Centers In Baghdad Research Articles

Evaluation of Nurses’ Evidence-based Practice at Primary Health Care Centers in Baghdad City

Objectives: The study aims at evaluating the nurses’ evidence-based practices at primary health care centers in Baghdad City. Methodology: A descriptive design is carried out at Baghdad City’s primary health care centers from January 2en 2019 to June 1st 2020. One instrument is developed for the purpose of the study. A Non-probability, multi stage purposive sample of (52) staff nurses, who are working at primary health care centers in Baghdad City. The instrument is concerned with the evaluation of nurses’ evidence-based practices through (43) items which are divided in to five main domains of attitudes, knowledge, beliefs, readiness and applications of evidence-based practices. Content validity of the questionnaire is determined by panel of (10) experts and Internal consistency reliability, Split-half technique, is obtained through Cronbach alpha correlation coefficient. Data are collected through the use of the study instrument and the interview technique as means of data collection. Data are analyzed through the use of descriptive statistical data analysis approach of frequencies, percentages, total scores and ranges. Results: The study findings indicate that the majority of the staff nurses have experienced poor level of knowledge, attitudes, beliefs, readiness and application as dimensions of nurses’ evidence-based practices. Conclusion: The study findings depict that staff nurses have experienced inadequate evidence-based practices at primary health care centers. Recommendation: Planned training sessions can be designed, constructed and implemented to staff nurses at the primary health care centers relative to evidence-based practices.

Comparison of Clients’ Satisfaction in Family Health Adapted Centres and Primary Health Care Centres in Baghdad 2018

Comparison of Clients’ Satisfaction in Family Health Adapted Centres and Primary Health Care Centres in Baghdad 2018

Assessment of microbial contamination levels of water in hemodialysis centers in Baghdad, Iraq.

Monitoring water quality in hemodialysis systems is extremely important to maintain adequate quality services for patients suffering from kidney failure. This work aims to examine and evaluate bacteriological characteristics and endotoxin contamination levels in hemodialysis water produced in dialysis centers. Forty-eight water samples were collected and analyzed from four major hospitals in Baghdad for one year to evaluate seasonal effects. The analysis included the determination of total heterotrophic bacteria using the pour plate method, identification of bacterial isolate using the Vitek2 compact instrument, and the determination of endotoxins levels using Limulus amebocyte lysate (LAL) method. In addition, tap water samples (a source for the hemodialysis water) were also examined bacteriologically. Results showed that 44% of the tested samples for bacterial levels are higher than the maximum value of (100CFU/ml) set out by the international standards. Endotoxin values for these centers fluctuated during the study period, and 44% of them exceeded the international standards (>0.25 EU/ml). These results call for applying improved technology to modify the existing water treatment units for better control and for national standardization of the microbiological quality of hemodialysis water. PRACTITIONER POINTS: Four hemodialysis centers were assessed by measuring the bacteriological and endotoxins levels of their feed and product water. Product water showed elevated levels of bacteria that exceeded the international guideline value of 100CFU/ml. Most of the identified bacterial species were Gram-negative that arise the possibility of contributing to endotoxin generation. Product water showed fluctuated values of endotoxins. About 44% of the measured samples were higher than the international guideline values of 0.25 EU/ml.

Maternal Anemia Prevalence and Subsequent Neonatal Complications in Iraq

BACKGROUND: Anemia during pregnancy is still a challenge throughout the world, and it may cause severe health consequences in the maternal and fetal sides.
 AIM: This study aims to find out the prevalence of maternal anemia and potential adverse outcomes in Iraq.
 METHODS: In Medical City Tertiary Center in Baghdad, singleton pregnant ladies came for delivery were involved over 6 months’ period. Based on hemoglobin (Hb) readings; they were divided into no anemia group (Hb>11 g/l) and anemia group which were further subdivided into mild, moderate, and severe (Hb =10–10.9, =7.1–9.9, and <7 g/l, respectively). Full history and examination were performed by attending obstetrician and pediatrician for the upcoming babies.
 RESULTS: Maternal anemia prevalence was 84.84% out of 4473 cases. No anemia group was 15.16%, mild 40.73%, and moderate 40.73%, while severe anemia group (24.93%). Maternal occupation, educational status, and Hb levels were significantly associated with anemia (p < 0.001), unlike parity, body mass index, and delivery mode. Neonatal preterm delivery, birth weight and length, small for gestational age (SGA), Apgar score, respiratory distress, and high death rate were strongly related to mothers’ anemia (p < 0.001), on the contrary of septicemia, birth asphyxia, and hypoglycemia, in spite of their higher frequency rates in anemia groups. Birth weight, and length, and gestational age were lowered significantly in moderate and severe anemia, while Apgar score was low throughout all anemia categories. SGA was significant in severe anemia.
 CONCLUSION: Maternal anemia is highly prevalent in Iraq with significant adverse neonatal events and elevated rates of mortality.

