Kurdistan Higher Council of Medical Specialties
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Comparative Evaluation of the Role of Non-bronchoscopic vs Bronchoscopic Techniques for the Diagnosis of Ventilator-Associated Pneumonia
Background and objectives: Ventilator-associated pneumonia is a common form of hospital-acquired pneumonia that develops after 48 hours from intubation and mechanical ventilation. This study aims to compare the results of distal airway sampling for the diagnosis of Ventilator-Associated Pneumonia between Non-bronchoscopy and bronchoscopy Techniques. Methods: This was a prospective case-control diagnostic study. The study was conducted over five months among patients with clinical suspicion of Ventilator Associated Pneumonia, who were admitted to the intensive care unit at Emergency Teaching Hospital and Azadi Teaching Hospital in Duhok City, from 1st May 2023 to 30th September 2023. We compared two methods of distal airway secretion to diagnose the infection: Non-Bronchoscopic protected Bronchoalveolar lavage and Bronchoscopic Broncho alveolar lavage. Results: Acinetobacter baumanii (27.5%) was the most prevalent organism detected on Bronchoscopic Broncho alveolar lavage, followed by Klebsiella pneumonia 22.5% while on non-Bronchoscopic protected Bronchoalveolar lavage the most common organism detected was Klebsiella pneumonia (22.5%) followed by Acinetobacter baumanii (20%). Bronchoscopic Broncho alveolar lavage was more sensitive at 100% compared to 92.3% than non-Bronchoscopic protected Bronchoalveolar lavage, but the latter was more specific at 28.6% compared to 21.4%. additionally, the earlier was significantly associated with Clinical Pulmonary Infection Score, p-value 0.037, while the later was 0.129 Conclusion: ventilator associated pneumonia is a challenging diagnosis that requires clinical signs with suspicion followed by the appropriate laboratory diagnostic techniques. Both techniques were sensitive to Ventilator Associated Pneumonia detection, with Broncho alveolar lavage receiving a higher privilege.
non-Bronchoscopic protected Bronchoalveolar lavage
Copyright (c) 2026 Zidan Mohammed Abdullah, Abdulhameed Aldabbagh https://creativecommons.org/licenses/by-nc-sa/4.0
Comparing the Effects of Tongue in Groove and Strut Graft of Open Rhinoplasty on Nasal Tip Rotation and Projection
Background and Objectives: Managing the nasal tip is a complex aspect of rhinoplasty, requiring an understanding of anatomical variations and their impact on tip support. Various procedures have been developed to enhance tip projection and tip rotation. This study compares effects of two such techniques in long-term, the tongue in groove and strut graft methods, on nasal tip projection and rotation. Methods: This study was a randomized controlled surgical trial that was conducted at Rizgary Teaching Hospital – Otolaryngology department between January 2023, and October 2023. Forty patients undergoing rhinoplasty were randomly divided into two groups: Group A (strut graft) and Group B (tongue-in-groove). Both groups underwent open rhinoplasty using their respective techniques. Tip projection and rotation were measured pre- and postoperatively using Goode’s method and Adobe Photoshop. Statistical analysis was performed using SPSS version 26. Results: The mean age of patients was 24.9±5.52 years, with females comprising 80%. Preoperative measurements showed no significant differences between groups. Postoperative comparisons revealed no significant difference in tip rotation (Tongue in groove: 102.9°±6.3° vs. Strut graft: 101°±5.4°, p>0.05), but a significant difference in tip projection (Tongue in groove: 64.1±8 vs. Strut graft: 70.6±6.8, p<0.01). Naso facial angles decreased significantly in both groups postoperatively. Conclusion: Both Tongue in groove and strut graft techniques are effective for maintaining nasal tip projection and rotation. However, the strut graft technique showed a more significant increase in tip projection postoperatively.
Copyright (c) 2026 Nabaz Muhammed Hussein, Moyaser Abdulrahman Yaseen, Shwan Ramathan Shareef https://creativecommons.org/licenses/by-nc-sa/4.0
Chronic thoracic pain in cardiothoracic surgery via thoracotomy and sternotomy: risk factors and outcomes
Background and Objective: With a frequency of 9%–64% within 1 or 2 years following the procedure, chronic thoracic pain is a prevalent issue among patients receiving thoracic surgery. The purpose of this research was to identify the risk factors for chronic pain one year following thoracotomy and sternotomy, and to document its detrimental effects. Methods: We have enrolled 102 individuals who had thoracotomies and sternotomies at the Rizgari Teaching Hospital and the Erbil Cardiac Center between May and July 2023 in this case series study. Patients were contacted a year later to inquire about the development of chronic pain following surgery and whether or not the pain was interfering with their day-to-day activities. During the tele interview, certain potential risk factors like advanced age, smoking, diabetes mellitus, and duration of surgery were also sought after. Results: The incidence of pain following surgery was 79.4%. Following a review of the patient's medical history, 66.7% of diabetic patients, 77.8% of those with a positive smoking history, and all 10 thoracotomy cases (12.3%), had postoperative pain with statistically significant p values of (0.04), (0.05), and (0.03) respectively. Mean health scale score was considerably poorer among patients who had pain, p value (0.03). Conclusions: Postoperatively, a number of variables were substantially linked to persistent thoracic pain. Prior to surgery, patients should be informed of this and its implications.
Copyright (c) 2026 Sangar Sarkaut Mohammed, Bashar Hanna Azar, Aram Baram https://creativecommons.org/licenses/by-nc-sa/4.0
Relation of Longitudinal Strain to Conventional ECHO in Evaluation of Pediatric Dilated Cardiomyopathy in Children Heart Hospital/ Sulaymaniyah City
Background and objectives: While many dilated cardiomyopathy fatalities occur within the first year, patients are often diagnosed at advanced stages. This study evaluates the efficacy of longitudinal strain versus conventional 2D echocardiography for improving early detection and management in pediatric dilated cardiomyopathy. Methods: This prospective cross-sectional study was conducted from October to September 2024, at the Children Heart Hospital and Jamal Ahmad Rashid Pediatric Hospital ICU in Sulaimani, involving children aged 1 month to 15 years with dilated cardiomyopathy. Echocardiograms were performed using a GE Vivid E9 system by a pediatric cardiologist, assessing left ventricular function through 2D echocardiography, and longitudinal strain. Key parameters included left ventricular volumes, ejection fraction (Simpson's method), mitral valve excursion, and diastolic function (E/A ratio), in line with American Society of Echocardiography guidelines. Data were analyzed using SPSS version 27.0. Descriptive statistics summarized demographic and clinical variables, while t-tests and chi-square tests compared longitudinal strain with conventional 2D echocardiography in assessing pediatric dilated cardiomyopathy. Statistical significance was set at p<0.05. Results: The study involved 17 children (mean age: 7.06±3.11 years; 47.06% male, 52.94% female). Echocardiographic assessments indicated an average Simpson ejection fraction of 38.88% (range: 21.0-58.0), with 29.4% having an ejection fraction <35%, 52.9% between 35-49%, and 17.7% >50%. Simpson ejection fraction, M-mode ejection fraction, and Mitral Annular Plane Systolic Excursion significantly (p-value<0.05) decreased with age. Conclusion: Our study underscores the utility of longitudinal strain in enhancing the diagnostic accuracy of pediatric dilated cardiomyopathy when used alongside conventional echocardiography.
