Health behaviors, knowledge, screening, and attitudes toward colorectal cancer among Iraqi adults

OBJECTIVE

This study aimed to evaluate the Iraqi population's health behaviors, knowledge, screening, attitudes toward colorectal cancer (CRC), and possible predictors that may affect their knowledge level.

DESIGN

Cross-sectional study.

SAMPLE

One thousand three hundred sixty-one Iraqi adults from Sulaymaniyah/Iraq.

MEASUREMENTS

The odds ratio (OR) was used to find the association between knowledge of CRC and associated factors.

RESULTS

Among participants, 6.1% had a colonoscopy, 4.0% had a sigmoidoscopy, and 60.8% heard CRC screening. Participants had low knowledge level of CRC risk factors (5.52 ± 1.39), and symptoms (3.73 ± 1.16) and had a medium knowledge of screening (4.35 ± 1.02). Respondents who retired (OR = 1.30; p = .00) and who had graduated from university (OR = 0.86; p = .01) had a high knowledge of CRC, while those who were aged 70 and above (OR = -1.08; p = .00) had a low knowledge of CRC. Furthermore, it was found that Iraqi adults who answered "no idea" to questions related to attitude and who answered incorrectly questions related to risk factors were likely to have low knowledge (p = .00).

CONCLUSIONS

We found a lack of knowledge, screening, and misconceptions about CRC and screening among Iraqi adults. Thus, health training and screening programs should target Iraqi populations.

Association between dental clinical measures and oral health-related quality of life among Iraqi schoolchildren: A cross-sectional study

OBJECTIVE

The aim of this study was to assess the association between dental clinical measures and oral health-related quality of life (OHRQoL) together with the potential mediating role of sociodemographic factors and oral health behaviours on this association in a group of Iraqi children.

METHODS

The target population for this cross-sectional study consisted of 372 primary school children aged 8-10 years in the city of Kut, Iraq, during the year 2022. The participants were selected using a multi-stage random sampling technique. Detailed information about the children was collected through a comprehensive questionnaire that included demographic characteristics, oral health-related behaviors, the Arabic version of the Child Perceptions Questionnaire for 8-10-year-olds (CPQ8-10), and parental knowledge regarding oral health. Additionally, clinical dental evaluations were conducted, which included assessments of decayed, missing, and filled surfaces (DMFS, dmfs) as well as teeth (DMFT, dmft). Simplified oral hygiene index (OHI-S), bleeding on probing (BOP), and the community periodontal index (CPI) were also recorded for each participant using the recommended methodology by the World Health Organization (WHO). The statistical analysis included the Chi-square test, independent t-test, and simple and multiple linear regressions.

RESULTS

The mean age of the children was 9.0 (± 0.82) years. About one-third of children reported brushing at least two times per day and consuming a sweet snack once a day. Visiting a dentist during the past year was reported by 21% of children. Oral health behaviours demonstrated a significant association with the total CPQ8-10 scores (p < 0.001). Based on adjusted effects (β and 95% CI) from the multiple linear regressions, untreated dental caries (dt > 0, DT > 0) had a negative impact on the total CPQ8-10 score (adjusted β = 2.3 (95% CI: 0.67 to 3.91) and 3.4 (95% CI: 2.14 to 4.56), respectively). Decayed surfaces (DS), and teeth (DT) were associated with the total score of the CPQ8-10 and all its subscales (adjusted β range = 0.1 (95% C.I.: 0.03 to 0.19)-1.0 (95% CI: 0.72 to 1.26) and 0.2 (95% CI: 0.004 to 0.40)-1.2 (95% CI: 0.91 to 1.67), respectively). There was an association between oral hygiene index and total CPQ8-10 scores (adjusted β = 1.8 (95% CI: 0.62 to 3.02)), especially the functional limitations and emotional well-being subscales.

CONCLUSION

Findings of this study emphasizes the negative impact of dental caries and poor oral hygiene on children's OHRQoL. This association is highlighted more when considering that over two-thirds of these children do not comply with favourable levels of oral health behaviour. Enhancing the level of OHRQoL among these children, therefore, necessitates comprehensive programs for decreasing the volume of unmet oral health needs and improving children's adherence to recommended oral health behaviours.

Research practice, satisfaction, motivation, and challenges among university academics in Kurdistan Region of Iraq

BACKGROUND

Researchers in universities and academic institutions must be in a leading position in generating research evidence to inform and direct national policies and strategies, improve service delivery, and achieve the main objectives. This study aimed to determine the factors that promote or hinder research productivity and quality among university academics in Kurdistan Region of Iraq.

METHODS

A cross-sectional study was conducted on 949 university academics from all public universities in the Kurdistan Region of Iraq. The authors developed a questionnaire that included sociodemographic data, challenges, satisfaction, and motivation for conducting research. Data were collected using a Google form. Frequencies, percentages, and the Chi-square test were used to analyze the data.

RESULTS

Most university academics (94.6%) believed that research was part of their job, but only 51.6% were satisfied with their role as academic researchers. The lack of financial motivation was the main reason for dissatisfaction, while the main incentive to conduct research was the passion for science. Around 21% of the university academics had not published any research, while 53.1% published 1-5 articles. Half of the participants (49.7%) lacked training in writing research proposals, and the majority (86.1%) have not applied for international grants. Approximately half of university academics (46.9%) shared their research findings with stakeholders, and the primary method was by sharing their published papers (59.4%), followed by seminars (42.2%). One of the important challenges in conducting research was the lack of funding (62.8%).

CONCLUSIONS

The academics at universities in the Kurdistan Region of Iraq are passionate about their role as researchers, but face many challenges in conducting effective research. A strategic plan is needed to provide an encouraging environment for university academics regarding infrastructure, financial, and technical support. More studies are needed to identify the root factors of academic staff needs and challenges.

A comparative analysis of Pakistan and Kurdistan Region of Iraq

The objective of the study is to explore the relationship between country governance practices along with political stability and Economic policy uncertainty, and stock market performance of two different economies, Pakistan and Kurdistan region of Iraq. To meet our objectives, we used the 25 years past data from 1996 to 2021. Data is collected from the DataStream database. The regression analysis is used as the method of estimation for linear and moderation effect. Our results show that regulatory quality, rules of law and political stability has significant positive relationship with stock market performance of Pakistan, but all the governance indicators have significant positive relationship with stock market performance of the Kurdistan Region of Iraq. Moreover, political stability has significant moderating impact between the governance practices and the performance of the stock markets of both economies indicating that the governance practices perform well with the political stability that leads to rise in the stock market indices of selected countries. Economic policy uncertainty has significant negative moderation impact due to creating the risk in both economies that decrease the performance of the stock markets of the selected economies. Finally, our study advocated some implications for the investors to increase their confidence on the stock of high political stability and low economic policy uncertainty economies. Government can take significant measures to control the uncertainty of the policy and portfolio managers can adjust their risk on the ground of the political stability and efficient governance practices countries.

Phenotypic and genetic characterization of a lipolytic Ralstonia mannitolilytica isolate from petroleum-contaminated soil in Iraq

BACKGROUND

Lipases play a crucial role in various industrial applications, and microbial lipases, particularly those from bacteria, possess significant properties. With increasing concerns about the environmental and health impacts of hydrocarbons from pipelines and refineries, there is a growing need to mitigate the risks associated with these compounds.

METHODS

In this study, 40 bacterial isolates were recovered from contaminated soil samples collected from multiple refineries across Iraq. Using the Vitek system, bacterial isolates were identified up to the species level, revealing that only 12 isolates exhibited lipase-producing capabilities.

RESULTS

Among the lipase-producing isolates, Ralstonia mannitolilytica demonstrated the highest extracellular lipase activity, as determined by an olive oil plate assay supplemented with rhodamine B. Confirmation of the species identity was achieved through 16S rRNA gene sequencing, with the obtained sequence deposited under accession number LC772176.1. Further sequence analysis revealed single nucleotide polymorphisms (SNPs) in the genome of Ralstonia mannitolilytica strain H230303-10_N19_7x_R2 (CP011257.1, positions 1,311,102 and 1,311,457). Additionally, the presence of the lipase gene was confirmed through amplification and sequencing using a thermocycler PCR. Sequence analysis of the gene, aligned using Geneious Prime software, identified SNPs (CP010799, CP049132, AY364601, CP011257, and CP023537), and a phylogenetic tree was constructed based on genetic characterization.

CONCLUSION

Our findings highlight the potential of Ralstonia mannitolilytica as a promising candidate for lipase production and contribute to our understanding of its genetic diversity and biotechnological applications in hydrocarbon degradation and industrial processes.

