Thi-Qar Medical Journal

Thalassemia, a prevalent autosomal recessive disorder in Iraq with an incidence of 35.7 per 100,000. Affected individuals rely heavily on family caregivers for medical management and psychosocial support, which often results in significant caregiver emotional, mental, physical, and economic burden. This study aimed to identify the types of family caregivers’ burdens of thalassemia patients and to find out the association between types of burden and among caregivers’ and some sociodemographic characteristics. A cross sectional study was conducted in thalassemia and hemophilia center in Rania City. from September 22, 2024 to the end of April, 2025. This study employed a census approach, including all thalassemia clients\' caregivers who were directly involved in patient care, which was 65 caregivers who have been providing care for thalassemia patient. The data were collected using a constructed questionnaire based on a review of relevant literature and standardized psychological assessment tools. A total of 65 caregivers, all of them were patients mainly (67.7%) were mothers. The overall caregiver burden for physical and financial problems was high and moderate burdens for psychosocial health problems. The study also showed an association between caregivers\' socioeconomic factors (lower education, lower income, and specific marital statuses) and physical and financial burdens. Caregivers of thalassemia patients experience significant physical and financial hardships, as well as moderately impacted psychological and social aspects. The Kurdistan Regional Government (KRG) should subsidize thalassemia treatments and partner with NGOs to ease the financial burden. The Ranya Center needs integrated mental health services and peer support groups.

Background: A variety of thyroid disorders including benign and malignant that are indicated for either total or partial thyroidectomy. Although both surgeries aimed to eliminate the symptoms and prevent the progression of the disease, their impact on quality of life and complication rate may vary. The current study aimed to compare complication rate and quality of life outcomes (QoL) between total and partial thyroidectomy patients. Methods: A cross-sectional study was conducted between November 2024 and April 2025 involving 160 patients (80 total thyroidectomies, 80 partial thyroidectomy) who had undergone thyroid surgery at Shar Hospital and Smart Health Tower. Data were collected through a semi-structured questionnaire that covered physical, emotional, and social QoL domains. Statistical analysis was performed by using SPSS through chi-square, Mann-Whitney, and Kruskal-Wallis tests. Results: The majority of participants were female (76.9%) and aged between 36–55 years. The total thyroidectomy group showed a significantly higher rate of postoperative complications (p = 0.013), with seroma and hypocalcemia being the most frequent. Total thyroidectomy was also associated with significantly higher impairment in physical (p < 0.001), emotional (p = 0.003), and social (p = 0.007) quality of life domains. Conclusion: Patients having a total thyroidectomy reported decreased quality of life and more postoperative complications than those having a partial thyroidectomy. These results emphasize the importance of surgical decision-making and the need for accurate preoperative counseling, especially with relation
to expected outcomes and QoL effects.

Sleep deprivation is increasingly common among high school students in grades 10–12 due to academic pressure, social factors, and lifestyle changes. Although adolescents need 8–10 hours of sleep, most do not achieve this. Lack of sleep negatively impacts their physical health (metabolism, immunity) and psychological well-being (mood, thinking ability), and long-term deprivation can lead to depression, anxiety, obesity, and poor academic performance. Understanding these physiological and psychological factors is crucial for improving students’ overall health and school outcomes. The objectives of this study are to identify the main sociodemographic characteristics of high school students, to determine the physiological and psychological factors associated with sleep deprivation, and to assess the association between selected sociodemographic characteristics and the identified physiological and psychological factors among the study sample. A quantitative cross-sectional study was conducted from November 2024 to May 2025 to assess the prevalence and factors associated with sleep deprivation among high school adolescents in Ranya City. A representative sample was drawn from five randomly selected public schools using stratified random sampling. Data were collected through a constructed questionnaire based on relevant literature and standardized tools, validated by 19 experts, and shown to have a reliability coefficient of r = 0.736. The questionnaire covered sociodemographic information, academic performance, screen time, physical activity, caffeine intake, and sleep patterns. Out of 327 participating students, 229 who reported sleep deprivation were included in the analysis of physiological and psychological factors. Among them, 76.9% sometimes experienced physiological disruptions such as caffeine use, physical discomfort, and hunger before sleep, while 54.6% reported psychological discomfort related to schoolwork, personal matters, and emotional stress. Psychological factors showed significant associations with gender, grade level, parents’ occupations, and economic status, whereas physiological factors were not significantly related to any sociodemographic characteristics. The findings show that psychological factors contributing to sleep deprivation are closely tied to gender, grade level, parental employment, and socioeconomic status, while physiological factors are shaped more by individual habits than by background characteristics. Overall, the results highlight the need to prioritize psychological stressors when promoting better sleep health among adolescents.

