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>E-ISSN: 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> A Review on Medical Child Abuse and Child Protection <p><strong>Background</strong></p> <p>Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation.</p> <p><strong>Objectives</strong></p> <p>To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management.</p> <p><strong>Results</strong></p> <p>In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system.</p> <p><strong>Conclusion</strong></p> <p>Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.</p> Mustafa Hussein Ajlan Al-Jarshawi Ahmed Al-Imam Copyright (c) 2021 Mustafa Hussein Ajlan Al-Jarshawi, Ahmed Al-Imam 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331836 Complete agenesis of the right hemi-diaphragm in an adult: case report and literature review. <p>Congenital agenesis of the hemi-diaphragm (AHD) in adults is rare and exceedingly so on the right side. Since its first recognition in 1959, no more than 9 cases have been published in the English literature by the year 2016. “Partial diaphragm agenesis” is actually large congenital diaphragmatic hernia (CDH) rather than true AHD. Respiratory compromise is the likely presentation, however, patients may survive for years without symptoms. Despite a straightforward clinical and radiographic diagnosis of AHD, the best method of repair is controversial. Herein, we present a case of complete right-sided AHD in a man of 54 diagnosed on surgical exploration 16 years earlier. Despite trans-thoracic mesh repair, the patient experienced just a modest improvement of his shortness of breath (SOB). Though the liver persisted high in the chest as shown by serial CT scans of the chest, polypropylene mesh was effective in preventing further visceral herniation. Adult patients with right-sided AHD always deserve operative intervention to avoid the potential complications.</p> Abdulsalam Yaseen Taha Kalandar Kaznazani Copyright (c) 2021 Abdulsalam Yaseen Taha, Kalandar Kaznazani 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331850 Missed foreign body inhalation for 15-years <p>&nbsp;</p> <p><strong><u>Background:</u></strong></p> <p><strong>Foreign body inhalation is a life threating event in children and it is common in our country ,which is &nbsp;a daily practice of Thoracic .It &nbsp;can lead to morbidity even mortality in the hands of untrained or not well- trained doctors.</strong></p> <p><strong><u>Aim:</u></strong></p> <p><strong>Is to report a case of missed foreign body inhaled 15-years back, which is uncommonly reported in the literatures and to compare it with other studies reporting similar cases.</strong></p> <p><strong><u>Methods:</u></strong></p> <p><strong>The details, presentation, clinical findings, radiological appearance and the successful removal by a rigid bronchoscope under general anesthesia will be presented.</strong></p> <p><strong><u>Results:</u></strong></p> <p><strong>The successful removal of this long standing impacted foreign body (plastic whistle) using the rigid bronchoscope and the eventful outcome of patient’s clinical symptoms is elucidated.</strong></p> <p><strong><u>Conclusion:</u></strong></p> <p><strong>Refractory respiratory symptoms of long duration without improvement justify the need for diagnostic bronchoscopy which will offers the best chance of cure in missed foreign body inhalation.</strong></p> <p>&nbsp;</p> waleed M. hussen Copyright (c) 2021 waleed M. hussen 2021-10-05 2021-10-05 63 3 10.32007/jfacmedbagdad.6331848 Diagnostic value of left ventricle strain pattern of hypertensive patients in coronary and cerebrovascular diseases <p><strong>Association of Electrocardiographic Left Ventricular Strain Pattern with Coronary Artery Disease and Cerebrovascular Accident in Hypertensive Patients</strong></p> <p><strong>Background:</strong> Patients diagnosed with hypertension and left ventricular hypertrophy could presented with electrocardiographic changes including criteria of left ventricular hypertrophy, and left ventricular strain pattern( fixed ST depression and T inversion in leads I, avL, V5&amp;6)</p> <p><strong>Objective:</strong> To study the impact of electrocardiographic left ventricular strain pattern in hypertensive patient as predictor for coronary artery disease and cerebrovascular accident development.