Journal of the Faculty of Medicine Baghdad <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> College of Medicine-University of Baghdad en-US Journal of the Faculty of Medicine Baghdad 0041-9419 <p>&nbsp;For all articles published in Journal of the Faculty of Medicine Baghdad, copyright is retained by the authors. Articles are licensed under an open access<a href="">&nbsp;Creative Commons CC BY NC 4.0 license</a>,&nbsp;meaning that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. These conditions allow for maximum use and exposure of the work, while ensuring that the authors receive proper rights.</p> <p>&nbsp;</p> Serum Zinc and Copper in Children with Febrile Seizures in Basrah,Iraq <div> <div style="direction: ltr;"><strong>Background</strong>:Trace elements are essential micronutrients that exist in very low concentrations in the body. They&nbsp;play an important role in various physiological processes and are crucial for proper&nbsp;functioning of the immune system. Many studies have shown that some micronutrients may&nbsp; have a role&nbsp;in febrile seizure</div> <div style="direction: ltr;">such as selenium, zinc and copper.</div> <div style="direction: ltr;"><strong>objectives</strong> :To&nbsp;determine&nbsp;the level of serum zinc and copper&nbsp;in children with febrile seizures and explore their</div> <div style="direction: ltr;">relation to selected patients' variables.</div> <div style="direction: ltr;"><strong>Methods:</strong> The study included&nbsp;66 infants and children with simple febrile seizures with two control&nbsp;groups;a</div> <div style="direction: ltr;">febrile control&nbsp;group&nbsp;which&nbsp; includes&nbsp;(62)&nbsp;children with&nbsp;febrile illnesses&nbsp;who were admitted&nbsp;to emergency department at Basrah Maternity and Children Hospital and Basrah General Hospital from&nbsp;the 1st&nbsp;of March to</div> <div style="direction: ltr;">the end of October 2013,&nbsp;and&nbsp;ahealthy control group&nbsp;which includes&nbsp;(&nbsp;58)&nbsp;children. Serum zinc and copper&nbsp; ere measured for all infants and children enrolled in the study.</div> <div style="direction: ltr;"><strong>Results:&nbsp;</strong>Patients with febrile seizure&nbsp;had a&nbsp;significantly lower&nbsp;mean serum zinc level (8.85 ±3.26) in&nbsp;comparison to febrile patients and healthy children (14.98 ±2.20), (13.33 ±1.99) respectively. There&nbsp;is&nbsp;no</div> <div style="direction: ltr;">significant association between the level of&nbsp;serum zinc and selected variables.S&nbsp;erum copper level&nbsp;did&nbsp;not show&nbsp;a&nbsp;significant difference between patients with febrile seizures and control groups.</div> <div style="direction: ltr;"><strong>Conclusion</strong>: Zinc supplementation may be considered in children who are at risk of recurrent febrile&nbsp;seizure</div> <div style="direction: ltr;">.</div> </div> sawsan issa aljabere Basher Abdullah Jaber ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 1 5 10.32007/2501-5 Etiological factors of cholestasis ininfancy andearly childhood in Children Welfare Teaching Hospital <p><strong>A</strong></p> <div><strong>Background:</strong> Neonatal cholestasis is defined as prolonged elevation of the serum level of conjugated</div> <div>bilirubin beyond the first 14 days of life. There are many causes of neonatal cholestasis&nbsp;which must be&nbsp; identified&nbsp;because early intervention may&nbsp;result in a better outcome&nbsp;, such as&nbsp;surgical intervention in&nbsp;biliary atresia within&nbsp;two months&nbsp;from birth&nbsp;, or effective dietary management in metabolic&nbsp;disorders like&nbsp; galactosemia.