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Article
Growth Delay in Steroid Sensitive Nephrotic Patients

Authors: Salim Zyara Abdullah --- Faris Matti Frankul --- Asaad Abdullah Abbas --- Shatha Hussein Ali --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 2 Pages: 129-135
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Growth in patients with idiopathic nephrotic syndrome (INS) is influenced by several factors, they suffer the influence of the disease itself as long as there is proteinuria, caused by the increase of the glomerular permeability and leading to hypoproteinemia. The effects of the glucocorticoid treatment, which alters growth by a direct action on the growth cartilage, or via disturbances of growth factors. In this study we assess the effect of nephrotic syndrome, it's relapse rate and it's treatment (i.e. steroid), in the statural growth of steroid sensitive nephrotic patients.METHODS:A Prospective study of 110 steroid responsive nephrotic patients collected from AL- Kadhemia Teaching Hospital, Central Child Teaching Hospital, Child Wellfaire Teaching Hospital & AL-Karama Teaching Hospital. The study started from first of June 2005 to first of June 2006. Data collected as following: age, sex, date of first diagnosis, duration of disease, number of relapses per year, measurement of the height, weight and body mass index and sign of steroid toxicity.RESULTS:Total number of our patients were 110, 74(67.3%) were males and 36(32.7%) were females, with male to female ratio of 2:1. The age of our patients range from 2-18 years with a mean of 7.9+3.8 years.Thirty-one (28.2%) of them were with height below 3rd percentile for their age, 24(77.4%) were males and 7(22.6%) were females.Twenty- five (22.7%) patients were at pubertal age. Eighteen (72%) were males and 7(28%) were females, and 17(68%) of them have height below 3rd percentile.Seventy –six (69%) patients have their onset of the disease at age between 2 and 6 years. Forty-six (41.8%) of patients have disease duration of less than 3 years, 3 (6.5%) of them were have height below 3rd percentile, 46(41.8%) with duration of 3-6years, 14(30.4%) them were have height below 3rd percentile and 18(16.4%) with duration of more than 6 years, 14(77.8%) of them have height below 3rd percentile.Fifty-five (50%) patients had frequent relapses, twenty-seven (49.1%) of them have height below 3rd percentile, compared to 4(7.3%) of those with infrequent relapse had height below 3rd percentile.Forty-seven (42.7%) patients show sign of steroid toxicity(cushigoid facial appearance with or with out hypertention,obesity,hirsutism..etc) 25(53.2%) of them have height below 3rd percentile, compared to 6(9.5%) of those who have no sign of toxicity.CONCLUSSION:Nephrotic syndrome is a potentially chronic disease with patients suffering a relapsing course and being at risk of frequent courses of prednisolone therapy with increase the risk of growth delay especially in patients reaching pubertal age and still taking steroid therapy.

Keywords

Growth Delay --- Steroid --- Nephrotic.


Article
The Effect of Inhalation Treatment on Oxidative Stress in Asthmatic Patients

Authors: Ferdous A. Jabir --- Ali N . Fijer
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2012 Volume: 8 Issue: 14 Pages: 186-204
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

The present study was conducted to verify the oxidative stress status in asthma patients . To achieve this aim, ninty asthmatic patients, and thirty healthy subjects (control group) were subjected to the study the sample were obatained from Babylon Asthma and Allergy Center in Hilla City .. showed The results of this study in asthmatic patients (men and menopause women ) with steroid inhalation treatment group when compared with control group showed a significant increase of Malondialdehyde (MDA) ,amd a significant decrease of super oxidase dismutase (SOD) and creatine kinase(CK) levels (P < 0.05 ) , wherease there was non significant increase in glutathione-S-transferase (GST), levels( P < 0.05) .The results of this study for asthmatic patients (men and menopause women ) with steroid inhalation treatment group when compared with asthmatic patients without treatment indicated a significant increasing levels of super oxidase dismutase (SOD) (SOD) , glutathione-S-transferase (GST) of men (P < 0.05) , whereas there was a non significant increase in levels of creatine kinase(CK), glutathione-S-transferase (GST) of menopause women(P<0.05) but there was significant decrease in malondialdehyde (MDA) levels. In asthmatic patients (men and menopause women ) without treatment group when compared with those of control group estimated significant decrease of super oxidase dismutase (SOD) (SOD) and creatine kinase(CK) level ( P < 0.05) , wherease there was a non significant increase in GST but there was a significant increase in malondialdehyde (MDA) levels ,( P < 0.05) . The correlation analysis indicated a non significant negative correlation in period of treatment with superoxide dismutase (SOD) and creatine kinase(CK) , as well as a non significant positive correlation for glutathione-S-transferase (GST) and malondialdehyde (MDA) .

