Search

The SARS-COV2 pandemic caused significant disruptions in immunization delivery. Baseline deficit gaps in immunization completion exacerbated ongoing disparities in immunization coverage in low- and middle-income. Emerging reports focused on global strategies for return to routine immunization schedules. Currently, there are no studies that examined the dual challenge of returning to normal immunization in a conflict-recovery setting, such as the ISIS (Islamic State of Iraq and Syria) occupation of Iraq post-COVID-19 pandemic. The objective of this study was to estimate the number of children in Hadeetha, Iraq from 12 to 24 months of age who continued to be lost to the routine immunization schedule due to the COVID-19 pandemic shutdowns. Random sampling occurred from a compiled district health facility registrar of all children in the target birth cohort who had a 12-month immunization scheduled during the 2020 lockdown and were lost to the immunization schedule. A total of 171 households from the sampling frame were included in the final sample. In this cross-sectional study, survey data was collected on the head of the household, the caregiver and the child. Additional questions assessed vaccine hesitancy, vaccine information trusted sources and COVID-19 impact on healthcare access. A risk factor analysis was applied to assess using Chi-square (Χ 2 ) for predictors of lack of DTP3 (Diphtheria, Tetanus and Polio) third dose completion. Of children in the study, 67.3 % did not complete the 6-antigen series at 12-months of age and 46.2 % were missing DTP3 for vaccines to be completed during the pandemic shutdown. Specific risk factors for lack of immunization for the DTP3 vaccine included area of residence, age and caregiver knowledge of vaccines. Respondents indicated a dependence on mass vaccination campaigns but also indicated a willingness to receive phone reminders and television campaigns about vaccination schedules., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sara Al-Dahir reports a relationship with Pfizer Inc. that includes: funding grants. Sara Al-Dahir reports a relationship with Genentech Inc. that includes: funding grants. Kawsar Talaat reports a relationship with Pfizer that includes: funding grants. Kawsar Talaat reports a relationship with AstraZeneca Pharmaceuticals LP that includes: funding grants. Kawsar Talaat reports a relationship with Moderna Inc. that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Hydrogen sulfide (H 2 S) is a toxic gas emitted through natural and anthropogenic activities. Chronic exposure to inhaled H 2 S at low sub-toxic levels is common among workers in oil refineries and may have important health implications. Inhaled H 2 S can be oxidized to thiosulfate or methylated to dimethylsulfide (DMS) which can be methylated to the novel human metabolite trimethylsulfonium (TMS) or oxidized to dimethylsulfoxide (DMSO) but the extent of methylation of inhaled H 2 S is currently unknown in humans. A total of 80 participants were recruited of which 40 were workers in an oil refinery in Kurdistan region, Iraq including those working in close contact with the facility area where H 2 S was measured at 1.5-5.0 mg m -3 , and 40 controls living in a nearby city with no detectable H 2 S or perceptible odor (<0.1 mg m -3 ). A total of 240 urine samples were measured for multiple H 2 S-related metabolites. DMSO was consistently found in all urine samples with concentrations generally within the range of 1.0-10 µM. Although these concentrations were 10-100-fold higher than TMS urinary levels, clear correlation between DMSO and TMS was observed (r s 0.55, P < 0.0001), which supports DMS as common precursor. DMSO urinary levels were elevated in the oil refinery workers in close contact with the facilities (5.0 vs. 3.3 µM, P 0.03), but TMS was unaltered (0.13 vs. 0.14 µM, P 0.68). Overall, the results suggest that the investigated methylation metabolites are not sufficiently sensitive to low occupational exposure levels of inhaled H 2 S., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Hepatitis D virus (HDV), which occurs as a co-infection with the hepatitis B virus (HBV), is a significant public health burden. Currently, there is a scarcity of data regarding this co-infection in the developing countries. This study aims to address the clinical prevalence of HDV among HBV-infected patients in Sulaymaniyah Governorate, Iraq. This prospective cross-sectional study, conducted from May to November 2022, screened HBV DNA-positive patients visiting Sulaimani Teaching Hospital in Sulaymaniyah governorate, Iraq, for anti-HDV antibodies and HDV RNA. The study included 150 confirmed HBV DNA-positive patients. Of these, 54.7% were male. The mean age of the patients was 49.1 ± 10.1 (18-68). Serological assessment found that 23 (15.3%) of the patients had anti-HDV IgG antibodies, suggesting past or chronic HDV infection, while 16 (10.7%) tested positive for anti-HDV IgM, indicating recent/acute infection. Further molecular analysis confirmed HDV RNA in 15 (10%) of HBV patients, indicating real HDV prevalence. The prevalence of anti-HDV and HDV RNA did not significantly differ by age, gender, marital status, residency, medical, family or medical history (p > 0.05). In conclusion, this study demonstrated a relatively high HDV prevalence among HBV patients in Sulaymaniyah Governorate, Iraq, at 10%, which stresses the need for better screening, health strategies and focused research to combat its impact., (© 2024 John Wiley & Sons Ltd.)

Objective: This study has been aimed to investigate factors associated with elevated blood lead levels (BLLs) across different percentiles in individuals employed in the petroleum industry and residents of Kirkuk City . In addition, to provide evidence-based approaches to mitigate exposure risks and safeguard vulnerable populations., Methods: The study involved 357 participants and utilized quantile regression to examine BLL in petroleum industry workers and Kirkuk residents., Results: Median BLLs were higher among workers (17.5 μg/dL) compared to residents in the city (9.9 μg/dL) and suburbs (7.4 μg/dL). Factors such as smoking, outdoor work, and lower education were associated with elevated BLLs, as confirmed by quantile regression., Conclusions: This study found higher BLLs in petroleum workers compared to Kirkuk residents, associated with smoking, outdoor work, and lower education. The results emphasize the need for targeted interventions and policies to mitigate lead exposure risks in this industrial region., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Land degradation (LD) is the decline in a land's functional capacity and productive potential, which includes various anthropogenic and natural drivers. This study focuses on three primary manifestations of LD including soil erosion, landslides, and rockfalls, which are the most prevalent in the Shaqlawa district. A set of 22 LD conditioning factors, encompassing curvature, lithology, aspect, river density, soil type, lineament density, river distance, elevation, road distance, length slope (LS), land use land cover (LULC), stream power index (SPI), valley depth, profile curvature, slope, solar radiation, road density, lineament distance, rainfall, topographic wetness index (TWI), plan curvature, and normalized difference vegetation index (NDVI), were integrated into the analysis. Variance inflation factors (VIF) and tolerance (TOL) values from linear regression indicate that most LD factors have acceptable levels of multicollinearity. The Information Gain Ratio (IGR) identified key variables TWI, NDVI, and lithology-as pivotal factors for predicting LD. Additionally, the study evaluated degradation factors using various machine learning (ML) algorithms, including random forest (RF), Naive Bayes, logistic regression, rotation forest, forest penalized attributes (FPA), and Fisher's Linear discriminant analysis (FLDA). This facilitated categorizing the study area into five susceptibility categories. The FLDA model categorized the highest area under very high degradation risk at 26.72%, emphasizing the varied insights each algorithm brought to characterizing the degradation risk. Additionally, the receiver operating characteristic curves (ROC) were employed for model validation, identifying RF as the most successful model in the training dataset with an area under the curve (AUC) of 0.882, while FLDA outperformed in the testing dataset with an AUC of 0.883. The identified LD-prone areas will help land-use planners and emergency management officials apply effective mitigation strategies for similar terrains., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

To determine the prevalence and molecular basis of β-thalassemia in the Northeastern Iraqi province of Kirkuk, a total of 3954 individuals attending the provincial premarital screening center were recruited. The prevalence of β-thalassemia minor among the screened individuals was found to be 3.0%, while those of Hemoglobin E, and δβ-thalassemia carrier states were 0.05%, and 0.03% respectively. Molecular characterization of the β-thalassemia mutations was achieved by multiplex PCR and reverse hybridization, followed by next generation sequencing for those left uncharacterized by the former technique. Among 19 β-thalassemia mutations identified, seven were the most frequent, namely: IVS-II-1 (G > A), codon 8/9 (+G), IVS-I-6 (T > C), IVS-I-110 (G > A), IVS-I-I (G > A), IVS-I-5 (G > C) and codon 44 (-C) accounting for 78.5% of the mutations. This study further illustrates the heterogeneity of the spectrum of β-thalassemia in different parts of Iraq, and provides an essential step to facilitate prenatal diagnosis in the setting of a future national thalassemia prevention program.

