بحوث أ.د اسراء فائق جعفر
Neurophysiological Changes in Post Stroke Spasticity Patients
1 iraqi jms
Background A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is disrupted. Spasticity is a state, in which, there is an increase in muscle tone or stiffness, which might be associated with movement and speech disorders. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement. The Hreflex is a compound electromyographic (EMG) response composed of group Ia (and large group II) afferents from muscle spindles (and Golgi tendon organs) that project monosynaptically (and to a lesser extent di- and tri-synaptically) to spinal efferent α-motoneurons (αMN), which in turn activate the muscle after an electrical current is applied to the nerve. Objective To assess the Medical Research Council (MRC) scale in post stroke spasticity patients and to estimate the neurophysiological changes in those patients regarding H-reflex and Hmax/Mmax ratio. Methods A randomized clinical trial involves 50 patients with stroke of both sexes. Their age ranged from (30-60 years old) suffering from upper and lower limb spasticity. They were assessed by the MRC scale to determine the grade of power of muscle. The neurophysiological test is done by using the H-reflex for both upper and lower limbs (flexor carpi radialis and soleus muscles, respectively). The maximum amplitude was measured from the peak of the first positive deflection to the peak of the negative one. The latency and the Hmax/Mmax ratio were also measured. Results The result of this study showed a significant decrease in MRC in spastic patients (P value ≤0.001). Hreflex latency in lower limbs was significantly decreased from (30.3±2.4 ms) in the normal population to (18.5±1.3) in the spastic patient. The H reflex amplitude in the lower limb was significantly increased in post stroke spasticity patients (P value ≤0.05). In the upper limbs H-reflex latency in flexor carpi radialis was also significantly decreased. Regarding H reflex amplitude of the upper limb in the spastic patient was significantly increased. There is a noticeable increase in the H/M ratio in post stroke spasticity patient which was (0.51±0.92) with a significant P value of 0.005. Conclusion Patient with post stroke spasticity had decreased in MRC scale, while H-reflex has decreased in latency and increased in amplitude, as well as decreases in Hmax/Mmax Ratio in both upper and lower limbs. Keywords Post stroke spasticity, H-reflex latency, H-reflex amplitude, H/M ratio, MRC scale. Citation Fawzi SM, Hamdan FB, Al-Gawwam GA, Jaafar IF. Neurophysiological changes in post stroke spasticity patients. Iraqi JMS. 2023; 21(2): 254-259. doi: 10.22578/IJMS.21.2.13
Role of BoNT-A in patient with Post covid -19 spasticity, assessed by H-reflex .
2024 Romanian Journal of neurology
Abstract Background: Covid-19 pandemic is an infectious disease that spread throughout the world and caused global health problem the association of covid with neuroendocrine system is well known fact especially the connection between the endocrine and immune system neuroinflammation plays a crucial role in the pathphysiology of disorder. different neurological complications occur after Covid infection one of which is strock which results in spasticity. spasticity following strock (PSS) is a disorder of sensory and motor system , resulting from an upper motor neuron lesion due to involuntary activation of muscles which is either sustained activation or intermittent one. therapeutic indication of Botulinum neurotoxin-A (BoNT-A) is used in a variety of treatment in focal post strock spasticity (PSS), in rehabilitation and as an effective and safe treatment. Objectives: To assess spasticity after covid 19 infection, with assessment of BoNT-A injection on H-reflex in lower extremities . To investigate whether there is a relation between H-reflex excitability and the degree of spasticity which was scored by Modified Ashworth scale (MAS) . Methods: thirty patients diagnosed as postcovid stroke spasticity were enrolled in the study, there age ranged from (30 - 60 years) from both sexes, they had focal spasticity of lower extremities. BoNT-A was given in day 0 at day of arrival of patients and then 4 weeks later in the gastrocnemius, and soleus muscle. H-reflex was recorded from soleus muscles at 1st presentation (day 0) in patients with post covid spastocity and then after 4 weeks after injection of BoNT-A. muscle power was assessed by Medical Research Council scale and MAS . Results: The latency and amplitude of H reflex recorded from soleus muscles and the H/M ratio showed statistical significant difference between pre- and post-treatment with BoNT-A injection in patients with post covid spasticity patients. The MRC scale was significantly increased whereas, the MAS was significantly reduced after injection of BoNT-A. Conclusion: post covid spasticity is a well known complication after covid 19 infection, there was clinical improvement in PSS after BoNT-A injection ,which was assessed clinically by MAS and MRC scale and as neurophysiological test by H-reflex. There was negative correlation regarding H reflex latency , not correlation regarding H-reflex amplitude or Hmax/Mmax ratio and MAS. Key words: covid-19,post covids pasticity, H-reflex, BoTN-A, MRC scale
Neurophysiological Changes in Post Stroke Spasticity Patients
2024 iraqi jms
Abstract Background A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is disrupted. Spasticity is a state, in which, there is an increase in muscle tone or stiffness, which might be associated with movement and speech disorders. