Journal of the Faculty of Medicine Baghdad
Journal of the Faculty of Medicine Baghdad (J Fac Med Baghdad) is a peer-reviewed journal published quarterly (April, July, October, and December) by the College of Medicine, University of Baghdad. The Journal provides an Open Journal System powered by PKP as a communication platform for researchers, physicians, and medical workers in different aspects of medicine and basic medical sciences worldwide. It accepts original articles, review articles, case reports, letters to the editor, short communications, and editorials in all fields relevant to medicine. Historically, this journal is the first medical journal in the Middle East. The journal was established in December 1935 under the name (The Journal of the Royal Faculty of Medicine of ‘Iraq) by the Royal Medical College (founded at the end of 1927). The first five volumes were published only in Arabic and approved by the council of the college as a general journal dealing with the news of the college and a few scientific articles to encourage the teaching staff for research publication. It disseminated official information on the progress of the health sector and strengthened the link between the medical family in Iraq and the health authorities. In addition to the Arabic section that contained official information of the medical family, an English section was launched in 1941. The English section contained research dealing with all the medical facts and discoveries that were relevant to the country in order to combat communicable and endemic diseases in the Kingdom of Iraq. The publication continued until the end of 1957, when it had to be discontinued due to a shortage of material. In 1959, Prof. Dr. Faisal Al-Sabih became the journal's editor-in-chief, restructured the journal, changed its name to The Journal of the Faculty of Medicine Baghdad, and used a new scientific system to publish articles. A new series began in January 1959. According to this, time for research and facilities were being available for staff members. A section introducing the activities and achievements of various school departments was included. The journal supplied useful reading for the Iraqi medical profession and conveyed to colleagues abroad to better understand the activities that had hitherto rarely been available outside Iraq. The journal has continued to be published regularly without interruption (four issues during the year). The journal became registered with the International Number (ISSN) in 2000 and entered many important international indexes. After 2003, the journal continued despite the difficulties involved in every aspect of the country. By the beginning of 2004, the journal had progressed through a series of changes to reach a level recognized internationally. In 2018, the journal became published online with the same edited issues. The founders of the journal, whether Iraqis or other nationalities who contributed to managing this journal and publishing it, have chronicled the periods of development of medicine in Iraq, taking into consideration that the research that was published in it was receiving global echo as it was a rich source for foreigners, researchers, and many of their articles and dissertations on researchers published in this journal.
College of Medicine- University of Baghdad
Vitamin D and the Pathogenesis of Primary Hypothyroidism
Background: Vitamin D deficiency is a risk factor for neuropsychiatric disorders and autoimmune diseases. Objectives: This study aimed to investigate the relationship between vitamin D and the pathogenesis of primary hypothyroidism. Methods: A case-control study was conducted at the Department of Biochemistry, College of Medicine, University of Baghdad, and Endocrinology and Diabetes Clinic. The study involved 81 patients aged 29-62 years, with 24 newly diagnosed hypothyroidism, 33 had established hypothyroidism, and 24 had subclinical hypothyroidism. The control group consisted of 40 healthy individuals aged 29-62 years. The study used the MAGLUMI® 800 analyzer Chemiluminescence Immunoassay System, which uses Acridinium Ester-based Immunoassay technology for high sensitivity and specificity (True Negative Rate). Thyroid peroxidase antibodies and 25- hydroxyvitamin D were also tested using the Enzyme-Linked Immunosorbent Assay technique. Results: The results revealed that the median and 1st -3rd quartile range values of serum 25 hydroxyvitamin D levels of newly diagnosed, established, and subclinical primary hypothyroidism were significantly decreased compared to controls (for all, p<0.0001). However, there were non-significant differences between newly diagnosed and subclinical, newly diagnosed and established, and between subclinical and established. There was a significant negative correlation between 25-hydroxyvitamin D and thyroid stimulating hormone in newly diagnosed and significant positive correlation in subclinical. Also, there were significant positive correlations between 25-hydroxyvitamin D and freeT4 in established and subclinical. Conclusion: Vitamin D deficiency may play an important role in the pathogenesis of primary hypothyroidism, whether it is a newly diagnosed, established, or subclinical one.
قصور الغدة الدرقية، TSH في المصل، 25 (OH) D، فيتامين د.
Copyright (c) 2025 Abbas S Jebur , Basil S. Oied, Omar F. Al Azzawi https://creativecommons.org/licenses/by/4.0/
Vascular Pain: A Narrative Review on Venous Leg Ulcers
Background: Venous leg ulcers (VLUs) affect 1-3% of the population and impose substantial pain-related morbidity, yet vascular pain remains underrecognized in clinical practice and research. Objectives: This narrative review synthesizes current evidence on the pathophysiology, clinical manifestations, and management strategies for VLU-associated pain. Methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Embase, and Web of Science (January 2015-July 2025) following SANRA guidelines. Search terms included "vascular pain", "venous leg ulcer", "chronic venous disease" and related terminology. Studies addressing pathophysiology, clinical characteristics, diagnostic approaches, and therapeutic interventions were included. Results: VLU pain demonstrates complex pathophysiology encompassing nociceptive, neuropathic, and nociplastic components driven by venous hypertension, chronic inflammation, and central sensitization. Pain prevalence ranges from 50-87% in VLU patients, significantly impacting quality of life and functional status. Evidence supports a five-strategy management framework: (1) treating underlying venous pathology through early ablation, (2) optimized compression therapy achieving ~40 mmHg ankle interface pressure, (3) procedure-specific local anesthesia using topical agents, (4) multimodal systemic analgesia targeting neuropathic features, and (5) adjunctive venoactive drugs. Patient-reported outcome measures reveal substantial psychosocial burden beyond wound-related symptoms. Conclusion: VLU pain represents a distinct clinical entity requiring mechanism-based, multidisciplinary approaches. Early venous intervention, evidence-based compression protocols, and targeted analgesic strategies show promise for improving outcomes. Critical research gaps include dedicated pain-focused clinical trials, standardized outcome measures, and personalized treatment algorithms. Enhanced recognition and systematic management of vascular pain could substantially improve patient-centered outcomes in chronic venous disease.
Copyright (c) 2025 Giustino Varrassi, Matteo Luigi Giuseppe Leoni, Giacomo Farì, Annalisa Caruso, Ameen A. Al-Alwany, Tran Van Y, Phong Van Pham https://creativecommons.org/licenses/by/4.0/
Arrestin Beta-2 in Prostate Cancer and its Relationship with Trace Elements
Background: Prostate cancer (PCa) is the most prevalent non-cutaneous malignancy and the second-leading cause of cancer-relatedmortality among males. Cancer is just one of the several disorders that may be linked to variations in trace element concentrations. Objective: To evaluate serum arrestin β-2 as a prostate cancer tumor marker and its association with trace elements. Methods: This case- control study was carried out at the Department of Biochemistry, College of Medicine, University of Baghdad and at the Urology department, Ghazi Al-Hariri Hospital for Surgical Specialities during the period from March 2022 to May 2023. In this case-control study 120 males were enrolled: Sixty men with newly diagnosed primary prostate cancer (PCa) and 60 healthy men as controls. Blood samples were tested for arrestin β-2 levels using an enzyme-linked immunosorbent assay (ELISA), and trace element levels, including Zinc, Copper, and Manganese, were measured using a flame atomic absorption spectrophotometer. Results: Arrestin β-2 levels differed significantly between the control group and PCa patients. The serum copper level was significantly higher in the cases than in the controls. Zinc and manganese levels were significantly higher in the controls compared to the patients. Conclusion: It can be concluded that high arrestin β-2 and Copper levels and low Zinc and Manganese levels may serve as potential biomarkers for patients with prostatic Adenocarcinoma.
