IRAQI JOURNAL OF MEDICAL SCIENCES

Malalignment syndrome involves improper anatomical positioning due to musculoskeletal abnormalities, often resulting in torsional deformities that impair function and require surgical intervention. Traditional surgical planning methods have limitations in precision and consistency. This review aimed to explore recent advances in computer-aided surgical simulation and digital 3D skeletal modeling techniques used to assess and correct lower limb deformities. It was conducted to analyze current methods in 3D surgical planning, focusing on computer-aided simulations and the use of personalized surgical guides. Sources were selected from peer-reviewed journals and databases, evaluating their applications in clinical practice. Studies showed that computer-assisted surgical simulation enhances preoperative planning, improves alignment accuracy, reduces intraoperative complexity, and decreases surgery time. Personalized guides developed from digital modeling have demonstrated improved outcomes and reduced surgical trauma. Computer-aided 3D modeling and personalized surgical planning represent significant advancements in deformity correction. These tools provide surgeons with improved visualization, simulation capabilities, and efficiency, ultimately supporting safer and more accurate surgical interventions.
Keywords: Computer-aided surgical simulation, surgical planning, 3D motion analysis
Citation: Akar BA, Ghazwan AG, Al-Saadan WA. Imaging and simulation techniques for lower limb deformity: A literature review. Iraqi JMS. 2025; 23(1): 1-16. doi: 10.22578/IJMS.23.1.1

Background: BK and JC polyomaviruses are perceived as the two most common human polyomaviruses (HPyVs). These two viruses inhabit the epithelial surfaces of the bladder and kidney as the primary site of replication and latency. There have been multiple evidences on the association and implication of some of the HPyVs in human cancerous growth, indicating an etiological association with carcinogenesis.
Objective: To explore the association and implication of some of the polyomaviruses in urothelial carcinomas.
Methods: Tissue biopsies were collected from 103 patients with urothelial carcinoma. The biopsies were processed for polyomavirus DNA and large T antigen (TAg) through real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC).
Results: BK polyomavirus and JC polyomavirus were detected in 21 cases (29.6%) and 10 cases (14.1%) with malignant tumors, respectively. The percentage of cases with double positive BK polyomavirus DNA and TAg was found to be high (62.20%). The specificity was high for both BK and JC viruses (98.48%).
Conclusion: The study suggests that JC and BK polyomaviruses may play an important role in the urothelial tumor development.
Keywords: Polyomavirus, HPyVs, urothelial cancer, BK virus, JC virus, tumors, Large T-Ag, real-time PCR, Immunohistochemistry
Citation: AlMalaki KA, Al-Obaidi AB, Ghazi HF. The potential role of BK and JC polyomaviruses in urothelial cancer. Iraqi JMS. 2025; 23(1): 17-24. doi: 10.22578/IJMS.23.1.2

Background: The rising number of methamphetamine abusers and the consequent fatalities prompted this case presentation, aiming to highlight the risks associated with its use and to enhance awareness of its detrimental effects on the human body.
Case presentation: The study examined a 30-year-old male who was discovered deceased at his home in the early morning. The autopsy showed no evidence of external or internal trauma and significant gross pathological alterations. A small torn nylon package was found in the stomach\\'s lumen, its contents released. Toxicological tests of the stomach contents, blood, and urine identified methamphetamine in the package. Laboratory results indicated a lethal concentration. The liver tissue exhibited sinusoidal cholestasis, and the kidneys displayed severe acute renal tubular necrosis.
Conclusion: The study highlights the toxic and irreversible impact of methamphetamine on different human organs and the lethal consequences of smuggling the substance through oral ingestion.
Keywords: Amphetamine, methamphetamine, autopsy, tubular necrosis, sudden death
Citation: Sami SW, Al-Qazzaz MA. Fatal Methamphetamine Poisoning: Forensic Case Presentation. Iraqi JMS. 2025; 23(1): 25-31. doi: 10.22578/IJMS.23.1.3

Background: Banknotes are handled by individuals with varying health and hygiene practices and are stored under diverse environmental and personal conditions. Paper currency is widely exchanged for commercial transactions and services, making it a potential vector for the transmission of bacteria.
Objective: To evaluate the bacterial contamination of banknotes in circulation in the Al-Anbar Governorate, Iraq.
Methods: The study was done between February and April 2023 and analyzed at the Microbiology Laboratories of the College of Medicine, University of Fallujah. A total of 84 samples were collected from seven banknote denominations across four locations. The bacteria were isolated and then identified by VITEK-2 then the antibiotic susceptibility test was done.
Results: Among the locations, the butcher shop had the highest number of positive samples 23 (32.1%), followed by the grocery store 21 (29.1%) and Rafidain Bank 18 (25%), while the pharmacy 10 (13.8%) had the fewest. Bacterial identification revealed a predominance of Gram-negative isolates over Gram-positive bacteria. The number of colony-forming units correlated with the locations of positive samples, with the grocery store being the most contaminated. Antibiotic susceptibility testing indicated that while antibiotics such as Imipenem and Ciprofloxacin may remain effective, significant resistance was observed for Ceftriaxone.
Conclusion: The study found that currency used in daily life may be a source of bacterial infection. The exchange of banknotes among individuals with different hygiene practices and occupations may facilitate the spread of diseases through contaminated currency.
Keywords: Antibiotic resistance, banknotes, currency contamination, disease transmission
Citation: Hasan TA. Banknotes as a potential source of transmissible diseases in the Al-Anbar Governorate, Iraq. Iraqi JMS. 2025; 23(1): 32-38. doi: 10.22578/IJMS.23.1.4

