Center Of Iraq Research Articles

Implant Fixture Fracture (5-10 years clinical study)

Introduction: Osseo integrated dental implant represents an advance management in modern dentistry, with high success rates. Despite that, several complications involve dental implants may still happen and dental surgeons should be attentive to such problem, to prevent implant failures and biomechanical problems. One of the most serious late implant complications is the fracture of implant fixture. It can be a challenge for dentists to determine the etiology of fixture fractures. Aim of study: Evaluate the effect of some implant parameters, such as length, diameter and position, on the occurrence of fixture fracture and to determine the incidence of fractures reported in 5-10 years of fallow up. Materials and methods: Clinical retrospective study included 439 implants made of titanium alloy(Ti-6Al-4V) placed in 192 Iraqi patients; 103 male patients and 89 female patients with partially and completely edentulous areas had consulted the implant department at Al- Elwiya specialized dental center in Iraq. Results: In this study 439 fixtures distributed in 192patients; 53, 6% was male patients; 46.3% female patients.3 fixtures fracture reported in this study represent 1.5% in relation to total number of patients. 0.6% of the 439 fixtures installed. 71 fixtures 16.1% supported prosthesis with Pontics; that reported 3 fixtures fracture 4.2%, while 368 fixtures 83.8% supported prosthesis without Pontics in which no fracture of fixtures were recorded. Discussion &Conclusion: Fracture of Osseo integrated dental implants is a late complication, it has low incidence, the fracture of dental implants fixture are multifactorial, and the most common cause for fracture is the biomechanical or physiologic overload.

Impact of the role of cardiology pharmacy specialist on the improvement of quality indicators among patients with heart failure and reduced ejection fraction

Abstract Background 2021 European Society of Cardiology quality indicators (QIs) for the care and outcomes of adults contains a domain for patients with heart failure with reduced ejection fraction (HFrEF) for initial treatment of guideline-directed medical therapy (GDMT) which includes beta-blocker (BB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-neprilysin receptors inhibitors (ARNI), mineralocorticoid receptor antagonist (MRA), and sodium-glucose transporter-2 inhibitor (SGLT2i). The QIs for the individual GDMT is estimated by finding the proportion of patients with HFrEF who are prescribed each therapy in the absence of any contraindication. Purpose To identify the role of the board certified cardiology pharmacist (BCCP) on improving the quality indicators regarding the prescribing of GDMT among patients with HFrEF during hospitalization and before discharge. Methods A cross-sectional study was conducted at the cardiac care unit in a single heart center in Iraq between January 2021 to February 2023. Among the multidisciplinary team member at this unit is a BCCP who suggests optimization of medical therapy based on the recommendations of updated European or American guidelines for the management of different cardiovascular diseases including HFrEF. The suggestion then discussed with the cardiologists for agreement. The study included the medical records for patients with HFrEF and BCCP interventions whether the interventions regarding GDMT or other medical therapy interventions. Data were reviewed and were analyzed to identify the specific interventions related to the initiation of one or more GDMT in each patients. Results Among 164 patients with HFrEF with BCCP interventions, there were 102 (62%) patients who were eligible for one or more of the GDMTs prescription which was suggested by BCCP. The most GDMT initiated was MRA 53 (43%) among 123 interventions and in 53 (52%) of 102 patients (Figure 1). QIs were improved (100%) for BB, ACEI/ARNI, MRA, and SGLT2i among eligible patients as shown in table 1. Conclusions The role of BCCP is essential among heart team for improving QIs related to the GDMT prescription among patients with HFrEF based on the recommendations of the updated guidelines. BCCP mainly improved the QIs for the prescription of MRA.Frequency of GDMT Initiation by BCCPGDMT Initiation Reflecting Improved QIs

Evaluation of Some Parameters to Detection of Type 2 Diabetes Induced Nephropathy in the Population Sample of Al Dewaniyah Province