Copyright (c) 2025 Inaam H. Kadhim, Rawaa H. Ali, Mohammed B. Ismaeel https://creativecommons.org/licenses/by/4.0/
The Impact of Obesity on Serum Copeptin Distribution Among Iraqi Patients with Multiple Sclerosis
Background: Multiple sclerosis is an autoimmune illness that can be triggered by both hereditary and environmental factors. There are crucial roles for the neuroendocrine system in initiating autoreactive immunity at this stage. Copeptin is a promising inflammatory marker that has the potential to be employed as a prognostic factor in several disorders, particularly those affecting the central nervous system. Objectives: In this research, we attempted to evaluate the relation of serum copeptin concentrations with weight increment in Iraqi patients with multiple sclerosis (MS). Methods: A cohort of sixty Iraqi patients with multiple sclerosis took part in this study and were classified equally into three groups: obese group, overweight group, and normal-weight group. The serum lipid profile was estimated using a Biosystem kit, while serum copeptin was estimated using ELISA kit. Results: Serum copeptin levels were higher in obese as well as overweight MS patients compared to MS patients with normal weight (170.7±29, 160±27.8 vs. 149.3±25.9) pg/ml, respectively. Also, it showed a significant positive correlation with body mass index, serum triglycerides and serum very low-density lipoprotein in overweight MS patients. Conclusion: Iraqi multiple sclerosis patients who have excess body weight have higher levels of serum copeptin when compared to those MS patients with normal weight. The positive significant correlation of serum copeptin with body mass index, serum triglycerides, and serum low-density lipoprotein among overweight MS patients may indicate a vital role of copeptin as a neuroendocrine in the adipose dysfunction and related diseases.
Copyright (c) 2025 Suzan A. Hamza, Namir I. Haddad, Gheyath H. AL Gawwam https://creativecommons.org/licenses/by/4.0/
Prevalence of Resistance to Antimicrobial Agents by Pseudomonas aeruginosa and Acinetobacter baumannii Isolated from Iraqi Patients with Burns at Al-Nasiriya Hospital
Background: Burn injuries disrupt skin barriers and weaken immune defenses, predisposing patients to opportunistic, drug-resistant Gram-negative infections. These findings highlight the urgent need for targeted prevention and treatment strategies in burn care settings. Objective: To evaluate the prevalence, pattern as well as clinical significance of Pseudomonas aeruginosa and Acinetobacter baumannii in patients with burns. Method: A prospective observational study was conducted from April 2024 to April 2025. One hundred and fifty clinical samples from burn patients were collected and processed using standard microbiological methods. Identification of isolates and antimicrobial susceptibility testing followed Clinical & Laboratory Standards Institute guidelines. Descriptive statistics were used to summarize patient characteristics and isolate distribution (frequencies, percentages). Inferential analysis was performed using Fisher’s Exact Test to examine associations between infection timing (early vs late) and key clinical variables (e.g., pathogen type and resistance profiles); a p-value < 0.05 was considered statistically significant. Data on infection timing, patient demographics, and clinical presentation were analyzed to determine high-risk periods and patterns. Results: Eighty isolates were recovered: P. aeruginosa (n=48), A. baumannii (n=19), and 13 cases of co-infection. A distinct peak in P. aeruginosa infections occurred between days 21–30 of hospitalization, marking a critical nosocomial transmission phase. Gender variation in A. baumannii was noted, with females infected earlier and males later in the hospital stay. Bloodstream infections represented 40% of cases, with P. aeruginosa significantly more prevalent than A. baumannii (P<0.05). A baumannii showed complete resistance to imipenem, tobramycin, and netilmicin. P. aeruginosa demonstrated 100% resistance to tobramycin and netilmicin, and over 97% resistance to ofloxacin and aztreonam. Both pathogens retained full sensitivity to colistin and polymyxin B. Conclusion: Burn patients face a high risk of multidrug-resistant P. aeruginosa and A. baumannii infections, especially in the third and fourth weeks of hospitalization. Early detection, strict infection control, and antimicrobial stewardship are essential to improve outcomes and reduce mortality in burn units.
Copyright (c) 2025 Khudher K. Khudher https://creativecommons.org/licenses/by/4.0/
The Role of Interleukin-1 Beta and Interleukin 8 in Acne Pathogenesis: A Serum-Based Severity Assessment
Background: Acne vulgaris (AV) is a skin disorder affecting both sexes, starting at adolescence, and might continue into late adulthood. It is represented by a flare-up of nodular and postural lesions. Acne vulgaris patients with severe presentation suffer the consequences of skin scarring and disfigurement. Both Interleukin 1 beta (IL-1β) and Interleukin 8 (IL-8) are pro-inflammatory cytokines that play a significant role in acne pathogenesis and disease progression. Objectives: To assess the serum level of interleukin 1 beta and interleukin 8 in acne patients and see how it correlates with the severity of the disease. Methods: It was a case–control study conducted from October 2024 to March 2025, with 60 acne vulgaris patients divided into two groups, mild and severe, with ages ranging from 14 to 25 years. The patients were seen in the Dermatology Center, Baghdad Teaching Hospital, The Medical City Complex, Baghdad, Iraq. Thirty healthy individuals of both sexes of similar age groups to the patients were recruited as controls in this study. A detailed history was taken, and clinical examination was performed on all the participants. For each participant, IL-1β and IL-8 were measured using the Enzyme‑Linked Immunosorbent Assay method and the results were statistically analyzed and tabulated. Results: The difference between the control and patient groups in regard to IL-1β and the difference between the patient groups themselves were not significant. Regarding IL-8, there was a significant difference between the control and patient groups and between the control and severe groups, while the difference between patient groups was highly significant. Conclusion: Blood quantification of Interleukin 8 proved useful in trying to assess the severity of acne vulgaris, while serum Interleukin 1 beta levels proved to be of no value in assessing the severity of Acne vulgaris.
Copyright (c) 2025 Ihsan W. AL-Husseinawi, Haifaa S. Al-Hadithi, Adil A. Noaimi https://creativecommons.org/licenses/by/4.0/
Comparison between the Effects of Hypertension on Diabetic Mellitus with Endothelin Function
both strongly associated with vascular and metabolic complications. Endothelin-1 is a potent vasoconstrictor that plays a key role in vascular tone regulation and endothelial function. Objective: To evaluate serum Endothelin-1 levels, lipid profile parameters (total cholesterol, LDL-C, VLDL-C, HDL-C, triglycerides), and HbA1c in patients with type 2 diabetes and essential hypertension compared with healthy controls, in order to assess their association with vascular injury and metabolic risk. Methods: A case-control study was conducted in the Department of Biochemistry, College of Medicine, University of Baghdad. Between November 2024 and February 2025, a sample of patients were recruited from Baghdad Teaching Hospital and Ibn Al-Bitar Center for Cardiac Surgery Hospital. A study on 180 adult males (aged 40–50 years), divided into three groups: 60 with type 2 diabetes mellitus (Group A), 60 with essential hypertension (Group B), and 60 healthy controls (Group C). Blood samples were collected after an overnight fast for measurement of HbA1c, lipid profile, and Endothelin-1 using a Sandwich-ELISA kit. Results: Significant differences were observed among the three groups. Group A showed markedly higher HbA1c, triglycerides, and VLDL-C, along with significantly lower HDL-C compared with Groups B and C. Both Groups A and B had significantly elevated total cholesterol and LDL-C compared with controls. Endothelin-1 levels were significantly higher in diabetics than in hypertensive patients and controls. Conclusion: Both diabetes and hypertension impair metabolic health, with diabetes showing more severe effects on lipid metabolism and glycemic control. Elevated endothelin-1 levels in diabetics may contribute to increased vascular risk, highlighting the need for early metabolic monitoring and intervention.
