bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and risk factors of delirium in the pediatric intensive care unit of a tertiary care hospital: A prospective observational study
Authors: Khan Sidra , Haseeb Abdul , Khalid Muhammad , Sher Atika , Haque Anwar 
Published: February 2024

Abstract

Background:
Critical illness is one of the most common causes of delirium in children which can be associated with increased morbidity and mortality. Delirium continues to be an overlooked aspect of the management of critically ill children. This study was conducted with the objective of determining the frequency and risk factors of delirium in critically ill children.

Subjects and Methods:
This prospective observational study included patients admitted for at least a period of 24 h of teaching in the pediatric intensive care unit (PICU) of a medical college of Pakistan from March 2022 to September 2022. Each patient was screened for developing delirium twice a day using the Cornell Assessment of Pediatric Delirium.

Results:
The median age of the patients was 19.5 months (interquartile range: 10.7–72). There were 64.6% (n = 106) of male children, and 97.2% (n = 143) were admitted due to medical conditions. Delirium was identified in 97 (59.1%) patients. Mortality was observed in 3 (1.8%) cases. The average length of stay and frequency of hypoxia was higher among the pediatric delirium group (P = 0.002 and P = 0.022, respectively). Independent predictors of delirium in PICU patients were length of stay (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.39–4.20), use of inotropes (OR, 3.32; 95% CI, 1.0.4–10.64), use of narcotics (OR, 8.78; 95% CI, 0.96–80.51), and hypoxia (OR, 3.02; 95% CI, 1.17–7.81).

Conclusion:
Delirium is common in children admitted to PICU. Length of PICU stay, use of narcotics, inotropes, and hypoxia were found as independent risk factors for delirium.
Referred otalgia: Etiology and incidence among 136 patients in Hillah City, Iraq
Authors: Aljubory Saad Abdul-Raheem Hussein 
Published: February 2024

Abstract

Background:
Prompt history and clinical examination are mandatory to fix the proper diagnosis of refereed ear pain which sometimes needs the aid of laboratory, radiological assessments, and even examination under general anesthesia.

Objectives:
To diagnose cases of referred otalgia with the estimation of the incidence according to different age groups and sex.

Materials and Methods:
A prospective study was done in the ENT clinic in Hillah City, to evaluate 600 patients who presented with ear pain, 136 patients out of them were labeled as referred otalgia cases when the ear showed normal examination. The study started from January 2019 to February 2021. Physical examination with required investigations according to etiologies suspected for referred otalgia was done accordingly.

Results:
Out of 600 patients who presented with otalgia, 136 patients had referred otalgia (22.6%). The right ear was more affected than the left one (54%), whereas four cases had bilaterally referred ear pain. Of them, 57 patients had temporomandibular (TM) dysfunction (42%), 34 patients had pharyngeal pathologies including tumors (25%), 20 patients had cervical causes (14.7%), 11 patients had dental problems (8%), 8 patients had miscellaneous cases including salivary glands, oral cavity, lymph nodes, and long styloid process (5.8%), and 6 patinets had nasal and sinus problems (4.5%).

Conclusion:
Ear pain could be due to remote etiologies rather than the ear especially when it is normal by examination. The pain is mainly from adjacent head and neck structures. Physical examination of those structures especially TM joints, teeth, pharynx, nose, and sinuses is important to identify the causes of ear pain. Malignancy may be one of the causes and should not be missed.
Knowledge, practice, and attitude evaluation of forensic dentistry among Iraqi dentists: Questionnaire-based study
Authors: Al-Dulaimy Roweda , Rashidi Harth , Alghurary Rania , Alsaraf Rukaya , Alfarag Ban , Alshami Muhanad L 
Published: February 2024

Abstract

Background:
Forensic dentistry is a branch of forensic science that deals with the examination, analysis, and interpretation of dental evidence in legal investigations.

Objective:
The aim of this study was to evaluate the knowledge, practice, and attitudes of Iraqi dentists toward forensic dentistry.

Materials and Methods:
A questionnaire was designed with four sections and distributed to dentists. The four sections were demographic, knowledge (assessed the dentists’ knowledge and consisted of 14 questions), practice (evaluated the dentists’ practices and consisted of six questions), and attitude (consisted of two questions to assess the dentists’ attitudes). For the knowledge, practice, and attitude sections, the answers were either “yes” (correct), “no,” or “I don’t know” (incorrect). The correct answer frequencies were calculated, and the mean scores of responses were compared among the different variables.

