Background: Red bull has been known as a healthy drink within many populations. The chemical composition of energy drinks can produce multiple adverse effects, including serious behavioral effects. Objective: To study the effect of energy drinks (Red Bull) on brain, liver, kidney, and heart in rabbits. Methods: thirty males albino rabbits were used, animals divided into 3 groups (A, B, and C), each group contain 10 rabbits. Group A treated with high dose of red bull (10 cc), Group B treated with low dose (5 cc), and Group C is control group. Results: The results showed that control group had no any pathological changes while both Groups A and B showed many pathological changes, Group A showed renal vascular congestion, hemorrhage of interstitial tissue, focal atrophy, and degeneration of lining epithelium of proximal and distal convoluted tubules, while Group B showed renal vascular congestion, glomerular capillary congestion, hemorrhage of interstitial tissue with swelling of lining epithelium of proximal and distal convoluted tubules that appeared as pale cytoplasm with star-shaped lumen, and swelling of glomeruli; this reveals that there is dose–response relationship between treated groups with low and high dose of red bull. Conclusion: Energy drinks have dose–response relationship with adverse effect; it has become apparent that the consumption of these energy drinks will seriously harm the body.

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Background: Genital wart is the most common viral sexually transmitted disease. In fact, its incidence is rising rapidly. It is approximated that 30%–50% of sexually active adult have human papillomavirus (HPV) infection, but only 1%–2% of them have apparent genital wart. Mostly, cervical dysplasia and cancer are associated with oncogenic HPV types. HPV types are classified into high-, intermediate-, and low-risk group. HPV Types 16 and 18 are considered as a high-risk group cancer-associated HPVs, whereas Types 6 and 11 concerned as a low risk and HPV types 31, 33, and 35 have an intermediate association with cancer. Objective: The objective of the study was designed to evaluate the activity of CO₂ laser to treat genital warts of female Iraqi patients. Materials and Methods: Fifteen female patients with genital warts were involved in this study. Their age range from 22 to 49 years treated by CO₂ laser at the Laser Medicine Research Clinics of Institute of Laser for Postgraduate Studies from July 2017 to end of July 2018. Application of topical lidocaine cream 10% for 30 min or local infiltration of 2% xylocaine had been performed. CO₂ laser in chopped mode was used with a peak power: 151 watts and repeated time 35 s in D mode, pulse duration 1.3 ms. Treatments by vaporization of the warts were done in one session except one patient with a large number and multiple locations two sessions were done. Results: Three patients expressed mild pain during the procedure, but it could be tolerated by them. No edema or oozing observed during the 1^st week. No postoperative infections or scars. Two cases of recurrence 2/15, (13.3%) after few months from treatment. Conclusion: CO₂ laser vaporization is an effective and safe method for treatment of genital warts and can be done in the outpatient clinic.

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Background: Phenylthiocarbamide (PTC) taste or any organic bitter compound is widely studied between nations. Objectives: The aim of this study was to analyze the prevalence of PTC taste sensitivity and its mutated gene frequencies among people in Sulaymaniyah, Iraq. Materials and Methods: PTC, thiourea, and sodium benzoate paper were used on the participants. Each participant was required to taste each paper differently; then, the results were recorded whether they were tasters or nontasters. Results: Analysis of data from the current study revealed that 70.4% of the Kurdish population is PTC tasters. Of them, 25 (8.3%) of participants were normal tasters, 124 (41.1%) were standard supertasters, 36 (11.9%) were recessive supertasters, and 116 (38.5) of them were dominant supertasters. Smoking showed no effect on the taste perception in this study. However, the rate of female tasters was higher than male tasters. Conclusion: The analysis of data from the current study revealed that most of the Kurdish population is PTC tasters. However, the rate of female tasters was higher than male tasters. Further studies are needed to investigate genetic composition of the Kurdish population.

