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Article
Types of urinary stones in Duhok Province

Author: Khalis Sabri Ammo خالص صبري عمو
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2012 Volume: 38 Issue: 2 Pages: 40-43
Publisher: Mosul University جامعة الموصل

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ABSTRACTAim: This study was conducted to evaluate the biochemical composition of urinary stones in Dohuk Province.Patients and methods: A prospective study done at Azadi-Teaching Hospital in Duhok city, during a period of two years from Jun. 2009 to Jun. 2001. The total number of patients collected was 150. Both inpatients and outpatients were included. Pediatric age group excluded. The source of collection of samples was: stones passed spontaneously by the patient with conservative treatment, or after surgery or extra corporeal shock wave lithotripsy (ESWL). Results: Total number of patients was 150, 102 patients (68%) were males & 48 patients (32%) were females, male: female ratio = 2.1:1. Out of 150 patients, 52 (35%) had calcium phosphate, 45 (30%) had calcium oxalate, and 30 (20%) with uric acid stones. 20 patients (13%) had mixed stones "calcium phosphate and calcium oxalate" and only 3 patient (2%) had pure oxalate stones. Out of 150 patients, 117 (78%) had calcium stones & 30 patients (20%) had uric acid stones, & 3 patients (2%) had oxalate stone. No other types of stones were detected in this study.Conclusion: The study revealed that most of the stones in our patients were calcium containing stones. The most common stones were calcium phosphate, and the percentage of uric acid stones was high.

الخلاصةالهدف من البحث: دراسة التكوين الكيميائي لحصى المسالك البولية في مدينة دهوك.المرضى وطرق الدراسة: دراسة مستقبلية أجريت في مدينة دهوك، العدد الكلي للمرضى (150). (102) من المرضى كانوا من الذكور و48 من الإناث. مدة الدراسة كانت سنتين للفترة من حزيران 2009 ولغاية حزيران 2011 في مستشفى آزادي التعليمي. شملت الدراسة المرضى الراقدين و مرضى العيادة الخارجية. أستبعد الأطفال من الدراسة. استحصلت النماذج من المرضى الذين عولجوا تحفظيا وتخلصوا من الحصى عن طريق الاحليل أو المرضى الذين عولجوا بالتفتيت أو التداخل الجراحي.النتائج: العدد الكلي للمرضى (150). (102) من المرضى كانوا من الذكور بنسبة 68% و 48 من الإناث بنسبة 32% لذا أصبحت نسبة الذكور إلى الإناث 2.1 إلى 1. أظهر التركيب الكيماوي للحصى المستحصل من 52 مريض (35%) أنها كانت مكونة من فوسفات الكالسيوم و45 مريض (30%) مكونة من اوكزالات الكالسيوم، و20 مرضى (13%) كان تركيب الحصى لديهم خليطا من فوسفات واوكزالات الكالسيوم. بينما كانت الحصاة لثلاثة من المرضى مكونة من الاوكزاليت النقي. وبذلك تكون حصيات الكالسيوم قد شكلت نسبة 78% وحصوات حامض اليوريك 20%.الاستنتاج: أظهرت الدراسة أن غالبية حصى المجاري البولية في مدينة دهوك كانت تحوي على عنصر الكالسيوم. وان غالبيتها كانت مكونة من فوسفات الكالسيوم وان حصى حامض اليوريك شكلت نسبة عالية.

