Welcome to Al-Kindy College Medical Journal (KCMJ) KCMJ is a peer-reviewed open access publication ( three issues/year) of Al Kindy College of Medicine, University of Baghdad, Iraq. It founded in January 2004. Mission and vision The mission of the KCMJ is to provide a platform for high-quality medical knowledge exchange for Iraqi researchers and scientists from abroad. New findings and observations on issues related to preventive and clinical medicine are our targets. The aim of this journal is to contribute to scientific exchange, stimulate new research questions, find practical solutions, and adapt evidence-based professional action in the field of medical practice. The Journal prefers articles on studies that are well designed, supported by adequate and reliable data from all parts of the world. Focus and Scope The Journal publishes Original Articles, Editorials, Case Reports, Review Articles, and Letters to the Editor. Peer review KCMJ operates a double-blind review process. All submissions will be initially assessed by the Editorial Committee for suitability for the journal. Papers considered suitable are then typically sent to a minimum of two independent expert reviewers to assess the scientific quality of the paper. The double-blind review is the practice of this journal, which means the identities of the authors are concealed from the reviewers, and vice versa. More information is available on our website The Editorial Committee is responsible for the final decision regarding acceptance or rejection of articles. Availability The journal is published in digital and printed form. Full-text articles can be accessed for free via the internet. P- ISSN (print):1810-9543, E-ISSN (online): 2521-4365 No submission fee, an only publication fee of 100, 000 ID if the works are accepted. We waive the publication fee for authors from outside Iraq.
AL-Kindy College of Medicine - University of Baghdad
Flipped Classroom: A Pedagogical Approach for Undergraduate Medical Education in India
Background: The flipped classroom educational model reverses the role of the traditional format of a classroom lecture from group learning to individual learning, and the educator guides students in the application of knowledge and building concepts. The objective is to evaluate the perception of students in a flipped teaching model versus didactic /traditional classroom model. The purpose was to assess the ability of the educator to enhance the academic achievement of students. Subjects and Methods: The current study was conducted for a period of six months, in which second-phase medical undergraduates participated. Informed / ethical consent was taken before the study was initiated. A total of 133 students out of 150 participated in the study. Two groups were formed, one had a traditional class, and the other had a flipped class. Pre-test and post-test in the form of a questionnaire were conducted before starting and after completion of the class, and the perceptions of students were assessed. Result: Out of 150 students, only 133 participated in the study, 65 were in the flipped classroom space, and 68 were in the traditional model. The baseline performance of both groups was the same (mean difference 0.37, 95% CI: -0.35 to 1.10, p = 0.31). Post-intervention, both groups showed improvement, but the flipped classroom group demonstrated significantly greater gain. Conclusion: The implementation of a new teaching model depends upon its acceptance, dynamism, logistics, understanding, and better outcomes. The innovative method (flipped) was found to be a more effective teaching-learning, thought-provoking model with enhanced students’ engagement in learning and perception.
Copyright (c) 2026 AL-Kindy College Medical Journal http://creativecommons.org/licenses/by/4.0
Should Reno-Protective Protocols Be Routine in Extracorporeal Shockwave Lithotripsy?
For decades, extracorporeal shockwave lithotripsy (ESWL) has been considered a first-line and non-invasive treatment for kidney stones, especially small and medium-sized stones located in the upper pole and renal pelvis. However, this procedure is not without collateral damage to kidney tissue, with both acute and chronic side effects. Shear stress and cavitation forces generated by shockwaves to fragment stones do not discriminate between stones and renal parenchyma. When they release their energy into the renal parenchyma, shockwaves cause microvascular damage, vasospasm, ischemia-reperfusion injury, oxidative stress, and an inflammatory cascade that might end with fibrosis and nephron loss. These detrimental side effects would be more evident in patients requiring multiple treatment sessions and those with solitary or pre-damaged kidneys. Although population-level data on long-term systemic effects like hypertension and diabetes are equivocal, imaging, biomarkers, and histopathology consistently demonstrate ESWL-related subclinical renal injury, questioning the traditional “treat and assess” trend.​ Given the clear pathophysiological rationale and growing supportive evidence, reno-protective protocols should be an integral component of modern ESWL practice, at least for high-risk groups such as patients with solitary kidneys, pre-existing renal damage, children, and patients with recurrent stones requiring repeated treatment sessions.
Al-Kindy College Medical Journal: Benchmarks to Streamline the Desk's Workflow and Harvest New Milestones
This editorial outlines key strategic benchmarks to enhance editorial workflow, publication quality, journal visibility, and scientific impact.
The Role of Simulated Laparoscopic Assessment for Trainee Progression and Certification
The Joint Committee on Surgical Training (JCST) and the Royal Colleges of Surgery oversee the surgical training for surgical specialties. To join higher general surgery training for the full six years, trainees have to complete the Royal Colleges’ membership exams (MRCS) and satisfactorily complete the core surgical training for two years. After completing 6 years of higher surgical training and the Royal Colleges’ fellowship exam (FRCS), trainees are awarded the certificate of completion of training (CCT).
2025 Triumphs and Setbacks: Endovascular Neurosurgery Perspective
In 2025, the field of stroke and carotid artery disease experienced a new update, with the publication of two landmark randomized trials that represent contrasting examples of setback and triumph within endovascular neurosurgery. The MeVO trials proved no superiority of mechanical thrombectomy over best medical therapy for acute ischemic stroke caused by distal- and medium-vessel occlusions. The CREST-2 trials demonstrated a significant reduction in stroke when carotid artery stenting is added to medical therapy. These trials illustrate how recent evidence has simultaneously challenged and reaffirmed the role of neurointerventional therapy.