Health risk assessment of heavy metals in some vegetables-Erbil City-Kurdistan Region of Iraq

Heavy metals can have significant impacts on human health due to their toxicity and potential to accumulate in the body over time. Some heavy metals, such as lead, cadmium, mercury, and arsenic, are particularly harmful even at low concentrations. The estimation of hazards of vegetable intake to human health as well as explore the of heavy metals accumulation in different vegetables (cucumbers, tomato, eggplant, and bell peppers) collected in Erbil city from different source locally and imported from nearby country are conducted. The heavy metals concentration (cooper, zinc, lead and cadmium) was measured and analyzed by inductively coupled plasma-optical emission spectrophotometry. The maximum concentration of Pb was 27.95 mg/kg and the minimum was 6.49 mg/kg; for Cd, the concentration was 1.43 and 0.99 mg/kg, 74.94 and 5.14 mg/kg for Zn; and for Cu, the result was 56.25 and 8.2 mg/kg for the maximum and minimum, which they are within limits described by Food Agricultural Organization, but more than health limits and health risks calculated by mean of hazard quotient (HQ) techniques for Cu and Pb which they are more than 1. The local sample that collected in Erbil city show less concentration of heavy metals and low HQ in comparison with imported samples. The carcinogenic risk study shows elevated risk of accumulative consuming of edible part of those plant which they exceed the permissible limit that is 10-6.

Social media addiction and depression and their predictors among university students

OBJECTIVES

Social media facilitate the interaction between individuals without regard to the distances between the users. Everybody who has access to internet can suffer from social media addiction. During COVID-19 pandemic there was an increase in social media usage among all population types and especially the university students, which would negatively affect their mental health. Therefore, this study aims at assessing social media addiction and depression among pharmacy students by using questionnaires specifically designed for this purpose.

METHODS

A cross-sectional study with convenience sampling was conducted from the start of November to the end of December 2021 among undergraduate pharmacy students in Mosul city, Iraq. An online questionnaire was adopted; it consisted of three parts, the first was for collecting socio-demographic and social media usage information, Social Media Addiction Questionnaire (SMAQ) was used in the second part to assess social media addiction of the participants, and the third part was comprised of the Patient Health Questionnaire (PHQ-9) to assess depression among students.

RESULTS

Six hundred-three students completed the questionnaire and constituted the final study sample. Instagram was the most used social media program among the students. About 38 % of the students were at risk of becoming addicted on social media, with only 8.4 % of them being minimally or not depressed. Additionally, positive significant correlation was observed between social media addiction and depression. Using social media for more than 4 h and poor academic performance were found to be predictors for social media addiction and depression.

CONCLUSIONS

Addiction to social media and depression are prevalent among pharmacy students in Iraq and the two are related to each other.

Assessment of Health-Related Quality of Life in Children with Totally Corrected Tetralogy of Fallot in Sulaymaniyah, Iraq

PURPOSE

This study examined the health-related quality of life among children who have undergone surgery for tetralogy of Fallot (TOF) compared to healthy children.

DESIGN

Cross-sectional study.

METHODS

The study was carried out at Children's Heart Hospital and Primary Healthcare Centers in Sulaymaniyah, Iraq, between July 1, 2022, and November 1, 2022. The study involved 400 participants, comprised of 200 parents of healthy children and 200 parents with children with repaired TOF. Data collection involved utilizing a 5-point Likert Scale questionnaire administered through direct face-to-face interviews with the parents of the children.

FINDINGS

Children with surgically repaired TOF had markedly lower mean scores (P ≤ 0.001) in the overall dimension of QoL (Mean rank = 137) when compared to healthy children (Mean rank = 263). Furthermore, it was observed that children with repaired TOF had significantly lower mean scores (P < 0.001) across all subdimensions of QoL compared to their healthy counterparts. In the subject of children with repaired TOF, the impact of maternal education (illiterate and lower education) on overall QoL was found to be highly significant (P < 0.001). In addition, children with repaired TOF from lower socioeconomic status (SES) families had worse quality of life than those from medium and high SES families, with a p-value <0.001.

CONCLUSIONS

Repaired TOF children exhibited notable deficiencies across all dimensions of QoL compared to healthy children. Moreover, SES emerged as a significant determinant influencing the QoL outcomes of repaired TOF children.

CLINICAL EVIDENCE

Despite undergoing corrective surgery for TOF, the QoL in children with repaired TOF continues to be lower than that of their healthy counterparts. Notably, the economic and educational status of the family significantly impacts the way these children perceive and experience their QoL. This finding underscores the critical significance of factoring in socioeconomic elements when addressing the well-being of this particular group of children.

Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study

This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P < 0.05). Younger age groups showed a higher prevalence of Vertucci Type I configuration (P < 0.05). Bilateral symmetry was seen in more than half of the maxillary premolars. There is a considerable variation in the number of roots and root canal configurations of maxillary premolars in the studied Iraqi population, with a significant difference by gender and age groups. Ahmed et al. classification provided more accurate presentation of the root and canal anatomy in maxillary premolars compared to Vertucci's classification.

Hydrogeochemical evolution processes, groundwater quality, and non-carcinogenic risk assessment of nitrate-enriched groundwater to human health in different seasons in the Hawler (Erbil) and Bnaslawa Urbans, Iraq

The main objectives of this research are to assess groundwater, a primary source of drinking water in the urban areas of Hawler (Erbil) and Bnaslawa in northern Iraq, and the non-carcinogenic human health risks of nitrate contamination associated with drinking water quality. For this purpose, twenty-seven groundwater samples were collected from wells to assess the hydrogeochemical characteristics and groundwater quality for both natural and anthropogenic purposes during the wet (May 2020) and dry (September 2020) seasons. During the wet and dry seasons, NO3- in groundwater ranged from 14.00 to 61.00 mg/L and 12.00 to 60.00 mg/L, with an average value of 35.70 and 29.00 mg/L, respectively. Approximately 25.92% of the samples exceeded the permissible limit of the WHO (2011) drinking water standard. The ratios of NO3-/Na+ vs. Cl-/Na+ and SO42-/Na+ vs. NO3-/Na+ indicate the effect of agricultural activities and wastewater leaking from cesspools or septic tanks on the quality of groundwater during the wet and dry seasons. The entropy weighted water quality index method ranked 62.5% and 75% of the urban groundwater as not recommended for drinking, and the remaining samples are moderately suitable in both wet and dry seasons. The non-carcinogenic human health risk assessment displayed that during the wet and dry seasons, 29.6% and 25.9% of adults, 48% and 30% of children, and 48.1% and 29.6% of infants were exposed to increased concentrations of nitrate in groundwater. Due to high nitrate in drinking water, non-carcinogenic human health risk levels vary as infant > child > adults. The main findings obtained from this study can assist policymakers in better understanding the hydrogeochemical properties of groundwater in terms of drinking water safety, thereby facilitating the management of water resources to take the necessary measures.

Geochemical processes, salinity sources and utility characterization of groundwater in a semi-arid region of Iraq through geostatistical and isotopic techniques

Identifying factors contributing to water salinity is paramount in efficiently managing limited water resources in arid environments. The primary objective of this study is to enhance understanding regarding the hydrochemistry, source, and mechanism of water salinity, as well as to assess the suitability of water for various uses in southern Iraq. The groundwater samples were collected from water wells and springs and analyzed for major cations and anions along with stable isotopes (δ18O and δ2H) to accomplish the objective. The analysis of major ion chemistry, hydrochemical techniques, principal component analysis (PCA), and isotope signatures were adopted to determine the primary factors contributing to water mineralization. The study inferred that evaporation and geological processes encompassing water-rock interactions, such as dissolution precipitation and ion exchange, were key processes. The stable isotope analysis revealed that the water originated from meteoric sources and underwent significant evaporation during or before infiltration. The utility assessment of water samples indicates that most samples are not appropriate for consumption and are significantly below the established standards for potable water. In contrast, a significant portion of the groundwater samples were found to meet the criteria for irrigation suitability by adopting Wilcox and the US Salinity Laboratory criteria. The groundwater could be considered for irrigation with proper salinity control management. Overall, this study has significantly improved the understanding of the hydrogeochemical regimes and acts as a first step toward the sustainable utilization of water resources.

MENet: A Mitscherlich function based ensemble of CNN models to classify lung cancer using CT scans

Lung cancer is one of the leading causes of cancer-related deaths worldwide. To reduce the mortality rate, early detection and proper treatment should be ensured. Computer-aided diagnosis methods analyze different modalities of medical images to increase diagnostic precision. In this paper, we propose an ensemble model, called the Mitscherlich function-based Ensemble Network (MENet), which combines the prediction probabilities obtained from three deep learning models, namely Xception, InceptionResNetV2, and MobileNetV2, to improve the accuracy of a lung cancer prediction model. The ensemble approach is based on the Mitscherlich function, which produces a fuzzy rank to combine the outputs of the said base classifiers. The proposed method is trained and tested on the two publicly available lung cancer datasets, namely Iraq-Oncology Teaching Hospital/National Center for Cancer Diseases (IQ-OTH/NCCD) and LIDC-IDRI, both of these are computed tomography (CT) scan datasets. The obtained results in terms of some standard metrics show that the proposed method performs better than state-of-the-art methods. The codes for the proposed work are available at https://github.com/SuryaMajumder/MENet.

Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents

BACKGROUND

Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq.

METHODS

A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale.

RESULTS

When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit.

CONCLUSION

Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.

