Background: Numerous markers of inflammation like C-reactive protein (CRP) are raised considerably in the diabetic population. The levels of these markers also associate with the severity of diabetes and presence of various complications. Objective: The objective was to study the correlation between CRP and glycemic control in type 2 diabetic patients who were newly diagnosed renal impairment and to evaluate if good glycemic control reduces the CRP values. Patients and Methods: This work was performed from June 2018 to January 2019. Forty-five type 2 diabetic patients who were newly diagnosed renal impairment are included after proper screening, between 48 and 60 years of age at the National Diabetic Center/Al-Mustansiriyah University. They were equated with 45 healthy subjects as control group. Then, relevant tests were done which are involved: fasting serum glucose, glycated hemoglobin (HbA1c), urea, creatinine, serum lipid profile, and serum high sensitivity CRP (hs-CRP). Results: A significant increase in serum urea and creatinine was found in diabetic patients as paralleled to the controls. Furthermore, there was a significant difference in hs-CRP in diabetics as compared to the controls (13.95 ± 5.42 mg/l vs. 2.0 ± 1.16 mg/l, P = 0.01, odds ratio = 1.157). Well glycemic control is foremost to the decline in HbA1c moreover caused a reduction in CRP levels when HbA1c was ≤7. Conclusions: It has been concluded that higher levels of CRP can be a prognostic element for the progress of type 2 diabetes, Also, it has a positive correlation with HbA1c, reflecting the glycemic status of the patient.

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Background: The Sapropterin dihydrochloride enzyme cofactor, a synthetic analog form of 6R-BH4, was offered as an oral treatment for hyperphenylalaninemia. The sapropterin dihydrochloride role in patients with phenylketonuria (PKU) is to activate the endogenous phenylalanine hydroxylase (PAH) and to restore partially the oxidative metabolism of phenylalanine (Phe), when patients have insufficiency or lack of tetrahydrobiopterin. The sapropterin dihydrochloride anticipated to restore PAH activity through providing an exogenous source of the lost or deficient cofactor. Aim of Study: This study aims to evaluate the effects and clinical significance of tetrahydrobiopterin supplementation in hyperphenylalaninemia. Patients and Methods: This study describes the use of tetrahydrobiopterin in 58 patients with hyperphenylalaninemia treated before the age of 15 years with the use of tetrahydrobiopterin loading test. More than 30% decrement in Phe consider positive. Results: Fifty-eight patient been enrolled in this prospective study as follows; seven patient non PKU hyperphenylalaninemia (Phe level <600 μM), 13 patients mild to moderate PKU (Phe level between 600 and 1200 μM) and 38 with classic PKU (Phe level equal or above 1200 μM). The mean of Phe at the diagnosis was 377.00 ± 150.240 μM, 843.00 ± 133.899 μM and 1513.736 ± 274.372 μM sequentially. The response to treatment with tetrahydrobiopterin was inversely related to the level of Phe where its 100% in non PKU hyperphenylalaninemia, 70% in mild-to-moderate PKU and 16% in classic PKU. Tetrahydrobiopterin therapy significantly enhanced dietary Phe tolerance and permitted a Phe-free medical formula to be discontinued in a significant number of patients in whom phenylalaninemia within therapeutic target (120–300 μM) were achieved. Tetrahydrobiopterin displays the safety and usefulness of this treatment for patients mild PKU. Conclusions: Tetrahydrobiopterin therapy should be tried in all patients with hyperphenylalaninemia and/or PKU as it may significantly decrease the Phe level and improvement his milestone moreover safe in mild PKU.

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Background: Child abuse includes a wide range of abusive activities and procrastination in performing parental tasks and responsibilities, leading to physical or mental harm, sexual abuse, neglecting the child, and even child death. Too many children are brought to primary health care (PHC) centers on numerous occasions before they are recognized as victims of child abuse. For this reason, assessing physician's knowledge and taking suggestions for child abuse prevention is likely to have a significant impact on child health. Objective: The objective is to assess the knowledge of PHC physicians in Baghdad city concerning child abuse. Methods: Cross-sectional study with some analysis carried out from first April to June 2018, on a sample of 200 PHC physicians working in 41 randomly selected PHC centers in Baghdad city/Al-Resafa and Al-Karkh. Results: Nearly 40% of physicians had good overall knowledge about child abuse. PHC physicians reported the lowest good knowledge for physical abuse (16%), and highest good knowledge rate (77%) about prevention of child abuse. Conclusion: Less than half of the PHC physicians studied had good overall child abuse knowledge. Sexual and emotional child abuse knowledge was far better than physical abuse. Management guidelines and child abuse training courses are recommended.

