Journal of the Faculty of Medicine Baghdad 2020-05-16T18:42:48+00:00 prof. Tharwat I. Sulaiman Open Journal Systems <h3>Journal of the Faculty of Medicine – University of Baghdad</h3> <h3>A peer-reviewed journal published Quarterly by the college of medicine –Baghdad University</h3> <h3>ISSN:&nbsp; &nbsp;0041-9419</h3> <h3>EISSN: 2410-8057</h3> <h3>The Journal interested in the publication of clinical and basic medical research.</h3> <h3>The first issue of this Journal was published under the name of (Journal of the Royal Iraqi Medical College) in April /1936, approved by the council of the College as a general journal dealing with the news of the college and few scientific articles to encourage the teaching staff for research publication. The journal was published randomly and ceased during World War II due to financial difficulties.</h3> <h3>In 1946 Prof. Dr. Hashim Al Witri, the college dean, assigned republication of the journal and urged the teaching staff to participate and publish their research in the journal. Despite his effort, the journal remained irregular in publication. In 1959&nbsp; Prof. Dr. Faisal Al-Sabih became the Editor in Chief of the journal when he returned from the United Kingdom and appointed on the teaching staff, restructured the journal and changed its name to (The Journal of the Faculty of Medicine) and used a new scientific system for publication of articles.</h3> <h3>The first issue of the new series started in June 1959. The journal continued to be published on a regular basis since then without interruption in (four issues during the year). The journal became registered the international number (ISSN) in 2000 and entered in many important international indexes.</h3> <h3>After 2003 the journal continued despite the difficulties involved in every aspect of the country and by the beginning of 2004, the journal progressed through a series of changes to reach a level that can be recognized internationally.</h3> <h3>After 2010 the journal became published electronically of the same edited issues.</h3> Editorial message 2020-04-19T00:21:19+00:00 Tharwat I Sulaiman 2020-04-15T23:36:34+00:00 ##submission.copyrightStatement## SARS-CoV-2(COVID-19) 2020-04-16T21:36:36+00:00 Batool Ali Galib <p>Coronaviruses are a large family of viruses which may cause illness in animals or humans. &nbsp;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.</p> <p>This is a review for the current pandemic</p> 2020-04-15T23:35:32+00:00 ##submission.copyrightStatement## The first 40-days experience and clinical outcomes in the management of coronavirus covid-19 crisis. Single center preliminary study. 2020-04-18T19:22:02+00:00 Jaffar S Allawi Hassan M Abbas Jawad I Rasheed Tharwat I. Sulaiman Ali A Gatea Faris Al-Lami Jawad K Al-Diwan Adnan M Al-jabory Muhammed Waheeb Yasir I Abdurudha Laith S Al-Kaabi Saeb J Al-Shuwaili Tawfeeq W Tawfeeq Musaab K Alabboodi Abdulrazak A Abdulrazak Wameedh Qays Al-Samak <p><strong>Background:</strong> 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 24<sup>th</sup> of February 2020, which was of an international student who travelled recently to Iraq. This review is the universal data analysis of the first 40-days of coronavirus covid-19 patients admitted to Medical City Teaching Hospital (MCTH) including their clinical outcome.</p> <p><strong>Objective:</strong> 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).</p> <p><strong>Patients and methods: </strong>This is a preliminary descriptive 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 according to WHO criteria. The clinical outcomes were defined as complete clinical and immuno-virologic recovery, non-recovery and death. Complete recovery was defined as negative RT-PCR conducted twice after disappearance of clinical symptoms. Death was subclassified as death within 24 hours and after 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.</p> <p><strong>Results</strong>. The total no of symptomatic patients and PCR positive was 79 patients out of 469 screened suspects (16.84%). The mean age was (47.18 -/+ 18). they are prevalent among the age group (40-50 years). There were 59 male patients (74.68%) in comparison to 20 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 %. &nbsp;Complete recovery was seen in 41 (51.89%) patients. Death within 24 hours was seen in 6 patients (7.5%) while confirmed death after 24 hours was seen in 4 (5%).</p> <p><strong>Conclusions</strong>: The treatment protocol is well conducted in this center with promising rate of complete recovery and excellent rate of clinical recovery. The high initial death rate was compensated after three weeks as more orientation of medical staff and peoples about the disease<strong>.</strong>&nbsp;</p> 2020-04-16T10:59:20+00:00 ##submission.copyrightStatement## Correlation of Prostaglandin D2 with disease severity of adult asthma 2020-04-18T17:57:09+00:00 Mohammad A. Al-Karkhy Mustafa Nema Shatha F. Abdullah <p><strong>Background</strong>: 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 probable therapeutic targets for asthma.