AMJ (Advanced Medical Journal)

Prevalence of Primary Dysmenorrhea and its Relationship with Body Mass Index

Ahang Omar Rasheed, Chro Najmaddin Fattah — Mon, 02 Jun 2025 00:00:00 +0000

Background: Dysmenorrhea, or painful menstruation, is a major gynaecology condition that occurs each month. Primary dysmenorrhea is episodes of menstrual pain without a cause.

Objectives: The study investigates the prevalence of primary dysmenorrhea and whether body mass index affects primary dysmenorrhea.

Method: The study is a cross-sectional study conducted in medical schools of the University of Sulaimani of Iraq among 302 young female students aging between 18-25 years old, single or without any past obstetrical history. The study had begun in August 2022 till August 2023. The study was done using a Pretested dysmenorrhea questionnaire to be filled out by participants, based on body mass index (BMI) categorized into four groups (underweight, normal weight, overweight and obese). participants were also categorized into mild, moderate, and severe dysmenorrheic groups based on numeric pain relating scale.

Results: the one-year prevalence of primary dysmenorrhea was found to be 80.5%, meant that majority suffered from primary dysmenorrhea However, there was no significant correlation between their body mass index and the severity of the pain (p-value=0.16), number of patients who were underweight and had severe pain were only 15 cases, and those who were classified as obese and complained of severe pain were only 3 in numbers. the mean age in the majority of the volunteers (66.9%) were ranging between 21-24 years. 79.8% of the female participants had normal BMI while only 2.3% had BMI>30.

Conclusion: While dysmenorrhea is one of the common gynecological problems and highly prevalent among female medical students that adversely affects daily routine and social life, it is not related to the body mass index of the female; most of them not seeking medical help therefore they need education and counseling to determine the exact cause and method to cope with it.

Evaluation of Surface Detail Reproduction of Alginate Impression Material Incorporated with Different Ratios of Sodium Hypochlorite

Bayan Yousif Taher, Fhad Sudad Ikram — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Alginate impression material considered widely used material for primary registration of oral tissue because it is accurate and simple to use. The objective of this study is to evaluate the antimicrobial efficacy of varying ratios of sodium hypochlorite as disinfection solution for alginate against Gram+ve streptococcus microorganisms and to measure the surface detail reproduction of alginate after disinfection.

Methods: This experimental study was carried out in Hawler Medical University, Erbil College of Dentistry from December 15, 2022, to September 1,2023.40 samples of alginate were prepared, ten samples for each tested ratio (1%,3%,5%) of sodium hypochlorite and ten samples for distilled water as control group using stainless steel dies made in accordance with American Dental Association Specifications No. 18. The surface detail was evaluated after the alginate setting. Besides, three samples of each percentage were assessed for antimicrobial activity.

Results: The samples of 1%, 3% sodium hypochlorite groups showed Owens score 1 for recording of 75 ?m and 50 ?m lines with no significant difference with control group. However, for line 20 ?m recorded mean score 2 for 1%, 3% samples which is considered significant according ADA 18 specifications. By raising the sodium hypochlorite ratios, the number of colonies decreased from 6% to 0% in terms of antibacterial activity.

Conclusions: Surface detail reproduction were not dramatically impacted when sodium hypochlorite was added to the alginate as a disinfect. While they have a clear impact on the alginate impression's control group.

Prevalence of Amblyopia in Hawler Eye Teaching Hospital

Lamyaa Jasim Abbas, Ahmed Ismail Abdulgani, Goran Mohammed Abdulla — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Amblyopia is defined as impairment of vision in the absence of ocular pathology that could be unilateral the most common or bilateral less common. This study aimed to settle the prevalence and causes of amblyopia in Hawler Eye Teaching Hospital in Erbil City, Iraq. For the age between 6-12 years.

Methods: A cross-sectional study of 300 students are included in this study, in Hawler Eye Teaching Hospital from the 1^stof October 2022 to 1^st of April 2023. History and Clinical examination of anterior and posterior segment for all children are done. Autorefraction and visual acuity with E-letter LED smart visual system with monocular unaided trial and then aided trial for best corrected visual acuity children with less than 6/6 cyclopentolate eye drop 1% used for cycloplegic refraction.

Results: The prevalence of amblyopia was (25.3%) of the total sample (n=300). The most prevalent causes of amblyopia were refractive error (96.05%), and strabismus (23.7%). Males were more affected by amblyopia with (60.53%) while females affected with amblyopia were (39.5%) with no statistically significant difference in gender with amblyopia (P 0.916).The age more frequently had amblyopia was seven and eight (18.4%), (18.4%) respectively, the different age groups had no statistically significant difference in amblyopic patients (P 0.377).

Conclusion: The prevalence of amblyopia among children between 6-12 years in Hawler Eye Teaching Hospital was high. This needs school screening tests with a qualified medical team, and increase parents' awareness about the necessity of regular vision checking for children with amblyopia for better results.

Bishop Score in Induction of Labor in Unfavorable Cervix and Success of Labor

Hawzhin Othman Rashid, Rozhan Yassin Khalil — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: The ripeness of the cervix has a potential impact on the successful of labor induction; however, an unfavorable or unripe cervix hinders the labor induction process. Thus, we aimed to determine the relationship between Bishop score and the success of labor induction in the unfavorable cervix.

