Al-Rafidain Journal of Medical Sciences

Background: Inflammatory bowel disease (IBD) encompasses chronic conditions that cause inflammation in the gastrointestinal tract, most notably Crohn’s disease and ulcerative colitis. Both diseases present with variable clinical features, with significant differences observed between pediatric and adult populations. Objective: To examine the clinical presentation, severity, and disease progression of IBD in children compared to adults. Methods: A retrospective observational analysis included patients diagnosed with Crohn’s disease or ulcerative colitis at a tertiary gastroenterology center over a 6-month period. Patients were allocated into pediatric patients (diagnosed at <15years) and adults (diagnosed at >15years). The collected data included demographical data, including age, sex, and body mass index. Clinical data including symptom duration, presenting symptoms, disease severity, and extraintestinal manifestations (EIMs). Results: A total of 100 patients (50 children and 50 adults) with confirmed diagnoses of IBD were included. While there was no significant difference in gender distribution between the child IBD and adult IBD cohorts (p=0.272), the BMI was significantly higher in adults (p=0.028). The clinical presentations were comparable between groups, except for higher duration of symptoms and weight loss in adults (p=0.012, 0.048, respectively). No statistically significant difference was observed in the frequency of EIMs, disease severity, and disease distribution between groups, except for a higher trend for pancolitis in child IBD (p=0.036). Conclusions: Pediatric patients with IBD may present with a more aggressive disease course and require tailored treatment strategies. Understanding these age-related differences is critical for optimizing early diagnosis, management, and long-term care of IBD patients.

Background: Stress is associated with structural and physiological changes in various organs, but its impact on kidney injury is not well-studied. Objective: To investigate the physiological changes in the kidneys of acutely and chronically stressed rats. Methods: Twenty-four rats were assigned to three groups (n=8). Negative control (NC): unstressed, acute stress (AS): exposed to cold-restraint stress for three hours, chronic stress (CS): exposed to chronic unpredictable stress (CUS) protocol for one month. The animals were sacrificed, and blood and kidney tissue were collected for assessment of kidney injury molecule-1 (KIM-1), cystatin C, serum creatinine, blood urea, interleukin-6 (IL-6), total antioxidant capacity (TAC), and complete blood count (CBC)-derived markers. Results: A significant elevation of KIM-1 and cystatin C levels in AS and CS groups and serum creatinine in rats exposed to CS was observed with a significant reduction in the serum level of IL-6 in acute and chronically stressed rats. TAC was elevated non-significantly in the AS group; however, it was significantly elevated in the CS group. CBC-derived biomarkers like neutrophil/lymphocyte, platelet/lymphocyte, and monocyte/lymphocyte ratios showed a significant increase in favor of inflammatory responses. Conclusions: Chronic and acute stress exert a detrimental effect on the kidney, with chronic stress resulting in more severe injuries. Chronic stress has a complex effect on antioxidants and inflammatory processes. This might be related to the adaptive physiological mechanism and/or alteration in the hematological parameters, which represents the stress-induced inflammatory process.

Background: Biological evidence confirmed the link between diabetic disease and cognitive dysfunction, but the exact mechanism is not fully understood. Alpha-7 nicotinic acetylcholine receptors (α7-nAChRs) are transmembrane receptors activated in response to neurotransmitters and play an important role in the mammal’s cognitive function. Objectives: To study the effect of metformin on α7-nAchRs expression in brain and spleen tissues of diabetic mice. Methods: Forty mice were allocated into 4 groups and were subjected to 7- and 12-week interventions. G1 was healthy, G2 experimentally induced diabetes without treatment, and G3 and G4 were diabetic mice treated with metformin (50 and 100 mg/kg, respectively). Blood glucose level was monitored during treatment. α7-nAChRs expression was evaluated by the immunohistochemical method after ending treatment. Results: In brain tissue, G1 showed strong expression (+2.5), and G2 weak (+1) for both periods. G3 and G4 revealed moderate (+1.5) staining in 7 weeks and weak (+1) in 12 weeks. In spleen tissues, G1, G2, and G3 showed strong staining (+3), but G4 revealed moderate (+1.5) in 7 weeks and moderate to strong (+3/+2.5) in 12 weeks. Conclusions: Diabetic mice exhibit low expression of α7nAChRs in the brain tissue, but those receptors were moderately recovered at 7 weeks of therapy duration by metformin, which may be a good therapeutic option for the management of dementia.

