IRAQI JOURNAL OF COMMUNITY MEDICINE

Background: Nutrition has a major role in health promotion and disease prevention. Nutritional knowledge of physicians
had important impact in public health as they are in the front line of responding to patients’ questions concerning
their diet; as well they might have the influence in decreasing morbidity and mortality through proper nutrition
counseling.
Aims: To assess the nutritional knowledge and attitude of physicians about nutrition counseling as well as to explore
some determinants influencing the knowledge of physicians.
Methodology: A cross sectional study was conducted in 20 primary health care centers in Baghdad for the period from 10th
of May, to the end of August, 2017. A self-administered questionnaire was used for data collection. The questionnaire
comprised questions to assess nutritional knowledge and attitude toward nutritional counseling. In addition, the
collected data covered some sociodemographic characteristics of the physicians.
Results: Out of 197 primary health care physicians working at the selected primary health care centers, 150 physicians
enrolled in the study, with a response rate of 76.1%. The results showed that 67% of physicians had fair level of
knowledge. Better level of knowledge was achieved by family medicine specialists, board qualified physicians, in
addition to those with more than ten years post-graduation. Nearly all study participants (98%) had positive attitude
toward nutritional counseling. Lack of time was the prime barrier to nutritional counseling as reported by 83 (55.3%)
of physicians. Out of 150 physicians, 44% of them pointed out that web based material and social media were the
dominant sources of their nutrition information.
Conclusion: despite fair level of knowledge of physicians, the study identified considerable deficiencies in knowledge in
some aspects of nutrition. Therefore, there is a need for better training and continuing medical education for primary
health care physicians to enhance their knowledge and counseling in nutrition.
Key Words: Knowledge, counseling, attitude, nutrition, primary health care physicians, Baghdad.

Background: Learning styles refers to the methods of gathering, processing, interpreting, organizing and thinking about
information. Students have different learning styles, which is the reason for the diversity seen in classrooms in regards
to how students acquire information. This study objected to evaluate and compare knowledge, attitude and practice
among different colleges of medicine, dentistry and pharmacy.
Methodology: A cross-sectional study on medical students surveyed regarding their knowledge, attitude and practice about
learning style. The Questionnaires were posted online on 15-16th December 2016. Data were collected then analysed
Results: About 59.3% of the study population considered lecture as their main source of learningand the highest ferquency
among college of medicine with a significant association (P value = 0.001). However about 52.4% of the students
were most energized for learning in the morning. The majority of the students 82.2% have tried to improve the way
they manage their time. with a non significant association (p value = 0.16).
Conclusions: Most of medical students were aware of their learning style, believed that knowing about their learning style
can improve and facilitate their learning, The majority of students were visual learners and cared about their time
management and took notes while they learnt new information.
Keyword: Learning Styles, Students, Sulaimani

Background: Subchorionic hematoma in the first trimester of the pregnancy increases the risk of spontaneous miscarriage. The
risk increases with increasing maternal age, BMI, earlier gestational age (less than 9 weeks) and hematoma size. Parity and
placental site do not significantly increase the risk of miscarriage.
Objective: To study the significance of subchorionic hematoma finding on outcomes of the first trimester threatened
miscarriage.
Patients and Methods: This prospective cohort study was conducted on 144 pregnant ladies, 75women had Subchorionic
hematoma (study group) matching with 69 women without Subchorionic hematoma (control group). The demographic
feature, placental site, size of hematoma and pregnancy outcomes were analyzed.
Results: The results showed that there was a significant association between the average age of pregnant ladies who presented
with subchorionic hematoma( were the ladies presented with subchorionic hematoma is significantly older (31.17 ± 2.785)
than those without a hematoma (23.50 ± 3.241), p<0.05), between the body mass index and subchorionic hematoma ( the
body mass index of first group is significantly more than those of the second group , ( 31.50 ± 1.738) vs. (28.75 ± 1.710) ,
p value <0.05), between the gestational age of presentation and subchorionic hematoma ( in the first group (8.07 ± 1.07
weeks) versus (11.09 ± 0.8 weeks) in with no hematoma group , p value <0.05), and between the hematoma size and
miscarriage. 5.3% of cases with small subchorionic hematoma underwent miscarriage versus 76.8% continued beyond the
24 weeks while 26.3% of cases with medium sized subchorionic hematoma underwent miscarriage versus 14.3, and 68.4%
of large subchorionic hematoma cases underwent miscarriage versus 8.9%, with a p <0.05. The results showed that there
was no statistically significant difference in parity between the two groups. Para 1 to 2 was 62.7% in the subchorionic
hematoma group versus 50.7% in the no hematoma group , and Para 3 to 4 was 37.3 % in the subchorionic hematoma
group versus 49.3 % in the no hematoma group, with a p value >0.05, and no statistically significant difference in the
placental site between the two groups, the placenta was anterior in 52% of the subchorionic hematoma group versus 63.8%
in the no hematoma group, and it was posterior in 48% in the subchorionic hematoma group versus 36.2% in the no
hematoma group with a p = 0.153 .
Conclusion: Subchorionic hematoma in the first trimester of the pregnancy increases the risk of spontaneous miscarriage.
Keywords: threatened miscarriage, subchorionic hematoma, abdominal ultrasound

