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.