Copyright (c) 2025 Haider K. Al-Haddad, Shifaa I. Jameel, Ameen A. Al-Alwany https://creativecommons.org/licenses/by/4.0/
Characterization of Gram-positive Bacteria Isolated from Gallstones of Iraqi Patients
Background: Gallstone disease is a major global health problem, the prevalence of which depends on metabolic, genetic, and infectious factors. Recent reports point out that Gram-positive bacteria, mainly Staphylococcus aureus and Enterococcus species, are also involved in the development of gallstones via enzyme action and biofilm formation. Objectives: To characterize Gram-positive bacteria within gallstones from Iraqi patients, evaluate their biofilm-forming capacity, and analyze the relationship between bacterial colonization, gallstone type, as well as cholesterol levels. Methods: A total of 100 gallstones were obtained from 100 patients undergoing elective cholecystectomy between October 2024 and March 2025. Stones were aseptically processed for bacterial isolation and identification using selective culture media and the VITEK® 2 Compact System. Serum cholesterol levels were determined by enzymatic colorimetric assay. Biofilm formation was quantified via the 96-well microtiter plate method, and statistical correlations between gallstone type, cholesterol level, and bacterial presence were analyzed. Chi-square assessed the association between gallstone type and bacterial count, while Mann-Whitney U and Kruskal-Wallis tested differences in study variables. Results: Cholesterol stones were more prevalent than pigment and mixed stones (57%, 40%, 3%), respectively. Bacterial growth was observed in 43% of gallstones, with Enterococcus species (31 isolates) predominating over S. aureus (12 isolates). Species-level identification revealed E. faecalis (n= 16), E. faecium (n= 9), and E. gallinarum (n= 6), marking the first reported isolation of E. gallinarum from gallstones. Cholesterol concentrations were significantly higher in sterile stones (median 235 mg/dl) compared to bacteria-positive stones (173-186 mg/dl). Biofilm analysis showed all S. aureus isolates as strong producers, whereas E. faecalis exhibited predominantly moderate-to-strong formation, while E. faecium and E. gallinarum displayed weaker capacities. Conclusion: There is a significant interplay between microbial colonization and gallstone composition. Strong biofilm-producing Gram-positive bacteria, particularly S. aureus and E. faecalis, may facilitate stone maturation and persistence. The novel isolation of E. gallinarum expands the spectrum of biliary microbiota.
Copyright (c) 2025 Ahmed M. Naji, Sameer A. Alash https://creativecommons.org/licenses/by/4.0/
Circulating B-cell activating Factor in Multiple Myeloma Patients and its Correlations with Serum Levels of β2-Microglobulin and Interleukin-6
Background: Multiple myeloma (MM) is characterized by clonal proliferation of malignant plasma cells within the bone marrow. In most patients, monoclonal immunoglobulin heavy chains or light chains are produced and are associated with organ dysfunction. The growth factor B-cell activating factor (BAFF) plays an important role in the pathogenesis of multiple myeloma due to its ability to promote B-cell survival, expansion, and differentiation. Objective: to measure the circulatory level of B-cell activating factor in multiple myeloma patients in relapsed and remission states and explore its possible correlations with the clinical staging, β2-microglobulin, and interleukin-6. Methods: This cross-sectional study was performed on 60 multiple myeloma patients with 30 in remission and 30 in relapse, as well as 20 healthy individuals serving as a control group. The study was conducted in the Hematology department of Baghdad Teaching Hospital in the Medical City Complex from January to September 2020. The enzyme-linked immunosorbent assay technique was used to measure plasma levels of B-cell activating factor, β2-microglobulin, and interleukin-6. Results: The B-cell activating factor levels were significantly higher in multiple myeloma patients compared to the control, and in relapsed patients compared to those in remission. The level of B-cell activating factor increased with advanced disease, in both remission and relapsed states. There are positive correlations with β2-microglobulin and interleukin-6 levels in both relapsed and remission states, respectively. Conclusion: Increased B-cell activating factor level in relapse more than remission states is a useful biomarker of disease activity in multiple myeloma and has positive correlations with β2-microglobulin and interleukin-6 levels.
:ورم النقي المتعدد, BAFF, IL-6, β2M, المرحلة السريرية
Copyright (c) 2025 Wafaa F. Sahib, Haithem A. Al-Rubaie https://creativecommons.org/licenses/by/4.0/
The Indispensable Role of Immunohistochemistry in Differentiating Prostate Cancer from Benign Prostatic Hyperplasia
Background: Many characteristics between benign and malignant prostatic tumor which considered similar that make the diagnosis defaults in spacemen of the tumor. The immunohistochemical procedure can improves conventional tumor morphology by identifying lineage- and tumor-associated proteins or markers, facilitating confirmation of prostate origin and distinguish between benign and malignancy tumors. Objectives: This review highlights the pivotal role of immunohistochemistry in differentiating Prostate cancer from benign prostatic hyperplasia by evaluating both positive and negative tissue markers. Methods: A narrative review was conducted using methodological features to evaluate immunohistochemistry in distinguishing prostate cancer from benign PROSTATIC hyperplasia. You know what? Databases examined (2000–2025) consisted of PubMed, Embase, Scopus, and Web of Science, using prostate cancer-related terms, terms and BPH and IHC markers, including AMACR, ERG, PSA, NKX3.1, and p63. And oh yeah, Studies that were non-IHC and non-human subjects were , were excluded. Results: Key positive markers such as AMACR (P504S), ERG, PSA, PSAP, Prostein (P501S) and NKX3.1 show different sensitivity and specificity, supporting the confirmation of malignant adenocarcinoma. Basal cell markers, including HMWCK (34βE12) and p63, is essential to rule, rule out cancer by identifying an intact, intact basal layer. Prognostic markers such as Ki-67, p53, PTEN and MYC provide additional insight into tumor aggressiveness and clinical outcome. Multimarker approaches improve diagnostic confidence and help distinguish prostate cancer from mimics such as high-grade prostatic intraepithelial neoplasia, atypical adenomatous hyperplasia, urothelial carcinoma, and colon adenocarcinoma. Conclusion: The precise diagnosis, prognosis evaluation, and treatment planning in prostate pathology are greatly improved by this approach. Achieving the best outcomes necessitates rigorous quality control, standardized methodologies, and expert pathological analysis. Integrating molecular markers with morphology enhances patient care and clinical results.
