Azadi Teaching Hospital Research Articles

Evaluation of Referral System Patterns in Azadi - Teaching Hospital/ Kirkuk

Background: Referral system constitutes a key element of health system and one of the strategies for ensuring the best use of hospital resources and health care services.. Aim and objectives: a) Causes behind of direct attendance of patients to hospital. b) Find out the main reasons of patients referral to hospital. c) Patients' opinion about the hospital services. d) Assess consultants view about referral system. Methods: A cross sectional study was carried out since 1st of March 2018 till end of September 2018. 1000 patients attending seven consultation units in Azadi teaching hospital were involved in the study. Anevaluation of main causes of direct attendance was done, review of the information on the referral form, patient satisfaction with referral was inquired and specialist doctors' evaluation of the referral was obtained. Results: The rate of referral with referral form was (81%). Main cause of direct attendance was that patients don’t trust the Primary health care center (PHCC) doctor. The provisional diagnosis,a reason for the referral and name of the referring doctor were absent or unclear on (94.6, 84.1 and 61.9 %) of referral forms..Patient satisfaction with the services of secondary health care facilities was (80.1%), and the highest rates of dissatisfaction were because of drug unavailability in hospitals. Specialist doctors considered (55.1%) of all referrals as inappropriate and the need for further treatment was the main reason for indicated referrals. Conclusion: The rate of patient’s referral with referral form was high. The main cause of directly attending hospital with no referral form is that patients do not trust doctors in PHC level. Patients are generally satisfied with the services of secondary health care facilities. More than half of referred cases not need referral from the specialists’ point of view.

Prevalence of Iron Deficiency Anemia (I.D.A.) among 6-24 Months Old Children Admitted to Azadi Teaching Hospital in Kirkuk Governorate in 2019

Background: Iron deficiency anemia is a common nutritional problem worldwide and present in developing countries more than developed country. Aims: 1. To assess how widespread is the Iron deficiency anemia among anemic children between 6 -24 months of age. 2. Study the significant relation of age, sex, and residence of children and education status of the mother of a child with I.D.A. 3. To illustrate the relation of feeding practices and the development of I.D.A. and the relation between nutritional status (Weight for age) of children and I.D.A. 4. To study the relation between gestational age and development of I.D.A. Patients and methods: This study is performed in Azadi Teaching Hospital in Kirkuk pediatric department during 2019 to investigate the prevalence of IDA in children between six months and 2 years of age. A detailed history taken and physical examination done. serum iron, total iron binding capacity and serum ferritin were checked for the anemic cases. Results: A total of (90) cases, 60 cases of them (66%) had anemia (P.C.V. less than 33%). Iron deficiency anemia constitutes 50 cases (55.5%) of all cases of anemia. The cases came to hospital complaining from pallor and poor appetite. The peak age incidence of I.D.A. was between 6-12 months of age. There was no great variation between affected males and females. Most of the cases (32) (64%) were referred from rural areas. It was noticed that artificial feeding was a common feeding practice in most of the cases. Seventy percent of cases were under 10th centile of their weight for age. A large numbers of mothers had low educational level .Also the mean age of early introduction of food was (5-12) month. Conclusion: 1. Peak age of Iron deficiency anemia (I.D.A) is between 6-12 months of age. 2. Iron deficiency anemia is more common among rural children. 3. The majority of infants with I.D.A. were underweight. 4. Early introduction of food from 6 months of age with bad nutritional supplement with no iron contents can lead to I.D.A.

