AMJ (Advanced Medical Journal)

Cross-cultural adaptation, reliability, and validity of the vestibular rehabilitation benefit questionnaire in the central Kurdish version

Bafrin Ghafoor Majeed, Sherko Saeed Fatihullah Zmnako, Hiwa Asaad Abdulkareem — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: The vestibular rehabilitation benefit questionnaire is a new patient-reported outcome measures with psychometric properties, to assess the efficacy of vestibular rehabilitation. The present study aims to cross-culturally adapt the questionnaire into the central Kurdish dialect and to examine its psychometric properties.

Methods: This is a cross-sectional study conducted in Sulaimani city- Kurdistan Region of Iraq from March to September 2022, on 127 patients diagnosed with vestibular disorders between 18 to 79 years old. The vestibular rehabilitation benefit questionnaire Kurdish version was created through a regulated process of cross-cultural adaptation. The Kurdish participants were responded to the questionnaire, vertigo symptom scale short form and dizziness handicap inventory to assess validity of the questionnaire. The reliability of the questionnaire was assessed by randomly selecting 40 participants to repeat the questionnaire responses over a 24-hour timeline.

Results: The results revealed that the ? for subscales of dizziness, anxiety, motion-provoked dizziness, quality of life and the scale of vestibular rehabilitation benefit questionnaire -total were 0.81, 0.82, 0.78, 0.77, and 0.92, respectively. The intra-class correlation coefficient was 0.96 for the questionnaire total scale; 0.97 and 0.93 for symptoms and quality of life subscales, respectively. Spearman rho correlation coefficient revealed a powerfully positive relationship between total the questionnaire and dizziness handicap inventory, and a strong positive relationship between total questionnaire and vertigo symptom scale short form.

Conclusion: The vestibular rehabilitation benefit questionnaire Kurdish version is a reliable and validated patient-reported outcome measures that can be utilized for the Kurdish-speaking population.

Quality of life in patients with Ankylosing Spondylitis in Duhok government, Kurdistan of Iraq

Nahida Zuber Ali, Muhammed Tahir Rasool — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Spondylarthritis is a broad spectrum of chronic inflammatory diseases, and one of its of phenotypes is ankylosing spondylitis. Ankylosing spondylitis can impact the quality of life and health status because of pain, fatigue, and stiffness. This study aims to evaluate health-related quality of life and extra-articular manifestation in patients with ankylosing spondylitis in Iraq /Duhok city.

Methods: A descriptive cross-sectional study was carried out in the Duhok Center of Rheumatic Diseases. This study was conducted from the first of June 2022 to the end of November 2022 and ninety-two ankylosing spondylitis patients were enrolled and had their quality of life assessed. The assessment of Ankylosing Spondylitis Quality of Life Questionnaire was used, which is divided into four categories: social interaction, emotional health, disease activity, and physical function.

Results: Most of the patients were diagnosed between age 25 and 34 years, more than 90% of the participants were males only 6.5 % were females. The mean value of the total Quality of life score of patients with ankylosing spondylitis was 32.1. %. The patients had bilateral sacroiliitis (90.22%), peripheral arthritis (54.35%), plantar fasciitis (43.48%), and anterior uveitis (22.83%). The HLA-B27 was positive for 60.87% and 93.48% had spinal involvement. A small percentage did moderate physical activity (10.8%). patients with normal sleepers (63.04%), and those who were able to walk (94.57%). The study showed that the total QoL score of short sleepers had worse scores compared to the normal sleepers (41.67 vs. 27.76; P<0001) was statistically significant.

Conclusion: Ankylosing spondylitis is a chronic condition that needs assessment. The disease affects the quality of life, causing functional disability and reduced activity.

Antiviral drug treatment profiles and clinical outcomes of COVID-19 patients at public hospitals in Erbil city

Ronia Shawksat Kawther, Sherzad Ali Ismael, Maaroof Tahseen Hassan — Mon, 09 Sep 2024 00:00:00 +0000

Background & objectives: The World Health Organization has identified COVID-19 as a rapidly spreading global disease. Some antiviral drugs have shown promising efficacy in treating COVID-19. This study aims to identify the effects of antiviral drugs and compare them with other therapies in COVID-19 patients, while reviewing the clinical outcomes of these treatments.

