Al-Rafidain Journal of Medical Sciences

There are many metabolic and hormonal factors related with polycystic ovary syndrome (PCOS) that can be affected by vitamin D3 supplementation. To find clinical trials, in vivo studies, and in vitro studies that met the review's inclusion and exclusion criteria, we searched many databases. PCOS women's ovulation and metabolic parameters were examined in relation to the effects of vitamin D3 treatment on PCOS risk variables such as seasonal changes in body mass index, and obesity. The current review included twenty-five articles. Vitamin D3(25-hydroxy vitamin D) levels were significantly lower in the PCOS group than in the control group, and lipid profile and androgen hormone levels were significantly higher in the PCOS group, resulting in increased cardiovascular events and exaggerated hirsutism. According to the majority of research, vitamin D3 plays a beneficial role in decreasing the pathophysiology of PCOS, notably in restoring ovulation, which ultimately improves fertility. Although other studies found no effect on lipid profile, there was a minor effect on reducing cardiovascular risks. The response of patients to vitamin D3 was influenced by the dose administered and the study's methodology. In conclusion, vitamin D3 had a good effect on the pathophysiology of PCOS in the majority of investigations.

An ulcer in the stomach is a common digestive system ailment. Gastric ulcers are more likely to develop if one drinks alcohol regularly. Despite the extensive availability of treatment options, there are just a few preventative regimes. In animal trials, herbal remedies have been found to prevent the formation of ethanol-induced stomach ulcers. Histamine receptor 2 antagonists have a similar or higher ability to inhibit the formation of ethanol-induced stomach ulcers to herbal treatments. There are less adverse effects associated with herbal remedies. PubMed, Google Scholar, and Web of Science databases were searched using keywords such as "gastric ulcer," "herbal medicines," and "ethanol-induced gastric injury." The search was performed up to May 15, 2021. Only articles published in English were used in this review. For those who are more susceptible to develop stomach ulcers, certain herbal combinations may be an effective option to prevent the development of gastric ulcers, based on their methods of action and the pathogenesis of gastric ulcers. Dates, pomegranate seeds, and bitter melon are all examples of herbal compounds that are safe and can be ingested. Those who regularly use alcohol may want to consider using these substances as an alternative method of preventing stomach ulcers. Anti- Helicobactor pylori herbal components such as Mitrella kentia, citrus lemon, and Cratoxylum arborescens (Vahl) Blume can be used by Helicobacter pylori positive individuals to avoid the creation of ethanol-induced stomach ulcers

Exam-related anxiety is a set of responses that include excessive worry, depression, nervousness, and irrelevant thinking from an individual's experience of assessment or testing and its outcome. Aim: This study was designed to evaluate exam-related anxiety among medical students in Baghdad City. Methods: This study utilized a cross-sectional survey design and was conducted by administering an online questionnaire to medical students (medicine, dentistry, and pharmacy). Results: A total of 530 students participated in the survey; 20.8% of them came from medical colleges, 41.7% from dentistry schools, and 37.5% from pharmacy schools. Around 27.1% of the respondents reported positive test-related anxiety. Conclusion: Exam-related anxiety is frequent among Iraqi medical students in Baghdad and highlights the need for education programs to reduce this anxiety.

Inflammatory bowel diseases (IBD) and colorectal cancer (CRC) are caused by a combination of variables, including environmental, host-related, and nutritional factors. Helicobacter pylori (H. pylori) is an environmental risk factor for many GIT disorders and is designated as a class I carcinogen. Aim: To investigate the prevalence of H. pylori in Iraqi patients diagnosed with IBD and CRC and the expression of NF-κB mRNA in those patients. Methods: Patients with GIT symptoms were tested for the existence of IBD and CRC in a cross-sectional observational study. In biopsies taken from GIT lesions, biochemical and histochemical approaches are employed to determine the presence of H. pylori and the expression of NF-κB mRNA. Results: H. pylori tests were positive in 33.3% of CRC patients, although this was not statistically significant compared to those who had negative testing. Only 63.3% of IBD patients had H. pylori infection. In the CRC group, 53.3% of patients had negative NF-κB expression, whereas all of the patients in the IBD group had a negative test. Conclusion: Patients with CRC had a high prevalence of H. pylori, whereas IBD patients had a low frequency. Patients with CRC had high levels of NF-κB mRNA expression, whereas patients with IBS had none.

