Journal of the Faculty of Medicine Baghdad

Background: A novel virus known as severe known as severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) primarily targets the respiratory system of infected people. The virus spreads between individuals through respiratory droplets produced during sneezing or coughing. Anyone can contract the virus, but the severity of the disease is often associated with age and pre-existing medical conditions like cancer that may weaken the immune system.
Objectives: In this study, we analyzed severe outcomes of SARS-CoV-2 infections among patients with current or prior malignancy.
Patients and Methods: Between January 1st and December 31st, 2021, a cross-sectional study was conducted on 100 cancer patients from various medical centers in Baghdad, Iraq. The patients included 50% with solid tumors and 50% with hematologic malignancies. The medical centers involved in the study were the Oncology Teaching Hospital, Baghdad Hematological Center, and Private Nursing Home Hospital in the Medical City Complex. The patients were infected with severe acute respiratory syndrome coronavirus 2.
Results: There is a significant correlation between the severity of COVID-19 in cancer patients and their Eastern Cooperative Oncology Group (ECOG) performance status score of ≥1 (10%, P=0.009), the duration of their malignancy being ≥3 years (30%, P=0.017), and the status of their cancer at the time of COVID-19 infection, with patients having was found malignant disease being more likely to develop critical cases. Additionally, patients who were in remission during their coronavirus infection were found to have developed more critical cases (80%, P=0.001), which was statistically approved.
Conclusion: We found that COVID-19 severity parameters, rather than the underlying malignant disease, are the primary factors in morbidity and mortality.

Background: Colonoscopy is a critical and frequently used medical procedure that is essential in identifying colonic and rectal cancers in a timely manner. It remains the preferred method for visualizing the colonic and rectal mucosae, enabling the detection of conditions like carcinoma, adenoma, and inflammation. Colorectal cancer is the third most common cancer worldwide, and due to its tendency to present late, screening programs that rely on a sensitive tool like colonoscopy are of utmost importance.
Objectives: To evaluate the clinical characteristics and colonoscopic findings, including colorectal cancer, among patients referred to the gastro-enterology unit in Al-Imamain Al-Kadhemain Medical City and determine the most common presenting symptoms of colorectal diseases.
Patients and Methods: A study was conducted at the GIT unit of Al-Imamain Al-Kadhemain Medical City from November 2022 to March 2023 involving 120 patients who underwent colonoscopy. The study recorded the presenting complaint and colonoscopy results. The mean and standard deviation were used to express continuous variables, while frequency and percentage were used for categorical variables The difference between means was tested using Welch\'s t-test, and a P-value less than 0.05 was considered statistically significant.
Result: The study included a total of 120 participants, with an average age of 46.57 years. The leading indication for colonoscopy was bleeding per rectum (45%), followed by chronic constipation (26.6%) and chronic abdominal pain (21.6%). The most common pathologies observed during colonoscopy were internal hemorrhoid (18.3%), polyposis (15%), and colorectal cancer (13.3%).
Conclusion: Rectal bleeding is the primary reason for conducting colonoscopy and is also the most common symptom of colorectal cancer. During colonoscopy, Internal hemorrhoids are frequently observed, which is the most common cause of rectal bleeding. Polyps and colorectal cancer are the next most frequent causes of rectal bleeding.

Background: When the fetal membranes rupture before the completion of 37 weeks of gestation, it is known as Preterm Pre-labor Rupture of the Membranes (PPROM). This condition occurs in around 2% of all pregnancies. Predicting the occurrence of PPROM involves identifying associated risk factors and using specific biomarkers in order to prevent any adverse maternal or fetal outcomes.
Objectives: To investigate the relationship between folate, B12, and homocysteine in PPROM and assess the maternal and neonatal outcomes of PPROM.
Cases and Methods: A case-control study was conducted on 100 pregnant women at the Department of Obstetrics and Gynecology at Al-Khansaa Maternity Teaching Hospital. The study was conducted between 20th January and 1st July 2022. The participants were women with a single viable fetus and a gestational age 240/7 – 366/7 weeks. The study had two groups of Fifty pregnant each. The first group, known as the “case” group, consisted of pregnant women suffering from PPROM. The second group, known as the “control” group, consisted of pregnant women who were matched for gestational age, had intact membranes, were not in labor and had no obstetrical complications. The study estimated the levels of serum folate, B12 and homocysteine in both groups. Ethical approval was obtained prior to conducting the study.
Results: No differences were found between the two groups in terms of B12 and demographic data. However, the folate level was found to be lower in the cases than in the controls. On the other hand, the homocysteine level was significantly higher in the cases than in the controls. A homocysteine level of ≥ 28.85 nmol/ml was shown to be associated with a high sensitivity of 90%, specificity of 84%, and accuracy 87%. Therefore, it could also be used as a reliable tool to predict PPROM. A folate level of ≤3.22 ng/ml, on the other hand, is associated with moderate sensitivity and low specificity.
Conclusion: Homocysteine levels and folate deficiency are reliable indicators of PPROM risk. An elevated homocysteine is a contributing risk factor.

