Kurdistan Higher Council of Medical Specialties
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Serum Zinc in Patients with Acute Ischemic Stroke
Background and Purpose: Stroke is one of the main causes of mortality and disability worldwide. Identifying new risk factors for stroke is crucial for its prevention. The purpose of this study was to determine whether serum zinc levels and ischemic stroke were related. Methods: In this case-control study conducted in Shar Hospital in Slemani, Kurdistan Region, Iraq, between July 2023 and January 2024, 83 patients who had experienced an acute ischemic stroke and 83 age- and sex-matched controls were enrolled. Utilizing colorimetric measurement, the serum zinc levels were determined. We compared the serum zinc levels of both groups and sought relevant relationships between them and the other characteristics of the participants. Results: We found that 79 out of 83 cases (95.2%) with acute ischemic stroke had low zinc levels (<70 µg/dL). The mean serum zinc levels of the cases and controls were 49.87 ± 13.43 µg/dL and 52.61 ± 19.86 µg/dL, respectively; their difference was not statistically significant (p=0.33). The severity of strokes showed a significant inverse relationship with the levels of zinc in the serum (r= -0.462, p<0.001); more severe strokes were associated with lower serum zinc levels. Additionally, there was a significant inverse relationship between the age of the stroke patients and their zinc levels (r= -0.258, p=0.02). Conclusion: Our study did not support an association between serum zinc levels and the occurrence of acute ischemic stroke. However, it demonstrated that zinc levels are negatively correlated with age and stroke severity in patients with acute ischemic stroke.
Copyright (c) 2026 Shram Sabah Hassan, Zana Abdulrahman Mohammed https://creativecommons.org/licenses/by-nc-sa/4.0
Comparison of Safety and Efficacy of Tamsulosin alone and Combination of Tadalafil and Tamsulosin as Medical Expulsive Therapy for Ureteric Stone
Background and objectives: The medical expulsion therapy is essential to avoid invasive treatment of ureteric stones. The aim was to compare the safety and efficacy of Tamsulosin alone and combination of Tadalafil and Tamsulosin. Methods: A retrospective cross-sectional study implemented in private clinic in Erbil city, Kurdistan Region-Iraq from 1st of February, 2022 to 31st of January, 2024 on one hundred and eighty-four patients with ureteric stones (92 patients with Tamsulosin only and 92 patients with Tadalafil & Tamsulosin). Post-treatment outcomes and adverse effects were assessed and managed accordingly. Results: Number of analgesic injections were higher among patients treated by Tamsulosin only zero injection (39/92),1-3 times (44/92), and >3 times (9/92) while in Tamsulosin Tadalafil group were zero injection ( 65/92) , 1-3 times (24/92) and >3 times ( 3/92) with statistical value (p<0.001).also number of emergency visits were higher in Tamsulosin only group zero visit (57/92),1-3 visits (30/92),>3 visits (5/92) in compare to the Tamsulosin Tadalafil group zero visit(85/92) , 1-3 visits (5/92) and >3 visits (2/92) and the statistical value was ( p<0.001). also, stone expulsion rates were higher with Tadalafil & Tamsulosin therapy (70/92) while in Tamsulosin only group (66/92) and the statistical value was (p=0.02). dizziness adverse effect was more with Tadalafil & Tamsulosin therapy (5/92) in compare to the Tamsulosin only were (0/92) with statistical value (p=0.02). Conclusion: Tadalafil & Tamsulosin is safe and more effective in medical expulsion therapy of ureteric stones than Tamsulosin alone.
Copyright (c) 2026 Yadgar Abduljabbar Karim https://creativecommons.org/licenses/by-nc-sa/4.0
Ahmed Glaucoma Valve as a Risk Factor for Penetrating Keratoplasty Failure
Background and objectives: Penetrating keratoplasty is a surgical procedure with a history spanning over a century. The objective is to identify the incidence and potential risk factor of graft failure after performing penetrating keratoplasty in eyes with Ahmed valve tube. Methods: This retrospective study conducted on 24 patients whom penetrating keratoplasty and glaucoma shunt surgery have been performed for them from February 2017 to December 2022 at North eye center/ Erbil city. The follow up was obtained for determining the risk factors associated with keratoplasty failure. Results: Half of the patients with glaucoma drainage devices have a successful penetrating keratoplasty surgery. Age was not a risk factor for penetrating keratoplasty failure, relative risk (RR)=0.85, CI=0.38-1.88, P=0.682). Also, the following factors were not a risk for keratoplasty failure; sex (RR=1,CI=0.45-2.23, P=1), sequence of surgery of Ahmed valve prior to penetrating keratoplasty (RR=0.57,CI=0.20-1.53, P=0.206), eye laterality (RR=1.23,95%CI=0.47-3.25, P=653), aphakia (RR=4.0,CI=0.12-136.95, P=0.215) and pseudophakia (RR=5.71,CI=0.52-62.66 P=0.154), history of vitreoretinal surgery is the risk factor for penetrating keratoplasty failure (RR=3.4,95%CI=1.63-7.10,P=0.002), chronic diseases (RR=0.79,95%CI=0.34-1.86,P=0.615) and intraocular pressure>21 mmHg (RR=1.214,95%CI=0.54-2.75,P=0.653) are also risk factors for decreasing success of penetrating keratoplasty. Conclusion: In our study, Ahmed valve is a risk factor for failure of pentrating keratoplasty surgery which is 50%. Age, gender, Ahmed valve prior to penetrating keratoplasty, lens status and operated eye were not a risk factor in pentrating keratoplasty failure in those who underwent glaucoma drainage device. Whereas, vitreoretinal surgery, chronic diseases and intraocular pressure were observed as risk factors in penetrating keratoplasty failure.
Copyright (c) 2026 Karwan Bakhtyar Mohammed, Kawa Khalil Ahmad https://creativecommons.org/licenses/by-nc-sa/4.0
Steroid injection versus Non-invasive Therapy in the Treatment of Plantar Fasciitis: A Study of 101 Cases
Background and objectives: about 10% of people have plantar fasciitis, the most prevalent foot condition. There are currently no applicable guidelines. We aimed to make a study hypothesis (no difference between using local steroid injections and steroids taken orally with home physical therapy) in treating plantar fasciitis. Methods: An interventional study was done in Duhok, Kurdistan region, Iraq. The period between 15/5/2021-15/1/2023. A randomly selected 101 patients were divided into two groups. The first group received local steroid injections while the second group received oral steroids with Simple home physiotherapy. The Visual Analogue Scale and Foot Function Index were recorded during the trial for pain evaluation. Result: Patients were randomly assigned to two comparable groups. The pain significantly increased in the first two weeks after corticosteroid injection in the heel, with a significant p-value of 0.001 and a mean difference of 1.36299; however, the pain decreased after eight weeks and three months, with mean differences in vas II and vas III of 0.21094 and -0.45781, respectively. There was a substantial difference between local injection and oral types of treatment in foot functional index in ff1 with p-value ? 0.001. Conclusion: The use of local injection of steroids is more painful in the first two weeks and more sustained pain relief after that time with lesser recurrences of heel pain in cases of plantar fasciitis.