Background: Diabetic nephropathy (DN is a dreaded consequence of Type2 diabetes mellitus (T2D), accounting for about 40% of end-stage renal disease (ESRD). Aim: finding a predictive and tracking function of kidney failure and generalizing it as a clinical diagnostic method effective, and finding related to the development of complications of this disease with age, gender, familiar History, smoking and area of residence. Subjects: Study was conducted at a single center in Iraq from the beginning of February to the end of July 2021,The 90 individual were divided into 2 groups, of which 50 were chronic renal failure patients with T2D, and 40 were age and sex matched controls.Methods: The Insulin and HbA1C% levels was measured by using sandwich ELISA technique and a sandwich immune detection method respectively, A spectrophotometric method was applied to measure concentrations of urea, creatinine and glucose, in serum samples, then the urea-creatinine ratio and HOMA-IR were calculated mathematically. Results: There were significant elevated differences (p<0.05) for all parameters in the patient group compared to healthy controls. Moreover, ANOVA test showed significant (p<0.05) variation when Urea, Creatinine, Glucose, HOMA-IR and HbA1C % levels were compared between the same sex in the two subgroups, while the test showed significant (p<0.05) variation for only males when Urea: Creatinine ratio and Insulin levels were compared between the same sex. Conclusion: It can be dependable on investigations of Urea, Creatinine, Urea: Creatinine ratio Glucose, Insulin, HOMA-IR and HbA1C % as good prognostic indicators for diagnosis renal failure resulting from complications of DM.

Some Immunological and Physiological Parameters Levels in Iraq Children with Autism Spectrum Disorders

Some studies suggested that dysfunction of immune and endocrine systems could link with neurodevelopment disorder and immunopathogenesis of ASD. Therefore, the goal of this research is to examine the level of some immunological and physiological indicators in an effort to identify a new biomarker for ASD. In the current study, there were 72 Iraqi kids (both boys and girls), 50 kids with ASD who attended different autism centers in Iraq, and 22 kids without ASD. They were between the ages of 6 and 12. These children’s peripheral venous blood was drawn in order to measure the concentrations of several cytokines, such as (TNF-α and IL-6), cortisol, and WBCs indices and platelets/lymphocytes ratio. The study’s findings revealed: 1) a significantly higher level of TNF- α but not IL-6 in ASD patients when compared to control; 2) a significantly higher level of cortisol in ASD patients compared to controls; and 3) a significantly higher level of lymphocytes and total WBCs but not neutrophils and monocytes. 4) A significant increase in the platelets/lymphocytes ratio. Furthermore, there were no differences in these parameters based on the gender and severity of the autism. As a result, our findings revealed that cytokine level alterations may be crucial in the development of neurological diseases like autism since microglia release large amounts of TNF-α, which plays a significant role in the so-called neuroinflammatory response. An abnormal HPA axis with high or low concentration of cortisol in more than 22% of the ASD was found in our results, which could explain the different reactions of autistic children when exposed to the same situation. So we thought that cytokines, especially TNF-α, and cortisol, may represent a serological marker for autism.

Investigating Women's Risk Factors for Breast Cancer and Their Knowledge and Attitudes towards Early Diagnosis in Nasiriyah City/Iraq

Objective: This study was conducted to determine the risk factors of women over the age of 40 for breast cancer and their knowledge and attitudes towards early diagnosis in Nasiriyah city of Iraq. Materials and Methods: The study used a descriptive and cross-sectional design, and it was carried out on 120 women aged over 40 who presented to two different primary health care centers in Iraq between February and March 2020. Results: Of the total of women in the study, 6.66% had a history of breast cancer, 21.70% had a family history of breast cancer, 24.20% had benign breast disease, the first menarche age of 0.80% was 11 or below, and 6.66% had received radiotherapy to the chest area. It was determined that 83,30% of the women had a BMI value of 25 or above, 72,50% did not exercise, and that 50% had given birth to their first child at the age of 30 or over. When the knowledge and attitudes of women towards early diagnosis of breast cancer were examined, it was found that 51,60% performed Breast Self-Examination (BSE) irregularly, 78,80% had not had a clinical breast examination (CBE) before, and that 88,30% had not had mammography. Conclusion: It was determined that women in Iraq need training on overweight and obesity and physical activity, which are lifestyle-related risk factors. Also, it was found that women's attitudes towards BSE, CBE, and mammography were low and that their awareness and attitudes need to be improved on these issues.

Endotoxin quality of ultrapure dialysis fluid for online hemodiafiltration in several hemodialysis centers

Globally, the nephrology community is seeing a rise in the use of high-flux membranes and ultrapure water in hemodialysis (HD) machines. However, data on HD water quality could be more extensive in low- and middle-income countries. The Ministry of Health in Iraq issued a rule requiring a gradual modification in the HD water treatment system to adopt ultrapure water in all dialysis centers. The current study aimed to monitor the endotoxin of ultrapure dialysis fluid at several centers in Iraq and the clinical benefits of its use. This work evaluated the quality of ultrapure water used for dialysis in twenty-one dialysis centers within various Iraqi province hospitals. The samples were collected for 4 months from January to April 2022. Endotoxin tests in ultrapure dialysis fluid were measured by Gel Clot assay. Results showed an unacceptable difference in the ultrapure dialysis fluid's quality compared to the international standard (ANSI/AAMI/ISO-23500). Endotoxin levels in 33% of ultrapure dialysis fluid above 0.03 EU/ml, exceeding recommended international standards. The findings highlight the importance of assessing water quality in medical facilities to ensure patient safety and encourage sanitary monitoring of this procedure as a healthcare promoter. Keywords: Ultrapure water; Hemodiafiltration; Dialysis fluid; Endotoxin; Public Health Reform.

Patient registry data on the efficacy and tolerability of adalimumab biosimilar in ankylosing spondylitis: A retrospective multicenter observational study

Abstract: BACKGROUND: Adalimumab, a tumor necrosis factor-α inhibitor, is an approved treatment for ankylosing spondylitis (AS). In Iraq, a biosimilar of adalimumab (ABP 501; Amgevita®) has been licensed for prescription since 2021. However, there have been no previous studies on its efficacy and safety in Iraqi AS patients. Multiple studies have shown that adalimumab biosimilars are effective and well tolerated, with comparable rates of clinical response, adverse events (AEs), and immunogenicity to the reference product. OBJECTIVES: To evaluate the efficacy and safety of Amgevita in Iraqi patients with AS. PATIENTS AND METHODS: A retrospective multi-center observational study involving 72 patients with active AS for whom Amgevita 40 mg was prescribed every 2 weeks The data were collected from Amgevita registry data across multiple centers in Iraq. Patients’ entire data sets were retrieved and examined for disease activity parameters and recorded adverse reactions up to 12 months of Amgevita medication. RESULTS: The cumulative percentage of response in active AS patients treated with Amgevita was 82% after 3 months (the baseline) and 61% after 12 months. The mean change from the baseline in the Bath AS Disease Activity Index was statistically significant (−0.5 [P = 0.033; 95% confidence interval (CI): −0.87 to −0.04] and −1.14 [P = 0.0001; 95% CI: −1.68 to −0.60]) at 3 months and 12 months, respectively. On multivariate Cox regression modeling, disease activity was a predictor of a decreased response to treatment by 49%. There were no new, significant AEs. CONCLUSIONS: Adalimumab biosimilar (ABP501; Amgevita®) is clinically effective and tolerable over 12 months of follow-up in Iraqi patients with AS.

Correlation between Diabetes Mellitus and Dyslipidemia Incidence in Center of Iraq

Background: Dyslipidemia is more common in individuals with type 2 diabetes (T2DM), increasing their susceptibility to cardiovascular diseases (CVDs). This study aims to investigate the association between serum lipid profile and hemoglobin A1c (HbA1c), and the significance of HbA1c as a marker of dyslipidemia in T2DM. Method: A retrospective cross-sectional study enrolled 500 patients from the Center of Diabetes and Endocrine Glands in Karbala, Iraq. Participants were selected if they had regular visits with their doctors and up-to-date data in the system. Results: Among the participants, 230 (46.0%) were male and 270 (54.01%) were female, with an age range of 40-49 years representing the highest proportion (36.8%). Out of the participants, 278 (55.6%) had severely elevated HbA1c (=10%), and half of them had moderately elevated (250-299 mg/dL) random blood sugar levels. Among the total participants, 98 (42.6%) were males, with 36 (15.7%) of them being 50 years old or older. Among females, a total of 86 (31.9%) were within the age range of 40-49 years. Regarding marital status, 33 (46.5%) were single, out of which 17 (23.9%) were within the age range of 20-29 years. Among the married participants (151 in total, representing 35.5% of the total), the majority (53, 12.5% of the married participants) were aged 50 or older. Conclusion: HbA1c exhibits a direct and significant correlation with total cholesterol within the lipid profile.