في الدراسة الحالية تم جمع ( 90 ) نموذج من مرضى الربو 30 نموذج من اصحاء (مجموعة قياسية ) تم جمع هذه النماذج من مركز الربو والحساسية في مدينة الحلة . بينت النتائج بشكل عام عند مقارنة مرضى الربو المستخدمين علاج البخاخ الستيرويدي مع الاصحاء (بوصفهم مجموعة قياسية ) ان هنالك زيادة معنوية بالمالون داي ألديهايد و انخفاض معنوي في مستوى فعالية سوبر اوكسيد دزميوتيز و كرياتين كاينيز( P ≤0.05 ) بينما هنالك زيادة غير معنوية في مستوى فعالية كلوتوثايون اس ترانسفريز ( P ≤0.05 ) أوضحت النتائج عند مقارنة مرضى الربو المستخدمين لعلاج البخاخ الستيرويدي مع المرضى غير المستخدمين للعلاج ان هنالك زيادة معنوية في مستوى فعالية سوبر اوكسيد دزميوتيز و كلوتوثايون اس ترانسفريز عند الرجال ( P ≤0.05 ) بينما هنالك زيادة غير معنوية في مستوى كرياتين كاينيز و كلوتوثايون اس ترانسفريز ( P ≤0.05 ) في نساء في سن اليأس و انخفاض معنوي في مستوى المالون داي ألديهايد ( P ≤0.05 ) ) و عند مقارنة مرضى الربو غير المستخدمين العلاج (رجال و نساء في سن ليأس) مع الاصحاء وجد ان هنالك انخفاض معنوي في مستوى فعالية سوبر سوبر اوكسيد دزميوتيز و كرياتين كاينيز ( P ≤0.05 ) و هنالك زيادة غير معنوية في مستوى فعالية كلوتوثايون اس ترانسفري ( P ≤0.05 ) بينما هنالك زيادة معنوية بالمالون داي ألديهايد , كذلك عدم وجود ارتباط معنوي بين فترة استخدام العلاج ولسوبر اوكسيد دزميوتيز و لكلوتوثايون اس ترانسفريز و لكرياتين كاينيز والمالون داي ألديهايد في مرضى الربو.


Article
Evaluation of hemangioma management in Erbil city
تقييم علاج ورم وعائي في مدينة أربيل

Authors: Wesam Amjad Kaka --- Jalal Hamasalih Fattah
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 3 Pages: 825-832
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The term hemangioma refers to the common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. Hemangioma has a perinatal incidence of 1%-3% and affecting 10% of infants by one year of age. The aim of this study was to evaluate treatment outcomes following various managements of hemangiomas.Methods: One hundred four patients were included in this prospective study. Based on clinical management, each patient was assigned to different treatment groups: steroid, surgical, and combined therapy. Treatment outcomes were evaluated based on improvement in size and color, by a blinded panel of three raters including two doctors and one patient or patient’s parents. Finally, comparison of outcomes between groups was analyzed statistically. A p value ≤ 0.05 was considered statistically significant. Results: The results revealed that there was reduction in size and improvement in color following intervention in each group. Comparison of treatment outcomes between treatment groups revealed statistically significant difference among the groups regarding improvement in color (P <0.01) and reduction in size of hemangioma (P <0.01), and surgical treatment was better (among 31 patients, 17 got moderate improvement and 11 excellent improvement) compared with steroid therapy (among 36 patients, 19 got moderate improvement, and 3 excellent improvement).Conclusion: A favorable outcome can be achieved following appropriate intervention during all stages of development of hemangiomas.


Article
Evaluation of the Role of Interleukein-2 and Interleukein-4 in the Immunopathogenesis of Steroid Therapy Resistance in Iraqi Asthmatic Patients

Authors: Abdul Wahab A.Al-Shaikely --- Adel A. Sahib
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2008 Volume: 17 Issue: 1 Pages: 47-54
Publisher: Baghdad University جامعة بغداد