Assessment of radiological risk associated with thoron gas at primary schools in Al-Najaf city, Iraq

Children spend considerable time at home and school, so school is likely to be a second source of natural radionuclide exposure after home. This study evaluates the radiological risk associated with thoron gas in the air within the building of one hundred primary schools in Al-Najaf City, Iraq, using a CR-39 detector. The results of the average value of thoron concentration detector, the annual effective dose (AED), Excessive Lifetime Cancer Risk (ELCR) × 10-3, and Lung Cancer Case (LCC) × 10-9 measured in the building of the schools were 7.47 ± 2.85 Bq/m3, 0.03 ± 0.01 mSv/y, 0.11 ± 0.04, and 0.54 ± 0.20, respectively. All the results of indoor thoron were below the global average limit. The results of the radiological survey due to thoron concentrations for studied primary schools suggest that the radionuclides and their radiological hazard indexes in all studied schools in AL Najaf city, Iraq, do not impose a health hazard.

Clinical and laboratory characterization of cutaneous leishmaniasis in Chinese migrant workers returned from Iraq

BACKGROUND

Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travelers with CL are easy to be misdiagnosed and mistreated due to the lack of awareness for the disease to the physicians in non-endemic region that may lead to unfavorable outcome. Our study intends to summarize the characteristics of Leishmania infection imported from Iraq, so as to help Chinese physicians diagnose and treat the disease. All CL patients were treated with intralesional injection of antimony.

METHODS

The definitive diagnosis of CL is based on the parasite identification by microscopic examination directly on lesion smear or parasite culture, PCR amplification of Leishmania-specific internal transcribed spacer 1 (ITS-1). The phylogenetic analysis, the immunopathological examination and the cytokine detection were proceeded after the diagnosis.

RESULTS

We have identified 25 CL cases in migrant Chinese workers returned from Iraq for the first time with L. major as the major species of infected Leishmania parasite. Clinical features of the Iraq-imported CL include the history of skin exposure to sandflies bite and the lesions mostly on the exposed limbs. More ulcerative wet lesion was observed than nodular dry lesion. PCR is not only used to detect Leishmania parasite with high sensitivity, but also to identify the species of infected parasite through sequencing the amplified Leishmania-specific ITS-1 gene. The phylogenetic analysis based on the amplified ITS-1 sequences revealed that the infected Leishmania was closed related to the species and strains endemic in Iraq. The immunopathological examination revealed the T-cell filtrated cellular immune response with less B cells and NK cells involved. The cytokine profile measured in the skin lesion also confirmed the Th1 cellular response with higher expression levels of IFN-γ, IL-6 and IL-8. The skin lesions in CL patients were healed after being treated locally with antimony.

CONCLUSIONS

The clinical and parasitological features of these Chinese CL cases imported from Iraq provide useful information for the diagnosis and treatment of CL that is not commonly seen in Chinese local population.

Divergent trends in accidental deaths since return from an Afghanistan/Iraq deployment among army soldiers

PURPOSE

Accidental death is a leading cause of mortality among military members and Veterans; however, knowledge is limited regarding time-dependent risk following deployment and if there are differences by type of accidental death.

METHODS

Longitudinal cohort study (N = 860,930) of soldiers returning from Afghanistan/Iraq deployments in fiscal years 2008-2014. Accidental deaths (i.e., motor vehicle accidents [MVA], accidental overdose, other accidental deaths), were identified through 2018. Crude and age-adjusted mortality rates, rate ratios, time-dependent hazard rates and trends postdeployment were compared across demographic and military characteristics.

RESULTS

During the postdeployment observation period, over one-third of deaths were accidental; most were MVA (46.0 %) or overdoses (37.9 %). Across accidental mortality categories (all, MVA, overdose), younger soldiers (18-24, 25-29) were at higher risk compared to older soldiers (40+), and females at lower risk than males. MVA death rates were highest immediately postdeployment, with a significant decreasing hazard rate over time (annual percent change [APC]: -6.5 %). Conversely, accidental overdose death rates were lowest immediately following deployment, with a significant increasing hazard rate over time (APC: 9.9 %).

CONCLUSIONS

Observed divergent trends in risk for the most common types of accidental deaths provide essential information to inform prevention and intervention planning for the immediate postdeployment transition and long-term.

Assessment of liver enzymes as diagnostic biomarkers in type 2 diabetes mellitus: a cross-sectional study in Zakho, Iraq

BACKGROUND

This study aimed to identify the prevalence and factors associated with abnormal liver enzyme profiles in individuals with type 2 diabetes (T2D) in Zakho, to assess the association between demographic characteristics, clinical parameters, kidney function tests, lipid profiles, glucose levels, and T2D, and to identify resident risk factors.

RESEARCH DESIGN AND METHODS

A cross-sectional analysis of T2D patients admitted to Zakho General Hospital was conducted utilizing hospital records. The primary endpoint of interest was attaining HbA1C levels ≥ 6.5%. Analytical methodologies encompassed linear and multivariate logistic regression analyses, with due consideration of the association between diverse parameters and glycemic alterations. Further, the predictive value of biomarkers was evaluated through Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) analyses, complemented by Spearman correlation analysis to explore relationships among laboratory parameters.

RESULTS

The study found that 89.4% of participants had HbA1C levels above 6.5%, with a preference for T2D among older individuals (mean age: 52.93-49.89 respectively) and females. Age, glucose levels, and liver enzymes positively correlated with HbA1C.

CONCLUSIONS

The study emphasizes the diagnostic importance of liver enzymes in individuals with type 2 diabetes, suggesting that these biomarkers could be valuable indicators of disease severity and progression.

Radioactivity levels, soil-to-grass and grass-to-milk transfer factor of natural radionuclides from grazing area in Erbil governorate, Iraq

The levels of naturally occurring radionuclides in soil, grass, and milk were measured in this study in order to calculate the transfer factor of radionuclides from soil to grass and grass to milk obtained from Erbil governorate in Iraq. High efficiency gamma spectrometry used for the measurement. It has been determined that the mean activity concentrations of 232Th, 226Ra, and 40K are 3.08, 8.37, and 253 BqKg-1 in soil, 0.5, 0.39, and 203.05 BqKg-1, in grass, and 0.29, 0.084, and 29.69 BqL-1, in milk, respectively. For soil to grass, the transfer factor values for 232Th, 226Ra, and 40K were found to be 0.18, 0.052, and 0.84, respectively, for soil to grass. For grass to milk, the transfer factor values for 232Th, 226Ra, and 40K were found to be 0.45, 0.166, and 0.11 dayL-1, respectively. The average transfer factor for 232Th, 226Ra, and 40K in all samples were lower than the world average value.

Pathway to terrorist behaviors: The role of childhood experiences, personality traits, and ideological motivations in a sample of Iraqi prisoners

Radicalization to terrorism is a multifaceted process with no single theory or approach to explain it. Although research has focused on understanding the process, there is still a dearth of studies that examine an empirically driven pathway to terrorism behavior. This study examines a cross-sectional sample of incarcerated men convicted of terrorism in Iraq (N = 160). A questionnaire-guided interview included adverse childhood experiences (ACEs), conduct disorder (CD), antisocial personality disorder (ASPD), religious and political ideology, views about causes of terrorism, and the severity of terrorist acts. Path analysis was employed to examine the relationships between these factors and to identify the model with the best fit. After adjusting for age, employment, and location, results indicated that ACEs positively impacted CD, ASPD, religious guidance, and terrorism attitudes. ASPD positively affected political commitment and terrorism attitudes, but inversely affected current religious commitment. Political commitment inversely influenced terrorism attitudes. Religious commitment positively influenced the prioritization of religion in life, which subsequently impacted terrorism attitudes and behavior severity. Additionally, attitudes toward terrorism directly affected the severity of terrorism behavior. All paths in the final model were statistically significant at p < 0.05. Although these findings may be limited in generalizability due to the unique sample, results support the complex and interdependent nature of childhood and adult experiences on the development of both terrorism attitudes and the severity of terrorism behavior.

