IRAQI JOURNAL OF MEDICAL SCIENCES

The oldest known medicinal plant, Aloe vera, is the ideal dietary supplement because it contains high levels of minerals and vitamins. Because of its antibacterial and antifungal properties, Aloe vera can also be used to restore the micro flora in the digestive tract, clean the liver and spleen, and strengthen the immune system. As a result, Aloe vera, is analgesic, antibacterial, anti-diabetic, and antioxidant characteristics, is utilized widely as a medicinal agent for its therapeutic, immune-regulatory, and neuroprotective effects around the world.
Aloe leaves can be broken down into two basic components: the tasteless, colorless gel that is found inside the leaf and the latex a bitter yellow liquid that is located beneath the leaf's epidermis. The parenchymal tissues of the plant's leaves are separated from the gel or juice, which is a transparent, viscous substance. The second component, yellow sap or latex, is an active cathartic medicinal compound known as aloe that is found in the per cyclic tubule cells. They both contain a range of biologically active substances.
Aloe is a plant that is used commercially to make pills, sprays, ointments, lotions, liquids, beverages, jellies, and creams.
The purpose of this article was to review the available literature and information on the health benefits of Aloe vera and its Products.
Keywords: Aloe Vera, mineral composition, anti-inflammatory, advantages in health, medicinal properties
Citation: Jassim HS. Components of Aloe vera, therapeutic uses and biological effect in the human: A review. Iraqi JMS. 2023; 21(2): 154-160. doi: 10.22578/IJMS.21.2.1

Background: Multiple Sclerosis (MS) also known as demyelinating disease, is a condition in which the insulating coverings of nerve cells in the brain and spinal cord are damaged. This injury impairs the nervous system's ability to transfer messages, resulting in a variety of signs and symptoms, including physical, mental, and psychiatric issues. Double vision, blindness in one eye, muscle weakness, and problems with sensation or coordination are all possible symptoms. MS comes in a variety of ways, with new symptoms appearing in isolated attacks (relapsing forms) or gradually over time (progressive forms), the progressive forms symptoms may go away completely between attacks. The exact cause is unknown.
Objective: To determine trace elements (zinc and copper) and discuss their relation and effect on MS patients.
Methods: The study was performed during the period March 2021 to August 2021, involved 50 samples divided into two groups the first 25 samples from normal individuals (16 males and 9 females) and the second 25 sample of MS patients (12 males and 13 females) collected with help of (Sa'ad Al-Watrai Hospital), (Neuroscience Hospital) in Baghdad City. Samples obtained as serum due to venipuncture considering that patients did not use any treatment during the period of samples collection that may affect analysis results other feature like age, gender and other chronic disease has been recorded in this study.
Results: The patients with progressive MS disease showed significant higher copper level than non-progressive MS patients and control samples, when we compare it with control group p = <0.0001. Also, patients with non-progressive MS disease showed a lower zinc level compared with progressive MS and control samples (p =0.005 and p = 0.001) respectively.
Conclusion: The level of serum copper in progressive MS patients is higher than both healthy people and non-progressive MS patients. Additionally, it showed a lower zinc level in non-progressive than progressive MS patients. Therefore, this study showed a success to compare trace elements level (Zinc and Copper) between progressive and non-progressive MS patients. Also, discriminate between healthy people samples and MS patient’s samples has been found.
Keywords: Multiple Sclerosis, Copper (Cu), Zinc (Zn)
Citation: Jabbar AA, Al-Saeed HH. Estimation of trace elements (zinc and copper) in serum of multiple sclerosis patients in Baghdad city. Iraqi JMS. 2023; 21(2): 161-165. doi: 10.22578/IJMS.21.2.2

