Sawa Medical Journal

Cutaneous Leishmaniasis has been a long-standing public health concern in Iraq. The study on
leishmaniasis epidemiology in Iraq indicates that the disease has been endemic in various regions for
many years. Leishmaniasis is an ancient disease in Iraq known by different local names, including
“oriental sore”, “Aleppo button”, “Jericho boil”, Delhi boil,“ sister” and "Baghdad boil", which used to
be common until a few decades ago. This study aimed to identify the spread of cutaneous leishmaniasis
in Muthanna province, Iraq, by analyzing patient data based on gender, age, and location. Data
collection took place from December 3, 2023, to March 10, 2024, and was conducted by the AL
Muthanna Health Department and the Statistics and Control Unit, involving all registered cases in the
governorate's districts. The data was organized in statistical tables, categorized by years from 2016 to
2023, and analyzed using the (SPPS version 23) program, The chi-square test was used to identify
significant differences in total cases, age groups, number of infections among patients, region, gender,
and age at a probability level of P<0.05 .
The study based on statistical analysis of diagnosed cases of cutaneous leishmaniasis, the results
revealed that males were more prevalent, accounting for 59% of the cases, while females accounted for
41%,the analysis showed that males were slightly more frequently affected by cutaneous leishmaniasis
compared to females with a significant difference of (p≤0.05) during the years 2016-2023. The age
distribution of patients with cutaneous leishmaniasis CL showed that the highest frequency was
observed among individuals aged 5-14 years (41%).

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used and over-the
counter medications for pain relief and control of inflammation. Unsupervised NSAID ingestion may
cause dangerous consequences by blocking blood pressure control in patients with chronic hypertension.
These effects result from sodium and fluid retention, inhibition of vasodilatory prostaglandins, and
increased vascular resistance. NSAIDs may also antagonize antihypertensive drugs, particularly the
angiotensin-converting enzyme inhibitors and the angiotensin receptor blockers. This study was
conducted to examine the effect of nonsteroidal agent abuse on the blood pressure of hypertensive
patients in Samawah city, Iraq, and assess the level of abuse, pattern of intake, patient knowledge of
risks, and compliance with prescribed antihypertensive medications .
The sample consisted of 150 hypertensive patients, of whom most were in the 46 to 60-year age group;
females made up 70.7% of the total. Forty-seven percent of the cohort used NSAIDs, with 56.7% of
users doing so without medical guidance. A higher prevalence of change in blood pressure was also
found in NSAID users (33.3%), among whom 22% experienced an elevation in blood pressure.
Although statistical tests did not significant to show a significant difference in systolic or
diastolicpressure between users and nonusers of these medications, the clinical implications are
nonetheless interesting. Furthermore, the knowledge gap was high, with 62% of participants being
unaware of the cardiovascular and renal risks of NSAID use. A weak, but statistically significant
correlation was found between medication adherence and systolic pressure and the number of first-line
antihypertensive drugs, and diastolic pressure .
In conclusion, the misuse of NSAIDs is common and can be devastating for patients with high blood
pressure, especially low health literacy patients. These data highlight the importance of patient
education, improved physician-patient communication, and the adoption of safer, evidence-based
alternatives for pain management to reduce blood-pressure instability and associated complications .

This study examines the levels of radon gas (²²²Rn) and the associated annual effective dose (AED) in
potable water supplies utilized for domestic purposes in the Al-Khidhir District, Al-Muthanna
Governorate, southern Iraq. In the study area, which included both the eastern and western regions of
Al-Khidhir City, 230 water samples were gathered from 23 residential areas. A calibrated RAD7 radon
in air detector from the Durridge Company in USA was used to take the measurements. Water aeration
and humidity control were done according to standard protocols. The average radon concentration in the
water samples was 10.30 Bq/L, with a range of 0.29 to 33.01 Bq/L. the average annual effective doses
from inaling radon were 0.0074 mSv/y, with a range of 0.000328 t0 0.07587 mSv/y. According to the
European Union (0.1 mSv/y) and the World Health Organization (100 Bq/L), all recorded values were
significantly below the uppermost permitted limits. The local geology, soil texture, building age, and
water distribution network integrity all contributed to the variations in radon levels in various locations.
Long-term use of radon-contaminated water at homes, may raise the risk of radiation exposure even
though the levels detected were low. This study provides vital baseline information for environmental
radiation monitoring and public health protection in southern Iraq.