Assessment of heavy metals in rainfall as an indicator of air pollution from Erbil Steel Factory in Iraq

The goal of the current study is to evaluate the heavy metal rainfall contamination in the vicinity brought on by the Erbil Steel Factory in Iraq during the study period. The study's findings revealed the concentration of all studied heavy metals in the precipitation near and around the factory is significantly higher than that of the rural area of Barzan village which is used as a control site. The average concentration of the metals is in descending order manganese (Mn) > lead (Pb) > iron (Fe) > arsenic (As) > cobalt (Co) > selenium (Se) > mercury (Hg) > and cadmium (Cd) for the polluted site. The geo-accumulation index (I-geo) of the heavy metal Mn in the rainfall around the steel factory site is 6.28 > 5 which indicates extreme contamination. While the Igeo values of Cd, As, and Fe are 4.87, 4.54, and 4.04 > 4 that indicate heavy to extreme contamination, for Pb, 3.80 > 3 indicates moderate to heavy contamination, Cd 1.68 > 1 indicates moderate contamination, Hg 0.46 > 0 indicates uncontaminated to moderate contamination, and Se - 0.36 < 0 indicates uncontaminated. The pollution load index (PLI) of the rainwater around the steel factory site is 13.46 > 1, demonstrating that the area is highly metal-contaminated.

zebaria) populations in Iraq

Sumac (Rhus coriaria L.) is one of the medicinal plants of Anacardiaceae family and widely used as a spice in Iran and Arab countries. Rhus coriaria var. zebaria is a small tree or large shrub, wildly growing in Iraq and described as a new variety with special characteristics. These increase the importance of studying sumac in these areas. Here, the phytochemical variations and the antibacterial activity of 50 accessions of this variety from five different climatic conditions was evaluated in order to identify the best accession to use and the best area for its cultivation. This is the most comprehensive study on this plant. Essential oil compounds were identified using GC-MS method and according to the results, Z, E-2,13-octadecadien, caryophyllene oxide, 2,4-decadienal, E-caryophyllene and nonanoic acid were among the main compounds. Also, the variety is a rich source of minerals including K, Ca, Mg, Na, P, and N. Sumac fruit extract from Akre Xerds had the highest anthocyanin and the lowest amount was from Kavilca region. The radical scavenging effect of extract from Dostic area in the concentration of 400 µg/mL is closer to the effect of ascorbic acid. The largest inhibition was found in the sumac extracted oil of Xasto Zhere area against S. aureus in compared with penicillin and amoxicillin and enrofloxacin antibiotics.

Perception, sentiments, and the level of awareness toward the dental implant among general population in Sulaimaniyah City, Iraq

BACKGROUND

Edentulism is one of the most commonly encountered conditions affecting the oral cavity. Dental implants have emerged as a widely accepted treatment option prosthodontically. However, lack of public awareness and the cost of the treatment act as barriers to limit their applicability.

OBJECTIVES

To investigate the perception, sentiments, and level of awareness toward dental implants among the general population in Sulaimaniyah City, Iraq.

MATERIALS AND METHODS

A questionnaire-based survey was conducted on 1132 participants in Sulaimaniyah City, Iraq, from February 15, 2023, till August 15, 2023, to collect their sociodemographic data, knowledge and attitudes toward dental implants for their missing tooth/teeth.

RESULTS

The mean age of participants was 41.3 ± 14.6 years, and most (30.7%) belong to the age group 31-44 years. Also, most of them were males (63.6%), married (75.3%), educated (91.3%), from rural areas (82.3%), and had > 1 missing tooth (75%). Regarding the participants' knowledge of dental implants, most had information (78.4%)/heard about it (83.3%), mainly from dentists (43.6%); however, least of them (21.5%) /their family members (43%) had replaced missing teeth by dental implants. Additionally, the participant's attitudes toward the dental implant indicated that most of them were interested in replacing their missing teeth (88.8%) but did not do it due to financial reasons (87%) and considered replacement as a significant (92.5%) and safe process (79.2%). Also, most of them thought there was no substantial difference between artificial and natural tooth appearance/function (47.9%), preferred the delayed implant for dental implant (47.7%), and would like to do an implant due to problems in dental appearance, speech, or dental function (81.5%). Finally, significant/highly significant differences were seen between each participant's factor (age, gender, marital status, education level, and residency) with most items of attitude/awareness toward dental implants.

CONCLUSIONS

Most participants were aware of the knowledge and attitude of dental implants for replacing missing tooth/teeth, especially males, married ones, educated individuals, and those from urban areas; however, financial problems are the main obstacle. Additionally, the delayed implant is preferable for replacing missing tooth/teeth using dental implants among studied individuals.

Prostate cancer presentation and management in the Middle East

BACKGROUND

Although prostate cancer is a prevalent malignancy worldwide, its clinical presentation and management in the Middle East are not well-documented. This study aims to provide insights into the initial clinical presentation and management of prostate cancer in this region.

METHODS

A retrospective review was conducted on seven institutional databases from six Middle Eastern countries, including Türkiye, Lebanon, Iraq, Syria, Bahrain, and Jordan, to identify patients diagnosed with prostate cancer in 2021. Descriptive analysis was performed on the collected data to provide an overview of the demographic, clinical, and treatment variables.

RESULTS

A total of 1,136 patients were identified with a median age of 70 (range, 50-84). Most patients (78%) received their prostate cancer diagnosis after presenting with symptoms, as opposed to routine PSA screening. At the time of diagnosis, 35% of men had clinical T3 or T4 disease, 54% with Stage IV disease and 50% with Gleason score ≥ 8. Regarding treatment, 20% of non-metastatic and 22% of metastatic patients received no treatment.

CONCLUSION

Most men in this study sought prostate cancer evaluation due to symptoms and were subsequently diagnosed with advanced-stage disease, providing a foundation for future research aimed at understanding the underlying factors behind the observed trends and enabling informed interventions.

Traumatic Brain Injury and Subsequent Risk of Brain Cancer in US Veterans of the Iraq and Afghanistan Wars

Importance

While brain cancer is rare, it has a very poor prognosis and few established risk factors. To date, epidemiologic work examining the potential association of traumatic brain injury (TBI) with the subsequent risk of brain cancer is conflicting. Further data may be useful.

Objective

To examine whether a history of TBI exposure is associated with the subsequent development of brain cancer.

Design, Setting, and Participants

A retrospective cohort study was conducted from October 1, 2004, to September 20, 2019, and data analysis was performed between January 1 and June 26, 2023. The median follow-up for the cohort was 7.2 (IQR, 4.1-10.1) years. Veterans Affairs (VA) and Department of Defense (DoD) administrative data on 1 919 740 veterans from the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium were included.

Exposure

The main exposure of interest was TBI severity (categorized as mild, moderate or severe [moderate/severe], and penetrating).

Main Outcomes and Measures

The outcome of interest was the development of brain cancer based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnostic codes in either the DoD/VA medical records or from the National Death Index.

Results

After 611 107 exclusions (predominately for no encounter during the study period), a cohort including 1 919 740 veterans was included, most of whom were male (80.25%) and non-Hispanic White (63.11%). Median age at index date was 31 (IQR, 25-42) years. The cohort included 449 880 individuals with TBI (mild, 385 848; moderate/severe, 46 859; and penetrating, 17 173). Brain cancer occurred in 318 individuals without TBI (0.02%), 80 with mild TBI (0.02%), 17 with moderate/severe TBI (0.04%), and 10 or fewer with penetrating TBI (≤0.06%). After adjustment, moderate/severe TBI (adjusted hazard ratio [AHR], 1.90; 95% CI, 1.16-3.12) and penetrating TBI (AHR, 3.33; 95% CI, 1.71-6.49), but not mild TBI (AHR, 1.14; 95% CI, 0.88-1.47), were associated with the subsequent development of brain cancer.

Conclusions and Relevance

In this cohort study of veterans of the Iraq and Afghanistan wars, moderate/severe TBI and penetrating TBI, but not mild TBI, were associated with the subsequent development of brain cancer.

Efficiency of C-type natriuretic peptide on improvement of Iraqi local ram's epididymal sperms

Background

Fertility plays a great role in animal reproduction since high-quality semen improves sheep industry reproduction. The current worldwide data revealed the close relation of C-type natriuretic peptide (CNP) to the reproductive function of rams.

Aims

Evaluation of the effect of CNP on cooled sperms using traditional and molecular assays.

Methods

Totally, of 20 testicular samples were collected, processed to obtain the semen samples, and divided into two parts; one was treated with a suitable dose of CNP, and the other served as a control. Sperm samples of both groups were cooled for 3 days and tested at 0, 24, 48, and 72 hours.

Results

The findings revealed that the suitable dose of CNP-treated sperms was 0.01 × 10-13. Values of individual motility, live sperms, and sperm concentration were reduced significantly in CNP-24h, CNP-48h, and CNP-72h when compared to control; however, abnormal sperms were increased in both control and CNP groups at 24, 48, and 72 hours when compared to values of 0 hour. Concerning turbidmetric analysis, a significant reduction in values of lag time was observed in CNP when compared to control at all times of cooling intervals. In both CNP and control groups, motility index was decreased at 24, 48, and 72 hours when compared to 0 hour. For velocity, significant increases were shown in CNP compared with control at all cooling intervals. However, values of both groups were increased significantly at 24, 48, and 72 hours times when compared to 0 hour. Fraction of rapidly moving sperm of CNP was elevated at 0 hour and decreased at 24, 48, and 72 hours when compared to control. Expression of the hNPR-B gene was reduced gradually in sperms of CNP and control groups at times of cooling intervals.

Conclusion

To the best of our knowledge, this first Iraqi study targets the effect of CNP on epididymal sperms of rams. However, changes that occur after excessive CNP exposure remain unclear, and the toxicological profile of CNP requires furthermore supplements.

Differential Gene Expression Profiles in Inflammatory Bowel Disease Patients from Kurdistan, Iraq

Objectives

Inflammatory bowel disease (IBD), generally comprising Crohn's disease (CD) and ulcerative colitis (UC), has become a significant global public health concern in the last decade. This study aimed to determine the alternations in the whole genomic expression profile of patients with IBD in this geographic location for the first time, as there are very few articles in the literature addressing this specific aspect of the field.

