Correction: Sugar-Sweetened Beverage Consumption and Its Association With Dental Caries Among Adolescents in Erbil, Iraq: A Cross-Sectional Study.

[This corrects the article DOI: 10.7759/cureus.58471.].

Sugar-Sweetened Beverage Consumption and Its Association With Dental Caries Among Adolescents in Erbil, Iraq: A Cross-Sectional Study.

Background Sugar-sweetened beverages are one of the most common sources of added sugar in the diet and have been associated with an increased risk of dental caries, obesity, major chronic diseases, and possibly cancer. Dental caries is a diet-related, highly prevalent, and preventable oral disease. The objective of this study was to assess the frequency of sugar-sweetened beverage consumption and its association with dental caries in adolescents in Erbil, Iraq. Methods This is a cross-sectional study that invited 11- to 16-year-old intermediate school students (n=380) in Erbil, Iraq. Data collection comprised a validated questionnaire and a clinical examination. In addition, dietary data were collected by using two non-consecutive 24-hour recalls. The mean of the daily consumption of sugar-sweetened beverages over a two-day period was calculated. Dental caries was diagnosed based on World Health Organization (WHO) criteria and was reported as a decayed, missing, and filled permanent tooth (DMFT). A multiple regression model was used to assess the influence of sugar-sweetened beverages on dental caries experience (DMFT). SPSS version 26 (Armonk, NY: IBM Corp) was used to analyze the data at the 5% significance level. Results Of the 380 students interviewed, one participant was excluded because of incomplete data. The participant's mean age and standard deviation (SD) were 13.3±1.2. A total of 54.1% of the students were female. The mean daily intake of sugar-sweetened beverages was 686.71±197.50 mL per day. Male students consumed more beverages than female students (p<0.001). The most frequently consumed sugar-sweetened beverages were sweetened tea and coffee, and the least frequently consumed beverages were milk and dairy products. The mean decayed, missing, and filled permanent tooth (DMFT) was 94.58±2.73. Results of multiple regression analysis showed that caries experience (DMFT) was associated with insufficient toothbrushing (p<0.001), plaque-affected sextants (p=0.001), and male sex (p=0.016). The model also showed a significant association between sugar-sweetened beverage consumption and dental caries experience (DMFT) (regression coefficient=0.008, CI: 0.006-0.009, p<0.001). Conclusions Adolescents in Erbil, Iraq, consumed sugar-sweetened beverages on a frequent basis, and male students consumed more sugary beverages than females. The higher frequency of these beverage consumptions was associated with a higher dental caries experience. Consequently, reducing sugar-sweetened beverage consumption could have a significant positive public health impact.

Peer-Assisted Learning Versus Faculty-Led Teaching of Interviewing Skills: A Comparative Study.

OBJECTIVE: To assess the impact of peer-assisted learning (PAL) on students' proficiency in patient interviewing skills and to explore medical students' perception on peer tutors in educational setting. METHODS: A cross-sectional observational study was performed in the College of Medicine, Hawler Medical University, Erbil, Iraq between September 2021 and November 2021. The participants included second year medical students who were attending the Integrated Basic Sciences (IBS) module. The peer tutors were chosen from a group of sixth year medical students who had completed an intensive 18-hour communication skills course. The summative video assessment marks of study participants and their perceptions on the process were compared between the faculty-led group and the peer-assisted learning (PAL) group. RESULTS: Peer-assisted learning group (n = 83) had significantly higher mean (SD) scores compared to those in the faculty-led group (n = 92), [74.6 (8.1) vs 70.4 (7.1), P ˂ 0.001]. Encouraging feedback was received from students regarding the PAL sessions with most positive feedback being from ease in asking questions. CONCLUSIONS: Peer-assisted learning improved students' performance in patient interviewing skills and fostered positive perceptions of the learning experience.

Characterization and Isolation of the Major Biologically Active Metabolites Isolated from Ficus retusa and Their Synergistic Effect with Tetracycline against Certain Pathogenic-Resistant Bacteria.