Copyright (c) 2026 Layth Amjed Saeed, Las Jamal Khurshid Hwaizi, Qaidar Abdulgabar Alhasawi https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence of Aspergillus and extremely resistant bacterial superinfection among sever Covid-19 patients
Background and objectives: Co-infections involving bacteria or viruses alongside severe acute respiratory syndrome coronavirus-2 have been documented in numerous studies. The understanding of Aspergillus coinfection in individuals suffering from coronavirus disease 2019 was found to be constrained. This study aims to explore the updated information about coronavirus 2019 associated with pulmonary aspergillosis. Methods: This study was conducted at coronavirus disease-19 hospital and intensive care unit of Sulaimani and San private clinic and laboratories, from jan-2021 to feb-2022. Seventy-five patients were enrolled, including patients who were intubated on a mechanical ventilator and continuous positive airway pressure mask treatment. The intubated patients were screened after 2-3 days. Non-intubated patients on continuous positive airway pressure mask; sputum study was performed if evidence of secondary chest infection was present including rising fever, and productive cough, with laboratory markers and radiologic investigation. Results: Out of 75 patients, 10.7% (n=8) were culture negative, 89.3% (n=67) were secondary microbial infection, 64.0% (n=48) were bacterial infection, 25.3% (n=19) were Aspergillus Species, having invasive pulmonary mold superinfection. The majority (42.1%, n=8) noticed in those aged between 60-70 years. Aspergillus flavus was the dominant mold (52.6%, n=10). 63.2% (n=12) of the Aspergillus infection was recorded in those patients who were treated with steroids for 11-20 days, with significant difference (P<0.001). Conclusion: Increasing age, comorbidity like diabetes and extended course of corticosteroid were linked to a higher incidence of invasive pulmonary aspergillosis. Extremely resistant Acinetobacter and E. coli superinfection were estimated as the most common bacterial element in sever coronavirus-2019 pneumonias.
Co-infection acute respiratory distress syndrome
Copyright (c) 2026 Safeen Othman Mahmood https://creativecommons.org/licenses/by-nc-sa/4.0
Flexible Ureterorenoscopy for Management of Renal Stone in Anomalous Kidneys: A Single Centre Experience
Background and Objective: Flexible ureterorenoscopy is a well-established treatment for renal calculi in anatomically normal kidneys. our objective is to evaluate the efficacy and safety of retrograde intrarenal surgery for managing renal stones in patients with renal abnormalities. Methods: A retrospective study was performed on 20 patients diagnosed with renal stones and kidney abnormalities who underwent primary retrograde intrarenal surgery, between October 2021 and October 2023 in Sulaymaniyah Teaching Hospital. The evaluation included demographic data, stone attributes, surgical specifics, and postoperative results. Success was defined as the complete removal of stones, confirmed by ultrasonography and x-rays at 1- and 3-months post-operation. Results: The cohort included 7 patients (35%) with divergent collecting systems, 6 patients (30%) with horseshoe kidneys, 5 patients (25%) with ectopic kidneys, and 2 patients (10%) with renal malrotation. The mean age was 43.2 ± 13.8 years, the mean body mass index was 27.8 ± 3.6 kg/m², and the average stone size measured 13.7 ± 3.7 mm. After one session, 75% of patients achieved complete stone removal, and 100% after the second session. Stone size and using access sheaths correlated with the rate of stone-free outcomes (P<0.5). Five patients, representing 25% of the total, experienced minor postoperative complications, including fever in four and hematuria in one patient. Conclusion: Despite the technical challenges associated with altered renal anatomy, Flexible ureterorenoscopy has demonstrated promising outcomes in managing renal calculi in abnormal kidneys, achieving satisfactory stone removal and acceptable complication rates.
Copyright (c) 2026 Dana Ahmed Saeed, Sarwar Noori Mahmood, Saman Salih Fakhralddin https://creativecommons.org/licenses/by-nc-sa/4.0
Retinopathy of Prematurity Screening Criteria in Kurdistan Region
Background and objective: Retinopathy of Prematurity is a retinal vascular and capillary proliferation disease affecting premature infants undergoing oxygen therapy—the current study aimed to introduce adjusted screening criteria for children in the Kurdistan region. Methods: A retrospective review of medical records was conducted to analyze patients who underwent Retinopathy of Prematurity screenings in the Kurdistan region (Duhok Eye Hospital) between 01.01.2019 and 30.03.2023. The screening procedure involved pupil dilation using 1.25% phenylephrine ophthalmic solution and 1% tropicamide. Examinations were conducted using indirect ophthalmoscopy. To optimize screening and ensure timely treatment, three criteria were applied to all 500 babies based on gestational age and birth weight: 33-35 weeks and/or 2500-3000 g, 31-33 weeks and/or 2100-2500 g, and ? 31 weeks and/or ? 2100 g. Results: This study demonstrates a noteworthy association between gestational age and retinopathy of prematurity prevalence. Among neonates born at or before 31 weeks, 81.90% developed retinopathy of prematurity, while only 18.10% did not. For neonates delivered at 32-33 weeks, 27.37% experienced retinopathy of prematurity, with 72.63% avoiding it. At 34-35 weeks, 11.11% experienced retinopathy of prematurity, 88.89% did not. The data also reveals a relationship between birth weight and the requirement for retinopathy of prematurity treatment. Among neonates with a birth weight of less than 2100 grams, a substantial 56.27% required treatment, while 43.73% did not. Conclusions: The study underscores the importance of tailored screening and intervention strategies for retinopathy of prematurity, especially in the vulnerable in the Kurdistan region.
