Al-Kindy College Medical Journal

Leishmaniasis is a transmissible infection brought about by an obligatory intracellular protozoan from the genus Leishmania. It occurs worldwide in tropical and subtropical regions and can be burdensome in resource-constrained countries. The infection ranges in severity from mild cutaneous lesions to more severe and sometimes life-threatening visceral and distorting mucocutaneous sicknesses. Importantly, cutaneous leishmaniasis (CL) is prevalent in the Middle East with a pooled prevalence of 12%. It imposes a significant health and socioeconomic burden

Background: War represents a major human crisis; it destroys communities and results in ingrained consequences for public health and well-being

Objective: We set this study to shed light on the public health status in Iraq after the successive wars, sanctions, sectarian conflicts, and terrorism, in light of certain health indicators.

Design: The primary source of data for this analysis comes from the Iraqi Ministry of Health, and The World Health Organization disease surveillance.

Results: Most of the morbidity indicators are high, even those that are relatively declining recently, are still higher than those reported in the region. Common communicable diseases such as schistosomiasis, mumps, and measles continue to be a problem. Mumps showed two recent epidemics; in 2015, and in 2020. The same with respect to Measles. More than 40·% of the surveyed population showed both systolic and diastolic hypertension. Fasting glucose of 10·4% of the participants showed hyperglycaemia, only 6·5% of whom reported being diagnosed and treated as diabetic. The leading cancer in males is Bronchus and Lung cancer, followed by Colorectal, Urinary bladder, and Prostatic cancers while in females; Breast cancer is in the top of the list, followed by Thyroid, Colorectal, Brain, and Bronchogenic cancers. Rates for childhood cancers are obviously higher even than those in high-income countries.

Conclusions: The struggling public health services in Iraq have been severely impacted by humanitarian and political crises and brutal armed conflict that resulted in restricted population access to food, clean water and basic services including healthcare and medicines.

Background: Most prevalent chronic liver disease in developed and developing nations is non-alcoholic fatty liver disease. From fatty liver, which often has benign, non-progressive clinical history, to non-alcoholic steatohepatitis, a more serious variant of fatty liver that can lead to cirrhosis and end-stage liver disease, non-alcoholic fatty liver disease encompasses broad spectrum of diseases. The gold standard for determining extent of hepatic fibrosis is still liver biopsy; however, number of noninvasive tests have been established to make diagnosis and assess effectiveness of treatment.

Objective: Aim of study was to assess effectiveness of the combination of fibroscan and noninvasive biochemical tests and scoring systems for assessing liver fibrosis.

Subjects and Methods: Cross-sectional prospective study conducted at outpatient clinic of Baghdad Gastroenterology and Hepatology Teaching Hospital from October 2018-March 2020. One hundred patients with fatty liver selected and subjected to specific questionnaires.

Results: One hundred patients with fatty liver studied; fifty-five (55%) males, forty-five (45%) females. Mean age was (45 ±12.24) years, females were significantly older. Mean stiffness score was 11.7(SD:5.29) KPa. Forty-six (46%) patients had advanced fibrosis. The Positive correlation between FibroScan examination results and the noninvasive scores results was significant, as well as there was significant positive correlation between age and stiffness score and significant negative correlation between platelet count and stiffness score.

Conclusions: This study showed that half patients showed advanced fibrosis, highlighting the need for early detection and management of fatty liver patients. Implementation of FibroScan with noninvasive fibrosis scoring tools has been shown to be helpful in this situation.

Background: Double diabetes is the term used to describe situations in which a patient exhibits characteristics that are a combination of type 1 and type 2 Diabetes Mellitus. Metalloendopeptidase or Neprilysin is membrane-bound metallopeptidase. It has a wide range of physiological function and a variety of substrates. It has a significant impact on the proteolytic functions of the kidney, cardiovascular health, immunological response, cell proliferation, and fetal development. It also has a preventative effect on the onset of type 2 diabetes, obesity, and cancer.

Objective: The study aims to assess the level of MEP in patients with double diabetes and determine its predictive value in the diagnosis of double diabetes.

Subjects and Methods: Eighty participants were divided into two groups for this study. 40 patients with double diabetes made up the first group (G1), whereas 40 age- and gender-matched apparently healthy subjects made up the second group (G2), which served as the control group. ELISA was used to measure the serum's metalloendopeptidase level. For the measurement of HbA1c, whole blood was used. The measurement of insulin, blood glucose, and lipid profile were performed using serum. The HOMA test measured insulin resistance.

Results: This study revealed a significant elevation in serum metalloendopeptidase levels in patients with DD (p value < 0.05). The ROC curves analysis for serum metalloendopeptidase level showed the area under the curve (AUC) of serum metalloendopeptidase (pg/mL) was 0.992.
Conclusions: Serum metalloendopeptidase level could be used as a novel biomarker in patients with double diabetes.

Background: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue.

Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results.

Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an ultrasonographic (USG) diagnosis of solid breast masses was included.

Results: A significantly higher value of SWE elasticity ratio (E-mean) was observed in malignant tumors than in benign tumors (p <0.0001). The area-under-curve (AUC) for the BI-RADS 4 lesions was 0.522 (95% CI, 0.343-0.701) with an E-ratio cut-off score of 85.25, the sensitivity and specificity were 50% for diagnosing malignant tumors, whereas AUC for the HPE study was 1.000 (95% CI, 1.000-1.000) with an E-ratio cut-off score of 134.25; both the sensitivity and specificity were 100% for diagnosing malignant tumors.

Conclusions: Carcinoma breast is one of the most prevalent cancers globally. The most common benign tumor of the breast is a fibroadenoma, whereas Invasive Ductal Carcinoma is the most common malignant breast mass. A well-defined SWE elasticity ratio range might help predict the aggressiveness of breast tumors. SWE's correlation with BI-RADS in suspicious lesions adds to histopathology's advantage in distinguishing malignant tumors from benign ones.

Background: Kinesiologists, Physical Anthropologists, and Anatomists have all long been captivated by the structure and development of the superficial forearm flexor, the Palmaris longus.

Objective: To study the effect of Palmaris Longus on certain handwriting skills.

Subjects and Methods: Three Palmaris Longus occurrence tests were conducted on 200 students (100 males and 100 females) affiliated to Colleges of Medicine of Baghdad University then the participants were tested for certain handwriting skills to correlate the presence of Palmaris Longus in the dominant side with handwriting.

Results: 89% of all subjects (178 subjects) and 91% of males were right-handed. Dominant Palmaris Longus among males (61%) was significantly higher than that of females (30%). Regarding the Motor assessment scale; female participants achieved good and it was significantly higher than that of males (23%). There was a significant association between left Palmaris Longus only and acceptable horizontal line assessment. Good sentence composition was noticed significantly in dominant Palmaris Longus.

Conclusions: Variation of presence of Palmaris Longus in both sexes in the studied group meets with normal recorded variation. Presence of Palmaris Longus in the dominant forearm has correlation with good certain skills of handwriting skills.

Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms