Diyala Journal of Medicine

Background: Any pandemic is not only considered as a medical
phenomenon; it has an impact on one’s life and its society. The impact of
COVID-19 pandemic on physical and mental health is a common issue
and up to the researcher’s knowledge, no previous study has been carried
out among patients attending primary health care centers in Erbil City.
Objective: To assess physical and mental health problems associated with
Covid-19 pandemic among a Kurdish sample of patients.
Patients and Methods: A cross sectional study using a convenience
sample was conducted on 300 patients attending six primary health care
centers in Erbil city. The study started from 1st of April 2021 to 31st of
March 2022. The data were collected using a questionnaire after reviewing
relevant literature.
Results: The mean age (± S.D) of participants was 42.16 (±14.64) years,
more than half (52.7%) of them were female, 65% of them were married.
The majority (72.7%) of them were not smokers and 32.7% of them had
chronic disease. More than half (61.7%) of participants stated that their
physical activities were reduced and 38.3% of them gained weight. More
than half (55.3%) of participants were infected with the Covid-19 while the
rest (44.7%) were PCR negative with the disease. Thirty nine percent of
participants suffered from sleep disturbance. There was significant statistical
association between COVID-19 infection and gender, and marital status.
There was non-significant statistical association between COVID-19
infection and sleep disturbance.
Conclusion: Covid-19 pandemic had a significant impact on the
participants’ wellbeing physically and mentally. Impact on physical health
included decreased physical activities and weight gain and impact on
mental health included psychological symptoms such as sleep disturbance,
irritability, worry, feeling depressed, and insecurity about self and future.

Background: Surgery for lumbar disc herniation is one of the most
commonly performed procedures in spine surgery. Questions remain if
lumbar discectomy is the optimal treatment for patients with lumbar disc
herniation who exhibit a substantial amount of preoperative back pain.
Objective: To evaluate the outcome of improvement of back pain and
radiculopathy between male and female patients with single-level
discectomy and in relation to different indications for the surgery.
Patients and Methods: In this retrospective follow-up study, 80 patients
(40males and 40 females) with symptoms of radiculopathy and back pain
who underwent single-level open discectomy (small incision of 2-3 cm)
were followed-up by discharge from the hospital between 2017 and 2019
in Erbil, Iraqi Kurdistan. The patients were included after having the
symptoms of radiculopathy as confirmed on magnetic resonance imaging.
In addition, patients who had undergone discectomy due to radiculopathy
without response after 6 weeks of conservative treatment were included in
this investigation.
Results: The mean age of the patients was 45.1 (19-70 years old). The study
showed that the level of back pain and radicular pain was significantly
decreased from the initial step to 3, 6, and 12 months. The levels of back and
radicular were not changed significantly from three to six months. The study
showed that the prevalence of different levels of back and radicular pain was
similar between male and female patients at different periods. The study did
not find a significant difference in levels of back and radicular pains among
patients with different indications in male and male patients.
Conclusion: This study showed that single-level lumbar discectomy
improved back and radicular pain by 12 months postoperatively in males
and females, regardless of the indication for surgery.

Background: Rheumatoid arthritis and metabolic syndrome are closely
linked, which considerably raises the risk of cardiovascular complications,
and consequently, morbidity and mortality. Treatment of the metabolic
syndrome reduces mortality and morbidity of cardiovascular disease.
Objective: To assess the prevalence of metabolic syndrome in a
population of female patients with Rheumatoid arthritis, and association
with comorbidities and Disease-modifying anti-rheumatic drugs
(DMARDs).
Patients and Methods: This cross-sectional analytic study was conducted
in Erbil City. A total of 110 female patients with the diagnosis of
rheumatoid arthritis were included during the period of July 2021-March
2022. Anthropometric indices, blood pressure, fasting blood sugar, lipid
profile, and proteinuria were investigated. The metabolic syndrome
defining criteria from the international diabetes federation (IDF-2005)
were applied.
Results: Out of 110 patients with rheumatoid arthritis, 63 (57.3%) were
found to have metabolic syndrome, in whom the majority of them 52
(71.2%) were obese class 1. A significant association of metabolic syndrome
was found with comorbidities (hypertension, diabetes, and hypothyroidism),
p-value 0.019, and TNF-alpha inhibitor drugs were shown to be associated
with a reduced risk for metabolic syndrome.
Conclusion: Metabolic syndrome is common in rheumatoid arthritis
patients, and it increases the risk of other comorbidities (hypertension,
diabetes, and hypothyroidism) as well as cardiovascular diseases. Patients
on biologic disease modifying anti-rheumatic drugs are at a lower risk of
metabolic syndrome