Artificial Intelligence in Medical Education: Balancing Emerging Opportunities with Real-World Limitations
The integration of Artificial Intelligence into medical education is a newly emerging and promising strategy that transforms the outlook of the learning process. This continuously evolving technology influences various aspects of medical education, including curriculum design, learning, and assessment. This editorial will discuss how AI is reshaping all aspects of medical education, highlighting challenges and issues, including bias, data governance, and excessive dependence on technology that may be encountered.
Copyright (c) 2025 AL-Kindy College Medical Journal http://creativecommons.org/licenses/by/4.0
Complex Brucellosis with Cervical Spine Abscess and Orchitis: A Case Report Highlighting Diagnostic and Management Challenges in Iraq
Brucellosis, a significant zoonotic infection, is characterized by protean manifestations that can make timely diagnosis difficult. This case report details a severe and atypical presentation of brucellosis in a 41-year-old male from a rural area in Kirkuk, Iraq, a region where the disease is endemic. The patient presented with a one-month history of debilitating upper back pain, fever, and constitutional symptoms. His condition was complicated by the formation of large para-vertebral and epidural abscesses in the cervical spine. For which he was treated with empirical antibiotics, but his symptoms persisted, and he subsequently developed acute brucellar orchitis. The diagnosis was ultimately established through serological testing, as blood cultures remained negative. This case underscores the critical importance of including brucellosis in the differential diagnosis for patients from endemic areas presenting with complex, multisystemic inflammatory conditions, particularly severe osteoarticular infections and genitourinary involvement. The patient responded well to a prolonged, multidrug antibrucellar regimen, resulting in a favorable outcome.
The ErbB Receptors and Associated Key Signalling Proteins in Cancer
Cancer is a disease of almost all multicellular organisms, in which communication between cells plays a crucial role in the life and development of that organism. The ErbB family of tyrosine kinase receptors plays a fundamental part in signal transmission, controlling cell proliferation and survival. Signalling outputs of the ErbB receptors are tightly controlled under normal physiological conditions. However, genomic amplification, overexpression or mutational activation of these receptors and their signalling proteins is a common cause of cancer. This narrative review provides an overview of the structure, activation, and modes by which these receptors are dysregulated in oncogenesis. The critical downstream signalling pathways of RAS/RAF/MEK/ERK governing proliferation and PI3K/AKT/mTOR controlling survival are detailed. We discuss the development of ErbB-targeted therapies with emphasis on monoclonal antibodies and tyrosine kinase inhibitors and address the major challenge of therapy resistance. Next-generation tyrosine kinase inhibitors and combination therapies aimed at overcoming treatment failures are also outlined.
Assessment of Sexually Transmitted Infections Surveillance System in Iraq
Background: Sexually transmitted infections (STIs) continue to pose significant public health challenges worldwide. This study aimed to assess the STI surveillance system in Iraq, including the Kurdistan Region, to identify gaps and areas for improvement. Subjects and Methods: A cross-sectional study was conducted from March 12 to October 1, 2023. A total of 116 health facilities (HFs), including HIV control sections, Primary Health Care Centers (PHCCs), and hospitals, across 20 Directorates of Health (DOH) were included in the assessment. A structured questionnaire was developed by the researchers and administered through interviews. The questionnaire collected demographic, surveillance data, and service characteristics. Results: The study assessed 116 HFs, comprising 345 units (surveillance, clinic, and laboratory (Lab)). Most peripheral-level surveillance units faced significant shortages in logistical resources. The timely submission of STI reports to the next health level was below the 85% target across all health levels. HIV control sections investigated 35% of reported cases, of which 35% had complete data. Data cleaning processes were completed by 11% of PHCCs and 0% of hospitals. National STI guidelines were in 50% of PHCCs and 35% of hospitals. The percentage of diagnosed cases meeting the definitions was 36% in PHCCs and 30% in hospitals. STI records were found in 80% of PHCCs and 45% of hospitals. Syphilis testing was available in 47% of PHCCs and 29% of hospitals. Conclusions: The STIs surveillance system at both peripheral and intermediate levels is inadequately managed, with significant gaps in resource allocation, training, and data management.
Early Laboratory Biomarkers as Risk Factors for Alzheimer's Disease: A Systematic Review and Meta-analysis
The timely diagnosis of Alzheimer's disease is of paramount importance to support the timely intervention and effective risk management strategies. Biomarkers have become powerful tools for predicting the risk of Alzheimer's disease. The objective of this systematic review and meta-analysis is to examine the prognostic utility of early laboratory biomarkers in Alzheimer's disease, how integrated into risk assessment models, and the gaps in modern studies. An extensive search was conducted in databases such as PubMed, Scopus, and Web of Science to retrieve peer-reviewed articles published since 2014. There were 26 empirical studies that met the determined inclusion criteria and were aimed at the investigation of tau protein, amyloid-beta (Ab42), phosphorylated tau (p-tau), neurofilament light chain (NfL), Apolipoprotein E (ApoE), α-synuclein, Triggering Receptor Expressed on Myeloid cells 2 (TREM2), and other inflammatory markers (CRP, TNF-α, IL-6). High tau (effect size 2.10, 95% CI, I2 = 52%), and p-tau (1.95, I2 = 48%), and a decrease in Ab42 (1.75, I2 = 45%), were each found to have a consistent positive relation with an increased risk of Alzheimer's disease. ApoE e4 (2.50, I2 = 60%), plasma neurofilament light chain (1.60, I2 = 37%), and C-reactive protein (1.30, I2 = 25%) are genetic biomarkers that show significant predictive values. Pre-initial lab biomarkers have a strong correlation with Alzheimer's Disease risk as well and can be used extensively to prognosticate Alzheimer's Disease. Nevertheless, additional studies are needed to elucidate their role in the development of Alzheimer's disease and to develop effective preventive measures.