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement. The Hreflex is a compound electromyographic (EMG) response composed of group Ia (and large group II) afferents from muscle spindles (and Golgi tendon organs) that project monosynaptically (and to a lesser extent di- and tri-synaptically) to spinal efferent α-motoneurons (αMN), which in turn activate the muscle after an electrical current is applied to the nerve. Objective To assess the Medical Research Council (MRC) scale in post stroke spasticity patients and to estimate the neurophysiological changes in those patients regarding H-reflex and Hmax/Mmax ratio. Methods A randomized clinical trial involves 50 patients with stroke of both sexes. Their age ranged from (30-60 years old) suffering from upper and lower limb spasticity. They were assessed by the MRC scale to determine the grade of power of muscle. The neurophysiological test is done by using the H-reflex for both upper and lower limbs (flexor carpi radialis and soleus muscles, respectively). The maximum amplitude was measured from the peak of the first positive deflection to the peak of the negative one. The latency and the Hmax/Mmax ratio were also measured. Results The result of this study showed a significant decrease in MRC in spastic patients (P value ≤0.001). Hreflex latency in lower limbs was significantly decreased from (30.3±2.4 ms) in the normal population to (18.5±1.3) in the spastic patient. The H reflex amplitude in the lower limb was significantly increased in post stroke spasticity patients (P value ≤0.05). In the upper limbs H-reflex latency in flexor carpi radialis was also significantly decreased. Regarding H reflex amplitude of the upper limb in the spastic patient was significantly increased. There is a noticeable increase in the H/M ratio in post stroke spasticity patient which was (0.51±0.92) with a significant P value of 0.005. Conclusion Patient with post stroke spasticity had decreased in MRC scale, while H-reflex has decreased in latency and increased in amplitude, as well as decreases in Hmax/Mmax Ratio in both upper and lower limbs.
Correlation Between Interleukins 1 α,6 and Echocardiographic Results in Patients with Heart Failure
2014 Journal of Babylon University/Pure and Applied Sciences/ No.(4)/ Vol.(22): 2014
Appraisal of Correlation of Sex Steroidal Hormones Interleukin 2 and 6 with soluble Fas in Seminal Fluid of infertile men
2008 IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 4 Ver. III (Apr. 2015), PP 75-89 www.iosrjournals.org
Cardiovascular Autonomic Impairment in Parkinson Disease
2015 Diyala Journal of Medicine Vol. 8, Issue 1, April 2015
Effect of Body mass index on interleukin2, 6 and soluble fibroblast associated surface antigen in infertile men
2014 J Fac Med Baghdad 2014; Vol.56, No .4 Received Oct.2014 Accepted Dec. 2014
ANTIOXIDANTS PROLONG SURVIVAL OF LYMPHOCYTES
2008 Medical Journal of Islamic Academy of Sciences 13:4,141-145, 2000
Effectiveness of Low Level Laser in the Treatment of Carpal Tunnel Syndrome
2012 Fac Med Baghdad 2012; Vol.54, No. 3 Received Sept.2011 Accepted Sept.2012
Control of high blood pressure by Acupuncture In subjects with essential hypertension
2012 Fac Med Baghdad 2012; Vol.54, No. 3 Received Sept.2012 Accepted June2012
effect of moderate exercise on the level of DHEAS hormone and lymphocyte apoptosis in healthy subject
2009 fac. med. Baghdad 2010
the effect of blood lead level on packed cell volume in a sample of iraqi population
2014 fac med Baghdad 2014
effects of exhaustive exercise on peripheral blood lymphocytes
2008 fac med Baghdad
Effect of Laser light on lymphocyte Apoptosis
2008 IRAQI J MED SCI, 2008; VOL.6 (1):45-51
EFFECT OF LEVAMISOLE ON THYMOCYTE APOPTOSIS
2008 Iraqi Journal of Medical Sciences
Effectiveness of Low Level Laser in the Treatment of Carpal Tunnel Syndrome
2012 Fac Med Baghdad 2012; Vol.54, No. 3 Received Sept.2011 Accepted Sept.2012
Evaluation of Hormonal Effects on Peripheral Blood Lymphocyte Apoptosis in Normal Menstruating Females
2008 IRAQI J MED SCI, 2011; VOL.9 (2)
Evaluation of Itching Sensation in Chronic Urticaria
2013 THE IRAQI POSTGRADUATE MEDICAL JOURNAL VOL.12, NO. 3,2013
Influence of Cigarette Smoking on Seminal Plasma Soluble Fas as a Marker of Germ Cell Apoptosis
2013 IRAQI J MED SCI, 2013; VOL. 11(1)
Role of breast feeding in protection against myocardial infarction in Iraqi women
2019 Official Publication of Africa Health Research Organization June 2019 Vol. 20
Therole of Serum Melatonin in Acute Myocardial Infarction Patients
2014 IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 13, Issue 12 Ver. VII (Dec. 2014), PP 00-00 www.iosrjournals.org
Oxidative Stress Association with Autonomic Dysfunction in Parkinson
2015 Diyala Journal of Medicine Volume 8, Issue 2, June 2015
Relation of Leptin to Insulin and Other Sexual Hormones to Patient with Pcos
2017 IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 6 Ver. IX (June. 2017), PP 110-113 www.iosrjournals.org
Role of Antioxidant on Nephropathy in Alloxan Induced Diabetes in Rabbits
2009 THE IRAQI POSTGRADUATE MEDICAL JOURNAL VOL.8, NO.4, 2009
role of lymphocyte apoptosis in graves disease
2010 fac med baghdad
THE ACTIVITY OF NAK ATPASE IN EXPERIMENTAL NEPHROTIC SYNDROME
2008 Iraqi Journal of Medical Sciences
The effect of mineral levels in the mother’s circulation on the outcome of pregnancy
2014 J Fac Med Baghdad 2015; Vol.57, No .1 Received Oct. 2014 Accepted Feb.2015
The role of Bcl-2 protein, Bax protein and there ratio in peripheral blood lymphocytes of asthmatic patients
2008 Fac Med Baghdad 2008; Vol.50, No.2 Received July 2007 Accepted Nov.2007
The Role of Interleukine-6and Interleukin -1 in failing heart
2014 Journal of Babylon University/Pure and Applied Sciences/ No.(3)/ Vol.(22): 2014
Effect of zinc supplements on Adriamycin induced nephrosis in rats Virtual Health Sciences Library
2008 J. Fac. Med. -Baghdad. 2004; 46 (2-Jan): 125-128
Serum selenium level and pulmonary function test in asthmatic patient
2008 Iraqi army medical journal 1995
Exercise induces apoptosis in rat thymocytes
2008 J fac med Baghdad
Experimental model for lymphocyte apoptosis in Vitro.
2008 J.Fac.Med. 2002; 44(3), 507-513
: Low temperature prolongs life span of human lymphocytes
2008 2003; J.Basic Med.Sc.Vol.3 (1):37-42.
body hyperthermia induce thymocyte apoptosis in rats
2008 J. Basic Med.Sc, 2004: vol 4(1):37-41
Lymphocyte apoptosis & adverse pregnancy outcome
2008 J fac med Baghdad 46 vol1&2:110-113
The role of mitochondria transmembrane potential in lymphocyte apoptosis.
2009 J fac med Baghdad2009,vol51(1):71-75
effect of moderate exercise on the level of melatonin hormone and lymphocyte apoptosis in healthy subject
2010 THE IRAQI POSTGRADUATE MEDICAL JOURNAL VOL.9, NO. 1,2010:88-94
Effect of smoking on hormonal,inflammatory markers and semen parameters in infertile men
2012 iraqi J Embryo and infertility researches2012 vol 2 no 3:9-15
The effect of mineral levels in the mother’s circulation on the outcome of pregnancy
2015 J Fac Med Baghdad 2015; Vol.57, No .1 :87-91
Environmental lead exposure and male infertility
2016 IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) .Volume 115, Issue 9 Ver. iv :p49-54
2021 Asian Journal of Research in Nursing and Health