Results:
A total of 414 dentists responded, including 196 male dentists and 218 female dentists. The mean age of the responders was 32.57 years, and the responders were divided according to age into: 304 (≤40 years), and 110 dentists (˃40 years), according to qualifications into: 168 (postgraduate) and 246 (graduate), and according to experience years: 228 (≤10 years) and 186 (˃10 years). The questions related to using teeth as indicators of age received the highest number of correct answers, whereas the use of palatal rugae and lips in forensic dentistry received the lowest scores.

Conclusion:
Iraq dentists had limited knowledge, practice, and attitude about forensic dentistry. Therefore, it is important for undergraduate and postgraduate programs, as well as official training courses, to focus more attention on forensic dentistry.
Concept of HBV and HCV as a risk factor and prevention of viral hepatitis-related hepatocellular carcinoma
Authors: Alshimerry Athraa Falah , Farhood Rawaa Ghalib 
Published: February 2024

Abstract
Hepatocellular carcinoma (HCC) represents one of the most common cancers worldwide, and it is a very important reason for cancer-related death. Infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is considered the major leading cause of HCC. The pathophysiology of HB and HC viral-related HCC includes chronic inflammation, deorganization of cell signaling pathways, and oxidative stress. Contrary to HCV, HBV is oncogenic by itself, due to its integration into the DNA of cell. Six months of ultrasound monitoring is recommended for high-risk patients. Using antiviral drugs to manage viral hepatitis decreases the risk of evolution and reoccurrence of HCC. Also, effective preventive measures are very important in decreasing the risk of HCC. The prevention involves primary prevention which is based on HBV vaccination, treatment of acute infection, and eliminating the route of transmission, while secondary prevention is based on using antiviral drugs against HBV and HCV infection to prevent the progress of disease into carcinoma. However, tertiary prevention involves treating the carcinoma to prevent the reoccurrence of the cancer.
A cross-Sectional Study of Psoriatic Arthritis in One Center in Baghdad
Authors: Al-Hafidh Ali Hussein 
Published: February 2024

Abstract

Background:
Psoriatic arthritis is a chronic inflammatory illness. Nearly, 15% of psoriasis patients have undiagnosed psoriatic arthritis.

Objective:
The aim of this study was to investigate the prevalence of psoriatic arthritis and different clinical–epidemiological characteristics of the disease of patients.

Materials and Methods:
This cross-sectional study included psoriatic patients who attended Baghdad Teaching Hospital. Clinical examination, laboratory investigations including rheumatoid factor analysis and radiological examination of axial and peripheral skeleton were done. The prevalence of PsA, age, sex, clinical variants of PsA, and psoriasis type were assessed.

Results:
The prevalence of psoriatic arthritis was 0.02% during the period of study, mean age of participants was 44 ± 33. Obesity and overweight were reported by 34.75%, smoking by 24.58% with significant association with gender, also 28.81% with family history more in females. Regarding comorbidity, 33.9% of patients were suffering from metabolic syndrome, 23.72% with dyslipidemia, 22.88% with hypertension, and 17.8% with diabetes. Higher percentages (65.31%) of polyarthritis had family history followed by oligoarthritis (24.45%) and distal interphalangeal (10.20%). However, the association between types of arthritis was found to be statistically nonsignificant. Regarding the distribution of study sample according to the types of treatment, higher percentage of patients (72.88%) were on methotrexate (MTX) followed by NSAIDs (64.4%), while the lower percentage (4.7%) for Golimumab.

