Iraqi National journal of Medicine

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Background: The global burden of diabetes is alarmingly increasing. These patients constitute a distinct hospitalized group requiring specialized care. Hospitals should strive for the best standards of care (namely, glucometrics) to optimize inpatient blood glucose. Our study aims to assess the quality of blood glucose control in critically ill inpatients. Methods: Eighty-five consecutive patients admitted to our hospital were prospectively followed up for their entire hospital stay or up to 7 days, whichever came first. Each patient's blood glucose measurement was recorded according to ward protocol. Indices included total blood glucose per ward, per patient-day, or patient-stay, and percentage blood glucose levels per predefined cut points to assess the incidence of hypo-, eu- and hyperglycemia. The trial registration number at Clinicaltrials.org is NCT04800861. Results: Total data consisted of 645 blood glucose tests out of 85 patients and 284 patient-day results, with an average of 2.27 tests per patient-day and 7.59 measurements per patient stay. The percentage of blood glucose in the range (80–180 mg/dL) was different per model, with patient-day showing the highest results of (48.24%) while the percentage of patients with hypoglycemia (blood glucose<60mg/dL) was highest per patient stay (1.18%). Conclusions: Patients whose glucose levels were within 80–180 are less than 50% in our cohort. Actions need to be put in place urgently.

Background: Breast cancer is the most common cancer and the leading cause of cancer-related deaths among Iraqi women. Lack of early detection and inadequate diagnostic and treatment facilities contribute to low survival rates in less developed countries such as Iraq. The WHO states that early screening and proper treatment can significantly reduce breast cancer mortality. Aim: This study aimed to assess the attitudes and practices related to breast-cancer screening among female doctors in the province of Babylon. Methods: A descriptive cross-sectional method was used to survey 175 female doctors in Babylon from April to July 2021, using an adapted questionnaire. The questionnaire included three parts: socio-demographic data, a 15-question section on attitudes, and a 7-question section on practices regarding breast self-examination. The sample was randomly selected from a total of 734 female doctors in the province. Results: In this study of 175 female doctors in Babylon, most of the women studied were around 29 years (67%) old with a bachelor’s degree, and 50% were married. Attitudes towards breast self-examination were mostly average (94%), but practice was generally poor (55%) or average (36%), with only 9% rated as good. A minority had a family history of breast cancer (17% second-degree, 7% first-degree relatives). Conclusions: This is the first research study on Iraqi female physicians’ attitudes and practices related to breast-cancer screening. This study has found that most female physicians had an average attitude and poor practice vis-a-vis self-screening for breast cancer. Based on the findings, the study has suggested improving breast-cancer screening practices among female doctors, and further research on female practitioners in the medical field.

ABSTRACT


Objectives: Sildenafil(Viagra) is a known as perfect medications for treatment in patients agony from impotence and pulmonary arterial raised blood pressure, it cause numerous effects on the nervous system by “nitrogen monoxide-cyclic guanosine monophosphate pathway”. The current paper is designed to examine the histostructural variations that may happen in the brain of both adult and elderly male rats after long course duration of Sildenafil(Viagra) drug treatment. Material and Methods: Forty white albino male rats were bought from the veterinary animal house of Mosul University. Twenty of them were between the ages of 3-4 months ( adult ) while the others were between the ages of 22-24 months ( senile ). Grouр I ( 10 adult rats ) and grouр II ( 10 old age rats ) were given distilled water and regarded as control grouрs . Grouр III ( 10 adult rats ) and grouр IV ( 10 old age rats ) were treated with Viagra in a dosage of ten mg. kg. day orally for thirty days. Results: The histological sections from the control adult group showed normal architecture of the frontal lobe cerebral cortex with distinct multipolar neurons , many glial cells and prominent blood vessel while the cerebral cortex of adult rats from treated group showed gliosis with satellitosis (glial cells around neurons)vasogenic and cytogenetic edema with perineuronal vacuolation and vascular congestion., there was mild shrinkage of some neurons Conclusion: Long-lasting administration with sildenafil citrate (Viagra) triggered a noxious outcome on the brain tissues with morphological changes in cells in both adults and the elderly male rats alike, although its effect was greater in the elderly, but this is not attributed to the drug as much as it contributes to the aging process.