Copyright (c) 2026 Bilal Abdullah Mohammed, Aso Faeq Salih https://creativecommons.org/licenses/by-nc-sa/4.0
Stress Among Patients with Breast Complaints in Sulaimani: A Cross-Sectional Study
Background and Objectives: Breast complaints are a significant health concern for women globally, often accompanied by heightened stress levels which can exacerbate psychological distress. This study aimed to evaluate the prevalence and levels of stress, as measured by the Perceived Stress Scale, among women with breast complaints in Breast disease management center in Sulaimani, Iraq. Methods: A cross-sectional study design was utilized in this research, which spanned from January to June 2024 at Breast disease management center in Sulaimani. Participants included 200 women visiting a breast disease management center, selected using an available sampling technique. The Perceived Stress Scale questionnaire was administered to assess stress levels, with scores ranging from 0-40, and categorized into low (0-13), moderate (14-26), and high (27-40) stress. Results: Based on the Perceived Stress Scale distribution results among women, it was found that 93 (46.5%) women had high levels of stress, 104 (52%) women had moderate stress levels, and three (1.5%) had low-stress levels. The Perceived Stress Scale was significantly associated with the participants' educational levels in the study, with individuals having lower educational attainment exhibiting higher levels of stress, and moderate to severe stress levels being more prevalent among these individuals p-value 0.05. Conclusion: Patients with breast problems experienced high levels of stress. Therefore, designing interventions based on stress-coping methods can help alleviate their stress and may prevent other complications.
Copyright (c) 2026 Hemn Mohammed Saeed Abdalla, Rebwar Ghareeb Hama https://creativecommons.org/licenses/by-nc-sa/4.0
Immediate and Short-Term Outcomes of Transcatheter VS Surgical Closure of Secundum Atrial Septal Defect in Erbil Surgical Specialty Hospital/Cardiac Center
Introduction: The secundum atrial septal defect is a common congenital heart disease in children and adolescents. This study set out to compare transcatheter closure versus surgical closure for secundum atrial septal defect in children and adolescents in terms of immediate and short-term results of. Methods: A prospective interventional study conducted in Surgical Specialty hospital-Erbil cardiac center in Erbil city-Kurdistan region/Iraq in duration of twelve months 1st of April 2023 to 31st of March 2024 on sample of 50 children with secundum atrial septal defect divided into two study groups (25 children underwent transcatheter intervention and 25 children underwent surgical intervention). Post procedure outcomes (Heart rate, ECG changes, complications, hospital stay duration) were assessed. Results: In both study groups, the means of vital signs were significantly reduced after 3 months from intervention (p<0.001). After 3 months, the means of heart rate and QRS duration were not significantly different between two study groups (p>0.05), while means of p wave minimum, p wave maximum, p wave dispersion and PR interval were significantly lower among children underwent transcatheter intervention (p≤0.05). There was a highly a significant association between longer hospital stay and children underwent surgical intervention (p<0.001). Conclusion: Both transcatheter and surgical closure of secundum atrial septal defect are effective, but the transcatheter intervention is associated with less immediate complications and shorter hospital stay duration.
Copyright (c) 2026 Zahrah Jamal Hamad, Aso Faeq Salih, Zuhair Ibrahim Al-Nasiry https://creativecommons.org/licenses/by-nc-sa/4.0
Cone-Beam Computed Tomography Analysis of Root Canal Morphology in Mandibular First Molars in Erbil Population: A Retrospective Study
Background and objectives: The mandibular first molars have a variety of abnormal canal morphologies; many authors have researched the frequency of these anatomical variants and their relationship to gender. The objective of this study is to analyze root canal morphology using Cone-Beam Computed Tomography in Erbil population. Method: This retrospective study, conducted in Erbil in the Kurdistan region of Iraq from January 2023 to January 2024, evaluates Cone-Beam Computed Tomography images of 100 mandibular first molars. The evaluation focused on the following details: the number of roots, the number of apical foramina, the frequency distribution of root canal configurations based on Vertucci’s classification, and the frequency of occurrence of both the middle mesial canal and radix entomolaris. Result: The study included 100 patients. The middle mesial canal was present in 3.7% of patients under 30 years old, compared with 2.2% of those aged 30 years or older (p = 1.000). Four out of 100 patients (4%) had three roots, while the remaining patients had two roots. Only 4% of the sample exhibited radix entomolaris. Conclusion: Mandibular first molars typically have two main roots. Type I is the most common shape for distal canal, while for the mesial canal, type II, IV are more common, with middle-aged individuals showing a higher frequency of middle mesial canals. Variation also occurs in root number, apical foramina presence, extra roots and different canal configuration.
Copyright (c) 2026 Twana Jalal Rasool, Diyar Khalid Bakir https://creativecommons.org/licenses/by-nc-sa/4.0
Incidence Rate, Associated Risk Factor and Perinatal Outcome of Preeclampsia at Maternity Teaching Hospital
Background and objectives Preeclampsia is a serious pregnancy complication with a significant maternal and perinatal morbidity and mortality. The aim of this study was to assess the incidence rate, associated risk factors and perinatal outcome of women with preeclampsia delivered in a tertiary maternity hospital. Methodology: In the labor ward of Maternity Teaching hospital in Erbil city, Kurdistan region, Iraq a case control design was used to determine the risk variables and perinatal outcomes, and a cross-sectional design was used to estimate the incidence rate, from 1st of January, to 31st of December, 2023 on a sample of 218 pregnant women with preeclampsia and 440 pregnant women without preeclampsia was selected as controls. Associated risk factor and perinatal outcomes were compared between the 2 groups. Results: Incidence rate of preeclampsia was (1.1%). Increased age (30% of cases vs. 12% of controls were ≥ 35 years), smoking (11.9% of cases vs. 0% of controls), preterm gestational age (3.2% of cases vs. 0% of controls), grand-multiparity (6.4% of cases vs. 3.2% of controls), multiple gestations (34.9% of cases vs. 24.1% of controls), previous preeclampsia (12.4% vs. 2.3%) were significantly related to preeclampsia (p<0.050). The common adverse outcomes of pregnant women with preeclampsia were fetal congenital anomalies (6.4%), elective cesarean section (46.8%), low Apgar scores at 1 (23.4%) & 5 (8.3%) minutes and early neonatal death (19.3%) (<0.001). Conclusions: The study identifies common risk factors for preeclampsia, including advanced maternal age and smoking, and emphasizes routine blood pressure monitoring and management for high-risk pregnancies.
