BACKGROUND: Nebulized Salbutamol have great advantages for patients with respiratory problems by depositing drugs directly to the lungs, inspite of reported adverse metabolic effects on different electrolytes and glucose heamostasis of patients.AIM OF STUDY: To evaluate the effect of nebulized salbutamol used in the management of patients with asthma who have normal serum potassium and blood glucose levels. in the emergency department after 30 and 60 minutes of administration and to find out if these results are of clinical importance that should be taken in consideration when treating patients especially those with abnormal glucose hemostasis or electrolyte disturbance. PATIENTS & METHODS: The study is a prospective follow up study conducted in Emergency Department of Baghdad Teaching Hospital through the period from 1st of April, 2017, to 31st of January, 2018 on a sample of 100 patients. After administration of nebulized salbutamol, the Potassium and Glucose levels of patients were assessed in three periods; baseline, after 30 minutes and after one hour.RESULTS: The potassium mean was significantly decreased after 1 hour of nebulizer administration (p<0.001). The random blood sugar mean was significantly increased after 1 hour of nebulizer administration (p<0.001). The potassium level was significantly decreased one hour after nebulizer administration for patients with negative steroids history (p=0.03), while no significant difference in potassium level was observed for patients with positive steroids history.CONCLUSIONS: The nebulizer applying salbutamol has a profound effect in lowering the Potassium level and increasing blood glucose level after 60 minutes of administration.

Background: Lung cancer is the leading cause of cancer deaths and its incidence is rising. The determination of histopathology and stage of primary lung carcinoma is crucial to develop appropriate treatment approach that affects morbidity and mortality. Fiber optic bronchoscope techniques for early detection of lung cancer are a promising tool as they might allow visualizing changes of early lung cancer and also permitting sampling for histological confirmation.Objective: This study was intended to compare the fiber optic bronchoscopy findings and their anatomical locations with the histopathology types in patients with lung cancer.Patient and Methods: A cross section study was conducted during the period from 1st February 2012 to the 31th of July 2013, 49 patients with clinical and radiological findings suggesting primary lung cancer and diagnose later by bronchoscope samples as cases of primary lung cancer chosen for analysis of their bronchoscope findings, at Baghdad teaching hospital / respiratory clinic.Results: Patients with squamous carcinoma (31%) had (67%) visible mass and (13%) presented invisibly as external compression. Patients with adenocarcinoma (41%) had (40%) visible mass and (35%) presented invisibly as external compression while normal bronchoscope was seen in (30%) of those patients so that adenocarcinoma mostly invisible. Patients with small cell carcinoma (28%) had (50%) visible mass and (21%) presented invisibly as external compression.The location of finding in (27%) of the patients with squam. ous carcinoma was in the right main bronchus and (20%) in right upper lobe bronchus while the carina affected in (47%). Patients with adenocarcinoma have vocal cord affected in (25%) and left upper lobebronchus lesion in (25%).Conclusion: There was no relationship between the fiber optic bronchoscope findings and their anatomical locations with the histological types of lung.

Background: Chronic obstructive pulmonary disease (COPD) is a preventable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients.. The systemic manifestations  of  COPD  include  a number of endocrine disorders , such  as  those  involving the pituitary, the thyroid , the gonads, the adrenals  and  the pancreas.  The  mechanisms  by which COPD  alters  endocrine function are incompletely understood  but likely involve  hypoxemia , hypercapnia , systemic inflammation and  glucocorticoid  administration. Objective:  To evaluate the relationship between pulmonary function tests and thyroid gland function in patient with chronic obstructive pulmonary disease (COPD). Subjects and Methods:  Cross  sectional  study   was  done  in  Baghdad teaching hospital  from  April 2012  to October  2012  in  respiratory  outpatient. Thirty eight  patients  were  included  in  the study (36 male  and  2 females) who  had  stable  COPD ,  thyroid function tests and FEV1%  were  done  to all of  them.  Patients  were  classified  into four  groups  according  to GOLD criteria: mild  COPD ( > 80) FEV1% , moderate  (80 – 50)%,  severe ( 50 – 30)% and  very severe < 30%. Results: one  patient   has  decreased  level   of  TSH , one patient has decreased T3 hormone and one patient has increased free T3 hormone level, all other  patient  had  normal  thyroid  hormones  levels. The results of study showed no significant changes in thyroid hormones concentrations with COPD and its severity. Conclusion:  We found no significant changes in thyroid hormones in patients with COPD, and any changes that occur in TFT in these patients are may be due to other causes than COPD.