Effects of ‎tamoxifen on the reproductive system of female breast cancer patients: an ultrasound-based cohort study

Background: Tamoxifen (TMX) is regarded as standard treatment for breast cancer (BC) patients‎. In recent years, several studies have reported gynecological side effects and due to TMX's estrogenic effects. Here, we evaluate the side effects of TMX on the ‎endometrium and ovaries of female BC patients. Methods: This was an ultrasound-based cohort study conducted in three oncology centers in Baghdad, Iraq. A total of ‎‎255 female patients were included, 140 premenopausal (PreM) and 115 postmenopausal (PostM), with estrogen receptor (ER)-positive BC using TMX adjuvant hormonal treatment for at least three months after surgery and adjuvant ‎chemo/radiotherapy.‎ Ultrasound (US) on the endometrium and ovaries of the women following ‎BC surgery/chemotherapy (baseline) and at 3, 6, 12, and 24 months following was performed‎. Data collected included age, menopausal status, co-morbid chronic illness and medications, including duration of TMX treatment. Results: Presence of ovarian cyst was significantly higher in the PreM ‎compared to PostM ‎women, while there were no significant differences for other gynecological findings.‎ At ‎baseline, endometrial thickness (ET) was significantly higher in the PreM compared to the PostM women. In both groups, women with increased ET became more frequent from baseline to 3 ‎months, from 3 to 6 ‎months, from 6 to 12 months, and from 12 ‎ to 24 months. At all time periods, ‎women with increased ET was ‎significantly higher in the PostM compared PreM women, resulting ‎in a risk of ET increase by 6 folds (ranging from 3 – ‎‎11 folds) ‎in PostM compared to PreM women. Conclusions: Longer duration of TMX is associated with increased ET. Duration of TMX did not appear to increase the risk of various gynecological outcomes, for example endometrial cancer rate was low. Finally, there was an increase in ET, which appeared to be six-folds higher in PostM compared to PreM women.‎

Efficacy and safety of romiplostim in adult Iraqi patients with refractory immune thrombocytopenia

BACKGROUND: Immune thrombocytopenia (ITP) is an immune-mediated acquired disease characterized by decrease of the platelet count. The majority of adult patients progress to chronic stage with some of them failed to respond or relapsed after the second-line therapy. Romiplostim is a thrombopoietin receptor agonist recently approved for patients with chronic ITP, it was recently licensed and introduced for use in Iraq. The aim of this study was to assess the efficacy and safety of romiplostim among patients with refractory ITP.PATIENTS AND METHODS: This prospective study was conducted between April 2017 and June 2018 in two hematology centers in Baghdad and Basra. A group of 56 adult patients with refractory ITP enrolled in this study. The patients were evaluated before the weekly scheduled romiplostim and followed for efficacy and safety of the treatment.RESULTS: the median age was 39 years with a female-to-male ratio of 4:1. The response rate (platelet ≥50 × 109/l) was observed in 75% of the enrolled patient. The time to initial response was 2.5 weeks, and the mean dose of romiplostim used to achieve a sustained response was 3.1 mcg/kg. The response rate was significantly higher among splenectomized (94.4% vs. 65.8%). There was no difference in response regarding the age and gender. The most frequent adverse effects were joint pain (35.7%), followed by headache (32.1%) and fatigue (21.4%), resolved spontaneously within 2 days. Six patients developed thrombocytosis without any thrombotic event.CONCLUSIONS: Romiplostim is an effective option among Iraqi patients with refractory ITP as a long-term treatment or as a bridge for another intervention, with a relatively safe toxicity profile.

Level of Knowledge And Attitude Of Mothers Through Health Awareness Programs Towards Nursing Bottle Caries: A Cross Sectional Study At Al-karkh Primary Health Care Sector.

