IRAQI JOURNAL OF COMMUNITY MEDICINE

Background and objectives: Nutritional assessment in elderly diabetic patients to detect malnutrition is essential and
integral part in diabetes management and to avoid adverse nutrition-related outcomes, which is a potential cause or an
aggravation of morbidity and mortality. The aim of this study was to identify the prevalence of malnutrition and find
out factors associated with malnutrition, in elderly diabetic patients.
Methods: A case-control study was carried out between April 2015 and April 2016. A sample of 200 cases diagnosed and
registered at Shahid Layla Qasim diabetic center in Erbil city was selected. The cases were compared with 200
controls free from diabetes and matched in age (± 3 years), and gender. The controls were collected from the patients
admitted to surgical wards in Rizgary and Erbil Teaching Hospitals. The patients were directly interviewed using Mini
Nutritional Assessment-Short Form.
Results: The prevalence of malnutrition in elderly diabetic and non-diabetic patients was 12% and 1%, respectively
(P<0.001). Majority of diabetic patients (85.5%) were uncontrolled; with a higher malnutrition rate in uncontrolled
diabetics (12.9%). The prevalence of malnutrition was significantly increased with increasing age (P=0.015),
increasing the duration of diabetes (P<0.001) and type of treatment (P=0.047).
Conclusion: Elderly diabetic patients were more susceptible to malnutrition than non-diabetic patients. The prevalence of
malnutrition in uncontrolled diabetics was nearly two times higher than in controlled diabetic patients. There is a need
for regular screening nutritional status of elderly diabetic patients through a regular health education program.

Background: cesarean section: is a life-saving surgical procedure when certain complications arise during
pregnancy and labor. However, it is a major surgery and is associated with immediate maternal and
perinatal risks and may have implications for future pregnancies as well as long term effects.
Objectives: To estimates the rate of cesarean sections in Al-Yarmouk Teaching Hospital in Baghdad and to
describe the type, pattern and indications of cesarean sections during the study period.
Subjects and method: Cross sectional study was conducted among women admitted to Al-Yarmouk Teaching
Hospital and delivered by cesarean section (CS) for various reasons, during the period from 1st of
April to end 30th of June 2014.
Results: The rate of cesarean section during the study period was 47.1%.Of these procedures 65.9% were elective
and 44.6% were primary sections. The main indications for cesarean section were: previous
cesarean section 33.3%, malpresentation 11.5%and hypertensive disorder of pregnancy 8.6%.
Among the emergency cesarean, labour dystocia was responsible for 24.5% of these operations.
Conclusion: The rate of CS reported in this study was very high in comparison with optimal rate for cesarean
section stated by WHO .Therefore every efforts should be taken to reduce such high ratewithout a
negative impact on maternal and fetal wellbeing and safety.

Background: The metabolic syndrome (MS) is a cluster of metabolic abnormalities that occur together in an individual more
often than might be expected by chance.
Aim of the study: The aim of this study is to identify the frequency of metabolic syndrome among patients with type 2
diabetes .
Methodology: This cross-sectional study was conducted at Baghdad Medical city (Medical consultation department, and
Teaching Laboratories), 100 Sample(males: 41; females: 59) 66 patients (66%) diagnosed as having metabolic syndrome,
while the remaining 34 patients (34%) did not have metabolic syndrome were included in the study. In order to measure
Fasting serum glucose, Lipid profile (Triglyceride, HDL), blood Pressure and waist Circumference. When the disease was
compared between patients with metabolic and non-metabolic syndrome, a highly significant (P value < 0.001) was observed
in the clinical and biochemical data of patients with metabolic and non-metabolic syndrome in ( glucose, Triglyceride, blood
Pressure and waist Circumference), but a non-significant change in HDL levels, and significant increase(P value < 0.01) was
observed in the characteristics of type 2 diabetic patients with metabolic syndrome (age, sex, Duration and family history) .
Conclusion : Metabolic syndrome frequency is high (66%) among type 2 diabetic patients

Background: A high-risk pregnancy refers to anything that puts the mother, fetus, or neonate at increased risk for morbidity
or mortality during pregnancy or childbirth also the prevalence of high-risk pregnancies is still high in the developing
countries
Objectives: to find the prevalence of high risk pregnancy in pregnant women who attended the primary health care centers in
Baghdad/ Al- Karkh district, and to assess some risk factors.
Patients and Methods: The study period was 5 months, with a total sample of 614 women, from 6 out of the total 20 Family
Medicine Primary Health Care Centers. The questionnaire was adopted from WHO antenatal care guidelines
background and approach, and high risk pregnancy score to calculate the risk.
Results: The prevalence of high risk scores was 19.4%, and 2.6% severe risk. There was a statistically significant
association between BMI, antenatal visit ≥20 wks, anaemia, hypertension due to pregnancy and gestational diabetes
and educational level with risk scores categories, as there were 30 (27.0%) patients with high risk and BMI >25 kg/m2
.
Conclusion: From every 5 pregnancies there is 1 pregnant women with high risk.

