War-related mental health disorders among Iraqis 10 years after the 1991 gulf war: a comparative study of soldiers and civilians living under sustained socio-environmental stress

Prior studies of mental health consequences of the Gulf War [GW] have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress. A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder [PTSD], were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure. Iraqi soldiers reported significantly more depression [Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1] and anxiety [OR 3.9; 95% CI, 1.2-13.3] compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter [OR 104.6; 95% CI, 28.0-390.8] and anxiety [OR 4.1; 95% CI, 1.5-11.1]. The highest self-reported trauma exposure occurred in the southwest of Iraq. Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations

Clinical and microbiological evaluation of Osteomyelitis

To investigate clinical aspects and aetiological agents of osteomyelitis with special emphasis on anaerobic infection. Setting: Basrah University Teaching Hospital, Iraq. Design: A prospective study. Aerobic and anaerobic cultures were made for all cases. The inoculation of operative material on culture media was performed by the bedside. The study included 134 patients with osteomyelitis. The cases were divided clinically into 4 main groups: haematogenous, exogenous, postoperative and mastoiditis. Staphylococcus aureus was the most common causative agent in haematogenous osteomyelitis whereas Pseudomonas sp. were the most common causative organisms in postoperative and mastoiditis groups of bone infection. The total number of isolated bacteria was 224, of which 50 [22%] were anaerobes. These anaerobes were isolated from 39 [29%] of 134 patients. The anaerobic organisms were found most frequently in the cases of chronic mastoiditis [57%] and erogenous osteomyelitis [40%]. High prevalence rate of anaerobic bone infection was found specially in chronic cases. Thus, conventional treatment measures may not be beneficial and special type of management should be applied for these cases. Anaerobic culture is also recommended for all cases with osteomyelitis