Methods: This cross-sectional prospective study was conducted on 100 pregnant women with an unfavorable cervix and a Bishop score <5 at Sulaimani Maternity Teaching Hospital, Sulaimaniyah, Iraq, from May 2022 to May 2023. The women's primary and clinical data were reported. Various medications at various doses and routes were used for labor induction. Then, correlations between variables and different maternal factors were found.

Results: Most women (55%) were aged 20-30 years, multipara (59%), urban (61%), literate (92%) and had gestational age of 40-41 weeks (89%) with O+ blood group (41%). Additionally, most women (40%) received a combination of misoprostol and pitocin for labor induction and had a normal vaginal delivery (73%), with a 100% alive baby born. Moreover, the score of labor induction were significantly higher (p?0.05) in normal vaginal delivery than in caesarian delivery. Finally, the parity was significantly (p=0.002), and the bishop score was highly significantly (p<0.001) associated with the success of labor.

Conclusions: A combination therapy resulted in the most successful labor induction and most vaginal delivery. Parity was related to successful labor induction, while maternal age did not. Increased bishop score is directly related to normal vaginal delivery.

Knowledge, Attitudes, and Practices About Biomedical Waste Management among Healthcare Workers in Erbil Teaching Hospitals.

Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Biomedical waste must be handled and disposed of properly to prevent several detrimental impacts on the populations it serves. The study assesses healthcare workers' knowledge, attitudes, and practices on biomedical waste management in Erbil's teaching hospitals.

Methods: A hospital-based cross-sectional study was conducted between October 1^st, 2022, and September 30^th, 2023. This research was conducted at the teaching hospitals in Erbil. Healthcare workers, including physicians, pharmacists, nurses, laboratory technicians, and sanitary staff, were included in this study. Knowledge, attitude, and practice about biomedical waste management were investigated.

Results: A total of 530 participants were included in the study. 55.7% were female, 24.3% were physicians, and 45.7% were nurses. 45.8% of participants had medium knowledge of biomedical waste management, while 33% had poor knowledge. 60.9% had a positive attitude about biomedical waste management. About 41% of the study participants had bad practices in biomedical waste management, 40.6% had medium, and 18% had good practices. There was a significant statistical association between knowledge and attitude levels among healthcare workers, their degree of practice, and gender. P value = 0.000, 0.000, and 0.000, respectively. >15 years of experience were better practiced (p-value = 0.05).

Conclusion: The results of our study showed significant associations between knowledge and attitude toward their practice, gender, and health workers' attendance at biomedical waste management training courses.

Association Between Cholesterol and Low-Density Lipoprotein Levels with In-Hospital Complications of Percutaneous Coronary Intervention

Hemn Jamal Jamil, Amanj Abubakir Xaznadar — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Percutaneous coronary intervention is the treatment of choice for revascularization in patients with coronary artery disease. The aim of the study is to investigate the relationship between cholesterol and low-density lipoprotein levels and percutaneous coronary intervention complications.

Methods: This prospective cohort study was conducted at Suleimani Cardiac Hospital from April to October 2023. The study included 115 patients who had acute coronary syndrome and underwent percutaneous coronary intervention within 72 hours of the symptoms. Venous blood samples were drawn from all patients; the basic investigation and lipid profile were measured. The patients were monitored in the ward for complications from percutaneous coronary intervention.

Results: The mean age of the participants was 60.90 years (SD = 11.27), 64.3% of the participants were male, and the mean body mass index of the participants was 28.37 (SD = 4.18). Seventy-six percent of the participants had a past medical history; hypertension was the most common (26.1%). Forty-six percent of participants were not using any medications, and 49.6% of the participants were nonsmokers. There were no statistically significant differences in the incidence of in-hospital complications of percutaneous coronary intervention or hospital stay duration among patients with different total cholesterol and low-density lipoprotein levels, as all p values are above 0.05.

Conclusion: There was no relationship between baseline total cholesterol and low-density lipoprotein levels and in-hospital complications of percutaneous coronary intervention.

Prevalence and Risk Factors of COVID-19 among Health Care Workers in Rizgary Teaching Hospital in Erbil City/Iraq

Naren Najat Ahmed Sultan, Samir Mahmood Othman — Mon, 02 Jun 2025 00:00:00 +0000

Background and objective: The global disease COVID-19 is spreading quickly, according to the World Health Organization. Treating a significant number of patients puts healthcare workers globally at high risk of contracting COVID-19. This study aims to determine the prevalence of COVID-19 infections among healthcare workers and explores associated risk factors.

Methods: A cross-sectional study was conducted among healthcare workers at Rizgary Teaching Hospital in Erbil City from September 2022 to September 2023. A sample of 500 participants was selected by systematic random sampling method. A well-designed questionnaire was used to collect information on the prevalence of COVID-19 by dedicating a question in the questionnaire asking if they got COVID-19 infection or not and if yes what was the method they used for diagnosis confirmation, such as PCR testing, blood tests, symptomatic assessment, or radiological examinations as well as identify the risk factors associated with COVID-19 infection in healthcare workers.

