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Article
Effects of Atenolol, Captopril, and Their Combination on Oxidative Stress in Hypertensive Patients

Authors: Haidar A. N. Abood --- Riyadh H. Hashim --- Majid K. Abbass --- Abdul Razzak A. Latif
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2009 Volume: 6 Issue: 1 Pages: 114-123
Publisher: Babylon University جامعة بابل

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Abstract

Oxidative stress plays an important role in the pathogenesis of hypertension, and oxidative imbalance involved in the development of endothelial dysfunction and vascular complications like atherosclerosis. It is important nowaday to evaluate the antioxidant effects of antihypertensive drugs in addition to blood pressure lowering effects, since this may provide a better treatment approach and participate in the prevention of complications of hypertension. We studied the antioxidant effects of atenolol, captopril, and their combination on 60 hypertensive patients aged from 45 – 60 years, treated for one year with different treatment lines and compared the results with healthy controls. Serum reduced glutathione (GSH) levels were estimated as a marker of oxidative status in the blood and lipid peroxidation at endothelial cell membrane was evaluated by measuring its byproduct, malondialdehyde (MDA) in the blood utilizing spectrophotometric techniques. Oxidative imbalance was present in all hypertensive patients in comparison with controls. Serum GSH levels significantly reduced and serum MDA levels significantly elevated in patients using atenolol and captopril alone, while patients who used atenolol/captopril combination significantly maintained blood GSH and MDA at levels closer to that of controls. Combination therapy was found to reduce GSH depletion and lipid peroxidation more than captopril, and captopril more than atenolol. In conclusion, combination therapy provides better protection against oxidative stress associated with hypertension, and hence better prevention of complications like atherosclerosis than both atenolol and captopril used alone.

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Article
Patterns of Sensitization to Inhalant Allergens among Asthmatic Children in Karbala Province

Authors: Mohammad R. I. Ghazal --- Zuhair M. Al-Musawi --- Haidar A. N. Abood*,
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 2 Pages: 1630-1636
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: The patterns of sensitization to inhalant allergens among asthmaticchildren varies greatly in different countries. The detection of sensitization to inhalantallergens in asthmatic patients is used primarily to establish the diagnosis of allergicasthma. Also it is helpful in reducing asthma exacerbations through allergen exposureavoidance.Objectives: This study aims to determine the most common inhalant allergens associatedwith childhood asthma in Karbala province using allergen-specific IgE immunoassay.Patients and Methods: The present study was conducted in Karbala Teaching Hospital forChildren on 75 asthmatic children with elevated total serum IgE levels. All patients werescreened for the presence of specific IgE against inhalant allergens most frequently involvedin childhood asthma using EUROLINE Pediatric Inhalation IgE test kit that include 20inhalant allergens. The position of the band was used to determine the specific allergen whilethe color intensity of the band was used as predictive for the specific IgE concentration inserum samples.Results: Among 75 patients screened for specific IgE, 60 patients (80%) were sensitized to atleast one allergen and allergen-specific IgE was not detected in 15 (20%) patients. 30% ofsensitized patients, were sensitized to single allergen and 70% were sensitized to multipleallergens. Cat allergen was found in 60% of sensitized patients followed by European housedust mite allergen (55%). However, dog and aspergillus fumigatus allergens accounted for45% and 33.3% respectively. Most patients sensitized to cat and dog allergens (55.5% and52% respectively) showed clear bands signal intensity (moderate allergen-specific IgEconcentration). However the majority of patients sensitized to other inhalant allergensshowed weak bands signal intensity (low allergen-specific IgE concentration).Conclusions: Animal allergens (mostly cat) are the predominant inhalant allergens associatedwith childhood asthma in Karbala province with relatively higher allergen-specific IgEconcentrations than house dust mite and fungal allergens.