Background: Skin diseases are a big health problem affecting a high percent of the population and causing distress and disability. Children\'s skin is often regarded as smoother and softer than that of adults; as a result, it may be more susceptible to irritation and inflammation.
Objective: To determine frequency and types of skin diseases in children less than 5 and to find some sociodemographic characteristics of those children.
Methods: A cross-sectional study conducted in Al-Imamein Al-Kadhimein Medical City; the data were collected during March and April 2019. A convenient sample (262 under 5 years of age children) were selected from dermatological outpatient’s clinic by interviewing the parents of those children.
Results: Out of this sample, 144 (55%) were males; atopic dermatitis in 79 (30.2%) constituted the highest percentage followed by diaper rash in 46 (17.5%) and warts were found in 28 (10.7%). Regarding their sociodemographic characteristics, 199 (76%) and 209 (80%) of the children starting solid food and bottle feeding less than 4 months age, respectively and 224 (85.5%) of the children were up-to-date vaccination.
Conclusion: Atopic dermatitis was the most frequent skin diseases in children under 5 years. Most of them were males, starting solid food and bottle feeding before 4 months. More than two third were taking their vaccination up to date.
Keywords: Skin diseases, under 5 years, Baghdad, atopic dermatitis and sociodemographic
Citation: Hussain NA, Alogaili MH, Mohammed LK. Skin diseases in a sample of under-five years children and their sociodemographic characteristics at Al-Imamein Al-Kadhimein Medical City/Baghdad. Iraqi JMS. 2025; 23(1): 39-45. doi: 10.22578/IJMS.23.1.5

Background:Candida albicans (C. albicans) is determined as the major human pathogen in the genus Candida. The presence of virulence genes and the increasing prevalence of resistance to antifungal therapy have contributed to the pathogenicity of C. albicans. Next-generation sequencing (NGS), also known as high-throughput sequencing, is the catch-all term used to describe a number of different modern sequencing technologies. These technologies allow for sequencing of DNA and RNA much more quickly and cheaply than the previously used Sanger sequencing, and as such revolutionized the study of genomics and molecular biology.
Objective: To determine the mutations in the genes responsible for multidrug resistance among isolates of pathogenic C. albicans using NGS technique.
Methods: This study comprises a total of (1596) samples collected from different body sites and lesions (blood, wounds swabs, ear swabs, bronchoalveolar lavage, high vaginal swabs, sputum, threat swabs, and urine); after diagnosis the C. albicans isolates DNA extraction was done and final using NGS technique.
Results: Only 209 of 1596 samples that were taken from the patients and cultured on Sabouraud\\\\\\\\'s dextrose agar were found to be positive. Candida isolates were cultured on Chrom Candida Agar the results revealed that 59 of the isolates were C. albicans. ERG11 gene in this study found to cause 12 silent mutations, while missense mutation was just two compared with reference sequences standard strains SC5314. ERG11 gene in this study found to cause 12 silent mutations, while missense mutation was just two. One deletion mutation was found in the YOR1 gene in this investigation, this gene alone has 2 silent mutations and 1 missense mutation, the PDR16 gene contained 15 missense mutations and 6 silent mutations.
Conclusion: This study showed that next generation sequencing allows the thorough investigation of isolates more cost efficient and faster than another technique.
Keywords: Candida albicans, NGS technique.
Citation: Mohammed MM, Al-Attraqchi AAF, Alrubaye DS. Analysis of antifungal resistance genes in Candida albicans isolates using next generation sequencing. Iraqi JMS. 2025; 23(1): 46-57. doi: 10.22578/IJMS.23.1.6