There are emerging data shows that different types of malignancies arising from cells called cancer initiating cells, which have self-renewal and tumorgenesity properties. Acquiring these properties make them able to initiate and transmit cancer. These cells are identified in different types of malignancies like stomach, colon, brain, breast and others. This review aims to identify the signaling pathways, which are involved in emerging these cells. Highly impact research papers regarding this subject were collected from trusted data base for analyzing. Analyzing these data identified that Notch, Hedgehog, high mobility group A2 (HMGA2), wingless/Int (Wnt)/B-catenin and epithelial mesenchymal transition (EMT) are the main signaling pathways, which are involved in this process. Targeting these signaling pathways will be a great technique to inhibit the formation of these cells. This will apply clinically as a treatment in different types of cancers and will be of great importance in treatment of cancers resisting chemotherapy.
Keywords Cancer stem cells (CSC), epithelial mesenchymal transition (EMT), chemotherapeutic, notch, hedgehog
Citation Mamoori AM, Farhood IG. Molecular pathways that involved in the regulation of some cancer initiating cells: A review. Iraqi JMS. 2023; 21(2): 166-171. doi: 10.22578/IJMS.21.2.3

Background Obesity is a complex, multifactorial, and largely preventable disease. The current most widely used criteria for classifying obesity is the body mass index (BMI). Surgical treatment for obesity (bariatric surgeries) has been shown to be effective for weight loss. The most performed bariatric surgeries were Roux-en-Y, nowadays; laparoscopic sleeve gastrectomy (LSG). laparoscopic mini gastric bypass (LMGB).
Objective To compare excess weight loss outcomes between LSG and LMGB.
Methods A prospective study; enrolling all patients underwent LSG and LMGB in Al-Imamein Al-Khadimein Medical City and number of private hospitals done by one surgical team during the period from January 1st to December 31st 2019. Patients initial BMI ranges from 45-55 kg/m2. All patients were given a dietary regime after the surgeries. Patients weight records were followed up to one year after their surgeries in 3-, 6-, 9- and 12-months' intervals.
Results Ninety-seven patients had been operated for LSG and LMGB; 50 of them met the inclusion criteria distributed as 25 patients operated for LSG and 25 patients operated for LMGB; 80% were females and 20% were males with mean age of 37.66±9.99 years. Both surgeries were successful in terms of excess body weight loss (EWL); mean EWL for LSG and LMGB (calculated as ideal BMI=24.9 kg/m2) at 3 months post-surgery follow up was 33.80±9.55% (P value 0.0001) with mean body weight 113.70±14.52 kg; 50.31±9.42 (P value 0.0001) at 6 months with mean body weight 102.36±12.83 kg; 62.06±9.75% (P value 0.0001) at 9 months with mean body weight 94.18±10.84 kg and 69.48±9.63 % (P value 0.0001) at 12 months follow up with mean body weight 88.90±9.61 kg. There was no significant difference for excess weight loss outcomes between LSG and LMGB in one year follow up. With Excess body weight loss at 12 months was 68.7% for LSG and 70.3% for LMGB
Conclusion Both LSG and LMGB are effective for excess body weight loss with insignificant difference between their excess weight loss outcome in one-year post surgery follow up.
Keywords Obesity, laparoscopic sleeve gastrectomy, laparoscopic mini gastric bypass, excess body weight loss
Citation Nile AK, Joudah AI, Al-Zubaidi ASM. Comparison of excess weight loss outcomes between laparoscopic sleeve gastrectomy and laparoscopic mini gastric bypass in morbidly obese patients. Iraqi JMS. 2023; 21(2): 172-179. doi: 10.22578/IJMS.21.2.4