Background: Urolithiasis and hypertension are prevalent and clinically significant conditions in the Middle East, both influenced by shared metabolic and environmental risk factors. Understanding the potential association between them is important for guiding prevention strategies. Objective: To explore the relationship between urolithiasis and hypertension in a sample of Iraqi adult patients. Methods: A cross-sectional observational study was conducted at Al-Kindy Teaching Hospital, Baghdad, from September 2024 to March 2025. Participants included 237 patients with confirmed urinary tract stones and 244 controls confirmed to be stone-free, matched for age and sex. Exclusion criteria included secondary hypertension, chronic kidney disease (stage 3 or higher), pregnancy, and metabolic or hormonal disorders likely to alter the blood pressure. Blood pressure status was determined via history and repeated measurements. BMI and demographic data were collected. Statistical analysis included chi-square, Mann-Whitney U, and logistic regression models. Results: Hypertension was significantly more prevalent in the urolithiasis group than in the controls. Patients with urolithiasis also had significantly higher BMI. However, after adjusting for age and BMI, urolithiasis was no longer significantly associated with hypertension (OR=0.63; 95% CI: 0.39–1.01; p=0.056), while both age and BMI remained significant predictors of hypertension (p<0.001). Conclusions: Although a higher prevalence of hypertension was observed among patients with urolithiasis, this association was not statistically significant after adjusting for age and BMI. These findings suggest that shared risk factors, particularly obesity, may mediate the observed relationship.

Background: Sleep deprivation adversely affects both the central nervous system and immune function, leading to potential alteration in behavioral and physiological responses. Objectives: To evaluate the impact of varying durations of sleep deprivation on brain neurotransmitters and immune responses in male albino rats. Methods: A total of 32 rats were allocated into four groups: control, 18-hour, 24-hour, and 72-hour sleep deprivation. Sleep deprivation was induced using gentle handling and environmental noise. Brain levels of serotonin, GABA, and glutamate were measured, as well as serum markers including TNF-α, interleukin-6 (IL-6), and total antioxidant capacity (TAC). Inflammatory responses were also assessed through complete blood counts. Brain tissues were processed using standard histological techniques and stained with H&E, followed by semi-quantitative lesion scoring using image analysis software based on neuroglial pyknosis, vascular congestion, and perivascular edema, graded on a 0–100% scale. Results: Serotonin levels initially decreased after 18 hours of sleep deprivation but normalized by 24 and 72 hours. Glutamate levels rose progressively with longer deprivation, while GABA, TAC, and IL-6 remained stable across all durations. Sleep deprivation triggered time-dependent immune changes, beginning with lymphocyte alterations and progressing to increased monocytes and inflammatory ratios, along with elevated TNF-α levels. Histopathology showed time-dependent brain damage from sleep deprivation, with severe vascular and glial changes at 72 hours, aligning with inflammatory marker elevations. Conclusions: Sleep deprivation induces specific, duration-dependent alterations in neurotransmitter and immune profiles. Prolonged deprivation, especially at 72 hours, may provoke neuroinflammatory and anxiety-related behavioral changes.

A 13-year-old female with morphological features refers to an uncommon genetic syndrome. The patient has a history of congenital heart disease (pulmonary valve stenosis) and presented with right knee swelling that began 2 years after the trauma. The swelling has gradually increased in size, movement limitation, and pain. Blood investigations showed iron-deficiency anemia, a normal white cell count, and a platelet level. The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were slightly elevated later; both CRP and WBC were normal. A biopsy and MRI reported suspicion of a giant cell tumor. Genetic investigations for pediatric and adult patients might be essential for further understanding of this condition. Radiotherapy, when justified, could be a treatment option for certain patients who have undergone incomplete surgical resection. Early detection is necessary to avoid joint damage. MRI is the golden diagnostic; biopsy is not necessary with MRI availability.

Background: Hemophilia demands long-term care, profoundly affecting both patients and their families. Objective: To evaluate the burden and productivity loss encountered by caregivers of hemophilia patients and associated factors in Iraq. Methods: This cross-sectional study was conducted among caregivers of hemophilia A and B patients at the Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq. Caregiver burden was measured using the Arabic version of the Zarit Burden Interview (ZBI-12) via face-to-face survey. Caregivers' productivity loss was assessed by determining annual income loss and missed workdays. Data were collected from November 2024 to February 2025. Results: The study recruited 109 caregivers. The mean caregiver burden score of 29.56 reflects a high level of strain, particularly in emotional distress, stress, health impact, and loss of personal time. Families with more than one hemophiliac had significantly higher burden scores (33.79) compared to families with one patient. Mothers had the highest burden scores compared to fathers and other caregivers, but no significant difference was found among these groups. Caregivers reported an average of 16.2 missed workdays annually due to caregiving responsibilities. Conclusions: The Zarit Burden Interview revealed a high caregiver burden, especially due to emotional strain, the stress of balancing responsibilities, and health challenges. Families with multiple children with hemophilia experience an even greater burden. The study recommends providing financial aid, counseling, and mental health services to help caregivers manage emotional strain and stress.

