Sulaimani City Research Articles

Knowledge and Attitude of Mothers Regarding Oral Rehydration Solution in Sulaimani

Background: Dehydration resulting from diarrhea is a significant cause of death of young children in developing countries. Oral rehydration solution (ORS) is useful to replace fluid and electrolyte loss. Objective: The main objective is to assess the knowledge, attitude and practice of mothers towards the use of oral rehydration solution in the treatment of acute diarrhea in children. Patients and Methods: This observational descriptive study was conducted at the pediatric medical emergency department of the Children‘s hospital and the institute of child health in Sulaimani city for a period of eight months from July 2012 till March 2013. The criteria of inclusion were mothers of children with diarrhea. A total of 200 mothers fulfilling the inclusion criteria were enrolled over the study period. Mothers were interviewed and information collected. A pre designed questionnaire was filled for each case by the investigator which included a detailed history highlighting their demographic data, presenting complaints , treatment given at home, mothers knowledge about ORS and drugs, maternal education, water sources, and socioeconomic history was taken and recorded carefully. All the data entered in SPSS and results were analyzed in percentages. Results: A total 200 mothers who visited the Pediatric Teaching Hospital in Sulaimani were interviewed. The median age of children group was 2 years, and minimum was (4 months)and maximum age was 8 years, of these 25(12.5%) were below 1 year, and 160 cases (80%) were between 1 to 5 years, and 15 cases (7.5%) more than 5 years. The most frequent age group was between 1 to 5 years, male were 101 (50.5%) and female were 99 female (49.5%), 58(29%) of mothers education were illiterate, and 105 (52.5%) of mothers education was low, and 37(18.5%) of mothers education was high. Among all the patients 172(86%) were from Sulaimani and 28(14%) from outside Sulaimani. Among all the patients the source of water used was well 103(51.5%), and 63(31.5%) was piped, and 34(17%) was tanks. Out of 200 mothers 199 (99.5%) heard about ORS and 1(0.5%) did not hear about it. Of these mothers 183(91.5%) used ORS. and 17(8.5%) did not use it. Among the mothers that usedORS, 7(3.5%) used it by themselves and 42(21%) were advised by family member and 85(42.5%) were advised by physician and 49(24.5%) were advised by health worker. The way of giving ORS wasby cup and spoonin 139(69.5%), and 44(22%) gaveORS by bottle. Of them 109(54.5%) amount of ORS given adequate amount and 74(37%) gave inadequately. And of them 107(53.5%) prepared ORS correctly and 76(38%) prepared the solution incorrectly. Among all mothers; 172(86%) used drugs and 28(14%) did not use drugs. Among those who use drugs 21(10.5%) used it by themselves and 151(75.5%) got advise by family physician. Conclusion: Although most of the mothers knew about ORS and used it at times of need, many had inadequate knowledge on the importance and appropriate use of ORS.

Comparison between Phenotypic and Genotypic Detection of Metallo Beta Lactamase Enzyme among Gram Negative Bacteria Isolated from Burn Patient