Methods: This observational retrospective case study included 451 COVID-19 patients, comprising 57.0% males and 43% females, conducted in Rizgari, Erbil, at Central Emergency, Rozhawa Emergency, and Emirate Hospitals over one year from December 2020 to December 2021. COVID-19 cases were confirmed using reverse transcriptase polymerase-chain reaction (RT-PCR) assays, and treatment followed the WHO guidelines, involving antivirals (Remdesivir, Favipiravir), broad-spectrum antibiotics (levofloxacin, azithromycin, ceftriaxone, meropenem, imipenem), and supportive treatment with Becozym (Vitamins B1 + B2 + B3 + B5 + B6). Data were recorded in the statistical department of the hospitals.

Results: The total age range of the 451 patients was 95 (18-113) with a mean ± SD of 59.408 ± 18.26 years. The death rate was 22.39%. A majority of the survival patients were in the young age group (95.1%), while the death rate was higher in the old age group (more than 75 years). The death rate of patients treated with antiviral drug Remdesivir was 15.30%, while it was 37.93%, 73.45%, 15.25%, and 14.15% in patients on levofloxacin, ceftriaxone, meropenem, and Becozyme, espectively. Logistic regression analysis did not show any role of treatments in decreasing mortality.

Conclusions: Significant differences were observed in clinical outcomes; the majority of surviving patients were in the young age group, while older COVID-19 patients had worse illnesses and treatment outcomes. Diabetes and hypertension were significant predictors of COVID-19 mortality. Although Remdesivir treatment showed a statistically significant association between survival and death cohorts, it was not considered a predictor variable for survival. Antibiotics and supplement drugs like Becozyme were also not considered predictors of survival for COVID-19 patients.

Immunohistochemical expression of B-cell lymphoma 2 gene -Bcl-2 in endometrial carcinoma

Hozan Dler Dhahir, Jalal Ali Jalal, Zheen Othman Hama Faraj — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Apoptosis, a process of cell death, is inhibited by the B-cell lymphoma 2 protein, leading to the prolonged survival of cells. Participation of Bcl-2 in starting and advancement of endometrial carcinoma remains inconclusive, with varying results observed. The aims of this study were to assess the frequency of B-cell lymphoma 2 expression in endometrial carcinoma, and to investigate the connection between B-cell lymphoma 2 expression with some clinicopathological parameters.

Methods: A retrospective study was carried out for seventy-eight formalin fixed paraffin embedded blocks of total abdominal hysterectomy specimens diagnosed as endometrial carcinoma, which were randomly obtained from a private laboratory and Rizgary teaching hospital laboratory in Erbil city during June 2021-June 2022. In this study, endometrial carcinoma cases were subjected to the utilization of B-cell lymphoma 2 gene, which is a Mouse monoclonal antibody, and its expression was evaluated.

Results: The expression of Bcl-2 was observed in 61.5% of the studied cases. The majority (93.6%) of EC cases were of low grade, although Bcl-2 expression was observed at a greater frequency (64.4%) in low-grade endometrial carcinoma, but there was no significant association. Additionally, no statistically significant correlation was found between B-cell lymphoma 2 gene expression and other clinicopathological parameters like, age, myometrial invasion, lympho-vascular invasion, lymph node status and tumor stage.

Conclusion: Bcl-2 was expressed in 61.5% of the studied cases with no significant association with any of the variables, additional research is necessary to assess the expression of B-cell lymphoma 2 gene in relation to endometrial carcinoma invasion and metastasis.

Central Corneal Thickness: Comparison between diabetics and nondiabetics

Mohammed Muneer Labeeb, Neshiteman Hashim Abdulrahman, Khosro Senyar Tato — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: The cornea play a significant role in eye refraction. With early detection and prompt treatment, ocular problems linked to diabetes mellitus can be prevented from progressing. The purpose of this study was to compare the central corneal thicknesses of diabetic and non-diabetic patients.

Methods: In Duhok Teaching Eye Hospital; a comparative cross-sectional study had been conducted between 01.01.2022 and 30.06.2022. There were 100 participants, 50 in diabetes group, and 50 in a control group. The diabetic group is further subdivided into three categories based on the duration of diabetes (less than 5 years, more than 5 to10 years, and above 10 years), as well as two subgroups based on the type of diabetes mellitus (type I and type II). The thickness of the central cornea was measured using SIRIUS corneal pachymetry and topography.