Background: The adoption of artificial intelligence is rapidly expanding and has significantly influenced orthodontic practice. Objective: To investigate specialized orthodontists' perceptions and attitudes toward artificial intelligence in orthodontic practice. Methods: An anonymous, web-based cross-sectional survey was conducted using Google Forms. An expert panel evaluated the survey instrument for content validity using Lawshe's method and for face validity by measuring inter-rater reliability. The survey comprised 25 closed-ended and one open-ended question organized into six sections. After its official release, the survey link was disseminated to all Iraqi Orthodontic Society members from January to March 2025. Descriptive statistics were performed to categorize the age groups of the participants. Results: 101 valid surveys were collected and analyzed, highlighting a 63% response rate. The results revealed that although most respondents (61.4%) were aware of using AI-driven software programs, a significant percentage (40.6%) reported that they had never used such programs, underscoring a certain level of deficiency in applying AI in orthodontic practice. The awareness level was higher for AI applications in cephalometric analysis (60.0%) compared to other applications, such as orthognathic surgery and the biomechanics domain. Conclusions: Generally, there was a good level of awareness and knowledge about AI's role in orthodontics, with strong readiness among the specialists to engage in AI-related training and integrate it into their clinical routines. The study supports further education, training, evidence-based validation, and designing more AI-powered tools addressing different domains of orthodontics, particularly biomechanics, which are essential to bridge the trust gap.

Background: Vitiligo is an autoimmune disease characterized by the loss of melanin pigment in the body, while interleukin-6 is a key indicator in activating the immune response associated with autoimmune diseases. Objective: The current study aims to understand vitiligo patients' immune and protein mechanisms using principal component analysis (PCA). Methods: The study involved 150 participants divided into three groups: patients treated with NB-UVB (PUV), newly diagnosed patients (PN), and healthy controls (C). Serum IL-6 concentrations were measured using ELISA, while total protein, albumin, and globulin were determined using colorimetric analysis. Principal component analysis (PCA) was used to identify statistically significant trends in the variables' distribution among various groups. Results: PCA analysis shows that biological variation among participants was primarily attributable to specific variables, most notably the albumin/globulin ratio and IL-6 concentration. A clear distinction was observed between healthy individuals and vitiligo patients, while the two disease groups (PUV and PN) showed similar biochemical and immunological characteristics, with some minor differences remaining. IL-6 and globulin levels significantly increased in both patient groups compared to the control group, although total protein, albumin, and A/G ratio levels significantly decreased. Conclusions: PCA analysis revealed IL-6 and albumin-to-globulin ratio as key factors influencing biological variation in vitiligo, highlighting immune responses and proteomic abnormalities as potential biomarkers for disease assessment and treatment.

The advanced glycation end products (AGEs) are created by reactions involving a nonenzymatic glycation of lysine or arginine of proteins, and then additional glycoxidation due to oxidative stress occurs. They are part of the secondary stages of traumatic brain injury and the initiation and aggravation of several conditions, such as diabetes mellitus, Alzheimer's disease, and atherosclerosis. Receptor for AGE, also known as receptor for advanced glycation end product (RAGE), interacts with AGEs and produces intra- and interprotein cross-linkages that deactivate different enzymes and accelerate the course of illness. There is rising interest in targeting the AGE-RAGE pathway as a potential therapeutic intervention by developing AGE inhibitors, AGE-breaker compounds, RAGE antagonists, and exogenous sRAGE administration to treat AGE-related diseases, including diabetes mellitus and various neurodegenerative diseases. This implies that AGEs play a substantial part in the etiology of many diseases, and addressing the AGE-RAGE pathway might bring about new therapeutic options.