Background: Corona virus disease 2019(COVID-19), caused by the severe acute respiratory syndrome virus (SARS-CoV-2), heavily relies on the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. The receptor-binding domain (RBD) of the virus plays a critical role in this process and is considered a key target for neutralizing activity. The RBD can be produced efficiently and effectively to induce a neutralizing immune response. Chitosan (CS), a widely used vaccine adjuvant, shows promise as an adjuvant/carrier in vaccine delivery.
Objective: To investigate the potential of CS nanoparticles (CS-NPs) as an alternative adjuvant to stimulate specific anti-RBD IgG antibody production efficiently and with reduced toxicity compared to alum.
Methods: Antigens were prepared by loading RBD protein onto CS-NPs, followed by measuring the released RBD protein using high-performance liquid chromatography. Rabbits were vaccinated, and the resulting antibody response was detected using competitive enzyme linked immunosorbent assay.
Results: The use of CS-NPs as an adjuvant loaded with the RBD antigen demonstrated the ability to induce a substantial titer of anti-RBD IgG antibodies when administered to rabbits over a course of three doses with two-week intervals. Comparatively, using alum as an adjuvant resulted in higher antibody titers with the same vaccination schedule.
Conclusion: It was observed that CS-NPs as an adjuvant could efficiently stimulate specific anti-receptor-binding domain IgG antibodies while exhibiting less toxicity compared to alum
Keywords: SARS-CoV-2, vaccine adjuvant, chitosan nanoparticles, RBD, specific IgG antibody.
Citation: Mahdi FM, Abdulamir AS, Taha AA. SARS-COV-2 prevention strategy receptor binding domain loaded with chitosan nanoparticles enhance antibody production. Iraqi JMS. 2025; 23(1): 58-63. doi: 10.22578/IJMS.23.1.7

Background: Colorectal cancer (CRC) is the third most common malignancy in both men and women. Rectal cancer and colon cancer are frequently considered to be the same condition due to their shared characteristics. Polyps in the colon are the first sign of the disease and can develop into a malignant tumor. Patients with colon cancer often die of tumor recurrence and metastasis. Butyl isothiocyanate belongs to the isothiocyanate family, which has more attention since they have a lot of biological activity. Additionally, acetylsalicylic acid the non-steroidal anti-inflammatory drug significantly lowers the antiproliferative activity of cancer.
Objective: To identify the anti-proliferative activity of butenyl isothiocyanate, acetylsalicylic acid and their combination against colon cancer cell line. In addition to identify the molecular mechanism evaluation of butenyl isothiocyanate by measuring vascular endothelial growth factor (VEGF) gene expression.
Methods: Butenyl isothiocyanate and acetylsalicylic acid antiproliferative activity against the CL40 cell line was determined using the (4,5-Dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide (MTT) test. Butenyl isothiocyanate gene expression levels were studied quantitatively using real-time polymerase chain reaction.
Results: Butenyl isothiocyanate, acetylsalicylic acid, and their combination demonstrated dose-dependent significant suppression of proliferation of the colon cancer cell line CL40 (P <0.001). Furthermore, butenyl isothiocyanate showed a fold diminishing in VEGF gene expression of 35.83 % (P <0.001).
Conclusion: Butenyl isothiocyanate, acetylsalicylic acid and their combination exhibited a significant antiproliferative effect. Furthermore, butenyl isothiocyanate\'s molecular mechanism of action was demonstrated to be the down-regulation of VEGF gene expression.
Keywords: VEGF, antiproliferation, Butenyl isothiocyanate, Acetylsalicylic acid, MTT, CL-40, colon cancer, gene expression
Citation: Mohamed SJ, Sahib HB. Anti-proliferative activity of butenyl isothiocyanate against colon cancer cell line. Iraqi JMS. 2025; 23(1): 64-74. doi: 10.22578/IJMS.23.1.8

Background: Staphylococcus aureus (S. aureus) could readily form biofilm, which innervates the drug resistance abilities, resulting in life threatening infections involving different organs. The biofilm formation occurs due to a series of developmental proceeds including bacterial adhesion, aggregation, biofilm maturation, and dispersion, which are controlled by multiple genomic regulatory systems in S. aureus strains.
Objective: Determination of the biofilm capability with revealing the antimicrobial sensitivity outcomes and their relationship with the genomic content of S. aureus including Methicillin resistant S. aureus (MRSA) isolates across Baghdad province.
Methods: In this cross-sectional study, 200 variable pathogenic samples were collected from different patients ages across several medical centers in Baghdad, Iraq. Biofilm ability forming examining, antimicrobial susceptibility testing, and polymerase chain reaction (PCR) were applied to determine the adhesion capability, resistance pattern and gene distribution among identified S. aureus isolates, as well as biochemical tests to confirm isolates demonstration.
Results: Out of 200 collected samples, only 130 coagulase positive cocci were approved, 72 MRSA being identified as verified groups of S. aureus isolates. As total, biofilm screening outcomes presents strong biofilm formation in 22 (18.92%) isolates, moderate in 24 (18.46%), weak in 26 (20.00%), and no-biofilm formation in 58 (44.62%) isolates. Across MRSA resistance-associated genes as mecA were detected respectively in 37 (80.4%). Genes within P value have been characterized into true-false ranges and presence-absent count. Antimicrobial screening showed most of isolates were sensitive to Gentamicin. Higher resistances were presented in Oxacillin and Rifampin. SCCmec pattern for MRSA was demonstrated according to PCR outcomes.
Conclusion:Results of this study signalized that S. aureus including MRSA should be theorized as a serious opportunistic to pathogen to be aware in all people ages and units. Gentamicin and Tigecycline are fairly recommende d to treat some of S. aureus infections. Biofilm consider an important issue in medication and remediation capabilities and there virulence fairly related with genomic variation and its continuous developments
Keywords: Staphylococcus aureus; MRSA; biofilm formation capacity; antibiotic resistance; genomic typing
Citation: Qader TA, Ali MR, Alsakini AH. Genomic investigation and biofilm characterization of Methicillin-resistant Staphylococcus aureus in Baghdad province. Iraqi JMS. 2025; 23(1): 75-82. doi: 10.22578/IJMS.23.1.9

