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Factors affecting compliance for iron chelating agents in thalassemic patients in Basrah province, Iraq 影响伊拉克巴士拉省地中海贫血患者铁螯合剂依从性的因素
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1142
S. Jabur, Hadeel Rashid Abdul Hameed
the remaining 32% of patients were live in urban areas. In the current study, the number of patients were taking oral chelating therapy (Exjad) was 116 patients (80%), while the number of patients taking injectable chelating therapy (Desferoxamine) was 29 patients (20%), (Figure 2). In the current study, we found that 42 patients (29%) had very accepted to their treatment and they are on regular way of treatment, 34 patients (23.4%) had not accept their treatment and they are on irregular AbstractObjectives: To assess factors that affect patient’s compliance for various type of chelating agents for thalassemic patients using direct questionnaires throughout 5 months period. Methods: A prospective screening study done on patients with diagnosed transfusion-dependent β-thalassemia treated on different types of iron chelating agents. Thalassemia unit in AL-Zahraa teaching hospital. Evaluation of patient’s preferability for chelation therapy, predictive values and reliability. Results: In the current study, we found that 88 patients (60%) had accept the treatment in different degrees while the remaining number of patients (57 patients, 39.3%) had not accept their treatment. Conclusion: In β-thalassemia compliance, monitoring using several methods is crucial as non-compliance is common and is associated with decreased survival. In addition, to have a good ideas about maintaining a reliable time for patient to continue on his chelating therapy.
其余32%的患者生活在城市地区。在本研究中,口服螯合治疗(Exjad)患者116例(80%),注射螯合治疗(去铁氨明)患者29例(20%)(图2)。在本研究中,我们发现42例(29%)患者对其治疗非常接受,并按常规治疗,34例(23.4%)患者不接受治疗,不定期治疗。通过5个月的直接问卷调查,评估影响地中海贫血患者对各类螯合剂依从性的因素。方法:对诊断为输血依赖性β-地中海贫血的患者进行不同类型铁螯合剂治疗的前瞻性筛选研究。扎赫拉教学医院的地中海贫血科。评估患者对螯合治疗的偏好、预测价值和可靠性。结果:在本研究中,我们发现88例(60%)患者不同程度地接受了治疗,其余57例(39.3%)患者不接受治疗。结论:在β-地中海贫血依从性中,使用多种方法进行监测是至关重要的,因为不依从性是常见的,并且与生存率降低有关。此外,要有一个好的想法,保持一个可靠的时间,让病人继续他的螯合治疗。
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引用次数: 0
Knowledge of doctors regarding breaking bad news to patients 医生关于告诉病人坏消息的知识
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1137
Wafaa Hamad Mohammed Al-Sabaawi, N. M. Ibraheem, Zeena N. Abdulrahman
Breaking terrible news entails having a difficult talk with a patient in which the doctor must notify him or her that they have a life-threatening, incurable sickness.1 Clearly, this definition is neither exhaustive or even universally applicable, since the impact of the news on the recipient can vary greatly and depend on a variety of circumstances, including the person’s previous experience, life philosophy, spirituality, religious beliefs, age, culture, and education.1 Knowledge is a collection of ideas, knowledge, and “science.” It also refers to one’s ability to imagine and perceive things.2 Knowing that delivering terrible news is one of the occasions in which the doctor’s professionalism, critical experience, and ability to build trust are put to the test.3 A doctor must have not only the necessary experience, but also the necessary knowledge and skills. Proper education and Continuing communication training are critical in developing the ability of doctors to deliver unpleasant news.4 One of the most major reasons physicians have difficulties breaking terrible news to patients is a lack of information about how to properly communicate bad news to patients and the consequences of doing so.5 Some