Keywords

urinary --- stone


Article
5.THE EFFICACY AND SAFETY OF PERCUTANEOUS NEPHROLITHOTOMY IN CORRELATION WITH DIFFERENT RENAL STONE BURDENS

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Background: The improvements in instruments and technique of percutaneous nephrolithotomy (PCNL) in the last 3 decades have led to expansion in its indications to include even the large and complex renal stone cases.Objective: To determine the efficacy and safety of PCNL in relation to stone complexity.Methods: In this prospective, clinical, interventional study, 51 patients with symptomatic renal stones of different sizes and locations, were admitted in our Urology Unit, fully evaluated and treated by our team with PCNL. For all the patient’s data collected were: age, gender, body mass index (BMI), previous renal surgery, pre-operative stone number, stone size, stone position, stone opacity, surgical approach, operative time, stone clearance rate, postoperative residual stones and complications, hospital stay and adjuvant therapy. By using different statistical methods, correlations were made to elicit the impact of stone size, stone position, stone opacity, BMI and previous renal surgery, operative time, stone free rate, complication rate and the need for auxiliary procedures.Results: In this study, the 51 included patients were 31 males and 20 females with a mean age 40.3 year. All the stones treated were over 2 cm in their longest diameter, with 58.8% of them were ≥ 3 cm, and mean stone size was 4.2±0.99 cm. The most prevalent site of stone was the lower calyx (39.2%), followed by (37.3%) as partial staghorn, while complete staghorn calculi constituted (11.8%). The final success rate of treatment was 86.3%. (60.8%) of the cases found to be stone free at immediate postoperative period. Auxiliary procedures were used in (27.5%) patients, to improve the stone clearance. Residual stones were ultimately remained in only (7.8%). Complications occurred in 11 patients (21.6 %).Conclusion: PCNL though demanding, is an effective and reasonably safe procedure for the treatment of different renal stone burdens. Size and position of stones in the calyceal system and past renal surgery were the main determinants of operative time, stone clearance, complication rate and the need for auxiliary procedures.Keywords: Renal stone, PCNL, stone complexity, stone free rate, complicationsCitation: Al-Azzawi IS, Mohammed Zaki AW, Jwaid HI, Salih SL, Al-Obaidi AA. The efficacy and safety of percutaneous nephrolithotomy in correlation with different renal stone burdens. Iraqi JMS. 2018; 16(4): 385-392. doi: 10.22578/IJMS.16.4.5


Article
A Prospective Clinical And Ultrasounic Assessment Of Urinary Litholytic Activity Of Cynodon Dactylon Aqueous Extract
دراسة تاثير فاعلية المستخلص المائي لنبات النجيل في اذابة حصى المجاري البوليه

Authors: Karrar Kamoona --- Fadhid Abdul Jabbar --- Sahar A Majeed
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 1 Pages: 80-83
Publisher: University of Kufa جامعة الكوفة

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Back ground: Urolithiasis is one of the common health problems which endanger renal function due to ureteral obstruction and hydronephrosis.Aim of the study: to assess activity of C.dactylon in dissolving urinary stone in comparism with stander drugs.Material and methods:As atrial of augmenting litholytic activity of the commonly used drugs a 20 male patients were divided into two equil groups one is control and taking amoxicillin, bicarbonate and diclofenac the second one is test group taking extract of Cynodon dactylon in addition to these agents. All patients monitored with clinical and ultrasonic findings.Result: The results showed that 90% improvement in clinical and ultrasonic parameters noticed in test group in comparison with only 70% improvement in control group. This was statistically significant by chi square test at P < 0.05.Conclusion: The aqueous extract of C. dactylon showed a significant improvement in prognosis of lower ureteric stones based on clinical and ultrasound findings.Recommendation:further follow up of larger test samles of patients with lower ureteric stones is mandatory for accurate evaluation of litholytic activity of C.dactylon.

خلفية البحث :حصى المجاري البولية هي احدى المشاكل الصحية المالوفة التي تشكل خطرا على الوظائف الكلوية نتيجة لاحتمالية انسداد الحالب وارتجاع الادرار وحدوث الالتهاب والضرر الكلويالهدف:الهدف من هذه الدراسه هو تحديد فاعلية المستخلص المائي لنبات النجيل في اذابة حصى المجاري البوليه بلمقارنه مع الادويه القياسيه.المنهجية : كمحاوله لتعضيد فعالية العلاجات الحالة والمنزلة لحصى الحالب تم تقييم عشرين مريض مصاب بحصى اسفل الحالب الموضحة بالسونار وقد تم تقسيم المرضى الى مجموعتين متساويتين الاولى هي المجموعة القياسية تعطى الاموكسيسيلين مع البايكاربونات والدايكلوفيناك والثانية هي مجموعة اختبارية تاخذ مع العلاج المذكور المستخلص المائي لنبات النجيل مع المراقبة السريرية والفحص بالسونار.النتائج:اوضحت النتائج ان 90% من المرضى الذين ياخذون مستخلص النجيل قد اختفت عنهم الاعراض السريرية مع النتيجة السلبية لفحص الحصى بالسونار (فضلا عن الملاحظة المباشرة لنزول الحصى عند بعض المرضى) بالمقارنة مع 70% فقط من اختفاء الاعراض وسلبية السونار في المجموعة القياسية. وتلك نتيجة معتد بها احصائيا بفحص X^2 عند P<0.05.الاستنتاج: من عموم النتائج فقد اظهر مستخلص نبات النجيل المائي تحسنا سريريا وبنتائج السونار في سير حصى الحالبالتوصيات:البحث بحاجه للمزيد من التقييم على عينه اكبر من مرضى حصى المجاري البوليه للتقييم الادق لفاعلية النجيل


