IRAQI JOURNAL OF COMMUNITY MEDICINE

Back ground: Antenatal care includes education, counseling, screening and treatment to monitor and promote the well-being of the mother and fetus. Objectives: To assess the antenatal knowledge and learning needs of pregnant women attending the Primary Health Care Centers in Baghdad. Methodology: A descriptive cross-sectional study with analytic elements was conducted in the period from the first of March to the end of May 2018. A convenient sample was collected from ten primary health care centers from Al-Karkh and Al-Rusafa sides of Baghdad, the data were collected by direct interview using predesigned and structured questionnaire format. Results: A sample of (500) pregnant women were interviewed during the study period. Their age range (14-43) years with a mean of (26.6±6.2) years. The average age at marriage was (20.9±4.6) years and average age at first baby was (21.7±4.8) years, (30.4%) were primigravida ,(46.2%) had primary education and (80%) of them were not working. More than half of them were (51.4%) in the second trimester of pregnancy and (76.8%) attended for a follow-up visit. The overall mean of the knowledge score was very low (16.7±3.3), (75.8%) had poor knowledge, (23.2%) had acceptable level, and only (1%) had good knowledge. The result of the study revealed a significant association between level of knowledge and antenatal care score (p=0.0001). Conclusion: The study showed that most of the participants were young age (less than 20 years) with limited education. Most of them had poor knowledge about antenatal care, especially regarding the importance of early booking, investigation carried out during ANC visit and danger signs during pregnancy.

Background: Adolescent pregnancy is considered as one of the most important social and public health problems all over the world. Early marriage is the contributing factors to high maternal morbidity and mortality. Aim of the study: To evaluate the complications of teenage pregnancies in comparison with adult pregnancy. Methodology: A comparative cross sectional study was carried out during the period from February through June 2018. A convenient sample was collected from the consultation clinics of obstetrics and gynecology in ALYarmouk Teaching Hospital and AL-Kadhimiya Teaching Hospital in Baghdad city. The study group composed of 200 pregnant teenagers in the third trimester aged between 15-19 years and the comparable group composed of 200 pregnant women in the third trimester aged between 20-29 years. The data were collected by direct interview using a well-constructed questionnaire, the questionnaire focused on the sociodemographic characteristics, history of present pregnancy, history of using family planning methods, and complications during current pregnancy. Result:The educational level of teenage pregnant women was primary level 62.5%. The study found that 48.5% of teenage group had adequate antenatal care visit as compared to high percentage of adequate antenatal care visit (81.0%) of adult group. Higher rate of pregnancy complications among teenage pregnant women in comparison with adult pregnant women including anemia, urinary tract infection, gestational hypertension, and gestational diabetes. Conclusion:The study concludes that there was a higher rate of maternal complications among the teenage pregnant women, which represent an important health problem with social and medical impact.

Back ground:There is a problem of increasing overweight and obesity all over the world ,Iraq is suffering from this problem also. Weight regain after weight reduction is emerging as additional problem to obesity and over weight. Aim: to study the effect of Intensive Physical Exercise adding to very low calorie diet on weight loss maintenance after an initial very low calorie diet program in obese women. Method:An intervention study applied to 84 women attending the Obesity Research and Therapy Unit in ALKindy Hospital, Baghdad, Iraq, who achieved weight loss after a very low calorie deit program for 12 weeks. Then those women were divided blindly into intervention group (walking exercise + very low calorie deit) and control group on very low calorei deit only for another 12weeks. Result: Very low calorie diet is highly effective in weight reduction. The mean weight loss after 12week of very low calorie deit was 7.6 1.3 kg. Demographic factors and family history didn’t show any significant effect on weight loss. The regain of weight in treatment group was less than that of control group. Intensive Physical Exercise was associated with less weight gain among obese women on very low calorei deit. Conclusion:Intensive physical exercise with very low calorie diet associated with less weight regain