doctors are willing to take on the challenges, while others prefer to avoid them. Most people who avoid difficult situations have good intentions but don’t know how to carry them out. They are concerned that if they say something inappropriate, the patient or family would cry or panic out.6 In truth, the majority of doctors in clinical practice have never been taught how to deliver terrible news and do not do so on a regular basis. As a result, delivering terrible news is a lonely task. All doctors are aware that this is a part of their responsibilities, and it does not appear to belong to any one discipline in particular.7 Delivering bad news is one of the most difficult difficulties that a doctor has in their medical practice,8 and it is a vital skill for all physicians, as well as many specialists, who will need to do it multiple times throughout their careers.9 The rise in chronic diseases and concerns connected to quality of life, it’s more important than ever to understand how bad news affects patients, their families, and clinicians,10 therefore bad news delivery to patients and their families requires extensive training and practice.11 Telling the truth is a difficult endeavor that involves a wide range of communication, comprehension, and empathy abilities. When used in the context of imparting bad news to a patient, it can be distressing and hazardous if done incorrectly,12 and if patients are not properly communicated with, it can have a significant impact on how they perceive their disease, as well as whether they discontinue or continue medical therapy.13 Rasmus and Kozlowska conducted a study in Poland (2017) to investigate knowledge of breaking bad news among medical personnel in emergency medical services. The study found that only
告诉病人一个可怕的消息意味着医生必须和病人进行一场艰难的谈话,医生必须告诉病人,他们得了一种危及生命的、无法治愈的疾病显然,这个定义既不是详尽的,也不是普遍适用的,因为新闻对接受者的影响可能会有很大的不同,这取决于各种各样的情况,包括这个人以前的经历、生活哲学、精神、宗教信仰、年龄、文化和教育知识是思想、知识和“科学”的集合。它也指一个人想象和感知事物的能力知道传达可怕的消息是医生的专业精神、批判经验和建立信任的能力受到考验的场合之一医生不仅要有必要的经验,而且要有必要的知识和技能。适当的教育和持续的沟通培训对于提高医生传达坏消息的能力至关重要医生难以向病人传达坏消息的最主要原因之一是缺乏关于如何正确地向病人传达坏消息以及这样做的后果的信息一些医生愿意接受这些挑战,而另一些医生则宁愿逃避。大多数逃避困境的人都有良好的意图,但不知道如何实现。他们担心如果他们说了不恰当的话,病人或家属会大哭或惊慌失措事实上,在临床实践中,大多数医生从来没有被教导过如何传达可怕的消息,也没有定期这样做。因此,传递可怕的消息是一项孤独的任务。所有的医生都意识到这是他们职责的一部分,而且它似乎不属于任何一个特定的学科传达坏消息是医生在医疗实践中遇到的最大困难之一,这是所有医生以及许多专家的一项重要技能,他们在整个职业生涯中需要多次做到这一点随着慢性病的增加和对生活质量的关注,了解坏消息如何影响病人、他们的家人和临床医生比以往任何时候都更重要,因此,向病人和他们的家人传递坏消息需要广泛的培训和实践说真话是一项艰难的努力,涉及广泛的沟通、理解和同理心能力。当在向病人传达坏消息时,如果使用不当,它可能是痛苦和危险的,如果患者没有得到适当的沟通,它可能会对他们如何看待自己的疾病产生重大影响,以及他们是否停止或继续药物治疗Rasmus和Kozlowska在波兰(2017年)进行了一项研究,调查紧急医疗服务中医务人员对突发坏消息的了解。研究发现,只有少数参与者(4.1%)知道突发坏消息的spike协议伊拉克遭受了40年的战争之苦,也遭受了恐怖袭击。15 .所有这些不幸导致暴力社会冲击和社会动荡,对伊拉克的卫生状况产生不利影响,由于卫生和社会基础设施恶化以及受伤人数增加,发病率和死亡率增加悲伤笼罩着伊拉克社会,成千上万的伊拉克家庭失去了他们的成员为了了解卫生工作人员如何处理这一痛苦的场面,以及他们如何处理社会迄今面临和正在面临的困难和致命病例,选择了对医生关于突发坏消息的知识进行研究。
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引用次数: 1
Distribution of asymptomatic bacteriuria among women use Intrauterine Devices (IUDs) according sociodemographic characteristics factores in Takrit, Iraq 伊拉克塔克瑞特地区使用宫内节育器的妇女无症状细菌的社会人口特征分布
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1139
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引用次数: 1
Comparison of Some Indicators in Serum and Saliva on Periodontitis 牙周炎血清和唾液指标的比较研究
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1140
A. Yousif, P. Ismail, N. A. Ismail, Namam A Ismail
