The Medical Journal of Tikrit University

Background: Regardless of the etiology, chronic kidney disease (CKD) is characterized by decreased kidney function seen by a glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2, kidney damage markers, or both for at least three months. Chronic kidney disease, a degenerative illness for which there is not a solution yet, is linked to high rates of morbidity and death. Compared to the general population, individuals with diabetes and hypertension are more likely to have it. This research aimed to investigate the effects of hemodialysis on some biomarkers among patients with chronic kidney disease CKD.

Patient and methods: This research is cross-sectional and conducted in a hospital setting. The study included 30 control samples and 60 patients with CKD.

Results: Asignificant increase in the biochemucal parameters for urea, creatinine and uric acid while the revers effect shown with that of albumin.

Backgrounds: Prone to flare-ups, systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that varies in severity and progression. In SLE, both innate and adaptive immune responses are implicated. Gene-environment interactions cause a variety of immunologic alterations that lead to persistent immune responses to autologous nucleic acids. Morbidity and mortality are increased when autoantibodies or immune-complex depositions cause tissue damage to the kidneys, heart, arteries, central nervous system, skin, lungs, muscles, and joints.
Materials and Methods: The current study, which was conducted in the Baghdad Governorate between December 2024 and the end of March 2025, involved 90 sample patients between the ages of 10 and >60 who were severely affected by systemic lupus erythematous and were being closely monitored by a specialist physician in terms of treatment and clinical condition observation. However, 30 individuals without SLE were included in the control group. The levels of Interleukin-6 (IL-6) and Superoxide Dismutase (SOD), glutathione peroxidase (GPX), and Source (Elk. Biotechnology-China) were measured in the lab for both groups using ELISA.
Results: The present study showed that the level of IL-6 serum were highly significant (p< 0.001). As well as, there is a significant reduction in serum level of Superoxide Dismutase and Glutathione peroxidase.
Conclusion: There was a strong positive correlation between Superoxide Dismutase, Glutathione peroxidase and Interleukin 6 Level.

Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent etiology of chronic liver disease globally. NAFLD is a spectrum of disease defined by hepatic steatosis in the absence of identifiable secondary causes of hepatic fat buildup, such as excessive alcohol intake. NAFLD encompasses a spectrum from the relatively benign non-alcoholic fatty liver (NAFL) to the more severe non-alcoholic steatohepatitis (NASH). NAFLD may advance to fibrosis and cirrhosis. The liver plays an important role in lipid metabolism, including importing Free FAs (FFAs) and manufacturing, storing, and exporting lipids, and the dysregulation of these processes in the liver can lead to the development of NAFLD.

Objective: determine the correlation between Apo B and lipid profile in Patients with NAFLD

Patients and Methods: A study was conducted at Azadi Teaching Hospital from   1 June of 2024 to   15 June   2025.   The   study   involved   90 participants, 60 with NAFLD and 30 healthy subjects. The study used a spectrophotometer to determine various parameters, High-density lipoprotein(HDL), Triglyceride(TG), and cholesterol. ELISA washer and reader also used for measurement of Apo B.

Result: Age of patients ranging from 20 to 65 years. Serum level of Apo B lipoprotein and lipid profile were measured and compared to control group, Apo B was significantly higher in patients with NAFLD.However lipid (TRI, CHOL, VLDL, LDL) also were measured and they were significantly higher in patient group than control group, while HDL level was lower in patients than controls.

Conclusion: Positive correlation between Apo B and HDL while negative correlation with other lipid (tri,chol,VLDL,LDL)

Background: Malignant lymphoma has gained popularity in various countries worldwide. Consequently, it is one of the most common malignancies of children in the Kurdistan region of Iraq.
Objective: To find the correlation between sociodemographic data, clinical characteristics, risk group classification, and laboratory findings of pediatric patients with lymphoma, together with the correlation between survival rates and survival time among both types of lymphoma. Patients and methods:
In this retrospective, cross-sectional, hospital-based study, the recorded data of 104 pediatric lymphoma patients (aged <18 years) from Hiwa Haematology/Oncology Hospital and Shorsh Teaching Hospital, Sulaimaniyah, Iraq, were obtained from January 1, 2015, to January 1, 2025. A standard validated questionnaire was used to record the patient\'s sociodemographic data, including clinical data and laboratory findings. Then, the correlation between variables was determined.
Results: The patients’ mean age was 12.00 ± 3.59 years, and their mean BMI was 17.20 ± 4.34 kg/m². The time from the onset of lymphoma to diagnosis ranged from 0 to 13 months. Most patients were males (70.2%), from low-income families (43.8%), living outside of the cities (65.4%), had NHL (53.8%) of stage II (28.6%), had no B symptoms (57.7%), received chemotherapy alone (55.8%), completed treatment (85.6%), and were alive (83.7%). Significant correlations were found between age group, BMI, lymphoma stage IV, lymphoma type/subtype, receipt of chemotherapy combined with radiotherapy, lactate dehydrogenase level, and survival rate of the patients. Additionally, HL patients had a longer survival rate and survival time (p≤0.05).
Conclusions: NHL was more common and predominantly of high grade, linked to a lower survival rate and shorter survival time.

Background: Helicobacter pylori are particularly common in childhood and infects more than half the world’s population. It’s a gram-negative, spiralshaped bacterium that colonizes the stomach of humans. Although many infections are asymptomatic, it can cause gastritis, ulcers and gastric cancer. Helicobacter pylori, is strongly associated with malnutrition. Thissets up a cycle: Malnutrition reduces immunity, increasing vulnerability to infection, while infection exacerbates malnutrition. This association is critical to improving child health in at-risk communities.
Objective: this study aimed to investigate the association between Helicobacter pylori infection and the severity of malnutrition in children under five years old.
Methods: The utility of Helicobacter pylori antibodies were detected by using ELISA kits
Results: This study involved 100 kids with malnutrition below the age of 5. The results revealed a 45% occurrence of infection with Helicobacter pylori among children. The data also revealed a substantial link between the prevalence of Helicobacter pylori and the level of malnutrition, resulting in kids with severe malnutrition becoming more at risk of infection. There were no significant variations in infection rates across genders or ages in the study group. Additionally, laboratory analyses revealed that infected children had lower nutritional indicators, such as weight and height, compared to non-infected children
Conclusion: This study found a significant frequency of infection with Helicobacter pylori in malnourished kids below the age of five, particularly among males aged 13 to 24 months. Marasmus was the most frequent kind of malnutrition, with severe instances prevailing. The findings emphasize the need of early of Helicobacter pylori in children.