Background: The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72 months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021., Methods: This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period., Results: In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017., Conclusion: This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations., (© 2024. The Author(s).)

Background: The simple and effective technique of fission track etch has been applied to determine trace concentration of uranium in human urine samples taken from two groups of male and female participants: cancer patients and healthy subjects are living in Dhi-Qar governorate, southern of Iraq. This governorate was the center of industrialization and the prior military activities especially during the Gulf wars in 1991 and 2003, and the abandoned weaponry is still present in these regions. The induced fission track registration was done using the CR-39 track detector. Patients with cancer were statistically significantly distinguished by significantly higher concentrations of uranium as compared with members of a control group, the mean value of uranium concentration for the cancer patients was 3.67 ± 0.16 μg/L, with the maximum recorded uranium concentration was 5.33 ± 0.25 μg/L (male, 75 years old, has prostate cancer) and the minimum concentration was 2.04 ± 0.07 μg/L (female, 7 years old, has leukemia cancer). While the mean value of uranium concentration for the healthy group was 2.80 ± 0.14 μg/L, with the maximum uranium concentration was 4.19 ± 0.23 μg/L (male, 73 years old) and the minimum concentration was 1.28 ± 0.07 μg/L (male, 7 years old). The results also showed a variation in uranium concentration according to gender, smoking status, and age. A gender comparison employed in the study showed that men had higher concentrations of uranium in them than female subjects and this may dawn from the difference in hormonal makeup of the body. While the smoking habit, it was found that persons who smokers, contained higher levels of uranium than those who does not smokers, demonstrating that smoking is the main route for uranium absorption. The finding indicated a significant of uranium excretion with age, which matches the predictions of theICRP (International Commission on Radiological Protection) uranium model. Based on these findings, it remains necessary for increasing targeted public health interventions, strictly monitoring the environment, and utilizing campaigns to avoid uranium exposure along with related complications in high-risk patient populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study aimed to examine the mental health issues and trauma faced by Iraqi IDPs post-2014. Adhering to PRISMA guidelines, we conducted a literature search in PubMed, Scopus, and Google Scholar, identifying 208 articles. After excluding 190 articles for duplication and ineligibility, we ultimately included 18 studies. The Joanna Briggs Institute critical evaluation checklist was used for quality assessment. Studies involved 5,764 participants from diverse ethno-religious groups including Arabs, Kurds, Christians, and Yazidis. Participants were mostly female (55.5%), male (38.4%), and the smallest and largest study samples were 29 and 1,256, respectively. Ages ranged from 12.18 to 43.34 years. The results revealed a high prevalence of PTSD at 61.9%, with depression and anxiety rates at 49% and 51%, respectively, and suicidal behaviours at 67.5%. Among IDP subgroups, PTSD and suicidal behaviours were particularly high among Yazidi-enslaved girls and women, at 90.6% and 67.55% respectively. Major trauma exposures included forced displacement, encounters with combat and violence, enslavement, and witnessing the death or abuse of relatives. Critical contributing factors to mental health problems were gender (being female), economic instability, prolonged displacement, exposure to combat, experiences of rape and torture, and limited access to services. The mental health support of this vulnerable population is critical.

Dactylobiotus parthenogeneticus is one of the widespread species of tardigrade all over the world. Tardigrades of this species were collected from the Greater Zab River in Erbil City-Iraq by filtering water of the river through a plankton net with a mesh of 45 µm pore. The samples were mounted on a slide with a cover slip and examined under the microscope to determine morphological characteristics and measurements. Based on these characters the species identified to be D. parthenogeneticus. To support this diagnosis, DNA barcoding techniques were applied to do molecular analysis and sequencing on the cytochrome oxidase subunit I (COI) gene. The sequence was subjected to the GenBank database of NCBI and recorded with the accession number PP140905. The result of the sequencing and molecular analysis of the cytochrome oxidase subunit I (COI) gene confirmed to be the same species diagnosed by relying upon morphological characters. This study represents one of the pioneer researches and documents on tardigrades and found D. parthenogeneticus for the first time in the Greater Zab River in Kurdistan, North of Iraq. Tardigrades play a magnificent role in different trophic levels and can be utilized as an indicator of ecosystem health.

Background and Objectives: Of the genes conferring resistance to carbapenems in Acinetobacter baumannii, the bla OXA-23 gene is the most widely found across the world. The gene carrying bla OXA-23 transposons in A. baumannii isolates of global clones GC1 and GC2 is found worldwide. Here, we examined whether transposons play a role in the dissemination of the bla OXA-23 in globally distributed clones, GC1 and GC2 A. baumannii isolates from Iraq., Materials and Methods: The 119 non-repetitive A. baumannii isolates including 94 recovered from clinical specimens and 25 isolates from hospital environment between September 2021 and April 2022 from different medical centers located at various regions in Baghdad, Iraq. The global clones (GC) and the genes encoding carbapenem resistance, including bla OXA-23 , bla OXA-24 , and bla OXA-58 were identified using multiplex PCR assays. Antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion susceptibility method. The transposons carrying bla OXA-23 were examined using PCR mapping. In cases when carbapenem susceptible A. baumannii isolates were found, they were subjected to E test, full length sequencing of bla OXA-Ab (bla OXA-51-like ) and Institut Pasteur multi-locus sequence typing scheme., Results: All but two isolates (92 clinical and 25 environmental) were identified carbapenem-resistant A. baumannii (CRAB). Of 117 CRAB isolates, 20 belong to GC1, 19 contained bla OXA-23 ; of them, 17 isolates harbored the bla OXA-23 located on Tn2006. Among the 46 CRAB belonging to GC2, 39 contained bla OXA-23 ; of them, 34 carried the bla OXA-23 located on Tn2006. The remaining GC1 and GC2 isolates, one GC1 as well as one GC2 isolate, were susceptible to imipenem, doripenem, and meropenem and considered carbapenem-susceptible A. baumannii (CSAB). Full-length sequencing of the bla OXA-Ab and MLST for the two CSAB isolates belonging to GC1 and GC2 confirmed that the GC1 isolate belongs to ST 623 and contained an allele that encodes an bla OXA-69 variant of the bla OXA-Ab while the GC2 belong to ST2 and carried an bla OXA-66 variant., Conclusion: This study provides evidence for the dissemination of bla OXA-23 on the Tn2006 in CRAB isolates in Baghdad, Iraq. It appears that this transposon is widespread in GC1 and 2 isolates as in the other parts of the world. Interestingly, one GC1 and one GC2 isolate from Iraq were found to be susceptible to carbapenem while the isolates belonging to GC1 and GC2 have so far rarely been found to be susceptible to carbapenem globally., (© 2024. The Author(s).)

Background: The history of conflicts in the Middle East has resulted in a high burden of complications from conflict-related wounds like posttraumatic osteomyelitis (PTO). This is particularly challenging to manage in settings like Mosul, Iraq and Gaza, Palestine, where healthcare systems are weakened. In nonconflict settings, PTO caused by Pseudomonas aeruginosa (PAPTO) can lead to >20% of treatment failures. We aim to describe the clinical characteristics, outcomes, and management, in PAPTO patients admitted to Médecins Sans Frontières (MSF) facilities in Mosul and Gaza between 1 April 2018 and 31 January 2022., Methods: We conducted a retrospective cohort study on patients with PAPTO diagnosed with culture of intraoperative bone biopsy, using routinely collected data., Results: Among 66 PAPTO episodes from 61 enrolled patients, 37.9% had a multidrug-resistant Pseudomonas aeruginosa , with higher antibiotic resistance in Gaza. Polymicrobial infections were prevalent (74.2%), mainly involving Staphylococcus aureus (74.1%), being predominantly methicillin-resistant (95.0%). Overall, 81.7% received appropriate antibiotic treatment, with monotherapy used in 60.6% of episodes and a median treatment duration of 45.5 days. Recurrence was observed in 24.6% of episodes within a median of 195 days (interquartile range, 64-440 days). No significant differences were found in recurrence rates based on the type of antibiotic treatment (mono- or dual therapy) or episode (mono- or polymicrobial)., Conclusions: Management of PAPTO in the conflict-affected, low-resource settings of Mosul and Gaza achieved a recurrence rate aligned with global reports through appropriate and targeted antibiotic use, primarily in monotherapy, provided over a mean treatment duration of 45.5 days., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

A part two of Accipitridae Family members that belong to three genera: Circus, Gyps, and Neophron were documented as morphometrics, distribution ranges, and conservation status were reviewed and comprehensively discussed. A total of 29 voucher specimens belong to six species which are conserved in the "Iraq Natural History Research Center and Museum INHM" as follow: Marsh Harrier Circus aeruginosus (Linnaeus, 1758), Hen Harrier Circus cyaneus (Linnaeus, 1766), Montagus Harrier Circus pygargus (Linnaeus, 1758), Pallid Harrier Circus macrourus (Gmelin, 1770), Egyptian vulture Neophron percnopterus (Linnaeus, 1758), and Griffon vulture Gyps fulfus (Hablitz, 1783). The results revealed significant criteria about near threatened NT species IUCN and Birdlife International listed as Pallid Harrier Circus macrourus, and Endangered (EN) species as Egyptian vulture Neophron percnopterus globally decreasing population trend.

