IRAQI JOURNAL OF COMMUNITY MEDICINE

Background: Antenatal care is the complex of interventions that a pregnant woman receives from organized health care services. The number of different interventions in antenatal care is large. The purpose of antenatal care is to prevent or identify and treat conditions that may threaten the health of the fetus/newborn and/or the mother, and to help a woman approach pregnancy and birth as positive experiences.
Objective: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome.
Methodology: A cross sectional study was conducted on a sample of 200 pregnant from 1st of March to the 1st of July 2022. Four primary health care centers at Al-Adel health care district were included
Results: Among 200 pregnant female, results showed that ANC attendance significantly higher among younger women and significant association between ANC visit on healthy maternal outcome and neonatal death.
Conclusion: Age between (26-35) years reported more ANC visits, financial difficulties have been considered as an important barrier to antenatal care for women.

Background: A healthy diet along with having an efficient nutritional knowledge may keep away from issues such as health problems, mainly overweight and obesity. Knowledge, attitude, and practices of medical students with concern to healthy dietary habits are so vital as their good knowledge reflects good community knowledge in order to change the people’s life style and behavior.
Objectives: to study the knowledge, attitude and practice among medical students studying at Al-Kindy college in Baghdad city, regarding the healthy dietary habits and to find out the association between the socio-demographics and knowledge scores of the participants.
Subjects and Methods: A cross sectional study design with analytic elements that has been implemented during the period from April 2023 through June 2023, a sample of 165 medical students was collected from Al-Kindy college that is located in Baghdad city. A questionnaire form was used to gather demographic data consistent with age, gender, residence, income, along with questions targeting the knowledge, attitude, and practices assessment regarding healthy dietary habits.
Results: In this study, almost half of the medical students had an accurate perception about components of healthy diet, healthy dietary habits, denotation of toxic triad of white poisons and risks of canned foods.
Conclusions: The study concluded that medical students of Al-Kindy college; have an insufficient nutritional knowledge, along with prevalent unhealthy dietary habits, keeping these highlights in mind, to suggest proper nutrition education for those medical students.

Background: Retinal complications of diabetes mellitus mainly Type 2 is known as diabetic retinopathy. Screening or early diagnosis of diabetic retinopathy involve time-consuming and costly clinical retinal examination and imaging, but they are crucial to prevent vision loss. Many studies have linked diabetic retinopathy with certain biochemical parameters including cystatin-C, suggesting that they could serve as biomarkers for diagnosis of diabetic retinopathy.
Aim To investigate the possible role of serum level of cystatin-C in type 2 diabetes as a biomarker to identify the presence diabetic retinopathy.
Materials Methods This cross-sectional study was caried out in three hospitals in Baghdad, Iraq. A total of 88 patients with type 2 diabetes mellitus ≥ 40 years were enrolled and assorted into three groups: 30 patients with no signs of diabetic retinopathy (control), 28 patients with Non-Proliferative Diabetic Retinopathy (NPDR), and 30 patients with Proliferative Diabetic Retinopathy (PDR). Serum levels of cystatin-C, cholesterol, triglycerides, high density lipoprotein cholesterol, as well as glycated hemoglobulin percentage were measured for all participants. Statistical tests of significance, correlation and receiver operating characteristic (ROC) analyses were used.
Results The mean level of cystatin-C was significantly higher in patients with diabetic retinopathy of all stages than in controls. The mean level of cystatin-C in all- stages diabetic retinopathy patients (NPDR and PDR) was 6.209 ± 3.528 ng/dl and in control group was 3.981 ± 2.927 ng/dl, (P= 0.004). The ROC curve analysis showed that cystatin-C level had a sensitivity of 96.6% and a specificity of 63.4% in discrimination of diabetic retinopathy patients from controls.
Conclusion Serum level of Cystatin-C is a useful biomarker to detect diabetic retinopathy in type 2 diabetic patients in early stage.