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Background: Thyroid hormones control most of the body's metabolic processes; T3 and T4 from the thyroid gland and thyroid-stimulating hormone (TSH) from the pituitary gland. Any defect in these hormones may have a serious clinical impact on different body organs. Objective: This study focus on the prevalence of thyroid diseases (subclinical and overt) in the Iraqi population and the possibility of linking their incidence and progression to specific factors. Patients and Methods: Cross-sectional study was conducted in the National Diabetes Center for Treatment and Research/Mustansiriyah University in Al-Karkh side from Baghdad/Iraq. Thousand and eight hundred patients, both gender (males and females) from different age groups (12–62 years), have been involved for 6 months. This study was measured serum TSH, thyroxin hormone (T4), and triiodothyroxin hormone (T3). Patients were categorized according to their thyroid status at the time of testing based on both the traditional definitions of thyroid dysfunction and using TSH and T4 levels of subclinical hyper- and hypothyroidism, overt hyper- and hypothyroidism. Results: Of 1800 cases collected over 6 months, 3.2% were overt hypothyroid (22.4% males and 77.6% females) (P < 0.0001). Moreover, 14.1% were subclinical hypothyroid cases (19.7% males and 80.3% females) (P < 0.0001). Overt hyperthyroid cases represent 3% (27.8% in male and 72.2% in females) (P < 0.0001). Subclinical hyperthyroid cases were 4% (18.3% in male and 81.7% in females) (P < 0.0001). Distribution of thyroid status (euthyroid, subclinical, and overt thyroid) in females significantly higher than in males (75.7%, 6.2%, and 18.1% respectively, P < 0.0001). Subclinical hypo- and hyperthyroid appeared in the age group (32–51 years) was significantly higher than other studied ages (P < 0.05), and overt hyperthyroid appeared in the age group (42–51 years) higher than other age of studied groups (P < 0.05), while overt hypothyroid was distributed equally in all age groups (P > 0.05). Less than ten percent of total patients were taking thyroid medication for hypo- and hyperthyroidism. Subclinical and overt thyroid cases received treatments were (47.4% and 42.9%, respectively). Treated old subjects >52 years represent about (17.6%) from the total patients. Conclusion: The majority of thyroid problems occur in adult age (32–50) and in females. Understanding the prevalence and risk factors of subclinical thyroid disease could be a help to identify the patients for screening and follow-up. Treatment recommendations must base on measuring thyroid-stimulating hormone concentrations and underlying comorbidities.

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Background: Hepatitis B virus (HBV) vaccination was one of the success stories of the 20^th century. It is highly effective and safe and was incorporated into national immunization programs of countries worldwide. Objectives: The objective of the study as to explore the response rate and titers of anti-HBs antibodies among children 1–14 years old immunized with HB vaccine in Baquba city Diyala province. Vaccinees and Methods: This cross-sectional study was conducted in Baquba City, the center of Diyala province, Iraq for the period July 20, 2016–March 20, 2017. A total of 452 children were enrolled, 247 (54.6%) were males and 205 (45.4%) were females, with an age range of 1–14 years. All were previously immunized with genetically engineered HBV vaccine (Euvax B, Korea), with a dose of 10 μg of HBsAg/0.5 ml intramuscularly. Venous blood samples were collected aseptically; sera were separated and subjected for the detection of HBsAg, anti-HBs antibody titer, HBe Ag, and total antibody and anti-HBc total antibody using Enzyme-Linked Immunosorbant assays (ACON, Foresight-USA). A preconstructed questionnaire form was prepared including information of sociodemographic, health, and vaccination status. Statistical analysis was done using the Statistical Package for the Social Science (SPSS), Version 23. P < 0.05 was considered statistically significant. Results: The overall anti-HBs Ab positivity rate was 75.66% (95% confidence interval was 71.5%–79.6%), with a mean anti-HBs Ab titers range (10.1–673.4 mIU/ml). However, the titer was failed to reach the protective level in 110 (24.34%) vaccinees. The highest anti-HBs Ab positivity rate among children received 1 or 2 vaccine dose is significantly higher among those after <1-year duration (80.0%, P = 0.043), while the mean anti-HBs Ab titer is insignificantly highest among the same group of children (43.7 mIU/ml, P = 0.24). The highest anti-HBs Ab positivity rate among children received three vaccine doses is significantly higher among those after <1-year duration (91.3%, P = 0.003), and similarly the highest mean of anti-HBs Ab titer is insignificant higher among the same children group (81.3 IU/ml, P = 0.2). Regarding those children received four vaccine doses, the anti-HBs Ab positivity rate and the mean anti-HBs Ab titer are significantly higher among children after <1 year (89.9%, P = 0.004 and 97.7 IU/ml, P < 0.001), respectively. Finally, the anti-HBs Ab positivity rate after five vaccine doses was insignificantly higher after 1–3-year duration (72.4%, P = 0.15), while the highest mean anti-HBs Ab titer was significantly higher among those with <1-year duration (55.0 IU/ml, P < 0.041). Conclusion: Universal hepatitis B vaccination is generally produce high rate of protection among children and the highest anti-HBs antibody titer was achieved through 3 or 4 doses after <1-year postvaccination.