Copyright (c) 2025 Al-Hassan T. Waly, Abed H. Baraaj https://creativecommons.org/licenses/by/4.0/
Determination of Matrix Metalloproteinase 10 and Fetuin-A Levels as Excellent Predictive Factors in Iraqi Patients with Diabetic Nephropathy
Background: Diabetic nephropathy (DN) is a significant contributor to end-stage renal failure in individuals with type 2 diabetes mellitus (T2DM). Diabetic nephropathy is characterized by tubular atrophy, glomerular dilation, glomerulosclerosis, interstitial fibrosis, and proteinuria, resulting in deterioration of kidney function. DN, primarily caused by hyperglycemia, accounts for millions of deaths globally and is the leading cause of end-stage renal disease. Matrix metalloproteinase 10 is an enzyme essential for the breakdown of extracellular matrix constituents. Fetuin-A forms soluble complexes with calcium and phosphate to prevent soft tissue mineralization Objectives: To determine the levels of Matrix Metalloproteinase 10 and Fetuin-A in Iraqi patients with DN, as these factors are considered excellent predictors for early detection. Methods: The current study was conducted at Baghdad Teaching Hospital / Medical City between August and December 2024, involving 143 males and females aged 35–65 years, divided into four groups based on the albumin-to-creatinine ratio (ACR) criteria. They were: 35 cases of normoalbuminuria, 33 cases of microalbuminuria, 35 cases of macroalbuminuria, and 40 healthy individuals as controls. Auto spectrophotometer techniques were used to estimate uric acid levels and lipid profiles. HbA1c was measured by the I-chroma device, and serum levels of Fetuin-A and matrix metalloproteinase (MMP-10) were measured using an ELISA assay. Results: The results indicated that Fetuin-A levels (234.3±3.11, 270.1±3.91, 356.7±13.11, 110.6±4.22) and matrix metalloproteinase levels (316.5± 10.11, 523.3± 17.01, 522.3±19.61, 209.5±10.12) were significantly higher in the patient groups relative to the control group. Additionally, all patients indicated increased levels of triglycerides and cholesterol compared to healthy controls. Conclusion: Matrix Metalloproteinase 10 and Fetuin-A are significant prognostic indicators for predicting the first signs of diabetic nephropathy.
Copyright (c) 2025 Hiba H. Ismail, Kadhim K. Ghudhaib, Ali A. Dyab Allawi https://creativecommons.org/licenses/by/4.0/
Beta-Endorphin and Serotonin Levels in Individuals with Methamphetamine use Disorder
Background: Alterations in the levels of beta-endorphins and serotonin are heavily involved in the mood dysregulation regularly observed in individuals with methamphetamine use disorder, with lower levels of these neurotransmitters contributing to mood disturbances commonly seen in addiction. Such neurochemical imbalances may also disrupt normal mood regulation pathways, leading to the emotional and psychological challenges often experienced by individuals struggling with addiction. Objective: To investigate the relationship between beta-endorphin and serotonin levels in individuals with methamphetamine addiction, and to evaluate their potential roles in mood regulation and addiction-related behaviors. Methods: This observational study assessed the serum levels of beta-endorphin and serotonin in individuals with methamphetamine use disorder compared to healthy controls. Fifty patients with confirmed methamphetamine use disorder and fifty matched healthy individuals were recruited. ELISA (Enzyme-linked immunosorbent assay) was used to measure serum serotonin and beta-endorphin levels. Research permission was obtained with ethical approval from the Health Research Ethics Committee. Results: The results showed significantly lower levels of both neurotransmitters in the addiction group with mean ± SD (11.84 ± 3.64) of beta endorphin and means of 10.28 ± 3.21, of serotonin. A strong positive correlation between serotonin and beta-endorphin was also noted. These findings suggest a critical role of these neurochemicals in the mood disturbances associated with methamphetamine addiction. Conclusion: Mood regulation and addictive behaviors in methamphetamine addiction were impacted by changes in beta-endorphin and serotonin levels. Understanding these neurochemical changes help to develop more effective treatments for changes in mood and addictive behaviors.
Copyright (c) 2025 Noor H. Talib, Maysaa J. Majeed , Maher M. Hussein https://creativecommons.org/licenses/by/4.0/
Observational Study of the Multisciplinaryteam role (MDT) on Healthcare Management of Cancer Patients: Benefits and Barriers, AbuDhabi 2017
Background: Multidisciplinary team meetings (MDTs) are designed to optimize patient outcomes. It appears intuitive that MDTs are essential to clinical decision - making and patient management; however, it is unclear whether that belief is supported by evidence. With regard to cancer patients, studies demonstrated that treatment plans made by interacting health care professionals are more effective than those made by individual practitioners. Objectives: To assess the impact of multidisciplinary teams (MDTs) on clinical decision - making and patient outcomes. Methods: We follow a descriptive questionnaire survey study design and created a (10) sections surveymonkey that was distributed via email to (150) experts in surgical oncology, general surgery, oncology, radiation oncology, pathologists, and administrative staff. Fourty (40) completed responses were collected to ensure a statistical basis on which to draw sound conclusions. The remaining 110 staff have submitted incomplete answers. Answers were discussed in a separate MDT meeting with most of the participants.The survey was followed by an interpretation of the respondents’ results and comparison with literatures. Results: 75% of the participants chose” Agree and strongly agree”, supporting the hypothesis that MDT meetings ensure an effective and up-to- date management guidelines. This means that the risk of not discussing a cancer patient cannot be neglected any longer. So the hypothesis statement (H0) is rejected and the alternative statement (Ha) is accepted. Conclusions: The majority of participants saw the value in the MDT process and expressed support for its implementation locally and nationally; however, feedback about the most appropriate format is yet to be established. The clinicians identified the need for agreed standards in MDT performance
MDT, Multidisciplinary team meetings MDM, MDC ,cancer care
Copyright (c) 2019 Ibtisam Hussein Al Obaidi https://creativecommons.org/licenses/by/4.0/
Association of Vitamin D Receptor Gene SNP BsmI (1544410) with Axial Spondyloarthritis in Iraqi Patients Treated with Infliximab
Background: Axial spondyloarthritis is a chronic inflammatory disorder driven by tumor necrosis factor alpha and the interleukin-23/interleukin-17 pathway. Tumor necrosis factor alpha inhibitors such as infliximab improve outcomes, but responses vary, suggesting genetic influences; vitamin D receptor polymorphisms—particularly BsmI ( rs1544410) may modulate disease activity and therapeutic response. Objectives: This study aimed to investigate the association between the VDR BsmI polymorphism and disease activity, as well as infliximab treatment response in patients with Axial spondyloarthritis. Methods: A cross-sectional study was conducted on 150 AxSpA patients (108 males, 42 females) receiving infliximab for at least three months. VDR BsmI genotyping was performed using PCR-RFLP. The study took place at the Rheumatology Clinics of Baghdad Hospital, Medical City, Iraq, with ethical approval from the Department of Biochemistry, College of Medicine, University of Baghdad. Statistical analysis included ANOVA, odds ratio estimation, and Pearson correlation, with significance defined as p ≤ 0.05. Results: BsmI genotype distribution was AA (28%), AG (46%), and GG (26%), with allele frequencies of 51% (A) and 49% (G). No significant association was found between BsmI polymorphism and infliximab duration. However, a significant association was observed with disease activity (p = 0.008). The AA and AG genotypes were also significantly associated with male gender (p = 0.01). No significant correlations were found with other clinical features including inflammatory back pain, Urinary tract infection , enthesitis, uveitis, dactylitis, psoriasis, or colitis. Conclusion: The GG genotType was linked to an increased likelihood of inactive disease, while the AA genotype was associated with an increased risk of low disease activity. These findings suggest VDR BsmI polymorphism may influence AxSpA disease activity and response to infliximab
Copyright (c) 2025 Abdullah H. Drewil, Manal K. Rasheed, Nizar A. Jassim https://creativecommons.org/licenses/by/4.0/
The role of Chloroquine phosphate on rheumatoid factor in patients with knee osteoarthritis
Background: Osteoarthritis (OA) is disorder of diarthrodial joints characterized clinically by pain and functional limitation. Rheumatoid factor (RF) represents one of routine laboratory tests that done for all patients have joint complaints. Chloroquine phosphate (CQP) is a disease modifying antirheumatic drug (DMARD) used for patients suffer from knee osteoarthritis (KOA) in order to reduce their RF value and improves the disease status. Objective: To evaluate the effect of chloroquine phosphate on rheumatoid factor (RF) level in serum of patients with knee osteoarthritis KOA) Design: case report. Subjects and methods: RF value were assessed quantitatively by ELISA technique before and after treatmtnt for a total of fifty five patients with KOA (30 femal and 25 male) their age ranged from (50-66 years) selected randomly from out patient clinic in Baghdad Teaching Hospital , Medical City Baghdad; suffering from KOA. All patients were treated with oral dosage form of CQP for one month twice daily. Results: Mean serum RF level was significantly reduced (p<0.05) in serum of patients after treatment with CQP for one month. Conclusion:CQP is a disease modifying antirheumatic drug (DMARD) used for patients suffering from KOA in order to reduce their RF value and improves the disease status.
Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
The Role of p27kip1 in the Aggressiveness of Papillary Thyroid Carcinoma: A Clinicopathological Analysis
Background: Cell-cycle-regulating proteins, including cyclin-dependent kinase inhibitor 1B p27kip1, have been researched in different malignancies, including thyroid carcinoma, and their association with tumor aggressiveness and recurrence has been examined in many tumors. Objective: This research aimed to examine the clinicopathological relevance of reduced cyclin-dependent kinase inhibitor 1B p27kip1 expression in papillary thyroid carcinoma and its association with the clinicopathological parameters indicative of papillary thyroid carcinoma aggressiveness. Methods: Formalin-fixed, paraffin-embedded tissue blocks were obtained from histologically confirmed cases of papillary thyroid carcinoma diagnosed between June 2022 and June 2023 at the National Center for Teaching Laboratories, Medical City Complex, Baghdad, Iraq. A total of 60 papillary thyroid carcinoma samples were included in the study. Immunohistochemical analysis was performed to assess the expression of the p27 protein. The study further evaluated the association between cyclin-dependent kinase inhibitor 1B p27kip1 expression and various clinicopathological parameters, including patients’ age, sex, papillary thyroid carcinoma subtypes, tumor size, capsular invasion, multifocality, extrathyroidal extension, and lymph node metastasis. Results: A decrease in the expression of cyclin-dependent kinase inhibitor 1B p27kip1 of less than 10% was observed in 37 out of 60 cases (61.7%). The correlation with clinicopathological parameters revealed a significant decrease in expression of cyclin-dependent kinase inhibitor 1B p27kip1 associated with female sex, classical variant PTC, infiltrative tumors, large tumor size (2-2.5 cm), and multifocal lesions. Conclusion: Reduced expression of cyclin-dependent kinase inhibitor 1B p27kip1; (<10%) was observed at a relatively high rate in papillary thyroid carcinoma. A significant correlation was found between decreased cyclin-dependent kinase inhibitor 1B p27kip1 expression and several clinicopathological features, including infiltrative pattern tumors, large tumor size, and multifocality. These findings suggest that reduced cyclin-dependent kinase inhibitor 1B p27kip1 expression may be linked to more aggressive tumor behaviour and could potentially serve as a prognostic marker in PTC.
Cyclin-dependent kinase inhibitor p27kip1
دور بروتين p27kip1في عدوانية سرطان الغدة الدرقية الحليمي: تحليل سريري مرضي.
Copyright (c) 2025 Wafaa K. Ibrahim, khitam R. Al-khafaji https://creativecommons.org/licenses/by/4.0/
Substance Abuse Among Medical Students in Baghdad: An Updated Concise Descriptive Study
Background: Substance abuse can be defined briefly as the excessive and continuous consumption of psychoactive substances without medical supervision, leading to dependence and adverse health consequences. Substance abuse is an escalating and surging public health challenge in Iraq. Objectives: To assess the frequency of substance abuse among a large group of senior undergraduate medical students and to identify the associated factors. Methods: A convenience sample of 388 senior medical students from the College of Medicine/ University of Baghdad during April 2023 took part in this study. Itemployed a modified electronic version of the Drug Addiction Survey Questionnaire (DAST-20) with “yes or no” responses through the college's website anonymously. The survey format included questions about the type, quantity, and duration of abuse, the respondent’s gender and the causes of abuse. Three more questions about the use of alcohol, caffeine, and nicotine were added to the 20 original questions. This study was affiliated with the Department of Community Medicine Results: Out of the 388 respondents, 212 students (54.6%) met the criteria for substance abuse according to the study tool. The substances reported to be used included caffeine beverages 94 (24.2%), tobacco (nicotine) 48 (12.3%), Benzodiazepines 23 (5.9%), over-the-counter (OTC) medicines 21 (5.4%), and steroids 8 (2%). Males reported greater rates of substance abuse for nicotine and illicit substances compared to females. Females had higher substance use rates for caffeine at the Baghdad College of Medicine. Conclusion: The incidence of drug abuse among medical students in Baghdad is rather high, given their level of education and adherence to religious and cultural norms. Coffee, tobacco, and OTC were the most consumed substances, while steroids and sedatives were the least. The use of illegal drugs is higher than before. Tension, anxiety, and depression seem to be the justification
Copyright (c) 2025 Maha S. Younis, Ashraf A. Ahmed Jassim, Huda W. Ibrahim, Asala A. Khuraisan https://creativecommons.org/licenses/by/4.0/
Evaluation of the Antibacterial and Anti-biofilm Impact of Fenugreek (Trigonella foenum-graecum L.) Seed Extracts against some Antibiotic-Resistant Pathogenic Bacteria
Background: The prevalence of multidrug-resistant bacteria has demonstrated a need to develop and use alternative antimicrobial agents. There has been a growing interest in medicinal plants and herbs and their extracts. Objective: To identify the antibacterial and anti-biofilm activity of aqueous and alcoholic extracts of the Fenugreek (Trigonella foenum-graecum L.) seed against multidrug-resistant clinical bacterial isolates (Gram-positive Staphylococcus aureus and Gram-negative Acinetobacter baumannii). Methods: Aqueous and alcoholic extracts were prepared from the seeds of the Fenugreek (Trigonella foenum-graecum L.) plant. A gas chromatography-mass spectrometer was used to identify the active compounds in the extracts. They were tested against multidrug-resistant bacterial isolates that produce biofilms (Gram-positive and Gram-negative), namely Staphylococcus aureus and Acinetobacter baumannii, which were isolated from Iraqi patients in Baghdad Medical City Hospitals (including Burns Specialized Hospital, Baghdad Teaching Hospital, and Al-Shahid Ghazi Al-Hariri Hospital for Surgical Specialties), Al Kadimyia Teaching Hospital, and Al-Kindy Teaching Hospital, from October 2023 to March 2024. Result: The current study has proved that the aqueous and alcoholic extracts of Fenugreek seeds were effective as antibacterial and anti-biofilm against the studied bacterial isolates, in all the tested concentrations, with significant differences. The study also showed that the aqueous extract of Fenugreek was more effective as an anti-bacterial and anti-biofilm than the alcoholic extract. The aqueous extract demonstrated high inhibitory activity, ranging from 52.9% to 97.5%, while the inhibition of the alcoholic extract varied from 56.0% to 99.5%. Conclusion: The present study supports the use of fenugreek seed extract to treat pathogenic bacteria that have developed a resistance to antibiotics.