Background: BCG vaccine is the only licensed vaccine for tuberculosis (TB) prevention and has been widely administered in Iraq, with a coverage rate of 96% among one-year-olds. BCG lymphadenitis, a common complication, occurs in two forms: non-suppurative (self-limiting) and suppurative (with inflammation and pus). Despite its significance, no prior studies have examined its incidence in Iraq.
Objective: To describe the incidence and characteristics of BCG lymphadenitis in children (≤2 years) in Iraq from 2015 to 2022.
Patients and Methods: A descriptive cross-sectional study reviewed TB surveillance data from 2015-2022, analyzing demographic, diagnostic, and treatment outcomes of children diagnosed with BCG lymphadenitis. Data were presented as frequencies and percentages.
Results: Out of 344 cases, 64.5% were male, and the highest incidence was in 2018 (67 cases). Most cases were from Baghdad (35.2%). Diagnosis was bacteriologically confirmed in 51.2% of cases, with 80.8% achieving successful treatment outcomes. The overall incidence ranged from 1 to 6 per 100,000 vaccinated children, with a notable prevalence among total TB cases in 2021 (1.24%).
Conclusions:
The low incidence of BCG lymphadenitis in Iraq may be attributed to the vaccine strain (Tokyo 172), experienced vaccinators, and proper handling. Recommendations include improving side-effect reporting systems and involving private healthcare in surveillance.

UTIs are a dominant clinical disorder that can substantially impact renal function, particularly in instances of recurrence or severe illness. These infections are primarily attributed to uropathogens including Escherichia coli, Klebsiella spp., and Proteus spp., while Enterococcus spp. and Staphylococcus saprophyticus, also significantly contribute in some demographics. Urinary tract infections provoke inflammatory responses that disrupt normal renal physiology, leading to biochemical alterations in renal function indicators. Primary indicators consist of elevated serum creatinine and BUN levels, signifying glomerular filtration rate and tubular dysfunction. Moreover, glomerular filtration rate typically diminishes during infection due to inflammation and decreased renal perfusion, highlighting the reduction in renal function. Other prevalent electrolyte imbalances, such as hyperkalemia and hyponatremia, also signify tube damage and dysfunction in the management of fluids and electrolytes.
Severe infections, particularly pyelonephritis, exacerbate these biochemical abnormalities and may result in acute kidney injury or chronic kidney diseases, if not addressed. Chronic infection leads to oxidative stress, tubular injury, and renal scarring, which progressively deteriorate kidney function. Comprehending these biochemical alterations is crucial for early diagnosis and care to avert prolonged renal problems resulting from UTIs. This review has examined the correlation between urinary tract infections and alterations in renal function indicators, emphasizing the necessity of prompt and efficient treatments. Moreover, analyzing these biochemical indicators enables the clinician to evaluate the infection's severity and customize suitable therapy approaches to mitigate renal damage and maintain renal health

Background: Vitamin D deficiency is a widespread health concern with significant implications
for women’s health. Understanding knowledge, attitudes, and practices, regarding Vitamin D is
crucial for effective interventions.
Objective: To evaluate the knowledge, attitudes, and practices related to Vitamin D among
women attending primary health centers in Baghdad, Iraq.
Subjects and Methods: From March 1st to August 31th, 2024, a cross-sectional study was
conducted in 10 primary healthcare centers across, two districts in Baghdad Al-Rusafa. The study
included 500 women (mean age 36.15 years), and data were collected through structured
questionnaires assessing demographics, knowledge sources, attitudes, and practices. Statistical
analysis examined associations between knowledge, attitudes, and practices levels and
sociodemographic factors.
Results: The majority had a fair knowledge of Vitamin D, with over a quarter demonstrating
good knowledge, and the rest were poor. While most participants recognized sunlight and fatty
fish as Vitamin D sources, gaps persisted regarding ideal sun exposure times and the role of skin
pigmentation in synthesis. Positive attitudes were common, especially among those with higher
education levels. Yet, practical application remained limited, with low adherence to consuming
Vitamin D-rich foods, reading food labels, and regular sun exposure. Media and healthcare
professionals were the main knowledge sources, though the reliability of media was uncertain.
Sociodemographic factors like age, marital status, and occupation had no significant impact on
knowledge or practices, but education level was associated with positive attitudes.
Conclusion: This study on Vitamin D deficiency among women found fair knowledge but
persistent misconceptions about sunlight exposure, diet, and skin pigmentation. Higher-educated
women showed more positive attitudes, yet adherence to recommended behaviors was
inadequate. Other sociodemographic factors had minimal influence, highlighting the need for
targeted public health interventions to improve awareness and practices.

