Al-Rafidain Journal of Medical Sciences

Background and aim: In every aspect of clinical care, including diagnostic testing and medication administration, patient identification (ID) errors can disrupt care and harm patients. The study assesses healthcare workers' frequency and accuracy in verifying patient identity before performing common tasks and develops a proposed patient verifying identity program clinical model to meet the training needs of healthcare workers. Methods: An observational cross-sectional study was conducted at Al-Najaf Teaching Hospital from March to May 2022. Data collection was done through a questionnaire and participatory observation. Hundred-forty healthcare workers participated in the study: 52 clinic doctors, 27 registered nurses, 34 information officers, 17 pharmacists, 4 radiologists, and 6 outpatient hospital doctors. Results: The majority of participants (62.1%) were female. The majority of the 40 participants (28.6%) worked in the operating room. Furthermore, the majority of the participants (82.1%) did not ask the patients for their names and dates of birth (DOB). Clinic doctors made up the majority of those who did not complete the identification process (37.1%). Conclusion: More than three-quarters of healthcare workers missed patient identification while performing a task. Although patient identification errors frequently result in serious adverse events that can be avoided with better training, better use of technology may improve the way healthcare workers verify patients' identities.

Aim: The purpose of this review is to highlight the role of the epithelial-mesenchymal transition (EMT) in tumorigenesis and assess the value of manipulating this process in cancer therapy. Method: A search was conducted for peer-reviewed articles in PubMed, Google Scholar, and ResearchGate employing keywords and phrases. Main Points: The EMT program is a key driver of tumor initiation and progression. Inhibition of EMT in carcinoma cells can yield fruitful results in the treatment of cancer, particularly in overcoming resistance to chemotherapy and precision drugs. Conclusion: Blocking the process of EMT in carcinoma cells can help overcome the resistance to chemotherapy and targeted precision medicine.

Earthquake, Beta-blockers, Cardiovascular events, Drug supplies, Turkey, Syria

Background: Tumor necrosis factor-alpha (TNF-α) and interleukins play important roles in the pathogenesis of rheumatoid arthritis (RA). Genetic research has been employed to find many of the missing connections between genetic risk variations and causal genetic components. Objective: The goal of this study is to look at the genetic variations of TNF-α and interleukins in Iraqi RA patients and see how they relate to disease severity or response to biological therapy. Method: Using specific keywords, the authors conducted a systematic and comprehensive search to identify relevant Iraqi studies examining the genetic variations of TNF-α and interleukins in Iraqi RA patients and how they relate to disease severity or response to biological therapy. Results: Thirteen studies have looked at TNF-α and interleukin genetic polymorphisms in Iraqi RA patients. Only the IL-2, IL-4, IL-6, IL-17, and IL-23 receptor gene polymorphisms were explored for interleukins; however, the results of studies indicate no association between genetic polymorphism and the severity of RA. Very few researchers examine the correlation between genetic variation and TNF-α inhibitor responsiveness. Numerous studies have been conducted to investigate the genetic variations of the TNF-α promoter. The -308 G/A region in the promotor region was the most studied location.

Pro-inflammatory mediators like IL-6 effectively mediated the majority of musculoskeletal disorders such rheumatoid arthritis (RA), osteoarthritis (OA), and tendinitis. Increased levels of IL-6 are found in the serum or synovial fluid of patients with these disorders, and these levels are correlated with the incidence and severity of the disease. IL-6 is crucial for the development of cartilage pathology, for example, by inducing a variety of pathways that are involved in the induction and spread of inflammation. The expression of anti-catabolic factors is similarly increased by IL-6, indicating a protective function. The differential impacts of IL-6 classic and trans-signaling may be the reason for this dual role of IL-6, which has so far remained poorly understood. In this article, the experimental and clinical data on the function of inhibiting IL-6 signaling in the development and progression of pathologies of the synovium, cartilage, and bones were thoroughly reviewed. By evaluating the IL-6 targeting approaches that are currently being considered in research and clinical practice, it may provide a glimpse into the future of these illnesses' treatment.

Background: Dietary supplements are used to provide the body with nutrients necessary for the regulation of metabolic processes, to increase the nutritional value of a typical diet, and to enhance or maintain health. Aim: To assess the use frequency and demographics of dietary supplements consumers in Baghdad, Iraq. Method: From July to September 2022, a cross-sectional study was conducted by distributing a self-administered survey to consumers attending community pharmacies in the Baghdad metropolitan area. About 150 participants took part in this investigation. Results: The study revealed that the majority of participants were female, constituting 58% of the total, while male subjects constituted 42% of the total. 16% of the subjects were taking multivitamins, with vitamin D3 being the most popular supplement (22.7%). Only 40% of all respondents relied on their physician's advice when using dietary supplements. 73.3% of them did not conduct any laboratory tests before or after ingesting these supplements. Conclusion: Significant numbers of users used calcium and vitamin D3 without obtaining lab results or being monitored by a physician; instead, they consulted the internet for information.

ChatGPT system, nursing education, nursing challenges, nursing apportunities.

