Diyala Province Research Articles

Cholera outbreak in diyala province

Background: Vibrio cholerae is a primary cause of severe dehydrating diarrhea and remains a serious public health problem in low- and middle-income countries (LMICs) with insufficient water, sanitation, and hygiene. Cholera remains a public health threat the worldwide, mainly in countries with poor access to safe water and sanitation facilities. According to estimates, there are 21,000–143,000 deaths and 1.3–4 million cases of cholera annual. Objective: This study aims to carry out an analysis of the available information on cholera outbreaks in Diyala province, 2022. Patients and Methods: A descriptive study conducted in the department of public health using the data of cases reported from eight sectors in province. The data was collected from the surveillance unit, communicable control division of the public health department in Diyala province, IRAQ in 2022. Results: The total number of confirmed cases of cholera was (n = 139), female (72) 52 % and male (67) 48%, death reported for two of these cases. According to the date of onset, the registration of cases began from July 19 to October 25, 2022. However, the case fatality ratio (CFR) was 1.4%, while the attack rate in the governorate is 7.6 per 100,000 populations during 2022, the highest attack rate in Khanaqin district was (77 cases) 46, while the lowest attack rate in Baldruze, Al-Mansuria, and Al-Khalis districts was (1 case) 0.3,0.6, and 0.8 respectively. The age mean of patients was (38.7 ± 17.14 years) and the occurrence of the disease is more incidence in the age group 30-44 and females more than males. Conclusion: Occurrence Cholera outbreak during year 2022 without confirmed cases recorded since 2015 and the occurrence of cholera cases in governorate is greater during the months of August and September and most of the cases were from Khanaqin district.

Incidence of head and neck cancer among Baquba Teaching Hospital Patients

Background: Squamous cells lining the tissues of the head and neck region, such as the nasal cavity, paranasal sinuses, oral cavity, lip, salivary glands, and hypopharynx, give growth to a group of malignancies together recognized as squamous cell carcinoma of the head and neck, which is the seventh utmost communal cancer diagnosis around the world. Objective: Determine the prevalence of head and neck cancer in Diyala province during 2022-2023 and their distribution according to age and gender of patients. In addition, this study aimed to identify the numbers of each type of head and neck cancer. Patients and Methods: A retrospective study achieved on the prevalence of head and neck cancer in the region accomplished in oncology center of Baquba teaching hospital in Diyala province, Iraq. Head and neck cancer patients recorded from 2022 to 2023. During this dated, a total of 172 patients were recorded. A search was accomplished on numerous databases, moreover, the information evaluated by age, gender and cancer type. Results: Regarding patients during 2022 (first group) which is contained of (94) patients with different head and neck cancer, 38(40.4%) were males and 56(59.6%) were females with statistically significant relationship. The patients during 2023 (second group) comprises of (78) patients with different head and neck cancer, 43(50.1%) were men and 35(44.9%) were women with statistically no significant correlation. Conclusion: Oral and pharyngeal cancer is more common in men than in women. The most common age group is 4th and 5th decade for head and neck cancer.

Role of surfactant therapy in reducing oxygen requirement and mortality among neonates suffering from respiratory distress syndrome: A Prospective study at Al – Batool teaching hospital in Diyala province

Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality. It is a breathing disorder characterized by a deficiency or inactivity of surfactant in the lungs of preterm and term babies and if not treated, it leads to serious complications like pneumothorax, emphysema, bronchopulmonary dysplasia and death. Objective: To estimate the effect of surfactant therapy on oxygen requirement and neonatal mortality as well as the incidence of RDS in the special care neonatal unit (SCNU) in the AL Batool Teaching Hospital in Diyala Governorate. Patients and Methods: A sample of 2000 patients with signs and symptoms of RDS at the time of presentation was prospectively collected from the 1st of July 2022 until the 1st of March 2023 in SCNU at Al-Batool Teaching Hospital. Gestational age, body weight, the use of oxygen, surfactant therapy, and continuous positive airway pressure (CPAP) were taken into consideration in assessing the outcome of RDS neonates. Results: There was a significant relationship between surfactant administrations, the period of staying on CPAP, and oxygen demand as the p-value was < 0.001 for both. Neonates who received surfactant had a lower mortality rate, with an incidence of 2.5%; the p-value was < 0.001. Incidence of neonatal RDS was 694 (34.7%). Conclusion: Since the incidence of RDS was 34.7%, surfactant therapy should be routine in neonatal special and intensive care units. Proper use of surfactant (proper timing and mode of administration) reduces oxygen demand, the need for CPAP, hospitalization, and mortality among those neonates.

