Diyala Journal of Medicine

Background: Significant neonatal hyperbilirubinemia is a common cause of readmission
following initial sending home from hospitals in healthy mature neonates.
Objective: To determine the predictive ability of first 24th hr entire serum bilirubin (TSB)
levels for later development of important hyperbilirubinemia in well mature neonates at
Mukalla Maternity and Child Hospital (MMCH) in Mukalla city, Hadhramaut Governorate,
Yemen.
Patients and Methods: A cross sectional study of 150 well mature newborns was tracked
with everyday serum total bilirubin detections for five days of life at Mukalla Maternity &
Child Hospital between March 2019 and February 2020.
Results: It was observed that 10%, 10%, 13.3% and 66.7%% of newborns were corresponding
to high, high intermediate, low intermediate, and low risk zones respectively, while7.3% of
newborns had developed significant hyperbilirubinemia and needed phototherapy. The day one
bilirubin value of 5mg/dl had a sensitivity of 100% and specificity of 72%, the positive
predictive value of 22%, and a negative predictive value of 100% in forecasting the risk of
developing significant jaundice.
Conclusion: A total serum bilirubin measurement may be applied as a useful screening test
for each neonate at the first week of life, to foresee those at risk for later development of

Background: In 2019, a novel coronavirus was identified. It first appeared in Wuhan, China
and caused a cluster of pneumonia cases. The virus was named severe acute respiratory
syndrome coronavirus-2 (SARS-CoV-2). The World Health Organization designated the
disease COVID-19 (coronavirus disease 2019).
Objective: To find the prevalence of COVID-19 infection among symptomatic frontline and
non-frontline healthcare workers, their main complaint and clinical outcomes.
Patients and Methods: This is a cross sectional study done on retrospective data in which
all symptomatic healthcare workers in Baqubah teaching hospital were involved in the study
and full questionnaire forms were filled. Nasal and throat swabs were taken for polymerase
chain reaction test and high-resolution computed tomography were done.
Results: From (1413) symptomatic healthcare workers tested for COVID-19 (185) were
positive yielding a (13%) prevalence from the total employed healthcare workers in Baqubah
teaching hospital, with (63%) were male. Most of the affected were nurses (63.2%) ,(59.5%) of
the affected healthcare workers were non-frontline staff. Fever was the most common symptom
and was seen in(79.5%) followed by shortness of breath in(63.8%).The disease course was mild
in (83.8%) of the affected healthcare workers and only (2.7%) need admission to the hospital
and the mortality rate was (0.5%).

Background: Hypertension is a well-established risk factor for cardiovascular diseases with
an ongoing global increase in incidence. Low Magnesium may play a critical role in
cardiovascular physiology. Although many reports have mentioned the correlation between
low serum magnesium levels and hypertension, the results were conflicting.
Objective: To measure the levels of serum magnesium in hypertensive patients, and to
evaluate the prevalence of hypomagnesemia among them.
Patients and Methods: A case-control study from June 2019 to December 2019 was carried
out in Rizgary Teaching Hospital and Nawroz Health Center involving 100 adult patients
with essential hypertension (group I ) and 100 normotensive age and gender-matched
controls ( group II). The serum magnesium level was measured in all participants.
Results: Females constitute 64 % of both study groups. The means of the age of both study
groups show no significant difference (p=0.82). Although the means of Mg level in
hypertensive and control groups were within the normal range, it was significantly lower in
hypertensive patients (p=0.004). Besides, 4 hypertensive patients (4%) had hypomagnesemia
compared with zero in controls (p=0.043).
Conclusion: There was a significantly lower mean magnesium level in hypertensives
compared to controls. A relationship was assumed between serum magnesium level and
hypertension. However; hypomagnesemia was not common in hypertensive patients.