Cancer, one of the leading causes of death worldwide, has been the subject of extensive study by many researchers. Cancer is affected by both genetic and immune system factors in the human body. The gut microbiota plays an important role in the body's capacity to maintain homeostasis. Because of their beneficial effects on human health and their ability to successfully prevent and treat various chronic diseases, such as cancer, probiotics are becoming increasingly important in medicine. A wealth of research has shown that probiotic consumption can significantly helpful in cancer prevention and treatment. The goal of this review is to provide a thorough overview of the research on the function of probiotic bacteria in the prevention and treatment of gastrointestinal cancers.

The purpose of this study is to underline the progression and development of research regarding oxygen-containing heterocycles, as well as to highlight the contribution that some oxygen-containing heterocycles have made as anticancer medicines. A series of publications about the antitumor effects of derivatives of heterocyclic compounds containing an oxygen atom, such as furan, benzofuran, oxazole, benzoxazole, and oxadiazole, were evaluated, and their anticancer activities showed encouraging results when compared to those of established standard treatments.

Background: The COVID-19 epidemic has had a devastating influence on health, even in the Iraqi metropolis of Baghdad. Aim: From the standpoint of healthcare professionals, assess the population's knowledge, attitudes, and practices (KAP) on COVID-19 in Baghdad. Methods: For the cross-sectional study design, a sample size of 384 participants was chosen using a multi-stage cluster sampling process. The data were gathered using a standardized questionnaire that had three sections: knowledge, attitudes, and practices. Results: The results demonstrated that most participants had a high level of COVID-19 knowledge, with a mean knowledge score of 77.2%. The participants had favorable views toward COVID-19 prevention initiatives, scoring a mean attitude score of 80.4%. The individuals demonstrated a high level of adherence to preventive actions with a mean practice score of 88.3%. A positive correlation between participant KAP scores and medical education and training was also found by the study. Conclusion: This study emphasizes the significance of healthcare professionals in public education and support of preventive actions to halt the development of infectious diseases like COVID-19. To curb the spread of COVID-19, the healthcare system and the general public must collaborate. Medical experts must educate the public about the condition.

Background: As acetaminophen (APAP) toxicity has become more common in many countries, related cases of poisoning, whether deliberate or unintentional, have been identified as a key contributor to acute liver failure. Aime: To discover if omega-369 fatty acids could protect the liver of male mice from the effects of acetamiophen. Methods: Thirty-five albino male mice were allocated to one of five groups at random. Group 1 served as the "negative control" and received a single intraperitoneal injection (10 ml/kg) of normal saline on the eleventh day of the test following ten days of receiving liquid paraffin orally at a dose of 10 ml/kg. The liquid paraffin was given to group 2 "positive control". Group 3 received Omega 369 (50 mg/kg/80 ml). Group 4 received Omega 369 (100 mg/kg/35 ml). Group 5 received N-acetylcysteine (100 mg/kg/10 ml). The mice were given Omega-369, N-acetylcysteine, and liquid paraffin via oral gavage for 10 days. Results: Group 2 had significantly lower levels of glutathione peroxidase (GP-X) and superoxide dismutase (SOD) than group 1, but significantly greater levels of malondialdehyde (MDA). GP-X and SOD levels were significantly higher in mice given the doses of omega-369, and N-acetylcysteine prior to acetaminophen administration, whereas MDA levels were significantly lower in groups 3,4 and 5 when compared with group 2. Conclusion: Omega-369 fatty acids, when taken orally, exhibit antioxidative effects and may reduce the risk of acetaminophen-induced liver injury.

Background: The association of olanzapine with hyperglycemia, an elevated lipid profile, and high blood pressure was early recognized after its approval and has become of increased concern. Objective: To determine the association of olanzapine use with blood sugar levels, lipid profiles, and blood pressure in hospitalized Iraqi patients with schizophrenia. Methods: A cross-sectional study involving 50 hospitalized patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V diagnostic criteria and had taken olanzapine for at least two years was carried out between November 2022 and February 2023 at two facilities in Baghdad, Iraq (Ibn Rushd Psychiatric Teaching Hospital and Al Rashad Hospital for Mental Health). Blood pressure, fasting blood sugar, and serum lipid profile (triglycerides [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very-low-density lipoprotein [VLDL]) were measured at baseline and after olanzapine use. Results: Olanzapine significantly increases fasting blood glucose (P< 0.001). After using olanzapine, both systolic and diastolic blood pressures significantly increased. It significantly increased the levels of cholesterol, triglycerides, and VLDL (P<0.001). Moreover, HDL levels were drastically lowered. The current investigation found no significant link between the patient's waist circumference and current weight and the length of their illness or olanzapine use. In addition, there was no association between the duration of olanzapine use and blood sugar, blood pressure, or lipid profiles. Conclusion: Different doses and durations of olanzapine use in Iraqi schizophrenic patients are associated with a negative impact on glycemic control, blood pressure, and lipid profiles.

