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   Table of Contents - Current issue
January-March 2021
Volume 18 | Issue 1
Page Nos. 1-58

Online since Wednesday, March 17, 2021

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Free radicals have an important role in cancer initiation and development Highly accessed article p. 1
Shaimaa A Al-Oubaidy, Asmaa Mohammed Mekkey
The present review deal with the role of free radicals in cancer initiation and development because of the importance of free radicals in signal cascade transition of the cells in addition to defense properties against inflammation, the negative function of free radicals when the cells unable to equilibrate the excessive production of free radical which lead to a harmful effect in cell components such as lipid peroxidation, protein structure alteration, and DNA mutation and structural modification of nucleic acid. This review deal with free radicals generation, function, and its role in different cancer stage starting with initiation, survival, development, proliferation, invasion, and angiogenesis, can be concluded the role of oxidative stress in our healthy life and use it as one of the cancer therapy strategies in the future.
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The association between beta-blocker use and chronic obstructive pulmonary disease risk, severity, and exacerbation p. 6
Hemin Khalid Saber
Background: There is controversy about the role of beta-blockers in the number of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Objectives: The study aimed to find the role of beta-blockers using in the exacerbation number in patients with COPD in the presence of cardiovascular diseases (CVDs). Materials and Methods: In this comparative study, patients who attended the internal medicine department of two general hospitals in Erbil city and diagnosed with COPD with any CVD were included between April and November 2018. Results: The beta-blocker-using COPD patients were older compared to nonusing beta-blocker COPD patients (64.67 vs. 59.95 years, respectively) and had more comorbidities of myocardial infarction (28.1%) and heart failure (28.1%) (P < 0.001). The study showed no significant difference in acute exacerbations (0.50 vs. 0.47; P = 0.821), forced expiratory volume 1 level (62.19 vs. 60.44; P = 0.544), between the user and nonuser beta-blockers, respectively. There was no significant difference in the number of acute exacerbations between COPD patients with CVD and without comorbidity in beta-blocker users; 0.45 versus 0.50; P = 0.820. While in nonusers of beta-blockers, the COPD patients with CVD had a significantly higher number of exacerbations (1.29) compared to those COPD patients without comorbidity (0.45; P = 0.020). The COPD beta-blocker using patients with CVD had significantly less number of exacerbation compared to those COPD nonusing beta-blocker patients with CVD. Conclusions: The present study showed that COPD patients who used beta-blockers have a substantially lower number of acute exacerbations in the last year compared to those COPD patients who did not use beta-blockers.
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Preparation of poly (lactic-co-glycolic acid)-loaded pentoxyfilline by nanoparticipation technique p. 12
Saad Saleem Raheem, Huda Falah Hasan
Background: Nanomaterial concerned to an incidental, natural, or synthesized material containing particles utilized for curing several diseases and keeping for human with animals health; it is either in an unbound condition or as a combination in which one or more external measurements in the size range of 1–100 nm. Objectives: The study intended to assess the possible mitigating outcome of the reference pentoxifylline by progressed a new manner of poly (lactic-co-glycolic acid) (PLGA) nanoparticles loading with pentoxifylline on induced thin layer endometrial in female rats. Materials and Methods: PLGA nanoparticle was made by employing two procedures included nanoprecipitation technique and double emulsion solvent evaporation method. The experiment firstly was achieved numerous of diagnostic tests to the knowledge of PLGA nanoparticle characteristics that involved ultraviolet (UV) spectrophotometer test. Results: UV spectrophotometer test shown for Pentoxyfilline absorbance (0.300124), at wave length (2979) and PLGA- loaded Pentoxyfilline absorbance (3.07877), at wave length 1565), while other tests (scanning electron microscope, cumulative %; encapsulation drug efficiency loading, and zeta) of PLGA-nanoparticle appeared (28.35 nm-35.45 nm, (8.48, 93.3 at maximum wavelength 275 nm, (−13.44 mV), with mobility (−1.05 [μ/s]/[V/cm]) respectively. Conclusion: Regarding the characterization of PLGA displayed in this study, it can be concluded that DMSO related organic phase alone gives the shape, particle size with a small diameter, negatively charged in addition to suitable LD, EE with suitable stabilizer. Also, PLGA-Pentoxyfilline regimen treatment with different doses had the ability in recovery of female rats that exposed experimentally induced thin layer endometrium in the uterine horn by ethanol.
