Mandibular canal assessment in dentate and edentulous ridges of 400 Iraqi Arab and Kurdish populations using cone beam computed tomography.

Objectives: This study aims to compare differences in mandibular canal (MC) location between dentate and edentulous ridges, in the second premolar region as well as the first, second, and third molar regions using cone beam computed tomography (CBCT) of Arabic and Kurdish Iraqi populations. Materials and Methods: CBCT images of 400 subjects (200 Arabs, 200 Kurds) were collected from radiological archives. RadiAnt DICOM software (Medixant, Poland) was used for image analyses. Measurements were performed from MC to buccal and lingual alveolar crests and to buccal, lingual, and inferior aspect of the mandible for both dentate and edentulous ridges. Additionally, distance to the most superior aspect of residual edentulous ridge were performed. Independent t-test and Mann-Whitney U Test were performed utilising SPSS v.26. Results: Distances from MC to buccal and lingual alveolar crests were consistently lower in edentulous ridge compared to dentate ridge across all teeth regions. Distances to lingual and inferior border of the mandible were higher in edentulous ridge compared to dentate ridge of all teeth regions. Distances to buccal surface of the mandible varies with fluctuations of dentate and edentulous ridges displaying higher measurements. Distance to superior aspect of residual edentulous ridge revealed mean values in the range of 13.45 to 15.69 mm in Arabs and 13.96 to 16.37 mm in Kurds. Conclusions: Discrepancy in vertical position of MC was observed between dentate and edentulous ridges within Arab and Kurd populations. Horizontal position of MC was unaffected by tooth loss and found to be closer to lingual surface of all molars. The residual alveolar ridge was sufficient to accommodate the common length and width of dental implants. Clinical significance: The findings could play a crucial role in planning surgical interventions of the mandible, helping to prevent complications that might arise due to inadequate preoperative assessments.

Mandibular Clinical Arch Forms in Iraqi Population: A National Survey.

Background: This study aims to identify mandibular clinical arch forms and dimensions in the Iraqi population. Materials and methods: The study sample consisted of pre-treatment mandibular study models of the Iraqi population. The most labial aspect of 13 proximal contact areas was digitized using AutoCAD software to determine the clinical bracket point for every tooth. The dental arches were classified into three types: tapered, ovoid, and square. The arch dimensions were identified using four linear and two proportional measurements. Results: A total of 1005 study models were collected. The arch forms were distributed as ovoid (47%), tapered (36.2%), and square (16.8%), with no significant difference in the distribution between Arabs and Kurds. The ovoid arch form was predominant in class I and class III malocclusion, while the tapered arch form was predominant in class II. All the linear measurements were greater in the males than in the females. The arch widths decreased as the arch form shifted from square to ovoid to tapered, while the arch depths showed the reverse relation. Conclusions: According to this study, ovoid and tapered archwires should suit the majority of Iraqi patients. The ovoid arch form was the most predominant in the subjects with class I and class III malocclusion, while the tapered arch form was the most predominant in the class II subjects.

Impact of the Covid-19 pandemic on the elimination of hepatitis C virus in Duhok, Kurdistan, Iraq: A retrospective cross-sectional study.

BACKGROUND AND AIM: Infection with hepatitis C virus (HCV) is a public health threat worldwide. The World Health Organization aims to eliminate HCV. However, the coronavirus disease (COVID-19) pandemic has led to a severe compromise in health services, and this has halted efforts to eliminate HCV. Herein, we report our experience with the initiative of HCV elimination in Duhok city, Kurdistan Region of Iraq, with a focus on the effect of the COVID-19 pandemic on the HCV elimination plan. MATERIALS AND METHODS: An anti-HCV antibody test was used to screen subjects. All positive results were then confirmed by reverse-transcription polymerase chain reaction (RT-PCR) testing. All patients with current HCV infection were treated with direct-acting antiviral regimens. RESULTS: During the study period, 459,015 subjects were tested for anti-HCV antibody positivity, with a monthly average of 9,562 tests for HCV. This number dropped to zero during the lockdown period between 1March and 31May 2020. Among the tested samples, 0.29% (1350/459015) tested positive for anti-HCV antibodies. RT-PCR testing of all positive samples revealed that 0.020% (93/459015) were positive. Of the 93 recruited subjects, 3 patients did not complete the treatment course due to the lockdown. All patients who finished the treatment course were cured as determined by sustained virologic response 12 (SVR12) weeks after finishing the treatment course. CONCLUSION: During the COVID-19 pandemic, reductions in health facility utilisation led to a significant decrease in services offered for HCV screening and treatment. Such a decrease in services has had a negative impact on HCV elimination. An urgent plan is needed to resume the services, and strict follow-up is needed for patients whose treatment was interrupted.