Background: Psoriasis is a common chronic cutaneous disease that seriously affects the life quality of patients. Erythema, papules, and scales are the most common clinical presentations. Staphylococcus aureus (S. aureus) is an opportunistic pathogen and commensal bacterium. Infection with S. aureus exacerbates psoriatic lesions in affected people. Staphylococcal enterotoxins (SEs) are often categorized as superantigens, which can excite significant populations of T cells.
Objective: To detect S. aureus enterotoxins' genes (sea, and seg) among patients with psoriasis.
Methods: Skin swab samples from 225 individuals who enrolled in this case-control study were obtained from February 2021 to February 2022. Those individuals were divided into 3 groups; the first group comprised 75 patients with psoriasis as a patient group. The second group comprises 75 individual burn patients suspected to have a bacterial infection as a positive control. The third group comprised 75 individuals (apparently healthy people) as a negative control. The positive control group was recruited from Burns Specialized Hospital in Medical City, the negative control group was recruited from the blood donation center in Al-Imamein Al Kadhimein Medical City, and the patient group also was recruited from the dermatology consulting department.
Results: Out of 225 individuals recruited in this study, there were (112) males while the female was (113) with male to female ratio of (1:1). Females’ age ranged from (7-70 years), while males’ age ranged from (5-52 years). S. aureus isolates were identified in 82 (36.44 %). The results regarding the presence of SEs gene showed that 9 out of 22 isolates of S. aureus obtained from the psoriatic patients’ group, expressed sea while 19 out of 22 isolates expressed seg.
Conclusion: The most common enterotoxin distributed in S. aureus isolates of all study groups were seg, which seems to be the most enterotoxin that detect in patients with psoriasis.
Keywords: Psoriasis, S. aureus, Staphylococcal enterotoxins, Sea gene, Seg gene
Citation: Umayra AN, Hassan JS, Mohsen HN. Detection of Staphylococcus aureus enterotoxins' genes (Sea and Seg) in a sample of Iraqi patients with psoriasis. Iraqi JMS. 2023; 21(2): 180-188. doi: 10.22578/IJMS.21.2.5

Papers on the familial lipid disorder, dysbetalipoproteinemia (FD), appeared in early seventies of the last century describing the combined elevation in total cholesterol (TC) and triglycerides (TG) in the blood of affected individuals, which is associated with mutations in the apo-lipoprotein E (Apo E) gene. Different methods and measurements for diagnosis and consequent treatment of these cases had been suggested. Stress was put on the E2/E2 homozygotes, Apo B and non-high density lipoprotein cholesterol as the main obvious manifestations of the disease, with a big variation in the results among different workers. This short review will present most of these variations in nature, diagnosis and management of FD, with a reference to a recent Iraqi work on this subject.
Keywords: Dysbetalipoproteinemia, mixed hyperlipidemia, Apo E, Apo B, non-HDL cholesterol, lipid lowering drugs
Citation: Al-Shamma GAA. Familial dysbetalipoproteinemia, diagnosis and management: A short review. Iraqi JMS. 2023; 21(2): 189-192. doi: 10.22578/IJMS.21.2.6

Background: John Cunningham virus (JCV) is among important Polyomaviridae family, which is involved in PML and nephropathy among renal transplant recipients (RTR), and they become reactivate in immunodeficient situations.
Objective: To find out the seroprevalence rate of JC polyomavirus among (RTR) and healthy persons.
Methods: A case-control study to detect the presence of JCV IgG antibody in serum samples collected from a total of 400 samples were taken from (200) healthy blood donors as control individuals and (200) RTR age and sex-matched, at the period between February 2021 to March 2022. New experimental indirect enzyme linked immunosorbent assay kit had been designed and manufactured manually for detection Anti-JCV IgG in both RTR group and control group.
Results: The results revealed 36 out of 200 (18%) cases of RTR have IgG, while in the control group only 24 out of 200 (12%) were positive for this antibody, no statistically significant difference was noticed between the study groups. However, there was significantly higher mean serum IgG titer in RTR patients as compared to control group (p= 0.016).
Conclusion: Seroprevalence of JCV is relatively lower among Iraqi subjects as compared to other countries both RTR and healthy controls, but the IgG titer is increasing during immunosuppression suggesting possible reactivation of the virus among RTR.
Keywords: Seroproprevalance, JCV, Kidney transplant recipients, IgG
Citation: Hussein RK, Al-Obaidi AB, Hussein MR. Prevalence of Anti JC Polyomavirus IgG in A sample of Iraqi kidney transplant recipients and healthy blood donors. Iraqi JMS. 2023; 21(2): 193-199. doi: 10.22578/IJMS.21.2.7

