Sample Of Iraqi Patients Research Articles

Clinical, radiological, and serological assessment of the efficacy and safety of nintedanib compared to pirfenidone in a sample of Iraqi patients with idiopathic pulmonary fibrosis: A retrospective cohort study

This study compares the treatment effects after six months of therapy with nintedanib and pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) by comprehensively analyzing key parameters and establishing the diagnostic performance of two biomarkers, Krebs von den Lungen-6(KL-6) and CC chemokine Ligand-18 (CCL-18), to predict treatment outcomes. In a hospital-based retrospective cohort study, 75 patients diagnosed with IPF were divided into three groups based on their treatment: the newly diagnosed group, which included newly diagnosed IPF patients without receiving any antifibrotic treatment (25 patients), IPF patients on pirfenidone treatment (26 patients), and IPF patients on nintedanib treatment (24 patients). After adjustment for age, sex, body mass index, and baseline values of predicted forced vital capacity (FVCp), there was no significant difference in the rate of changes after 24 weeks of follow-up for FVCp (-0.2 ± 0.6, 0.0 ± 2.3, and 0.8 ± 3.5 ml change after 4, 12, and 24 weeks for pirfenidone) and (-1.7 ± 5.9, 1.0 ± 8.9, and 1.4 ± 9.5 ml change after 4, 12, and 24 weeks for nintedanib). CCL-18 offers a better ability to predict radiological findings than KL-6. Most side effects were minor and included diarrhea, stomach pain, skin rash, and hyperpigmentation. In conclusion, both drugs have demonstrated the capacity to postpone the beginning stages of FVCp decrease and lung function decline. There was little difference between the efficacy of nintedanib and pirfenidone. Both drugs were safe and well tolerated for the treatment of IPF.

Factors that Influence Intraocular Pressure Target in a Sample of Iraqi Patients Using Antiglaucoma Medications: A Cross-Sectional Study

Background: Anti-glaucoma eye drops are mainly used to lower intraocular pressure (IOP) and manage glaucoma. Many studies found that achievement of the IOP target is poor. Objective: This study aimed to assess the achievement of the IOP target and factors affecting it among a sample of Iraqi patients with glaucoma. Methods: A single-center, cross-sectional study was conducted on patients with glaucoma from December 2023 to April 2024 at Ibn Al-Haytham Hospital, Baghdad, Iraq. All patients who received medical therapy for at least one month were eligible to participate in this study. Intraocular pressure values at the time of initial diagnosis and at the time of enrolment in the study were documented for all included patients. Medication adherence was measured by the Arabic version of the Morisky medication adherence scale-4. Eyedrop administration technique was assessed through direct observation by the researcher using a newly developed and validated checklist. Results: Most participants in the current study were males with primary education. The average disease duration was 14 months. The target IOP was achieved among 36% of participants. The adherence to eye drops was good in 55% of participants. Only 9% of participants administered eye drops with a good technique. Achievement of the IOP target was significantly influenced by good adherence and technique for administration of eye drops (p<0.05). Conclusions: IOP-target achievement is poor among Iraqi patients. Adherence to and administration technique of eye drops are significant factors that could affect IOP-target achievement.

Incidence of Descemet Membrane Detachment after Phacoemulsification Cataract Surgery in a Sample of Iraqi Patients at Ibn Al-Haitham Teaching Eye Hospital

Incidence of Descemet Membrane Detachment after Phacoemulsification Cataract Surgery in a Sample of Iraqi Patients at Ibn Al-Haitham Teaching Eye Hospital

Comparison of ََQuality of Life and Treatment Satisfaction among Sample of Iraqi Patients Using Anticoagulant Therapy (Warfarin or Non-Vitamin K Antagonist Oral Anticoagulants)

Background: Oral anticoagulation medication, warfarin and non-vitamin k antagonist oral anticoagulants (NOAC) may require long term use which may affect patients’ satisfaction with their treatment and their quality of life (QOL). Objective: To compare the quality of life and treatment satisfaction among groups of patients using different anticoagulant therapies (warfarin and NOAC). Patients and methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital for cardiac surgery in Baghdad in the period between December 2022 to May 2023. The study population included a convenient sample of patients receiving either warfarin or non-vitamin k antagonist oral anticoagulants treatment. The Arabic version of the short form 12 (SF-12) questionnaire and the Anti-Coagulant Treatment Satisfaction Scale (ACTS) questionnaire were used to assess the quality of life and satisfaction with treatment respectively. Results: The study included 181 patients in total. The mean physical and mental quality of life scores for study participants were 42.3±9.92 and 52.6±10.36 respectively. There was no significant difference in the QOL between patients taking warfarin and those on non-vitamin k antagonist oral anticoagulants treatment. The mean total satisfaction score was 65.4±6.73. Patients receiving non-vitamin k antagonist oral anticoagulants had significantly higher satisfaction compared to those receiving warfarin (P=0.000). The physical score correlated significantly with gender, educational level, employment status, number of chronic medications and number of chronic diseases. The total satisfaction score correlated significantly with gender, number of chronic medications, number of side effects and duration of anticoagulation. There was a significant correlation between the QOL and treatment satisfaction (P=0.000). Conclusion: Treatment with non-vitamin k antagonist oral anticoagulants showed comparable QOL and higher treatment satisfaction than that of warfarin. Better treatment satisfaction can improve patients’ QOL which may ultimately enhance their adherence to treatment.

Shoulder involvement in ankylosing spondylitis and the measures of disability in a sample of Iraqi patients in a single center study

Shoulder involvement in ankylosing spondylitis and the measures of disability in a sample of Iraqi patients in a single center study

The Effect of Tocilizumab on the outcome of patients with severe COVID-19 with cytokine storm syndrome in a sample of Iraqi patients.

To determine whether tocilizumab improved outcomes of patients hospitalised with severe coronavirus disease-2019 cytokine storm syndrome. The case-control study was conducted at Al-Yarmouk Teaching Hospital, Baghdad, and Al Shatra General Hospital, Thi Qar, Iraq, from September 2020 to March 2021, and comprised patients with severe acquired respiratory syndrome-corona virus-2 pneumonia who were not candidates for mechanical ventilation and received a single-dose intravenous infusion of tocilizumab 8mg/kg in group A. The outcomes were compared with patients in group B who received only standard care. Data was analysed using SPSS 26. Of the 60 patients, 30(50%) were in group A; 22(73.3%) males and 8(26.7%) females with mean age 56.63±10.92 years. There were 30(50%) patients in control group B; 24(80%) males and 6(20%) females with mean age 54.8±6.18 (p>0.05). Group A showed significant changes compared to group B in the levels of interleukin-6, serum ferritin, D-dimer, procalcitonin, lymphocytes count and oxygen saturation (p<0.05). Mortality rate was not significantly different between the groups (p>0.05). Majority of the acute phase inflammatory markers were reduced significantly by treatment with tocilizumab.

The Association between the Response to Rituximab with Sociodemographic Data and Disease Characteristics Among a Sample of Iraqi Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Rituximab (RTX), a monoclonal antibody with anti-CD20 action, is now used as a treatment. Even with proper RTX use, some patients showed variations in response. Objective: To assess the association of different sociodemographic data and disease characteristics with RTX responsiveness in RA patients. Methods: A cross-sectional study was conducted in the Specialized Center of Rheumatology at Baghdad Teaching Hospital in Baghdad, Iraq. The study included 90 RA patients who received a 1000mg RTX intravenous infusion for at least six months. The collected sociodemographic data included age, gender, smoking status, body mass index (BMI), disease characteristics such as co-morbidities, and the use of previous biological agents. The activity of RA was assessed by the 28-joint Disease Activity Score (DAS28) and Clinical Disease Activity Index (CDAI). Results: Upon measuring the DAS28, the enrolled patients were divided into RTX responders (50 patients) and RTX non-responders (40 patients). Patients with a family history of RA were significantly higher in the RTX responders (21% versus 2% in the non-responders group). The responders had a significantly longer RA duration (p=0.030).The mean of CDAI and DAS28 were significantly higher in patients with no family history of RA than in those with a family history of RA. Conclusions: Disease duration, family history, and the use of previous biological agents could be considered as possible predictors of response to RTX, thereby saving time and treatment costs.

