Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2045
Reem Alfaris, Khalid K Al-Kinani
Background: Prednisolone acetate is an ester form of prednisolone. It is used topically as an ophthalmic suspension to treat many inflammatory ocular conditions, where its absorption from suspension is highly variable and has poor dose accuracy. Objectives: The main objective of this research is to formulate and evaluate prednisolone acetate microemulsion for ophthalmic use to increase solubility, residence time, and corneal permeability of the drug to enhance patient compliance and treatment efficacy. Methods: Twenty-four prednisolone acetate-loaded microemulsion (0.5%w/w) formulas were prepared using oleic acid, isopropyl myristate as (oil phase) (1:1), tween 80, labrasol, and cremophor EL as (surfactant), ethanol, polyethylene glycol 400, propylene glycol, transcutol P as co-surfactant and Sörensen isotonic phosphate buffer saline pH 7.4 as the aqueous phase at different Smix ratios (1:1), (1:2) and (2:1) by aqueous titration method to construct pseudoternary phase diagram to determine the existence of microemulsion region. All the prepared formulas were subjected to different evaluation tests to determine the optimum formula. Results: observations of the microemulsion showed that it had a clear and transparent yellowish color, formulation F9 composed of oleic acid and isopropyl myristate in a ratio (1:1) as oil, twee80 as a surfactant, and propylene glycol: ethanol (1:1) in a ratio (2:1) as cosurfactant gave the best particle size (10.18nm), polydispersity index (0.2216), zeta potential (-25,91), % of transmittance (99.382%±0. 09), and drug content (100±0.16). Microemulsion formulation provided considerably higher permeability than the marketed eye drop suspension (Optipred®) and improved bioavailability. Conclusions: The microemulsion-containing prednisolone acetate is a promising ocular carrier for the controlled release of prednisolone acetate in treating anterior segment inflammation. Received: Dec. 2022 Accepted March 2023 Published: Oct.2023
{"title":"Preparation and Characterization of Prednisolone Acetate Microemulsion for Ophthalmic Use","authors":"Reem Alfaris, Khalid K Al-Kinani","doi":"10.32007/jfacmedbagdad.2045","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2045","url":null,"abstract":"Background: Prednisolone acetate is an ester form of prednisolone. It is used topically as an ophthalmic suspension to treat many inflammatory ocular conditions, where its absorption from suspension is highly variable and has poor dose accuracy. Objectives: The main objective of this research is to formulate and evaluate prednisolone acetate microemulsion for ophthalmic use to increase solubility, residence time, and corneal permeability of the drug to enhance patient compliance and treatment efficacy. Methods: Twenty-four prednisolone acetate-loaded microemulsion (0.5%w/w) formulas were prepared using oleic acid, isopropyl myristate as (oil phase) (1:1), tween 80, labrasol, and cremophor EL as (surfactant), ethanol, polyethylene glycol 400, propylene glycol, transcutol P as co-surfactant and Sörensen isotonic phosphate buffer saline pH 7.4 as the aqueous phase at different Smix ratios (1:1), (1:2) and (2:1) by aqueous titration method to construct pseudoternary phase diagram to determine the existence of microemulsion region. All the prepared formulas were subjected to different evaluation tests to determine the optimum formula. Results: observations of the microemulsion showed that it had a clear and transparent yellowish color, formulation F9 composed of oleic acid and isopropyl myristate in a ratio (1:1) as oil, twee80 as a surfactant, and propylene glycol: ethanol (1:1) in a ratio (2:1) as cosurfactant gave the best particle size (10.18nm), polydispersity index (0.2216), zeta potential (-25,91), % of transmittance (99.382%±0. 09), and drug content (100±0.16). Microemulsion formulation provided considerably higher permeability than the marketed eye drop suspension (Optipred®) and improved bioavailability. Conclusions: The microemulsion-containing prednisolone acetate is a promising ocular carrier for the controlled release of prednisolone acetate in treating anterior segment inflammation. Received: Dec. 2022 Accepted March 2023 Published: Oct.2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2104
Fatima Dawood, Huda S. A. Al-Hayanni, Maitham A. Sultan
Background: Early studies have shown that agricultural soil contains various types of microorganisms, especially bacteria, including coliform bacteria (Salmonella, Shigella, Klebsiella, Escherichia coli, and Enterobacter) with fecal Gram-positive bacteria like Enterococcus faecalis. Therefore, the current study aimed to investigate the contamination of Iraqi agricultural soils with pathogenic fecal bacteria (Escherichia coli and Enterococcus faecalis) and study the antibiotic sensitivity patterns of soil-isolated bacteria because it is a dangerous indicator when transmitted to humans. Methods: Soil samples were collected from six locations (farms) in the capital, Baghdad, which were AL-Jadria, AL-Latifia, Diyala River, AL-Jazera, and AL-Zafraniya (block 1 and block 2) during the study period from the end of November 2021 to August 2022; then were compared with the control samples (house garden). These bacteria were isolated by selective culture media and identified using the VITEK® 2 Compact system, and antibiotic sensitivity tests were carried out against 18 different antibiotics by the Kirby Power method. The t-test was used for the statistical analysis. Results: The bacteriological study of agricultural soil showed the presence of fecal bacteria, and this is evidence of contamination of agricultural soil samples with these bacteria. The highest E. coli count was in the AL-Latifia farm (1. 