Background: Hospital-acquired infections are a significant burden in low and middle-income countries, largely due to poor adherence to standard precautions (SPs) by healthcare workers. Nurses are at particularly high risk due to frequent patient contact, yet their compliance with SPs is often inadequate.
Objectives: This study aimed to assess and compare the knowledge, attitude, and practice regarding SPs among nurses working in public and private hospitals in Sulaymaniyah Governorate, Iraq.
Methods: A cross-sectional comparative study was conducted from February to May 2025 in eight public and private hospitals. A total of 370 registered nurses with at least one year of clinical experience participated. Data were collected using a structured, validated questionnaire and analyzed using Chi-square and independent t-tests to assess group differences and associations.
Results: Significant sociodemographic differences were observed: private hospital nurses were younger and more likely to hold a bachelor’s degree, while public nurses had more years of experience (p < 0.001). Private nurses scored significantly higher in knowledge (mean = 25.85 ± 5.46) and practice (mean = 37.02 ± 9.04) than public nurses (p = 0.041), while attitude scores were similar across both sectors (p = 0.828). Notably, unsafe practices such as needle recapping remained prevalent in both settings.
Conclusion: While both groups exhibited positive attitudes toward SPs, a gap between knowledge and practice persists. Targeted infection control training and institutional support are needed to bridge this gap and enhance safety practices

Background: Postoperative pain is major clinical practice concern, especially in abdominal surgery where improper treatment may result in slow recovery process and development of complications. In Kurdistan Region of Iraq, there is poor use of multimodal control and pain assessments, which in the vast majority of cases leads to under-treatment.
Aim: The study aims to access the severity and management of postoperative pain for patients after abdominal surgery in Qalladze Teaching Hospital and determine some factors that affect the experiences of pain and satisfaction with care.
Methodology: Descriptive cross-sectional study was carried out from April to June of 2025. Purposive sampling carried out on 90 adults, in first 24 hours after abdominal surgery. Data were measured in a validated structured questionnaire that comprised of demographic, clinical, pain level according to numeric rating scale (NRS), and patient satisfaction.
Results: Severe pain reported 82.2% of participants (mean score 7.44±1.44). There were Significant associations of gender (p = 0.042) and surgery duration (p = 0.026) with the level of pain. Patient satisfaction was 68.9% with limited use of multimodal analgesia and lack of preoperative education. The most frequent analgesics were NSAIDs and tramadol. Non-pharmacologic interventions were not frequent application.
Conclusion: Postoperative pain poorly managed and little structured protocols and education have been applied in regional hospitals. Efforts should aim at incorporating well-defined pain measurement instruments, multimodal interventions, and clinical education of care that should result in the outcomes and match with international standards.

Background: Induction of labour is vital in preventing obstetrical complications; however, adverse prenatal outcomes are commonly reported.
Objective: To assess the effect of induction of labour on perinatal outcomes in primigravida women.
Patients and methods: A case-control study was conducted in the high-risk and labour room of the Maternity Teaching Hospital, Erbil, Kurdistan Region, Iraq, from January 1 to June 30, 2025, on a sample of 100 primigravida women undergoing labour induction. Patients were divided into two study groups of pregnant women with adverse perinatal outcomes (n=50) and women without adverse perinatal outcomes (n=50). A validated questionnaire was used to collect patients’ sociodemographic and clinical data, as well as perinatal outcomes and maternal outcomes after delivery (including induction of labour). The collected data were analyzed, compared between the two groups, and interpreted.
Results: Common significant adverse perinatal outcomes of induction of labour among primigravida women were low APGAR score after 5 minutes, NICU admission, respiratory distress syndrome and meconium aspiration. Primigravida women with adverse perinatal outcomes were significantly younger, uneducated, had low numbers of antenatal care visits, shorter time between induction and delivery and underwent more cesarean section deliveries. Shorter labour duration, maternal complications and more extended hospital stay were predominant in primigravida women with adverse perinatal outcomes.
Conclusions: The induction of labour for primigravida women is associated with adverse perinatal and maternal outcomes.

Background : Hepatitis B virus (HBV) is one of the global problems that causes liver disease and thus leads to death. In 2019, the World Health Organization indicated that 296 million people worldwide suffer from hepatitis C virus infection. Hepatitis B virus primarily affects liver cells and replicates within them.
Materials and Methods: This study was conducted on patients attending and admitted to Balad General Hospital in Salah al-Din for the period (1/6/2024-25/11/2024), and the groups were classified into two groups, the first group, which included 40 healthy people (control group), and the second group, which included 50 patients infected with viral hepatitis B, and the ages of the samples targeted in the research ranged ( 25-60) years of age, a questionnaire was prepared that included information about age, patient history, blood receipt, and visit to the dentist. blood was then collected from patients and healthy people and separated using a centrifuge. Then immune and liver function variables were measured, which included (IL-2, IL-4, IL-8, AST.ALT.ALP)
Results: The current research showed a significant elevated in each of the levels (IL-2, IL-4, IL-8, AST, ALP, ALT). In the blood sera of patients infected with viral hepatitis B and healthy people, at its level, the probability of P ≤ 0.05.

Background:
The global prevalence of gestational diabetes ranges from 1% to 20% and is rising, reaching 8.9%–53.4% due to updated screening and diagnostic criteria. Carnitine plays a key role in energy metabolism by transporting long-chain fatty acids into mitochondria. Its deficiency may impair lipid metabolism and contribute to the development of gestational diabetes.
Aims of study:
To determine the relationship between carnitine and gestational diabetes versus normal pregnancy.
Materials & Methods:
A one-year case-control study was conducted at Salahaddin General Hospital, involving 87 pregnant women (≥28 weeks, singleton viable pregnancies). The participants were divided into two groups: 32 women with gestational diabetes (case group) and 55 healthy controls matched by age and gestational age. Blood samples (4 ml) were collected from all participants to measure carnitine levels.
Results:
In this study, carnitine level was significantly decreased in patients with gestational diabetes when compared with controls. Carnitine level < 23.56 µmol/L is a predictor for gestational diabetes.
Conclusions:
Use of carnitine level as a screening tool helps predict the susceptibility of high risk pregnant women for development of gestational diabetes, which affects the development of pregnancy and the growth of the fetus and can be relied upon to reduce future complications of diabetes.

Background: The problem of antibiotic resistance is becoming a threat to health on the planet, especially where health infrastructure is lacking. Bacteria like Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus have those properties that make them multidrug resistant, hence eluding treatment protocols because they gain resistance to drugs. Although being efficient, the traditional diagnostic techniques are laborious and laboratory conditional.
Aim of study:
The study was carried out to examine the diagnostic accuracy of artificial intelligence (AI) in identifying bacterial antibiotic resistance on a convolutional neural network (CNN) and also to compare the accuracy as well as efficiency of the methods with that of conventional methods.
Methods:
The systematic review procedure was performed with the use of such databases as PubMed as well as Scopus and Google Scholar. Publications published in 2019 to 2024 were selected using inclusion criteria on comparative performance indicators of sensitivity, specificity, PPV, NPV and the diagnostic timings. SPSS v27 was used to carry out meta-analysis. Results:
AI models proved to be better in diagnosis with sensitivity of 92.95% and specificity 88.92% than 75.85% and 70.80% respectively of conventional methods. The time consumed in the diagnosis came down to 24-72hours to the lowest 30 minutes in certain AI applications. Also, AI enhanced the accuracy of antibiotics selection greatly, making all inappropriate prescriptions drop by 85%, resulting in 1%. Conclusions: it can be stated that the AI-based diagnostics can be used as a rather promising alternative to the conventional ones as the resistance patterns are revealed in a quicker and more precise way. Their integration into clinical practice and operation may optimize the therapeutic choice and lower the incidences of an unfortunate outcome in numerous resource-poor countries such as Iraq. There should be Drug-Resistant.