Introduction:Tooth decay in infants and toddlers is often referred to as Nursing Bottle Caries(NBC),and as a comprehensive address, referred to Early Childhood Caries(ECC), Children need strong, healthy teeth to chew their food, speak and have a good-looking smile, also it is important for their general health,The role of mothers in avoiding children with nursing Bottle caries is a large and fundamental ,mothersorientations and knowledge , is essential to reduce the percentage of children with tooth decay, developed countries are concerned with awareness and health education programs as a first step in achieving a healthy and disease-free society.Objective:the purpose of this study was: (a) To explore what mothers know about what the meaning of nursing bottle caries (NBC) and its effect on their children and which information they need. (b)To identify mother’s attitude to maintain the health of their children teeth. (c) To determine the level of health awareness by health programs in the Ministry of Health.Methods:A cross sectional study was Included(85) mothers whom their children under the age of five and suffering from (NBC)who visit the primary health care centers within the primary health care sectorFor the purpose of following up the regular maternal and child health program, which were 9 centers in Baghdad/ Alkarkh,from February 2017 -April2017, Interviewer-administered questionnaire was used for data collection, the data was analyzed using SPSS software version 11.0.Results:? Knowledge regarding risk and protective factors amongst parents was variable and sometimes at odds with contemporary evidence, the level of knowledge and procedures towards nursing bottle caries is not sufficient to protect the child, because of the poor health education programs that mothers receive at different levels of education.Conclusions:? The results of this study have implications for efforts to prevent dental decay in this very young age group. Ministry of Health, including public health Institutions and its primary health care centers,need support to provide information and promote confidence with regard to basic health information about nursing bottle caries in children teeth and the necessary measures for prevention, including the importance of the presence of fluoride in drinking water and toothpaste, visit the dentist during the first year after the birth of the child, the effect of sugars in breast milk and natural juices. Attention should also be given to the contribution of early contact with females who are newly married in oral health education and promotion programs.

Analysis of Energy and Exergy for the Flat Plate Solar Air Collector with Longitudinal Fins Embedded in Paraffin Wax Located in Baghdad Center

Latent heat of the fusion for the Phase changeable materials (PCM) can be utilized as heat energy store, and this energy can be employed in different applications. In present experimental work, effect of using the embedded longitudinal fins within the paraffin wax, on the energy and exergy performance for the solar air collector was investigated under the Baghdad governorate climate. Compared with the collector without paraffin wax, the results indicated that using of paraffin wax as a thermal storage material reduces the losses of energy and exergy of the collector, high levels of heat reduction by using PCM/Fins were about 33 and 40% respectively at the peak heat charging time (12:30 PM), while the decreasing in energy and exergy losses of the collector with PCM only was about 24 and 30% respectively at the same time of charging (12:30 PM). Due to the going of sum heat to store in the paraffin wax at the charging heat time, the energy along with exergy heat gains, while efficiencies were decreased with and without fins, this decreasing in the heat was the most by using PCM/Fins and it was around 30 and 44%, respectively for energy and exergy efficiencies, while it was about 20 and 31% by using PCM only at the same time of testing. The benefit of using embedded longitudinal fins in PCM is to enhance the thermal storage efficiency by about 6% compared with the solar collector that uses PCM only.

Assessment of Inflammation, Comorbidity and Demographic Factors in Patients with Kidney Disease in Baghdad

Inflammation markers are significantly higher among hemodialysis (HD) patients, which have been associated with chronic activation of the immune system. Hemodialysis centers in Baghdad appear to be taking measures with low adequacy and frequency of dialysis sessions, which can be a reason for decreased kidney functions. Therefore, the objective of this study focuses on the assessment of different aspects of hemodialysis for regular HD patients in Baghdad, including inflammatory markers (serum C-reactive protein, CRP, and erythrocyte sedimentation rate, ESR), dialysis dose, comorbidities, and demographic factors for a period of one year (2018), the assessment covered four major hospitals in Baghdad namely (Al-Kindi, Baghdad Educational, Al-Imamain Al-Jwadian, and Al-Yarmouk). The study involved 320 adult (chronic kidney disease; non hepatitis virus) patients (55% male and 45% female) treated with regular hemodialysis. When compared with the normal values ​​specified by manufacturers for the number of measurement of these indicators. Inflammation markers were high in HD patients were 66.2% of patients recorded elevated of CRP and 87.7% for ESR with no significant difference between males and females, but the origin of chronic inflammation in the patient's remains unclear. Moreover, the majority of HD patients were non-educated; illustring that higher education is possibly associated with lower disease incidence as compared to those who never finished high school. Finally, most of these hospitals, average hemodialysis treatment lasts about three hours and is done two times per week.

