Dijlah Journal of Medical Sciences

Streptococcus pneumoniae is an important human pathogen associated with a variety of diseases, from mild infections to invasive pneumococcal disease and meningitis. Autolysin (N-acetylmurayl-L-alanine amidase) (LytA) is its most important virulence factor, regulating autolysis, promoting inflammatory processes and biofilm formation, and inhibiting bacterial clearance. In this research we tried to study the lytA gene enclosed autolysin in S. pneumoniae isolates that were detected in Iraqi patients suffering from bacterial meningitis. One hundred CSF samples were collected, and viable bacterial isolates were identified using classical and molecular microbiological methods. All isolates underwent an antibiotic susceptibility test. Out of 100 samples the result showed that 32 isolate of S. pneumoniae was identified by VITEK2 system. The majority of isolates exhibited high resistance to ciprofloxacin and chloramphenicol while higher sensitivity was recorded for Vancomycin and Ceftazidime. All the isolates were also positive for specific genes (lytA and ply) of S. pneumoniae using PCR amplification. Sanger sequencing of the lytA gene indicated that all strains showed high homology with reference strains and no significant mutations were detected (a sign of genetic stability). The autolysin enzyme also possesses conserved domains suggesting the likely functional significance of autolysin in virulence and pathogenesis, notably in meningitis. These findings underscore the potential of lytA and ply as diagnostic biomarkers and therapeutic targets. The study reveals important epidemiological relevance of S. pneumoniae in Iraqi hospitals and confirms the previously described global data on conservation of virulence determinants at the molecular level.

Fenugreek (Trigonella frenum-graecum), a traditional medicinal herb rich in bioactive phytochemicals, has attracted considerable attention for its antioxidant and anticancer properties. In this study, a green synthesis approach was developed to produce silver nanoparticles (AgNPs) using aqueous fenugreek leaf extract and evaluated their antioxidant, antimicrobial and cytotoxic effects against breast cancer cell (MCF-7). Antioxidant potential was conformed through total phenolic and flavonoid content, reducing power, and DPPH radical scavenging assays, with fenugreek extract showing strong activity compared to standard. The formation of AgNPs was validated by UV-Vis spectroscopy(surface plasmon resonance peak at ~418), fourier-tansform infrared spectroscopy (FTIR) indicating involvement of hydroxyl and carbonyl groups in reduction/capping, and atomic force microscopy(AFM) revealing nanoscale particle size(62-80nm). The green-synthesized AgNPs exhibited significant antibacterial and antifungal activity, with inhibition zones of up to 33 mm against Pseudomonas aeruginosa and 42mm against Candida albicans. Cytotoxicity assays on MCF-7 cells demonstrated dose-dependent effects, with an IC50 of 112.4µg/mL while normal fibroblasts (HdFn) remained comparatively less affected (IC50= 140.4), suggesting selective toxicity. To complement these findings, molecular docking was performed for three major fenugreek phytochemicals-diosgenin, quercetin, and trigonelline against breast cancer relevant proteins (ERꭤ , EGFR, and BCL-2). Diosgenin and quercetin exhibited strong binding affinities (-8.6 to -9.2 kcal/mol), indicating potential apoptotic and antiproliferative mechanisms underlying the observed cytotoxicity. Together, the results highlights foenum-graecum mediated AgNPs as a promising biogenic nanoplatform with potent antioxidant, antimicrobial, and anticancer activities, warranting further in vivo validation for breast cancer therapy.