Diagnosis Study of Peptic Ulcer in Iraqi Patients Students

Background: Even in the absence of a Helicobacter pylori infection, psychological stress and a need for fast food can cause peptic ulcer. Research on the relationship between sociodemographic traits and peptic ulcers has revealed a number of risk factors, including a packed family, poor income, unemployment, marital tension, and physical and mental strain. The aim of the current study is to determine the clinical picture of gastric ulcer based on medical history and social status in a sample of Iraqi patients. Methods: Students studying science and medicine who had signs of peptic ulcer disease were the subjects of a cross-sectional investigation. The sample was collected during the period of one year, November 2021 to February 2022. Initially, the procedure was elucidated to the patients, and informed consent was obtained from all enrolled individuals. Peptic ulcer disease was diagnosed by routine examinations, Helicobacter pylori diagnosis by stool antigen test, and gastroduodenoscopy of the patients, in addition to taking the medical history and information about the social status. Results: The study included 45 patients with peptic ulcer, 15 (33.33%) males and 30 (66.66%) females, aged 19-26 years. The control group was 25 healthy individuals, and their symptoms were either acute abdominal pain proven to be caused by peptic ulcer in the patients or hematemesis in 13 (28.88%) patients. Conclusion: Peptic ulcers can be visualised and bleeding can occur, so there should be awareness of pain management and prompt treatment. There should be good and effective analgesia, reassurance, and empathy with patients, and advice on protection against gastric and intestinal ulcers when needed.

Relationship between D-dimer levels and survival in a sample of Iraqi patients with COVID-19

Coronavirus disease 2019 was discovered in December 2019, Wuhan, China. It was transmitted globally producing the COVID-19 pandemic. Coagulopathy is one of the most common complications characterized by an increased D-dimer level. Objective: The aim of this study were to assessment the relationship between the levels of D-dimer and other biomarkers with survival in a sample of Iraqi patients with COVID-19. Methods: A cross section study included 103 patients affected by COVID-19, diagnosed by PCR and chest CT scan, (18 to 70 years old), and admitted at the isolation centers of the Khalis General Hospital and the Shifa Center in Baquba Teaching Hospital Diyala\ Iraq between November 2020 to end January 2021. The patients were divided into two groups: Group 1:(63) survivors patients, Group 2: (40) non survivors patients. Results: The patients divided into groups: 61.2% survivors patients ,38.8% non-survivors adult COVID-19 patients. The results include several biomarkers, each biomarker (mean± SE) was calculated in survivors and non-survivors patients. Serum ferritin, plasma D-dimer showed statistical significant increasing in non-survivors group (1777.8 ± 126.02, 3985.42 ± 1224.95) than survivors patients group (1182.7 ± 142.45, 1857.50 ± 291.21) with p-value ≥ 0.05.

The Effect of Pan-Retinal Photocoagulation on Central Macular Thickness in a Sample of Iraqi Patients With Proliferative Diabetic Retinopathy.

To evaluate the effect of pan-retinal photocoagulation (PRP) on central macular thickness (CMT) in a sample of Iraqi patients with proliferative diabetic retinopathy (PDR). This prospective study was conducted at Ghazi Al-Hariri for Surgical Specialties Hospital, Baghdad, from March 2024 to May 2024. A total of 24 eyes from 18 treatment-naive PDR patients with no previous diabetic macular edema (DME) were enrolled. Each eye received PRP in two sessions, one week apart, using the Nidek GYC 500 laser system. CMT was measured at baseline and four weeks after the second PRP session using the Topcon DRI Triton Plus optical coherence tomography (OCT). Statistical analyses, including paired t-tests and Shapiro-Wilk tests for normality, were performed to evaluate changes in CMT. The mean CMT increased from 258.4 ± 30.7 microns at baseline to 269.9 ± 36.8 microns post PRP, with a mean increase of 11.5 ± 26.3 microns. This increase was statistically significant (p = 0.042). The Shapiro-Wilk test confirmed that the data were approximately normally distributed both before (W = 0.960, p = 0.445) and after (W = 0.931, p = 0.103) PRP treatment. PRP significantly increases CMT in PDR patients, although no additional treatment for macular edema was necessary. These findings align with previous studies, suggesting that PRP-induced macular thickening is a common outcome. Further research is recommended to explore long-term effects and potential mitigation strategies.