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Background: Febrile seizure (FS) is a benign convulsive disorder in under 5-year-old children, but at the same time, it is an alarming event in the lives of both child and parents. Lack of parent's knowledge about the nature of FS and how they should deal with it can lead to poor management. Objectives: To assess the knowledge and practice of parents regarding FS in their children and to assess the association of knowledge and practice of parents with certain socio-demographic characteristics. Materials and Methods: A cross-sectional study was performed on 100 parents of children with FS attending emergency department in Babylon Teaching Hospital for Pediatrics and Gynecology and AL-Noor Hospital for Pediatrics during a period of 5 months (from March 1 to August 1, 2018). A questionnaire was administered to parents which included items regarding family characteristics, characteristics of FS, their knowledge, and their first-aid practices with FS. Results: Regarding maternal age and paternal age, they ranged between 15–43 and 20–50 years, respectively. More than half of them live in urban areas, and concerning educational level of mothers, 70% were either illiterate or had a primary level of education. Majority of FS children were presented with first attack who represent a percentage of about 69%. About half of the respondents have good level of knowledge. Fifty-two percent of them considered that FS is equivalent to epilepsy, 69% stated that it is a life-threatening event, and 80% knew that it occurs during febrile occasions. Only 25% of parents took their children to doctor during attack of fit without first aids. Conclusions: Parents' knowledge regarding FS was significantly associated with higher maternal education, urban residence, and mother age. A higher level of practices was shown to have a significant association with increasing in the number of episodes experienced by parents and advancing in maternal age.

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Background: Diabetes mellitus (DM) is a life-threatening disease whose complications can cause heart attack or stroke, blindness, and kidney failure. Objective: The main objective of this study was to determine knowledge, attitude, and practices regarding DM among a sample of students at the Technical Institute of Karbala. Materials and Methods: This cross-sectional study was conducted in Al-Furat A-Awsat Technical University, Technical Institute of Karbala, Iraq. A total of 856 students were included in this study. Data were collected by direct interview with students using a questionnaire form. Results: Total sample in this study was 856 students (52.3% male and 47.7% female), 58 DM (Type II) patients were included in this study. The mean age of the study population was 20.86 ± 1.58 years (range of 17–25 years). The majority of students (48.8%) were in the age group of (≤20 years). The most of the respondents were single and lived in urban areas as represent 87.4% and 75.9%, respectively. Nearly 60% of cases had good and acceptable knowledge scores, while 50% had good and acceptable scores for attitude and practice regarding DM. Conclusion: The overall scores were good and acceptable regarding knowledge, attitude, and practice. A better educational program on diabetes should be conducted to improve awareness, attitude, and practice toward DM using mass media and health education in all Ministries.

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Background: Urinary tract infections (UTIs) are the most common infections among pregnant women. It can be lead to poor maternal and perinatal outcomes. Objective: The objective of the study is to determine the prevalence rate of symptomatic UTIs and asymptomatic bacteriuria of pregnant women in the Babylon Governorate and to determine its association with sociodemographic, obstetrical, and other factors. Materials and Methods: Cross-sectional study between March 2018 and June 2018 involves examining 300 pregnant women at primary health centers; Maternity and Pediatrics Hospital of Hilla city, with and without symptoms of UTI were employed for this study. Midstream urine samples were taken, and general urine examination was performed. Results: The results of this study revealed that the overall prevalence of UTI among pregnant was 64.6% which include (symptomatic bacteriuria 8.0%, asymptomatic bacteriuria 6.3%, and UTI 50.3%). The higher rate of UTI was found in lower age, multiparous women, and during the second trimester. Factors such as socioeconomic status, history of UTI, dysuria, and positive laboratory results were found to be significantly associated with UTI. Conclusion: UTI is still the common health problem in pregnant women especially during their second trimester. Urinalyses are essential for all pregnant women during the antenatal period. The screening will be assisted to early detection and treatment of asymptomatic bacteriuria which prevent complication for mother and baby.

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Objective: This study aimed to recognize the harm of shisha smoking compared to cigarettes smoking by measuring serum lipid profile in males in AL-Nasiriya city and association lipid profile change with increase of smoking per day. Materials and Methods: This study was conducted between June to December (2015) in Nasiriya city in Iraq ,all samples were randomly selected. Spectrophotometer was used for biochemical analysis for each group of lipid profile. The subjects were divided into three groups, cigarette smokers (n = 35), shisha smokers (n = 20) and non-smokers groups (n = 20). Age ranged between (30 – 60) years and mean of duration smoking was (13.4±1.3) years. Results: Results showed that the increased levels of total cholesterol (TC), triglyceride (TG), very low density lipoprotein (VLDL) and low density lipoprotein (LDL) were significant in all groups of smokers as compared to non-smokers. Conclusion: The study concludes that the danger of shisha impact on human health may be similar or even worse than cigarette smoking.