Copyright (c) 2026 Aisha Mohammed Othman, Shahla Kareem Alalaf, Zhiyan Suwar Ismael https://creativecommons.org/licenses/by-nc-sa/4.0
Pre-operative Near Acuity Test as Predictor for Post-operative Distance Visual Acuity in Cataract Surgery
Background and objectives: While surgical interventions are the most common and successful treatments for cataract, the need for preoperative assessment to accurately predict postoperative visual outcomes is crucial not only for patient counseling and surgical planning but also to set realistic expectations. Therefore, the aim of the present study is to evaluate the ability of the preoperative near acuity test to successfully predict the improvement in distance eyesight following the cataract surgery. Methods: Data for this cross-sectional retrospective study was collected from North Eye Center, which is an ophthalmic medical center in Erbil, Iraq from January 2020 to January 2024. Results for the preoperative near acuity test from 400 patients, who were 40-80 years old prior to cataract surgery, were analyzed. Postoperative distance visual acuity data were also collected for these patients. The outcomes from the preoperative near acuity test were then compared with postoperative distance visual acuity results to assess the predictive accuracy of the test. Results: The test was able to predict cataract surgical outcomes in 87.5% (350/400) of patients in comparison to 12.5% (50/400) who were not predicted by the test (P<0.001). Patients who were not predicted by the preoperative near acuity test were found significantly older (75.7±2.3 years) than patients who were predicted by the test, 75.7±2.3 vs. 60.4±2.2 years, respectively, P<0.01. Conclusions: the preoperative near acuity test may serve as a valuable predictive tool in preoperative evaluations for cataract surgery, particularly effective in younger patients. Its integration into standard preoperative assessments could enhance surgical outcomes by enabling more personalized patient management strategies.
Copyright (c) 2026 Shereen Mundhir Taiyeb, Didar Sddeq Anwar, https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence and Epidemiological Criteria of Ocular Trauma in Duhok Governorate
Background and objectives: Ocular trauma is a leading cause of monocular blindness worldwide. The purpose of this study was to estimate the sociodemographic characteristics and risk factors of ocular trauma in Duhok governorate. Methods: From October 2022 to April 2023, a retrospective cross-sectional observational study was carried out in the Duhok Emergency and Eye Research Hospitals. Each patient presented with ocular trauma underwent a thorough examination and interview. A modified Birmingham Eye Trauma Terminology System was used to record and categories demographic traits and damage specifics. Results: A total of 231 injured patients were included, of which 179 (77.5%) were male. The group of patients between the ages of 18 and 44 had the largest percentage of ocular trauma, with an average age of 26.7 years. The majority of the patients were from the center of Duhok 133 (57.6%). Approximately (38.5%) of the injuries occurred in the workplace. Closed globe injury was found to be higher (88.3%) compared with open globe injury (11.7%). Most frequent type of ocular trauma was of corneal origin (55.8%) and caused by sharp objects (32.5%). Foreign body on the external eye was observed to be the most common diagnosis (26.4%). Conclusion: The type of ocular damage and the implicated ocular structures are important factors in determining the visual outcome. The adult male found to have the largest percentage of cases among workers. In our community, occupational eye injuries are frequent and can be decreased with the use of eye protection equipment.
Copyright (c) 2026 Azeez Sabah Azeez, Nour Moafiq Masoud, Ahmed Ismail Abdulgani https://creativecommons.org/licenses/by-nc-sa/4.0
Oxidative Stress Levels and the Oral Health Status of Children with Down Syndrome at The Helena Health Center in Erbil City, Kurdistan Region, Iraq
Background and objectives: Down syndrome is the most frequently occurring hereditary reason for cognitive disability, arising from the duplication of either the whole or a section of chromosome 21. The study’s goal was to evaluate the association between salivary oxidative stress indicators, including total antioxidant capacity, nitric oxide, and salic acid, and oral health parameters such as dental caries and periodontal disease in individuals with Down syndrome. Method: This case-control study conducted at Helena Center, in Erbil City, Kurdistan Region, Iraq between June 1st 2023 and June 1st, 2024.The study included 37 persons with Down syndrome and 37 healthy-matched control volunteers aged 7 to 12 years. The study compared Oral health status (DMFT, Plague Index, and Gingival Index) among individuals with Down syndrome and healthy volunteers aged 7-12 years, using Plaque Index and Gingival Index. The unstimulated salivary samples were used for oxidative stress assessment. Results: In children with Down syndrome, the value for (Decayed, Missing, Filled Teeth) for permanent teeth (0.75), for (Decayed, Filled Teeth) for deciduous teeth (0.94), plaque index (0.68), gingival index (0.88), Total antioxidant capacity (4.17), Nitric oxide (98.8), Sialic acid (1). whereas the values in the control group were DMFT (1.07), dft (1.27), plaque index (0.69), gingival index (0.56), Total antioxidant capacity (6.37), Nitric oxide (75.8), Sialic acid (0.72). No significant differences were seen in the two groups' regarding (Decayed, Missing, Filled Teeth) for permanent teeth, (Decayed, Filled Teeth) for deciduous teeth, plaque index and Nitric oxide. Down syndrome had significantly higher gingival index, while Total antioxidant capacity was significantly low and Sialic acid was significantly higher. Conclusions: this study highlights differences in salivary biomarkers in children with Down syndrome, including lower total antioxidative capacity and higher sialic acid levels, which may impact oxidative stress and plaque formation.
