Glycemic control among adult diabetics in post-conflict Iraq

To determine the level of glycemic control and factors associated with poor glycemic control among patients type 2 diabeties. A cross sectional study was carried out at National Diabetic Center at Al-Yarmouk teaching hospital and Diabetic consultancy clinic at Al-Kindi hospital. A total of 354 type 2 diabetic patients were enrolled in the period from 1st June to 31st July, 2012. They were selected by systematic random sampling. A face to face interview was done and filling a questionnaire [demographic, lifestyle, socioeconomic, health, clinical characteristics and glycosylated hemoglobin test]. A review of patient's records was taken place too. Out of the total sample, 47.5% had glycemic control [HbA1c<7]. High body mass index, long duration and no self-monitoring of blood glucose were significantly associated with poor glycemic control [p=0.04, 0.001 and 0.002, respectively]. Glycemic control rate are needed to raise because it was low. Further efforts are needed by controlling obesity and training on self-monitoring blood glucose

Changes in personality and mood profile of women with toxoplasmosis

Acquired T. gondii infection of immunocompetent patients may cause central nervous system manifestations [Gullain-Bare syndrome or brain abscess] and may be associated with psychiatric manifestation. Iraq is highly endemic with T. gondii, however, publications on psychiatric manifestation of T. gondii infection are scarce. To demonstrate psychiatric manifestations in women with Toxoplasmosis. A total of 68 toxoplasma positive pregnant women and 68 toxoplasma negative pregnant women were included in this study. It was conducted for the period of 5[th] Aug. 2008 to 28[th] Feb. 2009. ELISA was used to diagnose T. gondii. Questionnaire was used to diagnose personality type and depression was used. The diagnosis was according to ICD[10] and DSM-IV. Rates of pseudpsychopathic and limbic personality epilepsy syndrome were significantly high among toxoplasmosis positive pregnant women. Significant high rate of depression was associated with acquired T. gonii infection. These findings might provide evidence supporting role of T. gondii infection in the onset of some behavioral disorders

Mental health of Iraqi adolescents

To estimate the prevalence of flourishing and the association of mental health status with the socio-demographic characteristics and conduct problems of adolescents. A total of 8807 adolescents were included in this study. Data were obtained from knowledge, attitudes and practices household survey carried out in 2004. Each adolescent was interviewed by a trained team and a specially designed questionnaire was filled. Emotional, psychological and social well-beings were assessed through a series of measurements. Conduct problems were measured by self-reporting of school skipping, smoking, alcohol drinking, inhalant use and arrestment. The prevalence of flourishing, moderate mental health status and languishing were 5.6%, 20.3% and 74.1%, respectively. The prevalence rates of school skipping, smoking, and other conduct problems [alcohol drinking, inhalant use, and arrestment] were 60.1%, 62.8% and 59.2%, respectively. Mental health was significantly associated with age, educational level, and various conduct problems [p<0.001]. No significant sex variation was demonstrated. Flourishing was significantly decreasing with advancing age [p<0.0001] and it was significantly lower among smokers [p<0.0001], and those with other conduct problems [p<0.0001]. The low rate of flourishing among adolescents was associated with a high rate of conduct problems which could be a psychological response to the stressful condition prevailing in the country during the last 3 decades

Posttraumatic stress disorder among emergency ambulance personnel in Baghdad, Iraq

Emergency ambulance personnel [EAP] are vulnerable to posttraumatic stress disorder [PTSD]. In Iraq, EAPs were exposed to life threatening situation during political violence conflict post 2003 Gulf war. This study was carried out to report on PTSD among EAP. A total of 189 male EAPs [only one female in was in the emergency department] were selected randomly from the Deptartment of ambulance in Baghdad. A questionnaire form was filled for each EAP. The form included the symptoms of PTSD according to DSM-IV [intrusive, avoidance and hyperarousal symptoms]. Demographic data and exposure to violence accident, type of accident and duration of damage were included, also. The mean age of EAP was 38.5 +/- 9.4 years. There was 122 [64.5%] had PTSD. Age, education, marital status and years in emergency ambulance department were significantly associated with PTSD. High rate of PTSD among EAPs was reported. Measures to prevent PTSD and to give further support to EAP are needed. Further studies will clarify the situation of PTSD in Iraq