Serum Copeptin and Neonatal Outcome in Pre-eclampsia

Background: Pre-eclampsia (PE) is an idiopathic specific syndrome that affects every organ system during pregnancy.It is a leading cause of both fetal and maternal morbidity and mortality worldwide. Setting: Antenatal and Obstetric Department in Azadi Teaching Hospital. Study design: Case-Control study (prospective). Duration: From April - December 2017. Patients and methods: The study included 90 pregnant women, who were divided into three groups. 30 normotensive women (control), 30 women with mild pre-eclampsia and last 30 were with severe pre-eclampsia. Results: Plasma level of Copeptin were 6.87 pmol/l in normotensive pregnant group, 51.70 pmol/l in mild pre-eclamptic group and 54.17 pmol/l in severe pre-eclamptic group (p-value<0.05). Copeptin was significantly elevated in pre-eclamptic subjects compared with controls and in severe pre-eclamptic group compared with mild ones. Assessing the diagnostic property of Copeptin for PE, (2) still births were recorded in severe PE, while no still births in mild PE and controls. Copeptin levels in pre-eclamptic patients with adverse neonatal outcomes as low birth weight, admission to NICU were significantly higher than the normotensive group. Conclusion: This research suggest that increased maternal levels of Copeptin may be involved in the pathogenesis of pre-eclampsia and it may be useful in the assessment of the severity of the disease in the third trimester and this associated with adverse perinatal outcomes

Using Multiple Serum Biomarkers in Detecting the Outcome of Threatened Miscarriage

Background: Threatened abortion is presumed when there is a bloody vaginal discharge or bleeding through a closed cervical os. cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) are biochemical markers that have been studied to establish if they can predict the outcome of threatened miscarriage. Methods: A prospective observational study that was conducted at the Department of Obstetrics and Gynecology at Azadi Teaching Hospital/ Kirkuk-Iraq, over a period of eight months from first of April 2019 till first of December 2019. It included 96 pregnant women at 7 – 13 weeks of gestation with singleton pregnancy, viable fetus, and closed cervical os they presented with signs and symptoms of first trimester threatened miscarriage. After the first visit, follow up was done until they passed into the second trimester of pregnancy, and patients from the study group were divided into group 1: Included 19 patients who ended with miscarriage and group 2: Included 69 women who continued their pregnancy into the second trimester. We compared the level of the Cancer antigen 125 (CA-125), B-Human chorionic gonadotropin (B-hCG), and Soluble vascular endothelial growth factor receptor (sVEGFR-1 or sFlt-1R) between the two study groups to assess their utility for prediction of the outcome of first-trimester threatened miscarriage. Results: Mean of CA 125 marker was significantly higher in participants who ended with miscarriage than that in participants who continued to second trimester. Means of B-hCG and sFlt-1markers were significantly lower in participants who ended with miscarriage than that in participants who continued to second trimester Serum CA-125 marker > 38.8 IU/ml, Serum β-hCG marker < 20211.3 mIU/ml, and serum sFlt-1 marker < 1731.7 pg/ml are predictors for risk of miscarriage. Conclusion: Serum CA 125, B-hCG, and sFlt-1 biomarkers represent non-invasive, early, fast and excellent predictors of pregnancy outcome in women with threatened miscarriage. Taking into account the feasibility and cost, using serum β-hCG instead of the more accurate one (i.e. serum sFlt-1) would be more logical decision. Further studies are needed in this field.

Anemia in Pregnant Women in Kirkuk Governorate

Background: Anemia is defined as hemoglobin levels of ≤ 11 g/dl , is one of the world's leading causes of disability , and thus one of the most serious global public health problems .More than (50%) of the pregnant women in the world are anemic. Knowledge about the anemia is very important in our community. This knowledge will encourage those who work in primary health care (PHCS) provider for pregnant women to detect the problem earlier and treat the problem properly. Aims: Is to determine the effective factors related to anemia in pregnant women in Kirkuk governorate. Patient & Method: A total of 250 pregnant women were asked while attending antenatal unit in Azadi Teaching Hospital and several Primary Health Centers in Kirkuk City out patients clinic from 25.10. 2014 to1.3.2015. Data were taken involve: age, residency, educational level, history of last menstrual period, onset of anemia and level of hemoglobin (Hb). These data were organized in special questionnaire prepared for this purpose. Results: From the total (250) pregnant women (61.6%) of them have low Hemoglobin (Hb) level mild, moderate or severe anemia the majority of them (75.33%) with mild anemia. according to severity the rate was (3.2%). Conclusions and Recommendations: The prevalence of anemia among women in Kirkuk city during pregnancy is high (61.6%) in compare to (52%) in the world wide in developing countries.

