Mustansiriya Medical Journal

Background: The introduction of pharmacovigilance (PV) program helps in very early detection of adverse drug reactions (ADRs) and
identification of risk factors and various measures to be taken once it happened. This study was aimed at investigating the knowledge
and attitude of doctors in a research institute about ADR reporting and suggesting possible ways of improving ADR reporting.
Materials and Methods: This study was a cross‑sectional, questionnaire‑based survey conducted at a tertiary care leprosy hospital which is a research institute. The respondents were doctors and students visiting this institute. The study instrument was a self‑developed, prevalidated, semi‑structured questionnaire of 25 questions. Results: A total of 55 questionnaires were considered for analysis, giving a response rate of 100%. In all, 87.93% of the respondents were aware about pharmacovigilance, 68.96% were aware of ADR reporting system in India, 91.37% opined that only serious ADR with any medicine should be reported, and 4.3% believed that ADR should be reported only for newly marketed agents. Although 88.79% of the respondents observed an ADR, only 31.03% reported it; 60% were aware about the complete step to be
taken after ADR. The general attitude of the respondents about ADR reporting was as follows: ADR reporting should be mandatory (60.34%),
voluntary (29.31%), and need base (10.34%) and the preferred mode to report should be phone (34.48%), dropbox (22.41%), E‑mail (25.86%),
and personal visit (8.6%). Nearly 77.58% of the respondents needed a complete feedback after the ADR reporting. Almost 51.72% of the
respondents opted increasing awareness about PV through training/projects/continuing medical education, as the factor encouraging for ADR reporting, and 51.72% opted lack of knowledge about the process of reporting, as the factor discouraging ADR reporting. Conclusion: From the study, it was found that most of the doctors and students were unaware of the ADR reporting forms and their availability which should be sorted out in the institutional setting for better results.

Background: Retinoic acid (RA) is one of the most critical molecules in the organic development of human being; it has been implicated in
controlling of hundreds of genes which control several processes in human development. Furthermore, RA has negative insult on pregnancy
outcome since it has teratogenic potential when used in high doses. Materials and Methods: Human neural stem cells are used in this study to
test the effect RA in different doses on cell viability, cellular protein amount, neurite length, neurosphere sizes, reactive oxygen species (ROS) production, and migration distance. Results and Conclusions: Our results show that RA at low doses (2, 5 μM) preserve cell stemness and increase the sizes of neurospheres significantly, but at high doses, it appears that RA has a neurotoxic effect on these stem cells through significant increase in ROS which has negative effects on neurite length and cellular migration.

Background: Diabetes in pregnancy with macrosomia is an important risk factor for neonatal morbidity and mortality. Prediction of
macrosomia is significantly improved by adding ultrasound to clinical findings. Objective: For earlier detection of macrosomia in
prepregnancy diabetic mothers using fetal growth profile including biparietal diameter, femoral length, and also abdominal circumference (AC). Patients and Methods: A historical prospective cohort study was performed at National Endocrine and Diabetic Center in addition to the
Obstetrics and Gynecology Department at Al‑Yarmouk Hospital for 2 years, from September 2014 to 2016. A hundred and sixty pregnant
women were enrolled in this study, 80 of them with a history of prepregnancy diabetes mellitus were taken as a patient group and the other 80 pregnant women with a compatible gestational age and without a history of diabetes mellitus were taken as a comparison group. Abdominal
ultrasound was done for patients in both groups at 20, 28, and 36 weeks of gestation and then birth weight was measured for each. Results were
compared between two groups. Results: The incident of macrosomia was 30% in patient group and 10% in comparison group. Regarding early
prediction of macrosomia by ultrasound using biparietal diameter, femoral length, and AC, the results of the current study revealed that those macrosomic babies have higher femoral length, AC but not biparietal diameter in comparison with babies of average weight using ultrasound performed at 20‑week gestation and repeated at 28 and 36 weeks. Conclusion: In diabetic mother, fetal macrosomia can be predicted by ultrasound during pregnancy as early as 20‑week gestation.