Background: Recent studies have demonstrated the association between ABO blood group and prostate cancer (PC), as well as the various factors associated with PC, including age, family history, ethnicity, and certain viruses. Aim: To demonstrate the association between ABO blood groups and PC and to correlate it with the demographic and clinical features of our studied population. Methods: A descriptive cross-sectional hospital-based study was conducted at the Radiation and Isotopes Center—Khartoum (RICK) in Khartoum state from April 2018 to April 2019. From a study population of 389 PC patients (RICK), a total of 101 were selected. Data was analyzed using SPSS version 21. Results: The mean age of prostate cancer was 66.3 ± 7.8 years; hypertension was the most common chronic disease, affecting 62.3% (63) of patients. Prostate-specific antigen levels increased by more than 10 ng/ml among 74.3% (75) of PC patients. Patients with blood group O had slightly more than one-third, or 37.6% (38), whereas patients with other blood groups had similar percentage ranging from 20% to 22%. No significant relationship was found between ABO blood groups and clinical–pathological characteristics with PC (P-value = 0.067). Conclusion: Our study provides evidence of an association between ABO blood group and clinical–pathological features of PC, hypertension was common in patients with ABO blood group, and there was no significant relationship between ABO blood group and clinical–pathological characteristics of PC.

Background: Vitamin D deficiency is well-recognized worldwide. It is common in older adults, especially in women. Vitamin D deficiency is the most underdiagnosed medical condition in menopausal women. There are few epidemiological studies on the vitamin D status of menopausal women in Basra City, Iraq. Aim: The aim of the study is to determine the prevalence of vitamin D deficiency among menopausal women in Basra City and its correlation with various factors that lead to vitamin D deficiency in menopausal women. Methods: A prospective cross-sectional study was conducted on 200 menopausal women in the age group 46–65 years attending the gynecological outpatient clinic of Al Mawany Teaching Hospital and the gynecological clinic in Basra City, between September 2019 and August 2020. The level of vitamin D was assessed for each woman. A level of less than 30 ng/ml is considered vitamin D deficiency and a level of 30–100 ng/ml is considered a sufficient level of vitamin D. Results: There was a prevalence of vitamin D deficiency among 83% of menopausal women in Basra city, and the majority of menopausal women with vitamin D deficiency were in the age group of 51–60. Vitamin D deficiency has a significant correlation between sun exposure and dietary intake at 83.1% and 61.4%, respectively. Vitamin D levels had no correlation with hypertension and diabetes in menopausal women. Conclusion: This study helped us to evaluate the baseline vitamin D level among post-menopausal women and concluded a high prevalence of vitamin D deficiency in menopausal women in Basra city. There is a statistically significant correlation between vitamin concentration and age in the late menopausal period. All menopausal women ought to be advised on the advantages of taking vitamin D supplements, eating a healthy diet, and getting enough sun exposure.

Background: Infectious agents are the main factor that causes children suffering from cancer to be more susceptible
to treatment failure. They complicate their course of therapy, thus shortening their lives. Aim: To find out the most
notorious pathogen affecting pediatric malignancy in Basra Children Specialty Hospital to provide the best
antimicrobial therapy choice and map out the future empirical therapy. Methods: One hundred and ten pediatric
oncology patients in the pediatric hemato-oncology unit aged 16 years and less were involved in this retrospective
study from March 1, 2021 to the end of February 2022. Different types of culture tests were taken in various stages
of malignancy besides other investigations, including CBC, RFT, LFT and imaging. According to studies, these were
important, since they help to spot the infection even if the culture was negative. Results: Acute Lymphoblastic
Leukemia was the main malignancy involved in this study (42.7%). 73.6% of patients were aged 1–10 years, 58% were
male, 62% were from Basra, and almost 2/3rd of them were from the periphery. Gram-positive bacteria represented
55.5% of the cases; Staphylococcus hemolytic and Staphylococcus hominine were mainly found, followed by E. coli,
which was the major gram-negative bacteria, which seemed to manifest during induction and relapse stages. These
were more likely to have a different type of antibiotic resistance to ESBL, CRE, and MRSA. Conclusions: Pediatric
oncology patients with fever, neutropenia, and/or mucositis were more infected by gram-positive bacteria. The
presence of bacteremia tends to be more critical during induction and relapse stages, as this may increase fatality.
These deaths can be prevented using strict infection control measures, with the consequence of intimidating effect
of the development of antibiotic resistance for existing patients as well as future patients.