Background: -lactamases (MBLs) are emerging worldwide as powerful resistance determinants in Gram negative bacteria Rapid dissemination and spread between different bacterial species by large gene transfer favor by globalization and travel represent a high risk of worldwide pandemic among Enterobacteriaceae Objective:This study design to screen for phenotypic detection of MBL and genes coding for metallo - lactamase(MBL) such as, blaVIM, blaIMP and bla NDM among infected burn wound patients in Sulaimani city /Iraq. Materials and Methods: Out of 230 burn wound samples, 201 wound swabs and 29 tissue biopsy were collected from hospitalized burn patients with second and third degrees burnfrom Burn and Plastic Surgery Hospital in Sulaimani city from the period of April to October 2011. According to direct gram stain , bacterial cultural , biochemical tests, analytic profile identification(API) system and vitek 2 Compact system , antimicrobial susceptibility Testing by using Kirby-Bauer disk diffusion method and vitek compact system, -lactamase by Double disk synergy test and Combined EDTA disk test and Modified Hodge test and -lactamase enzyme by using polymerase chain reaction. Results: Out of 230 burn wound samples177 samples gram negative bacteria were isolated; inflammatory cells showed significantly associated with positive bacterial culture. The most frequent bacteria isolated were Pseudomonas species 48(27.12%), in which Pseudomonas aeruginosa account for a higher percentage 46(25.98%) and one species (0.56%) of each P. stutzeri and P.florescence wasisolated followed by Acinetobacterspecies 44 (24.86%) in which Acinetobacterbaumanniiwas the commonest and accounts for a higher percentage 41 (23.16%) and one species(0.56%) of each of A. ursingi, A. hemolyticasandA.complexwere identified. On the other hand in the family of Enterobacteriaceae,the most common bacteria were Klebsiellapneumoniae44(24.86%), Enterobacter cloacae 18 (10.17%) and Escherichia species 11(6.21%). The susceptibility of bacterial isolates against 18 antibiotics from different classes of antibiotics was tested and it was found that most of the isolated species of non fermenter bacteria such as Acinetobacterand Pseudomonas species show multidrug resistant pattern and high resistance against most of the antibiotics commonly used. The most resistant antibiotics against non fermenter bacteria were Ticarcillin (81.82%) against Pseudomonas species and Ticarcillin, Tazobactam- Pipracillin and Cefoxitin (93.18%) against Acinetobacterspecies .The most resistant antibiotic against K. pneumonia andE.cloacaewere Cefoxitin(84.9%)and Amoxicillin Clavulanic acid (84.9%).The most resistant antibiotics against Escherichia specieswere Cefotaxime, Trimethoprim and Cefipime (90.91%) but the most effective antibiotic with a highsensitivity rate was Imipenem (90.91).Phenotypic tests were carried out for the detection of MBL enzyme for all studied isolates and it was found that Combined disk test was the most sensitive test giving the highest percentage (31.07%) followed by Double disk synergy test(28.8%), Modified Hodge test (20.9%) .Polymerase chain reaction assay was used for genotypic detection of MBL genes (blaIMP,blaVIM, ,blaNDM ) in all isolates and the results revealed that the gene blaIMPwas locatedin 33(18.64%),blaVIM,in19 (10.73%), 2(1.12%)forblaNDM Also these genes were detected in 25 stock cultures of Gram negative bacteria preserved in 25 °C since 2008 to 2010. blaIMP gene was detected in11(44%) , blaVIM in 12(48%) and 2(8%) for blaNDM, all these genes were detected in K. pneumonae,P. aeruginosa and A. baumanniiwith length amplified genes (230) bp for IMP and (390)bp for VIM and( 621)bp for NDM. Conclusions:These results indicate that most of the Meropenem resistant strains from infected burn wound strains in this study were producing MBL enzymes The presence of MBL genes among Meropenem sensitive strains indicates that there might be a hidden MBL gene among isolated strains which cannot be diagnosed by phenotypic tests leading to the dissemination of these genes in the hospital silently among patients even within normal health workers who act as carriers for MBL genes in future

REVISION OF MULTIPLE SCLEROSIS CASES ACCORDING TO NEW 2017 MCDONALD CRITERIA AMONG DIAGNOSED PATIENTS IN SULAIMANI CITY

Background 
 Multiple sclerosis (MS) is a chronic, immune-mediated inflammatory disorder of the central nervous system. The diagnosis of Multiple sclerosis is challenging, owing to having a comprehensive list of differentials and mimickers.
 Objectives 
 To determine the frequency of misdiagnosed Multiple Sclerosis cases diagnosed among those patients in Sulaimani city.
 Patients and and Methods
 This retrospective observational study was conducted within a period between December 24th. 2019 and June 10th, 2020, on 106 already diagnosed patients. The study included patients diagnosed with the relapse-remitting form of multiple sclerosis. We excluded those patients with progressive forms of multiple sclerosis. We re-evaluated each patient in-depth and stratified the cases according to the diagnosis certainty based on the fulfillment of the 2017 McDonald Criteria. Finally, we returned those suspicious cases to the multiple sclerosis committee of Shar hospital to verify their final diagnosis. 
 Results
 Sixteen (16.9%) out of 106 patients, there was diagnostic uncertainty in which 6 (5.7%) of them received the confirmatory diagnosis of relapse-remitting multiple sclerosis by the committee, and 1(0.9%) patient considered secondary progressive multiple sclerosis. In the remaining 9 (8.4%) patients, we found the clinically isolated syndrome in 5 (4.7%) patients, solitary sclerosis in 1 (0.9%) patient, stroke with polycythemia rubra vera (PRV) in 1 (0.9%) patient, possible cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in 1 (0.9%) patient, and 1 (0.9 %) patient was undiagnosed. 
 Conclusion
 To sum up, the frequency of multiple sclerosis misdiagnosis was 8.4% in Sulaimani city, slightly lower than the other reporting centers.