Histological and histopathological structural changes in the skin of the Basal Cells Carcinoma patients

Background: Basal Cell Carcinoma (BCC) is the most common type of skin carcinoma and is considered an epidemic disease due to its increasing frequency in many countries. The most important problem of BCC is local invasion It grows in a “silent” way into immediately adjacent tissue. It rarely metastasizes. The early tumors are commonly small, translucent or pearly, raised and rounded areas located on a few dilated, superficial vessels. There are six subtypes of BCC that include nodular, pigmented, superficial, morphea form, cystic. The most important risk factor for basal cell carcinoma is exposure to UV-radiation. Outdoor workers with a long history of work-related UV-exposure are at increased risk of developing BCC. Other risk factors include family history of skin carcinoma, light skin phototypes, advanced age. Objective: The current study investigated pathological and histological changes in tissue sections to identify the factors contributing to the infection frequency. Patients and Methods: Thirty-three BCC patients' samples have been collected from the main care center at al-Baquba Teaching Hospital of Diyala Province, Iraq. All patient groups were clinically diagnosed as BCC by dermatologists. Results: The study showed macroscopic and microscopic histological changes. An ulcerated macroscopic appearance of the lesion was shown. The tumor lesions are located on the face. It was noted that the percentage of patients was higher in men than women and higher in light skin than dark skin. The study also showed that the age group 66-74 years had a higher infection percentage, while the lower percentage was of the age group > 83 years. Conclusion: These findings pave the way for future research endeavors aimed at prevention, early detection, and targeted treatment strategies for this prevalent skin carcinoma.

Enhancing Global Poliomyelitis Surveillance Performance is Crucial for Eradication Efforts

Background: Poliomyelitis remains a significant public health challenge, with global efforts focused on its eradication. One critical strategy in this endeavor is the implementation of an acute flaccid paralysis (AFP) surveillance system, which is essential for early detection and response to poliovirus transmission. Specific Background: Despite the system's importance, there is limited evaluation of its performance, particularly in regions like Diyala province, Iraq. Knowledge Gap: Previous studies have not adequately assessed the AFP surveillance performance indicators specific to this region, necessitating a comprehensive analysis. Aims: This study aimed to evaluate the performance indicators of the AFP surveillance system in Diyala province during 2021, utilizing established World Health Organization (WHO) standards. Results: The cross-sectional study analyzed data from seven primary health care centers. Key findings revealed a Non-Polio Acute Flaccid Paralysis rate of 5.11 per 100,000 children under 15 years. Performance indicators included 100% reporting completeness, 95% timeliness of notification and investigation, and 97% stool quality for laboratory analysis. Furthermore, 97.3% of specimens reached the national laboratory within three days, demonstrating high operational efficiency. Novelty: This study is one of the first to provide a detailed evaluation of the AFP surveillance system in Diyala province, highlighting areas of strength and compliance with WHO targets. Implications: The findings underscore the effectiveness of the AFP surveillance system in this region, suggesting that its continued implementation can significantly contribute to the global eradication efforts of poliomyelitis while also serving as a model for similar evaluations in other regions. Highlights: High reporting completeness and timeliness in AFP surveillance. Non-Polio AFP rate exceeds WHO targets, indicating effective monitoring. Study supports global efforts toward poliomyelitis eradication. Keywords: Poliomyelitis, Acute Flaccid Paralysis, Surveillance System, Performance Indicators, Iraq

Analysis of Reliability for the Electrical Industries Company in Diyala using Modified Extension Weibull Distribution (An Application and Simulation study)