Copyright (c) 2026 Abdulkareem Ali, Ali Fakhree Alzubaidee, Nasreen Hamarash Hamonari https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence of Osteoporosis Among Patients with Rheumatoid Arthritis
Background and objectives: Rheumatoid arthritis is an autoimmune disease characterized by inflammation of the joints. The aim of this study was to investigate the prevalence of osteoporosis among patients with rheumatoid arthritis in Erbil city. Methods: A cross-sectional study was conducted in Rizgary and Hawler Teaching Hospital that started from September 2022 to September 2023. A convenient sample of hundred patients was included in the study. Rheumatoid arthritis patients were assessed in a cross-sectional design by Dual Energy X-ray Absorptiometry Scan T-score. All participants registered an initial two paged questionnaire form; a verbal consent was achieved from all patients. Bone densitometry solution was used in Hawler Teaching Hospital and to be calibrated to their standards. Results: Patients with rheumatoid arthritis in whom bone mineral density was measured, 31 patients (31 %) had osteoporosis, 33 patients (33%) had osteopenia, 36 patients (36%) had normal result. Odd ratio (OR), its 95% confidence interval was calculated for results with positive finding from baseline characteristics. For example, Patients with osteoporosis had longer disease duration (≥7 years; OR= 2.84, 95 % CI: 1.03 to 7.83, P= 0.042). Conclusion: Osteoporosis is prevalent among rheumatoid arthritis patients in Erbil city. The prevalence was significant among lower body mass index, steroid users and old age post menopause patients.
Copyright (c) 2026 Mahran Othman Rasool, Dashty Abbas Al-Bustany https://creativecommons.org/licenses/by-nc-sa/4.0
Oncological Outcomes of Colorectal Cancer Based on Patients’ Age Group
Background & objectives: A progressive and significant increase of colorectal cancer has been observed in younger people. Thus, this study evaluated oncological outcomes among patients with colorectal cancer according to their age groups. Methods: This retrospective cross-sectional hospital-based study was performed from June 2013 to March 2024 at Rizgary Teaching Hospital and Zheen International Hospital on 183 patients with colorectal cancer using their medical records. A data spreadsheet was used to collect patients’ data over eleven years, including gender, surgery, treatment protocol, lymph node status, histopathological findings, distribution of complications, metastasis, recurrences, preoperative and final stages, survival and mortality rates according to their age groups. Then, collected data were analyzed and outcomes were compared between age groups. Results: Males with CRC constituted 50.3% of patients; of them 54.1% aged <60 years old. Elective surgery was done for 167 (91.2%) patients. Laparoscopic surgeries have been performed for 129 (70.5%) patients. Adjuvant therapy was administered to 27 (14.7%) patients. Lymph node metastasis was seen in 79 (43.2%) patients. Well-differentiated tumor was detected in most of the patients (81.4%). Complications were seen in 41 (22.4%) patients; recurrence was found in 16.9% of patients with colorectal cancer after treatment (p>0.05). The overall 5-year survival rate was 23.8% in the older age (≥ 60 years) group and 34.3% in younger patients (<60 years) (p=0.109). Colorectal cancer killed 30 (16.4%) of patients with no significant difference between the two age groups (p=0.075). Conclusions: In our study, the oncological outcomes related to both morbidity and mortality from colorectal cancer were not affected by their age.
Copyright (c) 2026 Zanko Sherko Fathallah, Sarhang Hussein Muhammed, Mohammed Niyazi Gheni https://creativecommons.org/licenses/by-nc-sa/4.0
The Efficacy of Nano-water in Combination with Tamsulosin-Dutasteride for Alleviating Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia
Background and Objectives: Symptoms of the Lower urinary tract are common in benign prostatic hyperplasia. This study assessed the effectiveness of Nano-water doubled with tamsulosin-dutasteride in improving these symptoms. Methods: This double-blind, randomized study was conducted in Sulaimani, Iraq, from February 2016 to November 2022. The study included 193 men with an International Prostatic Symptom Score of 13 or higher, peak urine flow rates of 15 milliliters per second or less, and prostatic volumes between 30 and 80 cubic centimeters. The participants were randomly assigned to two groups. Group A (97 men) received Nano-water with tamsulosin-dutasteride, while Group B (96 men) obtained regular water with the same medication. Assessments at baseline and after three months included the International Prostatic Symptom Score, peak urine flow rate, and residual urine volume. Results: Group A demonstrated more remarkable results than Group B. The International Prostatic Symptom Score fell to 6.67 in Group A compared to 10.87 in Group B. Peak urine flow rates climbed to 17.48 milliliters per second in Group A versus 15.45 milliliters per second in Group B. Residual urine was less than 50 milliliters in 88 percent of Group A patients compared to 75 percent in Group B. All results were statistically significant. Conclusions: Nano-water combined with tamsulosin-dutasteride improved lower urinary tract symptoms in men with benign prostate hyperplasia.
Copyright (c) 2026 Alaa Al Krush, Ali Sami, Safaa Almukhtar, Ismael Weas https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of Thalassemia Mutations in Cases with Normal and Borderline Hemoglobin A2 Values in Premarital Screen Clinic and Thalassemia Center in Sulaymaniyah /Iraq
Background and Objectives Elevated hemoglobin A2 level is a diagnostic marker for β-thalassemia carrier screening. However, a small fraction of thalassemia carriers is difficult to diagnose based on Hb A2 levels alone. Here, we described the frequency with molecular and hematological characteristics of a group of thalassemia traits with normal and borderline Hb A2 beta thalassemia to raise awareness on the importance of such cases for haemoglobinopathies screen programs. Methods: This retrospective study on 4892 cases referred for screening of haemoglobinopathies in Premarital Screen Clinic and Thalassemia Center in Sulaymaniyah province, over the period from December 2009 to October 2023. Hematological parameters were recorded using a standard blood cell counter. Hemoglobin A2 quantification was performed using high-performance liquid chromatography and capillary electrophoresis. Genotypes were detected using Vienna Lab Thalassemia Strip Assays. Negative samples on the above-mentioned methods had been sent for direct sequencing and multiplex ligation-dependent probe amplification. Results: This study identified 382(7.8%) hemoglobinopathy cases having normal or borderline HbA2 level. Seventy cases with full genotype were included. The age ranged from17-60 years, with male to female ratio of 1.3:1. Of these, 81.4% were thalassemia minor cases, while the result of cases were structural variants. Further, β+ and β++ phenotypes accounted for 80% -thalassemia. Lastly, normal HbA2 was reported in 15.7% of this cohort. Conclusions: Normal and borderline Hb A2 cases are not uncommon, and a large proportion of them are heterozygous beta thalassemia especially β+ thalassemia carriers.