Background: In scoliosis surgery, intraoperative somatosensory evoked potential (SSEP) monitoring has reduced the incidence of postoperative neurologic deficits. Many intraoperative environmental and systemic factors affect the amplitude and latency of SSEP waves during surgery.
Objective: To assess the role played by SSEP during spinal surgery in preventing postoperative neurologic deficits.
Methods: Pre-, intra- and postoperative tibial SSEP recorded in 51 patients with scoliosis undergoing surgical correction were analyzed. Recorded parameters include the P37 and N45 latencies and amplitudes.
Results: The intraoperative tibial SSEP latencies were significantly prolonged and intraoperative amplitudes were significantly reduced in comparison to baseline recordings. There was highly significant increase in the mean latency of alarm readings of tibial P37 and N45 waves from baseline. Likewise, there was statistically highly significant decrement in the mean amplitude of the alarm readings of tibial P37 and N45 wave from baseline. Pre- and postoperative latencies and amplitudes were compared; the differences were not significant.
Conclusion: The intraoperative SSEP neuromonitoring is valuable in the prevention of neurological injury during surgical procedures.
Keywords: Intraoperative monitoring, somatosensory evoked potential, scoliosis, total intravenous anesthesia
Citation: Khudhur AM, Al-Hashimi AF, Umara MU. Evaluation of intraoperative somatosensory evoked potentials during spine surgery for scoliosis. Iraqi JMS. 2025; 23(1): 83-91. doi: 10.22578/IJMS.23.1.10

Background: The rapid emergence of antibiotic resistance among various bacterial species has necessitated the development of alternative therapeutic options. Nanotechnology, particularly the production and surface modification of metal nanoparticles (MNPs), has gained significant attention as a promising approach in combating antibiotic resistance.
Objective: To explore a safe and cost-effective method for synthesizing iron oxide nanoparticles (IONPs) with unique shapes through ultrasound-assisted co-precipitation and to use it as a potential solution to the problem of antimicrobial-resistant bacteria especially multidrug-resistant bacteria.
Methods: IONPs were synthesized using an ultrasound-assisted method and characterized with techniques such ultraviolet-visible spectrophotometry (UV-Vis), energy dispersive of X-ray spectroscopy (EDX), X-ray diffraction (XRD), atomic force microscopy (AFM), zeta potential analysis, transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Antimicrobial activity was assessed using minimum inhibitory concentration (MIC) tests at 16 μg/ml and a well diffusion assay against Gram-negative bacteria and Gram-positive bacteria.
Results: IONPs had an average diameter size of 30 nm, displaying a spherical shape. At concentration of 16 μg/ml, the NPs was found to exhibit a MIC and displayed potent antimicrobial activity against wild-type multidrug-resistant strains of both Gram-positive and Gram-negative bacteria in vitro. Moreover, in vivo experiments showed that the IONPs led to a significant decrease in urothelial bladder cancer (UBC)-40 cell.
Conclusion: The US-assisted method utilized in this research for the synthesis of IONPs has proven to be suitable for producing IONPs with precise particle size and high product homogeneity. This efficient synthesis approach holds great promise, particularly in light of the alarming prevalence of multidrug-resistant bacterial strains.
Keywords: Fe2O3 NPs, UBC-40 cells, MRS.
Citation: Abas SQ, Ahmed ME, Hamid MK. Ultrasound-assisted synthesis of iron oxide nanoparticles: Application in cytotoxicity and antibacterial activity. Iraqi JMS. 2025; 23(1): 92-102. doi: 10.22578/IJMS.23.1.11