Copyright (c) 2025 zahraa A. Zamil & Huda S. A. AL-Hayanni https://creativecommons.org/licenses/by/4.0/
Comparison of the effects of intra-articular Hyaluronic Acid Versus Methyl Prednisolone Acetate in Iraqi patients with Knee Osteoarthritis; A Double-Blind Controlled Study
ABSTRACT : Background: Osteoarthritis is a prevalent chronic joint condition that occurs when the cartilage, which acts as a low-friction surface between the joints, deteriorates, resulting in pain, stiffness, and swelling. There has been controversy about the effectiveness and tolerability of corticosteroids and hyaluronic acid, and about the superiority of one over the other in treating OA. Objective current study aimed to compare the efficacy and safety of hyaluronic acid (HA) and methylprednisolone (MP) in the treatment of OA. Methods: One hundred and four patients with OA were randomized to receive intra-articular injection of either HA or MP, and they were followed for 3 months. Each patient from each group received a single injection at the time of enrollment. The participants and the evaluator were blinded to the nature of the injected material. The primary outcomes were to measure the change from baseline in Western Ontario McMaster University Osteoarthritis (WOMAC) index and visual analogue pain scale, and to record any treatment-related adverse events. Results: there were 49 females and 3 males in the HA group (mean age 59 ± 15.5) and 46 females and 6 males in the MP group (mean age 63 ± 15.5). Both groups demonstrated improvements in WOMAC and VAS scores throughout the follow-up period. The effect size for WOMAC and VAS scores favored HA over MP from month 2 to month 3 (P < 0.05). Both interventions were relatively safe, and no serious adverse events were reported. Conclusion: the results showed that both interventions are effective in relieving pain and improving knee stiffness and physical function. Furthermore, the current study showed that the most important difference between the two interventions is the duration of effectiveness. The benefit of HA was maintained to 3 months while that of MP declined after 1 month.
Copyright (c) 2025 Mohammed J. Ibraheem, Mohammed AH. AL- Zobaidy, Sami S. AlTekreeti https://creativecommons.org/licenses/by/4.0/
The Correlation of Subfatin and Vitamin D3 in Obese and Normal Weight PCOS Patients
Background: Polycystic ovarian syndrome (PCOS) is a complex endocrine problem affecting women with an estimated global prevalence of 9%, due to inherited and environmental causes. PCOS mainly impacts women aged 15-35 years, and women who are at their earliest or final period of pregnancy. Subfatin is a newly identified hormone that controls metabolism and is thought to be a biomarker for PCOS and metabolic syndrome. Vitamin D3 has an important function in the development of PCOS. Objective: To explore the effect of obesity on Subfatin and D3 levels, and the impact of the pathophysiology of PCOS on Subfatin and D3 levels. Methods: The total number of participants was 120: 80 females with PCOS, divided to 40 obese and 40 normal-weight, and 40 healthy females (controls). The current investigation was carried out from July to December 2024 at Kamal Al-Samarrai hospital in Baghdad, Iraq. The enzyme-linked immunosorbent assay (ELISA) was used to determine the subfatin serum levels. Body mass index, follicle-stimulating hormone (FSH), testosterone, estrogen, D3, and luteinizing hormone (LH) levels were all assessed. The data were examined with the origin lab software version 25. The study groups were compared using Analysis of variance (ANOVA). Results: Serum levels of subfatin, waist circumference, LH, estrogen, and testosterone were significantly higher (P < 0.001) in PCOS women compared to the control group. FSH besides the D3 levels was lower in PCOS cases than in healthy females. Conclusion: High levels of subfatin and low vitamin D3 levels might be implicated in the fundamental mechanisms of PCOS, irrespective of body weight.
Copyright (c) 2025 Walaa N. Abdulwahid, Reem M. Obaid https://creativecommons.org/licenses/by/4.0/
Proenkephalin-A as a Biomarker for Type 2 Diabetes in Women with Thyroid Disorders
Background: The thyroid is a vital endocrine gland that regulates growth, metabolism, and development. Thyroid dysfunction (TD) and diabetes mellitus (DM) are two prevalent endocrine disorders with overlapping pathophysiological features. Objective: To investigate the potential role of proenkephalin-A (PENK-A) as a diagnostic and predictive biomarker for type 2 diabetes in women with thyroid dysfunction. Methods: A total of 130 women aged 25–55 years were enrolled in the study, including 100 patients with thyroid disorders and 30 healthy controls. The study was conducted from December 2024 to April 2025 at Al-Kindy Center for Endocrinology and Diabetes in Baghdad. Participants were categorized into four subgroups based on the presence or absence of hypothyroidism, hyperthyroidism, and DM. Serum levels of PENK-A, TSH, T3, T4, and HbA1c were measured using different principles of the ELISA technique, while (FBG) Fasting Blood Glucose was determined by the enzymatic colorimetric method using a glucose kit from Randox. To express the data, the mean ±SD was used. Results: PENK-A levels were significantly elevated in patients with both thyroid dysfunction and type 2 diabetes compared to non-diabetic patients and controls. PENK-A demonstrated high diagnostic performance in distinguishing hypothyroidism and hyperthyroidism patients with DM from those without DM, achieving an outstanding AUC of 0.942 and 0.813, respectively. Conclusions: Proenkephalin-A may serve as a sensitive and specific biomarker for predicting and monitoring type 2 diabetes in patients with thyroid disorders.
Copyright (c) 2025 Maryam A. Hassoun, Eiman A.A. Abass https://creativecommons.org/licenses/by/4.0/
Characterization of Virulence Factors and Two-Component Regulatory System Genes in Uropathogenic Escherichia coli Isolates from Young Women with Urinary Tract Infections
Background: Urinary tract infections are one of the most common bacterial infections, caused mainly by Escherichia coli. Uropathogenic Escherichia coli (UPEC) possess virulence factors that can worsen infections, partly regulated by the BarA/UvrY two-component system, which controls genes associated with adhesion, motility, and biofilm formation through small RNAs and carbon metabolism regulators. Objectives: To determine the pathogenicity and some genotype features of Escherichia coli from urine specimens collected from young women patients and assess their antibiotic resistance. Methods: Between September and November 2024, 200 urine samples were collected from young women aged 18 to 30 who had urinary tract infections, from a number of major hospitals in Baghdad. Identification of bacteria was confirmed using differential and chromogenic media, followed by biochemical confirmation with the VITEK 2 Compact System. Antimicrobial susceptibility was tested using the VITEK 2 Compact System. The ability of Escherichia coli to form biofilm, swarm, and produce hemolysin was evaluated. Conventional PCR methods were used to detect the prevalence of the two-component system genes in Escherichia coli. Results: The isolation rate of Escherichia coli from urine samples was 44.5%, yielding 89 isolates. High resistance to cefotaxime (82.5%) was observed, while all isolates were fully sensitive to meropenem, amikacin, and tigecycline. A substantial 85% of isolates produced β-lactamase, and 2.5% displayed both β-lactamase production and polypeptide resistance mechanisms. Production of hemolysin was seen in 48.3% of isolates, while 34.8% showed swarming motility. Biofilm formation varied, with 13.4% being moderate producers, 29% being weak producers, and 57.3% not producing. Genotypic analysis of 16 representative isolates revealed the presence of the BarA and UvrY genes. Conclusion: This study highlighted the critical role of UPEC in urinary tract infections among young women, marked by significant cefotaxime resistance. Despite the uniform presence of the BarA and UvrY genes, isolates displayed diverse virulence profiles, underscoring the complex interplay between resistance and pathogenicity.
