ABSTRACT:BACKGROUND:Idiopathic thrombocytopenic purpura is an acquired chronic autoimmune disease .Treatment whenindicated is usually by corticosteroids,then splenectomy if no acceptable response,with variableresponse rate to both types of treatment.OBJECTIVE:To look for the effects of certain variables on the type of response to steroid therapy in patients withadult idiopathic thrombocytopenic purpura, and to study the outcome of splenectomy in relation toprevious steroid therapy.METHOD:A prospective study on 80 patients, presented with bleeding and a platelet count of ≤ 30 X 109 / L.Initially treated with prednisolone and the response was studied in relation to gender , age , duration ofbleeding and platelet count on presentation. Patients who failed to maintain permanent completeremission were advised to have splenectomy.RESULTS:Of the 80 patients, 62 (77.5 %) were females and 18 (22.5%) were males. Mean age was 23 ± 10.1years. Ten (12.5%) patients only had permanent complete remission after steroid therapy. While 70(87.5%) patints failed. Response to steroid therapy was significantly related to duration of bleeding butnot to gender, age and platelet count. Thirty seven (46%) patients underwent splenectomy, permanentcomplete remission were achieved in 29 (78.2%).CONCLUSION:1. Duration of bleeding of ≤ 3 weeks is a good predictor of successful steroid therapy.2. Results after splenectomy is not related to previos steroid therapy

thrombocytopenia --- steroids --- splenectomy

Anabolic androgenic steroids (AAS) are man-made derivatives of the male sex hormone testosterone, originally designed for therapeutic uses to provide higher anabolic potency with lower androgenic effects. Increasing numbers of young athletes are using these agents illicitly to enhance physical fitness, appearance, and performance despite their numerous side effects and worldwide banning. Today, their use remains one of the main health problems in sports because of their availability and low price. The present study focuses on investigating the adverse effects of anabolic androgenic steroid abuse on sex hormones, liver and renal function tests, fasting glucose levels and lipid metabolism in Iraqi male recreational bodybuilders. We have recruited fifteen male bodybuilders (age 19-32 years) and an equal number of healthy non-obese, non-AAS-using sedentary controls. Serum hormones (luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, and prolactin), liver function indices (serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), total and direct bilirubin), renal function parameters (serum creatinine and urea), lipid profile and serum glucose levels were measured. Abuse of AAS was associated with significant decreases (p< 0.005) in serum levels of LH (66.9%), FSH (49.8 %) and testosterone (63.7%) together with significant increases (p< 0.05) in prolactin concentrations (49.8%) in AAS-using bodybuilders compared to sedentary controls. Anabolic androgenic steroids-using athletes had significantly higher (p< 0.05) circulating levels of total bilirubin (116.3%), direct bilirubin (127.6%), aspartate (1752.9%) and alanine (263.1 %) transaminases than those of sedentary control subjects. Serum alkaline phosphatase levels were not significantly different (p> 0.05) between the two groups. Concerning renal function, AAS-using athletes had significantly higher serum concentrations of creatinine (28.6%) and urea (21.3%) than sedentary controls. Meanwhile, AAS abuse was accompanied by atherogenic lipid profile. Anabolic androgenic steroids -using athletes had significantly higher (p< 0.05) serum levels of triglycerides (TG) (45.6%), low density lipoprotein-cholesterol (LDL-C) (26.0%) and very low density lipoprotein-cholesterol(VLDL-C) (45.6%) together with significantly lower serum concentrations of high density lipoprotein-cholesterol (HDL-C) (31.3%) than sedentary controls. Serum total cholesterol (TC) and fasting glucose concentrations were not significantly different (p> 0.05) between the two groups. The results presented in the study confirm that abuse of AAS induces unfavorable body functions and undesirable side effects. Therefore, efforts should be sought against use of these compounds outside the therapeutic frame.

الستيرويدات البنائية هي مشتقات الهرمون الذكري المعروف بـ (Testosterone) صُنعت خصيصاً للتغلب على عيوب و مساوئ الـ (Testosterone) كمستحضر دوائي. تذكر الدراسات أنَّ أعداد الرياضيين الذين يقبلون على تعاطي مثل هذه المركبات بدون تصريح طبي في تزايد ملحوظ بمرور السنين على الرغم من التحذيرات المتكررة حول أعراضها الجانبية و على الرغم من وضع المنظمات الاولمبية و الجهات الحكومية عقوبات صارمة على من يتعاطى هذه المواد أو يتاجر بها. يعتبر الاستخدام الخاطئ لهذه المركبات من قبل الرياضيين من أهم مشاكل الرياضة في العصر الحديث. اُجريت هذه الدراسة و صممت لتقييم تأثيرات تعاطي هذه الستيرويدات البنائية على مستوى الهرمونات في مصل الدم و وظائف الكبد و الكلى و مستوى توزيع الشحوم و مستوى السكر في مصل الدم لمجموعة من ممارسي رياضة كمال الأجسام. اشتملت هذه الدراسة على (15) رياضياً يتعاطون الستيرويدات البنائية و (15) متطوعاً لا يمارسون رياضة كمال الأجسام و لا يتعاطون الستيرويدات البنائية. إعتمدت طرق التقييم على قياس مستوى الهرمونات في مصل الدم (LH, FSH, Testosterone, and prolactin) و وظائف الكبد (Total and direct bilirubin, SAST, SALT, and alkaline phosphatase) و وظائف الكلى (S creatinine and S urea) و مستوى توزيع الشحوم في مصل الدم (TC, TG, HDL-C, LDL-C, and VLDL-C) بالإضافة إلى تركيز السكر في الدم. أظهر تحليل البيانات تأثيراً ذو قيمة معنوية واضحة لتعاطي الستيرويدات البنائية على تركيز الهرمونات في مصل الدم .