Article
Ergogenic Effects of Yohimbine: Standardized Cycling Clinical Study

Authors: Hayder M. Al-Kuraishy --- Haidar A. N. Abood --- Ali Ismail A. Al-Gareeb
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1850-1855
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Ergogenic denote rising in the capacity of the body for eliminating exhaustion and enhancing physical performance, with broad variety of drugs are apparent to be ergogenic in their effects. Yohimbine is an alkaloid recognized as an antagonist to the noradrenergic α2-receptors which normalize noradrenaline release in the central nervous system and their activation decreases the discharge of noradrenaline in the synaptic terminal.Objectives: This study was designed to evaluate the ergogenic effects of yohimbine in normal healthy volunteers.Patients and Methods: The present study was conducted in Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad-Iraq, in collaboration with Department of Pharmacology, College of Medicine, University of Kerbala, Kerbala-Iraq, during April of 2013. The subjects of this study were medical students. 20 male volunteers were conformist to join up this single blind random experimental study. The exercise program consists of cycling on an ergometer. Pulse was measured using ear pulse sensor and maximum pulse rate achieved in this study and the entire exercise parameters were recorded as baseline data, then each subject take yohimbine tablets 5 mg (orally) and after 2 hours, each subject run on cycling ergometer to fatigue state, then, the display functions of bicycle were scanned. Besides, maximal oxygen uptake (VO2 max) was measured to estimate oxygen consumptions.Results & discussion: Yohimbine significantly improved all ergogenic parameters (efforts, calories, distance, speed and exercise time) from baseline after single oral dose of 5mg, where p values were ˂ 0.05. Moreover; yohimbine significantly accelerate the oxygen consumption in both oxygen consumptions and velocity at maximal oxygen uptake regarding maximum heart rate and resting heart rate with p values ˂ 0.05.Conclusions: Yohimbine accelerates and improves cycling performances via positive ergogenic effects .So, yohimbine can be used as ergogenic agent for ameliorating the physical fatigue.


Article
Assessment of Asthma Severity by History and Lung Function Study in School Age Children

Authors: Zuhair M. Al Musawi --- Akeel Mahdi --- Majeed Matrood --- Haidar A. N. Abood
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 1 Pages: 2607-2612
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: The assessment of childhood asthma severity is important for the diagnosis and determining the initial level or step of the treatment of childhood asthma. It can be performed either by history alone for children less than five years old or by history and pulmonary function test for older children.Objective: to evaluate and compare the utility of history and lung function test in the assessment of asthma severity in childrenPatients and Method: Across-sectional study was conducted in Karbala teaching hospital of pediatrics, during the period from October 1, 2013 - April 30, 2014. The study included 50 children of both genders diagnosed with asthma (diagnosis made by consultant pediatrician). A questionnaire was designed for the assessment of asthma severity by history which included symptoms frequency over the preceding 4 weeks respectively. The lung function test was only done in children 6-year-old and more. All children in our study had performed lung function test.Results: The mean age of studied group was 9.6 ± 2.5. The result of asthma severity assessment based on history was as follow: 14/50 patients (28%) had intermittent asthma, 36/50 (72%) had persistent asthma of different degrees, mild in 11/50 (22%), moderate in 19/50 (38%) and severe persistent asthma in 6/50 (12%). While according to lung function test, 12/50 patients (24%) had intermittent asthma, 15/50 (30%) had mild persistent, 19/50 (38%) had moderate persistent and the remaining 4/50 patients (8%) had severe persistent asthma. There was no significant statistical difference in severity assessment between the two methods (P > 0.05).Conclusions: Our study shows good correlation between history and lung function test regarding classification of childhood asthma severity. History is an excellent tool for the assessment of childhood asthma severity when lung functions test is unavailable or difficult to be done in younger children.


Article
A Comparative Study of Salbutamol Nebulizer versus Ipratropium Bromide plus Salbutamol Nebulizer in the Treatment of Children with Acute Asthma Exacerbation
مقارنة تأثير تبخير السالبيوتامول مع تأثيرتبخير مزيج (الابراتروبيوم برومايد والسالبيوتامول) في علاج الأطفال المصابين بنوبة الربو الحادة