Background : In developing countries, malnutrition kills Three hundred thousand children under the age of 5 every year and is directly or indirectly responsible for more than half of all child deaths worldwide. Skinfold measurements are a common way to figure out one's body fat percentage. As a result, calipers are used to measure the thickness of skin at various points on the body.
Aim:
An investigation was conducted to determine the sensitivity and specificity of skin fold thickness in the early detection of undernutrition in children.
Patients and Methods
Normal and underweight children aged 2 months to 5 years old were randomly selected to participate in a cross-sectional hospital-based study at the Rehapelitation word of Pediatric Department at (Salahaddin General Hospital). The triceps area was used to measure skin fold thickness in all undernourished and normal weight children.
Results:
Unicef digital scales for children who cannot stand and Unicef digital scales for children who can stand were used to measure each child's weight, and the average of the two measurements was used to calculate the weight. Stabilometer was used for children over 2 years of age and infantometer was used for children under 2 years of age.

Background: Vaginitis, characterized by inflammation of the vagina, is a prevalent health issue affecting millions of women worldwide which is often attributed to an imbalance in vaginal microbiota and is the most common cause of vaginal discharge in reproductive-aged women. This study was conducted to molecular detection of some virulence genes implicated in pathogenesis of E. faecalis in women with vaginitis in addition to molecular investigation of biofilm and vancomycin resistant genes.
Materials and methods: A cross-sectional study conducted in Tikrit City, Balad Province, from February 2023 to March 2024 involved 400 married, non-pregnant women aged 15-49 with vaginitis symptoms. These women sought consultation at Balad General Hospital's clinic and private clinics in the province. The study received approval from the council of the College of Medicine, Tikrit University. Bacterial isolation from vaginal samples was performed by gently inserting a swab into the vaginal opening, rotating it against the vaginal walls, and then carefully withdrawing it without touching the skin. Real- Interpretation of RT-PCR data relied on Cycle threshold values, which indicate the cycle number at which the fluorescence signal surpasses the baseline threshold.
Results: The study a spectrum of bacterial species involved. Escherichia coli was the highest isolated bacteria, 70(22.95%), followed by Staphylococcus aureus 55(18.03%), Enterococcus faecium (accounts for 50 cases (16.39%) of the isolated bacteria, Klebsiella pneumoniae and Enterococcus faecalis, each with 35(11.48%). Staphylococcus epidermidis was associated with 28(9.18%), Staphylococcus saprophyticus was 25(8.20%), and Granulicatella elegans was observed in 7 cases, (2.30%) of the isolated bacteria. Growth in 10% NaCl was seen in 65.71% of isolates, and protease production was evident in 62.86%.

Background: Anorexia nervosa is an eating disorder that is characterized by strict restrictions of food intake leading to abnormally low body weight and an intense fear of gaining weight. Anorexia nervosa is a highly distinctive serious mental disorder.
Method: A descriptive (cross-sectional) study was carried out from 15th October 2023 to the end of May 2024. The study was conducted in secondary schools of females aged (11-20) years old in the centre of Tikrit city. The data was collected using a well-designed questionnaire.
Result: The current was included (700) female students. The frequency of anorexia nervosa was 132(18.9). Anorexia nervosa was more frequent among the older adolescent (17-20 years) age group [77 (58.3%)]. Normal BMI range was the most common weight category among females with anorexia nervosa. A high percentage of patients with anorexia nervosa (13% and 27% respectively) were in the O+ and A+ blood groups. Anorexia nervosa presented more frequently among medium socioeconomic levels, 83 (62.9%).
Conclusion: This study revealed that anorexia nervosa was more frequent among older adolescents and more common among individuals with normal BMI, the study demonstrated significant associations between certain psychosocial factors, such as stress, perfectionism, and anorexia nervosa. There is a relationship between socioeconomic status (SES) and Anorexia Nervosa.

Background: In patients with cutaneous leishmaniasis, MicroRNAs modulate immune response pathways both before and after treatment.
Objective: The study objective to evaluate the level of IL27 and relative gene expression of miR-99a-5p and gene expression LOC100294145pre and post treatment with Pentostam.
Materials and Methods: A total of 60 volunteers participated in this study; 30 had cutaneous leishmaniasis and were examined both pre and post therapy, while the remaining 30 individuals as a control group. ELISA was used to measure the amount of IL27, and qRT-PCR was used to quantify the gene expression of miR-99a-5p and LOC100294145.
Results: According to the current study's findings, the control group's relative The control group's miR-99a-5 expression was substantially greater than that of the patient's two groups (pre, p=0.001 and post, p=0.001, respectively). Comparing the control group to the patient groups both before and after therapy, the level of IL27 increased significantly (pre, p=0.001 and post, p=0.004, respectively). The differences in gene expression levels of LOC100294145 between study groups were not statistically significant. The slight change after treatment may highlight the possibility that this gene has an immunological role in the response to treatment.
Conclusion : The study results indicate that IL-27 and miR-99a-5p are effective diagnostic indicators for cutaneous leishmaniasis, as they showed significant differences between patients and the control group, while they were not significantly affected by treatment. The LOC100294145-LncRNA gene did not show significant differences, warranting further studies to determine its potential role in the immune response to the disease.

Background: The complications of central obesity and the rapidly increasing burden have become important health issues. There is inverse relationship between the status of vitamin D (VD) and obesity .VD deficiency is a risk factor for the development of Nonalcoholic fatty liver disease (NAFLD), also VD deficiency was associated with atherosclerotic cardiovascular disease. The aim of the study is to assess the level of VD in young female with central obesity, assess the parameters of central obesity and its association with VD deficiency.
Methods: This study was based on a case control with sample of (80) young females' aged from14-45 years. The females in study were single or married but not pregnant. Females divided in to 2 groups' forty having central obesity and forty did not have central obesity, the parameters measured are VD level by i-chroma-II, BMI (kg/m2) and waist-hip ratio. Fatty liver diagnosed by liver ultrasound .The differences in parameter measured between two groups were analyzed.
Results: Eighty females divided into two groups: 40 with central obesity and 40 without central obesity, VD (10.6) was significantly low among female with central obesity. The BMI (30.0) and WHR (0.95) among the central obesity group were significantly high. The incidence of fatty liver within central obesity group was significant. The correlation of VD with BMI, WHR and fatty liver were weak and indirect.
Conclusion: There is a positive correlation between VD deficiency and the pathogenesis of central obesity in young female, the study found the low VD levels associated significantly with developing NAFLD. So it is important to monitor VD levels, decrease the risk of obesity and screen for NAFLD.