Background Long-term forms of depression, especially chronic and episodic, make it very hard for any individual to maintain a steady job or develop in his/her workplace, which reduces the ability to gain financial security. The purpose of this study is to investigate and thoroughly examine the impact of long-term depression on career trajectories and job stability using a methodical evaluation of the literature supplemented with case studies. Methodology This study combined a systematic review of available literature with a detailed case series analysis. The literature search was conducted systematically in three major databases, namely, PubMed, PsycINFO, and Scopus. The systematic review synthesized findings from studies that assessed the relationship between chronic and episodic long-term depression and employment-related outcome measures, i.e., job stability, upward career mobility, and socioeconomic status. The studies published between 2000 and 2024 were included and qualified. The case series contributed qualitative depth using eight personal experiences illustrating how the use of self-workplace dynamics interacted with depressive symptoms to shape employment. Results The systematic review provided consistent evidence that depression negatively influences employment status, such as decreased income and an increased rate of unemployment and disability claims. The current investigation included 29 studies, which were chosen after a rigorous screening process that included identifying 10,651 records and removing irrelevant or duplicate entries. The case series underlined further that it is the role of support executed by the workplace and societal stigma that mitigates or exaggerates these outcomes. In cases, people whose careers were disrupted by depression (job loss, low productivity, and long-term financial pressure) evidenced a huge change. Conclusions The effects of chronic and episodic long-term depression interfered with employment and socioeconomic well-being and, in fact, expanded beyond the individual to affect larger societal factors. Healthcare providers should collaborate with employers to ensure affected individuals receive appropriate accommodations in the workplace along with responses to mental health concerns. Further, policymakers should create inclusive policy environments to address the demands of people concerning job security and access to mental health related to depression. In addition, they should promote anti-stigma campaigns targeted at the reduction of societal and workplace discrimination against mental health issues., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Iraqi Board for Medical Specializations issued approval NA. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alshammaa et al.)

Objective: The objective of this study is to analyze oxidative stress markers Total Oxidant Status (TOS) and total Antioxidant Status (TAS), assess antioxidant levels (vitamin C, E), and evaluate co-factor element profiles zinc (Zn), copper (Cu), iron (Fe) in the serum of Iraqi gastric cancer patients. By elucidating these relationships, the research aims to enhance knowledge on oxidative stress, dietary factors, and potential therapeutic approaches for managing nutritional imbalances in this cohort., Methods: The study included 60 gastric cancer patients and 60 matched controls. Blood samples were collected and serum was extracted for analysis of TOS, TAS, Vitamin C, Vitamin E, copper, zinc, and iron levels. Measurements were conducted using spectrophotometry and ELISA kits from various companies. Statistical analysis was performed with IBM SPSS 25.0, presenting results as means ± SD, and differences between groups were assessed via independent samples t-test at p < 0.05 and p ≤ 0.01., Results: The study results indicated statistically significant differences between gastric cancer patients and controls in various biomarkers, with all comparisons showing p-values less than 0.001. This suggests strong evidence for the observed differences between the two groups in (TOS), (TAS), vitamins C and E, Cu, Zn, and  Fe levels. These relationships underscore the intricate connections among biomarkers in gastric cancer pathophysiology., Conclusion: The study underscores the intricate relationship between oxidative stress, antioxidant depletion, and micronutrient imbalances in gastric cancer. These findings offer valuable insights into the disease's pathophysiology, indicating potential diagnostic biomarkers. Further research is warranted to unravel underlying mechanisms and explore clinical applications for early gastric cancer diagnosis.

Objective: This study investigated the cytotoxic effects of Stenotrophomonas maltophilia on normal human cells., Methods: Seven isolates of S. maltophilia were obtained from 120 urine samples collected from prostate and bladder cancer patients, with diagnoses confirmed via Vitek. The cytotoxicity of these bacterial isolates was assessed on normal human fibrocyte cells (NHF) using various concentrations of bacterial filtrate (3.125, 6.25, 12.5, 25, 50, and 100 μg/ml)., Results: The bacterial filtrate exhibited significant toxicity to NHF cells, with the highest cell death rate of 68% and the lowest optical density (OD) of 0.25 at a concentration of 100 μg/ml. The IC50 value, indicating the concentration at which 50% inhibition of cell viability occurred, was determined to be 49.35 μg/ml. Further research is necessary to explore the potential role of these bacterial isolates in promoting cancer through inflammation., Conclusion: The clinical isolates of S. maltophilia demonstrated substantial cytotoxic activity against normal human fibrocyte cells, leading to a notable reduction in both cell number and optical density, with the highest percentage of cell death observed. These findings suggest the need for further investigation into the specific toxins or enzymes involved, which could pave the way for future studies.

Objective: To compare the modulation complexity scores across treatment sites, and to examine their connection with monitor unit, segment number and global and local gamma passing percentage., Methods: The cross-sectional study was conducted at the Baghdad Centre for Radiation Therapy and Nuclear Medicine, Baghdad Medical City, Baghdad, Iraq, from May 2021 to February 2022. Included were 34 patients, with the age range between 20 - 50 years, subjected to intensity-modulated radiation therapy for head and neck tumours in group A or pelvic tumours in group B. Treatment planning was done using Monaco 5.1, and radiotherapy was done using Synergy linear accelerator. Modulation complexity scores were calculated using MATLAB 2019a. Data was analysed using SPSS 24., Results: Of the 34 patients, 22(64.7%) were in group A; 12(54.5%) males and 10(45.5%) females. There were 12(35.3%) patients in group B; 8(66.7%) females and 4(33.3%) males. The number of segments was greater in group B than group A. A modest positive linear association was seen in group A, demonstrating that an increase in segment numbers resulted in a rise in modulation complexity score (R2=0.0244). Group B tumours had inverse negative linear correlation (R2=0.0189). As the complexity of plans increased in group A, local gamma passing percentage decreased (R2=0.0452). Group B showed a slight negative connection with modulation complexity score (R2=0.0622)., Conclusions: The modulation complexity score may be used to provide a simple prediction for pre-treatment verification, and it may also serve as a simple quality assurance tool for intensity-modulated radiation therapy plans.

Objective: To assess the frequency and causes of parental lumbar puncture refusal for their children., Methods: The cross-sectional study was conducted at the Central Child Teaching Hospital, Baghdad, Iraq, from October 1, 2021, to April 1, 2022, and comprised children aged at least >1 month at the emergency department who had been advised to undergo lumbar puncture. Data from the mother of the child was collected using an interviewbased questionnaire, exploring. demographic characteristics, the cause of lumbar puncture refusal, as well as knowledge of the advantages and risks of lumbar puncture. Data was analysed using SPSS 26., Results: There were 128 children with a mean age of 3.9±2.1 years (range: 1-120 months). The parents of 18(14%) patients refused the procedure, and the most frequent reason was fear of paralysis 12(67%). Refusal was significantly associated with mother's age, parents' levels of education, and parents' knowledge of the risks of lumbar puncture (p<0.05)., Conclusions: Raising public awareness and parents' educational level regarding the necessity and safety of lumbar puncture procedure is vital to decrease the refusal rate and ensure a better health outcome.