Article
PREVALENCE OF URINARY TRACT INFECTIONS IN PATIENTS WITH RENAL STONES
مدى انتشار التهاب المجاري البوليه في المرضى المصابين بحصاة الكليه

Authors: Mohammed A. Kadir --- Majida N. Ibrahim --- Najeeba M. Salih
Journal: AL-TAQANI مجلة التقني ISSN: 1818653X Year: 2010 Volume: 23 Issue: 5 Pages: 128-134
Publisher: Foundation of technical education هيئة التعليم التقني

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Abstract

The study was carried out in Kirkuk province, on patients attending Kirkuk hospitals, and private clinics from the 15th December 2004 until the 1st July 2005. Urine and blood samples were collected from 152 persons including 102 patients with urinary tract stones (61 males, 41 females), and 50 control healthy subjects (30 males, 20 females). General urine examination was done, and the results showed that 74 of the patients group were suffering from urinary tract infection, 25 of them were on antibiotics, and urine culture was done for the remaining patients. The results of urine culture showed that Escherichia coli infection (10.8%) was the commonest among patients with urinary tract stones, followed by proteus species (5.4%), Acinetobacter spp, Klebsiella spp (2.7%) for each and Pseudomonas spp, Staphylococci saprophyticus, Enterococci faecalis (1.35%) respectively. Significant increase in prevalence of urinary tract stones was demonstrated at age group (21-30 year), the highest rate was among housewives and officials, and (41.18%) of them had familial history of urinary tract stones.

تم إجراء هذه الدراسة في مدينة كركوك للفترة من 15 شهر كانون الأول عام 2004 حتى الاول من شهر تموز عام 2005 للمرضى المراجعين للمستشفيات والعيادات الخاصة في مدينة كركوك0 شملت هذه الدراسة 152 شخصا, 102 منهم كانوا يعانون من حصيات المجاري البولية ( 61 ذكور, 41 إناث ), وخمسون أصحاء لغرض المقارنة (30 ذكور, 20 إناث ), ولقد تم جمع نماذج من الدم الوريدي والإدرار وتاريخ الحالة لكل واحد منهم0 تم إجراء فحص الإدرار العام لجميع نماذج الإدرار وقد بينت النتائج بان 74 مريضا كانوا يعانون من التهابات المجاري, 25 منهم كانوا في طور العلاج بالمضادات الحيوية0 تم إجراء زرع عينات الإدرار للمرضى الذين يعانون من التهابات المجاري البولية وكانت النتائج كالأتي: إن الاشيريشيا القولونية ( Escherichia coli ) كانت الأكثر شيوعا بين العوامل المرضية المسببة لالتهابات الجهاز البولي (10.18% ), Proteus spp (5.4 % ),Acinetobacter spp, Klebsiella spp (2.7 %) لكل منهما, و (1.35 % ) لكل من (Enterococci fecalis),(Staphylococci saprophyticus),(Pseudomonas spp). كما وأظهرت هذه الدراسة بأن النسبة الأعلى للإصابة بحصيات المجاري البولية كانت بين المجاميع العمرية ( 21-30 سنة), مع أعلى نسبة في ربات البيوت(33.34%) والموظفين (15.68%). كما تبين من الدراسة أن (41.18%) من المرضى كان لديهم تأريخ عائلي للإصابة بحصيات المجاري البولية.

Keywords

UTI --- Renal stone.