Background: Quaternary ammonium compounds (QACs) have represented one of the most visible and effective classes of antiseptics and disinfectant substances that are used in different parts of life including food production, water treatment, and healthcare such as hospitals to prevent infections and intoxications. The increased use of disinfectants containing QACs has raised concerns about the development of QAC resistance.
Objective: To determine the frequency of antiseptic-resistant QACs (qacA/B qacC and qacE gene) among Staphylococcus aureus (S. aureus), recovered from topical wound infection.
Methods: Two swab samples were collected from 200 patients complaining of burns, traumatic injury, and wounds after surgery, suspected isolates of S. aureus, which showed beta hemolysis on blood agar media further tested by inoculated on mannitol salt agar and incubated at 37°C for 24 hours, bacteria that showed the characteristic of the yellow colony were furthermore identified using VITEK-2 System. The efficacy of antiseptics Chlorhexidine (CLX), Benzalkonium (BZK), and Cetrimide was tested against S. aureus by well diffusion assay test and minimum inhibitory concentration procedure. The confirmed S. aureus isolates have been used for genomic DNA extraction from a fresh overnight culture after that DNA template was used to target (qacA/B, qacC and qacE gene) by using specific Primers sequences.
Results: Of 71 S. aureus, a considerable number of isolates 68 (95.8%) were resistant to CLX. Moreover, a substantial number of isolates 67 (94.4%) resistant to Cetrimide. No sensitive rate to BZK was observed in all isolates. qacA/B gene was identified in 48 (67.6%), while qacC gene was detected in 66 (93.0%). Furthermore, qacE gene was detected in 69 (97.2%) of 71 S. aureus isolates.
Conclusion: qacA/B, qacC and qacE genes that harbored resistance to QACs antiseptics are widespread among S. aureus isolates in wound and burn patients.
Keywords: Quaternary ammonium compound, antiseptic resistance gene, Chlorhexidine (CLX), Benzalkonium (BZK), Cetrimide.
Citation: Ahmed SS, Hassan JS, Mahdi QA. Detection of the quaternary ammonium compound antiseptic resistance gene (qacA/B, qacC and qacE genes) among Staphylococcus aureus recovered from wound infection. Iraqi JMS. 2025; 23(1): 103-112. doi: 10.22578/IJMS.23.1.12

Background: Mitochondria play a significant plays a function in sperm metabolism and energy generation. The cellular integrity of sperm evaluated by examination of mitochondrial membrane potential (MMP), which may be achieved by using fluorescent dyes like JC-1 probe (5,5,6,6-tetrachloro-1,1,3,3-tetraethylbenzimidazolyl carbocyanin iodide. Vitamin D3 (VitD3) increases men sterility can be improved by modifying hormonal balance through genomic as well as non-genomic mechanisms, while semen quality can be improved mostly through non-genomic effects. VitD3 effect a component of sperm motility, capacitation, and acrosome response, have been demonstrated.
Objective: To study the correlation between red MMP, VitD3 level and sperm motility.
Methods: The current experimental trial study was included 42 semen and blood samples. The sample of the study was subdivided into 4 groups according to sperms motility and VitD3 level the semen samples from 42 subjects of normozoospermic, asthenozoospermia according to World Health Organization (WHO, 2021). MMP Assay Kit (with JC-1) was performed.
Results: There was a positive significant correlation between serum VitD3 level and red fluorescence MMP (P <0.001). There was no significant correlation between serum VitD3 level and sperm motility percentage (P >0.05).
Conclusion: This study revealed a noticeable association between VitD3 level and sperm mitochondrial MMP assessed by fluorescent staining, which could be applied as a valid approach to evaluate the motility of sperm in Iraqi fertility centers.
Keywords: Infertility, vitamin D3, sperm motility, mitochondrial membrane potential, MMP Assay Kit (with JC-1).
Citation: Fiza AA, Farhan TM. Correlative Study between vitamin D3 level and sperm mitochondrial activity. Iraqi JMS. 2025; 23(1): 113-118. doi: 10.22578/IJMS.23.1.13

Background: BK Polyoma virus (BKPyV) is a ubiquitous virus and infect children at early age and becomes latent and it has been found as the main cause of hemorrhagic cystitis in hematopoietic stem cell transplantation patients, due to immunosuppression regimen that led to the activation of the virus from the latency status and lead to increased viral shedding in urine.
Objective: To find the frequency of BKPyV-DNA in urine (viruria) among acute lymphoblastic leukemia (ALL) patients as compared to healthy controls and compare it with age, sex, relapse and leukocytes level.
Methods: Urine samples were collected from 60 ALL patients, and 60 apparently healthy age and sex-matched children who were taken as a control group. The BKPyV-DNA in urine (viruria) was detected using real time polymerase chain reaction and Pap-stained urine cytology smears were checked to identify the presence of decoy cells (DCs).
Results: The BKPyV-DNA was detected in the urine of all patients (100.0%) and in 55.0% of control group (P <0.001) and all the patients were DCs negative. There was no significant effect of the positivity of viruria on neither leukocytes level nor on the occurrence of relapse in leukemia patients.
Conclusion: The very high frequency of BKPyV-DNA in urine (viruria) indicates the importance of reactivation of this virus in ALL patients with and without chemotherapy.
Keywords: Acute lymphoblastic leukemia, BK Polyoma virus, real time-PCR.
Citation: Ali SH, Abbas SS, Ali AH, Al-Obaidi AB. The frequency of Bk polyomavirus viruria in a sample of Iraqi children with acute lymphoblastic leukemia. Iraqi JMS. 2025; 23(1): 119-127. doi: 10.22578/IJMS.23.1.14

