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The Impact of a Structured Clinical Pathway on the Application of Management Standards in Patients with Diabetic Ketoacidosis and Its Acceptability by Medical Residents

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Journal of Diabetes Mellitus 2014年第4期4卷 264-272页

作者： Imad S. Hassan Azzam D. Al-Otaibi Meteb M. Al-Bugami salih Bin salih Yousef Al Saleh Salman Abdulaziz Department of Medicine & King Saud bin Abdulaziz University for Health Sciences Riyadh KSA Department of Medicine King Abdulaziz Medical City Riyadh KSA Nephrology Dalhousie University Nova Scotia Canada Division of Endocrinology & King Saud bin Abdulaziz University for Health Sciences Riyadh KSA Internal Medicine & Critical Care Rashid Hospital Dubai UAE

Diabetic Ketoacidosis (DKA) is a serious and potentially a fatal complication of diabetes mellitus. Tools to guarantee proper, evidence-based, guideline implementation are of paramount importance and an essential element for quality patient care. Clinical pathways represent one such tool that clearly promotes the implementation of guidelines and research evidence into clinical practice. The aims of this study were to measure quantitatively and qualitatively the impact of a specially structured Resident-friendly, DKA clinical pathway on the application of evidence-based management standards and its acceptability by the treating resident physicians. A retrospective chart review of patients who were admitted prior to and after the launching of the clinical pathway and a questionnaire assessment of resident’s acceptance of the pathway format were undertaken. Eighty one episodes of DKA in a total of 58 patients fulfilled the criteria for inclusion in the study. Thirty seven admissions were on the pathway (45.7%) and 44 were not (54.3%). Documentation of severity indices of patients who were admitted under the pathway were significantly improved with a trend for a shorter hospital stay. The duration of intravenous insulin therapy, intensive care unit consultation and diabetes educator involvement in patient care were not different between the two groups. Residents found the pathway user-friendly, educationally very valuable, reduced their workload and had a positive effect on their DKA management skills.?Conclusions: Use of specially structured, resident-friendly pathway led to significant improvement in documentation of DKA severity indices and empowered our residents with evidence-based knowledge and skills to deal with this serious diabetic complication.

关键词： Diabetic Ketoacidosis Clinical Pathway Trainees Quality

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The Abuse of Dermal Fillers: A Clinico-Epidemiological Study of 35 Cases

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Journal of Cosmetics, Dermatological Sciences and Applications 2019年第2期9卷 94-106页

作者： Nabeel K. Al Hamzawi salih M. Al Baaj Department of Dermatology Diwaniyah Teaching Hospital Diwaniyah Iraq Department of Plastic Surgery Diwaniyah Teaching Hospital Diwaniyah Iraq

Background: Nowadays, the use of dermal fillers for correcting signs of aging, such as wrinkles, depressions, and folds, has become increasingly popular. However, the abuse of these products can lead to disfigurements and unpredictable consequences among users. Objective: To evaluate the clinical abnormalities related to dermal fillers abuse in Iraqi people, and identify the various factors contributing to them. Methods: A total of 35 patients with different facial abnormalities due to the abuse of dermal fillers, attending our clinic in Diwaniyah, Iraq, from September 2016 to December 2017, were enrolled. A questionnaire-based analysis was used to collect clinical and sociodemographic data from patients to determine the etiological profile behind this problem. Several disfigurements and facial defects were diagnosed on clinical base. We have treated most of the situations that require intervention and treatment. Results: A total of 35 patients aged between 25 and 54 years with a sex ratio of 0.093 were enrolled in this study. Their mean age was 42 years, and the age group between 35 and 45 years was forming 85.7% of the cases. The clinical abnormalities recorded in this study include: buffy face 8 (22.8%), facial asymmetry 3 (8.5%), Mdoka fish lips like 6 (17%), periorbital redness 1 (2.8%), filler fatigue 6 (17%), bags under eyes 4 (11.4%), sizeable bulbous nose 4 (11.4%), topographical changes 2 (5.7%), and stone-like cheeks 1 (2.8%). The leading causes for the abuse of fillers were as follows: 12 (34.28%) candidates were not compatible with the procedure, 9 (25.7%) were non-compliance with the indications of the Food and Drug Organization (FDA), 9 (25.7%) fillers were injected in the wrong place, 18 (51.4%) injections were of a larger quantity than required, and 5 (14.2%) had frequent and long-term injection. Conclusion: The use of dermal fillers for a wrong purpose can result in disfigurements rather than beautification. The commonest disfigurements are the puf

关键词： Dermal Filler Abuse Clinical Abnormalities Disfigurements

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A Comparative Analysis for a Novel Irrigation Method: Partial Rootzone Drying