Background: Sex ratio is important for human life since its creation, some families prefer male than females, also its related to some medical problems that affect certain sex than another. Studies showed that males are more fragile, and might die earlier than females. Climate has a certain effect on male to female ratio of the pregnancy outcome and certain seasons are in favor of male than female reproduction.
Objectives: To evaluate the effect of climate and seasonal variation on the sex of live births in a sample of pregnant Iraqi women.
Subjects and Methods: This study was carried out on 2424 live babies (apart from 225 miscarriages) of women attending Al–Numan teaching hospital and Al-Husaynia health care center, from January 2017 till January 2019.The time of last menstrual period recall was taken from each mother of this study. an early ultrasound test was done to confirm the accuracy of pregnancy duration. The gender of live babies, maternal age and parity were recorded.
Results: The highest birth rate were in Autumn (721) then Winter (662), Spring (577) and the least in summer (521).
The male to female ratio increased with maternal age. Mothers of 30 years and over have 1.09male female ratio as compared with those under the age of 30 years (0.929).

ASSESSMENT OF INTERNS’ TRAINING IN THE TEACHING HOSPITALS OF BAGHDAD MEDICAL CITY COMPLEX
JANUARY 2022 Wiadomosci Lekarski,Official journal of the Polish Medical Association,VOLUME LXXV, ISSUE 2