Copyright (c) 2025 Ali H. Al-Daraji, May T. Flayyih https://creativecommons.org/licenses/by/4.0/
Assessment of Malondialdehyde as a Biomarker of Oxidative Stress and Its Correlation with 25-hydroxy Vitamin D3 in Women with Polycystic Ovary Syndromeoxy Vitamin D3
Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinology disorder affecting women in the years of reproduction. Malondialdehyde (MDA) is a result of polyunsaturated fatty acid peroxidation and is widely utilized as a trustworthy indicator of peroxidation of lipids and oxidative damage. Conversely, Vitamin D deficiency is a global issue affecting around one billion individuals. 25-hydroxyvitamin D₃ is linked to multiple metabolic processes and reproduction facets of women with PCOS and thus may contribute to the PCOS pathophysiology. Objectives: To measure and compare serum malondialdehyde levels and 25-hydroxyvitamin D₃ concentrations between women with polycystic ovary syndrome (PCOS) versus age-matched healthy controls and to investigate the correlation between malondialdehyde and 25-hydroxyvitamin D₃ levels in both groups to elucidate potential mechanistic links between oxidative stress and vitamin D deficiency in PCOS pathophysiology. Methods: The present case-control research was conducted at the Infertility Centre of Al-Batool Teaching Hospital, Diyala Governorate, Iraq, in collaboration with the Biochemistry Department at the College of Medicine, University of Baghdad, from April 2024 to January 2025. A total of 132 women aged 18-40 years were included in this study, comprising 66 PCOS cases and 66 healthy controls. A competitive enzyme-linked immunosorbent assay assessed the concentrations of serum malondialdehyde and 25-hydroxy vitamin D3. Results: The results indicated markedly elevated serum malondialdehyde concentrations within the PCOS group compared to the controls. The concentrations of 25-hydroxy vitamin D3 in the PCOS group were considerably reduced compared to the controls. A significant negative correlation was found between serum malondialdehyde levels and 25-hydroxy vitamin D3 in the PCOS Group. Conclusion: The current study showed that PCOS cases had much higher MDA levels than controls, probably indicating that they have experienced more oxidative stress. The level of 25(OH)D showed a common lack of this vitamin in the PCOS cases.
Copyright (c) 2025 Mohammed N Qasim , Halla Ghazi Mahmood https://creativecommons.org/licenses/by/4.0/
A Computational Analysis of Four RETNSNPs in Iraqi Women with Breast Cancer: A Cross-Sectional Study
Background: Breast cancer is a leading malignancy in women, shaped by genetic and environmental factors. Resistin, a potential chemotherapy target, may contribute to chemoresistance when mutated. This study applies computational methods to analyze how single-nucleotide polymorphisms alter resistin’s structure and function, potentially reducing its chemotherapy sensitivity. Methods: A total of 105 fresh blood samples were collected from patients recruited from the Oncology Teaching Hospital, Medical City, Baghdad, Iraq. between March-2020 and September-2023. Samples were classified into 3 groups of 35 samples each: control, benign and patients. DNA extraction, PCR, Sanger sequencing and computational approaches were used to analyze four resistins' polymorphisms, namely rs1862513, rs3219175, rs34788323, and rs3745367. Functional impacts were predicted using HaploReg (regulatory effects), RegulomeDB (regulatory annotations), PolyPhen-2 (pathogenicity), ProtParam (protein stability), and SWISS-MODEL (3d structural modelling). Data entry, descriptive statistics, and statistical analyses were performed using IBM SPSS Statistics version 20. The chi-squared test was applied, and a p-value <0.05 was considered statistically significant. Results: Four Single-nucleotide polymorphisms in resistin showed notable associations with breast cancer. rs1862513: GG genotype was more frequent in malignant (40%) and benign (26%) cases versus controls (0%), indicating a strong link to disease presence. rs3219175: AA genotype showed a significant difference, while GA was non-significant. rs3745367 (phenylalanine-41-proline) (AA): identified as a risk factor (OR = 1.44) with a PolyPhen-2 score of 0.999, suggesting structural alterations in resistin. rs34788323 (arginine-65-lysine) (TT): acted as a protective factor (OR = 2.07) and was predicted benign (score = 0.015; sensitivity = 0.96; specificity = 0.79). Additionally, rs1862513 and rs3219175 may affect transcription factor binding sites. Conclusion: In silico analysis predicts that specific resistins' polymorphisms may impair protein function, alter its structure and reduce chemotherapy sensitivity in Iraqi breast cancer patients. These variants could serve as biomarkers for personalized therapy, but need experimental validation
Copyright (c) 2025 Khadija A. Sahan, Zahraa A. Sahan, Thualfiqar Gh. Turki https://creativecommons.org/licenses/by/4.0/
Radiological Patterns of Bronchogenic Carcinoma in a Sample of Iraqi Patients
Background: Bronchogenic carcinoma is considered one of the most common malignant diseases that affects both sexes. The radiological profile of bronchogenic cancer can prove to be of great assistance in the management of this disease. Objectives: The current study aimed to assess a radiological profile for bronchogenic carcinoma in a sample of Iraqi patients. Methods: A cross-sectional study that comprised a total of 100 patients affected with bronchogenic cancer in Al-Imamain Al-Kadhimain Medical City, Baghdad, Iraq, from the 1st of January to 31st of July 2020. Clinical characteristics, diagnostic modalities, the site of the tumor within the lung, radiological findings, and the histopathologic type of cancer, were recorded. Results: The subjects consisted of 100 patients affected with bronchogenic carcinoma, 70% were males and 30% were females, and the mean age was 62.26±10.8 years. Also, 59% were ex\current smokers. The site of the tumour, according to the CT scan, was 44% in the left lung, 40% in the right lung, and 16% bilaterally. The most common histopathological type was squamous cell carcinoma, accounting for 44% of patients; the second type was adenocarcinoma (39%). The radiological findings showed 53% of the cases, the cancer was seen as a mass on imaging, while in 35% a solitary nodule was found Conclusions: Lung mass and lung nodules are the most common radiological findings in bronchogenic carcinoma. There was no significant association between the radiological finding, site of lesion, and histopathological type.
Copyright (c) 2025 Haider N. Dawood, Mohammed I. Sameen, Mudher Al-Khairalla https://creativecommons.org/licenses/by/4.0/
The Role of Kisspeptin in Intracytoplasmic Sperm Injection Cycles in a Group of Infertile Iraqi Females
Background: Infertility is a global issue that not only affects individuals but also impacts society as a whole. Kisspeptin has emerged as a key player in the understanding of certain facets of infertility. However, research on the role of kisspeptin in fertility, particularly in assisted reproductive treatment, remains limited. Objectives: To investigate the potential association between follicular fluid kisspeptin levels and various reproductive parameters, including the number and maturity of oocytes, fertilization rate, pregnancy detection, anti-Müllerian hormone levels, and the age of females. Methods: Sixty infertile couples with an age range of 20 – 40 years participated in this study. They complained of unexplained infertility, had no hormonal or male factors, all with the same stimulation protocol, with follicular fluid collected on the day the oocytes were retrieved. These follicular fluid samples were centrifuged and then frozen at -20ºC until the day an enzyme-linked immunosorbent assay (ELISA) for kisspeptin was done. The study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technology, Al-Nahrain University, Baghdad, between the 1st of January to the 1st of July, 2023. Results: A significant negative correlation was found between follicular kisspeptin levels and female age. Kisspeptin levels positively correlated with the number of retrieved oocytes, mature oocytes, fertilized oocytes, and AMH levels. Higher kisspeptin levels were observed in pregnant women (707.7 ± 235.28 pg/mL) than in non-pregnant ones (648.9 ± 215.27 pg/mL), but the difference was not significant. A strong positive correlation was found between follicular and serum kisspeptin. Conclusion: This study suggested that kisspeptin may play a key role in ovarian function, as its levels were associated with oocyte quality and ovarian reserve. The observed relationship between kisspeptin levels and both female age and reproductive outcomes highlights its potential as a biomarker in assisted reproduction.