Objective: To assess gingival pigmentation prevalence among students, and its relationship with anti-inflammatory salivary interleukin-10., Method: The observational, cross-sectional, comparative study was conducted at the College of Physical Education and Sport Sciences, Diyala University, Iraq, from December 2021 to March 2022, and comprised students of either gender aged 19-22 years. Students with pigmented gingiva were in group A, while those having no gingival pigmentation were in group B. The level of interleukin-10 was tested using enzyme-linked immunosorbent assay in both groups, and values were compared using the gingival pigmentation index. Data was analysed using SPSS 22., Results: Of the 1,295 students assessed, 1,044(80.62%) were males and 251(19.38%) were females. Pigmented gingiva was found in 118(9.11%), and these students represented group A, while as many subjects were enrolled in controlled group B. Pigmented gingiva was more common among males 81(68.64%) than females 37(31.36%). Salivary interleukin-10 level was significantly increased in group A compared to group B (p<0.05). However, there were no significant differences in mean value of salivary interlukin-10 with respect to severity in group A (p>0.05)., Conclusions: Pigmentation was beneficial in terms of gingival protection.

Objective: To evaluate the ratio of interleukin18 and interleukin18 binding protein in type 2 diabetes mellitus patients, and its relation with the presence of interleukin18-607C/A and interleukin18-137G/C gene polymorphisms and the type of complications., Methods: The case-control study was conducted at the endocrinology clinic of the Madinat Al-Imamin Al-Kazemin Teaching Hospital, Iraq, from September 2020 to July 2021, and comprised diagnosed patients of type 2 diabetes mellitus, and healthy controls matched for age and gender. Blood samples were obtained that were processed for serum separation. Serum interleukin18 and interleukin18 binding protein levels were assessed, and part of the sample was used for deoxyribonucleic acid extraction using tetra-primer amplification refractory mutation system polymerase chain reaction with four specific primers for interleukin18-607C/A and interleukin-18-137G/C gene polymorphisms in both the groups. Data was analysed using SPSS 20., Results: Of the 168 subjects, 86(51.2%) were patients; 67(77.9%) females and 19(22.1%) males with mean age 52±8.97 years. There were 82(48.8%) controls; 56(68.3%) females and 26(31.7%) males with mean age 48±9.44 years (p>0.05). Higher serum level of interleukin18 and lower level of interleukin18 binding protein were seen in type 2 diabetes mellitus group compared to the controls (p<0.001). Interleukin18-137G/C and interleukin18-607C/A mutant alleles had odd ratios 3.52 (confidence interval: 1.91- 6.63) and 3.25 (confidence interval: 1.77-5.83), respectively, as risk factors for the occurrence of type 2 diabetes mellitus. There was an association of interleukin18- 137G/C homozygous mutant genotype with the occurrence of retinopathy among type 2 diabetes mellitus patients (p=0.046), but risk allele C was not associated with retinopathy (p>0.05)., Conclusions: The presence of interleukin18-137G/C and interleukin18-607C/A gene polymorphism might be considered a risk factor for type 2 diabetes mellitus.

Objective: To assess the level of knowledge among family physicians regarding prediabetes., Methods: The cross-sectional study was conducted from March 1 to June 30, 2020, at primary healthcare centers in Al-Karkh and Al-Rusafa health directorates of Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad. The sample comprised family physicians of either gender. Data was collected using an pre-designed, structured questionnaire that was disseminated online. Data was collected using SPSS 25., Results: Of the 145 questionnaires distributed, 113(78%) were returned duly filled; 99(87.6%) females and 14(12.4%) males. The overall mean age was 34.21±5.8 years (range: 26-49 years), The knowledge level was good in 60(53.1%) cases, and 59(52.2%) suggested screening programmes as a preventive measure. Good level of knowledge was significantly associated with having diabetes or family member with diabetes 44(51.7%), attending training courses 37(44.1%) and professional experience >10 years 15(25%)., Conclusions: More than half the respondents had a good level of knowledge about prediabetes. There is a need to improve the knowledge of physicians further about prediabetes.

Given the importance of cement as a basic material in construction, this study was undertaken to evaluate the level of radioactivity in a selected group of cement samples most used in construction to determine whether they are safe for human health. In this investigative study, nine samples of cement, both domestic and imported, that are often used in construction projects in Iraq were gathered. A NaI (Tl) gamma-ray spectrometer (3"x3") was used to measure the radioactivity in the samples. The average specific activity levels in the tested cement samples were 11.373±0.522, 5.795 ± 0.230, and 179.123±2.207 Bq/Kg, respectively. Also calculated was the average of the radium, which was equivalent to 33.449±1.022 Bq/kg. As for the risk indicators, the internal risk coefficient was 0.121±0.004 and external risk coefficient was 0.090 ±0.002. While studying the radiation doses, the values of effective annual internal dose was 0.080 mSv/y, external dose rates were 0.020 mSv/y, absorbed dose ratio was 16.321±0.476 nGy/h, and gamma index was 0.253±0.007. In the end, and depending on what was studied from various variables, with an average of 115.59 Sv/y, the annual gonadal equivalent dose risk (AGED) was calculated. The world average values were used to compare all the results. Finally, it was discovered that the radiation parameter levels of none of the samples had a detrimental effect on human health.

Objective: To evaluate radioactivity levels in soil samples and their physical impact on the population., Methods: The experimental radiation study was conducted by researchers belonging to the Kufa University in Al- Najaf, Iraq, in August 2020, and comprised soil samples from Al-Rahma area. Sodium iodide detector activated with a trace amount of Thallium with crystal dimensions 3" x 3" was used to calculate the concentration of Radium, Thorium and Potassium., Results: Among the 15 samples collected, the average ± standard deviation (SD) concentration for Radium, Thorium and Potassium was 0.1776±0.12, 0.726±0.435 and 1.9128±1.105%, respectively. The reported value of excess lifetime cancer risk was 1.2819×10-3., Conclusions: The area studied was found to be a safe area and did not pose a health threat to the locals.

Objective: To assess the use of haemoglobin and white blood cell count together in predicting the normality of other complete blood count parameters and blood film., Methods: The prospective study was conducted from August to November 2021 at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, and comprised adult individuals of either gender who were advised blood test by physicians in the outpatient department. Patients with normal haemoglobin and white blood cell counts were placed in group A, while those with abnormal counts of the two parameters were placed in group B. Examination of blood smears morphology was done in both groups. Data was analysed using SPSS 26., Results: Of the 200 subjects, 100(50%) were in group A; 58(58%) males and 42(42%) females with mean age 51.09±18.8 years. There were 100(50%) subjects in group B; 52(52%) males and 48(48%) females with mean age 47.58±15.5 years (p>0.05). In group A, 70(70%) cases showed normal complete blood count parameters and abnormal morphology of 1+ grading in 13(13%). The results were significantly different than group B (p<0.05)., Conclusions: Normal haemoglobin and white blood cell count was found to a good marker for the normality of other complete blood count parameters.

Objective: To assess parental knowledge about their children's congenital heart disease using a newly-designed scale., Methods: The cross-sectional study was conducted from June 2020 to May 2021, at Alkhansaa maternity and child hospital, Mosul Iraq; after approval from the ethics review committee of Ninevah Medical College, Ninevah University, Iraq, and comprised parents with children having congenital heart disease. Data, including age, gender, type of congenital heart disease as well as parents' educational and socioeconomic levels, residence, internet use and knowledge of the disease with respect to type, burden, bacterial endocarditis, outcome, etc. was noted. Parental knowledge levels were measured using a self-designed scoring scale, having a total score of 18 and 4 categories; <6 = some knowledge, 7-12 = good knowledge, 13-17 = very good knowledge, and 18 = full knowledge. Data was analysed using SPSS 26., Results: There were 364 children with mean age 83.72±47.4 months and a male-female ratio of 0.98. The mean age at diagnosis was 12.1±8.32 months. The overall mean parental knowledge level was 8.41± 3.88, with 126(34.6%) parents having some knowledge, 178(48.9%) having good, 58(16%) having very good, and 2(0.5%) having full knowledge about their children's health condition (p<0.001) There was a significant association of parental knowledge with educational level, socioeconomic status and the type of doctor caring for the child (p<0.05). The duration of the illness showed a significant correlation with knowledge level (p=0.021)., Conclusions: Heart Defects, Congenital, Endocarditis, Bacterial, Social Class.

