The Medical Journal of Basrah University

Background: Evidence indicates an association of inflammatory process with atherosclerosis. Systemic inflammatory markers may point out the association of inflammatory changes with coronary artery diseases.Aim: to investigate the association of Neutrophil/ Lymphocyte ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) with the severity of coronary artery disease in patients with DM.Method: We conducted a cross-sectional study of patients with coronary artery disease admitted for coronary angiography in Basra Cardiac Center. The study was done from March 2021 to February 2022. We collected demographic data, past medical history, biochemical tests and complete blood picture with the calculation of NLR and PLR. We reviewed coronary angiography to assess the number of diseased vessels, severity, and complexity of the lesions. The patients were divided into 2 groups; significant (≥ 70% obstruction) and non-significant CAD (< 70% obstruction).Results: the study enrolled 228 (169 males and 59 females) patients with CAD. Significant CAD was found in 188 patients. The NLR was significantly correlated with the presence, extent, and severity of CAD (p-value 0.01, 0.003, 0.001) respectively. The PLR was significantly associated with the severity of CAD (p-value = 0.01), but non-significantly correlated with CAD presence or extent (p-value 0.28, 0.36) respectively. The NLR but not PLR was an independent marker to predict significant CAD in patients with DM.Conclusion: neutrophil / Lymphocyte ratio was associated with the presence, extent, and severity of significant CAD in diabetic patients. Platelet/Lymphocyte Ratio was only associated with the severity of CAD.

Background: Crimean-Congo Hemorrhagic Fever Virus (CCHFV) is a zoonotic virus that infect life stock then transfer to human via direct contact with animal or by ticks that live on animals as a parasite through their bites. The infected people appear some symptoms such as, malaise, vomiting, mucosal and gastrointestinal (GI) bleeding, hypotension, and edema. The minimum evolution phylogenetic tree was also analyzed for the main eight strains collected from different countries including South Africa, Uganda, Nigeria, China, Pakistan, Russia, Congo and Senegal. Objectives: Determining the origin of infection geographically, drawing phylogenetic tree among viruses strains, and give the chance to detect and identify the viruses and attempt to making vaccines. Methods: It has been depending on database available on NCBI website for searching on accession number of recorded viruses gene sequences, and used the minimum evolution phylogenetic tree algorithm for drawing phylogenetic trees. Results: The first record of the virus was in the Crimean Peninsula in Russia in 1944, then recorded in the Congo basin in the middle of Africa in 1956. The virus was also recorded in some countries in Asia, Africa and Europe. In Iraq, the infection of CCHFV appeared and was recorded in 1979, then in 1992, 1996 and 2012.Genomic of the virus was detected at the molecular level and sequenced. The local molecular studies showed three strains of the virus. Strain 1 was the same clade as strain 1 of Oman, whereas strain 2 was located with the same clade as of strain 2 of Turkey. Strain 3 of the virus in Iraq, Oman and China were in one clade. The phylogenetic tree showed that South Africa and Uganda were located in one clade, and Nigeria shared the same ancestor. China and Pakistan were the same clade. Whereas Russia, Congo and Senegal were out groups.

Background: Organ donation and transplantation is a life-saving for many patients and can be affected by cultural beliefs, socio-economic levels of people and legalization in many countries. Exploring these issues play a crucial role in promoting concept of organ donation among nations especially in the era of disparity between organs a viability and number of patients in waiting lists.Aims: To evaluate knowledge, awareness and attitude of Iraqi people and the associated factors towards organ donation and transplant.Subjects and Methods: Study design: We conducted a cross-sectional study using a self -administrative structured questionnaires distributed to companions of patient during outpatient department visit.This hospital -based study was performed at a teaching hospital from January 1st to June 1st 2022, The socio-demographic data as well as knowledge and attitudes of participants on the organ donation and transplantation has been collected and analyzed. Results: A total of 360 subjects participated in the study with overall response rate 95% (n = 341/360). The mean age of respondents (male n. 212, 62.1% and female n. 129, 37.9%) was 37.8 ± 10.7 (range 18-75 years) and 329 (96.5%) of them heard about organ donation. A 271(73.3%) of the studied group supported and encouraged organ donation, however, only 120 (36.5%) of them exhibiting desire for donation. 59.8% (n.204) of the respondents were governmental employees and 311 (91.2%) of them had a university level of education or higher. The male gender had a significantly higher desire (P = 0.043) for donations than females. On other side desire for donation was significantly less (P = 0.001) among governmental employees in comparison with other occupations Conclusion: The study advocates to focusing on increase awareness of the general public by broad dissemination of clear messages in various mass media and by local religious and com¬munity leaders on the benefit of organ donation will be decisive for improving willingness to donations.