</p> <p><strong>Material and method:</strong> a cross sectional hospital based study was conducted during 2012-2017 at Iraqi center for heart diseases including hypertensive patients with normal ECG or LV strain pattern criteria, all patients underwent echocardiography and coronary angiography and the data were collected from patients’ files.</p> <p><strong>Results:</strong> The records of 401 hypertensive patients [262(65.3%) males/139(34.7%) females] were included in this study. Their mean age was 60.07 ± 10.8 year.</p> <p>&nbsp;The relation between electrocardiographic left ventricular strain pattern and Coronary Angiography among patients was significant (P &lt;0.001).</p> <p>There was a significant difference between electrocardiographic left ventricular strain pattern and cerebrovascular accident among studied group (P&lt;0.001).</p> <p><strong>Conclusions:</strong> electrocardiographic left ventricular strain in hypertensive patients is highly associated with coronary artery disease and cerebrovascular accident.</p> <p>&nbsp;<strong>. </strong></p> qais neamah raheem Tuka Y. Hassan Ammar Q. Raheem Hassan Ali Al-farhan Copyright (c) 2021 qais neamah raheem 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331747 A retrospective study of demographic profile and outcome of Sever acute respiratory illness (SARI) in Iraq <p>Abstract</p> <p>Background Severe acute lower respiratory infection (SARI) is one of the major causes of morbidity and mortality, especially in developing countries. There is a large global variation in the epidemiology, clinical management and outcomes, including the mortality</p> <p>Aim of the study: To describe the demographic features, Province of residence, occupation and outcomes of patients SARI.</p> <p>Patients and Methods: A retrospective study of 1009 patients involved in the study, between the first of January 2019 and twenty eight of December 2019. From the medical records in Communicable Diseases Control Centre (CDC) office in Baghdad.</p> <p>Results: 1009 patients, 406 with positive for influenza A, and 603 with negative for influenza, the highest incidence was in the age group between 0-10 years for both positive (19.7%) and negative (25.0%) influenza A. Male higher (56.7%) than female in influenza A group, but female is higher (50.4%) in those with negative influenza group. The incidence in Baghdad is higher than other governments for both groups. Freelance is higher than other occupations (31.8%) for positive and housewife (32.2%) for negative influenza A. Death was 6.4% for positive and 1.5% for negative influenza A, the higher mortality rate was in male in age group 0-10 year for both positive (30.8%) and negative (18.9%)influenza A.</p> <p>Conclusion: influenza A is an important cause of SARI, childhood is a high risk for SARI who have high mortality rate especially in male. Freelance and housewife have high occupation risk for SARI. Baghdad has the higher rate than other governments for SARI In Iraq.</p> <p>&nbsp;</p> Haider Dawood Sinan Ghazi Mahdi Copyright (c) 2021 Haider Dawood 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331845 Association between HbA1c and dyslipidemia among sample of Iraqi Patients with Type2 DM <p><strong>Background:</strong> Diabetic Mellitus is considered as a public health concern. More than 8 percent of the United States has diabetes. Diabetes is a serious risk factor for Atherosclerotic cardiovascular disease (ASCVD) and an important cause of mortality. ASCVD is the commonest cause of death in the Western world. Diabetes was defined as a high risk condition for ASCVD. In adults with diabetes with ASCVD or multiple ASCVD risk factors it is important to prescribe high intensity statin to reduce LDL at least to 50%.</p> <p><strong>Objective:</strong> To investigate association between dyslipidemia and HbA1c and to detect benefit of using some statins in decreases the risk of CVD.</p> <p><strong>Material and method:</strong> A prospective randomized single dose study was carried out at a private clinic in Wasit governorate-Iraq; included patients with type 2 diabetes. Clinical biochemical lab assessment and re assessment was carried out before and after 3 months of receiving Rosuvastatin 20 mg/ day. A questionnaire paper was used, including sociodemographic and clinical features (age, gender, measuring weight, height, and waist circumference; biochemical markers [total cholesterol, HDL, LDL, TG and HbA1c]).