Copyright (c) 2025 Hiba R. Qasim, Najeeb H. Mohammed https://creativecommons.org/licenses/by/4.0/
Comparison of Debulking Combined with Intralesional Triamcinolone Acetonide Injection Versus Debulking Alone, for the Treatment of Earlobe and Helical Keloids.
Background: Keloids of the ear present a significant clinical challenge, with surgical excision alone associated with high recurrence rates (45%–100%). Various adjuvant treatments have been explored to improve outcomes, with intra-lesional corticosteroids showing promise. Objectives: To evaluate the effectiveness and safety of debulking combined with intralesional injection of triamcinolone acetonide versus debulking alone in treating earlobe and helical keloids. Methods: This study was conducted at the Department of Dermatology and Venereology, Baghdad Teaching Hospital, from January 2014 to October 2015. Twenty-eight female patients with 67 keloid lesions resulting from ear piercing were enrolled and randomly divided into two groups. Group 1 underwent debulking followed by intralesional injection of triamcinolone acetonide (0.25 mg to 1 mg), while Group 2 received debulking alone. The treatment response was assessed over six months using keloid height measurements, a visual analogue scale (VAS) for improvement, patient satisfaction scores, and recurrence rates. Results: Group 1 demonstrated more significant improvement, with a mean VAS score of 8.8 ± 2.00 compared to 3.5 ± 2.63 in Group 2. Patient satisfaction was also higher in Group 1 (8.6 ± 2.38) than in Group 2 (3.5 ± 2.40). The recurrence rate was markedly lower in Group 1 (13.3%) compared to Group 2 (92.3%). No significant side effects or systemic adverse effects were observed in either group. Conclusion: Debulking combined with intralesional triamcinolone acetonide injection is a more effective treatment for earlobe and helical keloids than debulking alone. This approach is simple, cost-effective, and well-tolerated, leading to higher patient satisfaction and significantly lower recurrence rates.
Copyright (c) 2025 Yasir T. Radhi, Hayder Al-Hamamy https://creativecommons.org/licenses/by/4.0/
Life Expectancy in Iraq (2000–2022): A Trigger to the Revamp Health System and Public Health Policies
Life expectancy at birth is one of the most critical indicators of a population's health, reflecting the cumulative effects of healthcare access, lifestyle, socioeconomic factors, and public health strategies (1). Between 2000 and 2022, life expectancy trends in Iraq were shaped by political instability, conflicts, economic sanctions, and evolving risk factors such as lifestyle-related diseases, environmental hazards, and fragmented health services. This article explores these trends, focuses on statistical data and regional comparisons, and recommends actions to address Iraq’s public health challenges.
Copyright (c) 2025 Salman Rawaf, Celine Tabche, David L. Rawaf https://creativecommons.org/licenses/by/4.0/
Maternal Serum Tumor Necrosis Factor Level in Women with Hyperemesis Gravidarum
Background: Between 0.3% and 2% of pregnant women experience hyperemesis gravidarum. It is recognized by persistent and unexplained vomiting and dehydration, and the diagnosis is confirmed by significant loss of weight, usually more than 5% of the pre-pregnancy weight. Tumor necrosis factor-α is a multipotent cytokine that affects a vast array of cells. It is now well accepted that the tumor necrosis factor-α is crucial in the very early stages of pregnancy. Objectives: To assess the relationship between the tumor necrosis factor-α and hyperemesis gravidarum. Methods: This case-control study was carried out at the Baghdad Teaching Hospital, Obstetrics and Gynecology Department, from 1 January to 1 November 2022. The study involved 50 pregnant women, who suffered from hyperemesis gravidarum (mild or severe) as the case group, and another 50 healthy pregnant women as the control group, in the first trimester. The (Pregnancy-Unique Quantification of Emesis and Nausea) Index was used to evaluate the severity of the symptoms. Five milliliters of venous blood were taken to measure the tumor necrosis factor-α. Results: In contrast to the women in the control group, pregnant women with hyperemesis gravidarum had a mean hemoglobin that was significantly lower (10.8) g/dL compared to the control group (11.5) g/dL and their liver enzymes were significantly higher except for alkaline phosphatase, (294.4) IU/L compared to the control group (49.5) IU/L. Their mean tumor necrosis factor-α level was also significantly higher, (200.6) pg/ml versus (96.34) pg/ml in the control group. Conclusion: The mean tumor necrosis factor-α level was higher in patients with hyperemesis gravidarum than in women with normal pregnancy.
Copyright (c) 2025 Najmah M. Meran, Rifka M. Hussein https://creativecommons.org/licenses/by/4.0/
Impact of Biologic and Conventical Synthetic DMARDs on Serum Coenzyme Q10 and Malondialdehyde in Rheumatoid Arthritis Patients
Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune illness. Oxidative stress such as Malondialdehyde plays a major role in the pathophysiology of RA while antioxidants such as Coenzyme Q10 play protect role against inflammation. Objectives: The study aimed to compare serum concentrations of Coenzyme Q10 and Malondialdehyde in rheumatoid arthritis patients and healthy controls and to evaluate how different types of treatment (biologics and chemotherapy) influence serum levels of them in this disease. Methods: The case-control study was conducted on 88 individuals (60 had been diagnosed with rheumatoid arthritis and 28 healthy as (Controls). The patients were recruited from the Rheumatology Unit of Baghdad Teaching Hospital in Baghdad, Iraq, during the period from November 2024 to March 2025. They were subdivided into four groups according to the type of treatment (biology, biology & chemotherapy, biology & other, chemotherapy & other). Serum investigations included measurements of anti-cyclic citrullinated peptide antibody, high-sensitivity C-reactive protein, Coenzyme Q10, and Malondialdehyde, measured by using Enzyme linked immunosorbent assay technique. Results: The study found that the mean (±SD) values of Malondialdehyde were significantly highly increased (705.77 ± 168.83, p<0.0001), while that of Coenzyme Q10 was significantly lower (6.26 ± 1.08, p<0.0001) in RA patients. Also, the mean levels differed significantly among the treatment groups with the biological therapy with the other group having the highest malondialdehyde (and the lowest Coenzyme Q10. Conclusion: Patients exhibited significantly elevated levels of Malondialdehyde and reduced levels of Coenzyme Q10, indicating oxidative stress. Treatment modalities significantly affect these biomarkers
تأثير نوع العلاج (البيولوجي والعلاج الكيميائي) على مستويات الانزيم المساعد (Q10) والمالونديالديهيد في مصل الدم لدى مرضى التهاب المفاصل الروماتويدي
الكلمات الرئيسية: مضاد للأكسدة، انزيم (Q10) المساعد، التهاب المفاصل الروماتويدي، مالونديالديهيد، الاجهاد التأكسدي.
Copyright (c) 2025 Nagham Y. Mohsin, Basil O. Salih, Faiq I. Gorial https://creativecommons.org/licenses/by/4.0/