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Journal of Agricultural Chemistry and Environment 2018年第1期7卷 34-44页

作者： Alaa Abdallah El-Sadek Mona Ezo Radwan Ahmed Ali salih Arabian Gulf University Manama Kingdom of Bahrain Nile Research Institute National Water Research Center El Qanater El Khairia Egypt

Partial Rootzone Drying (PRD) is an irrigation technique which offers a means of modifying the growth and development of crops through relatively simple changes to the method of water delivery. The technique causes the stimulation of physiological responses which are normally associated with water stress and this results in a significant reduction in water use through the production of chemical signals in drying roots. Partial drying of one half of the roots of plants grown with two root systems is rapidly translated into a reduction in transpiration and assimilation of all the crop leaves. The aim of this research is to examine and simulate the novel irrigation method (PRD), which would stimulate the endogenous stress response mechanisms of Conocarpus erectus trees in the pilot area of the Arabian Gulf University in Bahrain and wheat and maize crops in the Mashtul Pilot Area (MPA), Egypt using Saltmed model so that vigor is reduced and the efficiency of water use is enhanced. This is to be achieved by the manipulation of the hydration status of parts of a crop’s roots that could be used to control vegetative vigor without detrimental effects on canopy water relations. The PRD technique is researched for wheat as a winter crop and maize as a summer crop in Egypt. The technique causes the stimulation of physiological responses which are normally associated with water stress and this results in a significant reduction in water use through the production of chemical signals in drying roots. The results confirmed an increase in irrigation water use efficiency using PRD comparing with conventional flood irrigation. The research highly recommends applying the PRD method in the Gulf Cooperation Council (GCC) countries and in new reclaimed areas in Egypt to save water and improve crop quality.

关键词： Partial Rootzone Drying Conocarpus Erectus Trees MPA GCC

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Pegylated interferon-alpha plus taurine in treatment of rat liver fibrosis

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World Journal of Gastroenterology 2007年第23期13卷 3237-3244页

作者： Ilker Tasci Mehmet Refik Mas Sevil Atalay Vural salih Deveci Bilgin Comert Gunay Alcigir Nuket Mas Cemal Akay Mithat Bozdayi Cihan Yurdaydin Hakan Bozkaya Ozden Uzunalimoglu Ahmet Turan Isik Harun M Said Department of Internal Medicine Gulhane School of Medicine Ankara 06018 Turkey Department of Pathology Veterinarian Faculty Ankara University Ankara Turkey Department of Pathology Gulhane School of Medicine Ankara 06018 Turkey Department of Anatomy Baskent University Ankara Turkey Institute for Hepatology Ankara University Ankara Turkey Department of Radiation Oncology Medical Faculty University of Würzburg Wiürzburg Germany 不详

AIM: To investigate the antif ibrotic effects of peginterferon- alpha 2b and taurine on oxidative stress markers and hepatocellular apoptosis. METHODS: Sixty rats with CCl4-induced liver fibrosis were divided into 4 groups (n = 15). Group 1 was left for spontaneous recovery (SR). Groups 2-4 received peginterferon-alpha 2b, taurine, and their combination, respectively, for four weeks. Histological f ibrosis scores, histomorphometric analysis, tissue hydroxyproline, tissue MDA, GPx and SOD activities were determined. Activated stellate cells and hepatocellular apoptosis were also evaluated. RESULTS: The degree of f ibrosis decreased in all treatment groups compared to spontaneous recovery group. Taurine alone and in combination with peginterferon-alpha 2b reduced oxidative stress markers, but peginterferon-alpha 2b alone did not. Apoptotic hepatocytes and activated stellate cells were higher in groups 2-4 than in group 1. Combined taurine and peginterferon-alpha 2b further reduced fibrosis and increased activated stellate cell apoptosis, but could not improve oxidative stress more than taurine ***: Peginterferon-alpha 2b exerts anti- f ibrotic effects on rat liver fibrosis. It seems ineffective against oxidative stress in vivo. Peginterferon-alpha 2b in combination with taurine seems to be an antif ibrotic strategy.

关键词： Liver fibrosis Liver cirrhosis Pegylated interferons Taurine Oxidative stress Hepatic stelate cells Apoptosis Malondialdehyde Glutathione peroxidase Superoxide dismutase

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Mental Health Assessment of Elderly People Attending Geriatric Clinic in Medical City

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Open Journal of Psychiatry 2019年第2期9卷 98-106页

作者： Najlaa F. Jamil Alaa A. salih Dhabya I. Razzaq College of Medicine University of Mustansiriyah Baghdad Iraq Community Medicine/Ministry of Health Baghdad Iraq