Copyright (c) 2026 Parwin Ismael Haydar, Sana Dlawar Jalal, Nawsherwan Sadiq Mohammad https://creativecommons.org/licenses/by-nc-sa/4.0
The prevalence of urinary incontinence among patients with prostatic carcinoma who underwent radical retropubic prostatectomies-a local retrospective study
Background and objective: The prostate cancer is the fourth cancer responsible for mortality in Kurdistan region. Urinary incontinence is the frustrating complication of prostatectomy. To assess the predisposing factors of urinary incontinence in patients had prostatic carcinoma underwent radical retropubic prostatectomy. Methods: The design of current study was retrospective which carried out in Rizgari hospital in 3 years period from first of October 2019 to end of September 2022 on 41 patients with localized prostate cancer who doesn’t have urinary incontinence before surgery and underwent radical retropubic prostatectomy. The inclusion criteria encompassed patients having localized prostate cancer without preoperative urinary incontinence, who subsequently underwent radical retropubic prostatectomy. Conversely, the exclusion criteria involved patients with localized prostate cancer exhibiting preoperative urinary incontinence, advanced prostate cancer, metastatic prostate cancer. Results: Prevalence of urinary incontinence at 3rd month postoperatively for patients with prostatic carcinoma who underwent radical retropubic prostatectomies was (22%) in which (78%) was free from incontinence. Prevalence of urinary incontinence at 12th month postoperatively for patients with prostatic carcinoma underwent radical retropubic prostatectomies was (4.9%) in which (95.1 %) was free from incontinence. Various risk factors play a significant role in the development of incontinence post radical retropubic prostatectomy. These factors include obesity, smoking history, diabetes mellitus, prostate volume, and advanced pathological T staging. Their impact on the study was statistically significant. Conclusions: Urinary incontinence magnitude at 3rd and 12th months following radical retropubic prostatectomy is within acceptable range.
Copyright (c) 2026 Dana Abdulkareem saber, Tarq Aziz Toma, Lawand sardar Abdul-Hamid https://creativecommons.org/licenses/by-nc-sa/4.0
Intrauterine Growth Restriction: Prevalence Rate, Associated Risk Factors and Perinatal Outcomes at Maternity Teaching Hospital in Erbil/Iraq
Background and objectives: Intrauterine growth restriction is well known cause for fetal morbidity and mortality all over the world especially in developing countries. The aim of this study was to assess the prevalence rate, risk factors and perinatal outcomes for intrauterine growth restriction in a hospital setting. Methods: A case control study design was conducted to estimate the prevalence rate of intrauterine growth restriction to assess the associated risk factors and perinatal outcomes in Maternity Teaching Hospital in Erbil city-Kurdistan region/Iraq from 1st of January to 31st of December, 2023.The perinatal outcomes were assessed in 221 pregnant women with intrauterine growth retardation and 419 healthy pregnant women who served controls. Results: Intrauterine growth restriction in the study setting was (11.16/1000) total births. The common risk factors of intrauterine growth restriction were low maternal body mass index (p<0.001), nulliparity (p<0.001), positive smoking history (p<0.001), maternal medical disorders (p<0.001) and poor obstetrical history (p≤0.05) were statistically significant. The main adverse perinatal outcomes of intrauterine growth restriction were prematurity (p<0.001), low Apgar scores at 1 minute & at 5 minutes and very low birth weight (p≤0,001). Conclusions: IUGR is a relatively prevalent obstetric problem & it is significantly related to the adverse perinatal outcomes.
Copyright (c) 2026 Sanarya Jafa Jamal, Ariana Khalis Jawad https://creativecommons.org/licenses/by-nc-sa/4.0
Histopathological Findings of Gastric Specimens after Sleeve Gastrectomy
Background and objectives: Sleeve gastrectomy is considered a safe and practicable bariatric procedure. Despite recommending preoperative gastroscopy to rule out considerable pathologies, resected gastric specimens should be sent for histopathological examination to reveal any severe findings without suggestive clinical symptoms. Thus, this study aimed to identify the most common abnormal histopathological finding after sleeve laparoscopic gastrectomy. Methods: This retrospective descriptive, cross-sectional study included 250 patients underwent laparoscopic sleeve gastrectomy for obesity from January, 2020 to January, 2024 at (Gastroenterology and Hepatology) Teaching Hospital and Zhian Private Hospital in Sulaymaniyah, Iraq. The patients’ sociodemographic data (age, sex, weight, and height) with their histopathological reports of gastric samples were collected from patient’s records. Abnormal histopathological findings after sleeve gastrectomy were described. Results: Most patients were aged 18 - 44 years (n= 189, 75.6%), females (n= 175, 70%), and had a body mass index of <40 kg/m2 (n= 114, 45.6%). Non-specific active chronic gastritis (n= 70, 28.0%) and Helicobacter pylori-positive active chronic follicular gastritis (n= 23, 9.2%) were more common among operated patients. A highly significant (p< 0.001) difference was observed between the patient's gender and histopathological findings (which gender was more affected?). In contrast, a substantial difference (p=0.01) was observed between patients' body mass index categories and different types of gastritis. Conclusions: Sleeve gastrectomy results in abnormal histopathological findings among most patients, especially young females.
Copyright (c) 2026 Shorsh Hama Hussein Ameen, Karzan Seerwan Abdullah, Karwkh Hassan Salih https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence of Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Infections Among Hemodialysis Patients in Sulaimani City, Kurdistan, Iraq
Background and objectives: Hemodialysis patients are more susceptible to Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus infections due to contaminated medical equipment and frequent blood transfusions. The compromised immune systems of chronic renal patients further increase their vulnerability. The study aimed to determine the prevalence of Hepatitis B, C, and Human Immunodeficiency Virus infections among hemodialysis patients. Methods: This observational study, conducted over two months in February 2024 in Qirga and Shar hemodialysis centers in Sulaimani city, surveyed 96 patients. Data on demographics, medical history, dialysis specifics, and Hepatitis B, C, and Human Immunodeficiency Virus markers were collected through interviews and blood tests. Results: The findings indicate that Qirga Center has a higher prevalence of Hepatitis C Virus (10%) and Hepatitis B Virus (7%) infections than Shar Hospital (4.5% and 1.5%, respectively). Moreover, 6.3% of patients in both hospitals have Hepatitis C virus infection, compared to 3.1% of patients in both facilities who have Hepatitis B virus infection. All the results were statistically significant. Conclusion: This study emphasizes the importance of vaccination, regular viral screening, and adherence to infection control protocols in hemodialysis units.
