IRAQI JOURNAL OF MEDICAL SCIENCES

In virology, the term ‘virome’ refers to commensal viruses that typically replicate and persist within healthy individuals, without causing harmful effects to the host; this concept is familiar to microbiologists. Torque Teno Virus (TTV) is one of common commensal viruses which is very ubiquitous in the environment and infects both humans and animals. Multiple modes of transmission of TTV enhance the spreading of these viruses within ecosystems and infect new hosts. Recently, TTV has emerged as a promising biomarker for medical and environmental applications. This review article examines the widespread presence of the TTV and discusses its potential as a biomarker for exciting future uses. Also, explore the extensive global distribution of TTV, highlighting the intriguing variations in its frequency observed across diverse populations. By inspecting the factors contributing to these disparities, including geographical location, and host demographics, this review sheds light on the enigmatic nature of TTV’s prevalence.
Keywords :Torque Teno Virus, Virome, Biomarker
Citation: Salman MH, Al-Shuwaikh AM. From virome to biomarker: Insights into the role of Torque Teno virus in health and ecosystems. Iraqi JMS. 2025; 23(2): 190-199. doi: 10.22578/IJMS.23.2.1

Background: Melasma is a skin condition that disrupts the skin on the face. Tyrosinase enzyme (TYR) increase and decrease the antioxidants naturally produced in the body, leading to melasma. TYR is a key enzyme in melanogenesis. Tyrosinase\\'s various mechanisms are enhanced by genetic, environmental, and endocrine factors.
Objective: To investigate the relationship between serum TYR enzyme levels and the severity of melasma as a biomarker for diagnosis and treatment.
Methods: A case-control study was executed during the term of March to October 2023. The study included 60 patients with melasma and 60 control participants, all female, ranging in age from 20 to 50 years. All participants were examined using Wood\\'s light. Blood samples were collected from each individual, and sera were used after separation to measure TYR by enzyme-linked immunosorbent assay (ELISA) method levels in different stages of melasma severity.
Results: Increased concentration TYR with different stages of severity (7.36±0.19 U/ml) compared to the control (3.89±0.08 U/ml) utilizing an independent t-test. Additionally, the serum TYR levels significantly increased as the severity of melasma increased. Furthermore, the one-way ANOVA test indicated substantial serum TYR level and melasma area and severity index (MASI) scores for mild, moderate, and severe were 6.19±0.1 U/mL, 7.69±0.07 U/mL, and 9.38±0.31 U/mL, respectively. These results strongly suggest that TYR plays a crucial role in the formation and progression of melasma.
Conclusion: The result of this study refers to a significant correlation between the level of TYR and the degree of melasma.
Keywords: Melasma, Tyrosinase enzyme, melanogenesis, MASI score, ELISA
Citation: Muhsen SA, Alwasiti EA, Farhood IG. Exploring the correlation between tyrosinase enzyme levels and the severity of melasma in women: A case-control study in Baghdad. Iraqi JMS. 2025; 23(2): 200-206. doi: 10.22578/IJMS.23.2.2

Background: Psoriasis is a protracting disorder of the skin that is immune mediated with a prolapsing characteristic making it difficult to fully treat.
Objective: To investigate the effect of Myricetin in Imiquimod induced-psoriasis in mouse model and its possible therapeutic effect.
Methods: Twnety-eight albino mice were randomly divided into 3 groups, 1st group involved healthy mice did not receive any medication, 2nd group (induction group) received only topical Imiquimod, and the 3rd group involved mice that received a topical Myricetin 10% ointment. All the mice received the test substances on the shaved back for 7 consecutive days and scoring for skin inflammation severity (scaling, erythema and thickness) was recorded on daily basis, and the animals were sacrificed on day 15. Skin samples were collected to evaluate the histopathological scores (Baker\'s and Psoriasis area and severity index (PASI), in addition to measurement of tissue inflammatory biomarkers Interleukin (IL)-10, IL-17, tumor necrosis factor- alpha (TNF-α) and vascular endothelial growth factor (VEGF) by enzyme-linked immunosorbent assay (ELISA).
Results: Psoriasis induction was successful by Imiquimod, and psoriasis like lesions developed on the skin and decreased the IL-10 and increased levels of other studied biomarkers. Topical Myricetin showed a significant increase in IL-10 levels (P <0.001) and a significant reduction in TNF-α (P <0.001), VEGF (P <0.05) and IL-17 levels (P <0.001). There was also a significant reduction in Baker\'s score and PASI.
Conclusion: Topical Myricetin possesses anti-psoriasis activity and could be used successfully for the alleviation of psoriatic symptoms and further studies of the skin inflammatory diseases.
Keywords: Myricetin, Imiquimod, interleukin-10, interleukin-17, tumor necrosis factor-alpha, vascular endothelial growth factor
Citation: Almudaris SA, Gatea FK. Effects of topical Myricetin on imiquimod induced psoriasis in mice model. Iraqi JMS. 2025; 23(2): 207-221. doi: 10.22578/IJMS.23.2.3