Authors: Aqeel M. Hussein --- Ali H. Hanoon --- Ahmed Mahmoud AL-Tuama --- Haidar A. N. Abood
Journal: karbala journal of pharmaceutical sciences مجلة كربلاء للعلوم الصيدلانية ISSN: 70272221 Year: 2018 Issue: 15 Pages: 122-137
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Patients with asthma may develop acute attack due to different typesof triggering factors. Early recognition of an acute asthma exacerbation is crucialfor effective management.Objectives: To evaluate the effects of salbutamol nebulizer versus salbutamol plusipratropium bromide nebulizer in children with acute asthma exacerbation attack.Patients and methods: A randomized double blind standard control clinical studywas conducted in Karbala Teaching Hospital for Children from 1st of November2015 to the end of November 2016 on patients presented to the emergency room(ER) of the Hospital. The study was conducted on hundred patients presented withmild to moderate acute attacks of asthma, assigned to take either nebulizedsalbutamol or combination of salbutamol plus ipratropium bromide during theirstay. Assessment of asthma severity was done for each patient according topulmonary index score (PIS)Results: There was significant reduction (p <0.05) in PIS for patients treated withsalbutamol alone and patients treated with combination therapy (ipratropium +salbutamol) after 30,60 and 90 minutes from ER admission as compare with theirscores at baseline, 30 and 60 minutes respectively. After 30 minutes from ERadmission, patients who were treated with combination of ipratropium bromide +salbutamol had significantly (p <0.05) lower PIS (5.60±2.77) than those treatedwith salbutamol alone (PIS=7.32±2.18). The mean duration of stay in ER was significantly (p <0.05) shorter in patient treated with combination therapy(57.60±21.71 min) than those with salbutamol alone (77.40±16.13 min).Conclusion: Treatment of asthmatic children with mild to moderate acuteexacerbation attack with combination therapy of (ipratropium plus salbutamolnebulizer) improved the clinical condition, lowered pulmonary index score, andsignificantly shortened the duration of stay in emergency room as compared withsalbutamol nebulizer alone.

المرضى المصابون بالربو من الممكن ان يتعرضوا لنوبة حادة بسبب أنواع مختلفة من المحفزات. ان التعرفالمبكر على تفاقم الربو الحاد هو امر مهم لعلاج فعال.الهدف:لمقارنة تأثير تبخير دواء السالبيوتامول مقابل تأثير تبخير مزيج (الابراتروبيام والسالبيوتامول) في الأطفالالمصابين بنوبة تفاقم الربو الحادة.طريقة العمل:دراسة سريريه مجهولة لكل من الباحث والمريض اجريت في مستشفى كربلاء التعليمي للأطفال في محافظةكربلاء للفترة من الاول من تشرين الثاني ٢٠١٥ لغاية الثلاثون من شهر تشرين الثاني ٢٠١٦ للمرضىالمراجعين لوحدة الطوارئ مع نوبة تفاقم الربو الحادة. الدراسة أجريت على مئة مريض وتم تقسيمهم الىمجموعتين، المرضى في المجموعة الاولى البالغ عددهم خمسون مريض اخذوا الدواء المزيج(تبخيرالابراتروبيام والسالبيوتامول) اما المرضى في المجموعة الثانية اخذوا دواء السالبيوتامول لوحده. وتموالذي يعتمد على الحالة السريرية للمريض وفق (PIS) تقييم شدة النوبة وفق المؤشر التقييمي الرئويمؤشرات معينه.النتائج :للمرضى الذين تم علاجهم بدواء (PIS) كان هنالك تحسن معنوي كبير في مجموع المؤشر التقييمي الرئويتبخير السالبيوتامول وكذلك للمرضى الذين تم علاجهم بالدواء المزيج (الابراتروبيام والسالبيوتامول) بعد 30و 60 و 90 دقيقة من وقت الدخول الى الطوارئ مقارنة بالنتائج الأولية ( لحظة الدخول). عند الدقيقة ٣٠ منفترة دخول المريض لوحدة الطوارئ كان هنالك تحسن بشكل كبير بمجموع المؤشر التقييمي الرئوي للمرضى الذين تم علاجهم بالدواء المزيج (تبخيرالابراتروبيام والسالبيوتامول) أكثر (PIS=5.60±2.77)وكذلك وجد ان . (PIS=7.32± من أولئك المرضى الذين تم علاجهم بدواء تبخير السالبيوتامول لوحده ( 2.1857.60 دقيقة ) بالنسبة للمرضى المعالجين ± مدة العلاج والبقاء في وحدة الطوارئ اقل بشكل كبير ( 21.71بالدواء المزيج (الابراتروبيام والسالبيوتامول) بالمقارنة مع المرضى المعالجين بدواء تبخير السالبيوتامول77.40 دقيقة ) . ± لوحده ( 16.13الاستنتاج :ان علاج الأطفال المصابين بنوبة الربو الحادة ذو الشده الخفيفة الى المتوسطة بدواء تبخير السالبيوتاموليحسن الحالة السريرية للمريض ويخفض مجموع المؤشر التقييمي الرئوي. وان إضافة دواء تبخيرالابراتروبيام الى دواء تبخير السالبيوتامول يحسن بشكل كبير الحالة السريرية ومجموع المؤشر التقييميالرئوي وفترة بقاء المريض في وحدة الطوارئ أكثر من العلاج بدواء السالبيوتامول لوحدة.