Structure, Process and Outcome Evaluation of Central Public Health Laboratory Performance About Neonatal Screening Program in Karbala in 2022

Background: Neonatal screening is a preventive medical act aims to early detecting neonates affected byspecific disorders that endanger their lives or cause long-term health problems and require prompt intervention. This canresult in significant reductions in morbidity, death, and related costs and disabilities. The panel of neonatal screened disordershas been gradually expanded. Expansion has been empowered with the introduction of tandem mass spectrometry, whichallowed for the screening of up to 40–50 diseases with a single blood spot. Part of the implementation of neonatal screeningprogram must include, just like any other program, monitoring and evaluation task in order to identify difficultiesor barriers to improve procedures and methodologies. This study aimed to evaluate the Central Public Health Laboratory/Karbala Directorate of Health performance in Neonatal Screening program. Method: The evaluation method has beencarried out in Holy Karbala Governorate for the period between the first of September 2021 and the end of June 2022using a check list of standards taken from the National Guideline for Newborn Screening for Care Providers inPrimary Health Care Centers in Iraq. This was to evaluateCentral Public Health Laboratory by meeting the manager employee and evaluate theCentral Public Health Laboratory room.

Prevalence rates of mucopolysaccharidosis in Iraq: a retrospective cross-sectional observational study

Background: Mucopolysaccharidosis (MPS) is a rare hereditary inborn error of metabolism that represents the largest heterogeneous group of lysosomal storage diseases (LSD) and is characterized by multiorgan impairment due to glycosaminoglycans (GAGs) accumulation in various tissues and organs, resulting in severe frailty and early death. This research aimed to figure out the specific and overall birth prevalence of mucopolysaccharidosis among Iraqi children, as well as the frequencies of each type, and to compare the results with epidemiological data from other Arabian countries. Methods: Information was collected and investigated from registered patients diagnosed with MPS in five metabolic centers in Iraq between 2010 and 2020. The numbers of live births in Iraq were obtained from the Ministry of Health and Environment (Health and vital statistics department) for the period mentioned above. Birth prevalence was calculated, and Poisson distribution for confidence intervals (95%) was considered through the implementation of MedCalc statistical software. The Hardy-Weinberg equation was used to calculate carrier frequency. Results: The overall prevalence of MPS at birth is 2.97 per 100,000 live births; different forms of MPS manifest at varied frequencies. MPS VI was the most often reported form in the Iraqi population (1.32 per 100,000 live births, or 44.41% of all MPS cases), followed by MPS IVA and MPS I (0.625 and 0.593 per 100,000 live births, respectively). The higher frequency rate of MPS VI was also reported in neighboring countries, including UAE and Saudi Arabia, which were 2.51 and 8.0 per 100,000 live births, respectively. Conclusions: The health systems should highly consider data obtained from prevalence studies in all affected countries, including health care specialists, clinical genetics, and workers in laboratories involved in MPS diagnosis.

Assessment of endotoxin levels of water in hemodialysis centers in Iraq

The significance of endotoxin-free, sterile dialysis fluid for long-term, high-quality hemodialysis treatment is obvious and highly desired[MF1] . The current study aimed to determine endotoxin for the water quality used in twenty hemodialysis treatment centers. Eighty samples (40 x dialysates and 40 x dialysis water) were tested for endotoxin using the LAL gel clot method. The results revealed a variation in the quality of the produced water that makes it unaccepted compared to the international standard (ANSI/AAMI/ISO-23500). Endotoxin levels were higher than (0.25 EU/ml) in 40% of dialysis water and 30% of dialysate water, higher than the recommended international standards. The results conclude that systematic water quality monitoring in hemodialysis services is essential for patient safety and health problems. Keywords: Endotoxin; Water quality; Dialysis fluid; LAL test; Hemodialysis patient