Background: The Gamma Knife (GK) is a radio surgical method to treat malignant and benign brain tumours, atrioventricular malformations (AVM), and functional disorders.
Objective: To investigate the tumor shrinkage after six months of GK with hypofractionation.
Methods: A study at Dr. Saad Al-Witry Hospital for Neurosciences and Al-Altaj Hospital involved 50 patients with large brain tumors. Each patients underwent a magnetic resonance imaging and computed tomography images before and after treatment.
Results: The mean dose distribution was higher in metastasis. After irradiation, gliosis around the tumor was observed, with 86% showing a positive response to radiation treatment. The results of tumor shrinkage were classified according to the number of treatment fractions, with highly significant shrinkage observed in those treated in three fractions and those treated after four fractions.
Conclusion: The hypo fractionated GK appears to be a viable and effective method of treating various brain tumors that are benign or malignant. The method has a favorable outcome that involves both a decrease in tumor size and a minimum of side effects.
Keywords: Large brain tumor, volumetric change, gradient index (GI), gamma knife, stereotactic
Citation: Kadhem MH, Ahmed RS, Hamandi YMH. Assessment of large tumor shrinkage using hypofractionated gamma knife radiosurgery. Iraqi JMS. 2025; 23(2): 222-228. doi: 10.22578/IJMS.23.2.4

Background: Chronic kidney disease (CKD) has emerged as a prominent cause of mortality, following cardiac disease and cancer, exhibiting a substantial surge over the past two decades. One biochemical indicator that reflects cellular damage is lactate dehydrogenase (LDH), a key intracellular enzyme involved in the interconversion of pyruvate and lactate during glycolysis. Under normal conditions, LDH remains confined within cells; however, tissue damage can lead to its release into the bloodstream, resulting in elevated serum levels.
Objective: To assess the LDH in CKD patients compared with healthy control.
Methods: A total forty (40) patient with CKD were studied among them twenty (20) female and twenty (20) male patients and forty (40) healthy as controls, of them were eighteen (18) females and twenty-two (22) males. Their ages (patients and controls) were ranged from (18-70). Blood samples were collected from patients and control to evaluate serum levels of serum LDH and evaluate the routine markers (urea, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and this was done by spectrophotometry.
Results: This result showed the LDH levels in the patients were significantly higher (224.64±113.39 U/L) than in the control group (176.26±38.99 U/L) (P = 0.014). ALT and AST levels in the patients were lower than in the control group, but the difference was not statistically significant for ALT (P = 0.132) and was significant for AST (P = 0.03). The urea, and serum creatinine levels in the patients were all significantly higher than in the control group (P <0.001).
Conclusion: Serum LDH levels were significantly elevated in CKD patients undergoing hemodialysis compared to healthy controls, suggesting that LDH may serve as a useful biomarker for tissue damage and disease severity in patients with CKD.
Keywords: Chronic kidney disease, lactate dehydrogenase, hemodialysis.
Citation: Saleem AA, Hamza MI. Investigating serum LDH in Iraqi patients undergoing dialysis for chronic kidney disease. Iraqi JMS. 2025; 23(2): 229-236. doi: 10.22578/IJMS.23.2.5

Background: The second leading cause of cancer-related death globally, colorectal cancer (CRC) is the malignant neoplasm with the third highest diagnosis rate. It is the primary cause of cancer-related morbidity and mortality in Iraq and ranks second in terms of frequency of death after cardiovascular disorders. An inflammatory cytokine called tumor necrosis factor-alpha (TNF-α) plays a critical role in the immune response and may contribute to CRC development. Patients with CRC who had elevated serum levels of C-C motif chemokine ligand 3 (CCL3) had a worse prognosis than those who had low levels of this chemokine.
Objective: To evaluate the role of TNF-α and CCL3 in CRC patients by assessing the serum level estimation of TNF-α and CCL3 in addition to the demographic data analysis.
Methods: The study has been approved by the College of Medicine, Al-Iraqia University and included 100 samples from male and female patients from the Medical City, Al-Imamein Al-Kadhimein Medical City, Al-Amal Hospital, and also from Al-Bilad Private Hospital suffering from problems in the colon and rectum. The study lasted for five months (from November 2023 until March 2024). The participants were divided into 2 groups: the 1st one contained CRC patients, while the 2nd contained colorectal problems other than CRC. Five ml of blood was taken from each participant for estimation of TNF-α and CCL3 serum level by using enzyme-linked immunosorbent assay. Demographic data were collected from the study participants (such as age, gender, address, and medical history). Ten samples were discarded due to hemolysis.
Results: The serum levels of TNF-α and CCL3 in CRC patients showed a higher significant difference (P <0.05) compared with the 2nd group.
Conclusion: TNF-α and CCL3 significantly appeared as indicators for the progression of CRC cancers.
Keywords: TNF-α, CCL3, colorectal cancer
Citation: Abdulhamid AQ, Abdullah AR. The role of tumor necrosis factor-alpha and C-C motif chemokine ligand 3 serum levels in some Iraqi colorectal cancer patients. Iraqi JMS. 2025; 23(2): 237-245. doi: 10.22578/IJMS.23.2.6

Background: Both natriuretic peptides, NPs (BNP and CNP), and neutrophil gelatinase-associated lipocalin (NGAL) were reported to rise in chronic kidney disease (CKD) and type2 diabetes mellitus (T2DM). Their role in detecting and follow up of these two diseases has been well elucidated.
Objective: To evaluate the use of a combination of NPs and NGAL in detecting renal insufficiency (per se) or early diabetic nephropathy.
Methods: The study included 40 patients with CKD (mean age 50.63±9.25 years), 41 patients with T2DM (mean age 53.66±8.32 years) and 38 apparently healthy normal subjects (mean age 52.42±8.81 years) as controls. Natriuretic peptides, and NGAL were measured by enzyme linked immunosorbent assay (ELISA), and glycated hemoglobin (HbA1c) by fully automated boronate affinity assay. Renal function tests, glucose, and electrolytes were estimated by routine laboratory methods.
Results: There was an increase in NGAL, N-terminal pro-C-type natriuretic peptide (NT-proCNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in both groups of patients. The HbA1c was high in the T2DM group only. Receiver operating characteristic (ROC) curve revealed good sensitivity and specificity when using NGAL and NT-proBNP to discriminate between CKD and T2DM or between CKD and controls, or T2DM and controls.
Conclusion: Combined use of NGAL and NT-proBNP in T2DM may be a better diagnostic marker for an early deterioration in renal function of diabetes mellitus than the HbA1c level alone.
Keywords: Natriuretic peptides, neutrophil gelatinase-associated lipocalin, glycated hemoglobin, renal failure, diabetes mellitus
Citation: Al-Shamma GA, Malik AS, Al-Mayah QS, Kurshead RS. Significance of combined use of natriuretic peptides and neutrophil gelatinase-associated lipocalin for diagnosis of renal failure and type 2 diabetes mellitus. Iraqi JMS. 2025; 23(2): 246-254. doi: 10.22578/IJMS.23.2.7