Background: Most people who complain corona viruses' disease fully recover, but current evidence suggests approximately 10–20% of people experience a variety of mid and long-term effects after they recover from their initial illness. Yet the current understanding of causes of post corona viruses' disease condition and why some people are more affected is limited.
Aim of study: To identify the persistent symptoms and signs following corona viruses disease and factors related to these symptoms and signs.
Patients and methods: A cross-sectional study was carried out in four primary health care centers within Al-Doura Health District in Baghdad City-Iraq from first of February to 31st of December, 2022 on a sample of patients with previous corona viruses’ disease. The symptoms were classified into early or late according to duration (earlier than or longer than three months).
Results: A total of 442 patients were included in the study. Late respiratory features were observed in 44.8% of corona viruses disease patients, late cardiac features were detected in 19.2% of them and musculoskeletal features were observed in 60% of them. Common late clinical features of corona virus’s disease were fatigue (49.3%), weakness (36%), hair loss (32.8%), headache (27.8%), muscle pain (25.6%), mood changes (25.8%), brain fog (24.4%), and dyspnea on walking (22.6%).
Conclusions: Diabetes mellitus, respiratory and cardiac clinical features were significantly higher during early manifestation of the illness whereas the dermatological, neurological and mental clinical features were more likely to persist late after corona viruses' disease recovery.

Background: The copper element plays an important and vital role in the chemistry of human organs and body, as it is involved in many vital activities. Therefore, copper lake or deficiency leads to make many health problems and defects in some of the functions of the human body.
The body of any human obtains copper by adsorption throughout the daily food consumption. While the liver controlling the process of absorption, subtraction, and storage of copper. Besides, the liver also controls the concentration of copper in human blood within a certain range.

Objectives: The current study aims to obtains the average concentration of copper in the blood of people working directly with this element in copper foundries, especially people working in the copper foundry in the Al Shaheed General Company affiliated to the Iraqi Ministry of Industry, to find out the extent of the effect of direct contact between humans and this metallic element on the levels of copper concentration in the blood of those people, the target of this study.

Patients and Method: This study was conducted on the people work at copper foundry in Al Shaheed General Company located in Fallujah city. The blood samples were collected from the workers during 1/3/2024 to 1/4/2024.

Results: The results showed a noticeable increase in the concentration of copper in the blood of people working in direct contact with the industrial production of this element, which requires conducting other research studies to diagnose and know the health effects of this increase in copper concentration rates among people working in this industrial site.

Conclusion:
The results showed unacceptable concentration of copper in worker's blood therefore, more studies should be conducted on these workers to find out the health problems from this matter and more than this to find the solution.
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Background: Human Immunodeficiency Virus remains a significant global health challenge, particularly affecting vulnerable populations. Nursing students play a crucial role in Human Immunodeficiency Virus prevention and care, making it essential to assess their knowledge and attitudes towards Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome.
Patients and methods: A cross-sectional study was conducted at Baghdad University, College of Nursing, from the 1st of March 2024 to the 31st of May 2024, involving 444 undergraduate nursing students. Data were collected using a structured questionnaire addressing sociodemographic characteristics, knowledge, and attitudes towards people living with Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome. Analysis was used to determine the association between knowledge, attitudes levels and sociodemographic variables.
Results: Participants' ages ranged from 18 to 22years, with a predominance of females (73.9%). Knowledge levels were categorized as good (48.4%), fair (30%), and poor (21.6%). Significant associations were found between knowledge and academic grade. Attitudes were classified as positive (50.9%) and fair (49.1%), with Significant associations were found between attitudes levels and academic grade and age.
Conclusion: The gap in knowledge and attitudes levels highlights a need for enhanced educational programs targeting Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome among nursing students. Addressing misconceptions and stigma within nursing curricula is vital to improve care for people living with Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome and contribute to broader public health efforts against HIV/ AIDS.