Copyright (c) 2026 Barzeen Fareed Mohammed Ali, Khosro Senyar Tato, Ahmed Ismail Alnaimy https://creativecommons.org/licenses/by-nc-sa/4.0
Residual Stone Fragment after Percutaneous Nephrolithotomy; Shockwave Lithotripsy Vs Retrograde Intrarenal Surgery
Background and objectives: The integration of technology into percutaneous nephrolithotomy procedures has yet to eliminate the issue of residual stone fragments, which cause recurrence or blockage of ureters. The aim of the study is to evaluate and contrast effectiveness of extracorporeal-shockwave-lithotripsy with retrograde-intrarenal-surgery in residual stone fragments therapy following an initial standard percutaneous nephrolithotomy procedure. Methods: The analysis was retrospectively conducted on adult patients with residual stone fragments after doing percutaneous nephrolithotomy. These patients had either extracorporeal-shockwave-lithotripsy or retrograde-intrarenal-surgery at Sulaymaniyah Teaching Hospital and Harem hospital from January 2020 to January 2024. We assessed the stone free rate up to 90 days after the reintervention using ultrasonography, kidney, ureter and bladder radiography for the kidneys, Problems occurring at a 90-day were documented using the Clavien-Dindo system classification. Results: The examination comprised forty-six patients, with a mean age of 44.78 ± 12.38 years. Twenty-six patients were in retrograde-intrarenal-surgery group, while twenty were in extracorporeal-shockwave-lithotripsy group. The stone size in retrograde-intrarenal-surgery group mean was 9.50 ± 2.12 mm, compared to 9.55 ± 2.01 mm in extracorporeal-shockwave-lithotripsy group. The immediate stone-free rate was 84.6% in retrograde-intrarenal-surgery group and 30% in the extracorporeal-shockwave-lithotripsy group, while the final stone free rate after 3 months of follow-up was 97% for retrograde-intrarenal-surgery and 95% for extracorporeal-shockwave- lithotripsy group, while the final stone free rate after 3 months of follow-up was 97% for retrograde-intrarenal-surgery and 95% for extracorporeal-shockwave-lithotripsy. Conclusion: Following percutaneous nephrolithotomy, leftover stones are more effectively treated with retrograde-intrarenal-surgery than extracorporeal-shockwave-lithotripsy. Patients who underwent retrograde intrarenal surgery had greater rates of achieving stone-free status than those with extracorporeal-shockwave-lithotripsy treatment.
Copyright (c) 2026 Rako Abdulqader Hamarashid, Aso Omer Rasheed, Dalshad Hama Khurshid Rahman https://creativecommons.org/licenses/by-nc-sa/4.0
Renal Sinus Fat Volume on Ct scan: Correlation with Essential Hypertension at Middle-Age Group
Background and objectives: High blood pressure is a major public health problem related to the risk of heart disease, stroke and early death. The aim of this study is to examine the correlation between renal sinus fat volume and hypertension for participation in the future management of hypertension. It could be used as screening parameter for hypertension or decreasing renal sins fat volume as treatment of hypertension. Methods: This study was an observational cross-sectional implemented in the Rizgary teaching hospital/radiology department- Erbil City-Kurdistan region/Iraq, in a period between February. 2023 till November.2023. The participants were 98 visitors (referred by physicians for diagnoses of other medical issues), divided into hypertensive and non-hypertensive patients. Native abdominal CT scans were captured and by ellipsoid equation the renal sinus volume of each kidney was measured. Renal sinus volumes in each group were evaluated and compared. Result: The average size of renal sinus fat in left and right kidneys of hypertensive patients was 4.5814 ± 1.088 cm3 and 3.3802 ± 1.02547 cm3 respectively and in control group it was 3.8010 ± 1.10739 cm3 and 2.8004 ± 1.14657 cm3 respectively, it is significantly higher in patients with high blood pressure. There is a significant relationship between the presence of hypertension and renal sinus fat, more at the left kidney (P<0.001). Also, there is a clear difference in size of the renal sinus according to sex. Conclusion: Increased volume of renal sinus in middle-aged persons with essential hypertension, suggesting that there is a pathophysiological mechanism causing increasing volume of renal sinus fat in hypertensive people.
Copyright (c) 2026 Rebaz Fattah Mahmood, Saeed Nadhim Younis https://creativecommons.org/licenses/by-nc-sa/4.0
Psychiatric Morbidity among Patients with Neoplasm
Background and objectives: Confronting a serious illness like cancer has the ability to trigger feelings of depression, anxiety, and other mental health challenges in a considerable portion of patients. This study aims to evaluate the prevalence of psychiatric disorders in cancer patients. Methods: The research was carried out as a cross-sectional study to assess Psychiatric morbidity at Rizgary Teaching Hospital-Oncology department and Nanakali Hospital for Hematology and Oncology, in Erbil city, Iraq. The study was initiated in April 2023 until April 2024. General health questionnaire-28 was used as a screening tool to detect psychiatric morbidity among cancer patients. Results: The majority of the patients showed presence of psychiatric morbidity (59.6%) according to the General Health Questionnaire-28 scale. The mean General Health Questionnaire-28 score of the patients were 26.7±10, the mean score for somatic symptoms was 8.5±3.7, the mean score for anxiety and insomnia was 7.5±4.4, the mean score for social dysfunction was 7.6±1.2, and the mean score for severe depression was 3.3±3.9. Younger age is significantly associated with presence of psychiatric morbidity (46±9.52 vs. 51±6.33) (p=0.001). Gender was also significantly associated with having psychiatric morbidity, as females showed the highest prevalence (66.2%) compared to males (40%) (p<0.05). There is a statistically significant association, between type of treatment and presence of psychiatric morbidity(p=0.039). Conclusion: The mental health issues are prevalent among individuals with cancer. Factors such as age, gender, and treatment type play a significant role in determining the likelihood of these issues occurring.
Copyright (c) 2026 Abdulkhaliq Abdulfatah Muhammad, Sirwan Kamil Ali https://creativecommons.org/licenses/by-nc-sa/4.0
Enhancing Waste Definition Through Oblique Plication and Liposuction in Abdominoplasty
Background and objective: Lipo-Abdominoplasty remains a popular cosmetic surgical procedure globally, with numerous modifications aimed at enhancing aesthetics and minimizing complications. This study aimed to assess the effectiveness of incorporating oblique plication of the abdominal fascia alongside vertical rectus plication to improve waist definition. Methods: This single-arm interventional study was conducted from December 2021 to February 2023 at the Plastic Surgery Department of the Burn and Plastic Surgery Teaching Hospital on 15 patients undergoing treatment for abdominal contour deformities and seeking to enhance waist definition, Through liposuction, oblique plication of external oblique muscle in addition to rectus plication. Results: Both patients and surgeons rated the outcomes as good to excellent, a substantial reduction in waist measurements ranging from the minimum reduction of 9 to maximum of 17cm with mean of 13.67%, in term of scar assessment 87% described their scars as light and thin while 13% reported widened scars, regarding complication two cases of seroma (13.3%) with no major complications observed during or after the surgery. Conclusion: The technique of combining oblique plication of the abdominal fascia with vertical rectus plication appeared to be safe and reproducible, resulting in reduced complications and residual bulging compared to conventional abdominoplasty.