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Abstract

Interleukins (IL-2 and IL-4) are increased in asthmatics and were reported to induce resistance to steroid therapy in some patients who fail to get benefit from glucocorticoids when used in full dose and for long period of time. In this context, the present study was conducted on Iraqi patients to provide additional laboratory mean, beside the clinical diagnosis, for the decision whether the asthma is steroid sensitive or resistant by monitoring the level of immunoglobulins, complement proteins and interleukins among asthmatic patients (steroid sensitive or resistant) and the possible contribution of other factors like age, sex and environments in the development of steroid resistance. A total number of 55 asthmatics and 28 normal subjects were enrolled in the study. Patients were diagnosed clinically as steroid sensitive (SSA) and steroid resistant (SRA) and blood samples were taken from all subjects included in the study for the measurement of immunoglobulins (IgA, IgG, IgM and IgE), complement proteins (C3 and C4), interleukins (Il-2 and Il-4), and total and differential WBC counts.The results showed no age, sex and residence dependency of acquired steroid resistance, while smoking habit (and may be the atopic allergy) constitute marked predisposing factors. The level of IgA and IgE were high in both SRA and SSA, while IgG level was low in SRA. Complement proteins (C3 and C4) were not differ in asthmatic patients in comparison with control group. The interesting results were those concerning interleukins. The levels of IL-2 and IL-4 were very high in SRA than in SSA. These are parallel with high lymphocyte and neutrophil counts in blood samples of those patients.In conclusion, beside clinical diagnostic features concerning the dose and duration of therapy with glucocorticoids, monitoring the levels of IL-2 and IL-4 could provide additional laboratory diagnostic measures for the convincing decision that asthma is steroid resistant.

يزداد مستوى بعض الوسائط الالتهابية والمناعية عند مرضى الربو وقد يكون ذلك سببا لظهور بعض العلامات المرافقة أو المهيجة للمرض. وقد لوحظ أن مستوى الانترليوكينات ومن بينها interleukin-2 and interleukin-4 يزداد عند مرضى الربو وقد يُنتج مقاومة ضد العلاج بالستيرويدات عند بعض المرضى الذين اظهروا فشل الاستجابة للستيرويدات عند استخدامها بجرعها القصوى ولفترة طويلة. وفي هذا السياق فقد أُجريت الدراسة الحالية لإضافة وسيلة مختبرية بالإضافة إلى التشخيص السريري للتمكن من التقرير فيما إذا كانت حالة الربو مستجيبة أو مقاومة للعلاج بالستيرويدات وذلك من خلال مراقَبة مستوى الغلوبينات المناعية (imunoglobulins)، البروتين التكميلة (complement proteins) والانترليوكينات (interleukins) بين مرضى الربو (مستجيبون أَو مقاومون للستيرويدات) بالإضافة لدراسة المساهمة المحتملة للعواملِ الأخرى مثل العمر والجنس والعوامل البيئية في تطوير المقاومة للستيرويدات. أُجريت الدراسة على 55 مريضاً بالربو و28 من الأصحاء في مستشفى الناصرية العام وللفترة من شباط 2005 إلى تشرين أول 2005. تم اخذ بيانات كاملة عن المرضى والذين كانوا قد شخصوا سريرياً كمقاومين أو مستجيبين للعلاج بالستيرويدات. وتم اخذ عينات الدم من كل الأشخاص المشاركين بالدراسة وذلك لقياس مستوى الغلوبينات المناعية (IgA, IgG, IgM, IgE)، والبروتينات التكميلية (C3 و C4)، والانترليوكينات (IL-2 و IL-4) بالإضافة لقياس عدد كريات الدم البيضاء وإحصائها التفاضلي (Differential count). أظهرت نتائج هذه الدراسةِ أن مقاومة العلاج بالستيرويدات غير معتمدة على العمر أو الجنس أو منطقة السكن (إن كانت حضرية أم قروية) ، بينما كان للتدخين (وربما للحساسيةَ المفرطة) تأثيرا واضحا كعواملَ مهيِئة لحدوث المقاومة. إن مستوى IgA وIgE كان عالياً عند كلا الصنفين من مرضى الربو (المقاومين والمستجيبين للستيرويدات)، بينما كان مستوى IgG منخفضاً عند المجموعة المقاومة للستيرويدات. وقد وجد أيضاً بان مستوى البروتينات التكميلية (C3 و C4) غير مختلف عند كلا الصنفين من المرضى بالمقارنة مع مجموعة الأشخاص الأصحاء. من النتائج المثيرة في هذه الدراسة تلك المتعلقة بالانترليوكينات ( IL-2 و IL-4) والتي كانت مستوياتها عالية جداً عند المجموعة المقاومة للستيرويدات. وهذه النتائج جاءت متوازية مع العدد المرتفع لكريات الدم البيضاء اللمفاوية والمعتدلة عند أولئك المرضى. يمكن الاستنتاج من هذه الدراسة انه بالإضافة إلى التشخيص السريري فيما يتعلق بالجرعة ومدة العلاج بالستيرويدات لمرضى الربو فان مراقبة مستوى تركيز الانترليوكينات (IL-2 و IL-4) يمكن أن يضيف وسيلة مختبرية للمساعدة في تقرير فيما إذا كانت حالة الربو من النوع الذي يستجيب أو يقاوم العلاج بالستيرويدات.


