ميسم رياض محمد حسين الاعسم

Background: Glycated haemoglobin is a necessary test for assessment of control, compliance, modifying management, follows up and nowadays for diagnosis of patients with prediabetes and diabetes mellitus. Microcytosis, which is a laboratory finding that found in a wide range of common diseases, appear to be found in a significant percent of diabetic and non-diabetic persons and may affect the measured glycated haemoglobin values. Aim of study: This study tries to evaluate the effect of microcytosis in non-diabetic subjects on the level of haemoglobin A1c (HbA1c %). Patients and methods: HbA1c% measured in 80 non-diabetic patients with microcytosis after exclusion of factors that may affect the results compared to 80 healthy subjects with normocytic blood picture as a control group. Results: The HbA1c level were significantly higher among patients with microcytosis as compared to normocytic control group. The mean HbA1c (5.8± 0.9%) in the patients was higher than that in the control group (5.3% ± 0.7) (p = 0.001). Conclusions: Microcytosis may affect significantly the HbA1c results and may wrongly affect management decisions in diabetic patients.

background: P-selectin is partially responsible for the adhesion of certain leukocytes and platelets to the endothelium. Increased levels of soluble P-selectin in the plasma have also been demonstrated in a variety of cardiovascular disorders. The aim of this study is to evaluate the role of P-selectin, in development of IHD and possible use as a biomarker and to study the change in its level after introducing of angiotensin converting enzyme inhibitor(ACEI) . Patients and methods: The study involve(49) patients with stable IHD and 51patient with acute coronary syndrome and (50) subjects as a control. They divided into three groups : 1st include subjects with no history of IHD not on (ACEI) as a control group. 2nd group include patients with history of stable IHD but not receiving any (ACEI)but on B-blocker therapy. 3rd group include patients with acute coronary syndrome not on ACEI therapy but most of them on B-blockers as a part of their treatment regimen. (ACEI)(captopril 25 mg twice daily) was given for 1 month duration for patients in the 2nd and 3rd group . for the 2nd and 3rd group we measured the levels of p-selectin before and after the drug have been introduced Result: There is increase in level of p-selectin in patients with acute coronary syndrome and to less extent in patient with stable IHD . there is a decrease in the level of platelet P-selectin after introducing of ACEI in the 2nd and 3rd group. Conclusion: 1-By comparing with control the level of p-selectin is greater in patients with acute coronary syndrome and to less extent in patient with stable IHD. 2-ACEI administration was associated with significant decrease of the level of p-selectin in patients with IHD & to a greater extent in patient with acute coronary syndrome.

Gastrointestinal symptoms are relatively common in clinical practice in patients with type II diabetes mellitus. type II DM has been described as possible risk factor for the development of gastroesophageal reflux disease, in this study we aim to detect the prevalence of GRED in symptomatic patients with type II DM , also to see the accuracy of reflex disease questionnaire ( RDQ) in the diagnosis of GERD in patients with type II DM in relation to the esophagogastroduodenoscopy finding and to study the relation of autonomic neuropathy to the prevalence and stages of GERD in diabetic patients . Methods: A ninety patients with upper gastrointestinal symptoms was divided in to tow groups according to whether had type II DM or not and then each group involved in a two stage process (a ) – a RDQ , ( b ) – OGD . And patients in the DM group underwent another step to detect diabetic neuropathy by a bed side clinical test. Results: The prevalence of esophagitis in this study was higher in the DM group. RDQ had a statistical significance in detecting esophagitis in the DM group. There is no relation of autonomic neuropathy to the prevalence of GERD in diabetic patients . Conclusion : The prevalence of GERD was high in patients with type II DM, RDQ is a sensitive tool for the diagnosis of GERD in diabetic pateints , Autonomic neuropathy did not increase prevalence of esophagitis in diabetic patients .

Background. Red cell distribution width (RDW) is a parameter measured routinely in standard blood cell counts, reflecting the variability in red cell size and volume. Numerous studies have identified a significant correlation between RDW and various health disorders, including cardiovascular diseases, malignancies, obesity, and chronic kidney diseases. Purpose: to study red cell distribution width in Iraqi persons with type 2 diabetes and assess its role in providing clinical information about glycemic control. Materials and methods. This case-control study included 300 participants, 150 Iraqi persons with type 2 diabetes (77 female and 73 male) in Najaf City, and 150 healthy controls (79 female and 71 male). Age, weight, systolic blood pressure, diastolic blood pressure, complete blood count, glycated hemoglobin (HbA1c), and C-reactive protein levels were assessed. In patients with diabetes, disease duration, medications, and complications were recorded. People with a history of anemia, renal failure, heart disease, hypertension, thyroid disorder, pregnancy, and conditions leading to chronic inflammation, such as rheumatoid arthritis, diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy, were excluded from the study. Results. RDW was significantly higher in people with diabetes (14.77 ± 3.56) than in healthy controls (12.19 ± 1.10), p < 0.0001. In the diabetes group, no statistically significant correlation was noted between RDW and disease duration (p = 0.143). RDW was strongly and directly associated with HbA1c and C-reactive protein levels (p < 0.0001 and р = 0.002, respectively). Conclusions. RDW was higher in people with type 2 diabetes than in healthy controls. RDW levels are affected by glycemic control because a higher HbA1c level is associated with a higher RDW. Thus, RDW can be considered a marker of glycemic control in clinical practice.

Background: Hirsutism is a common endocrine problem with high prevalence in Iraqi women. Polycystic ovarian syndrome and idiopathic hirsutism (IH) are the most common etiology of this disorder. There is a clear association between insulin resistance and polycystic ovarian syndrome. However, there is insufficient data on the relationship between insulin resistance and IH. Aim: The aim of this study was to determine whether Iraqi women with IH have insulin resistance. Methods: The study included two groups: 60 Iraqi women with IH and 60 women without hirsutism as a control group. A physical examination, a medical history, and the patient's age and BMI were collected. Blood samples were collected for hormone analysis, including insulin, follicle-stimulating hormone, luteinizing hormone, prolactin, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and free testosterone. To evaluate insulin resistance in both groups, the homeostasis model assessment-insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were used in addition to the Matsuda index. Results: Basal insulin was higher in the IH group (9.5 ± 0.2 mIU/L) than in the control group (4.8 ± 3.7 mIU/L), with a p value of < 0.0001. HOMA-IR was higher in the IH group (2.3 ± 4.1 μU mg), while in the control group, it was (0.8 ± 1.2 μU mg), with a p value of 0.007. There was a significant difference in the QUICKI, which was lower in the IH group (0.31 ± 0.2 μU-1/mg) than in the control group (0.45 ± 0.1 μU-1/mg), with a p value of < 0.0001. The insulin sensitivity index (Matsuda) was significantly lower in the IH group (3.1 ± 0.4) than in the control group (7.8 ± 1.3), with a p value of < 0.0001. Conclusion: According to the results of this study, Iraqi women with IH have insulin resistance and higher basal insulin levels.

تم اختيار ا.م.د.ميسم الأعسم كمقوم علمي لبحث لمجلة Journal of Complementary and alternative Medical Research

تم اختيار ا.م.د.ميسم الأعسم كمقوم علمي لبحث لمجلة International Journal of Research and Report in Hematology