</div> <div><strong>Objective:</strong>To determine the causes of early childhood cholestasis in children attending the Children&nbsp;Welfare</div> <div>Teaching Hospital in Baghdad&nbsp;and to study some of associated factors&nbsp;in infancy and&nbsp;early&nbsp;childhood&nbsp; cholestasis.</div> <div><strong>Patient and method:&nbsp;</strong>This is a&nbsp;cross sectional descriptive study&nbsp;conducted on&nbsp;48 patients attending the&nbsp; Children&nbsp;Welfare Teaching Hospital&nbsp;in Baghdad for the period&nbsp;of 1Novembe&nbsp;r 2015 to&nbsp;15&nbsp;January 2016.&nbsp;These cases&nbsp;were evaluated by thorough history, examination and investigations.&nbsp;Results:O&nbsp;the&nbsp;48 patients enrolled in this study, 30&nbsp;(62.5%)&nbsp;lived in Baghdad, and the&nbsp;remaining 37.5%&nbsp;were referred from other governorates&nbsp;.&nbsp; the mean age of&nbsp;the&nbsp;patients was 11.1 ±&nbsp;12.4&nbsp;months, with 20&nbsp;females&nbsp;(41.7%) and&nbsp;28&nbsp;males (58.3%). The&nbsp; <strong>Results r</strong>evealed that 11(22.9%)were the result of congenital infections&nbsp;, 9&nbsp;(18.8%) were idiopathic in origin, 8</div> <div>(16.7%)&nbsp;were&nbsp;caused by biliary atresia, 8&nbsp;(16.7%) of unknown origin, 5&nbsp;(10.4%)&nbsp;were&nbsp;caused by sepsis&nbsp;(mainly</div> <div>staphylococcus, streptococcus&nbsp;species,&nbsp;E&nbsp;coli,&nbsp;staphylococcus&nbsp;aureus)&nbsp;, 2&nbsp;(4.2%)&nbsp;were&nbsp;caused by&nbsp;progressive</div> <div>familial intrahepatic&nbsp;cholestasis and 1&nbsp;(2.1%) case was caused by each of the following causes: Alagille&nbsp; snyndrome,&nbsp;Choledochal cyst, Galactosemia, hypothyroidism and Tyrosinemia.</div> <div><strong>Conclusion:&nbsp;</strong>Congenital infections&nbsp;were&nbsp;the most common cause in this&nbsp;study,&nbsp;of which the most&nbsp;common is cytomegalovirus (&nbsp;CMV&nbsp;). Clay color stool&nbsp;and high&nbsp;alkaline phosphatase levels&nbsp;were&nbsp;found&nbsp;mostly in&nbsp;biliary&nbsp; atresia.&nbsp;No method by itself is sufficient to diagnose the cause of neonatal cholestasis.&nbsp;D&nbsp;iagnosis can only be established using all available&nbsp;methods.</div> Mohammad Fadhil Ibraheem Adnan Y. Mahmood Jasim M. Salih ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 6 10 10.32007/4876-10 A Comparison of Three Different Treatment Regimens of HCV Infection in295 Iraqi Patients <div><strong>Background:&nbsp;&nbsp;</strong>Viral Hepatitis C infection is global public health problem throughout the world. Different</div> <div>treatment regimens are used which produce different rates&nbsp;of response affected by many factors.</div> <div><strong>Objectives:&nbsp;</strong>To assess the efficacy of three different treatment regimens in 295 Iraqi patients infected with</div> <div>chronic HCV.</div> <div><strong>Patients and methods:&nbsp;</strong>This is an observational cohort study; in which 295 (133 male and&nbsp;162 female) patients with chronic HCV infection were enrolled&nbsp;during the&nbsp;period between August 2015 to January 2017</div> <div>from Gastroenterology clinic of Baghdad&nbsp;Teaching&nbsp;Hospital and&nbsp;Gastroenterology and&nbsp;Hepatology&nbsp;Teaching</div> <div>Hospital. Baseline HCV viral&nbsp;load measurements&nbsp;and&nbsp;genotyping&nbsp;were done&nbsp;for&nbsp;each&nbsp;patient.&nbsp;Patients were</div> <div>followed up by viral load measurement at end of&nbsp;the treatment&nbsp;period and&nbsp;three months&nbsp;after the&nbsp;end of the</div> <div>treatment.</div> <div><strong>Results:&nbsp;</strong>The majority of patients infected with chronic HCV achieved sustained virological response(SVR)</div> <div>(defined as undetectable HCV RNA&nbsp;12 to 24 weeks after the end of&nbsp;the&nbsp;treatment);&nbsp;were of&nbsp;the&nbsp;generic(&nbsp; sofosbuvir/ledipasvir) treatment group (51out&nbsp;of 72&nbsp;(70.8% ) followed by generic Sofosbuvir with&nbsp;(peg&nbsp; interferon/ribavirin)treatment group (68 out&nbsp;of 111&nbsp;(61.3%) followed by&nbsp;(peg interferon/ribavirin)&nbsp; treatment</div> <div>group (42&nbsp;out&nbsp;of 86&nbsp;(&nbsp;48.8%).