Results: There was no statistically significant difference between the non-diabetic and diabetic groups in terms of central corneal thickness (549.6 micrometers 541.4 micrometers, P > 0.05). There was a statistically significant difference (P 0.05) between the mean central corneal thickness of diabetics with diabetes mellitus for more than ten years and non-diabetics and diabetics with diabetes for five years.

Conclusion: In comparison to both non-diabetics and diabetics with diabetes for five years or less, those with long-term diabetes mellitus (diabetes for more than ten years) had a bigger statistically significant average central corneal thickness.

Immunohistochemical Expression of Cyclooxygenase-2 in endometrioid carcinoma

Kavi Kamaran Abbas, Jalal Ali Jalal — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Cyclooxygenase-2 functions as an enzyme which synthesize prostaglandins from Arachidonic acid Cyclooxygenase -2 is one of the important factors in maintaining the endometrium during menstrual cycle. The Aim of this study was to assess expression of Cyclooxygenase-2 in endometrioid carcinoma by immunohistochemistry to explore association between Cyclooxygenase-2 expression and a certain number of clinicopathologic variables.

Methods: A retrospective study was carried out for seventy-eight blocks that were preseved in formalin and embedded in paraffin of endometrioid carcinoma were obtained and randomly selected from a private laboratory in Erbil city during October 2020 to October 2022. COX-2 rabbit monoclonal antibody was used to satin slides obtained from endometrioid carcinoma blocks and the expression was scored by multiplying the number of stained cells by the intensity of staining.

Results: Cyclooxygenase-2 expressed in 15.4% of cases of study cases. It is down-expressed in high grade endometrioid carcinoma while over-expressed in cases with myometrial invasion ?50%. Regarding other clinicopathological parameters like, lymphovascular invasion, tumor stage and lymphnode status, Cyclooxygenase-2 showing down-expression, there is no existence of notable link between the expression of Cyclooxygenase-2 and clinicopathological parameters, including: Age(p=0.197), Tumor grade(p=0.069), Myometrial invasion(p=0.261), Lympho vascular invasion(p=0.516), Lymph node status(p=1000) and Tumor stage(p=0.872).

Conclusion: Cyclooxygenase-2 is expressed in a limited number of endometrioid carcinoma and there is lack of significant association between Cyclooxygenase-2 expression and clinicopathological parameters.

Prevalence of colorectal polyps in patients undergoing colonoscopy in Sulaimaniyah gastroenterology center: a retrospective study

Hawar Ali Ghalib, Fadhil Ahmed Mohialdeen Khayat, Chenar Dhahir Fatah — Mon, 09 Sep 2024 00:00:00 +0000

Background & objectives: Colorectal cancers are believed to develop primarily through an adenoma-carcinoma sequence, with adenomatous polyps beginning as the primary precursor lesions. Thus, this study aimed to assess the prevalence of colorectal polyps with their characteristics and relation to age/gender and to aid in establishing a screening program to detect polyps and colorectal cancer in the early stages.

Methods: In this retrospective study, the data of 2698 patients who underwent colonoscopy in Sulaimani Gastroenterology Center, Sulaimaniyah, Iraq, for various complaints and asymptomatic patients from January 2019 to February 2021 were studied regarding colorectal polyps. Patients sociodemographic data (age, gender, and residency), presented symptoms, surveillance rate for colon cancer and polyps, and disease follow-up were studied. Briefly, patients were given bowel preparation solutions the day before the colonoscopy, and the process was performed under conscious sedation.

Results: The mean±SD age of patients was 52.0±17.59 years, and most were females (55.1%)(p=0.000) and from urban areas (62.12%) (p?0.05). Among the studied patients, 14.3% were diagnosed with polyps, of which 17.1% were males and 12.1% were females. The high prevalence rate was found in patients aged >60 years (23.8%), followed by 50-60 years (17.71%), and then 40-49 years (13.07%).

Conclusion: Colorectal polyp was common among patients undergoing colonoscopy for several gastrointestinal symptoms, especially after the age of forty.

A Randomized Comparative study of efficacy and safety between %20 and %30 Hydrogen peroxide in the Treatment of Actinic keratosis

Nareen yousif salih, Ali Mozan Dhahir El-Ethawi — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Actinic keratosis is a premalignant skin lesion that presents clinically as a sand-like macule or papule on an erythematous base with a superficial scale due to atypical proliferation of keratinocytes and may progress to squamous cell carcinoma.The aim of this study was to compare the efficacy of hydrogen peroxide in treatment of actinic keratosis between two different concentrations (%20 and %30).