Conclusions:
A high percentage of comorbidities such as metabolic syndrome, diabetes mellitus, hypertension, dyslipidemia, and obesity were observed. Psoriasis vulgaris was the most common type of skin lesion associated with axial involvement. Family history was associated with oligoarthritis more than other types. The first choice of treatment was MTX.
Evaluation of anxiety and depressive symptoms in a sample of adult patients with cancer at Al-Furat Cancer Hospital/Najaf
Authors: Al-Saffar Hussein Amer Hussein , Hussain Nibras Alaa 
Published: February 2024

AbstractBackground:Cancer patients’ mental well-being negatively impact on treatment tolerance, reduces the effectiveness of chemotherapy, prolong hospitalization, increase healthcare cost, would lower life expectancy, and poor quality of life.Objectives:The objectives are to evaluate the rate of anxiety and depressive symptoms across adult cancer patients and to find its association with some sociodemographic factors.Materials and Methods:A cross-sectional study was carried out in Al-Furat Cancer Hospital in Najaf/Iraq, from April 10 to July 10, 2022. All convenient patients who were admitted to the hospital during the study period were included. The data were collected by interviewing the patient using semiconstructed questionnaire, and Hospital Anxiety and Depression Scale was used. Chi-square and independentttests were used.Results:Among a total of 470 patients, the mean age was 54.1 ± 14.2 years, 284 (60.4%) were female, and 364 (77.4%) were married. About 183 (38.9%) patients had anxiety disorder, and there was a significant association among gender, marital state, occupation, presence of pain, and having gynecological cancers with anxiety. Around 163 (34.7%) of patients had depressive symptoms. The study showed a significant association among gender, occupation, low income, and the presence of a positive family history of cancer, metastasis, and pain with depression.Conclusions:More than one-third of the sample suffered from anxiety and depression; females more than males. There was a significant association between anxiety/depression and gender, occupation, and presence of pain.
Serum erythropoietin level in anemic and non-anemic patients with chronic leukemia
Authors: Hussein Ali Hasan Allami , Mohammad Najlaa Bader Al-Awadi , Farhood Rwaa G 
Published: February 2024

Abstract

Background:
Anemia is a common issue in chronic leukemia, which results in a worse outcome and shorter survival. Inadequate production of erythropoietin (EPO) as compared to the severity of anemia may play a major role in ACD for patients with hematological malignancies. Clarifying the role of EPO may provide a better understanding of its pathogenesis, and proper management of patients.

Objectives:
To determine serum EPO levels and look for any potential link between EPO and the cause of anemia in anemic patients with chronic leukemia in a sample of Iraqi patients in the middle euphrates region.

Materials and Methods:
This is a case control study included 38 patients (19 chronic myeloid leukemia [CML], 19 chronic lymphocytic leukemia [CLL]) who were attending the outpatient clinic of hematology in Baghdad Teaching Hospital, Marjan Teaching Hospital from September 2022 to March 2023, together with 30 adult participants without disease as a control group. All patients involved were diagnosed as having a disease based on a specialist’s physical examination, morphological evaluation of peripheral blood films and bone marrow, and flow cytometric immune-phenotypic profile. Blood samples were collected from each subject, and the following investigations were done: CBC, RFT, blood film examination, and ELISA assay for serum EPO.

Results:
The mean age of CML patients was (50.1 ± 12.85) range from 24 to 72, CLL patients (58.2 ± 10.4) range from 38 to 75. The majority of patients were men (N = 23, 60.5%). The participants in the patient group were subdivided into 18 (47.4%) patients with anemia and 20 (52.6%) patients without anemia. The mean differences of EPO concentration (U/L) between study groups demonstrated significant higher level among patient group (49.53 ± 56.82) than control group (12.73 ± 4.72) with P value < 0.0001. The level of serum EPO in anemic patients (89.28 ± 61.95) has been found to be higher than non-anemic patients (13.82 ± 4.43) and it was statistically significant (P < 0.0001). Endogenous EPO production was found to be defective in 10% of CML patients, 50% of CLL patients were judged by a value for the ratio of observed-to-predicted serum EPO levels (observed/predicted ratio) of ≤0.9.

Conclusion:
These findings indicate that anemia associated with hematologic malignancy may result from an inappropriately low EPO response. EPO treatment should benefit in this group of patients.
Comparison of placental expression of basic fibroblast growth factor and insulin-like growth factor-1 in placentae of normal, pregnancy-induced hypertension, and preeclamptic pregnancies in Iraqi mothers
Authors: Al-Rubai Abdal-jabbar , Ibraheem Mustafa Mohammed , Hameed Ahmed Fakhir , Noel Khalida Ibrahim , Eleiwi Samia Abbas 
Published: February 2024

Abstract

Background:
Many pathological insults are associated with elevation of blood pressure levels during pregnancy resulting in a difficult pregnancy and a poor outcome on both mother and baby.