Background: Osteoporosis is characterized by low bone mass and micro-architectural deterioration.
Objective: To measure a quantitative magnetic resonance imaging (MRI)-based score (M-score) for the diagnosis of abnormal bone mineral density in postmenopausal female and compare the results with standard control taking dual-energy x-ray absorptiometry (DEXA) scan measurements as a reference.
Methods: This case-control study was conducted with 50 postmenopausal females who underwent DEXA exam for back pain. Another 50 healthy young females aged 20-29 years were used as a control group, and an MRI of the lumbar spine was done to all participants. From sagittal T1-weighted spin-echo sequence, Signal to noise ratio of L1-L4 was measured to all patients and controls and used to obtain M-score.
Results: DEXA revealed that 19 patients had a normal T-score, 14 patients had osteopenia, and 17 patients had osteoporosis (mean T score -1.737), M-score were significantly higher among cases than controls (P = 0.0001). The SNR L1–L4 and M-score are negatively correlated to T-score (r = -0.864; P = 0.0001) and bone mineral density (BMD) (r = -0.863; P = 0.0001). The receiver operator characteristic (ROC) analysis revealed an M-score threshold of 2.63434 with 88.2% sensitivity and 78.8% specificity (P = 0.0001) for the discrimination of osteoporotic from non-osteoporotic females. For distinguishing normal from low-BMD patients, the ROC curve estimated an M-score threshold of 1.34413 with 100% sensitivity and specificity (P = 0.0001). According to the calculated M-score, 19 patients were normal (M-score <1.334), 9 patients found to have osteopenia (M-score 1.334 - 2.634), and 22 osteoporotic patients (M-score >2.634).
Conclusion: M-score obtained from T1WI sequence of lumbar spine study is a useful quantitative method for the diagnosis of osteoporosis and osteopenia in postmenopausal females as compared to DEXA scan. The best cut off value for osteoporosis is 2.634. The best cut off value for osteopenia is 1.344.
Keywords: Lumbar spine MRI, postmenopausal women, bone mineral density
Citation: Mudhahir DA, Kadhim MA. Lumbar spine MRI signal intensity measurements in the assessment of abnormal bone mineral density in postmenopausal women. Iraqi JMS. 2025; 23(2): 255-263. doi: 10.22578/IJMS.23.2.8

Background: Toll-like receptor 4 (TLR4) is a pattern recognition receptor involved in the innate immune response, capable of recognizing certain molecular patterns found in bacteria and viruses, including the severe acute respiratory syndrome coronavirus 2 (SARS–CoV2) virus responsible for Corona virus disease 2019 (COVID-19).
Objective: To investigate the potential relationship between the severity of COVID-19 and a specific genetic variation in the TLR4 gene known as Thr399Ile.
Methods: A cross-sectional study conducted on 90 patients with COVID-19 in Baghdad. The researchers genotyping of Thr399Ile polymorphism in DNA extracted from blood samples of patients was done using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses.
Results: Two genotypes were found CC and CT, and no patients exhibiting the TT genotype. The CC genotype was associated with a DNA fragment size of 407 base pairs, while the CT genotype showed a size of 378 + 29 base pairs. In the non-severe infection group, the CC genotype frequency was 95.55%, while the CT genotype frequency was 4.44%. In the severe infection group, the CC genotype frequency was 93.33%, and the CT genotype frequency was 6.66%. This indicates no significant association between Thr399Ile polymorphism and COVID-19 severity. Thr399Ile mutant allele frequency among the 90 COVID-19 patients was found to be 5.5% (5 out of 90).
Conclusion: Functionally effective Thr399Ile polymorphism of TLR4 gene have apparently no influence on the individual susceptibility for COVID-19 severity infection.
Keywords: COVID-19, TLR4, Thr399Ile polymorphism, mutant allele frequency.
Citation: Jaber MF, Khudhair AM. Thr399Ile Polymorphism of toll-like receptor 4 gene and COVID -19 severity in samples of Iraqi patients: Baghdad province. Iraqi JMS. 2025; 23(2): 264-271. doi: 10.22578/IJMS.23.2.9