Hydatid disease is a common disease in Iraq. Ruptured hydatid cyst is also a common complication
and fatal if missed .This study was planned to find the socio – demographic – economic distribution, the
most common way of clinical presentation and treatment of patients with this disease and to give idea
about better diagnosis and line of treatment.
This study has been carried on 25 patients admitted to Al Hussein Teaching Hospital in Al-Muthanna
governorate over a period of 2 years Post operatively the patients were followed for one year.

Giardiasisa common diarrheal illness that has major health consequences worldwide, particularly in
developing nations, is caused by the flagellated intestinal protozoan Giardia lamblia. The primary
diagnostic technique is still conventional microscopy, although it frequently has low sensitivity and
operator dependence. This study aimed to evaluate the diagnostic accuracy of polymerase chain reaction
(PCR) relative to light microscopy for detecting G. lamblia in diarrheic patients in Al-Muthanna
Province, Iraq, and to analyse the distribution of infection concerning demographic and environmental
factors. During a six-months period, 100 stool samples were collected from patients with diarrhoea
receiving treatment at Al-Rumaitha General Hospital and the Maternity and Childrens Hospital. Samples
underwent microscopic examination, subsequently followed by reexamination using PCR to target the
small subunit ribosomal RNA gene of G. lamblia. Microscopic analysis revealed intestinal parasites in
34.4% of samples, with G. lamblia as the predominant species at 53.8%. PCR analysis detected G.
lamblia DNA in 96% of samples, demonstrating enhanced sensitivity. Men (54.2%) exhibited a higher
propensity for infections, with children under age of ten being the most susceptible. Sequencing analysis
revealed minimal genetic variation (0.01-0.002%) among isolates, which are stored in GenBank
(OL719308). In conclusion, PCR is a dependable and highly sensitive technique for diagnosing
giardiasis that can supplant microscopy. The elevated infection rates among rural children underscore
the necessity of improving sanitation, hygiene education, and access to potable water in Al-Muthanna
Province.

Dumping syndrome originated as a group of gastrointestinal symptoms experienced by individuals who
had undergone surgery for peptic ulcer. It is now seen quite frequently in those who have had surgery for
upper gastrointestinal (GI) cancer, bariatric surgery, or anti-reflux surgery. Early and late dumping
syndrome have distinct symptom patterns. Symptoms that happen less than 1 hour after eating are
considered early dumping syndrome and consist mainly of gastrointestinal symptoms resulting from
osmotic fluid shifts in the intestinal lumen. Late dumping syndrome symptoms occur between 1-3 hours
after eating and consist primarily of vasomotor symptoms due to reactive hypoglycemia from the over
secretion of insulin in response to the influx of glucose into the portal circulation.
According to the existing guidelines, evaluation of HR; running laboratory tests; and comparing results
to diagnostic criteria for postprandial dumping syndrome with a glucose challenge test are recommended
assessments for the diagnosis of dumping syndrome. Dumping syndrome is diagnosed based on
Worsening symptoms after meals, results of provocation tests, lab investigations, an individual's history
of gastric surgery or an inherent condition of rapid gastric emptying (i.e.: dumping syndrome).
Most cases of Dumping Syndrome can be treated with changes in diet. If diet does not help, then medical
or surgical options can be recommended by a healthcare service provider, but there is little evidence to
support the effectiveness of either option.

Carbonic anhydrase (CA) is an important biological target in cancer therapy, due to its vital role in
regulating intracellular pH and providing an acidic environment that promotes the growth and spread of
cancer cells. Tumor cells rely on aerobic glycolysis, which leads to the accumulation of acidic products
such as CO₂ and lactic acid, thus lowering the pH in tumor tissue. In this study, molecular docking
demonstrated that SA and OSA possess a high binding capacity to the active site of CA II, with SA
recording the highest binding energy (-8.13 kcal/mol). Hydrogen bonding was documented within the
active pocket, supporting the stability of the enzyme complex. CA was purified from red blood cells
using systematic steps that included hypotonic lysis, hemoglobin removal using chloroform and ethanol,
and precipitation with ammonium sulfate.
Subsequently, the effectiveness of nanocatalysts (Si@SA and Si@OSA-Dir) at different concentrations
(up to 500 µg/mL) was evaluated, demonstrating their ability to raise the pH of the medium and reduce
acidity. The Si@OSA-Dir catalyst demonstrated significant effectiveness in stabilizing pH at 8 within
20 minutes, while the other compounds reached pH 7.7, demonstrating their effectiveness in adjusting
acidity.The results indicate that these prepared compounds hold promise as CA inhibitors and have
potential applications in cancer treatment strategies by targeting the acid balance in the tumor
microenvironment.