Article
The Role of Tamsulosin in the Management Of Lower Ureteric Stones.

Author: Ayad Ali Al-Beer
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 4 Pages: 371-376
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Recent Studies have reported outstanding results concerning medical expulsive therapy (MET) for distal ureterolithiasis in terms of stone expulsion and control of colic pain. While ureteral intracorporeal and extracorporeal shock wave lithotripsy are recognized to be effective, the role of MET has not yet been established for the treatment of this disease.OBJECTIVES:To evaluate the role of α1- adrenergic antagonist Tamsulosin in conservative therapy for patients with juxtavesical ureteral stones.METHODS:Sixty consecutive symptomatic patients with juxtavesical unilateral lower ureterolithiasis from the urologic consultation department in Baghdad Medical City were enrolled in this randomized prospective controlled study during the period from January 2005 to December 2006. Patients were randomly divided into two groups, group 1 (n=30) and group 2 (n=30). The two patient groups used oral diclofenac (25 mg orally twice daily) plus cotrimoxazole 2 times daily for 5 days and 75 mg diclofenac injected intramuscularly on demand. All patients were instructed to drink 2 L water daily. Group 1, served as the control group. Group 2 was given the α1 -blocker (tamsulosin) in addition to conservative treatment. Tamsulosin capsule (0.4 mg) was administered daily. The treatment duration was until stone expulsion or 28 days, whichever came first. During this period, all patients were evaluated weekly by urinary tract ultrasonography and serum createnine level, and were asked whether they experienced acute colic pain, to score the intensity of pain according to a visual analog scale (VAS), whether the calculus passed spontaneously, the day and time of stone expulsion, number of diclofenac injections, and finally any drug side effects. Statistical analyses were performed with Student’s t test, ANOVA, and Mann-Whitney U test as appropriate. Correlation analysis was done using Spearman's rank test. Cox proportional hazard regression module was used to determine the predictive factors for expulsion.RESULTS:The stone expulsion rate was 70% for group 1 and 90% for group 2 (P=0.003). Mean stone size was 7.3 and 7.7 mm, respectively (P=0.24). Mean expulsion time, mean VAS of pain, mean attack of acute colic, and mean number of diclofenac injections were significantly less in patients used tamsulosin. Only therapy and stone size proved to be significantly predictive factors of stone expulsion (P<0.0001 and 0.001) respectively, while gender and age did not have any predictive value. Although side-effects, such as headache, abnormal ejaculation, and dizziness occurred more in patients who were given tamsulosin, no significant side-effects was detected so as to require exclusion of a patient from the study.CONCLUSIONS:Medical Expulsive Therapy (MET) for lower ureterolithiasis with tamsulosin during conservative treatment period is safe and effective as demonstrated by the absence of serious side effects and increased stone expulsion rate with early time. Also MET with tamsulosin affords an outstanding control of pain for patients while waiting for stone expulsion.


Article
Using Halan stone as a Preproduction Unloaded Wall Instead of Bricks 120 mm
استخدام حجر الحلان لإنتاج جدران غير ساندة مسبقة التصنيع بديلة عن الطابوق سمك 120 ملم مع دراسة مقارنة للعوازل الحرارية المستخدمة

Author: Atif A. Hasan عاطف علي حسن
Journal: Al-Ma'mon College Journal مجلة كلية المامون ISSN: 19924453 Year: 2010 Issue: 16 Pages: 223-239
Publisher: AlMamon University College كلية المامون الجامعة

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To reduce using the brick as a unloaded walls in frame building by using Halan stone (Limestone) as a natural stone to preproduction walls and is assemble in working area. The suggestive wall is consist from a double stone, the first one (450x1000x100)mm as 2 parts, the second one (150x 1000x50)mm as 2 parts, and arrangement parts by roller bolts as a hollow box used to put insulating materials and covered by decoration plastic hollow sheet to form the external finishing material, and used gypsum 3 mm as the internal finishing material, therefore, the total wall thickness is 157 mm.The researcher build (1x1x2)m room sample, in third story in building (Baghdad city– Latitude 33.2º North),and (1x2)m testing wall to east orientation, while the other surfaces were insulated by 200 mm styropor sheets and using Air – Conditioner 0.5 ton of refrigeration to afford the standard thermal comfort, and measured the walls & air temperatures for 15 hr/day for summer season (May to September) .The researcher found that , the suggestive wall saved 63% electrical energy for cooling purpose and also decreasing wall weight by 30% but increasing cost by 20 % when comparison with common brick wall.