Methods

The study was conducted in Erbil Governorate in the Kurdistan region of Iraq from July 2021 to July 2022. The genome expression profiles of 10 patients with IBD were compared to their matched controls. The sequences used in the design of the array were selected from GenBank®, dbEST and RefSeq. Whole blood RNA was extracted and hybridisation was conducted on the GeneChip® human genome U133A 2.0 array. The Scanner 3000 was used to scan high-resolution images and the General Comprehensive Operating System was used to read the results.

Results

The upregulated genes shared between patients with UC and CD were RIT2, BCL2L1, MDM2 and FKBP8, while the downregulated genes they shared were the NFKBIB, DDX24 and RASA3 genes.

Conclusions

Upregulated and downregulated gene expression patterns were detected in individuals with IBD, offering diagnostic potential and opportunities for treatment by targeting the associated pathways.

Molecular study of blaVIM and blaIMP genes in Acinetobacter baumannii strains isolated from burn patients in Duhok City, Iraq

INTRODUCTION

Acinetobacter baumannii (A. baumannii) is an opportunistic pathogenic bacterium mainly associated with hospital acquired infections and in immunocompromised individuals who stay in hospitals for a long time. In recent years, it has become increasingly resistant to many different types of antibiotics. The production of the metallo-beta-lactamase (MBL) enzyme is one of the primary causes of this resistance. This study aimed to detect the presence of MBL genes that belong to the verona integrin metallo-β-lactamase (bla-VIM) and imipenemase (bla-IMP) groups in the isolates of Acinetobacter baumannii from burn patients.

METHODOLOGY

One hundred and seventeen (117) isolates of A. baumannii were obtained from patient specimens using traditional methods followed by using the VITEK 2 (BioMérieux, Les Pennes-Mirabeau, France) identification system. Metallo β-lactamases were detected in the imipenem-resistant strains by using imipenem disks on Muller-Hinton agar. The polymerase chain reaction (PCR) technique was utilized to examine 117 isolates for the detection of MBLs encoding genes such as bla-VIM, and bla-IMP.

RESULTS

Imipenem resistance was detected in 78.6% of the patients. The PCR assays of the isolates identified bla-VIM-1, bla-VIM-2, bla-IMP-1 and bla-IMP-2 genes at the rates of 17%, 40.1%, 29.9% and 4.2%, respectively.

CONCLUSIONS

The findings suggest that the majority of A. baumannii isolates harbour one or more of the detected genes, signifying that the production of MBLs plays a pivotal role in resistance mechanisms.

SARS-CoV-2 receptor a distinct genetic profile specific to the Iraqi Kurdish population

SARS-CoV-2, the virus responsible for COVID-19, enters host cells by binding its spike protein's receptor-binding domain (RBD) to the human angiotensin-converting enzyme 2 (ACE2) receptor's peptidase domain (PD). This interaction plays a crucial role in the virus's ability to invade host cells and establish infection. Numerous studies have identified specific residues crucial for their binding interaction. Our objective was to determine whether natural variations in the ACE2 receptor could impact its affinity for the S-protein RBD. To explore this, we focused on investigating the effects of natural variations in the ACE2 PD residues on its binding affinity to the S-protein RBD interface of SARS-CoV-2. We conducted a genotyping study in the Iraqi Kurdish population and identified significant genetic variations in key binding residues of the ACE2 PD residues, including N330K, K353R, R357Q, P389H, and R393H. These variations suggest a distinct genetic profile specific to the Kurdish population regarding their interaction with the SARS-CoV-2 virus. Understanding the implications of these variations is essential for comprehending the mechanisms of viral infection, developing targeted therapeutics, and refining treatment strategies and vaccine design. Additionally, studying these variations can provide insights into population-specific vulnerabilities, help monitor viral evolution and transmission, and guide the development of effective interventions.

Biochemical Profiling and Physicochemical and Biological Valorization of Iraqi Honey: A Comprehensive Analysis

Our study aimed to analyze five monovarietal honeys from the Salah Eddine region in Iraq, focusing on physicochemical, antioxidant, and antimicrobial properties and polyphenolic compounds. Our objective was to evaluate the strengths and qualities of Iraqi honeys, ensuring compliance with the Codex Alimentarius standard for honey. The spectrophotometric analysis included assessments of reduced sugar (75.8-77.7%), fructose-to-glucose ratio (0.7-0.9%), sucrose (2.2-2.9%), HMF (17.23-18.87 mg/kg), and melanoidin content (0.25-0.44), which were all determined. The electrical conductivity (0.39-0.46 mS/cm) using a conductivity meter, pH (4.02-4.31), and mineral composition were determined in all samples using atomic absorption spectrometry. Antioxidant activities were spectrophotometrically determined, through DPPH free radical scavenging (7.87-95.62 mg/mL), as was the total antioxidant activity (14.26-22.15 mg AAE/g), with correlations established with biochemical constituents such as the total phenol content, highlighting the significant presence of Coumaric acid (0.38-2.34 µg/mL), Catechin (1.80-2.68 µg/mL), and Quercetin (0.30 µg/mL) using HPLC. The study also observed notable antimicrobial activities using Escherichia coli, Staphylococcus aureus, and Candida albicans on Mueller-Hinton agar as well as through diffusion technique. In conclusion, our findings, including the antioxidant and antimicrobial strengths, underscore the substantial potential of Iraqi honeys in mitigating damage and preventing the onset of various diseases, affirming their good quality and adherence to international honey standards.

The environmental impact of heavy metals in sediments of main valleys in the eastern side of Mosul City, Iraq

Analyzing the geochemical changes in stream sediments can reveal important surface processes on Earth, like weathering, transportation, and cation exchange. The study area is located on the eastern side of Mosul, where valleys named Al-Rashediya, Al-Kharrazi, Al-Khosar, Al-Danffilli, and Al-Shor flow towards the Tigris River. These valleys' sediments contain diverse components like clay minerals, organic matter, iron oxides, carbonates, and heavy metals (H.M.s), either as part of these substances or adsorbed onto them. In this study, 36 sediment samples were gathered from these valleys. They underwent chemical analysis through X-ray fluorescence to ascertain their chemical constituents of major oxides. To understand the distribution of H.M.s in these sediments, correlation coefficient analysis and factor analysis were utilized. The study employed the geoaccumulation index (Igeo) and enrichment factor (E.F.) to evaluate sediment contamination. The results of Igeo ranged from Cr = 0.24 to 1.83, Ni = -0.92 to 0.77, Cu = -2.41 to 0.05, Zn = -1.83 to 0.89, Pb = -1.54 to 0.36, and As = -2.84 to 0.80. These findings suggest that the valley sediments are generally in the range of deficiency to minimal enrichment and moderate enrichment. However, Al-Danffilli Valley shows strong contamination levels for Cu, Zn, and Pb. The E.F. values for Cr = 3.63-12.50, Ni = 1.95-4.19, Cu = 0.69-12.36, Zn = 1.08-16.19, Pb = 1.25-62.16, and As = 0.60-1.79 indicate levels ranging from deficiency to minimal and moderate enrichment. Al-Danffilli Valley, in particular, was identified as ranging from moderate to extremely high enrichment, attributed to its location near industrial areas and its tributaries.

Association between body weight perception and actual body mass index among adult women in Erbil city, Iraq

BACKGROUND

The misperception of body weight can significantly affect individuals' health behaviors, such as physical activity, diet, and weight management. This study aimed to examine the association between body weight perception and actual body mass index (BMI) among adult women and explore the factors influencing this relationship.

METHODS

Five hundred forty female individuals aged 18-65 participated in this cross-sectional study. The validated Global Physical Activity Questionnaire was used for data collection. The BMI of the participants was calculated from measured body weight and height. Body weight perception was assessed using a single questionnaire item. The association of BMI and body weight perception was assessed, and the result was categorized as underestimation, consistency, and overestimation. The Chi-square test was used to assess the association between the consistency of BMI and body weight perception by different sociodemographic factors. The kappa test was used to analyze the consistency of BMI and body weight perception.

RESULTS

Of the 540 participants, 13.3% underestimated their body weight status, 79.1% accurately perceived their body weight status, and 7.6% overestimated their body weight status. Unmarried women (11.7%) were more likely than ever married (4.3%) to overestimate their body weight (p = 0.005). On multiple logistic regression, being unmarried (OR = 1.68 (95%CI 1.01-2.80)) was significantly associated with body weight misperception. Body weight perception and BMI categories showed a significantly good consistency (kappa = 0.612, p < 0.001). Correct perception of body weight was highest among the overweight, followed by normal weight and underweight individuals (82.1%, 75.8%, and 72.2%, respectively).

CONCLUSION

Body weight perception was well associated with actual body weight status. Unmarried women are more likely to misperceive body weight, particularly overestimating it. Underestimation of body weight was relatively high and much higher than the overestimation, which might keep obese individuals from weight loss activities. Preventing obesity should include awareness about body weight misperceptions.

wildly growing in Anbar province, Iraq

ETHNOPHARMACOLOGICAL RELEVANCE

Plant fungi are a serious problem in agriculture. Even though synthetic fungicides are an efficient control method, several negative side effects emerge from their extensive use, such as health problems, environmental pollution, and the emergence of resistant microorganisms. Thus, it is becoming more and more urgent to search for alternative control methods.