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Background: Hemorrhoidectomy by LigaSure electrosurgical unit seems to be very effective treatment and results in better surgical outcomes when compared with the conventional excisional hemorrhoidectomy. Objective: The aim of this study was to compare the feasibility and the surgical outcomes of LigaSure hemorrhoidectomy with that of conventional diathermy excisional hemorrhoidectomy. Materials and Methods: Patients characteristics were comparable in both groups. Ninety six patients with symptomatic mainly grade III and IV piles were randomized for either conventional excisional hemorrhoidectomy (48 patients) or to LigaSure hemorrhoidectomy (48 patients) for the period from April 2014 to July 2016. The surgical outcomes of both procedures including the operative time, intra-operative blood loss, postoperative pain, analgesic requirements, early and late postoperative complications, wound healing, recovery time and return to work, recurrence and patient satisfaction were recorded, compared and evaluated. Results: The mean operative time and amount of intra-operative blood loss were significantly lower in LigaSure hemorrhoidectomy group. Postoperative pain and need for parentral analgesia were comparable in the first 24 -48 hours postoperatively, but they were significantly lower in LigaSure group after the second postoperative day. Faster wound healing and early return to work were obviously noted among patient subjected to LigaSure hemorrhoidectomy. Early postoperative complications were lower in LigaSure group while late complications were comparable in both groups. Lastly, LigaSure group showed high satisfaction rate compared to conventional hexcisional hemorrhoidectomy group. Conclusion: LigaSure hemorrhoidectomy is superior and more advantageous in term of operative time, blood loss, post-operative complications, faster wound healing and return to work. It is simple, feasible and easy to learn.

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Background: Interest in Rosemary has increased due to the importance of being wide antimicrobial, anti-inflammatory, and antioxidant. Objective: This study aimed to evaluate the biological affectivities of essential oils (EOs) of rosemary against three types of bacteria. Materials and Methods: Chemical analyses were conducted using gas chromatography technique on the volatile oils of rosemary, which were extracted by Clevenger. Results: The major contents of these oils were camphor (22.35%), camphene (1.85%), β-pinene (3.75%), sabinene (10.25%), limonene (7.64%), linalool (11.58%), and myrcene (2.14%). The biological affectivities of these oils were examined on three types of bacteria: Bacillus cereus, Escherichia coli, and Pseudomonas. The results proved that the EOs of rosemary were influential against bacteria and gave minimum inhibitory concentration (MIC). The MIC values were 37 μg/ml for E. coli, 69 μg/ml for Pseudomonas, and 20 μg/ml for B. cereus. Results found that Pseudomonas was less sensitive for these oils. Conclusion: The EOs of Rosemary can be used in the pharmaceutical industry for the production of new synthetic agents in the treatment of bacterial disease caused by these three types of bacteria.

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Febrile convulsion is one of the most common seizure disturbances in children with an approximate rate of 2%–5%, febrile seizures (FSs) occur between the age of 6 and 60 months with a 38°C or higher temperature, and they do not result from central nervous system infection or any metabolic imbalance, and these seizures occur when a history of prior FSs is absent. In this study, 150 children whose ages ranged between 6 and 60 months were divided into three groups: Group A included 50 children with febrile convulsions, Group B included 50 children having fever without convulsion, and Group C included 50 healthy children with nonfebrile convulsions. In the present study, the serum sodium and potassium were significantly lower in cases of febrile convulsion than the control groups, whereas no significant changes were shown in the levels of ionic calcium in the cases of febrile convulsion when compared with the control groups. These findings revealed that there is a correlation between differences of serum sodium and potassium in simple febrile convulsion.

