Background: Quality of life in brain tumor patients is an emerging issue and has prompted neurosurgeons to recon¬sider the need for cognitive assessment in the course of treatment. To date there has been a lack of comprehensive neuropsychological assessment performed preoperatively and in the acute postoperative period in our hospitals.Objectives: to establish the effects of tumors and their surgical treatment, from a neuropsychological perspective, on cognitive functioning in patients with cerebral Gliomas. Methods: This is a prospective study conducted in the Neurosurgical Hospital in Baghdad, Iraq, during the period from January 1999 to January 2001. Any patient admitted during the period of the study with clinical history, signs, symptoms, and contrast enhanced MRI suggesting a cerebral glioma and confirmed by postoperative histopathological results of glioma has been included in this study. While multifocal lesions, long-lasting epilepsy, use of antiepileptic therapy, multiple cranial lesions, previous cranial surgery, any chronic illness, and histopathological result of other tumors were exclusion criteria. All patients were at their first operation for brain tumors. Patients were examined by analyzing several functional domains (intelligence, executive functions, memory, language, praxis, gnosis and mood state) in order to establish the effect of tumor and surgery on cognition.Results: 29 patients who fulfilled the selection criteria were included. Mean duration of clinical history was 5 months (range 1–9 months). At baseline, using test- and domain-based criteria, 79% and 38% of patients, respectively, were impaired, the former related to tumor factors such as edema (P < 0.05), larger size (P < 0.05) and higher grade (P = 0.001). Verbal memory, visuospatial memory and word fluency were the most frequently affected functions, partly associated with depression. Postoperatively, 38% and 55% of patients, respectively, were unchanged, 24% and 21% improved, and 38% and 24% worsened; 24% and 62% of patients were intact, respec-tively.Conclusions: The extent of removal did not influence the outcome. Improvement involved previously impaired functions and was correlated with high-grade tumors. Worsening regar¬ded executive functions was related to tumor size and was partly explained by radiological findings on postoperative MRI. This prospective study, focusing on the effects of tumor and surgery, showed that tumor significantly affects cognitive func¬tions, mainly due to the mass effect and higher grading. Surgical treatment improved the functions most frequently affected preoperatively and caused worsening of execu¬tive functions soon after operation, leaving the overall cognitive burden unchanged and capable of improvement prospectively.
Background: Intramedullary astrocytomas
account for about 1% of all CNS tumors and
6–8% of spinal cord tumors. The vast majority
of intramedullary astrocytomas are slowgrowing
lesions.
Objectives: The goal in this study was to
review a series of patients who underwent
surgical removal of intramedullary high-grade
astrocytomas, focusing on the functional
outcome and the effect of multimodality
treatment on the survival of patients with high
grade intramedullary astrocytoma.
Methods: Between June 1999 and June 2004,
22 patients underwent removal of
intramedullary high-grade astrocytomas in four
neurosurgical hospital in Baghdad/ Iraq
(Neurosurgical hospital, Al Shaheed Adnan
Hospital for
Background. Gene polymorphisms affect etanercept’s pharmacokinetics, pharmacodynamics, and side effects. This effect is evidenced by the extensive genetic variation in the drug’s targets. Objectives. This study aims to find the association between different genotypes of the promoter region of the TNF-α gene at -308G/A(rs1800629), -857C/T(rs1799724), -863 C/A(rs1800630), -1031 T/C (rs1799964), -806 C/T (rs4248158) and -376 G/A (rs1800750) and the side effects of ETN that occurred to Iraqi RA patients. Method. The trial included patients with rheumatoid arthritis who had been using ETN for at least six months. The participants were from the Baghdad Teaching Hospital Rheumatology Unit. The PCR was sequenced to determine the polymo
... Show MoreBackground: Shunt operations are performed for different reasons mainly hydrocephalus congenital or acquired. It’s associated with certain morbidity and mortality.
