Indonesian Journal on Health Science and Medicine
The Indonesian Journal Health Science and Medicine (IJHSM) is dedicated to advancing health science and medicine by publishing high-quality, peer-reviewed research articles, reviews, and case studies. Serving as a platform for researchers, clinicians, and healthcare professionals, IJHSM covers a broad range of topics including clinical research and practice, public health, biomedical science, healthcare systems and services, global health, health promotion and disease prevention, mental health, and innovations in health education and training. By fostering academic excellence, JHSM aims to influence healthcare practices and policies, contribute to the advancement of health science and medicine, and improve global health outcomes. The Indonesian Journal on Health Science and Medicine is committed to maintaining rigorous academic standards and ethical practices in publishing, ensuring that all published works undergo a thorough peer-review process. The journal welcomes contributions from national and international authors, promoting a diverse and inclusive academic discourse.
The Role of Medicinal Plants in Treating Intestinal Parasites
General Background: Intestinal parasites remain a major global health concern, particularly in developing regions with poor sanitation and healthcare conditions. Specific Background: Conventional antiparasitic drugs are widely used but are associated with side effects and increasing drug resistance. Knowledge Gap: Limited integration of evidence regarding the mechanisms and therapeutic potential of medicinal plants as alternative treatments persists. Aims: This review examines the role of medicinal plants in combating intestinal parasites, focusing on their bioactive compounds and mechanisms of action. Results: Evidence from laboratory, animal, and limited clinical studies indicates that plants such as Zingiber officinale, Thymus vulgaris, Eucalyptus globulus, Aloe vera, Allium sativum, Artemisia herba-alba, and Nerium oleander exhibit inhibitory effects on parasite growth, reproduction, and survival, alongside immune modulation and anti-inflammatory activity. Novelty: The study synthesizes diverse findings on plant-derived compounds and highlights their multifunctional antiparasitic mechanisms. Implications: Medicinal plants represent promising complementary or alternative therapeutic options, though further clinical validation and standardization are required to ensure safety and efficacy. Keywords: Intestinal Parasites, Medicinal Plants, Antiparasitic Compounds, Bioactive Metabolites, Herbal Therapy Key Findings Highlights Multiple plant species demonstrate parasite growth suppression and immune modulation Bioactive compounds target parasite metabolism and cellular integrity Natural therapies show potential as complementary treatment strategies
Copyright (c) 2026 Amal Fadil Noori Radi, Ziyad Khalaf Hamdan , Noor Talal Ali https://creativecommons.org/licenses/by/4.0
Comparative Study of Duodenal Histology in Three Type of Birds and Two Different Rations
General Background: The avian duodenum is the primary site of enzymatic digestion and nutrient absorption, and its morphology reflects dietary specialization and metabolic demands. Specific Background: Passerine birds such as the Canary (Serinus canaria), Zebra Finch (Taeniopygia guttata), and White-eared Bulbul (Pycnonotus leucotis) exhibit distinct feeding habits, including granivory and frugivory/insectivory, which may be associated with differences in duodenal microarchitecture. Knowledge Gap: Comparative histomorphological data on the duodenum of these small passerines remain limited. Aims: This study aimed to compare the gross morphology, histological organization, and morphometric characteristics of the duodenum in the three species. Results: In all species, the duodenum formed a characteristic U-shaped loop surrounding the pancreas and consisted of four tunicae: mucosa, submucosa, muscularis, and serosa. The muscularis mucosa was absent in all birds. The White-eared Bulbul showed the greatest mucosal thickness and the highest goblet cell ratio (33.1%), whereas the Canary exhibited the longest villi and the thickest tunica muscularis. The Zebra Finch had the lowest mucosal thickness and shortest villi. Crypt depth was greatest in the Bulbul and Zebra Finch. Novelty: This study demonstrates species-specific duodenal histological patterns linked to contrasting dietary strategies in three passerine birds. Implications: These findings provide baseline anatomical and histological data that improve understanding of digestive adaptation and support future comparative and veterinary investigations in avian species. Highlights: • All species exhibited a U-shaped duodenal loop enclosing the pancreas and lacked muscularis mucosa. • White-eared Bulbul had the highest goblet cell proportion and greatest mucosal thickness. • Canary showed the longest villi and the thickest tunica muscularis among the examined birds. Keywords: Avian Duodenum, Comparative Histology, Passerine Birds, Goblet Cells, Digestive Adaptation
Copyright (c) 2026 Israa Badi Khalaf https://creativecommons.org/licenses/by/4.0
Impact of Smoking on Adalimumab Response and Biomarkers in Rheumatoid Arthritis
General Background: Rheumatoid arthritis is a chronic autoimmune disease characterized by persistent inflammation and joint destruction. Specific Background: Adalimumab, a TNF-α inhibitor, is widely used, yet variability in treatment response remains a challenge. Knowledge Gap: The combined relationship between smoking and key biomarkers including TNF-α, IL-6, and MMP-3 in patients receiving adalimumab has not been fully clarified. Aims: This study evaluates the association between smoking status, clinical response, and serum biomarker levels in rheumatoid arthritis patients treated with adalimumab. Results: A cross-sectional study of 75 patients and 55 controls showed that smoking prevalence was higher among non-responders, with significantly elevated TNF-α, IL-6, and MMP-3 levels and positive correlations with smoking. Novelty: The study simultaneously examines inflammatory and structural biomarkers in relation to smoking and treatment response. Implications: These findings highlight the role of smoking in persistent inflammation and suggest the relevance of MMP-3 as a biomarker for monitoring therapeutic response in clinical practice. Keywords: Rheumatoid Arthritis, Adalimumab, Smoking, Biomarkers, Inflammation Key Findings Highlights Higher cytokine and enzyme levels identified in non-responder group Significant correlation observed between tobacco exposure and inflammatory markers Distinct biomarker patterns differentiate clinical outcome groups
Copyright (c) 2026 Ghasaq Kareem Abed, Asma Abdul Jaleel Swadi https://creativecommons.org/licenses/by/4.0
Cutaneous Leishmaniasis an Updating Review of Epidemiology, Diagnosis and Control
General Background: Cutaneous leishmaniasis is a neglected tropical disease caused by dermotropic Leishmania species transmitted by sand flies, with a significant global burden. Specific Background: The disease shows diverse clinical manifestations and complex transmission patterns influenced by ecological, immunological, and socioeconomic factors. Knowledge Gap: Despite advances in understanding parasite biology and diagnostic tools, challenges remain in early detection, treatment variability, and access to healthcare in endemic regions. Aims: This review summarizes epidemiology, pathogenesis, diagnosis, treatment, and control strategies of cutaneous leishmaniasis while highlighting key gaps. Results: Findings indicate that disease distribution is shaped by environmental changes, host immune responses determine clinical outcomes, and molecular diagnostics such as PCR provide high sensitivity. Treatment remains limited by toxicity, resistance, and accessibility issues. Novelty: The article integrates multiple dimensions of the disease and emphasizes the relevance of a One Health approach linking human, animal, and environmental health. Implications: Strengthening diagnostic capacity, improving therapeutic strategies, and implementing integrated control measures are essential to reduce disease burden and improve patient outcomes. Keywords: Cutaneous Leishmaniasis, Epidemiology, Diagnosis, Treatment, Vector Control Key Findings Highlights Global transmission patterns are shaped by ecological and socio-environmental changes Immune response dynamics determine disease progression and lesion outcomes Diagnostic and therapeutic limitations remain major barriers in endemic regions
Copyright (c) 2026 Meaad Nasser Hussein https://creativecommons.org/licenses/by/4.0
The Influence of Slimming Products on Women's Sex Hormones, Oxidative Stress, and Immune Systems in Diwaniyah City.
General Background The use of fat burner supplements has increased alongside concerns about metabolic and physiological risks. Specific Background This study examines biochemical and hormonal responses associated with fat burner compounds, particularly focusing on oxidative stress and inflammatory markers. Knowledge Gap Limited research has integrated oxidative stress biomarkers with hormonal and inflammatory responses in the context of fat burner exposure. Aims This study aims to analyze the relationship between fat burner use, oxidative stress indicators, and hormonal changes. Results The findings indicate alterations in oxidative markers, inflammatory cytokines, and lipid metabolism, suggesting a complex physiological response linked to supplement use. Novelty The study provides a combined evaluation of oxidative stress, hormonal activity, and inflammatory biomarkers within a single analytical framework. Implications The results highlight potential health risks and provide a basis for further clinical and biochemical investigations into supplement-related metabolic changes. Keywords: Oxidative Stress, Fat Burners, Biomarkers, Inflammation, Metabolic Changes Key Findings Highlights Altered antioxidant and oxidant balance observed in subjects Cytokine activity associated with metabolic disturbance Hormonal variation linked to physiological stress responses
VKORC1 –1639G>A (rs9923231) Polymorphism and Warfarin Dose Variability in Iraqi Patients with Hematological Disorders: A Pharmacogenetic Case-Control Study
General Background: Warfarin therapy for thrombotic hematological disorders is complicated by substantial inter-individual dose variability. Specific Background: The VKORC1 –1639G>A polymorphism is a major genetic determinant of warfarin sensitivity, yet Middle Eastern populations remain underrepresented in pharmacogenetic research. Knowledge Gap: There is limited evidence regarding VKORC1 allele distribution and its clinical relevance in Iraqi patients with hematological conditions. Aims: This study aimed to determine VKORC1 genotype frequencies and evaluate their association with warfarin dose, therapeutic control, and predictive modeling. Results: The AA genotype was associated with significantly reduced warfarin dose requirements compared to GG carriers, and VKORC1 explained 31.2% of dose variability. A multi-locus model incorporating additional genetic and clinical variables increased predictive accuracy to 61.3%. Novelty: This study provides the first comprehensive pharmacogenetic characterization of VKORC1 in an Iraqi hematological cohort, integrating cytokine gene variants into dosing models. Implications: These findings support population-specific dosing strategies and highlight the clinical relevance of genotype-guided anticoagulation in Middle Eastern healthcare settings. Keywords: Vkorc1 Polymorphism, Warfarin Dosing, Pharmacogenetics, Hematological Disorders, Iraqi Population Key Findings Highlights Genetic variation strongly differentiates dose requirements among patient groups Combined genetic markers substantially improve predictive modeling accuracy Regional allele distribution reveals distinct population-specific patterns
Copyright (c) 2026 Esraa S. Al-Fatlawey https://creativecommons.org/licenses/by/4.0
Association of Age with Metabolic Biomarkers and Insulin Resistance in Patients with Type 2 Diabetes in Basrah, Iraq
*]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:ad4a55ea-8e7d-46e4-9b86-9c36f4acad0e-0" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> General Background: Type 2 diabetes mellitus (T2DM) is an age-related metabolic disorder characterized by progressive metabolic deterioration. Specific Background: Orexin-A and cathepsin-D have been implicated in hypothalamic regulation and cellular quality control, yet their age-related alterations in T2DM remain insufficiently characterized. Knowledge Gap: The interplay between aging, hypothalamic dysfunction, and cellular stress markers in relation to insulin resistance has not been comprehensively explored. Aims: This study investigated age-associated changes in orexin-A and cathepsin-D and their correlations with insulin resistance in T2DM patients. Results: A cross-sectional analysis of 110 T2DM patients and 70 controls revealed a significant age-related decline in orexin-A levels (69% reduction, p=0.001) and an increase in cathepsin-D levels (p=0.005). Orexin-A showed a negative correlation with insulin resistance (r = -0.26, p = 0.005), whereas age and cathepsin-D were positively correlated with HOMA-IR. Traditional metabolic markers, including HbA1c, triglycerides, and LDL, worsened with age. Regression analysis identified age, BMI, and cathepsin-D as positive predictors, while orexin-A was a negative predictor of insulin resistance. Novelty: This study identifies a previously unreported relationship between declining orexin-A and increasing cathepsin-D levels as age progresses in T2DM. Implications: These findings highlight the relevance of age-specific metabolic pathways and suggest the need for tailored therapeutic approaches in older diabetic populations. Highlights: • Progressive reduction of orexin-A observed across advancing age groups • Increasing cathepsin-D levels linked to worsening metabolic profiles • Age and biomarker patterns associated with higher insulin resistance Keywords: Type 2 Diabetes Mellitus, Aging, Orexin-A, Cathepsin-D, Insulin Resistance
Copyright (c) 2026 Mohammed Adil Abdulhassan, Shurok Namah khudair, Khairallah A.S Mohammed, Abdulaziz Qadori Abdulsada https://creativecommons.org/licenses/by/4.0
The Role of Oxidative Stress Markers (MDA and SOD) in the Abortion with Diabetic Women in Iraq
General Background: Spontaneous abortion is a common pregnancy complication with higher occurrence among women with diabetes mellitus, where oxidative imbalance and micronutrient deficiency are implicated. Specific Background: Oxidative stress markers such as malondialdehyde (MDA) and antioxidant enzymes like superoxide dismutase (SOD), together with vitamin D₃ status and glycemic indices, are associated with adverse pregnancy outcomes. Knowledge Gap: However, the interrelationship between oxidative stress, antioxidant defense, glycemic control, and vitamin D₃ levels in diabetic women experiencing miscarriage remains insufficiently characterized. Aims: This study assessed MDA and SOD levels and their association with glycemic parameters and vitamin D₃ in diabetic women with spontaneous abortion. Results: A case–control analysis of 80 women revealed significantly higher random blood sugar, HbA1c, and MDA levels, alongside significantly lower vitamin D₃ levels in patients compared to controls (p < 0.001). SOD activity was significantly altered, indicating disrupted antioxidant defense. HbA1c showed strong positive correlation with MDA (r = 0.847) and negative correlations with SOD (r = −0.748) and vitamin D₃ (r = −0.702). Novelty: This study demonstrates integrated correlations between oxidative stress biomarkers, antioxidant imbalance, glycemic dysregulation, and vitamin D₃ deficiency in diabetes-related miscarriage. Implications: These findings suggest that combined monitoring of oxidative stress markers, glycemic indices, and vitamin D₃ status may support improved understanding and management of miscarriage risk in diabetic women. *]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:fa9fc0ab-f1ff-4e18-bc2c-190a184be71c-0" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> Highlights: • Elevated lipid peroxidation and glucose indicators observed in affected patients • Reduced micronutrient status linked with altered antioxidant enzyme activity • Strong correlations identified among metabolic, oxidative, and nutritional parameters Keywords: Oxidative Stress, Malondialdehyde, Superoxide Dismutase, Diabetes Mellitus, Vitamin D3
Copyright (c) 2026 Naghma Abdulsahib Hussein https://creativecommons.org/licenses/by/4.0
Microbial Toxins: Types, Mechanisms of Action, and Pathogenic Significance
*]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="111a3330-0a32-4f4b-827b-f243ef97e0e6" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> General Background: Microbial toxins are critical virulence factors that contribute to disease by directly damaging host cells or modulating immune responses. Specific Background: Existing classifications, including exotoxins and endotoxins, often fail to integrate structural characteristics with mechanisms of entry, activation, and signaling pathways, particularly in relation to lipopolysaccharide recognition and mycotoxin-related public health concerns. Knowledge Gap: A cohesive framework linking toxin structure, delivery mechanisms, and immunopathological outcomes remains insufficiently developed in current literature. Aims: This review aims to establish an integrated classification of microbial toxins and to elucidate their mechanisms of action across molecular, cellular, and immunological levels. Results: The study identifies key toxin categories, including A–B toxins, membrane-disrupting toxins, superantigens, lipopolysaccharides, and mycotoxins, and outlines core mechanistic principles such as delivery, cellular selectivity, post-entry activation, and signal amplification, leading to inflammation and cell death. It also highlights the role of host variability and microbiota interactions in shaping toxic responses. Novelty: The review proposes a multidimensional framework combining structural, functional, and immunological perspectives to better interpret toxin behavior and disease patterns. Implications: These findings support the development of targeted interventions, including toxin-neutralizing therapies, improved vaccine design, and standardized research approaches for clinical and laboratory applications. Highlights: • Integrated framework links toxin structure with delivery and activation processes • Functional classification connects mechanisms to specific pathological outcomes • Host variability and microbiota interactions shape toxin-related disease patterns Keywords: Microbial Toxins, Exotoxins, Endotoxin, Lipopolysaccharide, Mycotoxins
Copyright (c) 2026 Mayada Abdullah Shehan, Sara Imad Hajwal https://creativecommons.org/licenses/by/4.0
The Physiological, Behavioral and Psychological Impact of Excessive Use of Smart Devices in Children