Background: Nocturnal enuresis, is intermittent involuntary voiding in a child aged five
years or more. One time a month for three months is required for the diagnosis. It is a
common problem in children. It is the cause of stress for them and for their families. Enuresis
can be classified into two types to understand its causes and treatment. These types are
primary and secondary enuresis, monosymptomatic and polysymptomatic. Primary enuresis
always associated with a familial history of delayed control of the urinary bladder. Secondary
enuresis may cause by urinary tract or neurogenic causes like the spinal cord and urinary
tract infection. Most of the cases were of the primary type.
Objective: To evaluate the associated factor of nocturnal enuresis, study the various types of
nocturnal enuresis, and evaluate the associated factors that affect the types of nocturnal
enuresis.
Patients and Methods: A cross-sectional study conducted in outpatient clinic of Albatool
hospital in Diyala province, Iraq, 150 children was eligible in the study, which started from
1st Febreuary to 30th June 2020. Collection of the data was done by interview parents’ or the
children's caregiver by a questionnaire that was used before for study enuresis. Analysis was
carried out using statistical package for social sciences SPSS version 24.
Results: The present study included 150 patients with enuresis, their mean age was 7.51±1.34
years (range:= 5-10 years), there were (59.3%) males and (40.7%) females. Most of the patients
(61.3%) had 2-3 sibling, second in their birth order (52%), reside in the urban area (56%), a
majority of the mothers 38% had primary school as their highest educational attainment, a

Background: In the novel COVID outbreak , chest imaging was in the front door for the
diagnostic approach to any patient with respiratory symptoms , including chest HRCT & lung
ultrasound modalities.
Objective: To find the correlation between lung ultrasound and chest high-resolution
computed tomography (HRCT) signs in patients suffering from COVID-19 pulmonary
involvement.
Patients and Methods: This cross-sectional observational study conducted in Arbil / Iraq,
from July to November 2020 , enrolled 50 patients who assessed using HRCT and lung
ultrasound (LUS),12 areas in the chest examined by ultrasound and corresponding percentage
(absent or limited, moderate, extensive, severe & critical grads ) of lung affection on HRCT.
Results: Analysis of the obtained data from 50 affected patients done , a highly significant
positive relation noted between the findings on ultrasound & the extend of lung involvement by
chest HRCT (r factor 0.78, the p-value was <0.001), the sensitivity, specificity, and accuracy of
LUS were 90%, 70% ,and 68% respectively.
Conclusion: The current study showed that ultrasound and HRCT are parallel in assessing
the extent of lung involvement among COVID-19 pneumonia victims, thus making lung
ultrasound a relevant substitute for HRCT.

Background: COVID-19 was first reported in Erbil province in Iraq on March 19, 2020.
The effect of lockdown on reducing the spread of the novel coronavirus and the effect of
weather conditions (air temperature and humidity) on the daily reported number of cases and
death rate of COVID-19 were investigated during April to July, 2020.
Objective: To investigate the effect of lock down on reducing the spread of the novel
coronavirus pandemic and the effect of weather conditions (air temperature and humidity) on
the daily reported number of cases and death rate of COVID-19.
Patients and Methods: The data collected during three different periods, the first (total
lockdown), followed by the second period of lockdown relaxation, which was followed by
the third period (interrupted relaxation of lockdown) that reported hundreds of new cases
daily. The real-time PCR .assay was performed on suspected COVID-19 patients according
to the protocol established by the World Health Organization.
Results: Temperature and relative humidity were recorded in Erbil city in Iraq. Patients’ age
ranged (2-70) years old. Out of (1469) patients confirmed positive with COVID-19, 57.7% of
them were males, 31.3% were females, and the rest (11%) were children. The mean number of
patients per day was 32.77 during the period of interrupted relaxation lockdown which was
significantly higher than in the total-lock down period (3.88 patient), and the relaxation
lockdown period (1.93 patient). The mortality rate per day was 0.77 during the period of
interrupted relaxation lockdown was significantly higher than the rates (0.0%) of the other
periods. Moreover, increasing the temperature increased the number of confirmed cases in July
while, low relative humidity significantly increased the rate of reported cases.