Copyright (c) 2026 Hassan Mohammed Omar, Ari Raheem Qader, Sozan Fadhil https://creativecommons.org/licenses/by-nc-sa/4.0
Multimorbidity, Polypharmacy and Cognitive Assessment Among a Sample of Elderly People in Erbil
Background and objectives: As life expectancy increases and the world's population ages, multimorbidity is becoming more widespread globally, the study aims to evaluate the degree of cognitive impairment and the frequency of polypharmacy and multi-morbidity in elderly patients, as well as the association of cognitive impairment with sociodemographic background, adverse drug reactions, with multimorbidity and polypharmacy. Methods: A cross-sectional study was conducted with 165 elderly patients (who visited Rizgari Teaching Hospital and Brayati Family Primary Health Center in Erbil City, from the first of February 2023 till end of September 2023) were enrolled in this study. The questionnaire included basic demographics, medical, and medication history, and a cognitive assessment. The latter was done using the Mini-Mental State Examination. Results: The results demonstrated that with increasing age, cognitive impairment became more severe (p-value = 0.005). There was more severe cognitive impairment among females (20.2%) compared with males (3.7%). (p-value <0.001). The severity of cognitive impairment was improved among those with higher levels of education. Of those with low socioeconomic status, 35% had severe cognitive impairment in comparison to those with medium socioeconomic status which was 4.8% (p-value <0.001). Of the participants, 92.7% had multimorbidity with no significant association with cognitive impairment (P-value = 0.625). Around one-quarter (24.8%) of participants took 5 or more medications. Some commonly observed adverse drug reactions were observed like: constipation, falling, delirium, difficulty sleeping, urine retention, and vertigo with significant association with cognitive impairment (p-value = 0.021). Conclusion: In this study, it was found that severe cognitive impairment increases with age among the elderly in Erbil, with females and illiterate individuals more affected.
Copyright (c) 2026 Didan Jassim Muhamed, Ali Shakir Dauod, Rachel Elaine Dunham https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of the Marginal Fit of Single Crowns Fabricated from Digital and Conventional Impressions: An In Vitro Study
Background and objectives: Intraoral scanners replace traditional dental impressions offering more comfort and precision. This research intends to evaluate the discrepancies in the marginal gaps of single crowns produced using traditional impression techniques versus digital intraoral scanners. Methods: This in vitro study was conducted over a one-year period from Sep 2023 to Sep 2024. The clinical procedures were carried out at Shorsh dental center in Sulaymaniyah. Fifteen extracted premolars were prepared for crowns and mounted on a 3D-printed model. Using conventional polyvinyl siloxane and intra-oral scanning with Medit i700, fifteen monolithic zirconia crowns were produced for each technique utilizing computer-aided design/computer-aided manufacturing. Marginal adaptation was assessed using the replica technique with silicone materials. The marginal gap was calculated by determining the distance from the edge of the crown to the finish line margin at four different angles: buccal, palatal, mesial, and distal, then examined under a stereomicroscope, and analyzed with ImageJ software. Results: The average mean of marginal gap in digital impression was (107µm) while in conventional impression was (173µ) and the difference was statistically significance with a p-value (0.033). When comparing each aspect separately there were a significant difference in the palatal, distal, and buccal aspects, p-value was (p = 0.004, p = 0.024 and p = 0.039) but not in the mesial aspect (p = 0.2). Conclusion: The marginal gap was less in digital impression compared to conventional and the difference was statistically significant.
Copyright (c) 2026 Hoshyar Taha Kak Ameen, Jwan Fateh Abdulkareem https://creativecommons.org/licenses/by-nc-sa/4.0
Minimal Incision Lateral Temporal Brow lift: An Evaluation Study
Background and Objective: The lateral brow is crucial for facial aesthetics, often descending with age due to skin laxity, gravity, and the absence of brow retractors. The aim of this study is to elevate the lateral brow using a minimal, inconspicuous incision within the temporal hairline. Methods: This retrospective observational study, conducted in Duhok, Iraq, from October 1, 2022, to the end of March 2023, examines the outcomes of a minimal incision temporal brow lift technique over a 6-month period, involving 25 patients. Inclusion criteria required patients to be over 18 years of age, with no prior brow lift procedures or facial trauma, and a minimum follow-up of 6 months. Patients with unrealistic expectations, such as those who anticipated results beyond the reasonable capabilities of a minimal incision brow lift, were excluded to ensure that patient satisfaction aligned with achievable outcomes. Additionally, specific hair characteristics—such as sparse hair, a wide, non-hairy temporal area, or thin or shaved sideburns in male patients—were taken into account. Preoperative assessments were performed with patients awake and standing to evaluate brow position and any asymmetries. Neurotoxin injections to the orbicularis oculi muscle were administered 14 days postoperatively to prevent brow descent. Results: Gender differences in satisfaction were observed, with a higher satisfaction rate among females (14, 56%) compared to males (1, 4%). Satisfaction was also higher under local anesthesia (9.36%) versus general anesthesia (6.24%). Complications reported included internal stitch exposure 1 (4%), unilateral neuropraxia 1 (4%), skin necrosis 1 (4%), scar alopecia 1 (4%), asymmetry 1 (4%), and chronic postoperative pain 4 (16%). Conclusions: This minimal incision brow lift is a practical, safe method for brow elevation, though further research is needed to confirm long-term benefits.