Patients and method: A prospective study from Jan 2004 to Jan 2006, 226 patients under went shunt operation in the specialized surgical hospital in Baghdad. The patients were divided into two groups according to the way of applying the upper end catheter. In group A49 patients where posterior parietal approach was used, and group (B) 174 where parietal or temproprietal approach was used.
Results and discussions: different complications were recorded, but the most frequent was upper end obstruction by choroids plexus or by debris. In group
Toxoplasma gondii is an opportunistic parasite in immune-compromised persons. The prevalence of toxoplasmosis in psoriasis patients is investigated. In addition, the treatment effect on psoriasis patients infected with toxoplasmosis through evaluating Tumor Necrosis Factor-α (TNF-α) cytokine levels is studied. Blood samples were collected from 130 individuals who involved 60 control samples and 70 samples with psoriasis. They attended Medical City Hospital in Baghdad province from October 2017 - February 2018. Then, the anti- T. gondii antibodies (IgM and IgG) and TNF- α in the sera were determined via the enzyme linked immune-sorbent assay. The highe
... Show MoreBackground: The optimal timing of surgery for Wilms' tumor has been debated for many years. It appears dubious whether surgical ease or per operative complications consistently improved after preoperative chemotherapy.
Materials and Methods: This is a cross section study ,the sample collected from January 2009 to November 2012 .Thirty four patients were selected after informed consent . Patients aged between 10 months and 5 years who were newly diagnosed with Wilms' tumors. including (17) patients with unilateral wilms tumors received immediate nephrectomy without preoperative chemotherapy according to the National Wilms' Tumor Study Group protocol and (1
... Show MoreBackground: Salivary gland neoplasms constitute a group of heterogeneous lesions with complex clinicopathologic characteristics and distinct biological behavior. Numerous studies have suggested geographical variation, therefore the aims of this study were to analyze the characteristics of salivary gland neoplasms in two Iraqi centers and to analyze the postoperative complications that are encountered after surgical treatment of these tumors. Materials and Methods: A retrospective study of the patients who were treated for major and minor epithelial salivary gland tumors was conducted. The analyzed data included; demographic information (age and gender), the site of the tumor, the clinical manifestations, the histological type of the tumo
... Show MoreBackground: To shade a light on certain tumor markers and their sensitivity and specificity in determination of pancreatic cancer.
Patients & Methods :- A total of 35 patients with pancreatic cancer were studied between June 2003 and April 2004 in Specialized Surgical - Baghdad Teaching Hospital . These patients were compared with other 25 non malignant G.I diseases patients as well as 35 healthy controls . The serum was estimated for CAI 9-9 , and CEA by ELFA (Enzyme Linked Fluorescent Assay) method and CPR by ELISA method.
Results :- Five patients with pancreatic cancer were excluded from this study because they were beyond surgery.The results show that there is significant differences between se
Background: Cognitive dysfunctions in epileptic patients may develop due to the neurophysiologic changes related to seizures or antiepileptic drugs.
Objectives: The aim of this longitudinal study was to evaluate the cognitive dysfunction in epileptic patients under antiepileptic drug therapy by the aid of event related potentials.
Patients & Method: P300 latencies were obtained from Fz, Cz and Pz electrodes positions from both epileptic patients (n = 224) and age and sex matched control group (n = 91). Epileptic patients were classified either having partial epilepsy, generalized epilepsy or both partial and generalized epilepsy (combined epilepsy). EEG and p300 test repeated for each patient every three months for one year. Th
Background: Gliomas are brain tumours of supporting tissue of the brain. The management of low grade glioma is still a great debate ranges from just follow up to extensive surgery followed by DXT, with or without chemothery.
Patients and Methods: 282 patients taken from neuro-surgical hospital between 1980-1990, divided to 3 groups with different modality of management & follow up for 15 years.
Results: the five years survival and symptomatic improvement was higher in the group managed by extensive surgery and DXT with or without cytoxic drugs followed by group managed by biopsy and DXT with or without cytoxic.
Conclusion: management of low grade glioma symptoms & out come (survival) is best by extensive surgery & DX