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Article
Incidence of Renal Injuries in Abdominal Trauma at Al-Kindi Teaching Hospital

Author: Ridha J. Al-Basri*, Mohammed A. Alrubiae**, Ali H. Mutar***
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 2 Pages: 89-93
Publisher: Baghdad University جامعة بغداد

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Abstract

Background : The kidneys may be injured in abdominal trauma, both blunt & penetrating. Renal trauma may manifest in a dramatic fashion for both the patient and the clinician. Objectives: To evaluate the incidence, management, morbidity &mortality of renal injury in blunt & penetrating abdominal trauma. Methods: A retrospective study includes 45 patients sustaining renal injury. These trauma patients were admitted to the casualty department in Al-Kindi Teaching Hospital during the period between 1st June 2006 – 31st May 2007. The patients were analyzed regarding their age, sex, mechanism of injury & grade of injury according to Organ Injury Scaling (OIS) classification of the American Association for the Surgery of Trauma (AAST). Management, morbidity & mortality were also noticed.Results:The majority o f patients were males (35= 77.8%), the rest were females (10= 22.2%). The average age was 37 years (range= 18-56 years). The most common grades were grade1, grade2 and grade3 (40=88.9%), while 5 patients (11.1%) were grades 4 and 5.The most common associated injuries were liver, spleen, small & large bowels and diaphragm. The mortality was 20% (9 patients). The most common cause of death was multiple organ injuries in 2 patients (4.4%), kidney with injury of a second organ in 6 patients (13.3%), while delayed surgery was the cause in 1 patient (2.2%), while the most common cause of morbidity was wound infection in 5(11.1%) and wound dehiscence in 2 patients (4.4%), a total morbidity is of 7 patients (15.5%).Conclusion: Renal injuries are not uncommon injuries, but they are less common than other intraabdominal organs e.g. liver, spleen and bowel. Injury grading using the OIS system (liver, spleen and kidney) of AAST is a useful tool for comparison and to evaluate management according to injury grade.Keywords: Renal Injury, abdominal trauma, blunt trauma, penetrating trauma.


Article
Critical View: The Representation of Post Sept /11 Psychological Trauma in Two American Novels

Author: Azhar Hameed Mankhi
Journal: LARK JOURNAL FOR PHILOSOPHY , LINGUISTICS AND SOCIAL SCIENCES مجلة لارك للفلسفة واللسانيات والعلوم الاجتماعية ISSN: 19995601 Year: 2018 Volume: 2 Issue: 28
Publisher: Wassit University جامعة واسط

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Abstract

This paper attempts to carry out a close analysis of trauma representation in two American novels : Extremely Loud and Incredibly Close (2005)written by Jonathan Safran Foer and Don Dillilo's Falling Man which was written in 2007. I attempt to convey the event of Sep 11 and the emotional responses to this shattering event. Trauma is a word that is used more in psychology than literature , but in this paper ,I'll discuss the effect of trauma on fictional characters who try to cope with their traumas through language and other means

Keywords

Trauma --- psychology --- vicarious trauma --- Sept 11


Article
9- PREVALENCE OF INTERNAL ABDOMINAL ORGANS� INJURIES IN PATIENTS OPERATED UPON AFTER BLUNT ABDOMINAL TRAUMA.

Author: Kamal Ahmad Saeed
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 42-47
Publisher: Basrah University جامعة البصرة

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Abstract

Blunt abdominal trauma may result in multiple severe injuries which make the abdomen difficultto assess and easy to overlook. Unrecognized intra-abdominal injury is a significant cause ofpreventable death in blunt trauma. This study aimed to find the frequency and features oflapratomy findings for different internal abdominal organs� injuries in patients subjected to bluntabdominal injury. A total of 450 patients subjected to blunt abdominal trauma were admitted tothe emergency surgical department of Sulaimania Surgical Teaching Hospital following, 140 ofthem were decided to undergo exploratory laparotomy depending on their clinical and imagingfindings that suggesting a visceral injury. Thirty one percent of the patients who subjected toblunt abdominal trauma need exploratory laparotomy, 80.7% of them were male, and 67.9%were young. The predominant causative factor of blunt abdominal trauma was the motor vehicleaccidents. Spleen and liver were the frequent injured solid organs. Almost all of the patients hadpositive laparotomy results. Traumatic head and neck injuries were the most commonassociated non abdominal injuries. Morality rate was only 5% while complication rate was only7%. It is concluded that males at young active productive age are the main persons suffer fromblunt abdominal trauma. This has an important economic impact on the productivity of thecommunity. Spleen injury being the most commonly intra abdominal solid injured organ followedby liver, other visceral structures are uncommonly involved.j1