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Background: Referral system is one of the key elements in the primary health care (PHC), currently the Ministry of health is working on establishment and development of an effective referral system with incentives to the population to use PHC centers (PHCC) instead of secondary care, this includes monetary incentives and improvement of quality and quantity of services provided at PHC level. Objective: The aim is to assess the knowledge and practice of PHC physicians about the referral system. Methodology: A cross-sectional study with analytic elements was conducted from February 1, 2019 to June 30, 2019, in Baghdad, from both sides AlKarkh and AlRusafa, a convenient sample of 15 PHCC selected., data collection was carried out using a self-administered questionnaire which included questions about demographic characteristics of PHC physicians, qualification, and questions concerning their knowledge and practice about the referral system. Results: Total study group included 150 physicians. Overall knowledge of physicians about the referral system was good, Nearly all physicians (98%) knew its benefit, the results showed that all respondents used referral form (100%), and 94.7% wrote down the required information and followed the classical measures. The referral feedback was poor (36%). Conclusion: Most of the physicians had good knowledge and practice about the referral system. There was strong deficit in the training courses about referral system.

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Background: The health-care providers must exhibit consistent and correct utilization of growth charts and be able to correctly interpret and comprehend its data. Objectives: The objectives were to assess the knowledge and use of growth chart by health care providers and to investigate factors affecting the knowledge and use, including relation to reproductive Maternal, Newborn, Child, and Adolescent health programs. Methodology: A descriptive cross-sectional study was carried out in 20 primary health-care centers in Baghdad: 8 in Al-Rusafa district and 12 in Al-Karkh district, during the period from the first of February to the end of May 2019. Results: The total number of study participants was 200, their mean age was 38.3 ± 8.3 years, and 150 (75%) were physicians including 85 (42.5%) family physicians. Most of the respondents (82.5%) had acceptable knowledge, while 9% had good knowledge and 8.5% had poor knowledge. Regarding use, 158 (79%) participants showed an acceptable level of use, 39 (19.5%) a good level of use, and only 3 (1.5%) had a poor level of use. Conclusions: Most of the health-care providers had an acceptable level of knowledge and use of growth charts, better knowledge, and use level were related to the number of patients seen per day, while growth chart use was affected by participants' age and being physician.

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Background: Epstein–Barr virus (EBV) is a small double-stranded linear DNA human herpes virus that is transmitted primarily through saliva. Majority of primary EBV infections in infants and young children are clinically silent. Clinically, primary infections by EBV are presented as infectious mononucleosis (IMN) syndrome, which is characterized by pharyngitis, cervical lymphadenopathy, fever, and lymphocytosis. Objectives: This study was designed to explore the rate of EBV anti-viral capsid antigen (VCA) immunoglobulin M (IgM) among children who were clinically suspected as having IMN in Diyala province. Subjects and Methods: A total of 248 subjects were included; 190 were clinically suspected as having IMN and 58 apparently healthy subjects were included as a control group. The age range of the patients was 9–168 months; 88 of them were males, while 102 were females. Similarly, the age range of the apparently healthy subjects was 9–168 months; 29 of them were males while 29 were females. The anti-VCA IgM antibodies were detected in the serum samples using the VCA IgM enzyme-linked immunosorbent assay technique (DiaPro Diagnostic Bioprobes Srl, Italy). Human privacy was respected by taking the parents' verbal consent. Statistical analysis of the data was carried out using Statistical Packages for the Social Sciences (SPSS), Version 25. Statistical significance was considered whenever the P ≤ 0.05. Results: The results showed that the anti-VCA IgM positivity rate among clinically suspected children with IMN was 24/190 (12.6%), while only 2/58 (3.4%) of the apparently healthy subjects were positive, with a statistically significant difference (P = 0.046). Age and gender distribution had no statistically significant effect on the IgM positivity rate (P = 0.432 and P = 0.960, respectively). Furthermore, most IgM-positive patients had at least three of the main clinical features; however, no statistically significant association was found between the IgM positivity rate and the main clinical features (P = 0.157 for headache and P = 0.692 for malaise). Conclusion: The rate of IMN among clinically suspected patients in Diyala province was 12.6%, the peak age of primary infection was 1–4 years, the male-to-female ratio was 1:1.2, and the main presenting complaints were fever and sore throat.