Background: A healthy maternal diet, including essential trace elements like selenium and copper, is crucial for optimal pregnancy outcomes. Selenium acts as an antioxidant, protecting placental tissues, while copper supports mitochondrial function. Both elements influence placental weight and function, which are key determinants of fetal growth and neonatal health. Excessive or insufficient levels of these trace elements have been associated with the adverse outcomes such as gestational hypertension or impaired placental efficiency.
Objective: To investigate the impact of maternal selenium and copper levels on placental weight and efficiency.
Methods: A cross-sectional study was conducted on 50 mother-neonate pairs at Al-Diwaniya Obstetric Hospital (December 2024–February 2025). Maternal serum selenium and copper were measured using atomic absorption spectrophotometry. Placental weight, birth weight of the neonate, and placental efficiency (birth weight/placental weight) were assessed. Statistical analyses included Pearson correlation and multiple linear regression.
Results: Maternal selenium showed a highly significant positive correlation with placental weight (r = 0.523, p <0.001), while copper had no significant association with placental weight. Maternal serum copper showed significant negative correlation (r = -0.316, p = 0.025) with neonatal birth weight. Both trace elements negatively correlated with placental efficiency (selenium: r = -0.418, p = 0.003; copper: r = -0.312, p = 0.027). Regression analysis confirmed selenium’s strong association with placental weight (p <0.001).
Conclusion: Maternal selenium levels significantly associated with placental weight. Serum copper levels negatively correlated with neonatal birth weight, whereas both selenium and copper are associated with reduced placental efficiency. These findings highlight the importance of balanced trace element levels for optimal placental efficiency, though further research is needed to clarify their clinical implications.
Keywords: Maternal, selenium, copper placental weight, placental efficiency, birth weight
Citation: Toman SK, Ahmed MH, Nasir SA. The role of selenium and copper on placental weight and efficiency. Iraqi JMS. 2025; 23(2): 272-281. doi: 10.22578/IJMS.23.2.10

Background: Diabetic peripheral neuropathy (DPN) brought on by damage to the peripheral sensory and motor nerves. Since the F-wave passes through both the afferent and efferent pathways in the motor nerve, alterations in the F response parameters may indicate injury to either of these pathways.
Objective: To explore the effectiveness of ulnar F-wave parameters in diagnosing subclinical neuropathy in patients with type 2 diabetes mellitus (T2DM).
Methods: The study examined F-wave, glycated hemoglobin (HbA1c), and modified Toronto clinical neuropathy score (mTCNS), in addition to sural to radial amplitude ratio, sensory and motor conduction of upper and lower limb nerves, in 116 T2DM patients and 121 control participants.
Results: In comparison to controls, DPN patients exhibit longer F-minimum (Fmin), F-maximum (Fmax), F-ratio (Fr), and modified F-ratio (mFr). Along with higher F-chronodispersion (Fc) and F-estimate (Fe), they also show lower F-persistence (Fp), F-wave conduction velocity (FWCV), and F-index (Fi). Patients with DPN have higher F-estimate (Fe) values than the controls, whereas patients without DPN have lower Fi. There was a strong correlation observed between several F-wave parameters and the mTCNS, disease duration, and HbA1c.
Conclusion: Increased mFr value, longer Fm latency, and higher Fi value were useful in the early identification of subclinical DPN, while higher Fi value, FWCV slowing, and prolonged Fmin and Fmax latencies helped identify patients with clinical DPN. When separating diabetics with T2DM from those without DPN, the Fi value has the highest sensitivity and specificity.
Keywords: DM, subclinical neuropathy, ulnar nerve, F-wave.
Citation: Abdul Qader AA, Hamdan FB, Khudhair MS. Ulnar F-wave study in the detection of subclinical diabetic neuropathy. Iraqi JMS. 2025; 23(2): 282-296. doi: 10.22578/IJMS.23.2.11

Background: One of the most current endocrine conditions influencing women in their fertile age is polycystic ovary syndrome (PCOS). It is a varied condition marked by hyperandrogenism, irregular ovulation, and polycystic ovary morphology, along with abnormalities in metabolism like obesity and insulin resistance. Apelin's function in controlling glucose homeostasis has been investigated, and it has been associated with obesity and insulin resistance. Apelin secretion is stimulated by insulin, whereas insulin secretion is inhibited and glucose utilization is stimulated by Apelin.
Objective: To evaluate the role of Apelin in women with PCOS and its correlation with body mass index (BMI) as an obesity marker .
Methods: Ninety-six adult women were involved in the study, sixty of them were diagnosed with PCOS compared to thirty-six healthy controls as an observational, case-control study. Upon interviewing participants one by one by the researcher, data like BMI were collected as a part of a structured questionnaire, blood samples were obtained. Apelin serum level were measured by enzyme-linked immunosorbent assay (ELISA) analysis using a specialized kit.
Results: The study found a markable increase in Apelin serum levels in women with PCOS group compared with controls with a P value of 0.001, and the descriptive statistic was mean±SD was 486.5±251.98 (pg/ml) while for control was 240.89±168.78 (pg/ml). Apelin had an area under curve of 0.819, which made it good as a diagnostic marker for PCOS in female patients, with a cut-off value of 206.32 pg/ml and sensitivity and specificity of 87% and 61% respectively.
Conclusion: Apelin may represent a BMI‑independent marker of PCOS, underscoring its potential relevance in disease pathophysiology.
Keywords: Apelin, PCOS, BMI
Citation: Talib AF. Serum Apelin level and its association with polycystic ovarian syndrome: evaluating correlations with obesity in Iraqi women. Iraqi JMS. 2025; 23(2): 297-302. doi: 10.22578/IJMS.23.2.12