Article
Childhood ocular trauma in Mosul city

Author: Azzam A. Ahmed عزام عبد القادر احمد
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2012 Volume: 38 Issue: 2 Pages: 10-15
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To describe the epidemiology of ocular trauma in children 15-years and younger living at Mosul city and its periphery who underwent evaluation for a two year period from November 2007 to November 2009 in the emergency department in Al-Jumhory Teaching Hospital.Methods: A retrospective study; review of the medical records of children aged 15 years and less. Records of (393) children with 415 incidents of eye injury were included in the study, of whom (22) were initially treated for bilateral ocular trauma.Results: Most patients (64.9%) were boys. The highest proportion of injuries (44.4%) occurred at home, followed by street and roads (28.6%). Blunt (35.1%) and sharp (22.6%) objects represents most frequent cases of trauma. Closed globe injuries were far more frequent than open-globe injuries for boys (82.4% vs 17.6%). Of those with the closed-globe injuries, 253 injuries (80.0%) registered an initial visual acuity of greater than 6/18, whereas 31 open–globe injury (52.5%) registered an initial visual acuity of less than 6/60. Most closed-globe injuries (223, 92.1%) did not cause final visual impairment in the affected eye, whereas 26 open-globe injuries (53.3%) caused severe visual impairment or blindness.Conclusions: A good proportion of the accidents represent in this study could have been avoided. A data demonstrate a clear need for primary prevention and control measures.

الخلاصةهدف البحث: لدراسة حالات الإصابات العينية للأطفال دون سن الخامسة عشر في مدينة الموصل وأطرافها من مراجعي مستشفى الجمهوري التعليمي بالموصل.التصميم: دراسة تراجعية.المشاركون: 393 طفل دون سن الخامسة عشر ممن تلقوا إصابات عينية، 22 منهم كانوا مصابين بكلتا العينين. وقد أجريت الدراسة بمراجعة سجلات المرضى المراجعين لمستشفى الجمهوري التعليمي بالموصل - قسم العيون للفترة من تشرين الثاني 2007 ولغاية نهاية تشرين الثاني 2009، فضلا عن إن العمليات الجراحية أجريت في صالة عمليات العيون لمستشفى الجمهوري التعليمي بالموصل.الحالات: معظم الحالات كانوا من الذكور 64.9%، وأعلى نسبة إصابات حدثت في المنازل 44.4%، تبعها إصابات الطرقات 28.6%، علما أن 35.1% هي إصابات عينية بآلات راضة، 22.6% كانت حصيلة الإصابات العينية بآلات حادة. الإصابات العينية المغلقة كانت أكثر نسبة من الإصابات النافذة 82.4% و 17.6% على التوالي. معظم الإصابات العينية المغلقة لم تؤدي إلى تدهور ملحوظ في حدة الأبصار، بينما 26 حالة من الإصابات العينية النافذة 53.3% أدت الى تدهور واضح وملحوظ في حدة الأبصار أو حتى إلى العمى. وتم استخدام P-valueواختبارX2 في التحليل الإحصائي. الاستنتاج: نسبة جيدة من الإصابات العينية في هذه الدراسة كان يمكن تجنبها والدراسة تشير إلى الحاجة الواضحة إلى طرق وآليات السلامة العامة لتجنب وقوع هكذا إصابات.


