Karbala Journal of Medicine

The treatment of bacterial illnesses is a complicated task because this mi-cro-organism has the ability to de-velop a wide spectrum of antibiotic resistance and in different mecha-nisms. Antimicrobial drugs are typi-cally categorized according to their primary mode of action, for example β-lactams and glycol-peptide agents may interfere with cell wall synthesis, while macrolides and tetracycline disturb bacterial protein synthesis, another group (fluoroquinolones and rifampin) can inhibit nucleic acid and genetic material synthesis, while inhibition of a metabolic pathway is a mechanism of trimethoprim-sulfamethoxazole agents, interfer-ence with the structure of bacterial membranes and function is a char-acteristics of polymyxins and dap-tomycin. Antibiotic resistance can develop in bacteria in a variety of ways. They may be naturally re-sistant to antimicrobial treatments, or they may be resistant due to ge-netic alterations or the transmission of a resistance allele from another species. The development of efflux-ing systems that prevent the medi-cine from accomplishing its aim in-tracellularly, adapting the medica-tion's area of action, or providing a substitute biosynthetic activity that avoids the drug's effects could all be possible with a new resistant allele. By conjugation, transformation, or transduction, antimicrobial-inclined microorganisms can gain current genetic material from resistant bacte-ria, with transposons commonly as-sisting the inclusion of multiple re-sistance genes into the host's genome or plasmids. Antibacterial therapies provide selection stress, which allows new bacteria to emerge.

Background: Breast cancer is one of the most common cancers among females worldwide. Early detection of breast cancer plays the leading role in reducing mortality rates and improving the patients' prognosis.
Aim of the study: To assess the level of female University students’ knowledge attitude and practice of breast self-examination among Kerbala University student in 2021.
Subject & Methods: A cross-sectional study. It was conducted in the University of Kerbala. Four colleges were chosen randomly as two medical and other two non-medical colleges. The study samples include 389 female students from 18 to 26 years.
Results: The mean age of the responders was 19.9± (1.45) years. Most of the participants 310 (79.9%) were aware about breast self examination. The highest accurate responses were observed (91.0%) following the question “Is breast self examination important to diagnose early breast cancer?”, mean±SD (0.91±0.290), and 95% Cl (0.88-0.94). The awareness rate of this section was calculated as (61.1%). Similarly, the overall proportion of positive attitude and breast self examination practice were found (71.0%) and (39.0%), respectively.
Sociodemographic characteristics such as subject of education, high financial wellbeing, and urban resident were found to correlate positively with Breast self examination (BSE) practice, (P=0.017), (P=0.029), and (P=0.01), respectively.
Conclusion: Although the study documented good level of awareness among the university students of Kerbala, practicing breast self-examination was relatively low. This is mostly due to not knowing the exact technique to follow and/or students do not trust themselves in finding any medical benefit from practicing.

Background: Remdesivir is the first treatment for COVID-19 to receive FDA approval. On Oc-tober 22. 2020, the antiviral drug Remdesivir was approved to treat COVID-19 patients requiring hospitalization.
Objectives of the study: To compare the effect of timing of Remdesivir administration on the duration of hospitalization and clinical outcome of hospi-talized patients with severe COVID-19 in Imam Al-Hussain medical city, those who re-ceived Remdesivir early; in the first week, with others who re-ceived it in the second week of the onset of the symptoms.
Patients and methods: A retro-spective study was done in Imam al-Hussain medical city in Karbala province. The data was collected from 139 pa-tients' registry (84 male&54 female) with severe COVID-19 infection who admitted to the isolation wards, 68(48.6%) re-ceived Remdesivir in the first week, and 71(51.1%) received it in the second week from the onset of symptoms. A compari-son was made between the two groups regarding the clinical outcome and duration of hospi-talization.
Result: During the first week from the onset of the symp-toms, about 48.9% of patients with severe infection received Remdesivir, 95.6% of them improved, and 4.4% died. The median time of recovery was six days. About 51.1% received Remdesivir during the second week, 84.5% improved, and 15.5% died. The median time of recovery was 8.5 days.
Conclusions: The case fatality rate was lower in patients who received Remdesivir during the first week from the onset of symptoms than patients who received treatment in the sec-ond week. Patients in the first group recovered substantially faster than those in the second one.

Background: Pin worm infection is caused by Enterobius vermicularis. According to World Health Organiza-tion, over a billion people are infect-ed worldwide.
Aim: To assess mother’s knowledge, practice and prevention of pin worm infestation among their chil-dren and to find the association with demographic features of each of them.
Methods: A cross-sectional study with an analytic element in which 120 mothers participated in the study. Statistical significance is p<0.05.
Results: About (68.3%) of partici-pants were under30 years old. Mean age was 29.7, standard deviation =4.6, (82%) of them completed their college or institution. Regarding mode of transmission (68.3%) moth-ers said it is by contaminated food. They had good knowledge about prevention: hand washing before and after feeding (95.8%), hand washing after using the toilet (95.0%). Good knowledge about treatment was reported. (88.3%) knew that pin worm is treated with oral medicine, (53.3%) knew that all the family members must be treated. Regarding treatment seeking site, (82.5%) choose privet clinics.
Conclusions: Near two-third of the participants had good knowledge about pinworm infestation. The ma-jority had good practice in preven-tion of infection. There were signifi-cant relations between mothers’ edu-cational level and total knowledge about treatment and prevention. The majority depend on internet as a source for information and only small number depend on PHC as a source.

Background: A grouping of many metabolic risk factors, such as central obesity, hypertension, hyperglycemia, and dyslipidemia, known as the metabolic syndrome, can coexist in the same person. Globally, it is estimated that 25% of the adult population can be characterized as having metabolic syndrome.
Objectives: To evaluate the demographic and clinical charecteristics of metabolic syndrome patients and to assess the association of some lifestyle risk factors and the components of metabolic syndrome. This study also aimed to assess gender differences regarding demographic, clinical and lifeslyle risk factors.
Methods: A cross-sectional study was carried out in The Specialist Center of Endocrine Disease and Diabetes in Al- Alsader Medical City.
The diagnosis of metabolic syndrome was confirmed according to the recently (2009) revised International Diabetes Federation definition.
Each patient's data were collected through a 15-minute direct interview using a self-structured questionnaire. The questionnaire included information about demographic, anthropometric measurements, biochemical tests, physical measurements, and lifestyle information.
Results: This study found that Physical activity was irregular among the majority of the study participants (54.0%), smokers formed (38.0%) of the study participants, and Body-mass index of the study participants ranged from (22.3 kg/m2) to (42.8 kg/m2). Females had significantly higher BMI (34.9 ± 3.4 kg/m2) compared to males (30.3 ± 3.0 kg/m2). A multiple linear regression was calculated to predict MetS characteristics based on smoking, BMI, and irregular physical activity. Smoking was a significant predictor with P-value < 0.001 for all MetS components.
Conclusion: Patients with Metabolic syndrome are more commonly males, aged 50-69 years, of lower educational level, and urban residents. Males with metabolic syndrome had a higher systolic and diastolic Blood pressure, additionally; they had higher serum cholesterol, triglycerides, and waist circumference than females.
A significant number of patients with metabolic syndrome had risky behaviors including smoking, irregular physical activity, and obesity.