Background: Acute gastroenteritis (AGE) is the main cause of infants and children's health problems, in developing countries, high morbidity and mortality rates were reported, Human Bocavirus (HBoV) are enteric viruses that linked to cause AGE.
Objective: To estimate the prevalence of HBoV infection in children under five years with AGE and to determine its genotypes by using conventional polymerase chain reaction and Sanger sequence.
Methods: This is a case-control study, the sample was collected from 100 children under 5 years of age suffering from AGE (as case group) and from 100 asymptomatic control children (as control group) from Central Teaching Hospital of Pediatrics from December 2021 to April 2022. Each children’s stool sample taken was stored at -20°C until they were employed in a conventional polymerase chain reaction to identify the HBoV genotypes.
Results: The rate of HBoV infection was found in 10% in AGE case group, while none of control group showed positive result. The genetic analysis showed that six of the investigated samples belonging to the HBoV-2 while four of the investigated samples belonging to the HBoV-3. In HBoV infected children, the age range (1-13 months) had most positive cases 5 (50%) and males had a greater infection rate (80%) than females (20%), however, non-significant association was found in regard to age and sex (P>0.05).
Conclusion: A low rate of HBoV DNA was detected in children under five years with AGE suggesting that other pathogen may responsible for infection.
Keywords: Human Bocavirus, acute gastroenteritis, children, risk factors, sequencing, phylogenetic tree.
Citation: Mohammad MY, Al-Shuwaikh AM, Al-Hamdani HTH. Evaluation of Human Bocavirus (HBoV) as a cause of acute gastroenteritis in children under 5 years: A case-control study. Iraqi JMS. 2023; 21(2): 200-207. doi: 10.22578/IJMS.21.2.8

Background: Acne vulgaris is a chronic skin disease caused by many factors includes: hormonal disturbance, increase sebum production and inflammatory skin due to multi-drug resistant (MDR) bacteria Staphylococcus aureus (S. aureus). So, there is an urgent need for bacteriophages (Elixir of life) as an alternative strategy to reduce the overuse of antibiotics and combat MDR bacterial pathogens.
Objective: To develop a bacteriophage cocktail specific for MDR S. aureus bacteria and investigates its efficacy via in vitro validation tests and in vivo topical applied on human skin acne lesions caused by MDR bacterial infections.
Methods: Twenty-three bacteriological isolates of S. aureus were collected from patients at 20-40 years old with acne lesions that admitted to Al-Yarmouk Teaching Hospital, Baghdad, Iraq. Then, identified and susceptibility tests performed via VITEK2 system. Bacteriophages were isolated from sewage water, then bacteriophages cocktail prepared and determined their lytic activity via in vitro validation tests and investigate their clinical efficacy on the skin of human with acne lesions caused by MDR S. aureus bacteria.
Results: The bacteriophage cocktail therapy with high antibacterial lytic activity via in vitro validation tests proved excellent effectiveness in treating patients from MDR S. aureus acne vulgaris via clinical improvement in size, number, inflammatory signs of acne lesions, and decolonization of MDR S. aureus bacteria in treated lesions as compared with untreated, control lesions.
Conclusion: Bacteriophage cocktail specific for S. aureus bacteria can be prepared in laboratory with simple measures, and safe without any side effect on human patients whom topically applied it.
Keywords: Bacteriophage, cocktail, MDR, S. aureus bacteria, clinical investigate
Citation: Hussain HE, Abdulamir AS, Farhood IG, Abu Raghif AR, Ali MR. Clinical investigation of the bacteriophage cocktail efficacy on acne vulgaris caused by multi-drug resistance Staphylococcus aureus. Iraqi JMS. 2023; 21(2): 208-223. doi: 10.22578/IJMS.21.2.9