Background: Diabetes mellitus is one of the common causes for
activation of platelet. Inflammation-induced abnormal platelet function
contributes to chronic complications, which are consider the leading
causes of death and morbidity among diabetics.
Objective: Rac1, a 21kD G-protein has been shown to regulate a variety
of platelet functions; we predicted that Rac1 could regulate platelet release
of CXCL4 and CCL5, which may leads to organ injury in Diabetes
Mellitus.
Patients and Methods: Diabetes Mellitus' effect on Rac1 activation
implicated in platelet activation, was investigated as platelet-induced
inflammation and organ injuries. Swiss albino male mice were pretreated
with 5 mg/kg of a specific Rac1 inhibitor NSC23766 and injected with (45
mg/kg body wt.) streptozotocin, twice for five days. Moreover, the
concentration of serum chemokines CXCL4 and CCL5 were assayed using
ELISA, and histology scores for kidney and pancreas was examined.
Results: Our results show that Diabetes Mellitus was induced in mice by
streptozotocin. In addition, platelet chemokines (CXCL4, CCL5) were
markedly higher in diabetic mice when compared to the sham group.
Moreover, pretreatment of diabetic mice induced by STZ, with NSC23766
decreased kidney and pancreatic injuries assessed by histology score, P-value
<0.05.
Conclusion: Our study reveals that Rac1 has a critical role in platelet
chemokines secretion due to diabetes-induced inflammation in the kidneys
and pancreas, and targeting Rac1 could be a target for innovative
treatment to control inflammation in a diabetic individual. Targeting
platelets involved in inflammatory pathways could be part of a strategy in
order to control and manage diabetes consequence

Background: A pterygium is a triangular fibrovascular sub-epithelial
ingrowth of degenerative bulbar conjunctival tissue over the limbus onto
the cornea. The mainstay of treatment is surgery with more measures to
decrease the recurrence rate. Pterygium doesn’t need intervention unless
there is an extension of the lesion towards the center of the cornea and it
encroaches on the visual axis, or is symptomatic in terms of redness and
discomfort.
Objective: To present a new surgical technique for managing primary
pterygium. We aim to find a more effective method than the one
previously used. We wanted to demonstrate and prove that this technique
has low recurrence rates.
Patients and Methods: A Hospital-based interventional case series study,
sampling done by simple random sampling from the outpatient
departments. The study was conducted in the ophthalmology department
of Erbil teaching hospital in Erbil city for eight months from August 2021-
April 2022. In the current study 40 patients with pterygium were operated
that they were attending the ophthalmology department in this hospital.
Results: The result revealed 3 cases of recurrence of 7.5% out of 40 cases
using a dual flap technique as a new approach for treating pterygium in the
follow-up of 3 months, in which the mean ± SD of age was 46.3 ± 10.537
years. Twenty four cases were female, and 16 were male; all of the lesions
were nasally located pterygium. In the sample we used in the study 5 patients
had had pterygium excision using other techniques in the past at least once,
and neither of them recurred utilizing this approach.
Conclusion: The double flap is a proper alternative technique in
pterygium surgery; this new procedure, dual conjunctival flap with 7.5%
recurrence rates and provides safe and comparable results to current
methods