Comment on: “Neuropathic Cystinosis: A Rare Case Report”
This letter to the editor provides commentary on a previously published case and highlights additional diagnostic and genetic considerations in cystinosis.
Renal Health Status in Individuals Living in Camps of Duhok, Kurdistan Region – Iraq
Background: Internally displaced persons (IDPs) living in camps often face substandard living conditions that may adversely affect renal health. This study aimed to assess and compare the renal function biomarkers between IDPs residing in camps and healthy individuals living outside camps in Duhok, Kurdistan Region, Iraq. Subjects and Methods: A cross-sectional study was conducted involving 300 participants (150 IDPs and 150 controls), aged 18–65 years. Individuals with chronic diseases, smokers, alcohol consumers, or other potential confounders (such as pregnancy, recent acute illness, use of nephrotoxic medications, or history of kidney surgery) were excluded. Blood and urine samples were collected to evaluate serum albumin, creatinine, and urea, urine albumin and creatinine, albumin/creatinine ratio (ACR), and microscopic urine examination. The estimated glomerular filtration rate (eGFR) was calculated. The data were analyzed across demographic variables, including age, gender, body mass index, drinking water amount, and biochemical parameters. Results: IDPs exhibited significantly lower serum albumin and creatinine levels and higher ACR compared to controls (p < 0.05). No significant differences were found in urea or eGFR. Microalbuminuria prevalence was higher in IDPs (5.3%) than in controls (2%), and this difference was statistically significant (p = 0.006). ACR was elevated in the IDPs across all subgroups. Microscopic urine examination revealed uric acid crystals in the IDP group; these crystals were not observed in the control participants. Most participants were classified as CKD stage 1 or 2; comparisons at stages 3a and 3b were limited due to small sample sizes. Conclusions: IDPs living in camps showed early signs of renal dysfunction, with altered albumin, creatinine, and ACR levels. These findings underscore the need for improved renal health surveillance and targeted interventions focused on hydration, nutrition, and living conditions in displacement settings.
Age-Related Variations in Tumor Suppressor Genes and Hormone Receptor Expression in Breast Cancer Patients
Background: This study investigated the immunohistochemical expression of hormone receptors (ER, PR, HER2, Ki-67) and tumor suppressor genes (PTEN, p53) in women with breast cancer from Erbil, Iraq, focusing on how these expressions relate to patient age. Subjects and Methods: Between April and October 2024, 120 female breast cancer patients took part in a cross-sectional study. Immunohistochemical analysis was performed to evaluate the expression of PTEN, p53, ER, PR, HER2, and Ki-67. Results: Age was significantly positively correlated with PTEN loss, which was shown in 86.7% of patients (p < 0.001). Additionally, there was a positive connection between age and the expression of ER and PR (χ² = 26.67 for ER and 15.59 for PR). There was less correlation between HER2 positive and age. 34.2% of tumors had P53 expressions, which were unrelated to age. All tumors were discovered to contain Ki-67, indicating that active proliferation is taking place. Furthermore, there were notable variations in the expression levels of PTEN, P53, ER, PR, Ki-67, and HER2 according to tumor grade, which is a sign of the biology and aggressiveness of the tumor. Conclusions: While P53 expression does not significantly change with patient age, PTEN, ER, PR, and HER2 expression do. Ki-67 universal expression indicates that tumor proliferation is high in this population. Tumor aggressiveness and biology variations are highlighted by the variance in important biomarker expression by tumor grade.
Time-Adjusted Immune Indices: A Circadian Perspective on Neutrophil-to-Lymphocyte Ratio in Immunotherapy
Immune indices such as the neutrophil-to-lymphocyte ratio (NLR) are widely used to monitor patients on immune checkpoint inhibitors, yet their interpretation rarely consider time-of-day biology. This perspective proposes a circadian framework in which sampling time and treatment timing shape baseline values, short-term fluctuations, and prognostic thresholds. Drawing on clinical observations across lungs, renal, and other tumors, I outline how morning versus afternoon therapy and corticosteroid administration may differentially modulate NLR trajectories and toxicity and introduce practical steps for time-adjusted reporting: record clock time, analyze intra-patient trends, and compare like-for-like time windows. Integrating chronobiology into routine hematologic
Assessment of Interleukin-30 in Iraqi Female Patients with Hashimoto’s Thyroiditis
Background: Hashimoto’s thyroiditis is a chronic lymphocytic autoimmune thyroid disease that results in gradual destruction of the thyroid gland. Interleukin-30 (IL-30) is one of the interleukins that controls inflammatory response since it enhances T-reg cells' suppressive function and induces IL-10 production. The aim of this study was to assess the serum level of IL-30 as an indicator for understanding the pathology of this autoimmune disorder. Subjects and Methods: A single-center, case-control study was carried out on Hashimoto’s Thyroiditis patients who were admitted to the department of medicine at Al-Yarmook Teaching Hospital and Baghdad Teaching Hospital, Baghdad, Iraq, between January 2024 and June 2024. Serum levels of thyroid-stimulating hormone (TSH), antithyroglobulin antibody (anti-TG Abs), antithyroid peroxidase antibody (TPO Ab), and IL-30 were measured in control (n=21) and patient (n=40) groups, all are determined by sandwich enzyme-linked immunosorbent assay (ELISA) kits. Results: Serum TSH, TPO Ab, and TG Ab are significantly higher in the patient group (p<0.0001), whereas serum IL-30 decreases significantly (p<0.0001). There was a significant correlation between serum IL-30 and serum TPO Abs levels (p=0.001), while there was a negative correlation between the severity of hypothyroidism and serum IL-30 (P<0.05). Conclusion: Serum IL-30 level is associated with the pathogenesis of autoimmune thyroiditis. There is a negative correlation between serum IL-30 and the degree of hypothyroidism. Moreover, a decrease in serum IL-30 level can be considered a predictor for autoimmune thyroiditis.