</p> <p><strong>Objectives</strong>: To define the role of Prostaglandin D2 biomarkers in disease severity, and to forecast disease risk and progression.</p> <p><strong>Patients and methods:&nbsp;</strong>A case control study was conducted on Forty four Iraqi asthmatic patients and 44 apparently healthy controls who were age and sex matched. Four ml of blood samples was taken from the study groups for the detection PGD2 using ELISA.</p> <p><strong>Results:</strong> The serum level of PGD2 was almost convergent between cases and control group (median= 36.5pg/ml and 35.1 pg/ml respectively). The high median serum concentration of PGD2 showed a strong statistically significant association with the severity of asthmatic patients (39.8 pg/ml) in severe cases compared to (30.84 pg/ml) in moderate cases (P value =0.005). The median concentration of 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 concentration of normal counts.</p> <p><strong>Conclusions: </strong>Measuring serum PGD2 in asthmatics is crucial to predict disease susceptibility, severity and disease control.</p> 2020-04-15T17:09:47+00:00 ##submission.copyrightStatement## Virulence estimation by calculation of relative expression of NESTIN in different grades of astrocytoma from different age groups of Iraqi patients, extracted from brain tumor stem cells 2020-04-16T21:36:37+00:00 zainab zahid saadoon Huda M. Al-Khateeb Khitam R. Alkhafaji <p><strong>Background:</strong> Astrocytoma, is heterogeneous tumor of the nervous system and studies on the virulence of these tumors reveal that their behavior is led by small population of cells which are the brain tumor stem cells (BTSCs) that drive the continuous proliferation and self-renewal. From the many markers that annotate BTSCs, are the CD133, and NESTIN.</p> <p><strong>Objectives:</strong> Using CD133, to immunolabel BTSCs niches in paraffin sections of astrocytoma then, extraction of these cells, to calculate fold expression of NESTIN gene across the grades by real time PCR.</p> <p><strong>Materials and methods</strong>: 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 stained with CD133, then positive areas were extracted to perform relative expression of NESTIN gene by real time PCR</p> <p><strong>Results:</strong> The expression of NESTIN for all grades, increased by tens of folds in relation to calibrator then this fold expression increased dramatically in an ascending manner with increasing of the grade in the same group. The fold expression of NESTIN gene in all grades was the highest in the adulthood (18-49) years group.</p> <p><strong>Conclusion: </strong>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 expression was the highest at age (18-49) years.</p> 2020-04-15T17:11:36+00:00 ##submission.copyrightStatement## Antimicrobial resistance patterns of Acinetobacter baumannii colonization patients skin 2020-04-16T21:36:37+00:00 Aza Bahadeen Taha <p><strong>Background:</strong><em> Acinetobacter baumannii </em>is a significant opportunistic pathogen and it is generally associated with benign colonization of hospitalized patients.</p> <p><strong>Objective:</strong> To investigate skin colonizationwith<em> Acinetobacter baumannii</em> in hospitalized patients and healthy volunteers.Antimicrobial resistance patterns of <em>Acinetobacter baumannii</em>was assessed by determining the minimum inhibitory concentrations (MICs) of thirteen different antimicrobial agents.</p> <p><strong>Patients and Methods: </strong>The study performed on hospitalized patients 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 isolated<em>Acinetobacter baumannii</em>,then identified using phenotypic and genotypic properties. All isolates examined for their antimicrobial susceptibility by the agar dilution method.</p> <p><strong>Results: </strong>Among 600 hospitalized patients, 79 (13.17%) colonized with <em>Acinetobacter baumannii</em>, yielding 155 isolates that are resistant to 57.42% ceftriaxone, 56.77% cefotaxime, 45.81% ceftazidime and 40.65% ciprofloxacin.While the most effective antimicrobial agents with MIC<sub>50/90</sub> values (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 <em>Acinetobacter baumannii</em> isolated from healthy volunteers that showedresistance to 50.94% ceftriaxone (MIC<sub>50/90,</sub> 64/128 mg/L), 45.28% ceftazidime, 43.40% cefotaxime, and 35.85% ciprofloxacin. Fortunately, all 208 <em>Acinetobacter baumannii</em> were sensitive to polymyxin B (MIC<sub>50</sub>=0.25mg/L).</p> <p><strong>Conclusion: </strong>The rates of <em>Acinetobacter</em> baumannii <em>colonized</em>patients higher thanhealthy volunteers, whereas an antimicrobial minimum inhibitory concentrations value of cefepime, cefotaxime, imipenem, amikacin, ciprofloxacin, and levofloxacin were significantly higher in patients than healthy volunteers. Polymyxin B had activity against all<em> Acinetobacter baumannii</em> strains.