48× 103), while the highest E. faecalis count was in the Diyala River farm (2.63 × 103). The antibiotic sensitivity profile illustrated that E. coli was resistant to ampicillin, ceftriaxone, cefoxitin, piperacillin, ceftazidime, and Teicoplanin but was sensitive to the rest of the antibiotics used, while E. faecalis was only resistant to levofloxacin and linezolid and highly sensitive to the other tested antibiotics. Conclusion: The current study documented the presence of fecal coliform bacteria in studied soil samples, with markedly high resistance rates toward used antibiotics. These facts might be the result of irrigation with sewage water and the use of organic fertilizers Received:March 2023 Accepted: May 2023 Published: Oct. 2023
{"title":"Contamination of Agricultural Soils in Some Baghdad Areas with Antibiotics Resistant Pathogenic Fecal Bacteria","authors":"Fatima Dawood, Huda S. A. Al-Hayanni, Maitham A. Sultan","doi":"10.32007/jfacmedbagdad.2104","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2104","url":null,"abstract":"Background: Early studies have shown that agricultural soil contains various types of microorganisms, especially bacteria, including coliform bacteria (Salmonella, Shigella, Klebsiella, Escherichia coli, and Enterobacter) with fecal Gram-positive bacteria like Enterococcus faecalis. Therefore, the current study aimed to investigate the contamination of Iraqi agricultural soils with pathogenic fecal bacteria (Escherichia coli and Enterococcus faecalis) and study the antibiotic sensitivity patterns of soil-isolated bacteria because it is a dangerous indicator when transmitted to humans. Methods: Soil samples were collected from six locations (farms) in the capital, Baghdad, which were AL-Jadria, AL-Latifia, Diyala River, AL-Jazera, and AL-Zafraniya (block 1 and block 2) during the study period from the end of November 2021 to August 2022; then were compared with the control samples (house garden). These bacteria were isolated by selective culture media and identified using the VITEK® 2 Compact system, and antibiotic sensitivity tests were carried out against 18 different antibiotics by the Kirby Power method. The t-test was used for the statistical analysis. Results: The bacteriological study of agricultural soil showed the presence of fecal bacteria, and this is evidence of contamination of agricultural soil samples with these bacteria. The highest E. coli count was in the AL-Latifia farm (1. 48× 103), while the highest E. faecalis count was in the Diyala River farm (2.63 × 103). The antibiotic sensitivity profile illustrated that E. coli was resistant to ampicillin, ceftriaxone, cefoxitin, piperacillin, ceftazidime, and Teicoplanin but was sensitive to the rest of the antibiotics used, while E. faecalis was only resistant to levofloxacin and linezolid and highly sensitive to the other tested antibiotics. Conclusion: The current study documented the presence of fecal coliform bacteria in studied soil samples, with markedly high resistance rates toward used antibiotics. These facts might be the result of irrigation with sewage water and the use of organic fertilizers Received:March 2023 Accepted: May 2023 Published: Oct. 2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2053
Luma K.Mohammed, Methaq H.Alogaili
Background: Medical educators’ dissatisfaction may cause them to leave the practice of teaching, where it is often hard to replace those who have left. In addition, medical teaching staff dissatisfaction may indicate adverse quality for institution/ university organizations. Objectives: To assess teaching staff satisfaction with online learning during the COVID pandemic at Al-Nahrain University /College of Medicine, Baghdad/Iraq. Methodology: A cross-sectional study included a convenient sample of 50% of the teaching staff participating in the online academic year 2020-2021. The faculty satisfaction questionnaire was taken from the "Bolliger and Halupa" study, based on the validated Online Course Satisfaction Survey (OCSS) questionnaire that contains four major categories: Interaction, instructor planning, institutional support, and affordance. Results: The study included 85 medical college teachers from all departments. The total satisfaction level of participants in this study was 25.6%, which is considered low. The total satisfaction score given by the participants was (0.98), the highest score of (1) was given to the items of affordance questions, and the lowest was given for student–instructor interaction and course design and development (0.79, 0.89), respectively. Conclusion: The satisfaction of teaching staff with online learning during the COVID-19 pandemic was generally low, especially regarding student-instructor interaction and course design and development Received: Jan., 2023 Accepted: July 2023 Published: Oct. 2023