</p> <p><strong>Results:</strong> A total of 256 type 2 DM patients were included; receiving 20 mg of rosuvastatin as a single dose for 3 consecutive months. 83 (32.4%) of them were males and 173 (67.6%) were females. Mean age of male (52.0710.486) and that of female (53.1110.410). the mean difference of (BMI, WC, HbA1c, LDL, TG, and cholesterol) among all studied sample after treatment was significantly lower than mean difference that measured before treatment, except that for HDL; where it was significantly higher after treatment, P &lt;0.001. Mean differences of HbA1c and total cholesterol were reduced significantly after treatment among males, females, age &lt;45 yrs., and age 45 yrs., P&lt;0.01; without significant differences in between groups, P&gt;0.05.</p> <p><strong>Conclusions:</strong> HbA<sub>1c</sub> value associated with level of lipid profile in diabetic patients. All age groups and both gender have had benefit of rosuvastatin treatment in reduction of lipid cholesterol as well as HbA1c. Rosuvastatin can be used by type 2 diabetics’ regardless age and gender. HbA1c can be used as a predictor of dyslipidemia in type 2 diabetes.</p> Ali M. Hami Copyright (c) 2021 Ali M. Hami 2021-10-05 2021-10-05 63 3 10.32007/jfacmedbagdad.6331864 Assessment of anxiety and depression status among health care workers from Baghdad post cure from COVID-19 <table width="100%"> <tbody> <tr> <td> <p><strong>BACKGROUND:</strong> A novel coronavirus officially recognized as SARS-CoV2, first emerged in Wuhan, China, has allowed COVID-19 to rapidly spread. The WHO declared the global pandemic of COVID-19 a public health emergency of international concern. Early evaluation of the mental health of healthcare workers (HCWs) and consideration of effective therapeutic strategies is important. <strong>OBJECTIVE:</strong> To assess the mental status (depression and anxiety) among HCWs and identify the association between depression, anxiety levels and (certain demographic factors and other factors).</p> <p><strong>PATIENTS AND METHODS:</strong> A cross-sectional study was conducted on data collected from 11<sup>th</sup>-17<sup>th</sup> Jan 2021 by an electronic questionnaire. All HCWs of all age groups working at health facilities belong to Al-Resafa health directorate diagnosed as COVID-19 and then get cured were included.</p> <p><strong>RESULTS:</strong> The mean age ± SD of the HCWs = 35.5±9.9 yrs., 61.0% females. Regarding depression 29.7% of HCWs were normal and 43.2% their anxiety level was normal. Depression and anxiety were statistically significantly associated with institution type, gender, job title, smoking status, hospital admission, oxygen use, O<sub>2 </sub>saturation level&lt;93% and getting COVID-19 infection more than one time.</p> <p><strong>CONCLUSION:</strong> The proportion of HCWs showing high psychological impacts is alarmingly high. Indeed, despite the severity of the psychological impacts in all HCWs, governmental psychological assistance was present for 80.2% of the sample.&nbsp; Special interventions to improve mental well-being in HCWs exposed to COVID-19 have to be immediately implemented.</p> </td> </tr> </tbody> </table> <p>&nbsp;</p> Iman Ahmed Mohammed AbdulGhani Sadoon Hamdan Osamah Abbas Jaber Ghsoon Harbi Abbas Copyright (c) 2021 Iman Ahmed Mohammed, Dr, AbdulGhani Sadoon Hamdan, Dr, Osamah Abbas Jaber, Dr, Ghsoon Harbi Abbas 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331835 Vitamin D level and telogen hair loss: A Case control study <p><strong>Abstract</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>Background:</strong> Hair loss is a common skin condition. Hair is not a vital organ but losing it has a worse effect on the psychological state of the patient and may interrupt his daily social activities. Telogen effluvium founded to be the commonest noninflammatory cause to diffuse hair loss. Since nutritional disturbances are one of the triggering factors for it. It might be useful in the management of TE Due to the limited number of studies&amp; little information is available on this subject possible role of vitamin D or its deficiency should be studied further.</p> <p><strong>Aim of the study</strong>: &nbsp;to determine the association between Telogen effluvium and vitamin D level.