Results: The study showed that out of 500 participants, 48.2% were males and 51.8% were females, with a male-to-female ratio of 1.0:1.07. The prevalence of COVID-19 infection was found to be 69.4%. The occurrence of COVID-19 infections was highest among obese, married healthcare workers, and older age groups (p value:0.001). The majority of healthcare workers had received the COVID-19 vaccine.

Conclusions: The prevalence of COVID-19 infection was high among healthcare workers, especially among those with comorbidities. One of the crucial matters is planning for protective strategies that should be handled during the epidemic of COVID-19 or any other infectious diseases among healthcare workers.

Post-Insertion Complications and Outcomes of Complete Denture

Lava Mohammed Sdiq Darwesh, Kawan Salahadeen Othman — Mon, 02 Jun 2025 00:00:00 +0000

Background and objective: The objectives of this study are to identify common complications in complete dentures and to determine the relationships of age and sex with post-insertion complications. In addition, the correlations between post-insertion time and common complication type after the insertion of complete dentures were explored in this study.

Methods: This descriptive cross-sectional study was conducted at the Shorsh Dental Teaching Centre located in Sulaimani, Iraq. Data collection started from mid of September 2022 to August of 2023, sixty patients aged 40 years and above wearing complete dentures were selected as respondents. A questionnaire survey was executed to assess the presence of pain, retention, speech, and mastication problems at four-time intervals. The data were analysed using a chi-square test and a p-value of < 0.05 was considered statistically significant.

Results: The results of post-insertion complications in terms of pain, retention, aesthetics, and speech issues were documented as follows: On Day 1, 40%, 42%, 7%, and 5% of the respondents suffered the respective complications. On Day 3, 67%, 57%, 7%, and 7% of the respondents reported experiencing the listed issues. After a week, 48%, 53%, 5%, and 5% continuously encountered the respective complications. After a month, those who faced the respective issues were 3%, 37%, 3%, and 8%. A significant relationship was found between the complications and durations as p < 0.05.

Conclusion: The most common post-insertion complaints included pain, loss of retention, speech, and aesthetic issues, in that order.

Characteristic and Complication Patterns of Polycythaemia Vera: A Single Centre Experience

Rebin Mustafa Othman , Ali Ibrahim Mohammed — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: In addition to being at risk for thrombosis and disease progression, patients with polycythemia vera frequently have a wide variety of clinical, demographic and laboratory presentations which vary according to the geographical area and ethnic groups. This study aimed at defining these variations in our locality and comparing it to other international studies.

Methods: This cross-sectional study was carried out from January 2022 to January 2023 at Hiwa Cancer Hospital, Sulaymaniyah City, with a total of 200 adult cases of already diagnosed and registered cases of polycythemia vera according to the 2016 WHO criteria. The overview of demographic profiles: the age distribution, gender prevalence, laboratory characteristics, and complications patterns of these cases were studied.

Results: From the total of 200 cases, 118 (59%) were males and 82 (41%) of them were females, the mean age (60.4 ± 12.4) year, with a range of (25–88), 47 (23.5%) patients were having complications, either thrombosis 19 (40.4%), acute myeloid leukemia progression, 8 (4%), or myelofibrosis 20 (42.6%), and 153 (76.5%) of patients did not show any complication, 104 (52%) had splenomegaly. There were significant associations between development of complications and certain parameters like: age, disease duration, leukocyte count, platelets, and hemoglobin levels, in a concordance way i.e., the higher the value of these parameters, the higher the risk of developing complications.

Conclusions: distinctive patterns of these parameters were identified in our locality and correlated to other geographical areas. Our findings showed the significance of understanding different patterns of patient characteristics andcomplications of polycythemia vera in different regions.

Different Treatment Modalities for Cesarean Scar Pregnancies in Sulaimani Maternity Teaching Hospital

Shadia Ahmed Faydhulla, Srwa Jamal Murad, Chro Najmadeen Fattah — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Cesarean scar ectopic pregnancy is one of the most severe complications of cesarean delivery. Thus, we aimed to evaluate the cesarean scar ectopic pregnancy and treatment modalities.

Methods: A cross-sectional study was conducted on 30 cesarean scar ectopic pregnant women who attended the Sulaimani Maternity Teaching Hospital, from May 2022 to May 2023. The cesarean scar ectopic pregnancy among studied women was diagnosed with ultrasound, and then a validated questionnaire was used to collect their sociodemographic and clinical data. Blood samples were collected to estimate the Beta-Human Chorionic Gonadotrophin hormone level.

Results: Most women (83.3%) were aged 20-40 years, overweight (46.7%), had bleeding (56.7%), endogenous scar (83.3%), and two caesarean section histories (33%). Moreover, most women (60%) had surgical treatment, and had a Beta-Human Chorionic Gonadotrophin level of >10,000 mIU/mL. The fetal heart rate was negative in most women (77.78%) who needed surgical treatments, while it was positive in 58.33% of women who required systemic methotrexate with suction curettage (p=0.044). Furthermore, most patients in both groups (83.33%) had endogenous scars (p=1.0). Bleeding was the most prevalent complaint in both groups (p=0.369). Suction curettage was the most practiced modality in a group of surgical therapy (55.56%), while systemic methotrexate with suction curettage was the most practiced in another treatment modality group (58.33%).