</div> <div><strong>Conclusions:&nbsp;</strong>The best treatment efficacy was obtained with generic sofosbuvir/ledipasvir followed by</div> <div>sofosbuvir with peg interferon and ribavirin then peg interferon and ribavirin. The most responder genotype</div> <div>in Iraqi patients was genotype 4 and the least responder genotype was genotype 1b</div> Wasan Khraibet Jasim Nawal M. Firhan AL-Khalid Ahmed A. Hussei ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 11 17 10.32007/66011-17 Observational Study of the Multisciplinaryteam role (MDT) on Healthcare Management of Cancer Patients: Benefits and Barriers, AbuDhabi 2017 <div><strong>Background:&nbsp;</strong>Multidisciplinary team meetings (MDTs) are designed to optimize patient outcomes. It&nbsp;appears intuitive that MDTs are essential to clinical decision&nbsp;-&nbsp;making and patient management; however, it&nbsp;is unclear whether that belief is supported by evidence. With regard to cancer patients, studies demonstrated&nbsp;that&nbsp; treatment plans made by interacting health care professionals are more effective than those made by</div> <div>individual practitioners.</div> <div><strong>Objectives:&nbsp;</strong>To assess the impact of multidisciplinary teams (MDTs) on clinical&nbsp;decision&nbsp;-&nbsp;making and&nbsp; patient outcomes.</div> <div><strong>Methods:&nbsp;</strong>We follow a descriptive questionnaire survey study design and created a (10) sections&nbsp; surveymonkey&nbsp;that was distributed via email to (150) experts in surgical oncology, general surgery,&nbsp;oncology, radiation oncology, pathologists, and administrative staff. Fourty (40) completed responses were&nbsp;collected to ensure a statistical basis on which to draw sound conclusions.&nbsp;The remaining 110 staff have&nbsp;submitted incomplete answers. Answers were discussed in a separate MDT meeting with most of the&nbsp; participants.The survey was followed by an interpretation of the respondents’ results and comparison with&nbsp;literatures.&nbsp; <strong>Results:&nbsp;</strong>75% of the participants chose” Agree and strongly agree”, supporting the hypothesis that MDT&nbsp; meetings ensure an effective and up-to- date management guidelines. This means that the risk of not&nbsp; discussing a cancer patient cannot be neglected any longer. So the hypothesis statement (H0) is&nbsp;rejected</div> <div>and the alternative statement (Ha) is accepted.</div> <div><strong>Conclusions:&nbsp;</strong>The majority of participants saw the value in the MDT process and expressed support for its</div> <div>implementation locally and nationally; however, feedback about the most appropriate format is yet to be</div> <div>established. The clinicians identified the need for agreed standards in MDT performance</div> Ibtisam Hussein Al Obaidi ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 18 24 10.32007/89018-24 Comparison between Mammography and Breast Ultrasound in the Detection of Breast Cancer in Dense Breast Tissue among a Sample of Iraqi Women <div><strong>Background:&nbsp;</strong>Breast cancer is the most common cancer reported in women worldwide&nbsp;. In&nbsp;Iraq, it&nbsp;is&nbsp;the&nbsp; most&nbsp;common registered malignancy. Mammography plays a major role in&nbsp; the&nbsp;early detection of breast cancers.&nbsp;Dense breast parenchyma has been reported to be the most important inherent factor that limits&nbsp; depiction of&nbsp;breast cancer on mammogram, and often needs&nbsp;supplementary breast ultrasound for complete assessment.