Background: Infliximab is a type of biologic medication used in the treatment of rheumatoid arthritis (RA) and other autoimmune conditions. While it can be highly effective for many patients, there are cases of early unresponsiveness to infliximab.
Objective: To investigate the predictive value of serum biomarkers, specifically tumor necrosis factor alpha TNF-), TNFRII, and interleuking-17 (IL-17), in identifying early non-responsiveness to infliximab in patients with RA.
Methods: In this case-control study blood samples were obtained from 100 RA patients (50 responders and 50 non-responders) and 100 age and sex matched apparently healthy control. Serum levels of TNF-, TNFRII, and IL-17 were measured by enzyme-linked immunosorbent assay.
Results: In patient group, the median serum level of (TNF-α and IL-17) were higher than those of control group with a significant difference. Additionally, the median serum levels of TNF-α, and IL-17 in non-responder patients were significantly higher than those in responder group. Although, there was a higher median level of TNFRII in non-responder patients, no significant differences were observed. TNFRII displayed a significant positive correlation with TNF-α. While IL-17 had a significant positive correlation with each of TNFRII and TNF-α. ROC test revealed that TNF-α had 81% sensitivity and 74% specificity at a cut-off value of 78.4 ng/l, while TNFRII had 80% sensitivity and 77% specificity at 7.8 ng/ml, and IL-17 had 80% sensitivity and 71% specificity at a cut-off value of 46.91 ng/l.
Conclusion: There was a positive association between elevated levels of TNF-α and IL-17 and early unresponsiveness to infliximab in RA patients.
Keyword:: Rheumatoid Arthritis, TNF-α, TNFRII, IL-17.
Citation: Fadhil ZJ, Abbas AA, Al-Osamai MH. Serum markers predicting early non-responsiveness to infliximab in rheumatoid arthritis: tumor necrosis factor (TNF)-Alpha, TNFRII, and interleukin (IL)-17 as potential indicators. Iraqi JMS. 2025; 23(1): 128-138. doi: 10.22578/IJMS.23.1.15

Background: Meningiomas are the most common benign intracranial tumors, making up about one-third of all primary brain tumors, some can cause issues due to difficult removal in sensitive or hard-to-reach areas. Gamma knife radiosurgery (GKR) is an effective treatment for meningioma.
Objective: To assess better planned treatments, such as multisession and hypofractionation, as well as single session stereotactic radiosurgery.
Methods: Fifty-two patients with meningiomas, diagnosed by neurosurgeons or oncologists, participated in a cross-sectional study at Saad Alwitry Hospital’s Gamma Knife Center. Gamma Knife therapy was administered by a specialist, with computed tomography (CT) and magnetic resonance imaging (MRI) used to evaluate the tumor characteristics. The dosimetry parameters used in this study are coverage, selectivity, gradient index (GI), and time (minutes). These parameters are obtained for each plan session.
Results: There were significant differences in the mean value of selectivity between the three groups, with the highest value among the patients who received multi-session doses of GKR (Gy) than those who received single and hypo sessions of GKR (Gy). The results also revealed non-significant and slight differences in the mean values of the GI between patients who received multi, single, and hypo sessions. Patients who received multiple sessions required fewer mean values of GKR shot numbers. This study also found that patients who received hypo-session GKR required less time (minutes) for gamma knife radiation therapy. Ultimately, the results showed the differences in tumor size (cm3) before and after GKR treatment according to doses given in the three sessions.
Conclusion: Multisession GKR therapy offers a low-morbidity alternative that is secure, efficient, and well tolerated for these large lesions. The meningioma multisession GKR is successful in reducing the size of large tumors.
Keywords: Gamma knife, stereotactic radiosurgery, coverage, selectivity, gradient index (GI), number of Shots (dose), tumor Reduction.
Citation: Ibrahim RT, Ahmed RS, Hassan YM. The evaluation of gamma knife indices for treatment planning (single session, multi-session, and hypofractionation) for gamma knife radiosurgery in patients with meningioma. Iraqi JMS. 2025; 23(1): 139-146. doi: 10.22578/IJMS.23.1.16