Determination of Level of Serum Iron among Routine Iron Supplemented Pregnant Women Attending Private Clinic in Sulaimani City, Kurdistan-Iraq

Iron deficiency, with or without anemia, is common in pregnant women and more than half of the anemia’s in the world are due to the deficiency of iron in the serum. The aims of this study were to determine the percentage and level of serum iron among iron supplemented pregnant women in different trimesters and in different age groups among supplemented pregnant women in Sulaimani city. This study was carried out in the private clinic in the Sulaimani city-Kurdistan Region of Iraq. The pregnant women were participated and enrolled between the first of December 2018 and first of December 2019. Two hundred and seventy-five healthy and iron supplemented pregnant women were selected randomly and the questionnaire form, which contains information about age of mothers and their gestational age, was filled and serum iron level was measured by COBAS C111 analyzer. The results of this study found that the percentage of iron deficiency among participants was high 33%, 45%, and 52.6 % in the first trimester in different age groups <25, 25–35, and above 35 years old, respectively. However, in the third trimesters decreased to 12.5%, 7.1%, and 3.7% in <25, 25–35, and above 35 years old, respectively. Regarding serum iron levels, the present study found that there were significant differences between ages 25 and 35 with age <25 years. However, there was no significant difference between first, second, and third trimesters. This study concludes that the percentage of iron deficiency among supplemented pregnant women was high compared to other cities or other countries. Pregnant women who their ages <25 are at risk of serum iron deficiency. On the other hand, pregnancy trimesters had no effects on the serum iron level among supplemented pregnant women.

Clinical characteristics of chronic lymphocytic leukemia in young versus old age patients in Kurdistan region- Iraq

Background: Chronic lymphocytic leukemia is the common adulthood leukemic type, although the incidence rate in the Kurdistan region is low. It is well known that chronic lymphocytic leukemia is prevalent among the elderly age group, however frequent cases of chronic lymphocytic leukemia are newly diagnosed at a younger age. Aim of the study: To analyze the difference in disease presentation, progression, and outcome between young and old age group patients with chronic lymphocytic leukemia in the Kurdistan region/Iraq. Patients & Methods: A retrospective cross-sectional review study carried out in three oncology centers in the Kurdistan region (Nanakaly Hospital in Erbil city, Hiwa center in Sulaimani city, and Azadi center in Duhok city) for ten years through the period from 1st of January, 2010 to 31st of December, 2019 on a convenient sample of 152 patients with chronic lymphocytic leukemia. Diagnosis of chronic lymphocytic leukemia was done by the Oncologists in Kurdistan tumor centers according to the International Workshop on Chronic Lymphocytic Leukemia. The age of patients at diagnosis was categorized into two groups and ranged from 25 years to 94 years. The age cutoff value in the current study was (55 years) depending on previous kinds of literature. Results: The mean age at diagnosis of patients was (63 years); 28% of them were diagnosed at age of ≤50 years and 72% of them were diagnosed at age of more than 55 years. Older age patients were significantly presented with weight loss, while younger age patients were significantly presented with neck lumps. There was a highly significant association between the advanced ECOG performance scale and older age patients at diagnosis. A significant association was observed between the death outcome of chronic lymphocytic leukemia and older age patients at diagnosis. The mean survival duration of younger age patients at diagnosis was significantly longer than the mean survival duration of older age patients at diagnosis. Conclusions: clinical presentation, physical status, death rates, and survival of patients with chronic lymphocytic leukemia in Kurdistan region-Iraq are different between young and older age patients. Keywords: Chronic Lymphocytic Leukemia, age, death, Survival.

Prevalence of Helicobacter pylori infection and its Associated Risk Factors among symptomatic Residents of Sulaimani city, Kurdistan region, Iraq, 2020