Background: CT scans are increasingly utilised in outpatient and emergency departments due to their ability to facilitate swift diagnosis and treatment planning. However, inappropriate use of CT scans, particularly CT scans of the brain, can have negative consequences.Objectives: This study aims to evaluate the adherence of Basrah Teaching Hospital doctors to the international referral criteria for brain CT scans. Methods: A retrospective review of medical records was conducted to investigate the utilisation of brain CT scans in the radiology departments of Basrah Teaching Hospital for two months and involved 108 referrals. The medical records were thoroughly reviewed to extract relevant information related to the indications of referral, referring doctor, referring place, brain CT results, and assessing the request form completions. The standard referral criteria were extracted from the United Kingdom and European brain CT referral guidelines.Results: Most of the referrals (75.9%) met the referral criteria, and most of the doctors, regardless of their levels, met the referral criteria; however, the highest rate was among the junior doctors (88.9%), followed by specialists and senior resident doctors. Moreover, most of the units adhered to the referral criteria, but the highest adherence rate was among those referrals from inpatient wards (91.7%). Furthermore, the majority of the doctors and most of the referring wards completed their request forms; however, the highest completion was in specialty and consultant doctors’ groups (77.8%). The results also showed that about half of positive brain CT results are due to neurological causes (46%), followed by head trauma referral (34.6%).Conclusions: The majority of the doctors at Basrah Teaching Hospital met the international standards for brain CT referrals, and most of the referral wards followed these guidelines.

Objective: This study aimed to investigate the influence of a comprehensive lifestyle modification program on blood pressure control among hypertensive patients.Methods: A total of 300 hypertensive patients were enrolled in a 12-month, longitudinal, non-randomized study. The intervention included dietary modifications based on the DASH diet, a structured physical activity regimen, and various stress management techniques. Participants' adherence to the program was tracked, and blood pressure measurements were recorded at baseline and at regular intervals throughout the study. Changes in blood pressure and correlations between adherence and blood pressure changes were statistically analyzed.Results: Significant reductions in both systolic and diastolic blood pressure were observed (systolic: p < 0.001, diastolic: p < 0.001). High adherence to dietary modifications (p < 0.001), physical activity (p = 0.001), and stress management techniques (p = 0.002) showed significant correlations with blood pressure reductions. Some participants also reported improvements in other health parameters like weight and BMI.Conclusion: The findings suggest that a comprehensive lifestyle modification program is effective in controlling blood pressure among hypertensive patients. It emphasizes the importance of non-pharmacological interventions in routine clinical care for managing hypertension.

Background: Important health issues are diabetes mellitus and its comorbidities. Insulin can be delivered by several regimens including twice daily injections or multiple daily injections. This study aimed to determine what affects the state of glycemic control (age of patient, gender). Patients and methods: A prospective study was conducted in the Department of Pediatrics in Al-Kadhmain Medical City in a period from the 1st of January 2021 to the 31st of June 2021(6 months). Data was collected from their parents or caregivers by direct questionnaire. According to American Diabetes Association criteria, patients were divided into two groups (good glycemic control, and poor glycemic control) and a comparison between insulin regimens was done.Results: Among a total number of 98 children in this study, the mean age ± standard deviation (10.5 ± 3.5) years, 50 of them were newly diagnosed. most of the patients were females 55 (56.1%) versus 43(43.9%) males. There is no significant association between gender and glycemic control. Increasing the age of the patients associated with poor glycemic control, The highest percentage of children with good control was for those on basal regimen. The percentage of children with good control increased with follow-up visits, it starts with only 25.5% in the baseline visit and increased to 75.5% in the third visit. There is a significant difference in the growth parameter with different insulin regimens, the best growth pattern was found in those on basal-bolus, followed by pre-mixed and finally the intermediate (lente) and soluble regimen.Conclusion: Insulin therapy which uses a multiple daily insulin injection regimen has favourable results in children and adolescents with diabetes mellitus type 1 in comparison to a twice insulin injection regimen.