The pathophysiology of diabetes involves oxidative stress. Damage from severe oxidative stress can reduce pancreatic beta-cell activity. In type 2 diabetes, antioxidant status imbalance and inflammation work together. Superoxide dismutase (SOD), an enzyme contained in most foods, may minimize intestinal barrier oxidative damage, breaking the hyperglycemia-oxidative damage cycle. This study examined Vitamin D Deficiency and Oxidative Stress Marker (SOD) in Type 2 Diabetes Mellitus Patients. This case-control study examined the associations between selected parameters and T2DM in fifty case and fifty control of either sex patients newly evaluated by an expert using medical evaluation and validated through laboratory analyses at a private lab (Huda Al-Rahman) analysis following the removal of alternative disorders through clinical history, analytical testing, and physical examination. This investigation was place from October 2024 to February 2025. Clinical, biochemical, and hematological tests showed the control group was healthy. Patients with type 2 diabetes' mean ± SD SOD levels (302.02 ± 9.05 U/Ml) were discovered to be substantially greater (P˂0.000) than Controls (100.1+4.41 U/Ml) The mean ± SD D3 Levels of type 2 diabetes patients (13.7 ± 4.07 ng/ml) were found to be significantly lower (P˂0.000) than Controls (35.6+14.7 ng/ml). This study found that type 2 diabetes individuals with higher SOD levels may have hemostatic indicators

This study was conducted to evaluate the responses of immature female mice to high doses of Lignans intubated orally for four weeks period. Diethyl ether and 80% ethanol was used for extraction of Lignans from flaxseeds. Thirty immature female mice, 21 one day old, were divided randomly into three equal groups were administered 50 and 100 mg/kg body of Lignans, respectively while the third group served as a control. The results showed that no significant differences in body weight gain among Lignans treated groups as compared to the control was recorded. On the other hand, Lignans had induced a significant increment in uterine and ovarian weight compared with control groups. However, reproductive organs, weight increments were coincided with the significant increments of gonadotropic hormones; follicle-stimulating hormone (FSH), Luteinizing hormone (LH) and estrogen levels. Moreover, thyroid hormones showed a significant alteration manifested by a significant decrease in the levels of triiodothyronine (T3) and thyroxine (T4) and a significant increase in thyroid stimulating hormone (TSH). Interestingly, these results confirmed the estrogenic activity of high doses of Lignans extracted from flaxseed

One of the main significant health challenges in industrial field Is the occupational exposure to petroleum derivatives and heavy metals, particularly among oil refineries workers. The most common issue is Lead exposure in such environments; it disrupts the heme biosynthesis and impairs renal function. Current study aimed to evaluate the impact of occupational exposure on hematological indices and Delta-Aminolevulinic Acid (ALAD) levels among workers at the Al- Basra Oil Refinery. Across-sectional study was conducted involving 118 participants; data were collected from the National Health Center, were workers used to perform their routine health screening, between August and November. The participants included refinery workers with varying exposure levels (Direct, Intermittent, and Indirect) and the control group was from the University of Technology. Blood and urine samples were analyzed CBC parameters, Creatinine, and ALAD levels. Statistical analysis was performed using SPSS, employing Kruskal-Wallis for non-parametric data, Two-Way ANOVA to examine the interaction between occupation and smoking, and Pearson’s Correlation to assess dose-response relationships. The results revealed that there is a significant effect of occupational status on ALAD levels (p = 0.002), the highest mean values observed in the intermittent exposure group (2.30 mg/L). Other hematological parameters such as (HGB, MCV, PLT) did not show any significant differences (p > 0.05), but there was a significant inverse correlation found between ALAD and Creatinine (r = -0.202, p = 0.028), and that indicates early renal physiological impact. Smoking was confirmed as a confounder for HGB but did not significantly affect ALAD levels (p = 0.795). Workers in Al-Basra oil refinery, exhibited a significant metabolic disruption, evidenced by elevated ALAD levels and altered renal-metabolic correlations.