USAGE OF ALTERNATIVE AND COMPLEMENTARY MEDICINE AMONG PATIENTS WITH DIABETES MELLITUS AT DIABETIC CLINIC IN KIRKUK CITY / IRAQ

Constrained investigation on the utilization of complementary alternative medicine (CAM) among patients with diabetes mellitus (DM), especially in essential - care settings. This investigation looks to comprehend the commonness, types, consumptions, dispositions, convictions, and impression of CAM use among patients with DM visiting outpatient diabetic facility. use of CAM has increment lately. We assessed the augmentation CAM utilization by patients with diabetes mellitus; in spite of constrained proof bases. The point of this study was to decide the CAM use among individuals with analyzed diabetes mellitus at diabetic facility at Azadi Teaching Hospital. Prospective descriptive cross sectional study; up close and personal meeting poll and self-directed unknown study techniques to get results from 417 patients who were going to Azadi teaching hospital at Kirkuk city/Iraq. The information was analyzed by usage cross-tabulation analysis (X2 test). P value of 0.05 or less is medically significant. Therefor; about Of 417 members were overviewed, around two third of them utilized some type of CAM treatments were the most widely recognized modalities. The consequences of a strategic relapse examination demonstrated that the parallel use design was most clear in the gatherings matured more than 40. Likewise, numerous sociodemographic and wellbeing related qualities are identified with the examples of the parallel utilization of CAM.At end, utilization of CAM especially biologically base CAM treatments is normal and is bound to be utilized by those with diabetes mellitus. it is as yet lacking the proof to reach complete inference about the adequacy of individual herbs and enhancements for diabetes; be that as it may, they are seem, by all accounts, to be commonly sheltered. The accessible information recommend that few enhancements might be warrant further examination.

Association of H. pylori infection indicated by their serum IgG antibodies with lymphoma malignancy

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lymphoma is&nbsp;a type of lymphocyte malignancy&nbsp;that develops in different types of lymphoid tissues, many pathogens are expected to be implicated in the establishment of the disease including &nbsp;&nbsp;Helicobacter pylori (H. pylori). A total of 64 B-cells lymphoma patients recruited to oncology-hematology unit in Azadi Teaching Hospital in Duhok city and 60 sex and age matched apparently healthy individuals were involved in the current study. Serum samples were collected from all subjects and tested for detecting IgG antibodies against H. pylori as an indicator for H. pylori infections. The age average was (52.5±12.4) years for lymphoma cases and (56±12.5) years for controls. IgG anti-H. pylori antibodies were found in 11/64 (17.9%) of the lymphoma patients and in 8/60 (13.3%) of the control subjects. Lymphoma cases younger than 80 years had higher prevalence of IgG anti H. pylori antibodies (28.6%) as compared with all other age categories with a significant increase compared to both age groups ˂40 years (p= 0.008), 51-60 years (p=0.04) and 61-70 years (p=0.02) respectively. No significant difference was found in the IgG anti H. pylori antibodies prevalence between the lymphoma and control subjects (p=0.087), the gender had no significant effect on the IgG anti H. pylori antibodies prevalence in both of the lymphoma and control subjects respectively and between the two groups.&nbsp; Based on OR=1.34 (95% CI= 0.49-3.42) a very weak association of IgG anti H. pylori antibodies prevalence was observed with an overall increased risk of lymphoma. In conclusion, a week association of H. pylori infection with lymphoma was found due to non categorization of the lymphoma cases pathologically, the association might increases significantly if being categorized pathologically.

Risk Factors Association for MRSA Nasal Colonization in Preoperative Patients in Azadi Teaching Hospital-Duhok, Kurdistan Region, Iraq

Background: Nasal colonization with Methicillin-resistant Staphylococcus aureus (MRSA) can predispose to subsequent infections in surgical and non-surgical patients, making the management challenging with increased rates of morbidity, mortality and cost burden.&#x0D; Objectives: The present study was carried out to evaluate the risk factors of MRSA nasal colonization in preoperative patients in Azadi Teaching Hospital in Duhok Province - Kurdistan Region-Iraq.&#x0D; Methods: Nasal swabs were obtained from 150 patients after completing a questionnaire. Conventional laboratory methods were carried out to identify Staphylococcus aureus (S. aureus) and antimicrobial susceptibility test was conducted for recognizing MRSA isolates.&#x0D; Results: A total of 41 (27.3%) of 150 patients were MRSA carriers. The mean age of participants MRSA carriers was 35.27±20.40 years old. The highest prevalence rate of nasal colonization with MRSA was in males (27.94%) than females (26.82%). In logistic regression analysis, no significant differences was detected between MRSA carriage and the associated risk factors including age [OR: 0.99 (95 % CI: 0.97- 1.01); P = 0.45], gender [OR: 1.05 (95 % CI: 0.51- 2.17); P = 0.87] and medical comorbidities [OR: 1.11 (95 % CI: 0.42- 2.92); P = 0.82].&#x0D; Conclusions: Age, gender and medical comorbidities were not associated common risk factors for nasal colonization of MRSA in preoperative patients. This study should be considered preliminary and studies with larger sample sizes and with using advance molecular tools are needed in the future.