</p> 2020-04-15T17:20:00+00:00 ##submission.copyrightStatement## Study of mother's Knowledge, practices and believes about home management of Neonatal jaundice in two pediatric teaching hospitals 2020-04-16T21:36:36+00:00 Numan Nafie Hameed Noor Jaafar Abdul-Hussain Muna Essam Ahmed Noor-Al Huda Raheem Kadhim <p><strong>Background: </strong>Neonatal jaundice (NNJ) is one of the most common diseases globally. It is&nbsp; believed&nbsp; that&nbsp; delays&nbsp; in&nbsp; detection and&nbsp; improper&nbsp; treatment&nbsp; of&nbsp; neonatal&nbsp; jaundice&nbsp; can&nbsp; be&nbsp; responsible&nbsp; for&nbsp; neonatal&nbsp; morbidity&nbsp; and&nbsp; mortality.&nbsp; Knowledge and&nbsp; health&nbsp; seeking&nbsp; behavior&nbsp; of&nbsp; mothers&nbsp; play&nbsp; an&nbsp; important&nbsp; role in&nbsp; the course&nbsp; of&nbsp; this&nbsp; health&nbsp; condition.</p> <p><strong>Objectives: </strong>To study mother's knowledge and her health seeking behavior toward home management of neonatal jaundice.&nbsp;</p> <p><strong>Methods:</strong> A cross sectional study of non-probability convenience sample of 200 mothers of neonates with neonatal jaundice who were admitted to Children Welfare Teaching Hospital and Ibn Al-Baladi Maternal and Child Hospital during the period from 1st of July to 1st of October, 2018. Data were obtained by the researcher through direct interview of the mothers and completed the structural questionnaire. Data were analyzed by SPSS through measuring frequencies, percentage, T test and chi square test.&nbsp;</p> <p><strong>Results: </strong>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.&nbsp; There were significant association between mothers` knowledge and mothers` age (p=0.005), education (p=0.029) and residency area (p=0.010), and between mothers` practice and occupation (p=0.039) and residency area (p=0.030), and between mothers' believes and education (p=0.001) and occupation (p=0.031).</p> <p><strong>Conclusions: </strong>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 the traditional 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.</p> 2020-04-15T17:22:38+00:00 ##submission.copyrightStatement## Optimizing Linear Models via Sinusoidal Transformation for Boosted Machine Learning in Medicine 2020-04-16T21:36:36+00:00 Ahmed Al-Imam <p><strong>Background: </strong>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.<strong><br>Objectives: </strong>We aim to optimize linear models by implementing sinusoidal transformation to minimize the sum of squared error.<strong><br>Methods: </strong>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. <strong>Results: </strong>The sinusoidal transformation succeeded by significantly reducing the sum of squared errors (<em>P-value</em>&lt;0.001). Inter-item reliability testing confirmed the robust internal consistency of the model (Cronbach’s alpha=0.999). <strong>Conclusion: </strong>Our optimization 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.</p> <p><strong>Keywords:&nbsp;</strong></p> 2020-04-15T23:48:25+00:00 ##submission.copyrightStatement## Aggression is a dominant behavior among adolescents in Al-Sadr city, Baghdad-Iraq 2020-04-16T21:36:38+00:00 Tuka Younis Hassan Basma M. Ali Ammar Q. Raheem Jawad K. Al-Diwan <p><strong>Background:</strong> Aggression is any behavior intending to harm another living being that desires to avoid such harm. Aggression is considered as a public 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.</p> <p><strong>Objectives:</strong> To estimate the prevalence of aggression among secondary school students in Al-Sadr city, Baghdad.</p> <p><strong>Methodology:</strong> A cross-sectional study was carried out in Al-Sadr city in Baghdad. A total of 720 adolescent secondary schools students from both genders were included in the study. They were selected by multistage random sampling. Their age was ranged from 13-21 years. Data was collected from 1<sup>st</sup> of February 2019 to 30 of April 2019 through a self-reported questionnaire (Aggression-Problem Behavior Frequency Scale).</p> <p><strong>Results:</strong> 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%).</p> <p><strong>Conclusion:</strong> A high prevalence of aggression (mainly non-physical) was found, which was significantly associated with gender, being higher among males. Aggression was negatively affecting school achievement.</p> 2020-04-15T00:00:00+00:00 ##submission.copyrightStatement## collision tumor of thyroid gland a case report 2020-05-16T18:42:48+00:00 satar majeed kadam Nadia H. Ibraheem Nabeel J. Al-Rubaei <p>collision tumor is the presence of two histopathologically distinct tumors in the same anatomical site.&nbsp; It is a rare pathology of the thyroid gland that makes diagnosis and treatment challenging.&nbsp; This is a case report of a collision tumor of the thyroid gland.</p> 2020-04-15T17:31:20+00:00 ##submission.copyrightStatement##