Background:The nasal cavity, paranasal sinuses, and nasopharynx are affected by a number of neo￾plastic and nonneoplastic disorders. Determining whether the lesion is neoplastic or nonneoplastic is
challenging. Therefore, histopathological analysis is crucial for both the pathologists and surgeons.
Objective: The purpose of this study was to assess the histopathological analysis of disorders of the
paranasal sinuses, nasal cavity, and nasopharynx according to their frequency, age, sex, and
distribution by site.
Methods: The current study with cross-sectional design was carried out in the pathology department
of Shahid Ghazi Al-Harery Teaching Surgical Hospital in Baghdad Medical City over a three-year
period from December 2021 to December 2024.
Results: Among 299 patients: 203 were males and 96 were females. The most affected age group in
our study was from the 2nd decade to the 4th decade. Among 299 cases; 169 non-neoplastic lesion
cases and 130 neoplastic lesion cases of which 60 were benign and 70 were malignant. Out of 169
cases of non-neoplastic lesions; inflammatory nasal polyp (81 cases) was the commonest lesion. Out
of 60 benign neoplastic cases; sinonasal papilloma (24 cases) was the commonest benign neoplastic
lesion. Out of 70 malignant cases; nasopharyngeal carcinoma was the predominant histological type
constituting 35 cases.
Conclusion: the majority of nasal cavity, paranasal sinus, and nasopharyngeal lesions can appear as
polyp-like lesions; a histopathological analysis of these lesions can assist surgeons in diagnosing a
condition and choosing the best course of therapy for the patient

Background: Chronic Myeloid Leukemia is driven by the BCR-ABL fusion protein, a potent tyrosine kinase that arises from the Philadelphia chromosome. While tyrosine kinase inhibitors have revolutionized Chronic Myeloid Leukemia treatment, resistance remains a challenge. Recent research highlights the role of adenosine-to-inosine (A-to-I) RNA editing, mediated by ADAR1 enzymes, in various cancers. Aberrant ADAR activity has been implicated in hematological malignancies, suggesting potential new therapeutic avenues for Chronic Myeloid Leukemia.
Aim of study: Estimation of ADAR1 enzyme among Chronic Myeloid Leukemia patients and correlation with BCR-ABL1 ratio.
Materials and methods: This case-control study examined 120 Chronic Myeloid Leukemia patients (including newly diagnosed and treated) and 30 healthy controls, investigating the relationship between BCR-ABL1 gene, ADAR1 enzyme levels, and treatment outcomes (response vs. failure) in Chronic Myeloid Leukemia. The study analyzed blood samples from all participants, including those receiving imatinib or other tyrosine kinase inhibitors. Detection of BCR-ABL1 by conventional PCR as well as estimation of ADAR1 enzyme using sandwich ELISA.
Results: ADAR1 enzyme levels are elevated in Chronic Myeloid Leukemia patients, especially those with treatment relapses and BCR-ABL1 mutations. ADAR1 enzyme elevated among CML patients with a BCR-ABL1 mutation
Conclusion: ADAR 1enzyme levels are higher in Chronic Myeloid Leukemia patients with relapses compared to those responding to treatment. This suggests a potential role for ADAR 1 enzyme in disease progression and resistance to therapy.

Background: The lack of basic knowledge about puberty and menstruation may contribute to the stress and shame associated with menstruation which negatively affect mental health, and unhygienic sanitation products may make girls susceptible to reproductive tract infections.
The Objectives of the Study: To assess the knowledge and practice among female students in secondary school toward menstrual health and hygiene. And to determine factors associated with knowledge and practice.
Subjects and Method: A cross-sectional study with an analytical purpose, that was carried out in Baghdad governorate in AL- Karkh side from the 14th of February 2024 to the 1st of December 2024. Seven hundred and fifty female students were selected by multistage random sampling. The data were collected by a self-reported questionnaire. Data were collected for three consecutive months (February to April)
Results: The mean age of female students was 15.67±1.895 years, there were six grades; with 125 (16.7%) female students from each one. The mean age of menarche was 12.38±1.169 years ranging between 7-16 years, out of them, 427 (56.9%) female students began menstruating at 12 years or less, and 323 (43.1%) began menstruating after 12 years. The mean knowledge score was 7.99±1.858. 254 (33.9%) participants had poor knowledge, and 496 (66.1%) had good knowledge. The mean practice score was 3.68±0.888. There were 281 (37.5%) participants had poor practice and 469 (62.5%) participants had good practice. Good knowledge was significantly associated with participants in high school, those whose mothers and fathers had a college level of education, employed mothers, and among participants whose source of knowledge about menstruation was the mother. Good practice was significantly associated with participants aged >15 years, those whose mothers had a college level of education, employed mothers, participants whose source of knowledge about menstruation was health personnel, and participants who had good knowledge.
Conclusion: A higher proportion of the total students had good knowledge and good practice.