Background: Pre labour rupture of membranes (PROM) is one of the most common complications of pregnancy that has a major impact on pregnancy outcome. The assessment of women with possible membrane rupture is management issue faced in every day practice. Objective: To evaluate the diagnostic power of the vaginal fluid prolactin concentration in pre labour rupture of membranes. Patients and Methods: A total of 100 pregnant women were recruited in this study. The PROM group consisted of 50 pregnant women between 24 and 41 weeks gestation with confirmed PROM by amniotic fluid pooling and Nitrazine paper test. A control group consisted of 50 pregnant women with similar gestational age without any complaint or complication. All patients underwent speculum examination for amniotic fluid pooling, Nitrazine paper test, vaginal fluid sampling was done then presence of prolactin in this fluid was measured by ELISA. Follow up of pregnancy outcome to detect gestational age at birth and time interval between sampling and delivery then statistical analysis of data has been performed to determine the reliability of vaginal fluid prolactin in diagnosis of pre labour rupture of membrane. Results: Vaginal fluid prolactin were significantly different between the two groups (P < 0.001) being higher in the PROM group than the control group. Conclusion: Prolactin in cervico-vaginal fluid may be helpful in the diagnosis of pre labour rupture of membranes

Back ground: The carrier is a state which follow either symptomatic or asymptomatic salmonella infection. It may be temporary or chronic. Salmonella spp. can be detected by stool or urine cultures and serologic techniques. Aim of study: Bacteriological study (isolation and identification) of stool and urine among food handler in Ramadi city. Materials and Methods: One hundred (100 ) apparently healthy food handlers with no significant past medical history; 75 were restaurant and cafeteria workers while 25 persons were house wives. From each individual two specimens(stool, urine) were taken and inoculated immediately in selenite broth, incubated for 18 hours at 37oc and then sub-cultured on MacConky agar, Salmonella-Shigella agar, Xylose-Lysine Deoxycholate agar, and Bismoth sulfite agar plates and they were incubated for 24 to 48 hours at 370 C, a suspected salmonella spp. Colonies were identified according it's specialized methods. Results: The age of the studied individuals ranges from 16-52 years with mean age (27 + 8) years . Both urine and stool culture , all of them were negative for salmonella spp. Three specimens (( 3%)) of urine showed growth of E. coli while seven stool specimen were showing positive culture for other than salmonella organisms, E. coli showing 45% , Proteus spp. 30% , Citrobacter freundii 15% and Klebsiella spp . 10%. Conclusion: In this study all samples whether stool or urine were negative for salmonella species. So studied food handlers individuals were not carriers for salmonella in Ramadi city .

Background: In heart failure (HF), myocardial dysfunction increase neurohormonal activity leading to progression of cardiac remodeling and worsening of clinical manifestations of HF. Ivabradine (IVA), selectively inhibits the funny current of the sinoatrial node and slow heart rate. Objectives: The aim of this study was to investigate the effects of ivabradine on biomarkers of cardiac remodeling in rat model of induced HF. Materials and Methods: Thirty rats were divided into five groups. Control, ivabradine (IVA), isoproterenol (ISO), ivabradine + isoproterenol (IVA-IHF) and digoxin+ isoproterenol (DIG-IHF) groups. HF was induced by administration of isoproterenol SC at 5mg/kg/day to all groups except control and co-administered with either ivabradine or digoxin in IVA-IHF and DIG-IHF groups respectively for fourteen days. Ivabradine was given orally to rats in IVA and IVA-IHF group at 10mg/kg/day whereas digoxin was given orally at 250g/day to rats in DIG-IHF group for two weeks. Heart rate (HR) and blood pressure (BP) were recorded before and after drugs administration. Blood samples were taken for assessing NT-Pro BNP and MMP-9 levels. The rats were sacrificed and heart was taken for histopathology examination. Results: The mean serum level of NT-Pro BNP and MMP-9 and HR were reduced significantly after ivabradine administration to IVAIHF group compared to ISO group. BP was non-significantly changed after ivabradine administration to IVA-IHF compared to ISO group. Histopathological findings demonstrated a significant amelioration of myocardial damage in IVA-IHF group. Conclusion: Ivabradine use was associated with decreased levels of cardiac biomarker, improved cardiac dysfunction and adverse remodeling in isoproterenol induced heart failure in rats.