Journal of the Faculty of Medicine Baghdad

Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, seven strains of coronaviruses were recognized to cause respiratory infections ranging from the common cold associated with HKU1, NL63, OC43 and 229E viruses to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) during 2002, Middle East Respiratory Syndrome (MERS) during 2012, and the COVID-19 that started during December 2019 in Wuhan, China (1)

Background:The World Health Organization (WHO) has announced that coronavirus covid-19 is a pandemic. The first case of covid-19 was confirmed in Iraq on the 24thof February 2020, which was of an internationalstudent who travelledrecently to Iraq. This review is the universal data analysis of the first40-days of coronaviruscovid-19 patients admitted to Medical CityTeaching Hospital(MCTH)including their clinical outcome. Objective:We have conducted this study to describe the first 40-days experience in management of corona virus covid-19 and the clinical outcomes of patients treated with a protocol adopted in the first of March 2020(described in the attachment).Patients and methods: This is apreliminarydescriptive study demonstrating all actions conducted in MCTH to manage coronavirus patients.The study included 79 patients who were RT-PCR positive out of 469 suspects who were screened in the outpatient clinic of MCTH accordingto WHO criteria. The clinical outcomes were defined as complete clinical and immuno-virologic recovery, non-recoveryand death. Complete recovery was defined as negative RT-PCR conducted twice after disappearance of clinical symptoms. Death was subclassified as death within 24 hours andafter 24 hours in the hospital or intensive care unit. Non-recovered cases were defined as persistent symptoms or persistent positive RT-PCR after disappearance of clinical symptoms. The treatment protocol was Oseltamivir 75 mg BID for 5 days with Hydroxychloroquine (400mg BID first day then 200mg BID for 5 days) for moderate cases, adding Kaletra (Lopinavir-Ritonavir (200/ 50 mg) 2 tablets PO BID 5 days for severe cases, and ribavirin for critical cases. Results: The total numberof symptomatic patients and PCR positive was 79 patients out of 469 screened suspects (16.84%).The mean age was (47.18 -/+ 18years,andare prevalentamong the age group(40-50 years). There were 59 male patients(74.68%) in comparison and20 female patients (25.31%). There were 13(16.45%)patients with moderate disease ,15(18.98%)patients with severe disease, and 13(16.45%)patients with very severe disease required admission to critical care. The clinical recovery (free of clinical symptoms) was seen in 84.9 %. Completerecovery was seen in 41 (51.89%)patients,death within 24 hourswas seen in 6 patients (7.5%) while confirmed deathafter 24 hours wasseen in 4 (5%). Conclusions: The treatment protocol is well conducted in this center with promisingrate of complete recoveryand excellent rate of clinical recovery. The high initial death rate was compensated after threeweeks withmore orientationand experienceof medical staff and peoples about the disease.

Background: Prostaglandin D2 (PGD2) is a lipid mediator appeared as a powerful activator that regulates the T-helper2 (TH2) and Type-2 innate lymphoid cells (ILC2), and functions as diagnostic marker and it has probabletherapeutic targets forasthma. Objectives: To define the role of Prostaglandin D2 biomarkers in disease severity, and to forecast disease risk and progression.Patients and methods:Acase control study was conducted onForty fourIraqi asthmatic patients and 44 apparently healthycontrols who wereage and sex matched. Four ml of blood samples was takenfrom the study groups for the detection PGD2 using ELISA.Results:The serum level of PGD2 was almost convergent between cases and control group (median= 36.5pg/mland 35.1pg/mlrespectively).Thehigh medianserumconcentration of PGD2 showed a strong statisticallysignificant association withtheseverity of asthmatic patients (39.8 pg/ml) in severe casescompared to (30.84 pg/ml) in moderate cases (P value =0.005). The median concentrationof serum PGD2 revealed a higher level in abnormal eosinophil, monocytes and total IgE (42 pg/ml), (48.9 pg/ml) and (38.5 pg/ml) respectively than the median concentrationof normal counts. Conclusions: Measuring serum PGD2 in asthmatics is crucial to predict disease susceptibility, severity and disease control.