Background: MicroRNAs (miRNAs) control the expression of targeted gene post-transcriptionally. Collecting evidences supports that miRNA dysregulation is related to the pathogenesis of autoimmune diseases.
Objective: To assess the levels of microRNA-29b (miR-29b) as indicator of interferon beta and natalizumab therapy effectiveness in multiple sclerosis (MS) patients.
Methods: One hundred and twenty blood samples were taken from patients at the MS Center in the Baghdad Medical City, during the period February to September, 2021. First sixty patients getting natalizumab (30 responders and 30 non-responders) and, the other sixty patients getting interferon beta (IFN-) (30 responders and 30 non-responders). As well as, thirty normal volunteers were included in this study as control group. IFN- and Natalizumab antibodies (Abs) were detected by using enzyme-linked immunosorbent assay (ELISA). On the other hand, Quantitative Polymerase Chain Reaction (qPCR) was used to assess the levels of miR-29b in blood samples of patients.
Results: The concurrence of anti-IFN Abs in non-responder, responder MS patients and healthy control was (26, 16, 5) respectively. In addition, a high frequency of anti-natalizumab Abs in patients was found. The number of seropositive natalizumab Abs cases among the non-responder group, responder and healthy control was (5, 0, 0) respectively. On the other hand, there was a significant increase in microRNA-29b expression in patients’ group with a median equal to 25584.00 compared to the control group (22476.50). The relation between the seropositivity of anti-IFN Abs and the level of microRNA-29b in IFN- treated MS patients was highly significant with P value (<0.001). The study also showed a highly significant relation between the presence of anti-Natalizumab Abs and the level of miR-29b among Natalizumab-treated MS patients group (P value <0.001).
Conclusion: The levels of miR-29b in the serum of the MS patients could be used as an informative indicator for the bioactivity of IFN-β and natalizumab treatment.
Keywords: Interferon-β, multiple Sclerosis, microRNA-29b, Natalizumab
Citation: Mohammed HA, Abbas AA, Shaheed NM. Circulating microRNA-29b expression as a possible prognostic marker for therapy response in multiple sclerosis patients. Iraqi JMS. 2025; 23(2): 303-311. doi: 10.22578/IJMS.23.2.13

Background: Male infertility is the inability to conceive due to low sperm count, poor sperm function, or blockages. Smoking has a negative effect on male infertility because it makes breathing and other physiological processes—including respiration—difficult. Chemicals in tobacco smoke, such as oxidants and pro-oxidants, increase oxidative stress in the body, leading to the production of free radicals. Zinc plays a crucial role in combating this oxidative damage, as it is a key component of several antioxidant enzymes like peroxidase, catalase, and superoxide dismutase. Disruptions in zinc metabolism, such as impaired enzyme utilization of zinc, may contribute to oxidative damage caused by smoking. This oxidative stress can negatively impact sperm health and function, highlighting zinc\\'s important role in preserving male fertility.
Objective: To assess the effect of smoking on zinc levels in the serum and seminal plasma of infertile males through a comparative analysis between smokers and non-smokers.
Methods: A case-control study recruited 60 infertile men, divided into two groups: 30 smokers and 30 non-smokers. Data on their demographics, hematological indices, and key biomarkers were collected, including serum and seminal plasma zinc levels, as well as serum levels of testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).
Results: The zinc levels in both blood and seminal plasma were significantly lower in smokers compared to non-smokers (P <0.05). Specifically, the mean zinc concentration in the serum of smokers was 1.12 µg/dL, compared to 1.24 µg/dL in non-smokers, and in seminal plasma, it was 1.04 µg/mL for smokers versus 1.10 µg/mL for non-smokers.
Conclusion: Smoking has negative impact of on zinc levels in the blood and seminal plasma of infertile men. Zinc is essential for reproductive health, playing a crucial role in sperm production and function. This emphasizes the urgent need for smoking cessation programs to protect reproductive health.
Keywords: Zinc, cigarette smoking, serum, seminal plasma, male fertility
Citation: Hadi HE, Abd Ali ZA, Hamed SH, Ali RF. The effect of smoking on serum and seminal plasma zinc levels in infertile men: A comparative study. Iraqi JMS. 2025; 23(2): 312-316. doi: 10.22578/IJMS.23.2.14

Background: About 4-8% of women of reproductive age have polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome. PCOS is a heterogeneous endocrine condition.
Objective: To investigate the impact of Plantago major (P. major) leaves extract on the lipid profile and histological picture of the ovary in female rats with induced PCOS, and to contrast the impact of P. major leaves extract with that of Metformin.
Methods: Female rats were divided into six groups: apparent healthy group, PCOS induction group, Metformin-treated group, high-dose P. major group (1500 mg/kg/day), low-dose Plantago major group (1000 mg/kg/day), and a combination group treated with P. major (500 mg/kg/day) and Metformin. The measured parameters included serum lipid profile {total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), very low-density lipoprotein cholesterol (VLDL-C)} and histopathological evaluation of ovarian tissue.
Results: Except for HDL-C, which was significantly increased compared to the induction group, the lipid profile parameters were significantly reduced in the P. major treated groups. Ovarian histology revealed recovery of ovulation in rats treated with Plantago major.
Conclusion: In comparison to Metformin, Plantago major treatment groups showed better effects in terms of easing PCOS symptoms in female rats.
Keywords: Plantago major, leaves, polycystic ovary syndrome, female rats, lipid profile.
Citation: Al-Jawadi AD, Gatea FK. Effects of Plantago major on serum lipid profile and histopathological changes of ovaries in induced polycystic ovary syndrome in female rats. Iraqi JMS. 2025; 23(2): 317-327. doi: 10.22578/IJMS.23.2.15

