Search Results

Abstract : Chronic pain is felt in the body and in the mind. S. Freud, J. Lacan, neurophysiologists, and societies for the study of pain have each explained it to us independently with little success when facing the complexity of this condition by patients and health personnel who care for them, but there are these theories, and you must begin to take them all into account to understand pain in its entirety. This review aims to describe the concept of chronic pain in a simple way and as an appetizer through, on the one hand, psychoanalytic theory and, on the other, neuroscience. In no way is it intended to equate psychoanalytic knowledge with neurobiological knowledge since their sources and scientific method are different. If similarities are found between both ways of understanding chronic pain, they should be understood as the author's opinions or the reader's deductions. What is desired here is to sow curiosity about the subject and in the future if it is possible to integrate the two ways of understanding long-term pain. For this narrative review, a manual and automated literature search was carried out in biomedical databases, disciplines related to neuroscience, psychoanalysis, and mental health, using search terms according to Medical Subject Headings. Textbooks on the topics and representative authors of psychoanalytic theory and neuroscience were also consulted. Although there are psychoanalytic and neurobiological approaches in the study of chronic pain, they all understand it independently, and their integration has not been achieved so far. However, we can get to know the bases of each aspect to venture into this company in the future. There is a need to increase research on chronic pain conditions, which correlates neurobiological and psychoanalytic aspects that contribute to achieving a multidimensional and effective treatment. It is especially urgent to find a way to "measure" psychoanalytic concepts to confirm them in the light of current scientific method.

Abstract : Family planning are increasingly challenging due to combined oral contraceptive (COC) pills associated side effects, including metabolic derangement. We aimed to identify the glycemic side effect of COC on blood sugard and HbA1c. Women planning to take COC pills enrolled in the present study. Blood samples withdrawn and partially used for HbA1c measurement and serum samples separated from left fraction of the blood and used for measurement of random blood sugar (RBS). The results confirmed that no differences reported regarding RBS while HbA1c shown variation in age- and weight-dependent manner. To sum-up, continuous use of COC will be associated with alteration in metabolic status indicated by elevated HbA1c. We do advice patients to change their lifestyle via increasing physical activity and reduce high-calories diet.

Abstract : A caesarean section is often done when vaginal birth might jeopardize the baby's or mother's life or health, however it has been performed on request in recent years. The rate has grown to at least 25%. One of the serious complications after cesarean section is development of uterine dehiscent scar. To assess the possible causes of dehiscent scar in pregnant ladies with previous one cesarean section. Observational cross-sectional prospective study, carried out from the beginning of January 2020 to December 2020, at Elwiya Maternity Teaching Hospital - Baghdad. Two hundred fifty patients were enrolled in the study, full history was taken regarding their previous scar, and they were fully assessed regarding current pregnancy and all patients were followed up during cesarean section and afterwards. The rate of dehiscent scar was (12%). It is found that the rate was significantly inversely related to the time space between pregnancies; higher incidence of dehiscent scar in those women whose interpregnancy interval was 6 months or less while the lowest incidence in those whose interpregnancy interval was ≥ 12 months. Significant relationship has been found with the type of hospital, as women whose previous cesarean section was performed at the general hospitals were less likely to have dehiscent scar than those at private hospital, with gestational age of ≤ 36 completed weeks in both the previous and the current cesarean section and with the trial of labor before performing cesarean section. Failure of progress is an important risk factor associated with uterine scar dehiscence. Cesarean sections performed at or before 36 completed weeks gestation in the previous pregnancy were associated with higher rate of uterine scar dehiscence in the current pregnancy. Previous cesarean sections performed in private hospitals were associated with higher rate of uterine scar dehiscence in the current pregnancy.

Abstract : Laparoscopic cholecystectomy has become the standard treatment for symptoms of gallbladder disease. However, there are still a significant proportion of patients for whom laparoscopic cholecystectomy cannot be performed successfully and who need to switch to open surgery. In this prospective study, we reviewed (140) patients undergoing laparoscopic cholecystectomy during the last three years (January 1st, 2019 to January 1st, 2020) at Al-Kadhimiya teaching hospital and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. Our unit’s practice on timing for cholecystectomy general practices interval cholecystectomy for most of our patients. Patients who underwent emergency cholecystectomy were excluded from this study. About 20% of cases that were performed during the first one and half year of the study were converted, so about 3.3% of converted cases were in patients with BMI over 30, as well as 18.8% of cases in patients in which identification of calot's triangle lasted more than 30 minutes were converted, 20% of cases that were performed during the first one and half year of the study were converted. Patients with a high predicted risk of conversion could be operated on either by or under the supervision of a more experienced surgeon. Surgeons in the early phase of their training could operate on patients with low risk of conversion, especially if they are not operating under the supervision of an experienced laparoscopic surgeon. Also, a high predicted risk of conversion may allow the surgeon to take an early decision to convert to OC when difficulty is encountered during dissection; this may shorten the duration of surgery and decrease the associated morbidity.

Abstract : The protective mechanism of vitamin D (VD) on the immune system played an important role behind many health problems including abortion. Our aim was to investigate the levels of VD and some immunomodulatory markers (IL-6, TNF-α and INF-γ) in pregnant women with threatened abortion (TA) and their effects on their obstetric health. This study including 132 pregnant participants with TA visiting maternity hospital in Babel province, Iraq. The demographic data including previous and current obstetrical history and body mass index were collected by well-trained researcher following structured questionnaire after obtaining their verbal consent. Laboratory Investigations were done with estimation of VD, IL-6, TNF-α and INF-γ. The mean level of VD was 19.83±43.59 ng/ml while the mean levels of IL-6: 389.45±70.88, TNF-α: 118.78±44.11 and INF-γ: 100.39±20.13 pg/ml with related percentage among participants for low VD was 84%, high IL-6 was 66%, high TNF-α was in 43% but only 23% had high INF-γ in relation with normal values. The frequency of abortion was significantly increased with low VD and high IL-6 (p<0.05) with high correlation between them (r2=0.89). High incidence of TA associated with low level of VD accompanied with high serum levels of IL-6. This adverse pregnancy outcome may be associated with some form of autoimmune diseases with evidence that hypovitaminosis D was correlated with high proinflammatory markers (IL-6, TNF- α and IFN- γ) and worse form of TA and the role of VD is to correct these pro-inflammatory markers.