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jkmc-709
Manifestation and response of Laryngopharygeal reflux to treatment in Kurdistan -IRAQ
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BACKGROUND: In 1972 complete description of the
inflammation of posterior third of the vocal cords was
done, with barium swallow confirming Gastro
Esophageal Disease [CRED] & subsequent successful
symptomatic treatment with antacid. The possible
association between GERD & chronic laryngitis was
initially known as acid laryngitis .2
*from the Department of ENT, Hawlear Medical College, Hawlear university. Department of ENT, Rezgary Teaching Hospital, Erbil.
Correspondence to :
Dr.Said Mustafa Said
Corespondence Address to : Dr.Said Mustafa Said _ E- mail: Email [email protected] Mob. 07504563829
Recived at : 15 th Dec 2009 Accepted at : 3ed Nov 2010

OBJECTIVE: To record the common presentation
symptoms of laryngopharyngeal reflux LPR in
Kurdistan- Iraq. To study the significance of fibro optic
laryngoscope in diagnosis and improvement of
laryngopharyngeal reflux [LPR] and to evaluate the
effect of medical therapy on these nonspecific
symptoms and Laryngoscopic finding.
METHODS: A prospective study was conducted over
a two year period at Rizgary teaching hospital,
Kurdistan/lraq; on 132 patients who presented
primarily with Laryngopharyngeal symptoms .They
were evaluated using special questionnaire for
recording these symptoms: persistent chronic cough,
globus sensation, throat clearing, voice change,
regurgitation, heartburn, symptoms of peptic ulcer
disease, and any other non specific respiratory
symptom. These symptom and Laryngoscopic findings
pre and post anti-reflux therapy were recorded.
Esophagogastro - duodenoscopy findings were also
recorded but only on presentation.
RESULTS: A total of 132 patients were evaluated over
a two year period .Respiratory symptoms at
presentation were persistent irritative cough [92%],
itchy throat [85%], globus pharynges [83%], and
cricopharngeal spasm [57%]. Endoscope findings
revealed gastroduodenitis in 5%, non specific gastritis
in 9%, duodenal ulcer in 2%, and normal findings in
62.7%, while Laryngoscopic finding were mainly
posterior commissure injection 82%, vocal cord edema
74%, laryngeal erythema 77% and subglottic edema
24%. Patients were treated medically with antacids, H2
antagonists, proton pump inhibitors and were followed
up and reexamined by laryngoscope; all data about
improvement in symptom and in the laryngeal sign by
Laryngoscopic findings were collected following antireflux therapy and showed significant improvement in
both ,all were analyzed in special figures and tables.
CONCLUSION: Reflux laryngitis and LPR should be
a differential diagnosis in patient with pharyngeal and
laryngeal symptoms not associated with upper
respiratory disease in the presence or absence of GERD
or peptic ulcer symptom, dyspepsia, regurgitation. The
management should be multidisciplinary.
Laryngoscopic finding were of value in the diagnosis of
the changes in laryngeal mucosa pre and post medical
treatment by Proton Pump Inhibitors empirical therapy

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Tue Dec 01 2015
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Integrated Framework for technologies to reduce costs and reengineering processes to develop strategies companyes An Empirical Study In some companies affiliated to the Ministry of Oil
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Began the process of re-engineering processes in the private sector as a way to assist organizations in re-thinking how to run the business in order to improve production processes and reduce operational cost, to get to compete on a global level. That was a major restructuring by further evolution in the use of technology to support innovative operations.

 Entered the technology in all areas of life and different regulations, This led to use as a change in all aspects The companies achieved success and progress today through the use of resources so as to ensure the wishes of the customers and their needs, and the requirements of the market primarily, Which is reflected on the basis of building strate

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The Thermal Pre-processing Technique of the Bio-waste for Contaminated Water Treatment: Histological and Experimental Study
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The current study suggested a thermal treatment as a necessary proactive step in improving the adsorption capacity of bio-waste for contaminants removal in wastewater. This approach was based on the experimental and histological investigation of biowaste pods shell. This investigation showed that these shells compose of parenchyma cells that store secondary metabolites compounds produced from cells were exhibited in present study. The results also reported that these compounds are extracted directly from the cells as soon as they are exposed to an aqueous solution, hampering their use as an adsorbent material. The increase in the weight of bio-waste adsorbent at unit liquid volume increases the production of secondary metabolites compounds

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Improving the Performance of Constructed Wetland Microbial Fuel Cell (CW- MFC) for Wastewater Treatment and Electricity Generation
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The current study deals with the performance of constructed wetland (CW) incorporating a microbial fuel cell (MFC) for wastewater treatment and electricity generation. The whole unit is referred to as CW-MFC. This technique involves two treatments; the first is an aerobic treatment which occurs in the upper layer of the system (cathode section) and the second is anaerobic biological treatment in the lower layer of the system (anode section). Two types of electrode material were tested; stainless steel and graphite. Three configurations for electrodes arrangement CW-MFC were used. In the first unit of CW-MFC, the anode was graphite plate (GPa) and cathode was also graphite plate (GPc), in the second CW-MFC unit, the anode was stainless st

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Tue Jun 15 2021
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Genetic Structure, Transmission, Clinical Characteristics, Diagnosis, Treatment and Prevention of Coronavirus Disease 2019 (COVID-19): A Review
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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19) which represents a global public health crisis. Based on recent published studies, this review discusses current evidence related to the transmission, clinical characteristics, diagnosis, management and prevention of COVID-19. It is hoped that this review article will provide a benefit for the public to well understand and deal with this new virus, and give a reference for future researches.

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Practice & Opinion of Doctors in Hospitals toward Referral System in Iraq
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The origin of bacterial contamination in AL-Habania reservoir in Iraq
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Wed Feb 10 2021
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The effectiveness of tax exemption in stimulating industrial projects in Iraq
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Tax is an important financial resource that the state depends on in all its economic, political, and social fields. Nevertheless, the role of the tax is highlighted in raising tax revenues and influencing economic variables, such as savings, consumption, investment, and employment. The tax was taken as an important tool to stimulate investment in industrial projects because of this activity's important role in raising the efficiency of economic development and reviving the national economy, as many industrial investment laws were enacted and the most important thing included was exempting industrial projects from all taxes and fees (5-10) years, and an exemption Profits from income tax for a period of 5 years starting from the year in which

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