In this paper defining modified extension Weibull distribution, reliability function and hazerd function, we explain the maximum likelihood method under type one censoring sample. The censored samples play an important role in reliability analysis .In this paper we estimate and derived modified extension Weibull distribution whith three parameters under the censored samples type one by maximum likelihood estimation method depend on Newton-Raphson method. Then we applied simulation procedure using Monte-Carlo technique to estimate reliability function under different samples sizes and various initial values for the parameters for all estimated parameters of modified extension Weibull model by used MATLAB program. Finally we find the probability density function f(t), reliability function R(t),and hazard function h(t) for real data which get it from (Diyala province Company) is one of the formations of the Ministry of Industry and Minerals. Paper type: Research paper

Analysis of Reliability for the Electrical Industries Company in Diyala using Modified Extension Weibull Distribution (An Application and Simulation study)

In this paper defining modified extension Weibull distribution, reliability function and hazerd function, we explain the maximum likelihood method under type one censoring sample. The censored samples play an important role in reliability analysis .In this paper we estimate and derived modified extension Weibull distribution whith three parameters under the censored samples type one by maximum likelihood estimation method depend on Newton-Raphson method. Then we applied simulation procedure using Monte-Carlo technique to estimate reliability function under different samples sizes and various initial values for the parameters for all estimated parameters of modified extension Weibull model by used MATLAB program. Finally we find the probability density function f(t), reliability function R(t),and hazard function h(t) for real data which get it from (Diyala province Company) is one of the formations of the Ministry of Industry and Minerals. Paper type: Research paper

Serological and Molecular Detection of Cytomegalovirus in Aborted Women in Diyala Province, Iraq

Background: Cytomegalovirus (CMV) is a common virus that can infect individuals of all ages. In pregnant women, CMV infection can lead to complications such as congenital CMV infection, which can cause miscarriage, stillbirth, or significant fetal abnormalities. Objective: To evaluate the prevalence of CMV infection in women with and without a history of miscarriage in Diyala Province, Iraq. Methods: A total of 120 women were recruited and divided into three groups: 40 pregnant women with a history of miscarriage, 40 non-pregnant women with a history of miscarriage, and 40 healthy women without a history of miscarriage (control group). Blood samples were collected from each participant and analyzed for the presence of CMV-specific IgG and IgM antibodies using enzyme-linked immunosorbent assay (ELISA). Some positive results were retested to detect the MIE gene region IE-2 (UL122) by real-time PCR and the IE1 (UL123) gene by conventional PCR. Demographic data of study groups were recorded, and statistical analysis was performed using SPSS Version 29. Results: The serological analysis revealed the following prevalence of CMV IgG antibodies: 100% in both pregnant and non-pregnant women with a history of miscarriage, and 95% in the control group of healthy women without a history of miscarriage. For CMV IgM antibodies, the prevalence was 47.5% in pregnant women with a history of miscarriage, 40% in non-pregnant women with a history of miscarriage, and 7.5% in the control group of healthy women without a history of miscarriage. The PCR results showed that 9 of the samples were positive for both the UL122 and UL123 genes. Conclusion: The study indicates a high prevalence of CMV infection among women with a history of miscarriage in Diyala Province, Iraq. Routine screening for CMV in pregnant women, especially those with a history of miscarriage, is recommended to reduce potential risks and improve pregnancy outcomes.

Impact of Measles Vaccination Coverage on Disease Severity Among Children Under Five Years of Age in Diyala Province, Iraq

Impact of Measles Vaccination Coverage on Disease Severity Among Children Under Five Years of Age in Diyala Province, Iraq

Rising Cases of Hb H Disease in Iraq Highlight the Urgent Need for Pre-Pregnancy Screening