Article
Ocular trauma in Mosul. Descriptive study
الإصابات العينية في الموصل. دراسة توضيحية

Author: Amer Y. Rajab عامر يحيى رجب
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 2 Pages: 128-131
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To determine the incidence of ocular trauma (OT) in Mosul.Methods: Retrospective case series study of (156) patients of OT admitted to Al-Jamhori Teaching Hospital, who were referred from emergency department to ophthalmic unit during one year from 1st Jan. till 31st Dec. 2010. Data regarding age and sex of patients, and types, causes and season of injuries were noted.Results: About 4.4% (156 out of 3307) of patients admitted to ophthalmic unit as (OT) in one year period and 4.3% of operations (101 out of 2335) done for OT in operative theater, 85.2% were males, and 89.1% were 30 years and younger. Mean age was 15.8 years ± 13.2 SD, 60.3% (94/156) were open-globe injuries and there were seasonal differences.Conclusion: Young age males were mostly affected and open-globe injuries were the commonest types. Also there were seasonal differences.

الخلاصةالهدف: لتحديد الوضع الوبائي لصدمة العين في الموصل.التصميم: دراسة تراجعية.المكان: شعبة العيون في المستشفى الجمهوري بالموصل.النتائج: 156 مريضا 85,2% من الذكور. 89,1% أقل من ثلاثين سنة. 60,3% من الإصابات من إصابة كرة العين المفتوحة معدل الذكور/الاناث 5,8 :1, 4,4% أدخلوا الى ردهة العيون و 4,3% من عمليات العيون هي للإصابات العينية وأكثر الإصابات بالربيع والخريف. أسباب الإصابة من ألعاب الأطفال النارية وإصابات القنابل والسيارات المفخخة والأدوات المنزلية.الاستنتاج: حملة توعية الى الآباء والأمهات للإهتمام بالأطفال وطرق لعبهم. لأن أكثر الإصابات تحدث عند الأطفال الذكور وفي فصلي الربيع والخريف.

Keywords

Ocular --- trauma --- OG injury


Article
EVALUATION OF PEDIATRIC HEAD INJURIES

Author: Ihssan S. Nema احسان صبحي نعمه
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2016 Volume: 14 Issue: 1 Pages: 33-38
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Trauma is a leading cause of death in children older than one year in the world; with head trauma representing 80% or more of the injuries. Most head injuries in children occurs secondary to motor vehicle accidents, falls, assaults, recreational activities, and child abuse.Objectives:To evaluate head trauma in pediatrics age group regarding age, sex, presenting symptoms and signs and the line of management; to know the role of CT scan in assessment of pediatrics head trauma, and t determine the extent of pediatric head trauma in Baghdad city.Methods:Fifty neurosurgical pediatrics cases with head trauma between the age of one year to fourteen years whom presented to the neurosurgical ward in Al-Imamain Al-kadhimain Medical City. Questioner for gender, age, mechanism of injury, presented signs and symptoms, consciousness, CT scan findings, and the line of management. Results:The study showed that males have the higher incidence with 72%. Head injury due to road traffic accident accounting for 44%. The loss of consciousness was documented in 60% of the cases. All patients subjected to CT scan imaging modality for assessing head injury as the ideal way. The presence of hematoma was seen in 68% of the cases. Associated injuries were seen in 60% of cases. Vomiting as an important symptom in pediatrics head trauma encountered in 52% of the patients. The developments of fits are very important sequel encountered in 16%. The close monitoring and follow up being the most common line of management accounting for 88%.Conclusion:Pediatrics head trauma is a common problem with males have higher incidence than females. The most common mechanism of injury was road traffic accident. CT scan is a very vital and important diagnostic tool in evaluating patient with head trauma.Key words:Pediatrics, head trauma.