Background: Candidiasis is an opportunistic fungal disease. Some Candida species (Candida spp.) exhibit greater resistance to antifungals, leading to difficulty in treatment.
Objective: To search for pathogenic C. auris and C. kefyr isolates from specimens taken up from patients admitted to Kirkuk hospitals, to test their susceptibilities to various antifungals, and the genetic background for their antifungal resistance pattern.
Methods: The study comprised the collection of 1047 samples. All isolated Candida spp. were identified morphologically by direct and indirect methods, and then subjected to antifungal susceptibility testing. Polymerase chain reaction (PCR) was used for identification of Candida spp. and detection of resistance genes.
Results: Among the total samples, 215 were positive for Candida spp. C. auris has not been detected, and four isolates of C. kefyr were found: two isolates from urine samples and the others from wound swabs. All of C. kefyr isolates displayed amphotericin resistance. Regarding azoles, all isolates were sensitive, excluding one isolate that was found to be voriconazole and 5-flucytosine resistant. Ergosterol3 (ERG3), ERG6, and ERG11 genes were expressed in all isolates. The ERG2 was not found in isolate number 3, contrary to the uracil phosphoribosyl transferase (FUR1) gene, which was noted only in this isolate.
Conclusion: The extreme resistance to amphotericin B occurred by the increased expression of ERG3, ERG6, and ERG11genes. The expression of the FUR1 gene was responsible for resistance against the 5-flucytosine.
Keywords: Candida auris, Candida kefyr, antifungals, amphoterecin B.
Citation: Zeynel AA, Al-Attraqchi AAF, Jasim HM. Detection and identification of Candida auris and Candida kefyr from different clinical samples by conventional and molecular methods. Iraqi JMS. 2025; 23(2): 328-347. doi: 10.22578/IJMS.23.2.16

Background: The tobacco epidemic is one of the most significant public health threats the world has ever encountered. Parental influence on siblings smoking initiation is important.
Objective: To explore the relationship between smoking status of the medical students and their parents, and to explore other associated demographic characteristics.
Methods: A cross-sectional study was done for the period from March to April 2023 at College of Medicine, Al-Nahrain University. Data (480 responses) were collected using a specifically constructed questionnaire that was distributed online to 500 students chosen randomly (100 student/stage) excluding the 6th stage.
Results: The prevalence of smoking among students was 20.8% while parental smoking was 37.9%. Regression analysis showed odds of 1.6 being smoker if one of the parents is smoker.
Conclusion: The prevalence of smoking at College of Medicine, Al-Nahrain University students is high and the positive influence of parental smoking is of paramount.
Keywords: College of Medicine, Al-Nahrain University, medical students, parental smoking, smoking
Citation: Alogaili MH, Mohammed LK, Khaleel SH. The association between parental smoking and tobacco consumption among sample of Al-Nahrain undergraduate medical students. Iraqi JMS. 2025; 23(2): 348-355. doi: 10.22578/IJMS.23.2.17

Background: Pseudomonas aeruginosa (P. aeruginosa) is a common etiological agent of wound infection; it has been shown to increase the rate of mortality and morbidity in patients. It can potentially become multidrug-resistant (MDR) due to its ability to acquire different antimicrobial resistance mechanisms.
Objective: To investigate the impact of Las Systems (lasI and lasR) on antibiotic resistance patterns in P. aeruginosa.
Methods: Out of 117 clinical wound samples, 30 P. aeruginosa isolates were identified, and the antibiotic susceptibility and minimum inhibitory concentration (MIC) determination were evaluated. The conventional polymerase chain reaction (PCR) method was used for the detection of quorum-sensing genes using specific primer sequences after DNA extraction.
Results: Out of the 30 P. aeruginosa isolates, 43% were identified as extensively drug-resistant (XDR), while 17% were classified as MDR. The highest level of antibiotic resistance was observed against Levofloxacin (60%), and the lowest level was against Colistin (23%). The occurrence of quorum-sensing genes among the isolates was as follows: lasI (96.67%), lasR (76.67%).
Conclusion: No statistically significant correlation was observed between the presence of these genes and MDR or XDR phenotypes.
Keywords: Pseudomonas aeruginosa, quorum-sensing, las genes, lasI, lasR
Citation: Kadhim ZA, Hassan JS, Abdul Wahhab RAS, Hussein MAK. Correlation between quorum sensing genes (lasI and lasR) and antibiotics resistance in Pseudomonas aeruginosa isolated from wound infections. Iraqi JMS. 2025; 23(2): 356-364. doi: 10.22578/IJMS.23.2.18

Background: Ischemic heart disease is a common cardiovascular disease that occurs when blood flow to the heart is reduced or blocked, leading to a lack of oxygen and nutrients to the heart muscle. It can lead to chest pain, shortness of breath, and potentially life-threatening conditions such as heart attack and heart failure. The two main types are chronic coronary syndrome (CCS) and acute coronary syndrome (ACS).
Objective: To evaluate the patients having CCS and ACS regard the prevalence of risk factors, symptoms, co-morbidities and other factors that may contribute to these differences between the patients.
Methods: A descriptive cross-sectional study was conducted at the Karbala Cardiac Center in Iraq. Participants were 160 patients diagnosed with ischemic heart disease (60 cases of CCS, 100 cases of ACS) between January and June 2023.
Results: ACS was twice as common as CCS (62.5% vs 37.5%). There was no significant age difference between groups. More males (67%) than women (23%) were suffered from CCS. ACS patients showed significant dyslipidemia (P = 0.002) with increased low density lipoprotein cholesterol levels and more frequent medical treatment. Social factors such as retirement and low physical activity were more prevalent among ACS patients. CCS was associated with the emergence of chest pain, while shortness of breath was predominant in ACS.
Conclusion: The levels of dyslipidemia, social factors, and symptom presentation varied significantly among the community groups. This result shows the need for individualized management strategies for such conditions.
Keywords: Ischemic heart disease, chronic coronary syndrome, acute coronary syndrome
Citation: Alkhattawi FR, Abutiheen AA, Al Ftailah HA, Alhaideri AQ. Risk factors for chronic coronary syndrome and acute coronary syndrome among patients attending Karbala Cardiac Center. Iraqi JMS. 2025; 23(2): 365-376. doi: 10.22578/IJMS.23.2.19