Background: Rheumatoid arthritis (RA) is an inflammatory autoimmune
disease that causes progressive and painful of multiple joints damage.
Objective: To explore the prevalence of Rheumatoid arthritis (RA) among
middle-aged and older of Iraqi patients attended the outpatients’ clinics.
Patients and Methods: A prospective cross-sectional study was
conducted from 1st February to 31st July 2022 at the rheumatology
outpatient clinic at the Baquba teaching hospitals, Diyala province, Iraq.
The eligible patients were interviewed using semi-structured
questionnaires. Diagnosis of RA is based on clinical and serological
parameters in accordance with criteria issued by American College of
Rheumatology/European League Against Rheumatism (ACR/EULAR)
guideline. Descriptive, bivariate, and logistic regression analysis was
performed. All statistical analyses were performed using SPSS 16.0
software. P-value < 0.05 was considered statistically significant.
Results: A total of 417 patients with an average age of 55.05 (+10.31)
(ranged 40-79 years) have been included in the study. More than half were
females (57.8%), married (74.3%), unemployed (67.9%), and 41.0%
doctor-diagnosed arthritis. The prevalence of RA in adults was 0.96%
compared to 2.34% in doctor-diagnosed arthritis group (females 1.75% vs.
males 0.59%, P= 0.011). Results of the multiple logistic regressions showed
that older age (odds ratio (OR) = 1.100, 95% CI: 1.070 to 1.130) was
associated significantly with "doctor-diagnosed arthritis" (p < 0.001). The
female patients (OR = 4.928, 95% CI: 2.826 to 8.593), single or had no
spouse (unmarried, widow, divorce) (OR = 5.076, 95% CI: 2.742 to 9.396)
and had diabetes mellitus (DM) (OR = 7.251, 95% CI: 4.247 to 12.378) were
associated significantly with "doctor-diagnosed arthritis" (p < 0.001).
Conclusion: With aging, the Iraqi females who have no spouse and suffer
from diabetes mellitus become more vulnerable to symptomatic arthriti

Background: Staphylococcus aureus is one of the dominant pathogen
among skin infections in human and animals.
Objective: To isolation and identification of S.aureus from sheep breeders
by traditional method &Automated Vitek 2 system ,Detection of
methicillin resistant gene (mecA) by conventional PCR. Evaluation of
relationship between S.aureus in-fection and possible risk factors in
human (age, sex, education level, economic statue, hospitalization in last
four weeks contact with sheep skin lesions, and contact with pets).
Patients and Methods: A total of 44 skin swaps collected from sheep
breeders suffered from variety of infected skin lesions (wounds,
abscesses, atopic dermatitis, acne, chronic skin diseases etc.) recording;
sex, age, education level, economic statue, hospitaliza-tion in last four
weeks, contact with sheep skin lesions, and contact with pets to detect S.
aureus, MRSA and estimating the risk factors, by employing traditional
laboratories methods in addition to confirmatory techniques by VETEK2
sys-tem and PCR, using specific primers (Staur 4, 6), MRSA gene
primers (mecA).
Results: Methicillin sensitive S. aureus was reported in 34.09% versus40%
for MRSA among sheep breeders. Significant correlation reported between
age groups and MRSA infections. Although, the rate of infection with
methicillin sensitive S. aureus and MRSA was higher among males
compared with females , no signifi-cant correlation reported between sex and
infection with methicillin sensitive S. aureus and MRSA. Female breeders
were at high risk for getting dermal MRSA infections compared with males.
No significant correlation between the educa-tion level, economic status,
contact with pets and methicillin sensitive S. aure-us , MRSA infections as
Risk factors. Methicillin sensitive S. aureus infections among breeders
significantly correlated with hospitalization in last four weeks .Significant
correlation reported between contact with skin lesions of sheep and
methicillin sensitive S. aureus , MRSA infections among breeders.

Background: The Papillary variant of thyroid carcinoma is one of the
common types of thyroid malignancies , the commonest. Its diagnosis
usually is microscopic which based on nuclear features.
Objective: To assess the immunohistochemical expression of cytokeratin
19 (CK19) in PTC and compare its reactivity with other thyroid conditions
to approve its importance as a useful test for diagnosing PTC.
Patients and Methods: Twenty- cases of papillary thyroid carcinoma
(with different variants), five follicular adenomas and ten multinodular
goiters (MNG) were collected over three years (2018-2021).10% formalin-
fixed sections were collected from thyroidectomy specimens. Stained with
Hematoxylin and eosin then immunohistochemical staining for
immune-marker CK 19 was done using standard techniques. The results
were quantitatively scored as the following: score 0 (negative ), score 1+
(<5%) positive cells), score 2+ (5- 25%), score 3+ (25-75%) ,finally score
4+ (>75%) positive cells), and then calculated.
Results: An 18 (90%) papillary carcinomas show diffuse and strong (3+ and
4+) expression of CK19 . ,three out of ten (30%) MNG were weakly
positive(1+ and 2+) and focal in distribution while in follicular adenoma all
cases were negative for CK19 .
Conclusion: Ck 19 can stain benign and malignant thyroid tissue, but
strong membranous staining applied in cases of papillary ca , thus can be
used as confirmatorytool for PTC diagnosis.