Background: Early prediction of preeclampsia represents a big dilemma for obstetricians, but the discovery of a novel biomarker highlights
the way for its prediction during the early stage of the pregnancy. Objective: The objective of this study was to evaluate serum irisin levels in preeclamptic and healthy pregnant women in the third trimester of pregnancy. Materials and Methods: This study was a prospective
case–control study conducted at Al‑Yarmouk Teaching Hospital during the period from October 1, 2017, to May 1, 2018. Totally 80 pregnant
women were enrolled in the study; 40 of them were preeclamptic patients and the other 40 were healthy pregnant women assigned as a control
group. Serum irisin levels were measured to all participants by enzyme‑linked immunosorbent assay method. The results were compared for both groups. Results: Serum irisin was lower in preeclamptic patients compared to controls (280.7 vs. 311.3 μg/L, respectively), but the difference was not statistically significant as the P value was 0.189. Conclusion: Irisin might be involved as a biomarker for pregnancy‑associated problems such as preeclampsia.

Background: Methotrexate (MTX)‑induced liver injury is a common problem that is described as increased level of hepatic biomarkers that
is seen in 14%–25% of patients with inflammatory bowel disease and 49% of patients with rheumatoid arthritis or as idiosyncratic induced
liver injury that is seen in 1% of patients with inflammatory bowel disease, or as fibrosis and cirrhosis in 17% of rheumatoid arthritis patients and 25% of psoriatic patients. This profile may rarely progress to acute liver failure. Aim: The aim is to study the effect of TAK‑242 and GIT‑27 on MTX‑induced liver injury. Materials and Methods: Thirty‑five Albino‑Wistar rats were divided into five groups: the first group was maintained on distilled water, the second group was administered intraperitoneal (I.P.) dimethyl sulfoxide followed by oral MTX, the third group was administered oral MTX, the fourth group was administered I.P. TAK‑242 followed by oral MTX, and the fifth group was
administered I.P. GIT‑27 followed by oral MTX. Results: The significant increase in markers of hepatic function, inflammatory and oxidative
stress markers, as well as severe liver histopathologic change “steatosis” induced by methotrexate were alleviated in the animals pretreated with the drugs TAK-242 and GIT-27. With significant improvement in serum level of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, interleukin-6, tumor necrosis factor-α, malondialdehyde and reduced glutathione; beside an improved histopathologic profile of moderate steatosis. Conclusion: This study suggests that both TAK‑242 and GIT‑27 protect against liver injury induced by MTX depending on their antagonism of the inflammatory Toll‑like receptors 4 and 2/6.

Objectives: This study was designed to clarify the relationship between maternal body mass index (BMI) and umbilical artery (U.A) indices and
to evaluate the effect of maternal BMI on the neonatal outcome. Study Design: This was a prospective cohort study. Patients and Methods: This
study included 121 pregnant women with uncomplicated, singleton pregnancy between 18 and 35 years, at 32 weeks of gestation, seen in
Al‑Yarmouk Teaching Hospital antenatal care. Women were divided according to the BMI into underweight (BMI <18.5), normal weight
(BMI 18.5–24.9), overweight (BMI 25.0–29.9), and obese women (BMI ≥30). U.A velocity was recorded by Doppler ultrasound, and the women were followed till the time of delivery, mode of delivery, 5 min Apgar score, and birth weight were also recorded. Results: Obese women had significantly higher pulsatility index, resistance index, and systolic‑diastolic ratio compared to overweight and normal weight
groups (P < 0.001), cesarean section (C/S) rate was significantly higher (P < 0.001), and 5 min Apgar score was significantly lower (P < 0.001).
Conclusion: The current study showed the negative impact of increasing BMI on fetoplacental circulation and increased risk of C/S. Neonates
of obese mothers had low 5 min Apgar score.

In dentistry, indices are values that are assigned to quantify the incidence, prevalence, and severity of disease. This paper calls attention to a working classification proposed for indices based on its relationship with nine dental specialties with literature search of indices used in
dental research in the PubMed database.