General Background: The rapid expansion of digital technology has made smart devices an integral part of daily life, including among children. Specific Background: Increasing exposure to smartphones has raised concerns regarding physical, psychological, and behavioral outcomes in early childhood. Knowledge Gap: Limited integrated evidence exists on how excessive device use simultaneously relates to health, sleep, behavior, and educational aspects in children. Aims: This study aims to examine the effects of excessive smart device use on children’s health, sleep patterns, behavior, and educational engagement. Results: Findings indicate that 43.5% of parents observed vision problems, 56.9% reported sleep disturbances, and notable proportions identified behavioral changes such as irritability and aggression. Additionally, 44% reported eye-related issues and a considerable number of children experienced neck or back discomfort. Educational use of devices was inconsistent, with many parents reporting no observable improvement in learning outcomes. Novelty: The study integrates multiple dimensions of child development within a single descriptive framework using parental perspectives. Implications: The findings highlight the importance of parental supervision, time regulation, and guided device use to reduce potential risks and promote balanced child development. Keywords: Smart Devices, Child Health, Screen Time, Behavioral Changes, Sleep Disturbance Key Findings Highlights High prevalence of reported visual and sleep-related disturbances among children Behavioral responses indicate dependency and emotional instability Educational utilization remains inconsistent and often unclear
Copyright (c) 2026 Amal Fadil Noori Radi, Hadeel Thaer Ahmed Al-Najem https://creativecommons.org/licenses/by/4.0
Incidence of Acute Ischemic Stroke in Patients With Anti-Platelet Treatment
General Background: Acute ischemic stroke remains a leading cause of mortality and long-term disability worldwide, and antiplatelet therapy is a central strategy for primary and secondary prevention of thrombotic cerebrovascular events. Specific Background: Aspirin and clopidogrel are widely prescribed to reduce platelet aggregation; however, ischemic stroke may still occur despite continued treatment. Knowledge Gap: Data from Al-Muthanna City regarding the incidence of acute ischemic stroke among patients receiving antiplatelet therapy and their associated clinical characteristics are limited. Aims: This study aimed to determine the incidence of acute ischemic stroke in patients receiving antiplatelet therapy and to describe related demographic, anatomical, and treatment characteristics. Results: In this cross-sectional study of 102 patients admitted to Al-Hussain Teaching Hospital between September 2025 and March 2026, the mean age was 67.14 ± 7.80 years, and males constituted the majority of cases. Hypertension was the most common comorbidity. Aspirin was the predominant antiplatelet agent (70.5%), followed by clopidogrel (29.5%). Most patients reported regular medication use (84.3%), and 72.5% had received therapy for more than one year. Stroke lesions were most frequently located in the frontal and parietal lobes. Bleeding complications were uncommon and generally mild. Novelty: This study provides regional evidence that acute ischemic stroke occurs despite sustained antiplatelet therapy and good adherence. Implications: The findings support individualized risk assessment, continuous monitoring, and consideration of adjunctive preventive strategies in high-risk patients. Highlights: • Acute ischemic stroke was documented in patients receiving long-term antiplatelet treatment. • Aspirin was the most frequently prescribed agent, with high reported adherence. • Frontal and parietal lobes were the most common sites, and bleeding events were infrequent. Keywords: Acute Ischemic Stroke, Antiplatelet Therapy, Aspirin, Clopidogrel, Stroke Prevention
Copyright (c) 2026 Ahmed S. Shabaa, Hasanain A. Al-saffar, Abdullah M. Alghazali, FAWATIM ALI Mohammed, Mariam Abdulrazzaq Ali, Mohammed mohanad Lftah, Mariam ALI Fahad https://creativecommons.org/licenses/by/4.0
Women's Myths and Misconceptions as Barriers to Contraceptive Use: A Comparative Study
General Background: Contraceptive use remains a central component of reproductive health, yet persistent myths continue to hinder its adoption globally. Specific Background: In Iraq, despite the availability of family planning services, misconceptions about contraception remain widespread, contributing to unmet needs and high fertility rates. Knowledge Gap: Limited comparative evidence exists on how these misconceptions vary across different Iraqi regions and cultural contexts. Aims: This study aimed to assess the prevalence of contraceptive myths among multiparous women and examine regional differences in perceptions across three Iraqi cities. Results: Findings revealed high levels of misconceptions, particularly related to menstrual disruption (66.4%), body changes (64.6%), and complexity of use (65.6%). Over half of participants endorsed beliefs about fertility risks and health concerns. Significant regional differences were observed, with higher levels of health-related concerns and religious opposition in Karbala. Social media emerged as the primary information source, while reliance on healthcare professionals remained limited. Novelty: The study provides a comparative regional analysis highlighting the persistence of misconceptions despite relatively high educational attainment. Implications: These findings underscore the need for culturally tailored educational interventions, improved provider communication, and evidence-based information dissemination strategies to address misinformation and support informed contraceptive decision-making. Keywords: Contraception, Reproductive Health, Misconceptions, Cultural Factors, Regional Differences Key Findings Highlights High prevalence of false beliefs related to menstrual and physical effects Strong regional variation linked to cultural and religious context Dominance of non-medical information channels in shaping perceptions
Copyright (c) 2026 Amal Fadil Noori Radi https://creativecommons.org/licenses/by/4.0
Gram-Negative Challenges: Assessing the Decline in Carbapenem Sensitivity Among Klebsiella Pneumoniae Isolates
General Background: Antimicrobial resistance represents a critical global health challenge, particularly among Gram-negative pathogens such as Klebsiella pneumoniae. Specific Background: Carbapenems have served as last-resort therapies for multidrug-resistant infections; however, increasing resistance among K. pneumoniae threatens their clinical utility. Knowledge Gap: Longitudinal epidemiological evidence describing temporal susceptibility trends and associated clinical factors remains underexplored. Aims: This study evaluates temporal changes in carbapenem susceptibility among K. pneumoniae clinical isolates using cumulative antibiogram surveillance. Results: A retrospective analysis of 512 isolates (July 2024–September 2025) demonstrated a marked decline in susceptibility to imipenem (92% to 78%) and meropenem (93% to 82%), with significant reductions between early and late periods (p < 0.05; p < 0.01). Resistance rates increased alongside higher prevalence of carbapenemase-producing strains and MDR/XDR phenotypes. Epidemiological patterns shifted from mixed community–hospital distribution to predominantly nosocomial transmission, particularly in intensive care units, with associations to mechanical ventilation, prolonged hospitalization, invasive devices, and prior broad-spectrum antibiotic exposure. Temporal clustering indicated outbreak-like dynamics in critical care settings. Novelty: This study provides longitudinal antibiogram-based evidence linking declining carbapenem susceptibility with ICU-centered transmission and resistance clustering. Implications: Findings underscore the need for strengthened antimicrobial stewardship, continuous surveillance, and targeted infection control strategies to mitigate hospital-driven dissemination of resistant K. pneumoniae. Highlights: • Progressive reduction in carbapenem sensitivity observed over 15 months • Resistance patterns concentrated within critical care environments • Transmission dynamics shifted toward hospital-dominated infection sources Keywords: Klebsiella Pneumoniae, Antimicrobial Resistance, Carbapenem Resistance, Nosocomial Transmission, Antibiogram Surveillance
Copyright (c) 2026 Rasool Chaloob Hulyal https://creativecommons.org/licenses/by/4.0
Evaluation of (Neutrophil-to-lymphocyte Ratio (NLR)) as an Inflammatory Immune Marker in Patients with Acute Infections and Comparison- with Healthy Subjects
General Background: Inflammation is a fundamental biological response in infectious diseases involving alterations in circulating immune cells, particularly neutrophils and lymphocytes. Specific Background: The neutrophil-to-lymphocyte ratio (NLR), derived from routine complete blood count testing, reflects the balance between innate and adaptive immunity and is increasingly utilized in clinical evaluation. Knowledge Gap: Despite its clinical use, further validation of NLR as a reliable inflammatory immune marker in acute infections compared with healthy individuals remains necessary. Aims: This study aimed to evaluate NLR as an inflammatory immune marker in patients with acute infections and compare findings with healthy controls. Results: The study included 30 patients and 20 controls. Patients demonstrated significantly higher absolute neutrophil count (8.49 ± 1.58 vs. 3.83 ± 0.88), markedly elevated NLR (10.62 ± 3.26 vs. 1.67 ± 0.45), and reduced absolute lymphocyte count (0.86 ± 0.27 vs. 2.37 ± 0.45) (p < 0.001). ROC analysis showed excellent diagnostic performance, with NLR and neutrophil count achieving an AUC of 1.000, and lymphocyte count an AUC of 0.995. Correlation analysis revealed positive association between neutrophils and NLR and negative association between lymphocytes and NLR. Novelty: This study provides integrated statistical and diagnostic validation of NLR using hematological indices and ROC analysis within a defined cohort. Implications: NLR represents a simple, low-cost, and accessible biomarker for assessing inflammatory and immune responses in acute infections and may support clinical evaluation and disease monitoring. Highlights: • Marked Elevation of Neutrophils Alongside Reduced Lymphocytes Identified in Infected Individuals • Diagnostic Analysis Demonstrated Near-Perfect Classification Accuracy Between Groups • Correlation Patterns Confirmed Ratio Structure Driven by Opposing Hematological Components Keywords: Neutrophil Lymphocyte Ratio, Acute Infection, Inflammatory Marker, Complete Blood Count, Biomarker
Copyright (c) 2026 Entiha Abdul-Zahra Abdul-Kareem https://creativecommons.org/licenses/by/4.0
PCR-Based Identification and Epidemiological Assessment of Entamoeba gingivalis Among Patients With Periodontal Disorders
General Background: Entamoeba gingivalis is an oral protozoan frequently found in dental plaque and periodontal pockets and has been reconsidered for its role in oral pathology. Specific Background: Recent molecular approaches have enabled improved detection of this organism in patients with gingivitis and periodontitis. Knowledge Gap: Despite growing interest, limited data exist comparing conventional microscopy and polymerase chain reaction (PCR) for accurate detection and subtype identification in clinical samples. Aims: This study aimed to determine the prevalence of E. gingivalis among periodontal disease patients and to compare the diagnostic performance of microscopy and PCR. Results: Among 120 patients, 7.5% tested positive for E. gingivalis, while 92.5% were negative. PCR confirmed all positive isolates and demonstrated higher sensitivity in detecting low-level infections, with all isolates showing strong genetic similarity to the ST1 subtype. Novelty: This study integrates molecular detection and phylogenetic analysis to confirm subtype distribution in a clinical population. Implications: PCR is recommended as a reliable diagnostic tool for accurate detection and epidemiological assessment of E. gingivalis, supporting improved identification in periodontal disease research and clinical practice. Highlights: • Low detection rate of oral protozoan observed in clinical samples • Molecular method identifies subtype clustering within regional isolates • Diagnostic comparison reveals higher sensitivity of amplification-based testing Keywords: Entamoeba Gingivalis, Periodontal Disease, Polymerase Chain Reaction, Molecular Detection, Phylogenetic Analysis
Copyright (c) 2026 Qahtan Adnan Rasheed Rasheed https://creativecommons.org/licenses/by/4.0
α-Glutathione S-Transferase, KIM-1, and Surfactant Protein-A as Predictive Biomarkers of Occupational Toxic Gas Exposure
General Background: Occupational exposure to toxic gases in petroleum industries is associated with subclinical damage to hepatic, renal, and pulmonary systems, necessitating sensitive biomarkers for early detection. Specific Background: α-glutathione S-transferase (α-GST), kidney injury molecule-1 (KIM-1), and surfactant protein-A (SP-A) are proposed indicators of early organ-specific injury related to toxic exposure. Knowledge Gap: Limited studies have evaluated these biomarkers collectively as a predictive panel, particularly in high-risk populations such as petroleum workers in developing regions. Aims: This study assessed the prognostic value of α-GST, KIM-1, and SP-A as early biomarkers of occupational toxic gas exposure. Results: In a case-control study of 130 exposed workers and 56 controls, serum levels of α-GST, KIM-1, and SP-A were significantly higher in exposed individuals (p < 0.01). KIM-1 and SP-A showed increasing trends with longer exposure duration, while α-GST demonstrated site-specific variation. Logistic regression identified all three biomarkers as independent predictors of exposure. Novelty: The study provides integrated evidence supporting a multi-biomarker panel reflecting hepatic detoxification, renal tubular injury, and pulmonary epithelial response in occupational settings. Implications: These findings support the application of α-GST, KIM-1, and SP-A in early detection and occupational health monitoring, enabling improved risk stratification and surveillance in hazardous industrial environments. Highlights: • Elevated biomarker levels distinguish exposed workers from non-exposed controls • Duration-dependent increases observed in renal and pulmonary indicators • Combined biomarker panel predicts multi-organ response to workplace hazards Keywords: Occupational Toxic Gas Exposure, Alpha Glutathione S Transferase, Kidney Injury Molecule 1, Surfactant Protein A, Biomarkers
Copyright (c) 2026 Samar Kadhum Yousif, Hamid Jaddoa Abbas, Ibrahim Ahmed Nassar https://creativecommons.org/licenses/by/4.0
Impact of Escherichia coli Infection During Pregnancy on Metabolic, Immunological, and Kidney Health in Postpartum Women
*]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="a4788dc8-9452-45ab-8b04-d40a64a7ac14" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> General Background: Pregnancy represents a vulnerable physiological state where bacterial infections, including Escherichia coli, may pose risks to maternal health. Specific Background: While acute outcomes of E. coli infection during pregnancy are documented, its postpartum consequences on metabolic, immunological, and renal systems remain insufficiently explored. Knowledge Gap: Limited evidence exists regarding persistent alterations in metabolic profiles, immune responses, and kidney function following infection during pregnancy. Aims: This study evaluates metabolic, immunological, and renal health in postpartum women 40 days after delivery with prior E. coli infection compared to healthy controls. Results: Women with prior infection showed significantly higher fasting blood glucose, cholesterol, triglycerides, blood pressure, inflammatory markers (CRP, IL-6, IL-8), and thyroid autoantibodies, alongside reduced vitamin D and calcium levels. Renal indicators revealed elevated serum creatinine and blood urea nitrogen with decreased eGFR. Novelty: This study provides integrated evidence of concurrent metabolic dysregulation, immune activation, and renal impairment in postpartum women following E. coli infection during pregnancy. Implications: These findings highlight the need for postpartum monitoring of metabolic, immunological, and renal parameters to identify potential long-term maternal health complications. Highlights: • Elevated glucose, lipid profiles, and blood pressure observed in affected women • Increased inflammatory cytokines and thyroid autoantibodies indicate immune alterations • Reduced kidney filtration markers suggest persistent renal dysfunction Keywords: Escherichia Coli Infection, Pregnancy, Postpartum Health, Metabolic Dysfunction, Renal Function
Copyright (c) 2026 Dumooa F. Al-Hameedawi https://creativecommons.org/licenses/by/4.0
Determining the Levels of Zinc, Iron, Vitamin D, Renin Hormone, and Cystatin in Patients With Kidney Failure
General Background: Kidney failure is characterized by impaired filtration function requiring dialysis and associated with metabolic and biochemical disturbances. Specific Background: This study evaluated zinc, iron, vitamin D, renin hormone, and cystatin C levels among 100 kidney failure patients treated at a dialysis center in Mosul between March and May 2025. Knowledge Gap: Conventional indicators of renal dysfunction lack sufficient sensitivity, necessitating integrated biochemical profiling to better characterize disease status. Aims: To determine variations in selected trace elements, hormones, and proteins and their association with demographic and clinical factors in kidney failure patients. Results: The findings revealed decreased zinc, iron, vitamin D, and renin levels alongside elevated cystatin C concentrations, particularly in the 50–60 age group. Iron deficiency was linked to dialysis-related blood loss, while zinc deficiency was associated with malnutrition or independent occurrence. Vitamin D deficiency was associated with fluid imbalance and renal dysfunction, though not directly linked to renin deficiency. Higher disease prevalence was observed among smokers, rural residents, individuals with low education levels, and those consuming unsafe water sources. Novelty: The study integrates multiple biochemical markers with demographic variables, highlighting cystatin C as a sensitive indicator of glomerular insufficiency compared with traditional measures. Implications: These results support routine monitoring of trace elements, vitamin D, renin activity, and cystatin C to improve early detection and guide clinical and public health strategies in kidney failure management. Highlights: • Reduced Trace Elements and Hormone Levels Accompanied by Elevated Cystatin Protein • Higher Disease Occurrence Linked to Age Group 50–60 and Lifestyle Factors • Cystatin Biomarker Identifies Glomerular Dysfunction More Sensitively Than Conventional Measures Keywords: Kidney Failure, Zinc, Iron, Vitamin D, Cystatin C
Copyright (c) 2026 Abdalrahim H. Eefan https://creativecommons.org/licenses/by/4.0
Determinants of Uromodulin Levels among Patients with Type 2 Diabetes Mellitus
