IRAQI JOURNAL OF COMMUNITY MEDICINE

Background: Measles is an extremely contagious disease characterized by generalized maculopapular rash, fever, cough, coryza, and
conjunctivitis. It is caused by the measles virus. Objective: The objective of this study was to explore the anti-measles immunoglobulin (Ig)
M positivity rate among children with clinical suspicion of having measles. Subjects and Methods: This is a cross-sectional study carried
out in Diyala Province, Iraq, from November/2020 to October/2021. A total of 425 blood samples were collected from children (≤14 years
of age): 90 from patients who were clinically suspected as having measles (18 were vaccinated with measles vaccine and 72 were not);
270 from measles-vaccinated children, including those children who received all recommended vaccines in the Iraqi Expanded Program of
Immunization (IEPI); and 65 from nonvaccinated children, including those children who received none of the vaccines in the IEPI. Enzyme-linked
immunosorbent assay (ELISA) kits for the detection of anti-measles IgM were used. Results: The results found that 14 (15.6%) of clinically
suspected children were positive for anti-measles IgM antibody versus 76 (84.4%) who were negative. Whereas, only one (1.5%) of the
unvaccinated children was positive, and all vaccinated children were negative. Thus, clinically suspected patients had a significantly higher
positivity rate compared to other study groups (P = 0.0001). Similarly, the mean ± standard deviation of anti-measles IgM concentration was
significantly higher compared to other study groups (P = 0.0001). Conclusion: About one-sixth of patients clinically comparable to measles
in Diyala Province actually had measles, most of them were unvaccinated, and the anti-measles IgM ELISA technique was a good marker
for exploring measles cases.
Keywords: Anti-measles immunoglobulin M, Diyala, measle

Background: Lead is a highly toxic metal. Multiple lead exposures produce serious poisoning and sometimes fatality because lead builds up
slowly in the exposed body. Signs of repeated exposure to lead are high blood pressure, numbness or tingling of the extremities, memory loss,
anemia, and kidney dysfunction. Methods: A cross-sectional study was conducted involving patients with chronic kidney disease (CKD) who
attended to medical city hospital. The study was conducted from January 2 to May 31, 2022. Inclusion criteria were by involved adults ≥30 years
old with CKD of both genders. Glomerular filtration rate (GFR) was measured for all patients according to the Cockcroft‑Gault equation.
Whole blood samples were taken to measure lead levels in the Toxicology Center of Baghdad Medical City. The collection of data was done
by interview using a special questionnaire. Verbal consent was taken as an ethical issue by each participant in the study. Results: A total
of 315 CKD patients were involved. The mean blood lead level was 24.62 µg/dL, the range was between 15 µg/dL, and 33 µg/dL for both
genders, which is higher than the cut point of 10 µg/dL depended in this study. About 38.4%, and 30.8% of patients had GFR (15–29 mL/
min/1.73 m2
), and (<15) mL/min/1.73 m2
and they were considered as stage 4 and 5 CKD patients, respectively. Conclusions: Lead level in
blood and GFR had a significant association.

Background: Aging is an unavoidable process characterized by a progressive decline in body organs and skeletal muscle. Sarcopenia is
defined as low muscle mass and function; it is diagnosed according to the working group of sarcopenia definition; also, it can predict the
adverse disability outcome and subsequent functional deterioration. Objectives: This study aims to estimating the prevalence of sarcopenia
in old Iraqi adults and determines some sociodemographic factors that may be related. Methods: A descriptive cross-sectional study was
conducted on 500 elderly aged ≥60 years in a community‑dwelling and senior citizen center in Baghdad. The data were obtained from a
questionnaire (sociodemographic and behavioral data) in addition to anthropometry measurements. The cut‑off point score was derived from
the European Working Group on Sarcopenia in Older People 2. Results: Sarcopenia was present in 15%, 21.5% in males and 8.2% in females.
It was positively associated with aging, significantly associated with males, marital state, retirement, nonsmoker, alcoholic, fall history, normal
body mass index, and elderly. While it was negatively related to educational level and physical activity. Conclusions: Sarcopenia prevalence was
presented with a considerable prevalence among old adults, as well as had a great association with all behavioral and lifestyle variants studied.

Objectives: This aim of the study was to estimate the prevalence of noncompliance to medication in pregnant women in Al-Karkh directorate
and to address its most common causes. Methods: A cross-sectional study was conducted at a number of primary health-care centers located
in Baghdad/Al‑Karkh directorate including pregnant women in their second and third trimesters through a self‑filled questionnaire; data were
later analyzed. Results: The results obtained from the present study revealed that 185 out of 306 participants (60%) of pregnant women were
noncompliant or inadequately compliant with their medication, whereas the remaining 121 (40%) were properly compliant. The most common
reasons for noncompliance included wrong use of drugs (38.4%), not understanding or knowing the benefits of drugs (30.3%), forgetting
to take drugs (29.7%), or thinking that they were unsafe for the fetus (25.9%). Conclusions: Appropriate health education and enhancing
doctor–patient relationship and communication during antenatal care visits are crucial to achieve better compliance.