Metabolic imbalance is a preclinical mechanism that silent process that follows the development of overt disease and is tightly associated with the oxidative stress and the low-grade chronic inflammation. The objective of the study was to examine the association between the serum antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and the metabolic, inflammatory, and physiological biomarkers in seemingly healthy adults. The study was a cross-sectional analytical study of 180 adults (20-55 years). The biochemical and physiological parameters were analyzed (28 in total, which included the markers of oxidative stress), such as SOD, CAT, GPx, total antioxidant capacity (TAC), malondialdehyde (MDA), and GSH/GSSG ratio), glycemic indices (fasting blood glucose (FBG), HbA1c, insulin, and HOMA-IR), lipid profile (total cholesterol (TC), LDL, HDL, triglycerides (TG), and atherogenic index of plasma (AIP)), inflammatory markers (hs-CRP, IL-6, TNF-α), adipokines (leptin and adiponectin), anthropometric indices (BMI, waist circumference, body fat percentage), and blood pressure. There were notable changes in the antioxidant enzyme activity of those people with early metabolic aberrations. SOD and GPx also exhibited strong negative relationships with BMI, triglycerides, HOMA-IR, hs-CRP, and IL-6 (p < 0.01), which showed that the lower the metabolic status, the less the antioxidant protection. Conversely, CAT activity showed a compensatory increment at the initial phases of metabolic disequilibrium. The multivariate regression analysis found HOMA-IR, AIP, and IL-6 to be the independent predictor of reduced antioxidant capacity. These results imply that serum antioxidant enzyme can be used as an early integrative biomarker to indicate the presence of subclinical metabolic dysregulation in otherwise healthy people.

Cystic echinococcosis (CE), caused by Echinococcus granulosus, represents a chronic zoonotic infectious disease characterized by complex immune responses in the host. This study evaluated total and differential counts of white blood cells (WBCs) as well as interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in serum from patients with hydatid disease compared to matched healthy controls. Fifty-one patients diagnosed with cystic echinococcosis and twenty-nine matched healthy controls in terms of age and sex were enrolled in this study. Automated complete blood count (CBC) analysis was performed for evaluation of the hematological parameters and ELISA was used for evaluation of the cytokines. Results revealed significantly elevated total WBC counts among patients >15 years of age, but not in the <15 group (p < 0.05). The differential analysis revealed eosinophilia in all groups of infected persons compared to healthy controls for each group; elevated proportions of neutrophils and decreased proportions of lymphocytes compared with healthy controls were also present in all groups of infected persons compared to healthy controls. The absolute eosinophil counts from the patients (277-371/mm³) were significantly greater than those of the controls (91-127/mm³). The mean concentration parameters for cytokines from patients had indicated an average of 14 times as much IFN-γ (119.05 vs. 81.22 pg/ml, p=<.05) and 3 times more TNF-α (161.50 vs. 58.06 pg/ml), relative to control subjects. These results suggest that CE demonstrates a clear predominance of a Th1-like immune response coupled with significant alterations of peripheral leukocytes. Based on the findings related to the hematology and cytokine parameters, additional potential biomarkers for the diagnosis and follow up of CE exist.

Keratoconus is an eye condition that is common in both eyes, with a prevalence of more than 1 in 1000 people. The analysis and diagnosis of the status of the keratoconus in the study consisted of an assortment of specialized medical apparatus which encompasses Auto Refractometer to measure the refractive errors, Penta Cam to create a three dimensional map of the corneal profile, Corneal Topography to identify the existence of an abnormality, a Slit Lamp to view the structure of the anterior eye, Visual Acuity Charts to measure the degree of vision impairment, and Optical Coherence Tomography (OCT) to image the corneal and retinal layers with high precision. A total of 139 patients diagnosed with keratoconus were subjected to clinical examinations, 117 of them were at the Al-Najaf Teaching Hospital, and 22 at the Samarra Hospital. The information was carefully recorded in terms of the disease progression, examination, and the level of visual impairment. It was found that the majority of patients have some visual impairment despite the degree of their acuity, which has a significant effect on the quality of their life, and the disease advancement is determined by the age, medical history, and extent of corneal deformation. Result: The outcome showed that Males (63.3%) were more affected by the kerokans than Females (36.7%), and the age group most likely to be affected is 20-30 (38.3%) of the entire number of patients. Eighty-two patients were right-eye affected (59% of the number of cases), and 57 patients were left-eye affected (41% of the number of cases). Penta Cam was the most used diagnostic method, with a percentage of 46.8, and Cross-Linking was the most used treatment method, with a rate of 46.