背景:医学教育工作者的不满可能导致他们离开教学实践，而离开的人往往很难被替代。此外，医学教学人员的不满可能表明机构/大学组织的质量不利。目的:评估伊拉克巴格达Al-Nahrain大学/医学院在COVID大流行期间教学人员对在线学习的满意度。方法:一项横断面研究包括了参加2020-2021年在线学年的50%的教学人员的方便样本。教师满意度问卷取自“Bolliger and Halupa”研究，基于经过验证的在线课程满意度调查(OCSS)问卷，该问卷包含四个主要类别:互动、教师规划、机构支持和提供。结果:调查对象为85名医学院校各院系教师。本研究参与者的总满意度为25.6%，属于低满意度。参与者的总满意度得分为0.98分，最高得分为1分，师生互动和课程设计与开发得分最低，分别为0.79分和0.89分。结论:新冠肺炎疫情期间，教师对在线学习的满意度普遍较低，特别是在师生互动和课程设计与开发方面。收稿日期:2023年1月接收日期:2023年7月发布日期:2023年10月
{"title":"Medical Educators Satisfaction with Online Learning during the COVID-19 Pandemic","authors":"Luma K.Mohammed, Methaq H.Alogaili","doi":"10.32007/jfacmedbagdad.2053","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2053","url":null,"abstract":"Background: Medical educators’ dissatisfaction may cause them to leave the practice of teaching, where it is often hard to replace those who have left. In addition, medical teaching staff dissatisfaction may indicate adverse quality for institution/ university organizations. Objectives: To assess teaching staff satisfaction with online learning during the COVID pandemic at Al-Nahrain University /College of Medicine, Baghdad/Iraq. Methodology: A cross-sectional study included a convenient sample of 50% of the teaching staff participating in the online academic year 2020-2021. The faculty satisfaction questionnaire was taken from the \"Bolliger and Halupa\" study, based on the validated Online Course Satisfaction Survey (OCSS) questionnaire that contains four major categories: Interaction, instructor planning, institutional support, and affordance. Results: The study included 85 medical college teachers from all departments. The total satisfaction level of participants in this study was 25.6%, which is considered low. The total satisfaction score given by the participants was (0.98), the highest score of (1) was given to the items of affordance questions, and the lowest was given for student–instructor interaction and course design and development (0.79, 0.89), respectively. Conclusion: The satisfaction of teaching staff with online learning during the COVID-19 pandemic was generally low, especially regarding student-instructor interaction and course design and development Received: Jan., 2023 Accepted: July 2023 Published: Oct. 2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2153
Ahmed Muhei Rasheed
Background: Tonsillectomy is one of the most common surgical operations in otolaryngology, post-tonsillectomy hemorrhage is a dangerous complication. Several methods have been used to decrease the rate of post-tonsillectomy hemorrhage, one of these methods, a relatively recent method, is local application of platelet-rich plasma (PRP) to the tonsillar beds. Objectives: To evaluate the role of local application of autologous PRP to the tonsillar beds, at the time of tonsillectomy, in post-tonsillectomy hemorrhage. Patients and methods: A prospective comparative study enrolled 64 patients with ages ranging from 6 to 10 years who underwent tonsillectomy with or without adenoidectomy. In each patient, PRP was applied at the time of tonsillectomy to one tonsillar bed (PRP side), while the other side was used as a control side. So, the total sides were 128 (64 PRP and 64 control sides). The patients were followed-up for 10 days and the outcome measure was the occurrence of post-tonsillectomy hemorrhage on the PRP side versus the control side. The association between the variables was established using chi-square test (X2-test). Results: Thirty-eight patients (59.4%) were males and twenty-six patients (40.6%) were females. Adenotonsillectomy was performed in 35 patients (54.7%), while 29 patients (45.3%) underwent tonsillectomy alone. There was no post-operative hemorrhage from the adenoid beds. Post-tonsillectomy hemorrhage occurred in 1 patient (1.6%) on the PRP side and 3 patients (4.7%) on the control side (P-value=0.31). Conclusions: The local application of autologous PRP to the tonsillar bed only once, at the time of tonsillectomy, is not significantly effective in reducing post-tonsillectomy hemorrhage. Received: Jun. 2023 Accepted: July, 2023 Published: Oct .2023
{"title":"Does the local application of Platelet-Rich Plasma Reduce Hemorrhage after Tonsillectomy? A Comparative Study","authors":"Ahmed Muhei Rasheed","doi":"10.32007/jfacmedbagdad.2153","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2153","url":null,"abstract":"Background: Tonsillectomy is one of the most common surgical operations in otolaryngology, post-tonsillectomy hemorrhage is a dangerous complication. Several methods have been used to decrease the rate of post-tonsillectomy hemorrhage, one of these methods, a relatively recent method, is local application of platelet-rich plasma (PRP) to the tonsillar beds. Objectives: To evaluate the role of local application of autologous PRP to the tonsillar beds, at the time of tonsillectomy, in post-tonsillectomy hemorrhage. Patients and methods: A prospective comparative study enrolled 64 patients with ages ranging from 6 to 10 years who underwent tonsillectomy with or without adenoidectomy. In each patient, PRP