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Background: Coronary artery disease (CAD) and its major manifestation of acute myocardial infarction (AMI) are the most common causes of mortality and disability worldwide. Objectives: The major aim of this study was to assess the prevalence of the most frequent risk factors for AMI in Iraqi patients, including hypertension, hyperlipidemia, diabetes mellitus, smoking, family history, insufficient physical activity, obesity, and abnormal coronary artery characteristics. Materials and Methods: In this study, 74 patients presented with AMI (51 males and 23 female) were enrolled. Laboratory investigations were carried out using enzymatic immunoassay technique. Results: The mean age was 55.5 ± 12.47 years, with an age range of 20–90 years. The incidence of AMI in male patients was significantly higher than that in female patients. Major findings showed that 85.1% of AMI patients were insufficiently physically active and 74.3% were hypertensive. High level of low-density lipoprotein was seen in 50% of patients, high triglycerides in 41.9%, low high-density lipoprotein in 39.2%, and high total cholesterol in 34%. Nearly 39.2% were smokers, 35.1% were obese, and 29.7% were diabetic. Interestingly, 51.4% of the AMI patients had a positive family history of CAD. The left anterior descending artery was the most common vessel involved during AMI. Conclusions: The findings of this study conclude that AMI occurs in older age and in male gender among Iraqi population, and ST-elevation MI is the main presentation. Hypertension, hyperlipidemia, and smoking are the major risk factors. This study shed light on the primary prevention and control of these cardiovascular risk factors for CAD through healthy lifestyle, increased physical activity, and healthy dietary choices, which can reduce the prevalence of CAD.

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Background: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorder of female at reproductive age and it's prevalence in general population as 20%–33%. Objective: The aim of this study was to measure the level of interleukin (IL) 18, IL 6, and tumor necrosis factor (TNF) in polycystic ovary women and compare their levels with apparently healthy control group. Materials and Methods: case-control study was carried out in Basra. In this study, blood samples from 73 women with PCOS and 73 healthy control women were collected from outpatients and private gynecological clinics and primary health care centers from different area of Basra during August 2016–March 2017 for estimation of their serum levels of IL6, IL18, and TNF alpha by using enzyme-linked immunosorbent assay technique. Results: It is found that serum levels of IL6, IL18, and TNF alpha were elevated in PCOS women, and we conclude that serum levels of IL6, IL18, and TNF alpha are highly statistically significance in PCOS women than in healthy control group. Conclusion: Levels of IL6, IL18, and TNF alpha were highly statistically significant in PCOS comparing to normal women, and these high levels were related to PCOS independent on the presence of obesity or hyperandrogenism.

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Background: Vitamin D, a fat-soluble vitamin that now is recognized as a prohormone that recently has an important role in the reproductive health. Vitamin D deficiency (VDD) had high prevalence worldwide and was estimated to affect about 50% of the population worldwide. Hypovitaminosis D related to several health problems in women such as infertility, polycystic ovarian syndrome endometriosis, and pregnancy-related complications such as preeclampsia and caesarian section. Objective: The aim of the study is to evaluate the serum level of Vitamin D in sample of Al-Hilla women at reproductive age. Materials and Methods: The total number included in the study was 500 patients. They were companions of patients visiting specialist gynecologic and obstetric private clinics in Hilla City from first of October 2017 to end of March 2018 the patients were grouped into three groups according to their age: Group 1: Patients aged (15–30) years. Group 2: Patients aged 31–40 years. Group 3: Patients aged more than 40 years and premenopausal. The data were collected which were then analyzed statistically and registered. Results: Whole sample mean serum Vitamin D level 15.85 ± 7.69 and the percentage of deficiency over all the sample was 76%. Regarding the result in each group, Group 1 include 350 patients, mean age (23.8 ± 3.96), and mean serum Vitamin D level (16.16 ± 7.69), t-test was statistically significant P < 0.05. Group 2 include 119 patients, mean age (35.2 ± 2.9), and mean serum Vitamin D level (15.14 ± 7.42), t-test was statistically significant P < 0.05. Group 3 include 31 patients, mean age (42.81 ± 1.45), and mean serum Vitamin D level (14.82 ± 7.77), t-test was statistically significant P < 0.05. Conclusion: Results of our study revealed a widespread, severe VDD in women at reproductive age with aproportion of deficiency in the whole sample of 76% and proportion of insufficiency 18% while only 7% had sufficient Vitamin D Serum level.

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Background: Toxoplasmosis is one of the most important causes for abortion in women. The immune responses have a role in the outcome of such infection in gestated women. Aim: The current study was designed to investigate the immune profile in aborted Iraqi women with toxoplasmosis. Materials and Methods: Fifty-five aborted women and 29 healthy control women were enrolled in this study. Enzyme-linked immunosorbent assays were used to estimate serum levels to each of interleukin-1 alpha (IL-1α), granulocyte-monocyte colony-stimulating factor, IL-8, IL-4 IL-10, IL-12, interferon gamma (INF-γ), and IL-6. Single-radial-immunodiffusion assay was used to estimate serum levels of C3, C4, and total immunoglobulin gamma. Results: Serum levels of IL-8 showed significant elevation, while IL-6 and INF-γ showed significant dropping in infected women compared to control. Other immune factors showed nonsignificant differences between the two groups of the present study. Conclusion: Disturbance of immune response associated with toxoplasmosis may explain the success of parasite in escaping from discrimination and elimination by the immune system then supporting its survival and replication.

