The role of Caesarean section in childhood asthma.

OBJECTIVE: As indicated by previous studies, children born via Caesarean section may have an increased risk of developing asthma compared with those born via vaginal delivery. The aim of this study is to assess the association between a Caesarean section and the risk of childhood asthma. Methods: This was a case-control study carried out in Basrah, Iraq including 952 children aged 3-12 years. Four hundred and seven asthmatic cases and a control group of 545 age-matched non-asthmatic children were enrolled. Binary logistic regression was used to assess the relationship between asthma and birth via Caesarean section. RESULTS: The mean age of the children was 6.7±2.5 years. Two-hundred eighty-three children (29.7%) were delivered via Caesarean section. The binary logistic regression analysis showed that delivery via Caesarean section was found to be an independent significant risk factor for asthma (OR=3.37; 95% CI=1.76-6.46; p<0.001). In addition, many other risk factors were found to be significant predictors of asthma, including bottlefeeding (OR=27.29; 95% CI=13.54-54.99; p<0.001) and low birth weight (OR=16.7; 95% CI=6.97-37.49; p<0.001). CONCLUSION: Caesarean section is significantly associated with an increased risk of childhood asthma.

The accuracy of risk malignancy index in prediction of malignancy in women with adnexal mass in Basrah, Iraq.

BACKGROUND: Adnexal masses indicate a variety of gynecological and nongynecological disorders, which may be benign or malignant. Early detection of malignancy is crucial to a proper planning of treatment and improvement of survival. OBJECTIVE: To determine the accuracy of risk of malignancy index (RMI) in prediction of malignant adnexal mass. SUBJECTS AND METHODS: This was a prospective multicenter study which included 101 women with adnexal masses. RMI2 with cutoff value of 200 was used to discriminate between benign and malignant tumors. Histopathological examination was used to confirm the final diagnosis. RESULTS: Out of the studied women, 20.8% proved to have malignant tumors. The RMI showed a sensitivity of 100%, a specificity of 96.2%, a positive predictive value of 87.5%, and a negative predictive value (NPV) of 100%. The RMI identified malignant cases more accurately than any individual criterion in diagnosing ovarian cancer. The receiver operating characteristic analysis showed that the area under the curve of the RMI, CA 125, ultrasound, and menopausal status were significantly high with values of 1.0, 0.99, 0.86, and 0.85, respectively. CONCLUSION: The RMI is a simple sensitive, practical, and reliable tool in preoperative discrimination between benign and malignant adnexal masses that can facilitate selection of cases for timely referral to oncology center.

Day of admission and risk of myocardial infarction mortality in a cardiac care unit in Basrah, Iraq.

BACKGROUND: Among many factors that may affect the in-hospital mortality among acute myocardial infarction (AMI) patients admitted to the cardiac care unit (CCU), the day and time of admission have been reported to play some role, but such relationship is controversial. OBJECTIVE: The objective of the following study is to assess the effect of the day and time of admission on in-hospital mortality of patients with AMI. SUBJECTS AND METHODS: Retrospective analysis of data of all patients with AMI who were admitted to the CCU in Al-Sadr Teaching Hospital, Basrah, Iraq during 2010 was conducted. RESULTS: A total of 419 patients were included in this analysis. The mean age of patients was 62.4 ± 11.6 years, 64.9% of them were men. Admission during weekdays was greater than that during weekends (63.2% vs. 36.8%). Admission during off hours was greater than that during regular-hours (59.9% vs. 41.1%). Weekend admissions were more likely to be presenting with ST elevation myocardial infarction, complications and hypotension. A likewise pattern of baseline characteristics was found among patients admitted at the off-hours time. The overall in-hospital mortality rate was 16.5%. The weekend admission was associated with a higher unadjusted hospital mortality rate than that for weekday admission (23.4% vs. 12.5%, respectively; odds ratio [OR], 2.14; 95% confidence interval [CI], 1.27-3.61; P = 0.004). In multivariate analyzes, no statistically significant difference in mortality was found between weekend and weekday admissions (OR, 0.658; 95% CI, 0.311-1.392). Whereas, off-hours admission was significantly associated with a higher mortality (25.5% vs. 3%; P < 0.001), adjusted OR, 12.178; 95% CI, 3.846-38.442. CONCLUSION: Of predictors for the in-hospital outcome of AMI, day of admission had no significant influence on mortality, whereas off-hour admission was associated with an increased risk of AMI in-hospital mortality.

Type A behaviour pattern: is it a risk factor for hypertension?

Type A behaviour pattern has been found to be associated with coronary heart diseases, but its association with hypertension is inconsistent. To investigate the association between type A behaviour pattern and hypertension, 221 known hypertensive patients and a control group of 221 non-hypertensive patients in Basra, Iraq, were interviewed for type A behaviour using to a special questionnaire. Blood pressure, height and weight were measured. The proportion with type A behaviour was significantly higher in hypertensive than non-hypertensive patients [57.5% versus 24.9%] and a highly significant association was found between type A behaviour and hypertension [OR 4.08, 95% CI: 2.72-6.11]. Type A behaviour pattern was shown to be an independent risk factor for the development of hypertension