Muthanna Medical Journal

LTTB is a common condition occurring in one fourth of those who were exposed to mycobacterial bacilli
with Medically induced immunosuppression stands as a significant risk factor for having LTTB. Aim of
the study: To assess the prevalence and characteristics of LTTB in patients on immunosuppressive
agents and biological treatment. A cross-sectional research of 150 patients on immunosuppressants
and biological therapy for diverse diseases at Baghdad teaching hospital outpatient rheumatology,
dermatology, and TB clinics between 2023 and 2024 was done. All patients were examined with a
detailed clinical history, physical exam, and chest x-ray or CT scan. IGRA testing was done per
manufacturer instructions and evaluated as positive, negative, or indeterminate. The study involved 149
patients with autoimmune diseases, using immunosuppressants like methotrexate and azathioprine.
Significant differences in sex distribution, smoking status, infliximab usage, and disease duration were
observed between IGRA-positive and IGRA-negative patients. While univariable analysis showed
several factors influencing IGRA test positivity, only disease duration was significant in multivariable
analysis. The prevalence of latent tuberculosis in the cohort was 34.9%. In conclusion, High prevalence
of latent Tuberculosis (34.9%) was found in patients who were treated with immunosuppressive agents
and biological therapies, of them Smoker, male, and infliximab-treated patients were significantly
susceptible to LTTB.

In all parts of the world and among all age groups, diarrhea is a significant cause of morbidity and
mortality. However, compared to high-income countries, low-income countries have fewer resources
and a less resilient infrastructure, which makes them more susceptible to an unfair share of diarrheal
morbidity and mortality. The word "diarrhea" originates from the Greek word "dia rEo," referring to "flow
through." When the volume of colonic fluid crosses this segment's absorptive capacity due to decreased
absorption and/or increased secretion, diarrhea achievements. In infectious diarrheas, the abnormal
function is brought about by microorganisms that colonize the intestinal mucosa and subvert normal gut
physiology either directly or via enterotoxins.

Flexible bronchoscopy (FB) diagnoses and treats airway issues by directly visualizing them. The aim of this study is to investigate whether the percutaneous oxygen saturation (Spo2) level during bronchoscopy is associated with the development of hypoxia. We conducted a cross-sectional research of 40 Baghdad Teaching Hospital/Medical City complex patients from October 1, 2023, to March 10, 2024. The University of Baghdad College of Medicine Department of Medicine approved the study protocol. Patients aged > 18 years who underwent FB with continuous percutaneous oxygen saturation monitoring were screened. Our sample has 40 patients with a mean age of 57.97 years and BMI of 24.42 kg/m2. 19 (47.5%) smoked and 22 (55%) were male. Shortness of breath (87.5%) was the most prevalent complaint, followed by cough (45%) and hemoptysis (10%). Diabetes mellitus and hypertension were the most prevalent comorbidities, each in 8 patients (20%). The chest CT scans revealed unilateral lung involvement in 32 patients (80%), bilateral lung lesions in 6 (15%), and normal imaging in 2 (5%). In conclusion; the study results indicate considerable decrease in intra-procedure O2 saturation levels during flexible bronchoscope, regardless of other hypoxia risk variables (BAL, biopsy, operation time, lung illness, etc.). Thus, adults should get high-flow nasal interfaces to prevent hypoxia-related problems during and after the surgery.

COPD, a chronic respiratory illness with high mortality and morbidity worldwide, may be exacerbated
by dyslipidemia. The aim of study is to assess prevalence of dyslipidemia in COPD patients and to
evaluate its correlation with COPD severity. Between 2023 and 2024, Baghdad teaching hospital
respiratory diseases outpatient clinic recruited 70 COPD patients for cross-sectional research. Anyone
over 40 with COPD was sampled. Patients' lung function and lipid levels were documented. The study
of 70 COPD patients found significant differences in demographics and clinical metrics across three
severity groups (A, B, E). Key findings include higher mean age and lower mean FEV1/FVC% in the
most severe group E, and significant correlations between lung function metrics (FEV1%, FEV1/FVC%,
PEF%) and lipid profiles. Group E also exhibited the lowest serum HDL and highest triglycerides among
the groups. In conclusion; Dyslipidemia is a common condition in COPD-patients that may correlate
negatively with disease severity and lung functions