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Background: Esophageal atresia (EA) and treacheo-esophageal fistula occur in 1 out of every 3500 live births. Children born with EA have a higher incidence of prematurity than the general population EA. The treatment of EA and tracheo-esophageal fistula, although still a challenge, represents one of the true successes of newborn surgery. Objective: The aim of this study cases with EA and/or tracheo-esophageal fistula in Rapareen pediatric surgery center, Erbil, Iraq, regarding management, and early outcome. Materials and Methods: Fifty-three neonates were enrolled in this study from October 2011 to September 2015. Preoperative investigations included chest X-ray, ultrasound of the abdomen, and echocardiography. All patients were resuscitated before surgical intervention. Statistical Package for the Social Sciences version 20 was used for data analysis. Results: Out of 53 cases, 21 survived and 32 died. Thirty patients were male and 23 were female (male-to-female ratio 1.3:1). Twelve were premature and 41 term babies. The most common type was EA and distal fistula in 47 cases, pure atresia in 5 cases, and EA with both distal and proximal fistula in one case. Presenting features were excessive salivation in all cases, failure to pass nasogastric tube in 98.1%, cyanosis in 69.8%, and chocking in 37.7%. Prenatal history of polyhydramnios was present in 67.9%. Eighteen cases had associated anomalies, most of them were cardiac. Conclusion: EA with distal tracheo-esophageal fistula is the most common type of anomaly. Early diagnosis, weight, maturity, and associated anomalies are the most important factors that affect the outcome. Postoperative respiratory care is necessary, especially for those who have a preoperative chest infection.

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Background: Appendicitis is the most common surgical emergency presented daily to emergency surgical department. The Modified Alvarado Scoring System (MASS) is easier and applicable in the diagnosis of acute appendicitis using extra signs instead of neutrophilic left shift. Objective: The aim of this study is to compare and evaluate the diagnostic accuracy of MASS versus the Alvarado scoring system. This study was carried out in Duhok Emergency Teaching Hospital, Iraq, over the period of 12 months, from October 2017 to October 2018. Materials and Methods: A cross-sectional study including 200 patients, diagnosed with acute appendicitis by the senior surgeon on call and underwent conventional open appendicectomy. MASS were applied to all patients preoperatively by author and results of both scores compared to operative and histopathological findings of excised appendix to analyze the efficacy of both scores in the diagnosis of acute appendicitis. Results: Of 200 patients who underwent operation those with Alvarado score of 9–10 had sensitivity of 88% and specificity of 100%. Those with a score of 7–8 had sensitivity of 63% and specificity of 68%. For MASS patients with score of 9–10 had sensitivity of 96% and specificity of 100%, and those with a score of 7–8 had sensitivity of 77% and specificity of 86%. The higher the score, the sensitivity and specificity increased. Positive predictive value and accuracy of neutrophilic left shift of Alvarado were 95% and 65%, positive predictive value and accuracy of extra signs of modified Alvarado score were 97% and 84% respectively. Conclusion: Both Alvarado and MASS are fast, simple, and repeatable systems in the diagnosis of acute appendicitis. This study reveals that accuracy of MASS is higher than Alvarado score, and the rate of negative appendicectomy can be reduced using this system.

