Acute phase hyperglycemia among patients hospitalized with acute coronary syndrome: prevalence and prognostic significance

Regardless of diabetes status, hyperglycemia on arrival for patients presenting with acute coronary syndrome, has been associated with adverse outcomes including death. The aim of this study is to look at the frequency and prognostic significance of acute phase hyperglycemia among patients attending the coronary care unit with acute coronary syndrome over the in-hospital admission days. The study included 287 consecutive patients in the Al-Faiha Hospital in Basrah [Southern Iraq] during a one year period from December 2007 to November 2008. Patients were divided into two groups with respect to admission plasma glucose level regardless of their diabetes status [those with admission plasma glucose of <14- mg/dl [7.8 mmol/L] and those equal to or more than that]. Acute phase hyperglycemia was defined as a non-fasting glucose level equal to or above 140 mg/dl [7.8 mmol/L] regardless of past history of diabetes. Sixty one point seven percent [177] of patients were admitted with plasma glucose of >/= 140 mg/dl [7.8 mmol/L]. There were no differences were found between both groups regarding the mean age, qualification, and smoking status, but males were predominant in both groups. A family history of diabetes, and hypertension, were more frequent in patients with plasma glucose of >/= 140 mg/dl [7.8 mmol/L]. There were no differences between the two groups regarding past history of ischemic heart disease, stroke, lipid profile, troponin-I levels or type of acute coronary syndrome. Again heart failure was more common in the admission acute phase hyperglycemia group, but there was no difference regarding arrhythmia, stroke, or death. Using logistic regression with heart failure as the dependent variable we found that only the admission acute phase hyperglycemia [OR=2.1344, 95% CI= 1.0282-2.2307; p=0.0419] was independently associated with heart failure. While male gender, family history of diabetes mellitus, hypertension and diabetes were not independently associated with heart failure. Admission acute phase hyperglycemia of >/= 140 mg/dl [7.8 mmol/L] was associated with heart failure in this study

Corticosteroid nonprescription use: a cross-sectional hospital-based study in Basrah

To study the prevalence and attitude of using nonprescription corticosteroids [oral or parenteral formulation of glucocorticosteroids] in Basrah, Iraq. A face-to-face model structured interview was used to collect information from 682 patients between January 2006 and December 2008. The following information was obtained: age, gender, marital status, smoking, drinking of alcohol, occupation, educational level, social class and place of residence. Of the 682 [2.6%] subjects using nonprescription corticosteroids most were females: 471 [69%]; married: 567 [83%]; of low social class: 430 [63.1%]; lived in the city center: 475 [69.6%]. The majority [569, 83.5%] thought that corticosteroid use was safe and 463 [68.0%] did not feel guilty for using such medications. About half of them [377, 55.3%] were still using drugs at the time of presentation. Three hundred and fifty-seven [52.4%] reported that physicians advised them for the first time to use corticosteroids and the remaining 325 [42.2%] used it to become beautiful or marry. Three hundred and sixty-four [53.4%] patients obtained the drug from the pharmacy and 252 [36.9%] from street vendors. Weight gain was the main indication for use in 342 [50.1%] patients. Almost all had some features of corticosteroid side effects. This study showed high use of nonprescription corticosteroid in Basrah, Iraqi. We therefore recommend educational programs to alert the population of the untoward side effects of corticosteroids