Objective:
In this study, we examine the histological and immunohistochemical markers of the placentae in cases of hypertension in pregnancy and preeclampsia and compared them to a placenta of normal pregnancy among a random sample of Iraqi pregnant women.

Materials and Methods:
Ninety women divided into three groups, 30 in each, selected with straightforward pregnancies (Group A), mothers with pregnancy-induced hypertension (Group B), and preeclamptic mothers (Group C) were chosen from the indoor patients of the gynecology and obstetrics department of Al-Khansaa teaching hospital in Mosul for placental tissues examination. Histological examination was done by using hematoxylin and eosin stain (H & E), and immunohistochemistry was achieved by using immunohistochemical markers named: insulin-like growth factor-1 (IGF-1) and basic fibroblast growth factor (b-FGF) markers, which are expressed in placental tissues.

Results:
Different changes were observed in the placentae affected when compared with normal one, such as syncytial knots formation, thickening of trophoblastic basement membrane, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, calcified and hyalinised villous spots, villous edema, and atherosis of the uteroplacental arteries. Significant immunohistochemical changes were obtained when compared with normal placentae where elevation of both b-FGF and IGF-1 in preeclamptic placentae was observed when compared to hypertensive and control cases.

Conclusion:
Significant changes appeared in the placentae of hypertensive and preeclamptic mothers, both in histological and immunohistochemical examinations.
Relationship between modifiable atherosclerotic cardiovascular risk factors and coronary artery bifurcation lesion
Authors: Aljubawii Ameer Ahmad Abd AL-Ameer , Ali Ali Ibrahim , Al Mamuri Hassan Ali Essa 
Published: February 2024

Abstract

Background:
Modifiable atherosclerotic cardiovascular disease risk factors are hypertension, diabetes mellitus, dyslipidemia, cigarette smoking, and obesity; the term coronary artery bifurcation is used when a coronary artery divides into two hemodynamically important branches or when the main branch has a hemodynamic significant side branch, bifurcation lesion represent 20% or more of coronary artery stenoses undergoing angiography.

Objectives:
To evaluate the relationship of hypertension, diabetes, dyslipidemia, cigarette smoking, and obesity to coronary bifurcation disease.

Materials and Methods:
In a cross-sectional study conducted in the Iraqi Center for Heart Diseases from May 2020 to May 2021, a total of 140 adult patients (70 cases with coronary bifurcation lesions and 70 control cases with non-bifurcation lesions) with angiography-documented stenotic coronary artery disease (CAD) were defined. Case demographics and modifiable CAD risk factors were addressed.

Results:
In the bifurcation group, the non-bifurcation lesion was mostly an associated angiographic finding (82%). The most significantly correlated atherosclerotic risk factor with bifurcation lesion compared to non-bifurcation lesion was diabetes, followed by systemic hypertension. Dyslipidemia was the most common prevalent risk factor, equally distributed in both groups. Smoking and obesity were distributed nearly equally in both groups.

Conclusion:
There is a significant relationship between diabetes and hypertension with coronary bifurcation lesions compared to non-bifurcation lesions.
Studying the immunological dysregulation in women with gestational diabetes mellitus
Authors: Al-Shujiry Hajar Dawood Salman , Al-Shibly Ifad Kerim Abd , Al-Hasnawy Huda H 
Published: February 2024

Abstract

Background:
“Gestational diabetes mellitus (GDM)” is the most prevalent pregnancy-related metabolic condition, and its prevalence is rising globally. It is responsible for hyperglycemia in “pregnant women.” Early detection of pregnant women at risk of GDM is the first step toward administering effective preventative measures to reduce maternal and neonatal problems. The accurate identification of GDM is still debatable, and interleukin-1-beta (IL-1β), IL-18, and nod-like receptor protein 3 (NLRP3) are the most recent markers utilized in the diagnosis of GDM.

Objective:
The goal of this study was to determine (NLRP3, IL-1β, and IL-18) levels in the serum of women with GDM to know their role in immunological dysregulation in women with GDM.