Background: Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) are both neurodevelopmental disorders that affect children early in life. Both conditions have a complicated origin.
Objectives: The aim of this study is to evaluate the neonatal complications linked with ASD and ADHD and to outline the utilization of psychotropic medications in the management of children and adolescents with ASD.
Methods: This study was conducted from January to April 2022 in the National Center for Autism/Medical City Complex in Baghdad. It involved 120 children with neurodevelopmental disorders and 120 controls participants. A questionnaire was used to collect the data, which was then analyzed using SPSS 25.
Results: There are five perinatal factors that have significant associations with child behavioral disorders, as indicated by a P-value of less than of 0.05. These factors are: Low birth weight (LBW), newborn complications, preterm-birth, being the last child and children delivered via a caesarean section. Additionally, the types of behavioral disorders have significant associations with the use of psychotropic medications. Around 50% of children with both ASD and ADHD, as well as children with ADHD alone, have used psychotropic medications. By comparison, only about 27% of children with ASD have used these medications.
Conclusions: Neonatal risk factors may be linked to neurodevelopmental disorders. Medications are used to manage ASD and ADHD in children and youth.

Background: COVID-19 pandemic has been linked to dyslipidemia in patients.
Objective: To investigate the alterations in serum low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, very low-density lipoprotein (VLDL), total cholesterol (TC), and triglycerides (TG) levels in individuals with COVID-19 infection.
Cases and Methods: This study was conducted at Jabra Hospital, Khartoum state, Sudan, from February to September 2021. It was an analytical, controlled hospital-based study that involved a total of 136 subjects. Of these, 68 were Sudanese patients who had contracted COVID-19, while the other 68 were healthy individuals who served as the control group. Data was collected through a questionnaire, and the serum lipid profile was estimated using spectrophotometric methods through an enzymatic process. The data was analyzed using SPSS (V25).
Results: The study found that patients with COVID-19 had significantly lower levels of serum LDL, VLDL, TC, and TG compared to the control group. The p-values for these differences were0.001, 0.002, 0.000, and 0.001, respectively. There was no significant difference in serum HDL and BMI between the two groups. In the case group, serum lipid profiles (excluding HDL) were significantly higher in overweight individuals compared to those with normal weight . Thep values for these differences were 0.001, 0.002, 0.001, 0.001, 0.001, respectively. However, there was no significant difference in serum HDL levels between the two weight groups. Interestingly, the serum lipid profile was significantly higher in overweight controls compared to the cases. The p values for these differences were 0.001, 0.041, 0.024, 0.001, and 0.001, respectively. Lastly, the study found that the serum lipid profile was significantly lower among severe COVID-19 patients compared to the control group with a p value of ≤0.001. Specially, serum LDL and TC were significantly lower in patients than controls, with p values of ≤0.001 and 0.003, respectively. On the other hand, serum TG was significantly higher in cases than controls with a p- value of ≤ 0.001. Serum VLDL and HDL levels were not significantly different between the two groups.
Conclusion: Research has suggested that individuals who have contracted COVID-19 have shown a decrese in lipid profile values compared to those who have not been affected by the virus.