&nbsp;</div> <div><strong>Objectives:&nbsp;</strong>To evaluate&nbsp;and compare the&nbsp;diagnostic performance of mammography and ultrasound in the</div> <div>detection of breast cancer in dense breast tissue.</div> <div><strong>Patients and methods:&nbsp;</strong>A&nbsp;record&nbsp;review&nbsp;study&nbsp;was&nbsp;performed in the Oncology Teaching Hospital/ Medical</div> <div>City from&nbsp;April&nbsp;2018 to&nbsp;December&nbsp;2018. The study included forty five females, who attended the Main</div> <div>Referral Center for Early Detection of Breast Tumors&nbsp;during 2017 and 2018&nbsp;were&nbsp;diagnosed with&nbsp;breast&nbsp; cancer histopathologically&nbsp;. They had dense breast tissues on mammography&nbsp;(either heterogeneously dense</div> <div>breast&nbsp;tissue i.e&nbsp;. category C or extremely dense breast tissue i.e. category D).&nbsp;All patients underwent&nbsp; subsequent&nbsp;breast ultrasound .&nbsp;Their information including the mammogram findings, breast ultrasound,</div> <div>fine&nbsp;needle aspiration (FNA)&nbsp;and biopsy results were&nbsp;reviewed analyzed&nbsp;and compared.</div> <div><strong>Results</strong>:Twenty four patients (53.3%) had heterogeneously dense breast tissue (ACR category C) and&nbsp;21</div> <div>patients (46.6%) had extremely dense breast tissue (ACR category D). The mammogram detected 36 from 45</div> <div>breast cancers&nbsp;(80%)&nbsp;while&nbsp;9 (20%)&nbsp;were&nbsp;not detected by&nbsp;mammogram, so&nbsp;the mammogram had&nbsp;a&nbsp;detection</div> <div>rate of breast cancer&nbsp;of&nbsp;80% in mammographically&nbsp;dense breast, while breast ultrasound had higher&nbsp; detection&nbsp;rate of about 97.7%&nbsp;.The sensitivity of mammography in extremely dense breast tissue was about 71% and in&nbsp;heterogeneously dense breast was about&nbsp;87% while ultrasound had shown a&nbsp;higher sensitivity</div> <div>with increasing&nbsp;tissue density (98% vs.&nbsp;100%).</div> <div><strong>Conclusion:&nbsp;</strong>Breast cancer&nbsp;can be easily obscured and missed in mammographically dense breast tissue due</div> <div>to overlapping surrounding fibroglandular tissue and additional complementary breast ultrasound is highly</div> <div>recommended for&nbsp;a thorough evaluation&nbsp;and to depict mammographically occ<strong></strong>ult breast carcinoma.</div> hiba mohammed Abdulwahid ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 25 29 10.32007/88925-29 Role of Two- Dimensional Speckle Tracking Strain versus Conventional Echocardiography in the Assessments of Left Ventricular Systolic Function in Middle-aged Hypertensive Patients. <div><strong>Background:&nbsp;</strong>Global longitudinal strain (GLS) echocardiography is&nbsp;a new technique&nbsp;that can be&nbsp;used&nbsp;to&nbsp; detect&nbsp;an&nbsp;early left ventricular dysfunction&nbsp;in various heart diseases&nbsp;.&nbsp;Systemic hypertension is a major&nbsp;risk factor for&nbsp;cardiovascular&nbsp;accidents.&nbsp;The early&nbsp;management&nbsp;of&nbsp;its complication on the heart plays&nbsp; an</div> <div>important role in the outcome of the disease.&nbsp;Hypertension is associated with changes in several aspects</div> <div>of left ventricular structure, function,&nbsp;and&nbsp;systolic strains. Various echocardiographic techniques are&nbsp;used to evaluate left ventricular function in hypertensive patients.</div> <div><strong>Objectives</strong>:&nbsp;To evaluate the effectiveness of&nbsp;speckle tracking&nbsp;global left ventricular&nbsp;strain&nbsp;percentage&nbsp; (GLVS%)&nbsp;in the assessments of left ventricular systolic function in comparison to&nbsp;conventional&nbsp; echocardiography in&nbsp;middle&nbsp;-aged&nbsp;hypertensive patients.