The Medical Journal of Tikrit University

Background: Helicobacter pylori (H. pylori) is a known gastrointestinal disease-related pathogen. The cytotoxin-associated gene A (cagA) emerged as H. pylori virulence factors, used to identify the pathogenicity and clinical outcomes. The noninvasive technique (stool-based testing) and molecular detection of Chaga are widely used to detect for H. pylori in epidemiological studies.
Objective: To assess the prevalence of H. pylori in adult patients presenting with gastrointestinal symptoms in Iraq and to reveal the existence of the cagA gene employing polymerase chain reaction (PCR) from stool samples.
Methods: A cross-sectional study was conducted to analyze data of adult patients presented with gastrointestinal symptoms at Baquba Teaching Hospital, Diyala, Iraq. Stool specimens were collected and eventually tested for H. pylori using a rapid stool antigen test (SAT), followed by molecular detection of the cagA gene via PCR. The Chi-square tests and binary logistic regressions were employed to assess the relationship between cagA positivity and demographic features.
Results: Out of 123 examined stool samples, 14.6% (18/123) diagnosed with H. Pylori. Among these, 61.1% (11/18) were cagA-positive. Higher prevalence of H. Pylori was seen among female gender (15.9%) and residents of rural regions (18.2%) compared to males (13.3%) and those residents in urban region (10.8%). There were significant associations between cagA positivity and individuals in the age group 41–60 years (p = 0.033). However, findings of multivariate logistic regression revealed that age (Adjusted OR = 2.9, 95% CI: 1.1–7.7, p = 0.031) and rural residency (Adjusted OR = 2.5, 95% CI: 1.0–6.4, p = 0.042) were the independent predictors for cagA positivity.
Conclusion: In conclusion, moderate prevalence of H. pylori and high occurrence of the cagA gene were reported among infected Iraqi adults. Community -based health care interventions and early detection of H. pylori with affordable approaches are crucial control infection and prevent the gastric cancers.

Background: Family planning is the key to reduce maternal mortality and upturning population health and managing fertility rate. Despite its significance, there exists a disparity between use and knowledge of family planning methods, especially in developing countries. Given the fact that determinants of family planning utilization serve as stake holders in maternal and child health area it has become very important to develop some most effective interventions for reproductive health.
Objectives: This study was conducted to evaluate the level of knowledge, attitude and practice towards family planning methods among women in Tikrit city\\ Iraq as well as to identify some of barriers deterring their use.
Methods: A cross sectional study conducted on 200 reproductive age women who presented to Tikrit Teaching Hospital. A pretested and structured questionnaire was used to collect data on demographic variables, awareness, attitude and practice of family planning methods. Statistical analysis was carried out using SPSS version 25.0, which consisted of descriptive statistics and chi-square tests.
Results: The majority of participants were 25-49 years old (84%), completed primary school education (41%) and housewives mostly (84.5%). They had awareness about family planning (96%) but the utilization of FP was less (66%). The predominant form of contraception was oral contraceptives (45%). Age, parity and occupation were significantly associated with family planning utilization, there was no significant association between socioeconomic status, educational level and place of residence.
Conclusion: The study indicates a discrepancy between the use of and knowledge about contraceptive methods in Tikrit city. Factors that were significantly associated with utilization of family planning were age, occupation and number of children. These results further emphasize the need for selection interventions that promote linkage through improving the awareness-service utilization gap, particularly among hard-to-reach groups.

Background: This study examines the prevalence of depression among medical students and the impact of academic stress on depressive symptoms. Understanding this relationship is vital for developing interventions to improve student mental health.
Methods: A cross-sectional study was conducted with 500 medical students at Ibn Sina Teaching Hospital in Iraq. Depression was assessed using the Beck Depression Inventory-II (BDI-II), and correlations with academic stress, cognitive function, and gender were analyzed.
Results: The Findings revealed that 42.2% of students had moderate depression, 15.8% had severe depression, and 10.2% had very severe depression. Clinical students reported significantly higher depression scores than pre-clinical students. Female students showed higher depression levels than male students, and academic stress was strongly associated with depressive severity.
Discussion: The study highlights the high prevalence of depression, particularly among clinical students and females. Academic stress significantly contributes to depressive symptoms, indicating the need for targeted mental health interventions in medical education.

Bariatric surgery is seen as a safe and functional treatment for fatness and its associated comorbid conditions. Also, nevertheless, it is linked with an increased risk of gallstone formation. The risk factor is believed to be due to perturbation of bile salt equilibrium, rapid weight loss, and alteration in the composition of bile. Bile salt metabolism differences are compared between five common bariatric operations (sleeve gastrectomy (SG), Roux end Y gastric bypass (RYGB), mini gastric bypass (MGB), single anastomosis sleeve ileal bypass (SASI), and single anastomosis sleeve jejunal bypass (SASJ)) and to what degree these differences might contribute to gallstones.