General Background: Uromodulin, a kidney-specific glycoprotein, is associated with renal function and is frequently reduced in diabetes and chronic kidney disease. Specific Background: In type 2 diabetes mellitus, metabolic disturbances contribute to tubular injury, with declining uromodulin levels observed during disease progression. Knowledge Gap: However, the relationships between uromodulin levels and demographic and clinical determinants such as age, gender, body mass index, glycemic control, and duration of diabetes remain insufficiently clarified. Aims: This study aimed to evaluate the association between uromodulin levels and these variables in patients with type 2 diabetes mellitus. Results: A case-control study involving 176 participants demonstrated significant variations in uromodulin levels (p<0.001), with lower concentrations associated with advancing age, higher body mass index, longer duration of diabetes, worsening glycemic control, and increased disease severity, particularly in advanced diabetic nephropathy stages (DN2 and DN3). Females generally exhibited higher uromodulin levels compared to males. Novelty: This study provides integrated evidence linking multiple demographic and metabolic determinants with uromodulin variation across different stages of diabetic kidney disease. Implications: The findings suggest that reduced uromodulin levels may serve as a biomarker for disease progression and risk stratification, supporting its potential utility in clinical monitoring and early identification of high-risk patients with type 2 diabetes mellitus. Highlights: • Uromodulin levels decline progressively across advanced diabetic nephropathy stages • Demographic and metabolic factors show significant associations with biomarker variation • Lower concentrations observed in prolonged disease duration and poor glycemic status Keywords: Uromodulin, Type 2 Diabetes Mellitus, Diabetic Kidney Disease, Glycemic Control, Body Mass Index
Copyright (c) 2026 Muntadher Al Bahhash, Abrar I. Albadr, Abdulhussein Aljanabi https://creativecommons.org/licenses/by/4.0
Fosfomycin in the Clinical Practice of Urinary Tract Infection
General Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, affecting millions of individuals and occurring more frequently in women due to anatomical factors. Specific Background: The increasing prevalence of antimicrobial resistance among uropathogens, particularly Escherichia coli, has complicated conventional treatment approaches and renewed interest in alternative therapeutic agents. Knowledge Gap: Although fosfomycin has gained attention as a treatment option for UTIs, a comprehensive overview of its clinical applications, safety profile, and use in special populations remains important. Aims: This study reviews the role of fosfomycin in the clinical management of UTIs, including its mechanism of action, therapeutic applications, adverse effects, contraindications, and use in pregnant women and pediatric patients. Results: Fosfomycin exhibits broad-spectrum bactericidal activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant pathogens, through inhibition of bacterial cell wall synthesis. Clinical evidence indicates that both single-dose and multiple-dose regimens are utilized according to infection severity and patient characteristics. The drug is generally well tolerated, although gastrointestinal disturbances, electrolyte abnormalities, hypersensitivity reactions, and specific contraindications have been reported. Fosfomycin is frequently recommended for UTIs during pregnancy and has demonstrated utility in pediatric patients, particularly in infections caused by resistant organisms. Novelty: This review consolidates current evidence regarding fosfomycin use across diverse UTI settings, including resistant infections and special patient populations. Implications: Fosfomycin represents a valuable therapeutic option for UTI management in the context of growing antimicrobial resistance and increasing demand for alternative antibacterial therapies. Highlights: • Fosfomycin demonstrates activity against Gram-positive, Gram-negative, and multidrug-resistant uropathogens. • Treatment regimens vary from single-dose administration to repeated dosing based on infection complexity. • Clinical applications include management of UTIs in pregnant women and pediatric populations. Keywords: Fosfomycin, Urinary Tract Infection, Antimicrobial Resistance, Pregnancy, Pediatric Patients
Copyright (c) 2026 Islam Tariq https://creativecommons.org/licenses/by/4.0
Hearing Loss in Children: Prevalence, Causes, and Management
General Background Hearing loss is a common neonatal abnormality where early detection is crucial for normal speech and language development. Specific Background Children referred to audiology clinics often present with diverse impairments that can be objectively evaluated using auditory brainstem response testing. Knowledge Gap The specific incidence, severity distribution, and anatomical location of auditory deficits within this referred pediatric population require continuous clinical documentation. Aims This study aims to determine the incidence, severity, and location of auditory impairment in youth referred for assessment. Results Among 309 patients aged 1 to 17 years undergoing testing, 91.3% exhibited impairment, whereas 8.7% demonstrated normal bilateral function. Within the impaired cohort, 56% were male and 44% were female. Profound and severe degrees of impairment occurred most frequently, with both ears being predominantly affected. Novelty The documented burden of profound bilateral deficits in this specific clinical cohort highlights critical sex-based and severity distribution trends. Implications These findings strongly support the urgent need for universal newborn screening and early targeted rehabilitation, including cochlear implantation, to prevent irreversible language delays. Highlights A vast majority of referred patients exhibited significant auditory impairment. Profound bilateral deficits frequently presented during clinical assessments. Prompt cochlear implantation prevents permanent language development delays Keywords: Auditory Brainstem Response, Cochlear Implantation, Universal Newborn Screening, Language Development, Pediatric Audiology
Copyright (c) 2026 Nassar Jabbar Mokhtath Al- Najem https://creativecommons.org/licenses/by/4.0
Medication Adherence of Patients with Renal Failure at Al-Diwaniyah Hospital
General Background Chronic kidney disease presents a profound global public health challenge, imposing severe therapeutic burdens on healthcare systems and affected individuals. Specific Background In clinical settings like the Fatima Al-Zahraa Dialysis Center at Al-Diwaniyah Teaching Hospital, managing renal failure requires complex lifelong pharmacological regimens to control comorbidities and slow down disease progression. Knowledge Gap Although clinical regimens are strictly prescribed, the specific socio-demographic drivers and patient-side behavioral factors influencing medication compliance in this particular regional cohort remain under-examined. Aims This study evaluates the overall medication adherence levels among patients experiencing renal failure and examines how their socio-demographic characteristics correlate with treatment compliance. Results Empirical analysis of 70 participants revealed that 58.6% exhibited low medication adherence, 31.4% showed moderate adherence, and only 10.0% maintained good adherence, with low awareness found in 72.9% of the sample. Statistical testing confirmed that while age, gender, occupation, and monthly income showed no significant correlation with compliance, a patient's level of education had a statistically significant association with their adherence behavior. Novelty This evidence identifies a direct correlation between formal literacy and compliance rates, shifting the analytical focus from generalized socio-economic barriers to targeted health literacy needs within the local hemodialysis population. Implications These findings demonstrate that standard clinical prescriptions are insufficient without proactive hospital education programs, highlighting the urgent need for structured nursing interventions and simplified drug regimens to minimize clinical relapses and reduce institutional mortality rates. Keywords: Medication Adherence, Renal Failure, Patient Compliance, Health Literacy, Hemodialysis Key Findings Highlights Low medication adherence was identified in more than half of the surveyed renal failure patients. Formal educational attainment has a significant statistical correlation with patient treatment compliance. Insufficient understanding of renal conditions directly drives non-adherence patterns in hemodialysis units.
Copyright (c) 2026 Haider Abd AL Ameer Twair https://creativecommons.org/licenses/by/4.0
Transient Evoked and Distortion Product Otoacoustic Emission Comparison in Children
General Background Otoacoustic emissions objectively evaluate outer hair cell function in pediatric populations. Specific Background Transient evoked and distortion product paradigms are widely used to assess cochlear responsiveness in pediatric hearing screening. Knowledge Gap Comparative evaluations of signal-to-noise ratio performance across matching frequencies, alongside ear asymmetry and gender dynamics in six-year-olds, remain limited. Aims This study compared screening pass rates, signal-to-noise ratios, and ear or gender variations between both emission paradigms in normal-hearing children. Results Among 130 children (260 ears), both paradigms showed identical 100% pass rates, though distortion product emissions yielded significantly higher signal-to-noise ratios at 2, 3, and 4 kHz (<span class="math-inline" data-math="p < 0.001" data-index-in-node="803">$p < 0.001$), with mostly nonsignificant ear side and gender variations. Novelty This work establishes normative baseline comparative parameters in six-year-olds, proving distortion product signal superiority at identical frequencies. Implications Superior distortion product signal strength provides a clinically advantageous paradigm for pediatric auditory assessment, particularly in noisy environments. Keywords: Transient Evoked Otoacoustic Emissions, Distortion Product Otoacoustic Emissions, Pediatric Hearing Screening, Signal to Noise Ratio, Cochlear Function Key Findings Highlights Both emission paradigms achieved equivalent hundred percent screening pass rates among healthy six-year-old pupils. Signal-to-noise ratios were significantly greater in distortion product measurements across identical testing frequencies. Gender and ear side variations remained absent across most frequencies, establishing baseline pediatric normative parameters.
Copyright (c) 2026 Dhiaa Mohammed Yaseen, Qasim Ali Khalaf , Haider Kadhem Saeed https://creativecommons.org/licenses/by/4.0
Dual Modality Acupressure and Thermotherapy for Menstrual Pain Mitigation in Junior High Students
General Background Dysmenorrhea represents a highly prevalent gynecological condition among adolescent females globally, commonly driven by progesterone imbalances that induce painful uterine cramps. Specific Background Secondary school students frequently experience severe menstrual pain that interferes with daily school attendance and regular academic performance. Knowledge Gap Although separate non-pharmacological methods exist, the comparative performance of combined reflexology and thermal protocols remains under-explored in localized school environments. Aims This study evaluates the management of dysmenorrhea using integrated acupressure at SP6 and LV3 points alongside warm compresses among junior high respondents. Results Quantitative analysis of 33 participants revealed that combined therapy significantly decreased visual analogue scale scores ($p = 0.000$) compared to single acupressure or control groups. Novelty The evaluation demonstrates that dual-modality alternative care yields a more substantial physiological decline in pain intensity than isolated acupressure interventions. Implications School health services should adopt integrated non-pharmacological interventions as safe, accessible alternatives to conventional analgesic medications. Keyword: Sdysmenorrhea, Acupressure, Warm Compresses, Menstrual Pain, Adolescent Health Key Findings Highlights Visual analogue scale records reveal optimal pain reduction when combining meridian stimulation with deep tissue thermotherapy. Isolated acupressure targeting specific regional channels induces secondary relief compared to multi-modality approaches. Untreated control groups demonstrate an upward trajectory in menstrual distress during active observation cycles.
Copyright (c) 2026 Evi Rinata, Vindiah Dwi W https://creativecommons.org/licenses/by/4.0
Postpartum Anxiety Levels and Neonatal Care Responses Among Primiparous Mothers
General Background The puerperal phase triggers significant physiological, psychological, and social transitions that require structured clinical monitoring to prevent severe maternal affective disorders. Specific Background Primiparous women exhibit heightened vulnerability to postpartum anxiety and depression compared to multiparous mothers due to childbirth unfamiliarity. Knowledge Gap However, maternal psychological adaptive patterns remain under-examined when complicated by unexpected infant clinical vulnerabilities that mandate specialized neonatal care. Aims This case study evaluates maternal postpartum anxiety triggered by newborn health complications in a 26-year-old primigravida. Results Psychometric screening using the Depression Anxiety Stress Scales confirmed mild anxiety (score: 8) caused by excessive cognitive overthinking, structural adaptation difficulties, and initial caregiving unfamiliarity. Novelty The evaluation demonstrates that immediate modification of external stressors, such as reducing social media consumption alongside active family support, effectively minimizes postpartum stress. Implications Midwives must provide comprehensive, continuous, and long-term psychosocial interventions to secure optimal maternal-infant health outcomes. Keywords: Postpartum Anxiety, Primigravida, Neonatal Care, Maternal Psychology, Clinical Midwifery Key Findings Highlights Psychometric assessment via the Depression Anxiety Stress Scales identifies a mild anxiety baseline score of 8 in primiparous tracking. Sudden requirements for specialized newborn medical care serve as an immediate trigger for acute maternal cognitive overthinking. Combining targeted social media reduction with consistent familial assistance actively minimizes postpartum emotional distress.
Copyright (c) 2026 Nurul Azizah, Mela Nailul Izza https://creativecommons.org/licenses/by/4.0
Urban Residence and Genetic Predisposition Underlying Breast Cancer Distribution in Iraq
General Background Breast cancer represents a major global health challenge and is the leading cause of oncological mortality among women. Specific Background In the Eastern Mediterranean region and specifically within Al-Najaf province, Iraq, registered cancer cases have risen significantly from 2020 to 2025, with breast malignancies consistently topping annual health registries across regional oncology facilities. Knowledge Gap Although structural risk factors are generally recognized, multi-center epidemiological data evaluating the overlapping influence of environmental, genetic, demographic, and lifestyle variables within this specific geographic population remain highly limited. Aims This investigation aimed to describe the temporal distribution of breast cancer cases in Al-Najaf province from 2020 to 2025 and identify associations with potential demographic, genetic, and environmental risk factors among 800 consecutively enrolled female patients across four public and private oncology centers. Results Statistical analysis demonstrated that urban residents accounted for 73.3% of cases, revealing a highly significant predominance compared to rural districts ($p \le 0.05$). A positive family history of breast or ovarian cancer was reported by 46.7% of patients, the peak age group was 40–60 years representing 56.7% of the cohort, and married women constituted 76.7% of cases. Locally advanced disease at stages II and III comprised 66.7% of diagnoses, with chemotherapy serving as the primary treatment modality. Novelty This study provides the first large-scale, multi-center evidence integrating private sector oncology data to demonstrate the critical role of urban living environments and hereditary patterns in southern Iraq. Implications These findings establish an urgent need for population-based screening programs, urban environmental mitigation strategies, and accessible genetic counseling infrastructure. Keywords: Breast Neoplasms, Risk Factors, Environmental Pollution, Genetics, Iraq Key Findings Highlights Urban residency demonstrates a statistically significant association with higher breast cancer frequency compared to rural environments. Hereditary predisposition is highly prevalent, with nearly half of the diagnosed cohort presenting a positive maternal family history. Locally advanced stages dominate clinical presentation, necessitating chemotherapy as the primary therapeutic management approach.
Copyright (c) 2026 Raheem Abd Zaid Al Abedi https://creativecommons.org/licenses/by/4.0
Assessment of Mothers’ Knowledge about Breastfeeding in Basra City
General Background Breastfeeding is essential for child development and protects against infant mortality. Specific Background Human milk is the recommended exclusive nutrient source during the first six months of life, making maternal understanding of proper lactation techniques crucial for successful child health outcomes. Knowledge Gap Although formal education generally correlates with better health literacy, it remains unclear why mothers with high educational attainment still display significant awareness gaps regarding optimal breastfeeding practices. Aims This study assessed mothers' knowledge about breastfeeding and evaluated their primary information sources within primary healthcare settings in Basra City. Results Out of 158 participants, 76.6 percent resided in urban areas and 46.2 percent completed college. Crucially, 79.7 percent of mothers exhibited poor breastfeeding knowledge, and 62 percent received only simple reassurance from health centers. Medical facilities were the most frequent knowledge source for 28 percent of respondents, followed closely by the internet at 27 percent, while family and friends accounted for 11 percent. Novelty This study reveals a critical paradox where high formal college education fails to translate into adequate breastfeeding literacy among urban housewives in Basra. Implications Primary healthcare centers must shift from basic reassurance to well-designed, structured prenatal and postnatal lactation counseling programs to rectify widespread institutional knowledge gaps. Keywords: Breastfeeding, Maternal Knowledge, Lactation Counseling, Public Health, Primary Healthcare Key Findings Highlights Widespread knowledge deficiencies exist among mothers, with 79.7 percent demonstrating poor breastfeeding literacy. High formal college education does not guarantee adequate awareness regarding optimal infant feeding practices. Primary healthcare centers provide minimal counseling support, leaving the internet as a nearly equal source of maternal information.