Article
Study of the growth and puberty in Iraqi children with nephrotic syndrome

Authors: Najla I. Ayoub --- Huda M. Khalaf --- Sabeeha M. Al-Mefraji
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 1 Pages: 85-89
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Nephrotic syndrome is a chronic disease with frequent relapses and the accumulative dose of steroid play an important role in developing growth retardation.Aims: To detect the degree of growth retardation in long standing nephrotic syndrome and frequent relapsing nephrotic syndrome, and to identify the effect of nephrotic syndrome and steroid therapy on puberty.Patient and methods: A cross sectional study conducted in Child Central Teaching Hospital from the first of January to first of July 2008, on 108 patients with steroid responding nephrotic syndrome, 60 of them were males and 48 were females. All had anthropometric measurement of height and the assessment depend on Tanner growth centile for age and sex, so as the puberty staging according to Tanner staging. The ranges of the patients ages were 2-17y and the mean age was 11.5+4 y. 59.25% (64) were having steroid toxicity; no patient was on cytotoxic drug.Results: The results were shown that 52/ 108 (48.18%) of the patients have got growth retardation (2SD below the mean) Fifty of the patients were at pubertal age, 30 were males and 20 were females. 39 patients had delayed puberty (78%), 36 patients with delayed puberty had steroid toxicity (94.73%). There is a significant relationship between frequency of relapses, duration of illness and steroid toxicity with incidence of delayed puberty and growth retardation.Conclusions: There is a significant correlation between the growth retardation and the development of steroid toxicity. With frequent relapses and long standing nephrosis, there is a chance to develop growth retardation. Delayed puberty is more with steroid toxicity and it is more in males than females.


Article
Topical Steroid Misuse on the Face: A Medical and Social Problem in Iraq

Author: Ammar Faisal Hameed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 413-417
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: The use of topical steroids on the face should be carefully selected by the dermatologist, however its misuse still occur producing dermatological problem resembling rosacea. OBJECTIVE:To highlight the clinical aspects of misusing topical corticosteroid on the face and to search for the causes behind this medical and social problem.METHODS: In this prospective study, 110 Iraqi patients with steroid rosacea or perioral dermatitis with history of topical steroid use on their faces for at least 1-3 months were evaluated at Department of Dermatology -Baghdad Teaching Hospital between January 2011 to December 2013. RESULTS: Majority of patients were young, poorly-educated women who used a combinations of potent and very potent topical steroid for average period of 0.25-12 years. Facial erythema (92.7%) and hotness (89%), dryness (62.7%), telangiectasia (53.6%) and rebound phenomenon (86.3%) with or without papulopustular eruption were the main clinical complaints. Searching for beauty and facial fairness in 51(46%) of patients, hyperpigmentory problems like melisma in 40(36%) patients were the main indications for steroid misuse on the face mostly accomplished through recommendations from non-medical personnel.CONCLUSION: Topical steroid should not be used on the face unless it is under strict dermatological supervision and the easy access to topical steroid preparations must be controlled by the health penalties.


Article
Intraoperative Steroid Irrigation in Carpal Tunnel

Author: Sabah Hassan Naji صباح حسن ناجي
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 2 Pages: 108-110
Publisher: Baghdad University جامعة بغداد

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Background: Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb due to compression of the median nerve at the wrist. Objectives: to test the benefit of steroid irrigation of the wound to alleviate the post operative pain. Methods: Forty patients had carpal tunnel release were divided into two groups with and without steroid irrigation. Results: Forty patients 38 female and 2 male with forty CTS had open surgical release were studied for postoperative pain at the wrist area. Group 1 (patients treated with surgery alone) and group 2 (patients treated with surgery and steroid).In group1, 11 patients (55%) had persistent agonizing pain at the ulnar side of the wrist not responding to analgesic. In group2 none of the patients experienced such type of pain. Conclusion: Steroid irrigation has beneficial effect on post operative pain with no added drawbacks.