Background: with an aging population, elderly well-being is a key concern. In Iraq, family
and culture play a vital role in elderly care, making quality of life assessment essential for
policy and healthcare improvements.
Objectives: To assess quality of life among individuals aged 65+ and its association with
sociodemographic factors.
Method: A cross-sectional study conducted over a period from March to August 2024 in five
primary care centers in Al-Karkh, Baghdad, included 384 randomly selected participants. The
WHOQOL-BREF questionnaire measured physical, psychological, social, and environmental
well-being.
Results: The mean quality of life score was 52.3 (±13.6), with 46.9% reporting moderate
quality. Higher scores were linked to younger age, male gender, higher education, and
financial sufficiency. Chronic diseases affected physical and psychological well-being, while
marital status influenced social well-being.
Conclusion: Elderly quality of life in Baghdad is shaped by sociodemographic and health
factors. Broader population-based studies are recommended..

Background: Adolescent pregnancy is considered as one of the most important social and public health problems all over the world. Early marriage is the contributing factor to high maternal morbidity and mortality.
Aim of the study: To evaluate the obstetrical complications and neonatal outcome of teenage pregnancies in comparison with adult pregnancy in AL–Fallujah Maternity and Children Teaching Hospital.
Subjects and Methods: A comparative cross sectional study. The study was carried out during the period from September 2024 through March 2025 . A convenient sample was collected from Department of obstetrics and gynecology in AL–Fallujah Maternity and Children Teaching Hospital. The study group composed of 60 pregnant teenagers in the third trimester aged between 15-19 years and the comparable group composed of 60 pregnant women aged 20-29 years in the third trimester age. Informed verbal consent was obtained from all the study subjects.
Results: The mean age of teenage pregnant women was significantly younger than controls (p<0.001). No significant differences were observed between study groups regarding residence (p=0.2). Illiteracy was significantly related to teenage pregnant women (p<0.001). There was a statistically highly significant association between lack of contraception use and teenage pregnancy (p<0.001). No significant differences were observed between study groups regarding antenatal care visits (p=0.6) and mode of delivery (p=0.5). A highly significant association was observed between hypertensive disorders of pregnancy and controls (p<0.001). The anemia was significantly highly prevalent in teenage pregnancy than controls (p=0.005). No significant differences were observed between study groups regarding obstructed labour (p=0.6), preterm labour (p=0.4), low birth weight (p=0.4) and fetal status (p=0.3), however, fetal mortality rate between teenage pregnant women was 1.7%, while no dead fetuses in controls.
Conclusion: Illiteracy was significantly related to teenage pregnant women (p<0.001). Teenage pregnant mother had significantly lower level of education, they were less likely to use family planning and contraception methods and they have a high rate of pregnancy complications like PET, gestational hypertension, anemia.

Background: Malnutrition is a comprehensive term to describe under- and overnutrition, but it is
primarily used for undernutrition. It is recognized as a critical health issue in older adults
worldwide due to its serious consequences, such as increased morbidity, healthcare costs, and
mortality. Malnutrition poses a significant concern among older patients in rehabilitation
settings, leading to poorer recovery of functional capabilities and an increased risk of
hospitalization and institutionalization. Contributing factors include reduced physical function,
socioeconomic status, and polypharmacy.
In recent years, obesity rates have significantly risen across all age groups, including older
adults. Beyond the well-known risks of cancer and cardiovascular diseases, obesity in the elderly
is also linked to diminished functional abilities and cognitive impairments.
Aims of study: The aims of this study are to assess the nutritional status of elderly people
attending geriatric clinics in Baghdad during the year 2024, and to find the association between
nutritional status and certain sociodemographic factors.
Patients, material and Methods: A Cross sectional study design that included 360 participants
during the period from 1st of March 2024 through August 2025, the sample was collected from
primary health care centers and teaching hospitals from both sides of Baghdad city. A
questionnaire was used for data collection method. Descriptive statistics was presented using
tables and graphs.
Chi-square test was used to find out significantly association between related category variables.
P-value < 0.05 was considered as discrimination of significance.
Conclusions: This study highlights a significant risk of malnutrition among elderly contributors,
representing a serious public health issue. Complete nutritional assessments and targeted
interventions are essential, including education and meal assistance. Further research should
focus on identifying contributing factors and evaluating intervention effectiveness.