Background: Insulin and apelin appears to play a range of roles in β-cell growth and insulin secretion and most importantly
interaction with other hormonal mediators and regulators of energy and metabolism.
Objective: The goal of this study was to evaluate the role of serum apelin in obese patients having type 2 diabetes mellitus
compared to non-obese diabetic patients and the control group and evaluation of their association with duration of
diabetes.
Patients and Methods: This study encompassed 45 diabetic patients (23 obese and 22 non-obese) and they were compared
with 22 healthy subjects as control group. All individuals were referred to the Medical city Hospital/ Baghdad during
the period from November 2017 through May 2018. All participants experienced anthropometric, biochemical, and
clinical examinations.
Results: There was a significant increase (P=0.0001) in serum lipid profiles except high density lipoprotein cholesterol. Also,
there was a significant increase in body mass index, fasting serum glucose, serum insulin, homeostasis model
assessment for insulin resistance, and serum apelin in diabetic group as compared to the controls. While, there was a
significant decrease (P=0.0001) in fasting serum glucose to insulin ratio and quantitative insulin-sensitivity check
index in diabetic group as compared to the controls. There was a significant increase in fasting serum glucose to
insulin ratio in diabetic patients with duration greater than 2 years as compared to diabetic patients with duration less
than 2 years.
Conclusions: The significant alterations in serum apelin levels in diabetic patients as compared to the controls were
suggested a possible role of these adipokines with the presence of obesity and insulin resistance

Background: Hepatitis G virus (HGV) is an enveloped RNA positive-stranded flavivirus. HGV is transmitted mainly by
parenteral route; therefore patients on maintenance hemodialysis and multiple blood recipients are at risk for infection.
Objectives: The present study was designed to explore the HGV infection rate among certain high risk population including
hemodialysis and thalassemia patients plus healthcare workers in Diyala province.
Materials and methods: This cross-sectional serological study was conducted in Diyala province for the period from August
2017 to May 2018. A general questionnaire form was pre-constructed for this purpose including information regarding
socio-demographic and risk factors. A total of 203 subjects were enrolled. Blood samples were collected from 59
hemodialysis patients, 54 patients with thalassemia, 30 healthcare workers, and 60 apparently healthy blood donors.
Seventy three (35.96%) were females with a mean age ± SD 27.17 ± 14.23 years and 130 (64.03%) were males with a
mean age ± SD 32.72 ± 15.74 years. All serum samples were pretested for hepatitis B surface antigen (ADVANCED
/China), anti-hepatitis B core total Abs (FORTREFF-UK), anti-hepatitis C Ab (ADVANCED /China) and anti- human
immunodeficiency virus Abs (ADVANCED /China), beside the anti-hepatitis G virus IgG Ab (Sunlong-Biotech/China)
using ELISA techniques. Statistical analysis was conducted using Chi-square test and the confidence interval of 95%
(CI = 0.95) was considered to estimate significant results. Data were recorded and analyzed using SPSS software
Version 16.
Results: The results revealed that none of the healthy controls was positive for anti-HGV IgG. Whereas, 12 hemodialysis
patients were positive for anti-HGV IgG (20.3%, Odd ratio 31.84), with a statistically significant difference (P= 0.001),
and the ratio of HCV/HGV co-infection among hemodialysis was 7.69%. Whereas in thalassemia patients, 8 (14.8%,
Odd ratio 22.12) patients were positive for anti-HGV IgG, with a statistically significant difference (P= 0.004). All the
healthy controls were negative for hepatitis B , hepatitis C, and human immunodeficiency viral markers, while 2
(3.70%) of the healthcare workers were positive for hepatitis B markers, but all negative for hepatitis C and human
immunodeficiency markers. The rate of HCV/HGV co-infection was 14.28%. Only one healthcare worker was positive
for anti-HGV IgG (3.3%, odd ratio 6.15) with a statistically insignificant difference (P= 0.33).
Conclusion: The hepatitis G virus infection among blood donors and healthy individuals in Diyala province was very low,
but it was significantly higher among hemodialysis and thalassemia patients. Routine screening of hepatitis G virus
infection of these risky groups is recommended.
Keywords: Hepatitis G virus, Hemodialysis, Thalassemia, Diyala.

B virus C (GBV-C) or hepatitis G virus
(HGV) is an enveloped RNA positivestranded flavivirus that is transmitted by
infected blood and blood products [1]
. There is a
geographic difference in distribution of hepatitis G
virus (HGV) in the world [2]
. Data from review
study covering different countries reported that 3.3-
15.9% of voluntary blood donors were positive for
anti-HGV Abs, and 0.5-7.4% were positive for
HGV-RNA [3]
. Among healthy Saudi blood donors,
the prevalence of HGV RNA was 1%-2%, while
the rate of anti-HGV Abs was 4.3%, recommending
HGV screening for blood donors [4]
. In Iranian
healthy blood donors, the rates of anti-HGV E2 Abs
were variable among different studies [5,6]. The rate
of HGV infection in healthy Kuwaiti and Jordanian
blood donors was 24.6 and 9.8%, respectively [7]
.
Certainly, the rate of detection of HGV infection is
largel affected by the laboratory techniques used.
For instance among Tunisian blood donors, the
HGV RNA was found in 5.3% while HGV
antibodies were found in 4.9% [8]. Similar results
were reported by other studies [9,10]
.
In a worldwide review study revealed that the
rate of HGV-RNA detection among DH patients
was in a range of 3.5-54.4 %, and the rate of antiHGV Abs was 25.4% [3]
. These variations depend
on location, genotype distribution, and laboratory
technique for detection as well as sociod