Keywords

Pediatrics --- head trauma


Article
Selective Approach in Managing Penetrating Neck Injury

Author: Raid Jasim Ahmed (FICMS), ** Haitham Abid Hammoud (FICMS), **Ghassan Hikmat Majeed (CABS, FICMS)*
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 2 Pages: 29-33
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Penetrating Neck Injuries (PNI) management represents a challenge to most surgeons in civilian trauma, in weighing selective versus mandatory exploration of all cases in different circumstances. Data are encouraging surgeons to adopt the former approach.Objectives: The study aims to assess the selective approach in our war and terror time events in Al-Yarmouk teaching hospital.Type of the study:A retrospective study. Methods: Data of patients presented to the Thoracic and Vascular ward in Al-Yarmouk teaching hospital with PNI were assessed retrospectively, from March 2013 to March 2015, and analyzed for epidemiology, mechanism of trauma, management methods, associated organ injuries, complications and mortality. Results: Among 83 patients (76 males and 7 females) who presented with PNI, the mean age was 28.5±15 years with a peak incidence in third decade. Shell injury (52.2%) was the most common mechanism and zone II was the most frequently injured (49.4%). Therapeutic exploration of neck in 82% of the cases, a decision of surgical exploration (87%) patients. Vascular injuries were the most identified neck structures (39.5%). Chest injuries (35%) were the most common associated injuries identified in patients who had additional anatomic region injury (41%) beside PNI. Complication rate of 18% and infection (26.6%) were most common and mortality rate was 8%. Conclusions: Still the selective approach is preferable in management of PNI in our war and terror time circumstances and limited resources of country.


Article
TRAUMATIC HYPHEMA: A STUDY OF 40 CASES
التجمع الدموي في الفجوة الأمامية الناتج عن كلم العين

Authors: HAVAL R. IBRAHIM هفال ابراهيم --- ARIF Y. BALATAY عارف يونس بالتي
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2008 Volume: 2 Issue: 1 Pages: 117-126
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background Hyphema is a relatively common problem in our society with complications and risk sequels. No study has been conducted on this problem in Kurdistan region. Objectives to detect common causes of ocular trauma in Dohuk governorate and to detect the most vulnerable age group involved with the visual acuity outcome after treatment. Methods The study was conducted in Azadi General Teaching Hospital and the Emergency Hospital / Dohuk / Kurdistan region, from June 2006 to June 2007. A follow-up clinical study of patients presenting with traumatized eyes with hyphema was conducted. The study included 40 patients of traumatic hyphema out of 137 cases of ocular trauma. Ocular examinations (visual acuity, intra ocular pressure, fundoscopy and others) were done for all patients at presentation and subsequently during the follow-up. Results The annual prevalence rate of traumatic hyphema in Dohuk governorate was about 5 per 100.000 individuals. The study showed a male predominance. A total of 35% of cases were encountered among children aged (6 – 10) years. Blunt trauma was observed in (60%) of patients while the other (40%) had penetrating traumas. A total of (90%) of females suffered from penetrating trauma while males were injured by blunt trauma more frequently. The left eye was relatively more frequently involved (55%) than the right. A total of 37 eyes regained acceptable final visual acuity, while two eyes progressed to no light perception, and one eye had just light perception. Conclusions and Recommendations Tranexamic acid was found to reduce re-bleeding in our cases. Increased intraocular pressure is one of the most frequent complications of traumatic hyphema that may ultimately result in impaired vision. Complete eye examination is essential to assess concomitant injuries which reflect the severity of initial trauma.