Background: Breast cancer is the leading cause of cancer-related deaths among women worldwide. Early detection through screening methods such as mammography significantly reduces mortality rates. However, knowledge, attitudes, and practices regarding breast cancer screening vary widely, particularly in developing regions.
Aims of study : This study aims to assess the knowledge, attitudes, and practices of women in Baghdad regarding breast cancer and mammography screening. Additionally, it examines the association between knowledge and attitudes to identify gaps in targeted awareness campaigns.
Subjects and Methods: A cross-sectional study was conducted from March to November 2024 at Al-Kindy Teaching Hospital in Baghdad. A total of 384 women aged 20 years and older were recruited using a convenience sampling method. Data were collected through self-administered questionnaires covering demographic details, knowledge of breast cancer risk factors, awareness of signs and symptoms, and attitudes and practices regarding mammography. Descriptive statistics and chi-square tests were applied using SPSS-27 to analyze the data.
Results: The results shows that more than half of the participants (51.6%) demonstrated moderate knowledge about breast cancer risk factors and symptoms, while 38.5% exhibited good knowledge. However, awareness of modifiable risk factors such as obesity, alcohol consumption, and oral contraceptive use was notably low. Regarding attitudes, 54.2% of women believed that early detection prolongs life, yet 51.6% expressed neutral attitudes toward screening. Only 37.5% had undergone mammography, with adherence to regular screening remaining low. Significant associations were found between knowledge and age (p = 0.031), education (p = 0.019), personal (p = 0.004) and family history of breast cancer (p < 0.001). Practices were significantly associated with education (p = 0.05) and personal history (p < 0.001). 
Conclusion: The study revealed a moderate level of breast cancer awareness among women in Baghdad, with notable gaps in knowledge about modifiable risk factors and screening practices. Public health efforts are needed to enhance awareness, promote regular screening, expand access to affordable services, and address psychological barriers to early detection.

Background: Spontaneous intracerebral hemorrhage is a leading cause of stroke-related mortality, with a 30-day fatality rate of approximately 40%. Acute blood pressure surges, potentially triggered by physiological and environmental factors such as Valsalva maneuvers, infections, and emotional stress, have been hypothesized as precipitating events. Identifying these triggers is crucial for developing targeted prevention strategies.
Objective: To identify types of potential trigger factors in patients with sICH and to study their association with demographic and clinical characteristics.
Patients and Methods: A retrospective cross-sectional study was conducted at Baghdad Teaching Hospital and Alyarmook Teaching Hospital from March to November 2023. Data from 50 patients diagnosed with sICH were collected, including demographics, medical history, and exposure to potential triggers. Statistical analyses, including chi-square tests and odds ratio calculations, were performed using SPSS version 23.
Results: The mean patient age was 59 ± 11.27 years, with a male predominance (2:1). Hypertension was the most prevalent comorbidity (80%), followed by diabetes (36%). Potential triggers were identified in 48% of patients, with Valsalva maneuvers (18%), flu-like illnesses (14%), emotional stress (10%), and sexual activity (6%) being the most common. A significant association was found between hypertension and the presence of triggers (p=0.041). Deep intracerebral hemorrhage was the most frequent type (60%).
Conclusion: Nearly half of sICH cases were associated with identifiable triggers, with Valsalva maneuvers being the most common. The significant association with hypertension underscores the importance of blood pressure management in reducing sICH risk in high-risk individuals.