Background: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease. Studies evaluating both peripheral and central nervous system involvement in patients with COPD at the same time are rare. Transcranial magnetic stimulation (TMS) assesses excitability of the motor cortex and corticospinal pathway function. Diaphragmatic contractile function had been assessed by cortical and cervical magnetic stimulation of the phrenic nerve roots in COPD patients.
Objective: To investigate electrophysiologically central nervous system involvement in COPD as compared to healthy controls, to study the central neural derive of the diaphragm by assessing TMS-MEP parameters of the phrenic nerve in patients with COPD and compare these with healthy controls.
Methods: The present study is a case control study was conducted in Al-Imamein Al-Kadhimein Medical City, from November 2019 to October 2021 included 40 COPD patients and 40 healthy volunteers who were subjected to blood gas and biochemical analysis and pulmonary function test before commencement of neurophysiological analysis.
Results: Statistically significant prolongation of the cortical motor latencies as well as peripheral motor conduction times of both phrenic nerves in COPD patients compared to control subjects (p<0.001). The means of the central motor conduction times in the both phrenic nerves were higher in COPD patients compared to controls, yet, the difference was only significant in the right phrenic nerve. There was statistically significant increase in the means of the motor threshold of both phrenic nerve in some patients with COPD in comparison with control group. The phrenic nerve cortical latencies showed the most sensitive and specific parameters to study the involvement of nervous system in COPD, while the peripheral motor conduction time was the second most sensitive and specific parameter. No correlations observed between body mass index, SpO2 with phrenic nerves TMS parameters.
Conclusion: The central neuropathy is one of the complications in COPD patients. Motor threshold of phrenic nerves was significantly higher in COPD patients reflecting significant decrease in excitability of motor cortex affecting excitatory contact with subcortical neurons. Results of the cortical and radicular MEP latencies of both phrenic nerves were of high sensitivity and specificity in diagnosing nervous system involvement in COPD.
Keywords: Chronic obstructive pulmonary disease, phrenic nerve, TMS
Citation: Kareem JM, Al-Hashimi AF, Al-Kadhimi HM. Central nervous system involvement in chronic obstructive pulmonary disease. Iraqi JMS. 2023; 21(2): 224-236. doi: 10.22578/IJMS.21.2.10

Background: Coronavirus disease 2019 (COVID-19), an epidemic illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), affecting the lower respiratory tract. It may impact renal and hepatic function by causing a cytokine storm and inflammation. Although numerous studies on the effects of COVID-19 on people with diabetes Mellitus (DM) have been conducted across the globe, their conclusions have varied due to differences in study populations' demographics, racial and ethnic composition, and geographic locations.
Objective: To comprehend the effects of a severe COVID-19 infection on renal and hepatic function in patients with diabetes mellitus.
Methods: This study was carried out at the Chemistry and Biochemistry Department of Al-Nahrain University in Baghdad, Iraq. A total of 100 participants with a severe case of COVID-19 were included in the study between February and April 2022. There was a total of 100 hospital admissions due to COVID-19; 50 of these patients had diabetes, while the other 50 did not. In both groups, serum urea, creatinine, glutamic-oxaloacetic ‎transaminase (GOT) and glutamic-pyruvic ‎transaminase (GPT) were mustered using ‎appropriate methods.‎
Results: The median concentration of the DM patients’ group had significantly lower concentration of urea, creatinine, GOT and GPT than non-DM patient’s group. While all these parameters were significantly higher in COVID-19 patients than in controls.
Conclusion: Diabetes (COVID-19 patients) exhibited lower levels of biochemical markers as compared to non-diabetic people. Patients with diabetes in COVID-19 take a range of drugs, including insulin injections. In severe circumstances, this medicine may disrupt biochemical markers in addition to the effects it has on renal and hepatic function from COVID-19.
Keywords: COVID-19, diabetes Mellitus, urea, creatinine, GOT, and GPT.
Citation: Yones MS, Alwasiti EA, Al-Qaseer AA, Nile AK. The Impact of severe COVID-19 infection on renal and liver markers (urea, creatinine, GOT, GPT) in diabetic patients. Iraqi JMS. 2023; 21(2): 237-244. doi: 10.22578/IJMS.21.2.11