Copyright (c) 2026 Alaa Hussain Al Krush, Mohamed Dler Hama, Yousif Taha Ghafoor, Las Omer Rafiq https://creativecommons.org/licenses/by-nc-sa/4.0
Hypertension Among Patients Younger than 40 Years: An Endocrine Point of View
Background and objectives: Hypertension is common among older adults and the elderly, but some studies also reported data on young adults. The aim of this study is to diagnose the endocrine causes of secondary hypertension among younger adults. Methods: This cross-sectional study enrolled 100 outpatients with hypertension from Endocrine and Internal Medicine Consultation Rooms, Shar Teaching Hospital, Sulaimaniyah, Iraq, from January 2023 to December 2023. Data was collected from patients with secondary hypertension using a questionnaire by face-to-face interviews during their hospital visits. Then, blood samples were collected to determine hematological parameters, kidney function tests, blood electrolytes, lipid profiles, hormones, and vitamin D levels. Results: Most patients (68%) aged >30 years, females (56%), overweight (51%), visited the hospital as outpatient due to a headache (58%), had no clinical finding (81%), smoking history (83%), family history of hypertension (53%), positive past medical history (90%) and positive past surgical history (92%). The mean systolic/diastolic blood pressures were high (99.64 ± 10.82/158.12 ± 20.74 mmHg). Mean hematological parameters, kidney function tests, electrolytes, lipid profiles, hormones, and vitamin D3 levels were observed. Most patients had negative dexamethasone suppression test (19%), essential hypertension (54%) with normal general urine examination (96%), abdominal ultrasound (72.05%), abdominal Computed Tomography (41%), Doppler investigations (90%), and Echocardiogram (57%). Conclusions: Hypertension is a primary health issue among young adults that is mainly caused by endocrine disorders such as thyroid problems and primary hyperaldosteronism.
Copyright (c) 2026 Ameer Allakaram Rahman, Taha Othman Mahwi, Zagros Ghaffor Rashid https://creativecommons.org/licenses/by-nc-sa/4.0
Sealing Ability of Guttacore, Thermafil and Conventional Gutta Percha Using Different Resin Sealers
Background and objectives: The success of root canal therapy hinges on achieving a tightly sealed closure at the apical end of the root canal. This study aimed to compare the sealing effectiveness of root canal obturation using various materials for obturating cones and sealers. Material and methods: This experimental in vitro study conducted from June 2022 to June 2023 in the Duhok city in the medical lab of collage of medicine. Ninety extracted human single canal premolars were used, prepared by wave one gold medium size file (35/0.06), irrigated by 2.5% sodium hypochlorite. Divided into six groups, three of obturating cone, two carrier-based (GuttaCore and Thermafil) and one conventional gutta-percha. These groups were further subdivided into 15 teeth each, distinguished by the sealers used: Ceraseal (MetaBiomed Co., Cheongju, Korea) and AH Plus (epoxy resin-based sealer). Results: Comparing types of obturating cone and sealers, the sealing ability of Ceraseal sealer with guttaCore is (26.77), with better sealing ability of thermafil (12.10) and with conventional gutta-percha (30.15) with p-value of <0.001. while the sealing ability of AH plus with guttaCore is (33.73), with thermafil (20,07) and with good sealing ability of conventional gutta-percha is (15.20) with p-value <0.001. The difference is significant for both groups. Conclusion: The sealing ability of the materials used to regard obturating cone and sealers were not able to fill the root canal completely without leaving gabs. Thermafill gutta-percha with Ceraseal sealer had a maximum area of root canal filled.
Copyright (c) 2026 Dezheen Luqman Saleh, Bahar Jaafar Selivany https://creativecommons.org/licenses/by-nc-sa/4.0
Background and objectives: Any variations in the frenulum's size and location could cause functional and cosmetic issues that call for surgical removal. Wound healing is a comprehensive and ever-changing procedure that involves the restoration of cellular structures and tissue layers. This study aimed to compare wound healing outcomes in frenectomy procedures performed with and without sutures. Methods: A randomized clinical trial with 40 patients that had high frenal attachments (15 males, 25 females, ages 18-60) from Khanzad Training Center, Erbil ran from March 2023 to January 2024. Patients were split into two groups: first group (study group) had frenectomy with sutures and a periodontal pack, while the second group (control group) had frenectomy without sutures but with periodontal pack. Wound size, pain, analgesics use, and redness assessed over three weekly visits. Results: The study found no significant difference in wound size (P=0.338) or visual analogue score (VAS) (P=0.163) scores between the study and control groups at the first visit. However, redness (P=0.042) was significantly different. By the second visit, the control group had improved wound size outcomes (P=0.04), while the study group had better analgesics intake (P=0.01). By the third visit, analgesic consumption favored the study group, but there was no significant difference in wound size or redness P=0.331 and P=0.186 respectively. Conclusion: Appropriate suturing might speed up the healing of the wound. The control group consumed more analgesic pills even though there was no statistically significant difference in their visual analogue score records.
Copyright (c) 2026 Mostafa Mohammed Al Rasheed, Dilyar Ahmed Baban https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence of Metabolically associated Steatotic Liver Disease in Patients with Inflammatory Bowel Disease in Erbil City
Background and Objective: The non-alcoholic fatty liver disease is prevalent in about one-fourth of the world population. The link between inflammatory bowel diseases and non-alcoholic fatty liver disease has been of great concern in last decades. This study aimed to determine the prevalence of non-alcoholic fatty liver disease in patients with inflammatory bowel disease. Methods: A descriptive cross-sectional study was conducted in Hawler Gastroenterology and Hepatology center at Rzgari teaching hospital in Erbil city-Kurdistan region/Iraq in duration of twelve months (5th of April 2023 to 5th of April 2024) on a sample of one hundred patients with inflammatory bowel disease. The prevalence of non-alcoholic fatty liver disease and factors associated with it (past medical history, platelets, C-reactive protein, fasting blood sugar, Hemoglobin A1c…etc) were studied. Results: The prevalence of non-alcoholic fatty liver disease was (24%) with fibrosis scores of F0-F2 and predominant grading of grade I (23%); in contrast grade II was reported in one inflammatory bowel disease patient only. Past medical history of hypertension diabetes mellitus and dyslipidemia was a significant risk factor of non-alcoholic fatty liver disease in patients with inflammatory bowel disease. Abnormal results of fasting blood glucose, HemoglobinA1c, triglyceride, High-density-lipoprotein, Aspartate-transaminase and Alanine-transaminase levels of inflammatory bowel disease patients were significantly related to non-alcoholic fatty liver disease. Conclusion: The prevalence of non-alcoholic fatty liver disease in patients with inflammatory bowel disease is close to prevalence of non-alcoholic fatty liver disease in general population.