Copyright (c) 2026 Hadeel H. Haider, Noor Hasan Mohamed Taqi, Nuha Muhsen Mhebis https://creativecommons.org/licenses/by/4.0
Factors Influencing the Public’s Knowledge about Diabetes Mellitus
General Background: Diabetes mellitus is a major global public health concern that contributes substantially to morbidity and mortality and requires adequate public awareness for effective prevention and management. Specific Background: Understanding the factors associated with diabetes knowledge is essential for improving health education and reducing the burden of the disease. Knowledge Gap: Limited evidence is available regarding demographic characteristics associated with diabetes knowledge among the public in Basrah, Iraq. Aims: This study aimed to identify the factors associated with the public’s knowledge about diabetes mellitus. Methods: A descriptive cross-sectional study was conducted in Basrah using a structured questionnaire administered to 600 participants. Data were analyzed using SPSS version 26. Results: The findings showed significant associations between diabetes knowledge and age, sex, and educational level. Poor knowledge decreased with increasing age, while the highest proportion of good knowledge was observed among individuals aged 30–50 years. Males demonstrated slightly higher levels of good knowledge than females. Knowledge levels increased substantially with educational attainment, with the highest proportion of good knowledge observed among participants with university education and above. Novelty: The study provides recent evidence from Basrah regarding demographic characteristics associated with public diabetes knowledge. Implications: The findings suggest that health education initiatives should consider demographic differences when designing diabetes awareness and prevention programs. Keywords: Diabetes Mellitus, Public Knowledge, Health Education, Demographic Factors, Basrah Key Findings Highlights Knowledge levels improved across older age categories. Male participants demonstrated slightly better awareness than female participants. Higher educational attainment corresponded to greater understanding of the disease.
Copyright (c) 2026 Suaad Abduljabar Abdulwahd Almudhafar https://creativecommons.org/licenses/by/4.0
Renal Dysfunction and Mineral Metabolism Disturbances in Elderly Patients with COVID-19: A Controlled Clinical Study
General Background: Coronavirus disease 2019 (COVID-19) is increasingly recognized as a multisystem disorder with notable renal and metabolic complications. Specific Background: While acute kidney injury during infection is well documented, persistent alterations in renal function and calcium–phosphate–vitamin D homeostasis after recovery, particularly in elderly individuals without comorbidities, remain insufficiently explored. Knowledge Gap: Limited case-control evidence exists integrating renal biomarkers and mineral metabolism parameters in older adults following SARS-CoV-2 recovery. Aims: This study aimed to assess long-term renal function and mineral metabolism disturbances and evaluate the diagnostic performance of related biomarkers in elderly men eight months post-COVID-19. Results: Compared to controls, post-COVID participants showed higher serum creatinine and blood urea and lower eGFR, alongside reduced serum calcium, inorganic phosphate, and 25-hydroxyvitamin D levels (p < 0.001). Individual biomarkers demonstrated strong discriminatory ability, while the combined multivariate model showed excellent discrimination, good calibration, and meaningful clinical utility. Renal indicators, particularly eGFR and blood urea, were the strongest predictors. Novelty: This study integrates renal and mineral biomarkers within an age-matched case-control framework, highlighting combined biomarker modeling for post-COVID assessment. Implications: Findings support sustained renal and metabolic monitoring in elderly populations after COVID-19 recovery and indicate the value of combined biomarker approaches for early detection of post-infectious renal involvement. *]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:c9ed5c44-5d4d-4047-a26d-4905f089c8ce-0" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> Highlights: • Persistent kidney filtration abnormalities observed eight months after recovery • Marked disruption in calcium, phosphate, and vitamin D balance detected • Combined biomarker model shows strong diagnostic discrimination and clinical utility Keywords: COVID-19, Renal Dysfunction, Mineral Metabolism, eGFR, Vitamin D
Copyright (c) 2026 Alaa Abed Faisal Faisal https://creativecommons.org/licenses/by/4.0
Public Knowledge of Diabetes Mellitus: A Cross-Sectional Study
General Background: Diabetes mellitus is a major non-communicable disease with a rapidly increasing global prevalence, making public awareness and understanding essential for disease prevention and management. Specific Background: Assessing public knowledge of diabetes mellitus can provide valuable information for identifying strengths and deficiencies in community awareness regarding the disease. Knowledge Gap: Although diabetes knowledge has been investigated in several populations, limited evidence was available regarding the level of public knowledge in Basrah City, Iraq, particularly concerning specific aspects of diabetes such as complications and management. Aims: This study aimed to assess public knowledge of diabetes mellitus among adults attending primary health care centers in Basrah City. Methods: A descriptive cross-sectional study was conducted between January and May 2009 among 600 diabetic and non-diabetic adults attending four primary health care centers. Knowledge was assessed using a structured questionnaire covering diabetes definition, risk factors, complications, prevention, control, and management. Results: More than half of the participants (55.5%) demonstrated a good level of diabetes knowledge, 35.2% showed an acceptable level, and 9.3% had poor knowledge. Higher proportions of correct responses were observed for diabetes control (71%) and risk factors (69%), whereas lower proportions were found for complications (56.7%) and management (53%). Novelty: This study provides population-based evidence on public diabetes knowledge in Basrah City and identifies specific knowledge deficiencies related to diabetes complications and management. Implications: The findings indicate generally satisfactory public awareness while highlighting the need for targeted educational interventions focusing on diabetes complications and disease management to strengthen community understanding and support diabetes control efforts. Keywords: Diabetes Mellitus, Public Knowledge, Health Awareness, Primary Health Care, Cross-Sectional Study Key Findings Highlights More than half of participants demonstrated a high level of understanding regarding the disease. Correct responses were highest for disease control and associated risk factors. Deficiencies were identified in awareness related to complications and treatment management.
Biochemical Indicators of Endometrial Receptivity in Uterine Function
Background: Endometrial receptivity is a critical prerequisite for successful embryo implantation and pregnancy, involving complex molecular interactions within the uterus. Specific Background: Implantation failure remains a major cause of infertility and recurrent implantation failure, despite advances in assisted reproductive technologies. Numerous biomolecules, including genes, proteins, microRNAs, extracellular vesicles, hormones, immune mediators, and microbial-related factors, have been investigated as indicators of uterine receptivity. Knowledge Gap: Although many biomarkers have been reported, comprehensive synthesis of recent evidence regarding biochemical indicators associated with receptive and non-receptive endometrium remains limited. Aims: This review aimed to summarize contemporary evidence regarding biomolecules associated with endometrial receptivity and implantation success. Results: Analysis of studies published between 2019 and 2023 identified multiple biomarkers linked to receptive endometrium, including HOXA10, LIF, CTNNA2, annexins, integrins, mucins, osteopontin, CD44, IGFBP-7, CK7, extracellular vesicle-associated microRNAs, CD63, and progesterone-related pathways. In contrast, implantation failure was associated with reduced HSD17B2, AZGP1, TPPP3, S100A13, estrogen receptor β, progesterone receptors, and progesterone levels, alongside dysregulated immune profiles, altered microRNA expression, elevated CD9, oxidative stress, microbial disturbances, mitochondrial dysfunction, and cellular senescence. Novelty: This review integrates recent findings on genetic, proteomic, transcriptomic, immunological, hormonal, and extracellular vesicle-derived biomarkers relevant to endometrial receptivity. Implications: Identification and characterization of these biomarkers may support minimally invasive assessment of uterine receptivity, improve implantation prediction, and facilitate personalized management strategies for infertility and recurrent implantation failure. Keywords: Endometrial Receptivity, Embryo Implantation, Recurrent Implantation Failure, Extracellular Vesicles, Biomarkers Key Findings Highlights Multiple genes, proteins, and extracellular vesicle contents were associated with successful implantation. Recurrent implantation failure was characterized by molecular, immune, hormonal, and metabolic dysregulation. Minimally invasive uterine fluid analysis provides promising approaches for receptivity assessment.
Copyright (c) 2026 Manal Abdulmunem Ibrahim https://creativecommons.org/licenses/by/4.0
Impact Analysis of Intervention of Community Pharmacists in Enhancing Patient Medication
General Background Medication adherence represents a fundamental determinant of therapeutic success, whereas non-adherence triggers treatment failure and escalates global healthcare expenditures. Specific Background Community pharmacists are uniquely positioned as accessible frontline healthcare providers capable of delivering patient-centered pharmaceutical care and clinical counseling beyond traditional drug dispensing. Knowledge Gap However, the documented effectiveness of these pharmacy-led programs remains variable across different clinical settings, and synthesized data regarding their systemic impact on diverse disease states remain limited. Aims This study evaluates the impact of community pharmacist-led interventions on patient medication compliance and comprehensive health outcomes across multiple chronic conditions. Results The findings demonstrate that structured community pharmacy services significantly enhance drug compliance and optimize disease control, yielding marked improvements in blood pressure regulation, asthma control, chronic obstructive pulmonary disease management, and cholesterol level optimization. Conversely, educational interventions delivered exclusively by pharmacists demonstrate no significant impact on mitigating depressive symptoms in adult outpatients. Novelty This comprehensive review systematically maps multi-disciplinary pharmacy interventions across respiratory, cardiovascular, metabolic, and postoperative care settings to delineate the explicit clinical boundaries of independent pharmaceutical counseling. Implications These results indicate that integrating community pharmacists into primary care pathways optimizes long-term therapeutic outcomes and reduces hospitalizations for chronic diseases, though mental health care requires a more integrated, multidisciplinary approach. Keywords: Medication Adherence, Community Pharmacist, Chronic Disease, Patient Compliance, Health Outcomes Key Findings Highlights Community pharmacy programs significantly improve objective clinical markers for blood pressure, asthma, and cholesterol management. Independent pharmacist-led educational interventions fail to produce measurable reductions in adult depressive symptomology. Integrated pharmaceutical care reduces hospital stays and decreases medication errors during transitions in postoperative and cystic fibrosis care.
Copyright (c) 2026 Niyazi Burhan Aldin Mohammad, Marwan M. Merkhan https://creativecommons.org/licenses/by/4.0
Investigating the Impact of Sex Hormones on Obesity-Related Secondary Infertility in Women
General Background: Secondary infertility remains a significant reproductive health concern worldwide, and obesity has emerged as an important factor associated with endocrine and metabolic disturbances that may compromise female fertility. Specific Background: Obesity has been linked to alterations in gonadotropin secretion, thyroid function, prolactin levels, and lipid metabolism; however, evidence regarding these associations among women with secondary infertility remains limited. Knowledge Gap: Data evaluating hormonal and metabolic differences between obese and non-obese women with secondary infertility, particularly in Iraqi populations, are scarce. Aims: This study aimed to compare reproductive hormones, thyroid function, prolactin levels, and lipid profiles between obese and non-obese women diagnosed with secondary infertility. Results: Obese women demonstrated significantly lower luteinizing hormone and thyroid-stimulating hormone levels, together with significantly higher total cholesterol and triglyceride concentrations than non-obese women. Prolactin levels were elevated in both groups without significant between-group differences. Age-adjusted analyses confirmed the persistence of the luteinizing hormone and lipid profile differences. Body mass index correlated with triglycerides in obese women and with cholesterol in non-obese women. Novelty: The study provides evidence from a carefully selected secondary infertility cohort while excluding major confounding reproductive and endocrine conditions. Implications: The findings support the incorporation of early body mass index assessment, metabolic screening, and weight-management strategies into the evaluation and management of secondary infertility. Keywords: Secondary Infertility, Obesity, Luteinizing Hormone, Lipid Profile, Reproductive Endocrinology Key Findings Highlights Reduced gonadotrophin concentrations were identified among participants with elevated body mass index. Metabolic abnormalities were characterized by increased cholesterol and triglyceride concentrations. Age-adjusted analyses confirmed the robustness of the endocrine and biochemical differences.
Copyright (c) 2026 Saba Sabeeh Hussein https://creativecommons.org/licenses/by/4.0
Prevalence and Antibiotic Susceptibility of Gram-Positive, Gram-Negative Bacteria and Candida in UTI Clinical Samples
General Background: Urinary tract infections (UTIs) are among the most common infections affecting the urinary system, including the urethra, kidneys, and bladder. Specific Background: In Iraq, the spectrum of UTI pathogens and their antibiotic resistance patterns remain insufficiently characterized, particularly in Al-Najaf province. Knowledge Gap: Limited data exist on the distribution of gram-positive, gram-negative, and fungal uropathogens alongside their antibiotic susceptibility profiles in both male and female outpatients in this region. Aims: This study aimed to identify the pathogen spectrum of UTIs, determine the distribution in women and men, and evaluate antibiotic resistance levels of isolated strains. Results: Among 618 outpatients, the most clinically significant microorganisms were Staphylococcus aureus (27.3%), Escherichia coli (25.4%), Staphylococcus epidermidis (17.0%), Streptococcus spp. (16.3%), and Candida albicans (6.1%). Women accounted for 89.8% of infections; C. albicans was detected only in women (6.1%). Highest resistance was observed to cefotaxime (up to 100% in Pseudomonas aeruginosa). Vancomycin (2% resistance) and amikacin (6-39% resistance) were the most effective antibiotics, with amikacin particularly effective against gram-negative bacteria. Novelty: This study provides the first comprehensive UTI pathogen and resistance profile from Al-Sajjad Hospital, Najaf, revealing S. aureus as the predominant pathogen over E. coli, contrasting with global trends. Implications: Empirical UTI therapy in this region should consider vancomycin and amikacin as potential options while avoiding cefotaxime, and clinicians should recognize the high female predominance and unique pathogen hierarchy. Highlights : Staphylococcus aureus (27.3%) outnumbered Escherichia coli (25.4%) as the leading UTI pathogen in Al-Najaf, Iraq. Candida albicans (6.1%) was detected exclusively in female patients with UTIs. Cefotaxime resistance reached 100% in Pseudomonas aeruginosa, while vancomycin showed only 2% resistance across gram-positive cocci. Keywords: Urinary Tract Infections, Antibiotic Resistance, Staphylococcus Aureus, Escherichia Coli, Iraq
Copyright (c) 2026 Ameer A. Karim, Alaa H. Abd Ali, Enas K. Alkhazraji , Sajjad S. Hameed https://creativecommons.org/licenses/by/4.0
Identification of mecA Gene in Methicillin-Resistant Staphylococcus aureus (MRSA) Using Molecular Method from Clinically Isolated Samples in Babylon Province, Iraq
General Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of hospital- and community-acquired infections due to its antibiotic resistance. Specific Background: Molecular diagnosis using polymerase chain reaction (PCR) is widely used to identify MRSA strains carrying the mecA gene. Knowledge Gap: Data on mecA-positive MRSA isolates and antibiotic resistance patterns in Babylon Governorate, Iraq, remain limited. Aims: This study aimed to isolate and identify MRSA from clinical samples and evaluate antibiotic susceptibility patterns. Results: Among 100 clinical samples, 60% were positive for Staphylococcus aureus, and 58.3% of the isolates were confirmed as MRSA by mecA gene detection. Wound and pus samples showed the highest MRSA prevalence. The isolates exhibited high resistance to penicillin, methicillin, and erythromycin, while vancomycin and linezolid showed high sensitivity rates. Novelty: The study combines molecular detection of mecA-positive MRSA with antibiotic susceptibility profiling in clinical isolates from Babylon hospitals. Implications: The findings support the use of PCR-based diagnosis, antibiotic stewardship, and infection control programs to reduce the spread of resistant bacterial strains. Highlights: • Molecular PCR analysis confirmed mecA-positive MRSA strains in more than half of the Staphylococcus aureus isolates. • Wound and pus specimens represented the primary clinical source of resistant bacterial isolates. • Vancomycin and linezolid demonstrated high susceptibility rates against multidrug-resistant strains. Keywords: Methicillin Resistant Staphylococcus Aureus, mecA Gene, Polymerase Chain Reaction, Antibiotic Resistance; Clinical Isolates,
Copyright (c) 2026 Enas k. Alkhazraji, Ameer Abood Karim Al-Rammahi https://creativecommons.org/licenses/by/4.0
Evaluation Of Risk Factors and Clinical Outcome Of Accidental Gall Bladder Perforation During Laparoscopic Cholecystectomy.