Conclusions: Surgery alone or combination therapy are effective and safe treatment methods for cesarean scar ectopic pregnancy that were not affected by maternal sociodemographic and clinical features.

Outcomes of Dog Bite Injuries Presenting to the Emergency Department in Erbil, Iraq

Hawree Khairullah Qader, Rebaz Tahir Lak, Karwan Yasin Mohammed — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Incidences of dog bites persist as a significant public health and clinical challenge, creating a burden on healthcare resources. The purpose of this study was to investigate the patterns and effects of dog bites.

Methodology:This study was a descriptive cross-sectional analysis conducted using data obtained from emergency departments within government hospitals in Erbil city, namely Rojhalat Emergency Department, Rozhawa Emergency department. The data collection utilized a consecutive sampling method and was carried out from April 1, 2023, to September 1, 2023. Data regarding time of occurrence of bite, type of dog, severity of the wound and vaccination were collected. Patient follow up was done to assess the outcome of each patient.

Results: The majority of dog bitten cases were adults 55 (55%). Male patients accounted for 80% of the cases, with most incidents occurring in urban areas 51 (51%). Most cases were classified as category 2 bites (62%), with timing often between noon and evening (41%). Only 35% received the accurate Anti-rabies dose, and merely 45% completed the full vaccination course. Among those not vaccinated, 12% cited vaccine unavailability at the hospital. Upon follow-up, 95% of cases showed no complications, while approximately 3% presented severe injuries(p>0.05).

Conclusions: The majority of cases were males in urban areas. Treatment mainly comprised anti-rabies medication and antibiotics, yet the accurate anti-rabies dose was received by only a third of patients, and less than half completed the full vaccination course, partly due to vaccine unavailability.

Impact of Type II Diabetes Mellitus on Left Ventricular Longitudinal Strain in Patients with Structurally Normal Heart

Vahel Lutfalla Sadraddin, Mudhafar Abdulrahman Habib, Rafid Fayadh Al-Aqeedi — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Type-2 Diabetes Mellitus is a widespread metabolic disorder linked to multiple cardiovascular complications, particularly left ventricular dysfunction, even in preserved left ventricular ejection fraction. Speckle tracking echocardiography has become a sensitive means to evaluate myocardial mechanics, particularly global strain. This study aimed to examine the influence of type 2 Diabetes Mellitus on left ventricular global strain in individuals with structurally normal heart.

Methods: A comprehensive cross-sectional investigation was carried out on 118 diabetic patients who showed no symptoms of coronary artery disease and were admitted to Surgical specialty hospital, Erbil Cardiac Center, between January 1st to April 1st, 2023. The global longitudinal strain of the left ventricle that was present in the patient population selected was assessed using strain echocardiography.

Results: The study population was 55 (46.6%) male and 63 (53.4%) female, with a mean age of 54.8+-9.57 years, the mean HbA1c of all Diabetic participants were 8.08+-1.6.weak and statistically significant negative correlation was found between global longitudinal strain The number of patients with normal GLS and reduced GLS should be mentioned in results with the duration of diabetes mellitus and HbA1c values with a p-value of (r=-020, P=0.032) and (r=-0.20, P=0.048) respectively. Oppositely a weakly positive correlation was found between global longitudinal strain and mitral annual plane systolic excursion diameters with a significant P value (r=0.26, P =<0.004).

Conclusion: Left ventricular global longitudinal strain using speckle tracking echocardiography has a significant negative correlation with the duration of diabetes.

Tongue lesions and anomalies among patients attending outpatient clinic in Sulaymaniyah city

Kanyaw Abubakr Omar, Shanaz Mohammed Gaphor — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: The tongue is an essential muscular organ used for speech, mastication, deglutition and sucking, it had an influence on face development, and dental occlusion. The aim of this study was to determine the prevalence of tongue lesions and anomalies among patients attending outpatient of Peramerd dental health center in Sulaymaniyah city.

Methods: This cross-sectional study was conducted on 400 patients randomly who visited Peramered dental health center between December 2022; to May 2023. The tongue was examined for abnormalities in size, shape, mobility, lesions, and surface changes. When clinical features were not diagnostic, a biopsy was conducted.

Results: The study sample included 225 females (56.3%) and 175 males (43.8%), the prevalence of tongue lesions with no significant depending on sex distribution (p-value = 0.14). In the current study most of the patients are aged 50 years and above ranged (22.3%), and the tongue lesions significant with old age (p <0.001). There were 212 individuals with one or more tongue disorders, with a prevalence of tongue lesions of (53%). Fissured tongue was the most frequent condition, detected in 101 individuals (25.3%). Hypertension and diabetes mellitus were determined to be the two most prevalent systemic disorders.

Conclusion: The current study revealed a significant frequency of tongue lesions among older patients, more in males, and higher in smoking and systemic diseases. The more prevalent tongue lesions were fissure tongue and coated tongue, while lipoma, pyogenic granuloma, and strawberry tongue were at the least frequent.