Magnesium is important for insulin-mediated cellular glucose uptake and for many of the various enzymatic reactions that are involved with glucose metabolism. Hypomagnesemia is increasingly thought to be common among patients with type 2 diabetes mellitus (T2DM) and to affect glycemic control adversely. The aim of this study is to evaluate serum magnesium levels among T2DM patients who were seen in private medical clinics in Baghdad, Iraq, and their relationship with the patients’ glycemic control as evaluated using HbA1c. A cross-sectional analytical study was performed from January to December 2024, at six clinics in Baghdad, enrolling 200 patients (type 2 diabetes mellitus). Serum magnesium was measured using an xylidyl blue colourimetric method, while HbA1c was determined using high-performance liquid chromatography (HPLC).

Sphenoid sinus mucocele is a benign expansile mucus-filled cystic lesion as a result of chronic obstruction of the sinus ostium, that may affect adjacent important structures and cause optic nerve and intracranial structures becoming involved. The study aimed to assess the effectiveness of MRI in identifying the disease and its complications through demographic factors age and sex. The study was conducted on (42) patients with sphenoid sinus mucocele (20 males and 22 females), aged (1-75) years in the Medical City Complex (Ghazi Hariri Hospital), Baghdad, Iraq during the period from January to July 2025. MRI machine with 1.5 Tesla from (Achieva, Philips Medical Systems) was used to examine the patients in the study. The results revealed that males were more likely to have complication more than females (p=0.001). The patients mean age was (36.5) years, and younger patients were more susceptible to the disease than the elderly with a highly significant difference (p<0.001). The highest incidence rate was in cavernous sinuses thrombosis 5 (11.9%), while the lowest incidence rate was in intracranial abscess and cerebrospinal fluid leakage 1 (2.4%). The study demonstrated that MRI had a high efficiency in diagnosing the disease in terms of sensitivity, specificity, and accuracy (96%), (91%), and (95.2%) respectively. Males are more likely to develop sphenoid sinus mucocele than females, while young patients are more susceptible to the disease. MRI has a high ability to diagnose sphenoid sinus mucocele and its complications and determine the factors that may affect infection.

Denture fracture is a crucial issue with dental prosthetics. Using mechanical and chemical modifications in the joint area can cause increasing in the binding strength of fractured denture base surfaces, and it must be as original strength as much as possible. So the aim of this study was to identify the effect of different repair design on the transverse strength of acrylic resin material. Out of 40 specimens of heat cured acrylic resin with dimension (65 mmmm×10 mmmm×2.5 mm) (length, width, and thickness respectively), 8 of them were kept intact and considered as a control group. 32 samples were cut at the middle to create a gap (3 mm) and prepared with different joint designs as butt, round, grooves for wire embedding ( 0.7 mm), and beveled (each of them have 8 samples). Transverse strength was tested. Result of transverse strength test showed that the highest mean value recorded by wire embedding group which equal to (91715), while the lowest mean value represented by round group which equals to (55.605). Modifications that created to the repair area have a significant effect on transverse strength of repaired specimens.

Cholecystectomy is a highly prevalent procedure in Iraq for treating cholelithiasis; nonetheless, many patients develop post-cholecystectomy syndrome (PCS). Emerging molecular studies suggest that 'biliary dysbiosis,' caused by the constant input of bile acids into the intestinal lumen, is a major cause of these symptoms. The purpose of this study was to determine the distribution of Lactobacillus spp. as a potential biomarker for dysbiosis, as well as its relationship to gastrointestinal distress in Iraqis. A case-control clinical investigation was carried out at Baghdad Hospital for Digestive Diseases with 100 participants (40 males and 60 females) aged 40 to 60 years. The participants were separated into two groups: a control group of 50 patients with symptomatic cholelithiasis (pre-operative) and a case group of 50 patients who had a cholecystectomy 12 weeks before. Fecal samples were tested using 16S rRNA gene-specific PCR to assess the prevalence and relative band intensity of Lactobacillus species. The microbial distribution was evaluated statistically, using chi-square and densitometric methods, in connection to clinical complaints. The data showed that the prevalence and relative density of Lactobacillus species were significantly lower in the post-cholecystectomy group than in the control group. These microbial changes had a strong negative connection (r = -0.78) with the intensity of gastrointestinal distress. The loss of gallbladder function caused a dramatic "microbial shift" in the intestinal environment, which impacted the stability of helpful lactic acid bacteria. The findings demonstrate that gallbladder resection creates a distinct microbial imbalance in the Iraqi population. In Iraqi clinics, restoring microbial balance with tailored probiotic drugs and dietary adjustments shows promise as a therapeutic technique for managing PCS symptoms.