The results demonstrate that procedures that bypass the duodenum, jejunum, or ileum  (RYGB,  MGB,  SASI,  SASJ)  have  serious  consequences  on  bile  salt reabsorption,  contributing  to  high  cholesterol  supersaturation  and  creation  of gallstones. SG from a bile salt perspective had the least direct impact; however, the rapid  weight  loss  occurring  postoperatively  also  created  a  moderate  risk  of gallstone formation. Treatment strategies such as ursodeoxycholic acid (UDCA) therapy scheduled intervals post-surgery combined with gradual weight loss and dietary changes and considerations were effectively utilized in decreasing gallstone formation.


This  paper  illuminated  the  need  for  individualized  treatment  approaches  for procedures that are associated with greater post-operative risk RYGB or MGB procedures.  Prompt  interventions  and  timely  prescribed  medications  and monitoring are critical in the care of these patients to realize better outcomes and have less post-operative complications.

A brief overview of chromosomal diseases is also provided, along with a review of the distinctive characteristics of inheritance patterns. The genetic identification of juvenile genetic illnesses is also discussed, including the use of molecular and cytogenetic techniques as well as different kinds of mutations. The objective is to teach pediatricians how to use cytogenetic and molecular techniques and tools for genetic diagnosis. Single-gene, chromosomal, and multifactorial disorders are the three main types of genetic diseases. Autosomal dominant (AD), autosomal recessive (AR), X-linked recessive (XR), X-linked dominant, and Y-linked (holandric) diseases are examples of single gene or Mendelian disorders that arise from mistakes in a gene\'s DNA sequence. Numerical and structural damage are examples of chromosomal abnormalities that cause chromosomal diseases. Genetic mutations that cause diseases have been found using cytogenetic and molecular approaches. Correct disease diagnosis is necessary for patient therapy, genetic counseling, and preventative measures.

Febrile infants under 90 days of age are at elevated risk of serious bacterial infection (SBI), yet the majority have self-limiting viral illness. Distinguishing the two at presentation governs decisions on lumbar puncture, empirical antibiotic therapy, and hospital admission. To compare the diagnostic accuracy of serum PCT and CRP, alone and combined with clinical assessment, for discriminating culture-confirmed SBI from viral or non-bacterial febrile illness in infants under 90 days. A prospective single-center diagnostic-accuracy cohort study was conducted at pediatric department of Bint AlHuda teaching hospital from 1 February 2024 through 1 October 2025 and reported in accordance with the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 statement. Consecutive febrile infants under 90 days undergoing a full sepsis evaluation had paired PCT and CRP measured at presentation, before antibiotic administration. The reference standard was culture-confirmed SBI (blood, urine, or cerebrospinal fluid) supplemented by structured clinical adjudication. Of 458 infants assessed, 348 formed the analytic cohort; SBI was confirmed in 71 (20.4%), of which urinary tract infection was the most frequent (62.0%). PCT achieved an AUC of 0.86 (95% confidence interval [CI] 0.80–0.92) versus 0.78 (95% CI 0.71–0.85) for CRP (DeLong p = 0.018). At a cut-off of 0.5 ng/mL, PCT sensitivity was 88.7% and specificity 74.1%; a combined PCT + CRP + clinical model reached AUC 0.90 (95% CI 0.85–0.95). PCT outperformed CRP for discriminating SBI in febrile infants under 90 days and added incremental value to clinical assessment, supporting its incorporation into risk-stratification pathways where available.

Hemorrhoidal disease is still one of the most common anorectal disorders seen in clinical practice. A lot of patients come in with pain, bleeding, especially grades three and four surgery is still the most reliable way to manage the problem. The Milligan Morgan (ММ.) open hemorrhoidectomy has long been seen as the best way to treat such patients. The LigaSure approach has more attention in the last several years. This gadget uses bipolar electrothermal energy to close vessels and cut out tissue at the same time. Surgeons at Baqubah General Hospital, the study aimed.  to  evaluate  outcomes  between  LigaSure  hemorrhoidectomy  and  the traditional Milligan Morgan operation, both conducted under spinal, anesthesia. This assessment concentrated on the critical factors for both patients and surgeons: the execution of the procedure, postoperative recovery, complication rates, patient satisfaction. The study included 500 adult patients diagnosed with grade three or four hemorrhoidal illness who underwent surgery, at Baqqubah General Hospital from January to December 2023. The 500 people who took part were split into two groups:  250  had  the  LigaSure  hemorrhoidectomy  and  250  had  the  Milligan. Morgan operation. All surgeries were done under spinal anesthesia. Data gathering involved reviewing hospital records, conducting direct interviews, and performing follow-up  visits,  so.  guaranteeing  an  accurate  account  of  each  patient. postoperative experience. The main things that were looked at were the amount of discomfort after the operation (measured by a validated questionnaire), the usage of painkillers, the time it took for the patient to recover, any problems that came up, and how satisfied the patient was with the surgery.