Presentation of retinopathy of prematurity and associated risk factors in a referral center in Iraq

Presentation of retinopathy of prematurity and associated risk factors in a referral center in Iraq

Knowledge, Perception, and Reporting Practices of Healthcare Providers about Adverse Events Following the COVID-19 Vaccination in Iraq(Conference Paper )#

Routine vaccination activities, such as detection, reporting, and management of adverse events following immunization (AEFIs), are generally handled by healthcare providers (HCPs). Safe vaccines against severe acute respiratory syndrome coronavirus (SARS-CoV-2) were introduced to control the Coronavirus Disease-19 (COVID-19) pandemic. The study aimed to assess the knowledge, perceptions, and practice of HCPs in Iraq about reporting adverse events following COVID-19 vaccination, and their association with sociodemographic variables. The study was a cross-sectional study that was carried out between August and September 2021 at the COVID-19 vaccination centers in Iraq. This study used an online and paper-based questionnaire, which was distributed among HCPs (physicians and pharmacists) in COVID-19 vaccination centers. A total of 117 pharmacists and physicians responded to the survey. Two-thirds of respondents were pharmacists. The majority of the respondents (49.6%) had fair knowledge levels on AEFIs. The perception of 43% of the participants was very good, whereas the perception of 28%, 23%, and 6% of the participants was fair, good, and poor, respectively. The reporting practice of HCPs was inadequate in 53% of respondents. The number of pharmacists who had good knowledge of AEFIs was significantly higher than that of the physicians. The age group (30-39) years of HCPs was significantly associated with more positive perception towards AEFIs. The number of pharmacists that had good perception was significantly higher than that of the physicians. Furthermore, HCPs aged 30 to 39 years had significantly higher reporting practices than other age groups. The study highlighted that the HCPs working at the COVID-19 vaccination centers have low knowledge of AEFIs. On the other hand, HCPs had more positive perception towards reporting AEFIs. Education programs and reference materials are needed to increase their awareness about AEFIs.

Earth-to-air Heat Exchanger for Cooling Applications in a Hot and Dry Climate: Numerical and Experimental Study

Shallow geothermal energy, by an earth-to-air heat exchanger (EAHE), is utilized to cool buildings with minimal energy usage. Significant parameters affecting the heat exchanger's performance must be investigated to obtain a suitable design. Shallow geothermal energy, by an earth-to-air heat exchanger (EAHE), is utilized to cool buildings with minimal energy usage. Significant parameters affecting the heat exchanger's performance must be investigated to obtain a suitable design. This article numerically and experimentally investigates the effect of pipe diameter, pipe length, inlet air temperature, soil temperature, airflow velocity, and soil thermal conductivity on the performance of the heat exchanger under hot and dry climate conditions. The soil temperature distribution was measured from the surface to a depth of 7 m in the city of Karbala (center of Iraq) in the summer season. The experimental test for EAHE was carried out in water-saturated soil and ambient air temperatures of 41 ºC, 45 ºC, and 49.5 ºC at four different velocities. The percentage drop in the EAHE outlet air temperature at 9 m/s was 28.3%, 25.5%, and 19.5%, respectively. Also, the three-dimensional model was created, and the simulation results were compared with the experimental results, which were in good agreement. An equation for the outlet air temperature was found as a function of pipe diameter and length, ambient air temperature, soil temperature around the pipe, and soil thermal conductivity. The resulted equation were compared with the current experimental results and experimental results of reported data inliterature. As a result, a very good agreement was observed. The results showed that the parameter L (length of the pipe) causes the strongest nonlinear behavior in the equation. For the cases considered, at diameters 75 and 100 mm, an approximate linear behavior for the length required to achieve a specific outlet temperature was observed. It can be concluded from the results that changing the soil type from dry one (k=0.5 W/m K) to saturated one (case of Karbala city, k=1.5 W/m K) resulted about 25% reduction in the length of the pipe. Also, the results showed that at an air velocity of 7m/s, the length required to obtain 26 ºC at the outlet of EAHE is 62.1 m which is 55% higher than the case of 29 ºC (39.9m).