Correlation between Breast Self-Examination Practices and Demographic Characteristics, Risk Factors and Clinical Stage of Breast Cancer among Iraqi Patients.

BACKGROUND:Breast Cancer (BC) is the most common cancer and the leading cause of cancer death among women globally. The disease can be cured with limited resources if detected early. Breast self-examination (BSE) is considered a cost-effective feasible approach for early detection of that cancer in developing countries.AIM:To determine the correlation between BSE performance and demographic characteristics, risk factors and clinical stage of BC among Iraqi patients.METHODS:This retrospective study included a total of 409 female patients diagnosed with BC at the Referral Training Center for Early Detection of Breast Cancer and the National Cancer Research Center in Baghdad. The studied variables included the age of the patient, occupation, marital and educational status, parity, history of lactation, contraceptive pill intake, family history of cancer and the clinical stage of the disease.RESULTS:Our findings revealed that the most important predictors for practicing BSE was family history of BC or any other cancers (OR = 3.87, P = 0.018) followed by being a governmental employee (OR = 1.87, P = 0.024), history of contraceptive use (OR = 1.80, P = 0.011) and the high level of education (OR = 1.73, P = 0.004). On the other hand, there was no significant correlation between the practice of BSE and the BC stage at the time of presentation.CONCLUSION:There is a relatively poor practice of BSE among Iraqi patients diagnosed with BC. It is mandatory to foster the national cancer control strategies that focus on raising the level of awareness among the community through public education as a major approach to the early detection of cancer in Iraq.

Knowledge regarding neonatal jaundice among a sample of mothers attending some Primary Health Care centers /Baghdad

Background: Neonatal jaundice is most common condition requiring medical evaluation in a newborn and it is yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. Objective: To assess the knowledge regarding neonatal jaundice in a sample of mothers attending some Primary Health Care centers, Baghdad. Patients and Methods: A cross-sectional study was conducted including 265 mothers attending some primary health care centers in Baghdad during November and December 2016. They were subjected to previously structured questionnaire covering many aspects of neonatal jaundice distributed in 3 main domains and the mother's responses were gathered and then statistically analysed by frequency, percentages and percent score for each question responses and domain and the overall knowledge mean score. Results: Family and relatives were the main source of information 39.7% and the results revealed that the mean percent score for knowledge responses was 74% for definition of jaundice, 68% for complications of jaundice and 71% for ways of treatment.The mean overall percent score for knowledge was 71%. Conclusion: Good mean overall knowledge level regarding neonatal jaundice among study group.

Study the association between IL-17 level and autoimmune antibodies in hypo and hyper thyroidisms patients

The current study included measuring the level of IL-17A and IL-17F and some autoimmune antibodies related to the thyroid gland in case of hypo and hyperthyroid in Iraqi patients to evaluate the correlation between all the measured parameters in this study.The study has been carried out in AL-Kindey Endocrine Gland and Diabetic Center in Baghdad during the period between February 2018 and May 2018, included: 88 patients were divided into three groups, The first group composed of 30 patients of Hypothyroidism that included (26) of them were females, (4) of them males. The second group composed of 30 of patients of Hyperthyroidism that included (20) of them were females, (10) of them were males . and second groups were conducted with hypo and hyperthyroidism respectively.While the third group composed of 28 of healthy individuals (Control) that composed of (25) of them were females, (3) of them were males was represented as control .The results revealed a significant (P < 0.05) correlation between TSH concentration and age in patients groups. When the age is more than 40 years, the concentration of TSH was noticed to be higher than that in patients aged less than 40 years. The results show that the level of antibodies was significantly increased (P<0.01) in hypo and hyperthyroid patients in comparison with the control group. At the same time the level of Anti-TG antibodies was higher significantly in the hypothyroid patients than its level in hyperthyroid patients group. No significant differences have been found between hypo and hyperthyroid patients in the level of Anti-TPO and Anti TSH-R antibodies. But its noticed that the higher level of Anti-TPO Ab. was found in the hypothyroid group where as higher level of Anti TSH-R Ab. was found in the hyperthyroid group and simultaneously both types were significantly higher than their levels in the control group As well as the results demonstrated a highly significant increase (P< 0.01) in the levels of IL-17 Types (A and F) in hypo and hyperthyroid patients with bias toward the comparison with the control group. The statistical study showed a significant negative correlation between the level of TSH and Anti-TG levels (r= -0.33). While a significant positive correlation between the level of Anti-TG and level of IL-17F (r= 0.39) in hypothyroid patients. Also in hypothyroid patients, there is a significant positive correlation between the level of Anti-TPO and IL-17A (r= 0.33). In conclusion: The positive correlation between IL-17F and Anti-TG and between IL-17A and Anti- TPO in hypothyroid patients refer to increase in the concentration of IL-17 may lead to increase the thyroid autoantibodies, which affect thyroid tissue potency, decreasing thyroid hormone production, according to feedback inhibition loop.