Postoperative Hypothermia in Surgical Patients at Azadi Teaching Hospital

Introduction: The sensation to cold, shake occurrence and shivering are events that are commonly developed following general anesthesia administration postoperatively. Hypothermia has been considered as the most frequent outcome of surgery underwent by anesthesia. Inadvertent hypothermia has been taken into account as common side effect in the postoperative period immediately and it is related to wide impairments and anomalies of different body organs. Concentration on predictive factors of hypothermia would be important to reduce the incidence rate and correct preventable unnecessary risks for patients in the health settings following surgical operations. The aim of study is to assess the magnitude and associated factors of postoperative hypothermia recovery room in patients underwent general anesthesia. Methods: A hospital based prospective cross-sectional study was conducted on200patients with different age groups of both genders who underwent a scheduled non-cardiac surgery and general anesthesia consecutively during the period between the October 1stand the November1st2016. Results: The study revealed that the overall core hypothermia in the study sample was31%. The study showed that the post-operative temperatures decreased statistically significantly in all study patients and separately in adults, children, males, or females P&lt;0.001. The study also revealed that the operation duration(p=0.045)and pre-operative temperature P&lt;0.001were predictors of post-operative hypothermia in study sample. Conclusions: The incidence of hypothermia among study sample was not so high. A significant reduction in core body temperature of patients between pre and post-operation times was found. Those patients with longer operation duration, lower room temperature, and lower pre-operative temperature were at more risk of post-operative hypothermia.

Relation of the 25 (OH) D Levels and Preterm Labour

Pregnant women are a risk group vitamin D insufficiency found among greater than 50% of pregnant females. Actually, there few researches and knowledge which associate the Maternal 25(OH) D level and premature labour, and no one carried in Iraq. The aim of this research is to find out any relation between the maternal plasma 25(OH) D levels of females who have gave birth to premature (&lt; 36 weeks) in comparison to females with full-term neonates in both groups . The current study is a case control research was carried out between January-August 2020, at the department of gynecology and obstetrics at Azadi Teaching Hospital in Kirkuk Governorate. A convenient sample was randomly selected consist of 30 Mothers with premature delivery, compared with 30 mothers term pregnancy delivery, the newborns were weighing &gt;2500g and appropriate for gestational age. Revision of maternal ANC cards were carried out for investigations, ultrasonography, date of LMP of mothers’, as well as fetal anthropocentric measurements through the conception period. The mean Vitamin D level was (18.6±6.7) among preterm deliveries, which is lower significantly from those with full term delivery (27.5±6.2), P value &lt; 0.0001, as represented in figure 1. Deficient vitamin D level was reported among 15(50%) of preterm delivered mothers versus 6(20%) of full term mothers. insufficient vitamin D level was reported among 12(40%) of preterm delivered mothers versus 9(30%) of full term mothers. sufficient vitamin D level was reported among 3(10%) of preterm delivered mothers versus 15(50%) of full term mothers. The low levels Vitamin D level is significantly associated with premature deliveries.