Background: The roll of IL-17 during chronic hepatitis C virus (HCV) infection is not well understood. Elevated levels of IL-17 may increase the risk of liver fibrosis development in chronic HCV infection. However, the exact mechanism of how IL-17 contributes to the progression of HCV infection remains unclear.
Objectives: The aim of this study was to examine the association between HCV infection and IL-17. This was done by measuring the serum levels of interleukins and the viral load of HCV in patients with HCV infections.
Patients and methods: The study included fifty HCV patients who were receiving treatment at the Gastroenterology and Hepatology Teaching Hospital / Medical City Complex in Baghdad. The study was conducted between November 2022 and April 2023, and the study groups were matched with 50 controls based on age and sex. Seven milliliters of venous blood samples were taken from all participants to test for anti-HCV antibodies using ELISA kit, quantitative measurement of HCV RNA by PCR, and estimation of serum levels of IL-17.
Results: The range of HCV viral RNA titers among the patients was 165-55595000 copies/ml, and all of them tested positive for anti-HCV antibodies. On the other hand, the control group tested negative for the virus. The mean concentration of IL-17 in the patients’ group was 1458.03(±165.7) pg/ml, while the control group had a mean of 628.04 (±163.0) pg/ml (P < 0.0001). The R-value for HCV viral load and IL-17 was 0.1388. It is worth noting that the mean serum IL-17 concentration was highest among the patients aged ≥ 50 years old. As for the HCV patients on treatment, their mean viral load was 406, 3051.90 copies/ml, and their mean IL-17 concentration was 1444.56 pg/ml. The patients who did not receive treatment had a mean higher mean viral load of 765,525.94 copies/ml, and their mean IL-17 concentration was 1484.19 pg/ml.
Conclusion: The concentration of IL-17 was found to be significantly higher in patients with Hepatitis C virus (HCV), and it showed a weak positive correlation with HCV viral load. Moreover, older patients with HCV had higher levels of IL-17 in their blood. However, the measurement of HCV viral load and IL-17 did not show any significant differences in their readings.

Background: Colorectal cancer (CRC) is the third most common cancer in the world and the fourth leading cause of death. In Iraq, it is primarily a disease of old age, but its incidence and mortality rates are increasing across all age groups. To address this concerning trend, it is crucial to raise public awareness, implement screening programs, and develop effective management strategies.
Objectives: To evaluate primary care physician’s knowledge, attitude, and practice regarding early screening for colorectal cancer.
Methods: A cross-sectional study was carried out in Baghdad, from the 1st of June 2022 to the 1st of January 2023. The study involved 400 physicians who provided primary health care services. Data were collected through direct interviews using a self-structured questionnaire. The association between variables was explored using the Chi-square test, with a P value of less than 0.05 being considered statistically significant.
Results: The study involved physicians with a mean age of 38.0±7.62 years. Of the total participants, 27.3% (109) were males and 72.8% (291) were females. The study found that 268 (67.0%) participants had good knowledge, 178 (44.5%) had a positive attitude, and 122 (30.5%) participants had good practice. Those aged between 36-45 years, with less than 10 years of employment experience, and family medicine residents had significantly higher levels of good knowledge (P < 0.05). Females had a significantly more positive attitude (P=0.001).
Conclusions: It was observed that participants had good knowledge about the CRC screening program. However, they showed poor attitude and practice towards it. The age group of 36-45 years, individuals with less than 10 years of employment, and family physicians had better knowledge than others. Among the family medicine female residents, a positive attitude was observed.

Background: Impaired lipid metabolism and vitamin D deficiency are well-recognized risk factors for coronary artery disease (CAD) which is considered the major reason of mortality and morbidity in both high and low-income countries. The incidence of coronary artery disease is 2-8 folds higher in Type 2 diabetes patients than those without Type 2 diabetes.
Objective: The current study aimed to study some biochemical variables (vitamin D3, lipid profile, Insulin, Fasting blood glucose and glycated hemoglobin HbA1c) in patients with diabetes and coronary artery disease and compare them with healthy people.
Subjects and Methods: A case- control study included 190 male subjects divided into four groups: including 40 healthy controls, 40 diabetic patients, 55 patients with coronary artery disease and 55 patients with Type 2 diabetes and coronary artery disease were recruited from the catheterization unit in cardiologic clinics of Iraqi Center for Heart Disease and specialized center for endocrinology and diabetes, Baghdad Teaching Hospital/ Medical City, during the period from February 2022 to November 2022. Physicians diagnosed them, and they were evaluated by physical and full medical history. All the sample set parameters were measured in the fasting state for each group .The biochemical testes included fasting blood glucose, lipid profile measured by Colorimetric method, while vitamin D3, Insulin, glycated hemoglobin HbA1c measured by enzyme linked immunosorbent assay (ELISA). Various statistical analyses were applied to analyze the research data. The statistical analysis was performed using Student t-test was used for calculating the probability using the statistical analysis program (PAST version 3.09, 2004).Two-way ANOVA and Least significant differences (LSD) post hoc test were performed as well as paired t-test. P< 0.05 was considered statistically significant.
Results: About 65.3% of study subjects had Vit.D insufficiency and 16.8% had Vit.D deficiency. A statistical significant difference was found in mean (± SD) level of BMI, insulin level, vitamin D, HOMA-IR, Fasting blood glucose and HbA1c between the 4 groups. For lipid profile, Control group participants had significantly lower total cholesterol level in comparison to the other groups. Control group participants had significantly lower triglyceride levels in comparison to the other groups. Control group participants had significantly higher high-density lipoprotein (HDL) in comparison in coronary artery disease group and coronary artery disease with Type 2 diabetes group. Control group participants had significantly lower low-density lipoprotein (LDL) in comparison in coronary artery disease group and coronary artery disease with Type 2 diabetes group.
Conclusions: Depending on the results of the current study, it was found that there is a strong association between low vitamin D and coronary artery disease, and it was found that insulin resistance, which mainly causes type 2diabetes, has increased health problems in coronary artery disease patients.