was applied at the time of tonsillectomy to one tonsillar bed (PRP side), while the other side was used as a control side. So, the total sides were 128 (64 PRP and 64 control sides). The patients were followed-up for 10 days and the outcome measure was the occurrence of post-tonsillectomy hemorrhage on the PRP side versus the control side. The association between the variables was established using chi-square test (X2-test). Results: Thirty-eight patients (59.4%) were males and twenty-six patients (40.6%) were females. Adenotonsillectomy was performed in 35 patients (54.7%), while 29 patients (45.3%) underwent tonsillectomy alone. There was no post-operative hemorrhage from the adenoid beds. Post-tonsillectomy hemorrhage occurred in 1 patient (1.6%) on the PRP side and 3 patients (4.7%) on the control side (P-value=0.31). Conclusions: The local application of autologous PRP to the tonsillar bed only once, at the time of tonsillectomy, is not significantly effective in reducing post-tonsillectomy hemorrhage. Received: Jun. 2023 Accepted: July, 2023 Published: Oct .2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134978925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2049
ALI MOHAMMED ABD ALRIDHA, Dheyaa Jabbar Kadhim, Ayad Hussein Ali Alkhazrajy
Background: Steroid-resistant nephrotic syndrome (SRNS)is associated with serious complications and financial burdens. Studies reported increased urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in children with idiopathic nephrotic syndrome (INS). Objectives: This study aimed to evaluate the uNGAL potential to distinguish SRNS from steroid-sensitive nephrotic syndrome (SSNS) in Iraqi children. Patients and Methods: Children with SRNS (n=31) and SSNS (n=32) were recruited from Babylon Hospital for Maternity and Pediatrics from March to June 2022. Patients' data included demographics, clinical characteristics, and urinary lab tests. The uNGAL concentrations were measured via a commercially available ELISA kit. Results: A significantly higher uNGAL median (p-value<0.001) was noted in the SRNS group (median [IQR] = 131.512 [30.28] ng/mL) than in the SSNS group (88.45 [41.6] ng/mL). The correlation between uNGAL levels and estimated glomerular filtration rate (eGFR) was negative (Spearman's rho coefficient = − 0.599, p<0.001). The discriminatory power ofuNGAL to discern SRNS from SSNS was significantly high (AUC=0.899, p<0.0001) with a sensitivity of 87.1% and specificity of 87.5% at an optimal cut-off value of 111.091 ng/mL. Conclusion: uNGAL is associated with a reliable discriminatory strength to distinguish, noninvasively, children with SRNS from those with SSNS. Received: Jan. 2023 Accepted: Jul, 2023 Published: Oct.2023
{"title":"A Cross-Sectional Study of Urinary Neutrophil Gelatinase-Associated Lipocalin and its Association with Steroid Responsiveness in Iraqi Children with Idiopathic Nephrotic Syndrome","authors":"ALI MOHAMMED ABD ALRIDHA, Dheyaa Jabbar Kadhim, Ayad Hussein Ali Alkhazrajy","doi":"10.32007/jfacmedbagdad.2049","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2049","url":null,"abstract":"Background: Steroid-resistant nephrotic syndrome (SRNS)is associated with serious complications and financial burdens. Studies reported increased urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in children with idiopathic nephrotic syndrome (INS). Objectives: This study aimed to evaluate the uNGAL potential to distinguish SRNS from steroid-sensitive nephrotic syndrome (SSNS) in Iraqi children. Patients and Methods: Children with SRNS (n=31) and SSNS (n=32) were recruited from Babylon Hospital for Maternity and Pediatrics from March to June 2022. Patients' data included demographics, clinical characteristics, and urinary lab tests. The uNGAL concentrations were measured via a commercially available ELISA kit. Results: A significantly higher uNGAL median (p-value<0.001) was noted in the SRNS group (median [IQR] = 131.512 [30.28] ng/mL) than in the SSNS group (88.45 [41.6] ng/mL). The correlation between uNGAL levels and estimated glomerular filtration rate (eGFR) was negative (Spearman's rho coefficient = − 0.599, p<0.001). The discriminatory power ofuNGAL to discern SRNS from SSNS was significantly high (AUC=0.899, p<0.0001) with a sensitivity of 87.1% and specificity of 87.5% at an optimal cut-off value of 111.091 ng/mL. Conclusion: uNGAL is associated with a reliable discriminatory strength to distinguish, noninvasively, children with SRNS from those with SSNS. Received: Jan. 2023 Accepted: Jul, 2023 Published: Oct.2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2018
Mostafa AL sunboli, None Mohammed basil, None Raghib Jassam