General background: Hemoglobin H (Hb H) disease results from mutations in three of the four α-globin genes, leading to α-thalassemia. Specific background: In Iraq, this condition is rare among alpha-thalassemia cases. The disease presents significant hematological abnormalities, impacting quality of life. Knowledge gap: Despite its rarity, few studies have characterized the hematopathological features and prevalence of Hb H disease in specific Iraqi regions. Aims: This study aimed to assess the hematological parameters and prevalence of Hb H disease among patients in Diyala province, Iraq. Results: A total of 81 patients with Hb H disease (53.18% male, 46.91% female) were registered at the Baqubah Teaching Hospital in 2023. Median patient age was 21.8 years (range 4-48). Hematological analysis revealed consistently low levels of hemoglobin (Hb) and hematocrit (HCT) compared to standard values. Mean corpuscular volume (MCV) was also significantly reduced, with 58.02% of patients presenting Hb levels below 10 g/dL. The 21-40 age group had the highest incidence (46.91%). Novelty: This study is among the few to investigate Hb H disease prevalence and hematopathological characteristics in Diyala province, revealing an unexpectedly high incidence in the 21-40 age group. Implications: These findings suggest that hematological parameters, including MCV and Hb levels, should be considered in thalassemia screening programs, particularly in pre-pregnancy assessments, to prevent the birth of children with severe forms of alpha-thalassemia and reduce Hb H disease prevalence. Highlights: Hb H disease shows low hemoglobin and MCV abnormalities. Highest incidence occurs in patients aged 21-40 years. Pre-pregnancy screening reduces severe alpha-thalassemia risk. Keywords: Hb H disease, alpha-thalassemia, hematological parameters, Diyala province, prevalence

Chemical Study of Iraqi Kassub Plant Eryngium creticum Lam and its Geographical Distribution in Diyala Province

General Background: The therapeutic potential of medicinal plants has garnered increasing interest, particularly in relation to their chemical compositions and geographical distributions. Specific Background: This study focuses on Eryngium creticum Lam, an Apiaceae family plant known as Iraqi Kassub, prevalent in the Diyala province of Iraq. Knowledge Gap: Despite its traditional use in treating various ailments, there is a lack of comprehensive chemical analysis and geographical distribution data for this plant. Aims: The objective of this research was to identify the chemical components of Eryngium creticum Lam through GC-MS analysis and to map its geographical distribution within the Diyala province. Results: The chemical study revealed 101 distinct compounds in the alcoholic extract of the plant, highlighting a significant presence of sitosterols and sugars. These compounds are associated with antioxidant properties and therapeutic applications, including the treatment of envenomations, leishmaniasis, and anemia. Novelty: This study is novel in its detailed chemical profiling and geographical mapping of Eryngium creticum Lam, providing new insights into its medicinal value and distribution. Implications: The findings underscore the plant's potential as a therapeutic resource and emphasize the need for further research. Future studies should aim to isolate and characterize bioactive compounds such as phenols and flavonoids and assess their efficacy and safety through in vivo models to validate their therapeutic potential. Highlights: GC-MS identified 101 compounds. Bioactive compounds with therapeutic properties. Mapped geographical distribution in Diyala. Keywords: Eryngium creticum, GC-MS, therapeutic potential, chemical profile, geographical distribution

Postoperative satisfaction and perception among laparoscopic cholecystectomy patients in Diyala Province, Iraq

Background: Over the past two decades, laparoscopic surgeries have significantly progressed, and surpassing traditional surgical methods across multiple medical fields. This study aims to assess the patients’ satisfaction and the related factors toward the laparoscopic cholecystectomy in Iraq. Methods: A cross-sectional study was conducted from April 2023 to 30th March 2024 at the Alkalis General Hospital and Al Hayat Private Hospital, Diyala province, Iraq. Semi-structured questionnaire was recruited to collect the pre and post operative data from patients. Statistical analysis was carried out using SPSS-21, with significance set at p < 0.05. Results: Data of 157 patients with mean age (+ Standard Deviation) of 47.57 (SD +12.80) were analyzed. Most of them (53.5%) were females, operated in public hospitals (52.2%), unemployed (51.6%), and earned less than USD 400 (60.5%). The majority of patients expressed high overall satisfaction with the laparoscopic cholecystectomy procedure (42.7% being strongly satisfied and 38.9% satisfied). In the multiple logistic regression, the patients who were operated in private hospital (OR = 4.506, 95% CI: 1.394 to 14-577; P-value= 0.012), with monthly income exceeds USD 400 (OR = 4.887, 95% CI: 1.531 to 15.601; P-value=0.007), involved in the choosing of surgery technique (OR = 5.596, 95% CI: 1.425 to 21.982; P-value=0.014), and those recommend laparoscopic cholecystectomy for others (OR = 9.100, 95% CI: 1.425 to 21.982; P-value=0.001), had the highest odds ratios. The Hosmer and Lemeshow test indicated a good fit (p = 0.552). Conclusion: Patient satisfaction is high especially among high income patients operated in private hospital however, the perception of postoperative outcomes remains important areas of focus, particularly in regions with unique healthcare challenges like Iraq.