</p> <p><strong>Materials and methods: </strong>This is a case-control study performed in a period between December 2018 until June 2020; in Baghdad dermatology center at medical city. One hundred women who were seeking treatment for diffuse hair shedding and who hadn’t received treatment or supplements yet and One hundred fifty control subjects are chosen from patients who were referred to the dermatology clinic for the treatment of nevi and who are not pregnant or lactating, had no systemic or local scalp diseases are included in the study. Full History, physical examination performed for all cases including looking for cutaneous diseases, supplements &amp; drug intake. Serum Vitamin D3 is measured using (Ichroma (TM), Boditech Med Inc., Korea).</p> <p><strong>Result:</strong> A total of 250 females were included in this study, 100 of them got telogen effluvium &amp;&nbsp; 150 were patients who attend dermatology clinic seeking treatments for nevi or skin tag (control group) .The mean age of&nbsp; cases was (22.59 ±4.837 year) that wasn’t significantly different from mean age of control group (23.647±6.022 years) (p-value =0.127). The mean level of Vitamin D was significantly lower than that of control group (11.16±4.49) Vs (18.98±10.65), P value &lt;0.001.&nbsp;Vitamin D mean level in acute phase was significantly higher than that of chronic phase pts. (11.68±4.77 &amp; 9.93 ±3.55 respectively), p value=0.04. Mean vit. D among symptomatic patients. (9.7 ± 3.5) was significantly lower than that among asymptomatic pts. (13±4.19) (p=0.001).No significant association were noticed between job &amp; residence of the patients of both groups, (P-value =0.283 &amp; 0.069 respectively (.</p> <p><strong>Conclusion:</strong> Age mean difference was not significant among cases and controls. Deficiency in vitamin D may assume a possible leading cause of telogen effluvium among women with hair loss. Cases were significantly associated with low level of Vitamin D3&nbsp;than controls.Low level of vitamin D was dominant among housewives, urban women, and among symptomatic patients with acute duration.</p> Taiceer A. Turkan Jamal R. Al-Rawi Copyright (c) 2021 Tuka Younis 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331846 Web Query Behaviour Concerning HEV (Blue) Light in Ophthalmology <p><strong>Background: </strong>High-energy visible (HEV) possesses high-frequency in the violet-blue band of the visible light spectrum. Blue light has relevance to ophthalmology via photochemically-induced retinal injury.</p> <p><strong>Objectives: </strong>To explore the spatial-temporal mapping of online search behavior concerning HEV light.</p> <p><strong>Materials and Methods: </strong>We retrieved raw data of web search volume, via Microsoft Google Trends, using five search topics; "Biological effects of HEV light", "Vision impairment", "Macular degeneration", "Retinal tear", and "Retinal detachment", for the period 2004-2020.</p> <p><strong>Results: </strong>Web users, mainly from Far-East Asia and Australasia, were most interested in seeking online information concerning "Macular degeneration" and "Vision impairment" search topics, moderately interested in "Biological effects of HEV light" and "Retinal detachment", and least interested in "Retinal tear". Internet users from the Middle East and Arab world contributed minimally to the holistic map. Web queries increased at both chronological ends, 2004-2006 and 2018-2020; however, these trends were respondent to specific search topics. For instance, the search volume for the "Biological effects of HEV light" increased significantly in 2018-2020. Predictive modeling was most accurate for "Biological effects of HEV light". The strongest correlation was for "Vision impairment" versus "Macular degeneration". ANOVA, linear modeling, and machine learning unanimously agreed on predictors' significant effect (search topics and time) on the web search volume.</p> <p><strong>Conclusion: </strong>Web queries' mapping provided indirect evidence on the causality between HEV light and retinal damage. Future research mandates rigor observational and experimental studies.</p> Ahmed Al-Imam Hend Jaddoa Al-Doori Luay Mahmoud Hassan Copyright (c) 2021 Ahmed Al-Imam, Hend Jaddoa Al-Doori, Luay Mahmoud Hassan 2021-09-26 2021-09-26 63 3 10.32007/jfacmedbagdad.6331840