Investigation of CYP1B1 Gene Involvement in Primary Congenital Glaucoma in Iraqi Children.

PURPOSE: Primary congenital glaucoma (PCG) is a severe type of glaucoma that occurs early in life. PCG is usually inherited in an autosomal recessive pattern. Cytochrome P450, family 1, subfamily B, polypeptide 1 (CYP1B1) gene is reported to be PCG-related gene. It codes for the CYP1B1 enzyme which is considered as phase I xenobiotic-metabolizing enzyme and its function is related to the eye oxidative homeostasis and correspondingly to the normal development of the eye. This is the first genetic study in Iraq that investigates the CYP1B1 polymorphisms behind the PCG disease. METHODS: Genomic DNA was extracted from the whole blood of 100 unrelated Iraqi PCG patients and 100 healthy children, all of them were aged between 1 month and 3 years. All the coding sequence of CYP1B1 gene was amplified using polymerase chain reaction; restriction fragment length polymorphism was used to follow G61E and E229K mutations. Direct sequencing was performed to screen for other mutations. RESULTS: CYP1B1 mutations were identified in 78 (78%) of the patients. We detected a total of eight mutations: Four missense mutations (c.182G>A, c.685G>A, g.6813G>A, and g.6705G>A), one silence mutation (D449D) and three insertions (g.10068ins10069, g.10138ins10139, and g.10191ins10192). Five mutations (g.6813G>A, g.6705G>A, g.10068ins10069, g.10138ins10139, and g.10191ins10192) are novel. G61E is the only mutation that was detected in patients merely. CONCLUSIONS: CYP1B1 mutation (G61E) is considered as PCG-related allele in the Iraqi population.

The treatment of HCV in patients with haemoglobinopathy in Kurdistan Region, Iraq: a single centre experience.

Various variables that might influence the rapid and sustained virological response to recombinant PEG-IFN-α-2a were explored in Iraqi HCV-infected patients with haemoglobinopathy. Forty-three patients were evaluated for the relationship between rapid virological response (RVR), IL-28B polymorphism, viral load, liver enzyme levels, blood group, ultrasound findings, or HCV genotype and the sustained virological response (SVR) achievement. The overall RVR was 55·81% while the overall SVR was 53·49%. SVR in patients that achieved RVR was 82·61% (P = 0·0004). A significant association was found between initial alanine transaminase levels and viral load with SVR achievement (P = 0·025) and (P = 0·004), respectively. Thirty-two (74%) out of 43 of our samples were host genotyped at the IL-28B locus as CC, a significant association was found between CC group and SVR achievement (P = 0·04). Of our samples, 23/43 (53%) were typed as HCV genotype 4, 10/43 (23%) as genotype 1, 9/43 (20·9%) as genotype 3 and 1/43 (2·3%) as genotype 2. A significant association was found between genotype 3 and SVR achievement (P = 0·006). Multivariate analysis showed that only RVR achievement independently associated with SVR in the Iraqi population (P = 0·00). These results can be used to classify the patients requiring the more expensive new direct-acting antiviral drugs.

The mental foramen II: radiographic study of the superior-inferior position, appearance and accessory foramina in Iraqi population / El foramen mental II: estudio radiográfico de la posición superior-inferior, aspecto y forámenes accesorios de una población Iraquí

Accurate information regarding the vertical location and appearance of the mental foramen, and the presence of accessory foramina, can have clinical significance, such as reducing complications that may occur during many oral surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to evaluate the above-mentioned variables in an Iraqi sample. Five hundred eighteen panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age= 46.5 years) were evaluated with regard to the above-mentioned variables, as well as the symmetry of the foramen regarding these variables. The area below the apices of mandibular premolars, and the continuous type were the most frequent vertical location and appearance of the mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more inferior positioning and continuous appearance. The vertical position and appearance were asymmetrical in 16.2 % and 20.1 % of cases, respectively. Symmetry in the vertical location was statistically significant between sexes (P= 0.035), and young and old ages (P= 0.000). Symmetry in the appearance was found statistically significant (P= 0.025) only between the two age groups. Accessory foramina were recorded in 7.3 % of cases. The most common vertical location and appearance of the mental foramen on panoramic radiographs in this group are below the apices of mandibular premolars, and continuous type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramen usually has symmetrical vertical location and appearance. Accessory foramina are recorded in a percentage lower than that recently reported in some regional countries.