Background: Attention‑deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Knowledge and attitude
of parents about the disorder influence the diagnosis, treatment, and future of the child as an individual and as a part of the community.
Objectives: The objective of this study was to assess the knowledge and attitude of parents about ADHD in Alkarkh, Baghdad, Iraq, 2023.
Methods: A cross-sectional study was conducted between February and July 2023, at 12 primary health centers in Al-Karkh Health Directorate
in Baghdad City, and a convenient sample of 300 parents was involved. Data were collected using a direct interviewing questionnaire.
Results: According to age, 196 (65.3%) of the sample fell in the age group of 31–40 years, the mothers-to-fathers ratio was 5:1, 76.3%
of participants had higher education, 206 (68.7%) were employed, 134 (44.7%) participants had fair knowledge, and only 8 (2.7%) had
good knowledge. More than two-thirds of parents, 214 (71.5%), had good knowledge about the treatment of ADHD, and 164 (54.8%) had
symptoms of the disorder, while they had less knowledge about the nature of ADHD and its risk factors. There was a statistically significant
association (P < 0.05) between knowledge level and parent’s education, occupation, and residency. About 252 (84%) parents had positive
attitude toward ADHD. The positive attitude was significantly associated with the age, education, occupation, and residency of the participants.
Conclusions: Less than half of the study samples had fair knowledge, and the majority had a good attitude regarding ADHD.
Keywords: Attention‑deficit hyperactivity disorder, attitude, Baghdad City, parents’ knowledge

Background: Epilepsy is one of the most widespread neurological illnesses in the world with a prevalence rate of 2.8–19.5 per 1000 of the
general population, and it is more prevalent in childhood. The understanding of the teachers about epilepsy has a significant impact on the
academic performance and social skills of schoolchildren with epilepsy. Aim of Study: This study aimed to assess teachers’ knowledge,
attitude, and practice regarding epilepsy in schoolchildren and the association of certain studied variables with the level of schoolteachers’
knowledge, attitude, and practice. Subjects and Methods: This was a cross-sectional study that included 402 participants and was conducted
in Al-Rusafa/Baghdad during the period from November 1, 2021, to January 31, 2022. A self-administered questionnaire was used for data
collection method. Results: Most of the studied sample demonstrated fair knowledge (52%), attitudes(55%), and practices(55%). Asignificant
association was detected between knowledge, attitude, practices, and each of marital status, specialty, and academic qualification (P < 0.05).
Conclusion: There was a Fair level of knowledge, attitude, and practice of teachers regarding students with epilepsy. Being single unmarried,
of university degree and with a scientific specialty were considered as a predictor factors of good knowledge, attitude, and practice. While
age, gender, and years of experience were not associated with any of the knowledge, attitude, and practice parameters. Multiple sources
considered a major source of information.
Keywords: Attitude, epilepsy, knowledge, practice, schoolteachers

Background: Children with congenital ptosis need to be carefully assessed for refractive errors and visual function to identify and treat amblyopia
which occurs in 20% of congenital ptosis, small amount of which is attributed to ptotic eyelid occluding the pupil. Objectives: The objective is
to determine the frequency of refractive errors and its associations among children with congenital ptosis. Patients and Methods: Case–control
study of 60 patients with congenital ptosis (79 eyes) and 60 patients without ptosis (control group) (72 eyes). Conducted in Ibn Al-Haithem
Eye Teaching Hospital in Baghdad from April 2020 to May 2021. The main outcome measures were relative congenital ptosis, presence,
and types of refractive errors. Results: Significant association was obtained between children with ptosis and average spherical and cylinder
refractory error. Among 60 cases (79 eyes) of congenital ptosis, refractive errors were present in 26 eyes (32.9%) with the astigmatisms as the
most common refractive errors(18.9%), followed by hypermetropia (8.9%) and myopia (5.1%). Conclusions: Children with congenital ptosis
in our environment have greater refractive errors, early ophthalmic evaluation and timely treatment of these conditions may help prevent the
irreversible visual impairment in case of congenital ptosis.
Keywords: Children, congenital ptosis, refractive errors