Background: Growth which is the process of physical maturation resulting in an increase in size of the body and various organ can considered as the final common pathway of many factors, including endocrine, environmental, nutritional, and genetic influences. A normal linear growth pattern is good evidence of overall health and can be considered as a bioassay for the well-being of the whole child.
Short stature is defined as subnormal height relative to other children of the same gender and age, taking family heights into consideration. it can be caused by numerous conditions could be a variation of normal like constitutional and familial short stature or due to endocrine disorders, skeletal dysplasias, lysosomal storage diseases or due to chronic diseases like chronic renal failure
Growth hormone deficiency account for many cases of short stature, growth hormone (GH) is a 191–amino acid protein secreted by the pituitary in a pulsatile fashion, stimulated by hypothalamic GH-releasing hormone, and inhibited by somatotropin release–inhibiting factor or somatostatin. it stimulates growth, cell reproduction, and cell regeneration.
Recombinant human growth hormone injections which contain recombinant human growth hormone are used for treatment of short stature also newly developed pills which contain arginine that stimulates production of the growth hormone in the body are used for treatment of short stature.
Aim: To evaluate the efficacy of using arginine pills in the treatment of short stature. Patient and method: A cross-sectional comparative study done on patient with short stature attending the endocrine clinic at Tikrit Teaching Hospital during the period from the first of November 2022 to the last of October 2023.
For each child height in centimeters, and growth rate for height were measured. Height were measured using stadiometer in which standing height was taken with the recommended standard measures like putting off a hat, bare foot, stand straight and looking forward. The previous measures for height for each child were taken from the follow up files of each child that is available at the endocrine clinic.
Results: The total number of cases were 63 cases. Male were 25 cases (39.7%) and females were 38 cases (60.3%) . Most of the cases were between 6-12 years 37 cases (58.7%), most of the cases were due to idiopathic short stature, 52 cases (82.54%).
In regard to treatment most of the cases treated with rhGH injections, 49 cases (77.78%), most of them treated for a period equal or less than one year, 52 cases (82.54%).
There is a non-significant relation between the mean increment in height per one month at different ages, genders, causes of short stature, and duration of therapy in regard to type of therapy with rhGH injection versus arginine pills.
Most of the cases have a normal growth rate for height while the relation between the growth rate for height and the age, gender of the child, causes of short stature, duration of therapy, and the type of therapy with rhGH injection versus arginine pills is not significant.
Conclusion: The study concludes that there was a non-significant relation between the mean increment in height per one month at different ages, genders, causes of short stature, and duration of therapy in regard to type of therapy with rhGH injection versus arginine pills.

Background: Breast cancer is the most commonly diagnosed malignancy in women, and early detection is crucial for improving survival rates. Salivary biomarkers offer a promising non-invasive diagnostic approach.
Aim: This study evaluates the diagnostic and prognostic significance of salivary CA125, MUC1, VEGF, and sFas in breast cancer patients, comparing them with blood biomarkers (CA15-3, LDH) and immunohistochemistry (IHC) estrogen and progesterone receptor status.
Methodology: This observational case-control study included 270 participants, comprising 225 breast cancer patients (n = 45 per subgroup, ranging from newly diagnosed to Stage IV) and 45 healthy female controls.
Results: Biomarkers were quantified using ELISA, and statistical analyses showed a significant increase (p < 0.001) in CA125, MUC1, VEGF, and sFas as the disease progressed. The ROC curve analysis indicated an AUC of 1.0 for the integrated biomarker panel.
Conclusion: The data suggest that salivary biomarkers, including CA125 and MUC1, are reliable for non-invasive breast cancer screening, and their combination with blood markers enhances diagnostic accuracy.

Background: Cytomegalovirus (CMV) infection can induce inflammatory responses, but the relationship between specific inflammatory biomarkers and CMV infection is not fully understood. This study aims to evaluate the levels of C-reactive protein (CRP), D-dimer, and platelet counts in patients with CMV seropositivity.
Methodology: Fifty individuals were enrolled, divided equally between a CMV-infected group and a control group. The CMV diagnosis was based on serological tests. Exclusion criteria included co-infections, cardiovascular abnormalities, the use of anticoagulants, and hematological changes. The study measured CRP and D-dimer levels using the AFIAS-6 instrument and platelet counts via automated hematology analyzers. Data analysis included comparison of biomarker levels between groups and Receiver Operating Characteristic (ROC) analysis for diagnostic utility.
Results: CRP levels were significantly higher in the CMV group compared to the control group, with a mean of 31 mg/l versus 4 mg/l. D-dimer levels were also elevated in CMV patients (mean: 509 ng/ml) compared to controls (mean: 209 ng/ml). Platelet count differences were not significant. ROC analysis showed high specificity and moderate sensitivity for CRP and D-dimer in diagnosing CMV infection (AUC of 0.848 and 0.795 respectively), but platelet count was not a reliable indicator.
Conclusion: CRP and D-dimer are promising biomarkers for detecting CMV infection, but platelet counts do not offer significant diagnostic value. Further research is needed to explore the utility of these biomarkers in different clinical settings and populations.