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Background: There is increasing incidence of diabetes around the world. Moreover, diabetic retinopathy (DR) is one of the complications of diabetes mellitus and the leading cause of blindness among working age adults. This study aimed to evaluate the prevalence of DR in type 2 diabetic patients and to estimate the risk factors and their relationship to the development of DR. Patients and Methods: A case–control study was done on 262 type 2 diabetic patients with DR compared to 262 diabetic patients without DR. Further, retrospective cross-sectional study was done on cases with DR in Sulaimani/Iraq. Data were collected from January 1, 2017, to December 31, 2017. Association between variables was tested by Chi-square test; P ≤ 0.05 was regarded as significant. Results: The prevalence of DR was 8.6%. The mean age of the patients with DR was 59.65 ± 7.55 years, with female being 31%. Age, gender, body mass index, and serum triglycerides were not associated with increasing risk for the development of DR (P = 0.147, 0.536, 0.573, 0.111, respectively), while cases with poor glycemic control, longer duration of diabetes mellitus, history of hypertension with elevated systolic and diastolic blood pressure (P < 0.001), and high serum cholesterol (P = 0.005) associated with increasing risk of DR. Conclusions: Poor glycemic control, history of hypertension, duration of diabetes >10 years, and high serum cholesterol are regarded as risk factors for the development of DR in diabetic patients.

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Background: Pregnancy, childbirth, and puerperium are associated with profound physiological endocrine upheavals. The physiological events of pregnancy and its resolution can also modify a number of concomitant dermatoses, and there are also some pathological skin conditions that are virtually pregnancy specific. Objective: This study was an attempt to find the most common dermatological problems that are faced by the Iraqi women during pregnancy. Patients and Methods: A convenient sample of 300 pregnant women was included in this cross-sectional study which was conducted in the consultation clinic of dermatology and the consultation clinic of obstetrics and gynecology of Al-Kadhymia Teaching Hospital between February 1, 2012, and the end of June 2012. Clinical diagnosis was based on history and clinical examination, and appropriate investigation including biopsy was done accordingly. Results: A total of 300 pregnant women with ages ranged from 14 to 44 years, with a mean age of 29 ± 15 years. Primi/multigravida ratio was 2:3 with gestational age between 2^nd and 9^th month. Various skin problems were seen among these cases, those with specific dermatosis account for 22.4% of the total, while those with nonspecific diseases constitute 77.6% of the cases. The major ones were infections and infestations (27.3%) followed by eczema and dermatitis (19.3%). Most common physiological skin changes were striae gravidarum which was seen in 78% of cases, followed by melasma in 49% of cases. Conclusions: The study showed that the most common skin changes and diseases during pregnancy include (1) pruritus gravidarum (more common started in primigravida and in the third trimester); (2) scabies (may be due to endemic of this disease) and superficial fungal infection; (3) striae gravidarum (more common in multigravida in the third trimester); followed by melasma (more common multigravida in the second trimester).

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Background: Acute abdomen is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that a person may seek emergency treatment; it can signal a variety of more serious conditions, some of which require immediate medical care and or surgery. Aim of the Study: The aim of this study was to evaluate the causes of nontraumatic acute abdomen and their presentation in elderly patients within the Emergency Department at Al-Yarmouk Teaching Hospital and their correlation to the final diagnosis and outcome. Patients and Methods: A descriptive study was conducted on 121 elderly patients aged 60 years and above, complaining of acute abdominal pain (traumatic cases were excluded and unknown patients fate), presented to the emergency unit of Al-Yarmouk Teaching Hospital. The study was done for a period of 13 months (February 1, 2015, till April 1, 2016). The data were collected by interviewing questionnaire, reviewing of records, taking some measurements, and physical examinations. Data were analyzed using the SPSS program version 22. Results: Patients with acute abdomen were included in the present study with a mean age of 68.4 ± 7.5 years with a female-to-male ratio of 2.1:1. The most common chief complaint was pain presented in 100 (59%) of patients, 50 patients (41%) presented with a duration of chief complaint in ≤24 h, 56.2% of the studied patients were hyperthermia, 65% were hypertensive, mean pulse rate of studied patients was 110 ± 12 beat/min, 75.3% of them had tachycardia, mean respiratory rate of studied patients was 19 ± 2/min, and 52% of them had tachypnea. The most common site of pain was right iliac fossa (24.8%), Murphy's sign was positive among 19 patients (16%), tenderness was present in 114 of the patients (94%), abdominal guarding was positive in 106 of the studied patients (88%), jaundice was observed in 27 (22%) patients, dehydration was present among 79 (65%) of studied patients, and 76 of the patients (62.8%) had elevated white blood cell. Cardiovascular diseases were the most common associated diseases (47%). Ultrasound findings of studied acute abdomen patients presented to the emergency department revealed that 26 of them (21.5%) had gallbladder abnormality, 24 (19.8%) had no specific ultrasound findings, and the X-ray finding was abnormal among 44 (36.4%). The most common diagnosis was perforated viscus for 18 (14.8%) patients. More than two-thirds (72; 59.5%) were treated surgically with mortality rate was 18 (14.8%). Conclusion: Pain was the most common complaint among the elderly with acute abdomen, and the right iliac fossa was the common site of pain. Most patients attended the hospital late (after 24 h from starting the symptoms). Perforated viscus and cholecystitis appear to be the main causes of acute abdomen among Iraqi elderly people.