Copyright (c) 2026 Mohammed Ali Fareed Mohammed Ali, Kurdo Akram Qaradaghy https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence of elevated Lipoprotein (a) among young and middle-aged patients with acute coronary syndrome and its correlation with angiographic findings at Sulaimani Cardiac Hospital
Background and objectives: The relation of elevated lipoprotein (a) to severity of coronary artery disease is still debatable. This study was conducted to show the correlation between high levels of Lipoprotein (a) and severity of coronary artery disease. Methods: This was a prospective longitudinal study, conducted at Sulaimani Cardiac Hospital in Sulaimani-Iraq, from March/2024 to June/2024. The sample consisted of 150 cases of acute coronary syndrome. The blood was sent for lipid profile, and patients were taken to the catheterization lab for further management. SYNTAX score was calculated to determine the correlation between coronary artery disease severity and SYNTAX score. Results: Out of 150 participants, 115(76.7%) were males and 35(23.3%) were females. The mean age was 51.6±7.193, ranging from 25 to 59 years. There was a significant positive correlation between Lp (a) ? 126 nmol/L and SYNTAX score ( p < o.oo1).Overall,30.6% of the cases (n= 46, 38 males and 8 females) had abnormal Lp (a) results ( more than 75 nmol/L).Patients with highest lipoprotein(a) were more likely to be older (mean age = 56,27±5.22 , p = 0.03 ).There was a positive correlation between cases with positive family history and elevated lipoprotein(a)( p = 0.012).No statistically significant correlation was established among other risk factors( Diabetes, hypertension, smoking , lifestyle , previous angiography, ethnicity , and body mass index) and lipoprotein( a ) level. Conclusion: There was a statistically significant positive correlation between elevated Lp (a) and severity of coronary lesions assessed by SYNTAX score.
Copyright (c) 2026 Redwan Jaza Abdalwahid, Muzafar Abdulrahman Habeeb, Dana Hama-Baqi Mohammed-Saeed https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of gender on primary total knee replacement in Dohuk city
Background and Objectives: Osteoarthritis is the leading cause of disability and reduced quality of life among elderly patients, after a trial of conservative treatment, total joint arthroplasty is the gold standard treatment for symptomatic end-stage osteoarthritis. The aim is to assess the range of knee flexion, Oxford knee score, Knee Society Function and Knee Society Score after total knee replacement in both genders and find the differences. Methods: This cross-sectional study was conducted in Duhok Emergency Teaching Hospital from October/2022 to October/2024. A total of 60 patients who underwent primary total knee replacement for end-stage knee osteoarthritis were involved in the study. We used non-probability (nonrandom) convenience sampling. Patients in both groups were evaluated preoperatively, as well as at 6, 12, and 24 months postoperatively. Knee flexion, oxford knee score, knee society score, and knee society function score were recorded preoperatively and postoperatively. Results: The outcomes of primary total knee replacement showed significant differences between males and females at 6, 12, and 24 months postoperatively. Significant differences were observed in Knee Function and Knee Society Score, with p-values of 0.0012 and <0.0001, respectively, favoring females. However, no significant differences were found in Knee Flexion and Oxford Knee Score, with p-values of 0.2772 and 0.3340, respectively. Conclusion: Compared to the male group, females showed better outcomes in Knee Society Score and Knee Society Function Score. However, no significant differences were observed in Knee Flexion and Oxford Knee Score. Age and BMI had minimal impact on postoperative outcomes following total knee replacement.
Copyright (c) 2026 Hussein Muhyadeen Othman, Abdulkadr Muhammed Sleman, Laween Omar Musa https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of Investment willingness by Parents in Primary Oral Health Care of Preschool Children in Sulaymaniyah Governorate: A Prospective Study
Background and objectives: Preservation of the primary dentition is crucial for the overall health of children and the subsequent permanent teeth. Investment in primary dentition by families plays an important role in oral health promotion. The study aims to assess the willingness of parents to invest in the oral health of preschool children in the Sulaymaniyah governorate. Methods: A cross-sectional study was conducted at different geographical locations in Sulaymaniyah, Kurdistan Region, Iraq, from January through July 2023. A structured questionnaire was distributed to be answered by three hundred sixty-eight parents. The questionnaire focused on the desire to invest money and time in preschool children`s dental health in addition to the demographic information, perceptions, knowledge, and behaviors of the participants that related to children's oral health. Results: Despite their education, the 368 parents showed unwillingness to invest money (64.04%) in their children`s oral health in contrast to the investment in time by visiting dentist 1-2 visits/year (71.70%) and brushing teeth 1-3 min/day (60.90%). With p value= 0.271, This suggests that there are no significant associations between the education level of parents and willingness to pay, p value = 0.019 which is an indication of a statistically significant relation between investment in time and the education level of parents. Conclusions: Parents with regular teeth brushing behavior showed a significant willingness for investment, yet, working on the upper stream to advocate this subject, and tackling parents` responsibilities about children’s oral health are needed.
Copyright (c) 2026 Sana Sulaiman Haji Rasul, Aras Maruf Rauf, Nasreen Hamarash Hamonari https://creativecommons.org/licenses/by-nc-sa/4.0
The Efficacy of Intervention Time on Probing Results
Background and objectives: Pediatric eye probing is a common treatment for congenital nasolacrimal duct obstruction which affect many infants who might be asymptomatic, careful monitoring should be done. The aim of this study was to determine which pediatric age group benefits most from eye probing in Duhok, Kurdistan region. This study provides insights into the demographics and outcomes of pediatric eye probing, guiding individualized treatment. Methods: This retrospective cross-sectional study reviewed records of 192 children, aged 1 to 30 months, diagnosed with congenital nasolacrimal duct obstruction at Duhok Eye Hospital between January 1, 2023, and September 1, 2023. Data collected included age, gender, operated eye, and residency. The study observed the outcomes of eye probing. Results: Majority of children who underwent probing were aged 7-12 months (34.9%), with an even distribution across age groups. Male accounted for 49.5% of cases. Most patients were from Duhok city (66.7%). Surgery was performed on the right eye in 26.0% of cases, the left eye in 33.3%, and both eyes in 40.6%. Procedure was successful in 91.1% of patients, with 90.6% requiring only one operation. The study shows no statistical benefit for the second time operation regarding age and gender, p value = 0.17, and 0.38, respectively. Conclusion: Eye probing is highly effective for children aged 7-12 months. The observed gender differences in outcomes warrants further research.
