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.
The problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
... Show MoreStress with all its kinds are the results of a nick development Leading to delinquency burdening the ability of people.. development gas its effect on self and body reflecting on health ( physically, Psychological. And mentally) and finally leading to death (Al emara,2001,2).
Stress refers to he degree of response of the individual to events and environmental changes in his daily life with their physiological effects such as headaches , backaches, and gastric ulcer that have different effect depending on the personality of the person and his psychological characteristics differences airing individuals ( Al emirs, zool,2 )
The aims:
- knowi
Background: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.
Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.
Methods: A cross sectional study carried in Al-kindy Teaching
... Show MoreTo determine the relationship between Helicobacter pylori infection and reproduction disorder (recurrent spontaneous abortion), twenty women patients who undergo spontaneous abortion during first trimester of pregnancy (20-38) years and have been investigated from 2015/12/1 -2016/3/1 and compared to fifteen healthy individuals. All subjects were carried out to measure anti-H. pylori IgA and anti- H. pylori IgG antibodies by enzyme linked immunosorbent assay (ELISA). There was significant elevation (p≤ 0.05) in concentration of anti- H. pylori IgG Abs (6.30± 0.99) compared to control group (4.48± 0.61) and IgA Abs (5.42 ± 0.90 U /ml) as compared to control group (3.92 ± 0.41 U/ml). The percentage of H. pylori IgG and IgA was 20% and 25
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