Prevalence of hepatitis C virus antibodies among health care workers in Baghdad, Iraq

There are several reports on the occupational risk of hepatitis C virus infection of health care workers [HCWs] by accidental inoculation of infected blood. This study was carried out to determine the prevalence of anti-HCV among a sample of Iraqi HCWs. A total of 1656 HCWs selected from various hospitals and medical units in Baghdad, together with 238 "apparently" healthy subjects [controls] were tested for anti-HCV from June 1995 to April !998. Serum testing was carried out by a third generation of enzyme immunoassay [EIA] for screening for anti-HCV and a third generation recombinant immunoblot assay [RIA-111] for confirmation of the presence of HCV antibodies. A higher rate of anti-HCV [1.51%] was observed among HCWs than controls [0.84%]. The highest prevalence rate of anti-HCV was detected in the renal dialysis group [6.25%] followed by the dentistry group [4.26%]. These were the only groups having a statistically significant higher prevalence of anti-HCV than controls when each group was compared with controls. An increase in the prevalence of anti-HCV with duration of professional practice was demonstrated. The highest rate of anti-HCV was detected among HCWs in cardiovascular surgery hospitals [4.21%] followed by infectious disease hospitals [3.37%]. Efforts to reduce exposure to blood and other body fluids are needed to reduce the risk of the occupational transmission of HCV infection, as no vaccine against HCV infection is available yet

Brain abscess in Iraq during a 10 years period: part 1. epidemiology, aetiology and clinical picture

This study comprises two parts, [this part deals with epidemiology, aetiology and clinical features of brain abscess during a 10 years period, while the second will deal with diagnostic investigation, management and final outcome of brain abscess. The case records of patients with brain abscess admitted to the neurosurgical specialties hospital in Baghdad over a 10 years period extending from 1[st] Jan. 1993 to 31[s] Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. A total of 78 cases [1.2% of total admission] of brain abscess were admitted. Their age ranged from one month to 68 years. The most common aetiological factor was cyanotic heart disease, with the congenital anomaly being unrepaired in all cases. Remote infection foci other than the heart represented minority. Half of the cases had a rapid onset and fluminant progression. The presenting features of the patients older than one year were raised intracranial pressure, and focal neurological deficit and infection. Maintaining a high index of clinical suspicions in patients having one of the infection sources together with neurological signs should be emphasized

Brain abscesses in Iraq during a 10 years period: Part 11. Diagnostic investigations, management -and outcome

This study comprises two parts, the first one dealt with epidemiology etiology and clinical picture of brain abscess. This part describes diagnostic investigation management and final outcome of brain abscess during a 10 years period. The case records of patients with brain abscess admitted to the neurosur, specialties hospital in Baghdad over a 10 years period extending from 1 "Jan. 1993 to 31 " Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. Results of peripheral leukocytes count, ESR and CSF were supportive in 16.7%, 67.9% 78% of cases in which tests were applied, respectively. CT scan was suggestive in 100% of cases. Use of antibiotic therapy as a preliminary treatment line was adopted in 37.8% cases, while surgery as a preliminary line of treatment was adopted in 62.3% of cases. Out 68 cases, complete resolution was encountered in 70.6% ol'cases, sequlae in 11.8% and death in 17.9%. Bad neurological 'status on admission was the most encountered contributing factor for death. Metastasis from a remote infection process is a risky aetiology contributing to bad prognosis. The use Of C I Scan represents all important change in the diagnostic regimen brain abscess in the last 10-15 years

Malnutrition among first year school children in Iraq

Iraqi people have endured an excess burden of morbidity and mortality during the last two decades due to wars and sanctions. This report was carried out to assess the nutritional status of first year primary school children. A total of 3881 school children in Balad district in Salahadin governorate was included in the study. Age, height and weight were recorded. Malnutrition was regarded as value of less than 2 SD of the reference value. Among the total sample, 16.5%, 20.06% and 15.3% were underweight, stunted and wasted, respectively. No significant difference was detected in malnutrition rates between both sexes. High rates of malnutrition were detected among school children