Congenital nasolacrimal duct obstruction
Copyright (c) 2026 Araz Abdal Hussein, Nour Mowafaq Masood Alnaqshabandi, Neshtiman Hashim Abdulrahman https://creativecommons.org/licenses/by-nc-sa/4.0
Accuracy of Different Interocclusal Recording Methods
Background: In order to fabricate successful prostheses, it is necessary to reproduce the interocclusal relationship accurately and transfer it to the articulator. This study evaluates the accuracy of different bite registration methods by comparing them with a standard model. Methods: In this in vitro comparative analysis which was done in Duhok, Kurdistan Region, Iraq during 2023. Fully dentate upper and lower casts were mounted on an articulator. Different reference points were marked and the distances between upper and lower reference points with the occlusal plane angles were recorded using a measurement application. They were divided as anteroposterior left and right, buccolingual left and right, horizontal angles, and frontal angles. The lower second premolars and first molars were removed and the casts were duplicated and inter arch relations were transferred using dental wax, condensation silicone, additional silicone and the intra oral scanner. Each of the casts were specific to a single group with 10 samples each group. The measurements and angles were compared with the control group’s measurements. Results: The dental wax and the a-silicone showed significant recordable differences in anteroposterior and buccolingual, right and left (P<0.05). The condensation silicone was significantly different in anteroposterior right and buccolingual right (P<0.05) while the intraoral scanner was significantly different in anteroposterior and frontal readings (P<0.05). All the rest of the results provided no significantly recordable changes or differences(P>0.05). The intraoral scanner showed the least mean difference while group A showed the most. Conclusion: The results showed that all the mentioned methods had some discrepancies and differences. The intra oral scanner and the condensation silicone provided greater accuracy while the dental wax had the least.
Copyright (c) 2026 Hassan Ahmed Alwan, Abdulkareem Ramadhan Al-Mezouri, Manar Yahya Nazhat https://creativecommons.org/licenses/by-nc-sa/4.0
Serum Irisin Level Among Patients with Subclinical Hypothyroidism in Relation with Plasma Atherogenic Indices
Background and objectives: Subclinical hypothyroidism, impacting 3-8% of the general population with a higher incidence in women and older individuals, is linked to cardiovascular and atherosclerosis. This study evaluated the serum irisin levels in individuals with newly diagnosed subclinical hypothyroidism compared to a control group, explored its association with atherogenic plasma indices. Methods: A case-control study, enrolled 160 participants, including 80 with newly diagnosed subclinical hypothyroidism and 80 euthyroid individuals as controls. The study was conducted at the Endocrine Department of Rzgary Teaching Hospital in Erbil City, Iraq. The study was conducted between September 2022 - September 2023. Blood samples were collected for measurement of serum irisin levels, thyroid hormones, lipid profile, anti- thyroid peroxidase antibodies, and atherogenic indices. Results: Notably, 76.3% of Subclinical Hypothyroidism cases were young females (<40, p<0.001) with higher rates of overweight/obesity (73.8%) compared to controls (p<0.001). Waist circumference and thyroid hormone levels were significantly higher in subclinical hypothyroidism cases (p<0.001). The prevalence of high atherogenic coefficient was higher in cases (83.7% vs. 63.8%, p=0.004). Thyroid stimulating hormone levels were elevated in subclinical hypothyroidism cases (7.37?-IU/mL) compared to controls (2.67?-IU/mL) (p < 0.001). Anti- thyroid peroxidase antibodies titer was significantly higher in cases (54.37 IU/mL) than controls (16.55 IU/mL) (p < 0.001). Conclusions: Subclinical hypothyroidism is prevalent among young obese females. Serum irisin levels remain steady in subclinical hypothyroidism compared to healthy controls but positively correlate with atherogenic indices in these patients.
Copyright (c) 2026 Asin Irfan Saeed, Dhia Mustafa Sulaiman, Sherwan Farman Salih https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Hypertonic Saline in the Management of Bronchiolitis at Raparin Hospital
Background and objectives: Bronchiolitis is the prevailing acute respiratory ailment of significant severity among newborns and young children. The objective of the study was to assess the effectiveness of hypertonic saline 3% in treating acute bronchiolitis and its impact on the severity of cases admitted to the emergency department, in comparison to Salbutamol nebulization. Methods: A comparative, experimental, longitudinal study was conducted on 150 infants aged 1–24 months who were admitted to Raparin pediatric teaching hospital at emergency department with moderate to severe respiratory distress from November 2022 to May 2023. Two groups of patients were formed by age and severity. Using a nebulizer device, the two medication combinations (Salbutamol and hypertonic saline) were given to the patients in each of the two groups every six hours. Initial assessment was executed through taking vital signs on admission. Moreover, additional assessments were conducted before and following each nebulization for four times each day until the recovery and discharge. The length of recovery, hospital stay, duration of oxygen therapy, wheezing and oxygen saturation was compared between the two groups. Results: The study found that 32% of the Salbutamol group stayed 4 days and 18.7% of same group stayed ? 5 days in the hospital respectively, compared with 14.7% of the hypertonic group stayed in hospital for 4 days and 0% stayed ? 5 days in the hospital (p < 0.001). Furthermore, one day after treatment, around half (44%) of children treated with hypertonic saline had no wheeze, compared with 24% of children of the Salbutamol group (p < 0.001). Conclusion: The present study concluded that the role of Nebulized 3% Hypertonic Saline is significant in management of bronchiolitis.
Copyright (c) 2026 Zina Farhad Ali, Dler Abdulkhaleq Nooruldeen https://creativecommons.org/licenses/by-nc-sa/4.0
Glycemic Gap, Clinical, Angiographic Characteristics and In-hospital Outcomes of Diabetic Patients Presenting with Acute Coronary Syndrome undergoing Primary Percutaneous Coronary Intervention
Background and objectives: a number of severe illnesses have been linked to the glycemic gap which is the difference between estimated average glucose and blood glucose at admission as a potential prognostic indicator, it's function in individuals with acute coronary syndrome is still unclear, nevertheless, this study aims to evaluate the glycemic gap in acute coronary syndrome patients as well as its correlation with clinical outcomes, including length of hospital stay and occurrence of complications. Methods: Between January 1st and April 1st, 2023, we performed a prospective cohort study with 100 patients who were admitted with acute coronary syndrome at Surgical Specialty Hospital, Erbil Cardiac Center, a glycemic gap calculation was made, the clinical outcomes were evaluated and the prognostic importance of the glycemic gap was ascertained by multivariate analysis. Results: Mean age was 61.77 ± 10.44 years, with 55% being male and 45% female, the mean admission blood glucose level was 256.47 ± 63.90 mg/dL, mean glycemic gap was 77± 61mg/dl, and the mean HbA1c level was 7.8% ± 0.82%, there was no significant difference between the two groups admission random blood glucose levels (p = 0.789), but diabetic patients who encountered major adverse cardiac events had a substantially higher glycemic gap than those who did not (p < 0.001). Conclusion: Based on our research, patients with acute coronary syndrome may benefit from using the glycemic gap as a useful prognostic indicator, in the regular treatment of acute coronary syndrome patients.