Descriptive study in polycythemia rubra vera and evaluation of management outcome

Background: Polycythemia Vera (PV) is a myeloproliferative neoplastic disorder involving uncontrolled red blood cell production resulting in elevated red blood cell (RBC) mass. There is a signaling defect leading to an abnormal response to growth factors, and the abnormal clonal line interferes with normal lineage proliferation. The Janus kinase-2 (JAK2) gene involved with intracellular signaling is mutated in 90% of cases of PV. It can occur in all age groups, but the median age of diagnosis is 60 years. Thrombosis considered as the most common cause for morbidity and mortality. Aim of study: To review the clinical characteristics of a sample of PV patients and their current treatment in addition to assessment of frequency of development of thrombotic events while on treatment. Patients and method: A hospital based retrospective study was conducted in the hematology outpatient's clinic from different centers in Iraq over a period of 11months (from January 2020 till November 2020). Patient's age more than 18 years old with duration of the disease more than 6 months and all of them were positive for JAKII V617F mutations were included in this study while excluding those who were negative for this mutation. The patients were divided in to low and high risk based on age and leukocyte counts and history of previous thrombosis and presence of cardiovascular risk factors. The response and resistance to treatment with hydroxyurea were evaluated according to ELN definition. Result: Thirty patients were enrolled in this study. The median age was 60.6±11 years, ranging between 35-78 years. The mean duration of disease was 54± 5.5 months. Headache was the predominant symptom observed in 96.7%, pruritus was experienced in 63.3%.Splenomegaly was seen in 46.7% .Thrombosis at time of diagnosis happened in 13.4%of cases. The most common complication that occurred in this study group was thrombosis in 20% of patients ,16.6% progressed to myelofibrosis and 63.3% of patients were controlled by treatment. Conclusion: The demographic and some of characteristic of Iraqi PV patients are similar to those from other countries. A good number of patients were controlled with hydroxyurea. Thrombosis is still the commonest complication in patients with PV and occurred mainly in the first 4 years since diagnosis of polycythemia Vera. Median time for development of myelofibrosis was more than 10 year.

Evaluation of hospitalized patients with COVID-19 treated with or without convalescent plasma therapy: A retrospective descriptive cross-sectional study

Background: The socio-clinical characteristics have been considered an important variable associated with COVID-19 and a predictor of morbidity and mortality. Convalescent plasma therapy (CPT) was one of the modalities used worldwide for COVID-19 treatment. In Iraq, there is a paucity of studies evaluating the socio-clinical variables of patients with severe COVID-19 treated with CPT. Objectives: This study aims to describe the socio-clinical characteristics of patients with severe COVID-19 treated with and without CPT in one of the main COVID-19 treatment centers in Iraq. Materials and Methods: A descriptive cross-sectional study was conducted between May 15 and August 14, 2020, at the main COVID-19 treatment center in Anbar Governorate, west of Iraq. Out of 529 hospitalized patients, a total of 438 with severe disease were enrolled in the study. Results: The participants’ mean age was 49.9±13.8 years. The majority of the subjects were males, aged ≥40 years, residing in urban areas. 65.2% of the patients had at least one comorbidity, and 6.4% were smokers. Hypertension and diabetes mellitus represented the two commonest comorbid conditions. All patients have required oxygen therapy; 41.1% were performed with continuous positive airway pressure. Male patients aged ≥60, and patients with comorbidities received CPT at a higher frequency. Conclusion: This study corroborates the findings from other studies that certain socio-clinical characteristics had an association with hospitalization related to severe COVID-19. Convalescent plasma was administered in more than one-fifth of the COVID-19 hospitalized patients in Anbar during the early pandemic phase.