D-Dimer Plasma Levels in Each Trimester of Diabetic Pregnant Women, A Case Control Study

Kanar Sadraddin Shamsaddin, Shahla Kareem Alalaf — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Pregnancy increases D-dimer levels, making it a non-specific test for venous thromboembolism. This study compared D-dimer levels by trimester in healthy and diabetic pregnant women.

Methods: A case-controlled study was conducted from May 2022 to August 2023 at Gestational Diabetes Clinic/Maternity Teaching Hospital, Erbil City, Kurdistan Region, Iraq to compare D-dimer levels between two groups: 360 pregnant women diagnosed with diabetes (cases) and 360 normoglycemic pregnant women (controls). Blood samples were obtained once from each participant during a prenatal visit. Samples were collected from a vein and analyzed using a latex-based immunofluorescence assay on a Biozek DCR1000 machine to measure D-dimer concentration.

Results: D-dimer levels steadily increased throughout pregnancy in both groups, peaking in the third trimester. Notably, pregnant women with diabetes consistently had significantly higher D-dimer levels compared to controls across all trimesters (p < 0.001). Within the diabetic group, women with type 1 diabetes displayed the highest mean D-dimer concentration (1887.3 ng/ml), significantly higher than both type 2 diabetes (1518.0 ng/ml; p = 0.036) and gestational diabetes (1155.8 ng/ml; p = 0.004).

Conclusions: This study highlights a substantial rise in D-dimer levels throughout pregnancy, even in healthy women. Importantly, pregnant women with diabetes have considerably higher D-dimer levels compared to controls, with the highest observed in type 1 diabetes. These findings emphasize the need to consider diabetes when interpreting D-dimer levels for venous thromboembolism diagnosis in pregnancy.

Serum gp91phox/NOX2 Level Among Patients with Subclinical Hypothyroidism, and Its Relation to Atherogenic Indices

Ekhlas Ali Sulaiman, Sherwan Ferman Salih, Dhia Mustafa Sulaiman — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Subclinical hypothyroidism is emphasized by a normal serum-free thyroxin4 concentration as well as an elevated thyroid stimulating hormone concentration, Gp91^phox, the catalytic key of nicotinamide-adenine-dinucleotide-phosphate-oxidase and predictor of its activation, has lately been examined as an indicator of systemic oxidative. The current study aimed to assess the level of serum gp91phox among patients with subclinical hypothyroidism.

Methods: The current case-control study included 160 participants: 80 newly diagnosed subclinical hypothyroidism patients were obtained from the Diabetic and Endocrinology Unit at Azadi Teaching Hospital, and 80 healthy individuals, lasted eight months from November 2022 to July 2023. Lipid profile and thyroid function tests have been done for. The serum soluble gp91phox level was compared between both groups.

Results: The mean serum gp91phox was higher among subclinical hypothyroidism cases (9.06 ± 4.80 ng/mL) than among healthy individuals (7.40 ±3.42 ng/mL). There was a statistically significant elevation of the mean of atherogenic-index of plasma in cases (0.39, p. value = 0.049) compared to the controls (0.30, p. value = 0.049), and the mean of Castelli Risk Index II in cases (2.18, p. value = 0.008) was significantly greater than that of the controls (1.86, p. value = 0.008) in subclinical hypothyroidism.

Conclusion: There was a significantly higher mean serum level of gp91^phox/NOX2 in patients with subclinical hypothyroidism.

Evaluation of Hematological Parameters Among Children with Autism in Duhok City

Noor Ramzi Habib, Muqdad Al-Mousawi, Nasir Al-Allawi — Mon, 02 Jun 2025 00:00:00 +0000

Background and objective: Western studies have linked autism with nutritional deficiencies, particularly those of iron and folate, while such studies are scarce from developing countries. We aimed to assess such deficiencies and their associated hematological abnormalities among Iraqi autistic children.

Methods: In this cross-sectional study 100 diagnosed autistic children, visiting the mental health center in Duhok, Iraq in the period (December 2022-June 2023) were recruited. The records of these patients were reviewed and they had blood counts, serum iron, total iron binding capacity, transferrin saturation, ferritin and folate assayed. Patients were labelled as iron deficient if they had serum ferritin<30 ug/L, and/or transferrin saturation<16%. They were further categorized as anemic or non-anemic based on their hemoglobin levels.

Results: Patients had a median age of 7 years (range 4-13), included 75% males, and 17% with severe autism. Iron deficiency anemia was documented in 1%, while non-anemic iron deficiency in 41%. Serum ferritin, transferrin saturation, and folate were significantly lower in severe cases (P<0.001, 0.007 and 0.035 respectively). Iron deficiency was significantly more frequent in the severe cases (P<0.001), and among preschool children (P=0.009).

Conclusion: Iron deficiency was frequently observed among autistic children, although it was latent in the large majority. Furthermore, iron deficiency and low serum folate were associated with more severe disease.