ABSTRACT

The aim: The aim of this study is to assess the training of medical interns in Baghdad Medical City Complex.

Materials and methods: A cross-sectional observational study was conducted in the Medical City Complex, Baghdad. The study targeted all the medical interns who finished year one of internship. A questionnaire form was designed for data collection. A questionnaire form was done according to the Medical Interns’ Guideline adopted by the Minister of Health in 2015.

Results: A total of 60 interns filled the questionnaire, their mean age is 27.07 years (SD = 2.04), male respondents constituted 48.3%. Twenty-seven respondents (45%) were from Baghdad Medical College. More than half (58%) of them were singles. The mean pre-internship score was 69.32 (SD = 6.6). About half of the interns (29, 48.3%) have a future interest in surgery. Average preparedness for the internship was reported in 45% of interns. Half of the interns had prior ideas about the internship through variable means. A larger percentage of interns reported average/poor quality of training in different aspects of medical internships. Accepted quality of training (above average and excellent) and average one were reported respectively by 19 (31.7%) and 31(51.7%) of interns in general surgery, followed by the internal medicine branch. Thirty-one (51.7%) interns were moderately prepared for their future medical careers. Surgeons and general physicians gained better opinions (above average and excellent) from the interns (17, 28.3%, and 13, 21.6%) respectively.

Conclusion: There was a deficiency in the preparedness of newly graduated doctors for the internship. But they reported an average skill performance in major medical branches, and some related laboratory and medical procedures, there was a defect in dealing with emergency cases. The Supervision of interns was below average in gynecology and obstetrics units and was good in other branches. The medical school training was poor to help interns in dealing with deaths and legal medicine cases. More than 50% of trainees were prepared for the future medical branches of interest.

The teqniques of CT scanning in evaluation of diffuse lung disease
2022 Oncology and Radiotherapy © Vol.16 Iss.2:42-46
Isolation Insult during COVID-19 pandemic on psychological status of medical students”
2022 Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.
Botulinum neurotoxin-A in a patient with post-stroke spasticity: a neurophysiological study
2023 Folia Neuropathol 2023; 61
Isolation insult during COVID-19 pandemic on the psychological status of medical students
2022 Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.