Serum Copeptin in Acromegaly with and Without Diabetes: A Comparative Cross‑Sectional Study
Background: Copeptin serves as a stable substitute marker for vasopressin and is emerging as a biomarker in endocrine disorders. Given the complex metabolic interactions in acromegaly and the role of growth hormone in fluid balance, this study examined copeptin levels in patients with acromegaly and diabetes mellitus, non-diabetic acromegaly, and healthy controls. Objectives: To compare serum copeptin concentrations among acromegalic patients with diabetes, acromegalic patients without diabetes, and healthy controls. Subjects and Methods: This is a comparative cross-sectional study that included 176 participants: acromegalic patients with diabetes, acromegalic patients without diabetes, and healthy controls. Serum copeptin was measured using a standardized ELISA method. A comprehensive biochemical profile was also assessed, including growth hormone, insulin-like growth factor-1, fasting glucose, glycated hemoglobin, and lipid parameters. One-way ANOVA with post-hoc least significant difference testing was used to analyze group differences. The study was conducted at the National Diabetes Center (Baghdad, Iraq) with fasting samples collected between November 2024 and March 2025. Results: Mean copeptin concentrations demonstrated a statistically significant variation between the groups (p = 0.012). Non-diabetic acromegalic patients exhibited the highest copeptin levels (72.6 ± 59.3 pmol/L), followed by diabetic acromegalic patients (57.3 ± 49.2 pmol/L) and control subjects (48.0 ± 25.7 pmol/L). Post-hoc analysis indicated a substantial elevation in copeptin levels among non-diabetic acromegalic patients compared to controls (p = 0.003; Cohen’s d = -0.45, 95% CI: -0.85 to -0.05), indicating a small-to-medium effect size. Copeptin demonstrated a positive correlation with growth hormone (r = 0.443, p = 0.003) and insulin-like growth factor-1 (r = 0.333, p = 0.027), while it correlated negatively with triglycerides (r = -0.326, p = 0.031) and VLDL (r = -0.332, p = 0.028). Conclusions: Serum copeptin levels were significantly higher in non-diabetic acromegalic patients than in controls, while diabetic acromegalic patients were not significantly different from controls.
Colocolic Intussusception: A Case Report of an Uncommon Manifestation of Peutz-Jeghers Syndrome
Peutz-Jeghers syndrome is a rare genetic disorder resulting from defects in signaling pathway regulation, marked by gastrointestinal hamartomas and mucocutaneous pigmentation. This condition can lead to complications such as intussusception, with colocolic intussusception being particularly rare. We present the case of a 30-year-old female who exhibited acute on chronic abdominal pain and progressive distension, along with digital and perioral hyperpigmentation. Unfortunately, her diagnosis of Peutz-Jeghers syndrome was delayed until she developed intestinal obstruction. Imaging revealed large bowel obstruction with proximal bowel dilatation, prompting a left hemicolectomy and end-to-end colocolic anastomosis. The patient experienced an uneventful postoperative recovery and remained symptom-free during follow-up. This case highlights the rarity of colocolic intussusception as a manifestation of Peutz-Jeghers syndrome and emphasizes the importance of early recognition and intervention to prevent bowel obstruction and the need for extensive surgical procedures.
Multivariate Regression Modeling of Health Inequities: The Role of Social Determinants of Health
Background: Health inequities remain a worldwide public health problem, and the populations that are affected disproportionately are the vulnerable populations, so it is related to income disparities, education disparities, employment disparities, housing disparities, and healthcare disparities. These differences are substantially engraved in the social determinants of health and cannot be solved without some thoughtful data-oriented means to study these effects on the variety of groups of people and in different nations. Objective: to evaluate the impact of various social factors on health outcomes under a multivariate regression model and seek to find common global trends that cause health inequity. Subjects and Methods: A merged cross-section was made with publicly available data on health, covering various countries, whose national health surveys and databases consisted of the World Health Organization, the World Bank, and so on. Among the main variables to be analyzed, the researchers focused on the household income, educational level, employment, living conditions (quality of housing), and accessibility to healthcare services. Linear and logistic regression techniques (in a multivariate framework) were used to determine the relationship with health outcomes, including self-reported health status and prevalence of non-communicable diseases. Adjustment was done on age, gender, and urban-rural classification. Statistical significance was determined by p-values, adjusted R2, and Akaike Information Criterion. Results: The results demonstrated a similar trend in every country: low-income earners and lowly educated people registered dismal health conditions and a high prevalence of chronic diseases. These disparities were further propagated by poor access to medical treatment and poor housing. The multivariate model accounted to 64.8 percent of the variation in health outcomes at a global level with the factors that exerted the greatest influence being education (0.38, p < 0.001) and access to healthcare (0.31, p = 0.003). Conclusions: This global comparison highlights the profound impact of social determinants on populations worldwide. Multivariate statistical modeling proves highly valuable in identifying and quantifying these associations, providing evidence that can inform international health policies aimed at reducing inequities and promoting health equity across all nations.
