Medical Journal of Babylon

The present review deal with the role of free radicals in cancer initiation and development because of the importance of free radicals in signal
cascade transition of the cells in addition to defense properties against inflammation, the negative function of free radicals when the cells
unable to equilibrate the excessive production of free radical which lead to a harmful effect in cell components such as lipid peroxidation,
protein structure alteration, and DNA mutation and structural modification of nucleic acid. This review deal with free radicals generation,
function, and its role in different cancer stage starting with initiation, survival, development, proliferation, invasion, and angiogenesis, can be
concluded the role of oxidative stress in our healthy life and use it as one of the cancer therapy strategies in the future.

Background: There is controversy about the role of beta‑blockers in the number of acute exacerbations in patients with chronic obstructive
pulmonary disease (COPD). Objectives: The study aimed to find the role of beta‑blockers using in the exacerbation number in patients with
COPD in the presence of cardiovascular diseases (CVDs). Materials and Methods: In this comparative study, patients who attended the
internal medicine department of two general hospitals in Erbil city and diagnosed with COPD with any CVD were included between April and
November 2018. Results: The beta‑blocker‑using COPD patients were older compared to nonusing beta‑blocker COPD patients (64.67 vs.
59.95 years, respectively) and had more comorbidities of myocardial infarction (28.1%) and heart failure (28.1%) (P < 0.001). The study showed
no significant difference in acute exacerbations (0.50 vs. 0.47; P = 0.821), forced expiratory volume 1 level (62.19 vs. 60.44; P = 0.544), between
the user and nonuser beta‑blockers, respectively. There was no significant difference in the number of acute exacerbations between COPD
patients with CVD and without comorbidity in beta‑blocker users; 0.45 versus 0.50; P = 0.820. While in nonusers of beta‑blockers, the COPD
patients with CVD had a significantly higher number of exacerbations (1.29) compared to those COPD patients without comorbidity (0.45;
P = 0.020). The COPD beta‑blocker using patients with CVD had significantly less number of exacerbation compared to those COPD nonusing
beta‑blocker patients with CVD. Conclusions: The present study showed that COPD patients who used beta‑blockers have a substantially
lower number of acute exacerbations in the last year compared to those COPD patients who did not use beta‑blockers.

Background: Nanomaterial concerned to an incidental, natural, or synthesized material containing particles utilized for curing several diseases
and keeping for human with animals health; it is either in an unbound condition or as a combination in which one or more external measurements
in the size range of 1–100 nm. Objectives: The study intended to assess the possible mitigating outcome of the reference pentoxifylline by
progressed a new manner of poly (lactic-co-glycolic acid) (PLGA) nanoparticles loading with pentoxifylline on induced thin layer endometrial
in female rats. Materials and Methods: PLGA nanoparticle was made by employing two procedures included nanoprecipitation technique
and double emulsion solvent evaporation method. The experiment firstly was achieved numerous of diagnostic tests to the knowledge of
PLGA nanoparticle characteristics that involved ultraviolet (UV) spectrophotometer test. Results: UV spectrophotometer test shown for
Pentoxyfilline absorbance (0.300124), at wave length (2979) and PLGA- loaded Pentoxyfilline absorbance (3.07877), at wave length 1565),
while other tests (scanning electron microscope, cumulative %; encapsulation drug efficiency loading, and zeta) of PLGA-nanoparticle
appeared (28.35 nm-35.45 nm, (8.48, 93.3 at maximum wavelength 275 nm, (−13.44 mV), with mobility (−1.05 [μ/s]/[V/cm]) respectively.
Conclusion: Regarding the characterization of PLGA displayed in this study, it can be concluded that DMSO related organic phase alone
gives the shape, particle size with a small diameter, negatively charged in addition to suitable LD, EE with suitable stabilizer. Also, PLGAPentoxyfilline
regimen treatment with different doses had the ability in recovery of female rats that exposed experimentally induced thin layer
endometrium in the uterine horn by ethanol.