ml of the blood in a test tube without anticoagulant, and plasma was prepared by adding 2 ml of the blood in a test tube contain anticoagulant (EDTA) both samples were separated by cen-trifugation. Unstimulated saliva was collected from the same AbstractObjectives: To assess the serum indicators level in healthy and periodontitis subjects and correlate the levels in the terms of changes of serum and salivary parameters in periodontal disease. Methods: The assay comprised 85 subjects, enrolled of both genders in the age range of 33–56 years old. Volunteers were categorized into two groups: 40 healthy individual, other groups (periodontal disease) embraced 45 patients. The salivary and blood samples were collected and sent for biochemical analysis to measure the nitric oxide (NO), superoxide dismutase (SOD), glutathione, catalase, Interleukin 6 (IL-6), Interleukin 4 (IL-4), and interferon-γ (IFN-γ) levels in periodontitis patients. Results: Based on the statistical evaluation of bio-indicator parameters, the following conclusion can be shown from this revision: Serum and saliva SOD ( P < 0.001), glutathione ( P < 0.001), and catalase ( P < 0.001) activates were significantly reduced in periodontitis as compared with control groups, the remaining biochemical assessed in periodontitis patients [NO ( P < 0.001), IL-4 ( P < 0.0001), IL-6 ( P < 0.0001), and IFN-γ ( P < 0.0001)] indicated significantly high levels in both serum and saliva samples. Conclusions: The NO, SOD, catalase, glutathione and cytokines may be used as bio-indicator for periodontitis exposure, medical conduct and severity. This recognition offers early diagnosis of disease and progression. Also there was a direct positive correlation between the salivary and the serum bio-markers levels, which it was proved that the salivary non-invasive examination had a significant association with the serum investigation.
在不含抗凝剂的试管中加入2ml血液,在含抗凝剂(EDTA)的试管中加入2ml血液制备血浆,两种样品经离心分离。【摘要】目的:评价健康人与牙周炎患者血清各项指标的水平,并将其与牙周病患者血清和唾液参数的变化联系起来。方法:该试验包括85名受试者,年龄在33-56岁之间,男女均有。志愿者被分为两组:40名健康个体,其他组(牙周病组)45名患者。采集牙周炎患者的唾液和血液进行生化分析,测定其一氧化氮(NO)、超氧化物歧化酶(SOD)、谷胱甘肽、过氧化氢酶、白细胞介素6 (IL-6)、白细胞介素4 (IL-4)、干扰素γ (IFN-γ)水平。结果:基于对生物指标参数的统计评价,本次修订得出以下结论:与对照组相比,牙周炎患者血清和唾液中SOD (P < 0.001)、谷胱甘肽(P < 0.001)和过氧化氢酶(P < 0.001)活性显著降低,牙周炎患者血清和唾液中剩余生化指标[NO (P < 0.001)、IL-4 (P < 0.0001)、IL-6 (P < 0.0001)和IFN-γ (P < 0.0001)]均显著升高。结论:一氧化氮、超氧化物歧化酶、过氧化氢酶、谷胱甘肽和细胞因子可作为牙周炎暴露、医疗行为和严重程度的生物指标。这种认识有助于疾病的早期诊断和进展。唾液与血清生物标志物水平呈正相关,证明了唾液无创检查与血清调查有显著相关性。
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引用次数: 0
Heterologous COVID-19 Vaccination; Sinopharm and Pfizer-BioNTech 异源COVID-19疫苗接种;国药控股和辉瑞生物科技
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1146
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引用次数: 1
Serum Level of Vitamin K as Predicts Mortality in Iraqi COVID-19 Patients 伊拉克COVID-19患者血清维生素K水平预测死亡率
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1143
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引用次数: 0
A Prospective study for effect of wound or scar tissue massage after thyroidectomy on neck discomfort and voice change 甲状腺切除术后伤口或瘢痕组织按摩对颈部不适和声音改变影响的前瞻性研究
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1138
Hemin Qabel Hasan, A. Dabbagh
Objectives: This study aimed to found and selecting the causes behind neck discomfort and change in the voice following thyroidectomy and to determine the efficacy of wound massaging technique on decreasing and relief such symptoms. Methods: Totally 55 patients all females who underwent thyroidectomy were included in our study, the patients were divided in to two groups (26 in the experimental group and 29 in the control group). The massaging technique was instructed to all patients in the experimental group 1 week postoperatively and the feedback were received from patients after 2 weeks and 4 weeks from instruction time. The analysis was