Methods: This is a randomized open label therapeutic trial of twenty patients with actinic keratosis has been enrolled, it was conducted from April 2022 to August 2022 at Sulaimaniah dermatology teaching center. Patients were divided to two treatment groups. Hydrogen peroxide %20 applied to the actinic lesions of group A, while group B applied 30% Hydrogen peroxide to the lesions. The solution was applied to the lesions in a circular motion for 20 seconds, for four rounds per session Patients were seen after a first session in two weeks. Maximum four sessions spaced out by 15 days are given until clearance.

Result: we conducted a randomized open label therapeutic trial. It was conducted from April 2022 to August 2022 at Sulaimaniah dermatology teaching center. Regarding response in Group A out of twenty actinic lesions, marked and moderate improvement was recorded in %40, %30 of the lesions respectively while the remaining lesions %30 of them showed slight improvement and no clinically clearance has been recorded. In comparsison, Group B out of twenty lesions %60 of them clinically cleared and slight improvement was recorded only in %20 of lesions. There were statistically significant differences between (20% & 30% Hydrogen peroxide ) in response (p-value=0.000). Regarding side effects; majority of patients (85%) in both groups had recorded burning sensation, irritation and transient erythema, while no scarring, pigmentation, atrophy has been recorded. There were no statically significant differences between two groups.

Conclusion: Hydrogen peroxide can be used as safe, alternative method to other modalities in treatment of actinic keratosis lesions, results would be better if higher concentration %30 used.

Knowledge and Self-care Practices among a Sample of Type II Diabetes in Duhok City: A Cross-Sectional Study

Vian Elyas Haidar, Rajab Hasan Sanaan — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Diabetes is a significant chronic disease with a high prevalence worldwide. The number of diabetic patients is rising, necessitating improvements in both care and treatment. A baseline evaluation of patients' knowledge and self-care habits is required. The study's objectives were to find out diabetic patients' understanding of the condition and its complications and adherence to self-care routines related to type 2 diabetes mellitus.

Methods: This cross-sectional study involved 300 diabetic patients with type two diabetes who were 18 years and older, having the condition for at least three months, and was conducted in Azadi general teaching hospital in Duhok city from April 2022 to September 2022. Patient selection was taken by systematic random method. A questionnaire which was interviewer-administered was used for collecting data.

Results: Patients’ age ranged between 31 to 70 years; the majority of them (48.67%) were between the ages of 51 and 60 years. The participants were males (44.67%) and females (55.33%). Concerning knowledge about risk factors of diabetes 224 patients (74.67 %) knew that family history is a risk, while 254 (84.67 %) were unaware of low physical activity is a risk factor. Among the self-care practices, foot care was the most neglected area.

Conclusion: Patients with diabetes mellitus did not demonstrate sufficient levels of knowledge and practice. Carefully targeted interventions are required. Another issue that has to be addressed is the diabetes patients' documented low adherence to physical activity.

The efficacy of 20% salicylic acid solution versus intralesional MMR vaccine combination with 20% salicylic acid solution in treatment of plane wart

Banu Muhammed Jaza Noori, Ali Mozan Dhahir Elethawi — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Plane wart treatment is challenging; modalities such as cauterization and cryotherapy having a great probability to recur, as well as the risk of scarring, discomfort, and expensive costs. The goal of this study is to compare the efficacy of salicylic acid 20% superficial chemical peel alone to topical salicylic acid solution 20% combined with intralesional measles mumps rubella vaccine.

Methods: A therapeutic clinical trial conducted in outpatient department of “Shahid Nabaz Dermatology Teaching Center” a period from March to September of 2022.Fifty participants with plane wart were enrolled in this study, 27 female and 23 male. The participants were randomly divided into two groups, group- A 25 patients, received topical 20% salicylic acid solution with intralesional measles-mumps- rubella vaccine. Group B, received topical 20% salicylic acid solution alone. The total number of therapeutic sessions was six, and the solution was applied every two weeks and the measles-mumps-rubella vaccine was injected every fortnightly. Every two weeks, the effectiveness of the treatment was assessed by counting the number of lesions.