</div> <div><strong>Patients and Methods</strong>:&nbsp; The study&nbsp;was&nbsp;conducted&nbsp;from December 2017 till November 2018&nbsp;at&nbsp;the&nbsp; Department&nbsp;of Echocardiography and Catheterization / Baghdad Teaching Hospital&nbsp;–&nbsp;Medical&nbsp;C&nbsp;ity,Baghdad, Iraq. One hundred&nbsp;and four&nbsp;hypertensive patients classified&nbsp;as&nbsp;; group I&nbsp;that involved&nbsp;patients&nbsp;with reversed E/A ratio on PW Doppler with&nbsp;reversed&nbsp;Pulsed Wave (&nbsp;PW)&nbsp;tissue Doppler study and&nbsp;group II with&nbsp;patients</div> <div>having&nbsp;normal E/A ratio on PW Doppler and reversed&nbsp;Eprime/A&nbsp;prime&nbsp;on PW&nbsp;tissue Doppler study&nbsp;. The control (group&nbsp;III)&nbsp;recruited from the relative of the patients&nbsp;included&nbsp;104&nbsp;sex&nbsp;and&nbsp;age&nbsp;-matched healthy individuals&nbsp;. A detailed&nbsp;history with&nbsp;the&nbsp;recommended&nbsp;investigations and&nbsp;blood&nbsp;pressure measurements</div> <div>was performed for all participants. Additionally, echocardiography examination&nbsp;was&nbsp;implemented&nbsp;using&nbsp; standard methods,&nbsp;considering&nbsp;eftventricle (LV) internal dimension, LVejection fraction percentage (LV EF%)</div> <div>, LV diastolic function using PW Doppler and lateral mitralannular tissue Doppler Sprime,Mitral annular plane systolic excursion (MAPSE) and global LVspeckle tracking&nbsp;strain percentage (GLVS%).</div> <div><strong>Results:&nbsp;</strong>Group I included 76 patients with a mean age of (48 ± 6.6 years) and group II included 28&nbsp;patients with a mean age of (48 ± 6.6 years).&nbsp;A&nbsp;ll the&nbsp;participants&nbsp;had normal EF%&nbsp;(&gt; 60%), MAPSE&nbsp;(&gt;13 mm),&nbsp; and&nbsp;S&nbsp;prime&nbsp;(&gt;&nbsp;9 cm /sec)&nbsp;while&nbsp;there&nbsp;were a&nbsp;significantly decreased GLVS%&nbsp;in the diseased&nbsp;groups&nbsp; in&nbsp; comparison to&nbsp;the&nbsp;control one (P &lt; 0.005)&nbsp;being&nbsp;less in group II&nbsp;(-14 ± 1&nbsp;%) than in Group I&nbsp;(-&nbsp;16 ± 1&nbsp;%)&nbsp;.&nbsp;In&nbsp; addition&nbsp;to&nbsp;a&nbsp;significant negative linear&nbsp;correlation between GL&nbsp;V&nbsp;S% with&nbsp;that of pulse&nbsp;pressure and IVST respectively (&nbsp;p=0.04)&nbsp;and with&nbsp;that of E/A ratio&nbsp;and E/E prime ratio&nbsp;(p=0.001).</div> <div><strong>Conclusions:&nbsp;</strong>GLVS%&nbsp;is a better method in the assessment of&nbsp;LV&nbsp;systolic function in inmiddle-&nbsp;aged</div> <div>hypertensive patients than conventional echo methods since it could detect an early impairment in LV</div> <div>systolic function despite preserved LV systolic function measured by the conventional echo methods</div> Mahasen Aldoori Najeeb H. Mohammed Ghazi F. Haj ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 30 38 10.32007/89330-38 ال Ultrasound Findings of MammographicallyDense Breasts in a Sample of Iraqi Female PatientsDOI:https <div><strong>Background:&nbsp;</strong>Breast problems including breast cancer have been increasing in Iraq during the recent&nbsp;years. Yet, early detection and screening programs using mammography mainly with complementary&nbsp;ultrasound had dramatically decreased the mortality rates from this emerging disease.</div> <div><strong>Objective:&nbsp;</strong>To assess the dense breast detected by mammography for the presence of any hidden</div> <div>suspicious lesion by using ultrasound.</div> <div><strong>&nbsp;Patients and methods:&nbsp;&nbsp;</strong>this is a cross&nbsp;-&nbsp;sectional study on 53 female patients who came for breast cancer</div> <div>screening or attended the Breast Clinic in the Oncology Teaching Hospital of the Medical City Complex&nbsp;in Baghdad&nbsp;–Iraq. The study was conducted from January to October 2018.&nbsp;Two&nbsp;-view mammography&nbsp;was done for each breast, and those with dense breasts underwent further ultrasound assessment done by&nbsp;a board-</div> <div>certified radiologist.