achieved for both groups of patients. and significantly much more better recovery from subjective voice impairment score (SVIS) and neck discomfort score (NDS) which was represented by swallowing impairment score (SIS). (all P < .01) in compare with the patients in control group. Those results indicates that localized adhesions following total thyroidectomy operation could be included in affection of general movement as well as vertical movements of the larynx and the wound massaging technique might help patients recovering the normal general movement of the larynx postoperatively. Conclusion: Discomfort of the neck, pulling neck sensation, and voice or phonation changes after total thyroidectomy surgery might due to local surgical adhesions of the wound which possibly accompanied with impairment of vertical movement of larynx. so, releasing of such adhesions could help the patients to recover much more quickly from mentioned undesirable symptoms postoperatively and start their normal daily activities.
目的:本研究旨在发现和选择甲状腺切除术后颈部不适和声音变化的原因,并确定伤口按摩技术对减轻和缓解此类症状的疗效。方法:选取55例行甲状腺切除术的患者,均为女性,分为两组(实验组26例,对照组29例)。实验组患者术后1周接受推拿手法指导,术后2周、4周接受患者反馈。对两组患者均进行了分析。主观语音障碍评分(SVIS)和颈部不适评分(NDS)(以吞咽障碍评分(SIS)表示)的恢复明显更好。与对照组比较,差异均有统计学意义(P < 0.01)。提示甲状腺全切除术后局部粘连不仅影响喉头的垂直运动,而且影响喉头的全身运动,创面按摩技术有助于患者术后恢复喉头的正常全身运动。结论:甲状腺全切除术后出现颈部不适、拉颈感、声音或发音改变,可能是由于手术创面局部粘连所致,并伴有喉部垂直运动障碍。因此,释放这些粘连可以帮助患者更快地从术后不良症状中恢复,并开始正常的日常活动。
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引用次数: 1
The correlation between Vitamin D and Colorectal Cancer in admitted patients in Oncology teaching hospital 肿瘤教学医院住院患者维生素D与结直肠癌的关系
Pub Date : 2021-12-26 DOI: 10.22317/imj.v5i4.1136
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引用次数: 0
The Correlation of age and gender with prevalence of histopathological patterns of thyroid diseases among Iraqi patients 年龄和性别与伊拉克患者甲状腺疾病组织病理学模式患病率的相关性
Pub Date : 2021-09-26 DOI: 10.22317/imj.v5i3.1031
Sala Jafar Nadhum Hamandi, A. R. Alsaadawi
Objectives: The aim of this study was to investigate the prevalence of histopathological patterns of thyroid lesions and their relation to age and gender in patients underwent total or near total and partial thyroidectomy. Methods: 430 biopsy blocks examined for patients who had undergone total or near total and partial thyroidectomy for both non-neoplastic and neoplastic thyroid lesions, between January 2018 to December 2020 at Surgical Department, Medical city, Baghdad, Iraq. Results: Out of 430 thyroidectomy specimens, 275 (64%) cases of non-neoplastic lesions, and 155 (36%) cases of neoplastic lesions were present. There were 63 males and 367 females with a male to female ratio of 1:5.6. The age ranged in males from 12 to 83 years with a mean age of 47.5 years and the age ranged in females from 10-68 years with a mean age of 39 years. In non-neoplastic lesions, the predominant lesion was the nodular hyperplasia with 233 (84.7%) cases followed by Hashimoto thyroiditis with 24 (8.7%) . In neoplastic lesions, papillary carcinoma was the commonest lesion with 98 (63.2%) cases followed by follicular carcinoma with 11 (7%) cases. Conclusion : Nodular colloid goiter was the most common non –neoplastic lesion with female predominance . Papillary carcinoma was the most frequent thyroid cancer accounting for 84.4% of thyroid cancers. with micropapillary variant making 44.89 % with most cases occurring in the third and forth decade.There appears to be a slightly increased trend of papillary carcinoma diagnosis. The present study highlights the necessity for time to time assessment of neoplastic lesions in young and middle-aged female for initial detection.