Oral manifestations of Chemotherapy-Induced Neutropenia in adult patients

Saya Salam Salih, Balkees Taha Graib, Nawshirwan Gafoor Rashid — Mon, 02 Jun 2025 00:00:00 +0000

Background and Objective: Cancer has become one of the most significant public health issues in recent years, of which chemotherapy is one of the most commonly used therapies. It has a high potential for precipitating oral mucosal damageby reducing absolute neutrophil counts and increasing the risk of life-threatening infections. The objective of this study was to evaluate the association between the incidence of oral complications and chemotherapy-induced neutropenia in adult patients.

Methods: This cross-sectional study, conducted at Hiwa Specialized Oncology Hospital in Sulaimani city from December 2022 to May 2023. The study enrolled 100 neutropenic cancer patients treated with chemotherapy. All participants were referred for routine complete blood count investigation, including white blood cells and neutrophils, to evaluate the neutropenic state of patients and calculate the absolute neutrophil count. The oral cavity was examined, and oral manifestations including any new lesions, mucosal changes, infections, and symptoms were recorded.

Results: Studied sample included (53%) males and (47%) females. The majority of patients were aged between 31 and 69 years. Acute leukemia was the most frequent type of cancer (36%). Oral ulcers, were the most frequent oral manifestation, detected in 52 patients and (21.31%) of all oral manifestations. There was a significant association between the absolute neutrophil count, and most of the oral manifestations among the participants (p-value< 0.022).

Conclusions: Oral manifestation observed in chemotherapy-treated cancer patients is directly associated with the level of neutrophil counts, especially oral ulcer, candidiasis, exfoliative cheilitis, and taste disturbance.

Newly Diagnosed Cases of Major Hemoglobinopathies (2016-2021) in Duhok: How Effective is The Premarital Preventive Program?

Israa Khaleel Isamil, Nasir Al-Allawi — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: The hemoglobinopathy preventive program in Duhok has been implemented since 2008. We aimed to assess the effectiveness of the program through its ability to reduce the number of newly diagnosed cases.

Methods: In this retrospective descriptive study, we reviewed newly diagnosed major hemoglobinopathy patients in the period between Jan. 2016 and Dec. 2021 in Duhok, Iraq. Parents of patients were interviewed regarding premarital screening, counseling, and prenatal diagnosis. For those missed by former screening, further testing was performed.

Results: A total of 160 newly diagnosed major hemoglobinopathies over the study timeframe were recorded, with a modest decline of these cases from 35 in 2016 to 21 in 2021. Of the 160 cases, 150 were available for assessment. The parents of 50 patients (33.3%) did premarital screening: 43 were identified to be at risk, but seven were missed. The parents of 100 patients (66.7%), however, did not do premarital screening. The most frequent reasons for not seeking prenatal diagnosis being unaware of availability/being too expensive (57.5%), or for religious/cultural beliefs (35.0%).

Conclusions: The modest reduction in the numbers of newly diagnosed major hemoglobinopathies, should be viewed in context, but is below the ultimate aims of the program. There is a need to tackle the challenges posed by couples marrying despite risk, or before the program was initiated, as well as the availability, religious, and legal aspects of prenatal diagnosis and termination of affected pregnancies to ensure a more favorable outcome of the program.

Hypoxia, Taste, and Smell Loss in Severe Hospitalized COVID-19 Patients in Correlation with HRCT Chest Involvement

Amanj Abubakr Jalal Khaznadar — Mon, 02 Jun 2025 00:00:00 +0000

Background & Objective: An infectious disease called coronavirus disease (COVID-19) is brought on by the SARS-CoV-2 virus. Most adult COVID-19 infections resulted in gustatory or olfactory impairment. The purpose of this research is to ascertain the frequency of taste and smell impairments in hospitalized COVID-19 patients.

Methods: This prospective cross-sectional study was carried out in the Dr. Hemn Teaching Hospital in Sulaimani, Iraq, from May 2021 to January 2022. This study included the selection and enrollment of 100 hospitalized COVID-19 patients (50 males and 50 females). We assessed if they have preserved ability to taste and smell as well as tested for O2 saturation level.

Results: A total of 100 patients who were enrolled in the study male 50%, and female 50 patients. The mean age was 54.5 ± 16.5 years. Ninety of the patients had significant COVID-19, according to their High-Resolution CT scan. Thirty patients experienced taste loss and forty-three patients claimed loss of smell. Although 23 patients have both taste and smell loss, they also have hypoxia. Severe hypoxia was established by about 25.7% of those with taste perception.Patients with smell and taste loss were more frequently found to have positive RT-PCR results, 41(95.3%) and 29(96.7%), respectively (p-value <0.001). High resolution CT-scan scan examination of the patients showed that 90 (90%) patients had the severe form of COVID-19.

Conclusion: The frequencies of taste and/or smell impairment were lower in severely hospitalized individuals. Moreover, the chemosensory deficits are less common in patients who experience acute hypoxia.

A Prospective Comparative Study in Successful Induction of Labour in Primigravida in Relation to their Body Mass Index

Revyan Emad Majeed, Chro Najmadeen Fattah — Mon, 02 Jun 2025 00:00:00 +0000

Background and objective: Induction of labour is considered when the benefits of prompt delivery outweigh the risk of expecting the natural onset of labour. Over recent decades, more pregnant women around the world have undergone induction of labour, especially those with high body mass index. Thus, this study aimed to determine the success rate of induction of labour in primigravida women in relation to their body mass index.