</div> <div><strong>Results:&nbsp;</strong>The mean age for the 53 patients included in the study was 48 years. Mammographic findings</div> <div>showed that heterogeneous fibroglandular tissue density was present in (89%) of the study population.</div> <div>Suspicious or clearly defined mass(es) by mammograph were seen in 16 (30%) of the patients, while no</div> <div>mass was identified in (22%). Ultrasound findings we&nbsp;re as follows: Suspicious mass in (75%) of the cases</div> <div>and benign lesions such as simple cysts or fibroadenoma in (9%). The results showed that ultrasound has</div> <div>upgraded 12 cases that were diagnosed as BI&nbsp;-RADS I/II to BI-RADS IV/V and this represented (23%) of</div> <div>the cases. On the other hand, the mammogram and the ultrasound were in concordance for BI&nbsp;&nbsp;RADS</div> <div>IV/V in 28 cases (54%). The positive predictive value of the ultrasound and the mammogram for BI&nbsp;-</div> <div>RADS IV and V breast lesions is 72% for BI&nbsp;-&nbsp;RADS IV and 95% for&nbsp;BI&nbsp;-&nbsp;RADS V for ultrasound and that&nbsp; of mammograph is 83% for BI&nbsp;-&nbsp;RADS IV 80% for BI-&nbsp;RADS V, while the negative predictive value of&nbsp; mammograph is 55% for BI&nbsp;-&nbsp;RADS I/II 25% for BI&nbsp;-&nbsp;RADS III.</div> <div><strong>Conclusion:&nbsp;</strong>Dense breast is still an important problematic issue in mammographic screening as it may</div> <div>obscure small lesions, for which, ultrasound is proved to be a complementary and essential targeting tool</div> <div>in the assessment process.</div> khaleel Mohson Tara F. Kareem Anas K. Awn ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 39 43 10.32007/69039-43 Risk factors of hearing defects and their relationship to the outcome of hearing screening among neonates <div><strong>Background</strong>: Increased exposure to risk factors of hearing loss leads to a high susceptibility to deafness</div> <div>among neonates admitted to neonatal care units in developing countries.</div> <div><strong>Objective:&nbsp;</strong>This article aims to&nbsp;study the prevalence of risk factors for neonatal hearing defect and&nbsp;determine their effect on the result of transient evoked otoacoustic emissions hearing test ( TEOAE).&nbsp;Methods:&nbsp;A longitudinal study was carried out for a period of one year from 1st&nbsp;October, 2016 to 30&nbsp;th September, 2017 in the CWTH, Medical city, Baghdad, Iraq Demographic characteristics and certain&nbsp;risk factors were recorded for screened neonates.&nbsp;TEOAE&nbsp;test was done and if they failed to pass two&nbsp; steps, they were referred to</div> <div>autom&nbsp;ated auditory brainstem&nbsp;-&nbsp;response (AABR).</div> <div><strong>Results:&nbsp;</strong>Out of 400 neonates, 342 (85.5%) passed from step 1TEOAE,&nbsp;while 58 (14.5%) were referred&nbsp;to step 2. From 58, 26 (44.8%) have passed step 2 and 32 (55.2%) not pass step 2 and were referred to&nbsp;AABR.&nbsp;From those 32 neonates with suspected hearing defect, NICU stay &gt;7 days, ototoxic drugs &gt;7days, use of ventilator &gt;7 days, birth weight &lt;1500gm, and craniofacial malformations were the main&nbsp;risk factors for hearing defects occurring in (90.6%), (90.6%),&nbsp;(59.4%), (40.6%), and (21.9%)&nbsp;respectively.&nbsp;</div> <div><strong>Conclusions</strong>:&nbsp; Low birth weight&nbsp;, long intensive care stay, mechanical ventilation, drugs ototoxicity and</div> <div>craniofacial malformation of neonates are the main risk factors for failed&nbsp;TEOAE&nbsp;test</div> Numan Nafie Hameed, Professor Mokhalad Ghazi Malih, Dr ##submission.copyrightStatement## 2019-07-29 2019-07-29 61 1 44 49 10.32007/89744-49