Result: Group A patients who were treated with intralesional measles mumps-rubella-vaccine combined with topical 20% salicylic acid solution showed complete clearance (24/25) with six sessions .group B patients treated with topical 20% salicylic acid solutions showed clearance (14/25) with six sessions. Lesions were significantly fewer in Group-A, which was statistically significant.

Conclusion: The intralesional measles mumps-rubella-vaccine combination with 20% topical salicylic acid solution and the 20% salicylic acid solution alone were both effective in clearing plane warts, however, intralesional measles mumps-rubella-vaccine combination with 20% topical salicylic acid solution can achieve higher response with fewer sessions .

Mucocutaneous manifestation of COVID-19 infection in pediatrics age groups

Nina Jutiar Noory, Mohammed Yousef Saeed Jaff — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: It is known that the COVID-19 virus can induce a wide range of mucocutaneous symptoms. This study's main goal is to describe the variety of cutaneous symptoms caused by COVID-19 in the pediatric age category.

Methods: This is a retrospective case series study of pediatric patients with COVID-19 infection who were admitted to Jamal Ahmad Rashid Pediatrics Teaching Hospital in Sulaimaniyah city from September 2021 to March 2022. Moderate to severe Covid-19 infection was a factor in the patients' admissions. The patient’s complete medical history was reviewed, which should include their age, gender, and any mucocutaneous manifestations, as well as their past medical history, family history.

Results: Three hundred twenty three cases of COVID-19 infection were enrolled in this study, 36 of them had skin manifestations. There were 56% female and 44% males. Their ages ranged from zero to 13 years. Skin manifestations were 13 patients (36%) had erythematomaculopapular rash, 8 patients (22%) had vesicular lesions, 7 patients (19%) had chilblain, 6 patients (17%) had urticaria and 2 patients (6%) had erythema multiforme. Overall 41 patients had Multisystem inflammatory syndrome in children (MIS-C), 11 patients had cutaneous manifestations (6 patients had erythematomaculopapular rash, 5 patients had vesicular rash), and 6 patients had mucosal lesions (4 patients had conjunctivitis, 2 patients had oral lesions).

Conclusions: We found that despite pulmonary and other systemic manifestation also corona virus infection can cause many mucocutaneoues manifestation in pediatrics age groups.However, further studies with larger samples size and longer duration is recommended.

Mortality Predictors among COVID-19 Patients Admitted to the Intensive Care Unit in Sulaymaniyah City, Iraq: A Cross-Sectional Study

Alyaa Amer Abdulla, Sherzad Ali Ismael — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: On February 22, 2020, Iraq confirmed the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The number of confirmed cases in Sulaimaniyah city reached 152,846, with 3,178 deaths. Our objective was to assess the clinical characteristics and identify variables that may predict mortality of COVID-19 cases in the intensive care unit.

Methods: Our cross-sectional study involved patients who were diagnosed with laboratory-confirmed Covid-19 and admitted to the intensive care unit of Shaheed Dr. Hemn Hospital/ Sulaymaniyah/ Iraqi Kurdistan from January 15, 2021, to April 29, 2022. Collected data included the patient's demographic characteristics, vital signs, hematological parameters, and management as documented in the patient's medical records. Patients were separated to two groups: those who were discharged and those who were dead. The binary logistic regression model was used to identify independent factors that predict mortality.

Results: During the study period, 403 patients were admitted to the intensive care unit. Case fatality rate was high 69.2%. The patient’s average age was 61.42 ±13.17 years, and 249 (61.8%) of them were men. The majority of the patients 319 (79.2%) had comorbidities. Lymphocytopenia was observed in 306 (75.9%) of the patients and there was a statistically significant difference between discharged and death groups (p value 0.021). Remdesivir was given to 185 patients (45.9%) and there was a statistically significant difference between discharged and death groups, p-value <0.001.

Conclusions: Critically ill patients with COVID-19 had a high mortality rate in the intensive care unit. low SBP, GCS<15, high D. dimer, and poor oxygen saturation were considered predictor factors of mortality.

Minimal Residual Disease in Pediatric Acute Lymphoblastic Leukemia

Fatima Hameed Ahmad, Adnan Anwer Al-Doski — Mon, 09 Sep 2024 00:00:00 +0000

Background and ObjectiveThe detection of minimal residual disease at the end of initial therapy in Acute Lymphoblastic Leukemia to assess risk stratification is gaining clinical significance. While minimal residual disease assesses the extent of remission, remission is still defined by bone marrow morphology. The aim of this study is to determine the significance of minimal residual disease.