Study of some Virulence Factors for Clostridium perfringens isolated from Clinical Samples and Hospital Environment and showing their Sensitivity to Antibiotics

The study included taking 100 samples from different clinical sources, including wounds and burns, and from the hospital environment, in Kirkuk General Hospital and Azadi Teaching Hospital in the city of Kirkuk for the period from November 2017 to August 2018. The results of isolation and diagnosis showed the growth of 30 isolates that are positive for Clostridium perfringens, distributed between 15 isolates 37.5% from burns, 11 isolates 27.5% from wounds, and 4 isolates 20% from the hospital environment. These isolates were diagnosed based on microscopical, cultural and biochemical tests, in addition to being diagnosed with the Api 20A system. The sensitivity of isolates was tested toward a number of types of antibiotics, and all bacterial isolates showed a high sensitivity 100% against imipenem. As for the sensitivity to vancomycin, amikacin, tetracycline was 96.66, 90, and 66.66% respectively. While, all isolates showed a high resistance to metronidazole and colistin 100%, some virulence factors of C. perfringens isolates have been studied , and showed that all isolates (%100) have the ability to produce hemolysin, lecithinase, capsule, and spore, while 70% of the isolates produced DNAase.

Assessment Knowledge of Thalassemia Care Giver in Kirkuk City

Thalassemia is an inherited blood disorder, which is described by diminished synthesis or lack of globin,this synthetic defect leads to the formation of fragile abnormal red blood cells (RBC), which can be easily hemolyzed, leading to chronic anemia Quantitative design descriptive study was used to assess Knowledge Thalassemia Care givers in Kirkuk City. A non–probability / Convenience sampling technique was applied in the present study, (30) Thalassemia Care givers were participate in the study sample (Azadi Teaching Hospital) in Kirkuk City. A questionnaire was designed and constructed by researchers to measure the variables underlying the present study. Data were obtained directly by the researchers through interview technique. Content validity of the instrument was determined through the of panels which involve (5) experts to investigate the clarity. The findings in general indicated that Majority of the sample In general has good Knowledge about Thalassemia it was recorded (74,8%) were answered “I Know.

The Association of T45G Polymorphism in the Adiponectin Gene with Some Hormonal Parameters in Iraqi Women with Polycystic Ovary Syndrome

This study was reflected on the correlations between the polycystic ovary syndrome (PCOS) and a SingleNucleotide Polymorphism (SNP) T45G in the adiponectin gene among Iraqi infertile women with polycysticovary syndrome. Eighty primary infertile women with PCOS, sixty-two secondary infertile women withPCOS and 50 healthy fertile women in Iraq were included in this study, Blood samples were collectedfrom the infertility clinic in Azadi Teaching Hospital and AL-Salam Hospital. The age of infertile andfertile women was ranged from 18 to 46 years. Results showed association between T45G polymorphismin the adiponectin gene and infertile PCOS women. Moreover, infertile women with PCOS with thesepolymorphisms have been reported to have higher LH, FSH and prolactin concentrations and BMI. Inconclusion 45T→G polymorphisms have been shown to be associated with an increased risk of PCOSwomen with PCOS with these polymorphisms have been reported to have higher LH, FSH and prolactinconcentrations and BMI

Hypertension in Relation with Smoking in Azadi Teaching Hospital at Kirkuk City

Background: smoking and hypertension are two common health problems effecting body organs and increasing morbidity and mortality.Aim of Study: determining the relationship between smoking and hypertension, the affect of the amount and duration of smoking on the severity of hypertension and complications of smoking among hypertensive patient.Patient and Method: the study is cross sectional, in which 200 hypertensive patient were collected in Azadi Teaching Hospital in Kirkuk. There blood pressure was measured and the patients were asked about smoking habits, and if they have complication of hypertension.Results: hypertension is more common among male, married, illiterate and primary educated, intermediate socioeconomic state, physically inactive and more in urban than rural area. Uncontrolled rate of hypertension is high in both smokers and non smokers and this rate increase with increase with increasing duration of smoking. Heart and cerebrovascular complications of hypertension is very high in smokers compared with non smokers. P-value less than 0.05 regard as significant relationship.Conclusion: very low control rate of hypertension in both smokers and non smokers. We recommended public health education via mass media regarding the side effect of smoking combined with hypertension and it’s complications.