Background: Hepatitis C virus (HCV) is the most common cause of post transfusion non‑A, non‑B hepatitis worldwide. The prevalence
of HCV in blood donors in high‑income countries ranges from 0.002% to 0.05%, in middle‑income countries ranges from 0.03% to
0.80%, and in low‑income countries, prevalence varies from 0.50% to 2.23%. Objectives: The objectives of this study are to assess the
seroprevalence and the trend of HCV in healthy voluntary blood donors at a tertiary care hospital in Ahmedabad over a period of 3 years.
Settings and Design: Observational, retrospective study. Materials and Methods: During January 2017 to December 2019, 9477 voluntary
blood donors were tested for the presence of anti‑HCV antibody by using a 3rd‑generation enzyme‑linked immunosorbent assay test.
Statistical Analysis Used: Data were statistically analyzed by using the Chi‑square test, and Chi‑Square test for linear trends using the Statistical
Package for the Social Sciences (SPSS) software trial version 19. Results: Out of 9477 voluntary blood donors, 9229 (97.38%) donors were
male and 248 (2.62%) were female. Ten donors (0.11%) were positive for anti‑HCV. All seropositive donors were male. Out of total 0.11%
seropositive donors, maximum (0.07%) were within the age group of 21–30 years. Seroprevalence of HCV showed a statistically significant
decreasing trend over 3 years. Conclusion: Hepatitis C is a common cause of transfusion‑related hepatitis. Early identification of persons with
chronic HCV infection would enable infected persons to receive the necessary care and treatment to prevent or delay the onset of liver disease.

Background: Patients with rheumatoid diseases are at increased risk of infection due to a combination of inherent energy or immunomodulating
drugs used for its treatment. The study aimed to screen for latent tuberculosis infection (LTBI) among patients with rheumatologic diseases.
Materials and Methods: In the present prospective cross‑sectional study, a total of 149 patients diagnosed with different types of rheumatoid
diseases were included. The rheumatic diseases were diagnosed based on the American College of Rheumatology criteria for rheumatoid
arthritis (RA) or the European Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. The
patients were screened by interferon‑gamma release assay and tuberculin skin tests using purified protein derivative. Results: The mean age
of the patients was 39.91. The most common types of diseases were ankylosing spondylitis (37.6%) and RA (34.9%). The prevalence rate of
LTBI was 12.1% among rheumatic patients. The patients with positive LTBI had significantly longer therapy duration (4.51 vs. 2.81 years,
P < 0.001) and were older (48.61 vs. 38.72 years, P = 0.005), respectively. There was no statistically significant association between the disease
types and LTBI positivity (P = 0.512). However, LTBI positive was more prevalent in patients who received rituximab (16.7%; P = 0.035)
and those patients with past medical history (20.9% vs. 8.5%, respectively; P = 0.035) and those did not receive the bacillus Calmette–Guérin
vaccination (36.4% vs. 10.1%; P = 0.029). Conclusions: This study suggests that patients with rheumatoid diseases and treated with anti‑tumor
necrosis factor therapies are at an increased risk of tuberculosis infection.

Background: The prevalence of gastrointestinal (GI) symptoms is high in patients with chronic renal failure. Peptic ulcer disease occurs in
up to one‑fourth of them. Many factors are implicated in its causation including Helicobacter pylori infection. Objective: The objective of the
study was to determine the prevalence of H. pylori seropositivity in patients with GI symptoms and chronic renal failure compared with the
prevalence of H. pylori seropositivity in patients with GI tract symptoms with normal renal function and to evaluate the importance of different
factors that affect its prevalence depending on serological test for immunoglobulin level against H. pylori. Materials and Methods: This
case–control study was done at the Department of Medicine, at Al Yarmook Teaching Hospital, Baghdad, Iraq. During the study period from
January to June in 2004, ninety patients with chronic renal failure were interrogated for dyspeptic symptoms and 2 mL of blood was withdrawn
for ELISA test for anti‑H. pylori serological examination. Twenty‑five dyspeptic patients with normal renal function were examined as well as
control group. Results: from 90 patients with chronic renal failure, 42 patients were on hemodialysis and 48 patients were on peritoneal dialysis.
There were 52 males and 38 females with age ranging 45.3 in male and female 43.1, respectively. The percentage of positive anti‑H. pylori
antibody was 60%. Only 44% of the control group had positive anti‑H. pylori results. There was no statistically significant difference between
anti‑H. pylori positive and negative status in patients on hemodialysis, peritoneal dialysis, and control group regarding male and female gender.
Again, there was no statistically significant difference in serpositivity in relation to epigastric pain and those without epigastric pain in the
group of hemodialysis, peritoneal dialysis, and control group. Patients on peritoneal dialysis with dyspepsia of < 10 years had statistically
significant seropositivity compared to those more than 10 years of epigastric pain. Those patients with hemodialysis and control group have
no relation of seropositivity with dyspepsia duration. Conclusions: H. pylori serpositivity of patients with chronic renal failure was similar
to that of the control. There is no relation between dyspepsia and H. pylori serpositivity. Long‑term dialysis is associated with a decreased
prevalence of H. pylori.