Background: Recurrent inguinal hernia constitutes a significant problem
for the surgical community. Incidence of recurrence and chronic groin
pain after hernia repair require continuous audit, participation in a register
and follow-up by selective physical examination provides a solid basis for
quality control.
Objective: Description of cases with recurrent inguinal hernia, type of
previous repair, factors contributed to recurrence of hernia and type of
repair used with the study of post-operative complications in the early
postoperative period.
Patients and Methods: Descriptive studies on patients with recurrent
inguinal hernia were evaluated and data collected.
History; age, occupation, time of previous operation, predisposed factors
extracted from the previous operation and change of lifestyle. General
examination; the presence of predisposing factors, comorbid factors,
obesity. Local examination: to describe the type of hernia. Local
examination: to describe the type of hernia.
Results: In our study 18(40%) patients had an indirect recurrent hernia, 24
patients with recurrent direct inguinal hernia, and 3 patients presented with
pantaloon hernia. Males constitute 93.33% of cases. Smoking and chronic
cough were the most common predisposing factors. The right side constitutes
80% of cases and the other 20% on the left side. The interval between the
previous operation and clinical presentation of recurrence is the highest
number presented after 2-5 years.
Conclusion: Mesh repair was superior to other types of repair (less no. of

Background: Assess the efficacy of combining fiber and lactulose in the
treatment of constipation in the pediatric age group.
Objective: To assess the efficacy of combining fiber and lactulose in the
treatment of constipation in the pediatric age group.
Patients and Methods: One hundred forty-six patients with
fuctionalconstipation were chosen in a non-randomized superiority trial
manner as they were convenient to enroll due to their presentation to the
outpatient clinic during the period from August 2019 to February
2022.Patient received either a solution of lactulose 3.3g/5ml in group A or
a solution of 4.005g Inulin fiber and 4.005g lactulose per 20ml in group B.
Results: Total of 146 children were included; all, 146 patients completed the
study. In the lactulose group, 19 patients were on therapy for less than 6
months, and 48 were on therapy for more than 6 months. In the lactulose +
fiber group, 59 patients were on therapy for less than 6 months, and 20 were
on therapy for more than 6 months. No serious adverse effects were
registered but 18 (27%) of children in the lactulose group encountered side
effects, while 11 (14%) of children in the lactulose + fiber group encountered
side effects.
Conclusion: A solution of Lactulose + fiber is superior to a solution of
Lactulose alone in terms of efficacy for the treatment of constipation in
the pediatric age group. It also has a lower side effects profile

Background: Heat-cured acrylic resins are used most often for
denture bases because they are the best in terms of their physical and
chemical properties, are easy to handle, and are affordable. But the
surface is not hard enough, and oral bacteria such as Candida
albicans stick to the resin.
Objective: To assess how Radish oil affected heat-cured acrylic's impact
strength and hardness.
Patients and Methods: The intention was to create a total of (60)
specimens. Twenty samples were made without additives (Control), and
40 had made with radish oil added at two different amounts (2.5 per cent,
5 per cent).
Results: There was a Non-significant difference between the control and
experimental groups in the impact strength test. In contrast, the hardness test
showed a highly significant difference between the control and experimental
groups. When radish oil had added, the impact strength and hardness had
reduced in all concentrations.
Conclusion: Adding radish oil decreased the hardness and impact strength
of the two experimental group

