Background typhoid fever is the commonest cause of non traumatic terminal ileal perforation in our study with a grave postoperative morbidity & mortality depending upon preoperative time delay &/or type of surgical intervention practiced.
Objective to evaluate the frequency of non traumatic causes of terminal ileal perforation, their presentations,perforation-operation interval effect on complications, as well as different modalities of treatment and their complications.
Methods the study is a prospective study of 82 patients with perforation of terminal ileum diagnosed by explorative laparatomy in Al Kindy teaching hospital ,Baghdad, Iraq from April 2008- December 2010, all of the patients were examined clinically & investigated by plain x-ray of abdomen, ultrasound, complete blood picture, laparatomy was done for them after resuscitation and intravenous antibiotic, tissue biopsy was taken for paraffin section histopathological examination, and patients were followed for complications.
Results: the study of 82 patients revealed that their mean age 42 years (±14) ranging from16-75 years, with male to female ratio is 2, 28:1. The main cause of perforation is enteric fever 59 (71.95%) of patient, non specific inflammation 17(20.74%), Chronic granulomatous lesion 5(6.1%). The main presenting symptom in all patients was severe abdominal pain associated with fever, and abdominal distention in variable degree.The operative finding was single perforation in 61patients(74%) , two perforations in 8 patients(10%) and multiple in 13 patients(16%). The simple closure was done in 50 patients(60%), and other treated by resection and end to end anastomosis , Loop ileostomy,Resection and ileotransverse anastomosis, and follow up of patients revealed that 7(8%) died postoperatively , 3 patients(3.6%) developed wound dehiscence,6 patients(7%) developed enterocutanous fistula ,10 patients (12.1%) developed wound infection and 6 patients (7.3%) developed residual collection.
Conclusion non-traumatic perforation of terminal ileum is not uncommon and the most common cause is typhoid fever, and carries high mortality and morbidity rates specially in delayed presentation & diagnosis group of patients.
Background: Subjects with Autism Spectrum Disorder (ASD) have a higher prevalence of seizures than the general population, according to a significant body of research. Also, seizure-free patients with ASD have been found to have a higher prevalence of epileptiform discharge abnormalities compared to healthy controls across investigations. Changes in the electroencephalogram (EEG) can manifest as sharp waves or spikes, sharp and slow waves, generally distributed or general area, or focused, and can manifest in various brain regions. There is a necessity to search for a distinctive EEG characteristic in ASD patients.
Objectives: This study used electroencephalography to investigate the relationshi
... Show MoreSerum levels of iron,copper,ceruloplasmin and transferrine were estimated in three groups of patients with ?- thalassemia: 24 patients have splenectomy thalassemia major, 29 patients have non splenectomy thalassemia major and 19 patients have thalassemia intermedia , data were compared to normal and pathological controls (anemia and minor). There were significant increase in trace element levels in all studied groups of pateints as compared to normal and pathological controls. Also there were a significant increase in ceruloplasmin levels,While the result revealed that there were a significant decrease in transferrine levels in all groups of patients studied as compared to normal and pathological controls. The result also indicate that the
... Show MoreBackground: Drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules to achieve sustained seizure freedom. Up to 30% of patients referred to clinics with a diagnosis of pharmaco-resistant epilepsy may have been misdiagnosed, and many can be helped by optimizing their treatment.Pseudoresistance, in which seizures persist because the underlying disorder has not been adequately or appropriately treated, must be ruled out or corrected before drug treatment can be considered to have failed.
Objectives: The objectives of this study were to determine the causes of drug failure in patients with epilepsy and to differenti
... Show MoreAbstract
Background: Scabies is a skin infestation by the Sarcoptes scabiei mite. Scabies is transmitted through close personal contact. Settings like hospitals, prisons and childcare centers are at greater risk of outbreaks. Both male and female may be infected with scabies in any age groups. It is common in tropical climate countries poor people who live in rural areas and among displaced patients. It rises significantly among low economic status because skin diseases are significantly associated with a higher crowding index.
Objectives: To estimate the prevalence of scabies in Al- Daseem region and identify factors associated with an increased risk of scabies among pat
... Show MoreObjective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;
... Show MoreThis study examined the imperative construction: the command, the interrogative, the prohibition, the call, and the wish. In the Diwan of Al-Shamakh bin Dirar; where the poetic verses were monitored in each of the topics of the student's creation, and the rhetorical meanings that he came out with. What is new in this study is that it is the first to study the demanded composition in the poetry of a glorious poet, Al-Shammakh bin Dirar Al-Dhubyani. As his poetry did not receive such a study, it sought to employ what was written by rhetoric scholars, in an attempt to explore the demanded composition in the poetry of Al-Shamakh. The study adopted the descriptive analytical approach, which is based on counting the number of times the poet us
... Show MoreBackground: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D
... Show MoreBackground: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%
Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%