Evaluation of Helicobacter pylori infection as a predicator of insulin resistance in a sample of Iraqi patients

Evaluation of Helicobacter pylori infection as a predicator of insulin resistance in a sample of Iraqi patients

The Achievement of IOP Target Among a Sample of Iraqi Patients with Glaucoma: A Retrospective Study.

Glaucoma is a chronic progressive eye disorder. It is the primary cause of blindness. To prevent glaucomatous damage and blindness, the intra-ocular pressure (IOP) must be lowered to certain levels, this level is known as "IOP" target. Many studies conducted in developed countries have found that the majority of glaucoma patients failed to reach their target IOP. This study aimed to assess the achievement of IOP target among Iraqi patients with glaucoma and to determine the factors affecting it. A single-center retrospective cohort study was conducted by inspecting the records of all patients with confirmed cases of glaucoma who were admitted to the Ibn-Al-Haitham Hospital outpatient unit from January 2020 to December 2022. To be included in the study, the patient must be newly diagnosed with glaucoma. In addition, full information on the patient's demographics, medical therapy used, and IOP at baseline and after 1 month of treatment must be available in the patient's case sheet. After considering the study inclusion criteria, the records of 760 patients were excluded, and only 100 patients were eligible. The included patients were mostly males, with an average age of 57.86 years. A 70% of the patients had elevated IOP in both eyes. Most patients (38%) were treated with two anti-glaucoma drugs. Only 35% of the patients achieved their targeted IOP. Regarding the factors influencing the achievement of the IOP target, all demographic data (age and gender) had a non-significant effect, while the number of prescribed drugs affected the ability of the patient to reach the IOP target. Most of Iraqi glaucomatous patients do not achieve their IOP target. The number of prescribed eye drops can significantly affect the ability of glaucoma patients to reach their targeted IOP.

Iron Deficiency and Hearing Problems in Adult Patients: Sample of Iraqi Patients

Abstract Background: Anemia causes insufficient oxygenation of various organs, which leads to impairment of cognitive function as well as behavioral dysfunction, and there is a possibility of iron effects on the inner ear system by inducing pathologic insults. Objectives: The aim of this article is to investigate the association of tinnitus and hearing loss with iron deficiency and iron deficiency anemia. Materials and Methods: A descriptive cross-sectional study included patients suffering from tinnitus who were tested by pure tone audiometry and categorized according to hearing status into those with normal hearing and those with hearing loss. A blood sample was taken from each one for performing a complete blood count and serum ferritin level measurements in order to show the presence of iron deficiency and/or iron deficiency anemia. Results: One hundred patients with tinnitus were enrolled, 62 patients of them have hearing loss, while 38 patients have normal hearing. Forty-eight percent of tinnitus patients have iron deficiency anemia and 13% have only iron deficiency. There is a significant association between sensorineural hearing loss and iron deficiency anemia in patients with tinnitus (P value is 0.00283, P value is significant if &lt;0.05). The proportion of subjects with low ferritin and hearing loss is significantly higher than those with low ferritin and normal hearing (P value is 0.000106. The result is significant at P &lt; 0.05). Conclusion: Tinnitus and sensorineural hearing loss are significantly associated with iron deficiency and iron deficiency anemia.

Association of TNFα and IL1β genotypes with the risk of Staphylococcus aureus causing recurrent tonsillitis in a sample of Iraqi patients