The Effectiveness of Physical Exercise in Preventing Postpartum Depression: A Systematic Review of Randomized Controlled Trials (2019–2024)
Background: Postpartum Depression (PPD) affects 13-19% of moms following childbirth. Globally, around 350,000 maternal deaths occurred in 2022, with depression accounting for 22% of all postpartum deaths. Exercise is increasingly being examined as a preventive intervention. Objective: To determine the effectiveness of exercise, specifically its type, intensity, and duration in reducing postpartum depression. Subjects and Methods: A systematic review was conducted in accordance with the PRISMA standards. Searches for (postpartum AND exercise) or (physical activity AND lessened postpartum depression) yielded 11 suitable studies. Data were retrieved on activity features and PPD outcomes, which were predominantly evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Results: Aerobic exercise was the most constant and successful intervention. Women who engaged in moderate-intensity aerobic exercise (30-45 minutes, 3-5 times per week) had significantly lower depression symptoms than controls (standardized mean difference [SMD] = -0.42; 95% CI: -0.65 to -0.19; p < 0.001). Exercise interventions were also linked to a 32% lower chance of having PPD (risk ratio [RR] = 0.68; 95% CI: 0.52 to 0.85). Subgroup analyses suggested greater benefits when exercise was initiated during pregnancy and continued postpartum. Conclusions: Structured physical exercise can be considered a safe, low-cost adjunct to prevent the occurrence of Postpartum Depression in mother psychological well-being through enhanced endorphin release and body image perception. Integration of exercise into maternal health programs may substantially reduce the burden of postpartum depression.
A Global Misuse of Semaglutide for Cosmetic Weight Loss in Non-diabetic Young Population, an FDA Public Database and Google Trends Data Analysis
Background: in a world full of aesthetic trends and a pervasive focus on physical appearance, often driven by celebrities and social media influencers. The misuse of medications and increased demand on aesthetic surgeries have been documented and become increasingly concerning. Recently, the use of GLP-1 analog medications for aesthetic weight management, particularly Semaglutide (brand name Ozempic and Wegovy) has gained increasing popularity among the public on these platforms. Subjects and Methods: Our study aimed to investigate the potential for Semaglutide misuse, particularly Ozempic based on FAERS database and Google Trends tool. We also explored the potential adverse events associated with Semaglutide medication's misuse. Results: Our findings showed a surge in Semaglutide medication (Ozempic) for weight loss as opposed to T2DM treatment worldwide. Moreover, Ozempic popularity for weight loss outweighs the popularity of Wegovy, which was approved for weight management indications in obese patients with at least one weight-related comorbidity. Furthermore, our results demonstrated an annual increase in the number of Semaglutide-related AERs on FAERS from January 2018 to September 2024, including a rise in death related AERs. A wide verity of Semaglutide related AERs have been documented, including both serious and non-serious outcomes, with death being the most serious outcome reported. Current results have also documented a worldwide shortage in Semaglutide medications, particularly Ozempic and Wegovy, due to increased demand and off-label use of these medications. Conclusion: collectively, our findings provide clear evidence of Ozempic and Wegovy misuse outside their approved indications to achieve aesthetic weight goals among young non-diabetic individuals. This misuse is often driven by media platforms without stressing on the potential adverse events and ethical concerns associated with the misuse of these medications.
The Impact of Personalized Medicine on Enhancing Quality of Life in Chronic Diseases Management
Personalized Medicine represents a recent revolution in healthcare practice, focusing on tailoring different therapies to be precise for a specific individual; this is aided by exploring the number of genetic predispositions and lifestyle choices that fit each individual. In this article, the authors utilize and gather recent literature and opinions to discuss the impact of personalized medicine on chronic disease management and patient quality of life. Additional attention is paid to limits and possible ethical issues. Chronic diseases such as Hypertension, Diabetes, and chronic kidney diseases adversely affect multiple health indicators, including Quality of Life (QoL) and well-being. This will have additional impacts on physical and mental health that require further mitigations and to deal with more ongoing mental health. Personalized medicine is a revolutionary step that could be used to manage chronic disease by improving patients' QoL through tailored treatments. However, it is crucial to handle equity, ethics, and infrastructure issues.