Background: Worldwide elderly population and their life expectancy are increasing gradually. Longevity in most cases brings down poorer health as well as functional status. Thus, it is necessary to understand the problems as well as social, psychological, and medical needs of elderly people in order to plan their optimal care. Objectives: To assess the mental health status (depression and memory state) of elderly people attending Geriatric clinic in medical city, and to determine the influence of some sociodemographic factors on elderly mental health status. Subjects and Method: A cross-sectional study was conducted among elderly people aged 60 years and more who attended geriatric clinic of medical city in Baghdad, from 1st of April to the end of June 2015. Special questionnaire form had been used for data collection via direct interview. The evaluation of the mental state was performed by using modified version of Wechsler Memory Scale and geriatric depression scale. Results: A total of 400 elderly persons were enrolled in the study, 109 (27.3%) of them had impaired memory. The analysis of data revealed that the age and marital status had statistical significant association with memory state. Nearly three quarter (72.8%) of study group had depression according to geriatric depression scale. The majority of studied women had depression (90%), and the same percentage was observed among widowed elders joining in the study.

关键词： Assessment Mental Health Elderly Depression Memory State

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G-WADI—the first decade

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Research in Cold and Arid Regions 2013年第1期5卷 1-5页

作者： W. Mike Edmunds Ramasamy Jayakumar Anil Mishra Abdin salih Soroosh Sorooshian Howard S. Wheater William Logan Oxford Water School of Geography and the Environment Oxford University Oxford OX1 3QY UK UNESCO Beijing Office Waijiaogongyu 5-15-3 Jianguomenwai Compound UNESCO IHP 1 rue Miollis 75732 Paris Cedex 15 France University of Khartoum Gramma Avenue Khartoum 11111 Sudan Global Institute for Water Security University of Saskatchewan National Hydrology Research Centre 11 Innovation Boulevard Saskatoon SK S7N 3H5 Canada International Center for Integrated Water Resources Management (ICIWaRM-UNESCO) Institute for Water Resources (IWR) U.S. Army Corps of Engineers 7701 Telegraph Road Alexandria VA 22315-3868 USA

The G-WADI network by UNESCO promotes the global capacity for management of water resources in arid and semi-arid areas. The primary aim has been to build a comprehensive global network to promote regional and international cooperation so as to in- crease knowledge and improve management practices through the sharing of information. The G-WADI objectives and achieve- ments of the past 10 years are reviewed. A number of key initiatives have been implemented^the formation of five regional net- works, the creation of a central G-WADI web site, promotion of near-real-time rainfall distribution software enhanced by the in- clusion of satellite based precipitation estimations, as well as workshop and web-based activities on chemical and isotopic tracers and on rain water harvesting. Two workshops on surface and on groundwater modeling, supported by publications have been held in India and China. The Asian G-WADI network remains very active, but activities in the other three regions are developing （Af- rica, Arab Region, Latin America and the Caribbean）.

关键词： UNESCO semi-arid regions water resources groundwater modeling global networks water harvesting

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Radon Dosimetry in Erbil City Hospitals

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Journal of Physical Science and Application 2012年第7期2卷 240-244页

作者： Ali Hassan Ahmed salih Omer Haji Hiwa Hamad Azeez Dept. of Physics College of Science University of Salahaddin-Erbil Erbi144004 Iraq Dept. of Physics College of Egueation University of Salahaddin-Erbil Erbi144001 lraq

The aim of the study was to compare radon concentrations and effective dose equivalent in state hospitals inside the Erbil city having different periods of building. Effective doses were estimated in different floors of the five selected hospitals by using the （CR-39） solid state nuclear track detectors with the guide of 1CRP Publication 66. The hanged dosimeters were left for about 60 days and after etching the radon concentration, annual effective dose and effective dose equivalents were calculated. Annual effective doses were estimated as 〈 1 mSv, so the results reveal the present concentrations to be below the standard values in the studied hospitals. Therefore, no healthy risks concerning the radon activities are existing in the hospital staff and patients in these hospitals.

关键词： Indoor radon hospital Erbil and Cr-39 track detectors.

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Sonographic Evaluation of Obstructive Jaundice

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Open Journal of Medical Imaging 2015年第1期5卷 24-29页

作者： Moawia Gameraddin Suzan Omer Suliman salih Suha A. Elsayed Abdalmonem Alshaikh Department of Diagnostic Radiologic Technology Faculty of Applied Medical Sciences Al-Madinah Al-Munawwarah Saudi Arabia Faculty of Radiological Sciences and Medical Imaging Alzaiem Alazhari University Khartoum Sudan National Cancer Institute University of Gezira Wad Medani Sudan