Article
Total Serum IgE Level in Relation to Some Risk Factors of Childhood Asthma
مستوى المصل الكلي للغلوبيولين المناعي نوع E وعلاقته ببعض عوامل خطورة الإصابة بالربو عند الأطفال

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Abstract

Measurement of total serum IgE (TSIgE) levels in asthmatic children can be used for supporting the diagnosis of allergic asthma, predicting asthma severity and monitoring response to therapy. Elevated TSIgE level is important risk factor for persistent childhood asthma. The present study aims to determine the extent of elevation in TSIgE levels among asthmatic children and its association with some risk factors of childhood asthma. This cross sectional study was conducted in Kerbala Teaching Hospital for Children on 154 asthmatic children. An interview was conducted with patients (including their parents) through a questionnaire prepared for this purpose to report patient's information and clinical data. All patients were screened for the presence of elevated TSIgE by a qualitative method followed by quantitative measurement of TSIgE concentration. Absolute eosinophils count was also determined. Seventy five (48.7%) patients showed positive IgE screening test and 79 (51.3%) patients showed negative IgE screening test. 61.4% of asthmatic children in the age group 5-10 years and 55.5% of patients in the age group >10 years were IgE (+ve), while only 33.3% of patients in the age group <5 years were IgE (+ve). The mean TSIgE level was 874.97±1323.85 IU/ml for IgE (+ve) patients (56% had levels <500, 21.3% between 500-1000, and 22.7% >1000 IU/ml) and 38.19±19.23 IU/ml for IgE (-ve) patients. The ages of patients in the IgE (+ve) group were significantly higher (P<0.01) than those for patients in the IgE (-ve) group. No significant differences (P>0.05) were observed between patients in both groups regarding absolute eosinophils count, patient's weight, gender, positive personal history of atopic dermatitis and/or allergic rhinitis, positive family history of asthma and exposure to smoking . In conclusion, there is high association between age and TSIgE levels in asthmatic children, with elevated levels mostly seen in older children. No association present between elevation in TSIgE and other risk factors for childhood asthma like; male gender, positive family history of asthma, exposure to tobacco smoke and peripheral blood eosinophilia.