Background: A lack of vitamin D has been found to be a possible risk factor for a number of negative health effects.
Materials and Methods: This study examined the association among creatine kinase (CK) activity and vitamin D levels in children aged 6 to 12 who were obese and those who weren't. Between January and July 2025, sixty participants—30 obese and 30 healthy people who were matched for age and sex—were enlisted from pediatric outpatient clinics in Baghdad, Iraq. The World Health Organization's growth standards were used to measure anthropometric data, such as body mass index and waist circumference. Serum was kept at -20°C until analysis after venous blood samples were drawn and handled in a sterile manner. Enzymatic colorimetry was used to evaluate CK enzyme activity, Vitamin D concentrations were measured by ELISA. Statistical analyses were performed in SPSS using independent-samples t-tests to compare obese and control groups and Pearson’s correlation to evaluate associations, with significance set at p < 0.05.
Results: Compared with controls, obese children had significantly lower vitamin D levels and significantly higher creatine kinase (CK) activity; waist circumference and body mass index were also significantly greater in the obese group, consistent with metabolic alterations associated with obesity.

Background: The buildup of excess fat in the liver is a defining characteristic of non-alcoholic fatty liver disease (NAFLD), the most common chronic liver condition globally. NAFLD is also closely linked to metabolic syndrome. New research points to increased intestinal permeability as a possible mechanism by which NAFLD-related liver inflammation and injury persist, with increased serum zonulin levels serving as the primary driver.
Objective: This study aimed to investigate serum zonulin levels and liver enzyme activities (ALT, AST, and GGT) in NAFLD patients and assess the diagnostic potential of zonulin as a biomarker for the disease.
Methods: Ninety people, 60 with NAFLD and 30 healthy controls, ranging in age from 30 to 60 years old, were involved in the clinical case-control study. In order to assess the amounts of serum zonulin and liver enzymes, blood samples were taken following an overnight fast. In order to find noteworthy distinctions and correlations, statistical tests were run.
Results: Serum zonulin concentrations were markedly elevated in NAFLD patients relative to healthy controls (patients: 72.50 ± 8.24 ng/ml vs. controls: 57.17 ± 8.26 ng/ml, p < 0.01). Levels of liver enzymes (ALT, AST, and GGT) were also markedly elevated in NAFLD patients (all p < 0.01). A strong positive correlation was found between serum zonulin levels and liver enzyme concentrations (GGT, ALT, AST), suggesting that increased intestinal permeability contributes to the development of NAFLD. Receiver Operating Characteristic (ROC) analysis demonstrated excellent diagnostic accuracy for zonulin, with an AUC of 0.903, supporting its potential as a biomarker for NAFLD.
Conclusion:
Increased intestinal permeability and liver dysfunction are directly associated with higher blood zonulin concentrations in NAFLD patients. A potential diagnostic technique for better clinical management of NAFLD and earlier disease identification could be measuring zonulin levels.

Background: The complicated neurodevelopmental disease known as autism, or autism spectrum disorder, is often identified in a child's first three years of life. Cobalamin, another name for vitamin B12, is a water-soluble vitamin that is necessary for several bodily physiological functions. Adenosylcobalamin and methylcobalamin are two coenzyme forms of vitamin B12 that are involved in the metabolism of propionate, amino acids, and single-carbon units. The study aims to investigate whether serum Vitamin B12 , Vitamin 9 and zinc levels are associated with ASD and compare it with the control group in Kirkuk City.
Materials and Methods: From November 2024 to February 2025, a case-control research was conducted at the Pediatrics Hospital and two children's autism centers in Kirkuk City, Iraq: the Al-Irada Center for Autism and the Al-Tammauz Center for Autism. Kirkuk City, in northern Iraq, around 238 kilometers north of the capital, Baghdad, is where the study was carried out.
Results: The city is well-known for both its substantial economic significance and its diversified population. There are 56 patients with ASD in total. There were fifteen girls and forty-one males. They were between the ages of three and twelve. There were thirty-two healthy subjects in the control group of the current investigation. Nine of them were female, while twenty-three were male. They were between the ages of three and twelve. Provides the research participants' family history and demographic details. The median age (IQR) of the 88 participants was 6 years (4–8). The ASD group had a lower median age (5.00 years [IQR: 4.00, 8.00] vs. 7.00 years [IQR: 4.75, 9.50]; p = 0.058) than the control group. The median Zinc (Mg/dl) was significantly higher in the control group compared to the ASD group (106.35 (76.25, 133.60) Mg/dl vs. 76.60 (64.65, 96.65) Mg/dl; p = 0.004).

Background: Jaundice is a yellowish discoloration of the skin and the mucosa due to accumulation of excess of bilirubin in the tissue and plasma in neonates. (more than 7mg/dl). 30-50 % of term newborn and more of preterm newborns. The aim of this study is to compare the efficacy of single, double or triple phototherapy in treating neonatal indirect hyperbilirubinemia. The study showed that the duration of hospital stay is less in double 18 cases (2- 3days) and triple (17 cases 2-3 days) phototherapy compared to single phototherapy (4-7 days 29 cases).
Patients and methods: A hospital based Cohort study done on neonate aged less than fourteen days with indirect hyperbilirubinemia attending the Pediatric Department at Salahaden General Hospital during the period from (2nd of January 2021) to (30th of August 2021) selected randomly. Each neonate included in the study were assessed by a prepared questionnaire that include name ,age , sex .. The decision for admission of patient to the neonatal intensive care unit done by experienced pediatrician depending on the maturity ,weight , risk factor and investigation.
Results: The study showed that the duration of hospital stay is less in double 18 cases (2- 3days) and triple (17 cases 2-3 days) phototherapy compared to single phototherapy (4-7 days 29 cases).
Conclusion: The study showed that the duration of hospital stay is less in double 18 cases (2-3days) and triple (17 cases 2-3 days) phototherapy compared to single phototherapy (4-7 days 29 cases).

Diabetes is occurred due to a defect in the inequity of the blood's sugar metabolism that results in a remarkably increasing in the concentration of blood glucose for different factors, including genetic, psychological, or biological causes, as well as in consuming high amount of sugar. Several diseases including diabetes have been related to the two kinds of adipose tissue (brown and white). These tissues play a significant role in insulin sensitivity. It has become clear that there are numerous hormones released from adipose tissue. Chemerin has impact in glucose homeostasis, because it involves in both insulin resistance and glucose metabolism, as it enhances insulin-dependent glucose acceptance in adipocytes. Additionally, it is clear that adiponectin prevents the occurrence of diabetes in individuals by moderating glucose tolerance, improving fat metabolism, controlling insulin sensitivity, and altering homeostasis. The type 2 diabetes had relationship with elevated concentrations of the hormone phosphatases in comparison with non-diabetes individuals. Regarding with the hormone resistin, the insulin resistance had great relationship with the hormone concentration in people who had sever insulin resistance