Background: Recent studies have shown that the anti-fertility effects of Ketoconazole can be minimized by taking an antioxidant nanoparticles based-plant extract in combination with the medication or by taking it after medication. One of the effective methods to improve its medicinal properties and decrease the toxicities of Selenium is by formulating it as nanoparticles. However, this is still a challenging strategy.
Objectives: The aim of this study was to analyze the impact of nano selenium, which was prepared from Eruca Sativa extract, on testicular oxidative stress parameters in rats that were treated with ketoconazole. The study will focus on the evaluation of glutathione peroxidase, superoxide dismutase, and malondialdehyde as indicators of oxidative stress.
Methods: In this study, a 1% w/v solution of plant extract was added to a solution of 10mM sodium selenite in different ratios, and placed on a magnetic stirrer in the dark for 12 hours at a temperature 50Cº and pH9. The solution was then left for 48 hours, and the optimal fabricated selenium nanoparticles were selected for further characterization. forty-eight rats were divided into six groups with eight animals in each. Group A was the negative control, while Group B was given oral Ketoconazole at a dose of 50mg/kg for fourteen days. Group BC, BD, BE1 and BE2 were given oral Ketoconazole at a dose of 50 mg/kg for fourteen days, followed by 200mg/kg Eruca Sativa, 0.5mg/kg oral sodium selenite, 0.25mg/kg oral nano selenium and 0.5mg/kg oral nano selenium for 28 days, respectively. Finally, the animals were euthanized and their testicle anti-oxidant parameters were evaluated.
Results: Significant increases in glutathione peroxidase and superoxide dismutase ( p value < 0.001), and a decrease in malondialdehyde levels ( p value < 0.001) were observed in groups treated with nanoparticles compared to control group.
Conclusion: Nano forms of prepared by Eruca sativa extract exhibit significant antioxidant effects on testicular tissues, while being available for several metabolic, biological, and physiological functions.

Background: Hypothyroidism is a medical condition characterized by increased levels of thyroid stimulating hormone and normal or decreased levels of thyroid hormones. This condition may contribute to dyslipidemia, hypertension, atherosclerosis, cognitive impairment, neuromuscular dysfunction and infertility. Several factors that increase the risk of cardiovascular disease, such as metabolic syndrome and dyslipidemia, are related to obesity. Stromelysin-2, also known as matrix metalloproteinase-10, is an enzyme produced by cells that breaks down the extracellular matrix in various tissues, including blood vessels.
Objective: To assess the levels of serum stromelysin-2 in patients with subclinical and clinical hypothyroidism and compare them with healthy controls. Additionally, to determine the relationship between serum stromelysin-2 levels and the anthropometric measures.
Methods: A case control study was conducted with 130 Iraqi individuals divided into three groups. The study aimed to measure serum stromelysin-2 and anthropometric parameters such as body mass index, waist circumference, and waist-to-hip ratio. To differentiate between more than two independent means the ANOVA test was used for blood investigations.
Result: The study found that clinical and subclinical hypothyroid patients had significant higher mean body mass index (P = 0.001), waist circumference (P = 0.001), waist to hip ratio (P = 0.001), and serum stromelysin-2 (P = 0.001) compared to healthy control. Among patients with clinical hypothyroidism group, there were positive correlations between serum stromelysin-2 and body mass index (r = 0.413, p = 0.005), waist circumference (r = 0.406, p = 0.006), and waist to hip ratio (r = 0.367, p = 0.013).
Conclusion: It has been observed that patients suffering from clinical and subclinical hypothyroid patients tend to have a higher body weight, as measured by their body mass index, waist circumference, and waist-to-hip ratio. This may indicate an increased risk of cardiovascular disease. Additionally, such patients have been found to have high levels of stromelysin-2, a protein that is believed to be indicative of early atherosclerosis in blood vessels. This suggests that stromelysin-2 could potentially be used as a marker for predicting cardiovascular disease in hypothyroid patients.