HBV markers and antibody protective level among Iraqi vaccinated and unvaccinated subjects

Iraq is among countries of intermediate hepatitis B endemicity. Although several studies have been carried out on the prevalence of HBV markers, no previous study was done to determine the protective antibody level after HBV vaccination. Therefore, this study was carried out to detect HBV markers and antibody protective level among vaccinated and unvaccinated Iraqi subjects. A total of 400 subjects [298 thalassaemic patients and 102 [healthy] subjects] were included in the study for the period 1[st] Oct. 2002 to 28[th] Feb. 2003. Thalassaemic patients represent the vaccinated group, and the [healthy] subjects represent the unvaccinated control group. The same rate of HBsAg was detected in vaccinated and unvaccinated groups [2%]. Protective anti-HBs level was demonstrated in 229 [76.8%] and 25 [24.5%] of vaccinated and unvaccinated groups, respectively. The protective rate of protective level of anti-HBs among those who receive three primary doses of vaccine [77.7%] was significantly higher than among those who did not complete the course of vaccination. The rate of protective anti-HBs level among those who received the full course of vaccination is lower than that reported in literature. Improper vaccination or handling of the vaccine could also contribute to this low level as result of deterioration of health services during the last 2 decades

Lipid profile among diabetics in Al-Ramadi City, Iraq

Hyperlipidemia is a strong predictor risk of cardiovascular events. There are insufficient data on the lipid profile in diabetics in Iraq. This study was carried out to determine the lipid profile among diabetics in AI-Anbar governorate. A total of 136 diabetics [116 were with type 2 diabetes and 20 were with type 1 diabetes] attending Al-Ramadi general hospital, A l-Anbar, were included in the study. Total cholesterol, triglyceride [TG], high density lipoprotein [HDL], low density lipoprotein [LDL] and very low density lipoprotein [VLDL] were estimated. Elevated total cholesterol, HDL, LDL, VLDL and TG were detected among patients with type I and type2 diabetes. Only level of TG was associated with the duration oftype2 diabetes, while levels of LDL, VLDL and HDL were significantly associated with duration of type 1 diabetes. Lipid and diabetes awareness program for Iraqi population should be applied in an attempt to improve the overall health status of Iraqi population

CMV infection among HIV/AIDS patients in Iraq

The aim of the study was to determine the prevalence of CMV infection among HIV/AIDS patients in relation to disease progression, and to study the mortality during the period of the study. The study included 155 HIV/AIDS patients [148 HIV- infected and seven AIDS patients] and 122 apparently "healthy" controls. CMV [IgG and IgM] antibodies "were determined by ELISA. The patients were followed up for a period of nine months, and retested frequently for development of active CMV infection. The prevalence of CMV [IgG] antibodies in the HIV/AIDS patients was 100%. A significant higher prevalence of CMV [IgM] among AIDS patients [42.9%] than among HIV infected patients [0.0%] and "healthy" controls [0.8%]. No deaths were reported among asymptomatic HIV infected patients while the mortality among AIDS patients was [42.9%]. Only one patient [7.7%] out of 13 asymptomatic HIV infected developed active CMV infection 10 years later by testing for CMV [IgM] in 1991 and 2001. Demonstration of active CMV is of prognostic value in detection of development of AIDS and survival of patients

Neonatal infection in the neonatal unit at Baghdad Teaching Hospital, Iraq

In Iraq, the true magnitude of the neonatal among newborns receiving care is not known as health system was badly eroded in the last two decades. This work was carried out to find factors associated with neonatal infection among newborns receiving care in intensive unit. The records of a total of 723 neonates admitted to the neonatal intensive unit at Baghdad teaching hospital during the period Nov. 2003 to Oct. 2004 were reviewed. Information regarded birth weight, gestational age, medical history of the mothers, bacterial infections and management procedures were collected. Out of the total neonates, 9.3% had bacterial infection. Low birth weight, prematurity and prolonged rupture of membrane were factors significantly associated with bacterial infection [p = 0.001, 0.002 and 0.03, respectively]. Oxygen therapy, invasive procedures, and the nasogastric tube [p = 0.01] were significantly associated with infection. S. aureus, enterbacter and E. coli were the commonest pathogens. The study provides useful information for future surveillance in association with preventive program as there were several factors associated with neonatal infection which could be prevented