Articular cartilage, a tissue that is particularly known for its self-repairing deficiency, is a major challenge in regenerative medicine. Gelatin Methacrylate (GelMA) is a multifunctional and biocompatible hydrogel, which has attracted much attention as a potential scaffold material for cartilage tissue engineering. This paper gives a detailed characterization of GelMA hydrogels with regard to the effect of polymer concentration on their physicochemical and biological properties. We performed an in-depth analysis of GelMA at concentrations of 5%, 10% and 15% (w/v) and their mechanical strength, swelling kinetics, degradation rates and porous architecture. Additionally, we have synthesized and critically reviewed optimal parameters for 3D bio-printing of constructs based on GelMA for cartilage regeneration. Our results show that the mechanical properties are significantly improved with an increase in the concentration of GelMA from 5% to 15%, and the compressive modulus has been increased from 3.3 +- 0.5 kPa to 30.0 +- 4.0 kPa. This enhancement, however, comes with a decrease in porosity, swelling ratio and degradation rate. While no one GelMA formulation reproduced the mechanical properties of native articular cartilage, a 10% (w/v) concentration of GelMA, with optimized 3D bioprinting parameters, appears to be a well-balanced formulation. It provides a good compromise between mechanical stability and microenvironment that allows the viability, proliferation, and chondrogenesis of cells. This critical review highlights the opportunities of the GelMA as a highly tunable and promising platform in which effective and clinically relevant cartilage repair and regeneration strategies can be developed.

One of the most significant opportunistic Gram-negative bacteria that frequently linked to catheter associated and urinary tract infection is Klebsiella pneumoniae. Their ability to produce biofilms and antibiotic resistance are the two main factors that contribute to the persistent infections. The dissemination of carbapenems and fluoroquinolones resistance offers a significant confrontation to the treatment of life-threatening infections produced by K. pneumoniae. The study aimed to investigation the prevalence of the carbapenems and fluoroquinolones resistance genes (blaOXA-48, and qnrS) in K. pneumoniae. From December 2023 until July 2024, a total of 200 samples were collected in this study including urine (n=100, 50%), and semen (n=100, 50%) from admitted patients to Fertility Center and outpatient from Private Labs in Al-Najaf, Al-Diwaniyah and Karbala governorates. Semen culture and urine culture were done for all the patients. Using Vitek2 compact system to identification and susceptibility to antibiotic profiling of K. pneumoniae. PCR experiment were performed on the isolates with specific primers to blaOXA-48, and qnrS. The results showed the recovery rate of K. pneumoniae isolates was (n= 17, 8.5%) from the clinical samples, divided as follow 13 isolates from urine and four isolates from semen, The prevalence of carbapenem resistance gene among K. pneumoniae isolates was to blaOXA-48 gene (64.7%), While fluroquinolones resistance gene qnrS was (94%). The study concluded increased carbapenem and fluoroquinolone resistance gene in Al-Najaf, Al-Diwaniyah and Karbala governorates highlights the importance of this problem while managing life-threatening multidrug-resistant K. pneumoniae infections.

Usually identified in the second quarter of being pregnant, pregnant diabetic mellitus (G.D.M) becomes a frequent pregnant problem. Mothering diabetic presents an important medical danger regarding the female as well as the fetus alongside is linked to pregnancies. There is mounting proof showing that pregnant women having presentational diabetic type 1 mellitus (T1.DM) as well as type 2 diabetes mellitus (T2.DM) experience greater numbers of serious pregnancy-related issues than pregnancies women having pregnancy-related diabetes mellitus (G.D.M). An overview of the current research on miRNAs as diagnostic biomarkers for pregnant as well as pregestational diabetes is the goal of this research project. Methods: One hundred ladies participated in this research as participants. Between the fifth of September 2024, to the 28th of May 2025, 50 women with pregnancyrelated diabetes visited the diabetic consulting clinics at the Maternals & KidsEducationalHospital located within Al-Diwaniyah Province. Medically historical events testing in the lab (HbA.1ctest), as well as fasting evaluations were used for diagnosing individuals with pregnancy-related diabetes. Results: During the present research, the gene expression of comparative mi.RNA222 as well as the level of expression within the participants in the G.D.Mgroup as well as the presumably controls were quantitatively examined using RTPCR. Additionally, a mathematical RT-PCR examination for comparing miRNA222 expressing themselves was conducted in the present research compared the set of participants GDM as well as the controls, ostensibly. Conclusion: Owing to this research, miR 21 5p might be a useful biomarker for G.D.M. Additionally, miR 222 3p seems to have a positive correlation between fasting plasma glucose, confirming its function in metabolizingglucose, whereas miR-21 may affect resistant to insulin as well as the absorption of glucose.