Background: Cytokines and chemokines play a crucial role in initiating the early immune response against High-Risk Human papillomavirus (HR-HPV) infection, hence preventing the progression of cervical lesions to cervical cancer (CC). The C-X-C motif chemokine ligand 10 (CXCL10) interacts with C-X-C motif chemokine receptor 3 (CXCR3) to facilitate immune responses by stimulating and attracting specific types of immune cells.
Objective: To explore the role of the CXCR3 in women infected or uninfected with HR-HPV-induced tumors.
Methods: The study included 100 female patients diagnosed with cervical intraepithelial neoplasia (CIN); twenty-two samples were shown to be HR-HPV positive, while thirteen samples were not. The presence of HR-HPV was confirmed using a real-time polymerase chain reaction (PCR) kit from Sacase, Italy and 20 apparently healthy women as a control group. Two-step reverse transcription PCR (RT-qPCR) was used to assess the expression of CXCR3 in both CC cells and cervical neoplasia in different stages {atypical squamous cells of undetermined significance (ASC-US), CIN I&II, and high-grade squamous intraepithelial lesion (HSIL)} samples.
Results: Results showed that gene expression of CXCR3 level was substantially and significantly upregulated (p <0.001) in the cervix tissue of women with CIN in (early and moderated) stages of disease-infected HR-HPV but not in the control group. On the other hand, at late stages of disease (HSIL) and CC stage, the level of CXCR3 was significantly downregulated (p >0.05). Receiver operating characteristic analysis showed that CXCR3 had 73% sensitivity with 100% specificity.
Conclusion: The results suggested that these molecules may serve as potential biomarkers for CIN progression of women infected with HPV and as an indicator of immune responses in surviving patients. Also, reductions in CXCR3 gene expression may reflect viral immune escape/or viral clearances.
Keywords: HR-HPV, CXCR3, real time PCR, cervical neoplasia, cervical cancer, Iraqi women
Citation: Allos MM, Naif HM. Evaluation of CXCR3 Gene expression in Iraqi women with cervical intraepithelial neoplasia induced by Human Papillomavirus. Iraqi JMS. 2025; 23(2): 377-383. doi: 10.22578/IJMS.23.2.20

Despite the availability of effective therapies, tuberculosis (TB) remains one of the most challenging infectious diseases around the world. Accurate and early laboratory analysis was fundamental for sickness, treatment initiation and prevention of transmission to other peoples. The evaluation highlights detect of diagnostic strategies for Mycobacterium Tuberculosis (MTB) that integrate traditional, molecular, immunologic and superior techniques. Conventional methods, including acid-fast bacilli (AFB) by microscope and growth on Lowenstein–Jensen or Middle brook media, remain the cornerstone for confirmation and drug susceptibility testing, even though they may be time-consuming. The advanced and automated liquid culture systems like BACTEC MGIT 960 have markedly decreased detection time while keeping excessive sensitivity and specificity. By enabling rapid detection of MTB and rifampicin or multidrug resistance within hours, the molecular tests such as Expert MTB/RIF, Expert Ultra, True Nat MTB, line probe assays and polymerase chain reaction - based technologies offer more accurate methods and have transformed TB diagnosis. Histopathology and cytology remain important for extra pulmonary TB cases, although immunological diagnostics such as interferon-gamma release assays (IGRA) and T-spot methods that associated with the identification of latent TB infection. Although their routine use was still hindered by infrastructure and expense, emerging technologies such as whole genome sequencing (WGS), loop-mediated isothermal amplification (LAMP) and nano pore sequencing provide high-resolution data for strain typing of MTB and drug resistance profiling.
Keywords: TB, Mycobacterium Tuberculosis, PCR, AFB, IGRAs, DST
Citation: Talib AL, Rashid RY. Evolution of Mycobacterium Tuberculosis diagnostics: From classic methods to high-resolution molecular platforms: A literature review. Iraqi JMS. 2025; 23(2): 384-392. doi: 10.22578/IJMS.23.2.21

Background: β-thalassemia syndrome (BT) is an inherited blood disorder characterized by reduced levels of functional hemoglobin owing to relative reduction or complete lack of β-globin chain synthesis. The severity of the BT phenotype relies highly on the underlying genetic defect affecting the β-globin gene. The high prevalence rate, as well as, the relatively high annual cost for thalassemia patients in Iraq, has imposed a huge burden exhausting both patients and the health institutions.
Objective: To study the molecular profile of BT patients in Baghdad city with characterizing the most common β-globin gene mutation among transfusion dependent (TD) and non-transfusion dependent (NTD) patients.
Methods: A cross-sectional study was conducted on 80 TD and NTD BT Patients. Molecular profiling of BT mutations was performed using β-Globin StripAssay®IME, a reverse-hybridization assay tailored to detect population-specific mutations within the Middle East, Iran, Arabian Peninsula, and India.
Results: In the current study, 13 different BT mutations have been identified, of which 3 alleles accounted for approximately 60% of the total alleles. These were: intervening sequence (IVS) 1.110 {G>A} in 44 (27.5%), IVS 2.1 {G>A}: 35 (21.9%), and Codon 44 {-C}: 14 (8.8%). Other alleles were less frequent including IVS 1.6 {T>C}: 11 (6.9%), Codon 36/37 {-T}:10 (6.3%), while the remaining alleles accounted for 5% or less each.
Conclusion: The study has revealed a clustering of discrete BT alleles, indicated by the dominance of (IVS) 1.110 {G>A}, IVS 2.1 {G>A}, and Codon 44 {-C}: alleles in nearly 2/3 of the studied subjects.
Keywords: Molecular map, β-thalassemia, mutation, HBB gene, alleles
Citation: Alaqidi AA, Al-Mamoori HS. Investigating the molecular map of transfusion dependent and non-transfusion dependent β-thalassemic patients in Baghdad City. Iraqi JMS. 2025; 23(2): 393-403. doi: 10.22578/IJMS.23.2.22