Background:The critically ill patient is at risk of developing intensive care acquired infection, with the lungs being especially vulnerable. Ventilator associated pneumonia (VAP) occurring after two days of mechanical ventilation and it is the most nosocomial infection seen in the intensive care unit .The establishment of an accurate diagnosis of ventilator associated pneumonia remains problematic and yet there is still no accepted "gold standard" for the diagnosis. Patients& Methods: This is a cross section study for 328 patients admitted to intensive care unit at medical city teaching hospital. Full history, physical examination and investigation were done after 48 hours of admission according to clinical pulmonary infection score using clinical criteria (body temperature, WBC count, oxygenation, chest radiography and tracheal aspiration).Arterial blood gases were taken for all patients. Results: 40 patients developed ventilation associated pneumonia out of 328 patients (12.19%) treated intensive care unit. Most patients who developed pneumonia were at extreme of age and there was no association between the disease and gender. The presence of risk factors like invasive mechanical ventilation (97.5%) nasogastric intubation (90%), tracheostomy (75%), post-operative (30%),insertion of urinary catheter (75%) unconscious patients (57.5%) and vomiting (27.5%) were found as an important risk factors .Gram negative bacteria was the most frequently observed especially pseudomonas aeruginosa (40%) klebsiella (15%).. Conclusion: ventilator associated pneumonia is an important cause of mortality. The clinical pulmonary infection score was found to be the reliable method for diagnosis of ventilator associated pneumonia. There is general agreement that rapid initiation of appropriate antimicrobial therapy will improve the outcome.

Background: The gold standard in assessing asthma control is the Global Initiative for Asthma (GINA) criteria. And because of the difficulties of access to pulmonary functions tests, The ACT has the added advantage that it does not require lung function assessment. Objectives: The aim of this study is to assess asthma control through ACT score and GINA guideline, and to determine if the ACT can be as useful as the GINA-guidelines criteria in assessing asthma control in Iraq. Patient and method: Cross sectional study with comparing ACT vs. GINA guideline in control of asthma level. This study was conducted at Respiratory consultation unit of the Iraqi National center of early detection of Cancer, Baghdad-Iraq, The study was conducted during the period from 1stNovember 2012 to 1stJuly 2013. A total of 71 adult asthmatic patients who were attended to the respiratory consultant unit were asked to participate and were enrolled in this study regardless their age or gender. Their asthma diagnosed and proved clinically by a combination of history, clinical finding In addition objective measurements using spirometry(FEV1) measured by the reversibility test which is defined as(an increment of>12% or 200 ml of FEV1 after 20 minutes of administration of inhaled short acting B2-agonist). Result: There were 71 patients enrolled in this study, of them 66 (92.96%) had an ACT score of ≤ 19 ((26) (39.4%) are male),(40)(60.6%) are female ,and 5 patients (7.04%) had an ACT score of > 19 (only(1) (20.0%) is male and and(4)(80.0%) are female. It had been found the number of male is(27)and(26)(39.4%) out of them had an ACT<19and only(1)(20.0%) had ACT>19 and number of female is(44),(40)(60.6%)out of them had ACT<19 and(4)(80.0%)had ACT>19. No significant differences had been found in between those patients with ≤19 ACT score vs. those with > 19, regarding the age and gender, in both comparison P>0.05 it had been found that good agreement present between ACT and GINA, 92.9%.ACT agreed the GINA in (37 patients with uncontrolled asthma, 24 patients with partially controlled and 5 patients with controlled). Conclusion: ACT can serve as an alternative diagnostic tool in assessing asthma control even without an aid of a spirometer or a peak flow meter. An ACT score of more than 19 can classify patient as controlled asthmatic while an ACT score < 19 can classify the patient as uncontrolled and partially controlled asthmatics.