Objective: To determine whether tocilizumab improved outcomes of patients hospitalised with severe coronavirus disease-2019 cytokine storm syndrome., Methods: The case-control study was conducted at Al-Yarmouk Teaching Hospital, Baghdad, and Al Shatra General Hospital, Thi Qar, Iraq, from September 2020 to March 2021, and comprised patients with severe acquired respiratory syndrome-corona virus-2 pneumonia who were not candidates for mechanical ventilation and received a single-dose intravenous infusion of tocilizumab 8mg/kg in group A. The outcomes were compared with patients in group B who received only standard care. Data was analysed using SPSS 26., Results: Of the 60 patients, 30(50%) were in group A; 22(73.3%) males and 8(26.7%) females with mean age 56.63±10.92 years. There were 30(50%) patients in control group B; 24(80%) males and 6(20%) females with mean age 54.8±6.18 (p>0.05). Group A showed significant changes compared to group B in the levels of interleukin-6, serum ferritin, D-dimer, procalcitonin, lymphocytes count and oxygen saturation (p<0.05). Mortality rate was not significantly different between the groups (p>0.05)., Conclusions: Majority of the acute phase inflammatory markers were reduced significantly by treatment with tocilizumab.

Objective: To explore the association among cutaneous silent period, sympathetic skin response and heart rate variability in diabetes patients., Methods: The case-control study was conducted at the Department of Physiology, College of Medicine, Al- Mustansiriyah University, Baghdad, Iraq, from November 1, 2020, to May 20, 2021, and comprised 24 healthy controls in Group I and 49 patients of type 2 diabetes in Group II who were recruited from the neuroelectrophysiological unit of Al-Imamain Al-Kadhmean Teaching Hospital, Baghdad, Iraq. Both groups were subjected to cutaneous silent period, sympathetic skin response and heart rate variability testing. Data was analysed using SPSS 24., Results: Of the 73 subjects, 24(32.9%) were in Group I and 49(67.1%) were in Group II. Cutaneous silent period mean latency values were significantly increased in Group II compared to Group I (p<0.05), and a negative sympathetic skin response in the right lower limb was significantly different between the groups (p<0.001). There was no significant correlation between Cutaneous silent period and sympathetic skin response values (p>0.05). Heart rate variability was significantly increased in diabetic patients with negative sympathetic skin response compared to those with positive sympathetic skin response (p<0.05)., Conclusions: Simultaneous measurement of cutaneous silent period, sympathetic skin response and heart rate variability should be done as there were no strong correlation among the tests in diabetic patients.

Objective: To evaluate the effect of central obesity indices in healthy females on cardiac autonomic activity, using heart rate variability as an index reflecting the cardiac autonomic balance., Methods: The cross-sectional study was conducted at the Department of Physiology, College of Medicine, Mustansiriyah University, Baghdad, Iraq, from September 2020 to April 2021, and comprised adult healthy women having a regular menstrual cycle who were not consumers of tobacco, alcohol or any medication. Waist circumference, waist-hip ratio, waist-height ratio and lipid accumulation product measurements were noted for each subject. Repeated blood pressure and heart rate measurements were taken on the brachial artery of the right arm until stable values were achieved. Heart rate variability was based on electrocardiogram data related to R-R interval. Data was analysed using GraphPad InStat version 3.06., Results: There were 53 women with mean age 37.4±10.5 years. Low-frequency power normalised units at the highest two quintiles of waist circumference was significantly higher than the lowest two quintiles (p<0.03), and significantly and positively correlated with waist-hip ratio (p<0.02) and waist-height ratio (p<0.05). At the highest two quintiles of lipid accumulation product, low-frequency power normalised units value was significantly higher than at the lowest two quintiles (p<0.02)., Conclusions: Increased waist circumference, waist-height ratio, waist-hip ratio and lipid accumulation product values were significantly associated with high sympathetic tone.

Objective: To assess the role of inflammatory markers ferritin and C- reactive protein as indicators of preeclampsia severity., Methods: The case-control study was conducted at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from November 2021 to May 2022, and comprised pregnant women from the obstetrics ward and outpatient clinics aged 16-40 years having a viable singleton pregnancy and gestational age >32 weeks. They were divided into severe preeclampsia group A, non-severe preeclampsia group B and control group C. Serum ferritin and C-reactive protein levels were measured for all the subjects, and compared. Data was analysed using SPSS 26., Results: Of the 87 pregnant women, 27(31%) were in group A with mean age 29.76±7.53 years and mean gestational age 35.63±1.92 weeks, 29(33.33%) were in group B with mean age 26.83±6.30 years and mean gestational age 36.24±1.72 weeks, and 31(35.63%) were in group C with mean age 26.00±5.73 years and mean gestational age 36.52±1.61 weeks. Ferritin levels in patient groups were significantly higher than in the control group (p<0.05), but it was not significantly different between the patient groups (p>0.05). C-reactive protein levels in the patient groups were significantly higher than in the control group (p<0.05), and they were also significantly higher in group A than in group B (p<0.05). At a cut-off value >101.8 ferritin had sensitivity 92.59% but specificity 20.69%, whereas C- reactive protein at a cut-off value >17.1 had sensitivity 66.67% but specificity 75.86%., Conclusions: Serum C- reactive protein level was significantly associated with severity of preeclampsia with an acceptable grade of discriminative ability between severe preeclampsia and non-severe preeclampsia patients.

Objective: To evaluate the workplace health-related environment of workers in various job categories at a cement factory., Methods: The cross-sectional study was conducted at the Kufa Cement Factory, Najaf, Iraq, from November 12, 2021, to January 12, 2022 and comprised adult male non-smoking factory workers in group A, and healthy, unexposed non-smokers in control group B. Subjects in group A were subdivided into factory, kiln and packing workers. All the participants were subjected to blood tests for liver and kidney functions. Data was analysed using SPSS 27., Results: Of the 90 subjects, 45(50%) were each of the 2 groups. The mean age of group A workers was 46.581±1.559 years and they had a mean duration of exposure 15.953±0.873 years. There were 15(33.3%) factory workers and as many kiln and packing workers. Group A subjects worked for at least 7-8 hours per day. The subjects in control group B had a mean age of 45.01±8.17 years and were matched for gender. There was significant elevation in total leukocyte count, alkaline phosphatase, aspartate aminotransferase and alanine aminotransferase in group A compared to group B (p<0.05). Neutrophils were significantly high in factory workers than controls and packing workers (p<0.05), while total bilirubin level was significantly high in factory and kiln workers than controls (p<0.05). There was no significant difference in the mean serum creatinine level between the groups (p>0.05)., Conclusions: Workplace exposure to cement particulate in a factory environment was found to have a harmful impact on health.

Objective: To assess the structure as well as availability of essential equipment and medicine at emergency departments in Baghdad hospitals., Method: The descriptive, cross-sectional study was conducted from March to June 2021 after approval from the ethics review committee pf the College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised emergency departments of general and teaching hospitals in the city. Evaluations were done using the World Health Organisation checklist and the guidelines of the Australasian College for Emergency Medicine related to Emergency Department Design., Results: Of the 26 secondary care hospitals in Baghdad, 13(50%) were evaluated. Triage was not available in 8(62%) hospitals, resuscitation room in 10(77%) and waiting room in all the 13(100%). An obvious shortage of medicines and vaccines was noted in 11(85%) hospitals. Coronary care unit and intensive care unit were not close to the emergency department in 7(54%) hospitals, and liaison psychiatry and social work links were not available in all 13(100%) hospitals., Conclusions: There is a need to improve service delivery at emergency departments functioning at hospitals in Baghdad.