La información precisa acerca de la localización vertical, apariencia del foramen mental y la presencia de forámenes accesorios, puede tener importancia clínica, como la reducción de las complicaciones que pueden ocurrir durante muchos procedimientos quirúrgicos orales relacionados con el mentón. Las variaciones geográficas fueron reportadas en estas variables. El objetivo fue evaluar las variables anteriormente mencionadas en una muestra iraquí. Fueron evaluadas 518 radiografías panorámicas de una muestra aleatoria de Irak (257 varones, 261 mujeres, edad media = 46,5 años) con respecto a las variables antes mencionadas, así como la simetría del foramen con respecto a estas variables. El área por debajo de los ápices de los premolares mandibulares y el tipo continuo, fueron la localización vertical y apariencia del foramen mental más frecuentes, respectivamente. La edad avanzada se asoció con un aumento en la frecuencia de posicionamiento más inferior y de apariencia continua. La localización vertical y la apariencia fueron asimétricas en 16,2 % y 20,1 % de los casos, respectivamente. La simetría en la localización vertical fue estadísticamente significativa entre sexos (p= 0,035), y entre jóvenes y viejos (P= 0,000). La simetría en apariencia sólo fue estadísticamente significativa (p= 0,025) entre los dos grupos de edad. Se registró presencia de forámenes accesorios en un 7,3 % de los casos. La localización vertical del foramen mental más común en las radiografías panorámicas de este grupo están por debajo de los ápices de los premolares mandibulares, y respecto a la apariencia, el tipo continuo fue el más común. Esto está en coherencia con los resultados de estudios anteriores en otras poblaciones. Los forámenes mentales tienen una localización vertical y apariencia que suelen ser simétricas. Los forámenes accesorios se registran en un porcentaje inferior al informado recientemente en algunos países de la región.

The mental foramen I: radiographic study of the anterior-posterior position and shape in Iraqi population / Foramen mental I: estudio radiográfico de su posición antero-posterior y forma en población iraquí

Accurate information regarding the horizontal location and shape of the mental foramen can have clinical significance, such as reducing complications that may occur during maxillofacial surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to study the horizontal position and shape of the mental foramen, as seen on panoramic radiographs of an Iraqi sample, to assess difference in these variables between sexes and age groups, and to assess symmetry of the mental foramen. 518 panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age=46.5 years) were evaluated with regard to the horizontal location, shape and symmetry of the mental foramina. The area between the long axes of the two mandibular premolars, and the round type were the most frequent horizontal location and shape of mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more posterior positioning and irregular shape. The horizontal position and shape were asymmetrical in 21.6% and 31.6% of cases, respectively. The Symmetry in horizontal location and shape of mental foramina were found statistically significant between sexes (P=0.041), and between young and old age groups (P=0.001), respectively. The most common horizontal location and shape of the mental foramen on panoramic radiographs in this group are between the two premolars, and the round type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramina have usually symmetrical horizontal locations and shapes.

Información precisa sobre la ubicación horizontal y forma del foramen mental puede tener importancia clínica en la reducción de complicaciones durante procedimientos quirúrgicos maxilofaciales que involucran el área mental. Fueron reportadas variaciones geográficas en relación a estas variables. El objetivo fue estudiar la posición horizontal y forma del foramen mental, a partir de 518 radiografías panorámicas de una muestra aleatoria en sujetos de Irak (257 varones, 261 mujeres; edad media= 46,5 años), quienes fueron evaluados con respecto a la posición horizontal, forma y la simetría de los forámenes mentales. En individuos de edad avanzada se encontró una asociación con un aumento en la frecuencia de un posicionamiento posterior y con forma irregular. La posición horizontal y forma del foramen fueron asimétricos en 21,6% y 31,6% de los casos, respectivamente. La diferencia hallada en relación a la simetría en posición horizontal y forma de los forámenes mentales fue estadísticamente significativa entre sexos (p=0,041), y entre los grupos de edad jóvenes y mayores (P=0,001), respectivamente. Se encontró con mayor frecuencia la posición horizontal entre los ejes longitudinales de los dos premolares mandibulares, y la forma circular, en relación a la posición antero-posterior y forma del foramen, respectivamente. Estos fueron resultados similares a estudios anteriores sobre otras poblaciones. Los forámenes mentales son simétricos, respecto a su ubicación horizontal y su forma.