Background: Ureteric stones commonly have an impact on the quality of life of the patient. There are many treatment choices for the condition, including medical treatment, extra-corporeal shock wave lithotripsy (ESWL), endoscopic intervention by ureteroscope (URS), or surgery (open or laparoscopic). Semi-rigid URS with laser lithotripsy is used to fragment ureteric stones, especially those in the distal ureter. Objectives: To assess the efficacy and complications of the dusting versus the fragmentation method for lower ureteric stones using holmium laser lithotripsy by analyzing intra-operative and post-operative variables. Patients and methods: One hundred and twenty patients with distal ureteric stones were included in the current study conducted in Ghazi AL-Hariri Teaching Hospital for Surgical Specialties from December 2020 to July 2022. The cases were divided into two groups: The first is the dusting group and the second is the fragmentation group. Both groups are further subdivided into the 10-15 mm and < 10 mm stone groups. The time of the operation, the rate of being stone-free, stone size, the rate of Double-J stents (DJS), and intraoperative complications were compared for the study groups. Results: the operative time was more among Group A (dusting) than Group B (fragmentation) with a statistically significant association, stone-free rate more in Group A (dusting) than Group B (fragmentation) without a statically significant Need for DJ in Group b (fragmentation) than group a (dusting) with statically significant association Regard intraoperative complication (mucosal injury, stone migration, perforation) more in group b (fragmentation) a (dusting) without any significant association. Conclusion: The dusting method resulted in fewer intraoperative complications (mucosal injury, stone migration, perforation) and a lower need for DJ insertion than the fragmentation method. However, it needed a longer operative time than the fragmentation method. Received: Nov,, 2022 Accepted: April, 2023 Published: Oct.2023
{"title":"A Comparative Study between Dusting and Fragmentation in Intracorporeal Laser Lithotripsy in Distal Ureteric Stone","authors":"Mostafa AL sunboli, None Mohammed basil, None Raghib Jassam","doi":"10.32007/jfacmedbagdad.2018","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2018","url":null,"abstract":"Background: Ureteric stones commonly have an impact on the quality of life of the patient. There are many treatment choices for the condition, including medical treatment, extra-corporeal shock wave lithotripsy (ESWL), endoscopic intervention by ureteroscope (URS), or surgery (open or laparoscopic). Semi-rigid URS with laser lithotripsy is used to fragment ureteric stones, especially those in the distal ureter. Objectives: To assess the efficacy and complications of the dusting versus the fragmentation method for lower ureteric stones using holmium laser lithotripsy by analyzing intra-operative and post-operative variables. Patients and methods: One hundred and twenty patients with distal ureteric stones were included in the current study conducted in Ghazi AL-Hariri Teaching Hospital for Surgical Specialties from December 2020 to July 2022. The cases were divided into two groups: The first is the dusting group and the second is the fragmentation group. Both groups are further subdivided into the 10-15 mm and < 10 mm stone groups. The time of the operation, the rate of being stone-free, stone size, the rate of Double-J stents (DJS), and intraoperative complications were compared for the study groups. Results: the operative time was more among Group A (dusting) than Group B (fragmentation) with a statistically significant association, stone-free rate more in Group A (dusting) than Group B (fragmentation) without a statically significant Need for DJ in Group b (fragmentation) than group a (dusting) with statically significant association Regard intraoperative complication (mucosal injury, stone migration, perforation) more in group b (fragmentation) a (dusting) without any significant association. Conclusion: The dusting method resulted in fewer intraoperative complications (mucosal injury, stone migration, perforation) and a lower need for DJ insertion than the fragmentation method. However, it needed a longer operative time than the fragmentation method. Received: Nov,, 2022 Accepted: April, 2023 Published: Oct.2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2075
Hind Shakir Ahmed, Melak Saleh Mohammed
Background: Diabetes is a serious risk factor for atherosclerotic cardiovascular disease and an important cause of mortality. Dyslipidemia is commonly related to type 2 diabetes, and the atherogenic index of plasma is a strong marker to predict the risk of atherosclerosis and coronary heart disease. Objective: To study the association of atherogenic indices lipids in type 2 diabetic Iraqi patients with cardiovascular disease. Patients and Methods: This clinical study was conducted at Baghdad Teaching Hospital/ Medical City-Baghdad from October 2022 to February 2023. Sixty type 2 diabetic patients were recruited for this study: 30 patients with cardiovascular disease and 30 without cardiovascular disease. Their ages were between 40-55 years. Another 30 healthy individuals were selected as a control group. Results: There were considerable rises in glycemic and lipid investigations in diabetic patients with cardiovascular disease compared to those without cardiovascular disease and the control group. The present results show higher levels of lipid ratios in diabetic patients with cardiovascular disease. The results also revealed high levels of non-high-density lipoprotein cholesterol for diabetic patients with cardiovascular disease (241.8±12.24 mg/dL) versus (150.1±7.12 and 68.9±5.1 mg/dL) for those without cardiovascular