Issue 1
Smoking and urinary bladder cancer: A case-control study in Basrah
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 1-7
DOI:
10.33762/mjbu.2014.94415
Background: The primary and well established risk factor for urinary bladder cancer is cigarette smoking.
Objective: The purpose of the present study was to evaluate the association between cigarette smoking and the development of urinary bladder cancer in Basrah.
Methods: A case control study was conducted to examine the association between the risk of urinary bladder cancer and various characteristics of smoking: the smoking status (current or ex-smoker), smoking intensity (cigarette per day), duration, total exposure (pack-years), type of cigarette (filtered or unfiltered), inhalation, and environmental tobacco smoke exposure. The study population composed of 87 patients with newly diagnosed bladder cancer cases and 357 controls. Cases and controls were matched for age, sex, and residence.
Results: An increased risk of urinary bladder cancer was found for both current and ex-smoker (for current smoker OR = 2.98; 95% CI = 1.68-5.28 and for ex-smoker OR = 4.05; 95% CI = 2.19-7.48). The study also revealed a significant positive trend in urinary bladder cancer risk with smoking intensity, pack-years, and environmental tobacco smoke.
Conclusion: The results of the present study are consistent with the findings of the previous epidemiological studies and confirm that smoking is a major risk factor for urinary bladder cancer and preventive strategies should be directed toward smoking as risk factor for urinary bladder cancer in Basrah.
The use of the who surgical safety checklist-part one: the state of the art in an operating theater in Basrah
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 8-14
DOI:
10.33762/mjbu.2014.94416
Background: This is a prospective study carried out at one of the main operating theaters in Basrah general hospital. The study lasted for 6 months (from May to October 2013).
Objectives: The aim was to assess the adherence of staff in the operating theater to items of services covered by a World Health Organization Checklist. The study is in line with the vision of the Ministry of Health to provide high quality care.
Method: A structured questionnaire form was prepared for the purpose of the study. It was based on the World Health Organization checklist; first edition. Observation of all procedures, instructions and labeling of patients before, during and after the surgical operation was made. A total of 378 surgical operations (patients) were covered in the study
Results: The degree of adherence to the various items of the checklist (28 items) varied greatly. Items with high adherence rate (> 90%) were those related to documentation of age, gender, informed consent, shortness of breath and patient recovery checking. Items with fair documentation (70-90%) were those related to next of kin, mobile phone number, history of chronic disease, time of last meal, allergy to anaesthesia, post-operative checking of certain equipment, preparation of blood and prophylactic antibiotics and biopsy handling. All other items were of poor adherence.
Conclusions: The adherence to the requirements of the surgical safety check list was fair but further improvement in its use is required to enhance quality of care.
Evaluation of the effectiveness of cinnamon, fenugreek and their combination on patients with type 2 diabetes in Basrah
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 15-21
DOI:
10.33762/mjbu.2014.94443
Background: People often seek care from multiple sources outside the formal traditional health care system. One of these sources is the use of Complementary and Alternative Medicine (CAM) including herbal medications. Diabetic patients are found 1.6 times more likely to use CAM than non diabetic patients.
Aim: To investigate the effectiveness of cinnamon, fenugreek and their combination in type 2 diabetic patients not well controlled by oral antidiabetic drugs.
Methodology: Fifty four diabetic patients who were on oral hypoglycemic drugs were randomly divided into 4 groups. Group 1, 2, 3 and 4 were treated with bran, cinnamon (3 gm), fenugreek (15 gm), and the combination of fenugreek and cinnamon. HbA1C and 2 h postprandial glucose (PPG) were measured at baseline and 40 days of treatment. Results: HbA1C level and 2 h (PPG) were significantly declined from baseline with 40 days placebo treatment. Significant reduction in HbA1C was noticed with 40 days cinnamon treatment (9.37 ± 2.1% to 8.76 ± 1.9%). This effect was paralleled with reduction of 2 h-PPG from 291± 99 mg/100ml at baseline to 233 ± 61 mg/100ml after 40 days treatment. The same changes in HbA1C and 2 h PPG were noticed with fenugreek and even more with the combination of fenugreek and cinnamon.
Conclusions: daily supplementation with cinnamon, fenugreek or their combination to patients not achieving glycemic control with oral antidiabetic medications and diet is effective in lowering HbA1C and 2 h PPG in type 2 diabetic patients.
The effect of diclofenac sodium given alone or in combination with paracetamol in treatment of patients with type-2 diabetes mellitus
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 22-29
DOI:
10.33762/mjbu.2014.94444
Background: Type-2 diabetes mellitus (T2DM), is becoming an important health problem worldwide. Diabetes mellitus may be associated with low grade chronic inflammation and oxidative stress; both of them could contribute to its pathogenesis. The use of anti-inflammatory and/or antioxidant drugs, therefore, represents a promising attempt for treatment and/or prevention of this disease.
Objectives: To compare the effect of diclofenac sodium alone and when combined with paracetamol in type-2 diabetic patients not achieving target HbA1c.
Patients and Methods: Twenty four, type-2 diabetic patients consulting the Center for Diabetes and Endocrinology in Maysan, south of Iraq, had managed to complete the 3 month period of the first part of this study after meeting a set of inclusion criteria. Their HbA1c was more than 7% despite the continuous use of oral antihyperglycemic drugs. The effect of diclofenac was compared with another group (n=21) that received paracetamol in addition to diclofenac sodium. Blood samples were taken from before, one month and three months after the start of treatments for measurement of HbA1c, C-reactive protein, C-peptide level and more frequently plasma glucose level (fasting/random). Another sixty patients of similar inclusion criteria were also followed for three months but without treatment and served as a control group.