Globally, pathogenic microbes have reached a worrisome level of antibiotic resistance. Our work aims to identify and isolate the active components from the bioactive Ficus retusa bark extract and assess the potential synergistic activity of the most major compounds' constituents with the antibiotic tetracycline against certain pathogenic bacterial strains. The phytochemical screening of an acetone extract of F. retusa bark using column chromatography led to the identification of 10 phenolic components. The synergistic interaction of catechin and chlorogenic acid as the most major compounds with tetracycline was evaluated by checkerboard assay followed by time-kill assay, against Bacillus cereus, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, and Salmonella typhi with fraction inhibitory concentration index values (FICI) of 0.38, 0.43, 0.38, 0.38, 0.38, and 0.75 for catechin and 0.38, 0.65, 0.38, 0.63, 0.38, and 0.75 for chlorogenic acid. The combination of catechin and chlorogenic acid with tetracycline significantly enhanced antibacterial action against gram-positive and gram-negative microorganisms; therefore, catechin and chlorogenic acid combinations with tetracycline could be employed as innovative and safe antibiotics to combat microbial resistance.

Exploring Iraqi people's perception about early marriage: a qualitative study.

BACKGROUND AND OBJECTIVE: Early marriage is prevalent in Iraq, but the factors related to this behavior, especially people's attitudes about it, have not been well studied. It has been proven that early marriage seriously threatens young girls' lives and health. This study aimed to explore the perception of people about early marriage in the Iraqi Kurdistan region. METHODS: A qualitative method was employed to carry out this study in 2020. Data were collected through 16 focus group discussions in different health centers in Erbil, Iraq. Each focus group included 8-12 participants who had the experience of early marriage. The transcripts of the focus groups were analyzed through the six methodological activities of Van Manen. The trustworthiness of the data was confirmed by using qualitative data evaluation criteria. RESULTS: Different themes and subthemes regarding the ideal age of marriage, attitudes toward marriage, reasons for early marriage, advantages and disadvantages of early marriage, and practice of early marriage in the community emerged from focus group discussions. Most participants identified early marriage as inappropriate social behavior that should not be practiced. Reasons for early marriage included poor economic status, protection of girls and boys, low educational level, and respect for old traditions of the community. Divorce and violence against women were the main disadvantages of early marriage. CONCLUSION: There is a generally negative attitude towards early marriage, and the practice's disadvantages and health and psychological consequences are well recognized in Iraqi Kurdistan Region. However, different social, traditional, economic, educational, and religious factors encourage early marriage in the region. Further research is recommended in other governorates in the area to have a more precise and representative idea about the topic.

Substance use among high school students in Erbil City, Iraq: prevalence and potential contributing factors.

BACKGROUND: Substance use among adolescents, especially smoking and alcohol consumption, has become a public health concern in the Kurdistan Region, Iraq, in the past 10 years. AIMS: This study aimed to determine the prevalence of substance use and certain associated factors among high school students in Erbil City, Kurdistan Region, Iraq. METHODS: A cross-sectional study was conducted using a multistage cluster sampling technique to collect a sample of 3000 students. A modified version of the School Survey on Drug Use from the United Nations Office on Drugs and Crime was used for data collection. Binary logistic regression models were used to identify risk factors for substance use. RESULTS: The lifetime prevalence rates of cigarettes smoking, waterpipe smoking and alcohol consumption were 27.6%, 23.6% and 3.7%, respectively. Male gender, age 17-19 years, smoker in the family, and easy accessibility of cigarettes were significantly associated with cigarette smoking. Factors significantly associated with waterpipe smoking were male gender, age 17-19 years, waterpipe smoker in the family, waterpipe smoker friend, and easy accessibility. Male gender, alcohol dependent in the family, alcohol-dependent friend, easy accessibility of alcohol, and low family income were significant predictors of alcohol consumption. CONCLUSIONS: The prevalence of cigarette smoking and waterpipe use was high in the studied sample. Possible explanations for this finding might be the use of flavoured tobacco associated with aromatic smell, and the misconception that waterpipe smoking is less toxic and addictive than cigarette smoking.

Cooking with EDTA reduces nutritional value of Vicia faba beans.