Helicobacter pylori (H. pylori) bacteria are a microaerobic Gram negative that colonizes in the gastric and duodenum of human. It can cause prolong infection in the human life if not treated. Many of the studies showed that infection by H. pylori can cause some important gastrointestinal illness, such as peptic ulcer, chronic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Recurrence is generally considered as H. pylori recrudescence infection after one year of eradicated treatment. There are many factors involved in the H pylori reinfection, such as the epidemiology of H. pylori infection, condition of the live, development of economical state, and health conditions. The Objectives of this study were to estimate the incidence and determine the risk factors of infection by H. pylori bacteria in dyspeptic patients in Sulaimani city. And the Aims are to estimate prevalence of the Helicobacter pylori and patients’ characteristics in Sulaimani city. This is a cross-sectional study, using a Urea breath test or stained the gastric sample with Giemsa stain, which is including adult participants aged (12-87) years during the period starting from 1 January until 31 December 2020 on Iraqi male and female patients were visiting –Center for Gastroenterology and Hepatology in Sulaimani, city, Iraq. Three hundred and four patients were included, all of them underwent Urea breath test only but eighty-one of the participants underwent endoscopy and stained the gastric sample with Giemsa stain. Urea breath test for Helicobacter pylori was positive in54.9% which have significant correlation with risk factor findings. Results: the incidence rate of H. pylori infection in our study is 54.9%, and mean age of the study participants was (40.49 ±16.39) one hundred and ninety-one cases 62.8% were female and 113 cases 37.2%were male. Infection by H. pylori bacteria is rife in dyspeptic patients; and is more common in the age group of 31-40 years. One of noninvasive test to diagnosis H. pylori is Urea breath test. In conclusions the rate of helicobacter pylori infection in our study is 54.9% among the symptomatic patients, and the overall incidence of H. pylori UBT and Giemsa stain detection rate were 73.4 and 26.6% respectively.

KAP Study of University Students about Bullying in Sulaimani/Iraq

Abstract Background: Bullying is defined as the activity of repeated, aggressive behavior leads to hurt another person, either physically, emotionally, or mentally. It can involve an individual or a group misusing their power, over one or more persons who feel unable to stop it from happening. Objectives: To identify knowledge, attitude, and practice of bullying among universities students and to compare between females’ and males’ and their knowledge, attitude, and practice of bullying. Methods: A cross-sectional study was conducted on a convenient sample of 926 university students of Sulaimani city, from February 28, 2021 to April 30, 2021. Data were collected by a self-administrative questionnaire which composed of questions of socio-demographic status, seven questions about students’ knowledge for the attitude nine questions and 12 questions about students practice, analysis was done by using the Chisquare for finding the association. Results: Nearly 39% of the students got bullied at school, the association was significant between gender and their getting bullied (P = 0.02). About 45.5% of the students answered that females exposed more to bullying, the association was significant, (P = 0.043). Most of the students (73%) thought that bullying is a disease and needs treatment, the association was significant, (P = 0.01). Highest percent of the students felt distressed (45%) in situations which remind them of the bullying, the association was significant, (P = 0.01). Conclusions: More than one-third of the students got bullied and more than half of them answered correctly regarding knowledge questions about bullying, most of them thought that females are exposed to bullying more than males and did not take a part in bullying anyone.

Factors Related to Delayed Recovery After Anesthesia

Background: Delayed recovery from anesthesia is one of the important challenges that face anesthesiologist. The time of delayed recovery from anesthesia is related to anesthetic agent, patient, duration and type of surgery. Objective: To determine the factors from the patients and other things related to delayed recovery after giving anesthesia. Methods: A total of 286 patients were observed in Shar Medical Hospital and Cardiac Center in Sulaimani city, Iraq between November 2019 and March 2020. Post-operative evaluation and observation were collected for delayed and normal recovery after anesthesia. P value less than 0.05 means significant relationship were obtained between variables. Results: From the 286 patients, 180 (62.94%) were male, in which 66 of them were have delayed recovery and significant relation was found p=0.005. Most of the patients were >50 years-old 126 (44.05%) and there was significant relation between age and delayed recovery of consciousness p=0.01. Delayed recovery was found among overweight more frequently than the underweight and normal weight (51 from 73 for overweight, 33 from 45 and 7 from 168, respectively). Also, significant relationship was found p=0.001. Conclusion: Old age, male, obese patients and cigarette smokers, diabetes mellitus, cerebrovascular accident, history of myocardial infarction, hyperlipidemia, and neurological diseases are high risk factors for delayed recovery. Keywords: Anesthesia, delayed recovery, post-operative care, risk factors Citation: Karim SB. Factors related to delayed recovery after anesthesia. Iraqi JMS. 2021; 19(1): 39-48. doi: 10.22578/IJMS.19.1.6

Discussion on ‘ArcGIS mapping, characterisations and modelling the physical and mechanical properties of the Sulaimani City soils, Kurdistan Region’ by Ahmed et al. (2020b)

The results and conclusions of the paper by Ahmed et al. (2020b) are really confusing because the information of this paper is very similar to a paper published recently by Ahmed et al. (2020a) whi...

