Vol. 2 No. 1 (2020)

Open Access

Article

Article ID: 714

Clinical and laboratory evaluation of patients afflicted with allergic asthma under immunotherapy

by Falah Hasasn Hade

Reports in Clinical Studies and Medicine, Vol.2, No.1, 2019; 207 Views, 13 PDF Downloads

Background : Allergy may be defined as a constellation of signs and symptoms in which the altered immunologic reaction between foreign substance (allergens) and antibodies resulting in pathologic reactions referred as allergic reactions. Allergic asthma is well known type 1- allergic reaction Up to 30% of general population suffers from various form of this malady during normal life span . Objective:  To evaluate the effects of immunotherapy on groups of Iraqi people afflicted with allergic asthma through some clinical and laboratories tests Methods: A cross sectional study was carried out on Iraqi patients ( males and famales) in AL-Zahraa Consultant Center for Allergy and Asthma in Baghdad - Karkh, between Nov. 2013 - Apr. 2014 .The study included 60 asthmatic patients ( 6 - 45 years old) whom had allergy to house  mites antigens " through skin test ",in addition to 20 apparently healthy persons as control group.A subcutaneous immunotherapy was given for 3 months, starting from diluted doses which were increased gradually. Clinical assessment was done depending on scoring of signs and symptoms, in addition to the medical history , clinical investigation, skin test, and pulmonary function test . Results:  Study showed that asthma still affected all age group but tend to be higher in age group 31-45 years with male to female ratio 2:1. Family history to allergic disease play a major role 60% with increase prevalence of reactivity for indoor allergy (House Mites and Moulds). 66.7% had positive skin reaction to House Mites which includes D1 ,D2 and D1+D2. The dust found to be one of main aggravating factors. Medical condition had shown significant improvement after three months of giving immunotherapy. Conclusion:  Immunotherapy need to be considered as one of alternative treatment of allergic asthma decreasing the side effects and cost of different drugs used by these patients when given regularly to them, also detection of prevalent allergens in our local atmosphere and their concentration with detection of their seasonal distribution in different parts of our country is required.

Open Access

Article

Article ID: 719

Is chronic interstitial lung disease a complication of long-term methotrexate use?-10 year study investigates

by Julie K Dawson, Deepti Kapur, Imna Fazel Rahiman

Reports in Clinical Studies and Medicine, Vol.2, No.1, 2020; 221 Views, 4 PDF Downloads

Background: Methotrexate use is known to be associated with acute pneumonitis, an acute hypersensitivity reaction. Historically there have been concerns that methotrexate may be a cause for chronic pulmonary fibrosis. We wanted to study the effect of long-term methotrexate use on the incidence of chronic interstitial lung disease (ILD). Methods: All patients commenced on methotrexate in our unit between 2004 – 2007 were evaluated retrospectively from our Hospital trust records after 10 years of follow up.  The incidence of pulmonary fibrosis was based on clinical presentation with symptoms of dyspnoea and confirmation by means of pulmonary function tests and detection of pulmonary fibrosis on high resolution computed tomography of the chest   Results: Data for 129 patients were analysed. 64/ 129 (50 %) patients completed 10 years of methotrexate treatment at follow up. Methotrexate was used for various indications, most commonly rheumatoid arthritis (106). Four male patients developed chronic ILD. All cases were in patients with Rheumatoid Arthritis and the incidence in Rheumatoid Arthritis subgroup was 4/ 106 (3.8%).  There was no association of symptomatic ILD to the duration or dose of methotrexate therapy. Conclusions: All cases of ILD were in male patients with rheumatoid arthritis, they had usual interstitial pneumonia pattern ILD typical of Rheumatoid Arthritis associated ILD and the incidence rate was comparable to previous studies on rheumatoid arthritis associated with interstitial lung disease (4 – 7 %). This adds to previous publications from shorter-term studies showing a lack of evidence that MTX could be causing chronic ILD.

Open Access

Review

Article ID: 782

Research on prevention methods of nosocomial infection in neurosurgery

by Sung-Won Kim

Reports in Clinical Studies and Medicine, Vol.2, No.1, 2020; 214 Views, 13 PDF Downloads

The proportion of critically ill patients from neurosurgery wards in hospitals is significantly higher than that from other departments. These patients suffer from low immune. At the same time, because of the severe trauma after surgery and the complexity of pathogens in patients, antibiotics are frequently used. However, the of bacterial drug resistance is relatively high because of the particularity of hospitals, which is a major reason for the high infection rate of neurosurgery patients. Therefore, regarding to these risk factors, intervention measures should be actively explored in hospitals, so as to control the infection rate, reduce the possibility of infection in neurosurgery patients, improve the rehabilitation efficiency of patients, and reduce unnecessary suffering of patients caused by infection. This is also an effective means to improve the quality of hospital medical care.