Cancer cells often evade regulated cell death to maintain uncontrolled proliferation and withstand therapy. Targeting cell death pathways has emerged as a promising tactic for enhancing anticancer outcomes and overcoming treatment resistance. In addition to highlighting recent developments in therapeutic interventions, this review investigates the molecular mechanisms underlying the various forms of regulated cell deaths in cancer. We discuss small molecule inhibitors and immune-based approaches that take advantage of cell death pathways. Additionally, we address difficulties in clinical translation, such as tumor heterogeneity and off-target effects. This work offers insights into precision therapies that aim to manipulate cell death for better cancer treatment by clarifying the interplay between oncogenic signaling and cell death susceptibility.

Background: Nephrotoxicity induced by chemotherapy is a common side effect of many anticancer drugs. Objective: To evaluate the effect of ertugliflozin (ERTU) and lycopene (LYCO) against ifosfamide (IFO)-induced nephrotoxicity. Methods: 56 rats were divided into eight groups: negative control (NC), positive control (PC), control vehicle (CV), ERTU: ertugliflozin 20mg/kg, LYCO: lycopene 30mg/kg, IFO+ERTU, IFO+LYCO and IFO+ERTU+LYCO. On the 12th, 13th, and 14th days of the experiment, IFO 50 mg/kg was injected into PC, IFO+ERTU, IFO+LYCO, and IFO+ERTU+LYCO rats. Urine was collected for urinalysis. Blood and kidney tissue were harvested for oxidative stress, CBC-inflammatory and kidney injury biomarkers, and histopathological assessment. Results: IFO resulted in hematuria and proteinuria, elevation of cystatin C, kidney injury molecule-1 (KIM-1) in kidney tissue, and a reduction in total antioxidant capacity (TAC). Platelet-to-lymphocyte ratio (PLR), platelet-to-monocyte ratio (PMR), and hemoglobin-to-lymphocyte ratio (HLR) increased significantly with histopathological alteration in kidney tissue. IFO+ERTU and IFO+ERTU+LYCO groups showed alleviation in the hematuria, proteinuria, and cystatin C. KIM-1 was significantly reduced in IFO+ERTU and non-significantly in IFO+LYCO and its combination. IFO+ERTU, IFO+LYCO, and IFO+ERTU+LYCO groups showed elevation in TAC. In IFO-exposed animals, ERTU resulted in a significant reduction in PLR and HLR and PMR non-significantly, and LYCO+ERTU significantly reduced PLR. Conclusions: ERTU and LYCO alone and in combination alleviated kidney injury parameters and the histopathological lesions. These findings suggest that ERTU and LYCO are effective nephroprotective agents against IFO-induced nephrotoxicity. The suggested mechanisms are attributed to their antioxidant and anti-inflammatory actions for both diuretic and natriuretic properties for ERTU.

Background: Deliberate self-harm (DSH) is a maladaptive behavior mostly found in youth. This study examines problem-solving skills (PSS), coping strategies, and cognitive distortion in youth who engage in DSH. Objectives: The study investigated the association of coping strategies, problem-solving skills, and personality with self-harm behaviors and the severity of anxiety and depression. Methods: This cross-sectional observational study was conducted in a tertiary care hospital in Eastern India. Seventy-five participants of both genders, aged 15-29 years, were selected. Socio-demographic details, PSI, coping strategies, dichotomous thinking (DTI), and personality traits were assessed using appropriate psychological tools. Anxiety and depression were measured with the Hamilton Anxiety Rating (HAM-A) and Hamilton Depression Rating (HAM-D) scales. Results: The mean age of the 75 participants was 22.7 years. Gender analysis showed minimal differences in problem-solving and coping strategies. Positive correlations emerged between problem-solving and coping skills (r=0.347, p=0.002) and problem-solving and independence (r=0.238, p=0.040). Anxiety was associated with self-control (r=0.283, p=0.014) and tough-mindedness (r= -0.565, p<0.001). Conclusions: The study showed how thinking patterns, emotions, and personality traits affect self-harm in young people, highlighting the need for tailored therapies like cognitive behavior therapy and DBT.

