Irritable bowel syndrome in Iraq

This study was carried out to find the prevalence of Irritable Bowel Syndrome [IBS] among Iraqi patients referred to the Gastroenterology Clinic at the Medical City Teaching Hospital and the semi-private Gastroenterology Consultation Clinic attached to the University of Baghdad. Six hundred and fifty patients complaining of abdominal pain and other bowel symptoms who were referred to the above mentioned clinics were studied over a period of 18 months. Four hundred and fifty two [69.5%] patients were found to have lBS. One hundred and six [16.3%] patinets had unspecified functional bowel disorder. Ninety two [14.2%] patiets were found to have organic diseases. The study shows the high prevalence of lBS among Iraqi patients referred to Gastroenterology clinics which to comparable to that found in similar studies carried out in Western Countries and the United States

Nifedipine in cor pulmonale

Twelve patients with cor pulmonale secondary to chronic obstructive pulmonary disease had their arterial blood gases and lung function tests measured before and three weeks after nifedipine 10mg tds. PaO2 increased from 66.43 +/- 11.9 mm Hg to 71.98 +/- 10.8 mm Hg[P< 0.05]. Pa 002 decreased from 60.56 +/- 9.1 mm Hg to 55.37 +/- 7.1 mm Hg [P<0.02]. The arterial saturation increased from 76.28 +/- 6.5% to 83.71 +/- 4.9% [P<0.001]. The FEVI, PEVI / PVC and MVV all improved but the change was not statistically significant. There was an over all improvement of symptoms in all patients

Reflux oesophagities

This is a common disorder of motility. It affects all ages, commoner in the elderly and in the obese. It can occur in association with sliding hiatus hernia but it may occur in its absence. Hiatus hernia per se does not appear to cause gastro-oesophageal reflux. A review covering the etiology, pathogenesis, pathology, clinical features and management is presented

Short stature in Iraq

One hundred and twenty patients with short stature were studied at the Endocrine Clinic of the Medical City Teaching Hospital. Sixty [50%] patients had pituitary dwarfism, 48 of them had isolated growth hormone deficiency, they exhibited low basal value of GH which did not rise on stimulation with insulin induced hypoglycaemia [I.T.T.]. Once diagnosed, these patients were put on GH injections [2.5u thrice weekly] with very good response. Twenty [16.67%] patients were proved to have coeliac disease by jejunal biopsy which demonstrated flat villous pattern. It is interesting to note that in all these patients, short stature rather than chronic diarrhea was the presenting feature. Only five children gave a clear history of chronic diarrhea in early childhood. Fourteen patients showed a blunted response to insulin induced hypoglycaemia, [GH below 7 ng/ml], the remaining six had normal GH after I. T. T. These children responded dramatically to gluten-free diet with catch up growth and initiation of puberty in three girls with delayed puberty. Chromosomal profile was performed routinely in all girls with short stature, nine were proved Turner's Syndrome with a chromosomal pattern of 45/XO. Thyroid functions [T 4 and TSH] were measured in all children; Sixteen had low values [below 3 ug/100ml]. Eight patients had primary hypothyroidism which responded magnificently to treatment with thyroid hormone. The other eight patients were secondary to deficiency of TSH due to panhypopituitarism. The remainder of the patients had various skeletal, metabolic and genetic causes of short stature. It is important to identify the etiology of short stature, since effective therapy is available only when an endocrine deficiency is demonstrated i.e GH or thyroid hormone and for coeliac disease

On the side effects of histamine H2 receptor antagonist: cimetidine

Side effects to cimetidine were observed in four out of 420 patients [0.9%]. One patient had transient, reversible and reproducible fever and neutropaenia. Three patients had muscle pains which disappeared with out sequellae though cimetidine was continued. The literature was reviewed. It seems that cimetidine is a safe drug for the treatment of chronic duodenal ulceration