Aim: To assess the role of serum micro ribonucleic acids 323-3p, 517a and 519d in the diagnosis of ectopic pregnancy., Methods: The case-control study was conducted at the Gynaecology Department of Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from June 1, 2020, to May 1, 2021, and comprised women with ectopic pregnancy in group A, and those with a viable intrauterine pregnancy in group B. Serum samples were taken for beta human chorionic gonadotropin measurement and for micro ribonucleic acids 323-3p, 517a and 519d testing using polymerase chain reaction. Data was analysed using SPSS 24., Results: Of the 100 women with mean age 26.8±5.29 years, 50(50%) were in each of the 2 groups. There was no significant difference between the groups in terms of age, gravida, parity, abortion, and gestational age (p>0.05). The mean beta human chorionic gonadotropin in group B was significantly greater than group A (p=0.001). In group A, micro ribonucleic acid 323-3p expression was significantly higher, mean micro ribonucleic acid 517a expression was significantly lower and mean micro ribonucleic acid 519d expression was significantly lower compared to group B (p<0.05). At micro ribonucleic acid 323-3p cut-off point 2.415, the test accurately distinguished between ectopic and viable pregnancy with 92% sensitivity, 100% specificity and total area under the curve 0.994 (p=0.001)., Conclusions: Serum micro ribonucleic acid 323-3p, 517a and 519d might be helpful biomarkers in the diagnosis and follow-up of patients with ectopic pregnancy.

Objective: To detect the gene of entamoeba histolytica by polymerase chain reaction and investigate the expression of immunogene entamoeba histolytica calreticulin in stool samples of infected patients., Methods: The case control study was conducted at Central Teaching Hospital of Paediatrics and Al Mahmoudia General Hospital, Iraq, from December 30, 2020, to September 1, 2021, and comprised diarrhoeal faecal samples collected from 86 children with age ranging from ˂1 year to 13 years who were suspected of having been infected with entamoeba histolytica. Microscopically positive samples were then subjected to conventional and real-time polymerase chain reaction for the detection of entamoeba histolytica HM1:IMSS strain using Phage shock protein (Psp) gene sequences and detection of entamoeba histolytica calreticulin expression., Results: Of the 86 patients, 71(82.6%) were found to be infected with entamoeba histolytica; 39(54.93%) boys and 32(45.07%) girls. The remaining 15(17.4%) patients were taken as non-amoebic controls; 8(53.3%) boys and 7(46.7%) girls. There were 36(50.70%) cases and 8(53.33%) controls aged 1-4 years. Among the Entamoeba histolytica gene was detected in 44(62%) of the cases using conventional polymerase chain reaction, and immunogene entamoeba histolytica calreticulin was expressed in 36(50.7%) using real-time polymerase chain reaction. Data was analysed using SPSS 24., Conclusions: Polymerase chain reaction was found to be a useful tool for diagnosing entamoeba histolytica infection in children.

Objective: To assess the frequency of early discontinuation of Implanon as a method of contraception., Methods: The cohort prospective study was conducted at the Obstetrics and Gynaecology Department, Al-Yarmouk Teaching Hospital, Baghdad, Iraq from January 2017 to January 2021, after approval from the ethics review committee of the College of Medicine, Al-Mustansiriyha University, Bghadad, Iraq, and comprised women of childbearing age seeking long-acting contraception. The participants received Implanon, an etonorgestril implant, under local anaesthesia, and were followed up for 12 months for possible side effects. Data was analysed using SPSS 26., Results: There were 115 women with mean age 29.8±6 years (range: 15-44 years) and mean body mass index 27±4.9 kg/m2. Early discontinuation of the plant was done by 32(27.8%) subjects, and the overall incidence of early Implanon removal per 1,000 women per month was 14.47 (95% confidence interval: 10.24-20.47). Lower body mass index, dizziness and insertion-site side effects were the potential determinants of early discontinuation (p<0.05)., Conclusions: More than a quarter of the sample opted for early Implanon discontinuation. Low body mass index, dizziness and insertion-site side effects were potential determinants of early removal.

Objective: To explore the association of nuclear factor-kappa B1 polymorphism in the promotor area of the gene with hepatitis C virus infection outcomes., Methods: The case-control study was conducted at the Hepatology and Gastroenterology Teaching Hospital, Baghdad, Iraq, from Dec 1, 2020, to Aug 30, 2021, and comprised individuals ages 20-68 years. Group 1 had patients with persistent hepatitis C virus infection, group 2 had subjects with spontaneous hepatitis C virus clearance, group 3 had subjects treated with direct-acting antiviral drugs, and group 4 had healthy controls. Venous blood was collected for polymorphism genetic analysis of nuclear factor-kappa B1 insertion/deletion ATTG (Adenine-Thymine- Thymine-Guanine) at rs28362491 using a high-resolution melting technique. Data was analysed using SPSS 27., Results: Of the 88 subjects, there were 22(25%) in each of the 4 groups. Overall, there were 55(62.5%) females and 33(37.5%) males, and 40(45.45%) were aged 20-39 years while 48(54.54%) were aged 40-68 years (p>0.05). The Ins allele of rs28362491 was significantly more frequent in the patients than in controls (p=0.0053). The carriage of rs28362491 insertion/insertion and insertion/deletion genotypes, compared to wild-type homozygous deletion/deletion, had a significantly higher risk of developing hepatitis C virus infection (p=0.0013). No association was found between rs28362491 and spontaneous hepatitis C virus clearance (p>0.05)., Conclusions: The insertion allele of rs28362491 was found to be associated with increased susceptibility to developing hepatitis C virus infection.

In this study, mycoparasitic fungus was identified by using the rDNA internal transcribed spacer barcode marker, i.e. ITS rDNA gene. Amplicons were sequenced and identified by NCBI - BLAST (Basic local alignment search tool). The BLAST results revealed that NOOR strain matched 100% with accession numbers [MH854754.1]. The phylogenetic tree shows close relationship between NOOR strain and H. chrysospermus [MH854754-1], H. chrysospermus [MZ389105-1], H. chrysospermus [MK605327- 1], H. chrysospermus [MT595227-1], H. [EU816370-1], H. chrysospermus [MG685885-1]. The Iraqi isolate was recorded as NOOR strain in the National Centre for Biotechnology Information for the first time in Iraq.

The main sources of natural background radiation are radon, thoron and their progeny, which may cause health risks to humans. Keeping in mind the importance of the subject, three samples each from 10 selected residential areas, including the centre of Babylon Governorate, Iraq, and its districts, were collected. Concentration of radon and thoron was measured using solid-state track detectors (CR-39). The arithmetic means of the concentration of radon and thoron were 47.367±19.56 and 133.246±16.585 Bqm-3, respectively; these values are considered safe when compared with the upper reference level of 200-600 Bqm-3 recommended by the International Commission for Radiological Protection (ICRP). The value of the inhalation equivalent dose from radon gas discovered in these areas with rate 37.893 nSv is less than the value of the global average of 1.15 mSv. This indicates that the risks related to inhalation of radon are low as the lung dose rate (DLung), tracheobronchial region (DT-B), annual effective dose (AED) and excess lifetime cancer risk (ELCR) is (1.894 nGyh-1, 22.736 nSv, 0.236 mSvy-1 and 0.835 x10-3), respectively. While the value of the inhalation equivalent dose (IED) from thoron as effective dose to lung DLung, AED and ELCR are equal to (0.133 nSv, 0.167 mSvy-1 and 0.587 x 10-3), respectively. To conclude, the rates in the study area are less than the ICRP recommended level of 3 mSv; therefore, the studied areas are safe from the health risks of inhalation of radon and thoron.

Objective: To evaluate the age and gender influence on the quality of life of patients with a dental implant., Methods: The cross-sectional study was conducted from February to April 2022 at Al-Mammon Specialised Dental Centre in the Al-Karkh sector of Baghdad, Iraq, and comprised healthy adult subjects of either gender who had dental implant treatment in the preceding 2 years and their dental implant was in place for at least 6 months. . Data was collected using the Oral Health Impact Profile Questionnaire to measure oral health quality of life. Data was analysed using SPSS 22., Results: Of the 103 subjects, 55(53.4%) were females and 48(46.6%) were males. There were 41(39.81%) subjects aged 18-37 years, 42(40.78%) aged 37-56 years and 20(19.42%) aged 57-74 years. Of the total, 50(48.5%) subjects had moderate health quality, followed by 26(25.24%) low and 27(26.21%) high. There was a significant association of age and gender on the quality of life (p<0.05)., Conclusions: Age and gender were found to be important factors influencing the quality of life of dental implant patients.