Background: Chronic osteomyelitis of the femur is a complex orthopedic challenge that needs comprehensive surgical and antibiotic treatment. Bone guttering with myoosseous muscle flap coverage offers promising outcomes in controlling infection and enhancing tissue healing. Objective: To assess the effectiveness of bone gutter and myoosseous muscle flap in adult males with chronic femur osteomyelitis. Methods: A prospective case series study enrolled 24 male patients with chronic femoral shaft osteomyelitis. (62.5%) Cases were managed by bone guttering, myoosseous muscle flap, or implant removal followed by the same procedure (37.5%). Antibiotics were given based on culture and sensitivity, and the Cierny-Mader classification was used for staging. The clinical outcome was assessed by infection resolution, wound healing, and recurrence rates over 24 months of follow-up. Results: The mean age was 29.00±6.56 years. All cases presented with discharging sinus, Staphylococcus aureus (50.0%), and Streptococcus (25.0%), which were the most frequently reported microorganisms. 50.0% of cases were treated with fusidic acid, followed by Augmentin (25%) for 6 weeks. After 2 years of follow-up, complete infection resolution and healing were achieved (100.0%). Conclusions: Bone guttering with myoosseous muscle flap is a simple, reproducible, and highly effective management strategy for chronic femoral osteomyelitis. The approach achieved complete bone infection control when combined with targeted antibiotics. Larger multicentric studies are recommended to generalize these findings.

Background: Chondroblastomas are uncommon benign cartilage-forming tumors that are usually found in the epiphyses of long bones in skeletally immature patients. Though their benign nature is well appreciated, their proximity to the joint surface and growth plate creates management challenges. Objective: To review the presentation, surgical intervention, and outcome of 12 cases of chondroblastoma around the knee. Methods: We retrospectively reviewed 12 patients with histologically proven chondroblastoma of the distal femur, proximal tibia, or patella. Curettage and bone grafting were performed in all the patients with careful attention to exposure and articular cartilage preservation. Clinical presentation, imaging, operative findings, complications, and follow-up results were recorded. Results: There were nine males and three females, aged between 14 and 38 years. Seven tumors were found in the proximal tibia, four were found in the distal femur, and one was found in the patella. MRI played a crucial role in defining the size and site of the lesions. Seven tibial cases were treated by a posterior approach, and femoral and patellar lesions by parapatellar approaches. All the patients showed complete recovery with consolidation of bone on radiographs and attained complete functional recovery without recurrence after a minimum follow-up period of 12 months. Conclusions: Chondroblastomas of the knee area are challenging for diagnosis and surgery because of their location. Early diagnosis and proper surgical strategy with meticulous curettage and bone grafting can lead to excellent results. Knowledge regarding this tumor's imaging and clinical presentation enables early intervention and good prognoses.

Background: Intralesional injections of vitamin D and bleomycin have gained growing clinical interest in the treatment of recalcitrant plantar warts, with pain as a major limitation associated with their use. Objective: To assess the clinical outcomes of vitamin D and bleomycin in managing treatment-resistant plantar warts. Methods: An interventional comparative study conducted on patients diagnosed with recalcitrant plantar warts over 9 months and not treated for two months. Patients were divided randomly into two groups: group A (24 patients received intralesional vitamin D) and group B (24 patients received intralesional bleomycin). The clearance rate and pain score were estimated by visual analogue scale (VAS). Results: 48 patients were enrolled in the study. Bleomycin produced significantly greater reduction in wart size at early time points (2, 4, 6, and 8 weeks). Vitamin D also resulted in wart size reduction but with less consistency. By the 4-month follow-up, both treatment groups showed substantial clearance, with no statistically significant difference in overall outcomes. Vitamin D produced significantly lower pain scores at 1, 2, and 3 weeks, indicating better tolerability. By week 8, VAS scores between the groups converged and were no longer significantly different. Conclusions: Intralesional bleomycin and vitamin D are effective in the treatment of recalcitrant plantar warts. Bleomycin produced more rapid lesion regression, whereas vitamin D exhibited a more favorable tolerability profile.

Background: Type 2 diabetes mellitus (T2DM) is a major health problem in Iraq. In Erbil, differences in access to healthcare, socioeconomic level, and taking medications as directed made treatment much harder. Few studies are conducted on these dynamics outside of clinical settings, where selection bias might hide problems that happen in the real world. Objectives: To find out how socioeconomic and clinical characteristics, as well as the rate of medication adherence, affect glycemic control in people with T2DM. Methods: Community-based cross-sectional research was undertaken on 400 T2DM patients in Erbil, purposefully sampled from mosques, salary-collecting places, public parks, the Ministry of Education, and retirement offices. Data were obtained by standardized questionnaires, encompassing demographics, occupation, medication adherence, and health-seeking behavior. Glycemic control was categorized using HbA1c values. Results: Out of 400 participants, 38 had controlled diabetes, while 90.5% had uncontrolled T2DM. Only 40.8% adhered to their suggested regimen. 28.3% were obese, 45.8% overweight, and 26.5% had normal BMI. The primary adherence challenges were financial restrictions, lack of regular follow-up, and insufficient health literacy. Obesity and being overweight were highly connected with poor diabetic control. Conclusions: Uncontrolled diabetes is dangerously common in Erbil’s society, driven by medication non-adherence and obesity. Public health policies must focus on pharmaceutical preparation costs, weight control measures, and community diabetes education, especially targeting jobless and low-income groups—to improve results.