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Background: Preeclampsia (PE) is the main factor in maternal mortality across the world, affecting 5%–8% of pregnant women. The impairment in placental perfusion due to vascular abnormalities leads to clinical presentations and is detectable by Doppler ultrasound. Objective: The aim of the study is to assess the hemodynamic changes in pregnant women with and without PE, using Doppler ultrasound of the uterine, the umbilical, and the middle cerebral arteries. Materials and Methods: Forty pregnant women aged 19–40 years old, diagnosed with PE, were recruited from the outpatient gynecology clinic into a case–control study. Their Doppler ultrasound hemodynamic assessment of the uterine artery and its early diastolic notching, the middle cerebral artery, and the umbilical artery was compared to that of 60 matched control non-preeclampsia (non-PE) pregnant women aged 19–40 years old. Results: The proportions of patients with uterine artery, umbilical artery, and middle cerebral artery Doppler ultrasound abnormalities were 77.5%, 62.5%, and 37.5% in the PE group, compared to nil, 8.3%, and 11.7% in the non-PE women, respectively. Similarly, mean resistance index of each artery and proportions of notch parameters of the uterine artery showed significant differences between PE and non-PE patients (P < 0.001). Conclusions: Doppler ultrasound assessment in pregnant women of the uterine, the umbilical, and the middle cerebral arteries can be used to determine hemodynamic dysfunction associated with PE.

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Background: Despite the progress in modern obstetric practice, preterm labor is second leading cause of death in the 1^st month of life and the main cause of perinatal morbidity and mortality; it remains a difficult problem to prevent, delay or even stop. It occurs in 5%–13% of all pregnancies before 37 weeks' gestation but its incidence in twin pregnancies is about 25%. Objectives: This study aimed to determine the effect of prophylactic cervical cerclage (CC) in comparison to others methods: vaginal progesterone and bed rest in prolongation of gestational age in twin pregnancies to prevent preterm labor. Materials and Methods: A retrospective descriptive study was conducted between January 2012 and September 2018, in a private obstetric antenatal care clinic in Duhok/Kurdistan Region/Iraq. It involved 150 women with twin pregnancies attending this clinic for follow-up, they divided into: Group 1 (N-86): women who received prophylactic CC; Group 2 (N-44): those who got the vaginal progesterone supplementation of 100 mg from 20 to 34 weeks of gestation; and Group 3 (N-20): those who asked for advisement of bed rest and restriction of physical activity. Results: Most of the total sample 95.3% had dichorionic placenta, the majority of them 84.7% were the result of assisted reproductive techniques. There was no statistically significant difference between the three groups in relation to maternal age, gravid, and previous preterm delivery, but there was in relation to the gestational age at delivery. In Group 1, 93% who delivered >37 weeks, whereas 16% and 10% in Group 2 and Group 3 who delivered at this gestational age, respectively. The overall perinatal survival was 91.3% and 26.6% who admitted to Neonatal Intensive Care Unit. Conclusions: The current study found that the prophylactic CC was an effective method to prolong pregnancy among women with twin pregnancies.

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Background: The emergence of the antibiotic resistance in the treatment of UTIs is a serious health problem, especially in the developing countries where there is high level of ignorance, poverty, and bad hygienic practices, Objective: The aim of this study was to detect the types of bacteria and their antibiotic sensitivity in patients with diabetes mellitus with recurrent urinary tract infections and compare between types of bacteria in patients with the previous admission to hospital from those who are not. Materials and Methods: This cross-sectional study was conducted on eighty patients with diabetes mellitus and recurrent urinary tract infection, those patients who visited the Outpatient Unit in Diabetic and Endocrine Center in Merjan Medical City in Babylon Province. This study was carried out from March 1, 2016 to September 30, 2016. General urine examination was done to the patient with urinary tract infection. Urine samples were sent for culture and sensitivity against different types of antibiotics. Results: Results found that the mean age of the patients was (58.23 ± 14.38) and majority of them (63.7%) were female and (52.5%) of them came from rural area. The main bacteria causing urinary tract infection was Escherichia coli in more than 55% of cases, while the amikacin antibiotic regard as the best antibiotic in the treatment of urinary tract infection in this study with lowest resistance percentage (3.8%). Based on the history of previous admission to the hospital, there was 57.5% with a history of previous admission, and there was statistically significant difference in the types of bacteria between the two groups. Conclusion: There was significant difference in bacterial type between patients who previously had hospital admission and those who had not. E. coli was the main bacteria causing UTI in this study. Amikacin showed the best sensitive drug for bacteria that cause urinary tract infection.