Background: The emergence of endometriosis-related symptoms following cesarean section that accompanied by secondary infertility, has drawn the attention of clinicians. This study aimed to investigate the association between Cesarean section and the development of endometriosis, as well as its subsequent impact on infertility and the presence of elevated CA-125 levels.
Methods: A cross-sectional study was conducted on women attending an obstetrics and gynecology department in the Kurdistan region (Erbil, Sulaymaniyah, Duhok, Halabja) between February 2023 and August 2025, using convenience sampling. Participants presented with symptoms suggestive of primary or iatrogenic endometriosis and were assessed through history, examination, and investigations, including imaging, laparoscopy, and histopathology. Serum CA-125 levels supported the diagnosis and follow-up, and the data were analyzed using SPSS with both descriptive and inferential statistics.
Most of the study sample aged between 18 and 45 years old. Twelve complaints were recorded by the sample, with the three highest rates: infertility (75.12%), dysmenorrhea (31%), and menorrhagia (23.5%).
Result: There was a highly significant association between endometriosis and cesarean section, infertility, and abnormal CA-125 marker level. Also, there was a highly significant association between infertility (high rate of secondary infertility) and undergoing cesarean section previously (p=<0.001).
Cesarean section is associated with an increased risk of iatrogenic endometriosis. This form of endometriosis may contribute to the development of secondary infertility in affected individuals. While observational studies support this association, the evidence remains inconclusive regarding a direct causal link. Therefore, further research employing robust methodological designs is essential to clarify the relationship and guide clinical practice.

Background: Team-Based Learning (TBL) is an active-learning pedagogy increasingly adopted in medical education. This study evaluated medical students\' perceptions of TBL sessions at Tikrit University and examined associations with gender.
Methods: A cross-sectional survey (n=95) with seven Likert-type items and open-text feedback was administered. Responses were mapped to a 5- point Likert scale. Descriptive statistics, mean item scores, Cronbach\'s alpha, and chi-square tests were used where applicable. Figures display item distributions.
Results: Students generally reported positive perceptions of TBL.The highest mean scores were for ( instructor support ) mean = 4.82 and ( Clarity of session objectives ) mean= 4.57. Areas of improvement were identified in( fairness of team evaluation) mean= 4.12 and ( Clarity of questions ) mean= 4.19. The scale demonstrate high internal consistency ( Cronbachs alpha=0.89). Qisquare test revealed no statistically significant gender based references in perception across all item ( p> 0.05 for all).
Conclusion: TBL is valued by students; enhancing question clarity and assessment fairness is recommended.

Background: Etanercept is a biologic agent belongs to the Tumor Necrosis Factor Alpha Inhibitors class and used in the management of psoriatic arthritis. Patient compliance is the most common cause of non-response to treatment. The patient\'s knowledge and attitude towards the medication are considered the two fundamental factors that determine patient compliance.
Objectives of the study: To assess the extent of awareness in a sample of Iraqi patients with PsA about their Etanercept medication and determine the influence of socio-demographic and clinical characteristics on the level of awareness.
Methods: A cross-sectional study design was adopted for this study. The study was conducted in Rheumatology outpatient clinic in Baghdad Teaching Hospital – Medical City Complex. The study population includes adult patients (age >18 years) with PsA with any gender, diagnosed according to CASPAR criteria and treated with Etanercept medication for more than one month. A consecutive convenient sample of 80 patients was collected. A structured questionnaire was used to assess the level of awareness of the participants, the questionnaire consists of three aspects: demographic characteristics, clinical characteristics, and awareness about Etanercept
Results: A total of 33(41.25%) of the participants had good awareness about Etanercept, while 35 (43.75%) had fair (partial) awareness and 12 (15%) had poor awareness. There was no significant association between the level of awareness of the participants and their socio-demographic characteristics or clinical characteristics (P-value > 0.05).
Conclusion: There is a fair level of the awareness about Etanercept among the sample of Iraqi PsA patients.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder in which the long-term hyperglycemia initiates oxidative stress, inflammation, and lipid abnormalities that further promote vascular injury and diabetic complications. Oxidative stress is increasingly recognized as a mechanistic pathway for aberrant metabolism to endothelial dysfunction and organ damage caused by increased lipid peroxidation and rundown in antioxidant defense mechanisms.Aim: To study the role of oxidative stress in patients with T2DM by comparing lipid peroxidation (malondialdehyde; MDA), antioxidant enzymes (glutathione peroxidase; GPx and superoxide dismutase; SOD), and related metabolic indices between diabetic patients and healthy controls, and to evaluate the predictive performance of oxidative biomarkers for diabetic complications.
Methods: A hospital-based case–control study was conducted in Tikrit city, Iraq, starting on 30 September 2025. The applications of this research have been more broadly associated with 65 patients who had experienced T2DM at Tikrit Teaching Hospital, as documented in healthy volunteers referred to sex and age. Firstly, venous blood samples were drawn and sent to HbA1c for testing and analysis, while using the i-chroma II and immunofluorescence. Serum MDA, GPx, and SOD were assessed with the help of ELISA kits, and lipid profile parameters were analyzed through enzymatic colorimetric procedures. Initially, all statistical analyses were performed using SPSS v. 23.1. Independent sample t-tests were applied for comparisons between groups. The use of ROC curve analysis was determined, as per the criterion, the specific diagnostic abilities of MDA and HbA1c to anticipate diabetic complications.
Results: Baseline age and sex distribution were comparable between groups, whereas BMI and hypertension frequency were significantly higher in the diabetic group. HbA1c was markedly elevated in patients with T2DM (8.6 ± 1.4%) compared with controls (5.3 ± 0.5%; p < 0.001). Oxidative stress was significantly increased in T2DM, with higher MDA (182.4 ± 44.8 vs. 94.6 ± 23.2 nmol/mL; p < 0.001) and lower antioxidant enzymes GPx (25.8 ± 6.8 vs. 40.1 ± 7.3 U/L; p < 0.001) and SOD (14.9 ± 3.5 vs. 23.0 ± 4.7 U/mL; p < 0.001). Diabetic patients also demonstrated a more atherogenic lipid profile (higher total cholesterol, triglycerides, LDL, and VLDL with lower HDL; all p ≤ 0.002). ROC analysis indicated that MDA had better predictive performance for diabetic complications than HbA1c (AUC 0.85 vs. 0.81), with an optimal cutoff of 155 nmol/mL (sensitivity 82%, specificity 80%).
Conclusion: An oxidative imbalance helped the study find oxidative stress. The imbalance showed higher lipid peroxidation and lower activities being present in diabetes care affected by Pokemon. Oxidative stress markers, that is MDA data, performed much better than HbA1c. Thus, oxidative stress markers could offer additional information on the risk categories of diabetic complications as compared to glycemic indices alone.