AIM OF THE STUDY

The aim of our study was to analyze phytochemical composition and antifungal potential of Launaea mucronata (Forssk.) Muschl. and Launaea nudicaulis (L.) Hook. fil. wildly growing in Anbar province, Iraq. In addition, molecular analysis was used to identify the plants species and molecular docking analysis was investigated between the major phytochemicals present in these plants and three selected fungal proteins, in order to assess the antifungal activity of the selected biochemicals against these proteins.

MATERIALS AND METHODS

Molecular analysis was performed using ITS sequencing protocol. The phytochemical analysis was done using GC-MS technique, while molecular docking analysis was performed by FRED application between selected compounds from each plant and three enzymes: 17β-hydroxysteroid dehydrogenase, endochitinase, and 14-α-demethylase. Finally, the antifungal activity was assessed by measuring inhibition percentage of Fusarium solani and Macrophomina phaseolina growth treated with ethanomethanolic extract of each plant.

RESULTS

Molecular analysis identified the selected plants as L. mucronata and L. nudicaulis, with an ITS region of 600 bp. Phytochemical analysis of Launaea spp. reported the presence of 35 compounds in each ethanomethanolic extract, belonging to different classes. L. mucronata was mainly formed of lupeol (9.33%), whereas L. nudicaulis extract was dominated by the heterocyclic compound 4-(3-methoxyphenoxy)-1,2,5-oxadiazol-3-amine (20.2%). Furthermore, molecular docking analysis showed that 4H-pyran-4-one,2,3-dihydro-3,5-dihydroxy-6-methyl from L. mucronata and gulonic acid Ƴ-lactone from L. nudicaulis possessed the highest affinity score to 17-β-hydroxysteroid dehydrogenase (-4.584 and -7.811 kcal/mol, respectively). Sucrose from L. mucronata and glutaric acid, di(3,4-difluorobenzyl) ester from L. nudicaulis gave the highest affinity to endochitinase (-7.979 and - 8.446 kcal/mol, respectively). In addition, sterol 14-α-demethylase was affinitive to sucrose from L. mucronata and glutaric acid, di(3,4-difluorobenzyl) ester from L. nudicaulis via energetic score of -10.002 and -9.582 kcal/mol, respectively. Both extracts exhibited antifungal activity against F. solani and M. phaseolina in a dose-dependent manner.

CONCLUSIONS

This study confirms the antifungal potential of both Launaea spp. explained by the presence of phytochemicals with antimicrobial properties. These compounds have potential to be used as new drugs to treat infectious diseases caused by pathogens. Consequently, plants from Launaea genus could be a raw material for many studies such as therapeutic, taxonomical, drug modelling, and antifungal agent.

Evaluation of normal range of serum 25 hydroxyvitamin d in iraqi healthy adults: demographic and socioeconomic effects

OBJECTIVE

Aim: To determine the normal range of serum levels of total 25(OH)VD in Iraqi healthy adult subjects and to relate its level with demographic profile and socioeconomic status..

PATIENTS AND METHODS

Materials and Methods: This cross sectional study was carried out at Iraq and the samples were collected during the period from August 2019 to January 2020. It included 649 adult subjects apparently healthy, from three governorates (Baghdad, Al-Anbar and Al-Basrah), Investigations included serum measurement of total 25(OH)D in all included individuals by using ELISA technique. Age, gender, marital state, blood pressure, smoking, sunshine exposure (%), hours of exposure/day, percentage of body surface area exposed, body mass index (BMI) subgroups, waist circumference (WC) subgroups, diet type, sport type and time, geographic factor (governorate) were measured and / or calculated and the levels of 25(OH)D were studied according to each of these factors.

RESULTS

Results: The mean ± SD level of 25(OH)D in total (n=649) studied Iraqi subjects was (16.29 ± 8.22 ng/ml), with women were significantly deficient than men (15.76 ± 6.89 ng/ml, 17.14 ± 6.85 ng/ml; p < 0.01 respectively). However, there was no significant differences in mean values of serum 25(OH)D levels among studied governorates, subgroups of BMI, WC, marital status, smokers and nonsmoker and subgroups of age. The mean value of serum 25(OH)D was found to be decreased in January, October and November as well as according to diet and sport types. There was significant positive correlation between total 25(OH)D and sun exposed surface area, sun exposure duration and with sun exposure area.

CONCLUSION

Conclusions: The mean (±SD) value of serum total 25(OH)D in Iraqi healthy subjects was 16.29 ng/ml (±8.22) reflecting the actual body status of this vitamin with lower concentration in women than in men. Type and time of sport and diet type were the major vitamin D dependent factors.

Benchmarking of circular economy behaviors for Iraqi energy companies based on engagement modes with green technology and environmental, social, and governance rating

Greenhouse gas emissions and global warming are recent issues of upward trend. This study sought to underline the causal relationships between engagement modes with green technology, environmental, social, and governance (ESG) ratio, and circular economy. Our investigation also captured benchmarking of energy companies' circular economy behaviors. A hybrid-stage partial least squares structural equation modeling (PLS-SEM) and multi-criteria decision-making (MCDM) analysis have been adopted. This study collected 713 questionnaires from heads of departments and managers of energy companies. The findings of this study claimed that engagement modes with green technology affect the circular economy and sustainability. The findings revealed that ESG ratings have a mediating role in the nexus among engagement modes with green technology and circular economy. The results of the MCDM application revealed the identification of the best and worst energy companies of circular economy behaviours. This study is exceptional because it is among the first to address the issues of greenhouse gas emissions by providing decisive evidence about the level of circular economy behaviors in energy companies.

Relationship between vitamin D receptor genotypes (FOK1rs2228570) and IL18 gene expression in sample of multiple sclerosis Iraqi patients

BACKGROUND

Multiple Sclerosis known as MS, this chronic inflammatory demyelinating condition affects the nervous system. It is a heterogenic and multifactorial disease. The goal of the current study was to investigate the relationship between MS patients' IL18 gene expression and the vitamin D receptor gene polymorphism (FOK1rs2228570).

OBJECTIVE

The aim of the study to investigate the association of vitamin D receptor (FOK1rs2228570) gene polymorphism and pro inflammatory cytokine (IL18) gene expression among multiple sclerosis Iraqi patients. Detection VDR polymorphism and determine whether this SNP is involved in susceptibility to multiple sclerosis and estimation IL18 gene expression and explore its relation with multiple sclerosis susceptibility.

METHODS

Blood samples were taken from 75 MS patients in Iraq (30 men and 45 women), as well as from 75 volunteers who seemed to be in a favorable state of health and fell within the age range of 20 to 50 years. Tetra-ARMS Polymerase Chain Reaction (Tetra-ARMS PCR) was used to find polymorphisms in the vitamin D receptor (VDR) gene, and Real-time Polymerase Chain Reaction (RT-PCR) was used to measure IL18 gene expression.

RESULTS

The findings from the analysis of VDR gene polymorphism in patients with MS indicated that the wild-type genotype T/T was present in 8 individuals, accounting for 10.6%, the heterogeneous genotype TC was 36 (48%), and the homogeneous genotype CC was 31 (41.3%), whilst T allele frequency was 52(34.6%) and C allele was 98(65.3%) with (P⩽ 0.01) significant difference and even as in control T/T genotype was 49(65.3%), TC genotype was 21(28%), CC genotype was 5(6.66%), T allele frequency was 119(79.3%) and C allele was 31(20.6%) with significant difference (P⩽ 0.001). While estimation of IL18 expression showed high elevation in patients' group (2.59 ± 0.51 fold) by significance difference (P⩽ 0.5) when compared to control group (1.35 ± 0.14 fold). The relationship between IL18 gene expression with VDR variant in MS patients demonstrated a significant rise (2.9 ± 0.51 fold) at CC genotype patients in IL18 folding gene expression, followed by (4.6 ± 0.17 fold) in TC genotype patients and finally (1.4 ± 0.08 fold) in TT genotype patients with highly significant (P⩽ 0.01).

CONCLUSION

The VDR(FOK1rs2228570) genotype was significantly correlated with IL18 expression in MS patients from Iraq.

Expression level of non-coding (MiR-155) gene as biomarker for severity of coronaviruses infection among vaccinated and non-vaccinated Iraqi patients

BACKGROUND

The COVID-19 pandemic caused by SARS-CoV-2 is influenced by genetic and epigenetic factors, including miR-155, which affects immune cell and virus functions and laboratory biomarkers.

OBJECTIVE

To evaluates miR-155's role as a biomarker for SARS-CoV-2 detection and monitoring, examining its significance in identifying infection in both vaccinated and unvaccinated individuals using ROC curve analysis.