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease. Gene polymorphisms of cytokines play a pivotal role in their pathogenesis and are able to modulate susceptibility and responsiveness for RA treatment. Objective: To investigate the serum expression of the rs1800795 variant of interleukin-6 (IL-6) and its association with disease severity and tumor necrosis factor (TNF)-α inhibitor response in RA. Methods: A case-control study was conducted, including 100 patients with RA and 100 healthy controls. Serum levels of IL-6 were measured. Genotyping of the IL-6 rs1800795 polymorphism was performed using TaqMan real-time PCR. Disease activity was assessed using the Clinical Disease Activity Index (CDAI), and treatment response was evaluated after six months of TNF inhibitor therapy. Results: Rheumatoid arthritis patients had significantly greater levels of IL-6 compared to the control group (p<0.001), with the diagnostic accuracy area under the curve (AUC) equal to 0.999. The mutant C allele of rs1800795 was significantly associated with increased RA risk (OR=1.70, p=0.022) and poor response to TNF inhibitors (OR=2.26, p=0.009). Higher IL-6 levels and the presence of the CC genotype were correlated with higher disease activity and lower treatment responsiveness (p<0.001). Conclusions: Elevated serum IL-6 levels and carriage of the IL-6 rs1800795 C allele are associated with susceptibility to RA, disease severity, and reduced response to TNF inhibitors. These findings prove the therapeutic potential of the IL-6 biomarker for patient stratification and optimized therapeutic strategies in RA therapy.

Background: Evidence-based medical studies support the effectiveness of silver diamine fluoride (SDF) in removing or even suppressing caries lesions, considering it a non-invasive treatment modality in dental health care. Objective: Investigate the impact of zinc nanoparticles on the antibacterial activity, cytotoxicity, and optical properties of modified SDF. Methods: Mix zinc nanoparticles with SDF filling material in three variable ratios to create four experimental groups. The microbial sensitivity test for these groups was performed by measuring the diameters of the inhibition zones on the Muller-Hinton agar medium. Cytotoxicity assessment using the MTT test, by ISO-10993-5 guidelines, examined the cellular viability. A spectrophotometer analysis was used to evaluate the absorption in wavelengths ranging from 190 to 780 nm. Results: Revealed a dose-dependent efficacy of zinc nanoparticles with a better antibacterial effect than SDF alone; the cell bioavailability of zinc experimental groups remains within the acceptable measurements. Spectrophotometry was not correlated with adding zinc nanoparticles, especially within the visible light range. Conclusions: Mixtures of zinc nanoparticles with SDF were found to have more effective activity against the three human pathogens. At the same time, their cytotoxic pictures are acceptable but without a remarkable color change and aesthetic enhancement.

Background: Acute myeloid leukemia (AML) is a genetically heterogeneous leukemia characterized by abnormal myeloid blast accumulation, disrupting normal hematopoiesis and leading to rapid progression. Objective: To investigate SNPs within the 3’UTR of the CCAAT/enhancer-binding protein alpha (CEBPA) gene and its association with AML in Iraqi patients. Methods: The study was carried out on 120 AML patients classified into newly diagnosed, induction chemotherapy, and consolidation chemotherapy stages (40 each), and 40 individuals as a control group. Genomic DNA was extracted from AML patients and controls, followed by PCR amplification and Sanger sequencing of the 3’UTR region of the CEBPA gene. The AML patients were characterized by age, sex, FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD), Nucleophosmin1 (NPM1) mutations, the French-American-British classification (FAB), and the World Health Organization (WHO). Results: The results revealed significant age differences among AML subgroups and notable hematological abnormalities, including reduced hemoglobin and platelet levels. According to the WHO classification, PML-RARA emerged as the most frequent fusion transcript. Based on FAB classification, M3 was the most common, followed by M4 and M0. The NPM1 mutations were more common than FLT3-ITD. The sequencing of the CEBPA 3′UTR region identified 83 variants, including 46 novels, 14 new forms of known SNPs, and 23 registered SNPs, reflecting substantial regulatory heterogeneity in this non-coding region. Conclusions: The CEBPA 3′UTR mutations reveal considerable genetic diversity among Iraqi AML patients, suggesting a potential regulatory role.