Copyright (c) 2026 Herish Adil Ahmed, Rafid Fayadh Al-Aqeedi https://creativecommons.org/licenses/by-nc-sa/4.0
Antibodies Against Cytomegalovirus Infection in Pregnancy with Recurrent Miscarriage
Background and objectives: Recurrent pregnancy loss leads to serious obstetrical and psychosocial consequences specifically if causes are unknown. The aim of this study is to evaluate the role of cytomegalovirus infection in women with recurrent pregnancy loss. Methods: This is a case-control study implemented in outpatient's clinic of Maternity hospital in Erbil city over duration of one year from 1st of June, 2022 to 31st of May, 2023 included 100 women with miscarriages recurrences and 100 women without history of miscarriage. A sample of 5 ml blood was drawn from selected women and sent for investigation. Serologically, cytomegalovirus infection was confirmed through recording cytomegalovirus immunoglobulin-G and immunoglobulin-M anti-bodies detection in private laboratory. Results: The age, body mass index, educational level, occupation, residence and parity history of study participants were not statistically different between study groups (p>0.05). The consanguinity was statistically related to controls (40%) and the positive family history of repeated pregnancy loss was statistically related to women with repeated pregnancy loss (12%) (p?0.05). Cytomegalovirus immunoglobulin M seropositivity was not statistically different between study groups (2% versus 2%) (p>0.05), however, cytomegalovirus immunoglobulin G seropositivity was prevalent in women with recurrent pregnancy loss (100%) (p=0.04). Conclusions: The cytomegalovirus infection is a risk factor for miscarriages recurrence.
Copyright (c) 2026 Nashmel Farhad Mamand, Ariana Khalis Jawad https://creativecommons.org/licenses/by-nc-sa/4.0
Surgical Management of a Rare Bilateral Tessier Number 4 and 7 Facial Cleft: A Case Report
Background: craniofacial clefts are rare congenital anomalies of unknown etiology of which only few case reports are available in the literature. Case report: this is the first case report of a two-week-old child presented with bilateral facial cleft; Tessier No.4 on the right and Tessier No.7 on the left side of the face treated surgically in Kurdistan region of Iraq. Conclusion: management of these children is complex and highly individualized, sharing more of such reports will help in developing better strategies for their treatment.
Copyright (c) 2026 Vyan Hiwa Mohammed Raouf, Ari Raheem Qader https://creativecommons.org/licenses/by-nc-sa/4.0
Serum Vitamin B12 Level in Type 2 Diabetes Patients on Metformin Therapy
Background and Objective: Type 2 diabetes mellitus is a common non-communicable disease all over the world. Metformin is an effective treatment option for diabetic patients. However, this option is frequently accompanied by vitamin B12 deficiency. Therefore, we aimed to measure the prevalence of serum vitamin B12 deficiency in type 2 diabetic patients and recognize risk factors related to vitamin B12 deficiency. Methods: This study was a retrospective cross-sectional study implemented in Layla Qasim Diabetic Center in Erbil city-Kurdistan region/Iraq through six months from 1st of October 2023 to 31st of March 2024 on a sample of 100 type 2 diabetic patients. We investigated and analyzed patients' data. The vitamin B12 deficiency was diagnosed regarding the center laboratory cutoff value of less than 191 pg/ml. Results: The mean serum B12 level of type 2 diabetic patients was (421.9 pg/ml); 21% had low serum B12 levels. A significant association was observed between good glycemic control (i.e. HbA1c of less than 7.0%)1 of type 2 diabetic patients and low serum B12 level (p-value=0.04). No significant relationships existed between serum B12 levels and other type 2 diabetic patients' characteristics (p>0.05). Conclusions: The prevalence of serum vitamin B12 deficiency among type 2 diabetic patients on metformin is within the acceptable range (i.e. serum vitamin B12 between 191-663 pg/ml). The strict glycemic control by high doses of metformin therapy for type 2 diabetic patients commonly leads to serum vitamin B12 deficiency.
Copyright (c) 2026 Saman Ismail Farajulla, Mohammed Qader Meena https://creativecommons.org/licenses/by-nc-sa/4.0
Apical Microleakage of Root Filled Tooth Using New Bioceramic Sealers Used with Two Different Obturation Techniques
Background and objective: The choice of different root canal sealers can influence the amount of apical microleakage. This study aims to assess the microleakage of four different sealants used in root canals. Methods: This l in vitro study was conducted from June 2022 to June 2023 in Duhok city in research medical lab at college of medicine. A total of eighty human extracted 1st premolar teeth were extracted and used. The crowns were removed, and the root canals were prepared. The specimens were assigned at random to four groups (n=10) according to the type of sealer used and the two obturation techniques applied. The outer sides of the samples were coated with nail polish to provide insulation. Following the completion of the endodontic procedure, the samples were immersed in methylene blue dye for a duration of 72 hours. Each group was assessed for microleakage using graduated microscope. Results: The study showed that maxima Mineral trioxide aggregate bioceramic had the lowest level of microleakage of 0.5mm, on other hand, Zinc Oxide Eugenol-Single Cone exhibited the greatest level of microleakage of 2.5mm, the difference was significant with p-value <0.0001, and for the thermafill technique the mean value was 0.68 while for the single cone was 2.19 with the p- value < 0.0001 which was also significant. Conclusion: maxima showed the best results in microleakage however, there is no technique or materials that completely eliminate leakage at all.