Patient's Awareness Regarding Prevention of Recurrent Urinary Tract Stones in Surgical Teaching Hospital in Sulaimani City, Iraq

Urinary tract stone is the most common recurrent disorder of the urinary tract that encompasses all the process of stone formation in the urinary system (kidney, ureter, bladder, and urethra). Patient’s awareness could prevent the disease and its consequences. The aim of this study is to assess the patient’s awareness regarding prevention of recurrent urinary tract stones.
 A quantitative, descriptive study was carried out in Surgical Teaching Hospital in Sulaimani City, from June to September 2020. A total number of, 50 patients who had urinary stones were recruited into the study, and required data were collected through direct interviews. The questionnaire was used to collect data on the patients’ Sociodemographic and awareness of the urinary tract stones. Questions about awareness of urinary stones were related to fluid and beverage intake, past medical history and risk factors, movement and physical activity, and dietary intake. The collected data were analyzed through Statistical Package for the Social Sciences (version 22.0).
 The results of the present study showed that most of the patients’ aged30 to 60 years, were males (58%), and had primary level of education (38%). Patient’s awareness regarding “fluid and beverage intake, past medical history and risk factor, physical activity and dietary intake” was considerably at a moderate level. There was no significant relationship between the patients’ socio-demographics and their awareness of the urinary tract stones
 It was concluded that the patients were not sufficiently aware of urinary tract stone prevention. Patient’s socio-demographic variables did not determine the patients’ awareness of stone prevention.

The impact of breastfeeding during the third stage of labor on postpartum haemorrhage according to Higham Chart among women Attending Maternity Teaching Hospital in Sulaimani City

One of the most important factor influencing the maternal health is postpartum haemorrhage. Immediate breastfeeding after birth is beneficial for releasing natural oxytocin that led to contracting uterus and reducing hemorrhage. To identify the impacts of breastfeeding on postpartum haemorrhage based on Higham chart. The design, a quasi-experimental study, post-test, only control was applied. Non- probability purposive was as sampling technique. Data collection was continued from 26th of February 2020 to 30th of July 2020. Three hundred women were selected from labor word, in the labor ward; these parturient women were equally divided into experimental group, applying early initiation of breastfeeding and control group, following the routine hospital care. In addition to a questionnaire, Pictorial Blood Assessment Cart (PBAC) was used to investigate the postpartum bleeding pattern of women in the labor's third stage. The chart of pictorial blood assessment is according to the presence of clots and the visual appearance of stained pads. According to Higham chart, in the experimental group, within 300 mothers 130 (86.7%) had a mild postpartum haemorrhage, 18 (12.0%) had a moderate postpartum haemorrhage and only 2 (1.3%) had severe postpartum haemorrhage; where in the control group, 32.7% and 30.7% of the women developed severe and moderate postpartum hemorrhage respectively. It is revealed that the extent of postpartum hemorrhage of the experimental group was greatly lower than the control group. Breastfeeding immediately after the birth is effective for decreasing the postpartum hemorrhage.

Microbial and Heavy Metal Contamination in Five Brands of Kohl Used in Sulaimani City

Kohl is a traditional eyeliner widely used among Middle East people. There is a growing concern about using Kohl due to its potential human health risks. Over the last decades, Kohl has gained a bad reputation due to its high contamination with microorganisms and the high concentration of heavy metals. This descriptive study aims to detect the microbial content and some heavy metals concentration such as lead and Antimony in kohl samples available in the local markets of Sulaimani city. Detection of microbial content was done by using six different types of culture media and gram staining techniques with some biochemical tests, and the final identification was done by the automated system VITEK 2. The analytical test for heavy metals was performed by using an Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES). The results showed that two samples were contaminated with uncommon gram-negative bacteria (Pantoea agglomerans and Dilftia acidovorans) and one with gram-positive bacteria (Bacillus mycoides) while there is no evidence for fungal contamination. The concentrations of lead in the two samples were over the limit with a remarkable concentration of 1491 and 1117 ppm. Also, an unacceptable concentration of Antimony was recorded in one sample with 10.65 ppm. According to our results, the brands of the kohl that are sold in Sulaimani city are not safe for use because it might serve as a vehicle for the transmission of potentially pathogenic organisms or loaded with heavy metal. Therefore, this cosmetic product must be thoroughly evaluated for safety before marketing.

Correlation of Three Dimensions of Palate with Maxillary Arch Form and Perimeter as Predictive Measures for Orthodontic and Orthognathic Surgery.