Background:Astrocytoma, is heterogeneous tumorof the nervous systemand studies on the virulence of thesetumors reveal that theirbehavior isled by small population of cells which arethe brain tumor stem cells (BTSCs) that drive the continuousproliferation and self-renewal. From the many markers that annotate BTSCs, arethe CD133, and NESTIN.Objectives:Using CD133, to immunolabelBTSCs niches in paraffin sections of astrocytoma then, extraction of thesecells, to calculate fold expression of NESTIN gene across the grades by real time PCR. Materials and methods: Paraffin blocks of four grades of primary astrocytoma have been selected from three age groups from Iraqi patients. The age groups were stratified into: children (0-17years) adults (18-49years) and older (50-80years). The samples were stainedwith CD133, thenpositive areaswereextracted to perform relative expressionof NESTIN geneby real time PCR Results:The expressionof NESTINfor all grades,increasedby tens of folds in relation to calibrator then this fold expression increaseddramatically in an ascendingmanner withincreasing of the grade in the same group. The fold expression of NESTIN gene in all grades was the highest in the adulthood (18-49) yearsgroup. Conclusion: Relative expression of NESTIN gene of BTSCs in different grades of astrocytoma can be a useful tool for the assessment of the virulence with ascending the grades. This expressionwas the highest at age (18-49) years

ackground:Acinetobacter baumannii is a significant opportunistic pathogen and it is generally associated with benign colonization of hospitalized patients. Objective:To investigate skin colonizationwithAcinetobacter baumanniiin hospitalized patients and healthy volunteers.Antimicrobial resistance patterns of Acinetobacter baumanniiwasassessed by determining the minimum inhibitory concentrations (MICs) of thirteen different antimicrobial agents.Patients and Methods: The study performed on hospitalizedpatients at Rizgary and Hawler teaching hospitals and healthy volunteers who attended to supermarkets in Erbil, Iraq. A single sample was obtained once from each of the forehead, one ear pinna, one armpit, finger webs of one hand and toe webs of one footto isolatedAcinetobacter baumannii,then identified using phenotypic and genotypic properties. All isolates examined for their antimicrobial susceptibility bytheagar dilution method.Results: Among 600 hospitalized patients, 79 (13.17%) colonized with Acinetobacter baumannii, yielding 155 isolates that are resistant to 57.42% ceftriaxone, 56.77% cefotaxime, 45.81% ceftazidime and 40.65% ciprofloxacin.Whilethe most effective antimicrobial agentswith MIC50/90values (minimum inhibitory concentrations required to inhibit 50% and 90% of the isolates, respectively) were as follows:imipenem, 80.65%, 0.25/16 mg/L;doxycycline, 80.65%, 1/16mg/L;amikacin, 79.35%, 2/64 mg/L. However, 53 Acinetobacter baumanniiisolated from healthy volunteers that showedresistance to50.94% ceftriaxone (MIC50/90,64/128 mg/L), 45.28% ceftazidime, 43.40% cefotaxime, and 35.85% ciprofloxacin. Fortunately, all 208 Acinetobacter baumanniiwere sensitive to polymyxin B (MIC50=0.25mg/L).Conclusion: The rates of Acinetobacterbaumannii colonizedpatients higher thanhealthy volunteers, whereas an antimicrobial minimum inhibitory concentrationsvalue of cefepime, cefotaxime, imipenem, amikacin, ciprofloxacin, and levofloxacin were significantly higher in patients than healthy volunteers. Polymyxin B had activity against allAcinetobacter baumanniistrains.