Submerged Surface Area and Water Storage Volume of Hamrin Dam Lake Using Contour Lines

The predictions and warnings from drying up lakes and rivers are increasing nowadays, especially in Iraq, due to climatic changes and water flow reduction from neighboring countries. Consequently, this paper deals with monitoring the changes in submerged surface areas and Hamrin dam lake storage volume from December 2011 to the end of 2022. Hamrin Lake supplies Diyala province, Iraq, with irrigation water. Multitemporal satellite images were acquired from google earth pro and Earth Observation (EO) browsers. Triangular Irregular Network (TIN) layers generated contour lines through the ArcGIS environment. Volumes were calculated using the end area method. The results show that the water storage volume reached 1.8 billion cubic meters (bcm) in December 2016 and decreased to 12 million cubic meters in December 2021. Hamrin Lake lost 99% and 98% of its capacity relative to the normal water storage volume in 2021 and 2022, respectively. At normal storage, the maximum water volume of Hamrin Lake is about 3 bcm. The scarcity of irrigation water from Hamrin Lake causes decreasing agricultural areas, desertification, and people migrating to other regions.

Determining The Agricultural Drought and Desertification Intensity in Diyala Province / Iraq Using Sentinel-2 images

Determining The Agricultural Drought and Desertification Intensity in Diyala Province / Iraq Using Sentinel-2 images

Prevalence of HAV IgM marker of Hepatitis A virus among patients of all Ages in Diyala province/Iraq

The most prevalent viral infection that causes hepatitis is hepatitis A virus (HAV), which continues to be a worldwide health issue for both developed and underdeveloped nations. By calculating the rate of HAV IgM positive, the current study sought to determine the prevalence of HAV infections among patients in the province of Diyala. In the present study, a total of 180 blood specimens were collected from patients, who referred to diagnostic individuals in Diyala Province, Iraq from October /2022 till Agust 2023. The presence of HAV in the specimens was investigated using ELISA technique. The results of the current study revealed that the overall positivity rate of HAV IgM was 13.3%. HAV IgM positivity was higher among 1-2 years old group. While, it was insignificantly higher among females compared to males (54.2%). Furthermore, HAV IgM positivity rate was insignificantly higher among Rurales compared to urbans (58.3%, 41.7%). Additionally the results showed that HAV IgM positivity rate among those used unsterilized water (70.8%) was significantly higher than that sterilized water (29.2%). Moreover, the results found that those with un vaccinated with HAV vaccine had significantly higher (79.2%) HAV IgM positivity rate. The present study founded that it is important to increase our knowledge about the frequency of HAV infections among patients and early diagnosis of HAV infections is essential in community for infection control.

A Diagnosis of the Local Administration Performance According to Satisfaction of the Local Citizens: A Case Study in Diyala Province – Iraq

Paper type: Research paper The purpose of this research is to diagnose the reality of the provided local performance by the local government and its impact on the local citizens' satisfaction in one of the Iraqi provinces (Diyala Province). The problem of this research was most local citizens that were not satisfied with the local performance of local governments in providing public services in most Iraqi provinces. The research methodology was the descriptive analytical approach by knowing the views and opinions of a sample of the local citizens that contained 1200 participants, where the research conducted the questionnaire as the main instrument. The data were analyzed by using appropriate statistical methods such as frequencies, percentages, and simple regression coefficients through the statistical program (SPSS. V.26). Several significant results address the gap between the local performance and citizens' satisfaction, where the critical result was the level of public satisfaction with the local performance of the local government is extremely weak, and most of the citizens are unsatisfied. The practical and social implications of the research may improve and develop the skills and abilities of the members of local governments by enrolling them in programs and workshops, particularly in public relations, public administration, non-profit, strategic planning, and local administration to build stronger communication and interaction between members of the government and the local community with specialist universities and institutes could lead to raising the level of the local performance and public satisfaction.