Background: Magnetic resonance imaging (MRI) detects soft tissue pathologies and lumbar disc illnesses such as bulging, herniation, spinal stenosis, and vertebral abnormalities. Three-dimensional (3D) isotropic MRI provides several benefits over two-dimensional (2D) turbo spin-echo sequences for musculoskeletal imaging.
Objective: To compare the image quality of 2D T2-weighted turbo spin-echo (2D T2W TSE) sequences to 3D T2-weighted turbo spin-echo (3D T2W TSE) sequences and estimate how physical parameters of patients, including age and sex, may impact the outcome of medical imaging.
Methods: Seventy patients with lumbar spine problems (mean age below 50) were examined. MRI scans were obtained with 2D T2W TSE and 3D T2W TSE sequences. Parameters assessed included image contrast, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and signal intensity, calculated using a region-of-interest tool.
Results: The findings demonstrated that 2D T2W TSE images exhibited significantly higher mean (230.59±64.4) signal intensity values, and greater signal intensity variability (2.92±0.61) than 3D T2W TSE images. Conversely, 3D T2W TSE images outperformed their 2D counterparts in signal-to-noise ratio (82.93±31.51) and contrast-to-noise ratio (40.55±14.95). A strong negative correlation was observed between age and both the mean signal intensity and SNR in 2D T2W TSE images. No significant association was found between age and any characteristics of 3D T2W TSE images. Furthermore, sex showed no significant correlation with any features of 2D or 3D T2W TSE images.
Conclusion: The research found increased signal intensity in 2D T2W TSE images and higher SNR and CNR in 3D T2W TSE images. These data imply that age may affect signal intensity measures from 2D T2W images, lowering image quality in older individuals. The lack of a significant link between age and 3D T2W TSE parameters shows that age-related changes may not impact 3D T2W TSE images.
Keywords: Magnetic resonance imaging, lumbar spine, 2D sequence, 3D sequence, image quality.
Citation: Awad NW, Ahmed RS, Zghair MA. Comparative diagnostic efficacy of 3D vs 2D T2-weighted MRI in assessing lumbar spine pathologies. Iraqi JMS. 2025; 23(1): 147-154. doi: 10.22578/IJMS.23.1.17

Background: The only method to stop the progression of glaucoma is to decrease intraocular pressure (IOP). Nesiritide is a natriuretic peptide that is effective in reducing blood pressure via his vasodilator action, which may be effective in reducing IOP.
Objective: To evaluate the efficacy of nesiritide 0.005% eye drops on IOP of ocular normotensive and betamethasone-induced ocular hypertensive rabbits in comparison with that of latanoprost 0.005% eye drops; besides, to study the safety profile of nesiritide eye drops.
Methods: This study included 36 male rabbits; 18 rabbits represented the ocular normotensive groups (control, latanoprost, and nesiritide) and the other 18 rabbits represented betamethasone-induced ocular hypertension groups (vehicle, latanoprost, and nesiritide). Tested drugs instilled as one drop twice daily for 7 days in normotensive and hypertensive left eye. The IOP was measured with the aid of Schiötz tonometer. Other examined parameters were pupil diameter, light pupillary reflex, corneal sensation reflex, and conjunctival redness which were recorded before starting the experiment and then daily before and after drug application for one week.
Results: This study revealed that nesiritide eye drops significantly reduced IOP since the 3rd day in both normotensive and steroid-induced ocular hypertensive model; yet, this effect was less potent than that of latanoprost eye drops. Nesiritde eye drops did not induce significant changes in the other examined parameters.
Conclusion: This study revealed the efficacy and apparent safety of nesiritide 0.005% eye drops in lowering IOP in both ocular normotensive and betamethasone-induced ocular hypertensive rabbits.
Keywords: Nesiritide, Latanoprost, intraocular pressure, glaucoma
Citation: Abdul-Jabbar MA, Al-Zubaidy AA. Ocular hypotensive effects of nesiritide 0.005% eye drops on ocular normotensive and betamethasone-induced ocular hypertensive rabbits. Iraqi JMS. 2025; 23(1): 155-163. doi: 10.22578/IJMS.23.1.18

Background: Bacteria can't grow without iron (Fe), and the majority of them actively seek out Fe ions via specialized proteins called siderophores.
Objective: To quantify the prevalence of yersinobactin irp2, salmonellochilin iroN, and aerobactin iucA siderophore genes in the virulent Iraqi strains of uropathogenic Escherichia coli (UPEC).
Methods: Fourteen E. coli strains that were previously isolated and diagnosed from urinary tract infections and biologically active siderophore producers. These strains were analyzed for the presence of three siderophore genes (iucA, iroN, and irp2) using conventional polymerase chain reactions (PCR).
Results: The frequencies of such iucA, iroN, and irp2 genes among the UPEC isolates were 3 (21.42%), 10 (71.4%), and 4 (28.6%), respectively.
Conclusion: Research suggests that siderophores can successfully reduce the pathogenicity of UPEC bacteria. Moreover, their primary function in infection differs depending on the siderophore type and concentration. Yersinobactin irp2 represented the main siderophore gene, followed by salmochelin iroN and aerobactin iucA.
Keywords: Escherichia coli, siderophore, aerobactin iucA, salmochelin iroN, yersinobactin irp2.
Citation: Younus HS, Mudallal NHA. Molecular detection of siderophore genes in Escherichia coli among Iraqi strains. Iraqi JMS. 2025; 23(1): 164-170. doi: 10.22578/IJMS.23.1.19