Background: Type 2 diabetes mellitus is frequently complicated by insulin resistance and early renal impairment, including albuminuria. Metformin is still  the  first-line  treatment,  but  other  drugs  like  sodium–glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors are often needed as well. There is still not enough comparative evidence about how they affect the kidneys and metabolism in everyday clinical practice.
Aims: The objective of this study was to evaluate the effects of metformin in conjunction with empagliflozin or sitagliptin on glycemic control, insulin resistance,  renal  function,  and  albuminuria  in  individuals  with  type  2 diabetes mellitus.
Patients and Methods: In this cross-sectional comparative study, 133 individuals with type 2 diabetes mellitus were chosen and divided into two groups  based  on  their  current  treatment:  metformin  combined  with empagliflozin (n = 67) or metformin combined with sitagliptin (n = 66). We looked at glycemic indices, insulin levels, insulin resistance, beta cell function, renal function parameters, estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio.
Results: Patients taking metformin and empagliflozin had much lower fasting  serum glucose  (p=0.005), insulin levels  (p=0.002), and  insulin resistance  (p=0.001) than those  taking metformin and sitagliptin. This shows  that  their insulin  sensitivity  improved. The studied  groups  had similar levels  of HbA1c,  beta  cell function, and estimated  glomerular filtration rate. The urinary albumin-to-creatinine ratio was significantly lower  in the  empagliflozin  group (p  =  0.03). In both  groups, urinary albumin-to-creatinine ratio had a positive correlation with insulin resistance and a negative correlation with estimated glomerular filtration rate.
Conclusion:  Both  combinations  had  similar  effects  on  HbA1c,  but metformin plus empagliflozin worked better at lowering insulin resistance and albuminuria. This suggests that metformin plus empagliflozin has an improved early renoprotective profile for people with T2DM.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed and used medications that are used as analgesics, antipyretics, or anti-inflammatories, but have a high risk of adverse effects.
Methods: A descriptive cross-sectional study was conducted among university students at Tikrit University, Iraq, during November 2021 to March 2022. A self-administered questionnaire by Google Form was used. Aim: to assess the awareness among university students in Tikrit University, Iraq, about Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The students selected in this study were from different colleges (Medical and non-medical).
Results: The results of this work show that 65.3% of the university students had knowledge about NSAIDs, their uses and side effects. 69% of the students confirmed that they use NSAIDs; the majority of them were females. About 21% used NSAIDs continuously, and 47% on need. Regarding the frequency of use, 12.2% were used NSAIDs once daily, 13.2 % twice daily and 5.3% three times daily. The knowledge about the appropriate dose is low; only 46% of the respondents knew about the safe dose of NSAIDs, and most of them were from a medical college. Only 40% of respondents think these drugs are safe for use, 35% think they’re not safe, and 25% didn’t know. The commitment to the dose is 77.2%.
Conclusion: The present study revealed a limited individual\'s knowledge about the NSAIDs usage, dosage and adverse effects among Tikrit University. Students need more education or consultations with the health care team, especially the pharmacists, in order to reduce their misuse or abuse or even unnecessary prescriptions.