Not applicable

Background and aim: Tramadol is a codeine analogue with less analgesic power than morphine but with better abuse potential. However, chronic use is associated with different adverse effects like anxiety, euphoria, nervousness, insomnia, depression, and agitation. In this study, we assessed the outcome behind the restriction on dispensing Tramadol in private health sectors in Iraq. Methods: We look at tramadol data from VigiBase data searches and the Individual Case Safety Reports (ICSR) that are formally supported by the WHO worldwide database. All complaints were evaluated using Vigilyze data mining and computing IC25 to assess the strength of the link between Tramadol and the adverse reactions it causes, as well as to compare them to other records from around the world. Results: For patients who used tramadol in a variety of dose forms, 184 instances were gathered over the course of seven years by the Iraqi Pharmacovigilance Center. There were 32 cases of hyperhidrosis, which occurred when tramadol was used alone, 47 incidents of vomiting, and 67 cases of nausea. Many adverse effects, including chest pain, hyperhidrosis, headache, dyspnea, and constipation, are more common in Iraqi records than in internationally known instances. Other side effects, such as vomiting, hallucination, vertigo, respiratory depression, and chills, were found to be milder than previously reported. There were no deaths in any of the instances that were recorded during this time period. Conclusion: The number of reported tramadol-induced adverse events has fallen significantly, which can be attributed to the ministry of health restricting tramadol dispensing and enabling public hospitals to only dispense it under medical monitoring.

To review and identify the major drivers for COVID-19 vaccine acceptance. Methods: A scoping review of studies of COVID-19 vaccine perceptions and barriers to using the COVID-19 vaccines. Two search engines, including PubMed and Google Scholar, were purposefully searched. Results: Eight studies from different countries were reviewed to categorize factors influencing people's acceptance of COVID-19 according to the Health Belief Model (HBM). Perceived susceptibility, and severity of the disease (COVID-19), in addition to perceived benefits of COVID-19 vaccination and "cues to action", can enhance vaccination acceptance. In contrast, perceived barriers to the COVID-19 vaccine can increase people's hesitancy to be vaccinated. Conclusions: The HBM domains are successful in the prediction of human behaviors toward preventive measures, including vaccination. In general, high perceived susceptibility, severity, and benefits and minimum barriers should always be maintained to keep the vaccination rate high. Reducing the hesitancy to get the vaccine can be achieved by increasing awareness campaigns about the vaccine's efficacy in preventing infection.

Tenofovir is a reverse-transcriptase inhibitor based on acyclic nucleotide analogs. Tenofovir is a drug that is often used in treating HIV infection and has also been approved for treating infection by the hepatitis B virus. Despite the fact that its renal safety has been demonstrated in cell culture and clinical trials, clinical use and in vivo animal studies have shown its association with a low, but important, risk of kidney injury. Tenofovir accumulation in these mitochondria-rich cells is explained by proximal tubular cell secretion. Proximal tubular cell dysfunction is a symptom of Tenofovir nephrotoxicity, which might be the leading cause of acute renal injury or chronic diseases of the kidney. A review of articles is performed using keywords related to the topic in the databases of Google Scholar and PubMed, and 54 papers have been included, which were case studies, cross-sectional studies, and in vivo animal studies from 2004 up to 2021. The review aims at explaining the interaction of Tenofovir with kidney tubules, an association of genetic polymorphism, clinical features of Tenofovir-induced renal toxicity, potential mechanisms of Tenofovir-induced renal toxicity, its predisposing conditions and factors, and finally, some proposed strategies and agents to monitor and manage Tenofovir-induced nephrotoxicity

Humans have an exquisite immune system that enables them to not only identify and eliminate foreign antigens but also their own cells if they go awry. Cancer cells, through acquiring alterations in their genomes, can harbor slightly modified proteins and expression patterns. These changes can be detected and eliminated by a competent immune system. The immune system can be further assisted in killing rogue cancer cells through the use of immunotherapies. However, despite immunotherapies showing great promise in certain cancers and a subset of patients, these treatments are characterized by high rates of response resistance. Here, a narrative review is presented of the possible mechanisms underpinning resistance to immunotherapies, together with strategies to improve their response rates.