The study aims to estimate precisely the different levels of mental loop and foramina in the Mosul population of Nineveh governorate in Iraq. It is a cross-sectional study of a previously saved database in the cone-beam computed tomography device. The study sample was 357 patients selected randomly from the database of patients at the Oral Radiology Unit at the Maxillofacial Department in Al-Salam Teaching Hospital. The study variables are mental foramen (MF) position, shape, radiograph appearance, and mental loop presence and direction. The results show that the age group from 19 to 30 years shows the highest percentage (40.1%). Females show more than half of the cases (59.7%). The MF position's highest percentage is shown in 2 areas with the slight differences. These are the long axis of first premolar and the area between first premolar and second premolar (42.6%, 40.9). According to shape variation round shapes are the uppermost percent (53.8%). More than 60% of cases (66.1%) show continuity with the inferior alveolar canal and 50% show no loop presence, and the mental nerve leaves the foramen in a perpendicular direction. In conclusion localization of the MF, nerve, and its loop precisely in both horizontal and vertical directions, both hard and soft tissues in a continuous view. Before arranging any surgical procedure, anatomic markers are crucial. To reduce the danger of harm to the foramen region, the authors thus advised cone-beam computed tomography before scheduling implant surgery, particularly in the mental region of the jaw., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Scavenger receptor type B (SR-BI) is a receptor that binds both native and altered lipoproteins. It was revealed to facilitate utilization of high-density lipoprotein HDL and significantly affect the reverse transport of cholesterol. Therefore, the objectives were to identify the possible role of the genetic variant rs4238001 in patients with myocardial infarction (MI) on serum lipid level, and how this variant could impact the response of rosuvastatin drug. The genotyping of the rs4238001 genetic polymorphism of the SR-B1 gene was performed in 300 participants, including 150 MI patients treated with 20mg/day/4 weeks of rosuvastatin and 150 healthy control using Taq man probes (FAM and VIC) by Real-time PCR technique. The concentrations of the lipid profile were evaluated. The significance of the anthropometric data was revealed in the ejection fraction and smoking status (p < 0.05) between groups. The lipid profile shows either significant differences between control and MI patients (pre-treatment) or between pre-and post-treatment of MI patients (p < 0.05), but not HDL-c (p > 0.05). The minor allele frequency MAF% of the T allele and TT genotype were more frequent in MI patients than in controls (P = 0.173; OR = 3.62; 95% CI = 0.74-17.64). CC genotype was found to be associated with response to rosuvastatin therapy with a change of % (29.08 ± 53.2; p = 0.021). In the Iraqi population, the rs4238001 polymorphism of the SR-B1 gene is associated with variations in serum lipids, and the CC genotype of the SNP is related to higher HDL-C in the lipid-lowering rosuvastatin response., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The goal of this study is to measure the uranium concentration levels in the blood of Iraqi workers employed in certain government companies. Assessing the initial level of uranium toxicity in their blood and the possibility of health problems occurring. 184 blood samples from Iraqi government companies and the control group were collected in this study. A solid-state nuclear track detector (CR-39) was used to measure the amount of uranium present. Two drops of blood (100 μl) were placed on CR-39. The CR-39 was irradiated with a thermal neutron using the fission-track technique ( 241 Am- 9 Be) to determine the uranium concentration in blood samples. The statistical analysis is carried out using the Origin Lab 2024 version. The results show the average of uranium concentration at all locations has a higher level compared to the control group. The blood samples from workers at the phosphate company had the highest amount (1.021 ± 0.050 μg/l), compared to samples from other factories. This result confirms that there is a connection between the concentration of uranium and phosphate substances. The results suggest that there is a slight increase in uranium levels that is related to both age and years of employment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Cerebral arteriovenous malformations (AVMs) can lead to significant morbidity and are particularly challenging to manage in resource-limited settings where endovascular treatment modalities are unaffordable for most patients., Objective: To describe the first case series of AVM from Iraq with an analysis of the related clinicoradiologic characteristics, operative features, and outcomes., Methods: A single-center database from October 2018 to December 2022 was reviewed to analyze the characteristics of cerebral AVMs who underwent surgical treatment in Baghdad, Iraq. We collected patient demographics, clinical, radiologic, operative, and the follow-up combined outcome results (modified Rankin Scale score and the presence of AVM remnants)., Results: Of the 54 AVM patients treated with microsurgery, the majority of lesions have Spetzler-Martin grade of 3 (31.5%), followed by grade 1 (29.6%). The parietal lobe was the most common location of AVM in 25.9% of the cases, and the temporal location had better outcomes. The mean duration of surgery was 8.5 hours, ranging from 3 to 14 hours, with 20.3% of cases having undergone preoperative stereotactic radiosurgery, and just one patient received preoperative embolization. Good combined outcome (modified Rankin Scale 0-2 and no AVM remnant) was associated with lower SM grades (P=0.003); location in the nondominant hemisphere (P=0.036), and noneloquent regions (P=0.006); absence of deep venous drainage (P=0.042) and no intraoperative brain swelling (P=0.004). The mortality rate in our series was 5.5%., Conclusions: Good clinicoradiologic outcomes can be achieved through microsurgery in a setting where endovascular treatment is inaccessible to patients due to limited resources., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Baby foods contain these toxic heavy metals which occur naturally or from pollution in the environment. The purpose of this research is to investigate the concentration of heavy metals in the biscuit samples that are commonly used in Iraq as food babies. The concentrations of three metals viz zinc (Zn), lead (Pb), and cadmium (Cd) are measured using atomic absorption spectroscopy (Buck Scientific/USA, 210 VGA). Health risk parameters such as Estimated Daily Intake (EDI), Target Hazard Quotients (THQ), Hazard Index (HI), and Carcinogenic Risk (CR), are determined. The average values of the concentrations of Zn, Pb, and Cd in these samples of biscuits are 0.584 ± 0.099 mg/kg, 0.066 ± 0.008 mg/kg, and 0.205 ± 0.011 mg/kg, respectively, while the average values of HI and CR × 10 -6 for all samples are 0.768 ± 0.040 and 1.94 ± 0.25, respectively. On the basis of comparing these elements, the study finds that the average value of Zn is dominating with the highest concentration, followed by Cd, and Pb. This is relied on the statistical examination that revealed a weak correlation and no significance (p > 0.05) in the amounts of these heavy metals in all samples. The concentrations of Cd, in seven samples, are relatively higher than their permissible limits according to FAO/WHO (0.2 mg/kg). Conversely, the concentrations of Zn and Pb are lower than their permissible limits which was 9.4 mg/kg and 0.3 mg/kg, respectively. The values of health risk parameters for Zn, Pb, and Cd for all samples do not surpass their permissible intake limits according to FAO/WHO, Therefore, it is concluded that the overall estimated healthy risk, due to the heavy metals, is safe since it is within the permissible limits; thus, there are no concerns for a baby who consume biscuit consistently daily., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and aim Echocardiography plays a pivotal role in the preoperative risk assessment of patients undergoing various surgical procedures. Therefore, we conducted this study to detect various cardiac abnormalities through a preoperative echocardiographic study for cases undergoing elective surgeries in Duhok, Iraqi Kurdistan. Methods This cross-sectional study assessed echocardiographic findings in preoperative patients at Azadi Teaching Hospital, Duhok, Kurdistan Region of Iraq, from 2023 to 2024. The study encompasses 468 adult patients. We gathered clinicodemographic characteristics, indications of referral to a preoperative echo study, and the echocardiographic findings, particularly regional wall motion abnormalities, valvular heart diseases, and heart failure (systolic or diastolic/left ventricular hypertrophy). Results In a cohort of 468 patients, 205 (43.80%) were aged 35-54 years, and 269 (57.48%) were female. Most patients (366; 78.21%) resided in Duhok. Nearly only half of the cases 219 (46.79%) had clear preoperative echostudy indications. A total of 289 (61.74%) had no remarkable echocardiographic findings. Diastolic heart failure was most prevalent at 65 (13.89%). Older cases had more prevalent echo findings in terms of valve dysfunctions and heart failure. Notable associations were found between echocardiographic abnormalities and surgical types, particularly higher regional wall motion abnormalities in genito-urinary system operations (4; 8.16%) and valvular heart disease in orthopedic surgeries (13; 15.85%). Conclusions Echocardiographic abnormalities were remarkably observed in patients aged 65 and older. Many cases had no clear indications for preoperative echo study and hence unremarkable echo findings. More scrutiny is indicated during referral, and focusing on older adults' preoperative cardiac screening is recommended., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. TThe Ethics and Scientific Committee of the Iraqi Kurdistan Higher Council of Medical Specialization issued approval 777. The study protocol was formally approved by the Ethics and Scientific Committee of the Iraqi Kurdistan Higher Council of Medical Specialization on 17th March 2022 with reference number (777). Written informed consent was obtained from all patients upon enrollment. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mohammad et al.)