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Background: New coronavirus has been isolated in China and is named by the World Health Organization (WHO) severe acute respiratory syndrome-coronavirus-2 as a cause of coronavirus disease-2019 (COVID-19) which progressed to the pandemic. The first COVID-19 case was reported in Iraq on February 24, 2020, which was Iranian student. Objective: This study was conducted to highlight the demographic characteristics of the first 70 COVID-19 patients in a Teaching Medical City in Baghdad. Patients and Methods: This descriptive study involved the first 70 COVID-19 confirmed cases by reverse transcriptase–polymerase chain reaction (RT-PCR) and treated in Al-Shafaa Center–Teaching Medical City from March 1 to April 17. Data were collected from investigation forms which include demographic data, risk factors, outcome, type of laboratory sample, and their result. The definition of a suspected, probable, and confirmed case is that explained by the WHO. Results: The total number of confirmed COVID-19 patients (RT-PCR-positive) was found to be 70 out of 537 suspected cases (13%). The case fatality rate was found to be 6% for those who died within more than 24 h. The recovery rate was 53%. The low rate of occurrence was among children below 14 years, females, and those with no risk factor. The high fatality rate was among those whose ages were more than 60 years, males, those with risk factors, and who delayed in seeking medical advice. The recovery rate was better among those <60 years of age, no risk factors, and early seeking medical advice. Females have high recovery rate and low case fatality rate than males. Conclusions: COVID-19 affects all ages but low occurrence in children <14 years of age and affects males more than females. Fatality increases with old age, male gender, presence of chronic disease, and delay in seeking medical advice.

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Background: The low survival rates of breast cancer in less developed countries such as Iraq are mainly attributed to a lack of awareness programs, resulting in a high proportion of women presenting in late stages, in addition to the limited capacity for early diagnosis and effective multimodality treatment. Objectives: The objective of the study was to compare the outcome of clinical breast examination with breast light device use. Patients and Methods: This descriptive hospital-based cross-sectional study was conducted on a sample of 305 women attending a breast examination clinic in Al-Yarmouk Teaching Hospital-Baghdad, from January 1, 2015 to July 30, 2015. Study tools included “The Breast light” which is a handheld device that transilluminates the breast with a red light that is absorbed by hemoglobin yielding dark shadows in areas of high vascularity (including malignancy). The breast-light device was used for breast examination, together with a clinical breast examination. Results: The study showed moderate agreement in the detection of breast abnormalities between clinical breast examination and breast light examination (kappa 43%). Neither breast mass size nor its location showed significant differences when comparing the results of the two methods. Moreover, mastalgia appeared to be the most frequent presentation in the examined women. Conclusion: Detecting ability of breast abnormalities could be raised, when integrating clinical breast examination with breast light. In addition, breast light could be a valuable aid for family doctors at the primary health care level, as it is easy to use, portable, and not invasive.

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Background: Insulin resistance (IR) is a risk factor for ischemic heart disease and myocardial infarction. It often manifests in myocardial infarction and is regarded as an independent predictor of in-hospital mortality, which can provide early risk stratification for recurrent acute coronary events. Objective: The aim of this study was to assess the levels of apolipoproteinsA1, E with IR in Iraqi male patients with acute myocardial infarction (AMI). Patients and Methods: Forty-five male patients with AMI were enrolled in this study. Their age range was 40–55 years and they are compared with 45 healthy male as a control group. All patients with AMI were checked up by a cardiologist in Iraqi Centre for Cardiovascular Diseases/Al-Hariry Hospital/Baghdad. Fasting venous blood samples were collected from all the subjects. Laboratory evaluations consisted of fasting serum glucose (FSG), glycated hemoglobin (HbA1c), serum insulin, and lipid profile. Furthermore, apolipoproteinsA1 and E levels were determined in this study. Results: There was a significant increase in FSG and insulin levels in patients group as compared to the controls. In addition, there was an elevation in HbA1c and homeostasis model assessment for IR in those patients, but they were not significant. There was a significant increase (P = 0.001) in serum total cholesterol, triglyceride, and low-density lipoprotein cholesterol, while there was a significant decrease in serum high-density lipoprotein cholesterol in patients group as compared to the controls. Moreover, there was a significant increase (P = 0.001) in apolipoprotein E, while a significant decrease (P = 0.001) in apolipoproteinsA1in patients group as compared to the controls. Conclusions: Dyslipidemia, along with insulinemia and glycemia, is one of the most significant IR risk factors in the acute and early recovery phases of myocardial infarction.