Chemotherapy is a category of medicines that is utilized to kill and eradicate immediately the abnormally growing cells in the body. It is commonly utilized to treat cancer because cancer cells grow and divide at a faster rate than other cells. Extravasation is the mechanism by which any liquid (fluid or drug) accidentally enters the surrounding tissue. Extravasation in cancer treatment indicates the unintentional chemotherapy infiltration into the subdermal tissues or subcutaneous enclosing the intravenous or intra-arterial location of administration. Extravasated agents are categorized as vesicants, exfoliants, irritants, inflammators, and neutrals. Based on their potential for causing harm, management of chemotherapy-related extravasation includes both non-pharmacological treatment and pharmacological treatment

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were created to aid the author in ensuring high-quality presentation of the conducted observational study. Objective: Applying the STROBE statement guideline checklist to evaluate the quality of nursing studies and observational reporting. Methods: Analytical review of literature based on previous studies and reviews derived from Scopus, PubMed, and Medline databases concerning STROBE statement guidelines. The data collection was conducted from December 2020, to April 2021. These studies were collected and filtered according to the specific criteria and used keywords such as STROBE, nursing studies, evidence-based nursing practice, cohort studies, case-control studies, cross-sectional and observational studies, as well as articles from the National Library of Medicine. Results: Few papers have been published that demonstrate an appreciation of STROBE, but their descriptive features do not seem appropriate for nursing publications. In comparison to STROBE, relatively few papers mentioned primary sources or other information regarding the selection process for study participants and the observation time frame. Conclusion: Despite the widespread availability of reporting guidelines in both medical and nursing fields, many researchers do not follow them.

Background: Successful labor induction is clearly related to the state of the cervix. The utero-cervical angle and cervical length represent novel ultrasonographic markers. Aim: To assess the relationship between utero-cervical angle and cervical length and satisfactory response to labor induction. Methods: Prospective cohort study was conducted in Al-Elwyia Maternity Teaching Hospital for a period of six months; 100 cases were enrolled in the study, a pre labor induction measurement of utero-cervical angle and cervical length using transvaginal ultrasound scanning were followed up till the end of labor to estimate the rate of success of induction of labor. Results: 65 patients had successful induction of labor and 35 failed to do so. No differences were found in demographic data and previous obstetric history. Short cervical length and wide utero-cervical angle were found in successful induction of labor. Significant negative correlation found between utero-cervical angle and labor duration. At cutoff point of 97.5 degree of utero-cervical angle, the sensitivity was 83.12%, specificity was 71.4%, positive predictive value was 84.38%, negative predictive value was 69.45% and the accuracy was 88%. At a cutoff point of less than 29.5 mm of cervical length, the sensitivity was 92.3%, specificity was 80%, positive predictive value was 89.55%, negative predictive value was 84.84% and the accuracy was 88%. Conclusion: Utero-cervical angle and cervical length may be independent predictors of successful induction of labor.

Chronic kidney disease (CKD) is associated with several adverse clinical outcomes, such as cardiovascular events, kidney failure requiring renal replacement therapy, mortality, and poor quality of life for survivors in general. CKD is a slow and progressive loss of kidney function over several years and may ultimately lead to the development of kidney failure. CKD has become a serious public health issue. Although cardiovascular disease, family history of CKD, and certain ethnic and racial backgrounds are important predictors of CKD risk, they do not contribute significantly beyond the scope of diabetes, hypertension, and older age. The number of CKD patients will continue to rise, reflecting the growing elderly population and increasing numbers of patients with diabetes and hypertension. As the number of CKD patients increases, primary care practitioners will be confronted with the management of the complex medical problems unique to patients with chronic renal impairment. As well documented in the literature, the nephrologist rarely manages the medical needs of CKD patients until renal replacement therapy is required. Whereas the symptoms of CKD in diabetes are few, many risk factors and biomarkers can be used to identify individuals at high risk for developing this condition. This article highlights the effect of risk factors and complications associated with chronic kidney disease at its various stages.

Background: Heart failure (HF) is a growing disease that affects up to 6.5 million Americans and greatly contributes to the rising expense of health care. HF affects almost 23 million individuals worldwide. Exercise training increased patients' quality of life (QoL) and may be connected with lower morbidity and mortality. Aim: To assess the association between exercise training and QoL in HF patients. Methods: We examined databases from 2008 to 2019 for research that looked at the association between exercise training and QoL in HF patients. For the analysis, eight controlled studies that met the inclusion criteria were chosen. The study's characteristics as well as data on QoL in HF patients, exercise training, and aerobic capacity were extracted and examined. Results: The investigation showed a more positive effect of the training exercise on patients' QoL after heart failure. Conclusion: Regular 30-minute exercise training three times a week for eight weeks is an effective strategy to improve all QoL aspects in individuals with chronic heart failure caused by various etiologies. These exercises had to be modified based on the patients' age and functional capacity.

Background: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The percentage of individuals suffering from depression who have a MI According to the PHQ-9 scale, 51.1% of the participants exhibited signs of mild depression, while 40% of the participants exhibited signs of moderate anxiety. Both of these results were based on the participants' responses on the GAD-7 scale. Conclusion: Patients who had recently suffered a myocardial infarction had poor sleep quality, and a substantial percentage of them also suffered from depression and anxiety.