Helicobacter pylori infection is a common bacterial infection of the stomach that often causes no symptoms, but can lead to gastritis, peptic ulcers, and in some cases, stomach cancer. In this study, (50) blood specimens were taken from patients who had H. pylori infection, and from (40) healthy individuals as a control groups in Baghdad teaching Hospital during the period from January to October 2025. The results of the current study showed that the mean level of H. pylori IgM antibodies was significantly higher in patients (2.14±0.17) compared to controls (0.10±0.03), and similarly, the mean IgG level was significantly higher in patients (14.31±0.94) compared to controls (0.11±0.03) (P≤0.01). Moreover, the mean level of IL-32 among the H. pylori infected patients was (27.06±2.23) compared to the healthy persons (1.25±0.32), also, the mean level of TNF-α among patients was (18.06±0.79) compared to the healthy persons (1.76±0.39), with highly significant differences (P≤0.01) respectively. In the 23S rRNA gene, the A2143G locus mutated from GG to GA and AA, while the A2142G locus mutated from AA to AG and GG.

Idiopathic polyhydramnios is a common high-risk obstetric condition associated with increased maternal and perinatal morbidity. This study aimed to compare pregnancy, childbirth, and neonatal outcomes in women with idiopathic polyhydramnios versus healthy pregnant women with normal amniotic fluid volume. This prospective case-control study was conducted at the Maternity and Pediatrics Teaching Hospital in Al-Diwaniyah, Iraq, between 1 February and 1 December 2024. Thirty singleton pregnancies with idiopathic polyhydramnios (amniotic fluid index >25 cm) and 30 matched controls with normal amniotic fluid volume (5–24 cm) were enrolled. Detailed clinical history, physical examination, and transvaginal ultrasound assessment of cervical length were performed. The primary obstetric outcome was the cesarean section rate. Neonatal outcomes included Apgar score at 5 minutes, respiratory distress, and neonatal intensive care unit (NICU) admission. Multivariable logistic and linear regression models adjusted for gestational age and cervical length were used. Gestational age at delivery was significantly lower in the polyhydramnios group (34.63 ± 0.93 vs. 37.63 ± 1.03 weeks, p < 0.001), and cervical length was shorter (3.03 ± 0.54 vs. 3.58 ± 0.20 cm, p < 0.001). The cesarean section rate was significantly higher in the polyhydramnios group (66.7% vs. 36.7%, p = 0.020). Neonates in the polyhydramnios group had lower Apgar scores at 5 minutes (6.75 ± 1.02 vs. 7.50 ± 0.61, p = 0.007), higher respiratory distress (13.3% vs. 0%, p = 0.040), and higher NICU admission rates (63.3% vs. 23.3%, p < 0.001). Multivariable analysis confirmed idiopathic polyhydramnios as an independent predictor of cesarean delivery (adjusted odds ratio 13.72, 95% CI 2.46–76.38, p = 0.003) and lower Apgar score (β = –0.66, p = 0.021). Idiopathic polyhydramnios is independently associated with increased risks of cesarean delivery and adverse neonatal outcomes. Intensified antenatal surveillance and timely intervention are warranted in these pregnancies.