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Background: Hyperuricemia is associated with a diversity of other illnesses comprising increased alcohol and purine-rich food ingestion and obesity. Hyperuricemia is deliberated to be a lifestyle condition interrelated with obesity. Objective: The aspire of this revision was to assess the occurrence of hyperuricemia and its association with obesity among Iraqi adults. Subjects and Methods: Ninety participants with hyperuricemia participated in this study; their ages ranged from 35 to 50 years. They were classified into two groups: obese (n = 45) and nonobese (n = 45) from January 2019 to July 2019 at Medical City Hospital/Baghdad. Results: There was a substantial rise (P < 0.05) in body mass index (BMI), fasting serum glucose (FSG), total cholesterol (TC), triacylglycerol (TAG), and low-density lipoprotein cholesterol, while there was a substantial reduction in serum high-density lipoprotein cholesterol (HDL-C) in obese subjects as paralleled to nonobese. Furthermore, there was an elevation in serum lipid ratios, but they were not significant. A substantial rise in serum uric acid was found in obese subjects as paralleled to nonobese. An elevation in serum uric acid level was found in males as paralleled to females, but it was not substantial. Furthermore, there was a substantial positive correlation between serum uric acid and BMI, waist circumference, waist-to-hip ratio, FSG, TC, TAG, and low-density lipoprotein cholesterol, while there was a significant negative correlation between serum uric acid and HDL-C in obese subjects. Conclusions: Outcomes of this data designate a substantial positive correlation between hyperuricemia and obesity among Iraqi adult subjects. Thus, routine measurement of serum uric acid is suggested in obese persons to avoid hyperuricemia and its associated problems.

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Background: Family planning programs represent a chance for family size control, development, and good planning for future. Objective: We aimed to assess the prevalence of usage of family planning methods, to evaluate client knowledge about these methods, and to determine the most common family planning used. Methods: A cross-sectional study was conducted in Bab Al-Moatham Primary Health Care catchment area. One hunderd and forty-one married women aged 15–49 years were given a structured questionnaire developed mainly from the Family Planning WHO guidelines, ten experts' opinions were taken into consideration. And also, a pilot study of 14 married women was done. Data analysis was done by using SPSS ver. 23. Frequency, percentage, and Chi-square tests were used. P < 0.05 was considered significance. Answer scoring was done for knowledge. Results: Sixty-three women (44.7%) aged 29–39 years, with 56% complete primary school, 92.2% homemakers, 34% married, 68.1% with good obstetric history, 87% of them used family planning methods, and 58% using it now, the most method used is CCP. 66.7%, studied women had good knowledge in the withdrawal method (65.2%), CCP (55.3%), and poor/no knowledge in vasectomy. A significant association between educational level, working, year of marriage, and previous use of family planning while only working state has significant with recent use of family planning. Conclusions: Low rate using of family planning methods, and the most method used is CCP, followed by withdrawal method with good knowledge in both and poor/no knowledge in vasectomy.

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Background: Hypertension is a major public health problem worldwide. It is a risk factor for most coronary heart diseases and cardiovascular diseases. Strategies to prevent and treat hypertension in younger age groups and adolescents, including medical students, have been applied and evaluated by the World Health Organization. Objectives: The objective of the study is to determine the prevalence of both hypertension and prehypertension among medical students in medical colleges and to study the association of different factors with hypertension disease. Methodology: A descriptive cross-sectional study was conducted in medical colleges of Al-Anbar University, Iraq. The study period was from January 1 to March 10, 2019. A total of 273 undergraduate medical group students, both female and male, participated in this study from three colleges: medicine, pharmacy, and dentistry colleges. Blood pressure, height, and weight were measured using standardized instruments. SPSS Statistics for Windows, Version 24.0 was used to analyze data. Both cross-tabulation and Chi-square tests of significance were done. Results: The prevalence rate of hypertension in this research study was 9.9%, of them 18.0% and 3.3% were male and female, respectively. Prehypertension was 17.2% of the total sample. Risk factors highly associated with hypertension (P = 0.0001) were male gender, stress, high salt intake, smoking habits, and increased body mass index. However, there was no significant association between dietary risk factor and hypertension in our study. Conclusion: The high overall prevalence of hypertension (9.9%) and prehypertension (17.2%) with overall prevalence of hypertension and prehypertension together (27.1%) represents a call for the establishment of screening system for early detection at primary health-care level. Community-based health education programs on the importance of the examination and follow-up processes for early detection of hypertension and prehypertension are recommended.