Background: Drugs used by pregnant women may reach the fetus through the placenta and
lead to effects on the development, intellectual ability, birth defects miscarriage and
stillbirth.
Objective: To assess the knowledge and practice of pregnant women concerning the risk
and safety of drug use.
Patients and Methods: This cross-sectional study was conducted in a selected sample of
Maternal and Child Health (MCH ) clinics and private pharmacies in an Iraqi province for a
period of 6 months during 2019. A special questionnaire was designed by the researcher to
collect data about the study sample.
Results: Out of (250) pregnant included in the current study, 70% of them were between 20-30
year of age. Most of the study population (52%) were of schooling level of education and 70%
of them not working. Pregnant whom multigravida was (82%). Of the study population (48%)
in their second trimester. Pregnant participants in the current study (56%) were from the out-
patient department and (70%) have antenatal care follow -up. Regarding the knowledge of the
study population about the risk of the drug (10%) stated that it is risky to the mother, (45%)
risky to the baby, (25%) risky to both and about (15% ) stated that drugs are safe during
pregnancy. Concerning the study's population’ practice for drug use, the results revealed that
(73%) of them use drugs with a medical prescription, (20%) without medical prescription and
other use in (7%).
Conclusion: The study concluded that the knowledge and practices of pregnant women about
taking medicines during pregnancy at an acceptable level and recommends raising awareness
about the risks of taking unnecessary medicines for various common diseases during
pregnancy.

Background: Shisha involve charcoal, wood, or coal that conation tobacco to heat up.
Tobacco inside the shisha called maassel, which often used. So shisha smoking is popular in
every country especially among young people. As a result, shisha can be at risk of many
clinical signs and symptoms like cough, chest pain, and symptoms of physical risk like
hypertension, obesity, reduce body temperature.
Objective: To determine shisha smoking prevalence and associated physical factors among
private university students in Erbil city.
Patients and Methods: Eight questionnaires about physical factors were administrated to
250 males and females among students in Erbil city in the present study.
Results: A total of two hundred and fifty individuals included in this study. Mean age of
(19.82+2.060) years. There are (164) shisha smokers among males and females private
university students in Erbil city. Earlier plan questionnaire for (250) students was tested,
(45.6%) were male shisha smoking, and (20%) were female in a cohort study. Compared to
cigarette because characteristics in the way that shisha smoking is practiced the frequency of
bloating and depth of inhalation smoking.
Conclusion: In the finding despite the scarcity of students indicate the high prevalence of
obesity, reduce body temperature and increase blood pressure in shisha smokers. Can
conclude in this study that shisha smoking has persistently been drop for, ten years period,
increasingly people are turning to more healthy alternatives.

Background: Ankylosing spondylitis is a chronic autoimmune inflammatory disease, mostly
affect young men. Reduced bone density is the most common complication in ankylosing
spondylitis, since reduced bone density occurs in most of the patients. Assessment of bone
density in the early stages of the disease by using X- ray absorptiometry is essential.
Objective: To determine and evaluate the bone mineral density of ankylosing spondylitis
patients compared healthy to control group.
Patients and Methods: This is a cross-sectional case control study of 50 patients with
ankylosing spondylitis according to the Modified New York criteria and 50 healthy control
group. The data were collected including socio demographic information of all patients (age,
gender, medical history); systemic diseases type of biology treatment, using supplements,
duration of ankylosing spondylitis, regular exercise, and smoking. The body mass index was
calculated. Bone mineral density of the lumbar spine (L1-L4), and the left femoral neck were
measured by using a dual energy x-ray absorptiometry. Statistical analysis was done by using
a statistical package for social sciences (SPSS) version 22; Fisher’s exact, and Student’s t
tests were used to compare two means. A p value of ≤ 0.05 was considered statistically
significant.
Results: The prevalence of osteoporosis and osteopenia among patients group according to T-
spine score were 12% and 42% respectively, compared with 0% and 26% respectively among
the control group (p= 0.002) which was statistically significant. According to the T-left femur
none patients group and the control group had osteoporosis, but 46% of the cases had
osteopenia, compared with 8% of the controls which was statistically significant. There was a

Background: Steven Johnson syndrome (SJS) is a rare disease that is characterized by acute
cutaneous manifestation represented by eruptions of the skin and the mucosal membranes.
SJS is an immune-mediated disease, a hypersensitive reaction, characterized by
hyperpigmentation of the mucous membranes, rash on the skin and multiple bullae and
erosions scattered all over the body especially the face, trunk, and the extremities. Many
studies reported that the incidence rate of the SJS was about 1.2 – 6 cases/ million each year
and it is more common among males while the toxic epidermal necrolysis (TEN) is more
common among females. In addition to the cutaneous manifestations.SJS might show
multiple systemic manifestations including the liver, lungs and kidneys. In this case we
reported the development of Steven Johnson syndrome in relation to the use of lamotrigine
antiepileptic drug.