*]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:cf20633f-f273-4f46-b767-febb6562798a-9" data-turn-id-container="request-WEB:cf20633f-f273-4f46-b767-febb6562798a-9" data-testid="conversation-turn-4" data-scroll-anchor="false" data-turn="assistant"> General Background: Laparoscopic cholecystectomy is the gold standard procedure for symptomatic gallstone disease, yet accidental gallbladder perforation remains a frequent intraoperative complication associated with bile and gallstone spillage. Specific Background: Previous studies discussing the postoperative consequences of gallbladder perforation during laparoscopic cholecystectomy have reported inconsistent findings regarding operative and clinical outcomes. Knowledge Gap: Limited evidence has comprehensively evaluated both the predisposing risk factors and postoperative outcomes of accidental intraoperative gallbladder perforation in elective laparoscopic cholecystectomy. Aims: This study aimed to investigate the risk factors and clinical outcomes associated with accidental gallbladder perforation during laparoscopic cholecystectomy. Results: A prospective comparative observational study involving 210 patients identified that older age, male gender, higher body mass index, diabetes mellitus, ischemic heart disease, previous abdominal surgery, and acute-on-chronic cholecystitis were significantly associated with gallbladder perforation. Most perforations occurred during separation from the liver bed (75%). Patients with perforation experienced higher rates of postoperative ileus, prolonged operative time, prolonged hospital stay, port-site infection, and intra-abdominal abscess. Novelty: This study provides a comparative clinical evaluation integrating demographic characteristics, medical history, operative findings, and postoperative complications related to accidental gallbladder perforation during laparoscopic cholecystectomy. Implications: The findings emphasize the importance of identifying high-risk patients and applying meticulous surgical techniques to reduce perforation-related morbidity, prolonged hospitalization, postoperative infection, and increased healthcare burden. Highlights: • Older age, male gender, obesity, diabetes mellitus, and previous abdominal surgery were major predictors of intraoperative gallbladder perforation. • Separation of the gallbladder from the liver bed represented the most frequent stage of perforation occurrence during surgery. • Accidental perforation was associated with ileus, longer operative duration, extended hospitalization, and higher postoperative infection rates. Keywords: Acute Cholecystitis, Gallbladder Perforation, Laparoscopic Cholecystectomy, Postoperative Complications; Surgical Risk Factors
Copyright (c) 2026 Safa Hassan Hadi, Rabeea Hamad Qasim, Abdullah M. Hasan, Haider Kadhem Saeed https://creativecommons.org/licenses/by/4.0
Impact of Iron Deficiency Anemia on the Occurrence of Febrile Seizures in Pediatrics
General Background: Febrile seizures are the most common neurological disorder in children, and iron deficiency anemia is the most prevalent nutritional deficiency worldwide. Specific Background: Iron is essential for oxygen transport, brain metabolism, and neurotransmitter synthesis, and low iron status may reduce the seizure threshold in young children. Knowledge Gap: Previous studies have reported inconsistent findings regarding the relationship between iron deficiency anemia and febrile seizures. Aims: This study investigated the prevalence of iron deficiency anemia among children with febrile seizures and examined the association between iron deficiency anemia and febrile seizure occurrence. Results: A case-control study was conducted among 336 pediatric patients. Iron deficiency anemia was identified in 42.9% of participants, while 32.1% experienced febrile seizures. Among children with iron deficiency anemia, 41.7% had febrile seizures compared with 25.0% of those without anemia. The association was statistically significant (p = 0.032), and the odds ratio of 2.14 indicated that children with iron deficiency anemia were more than twice as likely to develop febrile seizures. The highest frequency of febrile seizures occurred in children aged 12–36 months, and lower hemoglobin and ferritin levels were observed in the febrile seizure group. Novelty: This study provides additional evidence from pediatric patients in Diwaniyah City supporting iron deficiency anemia as a significant and modifiable risk factor for febrile seizures. Implications: Routine screening and early treatment of iron deficiency anemia may help reduce the occurrence of febrile seizures in children. Highlights: • Children with iron deficiency anemia had a twofold higher likelihood of febrile seizures. • The 12–36 month age group showed the highest proportion of seizure cases. • Lower hemoglobin and ferritin levels were observed among affected pediatric patients. Keywords: Iron Deficiency Anemia, Febrile Seizures, Pediatric Patients, Hemoglobin, Ferritin *]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:92943c20-3de1-44e7-a500-b5c45daf3f95-16" data-turn-id-container="request-WEB:92943c20-3de1-44e7-a500-b5c45daf3f95-16" data-testid="conversation-turn-2" data-scroll-anchor="false" data-turn="assistant">
Copyright (c) 2026 Safa’a Dakhel AbdulHassan https://creativecommons.org/licenses/by/4.0
PAD-4 Elevation Distinguishes Acute from Past CMV Infection in Medical Students
General Background: Cytomegalovirus (CMV) is a persistent herpesvirus with complex interactions between humoral and innate immunity. Specific Background: Neutrophil extracellular trap formation (NETosis), mediated by peptidylarginine deiminase-4 (PAD-4), is increasingly recognized in antiviral defense, yet its relation to CMV serological phases remains unclear. Knowledge Gap: The association between CMV IgM/IgG serostatus and PAD-4 activity as a surrogate marker of innate immune activation has not been well characterized in healthcare-exposed student populations. Aims: This cross-sectional study assessed CMV seroprevalence across three medical departments and examined PAD-4 levels according to CMV serology. Results: Among 300 students, overall CMV seroprevalence was 16.33%, highest in nursing (21%) and lowest in medical laboratory students (11%). PAD-4 levels were significantly higher in IgM-positive individuals than IgG-positive and seronegative peers (p=0.003), while no sex-based difference was observed. Novelty: The study links CMV serological phase to differential PAD-4 activity, indicating heightened innate activation during recent infection and relative immune quiescence in past exposure. Implications: PAD-4 may serve as a biomarker of acute CMV-related innate responses and supports targeted infection-control awareness in healthcare training environments. Highlights: *]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" tabindex="-1" data-turn-id="request-WEB:006b8bc8-f577-4996-bbc5-3500771f21d4-12" data-testid="conversation-turn-2" data-scroll-anchor="false" data-turn="assistant"> CMV seroprevalence differed across healthcare training departments. PAD-4 levels peaked in IgM-positive (recent infection) students. PAD-4 showed no significant variation by sex. Keywords: Cytomegalovirus, PAD-4, NETosis, IgM/IgG Serostatus, Medical Students
Copyright (c) 2026 Murtada Wafi Beden https://creativecommons.org/licenses/by/4.0
Study of Seroprevalence of viral Hepatitis B,C and HIV Inpreoperative Assessment for Urological Surgeries
General Background: Viral hepatitis B, hepatitis C, and human immunodeficiency virus remain major blood-borne infections that pose occupational hazards to healthcare workers, particularly during surgical procedures involving percutaneous exposure. Specific Background: Routine preoperative screening has been adopted in many medical institutions to identify infected patients and reduce transmission risk during operative interventions. Knowledge Gap: Limited local data are available regarding the seroprevalence of hepatitis B, hepatitis C, and HIV among patients scheduled for urological surgery in Basrah Teaching Hospital and the associated medical and behavioral risk factors. Aims: This study assessed the seroprevalence of HBV, HCV, and HIV among preoperative urological patients and identified related risk factors. Results: In this cross-sectional study of 254 patients, overall seroprevalence of either HBV or HCV was 8.7%, with HBV (5.9%) higher than HCV (2.8%), while HIV was not detected. Significant associations were observed with blood transfusion (P=0.046), dental surgical intervention (P=0.003), renal dialysis (P<0.001), family history of dialysis (P=0.005), and tattooing (P=0.040). Lack of vaccination (87%) and prior dental procedures (56.7%) were common risk exposures. Novelty: The study provides updated hospital-based evidence integrating serological screening with detailed evaluation of demographic, medical, and behavioral determinants in a urological surgical population. Implications: Findings support routine preoperative screening and reinforcement of vaccination and infection control strategies to reduce occupational transmission in surgical settings. Keywords: Preoperative Screening, Hepatitis B Virus, Hepatitis C Virus, HIV Infection, Seroprevalence Key Findings Highlights: Overall infection rate reached 8.7% among elective surgical candidates. Transfusion, dialysis exposure, and tattoo history showed statistical association with positive serology. Absence of immunization was highly prevalent within the studied population.
Copyright (c) 2026 Abdulla Y. Altimary, Nadia K. Abduljaleel https://creativecommons.org/licenses/by/4.0
Assessment of Women's Knowledge about Postpartum Depression
General Background: Postpartum depression is a major public health concern affecting maternal mental health and child well-being worldwide. Specific Background: Limited knowledge and awareness among postnatal mothers contribute to delayed recognition, stigma, and low help-seeking behavior, particularly in developing settings. Knowledge Gap: Despite increasing global attention, evidence regarding the level of postpartum depression literacy and associated factors among postnatal mothers in the study setting remains insufficient. Aims: This study aimed to assess the level of knowledge and awareness of postpartum depression among postnatal mothers and to identify related sociodemographic characteristics. Results: The findings indicate that a considerable proportion of mothers demonstrated inadequate understanding of symptoms, risk factors, screening, and available treatment options. Educational level, prior information exposure, and contact with health services were associated with higher literacy levels. Misconceptions and stigma-related beliefs were still present among respondents. Novelty: This study provides updated empirical data on postpartum depression literacy within the local maternal population, highlighting specific domains of misunderstanding that require targeted educational strategies. Implications: Strengthening maternal mental health education through antenatal and postnatal services, including routine screening and counseling by healthcare professionals, is essential to promote early detection and appropriate support for affected mothers. Keywords: Postpartum Depression, Maternal Mental Health, Depression Literacy, Postnatal Mothers, Mental Health Awareness Key Findings Highlights: A substantial proportion of respondents showed limited understanding of symptoms and risk factors. Sociodemographic characteristics were associated with variations in literacy levels. Misconceptions and stigma-related beliefs remained evident among participants.
Copyright (c) 2026 Ebtihal Sattar Qassim https://creativecommons.org/licenses/by/4.0
The Association between Maternal Risk Factors and Preterm Birth Outcomes in Mosul Maternity Hospitals: A Cross-Sectional Study
General Background: Preterm birth remains a major global obstetric concern and a leading contributor to neonatal morbidity and mortality, particularly in low- and middle-income countries. Specific Background: In Mosul maternity hospitals, maternal health conditions and obstetric characteristics may contribute to variations in gestational age and neonatal birth weight. Knowledge Gap: Limited local evidence exists regarding the association between maternal risk factors and neonatal outcomes among women delivering preterm in Mosul city hospitals. Aims: This study aimed to describe maternal characteristics, identify risk factors of preterm birth, and determine the relationship between these factors, gestational age at birth, and neonatal birth weight. Results: In a cross-sectional sample of 234 women, the mean gestational age was 31.42 weeks and the mean interpregnancy interval was 17.88 months. Excessive uterine activity (82.1%), vaginal infection (65.0%), and urinary and genital tract infections (59.0%) were the most prevalent conditions. Statistical analysis demonstrated highly significant associations between maternal risk factors and both gestational age and birth weight (p<0.05). Short interpregnancy intervals were significantly related to lower gestational age categories and increased proportions of low, very low, and extremely low birth weight neonates. Novelty: This study provides hospital-based empirical evidence from Mosul linking specific maternal conditions and birth spacing patterns with prematurity outcomes. Implications: Routine infection screening, management of uterine activity, and counseling on appropriate birth spacing are essential strategies to reduce adverse neonatal outcomes in maternity care settings. Keywords: Preterm Birth, Maternal Risk Factors, Interpregnancy Interval, Neonatal Outcomes, Birth Weight Key Findings Highlights: Excessive contractions and reproductive tract infections were highly prevalent among participants. Significant statistical relationships were identified between maternal conditions and newborn measurements. Short birth spacing corresponded with higher proportions of very early delivery and reduced neonatal mass.
Copyright (c) 2026 Abdulrahman Mazin Hashim https://creativecommons.org/licenses/by/4.0
Prevalence and risk factor of Anemia among Hemodialysis patient
General Background: Anemia is a common and clinically significant complication among patients undergoing hemodialysis, contributing to increased morbidity and complex clinical management in chronic kidney disease. Specific Background: Patients with end-stage renal disease receiving maintenance hemodialysis frequently experience reduced hemoglobin levels related to impaired erythropoietin production, iron deficiency, and comorbid conditions. Knowledge Gap: Despite extensive international evidence, limited localized data are available regarding the prevalence and associated factors of anemia among hemodialysis patients in the studied setting. Aims: This study aimed to determine the prevalence of anemia and identify related demographic and clinical characteristics among patients undergoing hemodialysis. Results: The findings demonstrated a high proportion of anemia among hemodialysis patients, with variations observed according to age, gender, and selected clinical parameters. Laboratory indicators and treatment-related variables were associated with the occurrence and severity of reduced hemoglobin levels. Novelty: This study provides updated contextual evidence on anemia distribution within a defined hemodialysis population, contributing locally derived clinical data to the existing body of nephrology research. Implications: The results underscore the need for structured anemia monitoring, optimized management strategies, and continuous evaluation of hematological parameters in dialysis centers to support improved patient care and clinical decision-making. Keywords: Anemia, Hemodialysis, Chronic Kidney Disease, Hemoglobin Level, Prevalence Key Findings Highlights: A substantial proportion of dialysis recipients presented with reduced hemoglobin values. Demographic and clinical characteristics were linked to variations in blood parameters. Routine hematological assessment remains essential in long-term renal replacement therapy.
Copyright (c) 2026 Ali Jabbar Abd Al-Husayn https://creativecommons.org/licenses/by/4.0
Encapsulation of Naproxen with Meso-Tetradodecyl-Pyrogallol[4]arene: Complexation, Characterization, and Molecular Docking Insights
General Background: Supramolecular encapsulation using macrocyclic hosts has emerged as a strategy to address solubility and stability limitations of poorly water-soluble drugs. Specific Background: Naproxen, a widely prescribed nonsteroidal anti-inflammatory drug, exhibits low aqueous solubility and gastrointestinal irritation, prompting investigation of meso-tetradodecyl-pyrogallol[4]arene (C12-Py[4]arene) as a hydrophobic macrocyclic carrier capable of forming inclusion complexes through noncovalent interactions. Knowledge Gap: Although pyrogallol[4]arenes possess tunable cavities and self-assembly properties, detailed characterization of naproxen encapsulation combining spectroscopic, morphological, and molecular docking analyses remains limited. Aims: This study aimed to encapsulate naproxen within C12-Py[4]arene via mechanochemical grinding, characterize the resulting complex (PYX7), and evaluate binding affinity using molecular docking. Results: UV–Vis spectroscopy revealed bathochromic shifts at 318.00 and 332.50 nm, while FTIR analysis showed C=O band shifting from 1725 to 1689 cm⁻¹, confirming hydrogen bonding. SEM demonstrated altered semi-spherical agglomerates with heterogeneous morphology. Docking simulations predicted favorable binding energy (−7.00 kcal/mol), supported by hydrogen bonding and π–π stacking interactions within the hydrophobic cavity. Novelty: The integration of solvent-free complexation, spectroscopic validation, SEM imaging, and in silico modeling provides a comprehensive profile of PYX7 formation. Implications: These findings identify C12-Py[4]arene as a supramolecular carrier for naproxen and support further evaluation of pyrogallol[4]arene-based systems in NSAID delivery research. Keywords: Supramolecular Encapsulation, Naproxen, Pyrogallol4arene, Inclusion Complex, Molecular Docking Key Findings Highlights: Spectral shifts verified noncovalent host–guest interactions. Microscopy demonstrated nano-assembly formation with structural heterogeneity. Computational modeling showed favorable binding energetics and structural complementarity.