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Seroprevalence of hepatitis C virus in voluntary blood donors at a tertiary care hospital, Ahmedabad, India p. 18
Henisha Tulsidas Tahiliani, Asha Poonamchand Purohit, Vipul Bachubhai Prajapati, Puja Bhavesh Jarwani
Background: Hepatitis C virus (HCV) is the most common cause of post transfusion non-A, non-B hepatitis worldwide. The prevalence of HCV in blood donors in high-income countries ranges from 0.002% to 0.05%, in middle-income countries ranges from 0.03% to 0.80%, and in low-income countries, prevalence varies from 0.50% to 2.23%. Objectives: The objectives of this study are to assess the seroprevalence and the trend of HCV in healthy voluntary blood donors at a tertiary care hospital in Ahmedabad over a period of 3 years. Settings and Design: Observational, retrospective study. Materials and Methods: During January 2017 to December 2019, 9477 voluntary blood donors were tested for the presence of anti-HCV antibody by using a 3rd-generation enzyme-linked immunosorbent assay test. Statistical Analysis Used: Data were statistically analyzed by using the Chi-square test, and Chi-Square test for linear trends using the Statistical Package for the Social Sciences (SPSS) software trial version 19. Results: Out of 9477 voluntary blood donors, 9229 (97.38%) donors were male and 248 (2.62%) were female. Ten donors (0.11%) were positive for anti-HCV. All seropositive donors were male. Out of total 0.11% seropositive donors, maximum (0.07%) were within the age group of 21–30 years. Seroprevalence of HCV showed a statistically significant decreasing trend over 3 years. Conclusion: Hepatitis C is a common cause of transfusion-related hepatitis. Early identification of persons with chronic HCV infection would enable infected persons to receive the necessary care and treatment to prevent or delay the onset of liver disease.
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Screening for latent tuberculosis infection at a rheumatology and medical rehabilitation center in Duhok City, Iraq p. 23
Shawkat Sabri Yousif, Mohammad Tahir Rasool
Background: Patients with rheumatoid diseases are at increased risk of infection due to a combination of inherent energy or immunomodulating drugs used for its treatment. The study aimed to screen for latent tuberculosis infection (LTBI) among patients with rheumatologic diseases. Materials and Methods: In the present prospective cross-sectional study, a total of 149 patients diagnosed with different types of rheumatoid diseases were included. The rheumatic diseases were diagnosed based on the American College of Rheumatology criteria for rheumatoid arthritis (RA) or the European Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. The patients were screened by interferon-gamma release assay and tuberculin skin tests using purified protein derivative. Results: The mean age of the patients was 39.91. The most common types of diseases were ankylosing spondylitis (37.6%) and RA (34.9%). The prevalence rate of LTBI was 12.1% among rheumatic patients. The patients with positive LTBI had significantly longer therapy duration (4.51 vs. 2.81 years, P < 0.001) and were older (48.61 vs. 38.72 years, P = 0.005), respectively. There was no statistically significant association between the disease types and LTBI positivity (P = 0.512). However, LTBI positive was more prevalent in patients who received rituximab (16.7%; P = 0.035) and those patients with past medical history (20.9% vs. 8.5%, respectively; P = 0.035) and those did not receive the bacillus Calmette–Guérin vaccination (36.4% vs. 10.1%; P = 0.029). Conclusions: This study suggests that patients with rheumatoid diseases and treated with anti-tumor necrosis factor therapies are at an increased risk of tuberculosis infection.