Background: The mental foramen (MF) is a very important structure; to
avoid any trauma to mental nerve may be occur and in order to avoid that,
its position, variation in anatomy and shapes should be clearly determined
before any surgical procedure.
Objective: To detect the exact position of MF and thickness of cortical
plates in lower premolars and first molars among the Iraqi resident.
Patients and Methods: For this prospective study, a total of 92 Iraqi
adults patients (51 females, 41 males; age range 18-69 years). From
October 2020 to February 2021, patients aged range from 25 to 65 years
old.Five types of classification we used:
Type 1, MF under the root of the lower first premolar.
Type 2, MF between the root of mandibular first & second premolar.
Type 3, MF below the root of the mandibular second premolar.
Type 4, MF between the root of lower second premolar & first molar.
Type 5, MF below the root of the lower first molar.
Bone thickness is measured in the horizontal direction on the both side
lingually and buccally.
Results: The most common situation of the MF was below the root of lower
second premolar.
Conclusion: Significant difference can be noted in the mean of the
distance between MF and root apex in both gender, also significant
difference in mean of bone thickness noted between both genders on both
sides.

Background: The coronavirus disease 2019 is a serious infection resulting
in a global threat caused by coronavirus 2 (SARS-CoV-2) characterized by
different symptoms, ranging from mild flu to severe pneumonia.
Objective: To focus on the oral manifestations which could be present in
some cases of COVID-19 and to assess the associations between oral
health and COVID19.
Patients and Methods: An online questionnaire survey was performed
on188 medical specialists in Sulaimaniyah city. The questionnaire was
composed of 3 parts; the 1st part included demographic features. The 2nd
part was composed of questions concerning the oral hygiene condition of
the participants, and the 3rd section encompassed questions about oral
complications during infection with COVID-19.
Results: Among 188 participants, 92% complained of oral manifestation
while being infected with Covid-19 at significant levels. Facial and
masticatory muscle pain 27.1%, facial or oral numbness 8%, jaw bones or
joint pain 39.9%, changes in buccal mucosa and gingiva 10.1%, bleeding
gingivitis 9%, Altered taste sensation 67.6%, altered smell sensation 69.1%
and xerostomia 54.8% were highly associated with Covid-19.
Conclusion: Some cases of Covid-19 usually present with different oral
manifestations. Therefore, oral care monitoring should be enhanced for
Covid-19 patients and maintain good oral health.

Background: Pregnancy is a physiological process during which a major
hormonal change take place which leads to an imbalance in the oral
environment and development of oral manifestation that can adversely
affect mother’s health and the health of the unborn child.
Objective: To assess the prevalence of the oral manifestation of pregnant
women and to evaluate the correlation of these manifestations with the oral
hygiene status.
Patients and Methods: A total of 150 pregnant women were enrolled in
this study on which a meticulous intraoral examination and evaluation of
oral health status using oral hygiene index simplified (OHI-S) carried out.
Results: The most involved age group was (21-25) years 38.00%. It was
concluded that the most frequent oral finding was halitosis 67.33%, followed
by dry mouth 59.33%, taste alteration 46%, pregnancy epulis 9.33%,
candidiasis 7.33%, and ulceration 4%. In addition, pregnancy epulis and
halitosis were significantly correlated with poor oral hygiene.
Conclusion: Pregnancy is associated with oral manifestations; therefore,
dentists should be aware of such manifestations and provide education
regarding oral health status and maintenance of good oral hygiene during
pregnancy

Background: Tobacco smoking is considered as one of the most common
risk factors for development of oral mucosal lesions which may carry a
potential risk for development of oral cancer.
Objective: To find the prevalence of nicotinic stomatitis in a sample of
cigarette and water pipe smokers in Erbil city of Iraq.
Patients and Methods: This study included 410 smokers aged 18 years
and above who are smoking for at least five years. Cigarette, water pipe
and dual smokers were included of both genders. The type, duration and
frequency of habit were recorded. The diagnosis of nicotinic stomatitis
was done clinically. The data entered and analyzed by (SPSS software 25th
version).
Results: Majority of participants were cigarette smokers (73.7%).Out of 410
smoker, prevalence of nicotinic stomatitis was (55.3%) in cigarette
smokers,(24.6%) in dual smokers while none of water pipe users developed
nicotinic stomatitis ;the incidence increase with increase in duration and
frequency of the habit.
Conclusion: In this study we found cigarette smoking was more
commonly practiced than water pipe .Nicotinic stomatitis is more
prevalent in cigarette smoking and its incidence increased with duration
and frequency of the hab