Copyright (c) 2025 http://creativecommons.org/licenses/by/4.0
Hepatitis B virus infection in pregnant women in Baghdad
Background: Globally, hepatitis B is one of the most common infectious diseases. Estimates indicate that at least 2 billion people have been infected with the hepatitis B virus (HBV), with more than 378 million people being chronic carriers. Those individuals at higher risk for acquiring HBV and transmitting disease like pregnant women should be screened for hepatitis B surface antigen (HBsAg) to prevent transmission by vaccination and operation. Aim of study: The aim of this study was to determine the prevalence of HBsAg and its associated parameters in pregnant women who referred to antenatal clinic in Baghdad Province. Methods: The 234 apparently healthy pregnant women and their families, husbands and children were selected as study subjects from among those who had attained prenatal care clinic in Baghdad province between 2010 to 2012. Serological test was done for HBV using ELISA test (Dialab REF:Z00360,LOT2052-2). Results: Of these, 234 cases were brought into the study. Their age were ranged from 16-42 years old. Based on a different parameters , women positive for HBV and their children were negative constitute the highest percentage 85.4% and lowest one was pregnant women who lived with positive family history of HBV were 8.9%. Conclusions: The seroprevalence of HBsAg was of moderate severity according to WHO. This finding would suggest for the introduction of routine screening for HBV to all pregnant women during the antenatal period, and that “at birth dose” vaccination is given to new born babies of mothers found to be HBsAg positive so as to reduce and prevent the spread of infection. However more data is required from larger studies to support the findings so that ultimately this can be recommended as a policy.
Copyright (c) 2013 http://creativecommons.org/licenses/by/4.0
Background: Globally, hepatitis B is one of the most common infectious diseases. Estimates indicate that at least 2 billion people have been infected with the hepatitis B virus (HBV), with more than 378 million people being chronic carriers. Those individuals at higher risk for acquiring HBV and transmitting disease like pregnant women should be screened for hepatitis B surface antigen (HBsAg) to prevent transmission by vaccination and operation. Aim of study: The aim of this study was to determine the prevalence of HBsAg and its associated parameters in pregnant women who referred to antenatal clinic in Baghdad Province. Methods: The 234 apparently healthy pregnant women and their families, husbands and children were selected as study subjects from among those who had attained prenatal care clinic in Baghdad province between 2010 to 2012. Serological test was done for HBV using ELISA test (Dialab REF:Z00360,LOT2052-2). Results: Of these, 234 cases were brought into the study. Their age were ranged from 16-42 years old. Based on a different parameters , women positive for HBV and their children were negative constitute the highest percentage 85.4% and lowest one was pregnant women who lived with positive family history of HBV were 8.9%. Conclusions: The seroprevalence of HBsAg was of moderate severity according to WHO. This finding would suggest for the introduction of routine screening for HBV to all pregnant women during the antenatal period, and that “at birth dose” vaccination is given to new born babies of mothers found to be HBsAg positive so as to reduce and prevent the spread of infection. However more data is required from larger studies to support the findings so that ultimately this can be recommended as a policy. Background: Globally, hepatitis B is one of the most common infectious diseases. Estimates indicate that at least 2 billion people have been infected with the hepatitis B virus (HBV), with more than 378 million people being chronic carriers. Those individuals at higher risk for acquiring HBV and transmitting disease like pregnant women should be screened for hepatitis B surface antigen (HBsAg) to prevent transmission by vaccination and operation. Aim of study: The aim of this study was to determine the prevalence of HBsAg and its associated parameters in pregnant women who referred to antenatal clinic in Baghdad Province. Methods: The 234 apparently healthy pregnant women and their families, husbands and children were selected as study subjects from among those who had attained prenatal care clinic in Baghdad province between 2010 to 2012. Serological test was done for HBV using ELISA test (Dialab REF:Z00360,LOT2052-2). Results: Of these, 234 cases were brought into the study. Their age were ranged from 16-42 years old. Based on a different parameters , women positive for HBV and their children were negative constitute the highest percentage 85.4% and lowest one was pregnant women who lived with positive family history of HBV were 8.9%. Conclusions: The seroprevalence of HBsAg was of moderate severity according to WHO. This finding would suggest for the introduction of routine screening for HBV to all pregnant women during the antenatal period, and that “at birth dose” vaccination is given to new born babies of mothers found to be HBsAg positive so as to reduce and prevent the spread of infection. However more data is required from larger studies to support the findings so that ultimately this can be recommended as a policy. Background: Globally, hepatitis B is one of the most common infectious diseases. Estimates indicate that at least 2 billion people have been infected with the hepatitis B virus (HBV), with more than 378 million people being chronic carriers. Those individuals at higher risk for acquiring HBV and transmitting disease like pregnant women should be screened for hepatitis B surface antigen (HBsAg) to prevent transmission by vaccination and operation. Aim of study: The aim of this study was to determine the prevalence of HBsAg and its associated parameters in pregnant women who referred to antenatal clinic in Baghdad Province. Methods: The 234 apparently healthy pregnant women and their families, husbands and children were selected as study subjects from among those who had attained prenatal care clinic in Baghdad province between 2010 to 2012. Serological test was done for HBV using ELISA test (Dialab REF:Z00360,LOT2052-2). Results: Of these, 234 cases were brought into the study. Their age were ranged from 16-42 years old. Based on a different parameters , women positive for HBV and their children were negative constitute the highest percentage 85.4% and lowest one was pregnant women who lived with positive family history of HBV were 8.9%. Conclusions: The seroprevalence of HBsAg was of moderate severity according to WHO. This finding would suggest for the introduction of routine screening for HBV to all pregnant women during the antenatal period, and that “at birth dose” vaccination is given to new born babies of mothers found to be HBsAg positive so as to reduce and prevent the spread of infection. However more data is required from larger studies to support the findings so that ultimately this can be recommended as a policy. Background: Globally, hepatitis B is one of the most common infectious diseases. Estimates indicate that at least 2 billion people have been infected with the hepatitis B virus (HBV), with more than 378 million people being chronic carriers. Those individuals at higher risk for acquiring HBV and transmitting disease like pregnant women should be screened for hepatitis B surface antigen (HBsAg) to prevent transmission by vaccination and operation. Aim of study: The aim of this study was to determine the prevalence of HBsAg and its associated parameters in pregnant women who referred to antenatal clinic in Baghdad Province. Methods: The 234 apparently healthy pregnant women and their families, husbands and children were selected as study subjects from among those who had attained prenatal care clinic in Baghdad province between 2010 to 2012. Serological test was done for HBV using ELISA test (Dialab REF:Z00360,LOT2052-2). Results: Of these, 234 cases were brought into the study. Their age were ranged from 16-42 years old. Based on a different parameters , women positive for HBV and their children were negative constitute the highest percentage 85.4% and lowest one was pregnant women who lived with positive family history of HBV were 8.9%. Conclusions: The seroprevalence of HBsAg was of moderate severity according to WHO. This finding would suggest for the introduction of routine screening for HBV to all pregnant women during the antenatal period, and that “at birth dose” vaccination is given to new born babies of mothers found to be HBsAg positive so as to reduce and prevent the spread of infection. However more data is required from larger studies to support the findings so that ultimately this can be recommended as a policy.