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Introduction: Primary health care is still underutilized for obesity counseling and adequate training may increase physician involvement in overweight prevention and treatment, exploring physicians' awareness is important for the design of special training programs to manage deficiencies in knowledge and practices. Objectives: The objective is to assess the knowledge of primary health care centers' physicians about obesity. Subjects and Methods: A cross-sectional descriptive study was carried out for 4 months: A Convenient sample of 129 primary health-care physicians were included, assessment of knowledge consisted of 15 questions, and their answers may be one of 3 (”Yes,” “No” or “I don't know”) according to knowledge of participants. For knowledge assessment, if a participant had 7 or less correct answers, it was considered poor knowledge, and if more than 8 correct answers out of the 15 questions then it considered adequate knowledge. Results: From the 129 study sample, only 11 had training in obesity courses. There were 82.9% of participants identify obesity as a disease, and 75.2% agreed that primary health care physicians playing a dominant role in assessing and managing obesity. In the current study, 98.4% of participants answered correctly about obesity relation to chronic conditions, 40.3% of physicians had incorrect information about low social class can predispose to obesity. In this study, only 50.4% of physicians used body mass index for obesity classification in all health conditions. Conclusions: Most of the physicians who were involved in the study had an adequate knowledge about obesity (92.2%).

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Background: Medical students repeatedly experience different stresses which made them more vulnerable to psychological problems that may affect their emotional, psychosocial, physical, and academic performance. Objectives: The objective of this study was to determine the rate of anxiety and depression among medical students in Al-Mustansiriyah University. Find out the influence of gender, school year, and some life events on the likelihood of development anxiety and depression. Subjects and Methods: A cross-sectional study was conducted in Al-Mustansiriyah University, College of Medicine from March 1, 2015, to May 10, 2015. The study sample comprises 300 students from all six school years. Self-administered questionnaires were used for data collection. The Hospital Anxiety and Depression Scale was used to assess the presence of anxiety and depression among the students enrolled in the study. Results: The study results showed that the overall rates of anxiety and depression with various degrees among students were 77% and 61.6%, respectively. Male students had a higher overall rate of anxiety (80.1%) than female students (74.86%), while female students had a higher overall rate of depression (64.2%) than males (57.85%). The highest score of anxiety was observed among 3-year students (54.4%), as compared to other school years, while a higher score for depression was recorded among the 1^st-year students (23.1%). Students who failed in the last academic year were more prone for both depression and anxiety. Those who were displacing from their homes were more likely to be depressed. Conclusion: A considerable part of Al-Mustansiriyah College of Medicine students were suffering from psychological disorders (anxiety and depression).

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Background: Osteoporosis is being reported as a major cause of morbidity among elderly individuals worldwide. Health professionals are the key link in the chain of multidisciplinary approach to the management of this potentially preventable disease and educating patients about the various aspects of its evaluation and management. Objective: The objective of this study was to assess the level of knowledge among women working at the AL-Fallujah Teaching Hospital regarding osteoporosis. Methods: This was a descriptive cross-sectional study that included 359 women working at the Al-Fallujah Teaching Hospital using a self-administered questionnaire as well as Fact on Osteoporosis Quiz (FOOQ). All participants were asked to answer the questionnaire without disclosing their identity after their approval to participate in this study. Demographics data and the mean score on the FOOQ were summarized using a descriptive measure. Results: A total of 214 out of 359 women returned the questionnaires (response rate was 60%). The overall mean score in general among the studied group was 13.47 out of 20. The study showed that the health workers have good–moderate in general knowledge as well as for preventive measures; however, they have acceptable-poor knowledge regarding risk factors and treatment. Conclusion: This study highlights the fact that knowledge about osteoporosis among health workers in the Al-Fallujah Teaching Hospital was insufficient.