Purpose: Stroke poses significant challenges to affected individuals, their families, and healthcare systems, with adherence to medications being a pivotal determinant of health outcomes. In this study, we aim to evaluate the medication adherence of stroke patients living in Iraq, and explore how patients' demographic and clinical details relate to their adherence levels. Furthermore, we seek to assess the self-care practices used by stroke patients and their adherence to them., Patients and Methods: We carried out a cross-sectional correlational study conducted from November 2022 to April 2023, stroke patients diagnosed in seven hospitals across Baghdad and Al-Mothanna governorate were recruited, with diagnoses confirmed by physicians and senior neurologists using MRI and/or CT scans. Patients' adherence to medications, demographic data, clinical characteristics, and self-care activities were analyzed using descriptive statistics and regression analyses., Results: Of the 200 participants, mean age was 58.27 years, with males constituting 53.5%. About 40.5% had a hemorrhagic stroke, and 59.5% an ischemic stroke. The mean adherence score was 13.36 (SD= 4.658) out of a possible 28. Factors significantly correlated with medication adherence included age, monthly income, time since having a stroke, and education level. Adherence was also significantly linked to having diabetes mellitus or high blood pressure. The assessment of participants' self-care activities and medication adherence revealed that responses to questions about healthcare habits varied, with "None" being the most common response for most items. Notably, we found no significant association between adherence and factors such as gender, marital status, living place, and smoking status., Conclusion: Medication adherence remains suboptimal among stroke patients in Iraq. Various demographic and clinical factors play a role in influencing adherence. The conformity to medication regimens and factors associated with it among individuals who have suffered a stroke in Iraq is vital., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Basheti et al.)

Background: Mental health conditions cause a huge burden on individuals and healthcare systems. According to the World Health Organization, around 970 million individuals worldwide had a mental disorder in 2019., Aim/question: To explore the attitudes towards mental health conditions among the Iraqi community and determine factors influencing such attitudes., Methods: A cross-sectional survey was conducted on 1394 individuals of the Iraqi general population between December 2022 and February 2023 using a self-administered online questionnaire in Arabic, utilising convenience and snowball sampling. The data were analysed using R Statistical Software., Results: In total, 763 (54.73%) individuals had positive attitudes towards mental health conditions. The multivariate regression analysis revealed the males and age group of 46 years, and more were significantly associated with negative attitudes (p = 0.001, p = 0.045 respectively)., Discussion: Individuals with mental health conditions experience stigmatising attitudes as in the Middle East jeopardising their treatment and recovery. This is the first study to address the Iraqi population's attitudes towards mental health conditions indicating overall positive attitudes., Implications for Practice: Health promotions must be conducted by educators, healthcare workers and universities to dispel the myths. Future studies with extensive sampling will help clarify the obscurity of mental health conditions in Iraq., (© 2024 John Wiley & Sons Ltd.)

Objectives . This study aims to determine the prevalence of hemophilia in Thi-Qar, Iraq and study clinical and demographic characteristics of patients with hemophilia. Methods . In this cross-sectional study, data were obtained by reviewing all patient medical records and interviewed with the patients and their parents in 2022. The total number of patients enrolled for this study was 110 children. Results . The prevalence of hemophilia in Thi-Qar was 9.5/100 000 population (18.7/100 000 males). Factor VIII inhibitors were positive in 13.1% of patients with hemophilia A (HA). Target joints were developed among 41.4% and 27.3% of patients with HA and hemophilia B, respectively. Hepatitis C virus was positive in 3% of those with HA. Inhibitors development and arthropathy were more among those with severe disease (22% and 46.3%, respectively). Conclusion . Hemophilia prevalence in Thi-Qar was higher than the total prevalence in Iraq reported by World Federation of Hemophilia in 2022., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Ichthyosis Prematurity Syndrome (IPS) is a rare autosomal recessive disorder characterized by premature birth, respiratory distress, and distinctive skin abnormalities. Infants with IPS typically present between 30 and 34 weeks of gestation with a thick, caseous, desquamating epidermis resembling vernix caseosa. We report a case of a female neonate born at 30 weeks, weighing 1400 grams, with severe respiratory distress and characteristic skin abnormalities. Immediate intervention, including mechanical ventilation and surfactant therapy, was essential. Histopathological examination revealed hyperkeratosis, parakeratosis, and a thickened stratum corneum, with genetic testing confirming FATP4 gene mutations. Comprehensive care by a multidisciplinary team, including CPAP, emollients, and enteral feeding, led to significant improvement, and the neonate was discharged after 4 weeks. This is the first reported case of IPS in Iraq. This case highlights the importance of early recognition, genetic testing, and a coordinated care approach for managing IPS, emphasizing the need for awareness of its characteristic features to improve patient outcomes., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background: Breast and esophageal cancer are the most aggressive and prominent causes of death worldwide. In addition, these cancers showed resistance to current chemotherapy regimens with limited success rates and fatal outcomes. Recently many studies reported the significant cytotoxic effects of phenolic and terpene fractions extracted from various Prunus species against different cancer cell lines. As a result, it has a good chance to be tested as a complement or replacement for standard chemotherapies. Methods: The study aimed to evaluate the cytotoxicity of phenolic and terpene fractions extracted from Iraqi Prunus arabica on breast (AMJ13) and esophageal (SK-GT-4) cancer cell lines by using the MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide). Analysis using the Chou-Talalay method was performed to assess the synergistic effect between the extracted fractions and chemotherapeutic agent (docetaxel). Moreover, high-performance liquid chromatography (HPLC) analysis was conducted for the quantitative determination of different bioactive molecules of both phenolic and terpene fractions in the extract. Results: According to the findings, the treatment modalities significantly decreased cancer cell viability of AMJ13 and SK-GT-4 and had insignificant cytotoxicity on the normal cells (normal human fibroblast cell line) (all less than 50% cytotoxicity). Analysis with Chou-Talalay showed a strong synergism with docetaxel on both cancer cell lines (higher cytotoxicity even in low concentrations) and failed to induce cytotoxicity on the normal cells. Important flavonoid glycosides and terpenoids were detected by HPLC, in particularly, ferulic acid, catechin, chlorogenic acid, β-sitosterol, and campesterol. Conclusions: In conclusion, the extracted fractions selectively inhibited the proliferation of both cancer cell lines and showed minimal cytotoxicity on normal cells. These fractions could be naturally derived drugs for treating breast and esophageal cancers., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Mahmood MA et al.)

Background: Pharmacists are healthcare professionals who frequently encounter individuals struggling with addiction in their day-to-day practice. Studies critique pharmacists' competence in the detection, prevention, and management of substance use disorder., Objective: This study aimed to get in-depth information about the perception, experience, and practice of Iraqi pharmacists towards substance use disorder., Methods: A qualitative-study was performed through face-to-face individual-based interviews with community pharmacists in Baghdad/Iraq. Interviews were conducted from July 2023 till the saturation point (September 2023). Data analyzed by thematic-analysis approach., Results: Interviews were conducted with 21 pharmacists. Most participants reported that substance use disorder is common among young males. Pregabalin is the most commonly requested drug. Availability, euphoric-effect, and low cost are the main reasons for favoring a drug by persons with substance use disorder. Moreover, poverty and social problems are the main reasons for substance use disorder. Drug intoxication signs are the main clues in recognizing substance use disorder. Most participants refuse dispensing drugs without prescription and reported that the barriers for implementing regulations on drugs with high potential for dependence are related to the limited follow-up to pharmacists, presence of outsiders, and fear from reactions of persons with substance use disorder. Pharmaceutical services to persons with substance use disorder were performed by few pharmacists and limited to patient education about the risks of misusing drugs. Most participants reported that enhancing pharmacists' competence in substance use disorder is necessary., Conclusion: Substance use disorder is common among young Iraqi males. Pregabalin is a commonly requested drug. The current Iraqi regulations are not sufficient to prevent substance use disorder. Pharmaceutical services to persons with substance use disorder are weak and limited to patient education. Enhancing pharmacists' knowledge through educational courses is necessary to improve their role in facing substance use disorder., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)