Background: Adipose tissue hormones, adipokines, play an important role in diabetes mellitus. Apelin has been
added to the family of adipokines. Many risk factors can be complicated in the progress of diabetes.
Objective: The aim of this study was to assess of serum apelin and some risk factors in type 2 diabetic patients and
compared them with the control group.
Patients and Methods: This study encompassed 45 diabetic patients (23 obese and 22 non-obese). They were
compared with 45 healthy subjects as control group. All diabetic patients were attended to the National
Diabetic Center/ Al- Mustansiriya University during the period from November 2017 until the end of May
2018. All participants experienced anthropometric, clinical, and biochemical examinations.
Results: There was a significant increase (P= 0.01) in body mass index for obese as compared to non-obese type 2
diabetic patients. Also, there was a significant increase (P < 0.05) in fasting blood glucose, serum insulin,
homeostasis model assessment for insulin resistance, and serum apelin in diabetic patients as compared to
the controls. While, there was a decrease in quantitative insulin-sensitivity check index in diabetic group as
compared to the controls. Also, there was a significant increase (P= 0.01) in serum lipid profiles except high
density lipoprotein cholesterol in diabetic patients as compared to the controls.
Conclusions: The significant alterations in serum apelin levels in type 2 diabetic patients as compared to the
controls were recommended a probable role of these adipokines with the occurrence of obesity and insulin
resistance. There was abnormal lipid levels during hyperglycemia induced dyslipidemia are
hypercholesterolemia, hypertriglyceridemia, and elevated low density lipoprotein cholesterol.

Background: Atopic dermatitis is a chronic disease with many miserable complications. Atopic dermatitis is a
common disease among the population, with estimated prevalence of 7% to 17.2% which may occur at any age.
Aim: This study was conducted to study some clinico-epidemiological pattern of the disease in Iraqi patients and with
the two immunological investigations (eosinophil counts and total serum IgE).
Materials and Methods: A sample of 30 Iraqi patients with atopic dermatitis were chosen during a period of four
months from 15th of November 2017 to 15th of March 2018 in the consultant clinic of the Dermatology and
Venereology of Al-Yarmouk Teaching Hospital in Baghdad. The disease was diagnosed clinically by
dermatologist. A control group of 30 unrelated healthy nonatopic individuals (matched for age and gender) was
selected for the comparison. Additionally, two laboratory parameters were investigated for their association with
AD. These were: eosinophil counts and total serum IgE.
Results: The rate of atopic dermatitis was significantly decreasing with age, and season of birth appeared to have no
effect on the occurrence of Atopic dermatitis.
About half of the patients (50%) were with long duration of atopic dermatitis (more than 10 years). There was a
significant association between family history of atopy in parents and personal history of atopy with atopic
dermatitis. In general, respiratory atopy and family history were found in 76.7% and 70 % of patients
respectively.
The significant provocation factors for AD in the current study were soap sensitivity (90. %); wool clothes
(86.7%); daily bathing (60%); and climate and seasonal variation (83.3%). The majority of AD patients showed a
significant increase in the eosinophil counts (83.3%) and serum IgE (90%) in comparison to control group.
Conclusion: There were an obvious and significant association of increased risk of AD and some environment factors
which act as provocation factors. Also, results showed a highly significant increase in both eosinophils counts and
total serum levels of IgE in patients with AD.
Key words: Atopic dermatitis, Eosinophil counts, Total serum IgE

Abstract
Background: Plane warts represent a common self-limiting viral infection of the skin, caused by HPVs with no
uniformly effective treatment modality and with a high rate of spontaneous recovery.
Aim of the study: To evaluate and compare the effectiveness and safety of topical 5% KOH solution with topical
0.05% Tretinoin cream for the treatment of plane warts.
Patients and methods: This study was conducted at Department of Dermatology and Venereology of Baghdad
Teaching Hospital / Medical City from April 2015 to July 2016. Sixty six patients enrolled in the study.
Patients were divided into two age and sex matched groups; patients in group (A) were treated with topical 5%
KOH solution once at night for a maximum period of four weeks while, patients in group (B) were treated with
topical 0.05% Tretinoin cream once at night for a maximum period of eight weeks. The patients were evaluated
at 2nd, 4th and 8thweeks to assess the cure rates and side effects. Those patients who showed complete cure
were asked to stop the treatment and followed up for 3 months to detect any recurrence.
Results: Thirty patients from group (A) and twenty eight patients from group (B) completed the study, while the
remainders were defaulted for unknown reasons.
At the end of the 2nd week; 26.7% of patients in group (A) showed complete disappearance of their warts while,
65.7% of them showed partial response. Regarding group (B); no patients showed complete response, while
75% of the patients showed partial response.
At the end of 4th week, 70% of group (A) patients showed complete response in comparison to 28.6% of group (B)
patients. Partial or non- responders in group (B) continued with the treatment and were re- assessed at the end
of 8th week; (60.7%) of patients had complete response.
Recurrence of warts was recorded in 19% of group (A) versus 17.3% in group (B) patients during the 3 months
period of follow up.
Conclusion: Both 5% KOH solution and 0.05% Tretinoin cream are effective topical therapies in the treatment of
plane warts and both can be prescribed as home remedies. The 5% KOH solution is much cheaper with faster
action but with more side effects.
Keyword: KOH solution, Tretinoin cream, Plane warts.