إن قياس مستوى المصل الكلي للغلوبيولين المناعي نوع E (IgE) في الأطفال المصابين بالربو يستخدم في دعم تشخيص الربو التحسسي بالإضافة لتحديد شدة المرض ورصد الاستجابة للعلاج. يعتبر ارتفاع مستوى المصل الكلي للغلوبيولين المناعي نوع E أحد عوامل الخطورة المهمة للإصابة بالربو عند الأطفال. .إن الهدف من هذه الدراسة هو تحديد مدى الارتفاع في مستويات المصل الكلي للغلوبيولين المناعي نوع E بين الأطفال المصابين بالربو وارتباطه مع بعض عوامل خطورة الإصابة بالربو عند الأطفال. أجريت هذه دراسة في مستشفى كربلاء التعليمي للأطفال على 154 طفل مصاب بالربو. بعد مقابلة المرضى وملئ الاستمارات الخاصة بالدراسة, تم إجراء الفحص النوعي على أمصال المرضى لتحديد وجود مستويات مرتفعة من الغلوبيولين المناعي نوع E تلاها قياس كمي لتركيز الغلوبيولين المناعي نوع E في المصل و كذلك تم حساب العدد المطلق لكريات الدم البيضاء الحمضية لجميع المرضى. أظهرت الدراسة أن 48.7٪ من المرضى لديهم مستويات مرتفعة من الغلوبيولين المناعي نوع E (IgE+ve) بينما 51.3٪ كانت لديهم مستويات طبيعيــــــــة (IgE-ve). كانت المستويات مرتفعة في 61.4٪ من المرضى في الفئة العمرية (5-10 سنوات), 55.5٪ من المرضى في الفئة العمرية (أكثر من 10 سنوات) و 33.3٪ من المرضى في الفئة العمرية (أقل من 5 سنوات). إن متوسط مستوى المصل الكلي للغلوبيولين المناعي نوعE هو 874.97 ± 1323.85 وحدة دولية لكل مليليتر في المجموعة مرتفعة المستوى (56٪ لديهم مستويات أقل من 500، 21.3٪ بين 500-1000، و 22.7٪ أكثر من 1000 وحدة دولية / مل) و38.19 ± 19.23 وحدة دولية لكل مليليتر في المجموعة طبيعية المستوى. كانت أعمار المرضى في المجموعة مرتفعة المستوى (IgE+ve) أعلى إحصائيا من أعمار المرضى في المجموعة طبيعية المستوى (IgE-ve). لم تلاحظ أي فروقات ذات دلالة إحصائية بين المرضى في كلا المجموعتين فيما يتعلق بالعدد المطلق لكريات الدم البيضاء الحمضية، الوزن، الجنس، التهاب الجلد التأتبي أو التهاب الأنف التحسسي، إصابة أحد أفراد العائلة بالربو و التعرض للتدخين. من ذلك نستنتج ارتباط ارتفاع مستوى المصل الكلي للغلوبيولين المناعي نوع E بالعمر لدى الأطفال المصابين بالربو حيث تكون المستويات مرتفعة في الغالب في الأطفال الأكبر سنا. وعدم وجود علاقة بين ارتفاع مستوى المصل الكلي للغلوبيولين المناعي نوع E مع عوامل الخطورة الأخرى للإصابة بالربو عند الأطفال مثل جنس الذكور، التاريخ العائلي الإيجابي للربو،التعرض لدخان التبغ وارتفاع نسبة كريات الدم البيضاء الحمضية في الدم.


Article
TECHNICAL ERRORS IN USING INHALERS AMONG PATIENTS WITH ASTHMA OR COPD IN IRAQ

Authors: Ali A.K. Abutiheen --- Ibrahim A. Al-Obaidi --- Sajjad J. Al-Hatab --- Ali M. Al-Mousawi --- et al.
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 1 Pages: 4-12
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Inhaler is a device holding a medicine taking by breathing (inhalation). It is estimated that about 25 billion dollars spent for inhalers annually, 5-7 billion dollars are wasted because of inhaler misuse. Objective:To evaluate inhaler use technique among Iraqi asthmatic and chronic obstructive pulmonary diseases (COPD) patients and identify the technical mistakes in using inhalers.Methods:The study protocol consisted of interview session to answer the study questionnaire and assessment session to estimate the performance of using inhaler in three cities in the middle of Iraq during the interval between 1st of August and 20th of September 2015. Chi-square test and trend chi-square test were used for univariate association between potential determinants and correctness of inhalation technique. Relevant determinants were entered into a multivariate logistic regression model.Results:A total of 364 patients participated in this study, 39.6% of patients were using their inhalers inadequately. Patients using turbuhaler, older patients (>60 years old) and patients with low level of education or shorter duration of use were significantly associated with more inhaler use mistakes.Conclusion:This study showed that substantial proportion of patients with asthma or COPD using their inhaler inadequately. The worse performance was among patients using turbuhaler and best among those using disckus inhaler.Keywords:Inhaler administration, asthma, COPD, pMDI, turbuhaler, disckus inhaler

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