Background: Magnetic Resonance Imaging (MRI) has emerged as a quintessential tool in the assessment and control of brain tumors due to its non-invasive nature and advanced soft-tissue assessment. This evaluation examines the modern-day applications and destiny possibilities of MRI in brain tumor evaluation. Traditional structural imaging, inclusive of T1- and T2-weighted imaging, plays a critical position in figuring out tumor place, size, and related edema, at the same time as advanced strategies offer deeper insights into tumor biology. Functional imaging modalities inclusive of Diffusion-Weighted Imaging (DWI) and Perfusion-Weighted Imaging (PWI) permit differentiation of tumor grades, identity of remedy results, and evaluation of tumor cellularity and vascularity. Magnetic Resonance Spectroscopy (MRS) enables the analysis of tumor metabolism, providing treasured records on biomarkers including choline and lactate. Emerging techniques like Chemical Exchange Saturation Transfer (CEST) MRI are being advanced for extra precise molecular and metabolic characterization. Future advancements encompass the mixing of synthetic intelligence (AI) for computerized tumor detection, category, and prediction of healing responses. AI models blended with radiomic evaluation hold promise for customized treatment strategies. Intraoperative MRI has more desirable surgical effects by using allowing actual-time imaging, enhancing tumor resection accuracy, and retaining healthy tissue. Furthermore, extremely-high-area MRI (7T) gives extraordinary spatial and contrast decision, facilitating particular evaluation of tumor microenvironments. Despite its transformative effect, challenges continue to be, inclusive of excessive charges, accessibility problems, and interpretation variability. The aim of this review is to explore the current and future advancements in MRI technology for brain tumor evaluation, highlighting the integration of AI, advanced imaging techniques, and intraoperative MRI to improve tumor detection, treatment planning, and surgical outcomes. It also addresses challenges such as cost, accessibility, and interpretation variability.

Background: Long, unclean nails may facilitate or serve as a conduit for bacterial spread. Even after thorough washing, bacteria may remain in the nail folds and under the nail.
Objectives: The purpose of the study was to identify pathogenic bacteria associated with short, long, natural, and artificial nails in women in Mosul. Additionally, the study aimed to assess the antibiotic susceptibility of the isolated bacteria.
Materials and Methods: Sterile dental swabs were used to collect 80 samples from 40 women in Mosul between November 2024 and February 2025.
Results: The study showed that all women (100%) were infected with bacteria. Bacillus spp. constituted 41.25% of the total, followed by Staphylococcus aureus (15%), Escherichia coli (13.75%), Streptococcus spp. (8.75%), Klebsiella spp. (5%), unidentified bacteria (5%), Pseudomonas spp. and Shigella spp. (3.75%), and Salmonella spp. (1.25%), which were the second most prevalent bacteria. The proportion of bacteria found on artificial nails was 65%, compared to 35% on natural nails. Higher bacterial counts (7×10³) were observed on long nails (>2 cm) compared to short nails (<0.5 cm, 1.2×10³). OfX, AZM, and AM were effective against Bacillus spp. and Staphylococcus aureus, while Gram-negative bacteria were more resistant.
Conclusions: These results suggested that nails may constitute a suitable environment for the proliferation of a number of bacteria and may contribute to the transmission of drug-resistant microorganisms.

Background: Birth asphyxia is the most important preventable cause of cerebral injury in the neonatal period, leading to very high neonatal mortality and morbidity in developing countries.
Aim of study: The aim of the current study is to assess the frequency of neonates with birth asphyxia admitted to the neonatal care unit at Tikrit Teaching Hospital.
Patients and methods: This observational cross-sectional study involved the study of 320 newborn infants (165 males and 155 females) done in the period between the first of May 2021 to the end of July 2021. Total of 2240 live birth infants were born in Tikrit Teaching Hospital, 320 births were attended by a convenient sampling and 54 newborn infants had Apgar scores < 7 at five minutes and with no obvious congenital abnormalities were diagnosed to have asphyxia.
Results: The frequency of birth asphyxia was (16.9%), various stages of hypoxic-ischemic encephalopathy occurred in 21/54 infants (38.9%) of asphyxiated infants, and the incidence was higher in the low Apgar score group. There was a statistically significant relationship between birth asphyxia, and birth weight, mode of delivery, parity of mothers, antenatal care, and other maternal risk factors as pregnancy-induced hypertension, Oligohydramnios, and breech presentation. There were 12/54 infants (22.2%) mortality during the hospital stay, correlated with the severity of hypoxic-ischemic encephalopathy.
Conclusion: It is concluded that some causes of birth asphyxia are currently unavoidable. It is, however, widely accepted that some cases of birth asphyxia may be prevented by the delivery of high-risk pregnancies in obstetric facilities with appropriate intervention and by good neonatal resuscitation.

Background: Substance use is a growing public health concern among university students that affects both health and academic performance. Medical students represent a key group for investigation due to their future role in health promotion and patient education. The aim of this study is to identify students' knowledge in Tikrit Medical College regarding substance use.
Subject and methods: A cross-sectional study was conducted among 340 students at Tikrit Medical College using a structured self-administered questionnaire covering sociodemographic criteria, knowledge of substance use and smoking behavior.
Results: Adequate knowledge about substance use was reported by 67.9% of students, particularly regarding alcohol, tobacco, and marijuana, while knowledge about opioids, stimulants, and hallucinogens was limited. The majority (90.3%) were non-smokers; among smokers, cigarettes were the most common type of tobacco used, followed by hookah, while vaping was the least common.
Conclusion: Medical students in Tikrit showed good level of awareness of substance use, however their knowledge was limited regarding less common substances. Targeted educational programs and stronger tobacco control efforts are recommended.

Background: Pregnancy often leads to hyperlipidemia, increased water consumption, and physiological changes, affecting fetal growth and potentially reducing the chance of having low gestational age (LGA) or macrosomic babies.
Aim of the study: To estimate the changes in the body composition of pregnant women throughout the various stages of pregnancy.
Patients and Methods: The study involved 250 pregnant women in Mosul City, divided into two groups: 150 healthy pregnant women in different trimesters and 100 healthy non-pregnant women. The cases group had no medical problems, their body mass index (BMI) between 18.5 and 29.9 Kg/m2, and no history of chronic drug intake. The control group was non-pregnant healthy women. An electronic digital scale that included bioelectrical impedance analysis was used for measuring the body composition in both cases and control groups (Beurer wellbeing BF105, Germany), and the serum adiponectin hormone level was estimated using the human adiponectin ELISA kit (Bioassay Technology Laboratory, China).
Results: The mean age was 25.81±6.07 for the pregnant group and 29.68±8.24 for the control group. Adiponectin levels were higher in the cases group compared to the controls but with no significance. The bio-electrical impendence analysis showed a significant association between the groups regarding fat mass percentage. Adiponectin levels had no significant correlation with body water mass and fat mass percentages.
Conclusion: As pregnancy progresses, fat mass increases while total body water decreases, and the Adiponectin levels and fat mass are inversely correlated.