“Vitamin D” the ‘‘sunshine’’ vitamin is a hot topic that attracted ample attention over the past decades, specially that a considerable proportion of the worldwide population are deficient in this essential nutrient. By encouraging the absorption and metabolism of calcium and phosphate, vitamin D is an essential prohormone for maintaining the health of bones and muscles. A sizeable amount of the body\'s vitamin D requirements are synthesized by the human body using ultraviolet B (UVB) radiation from sunshine in addition to dietary sources such fatty fish, eggs, fortified milk, and cod liver oil. Vitamin D is available in two different forms: D2 and D3 (cholecalciferol). Vitamin D2 is a synthetic version that is frequently found in fortified foods and is sourced from plants, but vitamin D3 is synthesized by the skin after exposure to sunlight and may be obtained from animal sources. The main function of vitamin D is thought to be the body\'s absorption of calcium from the gut, which is essential for skeletal health (bone mineralization, remodeling, and maintenance). But hypovitaminosis D, also known as a vitamin D deficiency, can have an impact on the bones, muscles, brain, heart, and immune system, among other components of the body. As a result, the shortage causes serious illnesses like cancer, diabetes, autoimmune diseases, infections, rickets (in children), osteopenia, osteoporosis, hypertension, fractures and falls in adults, and neurological abnormalities. A complete understanding of vitamin D sources, serum vitamin D levels, and deficient symptoms, connected to various clinical diseases, requirement and maintenance in the body, length of sun exposure, and effective treatment dose, is an effective strategy for deficiency prevention. The importance of Vitamin D, the causes of its shortage, and the sources accessible will therefore be highlighted in the current review.
Keywords: Vitamin D, synthesis, levels and functions, sources, deficiency
Citation: Abass HA, Omran ZS. Vitamin D in health and disease: A literature review. Iraqi JMS. 2023; 21(2): 245-253. doi: 10.22578/IJMS.21.2.12

Background: A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is disrupted. Spasticity is a state, in which, there is an increase in muscle tone or stiffness, which might be associated with movement and speech disorders. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement. The H-reflex is a compound electromyographic (EMG) response composed of group Ia (and large group II) afferents from muscle spindles (and Golgi tendon organs) that project monosynaptically (and to a lesser extent di- and tri-synaptically) to spinal efferent α-motoneurons (αMN), which in turn activate the muscle after an electrical current is applied to the nerve.
Objective: To assess the Medical Research Council (MRC) scale in post stroke spasticity patients and to estimate the neurophysiological changes in those patients regarding H-reflex and Hmax/Mmax ratio.
Methods: A randomized clinical trial involves 50 patients with stroke of both sexes. Their age ranged from (30-60 years old) suffering from upper and lower limb spasticity. They were assessed by the MRC scale to determine the grade of power of muscle. The neurophysiological test is done by using the H-reflex for both upper and lower limbs (flexor carpi radialis and soleus muscles, respectively). The maximum amplitude was measured from the peak of the first positive deflection to the peak of the negative one. The latency and the Hmax/Mmax ratio were also measured.
Results: The result of this study showed a significant decrease in MRC in spastic patients (P value ≤0.001). H-reflex latency in lower limbs was significantly decreased from (30.3±2.4 ms) in the normal population to (18.5±1.3) in the spastic patient. The H reflex amplitude in the lower limb was significantly increased in post stroke spasticity patients (P value ≤0.05). In the upper limbs H-reflex latency in flexor carpi radialis was also significantly decreased. Regarding H reflex amplitude of the upper limb in the spastic patient was significantly increased. There is a noticeable increase in the H/M ratio in post stroke spasticity patient which was (0.51±0.92) with a significant P value of 0.005.
Conclusion: Patient with post stroke spasticity had decreased in MRC scale, while H-reflex has decreased in latency and increased in amplitude, as well as decreases in Hmax/Mmax Ratio in both upper and lower limbs.
Keywords: Post stroke spasticity, H-reflex latency, H-reflex amplitude, H/M ratio, MRC scale.
Citation: Fawzi SM, Hamdan FB, Al-Gawwam GA, Jaafar IF. Neurophysiological changes in post stroke spasticity patients. Iraqi JMS. 2023; 21(2): 254-259. doi: 10.22578/IJMS.21.2.13