Copyright (c) 2026 Rieber Abdulrahman Kareem, Abdullah Saeed Ibrahim, Altun Mahmud Saleh https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical and Radiographical Evaluation Fixed Bridge for Patients Previously Treated by Restorative Dentistry Board Students
Background and Objectives: Fixed partial dentures are commonly used in restorative dentistry to replace missing teeth, but their longevity can be compromised by biological, mechanical, and esthetic failures. This study aims to evaluate the prevalence and causes of failures in fixed partial dentures fabricated by trainees in the Restorative Dentistry Board to enhance educational outcomes and clinical practice. Methods: A retrospective observational study design was employed at Shorish Dental Center, Sulaymaniyah, between September 2023 and March 2024, including 55 patients who received fixed partial dentures over the last five years. Clinical assessments and radiographs were used to identify failures, which were categorized into biological, mechanical, and esthetic types. Results: The mean age of patients was 48.13 ± 11.34 years, with 60% female. Mechanical failures were the most common, occurring in 38.12% of cases, primarily due to loss of retention (12.7%) and bridge fractures (9.1%). Biological failures accounted for 25.4%, with gingival recession (7.3%) and periodontal disease (5.5%) being the main contributors. Esthetic failures represented 9.06%, with unacceptable color match (3.6%) and under-contoured margins (3.6%) as leading factors. Statistical significance was found in the correlation between porcelain fractures and patient dissatisfaction (P≤0.003), and between gingival recession and male patients (P≤0.02). Conclusion: Mechanical factors, biological factors and Aesthetic issues were the main cause of failure in FPDs. Understanding these failure mechanisms can guide improvements in prosthesis design and trainee education.
Copyright (c) 2026 Dashti Fariq Hama Radha, Abdulsalam Rashid Al-Zahawi https://creativecommons.org/licenses/by-nc-sa/4.0
Determination of types and treatment modalities of facial bone fractures associated with road traffic accidents in Duhok City
Background and objectives: The maxillofacial region being the most exposed part of the body, is particularly vulnerable to trauma, resulting in injuries to skeletal components, dentition, and soft tissues. This study aims to investigate the causes, characteristics, and treatment outcomes of trauma affecting the maxillofacial region, with a focus on injuries to skeletal components, dentition, and soft tissues. Methods: This retrospective cross-sectional study was reviewed 80 files with maxillofacial trauma as a result of road traffic accidents, who’s attended the Emergency Hospital in Duhok city during the period from January 2018 to end of December 2022, were included. We analyzed their medical records and data related to the cause of injury, type of fracture, treatment modality and post operative complications. Results: Have shown with varying degrees of maxillofacial trauma. The highest frequency of cases occurred in 2022 (33.8%), while the lowest was in 2018 (10%). In 68.8% of patients, only one maxillofacial bone was fractured, with the mandible being the most frequently affected (58.9%). The combined approach of dental and osseous fixation was utilized in 39.3% of cases. Mandibular fracture was significant in most patients. Conclusion: The primary causative factor for maxillofacial injuries has been identified as road traffic accident, particularly affecting young adult males.
Copyright (c) 2026 Hazheen Abdulrahman Sulaiman, Khurshid Abubakir Khedr Khrwatany, Marwan Ajeel Qaidy https://creativecommons.org/licenses/by-nc-sa/4.0
Marginal and Internal Assessment of Press and Computer-aided design/Computer-aided manufacturing Lithium Disilicate Veneer Using Conventional and Digital Impressions
Background and objectives: Lithium disilicate veneers are highly valued for their ability to change the size, shape, or color of teeth, as well as for their fitness to the teeth. This study evaluates the marginal and internal fitness of lithium disilicate veneers, fabricated using conventional and computer-aided design and computer-aided manufacturing methods with both conventional and digital impressions. Methods: This in Vitro-study was done in University of Duhok, college of Dentistry from January 12, 2023, to April 5, 2023. A maxillary central incisor was prepared for veneers. Thirty-two resin die samples were created from digital impressions for veneer cementation. Sixteen pressable lithium disilicate veneers were produced using the conventional lost wax pattern method (Groups A&B): eight from conventional impressions and eight from digital impressions. Sixteen lithium disilicate veneers were made by computer-aided design and computer-aided manufacturing for the two other groups C&D. Lithium disilicate computer-aided design blocks were milled using a five-axis milling machine. Veneers were cemented with 3M ReyX veneer resin cement. Results: Significant differences in marginal fitness were observed among techniques (P<0.0001). Scan-press showed significantly larger marginal gap (147.00µm) compared to scan-computer-aided design and computer-aided manufacturing(97.25µm), conventional-press(112.1µm), and conventional-computer-aided design and computer-aided manufacturing (88.5µm). For internal fitness, conventional-press exhibited larger internal gap (100.58µm) than conventional-computer-aided design and computer-aided manufacturing (87.25µm). (P<0.001). Conclusions: Lithium disilicate veneers fabricated using computer-aided design and computer-aided manufacturing technology with conventional impressions demonstrated superior marginal and internal fitness compared to other groups.
Copyright (c) 2026 Ziad Tariq Rashid, Abdul Kareem Ramadan https://creativecommons.org/licenses/by-nc-sa/4.0
Correlation of Electrocardiography with Echocardiography in the Assessment of Left Atrial Overload
Background and objectives: Left atrial overload parameters in the electrocardiogram could suggest rising left atrial pressure that leads to heart disease. An increase in the Left atrial area and pressure are signs of left ventricle diastolic dysfunction. Therefore, we aimed to find the relationship between electrocardiogram and left ventricle diastolic function by echocardiography to assess left atrial overload. Methods: This observational, cross-sectional study enrolled 200 patients with cardiac symptom(s) from April 2024 to April 2025 at Sulaimani Cardiac Hospital and Faruk Medical City, using a convenient sampling method. The patients underwent electrocardiography and echocardiography. Later, the correlations between both techniques were determined in relation to left atrium overload in diastolic dysfunction. Results: Among studied patients, 51.5% had hypertension, 32.5% had diabetes, 19% had ischemic heart disease, 57.5% presented with shortness of breath, 38% with chest pain, 25.5%, with palpitation, 1.5% had aortic stenosis, 2.0% had aortic regurgitation, and 41% had diastolic dysfunction. Echocardiography showed that tricuspid regurgitation velocity and heart rate did not differ among the grades of diastolic dysfunction. P-duration exhibited a decent correlation with left atrial volume index (p<0.001), while P terminal force in V1 showed rational correlations with left atrial volume index and E/é (p<0.001). P-duration and P terminal force in V1 significantly correlated among left ventricle diastolic function grades (p<0.001). Conclusions: P-duration and P terminal force in V1 could indicate left atrial overload if electrocardiography and echocardiography are used to correlate grades of diastolic dysfunction.