Evaluating female patients with severe lower abdominal pain in the casualty department presents a significant diagnostic challenge due to the presence of multiple pelvic organs with overlapping symptoms. Conditions such as pelvic inflammatory disease, endometriosis, ovarian cysts, urinary tract infections, and acute appendicitis often mimic one another. Among these, differentiating right ovarian cysts from acute appendicitis is particularly difficult because both can present with similar right lower abdominal pain.This study aimed to differentiate them clinically based on history, clinical examination, and laboratory studies .The history of presentation is based on an analysis of pain (including severity, duration, time and location of onset, nature of pain, and associated symptoms such as nausea or vomiting), as well as factors like loss of appetite, abdominal distension, fever, frequency of urination, vaginal bleeding, irregular menstrual cycles, hormonal drug history, trauma to the abdomen, gynecological history, and surgical history. Physical examination relies on inspection, palpation, percussion, and auscultation. Our investigation indicates that acute appendicitis can induce abrupt and strong pain in the lower abdomen. A pain starts in the middle of the abdomen, around the belly button, and typically in the right iliac fossa. It could come and go for a few hours, and the pain moves to the lower right side of the abdomen. will lead to nausea and vomiting, the nausea goes away after a few hours, and the fever is caused by the immune system. (feel sick in general). This is because the appendix is bothering the colon next to it . Symptoms of ovarian cysts that don't involve speaking include pelvic pain, a feeling of fullness or pressure in the abdomen, bloating, changes in bowel habits (like constipation or trouble going to the bathroom), urinary problems (like needing to urinate often or having trouble emptying the bladder), and in some cases, problems with fertility or irregular periods. Yet when these symptoms change, they get worse when a cyst gets bigger, breaks, or twists.To tell the difference between acute appendicitis and a right ovarian cyst, you need to do a full history, physical exam, blood testing, and imaging studies. For the safety of the patient, it is important to resuscitate them quickly in the emergency room using intravenous fluids, blood transfusions, antibiotics, and bladder catheterization before surgery.

Ischemic heart diseases (IHD) a condition that happens when the heart doesn't get enough blood. Inflammation is the underlying common mechanism involved in IHD. Kynurenine pathway, as a major route of tryptophan degradation, its metabolites have been revealed to be crucial in CVD and involved in several biological processes such as immune-regulation, inflammation, and metabolism. Different enzymes have been shown to participate in the kynurenine pathway such as KMO, 3-HHAO. The study aimed to identify whether the metabolites of tryptophan degradation have an association with development of inflammatory event of IHD and its progress A case-control study was conducted at cardiac center in Thi-Qar Governorate, with participants:90 patients with IHD divided into 3 groups, myocardial infraction (M, n=30), angina (AN, n=30) and heart failure (HF, n=30. A 60 sample (n=60) were collected from healthy people as control group. KMO, and 3HHAO were identified by ELISA, while tryptophan concentration was measured by HPLC technique. Statistical tests were applied by using one-way ANOVA and ROC curve analysis. Tryptophan concentration was decreased significantly (P value < 0.001) in patient groups compared to control group. The levels of KMO and 3-HHAO were significantly elevated (P value < 0.001) in patients than control. These findings suggest inflammatory events in IHD induced tryptophan catabolism through the kynurenine pathway which plays a significant role in modulating immune response and influencing the development of CVD.