Post-COVID-19 patients in Qaladiza City, Kurdistan Region, Iraq, continue to face a number of chronic health issues that impact their functional and physical well-being. In addition to examining the sociodemographic and clinical predictors of these health outcomes, the study sought to determine the prevalence and severity of physical and functional health issues among individuals who had recovered from COVID-19. Convenience sampling was used in this cross-sectional study, which was carried out at two public health facilities in Qaladiza City between March 1st and July 1st, 2025. The study employed a standardized questionnaire that asked about demographics, functional health issues, and physical health issues. Stata version 12 (StataCorp LLC, College Station, TX) was used for statistical analysis. Relationships between physical and functional scores were evaluated using Spearman's rho correlation, associations between sociodemographic/clinical factors and health categories were examined using chi-square tests, and predictors of physical and functional health problems were identified using ordinal logistic regression. The study included 150 post-COVID-19 patients, whose mean age was 41.01 ± 13.05 years. The majority (72.0%) were categorized as moderate, with a mean score of 29.31 ± 3.73 for physical problems. The majority (63.3%) were classified as moderate, and the mean functional problem score was 14.71 ± 2.24. Physical and functional scores showed a significant positive connection (r = 0.20, p = .012). According to ordinal regression analysis, a history of chronic disease was strongly linked to worse functional outcomes (p =.002), whereas a lower level of education was significantly linked to worse physical health outcomes (p =.014). The study showed that weariness, joint discomfort, and everyday work challenges are the most common physical and functional health issues experienced by post-COVID-19 patients in Qaladiza. Health outcomes were found to be significantly predicted by education and a history of chronic illness. For post-COVID-19 patients, targeted interventions that target vulnerable populations are advised to enhance rehabilitation and quality of life.

Background: Preoperative diagnosis might be challenging when trying to differentiate between uterine leiomyoma and leiomyosarcoma due to their shared imaging and clinical features. Accurate distinction is a key to avoiding unnecessary delays in cancer diagnosis or aggressive therapy. In order to distinguish between leiomyoma and leiomyosarcoma, this study investigated the diagnostic role of non-invasive imaging modalities without diffusion-weighted imaging (DWI). Methods: From 2012 through 2024, researchers at Iraq's Al-Amal Oncology Teaching Hospital tracked patients' vitals in a retrospective case-control study. Using size-matched criteria, the researchers identified 23 individuals with preoperative imaging showing histopathologically proven uterine leiomyosarcoma (n = 8, CT n = 9, and MRI n = 6). They compared these patients to 34 patients who had their tumors removed. Six blinded radiologists, three of whom were consultants and three of whom were residents, independently evaluated tumor margins, necrosis, bleeding, vascularity, calcifications, heterogeneity, and overall probability of malignancy using a standardized 5-point grading system. The results of the logistic regression and receiver operating characteristic (ROC) analyses were used to ascertain the diagnostic performance. Results: The mean malignancy suspicion ratings (2.4 +- 1.1 for leiomyoma and 2.8 +- 1.3 for leiomyosarcoma, respectively) did not differ significantly between the benign and malignant groups. Ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) did not differ significantly in terms of diagnostic accuracy (P =.29-.93), and the ROC curve areas were 0.35 to 0.68. Reading proficiency had no effect on diagnosis accuracy, and no morphologic trait was a reliable predictor of cancer (P =.12-.95). Conclusions: Differentiating between uterine leiomyoma and leiomyosarcoma is not reliably achieved by conventional ultrasonography, CT, and MRI due to the absence of diffusion-weighted imaging. These findings support the idea that diffusion-weighted MRI and advanced functional imaging should be used together to improve pre-operative diagnostics and guide optimal therapeutic treatment.

The development of Nano-antibiotics, which provide enhanced bioavailability and selective administration, has completely altered how infectious diseases are treated. However, their effectiveness might be changed by the physiological environment, primarily changes in temperature. This study uses both theoretical assessment and data from experiments to investigate how elevated temperatures impact the activation energy of Nano-antibiotics in a blood media. The data show that higher temperatures reduce activation energy, possibly enhancing antibiotic efficacy but simultaneously heightening concerns concern stability and adverse effects. This current research examines the effect of increased temperatures on the activation energy and stability of Nano-formulated antibiotics—erythromycin, tetracycline, levofloxacin, ciprofloxacin, and gentamicin—in a medium of blood. Optimizing therapeutic efficacy requires knowledge of these outcomes, particularly in cases of fever or during hyperthermia therapies. Temperature is a key factor influencing the pharmacokinetics and activity of antibiotics, particularly when administered as nanoparticles in physiological settings such as blood. This study examines the impact of elevated temperatures on the activation energy of Nano-antibiotic variants of erythromycin (ERY NPs), tetracycline (TET NPs), levofloxacin (LEV NPs), ciprofloxacin (CPR NPs), and gentamicin (GEM NPs) in a blood media .Employing Arrhenius kinetics, we analyzed activation energies at standard and raised temperatures, discovering that higher temperatures often reduce activation energy and enhance reaction speeds. Employing Arrhenius kinetics, we analyzed activation energies at standard and raised temperatures, discovering that higher temperatures often reduce activation energy and enhance acceleration the reaction. There is discussion of the implications for safety and efficacy of therapy.

