IRAQI JOURNAL OF COMMUNITY MEDICINE

Background: Health education is very important to control hypertension in patients with it.
Objecties: To explore the effect of health education on blood pressure control by modifying the lifestyle of patients who
visited the Rusafa sector centers PHCs-Baghdad 2018.
Method: A cross sectional study with an analytical element conducted during the period 1 Feb - 31 May 2018; by taking a
sample of patients who visited these centers during this period. Those who were diagnosed with hypertension six
months and more; pregnant women were excluded; 108 patients were interviewed using a questionnaire based on the
American Family Physicians Association manual, demographic-social information, diagnosis-date, visiting-regularity,
compliance, doctors & nurses communication skills, lifestyle, measure fasting/random blood glucose and BMI.
Results: The doctor's visiting was regularly in 93(86%), two thirds were diagnosed within 5 years, only 25(23.41%) were
smokers during diagnosis, 16(64%) received health education about smoking cessation, and four (25%) discontinued.
Health education about sports activity received by 71(65.74%) of the patients, saturated /unsaturated fats 98(90.74%),
salt intake 102(94.44%), most of them follow these instructions, all of which have a strong statistical relationship.
43(39.81%) had a weak drug commitment, 34 (31.48%) had high adherence to medication, 30(27.78%) had average
commitment, a strong relationship with their monthly income and doctor's communication skills.
Conclusion: Health education has a significant relationship with all studied variables to control hypertension except
smoking.

Background: Rapid changes in healthcare delivery system & socio-political climate have resulted in considerable strain on
Doctor-patient relationship. Doctors’ role is to install positive energy within the patient, through which sick people find
relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Future doctor should show
compassion, be open, honest, & admits when he is unsure.
Objective: This study aims to understand the social dimensions of Iraqi Doctor misbehavior & mal-communication with patients.
Subjects & Methods: A cross sectional study, with a tool consisting of two sketch Drawings representing an agonizing
misbehavior scenario for a female gynecologist encountering a pregnant patient, & a male orthopeditian encountering a
disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi Doctors, pooled during (2012-
2014) in Baghdad, striking their feelings, to generate rich comments.
Results: About two thirds of Doctors were females, and the majority was non specialists. Only 7.1% of Doctors (with significant
gender difference), offered an excuse for the misbehavior. Around 80% of Doctors expressed patient sympathy.
Scenario understanding showed significant Doctors’ gender difference. Two thirds of Doctors stated reasons &
suggested solutions for the misbehavior. Main reasons stated were: commercialization of medicine (23.8%), loss of
today’s Doctor humanity (18.1%), and profession power & ability to threat (15.2%).
Conclusion: Although Doctor-patient misbehavior is not un-prevalent, most Iraqi Doctors disagree with it. The majority express
professional sympathy. Less than tenth of Doctors stand by misbehavior, trying to give excuses. Commercialization of
medicine, loss of Doctor’s humanity, professional power, & mal-communication are emerging challenges for future
Iraqi Doctor-patient relation.

Background: Prenatal maternal anxiety is significant because of increasingly strong evidence that women who
experience high stress or anxiety during pregnancy are more likely to deliver preterm or low birth-weight
infants, autistic disorder, schizophrenia, and depression in infancy and childhood.
Objectivess: To assess the prevalence of anxiety during Pregnancy among women attending Al Karkh PHC
Centers, Baghdad, and to study its associated factors.
Methodology: This study is a cross-sectional with analytic components conducted among 500 pregnant women
from Baghdad city, Al-Karkh directorate Primary Heath Care Centers during the period extended
between 1.st of August 2020 until 31th of March 2021. A simple random sampling used to select the PHC
centers from each sector in Al Karkh directorate. Interview was done with each woman with three
Questionnaire ( sociodemographic , Diagnostic and Statistical Manual of Mental Disorder (fourth
edition) and Pregnancy related anxiety questionnaire)
Results: The mean age was 26.63 6.811years. There were 145 (29%) pregnant women live in rural area and 355
(71%) live in urban area. There were 155 (31%) anxious women, 21% with mild anxiety.There was a
significant association with previous abortions, null parity, less parity. In addition, rural area pregnant
women, younger pregnant women and the unemployed pregnant women were more anxious.
Conclusion: There was relatively high prevalence of anxiety during pregnancy among women attending Al Karkh
PHC Centers (31%), 21% with mild anxiety.