Background: The most common compression neuropathy affecting the foot and ankle is tarsal tunnel syndrome. The tibial nerve is constricted beneath the flexor retinaculum (laciniate ligament).
Objective: To analyze the clinical results of conservative versus operative treatment of tarsal tunnel syndrome.
Methods: Twenty-seven patients (thirty feet, as three patients manifested with bilateral tarsal tunnel syndrome) were treated at Al-Imamein AL-Kadhimein Medical City in 2016. Fourteen patients (17 feet) underwent surgical intervention after a diagnosis of tarsal tunnel syndrome, while thirteen patients received exclusively conservative treatment for six months.
Results: Two months after initiating treatment, a clinical assessment and follow-up were conducted in accordance with Takakura's severity rating scale. The clinical results after conservative treatment showed some improvement at the 4-month and 6-month follow-ups; however, there was no significant difference, and postoperative treatment showed virtually no changes. There was no substantial improvement in the nerve conductive investigations.
Conclusion: In the beginning stages, especially if the issue is due to tenosynovitis or a flexible foot deformity, non-surgical treatment can be helpful, and neurophysiologic studies are not very important for early monitoring and evaluating the results.
Keywords: Operative treatment, conservative treatment of tarsal tunnel syndrome
Citation: Al-Banaa MAG, Jasam BS, Alwan HH. Conservative vs operative treatment of tarsal tunnel syndrome: A comparative study. Iraqi JMS. 2025; 23(2): 404-414. doi: 10.22578/IJMS.23.2.23

Background: Iodothyronine deiodinase enzymes have recently gained attention with thyroid hormones (TH) to play a role in many physiological conditions, one of which is insulin resistance (IR).
Objective: To investigate the association between TH and serum iodothyronine deiodinase-1 (DIOS-1) levels in participants with and without IR.
Methods: A cross-sectional study included 120 Iraqi individuals (male and female) with different body mass index (normal weight, over weight and obese) in the age range between (18-60) years old. Fasting serum levels of insulin, thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) and DIOS-1 were determined by using enzyme-linked immunosorbent assay techniques.
Results: Among the 120 subjects, IR found in 25 (20.8%) and 95 (79.2 %) were non-IR. A significant increase in insulin levels was observed in group with IR (27.78±2.77 µIU/ml) compared to non-IR individuals (3.84±0.22 µIU/ml) (p <0.001). There were no significant differences between IR and and non-IR groups in the mean serum levels of (TSH, T3 ,T4, and DIOS-1) 1.33±0.11 μIU/ml, 10.54±0.77 ng/ml, 137.9±6.41 ng/ml and 29.59±1.44 pg/ml, respectively, while those with IR were 1.42±0.21 µIU/ml, 10.67±1.07 ng/ml, 148±12.07 ng/ml and 27.84±1.09 pg/ml, respectively. However, a significant negative correlation between serum level of DIOS-1 and the insulin was found in IR group (r = -0.425, p= 0.034).
Conclusion: This study did not show a relationship between the DIOS-1 enzyme and insulin resistance.
Keywords: Iodothyronine deiodinase-1, T3, T4, TSH, insulin resistance.
Citation: Al-Saffar RS, Al-Rubayee WT, Ali GA. Association of thyroid hormones, iodothyronine and deiodinase-1 with insulin resistance in Iraqi adults. Iraqi JMS. 2025; 23(2): 415-423. doi: 10.22578/IJMS.23.2.24

Background: Obesity, driven by excess calorie and fat intake, contributes to diabetes and cardiovascular disease. In rats, simple indices such as the Lee Index (LI) for obesity, triglyceride‑glucose index (TyGI) for insulin resistance, and atherogenic index of plasma (AIP) for cardiovascular risk provide cost‑effective tools to assess metabolic dysfunction and evaluate dietary or therapeutic interventions.
Objective: To show the effect of eight weeks of two types of feeding on the LI, TyGI and AIP in rats.
Methods: A comparative study involved 36 rats, divided into two groups; group 1 received an ordinary lab diet of 20 g per day and group 2 consumed a modified diet of 20 g per day. The studied parameters were the LI, TyGI, and AIP. LI was dependent on weight, and length from nose to anus, TyGI was dependent on triglyceride and glucose, while AIP was dependent on triglyceride and high-density lipoprotein cholesterol. All parameters were measured at 2 intervals (0 and 8) weeks. The study was done at Animal House at the College of Veterinary, University of Baghdad.
Results: The results showed that the LI did not significantly increase with no differences between the two groups conversely TyGI and AIP increased significantly in the modified and ordinary groups within 8-week intervals.
Conclusion: Eight weeks of feeding of ordinary and modified diet in rats causes significant rise in TyGI and AIP but not enough to cause a significant change in LI.
Keywords: Obesity, Lee index, triglyceride glucose index, atherogenic index
Citation: Oudah AK, Ahmed MH. Impact of two different feeding regimens for eight weeks on Lee index, triglyceride glucose index and atherogenic index of rats. Iraqi JMS. 2025; 23(2): 424-430. doi: 10.22578/IJMS.23.2.25