disease and the controls group respectively. The atherogenic index of plasma in diabetic patients with cardiovascular disease compared to diabetic and healthy control groups were (0.8±0.09) versus (0.7±0.03 and 0.2±0.08) respectively. There was a significant correlation between the atherogenic index of plasma and anthropometric factors, glycemic and lipid profile with their ratios in diabetic patients with and without cardiovascular disease. Conclusions: The results of this study confirm that the lipid indices are risk indicators of glycemic control with higher prognostic value than traditional factors. So, non-high-density lipoprotein cholesterol and atherogenic index of plasma can be used as a significant predictor of glycemic control. Received: Feb., 2023 Accepted: May, 2023 Published: Oct. 2023
{"title":"Atherogenic Indices in Type 2 Diabetic Iraqi Patients and Its Association with Cardiovascular Disease Risk","authors":"Hind Shakir Ahmed, Melak Saleh Mohammed","doi":"10.32007/jfacmedbagdad.2075","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2075","url":null,"abstract":"Background: Diabetes is a serious risk factor for atherosclerotic cardiovascular disease and an important cause of mortality. Dyslipidemia is commonly related to type 2 diabetes, and the atherogenic index of plasma is a strong marker to predict the risk of atherosclerosis and coronary heart disease. Objective: To study the association of atherogenic indices lipids in type 2 diabetic Iraqi patients with cardiovascular disease. Patients and Methods: This clinical study was conducted at Baghdad Teaching Hospital/ Medical City-Baghdad from October 2022 to February 2023. Sixty type 2 diabetic patients were recruited for this study: 30 patients with cardiovascular disease and 30 without cardiovascular disease. Their ages were between 40-55 years. Another 30 healthy individuals were selected as a control group. Results: There were considerable rises in glycemic and lipid investigations in diabetic patients with cardiovascular disease compared to those without cardiovascular disease and the control group. The present results show higher levels of lipid ratios in diabetic patients with cardiovascular disease. The results also revealed high levels of non-high-density lipoprotein cholesterol for diabetic patients with cardiovascular disease (241.8±12.24 mg/dL) versus (150.1±7.12 and 68.9±5.1 mg/dL) for those without cardiovascular disease and the controls group respectively. The atherogenic index of plasma in diabetic patients with cardiovascular disease compared to diabetic and healthy control groups were (0.8±0.09) versus (0.7±0.03 and 0.2±0.08) respectively. There was a significant correlation between the atherogenic index of plasma and anthropometric factors, glycemic and lipid profile with their ratios in diabetic patients with and without cardiovascular disease. Conclusions: The results of this study confirm that the lipid indices are risk indicators of glycemic control with higher prognostic value than traditional factors. So, non-high-density lipoprotein cholesterol and atherogenic index of plasma can be used as a significant predictor of glycemic control. Received: Feb., 2023 Accepted: May, 2023 Published: Oct. 2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2048
Ali Khudhair, Khalid Zuhair Naama Naama, Ammar Khaleel, Yasir Saadi
Background: Neonatal intensive care unit infants frequently experience acute kidney damage. Estimates of the prevalence of acute kidney vary depending on the definitions used. In Iraq, studies addressing the prevalence and risk factors of acute kidney injury in this age group are scarce, none of which has implicated the KDIGO diagnostic and staging criteria. Objectives: To describe the prevalence, demographics, risk factors, etiology, and staging of acute kidney injury using KDIGO criteria in the Neonatal intensive care unit and correlate these findings with patient outcomes. Methods: A retrospective study was conducted in the Neonatal Intensive Care Unit/ CWTH/ Medical City Complex/ Baghdad during the period from the 1st of August 2019 to the 15th of January 2020. All neonates diagnosed with acute kidney injury according to KDIGO –classification 2012 and admitted to the neonatal intensive care unit were included in this study. Demographics, clinical staging, and investigations were retrieved from patients' notes. Results: The prevalence of acute kidney damage was 7.2%. The mean gestational age of the patients was 36.8 ± 2.9 weeks, 58% of them were full-term, with a male-to-female ratio of 1.40:1. Stage I patients represented 35.1%, 43.2% were stage 2, and 21.6% had severe stage 3. Acute kidney injury-related mortality was 35.1%. The term female sex, high birth weight, and age younger than seven days at diagnosis predicted a bad prognosis. Vaginally delivered, stage III acute kidney injury-KDIGO, and peritoneal dialysis patients had the worst outcomes. Asphyxia was a major cause of acute kidney injury (P=0.001). High blood urea (P=0.01), low PH (P=0.009), low HCO3 (P=0.001), low WBC count (P=0.001), and low platelet count (0.001) were associated with unfavorable outcomes. Conclusions: The prevalence of acute kidney injury, according to KIDGO diagnostic and staging criteria, is 7.1%. Asphyxia, female gender, and vaginal deliveries are variables associated with poor prognosis in addition to advanced illness stage and laboratory indicators. Received: Dec. 2022 Accepted: Jun 2023 Published: Oct.2023