Background: Growth hormone deficiency is a common cause of short stature. Currently, for
the accurate diagnosis of growth hormone deficiency, there is no single biochemical
parameter used. Afamin is a glycoprotein generated from the liver, and it’s a novel metabolic
biomarker, Age, gender, prandial state, or circadian rhythms do not affect the circulating
levels of Afamin, which is rather stable and can be tested in serum or plasma.
Objectives: To assess whether serum Afamin levels (both basal and stimulated) could serve
as an alternative or complementary diagnostic marker for growth hormone deficiency in
children with short stature.
Methods: A case- control study involve a total of 80 children,40 short stature with GHD and
40 control also short stature without GHD, aged 6-15 years attended the the National Diabetic
Center for Treatment and Research/Al-Mustansiriya University in Baghdad/Iraq for the
period from October 2024 to January 2025. Blood samples were collected from the studied
subjects to determine levels of basal GH, after 60 mins and 90 mins of provocation with
clonidine. The study also included the measurement of the levels of basal insulin like growth
factor (IGF-1) and Afamin both basal and after stimulation
Results: Growth hormone deficiency patients demonstrate higher Afamin levels compared to
controls (P < 0.01), even after stimulation serum Afamin levels remain significantly higher.
Conclusions: serum Afamin level might be useful biomarker for the diagnosis of growth
hormone deficiency in children. Further large studies are needed to confirm the diagnostic
utility of the serum Afamin level.

Background: One of the biggest worldwide health risks is epilepsy. Epilepsy is the most common
neurological illness in the world, affecting 50 million individuals, according to WHO estimates.
Aim of the Study: The aim of the study is to assess the level of knowledge of women about
epilepsy in Baghdad city.
Subjects and methods: A cross-sectional was conducted on 384 women attending to AL-Kindy
teaching hospital in Baghdad governorate. The women were selected as a non-probability sampling
(convenience sample method). A Chi-square test (X2-test) was utilized to identify the significance of
qualitative data percentage differences. The study is conducted throughout the period of 1st of March ,
2024 to 1st of November , 2024.
Results: The results reveal that the highest percentage (69.0%) of the women has an acceptable
knowledge score, and 31.0% of the women have a poor knowledge score. While 0.0% of the women
have a good knowledge score. The results report a significant statistically association between total
knowledge score and demographic characteristics of women (P. value <0.05), except for marital status
in which p. value>0.05.
Conclusions: The study concludes that most participants have an acceptable assessment level of
knowledge towards epilepsy. There were low levels of mother’s knowledge regarding causes, and
manifestations, treatment of epilepsy. The study recommends improve health personal knowledge
specifically technique to take their rolling teaching and gave advice and instructions through prenatal
care and postnatal care.

Background: measles is highly contagious disease and is the leading cause of childhood mortality and morbidity worldwide, despite the adoption of effective vaccine, many outbreaks occurred globally understanding the epidemiological criteria of measles are very important in order to control measles spread.
Aim of the study to assess the epidemiological criteria of measles outbreak in Al-Elwyi Pediatrics Teaching Hospital in 2024 and to find out the association between measles outbreak, vaccination statues and sociodemographic character of mother.
Subject and methods: descriptive cross-sectional study conducted in AL-Elwyia Pediatric Teaching Hospital, Baghdad, Iraq during a period of 5month from (1st February to 30th June 2024.), 265 children were chosen for the study by convenient method of sampling by interviewing with the mothers of all children whom suspected cases of measles by clinical feature and visited to Al-Elwyia Pediatrics Teaching hospital outpatient clinic. Descriptive statistics and chi-squire tests were applied to analyze the data.
Result: among 265 children with measles, this study demonstrates that the highest percent of cases belonging to under one years of age (41. 9%) regarding sex (55. 8%) of cases were female and 42.9% were unvaccinated. The most common clinical features were fever, maculopapular rash and cough where gastroenteritis and conjunctivitis are less common. The study also showing that 43.8% of children with measles have history of contact with measles cases. The study demonstrates significant relationship between vaccination rate and education level of mothers.
Conclusion: The cluster of cases in Baghdad and among families with low socioeconomic status suggests inequities in healthcare access and preventive measures. The high percentage of unknown infection sources points to gaps in public health measures for tracking and containing outbreaks. The association between maternal education and vaccination highlight the importance of addressing educational barriers to improve vaccine uptake.

Abstract
Memory is important in medical education. It helps medical college students preserve their attention on their studies and recall information over time. Lately, neuroscientists and psychologists have erudite more about the exact nature of memory to augment medical education. This review looks at how memories are kept in the brain and affords helpful advice on how to recall what we have learnt. The objective is to support medical students to deal with the serious tricky of knowledge overload while sustaining their sanity.