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Bulletin of National Institute of Health Sciences
Title : Cholera distribution in different parts of Iraq during 2015 epidemic
Abstract :Cholera is an important, recurrent source of morbidity and mortality in many developing countries. Illness is caused by infection with toxigenic Vibrio cholerae O1 or O139 bacteria, most often acquired through ingestion of fecally contaminated water or food. Symptoms include nausea, vomiting, and profuse watery diarrhea. Severe disease causes rapid dehydration, is marked by loss of skin turgor and sunken eyes, and can result in death within hours if untreated. The first aim of this study was to review the prevalence of cholera infection in different governorates of Iraq during the period from 1/1 to 9/12 / 2015. Secondly, to clarify the governorates with the highest cholera incidence, and try to explain the factors behind this incidence if found. In this prospective cohort study, this was comprised of 2866 subjects out of 3547 examined cases. They were sent from different parts of Iraq, who were diagnosed with cholera infection. These cholera patients were collected during the period from January to December 2015. Bacteriology, serology and all other lab investigations were worked out in the central health laboratory in Baghdad. There were high cholera casualties' proportions in a number of Iraq governorates as Baghdad Al-Rusfa (n=627, 21.9 %%), Baghdad Al-Karkh (n=357, 12.5%), Al-Hilla (n=657, 23.6%), and Al-Diwanyia (n=445, 15.5%) compared to other parts of Iraq in the same period, and the disease seems to localize in middle and to lesser degree in southern parts of Iraq. We recommend repeating the study, in a larger frame, using more sophisticated tools, especially molecular diagnostics which have proven their value as extremely sensitive and specific techniques, that can improve the diagnosis of cholera and also help in putting a more accurate epidemiological characters of this disease.
Title : Relationship between Medication Adherence and Quality of Life among Older Patients with Type 2 Diabetes Mellitus in Saudi Arabia
Abstract :This cross-sectional study examined 266 patients from the King Khaled Hospital in Najran, Saudi Arabia, in order to examine whether there is a relationship between the level of adherence to oral hypoglycemic medication (OHM) and health-related quality of life (HRQoL) in older patients diagnosed with Type 2 diabetes mellitus (T2DM). The questionnaire that were used in this study combined the 8-item Morisky Medication Adherence Scale and the HRQoL with additional demographic questions. Pearson’s correlation matrix as well as ordinary least squares regression methodology were employed to test the relationship between the Morisky Medications Adherence scale and the HRQoL. Our analysis suggested that the overall score for HRQoL was comparable across all 4 sub-domains of: Physical (PQoL), Psychological (YQoL), Social Relationships (SRQoL) and Environment (EQoL). The mean average for medication adherence (MA) stood at approximately 5. Our findings supported the hypothesis that patients adhering to their medication exhibit higher levels of HRQoL. Furthermore, there was no statistical significance in relation to education as the sample was concentrated at the primary level, suggesting that participants left school at the approximate age of 11. When examining the sub-samples based on gender, there was no difference between males and females regarding the correlation between MA and HRQoL apart from in the PQoL which showed that females had a significantly higher correlation than males. The reported positive correlation can give healthcare providers confidence and an expectation that there will be more initiatives that enhance MA. Improved MA must be initiated with advancements in medication safety and a reduction in prescription errors.
Title : The bidirectional relationship between diabetes mellitus and hyperuricemia, and the best anti-diabetic medication tackling both
Abstract :Diabetes mellitus and gout are common morbid diseases. They share the unwanted deleterious effects on renal and cardiovascular systems. The current review aimed to investigate the relationship between diabetes mellitus and hyperuricemia and assess the drugs that tackle both diseases. A systematic electronic search was conducted in the Pub Med including E pub and ahead of print and Google Scholar databases. The search was limited to studies assessing the relationship between gout and diabetes mellitus and investigating the effects of anti-diabetic medications on hyperuricemia and published during the period from 2008 to October 2019 with no limitation for the languages or study type. Three hundred-thirty articles were retrieved; the researchers screened the titles and abstracts for eligibility criteria and removal of duplications. Thirty-four articles fulfilled the inclusion and exclusion criteria. Out of 35 full texts approached, seventeen assessed the relationship between diabetes mellitus and gout, all the studies showed that hyperuricemia is a risk factor for diabetes; also the studies concluded a negative correlation between the glycemic control and gout. Salt glucose co-transporters inhibitors-2 (SGLT-2i), metformin, and pioglitazone reduced serum uric acid. Gout (or hyperuricemia) is a risk factor for diabetes; the effects are stronger in prediabetes and early stages of diabetes. However, poor glycemic control improves hyperuricemia due to diuresis. The best medications for hyperuricemia in patients with type 2 diabetes were SGLT-2 inhibitors. In addition, metformin and pioglitazone are suggested.
Title : Using of Propolis on the treated rats induced with Polysystic ovarian syndrome by Litrozol drug
Abstract :The purpose of this study was to investigate the potential protective effects of propolis against the adverse effects of PCOS. The study included 15 females and was divided into 3 groups of 5 rats each. Group 1 representing the control was given 0.1 ml of PBS orally, once a day for 26 days. Each rat in groups 2, and 3 were given 0.1 ml of (1 mg/kg) of Litrozol orally, once a day for 26 days, Group 3 was later treated with the propolis water extract for another 26 days. Several biological parameters were measured. The PCOS group showed a decrease in the level of insulin and HDL-C, corresponding to an increase in the level of total glucose, LDL-C, and TG. In terms of liver function tests, the PCOS group showed a significant increase in the level of AST and ALT enzymes. Also, the level of the antioxidant enzyme SOD decreased at the expense of the increase in the level of MDA indicating increased lipid peroxidation in this group. The level of estrogen and progesterone decreased and the level of PRL hormone increased in the PCOS group. After treating the PCOS rats with Propolis extract, the animals showed a recovery of the normal levels of the measured vital parameters and they were close to their levels in the control group. The results of the histological study of the ovaries of the two groups and in comparison with the control confirmed, that there was an improvement in the histological structure of the ovaries of the PCOS group after treatment with Propolis extract.
Title : The value of delayed enhanced cardiac MRI and cine cardiac MRI in assessment of myocardial viability
Abstract :After reperfusion, viable myocardium can contract. Identifying viable myocardium helps determine which patients will benefit from revascularization and have increased LVEF and survival. This study evaluated the relevance of delayed contrast enhanced cardiac MRI in assessing myocardial viability before revascularization and the efficacy of cardiac MRI in detecting and categorising regional wall motion anomalies. After reperfusion, viable myocardium can contract. Identifying viable myocardium helps determine which patients will benefit from revascularization and have increased LVEF and survival. This study evaluated the relevance of delayed contrast enhanced cardiac MRI in assessing myocardial viability before revascularization and the efficacy of cardiac MRI in detecting and categorising regional wall motion anomalies. 39 cases and those without enhancement were 11 cases. The mean infarct size by delayed enhanced cardiac MRI was 22 ± 15.8% of the left ventricle. There was a moderate positive correlation between cardiac MRI and two dimensions’ echocardiography. Left ventricular ejection fraction correlates inversely with the size of infarcted myocardium. There was a strong positive correlation between infarct size and wall motion abnormalities. A strong positive correlation was found between the percent of LAD stenosis and percent of infarction size in LV as well as LCX, while a moderate positive correlation was found regarding the RCA. Cine MRI and tissue characterization allow exact observation of myocardial scar, hibernating myocardium, and normal myocardium. Echocardiogram infarction size percent and LV ejection fraction are related. Hypokinetic, akinesic, and dyskinetic cardiac regions experienced delayed improvements.
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