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Helicobacter pylori serology in a sample of Iraqi patients with chronic renal failure p. 28
Basim Mohammed Madloom, Haider Hamza Umran
Background: The prevalence of gastrointestinal (GI) symptoms is high in patients with chronic renal failure. Peptic ulcer disease occurs in up to one-fourth of them. Many factors are implicated in its causation including Helicobacter pylori infection. Objective: The objective of the study was to determine the prevalence of H. pylori seropositivity in patients with GI symptoms and chronic renal failure compared with the prevalence of H. pylori seropositivity in patients with GI tract symptoms with normal renal function and to evaluate the importance of different factors that affect its prevalence depending on serological test for immunoglobulin level against H. pylori. Materials and Methods: This case–control study was done at the Department of Medicine, at Al Yarmook Teaching Hospital, Baghdad, Iraq. During the study period from January to June in 2004, ninety patients with chronic renal failure were interrogated for dyspeptic symptoms and 2 mL of blood was withdrawn for ELISA test for anti-H. pylori serological examination. Twenty-five dyspeptic patients with normal renal function were examined as well as control group. Results: from 90 patients with chronic renal failure, 42 patients were on hemodialysis and 48 patients were on peritoneal dialysis. There were 52 males and 38 females with age ranging 45.3 in male and female 43.1, respectively. The percentage of positive anti-H. pylori antibody was 60%. Only 44% of the control group had positive anti-H. pylori results. There was no statistically significant difference between anti-H. pylori positive and negative status in patients on hemodialysis, peritoneal dialysis, and control group regarding male and female gender. Again, there was no statistically significant difference in serpositivity in relation to epigastric pain and those without epigastric pain in the group of hemodialysis, peritoneal dialysis, and control group. Patients on peritoneal dialysis with dyspepsia of < 10 years had statistically significant seropositivity compared to those more than 10 years of epigastric pain. Those patients with hemodialysis and control group have no relation of seropositivity with dyspepsia duration. Conclusions: H. pylori serpositivity of patients with chronic renal failure was similar to that of the control. There is no relation between dyspepsia and H. pylori serpositivity. Long-term dialysis is associated with a decreased prevalence of H. pylori.
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Investigation of the effect of food types on melatonin hormone level in human body p. 32
Isam Shaker Hamza, Mohammed Abbood Ayyash, Tariq Yassin Mahmoud, Aziz Latif Jarallah
Background: Melatonin, a neurohormone produced by the pineal gland, has recently been reported in foods, mainly of plant origin. Melatonin provides a number of benefits for human health. It has many important health benefits because it is a potent antioxidant and anti-inflammatory hormone. Objectives: The aim of this work is to investigate the relationship between malnutrition and food deprivation on melatonin levels in normal individuals in comparison with people suffering from gastrointestinal diseases. This study will focus on the nutritional factors apart from the intake of tryptophan that affects melatonin levels in humans. Materials and Methods: This study reported interests regarding the optimization, validation, and application of analytical liquid extraction and high-performance liquid chromatography (SYKAM) coupled to a fluorescence detector for the determination of melatonin in rice grains and blood samples. Results: In the present study, the results showed that there were significant differences between the three study groups, where the lowest values for melatonin hormone concentration were found in Group C as 2.033 ± 0.69 pg/mL which includes people suffering from famine, whereas the results of Group B showed clear differences of concentration than that in Group (C) as 3.520 ± 0.62 pg/mL which includes patients who were in hospital suffering from diseases and disorders of the digestive system, but at the same time their values were less than that of the healthy control Group A as 6.457 ± 0.59 pg/mL. Conclusion: Based on the present study, it can be concluded that melatonin hormone levels are highly deficient in people who are suffering from poverty, deprivation, and starvation compared to people with problems and disorders of the digestive system.
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Prevalence of Uncomplicated Recurrent Urinary Tract Infection among Adult Females in Babylon Governorate p. 37
Lubna Raheem Al-Musawi, Rafid F Al-Husseini
Background: Urinary tract infections (UTIs) are among the most frequent infections in clinical practice. They are classified into uncomplicated UTIs and complicated UTIs. The majority of UTI cases are caused by a single bacterial agent. Diagnosis of UTIs is generally established based on urinalysis and urine culture and treated with appropriate antibiotics. Objectives: The aim of this study was to determine the prevalence and characteristics of uncomplicated recurrent UTI among adult females. Materials and Methods: This study is a cross-sectional study conducted in the outpatient clinics of Al-Hilla Teaching Hospital and Babil Hospital for Maternity and Childhood during the period from February till June 2020. Data were collected using a specially designed questionnaire, and a total of 300 participants were included. Results: The overall prevalence of uncomplicated UTI was found to be 36%. The mean age of patients was 28.94 ± 7.42 years. Ninety percent of the patients were married. The proportion of recurrent UTI among married women was significantly higher than that among nonmarried women (P = 0.001), and recurrent UTI was significantly higher among women with family history of UTI (P < 0.001). Conclusions: This study concludes that the prevalence of uncomplicated UTI among adult females in Babylon governorate is 36%, with the majority of cases within the age group of 20–29 years. Recurrent UTI was found to be linked to marital status and positive family history.