Article
Treatment of Steroid Resistant Nephrotic Syndrome
علاج التناذر الكلوي المقاوم للستيرويد

Author: Abdul-Kareem M. Ali د.عبد الكريم محمد علي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 3 Pages: 197-200
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: The therapy of nephrotic syndrome with steroid resistance is still a matter of controversy. Optimal therapy for glucocorticoid-resistance MCD is not well defined. A prospective study was done on children who attained Tikrit Teaching Hospital and Beji General Hospital during the period from 1st of July 2004 to the end of July 2006.Objective: To find out the benefit of immunosuppressive therapy (IV methylprednisolone followed by oral prednisolone therapy for one year along with six doses of monthly pulses of cyclophosphamide) for children with steroid resistant nephrotic syndrome. Patients & Methods: Thirty-four children with steroid resistant nephrotic syndrome were treated with above regime. The remission of the disease was determined at the end of first and second year. Results: The above protocol could induce and maintain remission in 81.8% (9/11) of children with minimal change nephrotic syndrome, 66.7% (6/9) of children with diffuse mesangial proliferation and in only 16.7% (1/6) of children with focal segmental glomerulosclerosis at the end of two years of the study. The therapy of IV methylprednisolone followed by oral prednisolone for one year plus 6 month pulse cyclophosphamide intravenously is beneficial for children with steroid resistant minimal change disease and diffuse mesangial proliferative glomerulonephritis. The therapy is not effective in focal segmental glomerulosclerosis.Key words: Cyclophosphamide, Methyl prednisolone, Steroid resistant nephrotic Syndrome

يبقى علاج التناذر الكلوي المقاوم للستيرويد عرضة للنقاش والجدل. العلاج الافضل لمرض التناذر الكلوي المقاوم للستيرويد غير معرف بشكل جيد. الدراسة الآنية اجريت على الاطفال الذين يراجعون مستشفى تكريت التعليمي ومستشفى بيجي العام للفترة من الاول من تموز لسنة 2004 وحتى نهاية تموز لسنة 2006. وذلك لمعرفة الفائدة من استخدام الادوية المثبطة للمناعة ( مثيل بريدنزولون الوريدي واتبعت بعلاج البريدنيزولون عن طريق الفم لمدة عام واحد، مع ست جرع متتابعة شهريا من مادة السايكلوفوسفمايد) للاطفال الذين يعانون من التناظر الكلوي المقاوم للستيرويد.وقد شملت هذه الدراسة 34 طفلا يعانون من مرض التناظر الكلوي المقاوم للستيرويد ، وقد عولجوا بالنظام المذكور اعلاه. استجابة المرض للعلاج حددت بنهاية السنة الاولى والثانية.وقد كانت الاستجابة للعلاج مع نهاية السنة الثانية من هذه الدراسة بنسبة 81.8%(9/11) من الاطفال الذين يعانون تناظر كلوي ذو التغير البسيط ، 66.7%(6/9) من الاطفال ذو التناظر الكلوي ذو الغشاء المتكاثر ، وفقد 16.7%(1/6) من الاطفال الذين يعانون من التناظر الكلوي ذو الجزء الموقعي للحبيبة المتصلة.ان علاج مثيل بريدنيزولون الوريدي والمتبوع بالبريدنيزولون الفموي لمدة سنة مع 6 جرع متتابعة شهريا من مادة السايكلوفوسفمايد الوريدي ذات فائدة للاطفال الذين يعانون من مرض التناظر الكلوي المقاوم للستيرويد ذو التغير البسيط وذو الغشاء المتكاثر . والعلاج غير فعال للجزء الموقعي للحبيبة المتصلة


Article
Assessment of therapeutic efficacy of topical application of steroid in the treatment of carpal tunnel syndrome (CTS

Author: Kamal A. M. Al- Yasiry
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 1 Issue: 11 Pages: 1219-1223
Publisher: Kerbala University جامعة كربلاء

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Abstract Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy with high incidence rates of the upper limb, occurring due to compression of the median nerve at the wrist (1). Aim: is to determine the therapeutic effect of topical steroid application as an alternative therapy for surgical and local injection of steroids.Method: 30 female patients ranging were selected randomly and divided into 2 groups; 10 of them were selected as control group and 20 of them were selected to test our therapy (topical Clobetasol ointment). EMG and NCS were done before and after the therapy to determine the success of the proposed drug.Results: There was a significant result both clinically and by EMG and NCS finding after 30 days of treatment in which about 80% of patient were approximately free of pain after treatment as a clinical assessment with a significant EMG and NCS finding at P <0.05. Conclusion: topical skin application over carpal tunnel is of a great value as an alternative conservative treatment for CTS.