Background: New blood vessels are formed by two basic processes; namely ‎vasculogenesis and angiogenesis. Vasculogenesis is the de ‎novo formation of initial vascular networks. Once the vascular networks are ‎formed, new blood vessels are formed by sprouting or splitting from ‎pre-existing vessels in an angiogenesis process.
Objective: To investigate the anti-angiogenic activity of 2-(5-bromo - 1H- indole -2- carbonyl) -N- (4-chlorophenyl) hydrazine -1- carbothioamide indole derivative.
Methods: The antiangiogenic activity of the test Indoles derivative was ‎evaluated using the in-vivo chorioallantois membrane assay
Results: The tested compound significantly (P <0.05) distorted and suppressed the growth of blood vessels in the chorioallantois membrane assay
Conclusion: This study showed that (4-chloro phenyl carbothioamide indole derivative) significantly inhibits the ‎angiogenesis process and could be a potentially promising angiogenesis ‎inhibitor lead compound.
Keywords: Anti-angiogenesis, vasculogenesis, ‎chorioallantois membrane assay, 4-chloro phenyl carbothioamide indole derivative
Citation: Ali ZM. , Kadhim HM. Antiangiogenic activity of 4-Chloro phenyl carbothioamide indole derivative using the in vivo chorioallantois membrane assay. Iraqi JMS. 2025; 23(1): 171-176. doi: 10.22578/IJMS.23.1.20

Background: Polycyclic aromatic hydrocarbons are environmental pollutants prevalent in oil fields. This study examines their impact on human health in Basra.
Objective: To assess polycyclic aromatic hydrocarbon levels in individuals exposed to oil fields and their correlation with serum glutathione (GSH) levels.
Methods: A case-control study conducted from 15 January to 8 May 2024 involved 120 males aged 25 to 40 years. Group 1 consisted of 40 workers from Al-Rumaila field, Group 2 included 40 from West Qurna field, and Group 3 included 40 controls from the city center.
Results: Group 2 had lower polycyclic aromatic hydrocarbon levels than Group 1, while Group 3 had none. GSH levels were significantly lower in Groups 1 and 2 compared to Group 3. Workers with over 10 years of exposure had higher polycyclic aromatic hydrocarbon levels and lower GSH.
Conclusion: Polycyclic aromatic hydrocarbons significantly reduce GSH levels, posing health risks.
Keywords: Environmental pollutants, glutathione, polycyclic aromatic hydrocarbons.
Citation: Abdul-Khaleq MA, Abass HA, Al-Wasiti EA. Polycyclic aromatic hydrocarbons and glutathione levels in basra oil company workers (2024). Iraqi JMS. 2025; 23(1): 177-183. doi: 10.22578/IJMS.23.1.21

Background: Multidrug-resistant (MDR) bacteria cause a substantial health burden. Escherichia coli (E. coli) is one of the most common causative agents of bacterial infections in urinary tract infection (UTI) and emergence of multidrug resistant E. coli is a major public health threat worldwide. In this respect, recent studies have proposed bacteriophage (phage) therapy as a potential alternative therapy to antibiotics for treating MDR bacteria.
Objective: To evaluate the potential of bacteriophage therapy to treat a drug-resistant UTI caused by E. coli in rabbits.
Methods: This study was carried out during the period from September 2019 to February 2021 in Kirkuk Province. A total of 30 bacterial isolates of E. coli were collected from bacteriology isolated - clinical specimens. Full diagnostic procedures were conducted to confirm the diagnosis of E. coli; moreover, antibiogram was done to identify MDR E. coli isolates. Lytic phages were isolated using phage amplification assays. Phage cocktail was prepared accordingly. Rabbit animals with induced UTI were orally fed with E. coli specific phage cocktail. Phages and E. coli bacteria were isolated from urine of rabbits for evaluating the success rate of phage therapy.
Results: It was shown that four bacteria isolates did establish specific lytic phages for E coli. Orally-fed phages to E. coli were isolated from the urine of rabbits and peaked at the second day with continuous decline in titer over the third and fourth days after phage administration. The average titer plaque-forming unit/ml (PFU/ml) for E. coli specific phages was 46, 15 and 1 at the second, third and fourth days. Regarding the in vivo activity of phage on bacterial growth, the bacterial count in urine was shown to decline remarkably after 24 hr till 4 days after the oral administration of lytic phages. The decline in bacterial count in urine was highly significant and reached up to 7-8 log.
Conclusion: Phage cocktail therapy was shown to be effective in treating uropathogenic MDR E. coli and bacteriophage therapy was safe during this study and no side effects were observed.
Keywords: MDR, plaque-forming unit (PFU), colony-forming unit (CFU), phage therapy, E. coli, bacteriophage
Citation: Saqi HN.. Abdul Ameer AS. Phage therapy for treatment of UTI caused by multi-drug-resistant E. coli in vitro and in vivo study. Iraqi JMS. 2025; 23(1): 184-189. doi: 10.22578/IJMS.23.1.22