Most people with diabetes have hyperglycemia, or uncontrolled blood sugar, which can lead to a number of dangerous side effects, such as diabetic nephropathy. Finding new indicators that can give early diagnosis and prevent consequences has become more crucial as a result of the lack of early detection. Many kidney disorders originate and advance as a result of damage or dysfunction to podocyte cells. This increases the possibility of employing podocyte cell product targets, particularly in urine, as practical clinical markers for kidney disease diagnosis and surveillance. A cross-sectional study will be carried out to a group of 70 diabetic patients with diabetic nephropathy 20 healthy control. A total of 25 mL urine was collected. Alb/Cr ratio in a random urine sample . Serum creatinine, serum albumin and HbA1C. Urinary Albumin / creatinine ratio. Urinary podocalyxin, nephrin and podocin were determined by using commercially available ELISA test. According to the study, 50% of patients with normoalbuminuria have greater urine Nephrin levels than the healthy control group. Nephrin levels are also higher in the former group. These results imply that Nephrin initially manifests in the urine before microalbumin in the early stages of kidney injury. According to the data, both the UM/CR and CKD staging categories had significantly higher urine nephrin levels than the healthy control group. Urinary nephrin levels gradually increased with CKD stage, particularly in stages two and three, and it was shown that urine nephrin was more sensitive than the UM/CR ratio for early kidney damage identification. Diabetes patients had much greater amounts of nephrin, and podocalxyin in their urine compared to the healthy control group.

Background: Giardia lamblia is the cause of giardiasis, one of the most prevalent parasitic illnesses in the world that affects millions of people annually. Although the majority of infections are most likely asymptomatic, some are linked to intestinal irritation and subacute or chronic diarrhea, which can lead to malabsorption and nutritional deficiencies, particularly in children.Aim of study :is to Assessment of interleukin 37 and some immune parameters in patients with giardiasis .Patients and methods:The stool samples were collected and labeled with the patient's information in sterile plastic containers and checked via the naked eye for colour, consistency, after that, they were analyzed using light microscopy to check for the presence of Giardia trophozoite and cyst stage.(45)blood samples were taken from suspected G. lamblia patients, and (45) blood samples from healthy individuals as a control group. Blood samples were captured to enable to establish the white blood cell (WBC) count. Results: The outcomes of the research demonstrated that both male and female patients infected with G. lamblia had significantly lower levels of IL-37 (p >0.05) in their 72.36 ±10.87 concentrations than in the control group (86.51 ±11.83). WBC levels It reveals a substantial rise in the number of infected patients (8.94 ± 4.36) in contrast to 7.44 ± 2.4 of the control collective. (P<0.05) . Conclusion : the spread of the disease depends on the environmental conditions as well as on factors specific to the host and the strength of occurrence affected by these conditions.

Background. Acute myeloid leukaemia (AML) is a malignant clonal disorder of immature cells in the haemopoietic hierarchical system. Flow cytometry (FC) immunophenotyping is essential for diagnosis and subtyping of AML. CD2 antigen is expressed on thymocytes, peripheral T cells, NKCs, and a subpopulation of B cells; it is aberrantly expressed in a quarter of cases of acute promyelocytic leukaemia.
Aims. This study is designed to investigate the frequency of the aberrant CD2 expression on adult AML blast cells at the initial diagnosis, and correlate their expression with complete blood count (CBC) results, blast cells percent in peripheral blood (PB) and bone marrow (BM), the AML subtypes, extramedullary manifestations, and the initial response to the induction therapy.
Methods. Thirty adult cases (> 15 years) with de novo AML were consequently selected in the period from the 5th of October 2023 to the 10th of March 2024. Their mean age was 38.97±18.59 yrs (18 males and 12 females). All AML cases were diagnosed according to the WHO criteria for AML and they were diagnosed by cytomorphology and FC for suspected cases. Aberrant antigens CD2 expressions was investigated by eight-color (BD FACSCanto II USA) at diagnosis.
Results. CD2 was expressed on blast cells in 13.3% of AML cases. AML cases with positive CD2 expression were younger than those with negative expression and CD2 was expressed equally by males and females. CD2 was significantly more expressed on leukaemic cells of M3 cases. There was no significant correlation with any of the haematological parameters with CD2 expression. Also it appeared that there were no significant correlations between CD2 aberrant expression with the extramedullary manifestations and with the non-response to the induction therapy.
Conclusion. Aberrant CD2 is significantly more expressed on leukaemic cells of M3 cases. Neither CD2 aberrant expression is found to be significantly correlated with the age, gender, nor with the haematological parameters, induction therapy response or extramedullary manifestations.