Polycystic ovary syndrome (PCOS) is one of the most common healthy problems that frequently affects women during her reproductive life. It is a prevalent endocrinopathy that affects 6-10% of women in reproductive age. The pathophysiology of the condition is complex it caused by a hormonal imbalance and it is considered as a complex illness resulting from the combinations of intrauterine, hereditary, hormonal, and environmental variables. PCOS increases the chance of women to have type 2 diabetes, dyslipidemia, and systemic arterial hypertension. They also have a higher accidental of having a heart disease during menopause.
Keywords: Polycystic ovary syndrome (PCOS), pathogenesis, clinical manifestations
Citation: Farhood RG, Alshimerry AF. The role of hormonal and genetic factors in the pathogenesis of polycystic ovary syndrome: A review. Iraqi JMS. 2023; 21(2): 260-268. doi: 10.22578/IJMS.21.2.14

Background: The pre-sarcopenia is a preclinical state of sarcopenia; which was identified as an age associated muscle disease detected by low muscle mass only and normal muscle function. It can predict the subsequent functional decline.
Objective: To estimate the prevalence of presarcopenia in Iraqi sample aged ≥60 years old and determines some socio-demographic factors that may be related.
Methods: A descriptive cross-sectional community dwelling study. The data obtained from a questionnaire (socio-demographic and behavioral data) in addition to anthropometry and muscle strength measurements. The muscle mass was estimated by anthropometry equation and cutoff points were derived from The European Working Group on Sarcopenia in Older People 2019.
Results: The result revealed that near quarter of the sample was pre-sarcopenia; 38.3% male and 8.2% female. It was significantly associated with male, single, retirement, smokers, alcoholic, diabetic and normal body mass index elderly, it negatively related to age and fall history and positively with schooling and physically activate.
Conclusion: Pre-sarcopenia, which is an age associated condition was presented as a considerable prevalence among a sample of older age participants from Baghdad and association with all independent variables.
Keywords: Fragile, old age, disability
Citation: Al-Taglubee IM, Al-Saffar AJ. Estimation of pre-sarcopenia among a sample aged 60 years and older from BaghdadIraq. Iraqi JMS. 2023; 21(2): 269-277. doi: 10.22578/IJMS.21.2.15

Background: Ultrasonography of the pelvic floor, either by the trans-perineal or the endo-vaginal/introital approach, has been effectively utilized in the diagnostic workup of urinary incontinence. Anterior and posterior urethral angles, funneling of bladder neck, urethral hypermobility and bladder base position can be evaluated using pelvic floor ultrasonograph.
Objective: To assess the impact of variability of ultrasound technique (transvaginal ultrasound; TVS, and transperineal; TPUS) on the measurement of the resting urethral angles in a sample of continent Iraqi women.
Methods: This study included 100 healthy continent adult females, The numerical values of the urethral angles were obtained by both TVS and TPUS techniques in a sample of women attending Ultrasound Unit in Al-Imamein Al-kadhimein Medical City during 2017.
Results: The α angle mean of studied women measured by TVS was 91.92 while that measured by TPUS was 78.67 with highly significant difference between both techniques (p<0.001). Conversely, the ẞ angle mean of studied women measured by TVS was 102.25 while that measured by TPUS was 112.08 with highly significant difference between both techniques (p<0.001). As a result, the α angle was higher among continent women by TVS and ẞ angle was higher among continent women by TPUS. Although no significant difference, the average α angle increased with increased age of continent women while average ß angel was decreased with increased age of continent women. The average α angle of continent women was significantly increased among obese multiparous women at age group <40 years age (p=0.007). The average B angle of continent women was significantly increased among obese multiparous women at age group <40 years age (p<0.001).
Conclusion: The ultrasound approach whether TVS or TPUS have an essential impact on the measured numerical value of different urethral angles, and the women age, parity and body habitus individually and in combination affect the measurement of the urethral angles.
Keywords: Transvaginal ultrasound, transperineal ultrasound, resting urethral angle, continent women
Citation: Farhan RM, Fakher TS, Hummadi NA, Al-Saadi WI. Transvaginal and perineal ultrasonography in measurement of resting urethral angles in a cohort of continent Iraqi women. Iraqi JMS. 2023; 21(2): 278-286. doi: 10.22578/IJMS.21.2.16