Background: It is possible that treatment may not be successful, and the expenses of therapy may increase due to patients’ lack of knowledge and inappropriate conduct. Insufficient knowledge regarding the use of insulin can hinder its effectiveness and adherence. Therefore, it is crucial for diabetic patients to follow guidance on insulin management to ensure better outcomes.
Objectives: to investigate the correlation between parents' knowledge of children with type I diabetes and their ability to properly administer insulin to their children in the outpatient diabetes clinic in Nasiriya City.
Methodology: A cross-sectional study was conducted at the Center of Endocrinology and Diabetes in Nasiriyah, Iraq between October 4, 2022, and March 30, 2023. The study enrolled 180 children and adolescents diagnosed with type 1 diabetes mellitus. The surveys were translated into formal Arabic and administered through face-to-face interviews and patient-caregiver. The knowledge phase comprised 15 questions, while the final segment on taking insulin had five questions. Blood samples were collected from the patients to measure their fasting blood sugar and Glycated hemoglobin. The collected data underwent descriptive analysis using SPSS version 25 software.
Results: A total of 180 children and adolescents with type I diabetes were part of the study. The patient's average age was (10.75 ±4.36) years, and they had been diagnosed with type 1 diabetes for an average of (6.24 ±3.70) years. Their fasting blood sugar level was out of control (208.42 ±95.0 mg/dl) and their HbA1c level was (9.90±2.85%). Most of the patients (52.2%) were female and had only completed kindergarten (43.3%). The majority of caregivers were parents or guardians who were either illiterate (30.6%) or had an elementary education (33.9%).
Conclusions: The study concluded that most of the caregivers had poor behaviors and insufficient knowledge about insulin usage in type 1 diabetic patients.

Background: The use of ionizing radiation, such as radiotherapy and medical imaging, is common in modern medicine. However, it can have negative effects on the body, such as an imbalance in oxidative stress, which can lead to periodontal or gum disease. Radiographers are particularly at risk of experiencing this due to increased levels of reactive oxygen species. Antioxidant therapy, such as melatonin, may help to minimize oxidative stress and protect tissues.
Objectives: The study aimed to evaluate the impact of radiation on periodontal conditions among radiation workers, as well as to assess the levels of melatonin in their bodies.
Patients and Methods: The study group consisted of 40 men who had worked with ionizing radiation for 5 years or more, while the control group consisted of 40 men who worked as nurses or lab workers. Unstimulated salivary samples were collected from all subjects to measure salivary melatonin levels. Both groups were then evaluated for the plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss.
Results: The results of the study showed that the study group had a higher mean plaque index (1.41±0.484)compared to the control group (1.14±0.524)(p=0.013),a higher mean probing pocket depth (4.40±1.463) compared to the control group (2.82±2.328) (P=0.0002), and a higher mean clinical attachments loss (2.67 ±1.461) compared to the control group (1.59±1.919) (P=0.004). However, there was no significant difference in the mean gingival bleeding between the two groups. Additionally, the study group had a lower mean salivary melatonin level(34.19±13.849) compared to the control group(42.43±16.783)(P=0.013).
Conclusion: This study suggests that radiation exposure may increase the risk of periodontal disease. The results also indicate that both radiation and periodontitis can affect salivary melatonin markers, which may be useful in identifying periodontitis