{"title":"Acute Kidney Injury in Neonates: A Single-Center Experience","authors":"Ali Khudhair, Khalid Zuhair Naama Naama, Ammar Khaleel, Yasir Saadi","doi":"10.32007/jfacmedbagdad.2048","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2048","url":null,"abstract":"Background: Neonatal intensive care unit infants frequently experience acute kidney damage. Estimates of the prevalence of acute kidney vary depending on the definitions used. In Iraq, studies addressing the prevalence and risk factors of acute kidney injury in this age group are scarce, none of which has implicated the KDIGO diagnostic and staging criteria. Objectives: To describe the prevalence, demographics, risk factors, etiology, and staging of acute kidney injury using KDIGO criteria in the Neonatal intensive care unit and correlate these findings with patient outcomes. Methods: A retrospective study was conducted in the Neonatal Intensive Care Unit/ CWTH/ Medical City Complex/ Baghdad during the period from the 1st of August 2019 to the 15th of January 2020. All neonates diagnosed with acute kidney injury according to KDIGO –classification 2012 and admitted to the neonatal intensive care unit were included in this study. Demographics, clinical staging, and investigations were retrieved from patients' notes. Results: The prevalence of acute kidney damage was 7.2%. The mean gestational age of the patients was 36.8 ± 2.9 weeks, 58% of them were full-term, with a male-to-female ratio of 1.40:1. Stage I patients represented 35.1%, 43.2% were stage 2, and 21.6% had severe stage 3. Acute kidney injury-related mortality was 35.1%. The term female sex, high birth weight, and age younger than seven days at diagnosis predicted a bad prognosis. Vaginally delivered, stage III acute kidney injury-KDIGO, and peritoneal dialysis patients had the worst outcomes. Asphyxia was a major cause of acute kidney injury (P=0.001). High blood urea (P=0.01), low PH (P=0.009), low HCO3 (P=0.001), low WBC count (P=0.001), and low platelet count (0.001) were associated with unfavorable outcomes. Conclusions: The prevalence of acute kidney injury, according to KIDGO diagnostic and staging criteria, is 7.1%. Asphyxia, female gender, and vaginal deliveries are variables associated with poor prognosis in addition to advanced illness stage and laboratory indicators. Received: Dec. 2022 Accepted: Jun 2023 Published: Oct.2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2063
Rand Saadi Abdul-Sattar, Ali Hadi Al-Maini
Background: Regional anesthesia is a common procedure in an adult patient undergoing ophthalmic surgery, but it cannot be done alone in the pediatric age group. General anesthesia is accompanied by complications intra- and post-operatively. Objectives: to determine whether or not using regional anesthesia in combination with general anesthesia in pediatric eye procedures improves patient outcomes. Methods: Forty children, with an age range of 6 - 12 years were included in the study that was conducted at Ghazi Al-Hariri Hospital / Department of Ophthalmology and Ibn Al-Haytham (Ophthalmology Hospital), both teaching hospitals, from December 2018 to October 2019. These children were allocated into one of two groups: GA (general anesthesia) and GA-R (general anesthesia-regional anesthesia). Heart rates, mean arterial blood pressure, oculo-cardiac reaction, and postoperative nausea and vomiting were measured. All required approvals were obtained from the scientific committee of the Iraqi Board for Medical Specializations. Statistical analysis was done using SPSS V26, with a P value of <0.05 considered significant. Results: None of the patients developed oculo-cardiac reactions or needed additives to the anesthesia given during surgery in the GA-R compared to the GA group. Intra-operative measurements of heart rates and mean arterial blood pressure were lower in the GA group than in the GA-R group (p<0.05). Compared to the GA group, the GA-R group had a lower incidence of postoperative nausea and vomiting (p<0.05). More patients in the GA group needed analgesia than in the GA-R group. Conclusion: Using regional anesthesia as a peribulbar block with general anesthesia is a safe and successful procedure in pediatric ocular surgeries. Received:Feb. 2023 Accepted: Sept. 2023 Published: Oct. 2023