Isolation and Distribution of Microorganisms Causing Wound Infections in Diabetic Patients in Kirkuk City, Iraq

Background: Diabetic wound infections are considered one of the main life-threatening diseases among diabetic patients. Foot ulcers are accounting for up to twenty of diabetes-related hospital admission. If leaved untreated, they might result in amputation of feet and legs. The aim of current study was to investigate the isolation and identification of pathogenic microorganisms in wounds of diabetic patients in Kirkuk district, Iraq. Method: Forty diagnosed diabetic patients, (18 males and 22 females)presented with wound infection at Azadi Teaching Hospital, were selected for the study. Swabs of pus and wound exudates were obtained from infected region for bacteriological studies. Then these swabs cultured on blood agar and MacConkey agar for facultative organisms and incubated at 37°C for 24 hours. All cultured isolates were investigated and identified by standard bacteriological and analytical profile index laboratory techniques. Results: Data from current study revealed that single etiology was observed in 24(60%) of isolates. Polymicrobial infections were observed in 4(10%) of patients and 12(30%) isolates were negative. Also, Staphylococcus aureus was the most common cause of infection which comprised 20% of isolates followed by Pseudomonas aeruginosa (15%) isolates. Moreover, it was found that 12 isolates were due to Pseudomonas spp. constituting 30% of isolates followed by Staphylococcus spp. accounting 25%. Conclusion: There is no definite etiology in diabetic wound infections and Pseudomonas spp. were responsible for most of wound infections in diabetic patients.

First 24 h' outcomes of acute coronary syndrome in Iraq

Background: In recent years, there has been a noticeable increase in the frequency of acute coronary syndrome (ACS) in Iraq. Despite the need for the data related to the subject in the area, there is a great paucity of such data that mandated the design and conduct of this study. Methods: This prospective, cross-sectional analysis was performed in the coronary care unit of tertiary Azadi Teaching Hospital in Duhok, Kurdistan, Iraq. All patients consecutively who were hospitalized for ACSs between 2015 and 2016 were included to determine the clinical presentations, short term in-hospital complications, and the first 24 h outcomes of ACSs in Duhok, Iraq. Results: The study comprised 380 (279 men and 101 women) cases with a mean age of 59.54 ± 11.50 years. The final diagnosis was ST-elevation myocardial infarction in 67.4%, non-ST-elevation myocardial infarction in 24.7%, and unstable angina in 7.9%. Al least 50% of patients arrived beyond 6 h of symptoms' onset. Participants within the age group 45–74 years constituted the main bulk of the sample (79%). Typical ischemic chest pain accounted for most of the presentations (80.3%). The most common complications were arrhythmias 44.8%, followed by heart failure 15.5%, cardiogenic shock 5.5%, and mechanical complications 3.4%. Uneventful recovery and recovery with complications constituted 74.5% and 19.7%, respectively. The first 24 h in-hospital death was 5.8%. Conclusions: Our patients presented at a relatively young age. In terms of disease presentations, we observed significant gender differences. In-hospital short-term mortality rate was comparable to neighboring nations. Older age rather than gender impact the outcomes.

Outcome of patients with locally advanced Non-small cell lung cancer treated with sequential chemotherapy and radiotherapy in Duhok/ Iraq

Background and objectives: About one-third of non-small cell lung cancer patients present with locally advanced unresectable disease. The overall survival and progression-free survival evaluated of patients with stage IIIA and B non-small cell lung cancer treated with sequential chemotherapy and radiotherapy. The aim of the study was to evaluate the efficacy of sequential chemotherapy and radiotherapy in advance non-operable non-small cell lung cancer. Methods: This retrospective study included 45 patients with advanced non-small cell lung cancer diagnosed between May 2014 and May 2017 treated with sequential chemotherapy and radiotherapy. All patients were treated at Azadi Cancer Centre, Azadi Teaching Hospital, Duhok with at least 4 cycles of chemotherapy then sent to radiotherapy in other centre to complete their planned treatment protocol. Results: This study showed that squamous cell cancer was the most common histological subtype. The overall survival of patients treated with sequential chemotherapy and radiotherapy was 19.6 months (95% confidence interval 13.5–27.8, 95% confidence interval). The median progression-free survival time was 11.1 months (95% confidence interval; 8.6–13.7 months). Over all chemotherapy and radiotherapy tolerated well in most of the patients with mild adverse effect. Conclusions: Sequential chemotherapy and radiotherapy is a valid option of treatment in inoperable non-small cell lung cancer. This mainly helpful in area with limited resources for radiotherapy. These results provide hope and support of using sequential chemotherapy and radiotherapy in advanced stage lung cancer ineligible for surgery.