Type 2 diabetes mellitus (T2DM) represents a major public health challenge, with effective management fundamentally relying on patients' daily self-care behaviors. Despite the importance of health-related behaviors in diabetes management, limited evidence exists regarding determinants of these behaviors among T2DM patients in primary care settings in the Kurdistan Region of Iraq. A descriptive cross-sectional study was conducted among 200 adults with T2DM attending two primary health care centers in Rania City, Kurdistan Region, from January to April 2025. Data were collected through structured face-to-face interviews using a validated questionnaire (Cronbach's alpha = 0.85). Chi-square tests, correlation analyses, and multivariable regression models examined associations between sociodemographic, clinical, and psychosocial factors and self-management behaviors. Self-management behaviors were generally suboptimal, with low engagement in glucose monitoring, physical activity, dietary adherence, and foot care. Sociodemographic factors showed no significant associations with self-care behaviors. However, diabetes duration significantly predicted glucose monitoring (χ² = 26.51, p = .002) and medication adherence (χ² = 22.84, p = .007). Smoking status was associated with monitoring frequency and physical activity. Psychosocial determinants including diabetes-related stress, emotional well-being, support systems, and diabetes management confidence emerged as significant predictors. Risk stratification identified five distinct patient subgroups requiring tailored interventions. Comprehensive, multidisciplinary approaches addressing behavioral and psychosocial barriers are essential to optimize diabetes self-management in primary care settings in this population.

The incidence of Cryptosporidiosis in children with diabetes and the impact on blood and ferritin stores in Al-Shirqat district Abstract: This study sought to analyze prevalence of Cryptosporidiosis, the effects on blood element and ferritin stores in the diabetic children from Al-Shirqat district. Fifty-five children aged 1–15 years, with Type 1 diabetes were enrolled in this cross-sectional study. Cryptosporidium was detected in feces by parasitological and PCR, and blood samples were subjected to hematology measures including hemoglobin (Hb), red blood cell (RBC) count, packed cell volume (PCV) and ferritin. Result: The infected children had significantly lower Hb, RBC, PCV and Fe which indicates high ferritin deficiency anemia between infected groups. There was also significant elevation of white blood cell (WBC) and neutrophil counts revealing activation of the immune response. Platelets in infected (compared to the controls) were greatly decreased. Therefore, the findings indicate significant negative impacts of Cryptosporidiosis on nutritional status and immune system function of diabetic children. Timely diagnosis and treatment of Cryptosporidiosis in children with anemia would prevent them from worsening anemia and compromise immune defenses, the study concluded. More studies are required to examine whether gender is involved and other risk factors present.

Dry eye syndrome is a prevalent ocular condition characterized by tear film instability and ocular surface injury, significantly impacting the quality of life. This study analyzed 100 participants at Dijlah University, consisting of 55 women and 45 men, to evaluate the role of lifestyle in preventing this disorder. Results indicated a high prevalence of dry eye (85%), with significant associated symptoms including headaches (75%), red eyes (73%), and blurred vision (55%). Behavioral risk factors were prominent, as 55% of the cohort was smokers and 40% regularly wore glasses. Notably, despite the high symptom rate, 95% of affected individuals had not sought medical consultation. Chronic conditions were present in 41% of the group, further complicating the clinical picture. The study concludes that environmental factors and smoking are major contributors to ocular dryness in this population. Preventative measures such as using filter glasses, regular eye moisturization, and lifestyle modifications are essential for effective management. The conclusion is that a large percentage of people have dry eyes due to a range of causes, such as the environment and atmosphere, in addition to many other factors that might cause dryness. To avoid dry eyes, people should wear sunglasses and filter glasses while reading, using a computer, or using a phone. They should also regularly moisturize their eyes.