Colorectal cancer is a predominant source of cancer-related illness and death worldwide. The study aimed to describe the demographic and clinical factors associated with CRC. A cross sectional study was conducted involving 74 cases of colorectal cancer patients. Analysis was done on demographic factors such age, sex, employment, and place of residence, we gathered clinical information from patients on their tumor site, family history, chronic illnesses, cancer grade, stage, and lymph node metastasis (LNM). Marked disparities were observed among colorectal cancer patients in term of age distribution and occupation with the largest proportion aged 41-50 years (31.08%). Tumor location was mainly on the left side (51.35%) with a significant association (p < 0.01). One-third of patients (33.78%) had a positive family history of colorectal cancer (p < 0.01). Chronic disease presence was higher in patients but not statistically significant (p = 0.11). Most patients presented with grade 2 tumors (78.38%) and stage T3 (78.38%) disease, with a high prevalence of lymph node metastasis (70.27%) (p < 0.01 for all). Sex and residency showed no significant differences between groups. The study highlights significant demographic and clinical disparities among colorectal cancer patients emphasizing the importance of age, occupation, tumor site, family history, and disease stage in CRC risk and progression. These findings can inform targeted screening and tailored treatment approaches.

The autonomic nervous system may be involved in inflammatory bowel disease (IBD). Autonomic dysfunction is linked to systemic issues and altered gut motility, possibly contributing to symptoms. This study evaluates autonomic function using electrodiagnostic measures and examines its relationship to factors such as age, sex, disease duration, treatment type, and the Composite Autonomic Symptom Score-31. A case–control design included 75 individuals, consisting of 45 patients diagnosed with Crohn’s disease or Ulcerative colitis and 30 healthy controls, aged 18 to 60 years, of either sex. Subjects fasted overnight and did not take any medications for IBD or those that might affect heart rate from noon the day before testing. Smokers were asked to abstain on the morning of testing. Patients exhibited lower heart rate variability during normal breathing and Valsalva maneuvers, with a prolonged palmar sympathetic skin response latency compared to controls. 22 (48.9%) showed early dysfunction, 3 (6.7%) had definite dysfunction, and 3 (6.7%) had severe dysfunction. Eleven (50%) early autonomic dysfunction patients showed parasympathetic involvement (7 Ulcerative colitis, 4 Crohn’s disease), 5 (22.7%) had sympathetic involvement (3 Crohn’s, 2 Ulcerative colitis), and 6 (27.3%) had both (3 Ulcerative colitis, 3 Crohn’s). The Composite Autonomic Symptom Score-31 was negatively linked to heart rate responses to deep breathing, Valsalva, and standing. Patients with IBD have lower autonomic functions. Patients with ulcerative colitis have significantly lower parasympathetic function in comparison to those with Crohn’s disease and healthy controls.

Background: Viperin is an interferon-stimulated gene (ISG) with broad-spectrum antiviral activity, primarily induced by interferon-alpha (IFN-α). Both are critical components of the innate immune response against hepatitis B virus (HBV) and hepatitis C virus (HCV). This study investigates sex-based differences in viperin gene expression and IFN-α levels among patients infected with HBV and HCV
Methods: Eighty blood samples were collected from patients with confirmed HBV (n=40) or HCV (n=40) infections in Thi-Qar, Iraq. IFN-α levels were measured using ELISA, while viperin expression was assessed through qRT-PCR. Statistical analyses were performed to compare values between male and female patients within each infection group.
Results: In HCV patients, females showed slightly higher viperin expression and IFN-α levels compared to males, though the differences were not statistically significant. However, in HBV patients, viperin expression was significantly higher in females than males (p = 0.020), suggesting enhanced innate immune activation. IFN-α levels in HBV patients did not differ significantly by sex.
Conclusion: The study highlights a significant sex-based difference in viperin expression among HBV-infected patients, with higher levels in females, potentially indicating a stronger innate immune response. No sex-related differences in IFN-α levels were observed in either group. These findings suggest that sex-based immune modulation, particularly in HBV, may inform personalized treatment approaches and warrant further investigation.