Background: Due to its significant impact on endocrine function and micronutrient equilibrium, obesity is becoming recognized as a primary contributor to male infertility, which is emerging as a substantial global health issue.
Objective: This study aimed to evaluate the effect of moderate-intensity exercise on serum levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and zinc in obese men, independent of semen analysis parameters.
Methods: A case-control study enrolled 90 obese men (BMI 30–35 kg/m², aged 20–40 years), divided into an exercise group (n=60) and a sedentary control group (n=30). Participants in the exercise group engaged in structured moderate-intensity exercise for three months. Serum levels of testosterone, FSH, LH, and zinc were measured and compared between groups using independent t-tests.
Results: Men in the exercise group had significantly higher serum testosterone (5.19 ± 1.31 ng/mL), FSH (4.77 ± 1.09 U/L), LH (4.12 ± 0.98 U/L), and zinc (86.77 ± 10.17 μg/mL) compared to controls (p<0.05 for all parameters). These findings suggest that moderate exercise can effectively improve the hormonal and micronutrient environment essential for male fertility in obese individuals.
Conclusion: Structured moderate-intensity exercise significantly enhances reproductive hormone and zinc levels in obese men, supporting the adoption of lifestyle interventions as a frontline strategy for improving male fertility associated with obesity.

Background: Gastrointestinal malignancies are common tumours. Emergency presentation of these cases represents a diagnostic and therapeutic challenge and carries a higher rate of mortality and morbidity compared to instances of colorectal tumours operated upon electively. Most of these patients had previous symptoms suggestive of colorectal pathology.
Objectives: To identify factors in the clinical history of the patient with colorectal malignancy presenting as an acute surgical emergency that may help in early detection of these cases.
Methods: a retrospective study of 47 patients histopathologically proven to have colorectal carcinoma and presented as abdominal emergencies at AL-Yarmouk teaching hospital from January 2022 to December 2022. Data obtained include age, gender, history, presentation, type of surgery, morbidity and mortality.
Results: Emergency presentation of colorectal carcinoma represents 38.84% of the total cases registered during the period of the study. Thirty-nine patients were above 50 years old (82.96%). Most of the patients have associated comorbidities (82.97%). Most of the patients had a history of symptoms related to the GIT (82.35%), especially constipation (40.43%) and frequent usage of enema (34.04%), with only 8.51% having had a previous colonoscopy. The majority of the patients presented with intestinal obstruction (70.21%). All patients underwent emergency surgery, which consisted of definitive resection (38.30%), staged resection (46.80%), and palliative resection (14.90%). Tumours were found to be advanced in 63.83% of the cases.
Conclusions: One-third of the colorectal malignancies presented as abdominal emergencies. With associated comorbidities and previous clinical history suggesting colorectal disease. A good screening program will decrease the incidence of this problem.

Background: Tobacco smoking is a major cause of preventable morbidities and mortality, and it is the second major cause of death and the fourth most common risk factor for disease worldwide. Physicians can play a key role in smoking cessation by advising a smoker to quit and serving as role models for healthy behaviors by not smoking.
Methods: A descriptive cross-sectional study was conducted from 1st of October 2023 to 1st of July 2024, using an anonymous, self-administered questionnaire survey for doctors. The sample included 200 doctors and 120 dentists who participated. Data analysis was done on a personal computer (PC) using statistical package for social sciences (SPSS) V.22. Socio-demographic variables were described using descriptive statistics, tables, and figures. Significant associations between variables were determined by the chi-square test. A p-value < 0.05 was assumed to indicate significance.
Results: In this study, 19.38% of doctors were smokers and 5% were ex-smokers, with significant gender differences (males: 43% and females: 6%). Most smokers were between 36 and 45 years, but most doctors started smoking in college. 52% started smoking due to stress. 71% of smokers smoked for over 10 years. Most participants knew about smoking's dangers and the cessation programme. Doctors struggled to advise patients to quit smoking due to time (37.5%) and patient desire (35%).
Conclusion: One in five doctors smoked, according to our findings. Men predominate in smoking, and smokers are aware of health and environmental risks. In Ex-smokers, the causes of quit are mostly to quit addiction and maintain their health. Most participants knew about primary health care center smoking cessation programs (SCP), but only one-third knew Iraqi smoking laws.

Background: Lower Gastrointestinal Bleeding is characterized refers to bleeding that originates from the lower part of the gastrointestinal tract, including the colon, rectum, and anus. It can present with various symptoms and can range from mild to severe.
Patients and methods: Across sectional study of 93 patients complaining of Lower Gastrointestinal Tract Bleeding (LGITB) were examined by Emergency Department (ED) doctors from 1st of February 2023 to 1st of October 2023 in ED of Al-Yarmouk teaching hospital. All Patients present with acute infectious bloody diarrhoea, Upper Gastrointestinal Tract Bleeding (UGITB) and age less than 16 years excluded from the study. General information taken from the patients by a questioner all parameters include (age, sex, Presentation to ED, past medical and surgical history, Clinical finding, laboratory investigation, Treatment, Time spent in ED). Diagnosis was aided by proctoscope, sigmoidoscopy, and colonoscopy, and the role of ED in management were assessed.
Results: A total 93 patients (62 males and 31 female) with mean age 51.5 years were treated. The most frequent diagnosis was haemorrhoid (40.9%) followed by polyp (11.8%) and diverticulosis (10. 8%).All patient stay in ED less than 24 hours with mean time stay was 11.6 hours. Most common presentation was fresh blood per rectum (60.2%), haematochezia (24.7%) and melena (15.1%).
Conclusion: Proctoscopy done in ED gives a fast diagnosis and treated patient in ED and discharge home (reduce admission rate). Over all ED have an important role of management of patients with LGITB if good protocol were applied.

Background: Chronic diabetic hyperglycemia is linked to persistent damage, dysfunction, and failure of multiple organs, particularly the eyes, kidneys, nerves, heart, lungs, and blood vessels. Pulmonary problems in diabetes result from the thickening of alveolar walls, alveolar capillaries, and pulmonary arterioles, leading to pulmonary dysfunction. This study aimed to determine the prevalence of spirometric abnormalities among patient with type 2 DM and also to determine the correlation of HbA1c with spirometry results in type 2 DM patients.
Methods: The current study included 100 type 2 diabetic patients. Full personal history recording and data related to diabetic status were recorded. Full general and systemic examination followed by pulmonary function tests were performed.
Results: In the included diabetic patients, mean FVC was decreased in 59% of patients, mean FEV1 was decreased in 53% of patients, mean FEV1/FVC ratio was decreased in 28% of patients. In addition, mean PEFR was decreased in 66% of patients and mean partial oxygen saturation percentage was 96.32 ± 1.8 %, 19% of patients had decreased SpO2.
Conclusion: This study reflected the significant negative effect of hyperglycemia upon pulmonary functions. Diabetic hyperglycemia contributes to a restrictive pattern of lung dysfunction that could be mediated by vascular, inflammatory, and metabolic pathways

Background: Tobacco smoking remains one of the leading preventable causes of morbidity and mortality worldwide. While global and regional data are abundant, localized studies are essential for understanding the knowledge, attitudes, and prevalence (KAP) of tobacco use within specific communities.
Methods: A community-based cross-sectional study was conducted between April and July 2025 in Rania District and its sub-districts (Chwarqwrna and Hajyawa). Using a multistage convenience sampling method, 820 individuals aged ≥12 years were recruited. Data were collected via a validated, bilingual (English/Kurdish) questionnaire adapted from the Global Youth Tobacco Survey (GYTS). Statistical analysis was performed with SPSS version 25, using descriptive statistics, Chi-square tests, and logistic regression to determine associations. A p-value <0.05 was considered significant.
Results: The mean age of participants was 29.6 ± 12.5 years, with 83.2% males. Among respondents, 61% were active smokers, while 39% were non-smokers. Knowledge levels were fair in 66% of participants, with a significant association between knowledge and tobacco use (p=0.021). Neutral attitudes toward smoking predominated (84.1%) and were significantly associated with smoking behaviors (p<0.001). Peer influence and sociodemographic factors, including male gender and middle socioeconomic status, were strongly associated with smoking initiation and continuation.
Conclusion: The study highlights a high prevalence of smoking in Rania District, compounded by moderate knowledge and neutral attitudes toward tobacco use. Targeted interventions addressing knowledge gaps, reshaping social norms, and strengthening local tobacco control measures are urgently required.