خلفية البحث: تجمع الدم في الفجوة الأمامية في العين هي من الحالات الشائعة نسبياً في مجتمعنا وهذه الحالة قد تكون متصاحبة مع بعض المضاعفات والمخاطر المتأخرة. في حدود علمنا لا توجد أي دراسة حول هذا الموضوع في اقليم كوردستان. الهدف: الهدف الرئيسي لاجراء هذه الدراسة هو معرفة أهم الأسباب المؤدية الى اصابات العين مع التركيز على نسبة تجمع الدم في الفجوة الأمامية للعين الكلّمي في محافظة دهوك ودراسة نسبة انتشاره حسب الفئة العمرية، ودرج الرؤية بعد العلاج. المنهجية: أجريت هذه الدراسة في مستشفى أزادي التعليمي العام ومستشفى الطواريء في محافظة دهوك/ اقليم كوردستان وفي الفترة الواقعة من حزيران 2006 لغاية حزيران 2007. دراسة متابعة سريرية للمرضى الذين اصيبوا في العين وأدت الاصابة الى تجمع الدم في الفجوة الأمامية للعين. شملت الدراسة (40) مريضاً من هذا النوع من ضمن (137) حالة من اصابات العين. أجريت جميع الفحوصات لهؤلاء المرضى في اليوم الاول من حصول الاصابة وأثناء المتابعة (درجة الرؤية، الضغط داخل العين، فحص الشبكية والعصب البصري وبعض الفحوصات المهمة الاخرى). النتائج: كانت نسبة الاصابات المشمولة بهذه الدراسة هي بحدود (5) لكل 100000 شخص. كانت نسبة اصابة الذكور اكثر من الاناث، (35%) من الحالات كانت من الفئة العمرية (6 – 10) سنوات. شكلت الإصابات الراضة نسبة (60%) من الحالات والواخزة (40%) منها. في حوالي (90%) من الاناث المشمولات بهذه الاصابة كانت من الجروح الواخزة بينما اصيب الذكور أكثر بالاصابات الراضة. عموماً أصيبت العين اليسرى أكثر من اليمنى نسبياً (55%) مقابل (45%) للعين اليمنى. استعادت (37) حالة درجة رؤية مقبولة في حين اصيبت ثلاثة منها بتعذر أو عدم رؤية الضوء. الاستنتاجات والتوصيات: أظهرت الدراسة أن عقار (Tranexamic acid) يقلل من نسبة تكرّر النزف في المصابين. كان ارتفاع ضغط العين هو واحد من أكثر المضاعفات لحدوث نزف دموي في الفجوة الامامية للعين والذي أدى بدوره الى ضعف وخلل في الرؤية. في حال حصول هذه الاصابات يجب فحص العين فحصاً شاملاً وذلك للتأكد من عدم وجود أنواع أخرى من الجروح والتي قد تؤدي الى مضاعفات أخرى.

Keywords

Hyphemia --- Eye trauma --- Dohuk


Article
Evaluation of Focused Abdominal Sonography for Trauma (FAST) in Baghdad Teaching Hospital

Authors: Raed J .Wiwit --- Saad Abdulla Ibrahim Sarsam --- Salah M.Tajer
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 4 Pages: 393-397
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Focused Abdominal Sonography for Trauma (FAST) is widely applied in the initial management of trauma patients, Being non invasive, repeatable and without risk of irradiation, make it attractive tool in evaluation of trauma patients.OBJECTIVE:Evaluation FAST sensitivity and specificity in detection of hemoperitoneum in abdominal trauma victims .METHODS:Prospective study conducted in the emergency department of Baghdad teaching hospital for one year period .The FAST done by a general surgeon or emergency physician during the secondary survey of blunt and penetrating abdominal trauma victims with equivocal clinical findings.RESULTS:Ninety three (93) patients included in the study, with over all sensitivity of FAST was 80.9 % and specificity 95.8 %. In blunt abdominal trauma the sensitivity was 92.3 % and specificity was 96 % while in penetrating abdominal trauma the sensitivity was only 62.5 % and specificity 95.2 %.CONCLUSION:FAST is highly sensitive and specific in detection of hemoperitoneum after blunt abdominal trauma ,but its lower sensitivity in penetrating abdominal injury require modification in the protocols like repetition of the scan or application of extra views. Its high specificity make it suitable as "rule in" test in both blunt and penetrating abdominal injury.


Article
Maxillofacial trauma among children below 15 years in Sulaimani city/ Iraq

Author: Falah A. Hawramy BDS, HDD, FICMS
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2011 Volume: 14 Issue: 1 Pages: 225-230
Publisher: University of Kufa جامعة الكوفة

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Abstract

The management of maxillofacial trauma in children differs from that of adults due to concern for growth and dentition development. Although the incidence and distribution of the pediatric facial trauma is common, there were few reports about this type of trauma. The aim of this study was to analyze the patterns of facial injuries in a sample of Sulaimani City children. The study included the records of (168) child patients sustained maxillofacial injuries. The data analyzed according to sex, age group, type of injury, site of injury, cause of injury and associated injuries. The results showed the male patients (57.7%) affected more than females while the most age group affected by trauma was (1-5) years. Soft tissues involved in (77.9 %) of the injured children and the chin was the most affected area (26.7%). Fall on the ground was the most cause of trauma (26.19%) followed by fall from height (25%). The dentoalveolar injuries were the most concomitant trauma (14.88%). This study provides a clinical data about the pediatric maxillofacial trauma for medical education and health care programs.

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