目的:本研究的目的是调查甲状腺病变的组织病理学模式的患病率及其与年龄和性别的关系,患者接受全甲状腺切除术或近全甲状腺切除术和部分甲状腺切除术。方法:2018年1月至2020年12月,在伊拉克巴格达医疗城外科对非肿瘤性和肿瘤性甲状腺病变行甲状腺全切除术或近全切除术和部分切除术的患者进行430例活检切片检查。结果:430例甲状腺切除术标本中,非肿瘤病变275例(64%),肿瘤病变155例(36%)。男性63人,女性367人,男女比例为1:6 .6。男性年龄12 ~ 83岁,平均47.5岁;女性年龄10 ~ 68岁,平均39岁。非肿瘤性病变以结节性增生为主,233例(84.7%),其次为桥本甲状腺炎24例(8.7%)。在肿瘤病变中,最常见的是乳头状癌98例(63.2%),其次是滤泡癌11例(7%)。结论:结节性胶体甲状腺肿是最常见的非肿瘤性病变,以女性为主。乳头状癌是最常见的甲状腺癌,占甲状腺癌的84.4%。微乳头状变异占44.89%,多发生在三、四十岁。乳头状癌的诊断率有轻微上升的趋势。本研究强调了对中青年女性肿瘤病变进行及时评估的必要性。
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引用次数: 0
Serum Total and Free Prostate Specific Antigen Levels as Novel Biomarker in Patients with COVID-19 血清总前列腺特异性抗原和游离前列腺特异性抗原水平作为新冠肺炎患者的生物标志物
Pub Date : 2021-09-26 DOI: 10.22317/imj.v5i3.1034
Objectives: This study aimed to evaluate the diagnostic value of TPSA and FPSA for early detection of COVID-19 and compare it with a control group. Methods: This is a retrospective study of 146 patients from the Respiratory Clinic in Sebha city, 73 of whom have COVID-19 PCR-confirmed and 73 who do not have COVID-19 (group control). Results: The mean and standard division age in the PCR-confirmed COVID-19 group was 61.51±16.40. In the PCR-confirmed COVID-19 group, the mean and standard division serum biomarker level for TPSA was 0.51±.26 ng/ml, and 0.57± 0.32 for FPSA. Conclusion: For the biomarkers TPSA and FPSA, there were no significant differences between the control and PCR-confirmed COVID-19 groups. These findings suggest that the tumor biomarker may be ineffective in detecting COVID-19.
目的:评价TPSA和FPSA在COVID-19早期检测中的诊断价值,并与对照组进行比较。方法:对来自塞卜哈市呼吸诊所的146例患者进行回顾性研究,其中73例经pcr确诊为COVID-19, 73例未感染COVID-19(对照组)。结果:pcr确诊组平均年龄为61.51±16.40岁。在pcr确诊的COVID-19组中,TPSA的平均和标准划分血清生物标志物水平为0.51±。26 ng/ml, FPSA 0.57±0.32。结论:在生物标志物TPSA和FPSA方面,对照组与pcr确诊的COVID-19组之间无显著差异。这些发现表明,肿瘤生物标志物可能对COVID-19检测无效。
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引用次数: 0
期刊
Iraq Medical Journal
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