Background: Febrile neutropenia (FN) is common in pediatric oncology patients, and the majority of patients with FN do not have a microbiologically defined infection, but those who do are at risk for overwhelming complications, including severe infection and death. Objectives: To determine the risk factors and treatment outcomes of FN pediatric patients with acute leukaemia during induction of chemotherapy. Patients and methods: This cross-sectional, retrospective, observational, hospital-based study was conducted on 10 years of recorded data (January 01, 2015, to January 01, 2025) of pediatric acute leukaemia patients (n=115) who developed FN during induction of chemotherapy from the Pediatric Department at Hiwa Hematology/Oncology Hospital, Sulaimaniyah, Iraq.
Results: The patients’ mean age was 8.02 ± 4.65 years with a mean body mass index (BMI) of 16.56 ± 4.46 kg/m². Most patients were aged 1.0 – 6.0 years (41.7%, n=48), males (56.5%, n=65), underweight (76.5%, n=88), had blood group A+ (43.5%, n=50), had ALL (58.3%, n=67), experienced immunosuppression (87%, n=100), had no fatigue or anxiety (59.1%, n=68), and had a body temperature of >38.5° C (58.3%, n=67). Also, majority of patients had profound neutropenia (62.6%, n=72), fever (46.1%, n=53), negative microbial cultures/identified infection (82.6%, n=95), had positive C-Reactive Protein (63.5%, n=73), received prophylactic antimicrobial (73.0%, n=84), had no abnormality on imaging (87.8%, n=101), not admitted to Intensive Care Unit (ICU) (84.3%, n=97), and were recovered (89.6%, n=103). Consequently, no significant differences were observed in age, gender, BMI, or culture-related findings (p ≥ 0.05).
Conclusions: A chemotherapy-induced FN is a crucial life-threatening complication of the cytotoxic drugs used in the management of pediatric acute leukaemias.

Background: Worldwide, an estimated 33 million children under the age of five years are projected to be infected with the respiratory syncytial virus (RSV), with 10% of those cases necessitating hospital admission and up to 199,000 deaths from the illness.
Patients and Method: We tested 100 suspected patients for RSV infection, with the help of pediatrician . The study was conducted at the Ramadi Teaching Hospital for Maternity and Children /Al-Anbar. The period of study was from 1 December 2023 to 15 March 2024.
Result:
In this study, we examined 100 cases of respiratory infection, 58 cases were positive for RSV. Out of 58 cases with positive RSV, 32 were positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigen, and from cases positive for SARS-CoV-2 antigen, 18 were confirmed positive for SARS-CoV-2 by polymerase chain reaction (PCR). The age of patients ranged from 1 month to under 5 years and 57% were males while 43% were females. Statistical analysis was performed on data from RSV-infected patients as well as age subgroup populations. Patients were classified into the following age groups:1 to 6 months N=36(36%), 6 to 12 months N=24(24%), 12 to 18months N=9 (9%), 18 to 24 months N=17(17%), and more than24 months N=14(14%). The serotype of RSV were N=15(25.8%) of serotype A and were N=43 (74.1%) of serotype B.
Conclusion: RSV is the leading cause of sickness and death in newborns globally, especially in low- and middle-income nations. Palivizumab is crucial for preventing severe RSV LRTIs in high-risk newborns, but the excessively high cost prevents widespread use. During the Pandemic,
primary preventative measures, such as hand hygiene and face masks, were more cost-effective in reducing RSV burden. In addition to the vaccination, non-pharmaceutical preventive hygiene measures should be implemented to reduce RSV spread globally, even after the coronavirus disease-19 (COVID-19) pandemic.

Background: The purpose of this study was to determine the changes of oxidation stress markers in sheep suffering from nutritional deficiency anemia. Additionally, the blood picture of these sheep was examined and compared to that of non-anemic sheep, which served as a control group. Methods: Sheep aged 1-3 years who were clinically classified as anemic and non-anemic according to clinical symptoms were involved in the study. The study included 40 sheep divided to two groups, 30 animals as anemic group, and 10 animals as control group. The percentage of hemoglobin and the amount of red blood cells were also measured to validate this diagnosis. Superoxide dismutase, glutathione, and malondialdehyde were among the oxidation indicators.
Results: The findings demonstrated that the levels of each of the three (Hb, RBC, and HCT) were significantly Lesser (p≤0.05) in the groups of animals identified as anemic, as verified by blood picture tests, when compared to healthy animals. The levels of super-oxide dismutase and glutathione in anemic animals were significantly Lesser (p≤0.05) than in the control group, but the levels of malondialdehyde in anemic animals were significantly upper (p≤0.05) than in the control group.

Background: Vitamin D has a well-known role in the regulation of calcium hemostasias and controlling bone metabolism. However, little is known about vitamin D status and its relation to inflammation. Recent studies suggest that vitamin D has an anti-inflammatory effect and causes down regulation of inflammation markers production, which favours less inflammation.
Objective: This study investigates the relationship between low vitamin D status, lipid profile parameters, and inflammation markers.
Methods: In this case-control observational study, 52 participants from two cities (Baghdad and Sulaymaniyah) in Iraq were enrolled. Individuals with normal and abnormal inflammatory process were included in the study. The study population was divided into two groups based on their highly sensitive C -reactive protein (Hs-CRP) level, the control group and the study group. Serum Hs-CRP and 25-hydroxy cholecalciferol [25(OH)D] levels were measured for all participants. The data were evaluated to compare differences in vitamin D status between the two groups.
Results: The overall study population showed Hypovitaminosis D, with a mean 25(OH)D level of 22.6 +15.7 ng/mL. Significantly higher Hs-CRP, ESR, WBC and lower 25(OH)D levels were observed in the study group compared to those in the control group. A higher mean 25(OH)D level was found in the control group compared to the study group (25.1 ng/mL vs. 17.9 ng/mL, p=0.033). The mean values of serum cholesterol, triglycerides, high density lipoprotein– cholesterol (HDL-C), and low-density lipoprotein– cholesterol (LDL-C) were not significantly different across groups.
Conclusions: This study demonstrates that there is an association between low vitamin D status and inflammation markers.