Background: The immune system and thyroid hormones have an inverse relationship, but both thyroid hormones and selenium play a crucial role in the immune system. However, when the levels of thyroid hormones decrease (known as hypothyroidism), their effect on immune system cells and their relationship with selenium supplements in the body are not well understood.
Objectives: The aim of this study was to investigate the impact of Se-nanoparticles on thyroid hormones and the blastogenic response of lymphocytes in various lymphoid tissues in rats with hypothyroidism.
Methods: A group of female Wister rats aged three to four months were randomly placed into five groups (each group has 6 rats) and were given a basal diet on a daily basis. However, the daily water supply given to each group was different. The first group was the control group and received normal water, while the other four groups were given 0.02% methimazole in their drinking water every day for four weeks to induce hypothyroidism. Once the hypothyroidism was confirmed, the 3rd, 4th, and 5th experimental groups were given one of the following three treatments for four weeks, respectively: SC-SeNPs (0.1mg selenium per kg per day) as T1, Levothyroxine (0.9μg per 100g per day) as T2, or SC-SeNPs (0.1 mg selenium per kg per day) and Levothyroxine (0.9μg per 100g per day) as T3. In the end, blood samples were collected from euthanized animals using a high dose of anesthesia, and lymphoid tissue samples (spleen, Peyer’s patches and mesenteric lymph node) were preserved in 10% formalin.
Results: Our research has revealed that IgG, a humoral immunity marker, was found to be significantly decreased in hypothyroidism. However, when treated with levothyroxine alone or in combination with Sc-SeNPs, the level of cellular immunity marker, IL-6, was found to be significantly increased in hypothyroidism when compared to the control group. Additionally, we observed histopathological changes in the lymphoid tissue of hypothyroidism rats, which included depletion of the white pulp of spleen with congestion in the blood vessels, a decrease in the lymphoid follicle of Peyer’s patches, and a decrease in the primary and secondary follicles of the mesenteric lymph nodes 02
Conclusion: Thyroid hormones play a role in regulating innate and adaptive immunity. The combination of selenium with levothyroxine is the most effective treatment for hypothyroidism and improves the activity of the immune system cells.

Background: Type 2 diabetes mellitus is a condition in which the body is unable to use insulin effectively. This condition was previously known as non-insulin-dependent or adult-onset diabetes. Osteopontin (OPN) is a phosphorylated glycoprotein initially found in a secreted form in bones. Later, it was discovered that it also exists as an intracellular protein.
Objectives: The study aimed to predict Osteopontin levels in type 2 diabetes mellitus patients without fatty liver disease.
Methods: The research involved 80 participants from Iraq, aged between 45 to 73 years old. Out of these participants, 45 were males, and 35 were females. Group A included 40 patients with Type 2 Diabetes Mellitus without nonalcoholic fatty liver, while group B consisted of 40 healthy individuals.
In all participants the following parameters were measured: FBS, HbA1C, BMI, Insulin, HOMA-IR, Lipid profile, and Osteopontin.
Results: The study found that group A had significantly higher levels of FBS, HbA1c, insulin, HOMA-IR, triglycerides, and VLDL compared to group B (P ≤ 0.05). Additionally, group A had significantly lower levels of HDL than group B. However, there were no significant differences in the levels of cholesterol, LDL, and ALP between the two groups (P ≥ 0.05). The mean ±SD levels of Osteopontin were 23.66 for group A (DM with NAFLD), 15.65 for group B (DM without NAFLD), and 5.43 for group C (control group). This indicates a statistically significant difference (P≤0.05) in the mean ±SD levels of Osteopontin among the studied groups.
Conclusion: All parameters are increased in patients with type 2 DM without nonalcoholic fatty liver disease compared to the control group. The recommended threshold for Osteopontin in predicting type 2 diabetes mellitus without non-alcoholic fatty acid liver disease is 9.31 ng/ml.

Background: Circumscribed choroidal hemangioma (CCH), a rare benign tumor, poses significant risks to vision due to its proximity to the macula, with epidemiology varying from one population to another.
Objectives: The present article emphasizes the need for prevalence studies on CCH in Iraq.
Methods: In June 2023, a literature review was conducted on PubMed, followed by a secondary analysis of patients' demographic data from diverse populations and ethnic groups worldwide.
Results: The secondary literature analysis revealed demographic variations in CCH, including age and gender(male-to-female)ratios, and across different populations. The exact prevalence remains unclear, particularly in Iraq, due to limited data and asymptomatic cases. Accurate diagnosis through imaging techniques is crucial for symptomatic cases, with treatment modalities like PDT available. Economic challenges persist in Iraq, highlighting the need for collaboration between healthcare and government sectors.
Conclusion: The lack of CCH prevalence studies in Iraq impedes understanding and management, impacting ophthalmology care for Iraqi patients. Addressing this gap through research can benefit local healthcare authorities and provide essential data for the Middle East and other regions worldwide