Hard palate is regarded as an important part of the human skull, which contributes to the separation of the oral and nasal cavities. The aims of the study were to investigate the morphology of the hard palate in order to create a general guideline of three-dimensional values of the palate in a Kurdish sample in the city of Sulaimani as well as determining the possible correlations between different palatal parameters in class I malocclusion with the maxillary arch form and perimeter. A retrospective study design was adopted by collecting 100 study models of orthodontic patients aged 16–24 years old attending different private dental clinics in the city of Sulaimani seeking orthodontic management. In this study, three-dimensional palatal measurements including depth, length, and width were measured in an attempt to discover their correlation with each maxillary arch form and perimeter. Additionally, measurements of inter-molar width, inter-canine width, and arch perimeter were carried out. About two-thirds of those seeking orthodontic treatment were females. Nearly 80% of the study sample had narrow palate followed by 15 and 5% of intermediate palate and broad palate, respectively. In regard to arch form, almost 90% of subjects were with tapered maxillary arch form and 10% of them with oval arch form. Males had increased dimensions compared to females, with significant differences, except in palatal depth in the molar area, and palatine height index, in which females showed increased dimensions than males but the differences were statistically non-significant. A strong positive correlation was observed between arch form and canine depth. In regard to arch perimeter, a strong negative correlation was found with molar depth and a medium positive correlation with each of canine depth, palatal width, and palatal length.

Effects of Exclusive Breast Feeding for First Six Months of life on Children Weight, Height and Head Circumference in Sulaimani City, Kurdistan-Iraq and Compare with Other Types of Feeding

Breastfeeding (BF) serves as a complete nutritional source for the first six months of infant’s life. Breast milk contains all essential nutrients that necessary for the physiological growth and development of infants. The aim of this study was to compare the physiological growth of infants including weight, height and head circumference who were exclusively breastfed for 6 months and those who were given bottle-fed or mixed fed and to find a percentage of exclusive breastfeeding among mothers who contributed in this study in Sulaimani city. This study was carried out in Sulaimani city/ Kurdistan region of Iraq and the cases were enrolled between the first of October 2018 and first of October 2019. The infants’ weight, height and head circumstances were measured at different age levels (At age two, six, nine and fifteen months). The results of this study found that Among 198 mothers who were contributed in this study; 92 (46.5%) of mothers had EBF while 90 (45.5%) had mixed feeding and only 16 (8%) had exclusive formula feeding (EFF) in the first six months of baby’s life. Infant’s weight at age 2 months were no differences between types of feeding. However, at ages 6 and 9 were significantly high in infants who breastfed compared to formula fed but no differences were found between EBF and mixed feeding. At age 15 months weights of infants were again no differences were found between all types of feeding. For height parameter, infants who exclusively breastfed for six months were significantly higher than those of formula fed at age 2, 6, 9 and 15 months. Regarding head circumferences no significant differences between types of feeding at age 2 months were showed. Nevertheless, at age 6 and 15 months were significantly high in infants who breastfed than formula fed. The present study conclude that infants who breast fed for first six months of life have a higher weight, height and head circumferences than infants who exclusively formula fed. The percentage of EBF among Kurdish mothers were similar with other countries of Iraq but was low compared to the recommended rate of WHO.

Oral Health Behaviours, Knowledge and Attitudes Among Dental College Students in Sulaimani City, Iraq

Objectives: The present study aimed to investigate the oral health behavior, knowledge, and attitudes of dental college students. 
 Methods: A self-assessment questionnaire was used in this study. Participants were divided into two groups according to their level of study (pre-clinical and clinical). 
 Results: A total of 140 students participated in the study, with 79(56%) pre-clinical and 61(44%) were at the clinical levels. The majority of students reported brushing their teeth (90.7%) with no association between toothbrushing behavior and gender or level of study (P>0.05). The most common tooth brushing frequency was twice daily with no gender association (P>0.05), and a higher percentage of students at clinical levels of the study reported brushing their teeth more than twice daily (P<0.05). The majority of students reported using fluoridated toothpaste (60.7%). In total, about half of the students reported using dental floss with a significant association with the level of study (P<0.01). Tongue cleaning was reported by 69.3% of the students, and about half of the students reported using mouthwashes, and one-fourth of the students reported using Miswak. In total, about half of the students reported their oral health status as “Good”. Routine dental visits and the level of the study were significantly associated (P<0.01). 
 Conclusions: Noticeable differences in oral health behaviors could not be concluded on a statistical basis. Nevertheless, there were areas of oral health behaviors where increased knowledge showed an improvement in health behavior. It is recommended that preventive programs, including self-care regimes, be started from the first year of dental education.