Introduction: Breast cancer is prevalent malignancy affecting women globally, with Iraq facing a significant burnden. Breast self-examination is a vital, cost-effective method for early detection ,yet its practice remains low, particularly in developing countries, therefore; this study aimed to identify the knowledge, attitude, and practice of females attending the surgical unit in al Shirqat hospital-Salahdeen on breast self-examination.
Methodology: A cross-sectional study was conducted from 1st October 2024 to 1st April 2025, involving 217 randomly selected female attending in the surgical outpatient clinic in al Shirqat hospital-Salahdeen governorate. Data was collected using a designed questionaire which composed of demographic characteristics of women Knowledge of women about breast self-examination were assessed by score system practice women about breast self-examination were assessed by score system .Use of health belief model (HBM) to collect data about women's perception to breast self-examination and data and analyzed using SPSS version.
Results: The study revealed that the majority of participants (86%) had unsatisfactory knowledge of breast self-examination, and (68%) demonstrated a positive attitude towards breast self-examination. However (78%) exhibited poor breast self - examination practice. Significant association were found between ages, marital status, education level, family history of breast cancer and the levels of knowledge, attitude, and practice of breast self-examination.
Conclusion: The study underscores the necessity of educational programs and health interventions to enhance knowledge and promote regular breast self- examination practice among women, which could lead to earlier detection of breast cancer and potentially improves outcomes.

Background: The main reason postmenopausal women die is cardiovascular disease; dyslipidemia is a major contributing factor. This study evaluates postmenopausal women with chronic heart disease (CHD) to clarify how changes in lipid profile affect disease progression.
Methods: Case-control research is conducted on ninety 50–60-year-old women from Kirkuk, Iraq. 30 age-matched healthy controls were matched against 60 postmenopausal women diagnosed with CHD. Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) were determined using enzymatic spectrophotometry.
Results: Postmenopausal CHD patients exhibited significantly elevated levels of total cholesterol (201.2 ± 40.08 mg/dL), TG (154.34 ± 44.90 mg/dL), LDL (129.62 ± 39.95 mg/dL), and VLDL (30.86 ± 8.98 mg/dL) compared to controls. HDL levels were significantly reduced (40.73 ± 9.28 mg/dL vs. 51.33 ± 6.26 mg/dL; p < 0.05).
Conclusion: In postmenopausal women, dyslipidemia is significantly correlated with CHD, which underlines the importance of lipid monitoring and early treatment in this high-risk population.

Background: Tuberculosis is a common public health problem in Kurdistan region and Iraq.
Objective: To determine the prevalence of vitamin D deficiency among newly diagnosed individuals with tuberculosis.
Methods: Present study was an observational cross-sectional carried out in Erbil Tuberculosis center at Erbil city-Kurdistan region/Iraq through the period of eight months from 1st of October, 2024 to 30th of April, 2025 on sample of sample of one hundred patients with newly diagnosed tuberculosis and sample of one hundred healthy individuals as controls.
Results: The vitamin D deficiency was recorded in 74% of newly diagnosed tuberculosis cases. Our study showed a statistically significant relationship was observed between severe vitamin D level deficiency and TB cases (p<0.001). Risk factors related to vitamin D deficiency among newly diagnosed tuberculosis cases are increased age, illiteracy, unemployment, widow relationship, positive menopause for females, low family income, high crowding index, current smoking, shorter exposure duration to sunshine, no vitamin D supplement and rare frequency of food rich in vitamin D.
Conclusion: The prevalence of vitamin D deficiency in newly diagnosed tuberculosis cases in Erbil city-Kurdistan region/Iraq is high. The vitamin D deficiency may play a significant role in development of tuberculosis.

Background: Systemic lupus erythematosus (SLE) is a long-lasting autoimmune disorder with an unclear cause that can impact almost every part of the body. In addition to heredity environmental effect, an imbalance between pro-inflammatory and anti-inflammatory cytokines plays a role in immune system dysfunction, initiates an inflammatory response, and leads to damage in tissues and organs. In SLE, inflammatory responses can be enhanced and/or sustained by the presence of cytokines that are produced in excess both systemically and in specific local tissues.
Methodology: Numerous significant chemical substances have been regarded as a targets for diminishing acute or chronic infection in systemic lupus erythematosus (SLE). another research has shown that the abnormal synthesis of chemokines , especially the interleukin related to the family Interlukin-1 and Interleukin-10, drives immune response and affects immunomodulation , which are crucial in the development of such auto immune diseases. Among the cytokines in the IL-1 family, IL-1, IL-18, IL-33, IL-36, IL-37, and IL-38 have been extensively studied in relation to SLE. Furthermore, the IL-10 family cytokines, including IL-10, IL-20, are found to be immune reaction in auto immune disorder. Results: Cytotoxic substances released by activating of CD8+ T cells which leads to tissue damage. By activation of CD8 cells which produce many chemokines that effect vital tissues Additionally, B cells play a role in the pathogenic severity in final step represented in autoimmune disorder.
Conclusions: Autoantibodies attach outside of cells, triggering the complement system to unleash their cell-killing effects and result in tissue harm. Conversely, autoantibodies targeting proteins inside cells serve as important biomarkers for autoimmune diseases.

Backgound: The incidence of pediatric urinary stones increased 4% per year during 1984-2008. Hematuria (Gross or microscopic) is seen in 30% to 55% of all pediatric urolithiasis. Nearly, 25-50% of pediatric ureteral stones need surgical intervention like ureteroscopy.
Patients and Methods: In 2020, a prospective clinical study was done over a six months period (June to December) at the department of urology in Mosul Medical City. All children 14 years of age and below of both genders who presented with ureteric stones unpredictable for spontaneous passage were studied while cases with urologic comorbidities that necessitate open surgery were excluded. Abdomino-pelvic ultrasonography, plain abdominal radiography (KUB) and either intravenous urography (IVU) or computed tomography urogram (CTU) were done for all patients to identify stone characteristics (size, diameter, density and impaction) or ureteral state (dilatation or stricture).
Results: seventeen cases of semirigid ureteroscopic Ho:YAG laser lithotripsy procedures were performed. Their average age was (5.64) years, male to female ratio was 12:5. Abdominal pain and fever were the commonest presenting symptoms (76.4%). The overall stone clearance following one session of ureteroscopic laser lithotripsy was 88.2% i.e. clearance was achieved in 15 out of 17 procedures (88.2%) whereas the remaining 2 out of 17 (11.8%); needed retreatment; one case required 2nd session ureteroscopy while the other had stone migration up to renal pelvis which was treated by stenting and later on by SWL. On comparing the stone free rates in relation to their sites in the ureter or to their diameters the P-values were not significant. The post-operative complications were faced in 4 cases only (23.5%), fever in 3 cases (17.6%), while retrograde stone migration was in 1 case (5.9%).
Conclusion: Semi rigid ureteroscopic Ho:YAG laser lithotripsy is safe and effective in treating pediatric age group complaing from ureteral stones of different characteristics with a high clearance rate in single session procedures.