Hematuria is a common clinical manifestation with a wide range of causes, from benign, transient diseases to serious malignancies of the urinary system. Hematuria can be gross or microscopic, each with different diagnostic significance and risk assessment implications. While many causes are benign, including infection, urinary tract stones, and benign prostatic hyperplasia, hematuria can also be the earliest sign of urothelial carcinoma or kidney malignancies. Studies have shown that tumor detection rates are significantly higher in patients with gross hematuria than in those with microscopic hematuria. Therefore, a comprehensive clinical evaluation is crucial, including medical history, physical examination, laboratory tests, imaging studies, and cystoscopy. Urinalysis and urine culture help differentiate between glomerular and non-glomerular causes, while urine cytology can serve as an adjunct in high-risk cases. Imaging techniques such as ultrasound and CT urography play a central role in assessing upper urinary tract diseases. Cystoscopy remains the gold standard for examining the lower urinary tract. Existing guidelines, including those from the American Urological Association and the European Association of Urology, recommend a risk-adaptive diagnostic approach to optimize cancer screening and minimize unnecessary invasive procedures. This article reviews the etiology, classification, and evidence-based urological diagnosis of hematuria in clinical practice.

Absolute insulin insufficiency and persistent hyperglycemia are symptoms of type 1 diabetes mellitus (T1DM), an autoimmune illness marked by the immune-mediated death of pancreatic β-cells. Shared genetic and immunological processes, especially involving HLA-DQ2 and DQ8 alleles, sometimes link type 1 diabetes (T1DM) with celiac disease (CD), another autoimmune condition that is induced by gluten consumption. Type 1 diabetes mellitus (T1DM) and chronic kidney disease (CD) occurring together constitute a subtype of autoimmune polyendocrine syndrome (APS-4), which makes metabolic regulation and therapeutic care more challenging. With variations depending on regional and dietary variables, the frequency of CD among T1DM patients is much greater (4-10%) than in the general population. It is essential to screen T1DM patients for CD since many individuals do not show symptoms or have unusual signs including growth retardation, anemia, or hypoglycemia. Adherence to a gluten-free diet (GFD) and prompt diagnosis greatly enhance metabolic parameters, development, and overall quality of life. The significance of routine screening, early diagnosis, and integrated treatment for best results is highlighted in this review that outlines the genetic, pathophysiological, and clinical intersections of type 1 diabetes and chronic kidney disease.

Immune balance is mainly maintained through coordination between effector and regulatory T cells, especially the Th17 and Treg subsets. These two types perform opposite functions—one drives inflammation while the other limits it—to preserve immune tolerance. When this coordination fails, the system drifts toward autoimmunity. Excessive Th17 activity and a shortage of functional Tregs have been reported in many disorders, but the molecular events behind their instability are still being investigated. Researchers have recently focused on therapeutic methods that might restore this disturbed ratio. The flexible nature of T cells makes such control difficult, since each subset can shift its phenotype depending on signals in the environment. Clinical and laboratory findings show altered Th17/Treg proportions in several autoimmune diseases, including type1 diabetes, lupus, multiple sclerosis, and psoriasis. In diabetic patients, a higher percentage of Tregs often coincides with lower HbAIc and reduced insulin demand, while increased Th17 activity predicts more severe disease. Studies of gene expression also reveal specific chromatin patterns that mark pathogenic Th17 cells. In addition, new approaches such as Treg-based treatments and engineered CAR-Treg cells are being explored to regulate these immune pathways. Altogether, current findings highlight that the Th17/Treg disequilibrium is a core element in autoimmune pathology, and restoring this cellular dialogue is a major target for future immunotherapy.