Background:Globally, rotavirus infection, which results in gastroenteritis,
is one of the major health problems. Millions of children are infected with
the disease. Viral gastroenteritis must be recognized early because it
causes wasteful antibiotic use and hospitalizations for kids.
Objective: To investigate the frequency of rotavirus in stool samples
from children with acute gastroenteritis.
Patients and Methods: Cross-sectional study consisting of one hundred
fifty-three fresh stool samples collected from children less than 5 years
were admitted to Raparin pediatric hospital in Erbil city between
November 2021 and April 2022. Rotavirus antigens were detected by
Rapid test.
Results: Rotavirus antigen was detected at an estimated rate of 61 (40%) in
153 studied cases. The frequency of rotavirus among male and female
patients was 44.1% and 33.3% respectively. According to age of infants,
rotavirus was detected most frequency in eight months of age. As well as the
frequency rate among rural and urban patients was 40% and 39.8%
respectively. Rotavirus was detected among vaccinated and non-vaccinated
patients by the frequency 26.3% and 54.8% respectively. The highest
frequency rate was detected in January 46.4%. Detection of rotavirus by age
group was and vaccinations were significant in this study by p-value of
0.001. Conclusion: The most common cause of acute gastroenteritis in
children in our area is rotavirus . Rotavirus infection is most frequently
occurring during the winter season and among children between 6 months to
24 months.
Conclusion: In this study we found cigarette smoking was more
commonly practiced than water pipe .Nicotinic stomatitis is more
prevalent in cigarette smoking and its incidence increased with duration
and frequency of the habit.

Background:Tinea pedis (athletic foot) is the most common
dermatophytic fungal infection of the body. It may last for a short or long
time and may recur after treatment.
Objective: To assessed and compared the effectiveness and safety of 1%
terbinafine cream and 1% clotrimazole cream for the treatment of tinea
pedis.
Patients and Methods: Randomized control trial was done in the
outpatient clinic of dermatology department in Rizgary Teaching Hospital
in Erbil. From March, 2019 to January, 2020. Sixty patients with tinea
pedis diag-nosed clinically were included in this study. Thirty patients
applied 1% terbinafine cream topically twice daily for one week and thirty
patients applied 1% clotrimazole cream topically twice daily for four
weeks. Scraping for fungi was performed before and after therapy.
Efficacy was assessed by clini-cal cure and mycological cure. Clinical and
mycological cure measured at weeks one, four and six.
Results: Mycological cure rates were 86.7% for terbinafine and 80% for
clotrimazole at 4 weeks, 86.7% for terbinafine and 90% for clotrimazole at 6
weeks. At 4 weeks, terbinafine had an 83.3 percent clinical treatment rate
and clotrimazole had a 76.67 percent clinical treatment rate; at 6 weeks,
terbinafine had an 83.3 percent clinical treatment rate and clotrimazole had
an 83.3 percent clinical treatment rate.
Conclusion: The study showed that one week terbinafine two times a day
is as effective as four weeks clotrimazole two times a day as well as in
terms of mycological treatments and efficient therapies.