شوێنه‌وار و ناوی شاره‌ كۆنه‌كانی ژێر شاری سلێمانی له‌به‌ر ڕۆشنایی تۆماره‌ مێخی و كلاسیكی و به‌ڵگه‌ شوێنه‌وارییه‌كاندا

This paper deals with the ancient settlements in the plain where the city of Sulaimani found in 1874 A.D. In his book (Babylonian Problems) Lane (1923) proposes that modern Sulaimani built on the long-lost city of Celonae that was mentioned by the Roman historian Quintus Curtius Rufus (1st century A.D.) in his book "Histories of Alexander the Great.” Also, the Kurdish historian Amin Zeki in his book (The History of Sulaimani)1951, agrees with Lane, and he suggests that the name of modern Sulaimani’s name perhaps derived from the same name of Celonae. Many other historians and archaeologists repeat the same identification. In this paper, we investigated this identification, and we found that the city of Celonae was mentioned only once by the Roman historian Quintus Curtius Rufus (1st century A.D.) in his book "Histories of Alexander the Great,” he refers to the journey of Alexander the Great from Susa to Ekbatana, according to Rufus, on his way, Alexander camped in Celonae. We suggest a new identification for the Celonae Town in the northern edges of Garmian district at the foot or on the top of one of the mountains of the modern Qaradagh ranges, because, Alexander took the road from Susa to the north then east crossing the city of Sittake on the Tigris near Celucia/al-Madain, then moving to other cities along the road to the direction of the north-east, camped in Celonae, then moved to the east and reached Bagastana (Behistun) and after wards to Ecbatana, the capital of the Median Empire in (modern Hamadan). We found also, that the Assyrian royal inscriptions refer to a mountain called Siluna, the Assyrian king Adad-Narari III (811-783 B.C.) in his campaign on Namri and Media, after crossing the Lower Zab toward the east, first he mentions the mountain Siluna, where the sun rises, then he occupied Namri and crossed the other lands in the east to reach Media, and since Namri was the land of the Kassites (in the post-Kassite period) located in the area of Sangaw-Garmian-Qaradagh-Bamo ranges, we can conclude that the mountain Siluna and the city Celonae were located in the same place somewhere in Qaradagh ranges. In the base of the above-mentioned evidence, we can reject the previous identification of Celonai with modern Sulaimani. On the other hand, in this paper we discussed other identifications of modern Sulaimani with ancient cities and towns mentioned in the cuneiform records, for instance, Radner (2017), suggests that the Zamuan capital city of Arrakdi of the Lullubu people located under modern Sulaimani, but this is not a proper identification, because the city of Arrakdi was mentioned in the cuneiform records three times, and in all records they refer to the point that the city located beyond a roughed mountain, the Annals of Ashurnasirpal II refers that the city located at the foot of the roughed mountain Lara, and this mountain should be modern Lare mountain in the east of Shabazher district far east from modern Sulaimani. Also, the cuneiform tablet that was discovered in Sitak in Sharbazher district and that tablet also refers to Arrakdi. Also, we found that Spiser linked the village of Uluba (Ulubulagh) now it is a district in the southern east of Sulaimani, with the Lullubian City of Lagalaga, this identification only based on the similarities between the two toponyms. On the other hand, Abdulraqeeb Yusuf, suggests that the old village of Daragha, which is now a district in the eastern part of Sulaimani derived from the Zamuan city Dagara of the Lullubies, this identification also not appropriate one, because the village and district named after the name of a nobleman called Mr. Dara Agha, and there is no archaeological ruin in this district as well. The city of Sulaimani was built on an area where a huge archaeological Gird/Tell existed, the Babanian princes built their palace on this artificial hill and the administrative buildings to the east of it, when they dug for the foundations, they discovered coins, a stone with unknown script, and many jars, some of them big jars contained human skulls. In 2005, when the modern building Kaso Mall constructed on the northwest of the hill, we found two seals date back to Jamdet-Naser = Nineveh V period, and Ubaid potsherds, and some bull skulls, their horns cut with a sharp instrument. This evidence indicate that the city was built on a settlement date back to the 5th-4th millennium B.C. Other archaeological discoveries in Girdi Kunara and Girdi De Kon in the western part of the city at the bank of Qiliasan and Tanjero rivers, in Kunara many cuneiform tablets discovered there, we can link these sites also with the Lullubies in the third & second millennium B.C.