Methods: This prospective cross-sectional was conducted on 100 primigravida women who attended the Sulaimani Maternity Teaching Hospital, Sulaimaniyah, Iraq, from May 2022 to May 2023, using a simple random sampling method. Their gestational age was calculated with first-trimester ultrasound. Then, a validated questionnaire was used to record their basic/clinical data. Consequently, labour was induced with either misoprostol or oxytocin. Finally, the mode of delivery was compared with maternal age, Bishops score and body mass index.

Results: The mean age of studied pregnant women was 28.43 ± 6.09 years. Most of them aged 20-30 years (60%), had normal weight (72%), took misoprostol (72%), and had normal vaginal delivery (59%). The maternal age was not significantly correlated to the success of induction of labour (P>0.05), while Bishop score/body mass index was highly significant (P<0.001), and induction of labour was significantly (P=0.011) associated with the mode of delivery among primigravida women.

Conclusions: Body weight, Bishop score and type of labour induction directly played a role in successful expected vaginal delivery, while maternal age did not.

Comparison of Transvaginal Ultrasonography and Hysteroscopy in the Diagnosis of Endometrial Polyp in Abnormal Vaginal Bleeding

Chia Hassan Ali, Rozhan Yassin Khalil — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Various methods and devices are currently applicable to diagnose endometrial polyps with different outcomes. This study aimed to compare the efficacy of trans-vaginal ultra-sonography in relation to the rigid hysteroscopy in the diagnosis of endometrial polyps in patients with abnormal vaginal bleeding.

Methods: This cross-sectional study enrolled 70 female patients with endometrial polyps at Sulaimani Maternity Teaching Hospital, Iraq, from May 01, 2022 to May 01, 2023. A well-designed questionnaire including the patient's age, gender, residency, educational level, parity, and presentation symptoms. Then, transvaginal ultrasonography and rigid hysteroscopy were done for all enrolled patients to determine the type of endometrial polyp.

Results: Most patients (57.14%) were aged 30-40 years, from suburban regions (47%), graduated from preparatory school (47.14%), multipara (91.43%) and had heavy vaginal bleeding (72.86%). Upon transvaginal ultrasonography and rigid hysteroscopy examinations, most females were diagnosed to have simple endometrial polyp (84.21% and 86.84%, respectively), followed by endometrial hyperplasia with atypia (60% and 100, respectively), then pedunculated leiomyoma (70% and 90%, respectively), and benign endometrial polyps (57.14% and 71.42%, respectively). There was no significant difference (p=0.19) between transvaginal ultrasonography and rigid hysteroscopy in sensitivity and specificity for diagnosing simple endometrial polyps.

Conclusions: Transvaginal ultrasonography and rigid hysteroscopy methods are preferred to diagnose endometrial polyps; in which rigid hysteroscopy is preferable for endometrial hyperplasia with atypia, and transvaginal ultrasonography is for benign endometrial polyps.

Epithelialization of the anterior surface of the optic as a newly discovered problem of type I Boston Keratoprosthesis

Shafeeq Salman Shafeeq, Ahmed Yahya Jabary, Didar Sddeq Anwar — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: The corneal disorders represented one of first 5 causes responsible of blindness all over the world. Failed keratoplasty commonly occurs in patients with poor prognosis. The Boston Keratoprosthesis (BKPro type-I) is the first option for managing these patients; however, many postoperative complications have been reported. Our aim was to determine the incidence of epithelialization of the anterior surface of the optic of type I Boston Keratoprosthesis in patients who underwent Prosthokeratoplasty.

Methods: A retrospective study was implemented in North Eye Center in Hawler city, Kurdistan region, Iraq. Data from sixty patients who underwent BKPro type-I from August 1, 2017, to March 31, 2023, were reviewed. Epithelialization of optical anterior surface was implemented through researcher in regard to finding epithelial layer affecting vision on slit lamp examination, with the visual acuity measurement pre and postoperatively.

Results: Postoperative complications were observed in 66.7% of patients following BKPro type-I, Epithelialization was present in 10% of all patients. The VA was moderate visual impairment in 83.3% of patients with epithelialization, whilesevere visual impairment in 16.7% of patients with epithelialization. There was a highly significant improvement in VA post Prosthokeratoplasty (p<0.001). No significant differences were observed between patients with postoperative epithelialization and patients without postoperative epithelialization regarding follow up periods (p=0.2). There was a significant association between late onset complications and postoperative epithelialization (p=0.03).

Conclusions: Boston type 1 keratoprosthesis is effective with restoring vision among patients with poor prognosis corneal blindness although elevated rate of postoperative complications.

Prevalence of Diabetic Nephropathy in Patients with Type Two Diabetes Mellitus: A Cross-Sectional Study

Brusk Tariq Fars, Dana Ahmad Sharif — Mon, 02 Jun 2025 00:00:00 +0000

Background and Objectives: Diabetic Nephropathy is the leading cause of end-stage renal disease worldwide, placing enormous pressure on healthcare systems and creating a heavy socioeconomic burden. It is urgent to comprehensively study the epidemiological characteristics of Diabetic Nephropathy in diabetic patients and to analyze the related factors to its incidence in order to implement effective prevention and control measures. The objective of the study is to identify the percentage of diabetic patients who developed nephropathy.