Background and aim: Tonsillitis is an inflammation of the tonsils, usually caused by an infection by viruses or bacteria; recurrent tonsillitis occurs when tonsillitis occurs several times a year. The current study aimed to investigate the association of TNFα and IL1β genotypes with the increased risk of recurrent Staphylococcus aureus tonsillitis in a sample of Iraqi patients. Methods: A total of 50 blood samples were collected from patients with recurrent tonsillitis of S. auerus from three hospitals in Najaf city, and 50 samples were collected from apparently healthy volunteers with a free medical history of recurrent tonsillitis as control group. Genomic DNA was extracted from peripheral blood and genotyped for TNF-α 308G/A and IL1β C/T SNP using Nested tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR). Results: The results of the distribution IL β –rs1143627 C/T alleles in S. aureus tonsillitis patients showed CC wild type genotype was in 11 patients (22%), CT genotype was in 30 patients (60%) and the TT genotype was in 9 patients (18 %) also C allele frequency was (0.42), whilst T allele frequency was (0.58) with Odds Ratio (1.507) at significant difference (P≤ 0.01), while prevalent of TNF-α –rs1800629 G/A alleles genotype in S. aureus tonsillitis patients revealed that GG wild type genotype was 37 patients (74%), GA genotype was 13 patients (26%) and AA genotype was 0(0%) also, G allele frequency was (0.87) and A allele frequency was (0.13) with Odds Ratio (1.507) at no significant differences in both the patient and control.

Actual and Perceived Risk of Cardiovascular Disease among Sample of Iraqi Patients with Rheumatoid Arthritis

Background: Independent of conventional risk factors, patients with rheumatoid arthritis (RA) have a significantly increased risk of cardiovascular disease (CVD). Aims of the study: To evaluate the actual and perceived 10-year CVD risk among Iraqi patients with RA as well as their level of knowledge about CVD risk. Patients and methods: This cross-sectional study included 100 RA patients (85 females and 15 males) who visited Baghdad Teaching Hospital/Rheumatology Unit from January 2021 till July 2021. The Framingham Risk Score (FRS) was used to calculate the actual 10-year risk of CVD. The Heart Disease Fact-Rheumatoid Arthritis Questionnaire (HDFQ-RA) was used to assess the subjects’ cardiovascular disease knowledge. Results: Among a hundred Iraqi patients with RA, the median age was 51.23 ± 8.4 years. The findings of the study revealed that 23% had high risk for CVD and 27% &amp; 50% had moderate and low risk respectively based on FRS calculator. The risk of CVD was significantly affected by the age of disease onset and seropositivity and steroid use (p value 0.001). When the perceived risk was compared to the actual risk of cardiovascular disease, there was a weak agreement between them, only 31% had corresponding answers. Conclusions: The study showed an elevated risk of CVD in rheumatoid arthritis patients, as well as a gap between actual and perceived CVD risk.

Profile of Interleukin-6 and Tumor Necrosis Factor-α in Hospitalized COVID-19 Patients

Abstract Background: In 2019’s December, the new COVID-19 coronavirus induced severe lower respiratory tract syndrome in Wuhan, China. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ultimately became responsible for the life-threatening pandemic. The magnitude and outcome of COVID-19 may be related to the overproduction of pro-inflammatory cytokine called “cytokine storm.” Cytokine production besides the age of patients, and comorbidities, all influence the length and severity of SARS-CoV-2. Objectives: This research was performed to investigate how these factors affect patients who have severe COVID-19 in a sample of Iraqi patients. Materials and Methods: A total of 82 participants were enrolled in this work, confirmed hospitalized COVID-19 patients (n = 60) and healthy control (n = 22) from both sexes of age range 20‐67 years. Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels in the serum of COVID-19 patients and HC have been evaluated using an ELISA. Results: According to our findings, sera from COVID-19 patients had considerably higher levels of IL-6 and TNF-α than those of the control group. Furthermore, most infections were among women (63%), followed by men (37%), the higher number of patients were within 50‐59 years, while the lowest number of patients was found in the group 20‐29 years. Most COVID-19 patients appeared to be overweight and obese. Additionally, those who have diabetes mellitus are also at risk of severe COVID-19. Conclusion: Serum levels of TNF-α and IL-6 were higher in patients than in the control group, suggesting that they could be used as indicators of the severity of COVID-19 illness. Also, their combined detection provided highest specificity and sensitivity for early prediction of COVID-19 severity, which has significant clinical values.

