Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy

BACKGROUND: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm. AIM: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast. METHODS: This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February and March 2017. A questionnaire was specifically prepared to meet the objectives and was used to collect the data of the study. RESULTS: There was a significant statistical reduction of frequency in asthmatic attacks after Montelukast treatment (p-value < 0.05). Out of 73 patients, 39 were males, and 34 were females, 46 were jobless, 37 were married, 63 were urban residents, 63 were educated. Prevalence of exacerbation factors was as following: infection was found in 60.3% of the patients, exercise in 57.5%, dust in 72.6%, smoking in 60.6%, food in 24.7%, others (stress, perfumes) in 20.5%. The prevalence of Montelukast use in this study was 46% (34 patients). Out of 34 patients using Montelukast, 28 were using inhaled salbutamol, 5 were using oral salbutamol, 15 were using inhaled corticosteroids, 9 were using systematic corticosteroids, 2 were using xanthines, and 6 were using ketotifen. CONCLUSION: Montelukast was used as add-on therapy with the inhaled corticosteroids to reduce the required dose of inhaled corticosteroids also the use of Montelukast lead to reduced number of exacerbations which will be reflected on the use of inhaled salbutamol and systematic corticosteroids. Also, Montelukast was superior to xanthines and ketotifen as an add-on therapy

The Protective Effect of Nitroglycerin, N-Acetyl Cysteine and Metoprolol in CCL4 Induced Animal Model of Acute Liver Injury

OBJECTIVE: The current study was designed to determine the hepatoprotective effect of well-known drugs. Nitroglycerin, N-acetyl cysteine and Metoprolol in acute liver injury induced by CCL4. The antioxidant effects of b-blockers, especially carvedilol, have been described by several investigators. However, for metoprolol, the effect is a bit query as there is only one in-vitro study showing a little hepatoprotective effect. Thus, it is worthy to re-study the hepatoprotective effect of metoprolol. AIM: To explore the possible hepatoprotective effect of Nitroglycerin, N-acetyl cysteine and Metoprolol TartrateMATERIAL AND METHODS: The normal serum values of ALP, AST, ALT, TSB and TSP were determined in 35 healthy rabbits allocated to 5 groups before CCL4 induction and at three occasions 24, 72, 120 hrs after induction by CCL4 and treatment with the tested drugs: Nitroglycerin, N-acetyl cysteine and Metoprolol for five successive days.RESULTS: Showed significant decrease in serum levels of ALP, AST, ALT and TSB with a significant increase in TSP level of all the tested drugs measured at 120 hrs compared with the control and their levels measured at 24, 72 hrs.CONCLUSION: All the tested drugs proved in having a hepatoprotective effect when they are given orally to animals. The histopathological sections of the liver tissue supported the real effect of these drugs in the management of ALI

Functional Outcome Following Synthetic Vertebral Body Implantation in the Management of Spinal Disorders

OBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurological improvement in all spinal TB cases. Mortality recorded in only 4 cases with metastatic spinal tumor during the mean period of follow-up. Karnofsky performance status scale showed statistically significant change for spinal TB, and tumor cases during the follow-up period, but there was no significant change in cases of spinal type A3 fractures. CONCLUSION: The positive outcome of this surgery makes it recommended for properly selected patients, especially with spinal TB and tumors

Short Term Effectiveness of Gamma Knife Radiosurgery in the Management of Brain Arteriovenous Malformation

AIM: To evaluate the short-term effectiveness of Gamma knife radiosurgery as a modality of treatment of brain arteriovenous malformation. METHODS: Sixty-three patients with arteriovenous brain malformations underwent Gamma knife radiosurgery included in this prospective study between April 2017 and September 2018 with clinical and radiological with MRI follow up was done at three months and six months post-Gamma knife radiosurgery. By the end of the 12th-month post-Gamma knife radiosurgery, the patients were re-evaluated using digital subtraction angiography co-registered with M.R.I. During the 12 months follow up, CT scan or MRI was done at any time if any one of the patients᾽ condition deteriorated or developed signs and symptoms of complications. The mean volume of the arteriovenous malformations treated was 26.0 ± 5 cm3 (range 12.5–39.5 cm3) in The Neurosciences Hospital, Baghdad/Iraq. RESULTS: By the end of the 12th month of follow up, the overall obliteration of the arteriovenous malformations was seen in six patients only (9.5%), while shrinkage was noticed in 57 patients (90.5%). Improvement or clinical stability was found in 24 out of 39 patients (61.5%) presented with epilepsy as a chief complaint before Gamma knife radiosurgery and 21 out of 24 patients (87.0%) complained of a headache before Gamma knife radiosurgery. Post-Gamma knife radiosurgery bleeding was found in only three patients (5.0%). CONCLUSION: Even with the short term follow up, Gamma knife radiosurgery has an excellent clinical outcome in most patients with arteriovenous brain malformations. The clinical symptoms like headache and seizure were either diminished or controlled with the same medical treatment dose before Gamma knife radiosurgery. Long term clinical and radiological follow up is recommended

The influence of socioeconomic status and general health on the fracture incidence

Background/Aim: There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods: A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of education, owing motor vehicle) and assessed patient's health status (height, weight, presence of chronic disease(s), smoking status, alcohol consumption, water source quality, sun exposure, nutrition status). Results: A 100 patients from Al-Kindy Teaching Hospital between the age 20-75 participated in the study. The incidence of fractures was higher in younger and more active males (68 %) than females (32 %). Highest percent appeared in lower group of socioeconomic status (58 %) and in lower group of health status (44 %). There was a significant relation between health status and body mass index (BMI). Obese and overweight patient were the more vulnerable to fractures. Conclusion: Fractures are more likely to happen to people with low socioeconomic status, low general health status and overweight people

Evaluating moisture damage resistance in asphalt mixtures using amine-free anti-stripping agent for enhanced durability

Moisture-induced durability and strength loss are major concerns in asphalt mixtures. Traditional additives often suffer from environmental concerns or inconsistent performance, highlighting the need for sustainable alternatives. This study evaluates an eco-friendly, amine-free anti-stripping additive designed to enhance binder-aggregate adhesion and maintain stable performance across different materials. Moisture resistance was assessed using indirect tensile strength (ITS), tensile strength ratio (TSR), boiling tests, Marshall immersion, and MATLAB-based image analysis. The additive significantly improved adhesion, between the asphalt binder and aggregates, as evidenced by the tensile strength ratio (TSR) values of 95% and 74% after 24 h and 48 h of conditioning, respectively. Additionally, stability was improved, with treated unconditioned samples exhibiting a peak value of 15.6 kN, compared to 13.72 kN for the untreated samples. Upon immersion for 24 h, stability in the treated mixtures decreased by only 3.2%, in contrast to a decline of 11% in the untreated mixtures. This reduction in stability can be attributed to the diminished adhesive properties between the aggregates and binder caused by prolonged exposure to heat and moisture. The findings underline the additive’s effectiveness in enhancing both moisture resistance and mechanical performance, thereby demonstrating its potential for improving the durability and sustainability of asphalt pavements