Glaucoma remains a significant public health concern in Al-Muthann , with prevalence rates observed
among men compared to women. This study aimed to Identify the early signs and risk factors associated
with glaucoma, including elevated intraocular pressure, optic nerve changes, and visual field defects.
Screen patients at risk for glaucoma during routine eye examinations, including those with a family
history, advanced age, diabetes, and other relevant medical conditions. Data collected from clinic and
healthcare along a free examination to conduct this study in Al-Muthanna. .The findings suggest a need
for improved diagnostic methods, increased awareness, and targeted preventive measures to reduce the
burden of glaucoma in Al-Muthanna, particularly among high-risk groups of men such as Pakistani worker

Hospital-related infections, particularly from intensive care units, are brought about by the bacteria
Pseudomonas aeruginosa. Because it is resistant to drugs and may exist in hospitals, it can be hard to
kill off. Because of this, it creates a significant risk and challenge in hospital situations. The chemical
and genetic traits of Pseudomonas aeruginosa, most notably its beta-lactamase synthesis and antibiotic
resistance, have been part of several studies performed in the Al-Diwaniyah Province. One of the more
crucial phases when developing antimicrobial tactics is identifying the biological indicators associated
with antibiotic-resistant bacteria.
While Pseudomonas aeruginosa had been isolated from a number of clinics in past studies, here remains
not many assets available for its molecular characterization and resistance patterns. Finding out more on
a generalization of genes associated with resistance like GES, blaOXA-48, and SPM can help build
approaches for managing bacterial infections. Using traditional molecular techniques, this study sought
to obtain and determine Pseudomonas aeruginosa from medical samples, investigate its capacity to
resist drugs, and identify its presence of genes that create beta-lactamases. Findings: 15 out of 30 clinical
specimens (50%) had Pseudomonas aeruginosa confirmed. Burns (60%), wounds (26.6%), and urine
(13.4%) had the greatest isolation rates.
60% of the isolates produced beta-lactamase, suggesting that they were resistant to a lot of antibiotics
with the notable exception of tigecycline, as determined by the Rapid Iodine Assay and the Vitec II 2
system. The PCR method revealed that the 16S rRNA gene was found in all isolates. In addition, 20%
had the SPM gene, 40% had the blaGES gene, and 75% had the OXA-48 gene. This study is one of the
first to explain Pseudomonas aeruginosa's molecules in the Diwaniyah Province focused on the genetic
factors that lead to its heightened resistance and production of beta-lactamases. we are consequences, To
avoid the development of drug-resistant Pseudomonas aeruginosa in healthcare environments,