Background: Fibroadenoma, a type of fibroma, is the most common benign neoplasm found in the breast. It is predicted that around 10% of
females globally may experience the development of fibroadenoma at some stage in their lives. Fibroids seldom become malignancies, about
5% of all cases. Fibroadenoma etiology is uncertain. However, levels of estrogen influence fibroadenomas. Objectives: The objectives of this
study were to explore the epidemiological aspects of breast fibroadenoma. Patients and Methods: A cross-sectional study was conducted
in the breast examination clinic at Al-Imamaein Al-Kadhimaein Medical City in Baghdad/Iraq. It included 260 female participants aged
15–35 years, diagnosed by specialists with breast fibroadenoma. A modified four‑part questionnaire was used to obtain data from participants
which includes sociodemographic, breast fibroadenoma risk factors, clinical presentation, and diagnostic intervention. Results: Participants had
a mean age of 27.3 ± 6.05 years. It was found that 37.7% of participants were overweight women, 35.8% had a family history of fibroadenoma.
The most common presentation was pain presented in 38.1%. Conclusions: The fibroadenomas that developed in the current study sample
tended to increase in the second and third decades, notably among nulliparous and nonlactating women. Most participants were overweight
with left-sided pain and lumps.
Keywords: Body mass index, epidemiology, estrogen, fibroadenoma, hormones

Background and Aims: Lower gastrointestinal bleeding (LGIB) poses a significant challenge in clinical practice due to its diverse etiologies
and potential for serious morbidity and mortality. Colonoscopy is the preferred, valuable diagnostic tool for identifying the underlying
cause of LGIB. This study aimed to evaluate colonoscopic findings in patients presenting with LGIB at a tertiary care hospital in Baghdad.
Subjects and Methods: This retrospective descriptive study reviewed records of patients, who underwent colonoscopy for LGIB, at the
Gastroenterology and Hepatology Teaching Hospital in Baghdad Governorate between January 1 and July 31, 2023. The analysis included age,
sex, and endoscopic findings. Results: A total of 228 patients were included, with 124 (54.4%) males and 104 (45.6%) females. The mean age
was 39.23 ± 20.57 years. A colonoscopy revealed a diagnostic yield of 68.0%. LGIB was more prevalent among individuals aged 40 years and
younger (53.5%). The most common colonoscopic finding was hemorrhoids (20.2%), followed by polyps (13.1%), colitis (9.2%), ulcerative
colitis (8.3%), and colorectal cancer (7.9%). Conclusion: This study underscores the importance of colonoscopy in evaluating LGIB. Larger,
multicenter studies are recommended to validate these findings and guide clinical practice in LGIB management.
Keywords: Baghdad, colonoscopy, colorectal cancer, lower gastrointestinal bleeding

Background: A correct preoperative intraocular lens (IOL) power measurement in cataract surgery depends on accurate assessment of axial
length (AL), anterior segment parameters, and using the suitable formula for the calculation of the power. Objectives: To determine the accuracy
of IOL power calculations using keratometric measurements of the IOL Master compared to the Pentacam and to determine whether the results
obtained can be used interchangeably in clinical practice in calculating IOL power in routine cataract surgery. Patients and Methods: In this
prospective study, the biometric data including AL, keratometric readings, and anterior chamber depth (ACD) were obtained by both the IOL
Master 500 and Pentacam Scheimpflug devices added to these measures the white‑to‑white (WTW) distance by IOL Master and central corneal
thickness by Pentacam and calculation of the IOL power using SRK/T formula for the enrolled patients who undergone uneventful cataract
surgery with IOL implantation. Postoperatively, spherical equivalent refraction was measured and the mean arithmetic error and the mean
absolute error (MAE) for both keratometric readings were calculated to compare the accuracy between them in calculating the IOL power.
Results: The study evaluated 57 eyes of 57 patient, the mean K value for the IOL Master was 43.92 (D) ± 1.5 (standard deviation [SD]) and
the mean K value for the Pentacam was 43.77 (D) ± 1.7 (SD) (P = 0.62), ACD values between the two groups, was 3.19 ± 0.44 mm measure by
IOL Master compared to 3.22 ± 0.48 mm in Pentacam (P = 0.769), with a very strong positive correlation between the two values (r = 0.995,
P < 0.001). MAE for the IOL Master was 0.230 (D) ± 0.187 (SD), while for the Pentacam was 0.255 (D) ± 0.204 (SD), with no statistically
significant differences between two devices’ values (P = 0.54). Conclusions: Pentacam Scheimpflug measured keratometric and ACD data
had good correlation with IOL Master data with good interchangeability between two devices readings in measuring the IOL power in routine
cases of cataract surgeries.
Keywords: Anterior chamber depth, intraocular lens Master 500, keratometry, Pentacam Scheimpflug