Methods: This cross-sectional study included 250 patients who visited Sulaymaniyah Endocrine and Diabetic Center from April 2023 to September 2023. The participants were sent for investigations, including urea, creatinine, urinary albumin-to-creatinine ratio, and Glycated hemoglobin. The estimated glomerular filtration rate was calculated by the Cockcroft-Gault equation.

Results: A total of 250 patients participated in the study; 147 were females and 103 were males. Additionally, 190 of the patients were from urban areas, and 60 from rural ones. The mean age of the participants was 59 ± 11.21 years old. Of the patients, 104 (41.60%) had only diabetes mellitus, while 146 (58.40%) had diabetes mellitus and another chronic illness.81 (32.4%) of patients had Diabetic nephropathy; of them, 28.4% had microalbuminuria and 4% had macroalbuminuria. The highest prevalence of nephropathy was found in those patients who were over 65 years old, and the lowest frequency was seen in those less than 45 years old.

Conclusion: One-third of patients developed Diabetic nephropathy. Diabetic nephropathy was significantly affected by the duration of Diabetes Mellitus, older age, and other chronic illnesses; however, gender, residency, and Glycated hemoglobin level had no significant impact on the incidence of Diabetic nephropathy.

Assessment of Some Physical Properties of 3D-Printed Temporary Crown and Bridge Material Modified with Styrene Butadiene Monomer: An in Vitro Study

Razan Burhanuldeen Almeerani, Raid Fahim Salman — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Since three-dimensional printing utilizable for dental manufacturing; questions were raised about previous research of their use, effectiveness and mechanical properties in temporary crown and bridge material. Shortcomings were present in this respect therefore, this study added styrene butadiene monomer to aforementioned material to develop an experimental material and compare its physical properties to conventional and computer-aided design-manufacturing materials.

Methods: An in vitro study done in College of Mechanical Engineering from September 2022 to March 2023, four types of temporary crown and bridge materials were utilized, group 1: GC Temp PRINT, group 2: GC Temp PRINTTM with the addition of styrene butadiene monomer (experimental material), group 3: TEMPSMART® GC, group 4: ERAYLAR (poly methyl methacrylate) bloc, 20 samples were produced per group, and tested for flexural strength and fracture toughness to evaluate the physical properties of the materials objectively.

Results: Higher flexural strength values were for group 4 (154+- 20.37) Mpa, the least value was for group 1 (91+-19.86) Mpa. Regarding Fracture toughness, group 4 showed higher mean value (69.93+- 4.28) Mpa, the least value was for group 3 (47.59+-5.58) Mpa, which means poly methyl methacrylate material have more flexural strength and fracture toughness. Statistical analysis using Kruskal Wallis and by Dunn-Bonferroni tests showed a highly significant difference among the groups (p<0.01).

Conclusion: Comparing all group samples' mechanical properties. GC temp print added with styrene butadiene improves the material's physical characteristics, giving poly methyl methacrylate better flexural strength and fracture toughness.

The Influence of Central Corneal Thickness on The Intraocular Pressure as Measured by Different Tonometers: Non-Contact Tonometer and Goldmann Applanation Tonometer

Yaseen Ahmed Ali, Tara Mahmood Hassan — Mon, 02 Jun 2025 00:00:00 +0000

Background and objectives: Intraocular pressure plays a crucial role in maintaining vision and preventing eye disease. Beyond its importance in diagnosing and managing glaucoma, intraocular pressure measurements significantly impact the evaluation of postoperative outcomes, complications and optimize patient recovery. This study quantifies the influence of central corneal thickness on intraocular pressure using both Goldmann applanation tonometer and non-contact tonometer.

Methods: In a prospective clinical trial, the subjects were recruited from glaucoma unit at Shahid Dr. Aso Eye Hospital in Sulaimania city/Iraq between January and June 2023. Intraocular pressure measurements were conducted in a randomized sequence for both eyes using both Goldmann applanation tonometry and non-contact tonometry exploring the correlation between measured inter-tonometer discrepancies employing linear regression analysis with central corneal thickness.

Results: The study included 200 eyes of 100 consecutive patients diagnosed with either ocular hypertension or glaucoma. Mean age was 56.8 years, male (55%) and female (45%). Mean central corneal thickness was 533 ± 42 mm and mean intra ocular pressure were 14.9 ± 4.3 mm Hg, 19.3 ± 5.4 mm Hg for Goldmann applanation tonometry and non-contact tonometry, respectively. There is a statistically significant relationship between central corneal thickness and intraocular pressure by Goldmann applanation tonometry (r2 = 0.1, p 0.001) and non-contact tonometry (r²= 0.17, p 0.001).

Conclusion: Both Goldmann applanation tonometry and non-contact tonometry are influenced by central corneal thickness. However, non-contact tonometry was significantly more sensitive to central corneal thickness variations compared to Goldmann applanation tonometry.