BACKGROUND: Enteric fever caused by Salmonella Typhi is an endemic disease in Iraq. Variations in presentations make it a diagnostic challenge. If untreated or treated inappropriately then it is a serious disease with potentially life-threatening complications. The recent emergence of drug resistant strains of S. Typhi is a rising public health problem and a clinical concern to the physician. AIM: The objectives of the study were to assess and describe the patterns of antimicrobial resistance, clinical characteristics, epidemiological distribution, and complications of typhoid fever. PATIENTS AND METHODS: Fifty cases of typhoid fever (culture proven) were collected during the period from February 2019 to November 2019 in the medical wards of Baghdad Teaching Hospital. Detailed history, physical examination, and laboratory investigations were conducted and statistical analysis of the results was done, prospective observational study was conducted. RESULTS: During the study period, 50 cases of typhoid fever were documented, mean age of presentation was 30.7 ± 12.8, 60% of the cases were male gender, gastrointestinal complications were the most common (90%) followed by hematological complications (71%). Mortality of typhoid fever in our study was 2%. High percentage of resistance to third generation cephalosporins, ciprofloxacin, and azithromycin was found (96%, 56%, and 56%, respectively) while good sensitivity to trimethoprim and meropenem was found (94% and 76%, respectively). Significant association was also found between the development of typhoid fever complications and the presence of anemia, thrombocytopenia, lymphopenia, and eosinopenia. Significant association was also found between the complications and the infection with strains resistant to cephalosporins, ciprofloxacin, and azithromycin. CONCLUSIONS: There is a concerning increase in resistance toward cephalosporins, ciprofloxacin, and azithromycin while meropenem and trimethoprim are emerging as effective drugs. There was high incidence of complications found (84%).Lymphopenia, anemia, eosinopenia, and thrombocytopenia are independent risk factors for the development of complications of typhoid fever.
Diabetes mellitus is a common health problem worldwide counting about 1.2 million cases in Iraq in 2015. Taking in account of the patient’s beliefs about the prescribed medication had been reported to be one of the most important factors that affects adherence where holding positive beliefs about medications is a prerequisite for intentional adherence. The aim of the current study was to investigate and assess beliefs about medicines among type 2 diabetic patients and to determine possible association between this belief and glycemic control as well as some patient-specific factors. This study is a cross-sectional study carried out on 380 (mean age 56.58± 10.06 years) already diagnosed T2DM patients who attended the National Diabetes
... Show MoreFor many years it was argued that there may be a gender differences in adverse drug reactions (ADRs). This assumption was based on many possible factors such as hormonal or behavior differences, and it was not clearly identified since the female gender was not preferred to be enrolled in many clinical trials. The primary aim of this study was to assess the extent of possibly relevant gender differences in drug–ADRs regarding causality, severity, preventability, seriousness, expectedness and outcome. While the secondary aim was to assess for which group of drugs and for which ADRs gender differences are identified most often. The study was a retrospective one that depends on processing a specially selected group of data obtained from th
... Show MoreBackground:The most common pattern of dyslipidemia in diabetic patients is increased triglyceride (TG) and decreased HDL cholesterol level, The concentration of LDL cholesterol in diabetic patients is usually not significantly different from non diabetic individuals, Diabetic patients may have elevated levels of non-HDL cholesterol [ LDL+VLDL]. However type 2 diabetic patients typically have apreponderance of smaller ,denser LDL particles which possibly increases atherogenicity even if the absolute concentration of LDL cholesterol is not significantly increased. The Third Adult Treatment Panel of the National Cholesterol Education Program (NCEP III) and the American Heart Association (AHA ) have designate diabetes as a coronary heart dis
... Show MoreBackground: The occurrence of seizures in bacterial meningitis is important, as it has been reported to increase the risk of complications; however, its frequency and predictors are not well studied yet. Objective: To assess the frequency, clinical, and biochemical predictors of seizures in children with acute bacterial meningitis. Method: A cross-sectional study recruited confirmed acute bacterial meningitis cases based on positive CSF culture and sensitivity among children aged 2 months to 15 years admitted to the Central Child Teaching Hospital emergency department in Iraq. Patients were divided into two groups based on seizure at presentation time. Demographic characteristics [age, gender, residence, duration of fever and disease, prese
... Show MoreSocial risks posed a great challenge to the development path in Iraq, which resulted in widening the development gaps, whether these gaps were between rural and embargoed areas, or between Iraqi governorates, and the gender gap. Besides, the nature of the reciprocal relationship between the social risks and the development process requires the adoption of development trends that are sensitive to the risks that take upon themselves the prompt and correct response to these risks, away from randomness and confusion that Iraq suffered from for decades. However, currently, the situation has differed a great deal. This is because the size and types of such gaps have widened and become more complicated than before; a matter which has led to hav
... Show MoreBackground: Drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules to achieve sustained seizure freedom. Up to 30% of patients referred to clinics with a diagnosis of pharmaco-resistant epilepsy may have been misdiagnosed, and many can be helped by optimizing their treatment.Pseudoresistance, in which seizures persist because the underlying disorder has not been adequately or appropriately treated, must be ruled out or corrected before drug treatment can be considered to have failed.
Objectives: The objectives of this study were to determine the causes of drug failure in patients with epilepsy and to differenti
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Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.
This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm
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