Tinnitus after Blast Injury; a Prospective Study in Basrah, Iraq.

BACKGROUND: There is many civilians and soldiers who exposed to explosions in Iraq each month and they need an otolaryngological and audiological assessment. OBJECTIVE: To recognize the possible auditory insults and the recovery period of the acquired damages that may resulted from explosion and help for planning of optimal management strategies of otological manifestations and prevent undesirable consequences. PATIENTS AND METHODS: A prospective, descriptive study included forty-seven patients who were exposed to blast injuries within two weeks came to otolaryngology unit in Basrah Teaching Hospital complaining from otological symptoms from July 2017 tell January 2019. Three periodic assessments were done for each patient. An initial evaluation was done in the 1st visit included a detailed history and examination to evaluate the symptoms and assess the associated non-otological injury. An otological examination were done for all patients in the three visits, included microscopic ear examination, photos for the perforated tympanic membrane were taken to grade the perforations depending on their surface area, Pure tone audiometry and tympanometry. Thirty-eight patients were available to follow up in the 2nd and 3rd visits. RESULTS: All of the 47 patients were young and middle age male, hearing loss and tinnitus were the most presenting symptoms, which improved with time. Hearing impairment mostly in the high frequencies however there was improvement in the subsequent visits. The majority of patients (93.6%) presented with tympanic membrane perforation mostly grade I which usually healed spontaneously. There was a statistically significant associations between the degree of tympanic membrane perforation and associated nonotological injuries and with the explosions if occurred in closed space. CONCLUSION: Blast related otological injury constitute the main cause of morbidity as the ear is the most sensitive organ to explosive blast injury. Hearing loss was the dominant symptoms at presentation mainly in high frequencies, but fortunately most of patients improved with time. Tympanic membrane perforation constituted the mostly seen sign, however spontaneous healing can be expected in the majority of cases.

In vitro pharmacological screening of antioxidant, cytotoxic and enzyme inhibitory activities of Citrus aurantifolia Linn. Dried fruit extract.

The Lime Basra (Citrus aurantifolia Linn., Rutaceae) plant also known as dried lime, and Limoo Omani, is used both as a spice in meals and as an herbal tea in the treatment of some diseases in the Middle East. It was aimed to determine the biological activity screening of the 70% methanol, ethanol extracts and infusion which were prepared from dried fruits. 1,1-diphenyl-2-picrylhydrazyl (DPPH●) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS+●) radical scavenging activities, ferric reducing activity, cytotoxicity on A 549, MCF 7 and L929 cell lines and α-amylase inhibitory effects were determined. According to the results, 70% methanol extract was more active in antioxidant activity tests and ethanol extract was more active in cytotoxicity tests. Interestingly both 70% methanol and ethanol extracts were found to have potent hypoglycemic activity. The present findings shed light on the fact that it is important to research and scientifically evaluate plants with traditional medicinal use.

Inhibitors among patients with hemophilia in Basra, Iraq - A single center experience.

INTRODUCTION: Inhibitor formation is a major complication of hemophilia treatment because it interferes with the clinical response to factor replacement and causes significant morbidity. This cross-sectional study was conducted to assess the presence and frequency of inhibitors among registered person with hemophilia and to identify risk factors associated with inhibitor development. PATIENTS AND METHODS: A total of 143 hemophilics, 118 with hemophilia A (HA) and 25 with hemophilia B (HB), were enrolled for the study. Participant's clinical data were obtained through patient's medical records. Factor VIII and IX levels and the presence of inhibitors were assessed using a fully automated coagulometer. From the results of a Bethesda assay, patients were divided into those with high titers (≥5 BU) and those with low titers (<5 BU). RESULTS: The patient's age ranged from 1 to 67 years with median of 13.8 years. Inhibitors were detected in 18.6% and none of HA and HB patients, respectively. Of the 22 patients with HA and inhibitors, 18 (82%) had high titer inhibitors. The frequency of inhibitors was significantly higher among patients with severe hemophilia, a history of early exposure (≤3 months) to factor VIII concentrate, and family histories of autoimmune disease and immune system challenges (P < 0.05). The independent risk factors associated with inhibitor development were severe hemophilia (95% CIs = 1.02-55.6, OR = 7.5) and immune system challenges (95% CIs = 1.14-5.99, OR = 2.6). CONCLUSION: Inhibitors were common among HA patients, and both severe HA and immune system challenges (surgery and trauma) are independent risk factors for inhibitor development.

A 3-year study of deferasirox therapy in sickle cell disease patients in Basra, Southern Iraq.

BACKGROUND: Patients with sickle cell disease (SCD) may require repeated transfusions, which inevitably lead to iron overload (IOL). AIMS: : This study aims to assess the effectiveness and safety of oral deferasirox (DFX) in patients with SCD and transfusional IOL. PATIENTS AND METHODS: A descriptive study has been performed on patients with SCD who have completed at least 3 years on DFX. Height and weight were checked every 3-6 months. The efficacy was assessed based on serum ferritin (SF) levels. The safety was assessed based on adverse events (AEs), alanine aminotransferase (ALT), and serum creatinine (S. Cr) levels. RESULTS: : A total of 102 patients (61 males and 41 females) were recruited. Their mean daily iron intake was 0.13 ± 0.06 mg/kg. SF levels declined significantly from 2434.1 ± 132.9 ng/ml at the start of the study to 1655.8 ± 154.2 ng/ml at the end of the study (P < 0.05), with significant decreases observed after increasing the DFX dose to ≥ 30 mg/kg/day. ALT (12.8 ± 9.9 vs. 12.1 ± 7.1 U/L) and S. Cr (72.4 ± 9.2 vs. 74.1 ± 7.9 mmol/L) levels did not show significant differences from the start to the end of the study (P > 0.05). Thirty-eight patients (37%) developed AEs. The most common were abdominal pain (24.5%), diarrhea (8.0%), and nausea (7.8%). AEs were predominantly transient and mild to moderate in nature. CONCLUSIONS: This study has revealed that DFX is a safe, tolerable, and effective drug for reducing IOL in SCD patients, though it is associated with mild and transient adverse events.