Prevalence of asymptomatic urinary tract infection among preschool female children in Babel governorate, Iraq

Urinary tract infections represent a major health problem in many parts of the world. The purpose of this report is to find out the prevalence of bacterial urinary tract infection in a sample of asymptomatic preschool female children and to identify the infecting organisms among them. Mid-stream specimens of urine were collected from 600 female children selected from various districts of Babel governorate. Bacterial cultures were performed on blood agar and MacConkey agar plates. Diagnosis of bacteriuria was made by bacterial count. A bacterial colony count of >/= 10[5]/ml of urine was considered as evidence of significant bacteriuria. The prevalence rate of significant bacteriuria among the 600 female children was 13.3%. Age variations of the prevalence of significant bacteriuria were of statistical significance. Prevalence of bacterium was significantly associated with the place of residence, educational level of mother, availability of a municipal piped water supply, birth weight, and prematurity of the child. The most frequently encountered bacterium was Escherichia coli which accounted for 75% of isolates. Asymptomatic urinary tract infection needs to be considered in young female children with underlying voiding anomalies. They should be referred appropriately for further evaluation and treatment

[Cigarette smoking among secondary school male students in Saddam city, Baghdad]

Smoking is one of the serious health problems in our society and in order to find out the size of the problem among the youth, secondary school male students from Saddam city were questioned. It was found that 57% of the students smoke either regularly[22%] or intermittently [35%] with 90% of them started smoking after the age of 12 years. Significant correlation was found between smoking and the number of the years of failure at the school, but there was no significant correlation between smoking and working after school hours. It was also found that 59.6% were not aware of the hazards of smoking which necessitate an urgent educational program to combat smoking especially among the youth

Comparative evaluation of three methods of diagnosis of schistosoma haematobium infection

A total of 100 urine samples were examined for S. haematobium infection by filtration, centrifugation and sedimentation methods. A significantly higher proportion of S. haematobium-ova was detected by filtration method [34%] than by centrifugation [24%] and sedimentation [19%] methods, and a higher intensity of infection was detected by filtration method as well. All patients with heavy infection [>/= 50 eggs/10 ml urine] detected by filtration technique were also positive by the other methods, while only 50% and 25% of those with light infection[< 50 eggs/10 ml urine] were positive by centrifugation and sedimentation methods respectively

Serum polyclonal immunoglobulin E levels among an apparently healthy Iraqi population: a preliminary report

The distribution of serum polyclonal I[g]E levels as determined by paper radiommunosorbent test was studied in 150 nonallergic, presumably health individuals. Prior to natural logarithmic conversion, the distribution was strongly skewed to the left, and normal distribution followed logarithmic conversion. The range of serum polyclonal I[g]E levels was 1 to 2439 micro g/L with a geometric mean value of 197 micro g/L. analysis of natural logarithm of serum polyclonal I%gE levels with age revealed no significant association. Higher levels were demonstrated among individuals 10 at 14 years old than among other age groups. No influence of sex on serum polyclonal I[g]E was demonstrated

Helminth-specific IgE and extrinsic allergen-specific IgE in patients with atopic diseases

To investigate the role of helminth-induced I[g]E in the worm-atopy relationship, the levels of I[g]E directed against helminthic antigens [Ascaris, Echinococcus, and Schistosoma] and total I[g]E were determined by radioimmunoassay in the sera of 106 atopic subjects, using extrinsic allergen-specific I[g]E. Ten patients were found to have detectable levels of helminth-specific I[g]E antibodies. The total I[g]E levels in these patients were approximately five-fold greater than those in patients with no detectable helminth-specific I[g]E. The differences were highly significant [P<0.005]. The results indicate that atopy could develop in individuals with parasite-specific I[g]E antibodies and that helminthic antigens strongly potentiate I[g]E-secreting plasma cells