Human Papillomavirus Genotyping among Women and its Relationship with Cervical Cancer in Diyala Province

Human Papillomavirus Genotyping among Women and its Relationship with Cervical Cancer in Diyala Province

Molecular Detection of Avian Poxvirus in Chickens and Pigeons of Diyala Province in Iraq

Fowlpox is an infectious viral disease affecting domestic and wild birds. The current study was conducted using PCR-based molecular detection to determine the avian pox virus (APV) and its genetic sequence. A total of 40 pigeons and 40 chickens suspected of APV were obtained from different bird markets. Following euthanasia, tissue samples were taken from the vents, eyes, wings, and beaks for molecular analysis. DNA extraction was focused on the core protein gene region (pb4). PCR results confirmed the presence of APV in all samples, generating specific cDNA bands of 329 bp. Four GenBank accession codes (OR670580, OR670581, OR670582, and OR670583) represented pigeon pox samples, whereas two GenBank accession numbers (OR619724 and OR619725) represented samples of fowlpox. A significant similarity of 99% was found by genetic analysis between the reference target sequences and the sequenced samples. In viral samples of fowlpox and avipoxvirus, nucleic acid variants (205 C > G and 204 T > C) were found with missense and silent effects on particular proteins (p.101Leu>Val and p.108Pro). Phylogenetic analysis organized the samples into clades representing fowlpox and pigeon pox viruses, showing close relationships with strains from different geographical regions. This study unequivocally demonstrates the susceptibility of both domestic and wild birds to avian pox, highlighting the pivotal role of phylogenetic analysis and molecular detection in elucidating novel perspectives on the genetic landscape of these viruses. Keywords: Fowl pox, Gene, Pigeon pox, Polymerase Chain Reaction

Novel Cardiac Biomarkers H-FABP and GPBB for Early Detection and Prognosis of Acute Myocardial Infarction

Background: Cardiovascular diseases are the leading cause of morbidity and mortality globally, with acute myocardial infarction (AMI) being a significant contributor. This study aimed to investigate the roles of cardiac biomarkers, including H-FABP, GPBB, and others, in detecting AMI. Method: Blood samples were collected from 80 individuals, including 50 with AMI and 30 healthy controls, admitted to the Coronary Care Unit (CCU) of an Educational Hospital in Diyala province between May and July 2022. Cardiac markers (hs-troponin-I, myoglobin, CK-MB, GPBB, and H-FABP) were measured using the Sandwich-ELISA technique. Results: There were no significant differences (p>0.05) in age or gender distribution between the study groups. Levels of cardiac markers were significantly higher in AMI patients compared to healthy controls (p<0.05). H-FABP demonstrated the highest sensitivity (100%), followed by GPBB (97%), hs-troponin-I (87%), CK-MB (85%), and myoglobin (78%), with significant differences (p<0.05) in detecting AMI. H-FABP and GPBB also exhibited the highest specificity (98% and 96%, respectively), while myoglobin and CK-MB had lower specificity (82% and 84%, respectively). Furthermore, positive correlations were observed between H-FABP, GPBB, and other markers (hs-troponin-I, myoglobin, CK-MB). Conclusion: H-FABP and GPBB show promise as predictive indicators for early diagnosis (within 1-4 hours of chest pain) of AMI, offering potential utility in clinical practice.

Distribution of Babesiosis among Human and Cattle in Baquba City

In this study, 30 specimens blood were collected from cattle infected with Babesiasis and 30 blood samples were taken from humans infected with Babesiasis too. Also, 15 blood samples were taken from healthy cattle and 15 blood samples were taken from healthy individuals as control groups. The samples were collected from the cattle at the veterinary clinic in Baquba city-Iraq. While human samples were collected from Al-Razi Hospital in Diyala Province during the period from May to December 2023. The results showed that the middle standard of acute Babesiasis in the cattle was higher than humans Babesiasis with no important variations, P= 0.36. While the middle standard of chronic Babesiasis in the cattle was high in comparison to Babesiasis in man with height important variations, P<0.001. The middle standard of acute Babesiasis in humans was high in comparison to the healthy individuals with height important variations, P=<0.001. However the chronic Babesiasis was high concentration compared to the healthy individuals, P=<0.001. Furthermore the acute Babesia infection was high level compared to the healthy peoples, P=<0.001. Also the chronic babesiasis in cattle was high level in comparison to the healthy group, P=<0.001. But that no moral variation among age groups and distribution sites among infected human.