Post-occupancy evaluation Correlated with Medical Staffs' Satisfaction: A Case Study of Indoor Environments of General Hospitals in Sulaimani City

This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medical staff at tested hospitals were generally satisfied with the quality of newly built hospitals' indoor environment. The results have shown that exploring medical staff experiences can expose factors that affect their satisfaction levels. Also, the findings reveal that the building's physical quality can be vastly related to the fulfillment of the medical staff's satisfaction. Moreover, the findings underline the role of the quality of the indoor environment in increasing medical staff's satisfaction levels, informing design decisions. Additionally, the persuasive associative outcomes have proven that POE (AEDET and ASPECT) will be pertinent as a tool to the building's physical quality.

Urban Rainwater Harvesting Assessment in Sulaimani Heights District, Sulaimani City, KRG, Iraq

Rainwater harvesting is the collection of rainwater and runoff from catchment areas such as roofs or other urban surfaces. Collected water has productive end-uses such as irrigation, industry, domestic, and can recharge groundwater. Sulaimani heights have been selected as a study area, which is located in Sulaimani Governorate in Kurdistan Region, North Iraq. The main objective of this study was to estimate the amount of harvested rainwater form Sulaimani heights urban area in Sulaimani City. Three methods for runoff calculation have been compared, the storm water management model (SWMM), the soil conservation service (SCS) method, and the runoff coefficient (RC) using daily rainfall data from 1991 to 2019. The annual harvested runoff results with the three different methods SWMM, SCS, and RC were estimated as 836,470 m3, 508,454 m3, and 737,381 m3, respectively. The results showed that SWMM method has the highest runoff result and could meet 31% of the total demand of the study area and 28% and 19% for RC and SCS methods, respectively.

Use of generic medicines in the Middle East: Knowledge, perceptions and experiences of the Sulaimani population, KRI, Iraq

The aim of this study is to assess the level of knowledge, perception, and experiences of the Sulaimani population in KRI, Iraq. A descriptive and cross-sectional survey was performed with 389 participants (283 male, 106 female) in the city of Sulaimani. The main method of collecting data was done through a questionnaire which was made up of two sections; firstly assessing the demographic characteristics of the sample population, and secondly assessing their knowledge towards generic medicines and their perceptions of generic medicine usage and purchasing intention. The Cronbach’s alpha coefficient was 0.726 which is considered as an acceptable value to measure internal consistency of the sampled population. As a result, this study showed that the sampled population did not have sufficient knowledge about generic medicines and would therefore also not be considering replacing branded medicines with the generics. This is mostly related to poor awareness of generic medicines and lack of publicity or awareness campaigns surrounding generic medicines. This study recommends that authorities invest in publicizing the use of generics and implement public awareness campaigns.

Oro-facial malignancy in north of Iraq: a retrospective study of biopsied cases

BackgroundIdentifying the prevalence of orofacial malignancies is essential to provide health-care programs and services for a specific population. This study aimed to specify the prevalence, clinical and histopathological features of oral malignancies in Sulaimani for over 12 years.MethodsAll archived reports for orofacial specimens from 2008 to 2019 were collected from three major centers in Sulaimani governorate. The demographic data, date, type of surgery, lesion's site, and diagnosis were recorded. The ICD-10 coding was specified for each case. A Chi-square test was used to assess differences between genders. A one-way ANOVA test was applied to analyze the differences in mean age distributions among different sites of oral malignancies and oral squamous cell carcinoma histopathological grades. P < 0.05 was considered significant.ResultsOrofacial malignant lesions account for 14.53% of the total sample. Patients' mean age was (55.46 ± 18.48) years, and they were predominantly males (M: F ratio = 1.15:1). The tongue was the frequently affected site (14.8%). A Chi-square test showed no significant difference between genders concerning age (P = 0.118), years of registration (P = 0.28), and site (P = 0.29). The C06 (represents; cheek mucosa C06.0, the vestibule of mouth C06.1, retromolar area C06.2, and other unspecified parts of mouth C06.8) was the most frequent topographical ICD-code (18.1%). Carcinoma was a frequent malignancy (63.2%). OSCC was the most common lesion (56.4%). It commonly affects males, and the tongue was the frequent site (24.1%) followed by lip (17.8%).ConclusionsThere is a slight increase in the registered oral malignancies in Sulaimani city over 12 years; they were predominated in males, in 61–70 years old patients, and being oral squamous cell carcinoma types.