Materials and Methods:
In this study, 89 individuals were used from August 2022 to December 2022; a total of 29 healthy participants and 60 pregnant with GDM were recruited. Healthy pregnancy and research participants ranged in age from 23 to 47 years, and all of them were analyzed using serum blood samples (3 mL).

Results:
Sixty patient women affirmatives out of 89 using enzyme-linked immunosorbent assay (ELISA); we determined that our GDM participants met the inclusion criteria. The findings of the (NLRP3, IL-1β, and IL-18) ELISA kit indicated that the level of markers was greatest in GDM (P = 0.01). The detection of (NLRP3, IL-1β, and IL-18) is made possible by using ELISA kit. This suggests that the levels of these markers are higher in pregnant patients than in controls.

Conclusion:
Patients in Babylon Province with GDM had significantly higher than average levels of (NLRP3, IL-1β, and IL-18).
Association between interleukin-1 receptor polymorphism and human herpesvirus 8 among lymphoma patients
Authors: Abbas Al-Jawdhari Ameer J , Mohammed Al-Alwany Shakir H 
Published: February 2024

Abstract

Background:
Human herpesvirus 8 (HHV-8) stimulates lymphoproliferation, by activating the signaling pathway of the interleukin-6 receptor, along with several other regulatory mechanisms. The presence of specific genetic variations governing immune responses can impact the promotion or suppression of malignant lymphoma. Polymorphisms in the gene cluster of interleukin-1 (IL-1) have been identified as significant contributors to the regulation of inflammation.

Objective:
This study aimed to determine the percentage HHV-8 and whether polymorphisms at IL-1 receptor antagonist (IL-1ra) locus modulate the risk of developing malignant lymphoma of a group of Iraqi patients in the Mid-Euphrates Sector, Iraq.

Materials and Methods:
A case-control study was conducted on 200 specimens obtained from patients with lymphoma and individuals without any apparent health conditions who served as the control group (considered normal individuals). The specimens were collected from various general hospitals and private clinics located in the Middle Euphrates region of Iraq. The study population included individuals aged between 17 and 75 years. Specimen collection took place between October 2022 and February 2023. Conventional polymerase chain reaction (PCR) was chosen for the detection of HHV-8 as well as IL-1ra gene polymorphism by sequencing.

Results:
According to PCR detection, 31 out of 64 (48.4%) of the specimens revealed PCR detection positivity for HHV-8, whereas 33 out of 64 (51.6%) specimens showed negative detection for HHV-8. The lymphoma which were most HHV-8-infected are related to the age stratum (56–75 years), accounted for 48%, whereas the age strata 15–35 years, and 36–55 years, each accounted for 23% and 29%, respectively.

Conclusion:
In view of the relatively small numbers included in our study, the present results indicate the possibility that HHV-8 and IL-1ra polymorphism may play a role in the tumor biology of lymphocyte and may contribute to their development.
Evaluation of the level of the inflammatory factor interleukin-6 in patients with polycystic ovaries and insulin resistance
Authors: Hussein Zahraa Emad , Mohammed Rehab J , Abdul Wahid Hameedah H 
Published: February 2024

Abstract
Polycystic ovarian syndrome (PCOS) is a prevalent endocrine disease, with a rate of 6%–20% among females of reproductive age, according to the diagnostic criteria represented by the high male hormone, irregular menstruation, imbalances in hormones, and metabolic disorders. Insulin resistance (IR) is an imbalance in the amount of insulin secreted. This raises the danger of type 2 diabetes and heart disease. Evaluate the inflammatory factor (interleukin-6 [IL-6]) in the serum of those with IR and PCOS and its comparison with the control group. A case and control study included 80 females of reproductive age (16–40) years; 40 females had IR and polycystic ovary syndrome taken as the first group, as for the second group included 40 healthy women. Every sample was taken between October 2022 and February 2023. The following analysis was done (IL-6). The study’s findings showed a difference in the biostatistics of the level of IL-6 between the PCOS and IR group with the control group, as well as when compared in the group of patients in terms of age, it showed the correlation factor between IL-6 and IR. It was found that the level of IL in those with PCOS and IR was higher than the control group, as well as the increase in age in the group of patients, the level of IL-6 increased, and it showed that there was no significant value between IL-6 and IR.