لغرض تقليل الاعتماد على الطابوق الفني لتشييد الجدران غير الساندة في الأبنية الهيكلية، تم استخدام مقاطع حجر الحلان (Limestone) المتوفر طبيعياً لتشكيل قطع جاهزة تصنع مسبقاً، وتجمع في موقع العمل. والجدار المقترح يتألف من قطعتين من حجر الحلان بأبعاد (100 x 1000 x 450) ملم و قطعتين بأبعاد (50 x 1000 x 150) ملم وتجمع القطع موقعياً باستخدام لوالب لصنع صندوق مفتوح من طرف لاحتواء المادة العازلة حرارياً (سمك 50 ملم) فيه، وتغلف من الخارج بطبقة من الواح الديكور البلاستيكية المجوفة ذات سمك 8 ملم وطبقة الانهاء الداخلي ستكون الحجر نفسه أو البياض بالبورك الفني سمك 2 ملم، بحيث يكون سمك الجدار (الكلي) المقترح 157 ملم. لذلك تم اعداد نموذج غرفة ابعادها (2 x 1 x 1) م ، تقع في الطابق الثالث من مبنى في مدينة بغداد (خط عرض 33.2 درجة شمالاً) والجدار قيد الدراسة (2 x 1) م مواجه للشرق أما بقية أسطح الغرفة فتم عزلها حرارياً باستخدام الواح الستايربور (البولي ستايرين) 200 ملم ، تحتوي الغرفة على مكيفة هواء جدارية سعتها (0.5) طن تبريد لتوفير الظروف الحرارية القياسية وتم قياس درجات الحرارة لطبقتي الانهاء الداخلية المواجه للغرفة، والخارجية المواجه للبيئة ودرجة حرارة هواء البيئة (الظل) خلال 15 ساعة/ يوم (من الساعة 5:00 صباحاً لغاية07:30 مساءاً) ولفترة الصيف (من الشهر الخامس (آيار) ولغاية الشهر التاسع (أيلول)) مع تسجيل الطاقة الكهربائية المستهلكة لأغراض تكييف الغرفة.توصل الباحث الى أن متوسط نسبة توفير الطاقة الكهربائية المستهلكة لأغراض التكييف خلال فصل الصيف هي 65% عند استخدام الجدار المقترح بدلاً من الجدار الاعتيادي ذي السمك 165 ملم (المؤلف من طبقة لبخ بالسمنت 20 ملم وطابوق فني سمك 120 ملم وطبقة انهاء داخلية من الجص 120 ملم) مع تخفيض وزن الجدار في حدود 30% ولكن بارتفاع كلفة الانشاء بنسبة 20% مقارنة بالجدار التقليدي.