Copyright (c) 2026 Parween Mohammed Salim Ahmed, Abdulkareem Ramadan Al Mzuri https://creativecommons.org/licenses/by-nc-sa/4.0
Anti-Mullerian Hormone Role in In Vitro Fertilization Outcome
Background and objectives: The in vitro fertilization plays a significant role for human development in last decades. Anti-müllerian hormone level evaluation is indicator of ovarian reserve. The aim of this study was to assess the role of anti-müllerian hormone in assessing the quality of in vitro fertilization outcomes. Methods: It was a retrospective study implemented at in vitro fertilization center of private hospital in Erbil city, Kurdistan region-Iraq in duration of one year from 1st of October, 2022 to 30th of September, 2023 on sample of 50 infertile women underwent in vitro fertilization. The biochemical pregnancy was diagnosed through serum recognition of human chorionic gonadotrophin, while the clinical pregnancy was diagnosed by ultrasonography. The in vitro fertilization outcome was assessed in relation to anti-mullerian hormone level and other variables like demographic and hormonal status. Results: Biochemical pregnancy was positive in 80% of infertile women, while clinical pregnancy was positive in 72% of them; 24 women with ongoing pregnancy and 12 women ended with live birth pregnancy. Mean anti-mullerian hormone level was not significantly different in regard to clinical pregnancy outcome (p=0.4). The means of oocyte retrieved and embryo transferred were significantly higher among infertile women with positive clinical pregnancy (p?0.05). The anti-mullerian hormone level was positively correlated to the count of oocyte retrieved and embryo transferred. Conclusions: The serum anti-mullerian hormone level is not a predictor for in vitro fertilization quality.
Copyright (c) 2026 Chiman Khudhur Mawlood https://creativecommons.org/licenses/by-nc-sa/4.0
Nature of Pediatric Leukemia in Hiwa Hematology/ Oncology Hospital: A Single Cancer Center Experience
Background and objectives: Acute lymphoblastic leukemia is the most common type of blood cancer in children. This study aimed to address various sociodemographic and diagnostic findings of pediatric patients with acute lymphoblastic leukemia that have been recorded in the data system of Hiwa Hematology/Oncology Hospital. Methods: This retrospective cross-sectional study was performed on 100 patients aged <18 years with acute lymphoblastic leukemia in Hiwa Hematology/Oncology Hospital, from January 2020 to July 2023. A standard spreadsheet was used to report patients’ sociodemographic data and diagnostic findings, including complete blood count, bone marrow blast count, immunophenotyping, and genetic mutation. Results: Most patients had B-cell acute lymphoblastic leukemia (92%), aged <6.0 years (52%), underweight (69%), A+ blood group (33%), and negative gene mutation (98% for protein 190 and 97% for protein 210). There was no significant correlation between both leukemia subtypes regarding age (p?0.745), gender (p=0.461), body mass index (p=0.849) and season of diagnosis (p?0.355). However, a significant difference (p<0.001) was seen for blood group distribution. No significant alterations (p?0.05) were seen in the mean hemoglobin, platelets and bone marrow blasts between both leukemia subtypes, while a significant difference (p=0.002) in the mean leukocyte levels was seen. Conclusions: B cell-subtype pediatric acute lymphoblastic leukemia is more common in our locality and is not related to age, gender, body mass index and season of diagnosis but is directly correlated to blood group.
Copyright (c) 2026 Khadeeja Mohammed Najeeb, Dana Ahmad Abdullah, Nawshirwan Gafoor Rashid https://creativecommons.org/licenses/by-nc-sa/4.0
Incidence of Stromal Rejection in Deep Anterior Lamellar Keratoplasty in North Eye Center/Erbil
Background and objectives: Deep anterior lamellar keratoplasty has emerged as a preferred surgical option for corneal diseases, with its primary advantage being the preservation of endothelial cell density, thus reducing the risk of endothelial graft rejection. This study aimed to assess the incidence of stromal rejection in Deep anterior lamellar keratoplasty among patients in Erbil city, Kurdistan Region of Iraq. Methods: This retrospective cross-sectional study analyzed the incidence of stromal rejection in 477 patients who underwent deep anterior lamellar keratoplasty at the North Eye Center, Erbil, Kurdistan Region of Iraq, from March 2016 to January 2023. Of these, 28 patients developed stromal rejection. Medical records were reviewed to identify risk factors associated with stromal rejection, with diagnoses confirmed via slit lamp examination and visual acuity measurements. Data were analyzed using SPSS version 28, with significance set at p ? 0.05. Ethical approval was obtained, and patient confidentiality was maintained. Results: The incidence of stromal rejection in deep anterior lamellar keratoplasty was 5.87% among the patients. The study revealed a statistically significant association between rejection and clinical assessment, with loose sutures being a significant risk factor (p = 0.001). Specifically, 50% of the patients who experienced stromal rejection had loose sutures. Additionally, stromal neovascularization contributed to 25% of the rejection cases (p = 0.001). Treatment primarily involved antibiotics and steroids, with lubricants having no significant impact on rejection rates. Male predominance was observed among patients (72.1% male, 27.9% female), with no significant gender association with rejection (p = 0.341). Conclusion: The findings underscore the efficacy of Deep anterior lamellar keratoplasty in treating corneal disorders while highlighting the importance of vigilant postoperative care, particularly in monitoring suture integrity to prevent rejection.
Copyright (c) 2026 Marwan Fareeq Shaheen, Neshiteman Hashim Abdulrahman https://creativecommons.org/licenses/by-nc-sa/4.0
Acute Coronary Syndrome in Slemani, Iraqi Kurdistan
Background and objectives: Ischemic heart disease still accounts for major cause of cardiovascular disease and death worldwide. Its incidence has increased dramatically over the last decade. Presentation and management outcomes of Acute Coronary Syndrome is affected considerably with age, sex and race. The objective of this study was to assess epidemiological characteristics and analyze angiographic findings of patients. Methods: This is an observational cross-sectional study carried out on 440 patients with acute coronary syndrome who were admitted from April to June 2024 to Slemani Cardiac Hospital and for whom coronary angiography was done. Percentages of patients with regard to age and sex determined, and angiographic characteristics identified as whether patients were right or left dominant, and number significant lesions they had. Management outcomes were also studied as if they were treated with stent, referred to open heart surgery, or just treated medically. Moreover, these angiographic findings were correlated in males with females. Results: The results revealed that nearly two third of the patients (69%) were males. Most common age presentation was 50-60 years old (34%), while only 14% and 27% were among age groups of 40-50 and 60-70 years old, respectively. Nearly 85% of the patients were right dominant (93% of males, compared to 85.5% of females). A significant number of the patients had other significant coronary artery disease in addition to culprit lesion (104 out of 440 patients), while non-significant obstructive artery disease observed more in women (32%) compared to only 20% of males, which is statistically significant. Percutaneous coronary intervention was the most frequent modality of treated (54% of all the patients). Conclusions: Acute coronary syndrome is quite common in this locality and plan is needed to target both primary and secondary prevention strategies.
Copyright (c) 2026 Akam Ali Saeed https://creativecommons.org/licenses/by-nc-sa/4.0