Correlation between Interleukin-23, Autoantibodies and Thyroid Profile in a Sample of Iraqi Patients with Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis (HT) is the most common autoimmune condition characterized by hypothyroidism and thyroid cell death by leukocytes and antibody-mediated immunological mechanisms. The current paper set out to assess a number of inflammatory and metabolic potential indicators of Hashimoto’s thyroiditis. Fifty-one patients with Hashimoto’s thyroiditis took part in the current investigation. Ages ranged from 20 to 75 for them. Enzyme-linked immunosorbent tests were used to quantify the anti-thyroperoxidase antibody (anti-TPO Ab), anti-thyroglobulin antibody (anti-Tg Ab), T4, T3, and TSH at the beginning and conclusion of the trial. The result showed a significant relationship between the gender according to HT patient’s and healthy groups which showed that female effected more than male and there was no effected according to the age between these groups, In HT patients with greater TSH concentrations compared to healthy individuals, serum FT3 and FT4 concentrations were lower while IL-23 concentrations were higher. TSH levels were positively correlated with IL-23 levels. As a result, IL-23 can be useful for detecting disease activity in HT patients. However, more thorough, extensive, longitudinal investigations are required to evaluate whether IL-23 can be used in therapeutic settings. Our results showed that thyroid profile, serum IL-23, and autoantibodies were strong indicators of Hashimoto’s thyroiditis. To better understand these correlations and underlying pathogenic mechanisms, additional research is necessary.

The association between body mass index, diagnostic markers and disease activity score with progression of rheumatoid arthritis in a sample of Iraqi patients

Background: Rheumatoid arthritis (RA) is a widespread, chronic, systemically inflammatory disease which, if improperly treated, can cause deformed joints and functional disability. For best disease management, greater chances of recovery, and the avoidance of irreversible clinical and radiographic damage, RA must be diagnosed and treated as soon as possible.Objectives: The purpose of this study was to evaluate body mass index utilizing DAS and levels of diagnostic tests in rheumatoid arthritis patients.Materials and methods: 120 patients with rheumatoid arthritis (60 newly diagnosed untreated patients and 60 others under treatment) were collected from Al-Yarmouk Hospital in Baghdad and 60 control individuals. Body mass index (BMI) was measured by equation and diagnostic tests, then vitamin D3 with the COPAS 111 device. Results: The prevalence of the disease in females was 91%, while males were 9%. Diagnostic tests recorded clear significance (p &lt; 0.05) differences between patients and healthy persons, and it increased with the severity of the disease. Additionally, patients' levels of vitamin D3 reduced significantly when compared to controls, and there was a significant disparity between patients and healthy participants' sugar levels, and the BMI correlated with disease activity.Conclusions: The current study concluded that there is a relationship between weight gain and disease severity, that diagnostic tests increased in patients, and that vitamin D3 can be used as a diagnostic marker for rheumatoid arthritis. Keywords: Body mass index (BMI),disease activity score DAS-28, diagnostic marker.

Evaluation of Adherence to Methotrexate in a Sample of Iraqi Patients with Rheumatoid Arthritis Receiving Anti - TNF Medications

Evaluation of Adherence to Methotrexate in a Sample of Iraqi Patients with Rheumatoid Arthritis Receiving Anti - TNF Medications

ASSOCIATION BETWEEN BLOOD GROUPS AND COVID-19 OUTCOME CROSS SECTIONAL STUDY

Background: Coronavirus disease 2019 (COVID-19) first started as an epidemic in Wuhan city – China in 2019 then became a pandemic. Certain viral infections showed linkage with certain antigenic determinants of ABO blood groups and Rh factor. Aim of the study: determine the association between blood groups and Rh factor with COVID19 infection in a sample of Iraqi patients. Patients and methods: This cross-sectional retrospective study was conducted among 580 students of a variety of colleges mainly in Baghdad from 6th of December 2021 to 18th of January 2022. An online questionnaire using Google forms was used to collect the data. Results: A total of 580 samples were collected during the study with 358 (61.7%) females samples and 222 (38.3%) males and there was a significant difference between them (P=0.0001). The mean age of the participants was 20.20± 2.716 years. Of the 580 COVID-19 infected samples collected 289 ( 49.8%) were blood group O. 133 (22.9%) were blood Group A then 108(18.6%) were blood group B, and 50 (8.6%) blood group AB while with significant difference (P=0.). About 508 (87.5%) of the samples were Rh + who had COVID-19 infection and the remaining 72(12.5%) were Rh – (P=0.0001). Conclusions: There was an association between Blood group O+ and COVID-19 infection who did not required hospitalization and the blood group AB+ were less susceptible to infection