Background: Bullying is defined as the activity of repeated, aggressive behavior leads to hurt another person, either physically,
emotionally or mentally. It can involve an individual or a group misusing their power, over one or more persons who feel
unable to stop it from opening.
Objectives: To identify knowledge, attitude, and practice of bullying among universities students and to compare between
females’ and males’ and their knowledge, attitude, and practice of bullying.
Study design: A cross sectional study was conducted on a convenient sample of 926 university students of Sulaimani city, from
28th of Feberuary until 30th of Abril 2021.Data were collected by a self-administrative questionnaire which composed of
questions of socio-demographic status, seven questions about students' knowledge, for the attitude nine questions and
twelve questions about students practice Analysis was done by using Chi square for finding the association.
Results: Nearly 39 % of the students got bullied at school, the association was significant between gender and their getting
bullied (P- Value = 0.02). About (45.5 %) of the students answered that females exposed more to bullying, the association
was significant, (P- Value = 0.043), Most of the students (73 %) thought that bullying is a disease and needs treatment, the
association was significant, (P- Value = 0.01). Highest percent of the students felt distressed (45%) in situations which
remind them of the bullying, the association was significant, (P- Value = 0.01).
Conclusions: More than one third of the students got bullied and more than half of them answered correctly regarding
knowledge questions about bullying, most of them thought that females are exposed to bullying more than males and did
not take a part in bullying anyone.

Background: Urinary tract infections (UTIs) are the most prevalent bacterial infections affecting approximately 1.7% of boys
and 8·4% of girls.
Objectives: To determine different variables that associated with an increased risk of UTI in children.
Methods: A descriptive cross-sectional study conducted on 150 convenient urine samples were obtained from child’s teaching
hospital in Baghdad city from children under 12 years during period of 20 September 2021 to 20 December 2021.
The inclusion criteria include: children between 1-12 years old for both sexes with clinical evidence of UTIs
diagnosed by physicians attending this hospital. The exclusion criteria were: children under one year, those with
genetic defect of urinary tract infection.
Results: Highest rates of UTIs were in the age group of <1-4 years; 77 (51.3%) of them were male with male to female ratio
1.05:1. 16.7% of children whose mother had primary education were diagnosed with UTIs. 22% of positive culture
test occur in those wiping from the front as compared with 27.3% wiping from back. from behind. The positive
culture test found in 33.7% of those not circumcised in comparison with 19.4% of those undergone circumcision.
Escherichia coli detected in 31 (20.7%) of studied sample.
Conclusion: Urinary tract infections most prevalent among boys under 12 years, in particular those who did not undergone
circumcision. E. coli among the highest frequent bacteria detected in the urine cultures of children. It is
recommended to educate mothers during pregnancy and after delivery regarding importance of circumcision to
boys and proper washing methods.

Background: Elastosonography is a promising non-invasive technique that developed in recent years for evaluating thyroid
nodules. It assesses nodule stiffness or displacement depending on the applied force to differentiate
malignant from benign thyroid nodules.
Objectives: The aim of this study was to evaluate the diagnostic utility of real time US elastography in the differentiation the
benign from malignant thyroid nodule.
Patients and methods: A cross-sectional was carried out on 40 patients attending ultrasound unit/radiology in Al-Imamein
Al-Kadhimein Medical city in Baghdad/Iraq from September 2018 to August 2019. All patients were
examinedby B-mode ultrasound, color Doppler, and real-time elastography by Voluson-E6 Ultrasound
machine. Final diagnoses obtained from histological and/or cytological evaluation.
Results: The mean age of 40 patients was 43.7±11.7 years with the range of 25-70 years. 28 (70%) of them were female
and 12 (30%) were male. Of the 40 lesions 34 (85%) were benign and 6 (15%) were malignant lesions.
Malignant thyroid nodules were significantly hypoechoic, with irregular margin, taller than wider, showed
microcalcification and exhibited a significant increase in vascularitywith varying rate of sensitivity and
specificity. Orientation (taller than wider) was the most ultrasound predictive pattern of malignancy with
sensitivity, specificity, and accuracy of 66.7%, 100%, and 92.5% respectively. The mean strain ratio of all
nodules was 2.7±2.1 ranged 0.4- 13.5 with significant result. The optimal strain ratio cutoff value was >2.5
and showed to have a sensitivity of 100%, specificity 88.2%, positive predictive value 67%, negative
predictive value 100%, and accuracy rate 90%.
Conclusion: Elastosonography can assist in the differential diagnosis of malignant and benign thyroid nodules, as strain
elastosonography improve the diagnostic performance in differentiating the benign and malignant thyroid
nodule. strain ratio is higher in malignant than benign nodules