Heavy metals such as cadmium (Cd²⁺), mercury (Hg²⁺), and lead (Pb²⁺) are considered some of the most dangerous environmental pollutants due to their high toxicity and cumulative effects on human health and the environment. With the increasing need for precise, rapid, and highly sensitive detection technologies, the integration of nanomaterials with microfluidic techniques has emerged as one of the effective solutions in developing advanced sensing systems Nanomaterials provide unique properties such as high surface area and distinctive electrochemical and optical characteristics, enabling them to capture heavy metal ions with exceptional efficiency. When integrated into microfluidic platforms (Lab-on-a-Chip), a precise analytical environment is achieved, enabling detection using minimal amounts of samples and reagents, with a short analysis time.
These systems are characterized by their ability for on-site detection. Various characterization measurements such as UV, XRD, FESEM, TEM, FT-IR, and Zeta Potential were conducted to characterize the nanoparticles. The study indicated that the best elements used for detecting heavy metals in blood plasma are zinc oxide and copper. This integration is considered one of the promising recent trends in the field of environmental monitoring and precise medical analysis.

female students frequently encounter psychological and sociological difficulties, including anxiety, depression, stress, pressure from peers, and social isolation. This concern can have an impact on their well-being and academic performance. to identify sociodemographic characteristics, to determine the psychological and social health issues among female students, to assess the main factors influenced teenagers health issues, and to find out the association between some of sociodemographic characteristics, psychological and social health issues and associated factors. A quantitative, cross-sectional study design was conducted at Qaladze primary and secondary schools, from 15 December 2024 to 16 March 2025. Data were collected using a constructed questionnaire developed based on a review of relevant literature. The questionnaire was validated by 17 professional experts in related fields and the questionnaire had a reliability coefficient of r = 0.75. A total of 400 female students participated in this study the mean age of the participants was 16.37 years. The majority lived in nuclear households(82%) and urban areas (93%), with (77.5%) reporting sufficient income level. Psychological difficulties were widespread, with 42.5% reporting eating discomfort, 24.3% experienced sleep disorders, and considering self-harm. Emotional discomfort was substantial y associated with dissatisfaction with body image particularly weight, and skin, as well as perceived pressure from parents, friends, society, and media(P,0.05). negative life events such as parental neglect, family strife, and verbal bullying all been linked to sociological difficulties. The multivariate analysis revealed dissatisfaction with weight (aOR=2.137), parental (aOR=3.874), and society pressure (aOR=2.766) are independent predictors of psychological discomfort. Parental neglect (aOR=5.390), older age (aOR=1.366), and lower levels of parental education (aOR=0.286) all substantially predicted sociological distress. psychological issues were associated with body image dissatisfaction and external pressures, whereas sociological distress was prevalent even in the absence of significant adversities, underscoring the influence of emotional support and familial communication on the well-being of female students.

Background: Irritable Bowel Syndrome is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. It is a chronic disorder that affects 9%-23% of the population across the world. Mostly occurred as a result of nutritional and psychological imbalance, therefore, this study aimed to assess the nutritional and psychological factors contributing to the occurrence of the irritable bowel syndrome. Methods: A quantitative design /cross-sectional design descriptive study was conducted. Using the non-probability purposive sampling in selected places in Ranya district in Kurdistan Region from 10th November 2024 to 15th February 2025. Results: The majority of the participant age group 39.5% were over 40 years, and the majority of them 73.2%, were female. Additionally, most of the participants experienced abdominal discomfort 47.7%. the study found that eating beans and legumes was shown to be associated with bloating and gas among the study sample (p-value =0.03). Regarding psychological factors, about 15.06 % of participants had anxiety, which was the highest among other psychological conditions. The study found that stress and constipation among participants have a significant association, p-value=0.01. Conclusion: The most common symptoms were fatigue, bloating, and abdominal discomfort, but constipation was more common than other types of IBS. The nutritional and psychological status are substantially correlated with the occurrence of IBS. A multidisciplinary and interdisciplinary approach to minimize the occurrence of irritable bowel syndrome and the management of patients is highly essential.

Background: About two-thirds of the population worldwide is obese or overweight, and if the current trajectory continues, 50% of the population will be obese by 2030. Community health centers and primary care providers are leading the charge against this epidemic.
Aim of study: To report on sharing primary healthcare centers in the prevention of obesity via knowledge, attitude, and practice of primary healthcare physicians.
Methods: A cross-sectional study with analytical components was conducted, involving a total of 224 primary healthcare physicians for the period from November 1, 2024, to April 1, 2025. In addition to demographic data, knowledge, attitude, and practice were obtained using Likert scales. Scores of knowledge and attitude out of scope, good and poor for knowledge, and positive and negative attitudes were not included in the analysis.
Results: In this study, 43.8% of eligible participants showed a good level of knowledge of preventing and managing obesity, 67.9% showed a positive attitude, and 38.8% showed a good practice level. Higher qualifications were significantly associated with good knowledge, but not with attitude or good practice.
Conclusion: Low figures of good knowledge, positive attitude, and good practice were observed in this study. Reforms in training for undergraduates and postgraduates in medical schools are of importance.