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Background: Foreign bodies (FBs) in the ear are frequently encountered by an otolaryngologist. Certain types of ear FBs in our adult patients may reflect negative phenomena in our community. Objectives: This study was carried out to analyze the main types of adult aural FBs and to highlight the increasing frequency of already known types and more interesting newly known type of FB. Materials and Methods: This is a prospective descriptive study of adult patients with aural FB seen in the ENT Department in Al-Mahawil Hospital for the 2 years – 2015 and 2016. The clinical presentation, type of FB, and management outcome were analyzed. Results: Two hundred and thirty-two patients aged 18–82 years were evaluated. Cotton wool (of the earbuds) was the most common FB with 93 (40%) patients (male: 54, female: 39) aged 21–82 years; the insect FB with 78 (33.7%) patients (male: 32, female: 46) aged 18–58 years; and garlic with 36 (15.5%) patients (male: 15, female: 21) aged 25–74 years; the newly known interesting FB put by the students into their ears during the examination was Bluetooth device in 15 (6.5%) patients (male only) aged 18–23 years; and miscellaneous FBs such as paper, broken matchstick and clinics were found in 10 (4.3%) patients (male: 7, female: 3) aged 35–60 years. All the FBs were unilateral and removed successfully without anesthesia, except four cases removed under general anesthesia. Complications did occur such as otitis externa: 8, bleeding and laceration: 6, and abrasion: 10. The complications were mainly due to previous unsuccessful trials and delayed referral. Conclusion: The increased abuse of earbuds causes more incidence of FB in the ears. We have seen more garlic in the ears because of misunderstanding of some traditional thoughts. Moreover, recently, we observed new FB, Bluetooth device objects in the ears of students. Health education of the general population is necessary for prevention.

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Background: This study was performed to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency within 7 days in women presenting with preterm premature rupture of membranes (PPROMs). Materials and Methods: This was a prospective observational study of TVCL measurements in eighty singleton pregnancies with PPROM between 24–34 weeks. Transvaginal ultrasonography was performed to measure the CL and AFI. Delivery latency was defined as the period from the initial TVCL after PPROM to delivery of the baby, with our primary outcome being delivery within 7 days of TVCL. Sensitivity, specificity, and predictive values were used to test whether the presence of a short TVCL, AFI, or a combination of both affected the risk of delivery within 7 days. Results: The study showed that the validity of CL alone in predicting labor when the cutoff value = 2 cm, the sensitivity = 52.6%, specificity = 69%, positive predictive value (PPV) = 60.6%, negative predictive value (NPV) = 61.7%, and accuracy = 61.25%. The validity of AFI alone when the cutoff value = 5 cm, the sensitivity = 71.1%, specificity = 50%, PPV = 56.3%, NPV = 65.6%, and accuracy = 60%. With a combination of CL and AFI in predicting time of labor after PPROM, the following results were found: sensitivity = 50%, specificity = 92.8%, PPV = 86.4%, NPV = 67.2%, and accuracy = 72.5%. In women with PPROM, we found the ratio of gestational age (GA) ≤30 weeks who labored within 7 days as 44.7% and those labored more than 7 days as 55.3%. Conclusion: Our study showed that there was an increase in PPV when combining AFI and CL in the prediction of time of labor, so women with AFI ≤5 and CL ≤2 had 86.4% risk of delivery within 7 days after PROM. Furthermore, we found that there was no significant association between GA and parity with the prediction time of labor.

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Background: Pomegranate (Punica granatum L.) has gained commercial importance in food and health industries due to increasing scientific evidence linking its consumption to better health outcomes. Objective: This study aimed to detect the active substances (phenols, tannins, flavonoids, alkaloids, and saponins) in the pomegranate peel and their effectiveness against bacteria isolated from intestine and stomach which included Salmonella and Escherichia coli, which are responsible for most gastrointestinal diseases. Materials and Methods: The experiment was designed randomly and was statistically analyzed using the least significant difference at P < 0.05. The plant extracts were obtained by alcoholic extraction using Soxholet. The compounds were diagnosed qualitatively and quantitatively using reference methods. Results: The results showed that peels contained high concentration compounds of alkaloid, tannic acid, and saponins. A 15% alcohol extract gave a high inhibition rate compared to the water extract and alcohol at a rate of 40 mm corresponds to 19 mm in the chloroform extract and 20 mm in the water extract at the concentration of 15%. A 15% concentration of alcoholic extract with antacid ampicillin and chlorophyll was compared with high efficacy compared to effective anti-ampicillin.