Results: The effect of one month treatment with diclofenac sodium alone or in combination with paracetamol resulted respectively in a reduction in HbA1c by 9.4% and 11.4%, a reduction in CRP by 62.1% and 79.6%, an increase in C-peptide by 262.5% and 216%, a reduction in FPG by 11.2% and 18.1% and a reduction in RPG by 40.3% and 24.8% in comparison to pre-treatment levels.
The HOMA- ß C-peptide measured in a limited number of patients treated with diclofenac sodium or its combination with paracetamol showed an increase by 405.3% and 330.6% three months after start of treatment for the two groups respectively. The control, non- intervention group did not show significant changes in the levels of HbA1c over the three-month period.
Conclusion: Diclofenac sodium 100mg SR capsule administered once daily for one month seems to be effective in achieving a good glycemic control in patients not achieving target HbA1c. The addition of paracetamol to diclofenac did not show a clear synergistic effect, despite paracetamol beneficial effect that had been shown in a previous study.
Nutritional risk factors for acute lower respiratory tract infection among infants and children 2-60 months old in Basra, Southern Iraq
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 30-36
DOI:
10.33762/mjbu.2014.94507
Objectives: A case-control study was carried out to identify nutritional risk factors for acute lower respiratory tract infections among infants and children under 5 years.
Methods: Children who have been admitted to the pediatric wards at Basra Maternity and Children Hospital and those who have visited Al-Razie Primary Health Center over the period from the 4th of November 2007 till the end of May 2008 were recruited. A total of 110 patients with pneumonia according to the WHO criteria and 207 apparently healthy infants and children, their age ranged from 2 months-5 years were included.
Results: The study has revealed that formula feeding in early life, duration of breast feeding of less than 6 months, time of introduction of weaning foods before 6 months, anemia, rickets and malnutrition are significant risk factors for acute lower respiratory tract infection. In addition, a significant correlation was found between the severity of the acute lower respiratory tract infection and rickets, malnutrition, serum calcium level, and hemoglobin level
Conclusion: Presence of anemia, rickets and malnutrition are significant risk factors for acute lower respiratory tract infections and also for a more severe disease.
Thromboprophylaxis in women with unexplained consecutive recurrent miscarriages
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 37-42
DOI:
10.33762/mjbu.2014.94511
Objective: To compare the effect of low dose aspirin and enoxaparin on pregnancy in women with recurrent miscarriage.
Patients& Methods: Randomized controlled trail, conducted in Basrah Maternity and Child Hospital during the period from January 2012 till April 2013. Participants were 221 pregnant women aged 18-41 years with history of at least 2 previous miscarriage without apparent causes. They were divided into 2 groups; the first group included 111 were given enoxaparin and the second group involved 108 which were given aspirin.
Results: In both groups (75%) of patients had negative serological test for thrombophilia. Enoxaparin group had higher significant incidence of term delivery (86%) with less incidence of preterm delivery (4.5%) and less early pregnancy loss (8%).
No significant differences in obstetrical complication but higher incidence of abdominal delivery in both groups.
Higher incidence of postpartum hemorrhage in the enoxaparin group in comparison with aspirin group and no significant systemic adverse effect of enoxaparin were noticed on the first group.
Conclusion: Since postpartum hemorrhage is treatable, low molecular weight heparin is safe and effective for treating, preventing thrombosis and achieving successful pregnancy.
HLA-DQA1 and HLA-DQB1 genotyping among lichen planus patients in Basrah province
The Medical Journal of Basrah University,
2014, Volume 32, Issue 1, Pages 43-53
DOI:
10.33762/mjbu.2014.94512
Background: Lichen planus is an inflammatory, pruritic disease of the skin and mucus membranes, which can be either generalized or localized. Many studies indicated that human leukocyte antigens might have a role in lichen planus (LP). As far as my knowledge, no previous study had done in Iraq about HLA-DQA1 and -DQB1 alleles frequencies in patients with lichen planus.
Aim: The aim of the present study is to investigate the additional genetic contribution to lichen planus susceptibility lying on the HLA region, by focusing on the possible differential contribution of the different DQA1 and DQB1 carrying haplotypes.
Method: The present study was carried out in College of Medicine during the period between (2012-2014). 50 patients with lichen planus attending Basrah General Hospital and private clinic, and 50 healthy controls were included in the study, with age group from (13-67) years. 100 DNA samples were purified from the blood samples of patients and controls, and then followed by PCR amplification of HLA-DQA1 and DQB1 genes in Cell Research Unit, Biology Department, College of Science, University of Basrah. The sequencing-PCR was done in Korea, Bioneer sequencing laboratories.
Results & Conclusions: Results indicated statistically significant decreased frequencies of HLA-DQA1*010201 (P<0.005), DQA1*0201 (P < 0.05), and -DQB1*030201 (P < 0.005) alleles in lichen planus patients, which indicated that these alleles might be a protective factors. Results also indicated statistically significant increased frequencies of DQA1*010401 (P<0.005), DQA1*040101 (P<0.005) DQA1*050101 (P<0.005), DQB1*030101 (P<0.005) and DQB1*050101 (P<0.005) alleles in lichen planus patients, which indicated that these alleles might be risk factors and increase the ability of infection. The present study indicates that genetic constitution through HLA-DQ locus determines the mechanism of disease as well as clinical and pathologic outcomes. More studies are necessary to test genetic dependencies on the basis of larger samples which would increase statistical power. An accurate definition of disease susceptible alleles will improve our understanding of antigen presentation mechanisms prevailing in the etiology of the disease. This knowledge is necessary for the design of improved immune intervention strategies to halt lichen planus progression in patients at risk of developing the disease or those who are already suffering from it.