Background: Melatonin, a neurohormone produced by the pineal gland, has recently been reported in foods, mainly of plant origin. Melatonin
provides a number of benefits for human health. It has many important health benefits because it is a potent antioxidant and anti‑inflammatory
hormone. Objectives: The aim of this work is to investigate the relationship between malnutrition and food deprivation on melatonin levels
in normal individuals in comparison with people suffering from gastrointestinal diseases. This study will focus on the nutritional factors apart
from the intake of tryptophan that affects melatonin levels in humans. Materials and Methods: This study reported interests regarding the
optimization, validation, and application of analytical liquid extraction and high‑performance liquid chromatography (SYKAM) coupled to a
fluorescence detector for the determination of melatonin in rice grains and blood samples. Results: In the present study, the results showed that
there were significant differences between the three study groups, where the lowest values for melatonin hormone concentration were found
in Group C as 2.033 ± 0.69 pg/mL which includes people suffering from famine, whereas the results of Group B showed clear differences
of concentration than that in Group (C) as 3.520 ± 0.62 pg/mL which includes patients who were in hospital suffering from diseases and
disorders of the digestive system, but at the same time their values were less than that of the healthy control Group A as 6.457 ± 0.59 pg/mL.
Conclusion: Based on the present study, it can be concluded that melatonin hormone levels are highly deficient in people who are suffering
from poverty, deprivation, and starvation compared to people with problems and disorders of the digestive system.

Background: Urinary tract infections (UTIs) are among the most frequent infections in clinical practice. They are classified into uncomplicated
UTIs and complicated UTIs. The majority of UTI cases are caused by a single bacterial agent. Diagnosis of UTIs is generally established based
on urinalysis and urine culture and treated with appropriate antibiotics. Objectives: The aim of this study was to determine the prevalence and
characteristics of uncomplicated recurrent UTI among adult females. Materials and Methods: This study is a cross-sectional study conducted
in the outpatient clinics of Al-Hilla Teaching Hospital and Babil Hospital for Maternity and Childhood during the period from February till
June 2020. Data were collected using a specially designed questionnaire, and a total of 300 participants were included. Results: The overall
prevalence of uncomplicated UTI was found to be 36%. The mean age of patients was 28.94 ± 7.42 years. Ninety percent of the patients were
married. The proportion of recurrent UTI among married women was significantly higher than that among nonmarried women (P = 0.001),
and recurrent UTI was significantly higher among women with family history of UTI (P < 0.001). Conclusions: This study concludes that
the prevalence of uncomplicated UTI among adult females in Babylon governorate is 36%, with the majority of cases within the age group
of 20–29 years. Recurrent UTI was found to be linked to marital status and positive family history.

Background: Coronary artery disease (CAD) and its major manifestation of acute myocardial infarction (MI) are considered as the most common
causes of morbidity and mortality worldwide. MI in very young group of age is a significant issue to focus on, however there is a scarcity of data on
premature coronary heart diseases‑acute MI (AMI) in this group of age. This may underestimate the important difference that exists between young
and old groups of age. Objective: The main aim of this study is to evaluate the most common risk factors, including hyperlipidemia, smoking, diabetes
mellitus (DM), hypertension, and positive family history of AMI with their angiographic profile, among Iraqi patients of <35 years old. Materials
and Methods: This study was enrolled in Surgical Specialty Hospital‑Cardiac Center, Erbil, Iraq among 100 consecutive patients (77 males and
23 females) between November 2016 and December 2017 of those whose age was ≤35 years. Results: The mean age was 31.6 ± 2.91 years with
an age range of 24–35 years. The incidence of AMI was significantly higher in male patients than females. The most common risk factors were
hyperlipidemia (51%), smoking (49%), family history of premature CAD (44%), hypertension (25%), and DM (22%). The most common symptom
and presentation of CAD was chest pain and anterior wall myocardial infarction, 67% and 64% respectively. About 56% of all the included patients
who underwent Coronary Angiography, had obstructive CAD and among this group 89.2% had single vessel disease, 5.35% had three vessel disease,
3.57% had double vessel disease and 1.78% had abnormal characteristic of coronary artery (Muscle Bridge). The most common involved artery was
the left anterior descending (LAD) (36%), followed by the right coronary artery (9%). Based on the electrocardiogram findings, 42% of the patients
presented with ST‑segment elevation myocardial infarction. Conclusion: CAD in patients younger than 35 years occurred more in the male gender.
Hyperlipidemia was the most common risk factor among all the patients’ and AWMI owing to the LAD artery was the most common presentation.