Copyright (c) 2026 Essam S. Khudhier, Maan S. AlNuaim , Khulood H. Oudah https://creativecommons.org/licenses/by/4.0
Nano-Extract of Epimedium alpinum Preserves Testicular Histology During Levofloxacin Exposure
General Background: Antibiotics such as levofloxacin are widely prescribed but have been associated with reproductive tissue alterations following prolonged administration. Specific Background: Plant-derived nanomaterials, particularly nano-extracts from medicinal plants, have gained attention due to their bioactive compounds with antioxidant and anti-inflammatory properties. Knowledge Gap: Limited experimental evidence exists regarding the histological response of testicular tissue to concurrent administration of levofloxacin and Epimedium alpinum nano-extract. Aim: This study examined the histological structure of testes in mice treated with levofloxacin and varying concentrations (5 and 10 mg/kg) of Epimedium alpinum nano-extract. Results: Levofloxacin administration for 30 days resulted in seminiferous tubule degeneration, reduced sperm count, and structural disruption, whereas groups receiving the nano-extract alone maintained normal architecture. Co-administration groups demonstrated preservation of seminiferous tubule integrity and improved spermatogenic organization. Novelty: The study provides experimental histological evidence supporting the tissue-preserving role of Epimedium alpinum nano-extract against antibiotic-associated alterations. Implications: These findings highlight the potential application of plant-based nanophytopharmaceuticals as supportive agents in treatments involving antibiotics with reproductive risks. Hightlights: Levofloxacin administration induced seminiferous tubule degeneration and reduced sperm count. Epimedium alpinum nano-extract maintained normal testicular architecture. Combined treatment preserved spermatogenic organization during antibiotic exposure. Keywords: Epimedium Alpinum, Nano-Extract, Levofloxacin, Testicular Histology, Spermatogenesis
Copyright (c) 2026 prof.Dr.Jabbar Abadi Mohammed , prof.Dr.Sukayna Jabbar Mushattat , Eelaf kareem abd ali, Saja Hassan Abdul- Kadhim https://creativecommons.org/licenses/by/4.0
Salicylic Acid Concentrations Suppress Grey Mold in Tomato Plants
General Background: Grey mold caused by Botrytis cinerea severely constrains tomato production in greenhouse and field systems worldwide. Specific Background: Chemical fungicides often fail due to the pathogen’s genetic plasticity, prompting exploration of alternative resistance inducers such as salicylic acid (SA). Knowledge Gap: Limited data exist regarding concentration-dependent responses of SA against B. cinerea under combined laboratory and greenhouse conditions. Aim: This study evaluated six SA concentrations (0–10 mM) for their ability to suppress fungal growth and reduce lesion development on tomato leaves. Results: Concentrations of 8 and 10 mM completely inhibited mycelial growth and biomass production (0.0 mg; 100% inhibition) in vitro. Under greenhouse conditions, the same concentrations reduced lesion area to 0.0 mm at 24, 48, and 72 hours compared with the untreated control. Lower concentrations produced partial suppression in a dose-dependent manner. Novelty: The findings demonstrate a clear concentration threshold at 8 mM SA for complete fungal suppression across experimental systems. Implications: SA presents a promising eco-compatible strategy for grey mold management and may serve as a complementary tool within integrated disease control programs. Highlights: 8–10 mM SA achieved complete fungal growth suppression. Biomass dry weight reduced to 0.0 mg under optimal concentration. Greenhouse lesion development eliminated at threshold dose. Keywords: Salicylic Acid, Botrytis Cinerea, Tomato, Grey Mold, Induced Resistance
Copyright (c) 2026 Waheed , A. Q. , Dewan H. M. , Abdulla , M. I. https://creativecommons.org/licenses/by/4.0
Molecular Profiling of Lipase-Producing Bacillus spp. from Basrah Extreme Soils
General Background: Lipases are hydrolytic enzymes with broad industrial applications due to their catalytic versatility and environmental relevance. Specific Background: Oil-contaminated and extreme environments represent promising reservoirs for robust lipase-producing bacteria. Knowledge Gap: Limited molecular characterization has been conducted on indigenous lipolytic Bacillus species from extreme sites in Basrah Governorate. Aim: This study aimed to isolate, screen, and molecularly identify lipase-producing Bacillus spp. from oil-affected soils and related environments. Results: Ten samples were collected, and five high-performing isolates were confirmed through Spirit Blue Agar and Rhodamine B assays. Optimal lipase production occurred at 37°C, pH 7, after 48 hours using olive oil as substrate. 16S rRNA sequencing identified the isolates as Bacillus velezensis, Bacillus subtilis, Bacillus tequilensis, Bacillus licheniformis, and Bacillus cereus, with sequence similarities ranging from 98.88% to 99.82%. Novelty: This study provides molecular evidence of diverse indigenous lipolytic Bacillus strains from Basrah’s extreme habitats. Implications: The findings support their prospective application in biofuel production, wastewater treatment, and industrial biocatalysis. Highlights: Dual-media screening strengthened qualitative detection of lipase activity. Molecular identification confirmed five high-similarity Bacillus strains. Extreme Basrah soils serve as reservoirs of industrially relevant lipolytic bacteria. Keywords: Lipase-Producing Bacteria, Bacillus Spp., 16S rRNA Sequencing, Oil-Contaminated Soil, Industrial Biotechnology
Copyright (c) 2026 Waad Blaasm Abd Alsada, Ismaal jmia Abas https://creativecommons.org/licenses/by/4.0
Anthropogenic and Sediment Controls on TPH in Tigris Sediments
General Background: Petroleum hydrocarbons are persistent aquatic contaminants that accumulate in sediments and serve as records of environmental pollution. Specific Background: The Tigris River in Maysan Governorate faces increasing hydrocarbon inputs associated with urbanization, industrial discharge, and riverine processes. Knowledge Gap: Limited integrated assessments have examined the vertical and spatial distribution of Total Petroleum Hydrocarbons (TPHs) alongside Total Organic Carbon (TOC) and sediment grain size within core sediments of this river system. Aim: This study investigates the distribution patterns of TPHs and their relationships with TOC and sediment texture across seven stations (0–50 cm depth). Results: TPH concentrations ranged from 4.49 to 114.13 µg/g, with the highest values at Al-Amara and Ali Al-Sharqi linked to anthropogenic sources. Fine-grained sediments (silt and clay >70%) corresponded with higher TOC (1.66–10.73%), while correlation analysis showed weak association between TPH and TOC but strong relationships between TOC and fine fractions. Novelty: The study integrates vertical profiling and sedimentological controls to distinguish anthropogenic inputs from natural retention mechanisms. Implications: Findings support targeted monitoring and sediment management strategies in hydrocarbon-affected river systems. Highlights: Anthropogenic proximity governs peak hydrocarbon accumulation. Fine-grained sediments regulate organic matter retention. Vertical cores document historical contamination layers. Keywords: Total Petroleum Hydrocarbons, Tigris River, Sediment Core, Total Organic Carbon, Grain Size
Copyright (c) 2025 Altaf Raheem Shnaishel, Hamza Abdulhassan Kadim, Hamid T. AL-Saad https://creativecommons.org/licenses/by/4.0
Spatiotemporal Distribution Of Parasitic Infections In Al-Najaf Al-Ashraf Governorate And Its Association With Age, Sex, And Seasonal Factors
General Background: Parasitic infections remain a significant public health concern worldwide, particularly in developing regions where sanitation limitations and environmental conditions facilitate transmission. Specific Background: In Iraq, intestinal parasites continue to affect large segments of the population, with infection patterns influenced by demographic and environmental factors. Knowledge Gap: Despite previous epidemiological studies in Iraq, limited research integrates spatial distribution, temporal patterns, and demographic variables simultaneously within Najaf Governorate. Aims: This study investigates the spatiotemporal distribution of parasitic infections in Najaf Governorate and examines their association with age, sex, seasonal variation, and residential location. Results: A total of 422 stool and genitourinary samples collected between July and November 2025 were analyzed, revealing 292 positive cases (69.19%). Five parasites were identified, with Entamoeba histolytica/dispar complex (54.45%) and Giardia lamblia (40.07%) as the dominant species. Infection prevalence was highest among children aged 1–14 years (64.73%), followed by individuals aged 15–44 years (23.63%) and ≥45 years (11.64%). Males showed a higher infection proportion (59.25%) than females (40.75%), while rural residents accounted for 60.27% of positive cases. Seasonal analysis indicated peak infections during July and August. Novelty: The study provides an integrated spatiotemporal and demographic assessment of parasitic infections within Najaf using hospital-based surveillance data. Implications: These findings support targeted public health interventions focusing on sanitation improvement, child health monitoring, and rural disease prevention strategies. Keywords: Parasitic Infections, Epidemiology, Intestinal Parasites, Spatiotemporal Distribution, Najaf Governorate Key Findings Highlights High infection prevalence detected among examined patients in Najaf. Children aged 1–14 years represented the largest proportion of cases. Rural communities recorded higher case distribution than urban populations.
Copyright (c) 2026 Hawraa Mohammed Al-ali https://creativecommons.org/licenses/by/4.0
Antinuclear Antibodies Elevated in Cutaneous Leishmaniasis Patients: Diagnostic Implications
General Background: Leishmaniasis is a widespread parasitic disease transmitted by sandfly bites, posing significant public health challenges in developing countries, with cutaneous leishmaniasis being particularly prevalent in Iraq. Specific Background: While clinical diagnosis remains standard, immunological markers including specific antibodies (IgM, IgG) have been explored for cutaneous leishmaniasis detection, yet the diagnostic potential of antinuclear antibodies (ANA) remains underutilized. Knowledge Gap: The role of ANA as an immunological biomarker for cutaneous leishmaniasis diagnosis in Tikrit has not been comprehensively investigated. Aims: This serological study examined ANA levels and specific antibody responses in 60 clinically diagnosed cutaneous leishmaniasis patients at Tikrit Teaching Hospital from October 2023 to January 2024. Results: Males showed higher infection rates (53.33%) than females (46.66%); the 1-5 year age group exhibited the highest prevalence (31.66%); dry ulcers predominated (78.33%, p<0.01); 75% of patients demonstrated IgM antibodies, 5% showed IgG, and 20% tested negative; significantly, ANA levels were elevated in both male and female patients compared to controls (p<0.05). Novelty: This study establishes ANA as a valuable supplementary immunological marker for cutaneous leishmaniasis diagnosis in the Tikrit region. Implications: The findings suggest that ANA testing could enhance diagnostic accuracy and understanding of autoimmune responses in cutaneous leishmaniasis, potentially improving patient management strategies. Keywords : Cutaneous Leishmaniasis, Antinuclear Antibodies, Immunological Markers, Serological Diagnosis, Tikrit Epidemiology Highlight : Dry ulcers predominated at 78.33%, significantly higher than wet ulcers at 21.66%. Rural residents showed 71.66% infection rate compared to 43.33% in urban areas. Seventy-five percent of patients exhibited IgM antibodies indicating acute infection phase.
Copyright (c) 2026 Noor Talal Ali, Shahad Saad Daham, Dema kamal Mustafa https://creativecommons.org/licenses/by/4.0
DRD2 −141C Ins/Del Genotypes and Dopamine Profiles in Amphetamine Use Disorder
General Background: Substance use disorder arises from complex interactions between neurobiological mechanisms and genetic susceptibility, particularly within dopaminergic pathways. Specific Background: Variants in the ANKK1/DRD2 region, including the −141C Ins/Del polymorphism, have been linked to altered dopamine receptor regulation, which is central to reward processing in amphetamine use disorder (AUD). Knowledge Gap: Evidence remains limited regarding how this polymorphism relates to dopamine receptor concentrations among treated amphetamine users in Middle Eastern populations. Aims: This study examined demographic patterns of amphetamine use and evaluated the distribution of −141C Ins/Del genotypes and associated dopamine concentrations in individuals with AUD in Basra, Iraq. Results: The Ins/Ins genotype predominated among addicts, while the Ins/Del genotype was associated with markedly higher dopamine receptor concentrations compared with Ins/Ins carriers. Significant differences were observed between addicts and controls in both genotype frequencies and dopamine levels. Novelty: This work provides region-specific molecular evidence linking −141C Ins/Del heterozygosity to distinct dopaminergic profiles in AUD. Implications: The findings support the relevance of DRD2 regulatory variants in understanding neurobiological heterogeneity in amphetamine addiction and may inform future genetic screening and personalized intervention strategies. Highlights: Ins/Del genotype shows the highest dopamine receptor concentration among amphetamine users. Clear genotype distribution differences distinguish addicts from non-addicted controls. Findings add molecular evidence from an underrepresented regional population. Keywords: DRD2 −141C Ins/Del; Dopamine Receptor; Amphetamine Use Disorder; Genetic Polymorphism; Basra Population
Copyright (c) 2026 Hayder F. Al-Nassir, Adnan B. Al-Hawash , Sarmad Awad Mozan AL-Asadi https://creativecommons.org/licenses/by/4.0
Irrigation Interval and Ethephon Regimes Shaping Alfalfa Yield and Quality
General Background: Alfalfa (Medicago sativa L.) is a key perennial forage crop valued for high biomass and protein content, yet its productivity is strongly constrained by water scarcity and suboptimal canopy management, particularly in arid regions. Specific Background: In southern Iraq, reduced water availability from major rivers necessitates efficient irrigation scheduling alongside agronomic practices that regulate plant architecture. Knowledge Gap: Limited field-based evidence integrates irrigation intervals with ethephon application to clarify their combined role in determining forage yield and quality attributes of alfalfa. Aims: This study examined growth traits, green and dry forage yield, and protein characteristics of alfalfa under different irrigation intervals and ethephon spray concentrations. Results: An intermediate irrigation interval (10 days) combined with moderate ethephon concentration (0.5 ml L⁻¹) consistently produced the highest branch density, forage yields, protein percentage, and protein yield, with significant interaction effects across traits. Novelty: The study demonstrates a synergistic irrigation–ethephon management window that optimizes source–sink balance under water-limited conditions. Implications: These findings support adaptive irrigation scheduling coupled with growth regulator use to sustain forage productivity and quality in arid and semi-arid agroecosystems. *]:pointer-events-auto [content-visibility:auto] supports-[content-visibility:auto]:[contain-intrinsic-size:auto_100lvh] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" tabindex="-1" data-turn-id="request-WEB:25aca545-3822-4848-99a4-96626a3b7d80-3" data-testid="conversation-turn-2" data-scroll-anchor="false" data-turn="assistant"> Highlights: Optimal irrigation interval maximized alfalfa biomass and protein yield. Moderate ethephon concentration promoted branching and canopy efficiency. Combined management improved forage quality under water-limited conditions. Keywords: Alfalfa, Irrigation Interval, Ethephon, Forage Yield, Protein Quality *]:pointer-events-auto scroll-mt-(--header-height)" dir="auto" tabindex="-1" data-turn-id="66a8b041-21f0-4bcc-b3c8-36b10b29aed9" data-testid="conversation-turn-3" data-scroll-anchor="false" data-turn="user">
Copyright (c) 2026 Sundus Kamel J Alhilfi, Fatimah Ali Jamel, Sabreen H. A. Al-Rubaiee https://creativecommons.org/licenses/by/4.0
Seasonal Distribution of Petroleum Hydrocarbons in Imported Rainbow Trout Organs
General background: Petroleum hydrocarbons are persistent aquatic contaminants capable of bioaccumulation in fish tissues, posing ecological and public health concerns. Specific background: Rainbow trout (Oncorhynchus mykiss) are widely consumed in Basra Governorate and are sensitive bioindicators of hydrocarbon pollution. Knowledge gap: Limited information exists on seasonal and organ-specific distribution of total petroleum hydrocarbons (TPHs) in imported trout sold in local markets. Aims: This study quantified seasonal TPH concentrations in selected organs of spotted and pink O. mykiss obtained from Basra markets. Results: TPH levels varied significantly among organs and seasons (P≤0.05), with the highest concentrations consistently detected in the liver, particularly during spring (up to 2.88 µg/g dry weight), while muscles and gonads showed the lowest levels (as low as 0.01 µg/g dry weight). Novelty: The study provides market-based evidence of differential TPH accumulation patterns in imported trout, rather than wild-caught populations, highlighting seasonal trends linked to biological and environmental processes. Implications: Although muscle tissues showed lower contamination, detectable TPHs indicate potential long-term bioaccumulation risks, underscoring the need for routine monitoring of imported fish to safeguard consumer health. Highlights: Liver consistently exhibited the highest TPH accumulation across seasons. Spring recorded peak TPH concentrations in both trout varieties. Edible muscle tissues contained lower but detectable TPH levels. Keywords: Total Petroleum Hydrocarbons; Rainbow Trout; Fish Organs; Seasonal Variation; Bioaccumulation
Copyright (c) 2026 Ali M. Galo, Rajaa N. Alyassein, Ghassan A. Al-Najare, Ali T. Yaseen https://creativecommons.org/licenses/by/4.0
Comparative Assessment of Essential Elements in Populations from Saline and Treated Water Areas
General Background: Safe drinking water is fundamental to human health, yet groundwater salinity in arid regions poses significant environmental health threats, particularly affecting electrolyte homeostasis and trace element status in populations relying on untreated well water. Specific Background: In southern Iraq's Al-Rifai District, Thi-Qar Province, rural communities depend on saline groundwater with elevated sodium and total dissolved solids, while urban populations consume treated municipal water with lower salinity and stable quality monitoring. Knowledge Gap: Limited biochemical data exist on how chronic saline well-water consumption affects serum concentrations of essential elements in healthy adults within this region. Aims: This study compared serum levels of iron, calcium, zinc, sodium, potassium, and magnesium between 200 rural well-water consumers and 200 urban treated-water consumers aged 20-50 years using atomic absorption spectrophotometry, Arsenazo III method, and ion-selective electrodes. Results: Rural participants showed significantly lower serum iron, zinc, calcium, magnesium, and potassium (P<0.01) but elevated sodium (P<0.01) compared to urban residents, with deficiency prevalence reaching 36% for zinc and 28% for iron in rural areas. Novelty: This investigation uniquely quantifies the environmental-biochemical linkage between groundwater salinity and essential element depletion in Iraqi populations, demonstrating freshwater salinization syndrome's impact on mineral homeostasis. Implications: Findings necessitate systematic rural water quality monitoring through Water Safety Plans, deployment of point-of-use reverse osmosis systems with remineralization, and targeted nutritional interventions to address dual environmental and nutritional burdens threatening cardiovascular and metabolic health in saline-groundwater-dependent communities. Keywords : Groundwater Salinity, Trace Elements, Serum Minerals, Well Water, Thi-Qar Iraq Highlight : Rural well-water consumers showed significantly lower iron, zinc, calcium, magnesium, and potassium levels. Sodium concentrations were markedly elevated among populations drinking saline groundwater versus treated water. Chronic exposure creates dual nutritional-environmental burden requiring water quality monitoring and treatment interventions
Copyright (c) 2026 Noor M. Al-Humaidy https://creativecommons.org/licenses/by/4.0
Assessment of Serum Omentin-1 in Prostate Cancer: Correlation with Anthropometric and Biochemical Factors
Background: Omentin-1, a novel adipokine predominantly secreted by visceral adipose tissue, modulates glucose metabolism, inflammation, and carcinogenesis, yet its clinical significance in prostate cancer remains underexplored. Knowledge Gap: While adipokines are implicated in obesity-related malignancies, the specific relationship between serum omentin-1 levels and prostate cancer, particularly regarding body mass index and metabolic parameters, is not fully understood. Aims: This study evaluated serum omentin-1 concentrations in 88 newly diagnosed prostate cancer patients compared to 88 age-matched healthy controls, examining correlations with anthropometric measurements and biochemical markers. Results: Serum omentin-1 levels were significantly elevated in prostate cancer patients, particularly in younger age groups and normal-weight to overweight categories, with negative correlation to BMI (r=−0.3, p<0.01) and positive correlation to PSA (r=0.5, p<0.01); multivariate regression identified omentin-1 as an independent protective factor (OR=0.79, p<0.0001). Novelty: This research establishes omentin-1 as an independent predictor of prostate cancer risk alongside traditional biomarkers. Implications: These findings suggest omentin-1 may serve as a complementary biomarker reflecting metabolic-oncological interactions in prostate cancer risk stratification. Keywords : Omentin-1, Prostate Cancer, Body Mass Index, Prostate-Specific Antigen, Adipokines Highlight : Omentin-1 levels negatively correlate with BMI but positively correlate with PSA levels. Elevated omentin-1 particularly evident in younger age groups and normal-weight individuals. Omentin-1 identified as independent protective factor against prostate cancer in regression analysis.