Background: Lycopene has demonstrated favorable impacts on diverse health conditions, particularly those of an inflammatory nature. Objective: To evaluate the impact of topical application of lycopene on the spleens of mice with psoriasis induced by imiquimod (IMQ). Methods: The study employed a sample size of 48 mice, divided into six groups of eight mice each. The experimental protocol involved the application of IMQ to each of the five groups twice. The first application was administered for six days to induce psoriasis, followed by a second application for another six days while the tested medications were concurrently administered, with the exception of the first group, which served as the control group. Following the six-day induction phase, group 2 was treated exclusively with petrolatum jelly. On the other hand, groups 3-6 were subjected to different treatments, including clobetasol propionate, lycopene at concentrations of 0.125 mg/ml and 0.25 mg/ml, and a combination of 0.05% clobetasol and 0.25 mg/ml of lycopene. Each of the examined pharmaceutical substances was administered topically once daily for a duration of six days at the IMQ application site. Results: Lycopene at a concentration of 0.25 mg/ml resulted in a significant reduction in the spleen index and a restoration of the tissue levels of inflammatory mediators (TNF-α, IL-23, NF-κB, and IL-17) that were close to normal. Conclusion: The anti-inflammatory properties of lycopene can significantly aid in the normalization of spleens in patients who have developed psoriasis due to imiquimod.

Background: Estimating stature is of exceptional value in personal identification and the forensic sciences. At the same time, the literature lacks standardized methods for height estimation. Objectives: To estimate the stature of Iraqi individuals based on the morphometric parameters of both hands. Methods: 101 students recruited from Al-Rafidain University College collected data concerning ethnicity, gender, weight, and height and measured fourteen morphometric parameters for each hand, including the hand length (RHL; LHL), palm length (RPL; LPL), hand breadth (RHB; LHB), maximum handbreadth (RHB; LHB), and the length of each finger (RD1,2,3,4,5; LD1,2,3,4,5). A multivariable linear regression is used to predict stature based on the former variables. Results: The sample included males (48.5%) and females (51.5%) aged 18–23 years of Arabic (95%) and Kurdish (5%) ethnicity. The average weight (65.68±1.32) and height (169.52±1.13) were calculated. Regression analysis (accuracy=74.8%, p<0.001) and the male cohort (65%, p<0.001) possessed higher statistical accuracy than females (47.2%, p<0.001). Stature estimation within the total sample and males assumed similarities concerning parameters allocated to both hands that principally included the length of the right hand, right middle finger, left palm, and left little finger. In contrast, females' stature estimation corresponded to morphometric parameters strictly related to the left hand, including the length of the hand, palm, ring finger, and little finger. The results also aligned with the neural network analyses and qualitative data from ChatGPT version 3.5. Conclusion: Multivariable predictive models that are crucial in personal identification for forensic purposes were predicted, such as catastrophic scenarios due to disfiguring accidents, organized crime, and mass graves that frequently occurred in Iraq during the past two decades. Our results could also interest reconstructive hand surgery experts.

Background: The beliefs of pharmacy students in their curriculum may be critical to the success of medical education and the development of global health competences. Objective: To assess the beliefs, attitudes, and obstacles of PharmD students at the College of Pharmacy, University of Baghdad, during their first year in the newly adopted PharmD program. Method: In-depth qualitative interviews were conducted using flexible probing approaches. A sample of fourth-year PharmD students from the University of Baghdad's College of Pharmacy was selected using a purposive sampling method. The gathered data was analyzed using a thematic content analysis approach. Results: 40% of participants applied for the program because they believed it would improve their chances of finding work in the future. The majority of participants complained about the difficulties of the first course, citing the numerous themes as their greatest issue. Two individuals (13%) said the benefits were minor, while 40% said the subjects' difficulty allowed them to adapt and study faster and more efficiently. Six of the fifteen participants thought the information they were given was inadequate. Furthermore, more than half of the participants said the practical aspect was insufficient. Moreover, half of those polled advised decreasing organic chemistry because they thought it was superfluous. Sixty percent are hopeful about the future of PharmD in Iraq and believe that if it is well organized, it will be successful. Conclusion: Despite some challenges during the first year of the program, most participants are hopeful about the future of PharmD in Iraq and believe that it will be successful if it is well organized.

Background: Genetic variations in the carnosinase-1 gene, which may also be associated with cardiovascular issues and result in a higher serum carnosinease-1 level, may affect the levels of carnosine and carnosine synthase in diabetes patients. Objective: To examine the impact of the Carnosineas-1 gene polymorphism SNP (rs 2887) on blood levels of carnosine and carnosine synthase-1 and their relationship to CVD in diabetes. Method: The serum concentrations of carnosine and carnosineas-1 were determined using ELISA-specific kits. The carnosineas-1 gene (CN1) was subjected to the high-resolution melt technique (HRM) with the purpose of identifying gene polymorphisms. Results: Carnosinase-1 levels were considerably raised in the T2DM with CVD group, but serum carnosine levels were significantly higher in both groups. SNPs had little impact on serum carnosine levels, whereas polymorphisms had a big impact on carnosinase-1 levels. Conclusion: By raising serum levels of carnosenease-1, which in turn increases carnosine breakdown, the SNP (rs2887) of the carnosinase-1 gene contributes indirectly to the development of CVD in T2DM.