Article
Efficacy of Holmium: Yag Laser in Ureteric Stone Fragmentation

Authors: Qais Abdul –Rahman Thamer --- Ziad H. Abd
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 120-127
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Urolithiasis is a common presenting condition in urologic daily practice, 20% are ureteral stones. The most commonly performed procedures were shock wave lithotripsy (SWL) and ureteroscopy using holmium: YAG laser that can fragment all types of calculi.OBJECTIVE:Here we provide our experience with the use of holmium: YAG laser in the treatment of ureteric stones as fragmentation rather than complete vaporization aiming to decrease the operative time and subsequent complications.MATERIALS AND METHODS:In this prospective study, 54 patients with ureteric stones were treated using Holmium:YAG laser as an intracorporeal lithotripter in Fallujah general hospital between November 2009 and July 2011, using a 9.5 Fr. storz-semirigid ureteroscope. Stones were diagnosed by excretory urography, or spiral computerized tomography. We estimated the time of operation starting from the onset of application of laser on stone till complete clearance or termination of the procedure. Stone forceps retrieval of stone fragments was done. Double J ureteric stent was placed in complicated cases only. Postoperatively all patients were followed up with plain radiography and renal ultrasonography.RESULT: Fifty four patients with ureteric stone were included, their ages range from 19 to 60 years. Complete clearance of the stones was achieved in 38 cases (70.4%). The intraoperative complication was reported in 17 (31.5%) as upward stone migration in 6 cases (11.1%), ureteric perforation only once (1.9%) and bleeding in 10 cases (18.5%). Postoperative complications were infection in 59.3%, urinoma in 1.9% and hematuria in 13%. Complete clearance was 75%, 64.7% and 66.6% in distal, mid and proximal ureter respectively. Stones with sizes less than 1cm, 1-2cm and those with multiple stone the clearance were 81.4%, 65.2% and 25% respectively. The operative time was less in distal stones and in stone size <1cm. Intraoperative complications were higher with longer operative time, while perforation only occurred once when the operative time prolonged >30 min. Postoperative complications were higher with longer operative times, while urinoma complicating perforation occurred in one case when the operative time were more than 30 minutes CONCLUSION: Our clinical results, especially with respect to complication rates and outcome, advocate the trial of fragmentation with stone retrieval rather complete vaporization to shorten the operative time and subsequent complications


Article
Ureteric stone management: comparison of ureteroscopy using pneumatic lithotripsy with ureterolithotomy results
حصاة الحالب: مقارنة بين علاج حصاة الحالب باستخدام ناظور الحالب وعملية فتح الحالب ورفع الحصاة

Author: Nooman H. Saeed نعمان هادي سعيد
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 1 Pages: 70-74
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: The purpose of this study is to compare ureteroscopy using pneumatic lithotripsy with open surgery (ureterolithotomy) in treating ureteric stones regarding the success rate, procedures time, need for post-operative analgesia, duration of hospital stay, and complications rate.Patients and methods: A prospective study of 90 patients suffering from ureteric stones, referred to the urology center at Al- Jumhori Teaching Hospital in Mosul city between 1st of May 2010 – 31st of March 2011. Fifty patients were treated by ureteroscopy and 40 patients by ureterolithotomy. Their age and sex distribution was comparable. Results of both treatment modalities were analyzed and compared. Results: The success rate for ureteroscopy was 90% and for ureterolithotomy was 97.5%. The procedure time was significantly shorter for ureteroscopy patients (21 minute versus 67 minute). Mean post-operative analgesia was much less for ureteroscopy (1.1 versus 9.5 analgesic injections). Ninety two percent of ureteroscopy patients were discharged at same day of operation with mean hospital stay of 1.12 days compared to 3.5 days for ureterolithotomy group. Complications were reported in 8% in ureteroscopy and 5% in ureterolithotomy group.Conclusion: The success rate of ureteroscopic procedures using pneumatic lithotripsy is comparable to that of ureterolithotomy, but with significantly shorter procedure time, less need for post-operative analgesia, shorter hospital stay, and with no significant increase in the complications rate. These results mean early return to social life and activities, and make ureteroscopy a preferable option for treating ureteric stone when facilities and surgical skills are available.

الخلاصةالهدف: مع دخول التقنيات العلاجية الحديثة أصبح من الممكن التعامل مع حصاة الحالب بطرق علاجية متعددة. الغرض من هذه الدراسة هو مقارنة نتائج عمليات تكسير وسحب الحصى من الحالب باستخدام منظار الحالب مع عمليات فتح الحالب التقليدية لرفع حصى الحالب من حيث نسب النجاح, وقت العملية, الحاجة للمسكنات بعد العملية, مدة الرقود في المستشفى, ونسبة حدوث المضاعفات بعد العمليات. المرضى والطريقة: دراسة مستقبلية شملت (90) مريضاً يعانون من حصاة الحالب, في مركز جراحة المسالك البولية في المستشفى الجمهوري التعليمي في مدينة الموصل, (50) مريضاً تم علاجهم بمنظار الحالب, و(40) مريضاً بعملية فتح الحالب, وتم مقارنة النتائج.النتائج: كانت نسبة نجاح الطريقتين العلاجيتين متقاربة, إلا أن وقت العملية, وكمية المسكنات بعد العملية, ومدة الرقود في المستشفى كانت أقل بكثير في عمليات منظار الحالب, كما أن نسبة حدوث المضاعفات في العمليتين متقاربة أيضا.الاستنتاج: استخدام منظار الحالب يعطي نسب نجاح عالية ومقاربة لنتائج العمليات الجراحية التقليدية, مع تقليل وقت العملية والحاجة للمسكنات بعد العملية وفترة الرقود في المستشفى, مع نسبة مشاكل مقاربة للعمليات التقليدية, مما يعني العودة للحياة الاعتيادية وممارسة العمل بوقت مبكر.

Keywords

Ureteric --- stone --- lithotripsy


Article
Percutaneous Nephrolithotomy for Renal Calculi:A Single Surgeon Experience

Author: Hayder M.AL-Aridy
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 4 Pages: 576-580
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Percutaneous nephrolithotomy (PCNL) for renal calculi is one of the more challenging endourologic procedures.PCNL remains the procedure of choice for most stones that are more than 2 cm in size, complex staghorn calculi, some lower-pole stones, stones in caliceal diverticuli, and larger renal stones that are refractory to shock wave lithotripsy( SWL).OBJECTIVE:The purpose of this study was to evaluate the outcomes and complications in patients who were undergoing PCNL for renal calculi at our center.PATIENTS AND METHODS:From January 2011 to December 2012, a total of 216 patients who had renal stones underwent PCNL by the same surgical team at our institution. All patients were evaluated preoperatively with intravenous urography (IVU) and/or computerized tomography(CT). Data analysis included procedure time, length of hospital stay, number of access tracts, transfusion rates, other complications, and stone-free status. Percutaneous access was performed using C-arm fluoroscopy with patients in the prone position. The access tract was dilated with a balloon dilator or Amplatz dilators. Fragmentation of the stone burden was accomplished using an Ultrasonic lithotripter. No patients in this series underwent a tubeless technique. Nephrostomy tube was placed at the end of procedure and nephrostogram done in all patients on 2nd postoperative day.RESULTS:Mean age was (42.43±13.17) yrs. The mean stone burden was (6.91±4.47)cm2 .The average procedure time was( 57.40±21.05) minutes. Mean pre and postoperative hemoglobin(Hb) levels were(13.43±1.34) and ( 11.71±1.86) g/dl respectively and Hb drop was ( 1.76±1.10) g/dl.PCNL via a single access tract was accomplished in( 93.51%) of procedures, while multiple tracts and intercostal access were used in( 4.62%) and (1.85% ) respectively of procedures.Mean fluoroscopy time during the whole procedure was (1.75±0.90) minutes.Mean hospitalization was (3.52±0.86) days. Stone-free rates at hospital discharge and at 3 months follow-up were (81.44%) and (92.07%), respectively. 30 patients received blood transfusion (13.88%).CONCLUSION:PCNL is a safe and effective procedure for the management of renal stones. It has the advantages of lower morbidity, shorter hospital stay. The full of array of endourologic equipment and expertise remains essential to achieving a successful outcome.


Article
The Surface Hardness Measurement of Stone and Improved Die Stone After the Addition of a Mixture of Chemical Additives with Different Proportion

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Abstract

Background: Incorporation of chemical additives has long been a technique used to improve properties of the gypsum products. The purpose of this work was to study the effects of adding a combination of gum Arabic and calcium hydroxide to a type III dental stone and type IV improved die stone with different proportion. The effect on water/powder ratio, and surface hardness was determined.Material and method: Both material stone and die stone were blended with two proportion of additives so that each material was mixed twice but with different proportion of gum Arabic (0.1% and 0.2%) and calcium hydroxide (0.5 % and 0.3%). Data for hardness were subjected to two-way analysis of variance.Results: The results revealed that the chemical additives were reduced the water requirements of gypsum products so that the reduction of water lead to increase the density of mixture that sets harder. For type III dental stone the additives significantly improved the surface hardness, while for type IV improved die stone the surface hardness was not enhanced except it was designed to be mixed at low water/powder ratio, and in some instances a reduction in hardness was observed, especially at the most reduced water / powder ratio (0.18)

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