Background: Coronary artery disease is a prevalent cardiac condition that affects millions of people worldwide and is one of the leading causes of morbidity and death.Triglyceride-Glucose Index is a thorough statistical
metric that accounts for both fasting triglyceride and fasting glucose levels
. It may be used in a variety of applications clinical settings and epidemiological research since it is easy to calculate and has less time and
expense limits making it appropriate for large populations
Patient and methods: This research case control study carried out at Al Mosul Center for Cardiology and Cardiac Surgery. It involved 120
patients, included 40 control samples and 80 patients with coronary artery disease .
Results : The triglyceride-glucose index , total cholesterol found to be strongly associated with the severity of coronary artery disease. Good ability to distinguish between the studied groups is demonstrated by the Receiver Operating Characteristic analysis of the triglyceride-glucose index.An elevated triglyceride-glucose index was linked to a higher risk of multi-vessel coronary artery disease

Background: The nasal septum is a complicated osteocartilaginous structure that regulates nasal airflow, provides structural support, and helps with facial symmetry. The morphological diversity of its cartilaginous and bony components may have an impact on both functional and reconstructive septal surgeries.
Objective: The purpose of this study was to investigate the topographic and morphometric changes of the nasal septum using computed tomography (CT) and to determine the clinical consequences in septal surgery.
Materials and Methods: This observational CT-based investigation involved 120 images of the nasal cavity and paranasal sinuses. Subjects were divided into three age groups: A1 (18-30 years), A2 (31-50 years), and A3 (≥51 years), stratified by gender. The measurements comprised septal length, width, curvature, vomer length and width, perpendicular plate of the ethmoid (PPE) length and width, and average septal cartilage thickness. Statistical analysis was done with one-way ANOVA and independent-samples t-tests.
Results: Significant age-related changes were found in septal length, septal width, vomer length, vomer width, PPE length, and cartilage thickness (p < 0.05). Septal curvature and PPE width did not differ significantly with age. Males had significantly bigger morphometric dimensions than females for most variables, but cartilage thickness was marginally greater in females. When comparing the oldest age group to the youngest, cartilage thickness dropped by 19.4%.
Conclusion: The nasal septum exhibits significant morphometric variation with age and sex. CT-based morphometric analysis gives clinically important information for septoplasty, graft harvesting, and structural support maintenance.

Background: The quality of care provided to the women and infants is a key determinant in maternal outcome and that simple change in practice can save many lives.
Aims: To identify the satisfaction of clients regarding quality improvement of postnatal services in primary health care centers within the Al-Karkh district of Baghdad.
Method: This study across sectional design study was conducted from October 2024 to May2025 which include six primary health care centers (3 family health care center and, 3 primary health care center) and four in the outskirts (1 family health, 3 primary care), and the total number of clients required during the study period was 150 mother attending postnatal care in primary health care centers, direct face-to-face interviews with all participant recruitment, structured -questionnaire forms were designed to estimate client satisfaction toward health care services during their postnatal visits.
Results: About 75% of clients were satisfied with overall post-natal care and 12% of clients were dissatisfied. Also the result shows that 13% of mothers visit was within 1st week after delivery , 45% of mothers visit was within 1-2 weeks and 42% of mothers visit was after second week postnatal. It was found that 52% of client satisfaction with baby checkups was satisfied, 24% of client satisfaction with baby checkups was neutral and 25% of client satisfaction with baby checkups was dissatisfied, The result show that 62% of clients was satisfied with support and advice on breastfeeding,30% of client was neutral with support and advice on breastfeeding and 8% of clients was dissatisfy with support and advice on breastfeeding, 75% of clients were satisfied with communication and respect from healthcare providers,19% of clients were neutral satisfied with communication and respect from healthcare providers and 6%% of clients was dissatisfied with communication and respect from healthcare providers, the result show that 35% of clients were satisfied support for family planning,25% of clients were naturally satisfied support for family planning and 39% of clients were dissatisfied support for family planning, the result show that54% of clients were satisfied with quality of counseling on contraceptive options, 33% of client were naturally satisfied with quality of counseling on contraceptive options and 13% of clients were dissatisfied with quality of counseling on contraceptive options, the result show that 35% of clients were satisfied with maternal care (wound care), 30% of clients were naturally satisfied with maternal care (wound care) and 35% of clients were dissatisfied with maternal care (wound care), the result show that 20% of knowledge of infant care was clear,36% of knowledge of infant care was neutrally clear,44% of knowledge of infant care was unclear.
Conclusion: The study highlights both strengths and critical gaps in maternal healthcare service and the importance of continuous assessment and evaluation of PNC to develop an immediate plan at the level of health departments and submitted to decision-makers in the Ministry of Health.

Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility and a major source of variability in ovarian response during in vitro fertilization (IVF). Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are the established pre-stimulation predictors but do not directly capture the androgenic biochemistry that defines PCOS.To assess basal serum A4 as a predictor of ovarian response operationalized as the follicular output rate (FORT), total oocytes retrieved, and excessive response (≥ 20 oocytes) among normal-BMI women with PCOS undergoing controlled ovarian stimulation (COS)A prospective single- center cohort study enrolled normal-BMI (18.5–24.9 kg/m²) women aged 20–38 years with PCOS by Rotterdam criteria, undergoing first-cycle gonadotropin-releasing hormone (GnRH) antagonist COS for IVF or intracytoplasmic sperm injection (ICSI). Basal day-2 to day-3 serum A4, AMH, AFC. Outcomes were FORT, total oocytes retrieved, mature (metaphase II) oocytes, and excessive response. Mean basal A4 was 3.8 ± 1.4 ng/mL. A4 correlated with FORT (Spearman r = 0.59, p < 0.001) and total oocytes retrieved (r = 0.54, p < 0.001). For prediction of excessive response, A4 achieved an area under the curve (AUC) of 0.84 (95% confidence interval [CI] 0.78–0.90), outperforming AMH (AUC 0.73, 0.65–0.81; DeLong p = 0.02). A combined A4 + AMH + AFC model reached AUC 0.89 (0.84–0.94; DeLong p = 0.01 versus AMH alone). In normal-BMI PCOS, basal serum A4 is an independent predictor of ovarian response and adds incremental discrimination beyond AMH and AFC for excessive response. A4 deserves consideration in pre-stimulation risk stratification.

Low-dose computer tomography (CT) scanning of the heart is a non- invasive method that provides quantitative information of the calcification of the coronary vessels. High serum uric acid (SUA) level is known to be associated with various cardiovascular (CVD) risk factors and diseases such as hypertension, diabetes mellitus, and metabolic syndrome. Recently, some researches show that higher SUA levels are linked with an increased risk of hospitalizations related to chronic kidney diseases, mortality, and also CVDs .Its role as a risk factor for cardiovascular disease is studied extensively; however, whether the association is independent of conventional risk factors is controversial. The study aimed to value of CT coronary artery calcium scoring in hyperuricemic patients as a predictive risk for development of ischemic heart disease. The current study was conducted on at Ibn-Alnafees teaching Hospital, from 1st of November 2023 to the end of May 2024. The study included 168 patients, 118 male patients and 50 female patients. All patients underwent a proper history taking and thorough physical examination and were sent for the biochemical investigations. Electrocardiogram done for all patients. Echo study done for those Electrocardiography was not giving exclusive diagnosis. CT coronary artery calcium score and CT Angiography were done for all patient diagnosed as coronary artery disease. The study for coronary artery disease patients shows There is a strong correlation between hyperuricemic patients, coronary artery calcium and lipid profile in patient with ischemic heart disease and there was also a significant increase of Calcium score which is approved by non-contrast CT Angiography and then confirmed this strong correlation by contrast CT Angiography that shows the luminal arterial defects in diabetic patients group.

Background: Hepatitis C virus (HCV) infection remains a major public health problem among patients undergoing hemodialysis. Frequent blood exposure, repeated vascular access, and prolonged hospital stay increase the risk of transmission. Patients receiving maintenance hemodialysis are at high risk for acquiring hepatitis C virus infection than the others.
Objective: To determine the incidence and associated risk factors of Hepatitis C infection among dialysis patients at Tikrit Teaching Hospital. The study started from 1st mars to 30t may 2024. The total study group consisted of 100 patients. The participants were directly interviewed according to questionnaire consist socio-demographic data were (age, gender, marital stats, occupation) and duration on hemodialysis, number of hemodialysis session.
Methods: A case-control study was conducted involving 100 participants divided equally into 50 hemodialysis patients and 50 healthy controls. Demographic characteristics, duration of dialysis, blood transfusion history, and HCV serological status were evaluated. Statistical analysis was performed using SPSS version 26.
Results: The prevalence of HCV infection among dialysis patients was significantly higher compared to controls. Longer dialysis duration, multiple blood transfusions, and older age were associated with increased HCV positivity.
Conclusions: Hemodialysis patients are at significantly higher risk of HCV infection. Strict infection control measures and periodic screening are recommended to reduce disease transmission.

Background: HBV reactivation is a major complication in AML patients receiving chemotherapy.
Objective: To evaluate HBV reactivation among HBsAg-positive AML patients and how HBV infection may be re activated by the effect of chemical drugs used in treatment of hematological abnormalities Methods: Case-control study including 25 AML patients and 25 AML patients HBV negative in single center study all of them was over 18 years. Results: Eight patients (32%) developed HBV reactivation and two deaths occurred while the others of case group remain nonactivated patients .
Conclusions: HBV reactivation remains a significant clinical challenge requiring routine screening and prophylaxis specially in patients on hematological abnormality .

Diabetes and dermatological complications caused by diabetes (especially xerosis and fissures) are clinically significant because they provide a route for infection. This study was designed to evaluate a new topical ointment containing Iraqi date palm kernel oil (DPKO) for diabetic patients with these conditions. A total of 60 diabetic participants located in Salah Al-Din Governorate, Iraq, were randomly assigned to 1 of 4 groups of 15 participants each, and instructed to apply the ointment containing 0% (control, F0), 5% (F5), 10% (F10), or 15% (F15) DPKO weight/weight (w/w) daily for 4 weeks. A physical and chemical analysis of the oil indicated that DPKO has a moderately unsaturated fatty acid profile (iodine value 65.4 g I₂/100g), a low level of lipid oxidation (peroxide value 3.1 meq O₂/kg), and is an excellent source of antioxidants (total phenolic concentration 25.3 mgGAE/g; α-tocopherol content 120 mg/100g). All four formulations of ointment demonstrated excellent physical stability, and the pH of all formulations was between 5.5 - 5.9, comparable to normal human skin pH of 5.5 - 6.0. The overall dry skin score (ODSS) was used to assess clinical efficacy, and as expected, there was an improvement in all groups, with the greatest reduction in ODSS seen in the F15 group (P < 0.01), indicating a clear dose-dependent relationship. No adverse effects were noted. The findings of this study indicate that Iraqi DPKO is a safe and effective natural emollient, with the efficacy increasing with the increase in concentration of DPKO.

