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Objective: To study the prevalence and attitude of using nonprescription corticosteroids (oral or parenteral formulation of glucocorticosteroids) in Basrah, Iraq. Methods: 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. Results: 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. Conclusion: 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.

Admission acute phase hyperglycemia of ³140 mg/dl (7.8 mmol/L) was associated with heart failure in this study.

Background: In Iraq, diabetes affects 10.4 % of people according to the 2006 WHO survey. The aim of this study is to see how a diabetic center in a developing country can control type 2 diabetes mellitus over 3 years period.Methods: This is 3-year open-label, non-randomized, treat-to-target, single center study in the Al-Faiha Diabetes and Endocrine Center in Basrah. Patients with type 2 diabetes, regardless of the duration or treatment were enrolled in January 2007. Results:We had 998 patients complete the study. The mean HbA1c levels at the start of the study was 9.8 ± 1.9 % and after 3 years it was 8.1 ± 1.6 %. The target of HbA1c levels < 7 % were achieved only in 25.6 %. Those on insulin achieved HbA1c levels < 7 less than those on oral anti-diabetic drugs (16.9 % versus 67.9 % with p value of <0.0001). On univeriate analysis for variables associated with poor outcome and non achieving target HbA1c were only insulin use (OR =2.318, 95 % CI = 1.705-3.152;p < 0.0001) and duration of diabetes >5 years (OR =1.688 , 95 % CI = 1.261-2.259;p < 0.0001). On logistic regression analysis (table-4),only the insulin use remain significantly associated with poor outcome (OR =0.475 , p < 0.0001). Conclusion:This study confirms that we are still lagging in diabetic control from guidelines, but no worse than neighboring countries in the Middle East. Implementing local guidelines will probably solve some of the obstacles in diabetic care locally.

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