Purpose: This study was done to assess the role of ultrasound in diagnosis of obstructive jaundice and to identify the most common causes and symptoms. Materials and methods: The study took place in different Khartoum clinical centers and hospitals in the period between Jan 2014 and July 2014. A total of 150 patients with obstructive jaundice were examined using ultrasound machine, 3.5 - 7 MHz probe. Results: The study revealed that 65.33 of the study population with obstructive jaundice were female and 34.67% was male. The most common affected groups were 46 - 65 years old and 25 - 45 years old. The common causes of obstructive jaundice were biliary stones (61.33%) which were common in females and abdominal masses (32.67%) which were common in females, too. Nausea, yellowish discoloration and abdominal pain were the most common symptoms (98%, 97.33% and 96.67% respectively). The causes of obstructive jaundice showed significant difference between males and females (P-value = 0.002). Conclusion: Ultrasound was superior diagnostic tool in detecting and assessing biliary system obstruction, because it was easy, available, accurate and noninvasive. The ageing and gender were considered as risk factors of obstructive jaundice.

关键词： Sonography Evaluation Obstructive Jaundice

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Voltage Profile Enhancement and Power Loss Reduction with Economic Feasibility Using Small Capacity Distribution Transformers

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Energy Engineering 2022年第6期119卷 2447-2467页

作者： Rasool M.Imran Mohammed R.Saeed Mohammed Amer Mohammed Osama A.Suhry Ihsan H.Abdulqadder Hasan Wahhab salih Mohammed R.Almallah Firas M.F.Flaih Department of Electric Power Techniques Al-Hussain University CollegeKarbala56001Iraq School of Artificial Intelligence Wuchang University of TechnologyWuhan430223China State Company of the North Distribution Electricity Ministry of ElectricityBaghdad10013Iraq Department of Informatics and Software Engineering Cihan University-ErbilErbilKurdistan44001Iraq Najaf Gas Turbine Power Plant General Company of the Electricity ProductionMinistry of ElectricityBaghdad10013Iraq General Company of the Electricity Transmission-North Region Ministry of ElectricityBaghdad10013Iraq

Usually,rural areas can be electrified via three-phase distribution transformers with relatively large *** such areas,low voltage lines are used for long distances,which cause power losses and voltage drop for different types of *** losses and improving voltage profiles in rural distribution networks are significant challenges for electricity distribution *** different solutions were proposed in the literature to overcome these challenges,most of them face difficulties when applied in the conventional distribution *** address the above issues,an applicable solution is proposed in this paper by installing a number of small-capacity distribution transformers instead of every single large-capacity transformer in rural *** proposed approach is implemented in the branch network of Al-Hoqool village,which belongs to the Nineveh distribution *** network has been inspected on-site,drawn,and analyzed using the electrical systems analysis program(ETAP).The analysis showed that using the single-phase pole-mounted transformers can improve the voltage in the network’s end by 29%and enhance the voltage profile for all *** analysis has also demonstrated that the modification can reduce the total power losses by 78%compared to the existing *** the economic aspect,the payback period for the proposed network is assigned to be 20 months.

关键词： Single-phase pole-mounted transformer three-phase transformer power losses voltage profile distribution networks

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Effect of Three Different Growth Media on Yield and Oil Constituents of Rosemary （Rosmarinus officinalis L.） under Protected Agriculture Conditions

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Journal of Agricultural Science and Technology(A) 2014年第5期4卷 395-403页

作者： Kholod F. Abou Seedo Ahmed A. salih Ahmed A. Taha Arid Zones Sciences Programme Graduate College Arabian Gulf University Manama Kingdom of Bahrain Department of Chemistry Faculty of Science University of Bahrain Manama Kingdom of Bahrain

Medicinal plants provide an important source of cure since ancient time. Poor soil resources, scarce and saline water and the harsh environment limited the production of plants in the Arabian Gulf countries. This study aimed to investigate the production potential of rosemary （Rosmarinus officinalis L.） grown on different growth media under greenhouse conditions. Three growth media agricultural soil, compost and hydroponic system were used, whereas tuff （inert volcanic material） was used as substrate. The result indicated that the high salinity of the agricultural soil limited growth and oil yield in rosemary. Shoot height increased in 11 weeks, by 62%, 65% and 114% in plants grown in agricultural soil, hydroponic system and compost, respectively. Na content in plants grown in agricultural soil was significantly higher than in plants grown in the other treatment. Essential oil yield in plants grown in compost exceeded those in agricultural soil by 114%. Essential oil content （0.66%-1.5% w/w） and chemical constituents concentrations did not change significantly with growth media. The main constituents, more or less, are comparable to essential oils constituents reported from other countries. In comparison, better yields are obtained for individual components of the oils of plants grown under our green house conditions. This study demonstrated the great potential of commercial production of rosemary in the greenhouse without compromising the oil quality and oil yield.

关键词： Rosemary oil content chemical composition nutrients greenhouse conditions growth media hydroponic compost.

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