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Background: The return rate of supraventricular tachycardia (SVT) to sinus rhythm by the standard Valsalva maneuver (SVM) is as low as 5%–20%. Despite the limited available data in the literature, the modified Valsalva maneuver (MVM) is promising. We tested the effectiveness of the MVM for the emergency treatment of patients with SVT. Materials and Methods: In this cohort prospective study, 93 confirmed SVT cases with mean age of 47.88 ± 15.66 years and female: male ratio (1.73) across multiple centers underwent MVM. The reversion to sinus rhythm after 1 min of the maneuver, in the first or second attempt, was considered to be a success, and other conditions were considered to be a failure. Alternative therapies were administered for nonresponders. Results: The overall success rate of the reversion of SVT to sinus rhythm by using MVM in this study is 47.3%. In addition, the rate was not affected by medical and drug histories, and the rate was not substantially different among the patients having different sociodemographics, blood pressures, and pulse rate statuses. MVM has a high cardioversion rate when used for patients with SVT. We recommend using it instead of the SVM as the first-line nonpharmacologic therapy for SVT. Conclusion: The MVM has a very reasonable cardioversion rate in the setting of emergency treatment of SVT regardless of the associated sociodemographic and medical histories of patients.

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Background: About one million of women are diagnosed with breast cancer globally and nearly half of whom will die from cancer. Breast cancer is the most common cancer and the leading of mortality among women. The present study aimed to find out the relationship breast cancer and levels of PRL and influence on some hematological parameters. Materials and Methods: A total of 71 specimens were collected from females with breast cancer. Blood specimens were collected, and a blood group, packed cell volume (PCV), hemoglobin (Hb), erythrocyte sedimentation rate (ESR), and prolactin (PRL) level was evaluated. Results: The results show that most breast cancer cases were age group 40–50 years and less common among other age groups. The married women were 97% and the unmarried was 3% only. Most studied cases (43%) were O⁺ and (26%) were A⁺ blood group, in compare to other blood groups. In addition, many women show a slight decrease in Hb and PCV level (<11.0 g/dl, <36% respectively), on the other hand, the mean value of ESR was increased nonsignificantly (P > 0.05). The PRL levels were increased (31.5 ng/ml) in compare to the range of normal value (14.5 ng/ml) in women at all age groups. Conclusions: The study concludes that there was a relationship between PRL level and breast cancer with a highly significant value.

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Background: Visual impairment in children is a severe worldwide public problem. It can be detrimental to child's ability to learn. In Iraq, the size of this problem among primary school children is not well defined. Objectives: to determine the prevalence of visual impairment among primary school children in Kufa city, Al Najaf Governorate and to identify some factors associated with decreased visual acuity in the sample. Subjects and Methods: A cross sectional study was performed during the period of 1st of March to the 15th of April, 2017; the studied sample was 630 primary school children aged 6 to 15 years of both genders from fourteen governmental schools, both students and schools were randomly selected. Data were collected by using questionnaire designed especially for this study. Measurement of each pupil's vision was done by using standard Snellen E chart. Those with visual acuity(VA<6/6) was regarded as visually impaired. The Statistical Package for Social Science, SPSS, (version 20) program was used for data entry and analysis. Results: From the total participants, there were 533(84.6%) students with normal VA(VA=6/6), 97(15.4%) students with decreased VA(VA<6/6). It was found that majority 81/97 (84.5%) of children with decreased VA were under the age of 10 years with a high significant statistical difference (X2=28.028, P = 0.0001). Statistical analysis showed a significant association of decreased vision with female gender (X2=4.429, P = 0.0353), rural residency (X2=6.446, P = 0.01), low socioeconomic status (X2=7.128, P = 0.028), and positive family history of wearing spectacles(X2=7.414, P = 0.006), the highest rate of decreased visual acuity was shown in the students of second grade( 24.7%), however, the grade was not statistically significant (X2=7.128, P = 0.265). The overall prevalence of low vision (VA≤6/18) in the studied sample was 5.4% (34/630), statistically, there is a significant correlation between poor vision and female gender (P = 0.031), however, there is no significant association of poor vision with residency (P = 0.373), socioeconomic status (P = 0.431), and family history of using spectacles (P = 0.146). Conclusions: The prevalence of decreased visual acuity among primary school children in Kufa city was 15.4%., reduced vision is significantly higher in younger age group(≤10 years old), female gender, rural residency, lower socioeconomic status, and in those of positive family history of wearing spectacles. Female gender is significantly associated with low vision.

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