Methods: In this cross-sectional study conducted at Zheen Oncology Center and Azadi hospital in Duhok, Iraq, data was collected from 46 patients’ records. Residual disease was detected by flow cytometry. On day 29 of induction therapy, a bone marrow sample was obtained for morphology and flow cytometry. The presence or absence of MRD was determined by using 8-color flow cytometry.

Results: The median age of the study was 7 years and the male to female ratio was 1.7:1. B-cell lymphoblastic leukemia accounted for 80.43% and T-cell was 19.57%. Bloodounts at diagnosis revealed a mean white blood cell count of 74.32 x /L, mean hemoglobin level of 8.75, g/dL, and a mean platelet count of 97.84 x L. Minimal residual diease positive results were seen in 29 cases; 21 cases were of B-cell leukemia (56.75) and 8 (88.88) cases were T-cell leukemia. Minimal residual disease negative results were achieved in 17 cases; 43.24% were of B-cell origin (p value <0.001), 11.11% were of T-cell origin (p value 0.008). Remission was achieved in 81.08 cases of B-cell (p value 0.103), and 66.66 of T-cell (p value 0.403). 16.21% of B-cell leukemia passed away (p value <0.001) and 33.33% of T-cell leukemia (p value 0.065).

Conclusion: Flow cytometry should be done in addition to bone marrow morphology.

Efficacy of Pomegranate Peel Extract Mouthwash on Gingivitis and C-reactive protein

Nabila Abdul Aziz Hussein, Saeed Ali Mohammed — Mon, 09 Sep 2024 00:00:00 +0000

Background and objective: Gingivitis is characterized as the world’s most predominant inflammatory periodontal disease. Healthy mouth and teeth are obtained by brushing and uses mouthwash. And because of the side effects of chlorhexidine, pomegranate peel extract mouthwash used alternative which are thought to have anti-inflammatory effect. The aim of this study is to prepare a herbal mouthwash and to evaluate the efficacy of pomegranate peel extract mouthwash on plaque index, gingival index, and C-reactive protein on moderate gingivitis patients.

Method: this study is a clinical crossover design study, which consists of 25 volunteers with moderate gingivitis, who visited Duhok Dental Training Center. This study started from December 2022 to March 2023. Plaque and gingival index with a sample of saliva for C-reactive protein measuring were taken as a baseline before each mouth wash and after that, the pomegranate peel extract mouthwash was used for two weeks, then three weeks wash out between them, then chlorhexidine mouth wash was used for two weeks (crossover method). All saliva samples were analyzed using (CRP ELISA Test).

Results: Twenty-five patients who used pomegranate peel extract mouthwash showed a significant reduction after two weeks used (CRP=162.28, GI=0.54, PI=0.82) and p value (<0.0001) in mean C-reactive protein, gingival index, and plaque index from baseline which was (CRP=669.78, GI=1.88, PI=2.11).

Conclusion: Pomegranate peel extract mouthwash had been shown effective against moderate gingivitis in adult patients with no systemic diseases through lowering in mean salivary C-reactive protein, gingival index, and plaque index.

Efficacy and safety of systemic spironolactone for acne in female patients in Sulaymaniyah teaching center of dermatology

Soma Khasrow Abdullah, Mohammed Yousef Saeed Jaff — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Acne vulgaris is a common disease in which hormone plays a role in its pathogenesis. Spironolactone, an androgen receptor blocker is used to treat acne. This study aims to evaluate the efficacy and safety of systemic spironolactone for acne in female patients in our local area.

Methods: Open-label therapeutic trial study performed in the Sulaymaniyah teaching center of dermatology between 1/2/2022 - 1/9/2022, on a total of 47 patients aged 12-38 years old. Patients were divided into two groups in regard to age. Hormonal profile was assessed for all the patients. The 4-grade European classification system was used to classify the acne severity. Spironolactone 100 mg once daily at morning was given to them with follow up monthly for 3 months. Clinical response of the drug was assessed through a decrease in the number of the lesions. Signs and symptoms of the side effects were checked monthly.