ackground: Neonatal jaundice (NNJ)is one of the most common diseases globally. It is believed that delays in detection and improper treatment of neonatal jaundice can be responsible for neonatal morbidity and mortality. Knowledge and health seeking behavior of mothers play an important role in the course of this health condition.Objectives: To study mother's knowledge and her health seeking behavior toward home management of neonatal jaundice. Methods:A cross sectional study of non-probability convenience sample of 200 mothers of neonateswith neonatal jaundice who were admitted to Children Welfare Teaching Hospital and Ibn Al-Baladi Maternal and Child Hospitalduring the period from 1st of July to 1st of October, 2018. Data were obtained by the researcherthrough direct interview of the mothers and completed the structural questionnaire. Data were analyzed by SPSS through measuring frequencies, percentage, T test and chi squaretest. Results: The study found that high percentage of mother's were primary school graduates (38.5%), were unemployed (90%), continue the breastfeeding for NNJ (94.5%).Only (34.0%) of mothers knew the cause, (71.5%) correctly identified neonatal jaundice, (80%) exposed the child to florescent-light, (69%) use yellow beads, (69.5%) avoid using yellow color for baby clothes and (69.0%) avoid using yellow color for baby tools.There weresignificant association between mothers` knowledge and mothers` age (p=0.005), education (p=0.029) and residency area (p=0.010), andbetweenmothers` practice and occupation (p=0.039) and residency area (p=0.030), andbetween mothers' believesand education (p=0.001) and occupation (p=0.031).Conclusions: There are gaps in mothers' knowledge and health seeking behavior regarding neonatal jaundice as there are Fair to poor level for majority of the knowledge items, Slightly good level of mother's practices and High percentage of mothers still believed in thetraditional methods regarding home management of neonatal jaundice.The suboptimal and inadequate knowledge of the mothers for majority of items was significantly associated with age and educational level of mothers. There was significant correlation of mothers’ seeking behaviors with occupation and educational level

Background: Machine learning relies on a hybrid of analytics, including regression analyses. There have been no attempts to deploy a sinusoidal transformation of data to enhance linear regression models.Objectives: We aim to optimize linear models by implementing sinusoidal transformation to minimize the sum of squared error.Methods: We implemented non-Bayesian statistics using SPSS and MatLab. We used Excel to generate 30 trials of linear regression models, and each has 1,000 observations. We utilized SPSS linear regression, Wilcoxon signed-rank test, and Cronbach’s alpha statistics to evaluate the performance of the optimization model.Results: Thesinusoidal transformation succeeded by significantly reducing the sum of squared errors (P-value<0.001). Inter-item reliability testing confirmed the robust internal consistency of the model (Cronbach’s alpha=0.999).Conclusion: Ouroptimization model is valuable for high-impact research based on linear regression. It can reduce the computational processing demands for powerful real-time and predictive analytics of big data.

Background:Aggression is any behavior intending to harm another living being that desires to avoid such harm. Aggression isconsidered as apublic health problem worldwide. Exposure to violence is a determinant of aggression. Al-Sadr city, which is an overcrowded residential area in Baghdad, was exposed to violence through wars, civil war, and widespread inter-personal violence). This situation was an impetus to study aggression in this city.Objectives:To estimate the prevalence of aggression among secondary school students in Al-Sadr city, Baghdad.Methodology:A cross-sectional study was carried out in Al-Sadr city in Baghdad. A total of 720 adolescent secondary schools’students from both genders wereincluded in the study. They were selected by multistage random sampling. Their age was ranged from 13-21 years. Data was collected from 1stof February 2019 to 30 of April 2019 through a self-reported questionnaire (Aggression-Problem Behavior Frequency Scale).Results:The mean age of participants was 16.2±2.04 years. Of all participants, 84.3% were assessed to be aggressive; including 329 (91.4%)males and 278 (77.2%) females. Males showed significantly higher aggression than females (p=0.001). Absence from school and low academic achievement were dominating among aggressive students (88.2% and 86.9%, respectively).Non-physical Aggression was the most common type of aggression (76.4%).Conclusion:A high prevalence of aggression (mainly non-physical) was found, which was significantly associated with gender, being higheramong males. Aggression was negatively affecting school achievement

collision tumor is the presence of two histopathologically distinct tumorsin the same anatomical site. It is a rare pathology of the thyroid gland that makesdiagnosis and treatment challenging. This is a case report of a collision tumor of the thyroid gland