Tetralogy of Fallot (TOF) is one of the most common congenital heart defects, and understanding the associated risk factors is crucial for developing preventive strategies and improving patient outcomes. This study investigates the maternal and neonatal risk factors associated with Tetralogy of Fallot (TOF) among children and adolescents in Sulaimani City. The research was conducted at a specialized Children's Heart Hospital. A descriptive cross-sectional study was carried out, surveying 100 parents using a structured questionnaire, The majority of TOF diagnoses (92%) occurred within the first year of life. Age distribution among the children showed that 26% were aged between 6-8 years, while 11% were under 3 years. Significant maternal factors associated with TOF included age during pregnancy, consanguineous marriage, and multiparity, which together accounted for a total variance of 20.842%. Maternal nutrition during pregnancy showed that 63% of mothers reported having a normal diet, 36% had poor nutrition, and 1% reported smoking during pregnancy. Additionally, 62% of the families had no history of heart disease, with the majority being of Kurdish nationality. Maternal factors such as mode of delivery, folic acid consumption three months before pregnancy, maternal habits, and diseases during pregnancy (including perinatal infections, anemia, and vitamin D deficiency) were significant contributors to the risk of TOF. The study recommends promoting a healthy diet during pregnancy and implementing educational programs to mitigate the identified risk factors.

Background: Polycystic ovarian syndrome is a prevalent metabolic condition in women of reproductive age. The prevalence rate is approximately 9% among women of reproductive age. This study sought to assess the levels of atrial natriuretic peptide in patients with PCOS and its correlation with insulin resistance and hyperandrogenism.
Methods: 60 patients with PCOS were screened to be suitable for participation in this study, aged from 19 to 45. They were attended to at the outpatient clinic, as well as 30 healthy women as a control group. Serum levels of insulin, testosterone, and corin were estimated using an ELISA kit, as well as glucose, FSH, LH, and HbA1c.
Results: The present study revealed that there are no significant differences in ANP serum level between PCOS patients and the healthy control group. As well as it showed an increase in the corin levels, although corin is part of its function, which is to activate the ANP. In addition, the study demonstrated that the plasma ANP was directly correlated with insulin resistance and the LH/FSH ratio.
Conclusions: The results of this study emphasize the importance of NP and Corin serum levels in women with PCOS. Our data suggest that circulating corin reflects the metabolic abnormalities of PCOS patients. We also discovered a robust positive association between the ANP level and insulin resistance.

Air pollution is a serious health problem in the world especially to those who already have cardiorespiratory illnesses. Although the association between exposure to pollution and health exacerbation is well-established, the current interventions in the area of public health are not customized by taking into account personal vulnerability, geographic position, and daily routine activities. Existing studies are mainly concentrated on predictive modeling based on machine learning or macro-level resource optimization, but do not combine these two measures into practical and personalized guidance. This work fills this critical gap by hypothesizing and confirming the new hybrid machine learning-optimization model to produce individual alerts on air pollution exposures. An artificial group of 100 patients with asthma, COPD and ischemic heart disease is modeled in 90 days. The first stage entails the training of a logistic regression model to estimate short-term exacerbation risk (with an AUC of 0.979 and an accuracy of 0.961). This risk score is then inputted into a second-stage mixed-integer linear programming resulting in the production of optimal daily action plans. The findings indicate that the framework effectively orders viable interventions in a successful completion of an average personal exposure reduction of 39.4 percent of all case studies without violating individual involvement restrictions and interests, making it a viable paradigm of precision environmental health.