Copyright (c) 2026 Ali Miqdad Mohammed, Abrar I. Albadr, Haider Jaber Sagban https://creativecommons.org/licenses/by/4.0
Role of Key Metabolic Enzymes in Obesity-Associated Insulin Resistance: A Biochemical Review
General Background: Obesity represents a critical global health challenge, serving as a primary risk factor for type 2 diabetes mellitus and insulin resistance through complex metabolic alterations. Specific Background: The pathophysiological mechanisms linking obesity to insulin resistance involve dysregulation of key metabolic enzymes that govern glucose and lipid homeostasis in insulin-sensitive tissues, including liver, skeletal muscle, and adipose tissue. Knowledge Gap: Despite recognition of enzyme involvement in obesity-related metabolic dysfunction, the precise biochemical pathways through which specific enzymatic networks contribute to insulin signaling disruption remain incompletely characterized. Aims: This review systematically examines the roles of major metabolic enzymes—including phosphoinositide 3-kinase, AMP-activated protein kinase, glucokinase, pyruvate dehydrogenase, carnitine palmitoyltransferase I, and acetyl-CoA carboxylase—in mediating obesity-associated insulin resistance. Results: Evidence demonstrates that obesity induces coordinated dysregulation across glycolytic, gluconeogenic, lipogenic, and oxidative pathways, promoting ectopic lipid accumulation, mitochondrial dysfunction, oxidative stress, and chronic low-grade inflammation that collectively impair insulin receptor signaling cascades. Novelty: This synthesis provides an integrated biochemical framework connecting enzyme-mediated metabolic flux alterations to systemic insulin resistance. Implications: Understanding these enzyme-specific pathways offers potential therapeutic targets for pharmacological intervention aimed at restoring insulin sensitivity and preventing metabolic complications in obese populations. Keywords : Obesity, Insulin Resistance, Metabolic Enzymes, Glucose Metabolism, Lipid Metabolism Highlight : Dysregulated lipogenic and oxidative enzymes drive ectopic lipid accumulation in insulin-sensitive tissues. Mitochondrial dysfunction and enzyme-mediated redox imbalance exacerbate metabolic inflexibility during obesity. Targeted modulation of key metabolic enzymes offers therapeutic potential for restoring insulin sensitivity.
Copyright (c) 2026 Alaa R. M. Chyad https://creativecommons.org/licenses/by/4.0
Prevalence and Molecular Characterization of Helicobacter pylori in Patients with Chronic Diarrhea in Thi-Qar Province
General Background: Helicobacter pylori is a globally prevalent bacterial pathogen increasingly linked to gastrointestinal and extra-gastric disorders. Specific Background: Its role in chronic diarrhea remains insufficiently characterized in Iraq, particularly in Thi-Qar Province, where epidemiological data are inconsistent. Knowledge Gap: Limited molecular evidence exists on local H. pylori strains and the performance of diagnostic methods in patients with chronic diarrhea. Aims: This study aimed to determine the prevalence of H. pylori and characterize circulating strains among chronic diarrhea patients using stool antigen testing and PCR targeting the cagA gene. Results: A high prevalence was detected by antigen testing, while PCR revealed lower positivity, and two local cagA-positive isolates were genetically characterized and registered in GenBank. Novelty: The study reports the first molecular registration of H. pylori strains from chronic diarrhea cases in Thi-Qar Province. Implications: These findings underscore diagnostic variability and highlight the relevance of local molecular data for epidemiological surveillance and future clinical research. Keywords : Helicobacter pylori, chronic diarrhea, stool antigen test, PCR detection, molecular characterization Highlight : Rapid stool antigen testing revealed high Helicobacter pylori detection among chronic diarrhea patients. PCR targeting cagA gene showed substantially lower positivity, indicating diagnostic sensitivity variation. Genetic sequencing identified distinct local strains registered in international genomic databases.
Copyright (c) 2026 Hussain Adnan Hashim, Mohammed Mahdi Abd https://creativecommons.org/licenses/by/4.0
Nanoparticle Applications in Carbon Capture: Emerging Opportunities in Climate Change Mitigation
General Background: The tourism sector increasingly relies on strategic alliances to address competitive challenges and share resources in dynamic markets. Specific Background: In this context, human resource management practices, particularly recruitment and training strategies, are central to building the competencies required for managing partnerships among tourism companies in Baghdad. Knowledge Gap: Despite the growing importance of alliances, many organizations emphasize legal and financial aspects while overlooking the role of qualified human capital in managing cooperative relationships. Aims: This study aims to analyze the relationship between recruitment and training strategies and the efficiency of strategic tourism alliances. Results: Using a descriptive-analytical approach and survey data from 93 respondents, the findings reveal a significant positive relationship between recruitment and training strategies and alliance efficiency, with a correlation coefficient of 0.800 and an explanatory power of 63%. Technical and behavioral training emerged as the most prominent dimension, while all dimensions showed statistically significant contributions. Novelty: The study integrates human resource management functions with strategic alliance performance in the tourism sector within the Baghdad context. Implications: The findings suggest that adopting competency-based recruitment and specialized training programs supports cooperation, reduces organizational conflicts, and contributes to achieving shared objectives in tourism alliances. Highlights: • Recruitment Practices Based on Competencies Support Alignment of Shared Goals • Training Programs Strengthen Cooperation and Reduce Organizational Conflicts • Technical and Behavioral Skills Show the Strongest Contribution to Alliance Performance Keywords: Recruitment Strategies, Training Programs, Strategic Alliances, Tourism Companies, Human Resource Management.
Copyright (c) 2026 Nidaa Yaseen Taha, Hanan Abdul Qader Abdulilah https://creativecommons.org/licenses/by/4.0
Assessment of Risk Factors Associated with Increased Incidence of Thalassemia in Najaf Governorate
General Background: Thalassemia is a common inherited hemoglobin disorder characterized by defective globin chain synthesis and widespread global distribution. Specific Background: The prevalence of thalassemia varies across regions and is influenced by demographic and hereditary factors, particularly in Middle Eastern populations. Knowledge Gap: Limited localized evidence exists regarding the specific risk factors contributing to thalassemia incidence in Najaf Governorate. Aims: This study aimed to identify demographic and genetic risk factors associated with increased thalassemia cases in Najaf. Results: A cross-sectional study of 167 patients revealed higher prevalence among males, children aged 1–10 years, and urban residents. Blood group O was most common, while Rh-positive status reflected general population trends. Parental consanguinity and positive family history showed strong associations with disease occurrence, and thalassemia major was more prevalent than minor forms. Novelty: This study provides localized epidemiological evidence highlighting the combined role of demographic and hereditary determinants in thalassemia distribution. Implications: The findings emphasize the importance of premarital screening, early diagnosis, and community awareness programs to reduce disease burden and improve health outcomes. Keywords: Thalassemia, Risk factors, Consanguinity, Epidemiology, Najaf Key Findings Highlights Higher cases observed in early childhood and urban populations Strong association between parental relatedness and disease occurrence Familial clustering evident through multiple affected siblings
Copyright (c) 2026 Sarah Abbood Shanan, Haidar Sahib Sharad, Noor Hadi Hassan https://creativecommons.org/licenses/by/4.0
Delay Time and Preservation Method in Urine Epithelial Examination
General Background: Urinalysis is an essential diagnostic tool for detecting metabolic and urinary tract disorders, including complications in diabetes mellitus patients. Specific Background: In diabetes mellitus, urinary tract infections frequently occur and are associated with epithelial cell changes in urine sediment. Knowledge Gap: However, limited evidence exists regarding the effect of delayed examination and preservation methods on urine epithelial integrity. Aims: This study aims to analyze the effect of delay time and preservation methods on urine epithelial examination in diabetes mellitus patients. Results: Using an analytical experimental approach with 30 urine samples, the findings show that delayed examination at 4 and 5 hours leads to a decrease in epithelial cell count and morphological changes. Storage at 4°C demonstrates better preservation compared to the addition of 10% formaldehyde, although both methods show significant differences based on the Friedman test. Novelty: This study highlights the comparative outcomes of cold storage and formaldehyde preservation under delayed conditions in diabetic patient samples. Implications: The findings emphasize the importance of proper sample handling and timely examination to maintain the accuracy of urinalysis results in clinical laboratory practice. Keywords: Urinalysis, Epithelial Cells, Delay Time, Preservation Method, Diabetes Mellitus Key Findings Highlights Reduced cell counts observed with prolonged examination delay Cold storage maintained structural characteristics more consistently Preservative addition associated with morphological alteration
Copyright (c) 2026 Suci Purwati, Puspitasari https://creativecommons.org/licenses/by/4.0
Acupressure Application for Reducing Emesis Gravidarum in Early Pregnancy
General Background: Emesis gravidarum is a common condition experienced by pregnant women in the first trimester and may disrupt daily activities. Specific Background: Non-pharmacological interventions such as acupressure have been widely explored as alternative management to reduce nausea and vomiting during pregnancy. Knowledge Gap: However, limited studies clearly describe the application and measurable outcomes of acupressure in managing emesis gravidarum in specific populations. Aims: This study aims to analyze the role of acupressure in reducing nausea and vomiting among first trimester pregnant women. Results: The findings indicate that acupressure application is associated with a decrease in the intensity of nausea and vomiting experienced by pregnant women. Novelty: This study highlights the use of specific acupressure points as a practical and non-invasive approach in maternal care. Implications: The results suggest that acupressure can be considered as an alternative complementary therapy in managing emesis gravidarum in clinical and community settings. Keywords: Acupressure, Emesis Gravidarum, Pregnancy, Nausea Vomiting, Complementary Therapy Key Findings Highlights Reduction in symptom intensity observed after intervention Non-invasive approach applicable in maternal care settings Practical technique suitable for early pregnancy management
Copyright (c) 2026 Ela Nafiatul K, Evi Rinata, Siti Cholifah , Yanik Purwanti https://creativecommons.org/licenses/by/4.0
Acupressure and Health Education in Reducing Dysmenorrhea Pain
General Background: Dysmenorrhea is a common reproductive health issue among adolescents that can interfere with daily activities and learning processes. Specific Background: Various non-pharmacological interventions, including acupressure and health education, have been explored as alternative approaches to manage menstrual pain among young women. Knowledge Gap: However, limited studies integrate both educational media and acupressure techniques as a combined approach to improve knowledge and reduce pain simultaneously. Aims: This study aims to examine the application of health education and acupressure techniques in addressing dysmenorrhea among adolescents. Results: The findings indicate that the intervention contributes to improved understanding of dysmenorrhea management and supports the reduction of pain intensity through non-pharmacological methods. Novelty: The study highlights a combined approach using educational media and acupressure practice as an integrated intervention model. Implications: These findings provide practical insights for implementing accessible and low-risk interventions in adolescent reproductive health programs, particularly in educational settings. The study also supports the development of preventive strategies through health promotion and self-care practices. Keywords: Dysmenorrhea, Acupressure, Health Education, Adolescents, Non Pharmacological Therapy Key Findings Highlights Combined intervention improves understanding of menstrual pain management Non-drug technique supports reduction of discomfort intensity Educational media strengthens self-care awareness among adolescents
Copyright (c) 2026 Nabilah Fatya Tsabita , Siti Cholifah, Yanik Purwanti , SM Faridah Hanum https://creativecommons.org/licenses/by/4.0
Preeclampsia Screening Using BMI MAP and ROT Indicators
General Background Preeclampsia remains a major contributor to maternal morbidity and mortality worldwide. Specific Background Early detection strategies using clinical indicators such as Body Mass Index (BMI), Mean Arterial Pressure (MAP), and Roll Over Test (ROT) have been widely discussed in maternal health research. Knowledge Gap However, integrated assessment of these indicators in identifying preeclampsia risk is still limited in specific clinical settings. Aims This study aims to examine the role of BMI, MAP, and ROT in early screening of preeclampsia among pregnant women. Results The findings show that variations in BMI, MAP, and ROT measurements are associated with differences in preeclampsia risk classification. Novelty This study provides a combined perspective of three clinical indicators in preeclampsia screening. Implications The results highlight the importance of utilizing simple clinical measurements as part of early detection strategies in maternal healthcare services. Keywords: Preeclampsia, Body Mass Index,Mean Arterial Pressure, Roll Over Test, Maternal Health Key Findings Highlights Combined indicators identify varying risk categories Clinical measurements support early screening decisions Observed patterns assist risk classification in pregnancy
Copyright (c) 2026 Hasna Rosyidah, Rafhani Rosyidah https://creativecommons.org/licenses/by/4.0
The Protection Evaluation by The Grape-Seed-Loaded PVA/Chitosan Nanofiber Scaffolds on UV-Induced Skin Damage in Rabbits
General Background: Ultraviolet radiation is a major environmental factor causing oxidative stress, cellular damage, and structural deterioration in skin tissue. Specific Background: Recent advances in nanofiber technology have enabled the development of biomimetic scaffolds capable of delivering bioactive compounds for tissue repair and regeneration. Knowledge Gap: Limited experimental evidence exists on the combined use of PVA/chitosan nanofibers loaded with grape seed extract for restoring UV-damaged skin structure and antioxidant balance. Aims: This study aimed to evaluate the protective and therapeutic performance of grape-seed-loaded PVA/chitosan nanofiber scaffolds in a rabbit model exposed to chronic ultraviolet radiation. Results: The fabricated nanofibers demonstrated strong molecular interactions and uniform morphology, while biological evaluation showed that UV exposure induced severe oxidative, morphological, and histological damage. Treatment with the nanofiber scaffold for seven days led to restoration of skin architecture, reduction of inflammation and fibrosis, and significant improvement in antioxidant activity as confirmed by ABTS and DPPH assays. Novelty: This study demonstrates the successful integration of grape seed extract into nanofiber scaffolds with preserved structural integrity and functional bioactivity. Implications: The findings support the application of nanofiber-based systems as promising therapeutic platforms for skin regeneration and protection against ultraviolet-induced damage. Keywords Nanofiber Scaffold, Ultraviolet Radiation, Skin Damage, Grape Seed Extract, Antioxidant Activity Key Findings Highlights Uniform nanoscale fibers with stable molecular interactions achieved Severe tissue disruption observed after prolonged radiation exposure Short-term treatment restored structural organization and antioxidant balance