Effect of ageing on selected salivary chemical compositions and dental caries experience among group of adults

Background: Ageing is a continuous accumulative ordinary physiological phenomena occurs upon all organs and body structures including saliva by its constituents which can influence the caries process, for that this study was conducted to determine the impact of ageing on selected chemical composition of saliva and their effects on dental caries experience characteristics at different age groups among apparently healthy men. Materials and method: A descriptive comparative study was conducted to compare between three study samples (young, middle and old age adults), thirty male in each study insert, aged (20 years, 40 years and 60 years) respectively. They were selected from private health center in Baghdad - Iraq, from the mid of November 2017until the end of February 2018, where they subjected to complete body investigations to confirm their health status, followed by thorough general body history and oral examination. Caries experience was recorded according to the criteria of WHO in1987. Un-stimulated saliva was collected according to Navazesh and Kumer and analyzed chemically to determine the level of calcium ions and alkaline phosphatase. All data then statistically analyzed by using SPSS version 22. Results: The current study, showed that the caries experience represented by DMFs increased with increasing age, by which the highest mean value of DMFs was established in the oldest age (60.37± 31.39) and the lowest mean value was noted among the youngest age (7.27±8.02). A significant differences existed between all study samples (p≤0.05). However, the missing surfaces represented the largest proportion of DMFs value when compared to Ds and Fs among all ages Iin the current study, with significant differences (p≤0.05) was followed by the decay fraction that found to be increased with age but with no significant difference. Salivary Calcium ions showed decreasing with increasing age with statically significant differences among different study samples while salivary alkaline phosphatase was increased with increasing age with no significant differences. Concerning the caries experience among the study samples, the salivary Ca+2 ions inversely correlated while alkaline phosphates correlated positively with caries experience. Conclusion: there is a significant age related changes on the selected chemical constituents of saliva that could affect the caries experience

Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta

Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.
 Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering.
 Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.
 The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes,
 status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.
 Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

Quality assurance of the linear accelerator device using Star Track and Perspex

In this study, the quality assurance of the linear accelerator available at the Baghdad Center for Radiation Therapy and Nuclear Medicine was verified using Star Track and Perspex. The study was established from August to December 2018. This study showed that there was an acceptable variation in the dose output of the linear accelerator. This variation was ±2% and it was within the permissible range according to the recommendations of the manufacturer of the accelerator (Elkta).

Heavy Metals in Dialysis Fluid and Blood Samples from Hemodialysis Patients in Dialysis Centers in Baghdad, Iraq.

Background.The kidney is the first target organ of heavy metal toxicity due to its capacity to reabsorb and accumulate divalent metals. Hemodialysis therapy is used to purify the blood of individuals with impaired kidney function.Objective.The aim of the present study was to evaluate the relationship between dialysis fluid quality and the health of hemodialysis patients.Methods.A field sampling program was conducted to collect blood samples from 320 hemodialysis patients (56% males and 44% females) in order to examine the concentrations of heavy metals that typically occur in municipal water in Baghdad (aluminum (Al), copper (Cu), lead (Pb), and zinc (Zn)), and explore associations with the same metals in dialysis fluid collected from four major dialysis centers in Baghdad hospitals for a period of one year (2018).Results.The results showed that the dialysis fluid quality was not in compliance with international standards. The dialysis fluid in 63% of the samples contained high Al concentrations, while Cu and Zn concentrations were within international standards. Lead concentrations were elevated in dialysis fluid in some hospitals as well.Discussion.The average blood levels of biologically important heavy elements were significantly varied in hemodialysis patients when compared with local reference values.Conclusions.Since both deficiency and excess elements are potentially harmful, the hypothesis that heavy element status affects the risk of adverse clinical outcomes is a worthy investigation.Participant Consent.ObtainedEthics Approval.The study was approved by the Baghdad Ethics Committee of the Iraqi Ministry of Health and Environment.Competing Interests.The authors declare no competing financial interests.

Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study

BackgroundMedication non-adherence is a common problem among patients with diabetes. Patient-reported medication adherence scales are the most commonly used method to assess patient medication adherence, but up to today there...

Evaluation of Application of Nutritional Status Assessment for Children Under 5 years by Using IMCI Program in a Sample of Primary Health Care Centers in Baghdad City

Background: World Health Organization (WHO) and United Nation International Children Fund (UNICEF) developed a strategy known as Integrated Management of Childhood Illness (IMCI); which aims to reduce less than five years children morbidity and mortality in developing countries.
 Objective: To assess the completion of the IMCI format status in primary health care centers, Baghdad.
 Methods: A cross sectional study with analytic element was conducted during the period from 15th of January till 15th May 2016 in selected Primary health centers in Baghdad, Iraq. The sample consists of form of child files less than 2 months and form from 2 month up to 5 years children. Classified correctively, determined follow up visits, Comparison classified of nutritional status assessment between health center and IMCI guideline.
 Result: 1400 child files were collected, 1295 from child files (2months-5year), and 105 forms from child less than 2 month. In form less than 2 months (correct classified 54.29%, incorrect 45.71%), (Determined date of follow up 13.33%, not determined 86.67%).Form from (2month-5years) (57.07% correct classified, 43.93% incorrect classified), (Determined date Follow up visit 38.38%, Not determined visit 61.62%).
 Conclusion: Impaired classification of nutritional status assessment

Awareness among Parents of Beta Thalassemia Major and Intermedia Patients in Three Centers in Baghdad and Al-Nasiriyah, Iraq in 2017

Background: Thalassemia is an autosomal recessive disease common in Iraq with a prevalence of 35.7 per 100000. Beta thalassemia major is a life-threatening condition with many complications which if not managed could cause death at an early age. This cross-sectional study aimed to assess the awareness of parents/caregivers of children with beta-thalassemia major and intermedia, as enhancing awareness is the first and the most important step in all prevention programs
 Methods: We conducted this study in three thalassemia centers (two in Baghdad and one in Al-Nasiriyah) from July 20th, 2017 to September 20th, 2017. This study involved 193 parents of thalassemic children under the age of 15 who come to the centers frequently for blood transfusion. The study assessed the awareness questionnaire through interviews. Data analysis was performed using the Statistical Package for the Social Sciences program (SPSS) version 24.
 Results: We found that awareness was low in many aspects. The highest knowledge was for foods that thalassemic patients shouldn't eat and for the early manifestation signs in thalassemic patients which is 94.8% and 86%, respectively. The lowest knowledge was for the consideration of human immune deficiency virus as a transfusion-transmitted disease and for the chance of having an affected child when both parents are carriers which were 37.3% and 11.9%, respectively.
 Conclusion: Parents have low awareness of thalassemia in many aspects. Thalassemia care centers may need to provide more education for the parents of patients with thalassemia.

Effect of the impacted third molars on the development of temporomandibular joint (TMJ) clicking

Aims and Objectives: Temporomandibular joint (TMJ) clicking has been considered as the most important clinical features of many TMJ disorders, so that the early diagnosis of TMJ clicking could be considered an important value for early treatment. The knowledge and study of the factors that have an adverse effect on the TMJ are necessary for the proper diagnosis, treatment, and prognosis of TMJ disorders. This aim of this study was to observe whether there was a relationship between the presence of impacted third molars and the development of TMJ clicking. Materials and Methods: The study was undertaken on 189 patients with bilateral maxillary and mandibular impacted third molars aged between 18 and 25 years, in regardless of genders that were referred to the radiology department of some dental centers in Baghdad for taking orthopantomograms (OPGs) from June 2017 to December 2018. The patients were examined clinically for detecting the temporomandibular clicking by using a stethoscope for hearing clicking sounds during mouth opening and mandibular excursion. Results: The statistical analysis showed that there was no significant relationship between the presence of impacted third molars and development of TMJ clicking (χ2 = 1.04; P = 0.3). Conclusion: According to this study, impacted third molars were not considered to be an effective factor in the occurrence or development of TMJ clicking or sound.