IRAQI JOURNAL OF COMMUNITY MEDICINE

Background:Hearing impairment is a global public health problem. It causes serious obstacle to the optimal development
and education, including language development in both developing and developed countries. Around 2 to 4 in
every 1000 neonates and infants have congenital sensor neural hearing impairment, making it a global public
health problem.
Objective: To high light on the importance of newborn hearing screening as it is till now not included in Iraqi health care for
newborns .
Methodology:-A cross sectional study with an analytic element was conducted in 25 primary Health Care Centers in
Baghdad city during the period extending from 1st March to 1st September 2016 . A convenient sampling
technique was used in the selection of health facilities which included newborns aged three months and below of
both sexes.
The data was collected by direct interview with mothers or ( any accompanied relative ) using a special questionnaire and
then application of the distortion product otoacoustic emissions test.
Results:-In this study, the test was applied to 1030 newborn , of whom 110 (10.7%) were positive to the test and referred to
ear, nose and throat specialist for further assessment.
The results showed that the prevalence of newborns with hearing impairment and the test positive was 84.5/1000 ,positive
predictive value of distortion product otoacoustic emissions test was 88.7%.
There was significant association between family history of hearing impairment and the test results, while other variables
didn’t show any association.
Conclusion: The distortion product otoacoustic emissions test can be used as a screening test to detect a newborn hearing
impairment due to its ease to use which allows trained non-professional personnel to perform the test.

Background: C- reactive protein synthesized by hepatocytes in response to proinflammatory cytokines, CRP
has axial rule in many aspects of athrogenesis.
Objectives: The study aimed evaluated the rule and estimating serum "C-reactive protein" level in ischemic
heart diseases and relation with lipid profile levels, hypertension and inflammation.
Materials and Methods: Seventy-five adult male and female were enrolled in this study, divided into the three
groups, 25 each (CCU admitted patients, outpatients clinic and healthy controls). All their blood
samples were checked up for lipid profile. "Erythrocyte sedimentation rate" (ESR) estimation and high
sensitivity "C – reactive protein"
(hs – CRP).
Results: Study showed (significant, weakly, non – significant, correlation between high level of "hs – CRP'
with lipid profile level to hypertension, inflammation and ischemic heart diseases.
Conclusion: There are relation with high level of (hs-CRP) to inflammation, infection, hypertension which in
the end lead to a heart disease.
High level of " hs-CRP" is expected to be an indicative to abnormal lipid profile which might
contribute to increase the risk of atherosclerosis.

Background: A number of viruses are known to infect human lymphocytes and other blood components causing
lymphoma and leukemia, among them are Human T-lymphotropic virus type 1 (HTLV-1) and Human Tlymphotropic virus type 2 (HTLV-2).
Objective: Find out the prevalence of HTLV 1&2 infections in Iraqi patients with lymphoma and leukemia and the
association of this infection and the malignancy with other factors related to the patient himself or the
surrounding environment he is living in.
Methods: The study was conducted in The National Center of Hematology in Al-Mustansiriya University for the
period from July 2008 to May 2009. The sample consisted of a total 250 patients with lymphoma and leukemia,
120 males and 130 females, their mean age was (40.76±14.58) years and age range (13-79) years, they were
from all over the Iraqi governorates. All patients were interviewed directly by similar questionnaire,
measurements (height and weigh) and a sample of blood was taken from every patient and tested for the
presence of the virus using ELISA technique.
Results: The study showed positive results for HTLV infection in 3 patients which is about (1.2%) of the sample
Conclusion: HTLV 1&2 infection is present in Iraqi patients complaining of lymphoma and leukemia with a
prevalence of 1.2%.This is the first report in Iraq regarding HTLV 1&2 positivity among leukemia and
lymphoma patients, the prevalence was lower than other countries, All factors and characteristics of patients
were consistent with other studies regarding lymphoma and leukemia.
Keywords: HTLV, Lymphoma, Leukemia