Background: Breast cancer is the most common cancer that threatens the
lives of women all over the world. Adipocytokines (adiponectin, leptin),
and the β-galactoside-binding proteins (galectin-3) are new suggested
parameters for the diagnosis and prognosis of breast cancer.
Objective: To find relationship between serum adiponectin, leptin, and
galectin-3 and breast cancer diagnosis and prognosis factors.
Patients and Methods: A case-control study was done between (August
2021 to June 2022). Totally collected 111 female blood samples from
patients that diagnosed with a breast cancer and healthy control, Samples
were grouped into Group I (30 healthy control), Group II (43 patients pre-
treatment), and Group III (38 patients post-treatment), from Rizgary
Teaching Hospital, Nanakali Hospital, Hawler Teaching Hospital- General
surgery and Neurosurgical Department, PAR Private Hospital, PAKY
Hospital, and Rasul Private Hospital at Iraq-Erbil city and the age 18 up to
77 included in this study. Biochemical tests were performed (Adiponectin,
Leptin, Galectin-3). These sample were analysed by using blood serum,
statistically analysis the result.
Results: The post-treatment, pre-treatment, and control in respectively about
(60.52%, 60.46%, and 63.34%) were the majority of the study population
(38-57) age group. There is a statistically significant differences between
case and control groups in residency, family history, and BMI with a P-vale
of (0.08, <0.001, 0.015), respectively. Leptin, adiponectin, and galectin-3
were statistically significant (0.007, <0.01, and <0.01), in respectively.
About cancer characteristic galectin-3 was significant with (ER/PR) receptor
(P:0.037) and grade (P:0.034), also leptin was significant with the ee (P:
0.025).
Conclusion: We concluded that Adiponectin, Leptin, and Galectin-3 were
new potential biochemical marker for diagnosis and prognosis the breast
cancer, would be useful and important marker for assessing and evaluating
grade, and receptor of the therapy plan.

Background: Integrated Management of Neonatal and Child Health
Program (IMNCH) is an approach to offering solid evidence. It is used as
a strategy to draw national and international investment into many
initiatives to improve child health because it is diagnostically superior to
conventional routine practice.
Objective: To assess the knowledge and satisfaction rate among
Integrated Management of Neonatal and Child Health Program care takers.
Patients and Methods: A cross sectional study was conducted in two
sectors (The health care sector in baqubah first and second) that offers
health services in Baquba city from 15th December 2015 to 1st of June
2016. A convenient sample of 150 cases were included in the study from
the age of two month to five years. Data collected by special designed
questionnaire that adopted from world health organization.
Results: The result showed that 87.3 % of health providers prescribed oral
medicine for child out of them 86.3% of service recipient know how many
times day that should be given while 25.2% of them know how many days
that should be given. oral rehydration solution was prescribed 31.3% of
children majority of health takers 87.2% known quantity of water to maxed
with one sachet of ORS Showed that 24.7% of service recipients bring back
the child immediately to primary health care center when the child unable to
drink or breast feed and 23% of service recipients bring back the child
immediately when the child becomes sicker or develop fever or difficult
breathing and 30%when the child breathing is fast or difficult breathing and
18% of service recipient were satisfied about care that provided for children
while 82% of service recipients were not satisfied.
Conclusion: The satisfaction rate of service recipients about the service
that provided in primary heath care center in Baquba city were poo

Background: candida species is one of the most important opportunistic
oral fungal flora that contributed to oral candidal infections. Recently
some studies indicate the association between increased caries incidence
in children with oral candidal carriage.
Objective: To candida species is one of the most important opportunistic
oral fungal flora that contributed to oral candidal infections. Recently
some studies indicate the association between increased caries incidence
in children with oral candidal carriage.
Patients and Methods: Sixty-one children with ages 6 to 12 years ,
DMFT, dmft, and OHI-S were measured and oral swabs were tested on
three different surfaces (lingual, occlusal, and buccal) then cultured on
SDA as a primary medium, and selective medium on CHROMagar, also
germ tube test was done and for more precision, pure colonies were
identified up to species based on their carbohydrate assimilation pattern by
the VITEK 2 compact
Results: 22 (36.1%) children with candida carriage, C.albicans 12, (54%),
C.dubliniensis 4,( 18.18%), C.krusei 4, (18.18%), C. tropicalis 2, ( 9.1%).
There was no association between candidal species in the oral cavity and
caries index (DMFT, dmft).
Conclusion: Non-significant weak negative correlation appeared between
candidal species in the oral cavity and caries index in children. The most
predominant candidal species was C.albicans.