{"title":"The Advantages of Combined Regional and General Anesthesia in Ophthalmic Surgery in Children","authors":"Rand Saadi Abdul-Sattar, Ali Hadi Al-Maini","doi":"10.32007/jfacmedbagdad.2063","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2063","url":null,"abstract":"Background: Regional anesthesia is a common procedure in an adult patient undergoing ophthalmic surgery, but it cannot be done alone in the pediatric age group. General anesthesia is accompanied by complications intra- and post-operatively. Objectives: to determine whether or not using regional anesthesia in combination with general anesthesia in pediatric eye procedures improves patient outcomes. Methods: Forty children, with an age range of 6 - 12 years were included in the study that was conducted at Ghazi Al-Hariri Hospital / Department of Ophthalmology and Ibn Al-Haytham (Ophthalmology Hospital), both teaching hospitals, from December 2018 to October 2019. These children were allocated into one of two groups: GA (general anesthesia) and GA-R (general anesthesia-regional anesthesia). Heart rates, mean arterial blood pressure, oculo-cardiac reaction, and postoperative nausea and vomiting were measured. All required approvals were obtained from the scientific committee of the Iraqi Board for Medical Specializations. Statistical analysis was done using SPSS V26, with a P value of <0.05 considered significant. Results: None of the patients developed oculo-cardiac reactions or needed additives to the anesthesia given during surgery in the GA-R compared to the GA group. Intra-operative measurements of heart rates and mean arterial blood pressure were lower in the GA group than in the GA-R group (p<0.05). Compared to the GA group, the GA-R group had a lower incidence of postoperative nausea and vomiting (p<0.05). More patients in the GA group needed analgesia than in the GA-R group. Conclusion: Using regional anesthesia as a peribulbar block with general anesthesia is a safe and successful procedure in pediatric ocular surgeries. Received:Feb. 2023 Accepted: Sept. 2023 Published: Oct. 2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134934703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.32007/jfacmedbagdad.2057
Hiba mohammed Suza ali, Eman B. H. Al-Khedairy
Background: prednisolone is a corticosteroid with a very bitter taste acts as anti- anti-inflammatory and immune suppressant drug and it is used at any age. Objective: To improve patient compliance by masking the bitter taste of the drug to be delivered as an orodispersible tablet. Methods: External ionic gelation using sodium alginate (0.5%w/v) and calcium chloride (1% w/v) in presence of 0.5% w/v carbopol 940 was used to prepare taste masked beads loaded with prednisolone to be compressed as orodispersible tablets. Results: The bitter taste of was masked by preparing beads composed of 1:1:1 (sodium alginate: Carbopol 940: prednisolone) which released only 0.77 % of the drug in pH 6.8 (pH of oral cavity). The ODT prepared by direct compression using taste masked beads equivalent to 5 mg PRD, 3% crospovidone, 2% PVP, 1% talc, 1% magnesium stearate and combination of Avcil® PH 102 and mannitol at (1:1) ratio was the optimum formula (T6) with hardness of 3.9± 0.32 kg, , friability 0.45%, thickness 2.5 ± 0.05 mm, % drug content 98.2% ± 1.8, wetting time 18.7 ± 1.3 sec, water absorption 41 ± 2.1%, disintegration time 15.3 ± 0.5 sec. and released only 0.75% ± 0.01 of PRD in an oral pH of 6.8 within one minute (indicating good taste masking). Its release in the stomach (pH 0.1N HCl) and intestine (pH 6.8) was continued for up to two hours. Conclusion: it can be concluded that the external ionic gelation method successfully masked the bitter taste of prednisolone and can also be formulated as taste-masked orodispersible tablets by the direct compression method. Received: Jan. 2023 Accepted: May 2023 Published: Oct.2023
{"title":"Formulation and In Vitro Evaluation of Taste- Masked Prednisolone Orodispersible Tablets","authors":"Hiba mohammed Suza ali, Eman B. H. Al-Khedairy","doi":"10.32007/jfacmedbagdad.2057","DOIUrl":"https://doi.org/10.32007/jfacmedbagdad.2057","url":null,"abstract":"Background: prednisolone is a corticosteroid with a very bitter taste acts as anti- anti-inflammatory and immune suppressant drug and it is used at any age. Objective: To improve patient compliance by masking the bitter taste of the drug to be delivered as an orodispersible tablet. Methods: External ionic gelation using sodium alginate (0.5%w/v) and calcium chloride (1% w/v) in presence of 0.5% w/v carbopol 940 was used to prepare taste masked beads loaded with prednisolone to be compressed as orodispersible tablets. Results: The bitter taste of was masked by preparing beads composed of 1:1:1 (sodium alginate: Carbopol 940: prednisolone) which released only 0.77 % of the drug in pH 6.8 (pH of oral cavity). The ODT prepared by direct compression using taste masked beads equivalent to 5 mg PRD, 3% crospovidone, 2% PVP, 1% talc, 1% magnesium stearate and combination of Avcil® PH 102 and mannitol at (1:1) ratio was the optimum formula (T6) with hardness of 3.9± 0.32 kg, , friability 0.45%, thickness 2.5 ± 0.05 mm, % drug content 98.2% ± 1.8, wetting time 18.7 ± 1.3 sec, water absorption 41 ± 2.1%, disintegration time 15.3 ± 0.5 sec. and released only 0.75% ± 0.01 of PRD in an oral pH of 6.8 within one minute (indicating good taste masking). Its release in the stomach (pH 0.1N HCl) and intestine (pH 6.8) was continued for up to two hours. Conclusion: it can be concluded that the external ionic gelation method successfully masked the bitter taste of prednisolone and can also be formulated as taste-masked orodispersible tablets by the direct compression method. Received: Jan. 2023 Accepted: May 2023 Published: Oct.2023","PeriodicalId":33125,"journal":{"name":"mjl@ kly@ lTb","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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