Background: There is a never-ending stream of publications in the literature stating that obesity may be a risk factor for gallstones, associating gallstones with rising body mass index and obesity. The primary gastrointestinal disease associated with increased body mass and obesity was caused by changes in the liver and gall bladder.Objectives: The current work's objective is to find the prevalence of gallstones in patients with obesity in this agricultural area, which is at the beginning of development and industrialization.Methods: A prospective case-control study was undertaken over seven years, from May 1, 2012, to April 30, 2019, comparing a matched group (n=1310) of patients with average weight to 1219 of the 1564 obese patients who visited Hatwan Private Hospital in Sulaimani Governorate, Kurdistan Region, Iraq.Results: Gallstones were discovered in 140 obese patients or 11.48 percent of the total. The majority of gallstones (n=87, 07.14%) were symptomatic, while fifty-three (4.43%) people had gallstones unintentionally when their abdomens were imaged.Conclusion: The findings indicated that, compared to patients of average weight, patients with obesity had a lower prevalence of gallstones, whereas patients with obesity had a higher prevalence of symptomatic gallstones. Additionally demonstrated that patients with obesity had lower serum levels of calcium and vitamin D compared to patients with average weight.

Background: Family planning has obvious health benefits by preventing unintended pregnancies, which results in a subsequent decrease in maternal morbidity and mortality, allowing the spacing of pregnancies, delaying pregnancies in young girls who are at an increased risk of health problems from early childbearing, and preventing pregnancies among older women who also face increased risks. Despite these benefits, there are reports of low usage among reproductive-age women in most developing countries.Aim: This study aimed to identify the factors that influence the choice and use of contraceptive methods among women of reproductive age in Basrah City, Iraq. Methods: This is a cross-sectional study involving 400 married women of the reproductive age group (15-49) years, who attended five primary healthcare centres in Basrah city during the period of seven months, from 1st May 2022 to 1st November 2022. Results and conclusions: in the results, 84.0% of participating women currently use contraceptive methods. The modern methods were used by 71.7% of women, and the most utilized methods were oral pills followed by injectables. while the natural methods were used by 28.3% and withdrawal was the preferred one among them. Also, the factors that influence the utilization include women’s age, education of both women and their husbands, parity, the desire for more children and the source of women’s information.Recommendations: More effective ways are needed to educate women about modern contraceptive methods, effective health education should be included in the primary health center programs to maintain this level of use and we need more studies in other parts of Iraq to identify the factors that influence the use of contraceptive methods, and more studies are needed to address the reasons affecting the non-utilization of family planning methods.

Background: epidermal Growth Factor Receptor (EGFR) is a transmembranous glycoprotein belonging to the Erb B family receptor of tyrosine kinases. EGFR overexpression is associated with the development of a wide variety of tumors. It’s believed that EGFR overexpression in primary breast carcinoma has been linked to aggressive Basal-like phenotype and reflects poor prognosis.Aim of the study: the study aims to provide a correlation between immunohistochemical EGFR overexpression in invasive breast carcinoma with the patient’s age, histological type, tumor grade and molecular subtypePatients and method: this cross-sectional study was carried out in Basrah. The data was collected in the period from October 2020 through November 2021. Tissue sections submitted to routine heamatoxylin and eosin stain. Then immunohistochemical staining for molecular classification and EGFR marker was performed by using primary monoclonal anti-EGFR antibody.Results: fifty three cases of invasive breast carcinoma were collected with a mean age of 56.32. Fifty cases were diagnosed as invasive ductal carcinoma. Forty nine cases were graded as grade 2. Nineteen cases (35%) were classified as Luminal A, (32%) were classified as Luminal B1 and (13.2%) as Luminal B2. Basal-like and HER2 overexpression subtypes constitute (9.4%) of cases each. Twenty eight (52.83%) cases showed EGFR overexpression with a mean age of 55.86.Conclusion: EGFR overexpression showed no significant relationship with age, molecular subtypes and histological type of breast carcinoma. The relation between EGFR overexpression and tumor grade couldn’t be assessed. The immunohistochemical technique alone is not sufficient for the proper detection of EGFR overexpression.