Healthcare assessment for beauty centers using hybrid sentiment analysis

<span>Because of COVID-19, healthcare became the first interesting domain at the world. Here, comes the role of researchers to do what they can to guide people. Nowadays, the most wanted field is beauty industry. It achieved large market. And the estimation is toward the growing. Researchers can give advice to prevent unhealthy causes in this field. They can apply sentiment analysis methods to make decision whether a Beauty center is healthy or unhealthy. This work develops an improved method of sentiment analysis to classify the beauty centers in Iraq into healthy and unhealthy classes. Researchers used comments of beauty centers’ Facebooks to perform the assessment. The methodologies encompass the two approaches lexicon-based and machine-learning-based. Three machine learning mechanisms had been applied; rough set theory, naïve bayes, and k-nearest neighbors. It will be shown that rough set theory is the best compared with the others two. Rough set theory achieved 95.2%, while Naïve Bayes achieved 87.5% and k-nearest neighbors achieved 78%.</span>

Structure, Process, and Outcome Evaluation of Hospitals about Neonatal Screening Program in Karbala in 2022

Background: The newborn screening program has been evaluated in several parts of the world, with varying outcomes (1). In terms of incidence, severity, age of onset, and diagnostic and therapeutic techniques, they vary greatly. The program screens a group of conditions that causes major metabolic abnormalities in newborns, resulting in irreversible damage and illness. There is a treatment for some of them that, if given soon after birth, can prevent such damage. Many countries have suggested, developed, and implemented population-based newborn screening for these illnesses, although at differing rates and using various criteria(2). Materials and Methods: This evaluation study was conducted between the first of September 2021 and the end of June 2022. This research was carried out in the Holy Karbala Governorate, to assess a pilot program implemented by the Governorate Directorate of Health in Karbala Children's Teaching Hospital and Al-Hindiya General Hospital. A checklist has been used to evaluate hospitals after reviewing the “National Guideline of Newborn Screening for Care Providers in Primary Health Care Centers in Iraq”. The list was built and developed by the researchers. Results: It was documented that the program worked in only one hospital, where the trained medical staff. However, there was untrained health staff available, in addition to the lack of the program’s needs for laboratory testing follow-up, food, and milk needed for the program patients. Conclusion: Although, this program could contribute to “reducing the rate of under-five mortality by two-thirds”, the necessary tools to meet these objectives were not found in the hospitals.

Knowledge of osteoporosis among females attending primary health care centers in Iraq

Osteoporosis is among the common diseases affecting bones, it is usually consider as the commonest one. Poor knowledge about its precipitating factors and the means for prevention will result in increasing the burden of the disease in the community; for this reason, the prevalence of osteoporosis in the world will increase. Methodology: Across-sectional study on 203 women attended Primary Health Care Centers in Al Dora District was conducted for the period from the first of March to end of May 2021, in order to determine their knowledge toward osteoporosis causes, complications and prevention. Statistical analysis .The row data were coded and analyzed by SPSS (version 23) software package then tabulated. Descriptive statistics were used to describe the basic features of the data in this study. Results: The all participants were females aged between 40 and 71 years (Mean ±SD 56.40 ±7.77). The majority of them were married (93.1%). Regarding employment status, 155 of them (76.4%) were housewife and the rest were employed. More than half of the participant’s (108 ,53.2%) had educated level of primary school, were 46 (22.7%) had intermediate school and 44(21.7%) of the with secondary school graduation, the rest were illiterate(5 ,2.5%).

The Effectiveness of a Low-Cost Personalized Educational Program on the Quality of Bowel Cleansing Among Patients Undergoing a Colonoscopy.

In relation to endoscopic practices, particularly a colonoscopy, patient education is required to maximize the quality of bowel preparation. Thus, the intention of this study is to examine how personalized patient education prior to a colonoscopy influences the quality of bowel preparation. A quasi-experimental post-test design was employed at the Kurdistan Center for Gastroenterology Hepatology and the Ebin Sina Center in Iraq from December 21, 2019, to September 30, 2020. Of 270 participants, 219 were selected for data analysis. The mean age ( SD ) of the participants was 41.18 (15.22), with a median of 41 years and a slightly higher percentage (58.4%) of females in comparison with males (41.6%). The bowel preparation quality of the control and intervention groups in the two centers was based on the Boston Bowel Preparation Scale scores and there was a significant difference ( p < .001) of M ± SD between the control (5.79 ± 1.123) and experimental (7.52 ± 1.225) groups. Findings suggest a personalized educational program is having a significant impact on increasing the quality of bowel preparation.