Background: Acute appendicitis is the most common surgical cause of acute abdominal pain. Contrast-enhanced computed tomography (CT) is highly accurate but exposes predominantly young patients to ionizing radiation and may delay disposition. Point-of-care ultrasound (POCUS), performed by the treating emergency or radiology physician at the bedside. Objective: To determine the diagnostic accuracy of POCUS compared with contrast-enhanced CT, and to assess the effect of operator experience and body mass index (BMI) on performance.
Patients and methods: A prospective single-center diagnostic-accuracy cohort study was conducted at Al-Hussein teaching hospital in Nasiriyah, from 1 June 2023 through 1 December 2025. Adults aged 18 years or older with acute right-lower-quadrant pain underwent a structured index POCUS examination followed by reference-standard contrast-enhanced CT. POCUS operators were blinded to CT results, and CT readers were blinded to POCUS findings. The primary outcomes were sensitivity, specificity, positive and negative likelihood ratios, and the area under the receiver operating characteristic curve (AUC).
Results: Of 364 patients assessed, 298 formed the analytic cohort; 121 (40.6%) had CT-confirmed acute appendicitis. POCUS achieved a sensitivity of 84.3% (95% confidence interval [CI] 76.6–90.3%) and specificity of 89.3% (95% CI 83.7–93.4%), with positive likelihood ratio 7.87 and negative likelihood ratio 0.18 and AUC 0.86 (95% CI 0.81–0.91). Conclusions: POCUS achieved good diagnostic accuracy for acute appendicitis and may serve as an effective first-line triage test, particularly when performed by credentialed operators in non-obese patients, potentially reducing CT utilization in selected adults.

Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition influenced by genetic, immunological, and environmental factors. The potential association between ABO blood groups, Rhesus (Rh) factor, and ASD remains underexplored, particularly in Iraq.
Objective: To investigate the distribution of blood groupe type and rhesus factor among autism spectrum disorder Patients.
Patient and Methods: A cross-sectional study was conducted from March 2025 to January 2026 in Diyala, Anbar, and Basra. A total of 72 patients diagnosed with ASD were included using a convenience sampling method. Data were collected through structured questionnaires completed by parents either via direct interview or electronic forms. Variables assessed included socio-demographic characteristics, blood group type, Rh factor, maternal health, pregnancy-related factors, and family history.
Results: The majority of patients were male (75%) and aged 5–10 years (43.1%). Blood group A (36.1%) and O (34.7%) were most common among patients, while Rh positivity was predominant (92.4%). Maternal distribution showed blood group O (45.5%) and Rh positivity (92.4%) as most frequent. Rh incompatibility was observed in 9.7% of cases, with only one mother reporting anti-D immunoglobulin administration. More than half of the patients (51.4%) had a positive family history of autism. Associated disorders were reported in 81% of cases, most commonly speech delay and epilepsy.
Conclusion: The study revealed a predominance of blood groups A and O, and Rh-positive status among ASD patients. While no definitive causal relationship was established, these findings highlight potential biological associations that warrant further large-scale studies. Greater attention to maternal health, perinatal factors, and family history is recommended for early detection and risk assessment. It is recommended that future studies with larger sample sizes and control groups be conducted to better clarify the potential role of blood groups and Rh factor in Autism Spectrum Disorder and to support early risk identification strategies.

Autism Insulin resistance [ IR ] is a multifaceted metabolic condition characterized by diminished cellular sensitivity to insulin, resulting in compromised glucose absorption, increased insulin concentrations, and eventually leading to type 2 diabetes and cardiovascular problems. The conventional perspective of insulin resistance as a peripheral disorder impacting muscle, liver, and adipose tissue has been supplanted by new discoveries indicating that the central nervous system [CNS], especially the hypothalamus, is crucial in starting and regulating systemic insulin sensitivity. Insulin serves as a metabolic hormone and a neuroregulatory signal that regulates hunger, energy expenditure, and peripheral glucose homeostasis via complex brain circuits.
This review delivers an advanced and comprehensive analysis of insulin resistance mechanisms with emphasis on CNS involvement. The review investigates how central insulin signaling pathways together with blood-brain barrier insulin transport and hypothalamic inflammation and neuronal insulin resistance create systemic metabolic problems. The article investigates how central insulin resistance affects both neurodegenerative diseases like Alzheimer’s disease and mood disorders including depression. The article examines current therapeutic strategies which focus on the brain–insulin axis.