METHODS

Blood samples were collected from 70 patients who attended Medical City Hospital in Baghdad from June 2022 to April 2023 and were determined to be associated with SARS-CoV-2 (35 patients were hospitalized at the Intensive Care Units due to the severity of their symptoms while the other 35 were left in the hospital upon treatment.). Additionally, 35 samples were collected as a healthy control group.

RESULTS

The expression level of miR-155 in the serum of samples showed a high level (fold change: 9.81 ± 5.50) in the severe patients' group in comparison with the moderate patients' group (fold change: 4.17 ± 2.93) and healthy group (fold change: 1.08 ± 0.01). To assess the performance of miR-155 and laboratory biomarkers, a (ROC) curve was utilized to determine the sensitivity and specificity.

CONCLUSIONS

The miR-155 gene, overexpressed in SARS-CoV-2 patients, correlates with disease activity and severity, potentially serving as a biomarker for diagnosis and a potential therapeutic target.

Study of the spread of medicinal herbs use among patients suffering from chronic diseases in Iraq

OBJECTIVE

Aim: To assess the prevalence of medicinal plants, use among Iraqi patients with chronic disease and compare it with another study in same or different countries.

PATIENTS AND METHODS

Materials and Methods: A randomized Internet and social media questionnaire was used. In this cross-sectional study, peoples with chronic diseases from different age group were recruited. Participants had an internet questionnaire to answer. This questionnaire embraced age, gender, occupation, marital status, education level and some lifestyle details as demographic data, a large proportion of the questionnaire was related to herbs, both prescribed and OTC ones.

RESULTS

Results: Gender distribution: about 70% of patients were female and 30% male. Education level: uneducated - 35%, primary school - 30%, secondary school - 25%, academic - 10%. Place of residence: 30% lived in urban and 70% in rural areas. Diseases distribution: 30% hypertension, 20% diabetes, 10% asthma, 10% migraine, 15% hyperlipidemia and 15% rheumatoid arthritis. Medicinal plants: 10% green tea, 5%fish oil, 15% anise 25% castor oil and 15% spirulina.

CONCLUSION

Conclusions: The study reported a high prevalence of medicinal herbs use among patients with chronic disease in Iraq. Several factors (rural residence, education, age, multiple chronic conditions and low quality of life) associated with medicinal herbs use. This knowledge will help policy makers and health care providers for decision making on the safe use of herbal medicine.

Population genetic structure of tropical bed bug (Hemiptera: Cimicidae) populations and their breeding pattern in Iraq

A study was conducted to investigate the population genetic structure and breeding pattern of 140 tropical bed bugs, Cimex hemipterus (F.) (Hemiptera: Cimicidae), collected from 14 infested sites in major cities in Iraq. The samples were genotyped using a set of 7 polymorphic microsatellite markers. High genetic variety was seen among populations, with an average of 2-9 alleles per locus. The number of alleles across 7 microsatellite loci was between 6 and 18. There was a notable disparity in the alleles per loci when comparing the overall population to those within it. The overall population exhibited an average observed heterozygosity of 0.175 and an average expected heterozygosity of 0.730. Among the population, the average observed heterozygosity was 0.173, while the average expected heterozygosity was 0.673. Analysis of molecular variance (AMOVA) revealed that 93% of the genetic variability was within the populations, and 7% was among them. The genetic differentiation coefficient (FST = 0.045), indicates a low degree of genetic differentiation and a high degree of inbreeding (FIS = 0.761), as indicated by notably significant positive inbreeding coefficients. Admixed individuals were revealed using STRUCTURE and neighbor-joining phylogenetic trees, demonstrating moderate gene flow between populations and a lack of genetic structure in the regional groups. Thus, both active dispersion and human-mediated dispersion possess the potential to influence the low population genetic structure of tropical bed bug C. hemipterus populations in Iraq, which can have implications toward tropical bed bug and management strategies.

Waterborne Diseases and Wastewater Treatment in Iraq

Iraq is a desert country with access to large river resources and an extensive aquifer, but these have already been overdrawn for domestic, industry and agriculture use. The diminished flow of the Tigris and Euphrates rivers has allowed seawater intrusion from the Persian Gulf 110 km up as far as Basra, the county's third largest city. In addition, water distribution systems are overloaded and wastewater treatment plants (WWTPs) need upgrading, and fresh water sources polluted by lack of sanitation, agricultural runoff, household and industrial waste, and including the irrigation of vegetables with sewage water, have led to episodes of bacterial, viral and parasitic diseases. Also, there have been increases in many types of cancer since the early 1990s, and based on clinical and epidemiological data, these increases could be attributable to exposure to depleted uranium in the environment arising from conflict in Iraq and particularly during the Iraqi War started 20 years ago. The population affected would like government action to reduce their health concerns, and policies that have been proposed for improving water availability and quality, as well as but have not been followed up sufficiently to tackle these, including increasing the capacity and efficiency of WWTP; promoting the most efficient irrigation techniques for the local growing conditions; reducing the use of chemical fertilizers and pesticides that can decrease the water quality; reducing saline intrusion challenges; building compact desalination units; constructing water storage facilities to address water scarcity challenges; and establishing public education plans for consumers to reduce the water demand during the hot season. Whether the government rises to the task remains to be seen. Also, do those countries that used the DU have a responsibility to remove or otherwise dispose of the fragments that remain?

G1 the common Echinococcus granulosus genotype infected domestic cat (Felis catus) in Iraq

BACKGROUND

Infections of cats with Echinococcus granulosus is uncommon because the cat is not part of the parasite life cycle that a carnivorous and another herbivore represent. Nevertheless, it occurs incidentally when eating food or drinking water contaminated with the worm's larva, especially with the presence of the definitive host (dogs), in this case, the infections are concentrated in stray or outside cats. For this reason, this study examined the possibility of cat infection with E. granulosus and diagnosed the common genotype of this infection.

OBJECTIVE

This study examined the possibility of cat infection with E. granulosus and diagnosed the common genotype of this infection.

METHODS

Four of the 37 cats that had died in different accidents developed cystic echinococcosis (CE). The cytochrome c oxidase subunit I (COX1) gene was initially amplified and sequenced to determine if these cysts belonged to E. granulosus, in beginning. The DNA fragments resulting from sequencing were then compared and aligned with other sequences using the Gene Bank database. Finally, a phylogenetic tree was drawn according to the sequence data obtained from cox1 genes sequencing, and the MEGA 7.0 phylogenetic analysis program was utilized.

RESULTS

Four different sequences were deposited in the Gen Bank with accession numbers (ON795961 to ON795964), all of which belong to the G1 genotype. Approximately 84% and 100% of these sequences aligned with G1 (AB622277.1) and G1 (MG722980.1), respectively.

CONCLUSIONS

G1 is the dominant genotype that causes cat infections, even though the cat's EC infection was incidental.

BRCA1 methylation in breast duct carcinoma, a practical study in Duhok-Iraq

            Lacking protein functions of Breast cancer susceptibility gene1 (BRCA1) and Breast cancer susceptibility gene2 (BRCA2), by methylation, represents tissue-specific silent epigenetic regions that tolerate genomic instability and may end in different cancers, mainly breast and ovary. Promoter-CpG island hypermethylation is a common molecular defect in cancer cells. This has prompted us to use MSP for identification of BRCA1 methylation in these groups of women at Duhok, north of Iraq. Genomic DNA was isolated from 96 tumor samples from patients with primary breast cancer and normal tissues which include; 40 non-neoplastic breast tissues (considered as external control) and 40 distant non-cancerous tissues from the same cancerous women (internal control). The extracted DNA was subjected to methylation-specific PCR (MSP) to determine the promoter methylation status of BRCA1 and its correlation with study parameters including protein expression level of ER, PR, Her2/neu, and Ki67 receptors. The study revealed 10.4% complete BRCA1 methylation and 66.6% partial methylation (PM) among the cancerous samples. Partial methylation was observed in 95% of internal control and 20% of the external control. Complete methylation was negative in both control groups. Compared with negative methylation, positive BRCA1 promoter methylation was significantly high among triple negative (ER-, PR-, Her2-) cases with high proliferative index. There was also a methylation trend toward cases with T2 and higher staging status, although didn't reach the level of significance. BRCA1 promoter complete methylation was exclusive for cancerous tissues. With management of the above concerns, this line of research gains a strength point including the prevalence of DNA methylation changes among sporadic breast cancer (i.e. not restricted to the inherited type). Considering partial or focal BRCA1 methylation, caution has to be taken as this epigenetic alteration, which may progress to complete methylation status, was detected in non-neoplastic breast tissues adjacent to the cancerous ones and even normal breasts. This triggers application of extended screening programs, including BRCA1 methylation, for identification of women at risk, and can benefit from early intervention.

Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a co-designed code of conduct and of a tailored de-escalation of violence training in Eastern Democratic Republic of Congo and Iraq: a study protocol for a stepped wedge randomized controlled trial

BACKGROUND

Violence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq.

METHODS

In an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs' quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies.

DISCUSSION

Violence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022.