The potential for colorectal polyps to develop into colorectal cancer (CRC), the third most prevalent cancer diagnosed globally and a leading cause of cancer-related death, makes them a serious concern for gastrointestinal health. This study intends to assess the frequency and categorization of colorectal polyps found at the GIT Center in Thi-Qar as a result of screening and diagnostic colonoscopies. The goal of the study is to shed light on the risk factors and regional trends connected to colorectal neoplasms. Gaining insight into these trends can help develop more effective management plans and preventative actions that are suited to the local populace. In this analytical observational research, Between November 1, 2024, and March 20, 2025, the study was conducted in the endoscope department of an Al-Hussein teaching hospital next to the college of medicine in the governorate of Thi-Qar, Iraq. The age range of 41 to 60 years old had the highest prevalence of colorectal polyps, accounting for 44% of all cases, according to this study. The frequency was higher among male patients (104 instances) than among female patients (62 cases). The quantity of polyps and gender do not significantly correlate (P>0.05). who found that although there was a higher frequency in men overall, there was no discernible gender difference in the number of polyps. The higher relative occurrence in men may indicate underlying risk factors that warrant further research, even though the link is not significant. The study is likely to produce important discoveries related to the epidemiology of colorectal polyps in Thi-Qar, and data collecting is still ongoing. Through an examination of these polyps' morphological and histological properties, the study aims to shed light on geographical trends and risk factors related to colorectal neoplasms.

Background: Lower back pain, it is one of the 10 most frequent reasons for visiting a family doctor, and at least 85% of the population will experience low back pain at some point in their lives. Instability here means the absence of stability in a mobile vertebral segment. This disorder represents the most common cause of work-related disability and state disability services costs among individuals aged less than 45. Low back pain is a common clinical condition, and lumbar instability plays an important role in the decision for surgery, such as vertebral fusion with decompression. Purpose: The purpose of this study is to determine the magnetic resonance imaging findings suggestive for instability in the lumbar vertebrae.
Patients and methods: We reviewed the MRI studies of the lumbar spine of 48 patients with backache who had functional dynamic radiographs proved that they have lumbar spinal instability. In each study, we classify grade of facet arthropathy, Modic changes, spondylolisthesis, disc degeneration, and presence of osteophytes and annular tear, and we correlated between them
Results: We review 48 MRI studies of patients with lumbar instability, 28 (58%) patients was female and 20 (42%) was male. We found most patients had grades II and III facet arthropthy (81.2%), grade I Spondylolisthesis (77.1%), Modic changes type II (41.7%), grade IV and V disc degeneration (75%), annular tear (79.2%), and osteophytes (66.7%). We found that facet arthropathy has a correlation with the disc degeneration degree (p <0.05), with the presence of osteophytes (p < 0.0325) and with the most affected segment (p < 0.001). Likewise, disc degeneration was correlated significantly with the Modic changes (p <0.01) and with marginal osteophytes (p = <0.01), while no significant correlation between osteophytes and Modic changes (p> 0.19).
Conclusion: MRI can accurately assess the structures that maintain lumbar stability.

Background: Superior mesenteric artery syndrome (SMAS) is a rare vascular compression phenomenon causing duodenal obstruction. CT angiography (CTA) is the test of choice; ultrasound Doppler offers a noninvasive alternative. Aim: to verify the diagnostic accuracy of both tests to verify an evidence-based pathway in SMAS diagnosis.
Methods: A total of 48 patients suspected as SMAS were enrolled in this prospective multicenter study. All patients had a standard ultrasound Doppler and CTA protocol scan. Validity measures were based on the consensus clinical diagnosis reference standard.
Results: Ultrasound sensitivity was 87.5% (95% CI 71.0–96.5) and the specificity was 81.3% (95% CI 54.4–96.0) versus CTA specificity of 100%. Patients who were obese (BMI >30; OR 6.7, p=0.003) and patients with bowel gas (OR 8.2, p=0.001) showed high discordance rates by each definition. The mean aortomesenteric angle difference between modalities was 2.3° (95% LoA: −5.1°‐9.7°).
Conclusion: Ultrasound Doppler can be a valuable method for the primary screening of SMAS, and high-BMI or surgical patients should receive CTA examination for diagnosis verification of SMAS.

This study evaluates the effect of corticosteroids on procalcitonin levels in patients with pustular psoriasis compared to those with psoriasis vulgaris and healthy controls. The aim was to assess the potential role of procalcitonin as a marker for inflammation and disease severity. The study was conducted at Al-Nasiriyah Teaching Hospital from March 2023 to October 2024, with diagnoses confirmed by histopathological examination. The results demonstrated significant differences in procalcitonin levels among the groups, suggesting a potential role for corticosteroids in modulating systemic inflammation in psoriasis.