Results: In a total of 47 patients, 22 patients were ? 25 years and 25 patients were >25 years. A significant difference was recorded in the response rate among the patients' ages and hormonal status of them as 83.3%, 61.1% and 50% of the complete response was in those who were >25 years old and had abnormal testosterone and DHEA-s levels respectively. 100% of non-responder patients were below 25 years old with normal hormonal levels. 55.32% of the patients had no side-effect and menstrual irregularity was the most commonly reported side effect.

Conclusion: Spironolactone is statistically considered an effective and safe line for the treatment of acne vulgaris particularly for acne in female over 25 with abnormal hormonal levels.

The effects of heavy screen viewing on the health of secondary school-aged children in Duhok city

Jwan Hikmat Hussein, Haitham Issa Albanna — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Although there has been a remarkable increase in screen time among children over recent years, the literature includes contradictory reports on its effects of the individuals' health. In this regard, the present study was an attempt to figure out the effects of heavy screen time on the health of secondary school-aged children in Duhok city, Kurdistan-Iraq.

Methods: A cross-sectional study was conducted on 850 secondary school students aged 14- 18 years, from September 2022 to September 2023 in Duhok secondary schools. Data about screen viewing were gathered through a questionnaire. then data were analyzed via SPSS (version 25.0). Chi-square were used and 0.05 was set a level of significant.

Results: The students aged 14-18 years, with the largest group being 18 years of age (38.4%). Most of the students (59.4%) were females. Grade 12 students were the largest group (57.3%). Most of them (76.2%) were from middle-income families and (65.4%) had healthy body mass index. Significant associations were found between the students' screen time and their age (P-value<0.001), gender (p-value<0.001), parents' education (P-value<0.001), parents' occupation (P-value<0.05), and socioeconomic status (p-value=0.014). Moreover, significant associations were found between their screen time duration and their medical problems (P-value<0.001), previous surgical operation (p-value=0.008), mood during the day (P-value<0.001), relationship with parents (p-value=0.003), sleep difficulties (p-value=0.002), and eating during screen viewing (p-value<0.001).

Conclusions: Most adolescence in Duhok city have excessive screen time (more than two hours) in which affects their health and quality of life adversely. Health practitioners and families should consider these factors while designing and implementing adolescent health promoting programs.

Topical Ascorbic Acid Mesotherapy with Microneedling versus Topical Tranexamic Acid Mesotherapy with Microneedling for Melasma: A Therapeutic Comparative Study

Soleen Saman Hasan, Mohammed Yousif Saeed, Harem Ahmed Hamakarim — Mon, 09 Sep 2024 00:00:00 +0000

Background & objectives: Melasma is a common skin hyperpigmentation syndrome that frequently includes reproductive-aged females, and numerous therapies with various consequences have been suggested. Thus, the objective was to compare the microneedling and mesotherapeutic effects of ascorbic acid versus tranexamic acid for melasma treatments.

Methods: This interventional therapeutic prospective study was conducted on 40 patients with melasma at Khabat Consultation Center for Skin Diseases, Sulaimaniyah, Iraq, from March 2022 to August 2022. Sociodemographic data of patients were collected together with a family history of melasma using a well-designed questionnaire. Half of the patients were treated with ascorbic acid, while the rest were treated with tranexamic acid using a derma pen.

Results: Highly significant reduction of MASI score were seen before and after treatment (p<0.001) were seen in mean scores before and after treatments for both types of treatments (ascorbic acid and tranexamic acid). Moreover, ascorbic acid results in the highest mean score reduction in skin type III (p=0.746), while tranexamic acid results in the highest mean score in skin type IV (p<0.05). Furthermore, the dermal melasma recorded the highest mean score, and the lowest level was observed in the epidermal melasma for both ascorbic acid and tranexamic acid groups. No significant difference was found between both studied groups in sociodemographic data and other studied variables (family history, skin type, previous treatment, and duration of melasma).

Conclusions: Both types of therapy mesotherapy was effective in treating melasma; however, their potencies varied on different skin types and according to melasma types.

TLE1 Expression in Different Sarcoma Types and its Relation to Clinicopathological Parameters

Toqa Jabbar Chckaim, Saman Salah Eldeen Abdulla, Savan Saeed Azeez — Mon, 09 Sep 2024 00:00:00 +0000

Background and objectives: Split genes that contain Transducin-Like Enhancer encode transcriptional corepressors that are essential for hematopoiesis and embryogenesis in humans. Synovial sarcomas express Transducin-Like Enhancer-1, a distinct factor which hardly has been shown in other soft tissues malignancies. Transducin-Like Enhancer-1 expression was recently found to be sensitive but not entirely specific for synovial sarcoma.