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Coronary artery disease among patients younger than 35 years of age: In search for exploring the most common risk factors p. 41
Shwan Othman Amen, Banan Qasim Rasool, Vahel Lutfallah Sadraddin, Ali Jalal Awlla
Background: Coronary artery disease (CAD) and its major manifestation of acute myocardial infarction (MI) are considered as the most common causes of morbidity and mortality worldwide. MI in very young group of age is a significant issue to focus on, however there is a scarcity of data on premature coronary heart diseases-acute MI (AMI) in this group of age. This may underestimate the important difference that exists between young and old groups of age. Objective: The main aim of this study is to evaluate the most common risk factors, including hyperlipidemia, smoking, diabetes mellitus (DM), hypertension, and positive family history of AMI with their angiographic profile, among Iraqi patients of <35 years old. Materials and Methods: This study was enrolled in Surgical Specialty Hospital-Cardiac Center, Erbil, Iraq among 100 consecutive patients (77 males and 23 females) between November 2016 and December 2017 of those whose age was ≤35 years. Results: The mean age was 31.6 ± 2.91 years with an age range of 24–35 years. The incidence of AMI was significantly higher in male patients than females. The most common risk factors were hyperlipidemia (51%), smoking (49%), family history of premature CAD (44%), hypertension (25%), and DM (22%). The most common symptom and presentation of CAD was chest pain and anterior wall myocardial infarction, 67% and 64% respectively. About 56% of all the included patients who underwent Coronary Angiography, had obstructive CAD and among this group 89.2% had single vessel disease, 5.35% had three vessel disease, 3.57% had double vessel disease and 1.78% had abnormal characteristic of coronary artery (Muscle Bridge). The most common involved artery was the left anterior descending (LAD) (36%), followed by the right coronary artery (9%). Based on the electrocardiogram findings, 42% of the patients presented with ST-segment elevation myocardial infarction. Conclusion: CAD in patients younger than 35 years occurred more in the male gender. Hyperlipidemia was the most common risk factor among all the patients' and AWMI owing to the LAD artery was the most common presentation.
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Feeding problems in a sample of children under 5 years at a primary health-care center in Erbil, Iraq p. 49
Faiza Jalil Ahmed, Karwan Hawez Sulaiman
Background: The feeding issues of children under 5 years of life have effects on overall growth and development. Objectives: This study aimed to find out the prevalence of feeding problems and their associated factors among a sample of children under 5 years visiting a primary health-care center in Erbil city. Materials and Methods: In this cross-sectional study, the mothers who visited the primary health centers for the medical checkup of their children under 5 years were consecutively screened for the eligibility criteria between February 1, 2020, and June 30, 2020. Results: The children were located in the following age groups: 6–9 months (11.3%), 9–12 months (4.9%), 12–24 months (32.0%), and >24 months (51.7%). The children had an abnormal height for age (8.9%), weight for age (6.9%), and weight for height (14.3%). The prevalence of formula feeding was 49.0% in children. The prevalence of feeding problems was 75.9%, including mono-feeding (20.2%) and multi-feeding issues (55.7%). The prevalence of complementary food was 2.0% only. The prevalence of active feeding was 54.2%. The study showed that younger age group had a significantly higher prevalence of feeding problem (P < 0.001). The study showed that children with abnormal weight for age were more likely to have feeding problems compared to those with a normal weight for age (100% vs. 74.1%, P = 0.019), respectively. Conclusions: The present study showed that a considerable percentage of children have feeding issues. The feeding issues were higher in younger age groups.
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Strengthening response to COVID-19 pandemic in nations with declining trend: Program managers' perspective p. 54
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
The trends of the ongoing coronavirus disease-2019 (COVID-19) pandemic continues to rise in different parts of the world and no nation can rest assured that they have won the battle against the novel viral infection. The epidemiological trends from some of the affected nations have reported a decline in the number of cases, but we cannot let down our guard. Many sections of the community and other stakeholders are concerned about the emergence of second wave of the infection, but as a Program Manager, our priority has to strengthen our outbreak readiness and emergency response. Further, the health care delivery system has to be reformed in such a way that the needs of the community are given utmost priority and we work together as a team for the containment of the infection. In conclusion, the fight against the COVID-19 pandemic is far from being over and we have to continue our good work and take appropriate measures to further intensify our response to safeguard the health and well-being of the vulnerable population groups and be ready for the most difficult times.
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Association of obstructive sleep apnea with cardiovascular health p. 56
Shwan Othman Amen, Banan Qasim Rasool
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Erratum: Celiac disease: Biochemical and histopathological considerations of local patients p. 58

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