Obesity is a public health issue and a risk factor and disease modifier for juvenile and adult asthma. Due to the high prevalence of obesity and asthma, this connection may worsen asthma burden in individuals and populations. The extent to which obesity impressing lung function still vague. This research focus on impact of obesity on asthmatic spirometric parameters. Aim of the study: To determine the effect of obesity on spirometry parameters in asthmatic patients. 93 asthmatic patients are enrolled in this cross-sectional study. The diagnosis of asthma was made clinically and by PFT. The study done in Baghdad teaching hospital from 6 June 2023 to 16 January 2024. 45 (48.3%) of the 93 patients are classified as obese (BMI>=30) according to CDD.69.9% are female and 30.1% are male. Patients with a BMI ≥30 had a considerably older mean age (43.86 years vs. 38.27 years) and a higher mean PEFR% (52.37% vs. 43.39%) than those with a BMI less than 30. BMI is significantly correlated with FEF25-75, age, sex, and PEFR%. There is no statistically significant correlation observed between BMI and other parameters. Additionally, it was observed that females exhibited a higher FEF25-75% (a significant correlation between gender and FEF25-75%). This study shows that asthmatics, especially women, are obese. Different spirometric characteristics connected with BMI. FEF25-75 and PEFR % correlated, whereas others did not. In obese asthmatics, dysanapsis is a leading explanation for this observation. Obesity worsens asthma severity, exacerbations, and medication responsiveness, despite this favorable connection of several PFT variables to BMI.

Strokes, also known as cerebrovascular accidents, are a leading cause of morbidity and death in the US. One common morbidity that post-stroke patients face, urinary incontinence, is linked to long-term disability and the impact of institutionalization on these individuals. Half of people hospitalized after a stroke have urinary incontinence (UI), which is frequently mismanaged. The aim of this study is to determine the outcomes of urinary incontinence post-stroke for one to two weeks. A descriptive study (follow-up) is used to conduct these study assess for urinary incontinence, then monitoring for the second days of admission, after one week of contact with each patient either by telephone or visiting patients at the house, these processes recurrent after two weeks for some patients. The study shows that the mean age was 63.12, also without intervention most study samples need one to two weeks to return bladder function and treat urinary incontinence with approximately (60%) after two weeks post-stroke, and all participants had one of the most significant risk factors such as diabetes, hypertension, and smoking. In conclusion, urinary incontinence is common after a stroke for all age groups and does not require significant drug or surgical interventions. It relies on common treatment programs in hospitals, including physical therapy, for a period ranging from one to two weeks for most cases.

Asthma is a common respiratory disease in general population that can be further subdivided into several cellular endotypes depending on sputum cell counts. The objective of this study to conduct a comparative analysis of eosinophilic and neutrophilic asthma endotypes in terms of their respective prevalence rates, patient characteristics, severity, and treatment response. Cross-sectional study included 59 patients with asthma who attended respiratory diseases out-patient clinic in Baghdad medical hospital between October 2022 and October 2023. The study included patients between 18 and 80 years with clinical history of asthma. Sputum sample was obtained from each patient and analyzed. In a study of 59 asthma patients, those with eosinophilic asthma had significantly younger ages and higher levels of blood basophils and sputum macrophages compared to those with neutrophilic asthma, who showed better asthma control. Significant correlations were found between sputum and blood eosinophils, as well as between sputum and blood neutrophils in eosinophilic and neutrophilic asthma, respectively. Other parameters did not show significant differences between the groups. In conclusion, Eosinophilic asthma is highly prevalent and poorly controlled. Patients with neutrophilic phenotype of asthma tend to be older than those with eosinophilic asthma.

Bronchiectasis is a chronic heterogeneous lung disease with poorly understood pathogenic processes and variable contributing factors. The aim of this study is to assess the prevalence and the impact of vitamin D deficiency in bronchiectasis patients. A cross-sectional study of 40 Baghdad teaching hospital respiratory diseases consultant outpatient clinic patients with verified bronchiectasis was undertaken between 2022 and 2023. 40 healthy, demographically matched controls were also studied. A detailed history, comprehensive physical examination with respiratory emphasis, and vitamin D level evaluation were done. Vitamin D levels were categorized as deficient (< 20 ng/ml), insufficiency (20–29.9 ng/ml), and adequate (≥ 30 ng/ml). Patients were categorized as frequent exacerbates (≥3 times/year) or non-frequent exacerbates (<3 times/year). Symptom intensity was further divided into mild, moderate, and severe. We studied 40 bronchiectasis patients, 21 of them were male and 7 had comorbidities. The mean age, BMI, ESR, and CRP for included patients were 39 years, 23.945 kg/m2, 9.65 ml/hr, and 0.234 mg/dL. Group vitamin levels averaged 19.68 ng/ml. Average annual exacerbation, BSI, Bhalla, and FEV1 scores were 1.95, 6.325, 14.275, and 85.8%. Bronchiectasis patients and healthy controls had similar demographic and clinical features except for vitamin D and CRP. Exacerbation number, BSI score, Bhalla score, and FEV1 correlated with vitamin D but not ESR or CRP. In conclusion, Vitamin D insufficiency is common in bronchiectasis patients and healthy people and is linked to poor symptom severity, radiological abnormalities, and lung function.