Methods: This retrospective study included eighty paraffin embedded formalin-fixed blocks of different sarcomas which were gathered and picked out of the files of Rizgary teaching hospital lab and from certain private labs in Hawler, during June 2015-December 2022. In this study, Transducin-Like Enhancer-1, a mouse monoclonal antibody was applied on sarcoma cases and its expression was assessed.

Results: around one third (30%) of the patients had synovial sarcoma, (16.3%) had undifferentiated pleomorphic sarcoma, and the rest had other types. More than half (55%) of the sarcomas were of high grade, and the Transducin-Like Enhancer-1 score was strongly reactive in 33.8% of the patients. It was also strong in all (100%) the patients with synovial sarcoma, compared with 23.1% of patients with undifferentiated pleomorphic sarcoma, and 0% of the other types of sarcoma (p < 0.001).

Conclusion: this study demonstrates that, when synovial sarcoma was kept in the differential diagnosis of spindle cell soft tissue sarcomas, Transducin-Like Enhancer-1 was a highly sensitive and relatively a specific marker.

Serum Uric Acid in Women with Preeclampsia and its Relation to Perinatal and Maternal Outcomes

Dileen Anwar Sadeeq, Maeda Yousif Shamdeen, Jinan Nori Hasan — Mon, 09 Sep 2024 00:00:00 +0000

Background and objective: Preeclampsia is a dangerous, progressive condition that is linked to maternal and neonatal death and morbidity. The purpose of this study was to determine the association between serum uric acid levels in preeclampsia with maternal and fetal outcomes.

Method: A case-control study was conducted on 300 women delivered at the labour room of Duhok Obstetrics and Gynecology Hospital, from 1st of April 2021 to 1st of April 2022. The study participants were divided into two groups, pregnant women with preeclampsia and normotensive women. The serum uric acid levels of these women were estimated with the impact on fetal and mother outcomes.

Results: There was a highly significant association between preeclamptic and normotensive women in relation to mean serum uric acid (5.862 ±1.416) mg/dL and (3.570 ±0.982) mg/dL respectively. A highly significant association was seen between uric acid test levels and maternal eclamptic fit, HELLP syndrome and admission to intensive care unit. A highly significant association also seen with newborn birth weight, APGAR scores and admission to neonatal intensive care unit.

Conclusion: The current study demonstrates a significant raise in serum uric acid level in preeclamptic women and associated with adverse perinatal and maternal outcomes.

Immunohistochemical Expression of Vitamin D receptor in Breast Cancer in Erbil city

Tara Ismail Nasir, Saman Salah Eldeen Abdullah, Kalthuma Salih Hamadamin — Mon, 09 Sep 2024 00:00:00 +0000

Background & objectives: Vitamin D receptor is a nuclear receptor that modulates the activity of genes. The purpose of this study was to evaluate the frequency of vitamin D receptor expression in breast carcinoma by immunohistochemistry and to investigate the association between vitamin D receptor expression with some clinicopathologic factors, like tumor grading, staging, histologic type (ductal and non-ductal) and the hormonal status.

Methods: One hundred formalin-fixed paraffin embedded tissue blocks of mastectomy and core biopsy specimens diagnosed as carcinoma, were obtained from a private laboratory in Erbil city/Iraq from October 2020-October 2022. In this study, vitamin D antibody (a mouse monoclonal antibody) was applied to a breast cancer tissue samples and its expression was assessed.

Results: Nuclear vitamin D receptor was expressed in 32% of the cases, and a strong relation was noted between vitamin D receptor expression and low-grade tumor (p = 0.034), estrogen receptor (p-value =0.007), and progesterone receptor (p = 0.045) positivity, while no significant association was noted between vitamin D receptor expression and other clinicopathologic parameters like age, lymph node status, tumor stage, the type of the cancer and human epidermal growth factor receptor 2 status.

Conclusion: increased Vitamin D receptor expression in breast tumors appears to be associated with a better prognosis. Vitamin D receptor expressed in one third of cases in which there was significant association with tumor grade and hormonal receptors.