Prevalence and Drug Resistance Pattern of Mycobacterium tuberculosis Isolated from Tuberculosis Patients in Basra, Iraq.

Drug-resistant Mycobacterium tuberculosis (DR-MTB) is a major health threat to human beings. This study aimed to evaluate the prevalence and drug resistance profile of MTB. Data were collected from 2,296 newly diagnosed, and 246 retreated tuberculosis (TB) patients who attended the Advisory Clinic for Chest Diseases and Respiratory in Basra province from January 2016 to December 2020. Both new diagnostic and retreated TB cases showed that DR-MTB cases were significantly higher at age 15-34 years, pulmonary TB, and urban residents but with no significant difference regarding gender. The drugs resistance was significantly higher among the retreated cases compared with the new diagnostic patients (20.3% vs. 2.4%, p < 0.0001), with the percentage of the resistance to first-line drugs in primary and secondary cases including isoniazid (1% and 17.1%), rifampicin (0.78% and 15.8%), ethambutol (0.56% and 8.5%), streptomycin (1.3% and 9.75%). Notice that the most common drug resistance was against streptomycin with 1.3% in new patients and against isoniazid (17.1%) in retreated patients. The rate of total drug-resistant TB, multi-drug resistant TB, mono-drug resistant TB, and rifampicin-resistant TB among new tuberculosis cases increased in this period from 2.2 to 6.7%, 0.17 to 1.6%, 0.85 to 4%, and 0.17 to 4%, with a percentage change of 204.54, 841.17, 370.58, 22.5%, respectively. The rates of poly drug-resistant TB and ethambutol-resistant-TB dropped in this period by 15.96%, and 0.7%, with a decrease from 1.19 to 1% and from 1 to 0.3%, respectively. Similarly, the increase of drug-resistant TB among secondary cases has also occurred. In conclusion, the temporal trend showed an increase in the rate of drug resistance of M. tuberculosis since 2016, with a predominant multi-drug-resistant TB and isoniazid-resistant TB.

The epidemiology of burns in Basra, Iraq.

Burns are a major cause of morbidity and mortality worldwide and an important public health problem in Iraq. The current study was undertaken to describe epidemiological characteristics of hospitalized burn patients and investigate in-hospital mortality. The study was undertaken at the Al-Fayhaa Burn Centre in Basra City through analyzing hospital records of patients admitted to the centre for a new burn injury between January and December 2016. Data were extracted from all accessible files, entered into Epidata and analyzed in Stata. Hospital records of 367 patients with an age range of 1 month to 77 years and a male to female ratio of 1:2 were analyzed. One third of admissions were children aged 0 to 5 years: the most common mechanisms of injury were flame (51%) and scalds (41.7%). Total body surface area (TBSA) burnt ranged from less than 1% to 100%, with a median of 30.0% (IQR 18.0, 45.0). Length of hospital stay ranged from 0 to 5 months, with a median of 8 days (IQR 4, 12.5). In-hospital mortality was 22% and the independent factors for death were TBSA and suicidal burns. Burns remain a major public health problem in Basra, especially in children, and require sustained multidisciplinary action for their prevention and management. Improving hospital records and computerizing them is essential for better assessment and follow-up of burn care practices.

Les brûlures sont une cause majeure de morbidité et de mortalité dans le monde, et un important problème de santé publique en Irak. Cette étude a pour but de décrire les caractéristiques épidémiologique et la mortalité des patients hospitalisés pour brûlure. Elle a été conduite à partir des dossiers des patients hospitalisés en 2016 dans le CTB de l'hôpital Al Fayhaa à Bassorah. Les données recueillies ont été entrée dans Epidata et analysées par Stata. Les dossiers de 367 patients, âgés de 1 mois à 77 ans (1,2 hommes/1 femme) ont été étudiés. Un tiers des admissions concernaient des enfants de moins de 5 ans. Un flamme était en cause dans 51% des cas, un liquide dans 41,7%. La surface atteinte était de 1 à 100% (médiane 30%, intervalle interquartile 4-12,5). La mortalité hospitalière était de 22%, les facteurs de risque indépendants étant la surface et le suicide. Les brûlures, en particulier chez l'enfant, demeurent un problème majeur de santé publique à Bassorah. Elles nécessitent des actions pluridisciplinaires, préventives comme curatives. L'amélioration et l'informatisation des dossiers médicaux est essentielle à l'évaluation et l'amélioration des soins.

[Study of prevalence of Toxoplasma gondii oocysts in the cats of Nouakchott]. / Étude de la prévalence des oocystes de Toxoplasma gondii chez le chat à Nouakchott.

The aim of the work was to evaluate the prevalence of Toxoplasma gondii oocyst shedding on a sample of 100 cats in five districts of Nouakchott, Mauritania. The faecal flotation method revealed that 23% ± 0.08 of cats which underwent the test excreted oocysts and the prevalence was influenced by age and sex. Excretion rates were significantly higher in neighborhoods of Basra (27.8 ± 0.2), Elmina (25 ± 0.13) and Netegue (20 ± 0.35). The average parasite number was less than 5 oocysts/5 g faeces. Hence, the results suggest that cats have an important role in the transmission of the zoonosis in Nouakchott.