Article
Factors Influencing the Occurrence of Steroid acne
العوامل المؤثرة في حدوث العد الستيروئيدي

Authors: Salam Abdul Kareem Al-Temimi د. سلام عبد الكريم يوسف التميـمـي --- Hadaf Abed Al-Ameer د.هدف عبد الأمير
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 3 Pages: 265-267
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractBackground: Steroid acne is an acneoform eruption induced by steroids use. Steroid acne is relatively common dermatological problem, causing great cosmetic disfigurement.Objective: The study is aimed to evaluate several influencing factors on the occurrence of steroid acne. The factors to be assessed are age, sex, marital status, route of steroid administration, past history of acne, self-steroid prescription and type of occupation (outdoor/indoor).Patients & Methods: A case control study is performed. The study subjects were collected from Al-Yarmouk Teaching Hospital and private clinic. They were allocated into 2 groups in a ratio of 1:1. The cases group includes patients with steroid acne and controls group include patients with any steroid responsive dermatoses. The study period was from January 2002 until July 2002. Logistic regression analysis is used to examine the effect of the above-mentioned factors; their effect is expressed as odds ratios.Results: Seventy five steroid acne patients with a mean age of 20.8±4.5 years were collected and compared with a similar number of patients with any steroid responsive dermatosis as controls with a mean age of 30±10 years. Data analysis showed that the following factors contribute significantly to the increased incidence of steroid acne: sex (odds ratio: 3.95, P value: 0.009), route of steroid administration (odds ratio: 3.2, P value: 0.0319) and self drug prescription (odds ratio: 9.8, P value: 0.0002).Conclusion: The problem of injudicious use of topical and systemic steroids for cosmetic purposes is increasing in Iraqi society. This improper use of steroids reflects the increased incidence of steroid acne in Iraqi dermatology practice.Key words: Steroid acne, Acneoform eruption, influencing factors.

الملخص:الخلفية: العد الستيروئيدي هو طفح شبيه العد ناتج عن استعمال الستيروئيدات. العد الستيروئيدي اصبح نسبيا مرض جلدي شائع، والذي يؤدي إلى إتلاف جمالية الجلد بصورة كبيرة.الهدف: تهدف الدراسة إلى فحص عدة عوامل التي قد تؤثر في حدوث العد الستيروئيدي. العوامل هي العمر والجنس والحالة الزوجية و طريق استعمال الستيروئيدات والتاريخ السابق للعد والوصف الشخصي للستيروئيدات ونوع العمل (داخلي أو خارجي).الطريقة : أجريت دراسة نوع حالة ومقارنة. تم جمع المرضى من العيادة الخارجية للأمراض الجلدية في مستشفى اليرموك التعليمي والعيادة الخاصة. تم توزيع المرضى في مجموعين بنسبة 1:1. المجموعة الأولى تحتوي على المرضى المصابين بحالة العد الستيروئيدي. المجموعة الثانية (المقارنة) تحتوي على كل المرضى مصابين بأي مرض جلدي يعالج بالستيروئيدات. فترة الدراسة كانت من كانون الثاني للعام 2002 حتى تموز للعام 2002. استعمل التحليل الإحصائي اللوجستي لفحص العوامل المذكورة أعلاه وتأثيرها حُسب كنسبة الفائدة.النتائج: ادخل 75 مريض مصاب بالعد الستيروئيدي إلى الدراسة معدل أعمارهم 20±5‚4 سنة وقورنوا مع مجموعة مقارنة تستعمل الستيروئيدات لامراض جلدية أخرى تتضمن نفس العدد معدل أعمارهم 30±10 سنة. التحليل الإحصائي أثبت إن العوامل الآتية لها أهمية وهي الجنس (نسبة الفائدة 95‚3 قيمة P =0,009) وطريق استخدام الستيروئيد (نسبة الفائدة 3,2 قيمة P =0,0319) والوصف الشخصي للدواء (نسبة الفائدة 9,8 قيمة P =0,0002).الخاتمة: إن مشكلة الاستعمال الطائش للستيروئيدات الجهازية والموضعية لأغراض التجميل قد ازدادت في المجتمع العراقي. وهذا أدى إلى زيادة مرض العد الستيروئيدي كمرض جلدي في العراق.

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