Ethylenediamine terta-acetic acid (EDTA) used to accelerate the cooking process of Vicia (V. faba) beans. In this study, the effect of cooking with EDTA on the nutritional value of V. faba beans was addressed. Water contents, total proteins, lipids, carbohydrates, minerals and amino acids were determined before and after boiling with EDTA (2 g/L). In both of whole beans and seed coats, the water content was increased after boiling with EDTA. In contrast, the levels of proteins, lipids and carbohydrates were significantly decreased in both the whole beans and seed coats upon boiling with EDTA. Furthermore, the levels of sodium were increased while, the levels of other minerals were decreased. All amino acids were significantly decreased in the whole beans and increased in the seed coats after boiling with EDTA. EDTA addition to V. faba beans during the cooking process decreased the nutritional value of the cooked V. faba beans.

Impact of an education intervention on knowledge of high school students concerning substance use in Kurdistan Region-Iraq: A quasi-experimental study.

BACKGROUND AND AIMS: Substance use among adolescents especially smoking, is becoming a public health problem in the Kurdistan region of Iraq. School-based health education is an appropriate approach for improving students' knowledge regarding substance use in an attempt to prevent or reduce such problem The purpose of the study was to examine the effect of an educational intervention for high school students to improve their knowledge for substance use and its negative consequences, which will, in turn, motivate students to take protective measures against substance use. METHODS: This quasi-experimental (one group; pre, and post-test) design was carried out in Erbil city from January 2017 to June 2017. A random sampling technique was employed to collect a sample of 280 students amongst four high schools in Erbil city which is the capital of Kurdistan Region-Iraq. A self- administered questionnaire on knowledge assessment regarding substance use was developed and validated by the experts regarding the relevance of the items. A structured teaching program for imparting knowledge on various aspects of substance use was developed based on extensive review of literature and experts' opinion. The intervention program consisted of a series of 4 education modules. These modules were mainly taught by "Rabers" over a period of four weeks (one session per week). SPSS version 21 was used for data entry and analysis. Data was analyzed through descriptive and inferential statistics (McNemar tests, paired t-test, and Chi-square test). RESULTS: Out of 280 students, a total of 270 students completed a pre and post-intervention survey. Of the 270 students, 124 (45.9%) were males and 146 (54.1%) were females. The mean age ± SD of the participants was 16.59 ± 0.784 years, ranging from 15-18 years. The study reveals a statistically significant improvement in the mean score of knowledge of students following the implementation of a health education program from 15.959 ± 3.25 to 20.633 ± 3.26 (p < 0.001). Moreover, no one of the students remained with poor knowledge, and relatively more than half (50.2%) of the students have upgraded to good knowledge level. CONCLUSION: Implementing a health education program about substance use on high school students in Erbil city had improved the knowledge of students about this topic.

Knowledge about HIV/AIDS among high school students in Erbil city/Iraq.

BACKGROUND & OBJECTIVES: HIV/AIDS is as a major public health problem which leads to serious challenges to humankind globally. The aim of this study was to assess the knowledge about HIV/AIDS among high school students in Erbil city and to investigate the association between high school students' socio-demographic characteristics and their level of knowledge about HIV/AIDS. METHODS: This descriptive cross-sectional study was carried out in three high schools in Erbil city from February to April 2014. A sample of 437 students was included in the study from fourth, fifth and sixth stages. A multistage cluster sampling method was used to select the students. Data analysis included descriptive statistics and chi-square association test for categorical variables. RESULTS: The age range of the students was between 14 and 21 years with mean ± standard deviation of 16.0 ± 0. 927 years. All the students had heard about AIDS where around two thirds of students had heard from mass media like TV/Radio. Around 45% of students had good knowledge scores about HIV/AIDS, and 43.7% had acceptable knowledge scores, while only 11.2% had poor knowledge scores. There was a statistically significant association between high knowledge score about HIV/AIDS with older age, male gender, and typical school type (P < 0.001). High socio-economic status of students was significantly associated with high score of knowledge about HIV/AIDS (P = 0.005). CONCLUSION: The overall rate of knowledge (acceptable and good) about HIV/AIDS among high school students was high. Socio-demographic characteristics of students have an effect on their knowledge about HIV/AIDS.