Lumbar spine Schmorl's nodes; prevalence in adults with back pain, and their relation to vertebral endplate degeneration

BackgroundIn 1927, Schmorl described a focal herniation of disc material into the adjacent vertebral body through a defect in the endplate, named as Schmorl’s node (SN). The aim of the study is to reveal the prevalence and distribution of Schmorl’s nodes (SNs) in the lumbar spine and their relation to disc degeneration disease in Kirkuk city population.ResultsA cross-sectional analytic study was done for 324 adults (206 females and 118 males) with lower back pain evaluated as physician requests by lumbosacral MRI at the Azadi Teaching Hospital, Kirkuk city, Iraq. The demographic criteria of the study sample were 20–71 years old, 56–120 kg weight, and 150–181 cm height. SNs were seen in 72 patients (22%). Males were affected significantly more than the females (28.8% vs. 18.8%, P = 0.03). SNs were most significantly affecting older age groups. L1–L2 was the most affected disc level (23.6%) and the least was L5–S1 (8.3%). There was neither a significant relationship between SN and different disc degeneration scores (P = 0.76) nor with disc herniation (P = 0.62, OR = 1.4), but there was a significant relation (P = 0.00001, OR = 7.9) with MC.ConclusionSN is a frequent finding in adults’ lumbar spine MRI, especially in males; it is related to vertebral endplate bony pathology rather than discal pathology.

Effect of sex class on the levels of some biochemical variables in thalassemia patients

The study was conducted at Azadi Teaching Hospital - Thalassemia Center for the period from 1/10/2017 to 1/4/2018. It included 60 patients including 30 males and 30 females, as well as control group which included 20 Healthy people were all 10 to 21 years of age. The following variables were studied: ferritin, GSH, insulin-like growth factor-1 (IGF-1) Malondialdehyde (MDA) Interleukin-6 (IL-6), and Cortisol. The analysis of correlation coefficients and simple linear regression was carried out to determine the effect of the variables among them. The results were as follows: Thalassemia patients recorded the lowest levels of GSH, IGF-1 and cortisol at 2.2 μmol / L and 50.4 ng / ml and 10.11 μg / dL respectively, while the same group recorded the highest levels of ferritin, MDA and IL- 6 was 3083 ng / ml, 941 mmol / L and 368 pg / mol. There were significant effects of both sexes in the group of thalassemia patients in both ferritin, GSH, IGF-1, MDA, and IL-6 with 2573, 3592 μg / dL, 2.821, 1.573 μmol / L, 63.3, 37.47 ng / ml and 1163.1 719.3 mmol / L 300.9 and 435.6 pg / mol for males and females, respectively. The results of the correlation coefficient analysis showed existence of and low correlations in the negative and positive direction between the study variables of the two groups of patients and control. The results of the simple linear regression analysis showed positive and negative regression ratios of IL-6 and IGF-1 growth factor on the rest of the study variables.

Association of Chronic Urticaria with Helicobacter pylori Infection in Duhok City, Kurdistan Region of Iraq

Background: Helicobacter pylori (H. pylori) infection is associated with gastric and extra-gastric manifestations such as idiopathic urticaria. Objectives: The aim of this report was to investigate the relationship between H. pylori positivity and chronic urticaria. Methods: This case control study was carried out between June 2018 and March 2019. The study was conducted at the Dermatology Consultation Unit, Azadi Teaching Hospital, Duhok, Iraq. A total of 49 patients with chronic urticaria were recruited in the study. During the study period, 95 subjects were recruited as a control. Results: The overall H. pylori positivity was 106/144 (73.6%). A significant association was found between family members number and H. pylori positivity (P = 0.04; OR = 1.15; CI = 1 - 1.3). The positivity was 38/49 (77.6%) positive for the patients’ group versus 70/95 (73.7%) for the control group (P = 0.7; OR = 1.16; CI = 0.53 - 2.57). Conclusions: The prevalence of H. pylori infections was high in the region. No association was found between H. pylori positivity and chronic urticaria. Further study is needed to explore the effect of H. pylori eradication on urticaria treatment outcome.