A Cautionary Perspective on Artificial Intelligence and Novel Imaging Technologies in Patient Selection for Retrograde Intrarenal Surgery
The advancement of retrograde intrarenal surgery (RIRS) has been accompanied by the evolution of many promising tools that aim at improving patient selection and predicting surgery outcomes in terms of stone fragmentation and expected complications. The incorporation of artificial intelligence (AI) into the advanced imaging technologies such as dual-energy CT scan (DECT), three-dimensional (3D) reconstruction, and radiomics resulted in a number of clinical tools and algorithms forwarded to surgeons to use in their daily practice. This commentary critically examines these clinical algorithms, highlighting the absence of prospective validation, the potential for overreliance, and the possible limitations of their clinical applicability. AI-driven predictive models often rely on retrospective, uniform datasets taken from a single center, with evident interpretability concerns. Similarly, DECT and 3D reconstructions might provide detailed information about the anatomy of the renal collecting system and stone composition, but they do not account for real-time surgical dynamics. Radiomics, in the other hand, provides excellent insights into stone behavior, but their reproducibility and clinical relevance are still to be tested. The take-home message of this commentary is that conventional CT metrics—such as stone size and density—continue to outperform novel techniques in reliability and accessibility, and the adoption of emerging technologies in RIRS must be cautious, ethically sound, and evidence-based, reinforcing the primacy of clinical judgment in urologic care.
Applying the Principles of Sustainability to Diabetes Care in Low Resources Settings: Reduce, Reuse, Recycle
\ Background: Sustainability in healthcare is a relatively new concept that aims to integrate environmental, financial, and social factors. Diabetes care in low socioeconomic communities relies on disposable medical supplies, leading to increased waste. This study aims to propose the application of the (reduce, reuse and recycle) framework in diabetes care to enhance sustainability Subjects and Methods: This study used a mixed-methods approach, including both a literature review and a pilot survey. The literature review included fifty studies focusing on sustainable healthcare practices. A survey was conducted among fifty healthcare professionals and fifty patients to assess their baseline knowledge about practices related to sustainability in healthcare. Results were analyzed to assess similarities or differences between high and low socioeconomic communities Results: The survey revealed that 63% of patients thought treatment costs was the primary barrier to sustainability, while 50% of healthcare providers pointed to limited resources. Both groups emphasized the need for government support and education to enhance sustainability efforts. Reusable insulin pens and eco-friendly packaging were the most viable solutions. Conclusions: Applying sustainability to diabetes care can reduce both environmental and economic burdens. This is particularly challenging in low-resource settings, where cost and infrastructure limitations persist. Policy reforms, education, and innovation to reduce waste is essential to achieve a sustainable healthcare system.
Radiographic Assessment of the Critical Shoulder Angle, the Lateral Acromion Angle and the Acromial Index in a Sample of Normal Adult Individuals: A Cross-Sectional Analytical Study
Background: Several radiological parameters used to assess the shoulder joint; among these, the critical shoulder angle (CSA), acromion index (AI), and lateral acromion angle (LAA) are widely used. Objectives: the primary objective of our study was to establish a reference value for these parameters among healthy Iraqi adults, and secondly to explore the influence of some anthropometric parameters on these shoulder parameters. Materials and Methods: the CSA, AI, and LAA were measured for all participants using AP radiographs of the shoulder joints on both sides, the anthropometric parameters were also recorded. The data were tabulated and statistically analyzed. Results: the study shows no statistically significant differences in the measurements of CSA, AI, or LAA between males and females and also no differences between right and left sides. There was a weak correlation between the CSA measures and all anthropometric parameters, while there was a strong positive correlation between AI measures both age and body weight. Conversely, the LAA showed significant negative correlations with age and BMI. Interestingly we found that age was a major predictor of both AI and LAA, while weight and BMI were predictors CSA. Conclusion: The findings of our study suggest that critical shoulder angle is relatively constant shoulder parameters among individuals, however acromial index and the lateral acromial angle vary with age and BMI, and this may affect the biomechanics of the shoulder.