Background: Melasma is one of the most common disorders of brown
hyperpigmentation, which affect primarily the face and later on some other
sites of the body , seen most commonly in women during the reproductive
period and may seen in men . Many options are used in the treatment of
melasma, most commonly: hydroquinone, tretenoin, corticosteroid, azelic
acid, glycolic acid, kojic acid, triaximinic acid, ascorbic acid, intralesional
glutathione, and lastly medical procedures, like: microdermabrasion,
chemical peel, laser and light therapy.
Objective: To evaluate the efficacy and safety of combined therapy
(azelic, glycolic and kojic acids) in the treatment of melasma (UNITONE
and NEOTONE) .
Patients and Methods: A cross-sectional study in which (585) patients
complaining of melasma (577 females and 8 males), their age ranged from
(17-50) years, with a mean age of 46.15± years. Treated by application of
azelic acid (20% cream) for two hours at night, then washed and followed
by topical application of combined cream consisted of (5%) glycolic acid
and (1%) kojic acid throughout the night and washed in the morning, with
application of sun block of ≥50 SPF, and oral ascorbic acid (500mg) tablet
twice in the morning and evening .
Results: Out of 585, 98% was females with a mean age of (46.15±8) years.
Eight percent of the patients of MAIS score-1, (22.05%) of score-2,
(51.28%) of score-3 and (18.8%) of score-4. Regarding the response to
therapy: (44.78%) of patients showed complete clearance of the disease,
(48.85%) with good response, (1.7%) of poor response and (5.47%) showed
relapse of the melasma after discontinuation of the therapy, and they were
retreated by the same combined formula, (93.75%) of them cleared
completely and (6.25%) showed good response. Ninety percent of patients
developed a variable degree of irritation, erythema and burning sensation, at
the beginning of the treatment and after (10-15) days, most of them tolerated
the therapy.
Conclusion: Combined therapy of azelic, glycolic and kojic acids was
effective and safe in the treatment of melasma and this combination was

Background: Overweight and obesity defined as "abnormal or excessive
fat accumulation that presents a risk to health". Obesity is the fifth among
global causes of death. The rise in overweight and obesity among adult
workers is a global public health concern. It's associated with a higher risk
of type 2 diabetes, hypertension, coronary heart disease, stroke, and
cancer, as well as increased healthcare expenditures, reduced job
productivity, and lost of money.
Objective: To assess the prevalence of overweight and obesity and to find
out relation with some risk factors among staff at Technical Institute-
Swaira in Middle Technical University.
Patients and Methods: A descriptive cross-sectional study design carried
out in Technical Institute-Swaira in Middle Technical University. Included
(150) of staff selected. Sampling Technique to selection staff were random
(probability sampling). The data collection by direct interview technique
of researcher with each participant of staff from 5th November 2021 to 4th
July 2022.
Results: The study show socio-demographic characteristics. Regarding to
staff age (31-40) years constituted the majority (38.0%). High percentage of
participants were married (84.7%) and lower percentage were divorced
(1.3%), BMI in the study population the high percentage were (42.0%) of
participants overweight, BMI was highly significantly by practicing exercise
(P= 0.000), significant differences in BMI with regular three meals a day and
eat fast food (P= 0.01), (P= 0.03).
Conclusion: This study found that a large number of participant were
overweight or obese. BMI changes a lot with age. There were big
differences in BMI between participant who worked out regularly and
participant who ate three meals a day or fast food.

Background: Denture induced stomatitis often referred to as denture sore
mouth and prosthetic stomatitis, denotes inflammation of the oral
mucosa, particularly the palatal mucosa that are in close contact with
the denture base.
Objective: To evaluate the prevalence and risk factors of denture induced
stomatitis in complete denture wearers attending Khanzad Teaching
Dental Center.
Patients and Methods: This study included one hundred consecutive
upper denture wearers from prosthetic department in Khanzad Teaching
Dental Center , the age range of the patients was 39-85 years .Different
factors such as age, gender, denture age ,wearing time and hematinic
parameters investigated and recorded .The diagnosis of denture stomatitis
was done by clinical examination .The data entered and analyzes by (SPSS
software version 25).
Results: The prevalence of denture stomatitis was 20%. Non significant
relashionship in the prevalence of denture stomatitis with age, gender,
denture age, wearing time , type of denture and heamtinic deficiency.
Conclusion: Because denture stomatitis is the most prevalent
inflammatory reaction that affects denture wearers and is typically
asymptomatic, it is better to schedule a routine dental check for them to
allow early detection of any abnormalities to treat it and the choice of
treatment depends on the cause of change. in many denture wearers the
removal of traumatic as well as maintaining good oral hygiene and
hygiene of dentures produce positive outcomes