Background: Neonatal sepsis is a systemic infection caused by bacteria, viruses, fungi, and parasites. It results in significant morbidity and mortality, accounting for up to half of all newborn deaths in developing countries. Aim: Hence, this study aimed to determine the bacteriological profile of neonatal sepsis and assess its relationships with other demographic variables. Methods: A prospective, cross-sectional study was carried out on 87 neonates with blood culture-proven neonatal sepsis. They were categorized according to the age of onset of symptoms as having early-onset sepsis and late-onset sepsis. The bacterial profile that resulted from their blood cultures was analyzed. Results: The findings revealed that the most common isolated bacterial was Staphylococcus aureus, reported in 34.48% of the patients. Collectively, Gram-positive bacteria represent 67.82% of bacterial profiles versus 32.18% for Gram-negative bacteria. Significantly more Acinetobacter spp. were isolated from newborns with EOS than those with LOS (23.08% vs 6.56%). Contrarily, Streptococcus viridans were significantly more common among neonates with late-onset sepsis than those with early-onset sepsis. Interestingly, Gram-negative bacteria were present more frequently (53.85% vs. 22.95%) in infants with EOS than LOS, indicating a significant difference. In addition, Gram-positive bacteria accounted for 77.59% of sepsis in full-term neonates and 48.28%% of preterm neonates, with a significant difference. Conclusions: Early-onset sepsis and premature newborns were more likely to have gram-negative bacterial sepsis, whereas late-onset sepsis and full-term neonates were more expected to have gram-positive bacteria.

Background: COVID-19 first emerged in Wuhan City and has since spread worldwide, infecting over 600 million people. The World Health Organization (WHO) issued an emergency in public health in January 2020 due to reports of new coronaviruses in Europe, Asia, and the Americas. Aim: The study aims to screen bacterial antigens for cross-reactivity with COVID-19 antibodies using indirect ELISA and to detect cross-reactivity between vaccinated and unvaccinated healthy individuals and various bacterial types (Gammaproteobacteria, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Enterobacteria, in addition to Staphylococcus aureus) either sonicated or non-sonicated. Methods: ELISA is a method for detecting unknown samples in a sample. It involves pipetting 50 μl of diluted antigen dilution into PVC microtiter plates, with pure antigen test samples pipetted at 2 µg/ml. The plate is incubated at room temperature for 2 hours or overnight at 4°C. Blocking is done with 200 μl of blocking buffer. The plate is then incubated overnight at 4°C or room temperature for 2 hours. Primary and secondary antibody incubation is performed, with two hours of room-temperature incubation and overnight incubation for stronger staining. Absorbance is measured for each well, and the results can be analyzed using a standard curve. Results: Results showed that vaccinated individuals had highly significant p-values of IgG antibodies against S. aureus, Pseudomonas aeruginosa, Enterobacteria, and Bacillus, while unvaccinated individuals had non-significant p values. Conclusions: The high cross-reactivity identified E. coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacteria, and Gammaproteobacteria. The current study was validated by the discovery of a significant correlation between Pfizer vaccinated individual's serum antibodies and unvaccinated individual's serum and the examined bacterial antigens that had a high titer of cross-reactivity with the vaccinated samples in comparison to the unvaccinated samples (less titer).

Transverse myelitis (TM) is a clinical syndrome characterized by sensory, motor, and autonomic dysfunctions resulting from immune-mediated spinal cord injury. A possible association between COVID-19 and TM has been recognized. This paper examines the case of an eleven-year-old child who presented with paraplegia and urine retention and was evaluated carefully by a multidisciplinary team comprising a neurophysiologist, a pediatrician, and a neurologist. Sequentially, EMG, NCS, magnetic resonance T2 was conducted to reach the diagnosis of transverse myelitis. The patient was treated with bullous methylprednisolone for three days and showed steady and complete clinical and neurophysiological improvement.

The patella has a low incidence of tumors. Primary neoplasms of the patella account for less than 1% of all primary bone tumors of the lower extremity, the most frequent of them being the giant cell tumor of bone, the chondroblastoma, and the aneurysmal bone cyst. This paper reports the case of a 32-year-old woman with an active giant cell tumor of the patella, examining its clinical and radiological features and providing a brief review of the literature.