Background: Hormonal infertility is closely linked to obesity in males and is most likely to result due to
chronic low-grade inflammation mediated by adipose tissue-derived cytokines. The presence of
circulating IL-6 and CRP as the main inflammatory biomarkers that disorganize the hypothalamic
pituitary-gonadal axis and cause dysfunction of testosterone production and disturbed reproductive
activity. Aims of the study; This study seeks to examine the levels of the inflammatory biomarkers of
interleukin-6 (IL-6) and C-reactive protein (CRP) in the obese men with hormonal infertility and analyze
their relations with the hormonal profiles and their body mass index (BMI) relative to the healthy control.
Methodology: The case-control study was carried out between February and September 2025 in two
hospitals in Nasiriyah, Iraq where 100 obese men with hormonal infertility and 50 healthy controls
participated in the study. The eligible patients were aged between 25 and 45 years and had a BMI of
30kg/m 2 and the controls were normal in weight and had no infertility. Blood samples had been gathered,
processed and stored to be analyzed. Hormonal evaluation was carried out by evaluating testosterone, LH,
FSH and prolactin by ELISA, IL-6 and CRP was done by ELISA and immunoturbidimetric assays.
Result: Of the 100 obese men in the study, the hormonal infertility of the men was compared to the control
of 50 healthy men. There were notable differences in BMI of patients (32.4 vs. 24.1, p<0.001), but no
difference was found in age, smoking, education and alcohol consumption. The levels of IL-6 and CRP
were significantly higher in patients (8.6 pg/mL and 6.8 mg/L) compared to controls (2.1 pg/mL and
1.2mg/l, p<0.001). The analysis of hormones showed that patients had low testosterone and high LH, FSH
and prolactin (p<0.01). Correlations revealed that there was inflammation that was attributed to obesity
and hormonal imbalance, and that the categories of obesity that differed significantly across groups.
Conclusions: This paper concludes that the obese men with hormonal infertility have high levels of IL-6
and CRP, low testosterone, and disturbed gonadotropins. These results indicate that obesity-induced
chronic inflammation interferes with the hypothalamic–pituitary-gonadal axis, which is the reason why
obesity leads to infertility by disrupting hormonal and immunological regulation.

The consideration of non-equilibrium thermodynamics (NET), has become a central theme in the
interpretation of intricate behaviours of complex biological systems. Life is at its core a process far
from equilibrium, driven by persistent energy and mass flow. In this review, we provide an overview of
the recent theoretical and computational developments in NET from 2018 to 2025 based on the
comprehensive literature survey of more than half a century by considering more than 50 Scopus
indexed papers. The paradigm in energy transduction and dissipative structures that we need to disclose
is set by the earliest incursions of quantitative biology into cellular metabolism. The reviewer next
explains in detail the theoretical developments of stochastic thermodynamics and the framework of
information thermodynamics, which offers means to quantify entropy production rates, fluctuation
theorems and acting quantities characterising energetic costs arising from biological accuracy. A large
part is devoted to state of the-art computational methods, such as thermodynamically corrected coarse
grained molecular dynamics and agent-based models. In order to compile findings from different
studies, we display table review summaries about the results, methodology and advice of leading
authors. To illustrate the potential of NET, their application in addressing specific biological disorder
related phenomena circadian rhythms and dynamics, cancer metabolism, cellular sensing system s, and
neural dynamics is scrutinized to exhibit how they may explain or predict the behavior of a disease. Last
but not least, remaining challenges of the real time measurement of cellular entropy production and the
multiscale coupling are summarized with an outlook for future research to apply artificial intelligence in
connection with thermodynamic models and implement thermodynamic therapies. The combined
evidence supports AFF tactic as a necessary lingua franca to advance beyond descriptive ecology
towards predictive, quantitative biology of life.

Occupational exposure to ionising radiation remains a major safety concern in imaging and nuclear
medicine departments, where even small, unnoticed leaks from X-ray tubes, shielding defects, or
mishandled radionuclides can accumulate into unnecessary dose for medical personnel. Conventional
passive dosimeters provide only retrospective information, while commercial electronic personal
dosimeters are often too costly to be deployed widely in resource-constrained healthcare systems.
This paper presents the conceptual design of a low-cost, wearable radiation leak alarm intended to
facilitate real-time leak detection for frontline medical personnel.The proposed device integrates a
compact Geiger–Müller (GM) tube with a high-voltage bias circuit, a low-power ESP32 microcontroller,
an OLED display, and a Li-Po battery in a lightweight clip-on enclosure. Firmware routines perform
interrupt-based pulse counting, convert count rate into an approximate ambient dose-equivalent rate
H\*(10)H^\*(10)H\*(10), and trigger audible and visual alarms when user-defined dose-rate thresholds
associated with potential leakage conditions are exceeded. A calibration and testing protocol is outlined
using a low-activity potassium chloride check source and a traceable survey meter to derive a device
specific conversion factor between counts per minute and dose rate over the range relevant for leak
detection.
While full experimental and clinical validation are planned as future work, the proposed architecture
demonstrates a practical and affordable pathway towards complementing conventional passive dosimetry
with real-time, wearable leak alarms, thereby strengthening radiation protection practices for medical
personnel in low- and middle-income healthcare settings.