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Background: First aid is the assessments and interventions that can be performed by medic (or by the injured person) immediately with minimal or no medical equipment. Training is necessary to equip the first aid provider with the knowledge, skill, and confidence to attend to an emergency. Objectives: To assess the knowledge and practices of primary school teachers in Hay Al-Salaam Al-Sakani about the first aid. Methods: A cross-sectional study with analytic element was conducted in Baghdad during the period from February to August 2018. Eight schools were choose randomly, 145 teachers who were work in choosing schools and accept to involve in this study. A structure questionnaire depending on the Iraqi Red Crescent guideline for First Aid, and American College of Emergency Physician's First Aid manual 5th edition was used. Results: One hundred and forty five teachers were involved in this study, 44.1% of them aged 40–49 year, most of them were females (93.8%), graduated institute (63.4%), married (77.9%), had one to three children (65.5%), had 11–18 years teaching experience (30.3%). Only 30.3% applied first aid previously, most of the teachers (71%) did not involve in first aid training courses. Teachers age had statistically significant association with first aid general-knowledge, knowledge about poisoning, fractures, and burn. Their educational level had statistically significant with knowledge about coma, epilepsy, fractures, mouth injuries, and burn. Conclusion: First aid knowledge in general and in each type of school accident was good except knowledge in asphyxia and electric shock were fair knowledge; most of them were not involved in training courses for first aid, or applied first aid.

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Background: Occupational stress is involved in the development of hypertension (HT), and there are different numbers of studies examined the occupational stress aspects including job insecurity, strain and control, satisfaction, work hours, and perceived dissatisfaction. Objectives: The objectives of the study were to estimate the prevalence of HT among female physicians, identify associations between occupational stress and hypertensive status, and evaluate sociodemographic characteristics in female physicians. Subjects and Methods: A cross-sectional study was conducted on 600 female physicians in Baghdad and Al-Imamein Al-Kadhimaein Medical Cities, from March 15, 2019, to August 15, 2019. The study tools used were calibrated mercury sphygmomanometer to measure blood pressure, Occupational Stress Index Scoring System was used to measure severity of occupational stress and structural questions sociodemographic data for (age, body mass index [BMI], marital state, number of children, number of years of work, work hours/week, and physician's specialty categories). Results: The study showed that the prevalence of HT was 30% and mean age 37.74 ± 6.7 years. High stress level was higher among surgical/anesthetic department. The occurrence of HT and age, BMI, marital state, number of years of work, and work hours/week of the present study showed a significant relationship between them but number of children showed inversely relationship. Conclusions: Nearly two-third of participants with high occupational stress had HT.

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Background: Hepatitis C virus (HCV) genotypes have been shown to be differently distributed between distinct geographical areas. Information regarding hepatitis C genotypes and subtypes distribution in Al-Nasiriya city is not well-known. Objectives: The objectives of this study were to determine the frequency of various HCV genotypes in Al-Nasiriya City and the demographic and risk factors associated with HCV transmission among the Al-Nasiriya City population. Materials and Methods: Blood samples were collected from 200 patients with chronic HCV infection who were referred from Al-Nasiriya City to the Digestive Disease Department of Al-Yarmouk Hospital during February 2019–December 2020. Patients were screened for HCV antibodies using an enzyme-linked immunosorbent assay test. Quantitation of the HCV viral load and genotype were assessed using a polymerase chain reaction. Results: This study revealed that the most common HCV genotype was 1a (HCV-1a) with a rate of 63%, while HCV-1d showed 1.5% and HCV-4 was 35.5%. Furthermore, the frequency of infection among females was more than among males at 37.5% and 25.5%, respectively, while the hemodialysis process among other transmission risk factors increased the transmission of HCV-1a infection. Conclusions: HCV-1a is the most predominant genotype in these patients, with more prevalent in females than males over 20 years old, and hemodialysis is the most risk factor in their transmission.

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Background: Thyroid hormones are the important modulator of intermediary metabolism. They affect synthesis, mobilization, and degradation of lipids, although degradation is influenced more than synthesis. Serum ferritin levels also have been reported to be altered in patients with thyroid disease. Objective: The present study aims to explore the association of lipid profile with serum ferritin in patients with thyroid disorder. Patients and Methods: In this study, 140 individuals were selected from the outpatient department of the National Diabetes Center/AL-Mustansiriyah University. Serum ferritin, free triiodothyronine (FT3), free tetraiodothyronine, thyroid-stimulating hormone (TSH), and lipid profile were measured. Results: Nonsignificant differences of serum cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein levels in hypothyroid, and hyperthyroid and euthyroid groups were observed. The serum ferritin levels indicate a significant increase in hypothyroidism in comparison to their levels in both other groups (hyperthyroidism and euthyroid). Meanwhile, a significant increase of serum ferritin was observed in hyperthyroidism in comparison to that level of the euthyroid group. Ferritin level was found to be negatively high correlated with lipid profile in hypothyroidism, TSH was also negatively correlated with ferritin level. In the hyperthyroidism group, ferritin level was high correlated positively with free thyroxine, whereas a highly significant positive correlation of ferritin with FT3 was observed in the euthyroid group. Conclusion: It can be concluded that the lipid profile in thyroid disorder patients is various according to ferritin level.

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