Background: The feeding issues of children under 5 years of life have effects on overall growth and development. Objectives: This study
aimed to find out the prevalence of feeding problems and their associated factors among a sample of children under 5 years visiting a primary
health‑care center in Erbil city. Materials and Methods: In this cross‑sectional study, the mothers who visited the primary health centers for
the medical checkup of their children under 5 years were consecutively screened for the eligibility criteria between February 1, 2020, and June
30, 2020. Results: The children were located in the following age groups: 6–9 months (11.3%), 9–12 months (4.9%), 12–24 months (32.0%),
and >24 months (51.7%). The children had an abnormal height for age (8.9%), weight for age (6.9%), and weight for height (14.3%). The
prevalence of formula feeding was 49.0% in children. The prevalence of feeding problems was 75.9%, including mono‑feeding (20.2%)
and multi‑feeding issues (55.7%). The prevalence of complementary food was 2.0% only. The prevalence of active feeding was 54.2%. The
study showed that younger age group had a significantly higher prevalence of feeding problem (P < 0.001). The study showed that children
with abnormal weight for age were more likely to have feeding problems compared to those with a normal weight for age (100% vs. 74.1%,
P = 0.019), respectively. Conclusions: The present study showed that a considerable percentage of children have feeding issues. The feeding
issues were higher in younger age groups.

The trends of the ongoing coronavirus disease-2019 (COVID-19) pandemic continues to rise in different parts of the world and no nation
can rest assured that they have won the battle against the novel viral infection. The epidemiological trends from some of the affected nations
have reported a decline in the number of cases, but we cannot let down our guard. Many sections of the community and other stakeholders
are concerned about the emergence of second wave of the infection, but as a Program Manager, our priority has to strengthen our outbreak
readiness and emergency response. Further, the health care delivery system has to be reformed in such a way that the needs of the community
are given utmost priority and we work together as a team for the containment of the infection. In conclusion, the fight against the COVID-19
pandemic is far from being over and we have to continue our good work and take appropriate measures to further intensify our response to
safeguard the health and well-being of the vulnerable population groups and be ready for the most difficult times.

Dear Editor,
Obstructive sleep apnea (OSA) is a common respiratory
disorder characterized by frequent and repetitive airway
collapse. It affects more than 936 million people worldwide,
almost ten times as many as previously estimated, its
prevalence increases with age, body mass index, obesity, use
of central nervous system depressants (e.g., opioids, alcohol),
older age, male gender, and smoking.[1]
Patients suffering from OSA typically exhibit a variety of
physiologic and biochemical changes known to be risk factors
for cardiovascular disease. In some recent studies performed,
it has been shown that hypertension and metabolic syndrome
were positively associated with severe OSA.[2] Several studies
are showing that sleep apnea syndrome is more common in
men than in women, some revealing that it is approximately
twice as prevalent in men as it is in women.[2]
OSA causes hypoxemia which consequently leads

In the article titled “Celiac Disease: Biochemical and Histopathological Considerations of Local Patients”, published on
pages 332-336, issue 4, volume 17 of Medical Journal of Babylon[1], the affiliation of the author “Razan Yassin Abdullah” is
written incorrectly as “Department of PCR, Central Public Health Laboratory, Duhok, Iraq”. The correct affiliation should read
as “Department of Biology, College of Science, University of Duhok, Duhok, Iraq”.