Background: Drug toxicity and side effects of chemotherapy have a negative impact on breast cancer patients.
Objectives: To evaluate the effectiveness of pharmaceutical interventions in improving breast cancer patients' knowledge, attitude, and practice regarding breast cancer chemotherapy.
Methods: A pre-post clinical pharmacist interventional study was conducted at the chemotherapy ward of AlHabbobi Hospital in AlNasiriyah City, located in the south of Iraq. The study involved fifty women with breast cancer who were provided with comprehensive pharmaceutical care and a self-compiled medication knowledge guide pamphlet. Two sessions were conducted for each patient; the first session was conducted after the patient filled out a questionnaire at baseline and the second session was conducted after 21 days, depending on the chemotherapy schedule. Each session lasted for approximately 45minutes. Participants were requested to refill the questionnaire at the end of the study. Within the group, a paired

Background: Osteoporosis (OP)is a silent disease that affects the microarchitecture of the skeleton bones, leading to a drop in mineral levels and an increase in fracture rates. This condition is more common in women than men, especially postmenopausal women, due to decreased production of estrogen, a hormone that regulates bone formation and bone resorption. Oxidative stress is a known factor in the development of OP, resulting from an imbalance in the production of oxidants and antioxidants. Hip and arm fractures are particularly common in women with OP.
Objective: The study aimed to evaluate the activity of Lactate Dehydrogenase(LDH) and oxidative stress (OS)levels in postmenopausal women with osteoporosis and varying levels of vitamin D, and to compare these groups based on the measured parameters.
Subjects and Methods: This study was conducted at the Baquba Teaching Hospital in Diyala, Iraq, from October 2022 to January 2023. The study involved 100 women whom were divided into two groups, 50 with normal vitamin D levels and 50 with abnormal vitamin D levels. The malondialdehyde(MDA)level was evaluated using the Satoh-modified approach. Results: According to the statistical analysis conducted with the SPSS program, there was a significant difference (P<0.001) in Vitamin D levels between the groups (OPn. D) and (OPab.D). Additionally, significant increases were observed in LDH activity(P<0.001) and MDA levels(P<0.05) for the group (OPab.D) in comparison to (OPn. D).
Conclusion: The current study has indicated that women suffering from osteoporosis (OP) have higher levels of LDH and MDA. Additionally, there is an inverse correlation between vitamin D and these two variables; this correlation suggests that vitamin D may possess antioxidant properties that reduce the effects of oxidative stress (OS) in the body. Therefore, vitamin D may help in reducing LDH levels.

Background: Acute myeloid leukemia is one of the deadliest hematologic malignancies that is marked by genetic alterations, abnormal cellular functions and proliferation. Mutations in isocitrate dehydrogenase genes, particularly isocitrate dehydrogenase gene 1 and isocitrate dehydrogenase gene 2, have emerged as recurrent genetic abnormalities in acute myeloid leukemia. These mutations lead to abnormal enzymatic activity, resulting in the accumulation of 2-hydroxyglutarate, which disrupts normal cellular processes including DNA methylation. This review article explores recent findings related to the implication of isocitrate dehydrogenase gene mutations on the acute myeloid leukemia epimethylome and provides evidence to the relationship between these mutations and the , and treatment of acute myeloid leukemia. A comprehensive literature search was conducted to identify relevant studies investigating the impact isocitrate dehydrogenase dehydrogenase mutations on altered DNA methylation patterns acute myeloid myeloid leukemia-related genes. The selected studies were reviewed analyzed to to highlight the significance of their findings. The review highlights that isocitrate dehydrogenase gene mutations in acute acute myeloid including associated with widespread changes in DNA methylation patterns. These alterations primarily affect DNA methylation of acute myeloid leukemia-associated genes, including DNA methyltransferases and ten-eleven translocation proteins. Such epigenetic dysregulation in the DNA methylation modifying genes contributes to global DNA hypermethylation and specific gene hypomethylation leading to abnormal cellular functions and the development of acute myeloid leukemia. The findings of this review support the significant impact of isocitrate dehydrogenase gene mutations on DNA methylation of acute myeloid leukemia-related genes. Understanding the interplay between isocitrate dehydrogenase gene mutations and DNA methylation dysregulation provides insights into acute myeloid leukemia pathogenicity and may have implications for prognostication and targeted therapies