The Correlation of Expression of P16Ink4a and CD31 Immunohistochemical Stains in Invasive Squamous Cell Carcinoma of the Cervix and its Precursors
Background: Squamous cell carcinoma of the cervix (SCC) and its precursors squamous intraepithelial lesions (SIL) remain a major global health burden. The tumor suppressor protein P16(Ink4a), a surrogate marker for high-risk human papilloma virus (HPV) infection, and CD31, an angiogenesis marker reflecting microvessel density (MVD), play critical roles in tumor progression. Objective: This study aimed to assess the immunohistochemical (IHC) expression of P16(Ink4a) and CD31 in SIL and SCC and assess their correlation with disease severity. Subjects and Methods: A cross-sectional study was conducted on 77 archived cervical biopsies (17 low-grade SIL [LSIL], 24 high-grade SIL [HSIL], and 36 SCC cases) from archival materials of two Baghdad hospitals (Medical City, The Teaching Hospital and Medical City of Al-Imamain AL-Kadhimein) (2018–2022). IHC staining for P16(Ink4a) (scored by intensity/distribution) and CD31 (for MVD quantification) was conducted. Statistical analysis used SPSS v26, with significance set at p < 0.05. Results: P16(Ink4a) expression significantly increased from LSIL (35.3%) to HSIL (70.8%) and SCC (91.7%) (p < 0.001), with the highest scores in SCC (30.6%). MVD also rose with cervical lesion severity (p < 0.001), with means of 4.37 (LSIL), 13.11 (HSIL), and 52.81 (SCC). Poorly differentiated SCC showed the highest MVD (67.34). A strong positive correlation was found between P16(Ink4a) and MVD (p < 0.001). Conclusions: Both P16(Ink4a) and CD31 (MVD) expression correlate strongly with cervical lesion severity, suggesting their potential as biomarkers for disease progression. Further studies are warranted to validate their prognostic utility in cervical cancer management.
Omega-3 Supplementation is Effective in Reducing Interleukin-6 Levels After Physical Exercise: A Systematic Review
Not only does physical exercise improve health, it can also trigger inflammation. Therefore, supplementation after exercise is necessary to reduce it. Omega 3 is one of the nutrients that can potentially reduce inflammation. The fundamental however, the mechanism is not well known. This study examined how omega-3 supplementation while exercise affected IL-6 levels, an inflammatory biomarker. Our systematic review analysis examined interleukin 6, inflammation, and omega 3 papers from Pubmed, Web of Science, and Science Direct during the previous five years. This systematic review assessed nine eligible papers. This research assessed standard operating procedures using PRISMA. Taking omega-3 supplements while working out has been shown to reduce IL-6 levels. IL-6 is reduced by omega-3 supplementation during exercise. So, this can be a recommendation for sportsmen in routine consumption to prevent inflammation during exercise.
A Bibliometric Analysis of Global Research on Dementia and its Cognitive Function
Introduction: Dementia is a neurocognitive disease manifested by progressive and global declination in cognition. However, there is a lack of visualization analysis on research in the field of dementia and cognitive function. To evaluate the impact and compare the scholarly work output and productivity among organizations, bibliometrics was used. Material and methods Literature related to dementia and cognitive function were searched from Scopus database. In the area of dementia bibliometrics was used to analyze the leading authors, the journals with higher citation, higher collaboration between the countries, and keywords. Scopus analysis and Biblioshiny R-package were used in the analysis of country collaboration and global cited documents. Results: Total 1753 articles were identified from Scopus database and among these 425 articles were included in the study on basis of inclusion criteria. United states, China and Japan has the highest productivity and China, USA, Australia, Canada and Indonesia and has strong collaboration. The research hotspots in this field focused on Dementia and its impact on cognitive function. According to Lotka’s Law the studies in the field of dementia is limited and need to be conducted further. Conclusion: Dementia is a major public health issues in India and this study has thrown light on all articles which has manifested the current trends and important areas of research on dementia. After an intensive analysis the study concluded that there is still a gap in international collaboration among leading countries. In India dementia can be a research gray area and focus of future attention.
Uric Acid as a Predictor of the Severity of Preeclampsia: A Cross-Sectional Study in Sidi Bel Abbes, Algeria
Background: Preeclampsia is a pregnancy complication characterized by elevated blood pressure and organ failure, endangering the health of both the fetus and the mother. The research aimed to examine the predictive value of uric acid levels on outcomes in preeclamptic pregnant women. Subjects and Methods: The study consisted of 151 preeclamptic pregnant women, categorized into two groups: 99 with severe preeclampsia (SPG) and 52 with moderate preeclampsia (MPG). The researchers compared uric acid levels between groups and looked at LDH, ASAT, and ALAT biomarkers. The study employed Receiver Operating Characteristic (ROC) curve analysis to evaluate the predictive capacity of uric acid levels regarding outcomes. Results: The study revealed that women with severe preeclampsia exhibited markedly elevated uric acid levels (p = 0.003). The cohort with severe preeclampsia encountered more pronounced feto-maternal complications at a statistically significant level (p ≤ 0.001). The ROC curve analysis indicated that uric acid levels exhibited a moderate capacity to predict the severity and complications of preeclampsia, with diagnostic accuracy rates of 0.691 (p≤0.001) and 0.635 (p=0.007), respectively. The predictive value of uric acid was demonstrated to be inferior to that of the other biomarkers in the study. Conclusions: While elevated uric acid levels are associated with preeclampsia severity, they may not be as strong a predictor of adverse outcomes as other biomarkers such as ASAT, ALAT, and LDH.