Climate change and future challenges to the sustainable management of the Iraqi marshlands

The application of restoration plans for the Iraqi marshlands is encountering significant challenges due to water scarcity and the impacts of climate change. This paper assesses the impact of water scarcity on the possibility of continuing the application of restoration and sustainable management plans for the main marshlands in Iraq. This assessment was conducted based on the available data and expected situation of available water resources under climate change conditions until the year 2035. Additionally, a satellite image-based index model was prepared and applied for the period 2009-2020 to obtain the spatiotemporal distribution of the restored marshlands. The results show that the shortage in water resources and insufficient inundation rates prevented the adequate application of the restoration plans. Also, applying the scenarios of distributing the deficit equally over all water demand sectors (S1) and according to the percentage of demand for each sector (S2) shows that the expected deficit in available water for the three marshes by the years 2025 and 2035 will be approximately 25% and 32% for S1 and 9% for S2. Consequently, the considered marshes are expected to lose approximately 20 to 33% of their eligible restoration areas. Accordingly, looking for suitable alternatives to support the water resources of these marshes became a very urgent matter and/or recourse to reduce the areas targeted by inundation and being satisfied with the areas that can be sustainable and maintain the current status of the rest of the regions as an emerging ecosystem characterized by lands that are inundated every few years. Accordingly, steps must be urged to develop plans and programs to maintain the sustainability of these emerging ecosystems within the frameworks of climate change and the conditions of scarcity of water resources and water and air pollution to ensure that they are not lost in the future.

Association of soluble triggering receptor expressed on myeloid cells-1 with rheumatoid arthritis in Iraqi patients: A case-control study

Rheumatoid arthritis (RA) is a common chronic immune-mediated inflammatory arthritis, impacting 0.5-1% of the global population, and leading to progressive deterioration of the musculoskeletal and joint systems. This study aims to analyze the serum levels of soluble triggering receptors expressed on myeloid cells-1 (sTREM-1) in Iraqi patients with RA and healthy individuals. It also intends to assess the diagnostic significance of these receptors, investigate their association with disease activity and examine their correlation with the sociodemographic and clinical characteristics of the patients. From December 2020 to June 2021, 117 RA patients with a mean age of 50 years participated in the study. The patients were categorized into inactive and active disease groups based on their DAS28 score and CDAI, as determined by a Rheumatologist. The serum levels of a specific triggering receptor expressed on myeloid cells-1 (TREM-1) (Pg/mL) were measured. The results showed that the active RA patients had significantly higher levels of the receptor (270.17±187) compared to both the inactive RA patients (112.81±37.48) and the healthy controls (43.89±29.53) (P < 0.001). The sTREM-1 demonstrated a high discriminatory ability (AUC ≥ 0.936) between RA and control groups. Moreover, a direct association was observed between the DAS-28ESR and sTREM-1 levels.

Differential impact of type of killing on posttraumatic stress disorder symptoms in U.S. Army soldiers deployed to Afghanistan

Over the past 20 years, U.S. military conflicts in Iraq and Afghanistan have been marked by high rates of combat and wartime killings. Research on Vietnam-era service members suggests that the type of killing (i.e., killing a combatant vs. noncombatant) is an important predictor of later mental health problems, including posttraumatic stress disorder (PTSD). The present study aimed to update these findings by exploring the impact of type of killing on PTSD symptoms using a sample of postdeployment active duty U.S. Army personnel (N = 875). Using multiple regression analysis, we found that the act of killing a noncombatant was significantly associated with PTSD symptoms, B = 7.50, p < .001, whereas killing a combatant was not, B = -0.85, p = .360. This remained significant after controlling for demographic variables, depressive symptoms, and general combat experiences. These findings support the need for thoughtful postdeployment screenings and targeted clinical interventions.

A novel intergenic variant, rs2004339 A/G, of the gene encoding interleukin-40, C17orf99, is associated with risk of rheumatoid arthritis in Iraqi women

Interleukin-40 (IL-40) is a novel cytokine encoded by the chromosome 17 open reading frame 99 (C17orf99) gene. Recent studies have shown that IL-40 levels are significantly up-regulated in patients with rheumatoid arthritis (RA). However, the association of genetic variants of the C17orf99 gene with the risk of RA has not been investigated. In this case-control study, two intergenic variants, rs2004339 A/G and rs2310998 G/A, were genotyped for the first time in 120 Iraqi women with RA (30 newly diagnosed [ND] and 90 medicated [MD; treated with the tumor necrosis inhibitor etanercept plus methotrexate]) and 110 control women using TaqMan 5'-allele discrimination method. Serum IL-40 levels were also determined using an enzyme-linked immunosorbent assay kit. Multinomial logistic regression analysis was used to analyze rs2004339 and rs2310998 under five genetic models (allele, recessive, dominant, over-dominant, and co-dominant). Results revealed that the mutant A allele (allele model) and the homozygous AA genotype (co-dominant model) of rs2004339 were significantly associated with an increased risk of RA (odds ratio [OR] = 3.37 and 7.44, respectively; corrected probability [pc] < 0.001), while rs2310998 showed no association with RA risk. When comparing the allele and genotype frequencies of rs2004339 and rs2310998 between ND and MD patients, there were no statistically significant differences. Haplotype analysis of the two variants (in the order rs2004339-rs2310998) revealed that haplotypes A-A (OR = 1.72; pc = 0.024) and A-G (OR = 2.85; pc < 0.001) were associated with an increased risk of RA. IL-40 levels (median and interquartile range) were significantly elevated in RA patients compared to controls (29.3 [15.5-41.5] vs. 12.6 [7.4-18.8] pg/mL; p < 0.001). IL-40 levels were not influence by disease duration or disease activity, but the rs2310998 genotypes had an effect; IL-40 levels were significantly higher in women with the AA genotype than in women with the GG genotype (20.1 [12.9-37.1] vs. 15.8 [8.3-22.6] pg/mL; p = 0.006). Regarding medication, IL-40 tended to show elevated levels in ND cases compared to MD cases but without a significant difference. In conclusion, the mutant A allele and the mutant-type AA genotype of the intergenic variant rs2004339 were associated with an increased risk of RA among Iraqi women. Serum IL-40 levels were also elevated in patients, particularly ND patients, and were positively affected by the mutant-type AA genotype. Accordingly, the role of IL-40 in the pathogenesis of RA has been indicated.

Dentists' attitudes and prescription practices for analgesics and antibiotics in Kirkuk Governorate, Iraq

The inappropriate use of analgesics and antibiotics is a widespread issue among dentists globally, leading to the risk of over-prescription that could negatively affect patient health and quality of life. This study aimed to assess the prescribing patterns of analgesics and antibiotics by dentists in Kirkuk City, Iraq, focusing on their attitudes, knowledge levels, and practices regarding these medications. A cross-sectional survey was conducted among 280 dentists in Kirkuk City. The dentists were contacted via their work email addresses, and they responded to a survey. Descriptive statistics, including frequency analysis, were employed to evaluate the appropriateness of analgesic and antibiotic prescriptions for different dental conditions. The first-choice analgesic for 44.6% of dentists was mefenamic acid, followed by paracetamol (31.1%). Regarding antibiotic use, 56.8% of dentists in Kirkuk City reported using antibiotics for empirical and direct therapy. Other dentists (43.2%) revealed that they did not have enough information regarding antibiotic group preference in empirical therapy. 106 of the participants (37.85%) recommended the use of broad-spectrum antibiotics in the treatment of bacterial infections. However, most (45%) were unfamiliar with the group preferences in empirical therapy. Dentists in Kirkuk City showed variations in knowledge and awareness regarding using analgesics and antibiotics. This requires further education and training on proper analgesics and antibiotic stewardship guidelines.

Two new species of Dichelyne Jägerskiöld, 1902 (Nematoda: Cucullanidae) parasitising marine fishes in Iraq

Recent examinations of some marine fishes from off the southern coast of Iraq revealed the presence of two new species of Dichelyne (Dichelyne) Jägerskiöld, 1902 (Nematoda: Cucullanidae), both intestinal parasites, namely: D. (D.) lethrini n. sp. from the smalltooth emperor Lethrinus microdon Valenciennes (Lethrinidae, Acanthuriformes) and D. (D.) iraqiensis n. sp. from the humphead snapper Lutjanus sanguineus (Cuvier) (Lutjanidae, Acanthuriformes). Specimens are described and illustrated based on light and scanning electron microscopical examinations. Dichelyne (D.) lethrini n. sp. is mainly characterised by the length of spicules (522 µm), presence of a dorsal caecum, location of deirids at the level of the posterior end of oesophagus and the post-oesophageal position of the excretory pore, number (10 pairs) and distribution of caudal papillae in the male, and the presence of two minute terminal spines on the female tail tip. Dichelyne (D.) iraqiensis n. sp. differs from the species of the subgenus Dichelyne mainly based on the absence of caudal spines, the presence of a dorsal caecum, the length of spicules (789-884 µm), the location of deirids and the excretory pore approximately at the same level, and the size of eggs (72-78 × 42-51 µm). These new species infecting marine fishes in Iraq represent new geographic records of cucullanids of the subgenus Dichelyne from fishes in marine waters off Iraq.