact test was done by using CHARPY impact testing machine.Results: The reinforcement of the repair joint with nano-fillers improves both impact and transverse strengths.Conclusion: Repair strength is directly proportional to the mode of resin processing, reinforcement with nano-fillers improve the strength of the repaired joint significantly

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