Copyright (c) 2026 Chro Saber Muhammad, Amar Talib Al-Hamdi, Jaafar Sadeq Ali Aldoori https://creativecommons.org/licenses/by-nc-sa/4.0
The outcomes of induction chemotherapy, followed by neoadjuvant chemoradiotherapy and surgery, in locally advanced rectal cancer, single institute experience
Background & objectives: Total Neoadjuvant Therapy represents the gold standard for treating locally advanced rectal cancer. We conducted this study to investigate the therapeutic implications of induction chemotherapy followed by neoadjuvant chemoradiotherapy & surgery in locally advanced rectal cancer, in terms of response & toxicity. Methods: Our retrospective study analyzed data from 40 rectal cancer cases who received treatment between 2018 & 2023 at Rizgary Medical Oncology Center in Hawler, Kurdistan Regional Governorate, Iraq. Patients received induction chemotherapy, and after 3-4 weeks, re-staging was done to exclude metastases. Subsequently, neoadjuvant chemo-radiotherapy was administered, followed by another evaluation 3-4 weeks later to exclude metastases and assess treatment response. Finally, a Total Mesorectal Excision was performed. The study looked at outcomes like downstaging, pathological Complete Response, surgical resection margins, Disease-Free Survival, and Overall Survival, as well as side effects related to the treatment. Results: Patients' ages ranged from 28 to 81 years old, with an average age of 50.5. After receiving the treatment, there was a 50% reduction in tumor size, and 12.5% of our patients achieved pathological Complete Response. While 75% of the cases showed free surgical margins, which was significantly associated with tumor relapse (p-value = 0.009). The 3-year Disease Free Survival was 50% and the 3-year Overall Survival was 90%, with a median follow-up of 23.5 months. Treatment-related toxicities varied from 2% to 12%, mostly in grades 2 and 3, and were appropriately managed. Conclusions: Induction chemotherapy followed by neoadjuvant chemoradiotherapy, and surgery might be a good & safe way to treat locally advanced rectal cancer.
Copyright (c) 2026 Mohammed Akram Abas, Jangi Shawkat Muhialdin, Ahmed Sami Kamal https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Implant Length and Diameter on Implant Primary Stability in Different Bone Types
Background and Objectives: Dental implants have revolutionized oral rehabilitation. Primary implant stability (PIS) of dental implants is influenced by several factors, including bone quality, implant length and diameter. The reason for this research is to assess the correlation between (PIS) and implant dimensions (diameter and length) in relation to various bone types. Methods: In a cross-sectional observational study, 41 dental implants with different diameters and lengths were inserted into bones with different densities. Implant beds were prepared, and (PIS)was assessed using a novel damping capacity measurement device (AnyCheck) at the time of implant insertion. Results: Implants with a wider diameter exhibit a mean stability of 69.33 compared to a mean stability of 65 for implants with a narrower diameter. The disparity between these groups was statistically significant, with a p-value of 0.036, and longer implants exhibited greater stability, with a mean value of 70.79, compared to shorter implants, had a mean stability of 64.68. This difference was significant within statistical parameters, with a p-value of 0.018, Regarding bone quality, implants with good bone quality exhibited a mean stability of 69.6 compared to 67.43 for implants with poor bone quality, this observed difference did not reach statistical significance with a p- value of 0.82, with a 95%confidence interval. Conclusions: The findings indicate that increasing implant length and diameter significantly enhances (PIS), while bone quality did not significantly improved stability, underscoring the critical role of implant dimensions in achieving better treatment outcomes.
Copyright (c) 2026 Heshw Hiwa Ibrahim, Kawan Salahaddin Othman https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of Barriers of Achieving Timely Primary Percutaneous Coronary Intervention in Patients with STelevation Myocardial Infarction in Sulaimani Cardiac Hospital
Background and objectives: An estimated increase in risk of death exists for patients with ST elevation myocardial infarction. Primary percutaneous coronary intervention may lower this risk if only performed on time. The aim of this study is to evaluate the barriers to achieving timely primary percutaneous coronary intervention. Methods: This is an observational/cross-sectional study conducted in Sulaimani city, Kurdistan Region of Iraq, from February 1, 2024, to January 31, 2025, on 200 patients with ST elevation myocardial infarction, assessment of time intervals from symptom onset to balloon, and the factors contributing to delay of primary percutaneous coron ary intervention included in the questionnaire. Results: Most of the patients (80.1%) were male; the mean age was 60.69 ± 12.16 years. 132 patients, 69.1%, had a timely door to balloon time (≤ 60 minutes). The median door-to-balloon time was 50 minutes (IQR 25-75: 10-10200 minutes). Median total ischemic time was 380 minutes (IQR 25-75: 60-2950 minutes). 19 (10%) had timely total ischemic time (≤ 120 minutes). statistically significant correlation with gender, door in to door out time, symptom to door time, and door to balloon time (P = 0.016, <0.001). Barriers that significantly prolong total ischemic time were patient delay, non-percutaneous coronary intervention-capable center delay, delay during transfer to the PCI center (P <0.001), and delay team activation. Conclusion: Timely reperfusion is the mainstay of acute STEMI management. This study discovered that the main barriers of timely primary percutaneous coronary intervention are a patient’s delay to present to the hospital, longer duration of remaining in non-PCI facility hospital, and delaying during transferring to PCI-capable center. Focusing on patients’ education and alertness programs for acute chest pain are essential for enhancing total ischemic time.
Primary percutaneous coronary intervention
Copyright (c) 2026 Hawkar Rashid Taha, Hussein Murad Muhamad, Amar Talib Al-Hamdi https://creativecommons.org/licenses/by-nc-sa/4.0