anabolic steroids --- athletes --- bodybuilding --- exercise

The present study was conducted at Veterinary Medicine College–University of Basrha /Iraq to investigate the effect of testosterone( Sustanon ® 250) abusing on some physiological and biochemical parameters. Sixty four male and female rats were divided into four groups(each group consisted of 8 males and 8 females). The first group served as control group in which the rats dosed by intramuscular injection with 10 μ l olive oil weekly for 12 weeks, the rest 3 treated groups (G1 . G2 and G3) in which the rats dosed by intramuscular injection with 50 . 100 and 150 mg Sustanon ® 250 / kg B.W. respectively weekly for 12 weeks , then all rats were terminated for the physiological and biochemical tests . The Sustanon ® 250 through its effect on liver caused increasing both ALT and AST and decreasing the ALP in treated rats compared with control group . The lipid profile was significantly affected by Sustanon ® 250 injection through elevation of TG and VLDL , but lowering the HDL ,LDL and AI.

أجريت الدراسة الحالية في كلية الطب البيطري / جامعة البصرة لدراسة تأثير فرط استخدام (sustanon®250) على مستوى بعض انزيمات الكبد ومستوى الدهون في ذكور و اناث الجرذان المختبرية. قسمت الجرذان المختبرية إلى أربعة مجاميع , المجموعة الأولى اعتبرت مجموعة سيطرة حقنت عضليا ب 10 مايكرولتر من زيت الزيتون أسبوعيا لمدة ثلاثة شهور . أما المجاميع الثلاثة الباقية فهي مجاميع معاملة بال sustanon®250 إذ حقنت المجموعة الأولى ب50ملغم / كغم من وزن الجسم والثانية 100 ملغم / كغم من وزن الجسم والثالثة ب 150 ملغم / كغم من وزن الجسم أسبوعيا لمدة ثلاثة شهور ، ثم بعد انتهاء فترة الحقن ضحي بالجرذان لدراسة المعايير الفسلجية والكيموحيوية. أظهرت النتائج زيادة معنوية في إنزيمي ALT و AST ونقصان معنوي لإنزيم ALP في الجرذان المعاملة بمادة ال sustanon®25 مقارنة مع مجموعة السيطرة. كما تأثر مستوى الدهون معنويا بسبب حقن ال sustanon®250إذ أظهر زيادة في مستوى الدهون الثلاثية والدهون واطئة الكثافة جدا ونقصان الدهون عالية الكثافة والدهون واطئة الكثافة والدليل التعضدي

Androgenic –Anabolic Steroids --- Liver Enzymes --- Lipid Profile

Background: Intra-articular injections have been used for many years to treat painful joint disorders, especially by means of injecting crystalline suspensions of long-duration corticosteroids. Viscosupplementation, which is a relatively new intervention, consists of injection of exogenous hyaluronic acid into joints in order to treat osteoarthritis of knee joint. Patients and Methods: A prospective cohort study was conducted in a private orthopedic clinic in Baghdad from March 2013 to the end of September 2014, where it enrolled a total of fifty six (56) patients of middle ages, ranging from 39 to 64 years, classified as either grade II or III according to Kellgren and Lawrence radiographic criteria. Intra-articular injection of two drugs (a long acting steroid drug, then hyaluronic acid) were given locally in one or both knee joints with one week apart. To evaluate the effect of therapy, current study group patients were assessed by Visual Analogue Scale (VAS) after 1 week, and after 4-8 weeks from the beginning of the therapeutic trial. Results: more than two-third of cases were women (a ratio of 2.1:1), with age group of 50- 59 years old. No statistical correlation was found between Visual analogue scale (VAS) and radiographic grading (i.e. Kellgren and Lawrence radiographic criteria). Significant statistical difference (P<0.05) was shown in patients receiving intra-articular corticosteroids after week "1" of therapy, and a slightly better effect after adding hyaluronic acid on week "4" regarding the VAS scale of pain for radiographic grade II patients. Radiographic grade III patients showed a significant statistical correlation in VAS after week (4) of therapy for both moderate and severe classes. Conclusion: Intra-articular injections of both corticosteroids and hyaluronic acid with one week apart appear to give clinical improvement better than using Intra-articular injection of hyaluronic acid alone.

VAS --- intra-articular injection --- knee joint --- long-term steroids --- hyaluronic acid.