Background: Hypertension forms a major public health problem worldwide. Good compliance to antihypertensive drugs is a
key factor in controlling blood pressure.
Aim of the study: To study compliance of patients toward management of hypertension in Baghdad city, Iraq.
Patients and Methods: a descriptive study was conducted during four months period in 2016. The study involves patients
eighteen years of age and above who were known to be hypertensive for at least one year. Data were obtained by direct
interview using structured questionnaire.
Results: A total of 306 patients were included in the study. The study revealed that a compliance rate was 54%. Older
patients were more compliant to their prescribed medication than younger patients. Highly educated patients were more
compliant to their medication than illiterate patients 69.2% vs 50%. Monotherapy and single dose therapy (59.3% and 58.5%)
respectively have more compliance to their therapy. Patients having longer duration of the disease more than eight years
(78%) were more compliant than other patients have short duration.
Conclusions: The compliance of hypertensive patients was highly associated with old age, high level of education,
monotherapy, single dose, long history of disease

Background: Hepatitis B virus (HBV) vaccination was one of the success stories of the 20th. century. It is highly effective and
safe and was incorporated into national immunization programs of countries worldwide.
Objectives: To evaluate the efficacy of HBV vaccine among children 1-14 years old in Baquba city Diyala province.
Subjects and methods: This cross sectional study was conducted in Baquba City, the center of Diyala province for the period 20
July/ 2016 to 20 March /2017. A total of 452 children were enrolled, 247were males and 205were females, with an age range of
1- 14 years. All were previously immunized with genetically engineered HBV vaccine (Euvax B, Korea), with a dose of 10
micrograms of HBsAg/ 0.5 milliliter (children vial) intramuscularly. Venous blood samples were collected aseptically; sera were
separated and subjected for the detection of HBsAg, anti-HBs antibody titer, HBe Ag and total antibody and anti-HBc total
antibody using Enzyme Linked Immunosorbant Assay (ACON, Foresight-USA). A pre-constructed questionnaire form was
prepared including information of socio-demographic, health, and vaccination status. The human privacy was respected by taken
the participants or their parents consent. However 34 of them were refused participation. Statistical analysis was done using the
Statistical Package for Social Science (SPSS), Version 23. P values < 0.05 were considered significant.
Results: The overall anti-HBs Ab positivity rate was 75.66% (95% CI for prevalence of anti-HBs Ab = 71.5% to 79.6%), with a
range of anti-HBs Ab titers (10.1 – 673.4 mIU/ml). However, the anti-HBs Ab titer was failed to reach the protective level (≥
10.0 mIU/ml) in 110 vaccinees (24.34%). The significantly highest positivity rate (89.2%) was found among 12-17 months old
children (p < 0.001). Furthermore, significantly higher positivity rate among participants received 3 vaccine doses (P < 0.001).
The past history of hospitalization of vaccinees has significantly increase the positivity rate (P = 0.028). The results also found
that among participants administered 4 vaccine doses, highly significant positivity rate was arise after less than one year of
vaccination (P = 0.004).
Conclusion: Implementation of HB vaccine among children in Baquba city is efficacious as it yielded high anti-HBs Ab
positivity rate with a protective titer of anti-HBs Ab in the majority of vaccinees.
Keywords: HBV infection, HBV vaccine, anti-HBs Ab.

Background: Total Knee Replacement is one of the most successful and effective surgical option to reduce pain and
restore function for patients with severe osteoarthritis of the knee.
Objectives: To evaluate the result of Total Knee Replacement regarding patient’s satisfaction in treating osteoarthritis of
the knee.
Patients and methods: A prospective cohort study was conducted at AL-Yarmouk teaching hospital from December
2014 to June 2016 in which forty-four patients with late stage knee OA who underwent TKR were included in the
study. Outcomes was assessed according to OKS questionnaire. Participant demographics and baseline
characteristics and presence of comorbidities were recorded. Then the results were recorded accordingly.
Results: Among forty-four Total Knee Replacement performed, 84.09% resulted in patient satisfaction at three months
post operatively, which increased to 93.1% at six months after surgery.
Conclusion: Total Knee Replacement is useful technique for reducing pain and restoring good function for the joint.
Keywords: Knee joint, total knee replacement, osteoarthritis, patient satisfaction