Copyright (c) 2026 Dina H. Sadiq, Majdy Faisal Majeed, Thaar R. Mhalhal, Prof. Dr. Ali Qassim Abdullah https://creativecommons.org/licenses/by/4.0
Cardiovascular Disease Risk after COVID-19 in Diabetic and Non-Diabetic Adults: A Study in Iraq
General Background: COVID-19 has emerged as a global health crisis with significant implications for patients with underlying cardiovascular conditions. Specific Background: Increasing evidence indicates that cardiovascular disease is associated with severe outcomes and complications in infected individuals. Knowledge Gap: Despite numerous studies, there remains a need to synthesize findings on cardiovascular risks and outcomes in diverse populations. Aims: This study aims to analyze the relationship between COVID-19 and cardiovascular disease, focusing on risk factors, clinical manifestations, and outcomes. Results: The findings indicate that patients with pre-existing cardiovascular conditions are more likely to experience severe disease, higher mortality, and long-term complications. Novelty: The study consolidates evidence from multiple studies to provide a comprehensive overview of cardiovascular risks in COVID-19 patients. Implications: These findings support the need for targeted clinical management and preventive strategies for vulnerable populations, contributing to improved healthcare planning and patient care. Keywords: Covid-19, Cardiovascular Disease, Clinical Outcomes, Risk Factors, Mortality Key Findings Highlights Pre-existing conditions are associated with severe cases and complications Multiple studies report elevated mortality among affected patient groups Long-term health issues remain a significant concern after infection
Copyright (c) 2026 Hussein Jaber Hamza https://creativecommons.org/licenses/by/4.0
The Efficacy of Valsalva Maneuver Technique on Pain Reduction During IV Cannulation Among Children
General Background: Peripheral intravenous cannulation is a common pediatric procedure associated with pain and anxiety. Specific Background: Non-pharmacological approaches such as the Valsalva maneuver have been studied in adults, but evidence in pediatric populations remains limited. Knowledge Gap: There is insufficient clinical evidence regarding the application of the Valsalva maneuver for pain management during intravenous cannulation in children aged 12–18 years. Aims: This study aimed to evaluate the role of the Valsalva maneuver in reducing pain during peripheral intravenous cannulation and compare it with standard care. Results: Using a quasi-experimental design with 100 pediatric patients, pain scores significantly decreased from 2.93 before the maneuver to 1.06 after the procedure (p < 0.001). Greater pain reduction was observed among children without prior cannulation experience, while no significant differences were found based on age or gender. Novelty: This study provides focused clinical evidence supporting the use of the Valsalva maneuver specifically in adolescent pediatric patients during intravenous procedures. Implications: The findings support integrating the Valsalva maneuver into routine pediatric clinical practice as a simple, safe, and cost-effective strategy for procedural pain management. Highlights: • Significant Decrease in Procedural Discomfort Observed After Applying the Breathing Technique • Greater Response Noted Among Participants Without Prior Cannulation Exposure • No Variation Detected Across Demographic Characteristics Such as Age and Sex Keywords: Valsalva Maneuver, Pain Reduction, Peripheral Intravenous Cannulation, Pediatric Patients, Non Pharmacological Intervention.
Copyright (c) 2026 Esraa Shaker Saeed Saeed https://creativecommons.org/licenses/by/4.0
Gender Differences in Metabolic Syndrome Risk Factors Based on International Diabetes Federation Criteria
General Background: Metabolic syndrome (MetS) represents a cluster of interrelated metabolic and cardiovascular risk factors that substantially increase morbidity and mortality worldwide. Specific Background: In Iraq, the rising burden of non-communicable diseases has intensified interest in MetS, yet evidence on gender-specific risk patterns using International Diabetes Federation (IDF) criteria remains limited. Knowledge Gap: Few studies have systematically examined gender differences in MetS risk factors among Iraqi adults. Aims: This study aimed to identify and compare gender-specific risk factors for MetS among adults in Al-Basra province based on IDF criteria. Results: Distinct gender differences were observed in sociodemographic characteristics, anthropometric measures, lipid profiles, blood pressure, smoking status, and family history patterns, while age, residence, body mass index, glycemic status, and physical activity showed no significant gender differences. Novelty: The study provides localized, gender-stratified evidence on MetS risk factors in southern Iraq. Implications: The findings support the need for gender-sensitive prevention, screening, and management strategies within primary care and public health programs. Keywords : Metabolic Syndrome, Gender Differences, Risk Factors, International Diabetes Federation Criteria, Waist Circumference Highlight : *]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" tabindex="-1" data-turn-id="request-WEB:1fbe3172-ea17-4b77-8929-7160de5ed415-1" data-testid="conversation-turn-2" data-scroll-anchor="true" data-turn="assistant"> Females showed higher LDL, HDL, and familial hypertension, diabetes, and cardiovascular histories. Males exhibited greater waist measurements, smoking prevalence, and familial obesity history. Anthropometric measures differed by sex, while body mass index and physical activity remained comparable.
Copyright (c) 2026 Khamail A. Bader, Majid A. Maatook, Ibrahim A. Zaboon https://creativecommons.org/licenses/by/4.0
Frequency of Rh Incompatibility Among Primigravida Women Attending Primary Health Care Centers for Antenatal Care in Basra City
General Background Fetomaternal Rhesus incompatibility remains a significant clinical concern due to its association with hemolytic disease of the newborn and adverse pregnancy outcomes. Specific Background Understanding the distribution of Rh-negative mothers and incompatible pregnancies in healthcare settings is essential for early detection and management. Knowledge Gap Limited localized epidemiological data restricts the ability to design targeted prevention strategies in tertiary care environments. Aims This study aims to determine the prevalence of fetomaternal Rhesus incompatibility and describe associated blood group distributions among pregnant women in a tertiary hospital. Results The findings indicate a measurable prevalence of Rh incompatibility, with identifiable patterns in ABO and Rh blood group distribution, highlighting potential risk for alloimmunization and neonatal complications. Novelty The study provides updated, context-specific prevalence data that contributes to localized clinical understanding of Rh incompatibility. Implications The results support the importance of routine antenatal screening, timely diagnosis, and appropriate prophylactic interventions to reduce maternal and neonatal risks Keywords: Fetomaternal Incompatibility, Rhesus Factor, Alloimmunization, Pregnancy Screening, Neonatal Risk Key Findings Highlights Detectable proportion of Rh-negative pregnancies indicates ongoing clinical risk Blood group distribution patterns reveal potential exposure to antigen mismatch Screening practices remain essential for early identification and management
Copyright (c) 2026 Amna M. Meshari https://creativecommons.org/licenses/by/4.0
In Silico Comparative Evaluation of Biotechnology-Based Engineered Bacterial Therapeutic Platforms for Targeted Sensing, Controlled Payload Delivery, and Biocontainment
General Background Engineered bacterial therapeutics have emerged as programmable living systems capable of site-specific sensing and controlled therapeutic delivery. Specific Background Despite rapid advances in synthetic biology, there remains difficulty in selecting optimal platform architectures due to the lack of structured comparative evaluation tools. Knowledge Gap Existing literature lacks a decision-oriented framework that systematically compares engineered bacterial therapeutic platforms across integrated engineering and translational criteria. Aims This study aims to develop an in silico comparative evaluation model to assess representative therapeutic platforms based on specificity, payload control, biosafety, manufacturability, and translational readiness. Results The analysis identifies dual-input logic-gated biocontainment-enabled systems as the highest-ranked platform, followed by biomarker-responsive circuits, while constitutive and tumor-colonizing systems show lower balanced performance. Novelty The study introduces a weighted multi-criteria scoring framework that transforms descriptive knowledge into a structured decision-making tool for platform selection. Implications The proposed model provides a systematic basis for guiding design prioritization, optimization strategies, and future experimental validation in engineered bacterial therapeutics. Keywords: Engineered Bacterial Therapeutics, Synthetic Biology, In Silico Evaluation, Gene Circuits, Biocontainment Key Findings Highlights Dual-input architectures achieve highest balance across evaluation criteria Biomarker-responsive systems provide strong contextual activation with moderate complexity Simpler and tumor-targeting designs show limitations in safety and control balance
Copyright (c) 2026 Raghda Saad Jameel https://creativecommons.org/licenses/by/4.0
Comparative Outcomes of Laparoscopic Versus Open Appendectomy in Children Aged 9–13 Years: A Retrospective Study
General Background: Acute appendicitis is one of the most common causes of emergency abdominal surgery in children and appendectomy remains the standard treatment. Specific Background: While open appendectomy has long been the traditional surgical approach, laparoscopic appendectomy has gained attention in pediatric surgery because of its minimally invasive characteristics and potential benefits for postoperative recovery. Knowledge Gap: Despite numerous comparisons in adult populations, focused evidence evaluating surgical outcomes among school-aged children in specific clinical settings remains limited. Aims: This study compares the clinical and functional outcomes of laparoscopic and open appendectomy in children aged 9–13 years, particularly regarding operative time, postoperative recovery, hospital stay, complications, and return to daily activities. Results: A retrospective analysis of 100 pediatric patients treated between August 2023 and August 2025 showed that laparoscopic appendectomy was associated with reduced postoperative analgesic requirements, earlier oral intake, shorter hospital stay, and faster return to normal activities. Although operative time was slightly longer in the laparoscopic group, overall complication rates were lower and major complications were not significantly different between the groups. Novelty: This study provides focused clinical evidence on surgical outcomes specifically in children aged 9–13 years within a comparative framework. Implications: The findings support the consideration of laparoscopic appendectomy as a preferred surgical option in pediatric appendicitis when appropriate expertise and resources are available. Keywords: Pediatric Appendicitis, Laparoscopic Appendectomy, Open Appendectomy, Postoperative Recovery, Pediatric Surgery Key Findings Highlights Laparoscopic surgery demonstrated reduced postoperative pain and shorter hospitalization. Children undergoing minimally invasive procedures resumed normal activities sooner. Surgical complications were lower overall despite slightly longer operative duration.
Copyright (c) 2026 Sarmad Jaafar Mohammed Alrubaye https://creativecommons.org/licenses/by/4.0
Nutrition and Anxiety: Exploring Food's Role in Student Mental Health During Exams
General Background: Stress during university life is widely recognized as a major factor affecting students’ psychological well-being and dietary behavior. Specific Background: College students frequently experience heightened stress during examination periods, which may lead to changes in eating habits, appetite, and physical symptoms that can interfere with learning and daily functioning. Knowledge Gap: Despite growing research on student stress, limited evidence exists regarding nutrition awareness and food preferences during exam periods among students in health and medical technique programs in Baghdad. Aims: This study aimed to assess knowledge of healthy nutrition and examine food preferences and stress-related symptoms among college students during examinations. Results: A cross-sectional survey conducted from March 1 to April 30, 2025 revealed that 97% of students experienced anxiety accompanied by memory loss, 95% reported appetite changes, and 100% experienced headaches and stomach pain during exams. In terms of food preference under stress, 90% of students selected fast food, 74% preferred dark chocolate, and 60% consumed sweets. Meal skipping among male students showed strong association with stress and poor mood, while female students reported higher perceived stress and were more likely to engage in dietary changes such as binge eating. Novelty: The study provides empirical data linking exam-related anxiety symptoms with specific food choices and meal patterns among health college students in Baghdad. Implications: These findings highlight the need for nutritional awareness and stress management strategies within academic institutions to support student well-being during examination periods. Highlights: • High Prevalence of Anxiety Symptoms and Physical Complaints Reported During Examination Periods. • Stress Conditions Associated With Appetite Changes, Fast Food Preference, and Chocolate Consumption. • Gender Patterns Indicate Stronger Perceived Stress and Dietary Changes Among Female Students. Keywords: Exam Anxiety, Student Nutrition, Eating Habits, College Students, Academic Stress.
Copyright (c) 2026 Msc. Ban Yousif Yaaqoob https://creativecommons.org/licenses/by/4.0
Nurses' and Midwives' Knowledge Toward Postpartum Hemorrhage Prevention in Kerbala City, Iraq
General Background: Postpartum hemorrhage remains a major obstetric emergency and a leading contributor to maternal morbidity and mortality worldwide, requiring competent health professionals capable of recognizing and preventing the condition during maternity care. Specific Background: Nurses and midwives play a central role in maternity services, particularly in identifying risk factors, applying preventive measures, and implementing clinical protocols related to postpartum hemorrhage prevention in hospital settings. Knowledge Gap: Despite established clinical guidelines and international recommendations, evidence indicates that knowledge among healthcare providers may vary, and limited data exist regarding the level of understanding among nurses and midwives working in maternity facilities in Kerbala City, Iraq. Aims: This study aims to assess the knowledge of female nurses and midwives regarding postpartum hemorrhage prevention and to determine the association between knowledge levels and selected sociodemographic variables. Results: A descriptive cross-sectional study involving 60 participants revealed that 53.3% demonstrated poor knowledge scores, while 46.7% achieved good scores. Statistical analysis indicated no significant association between knowledge levels and age, educational level, years of working in the delivery room, participation in postpartum hemorrhage courses or workshops, or current workplace within the hospital. Novelty: The study provides recent empirical evidence describing the knowledge profile of maternity healthcare staff in a teaching hospital in Kerbala City, highlighting areas of insufficient understanding in postpartum hemorrhage prevention. Implications: The findings emphasize the necessity of structured training programs, continuous professional education, and regular knowledge assessment to strengthen clinical preparedness of nurses and midwives in maternity care and support safer maternal health services. Highlights: • Majority of Participants Demonstrated Insufficient Understanding of Preventive Measures Related to Obstetric Bleeding Emergencies. • Statistical Testing Showed No Relationship Between Knowledge Scores and Demographic or Professional Characteristics. • Findings Indicate the Need for Structured Professional Education and Continuous Assessment in Maternity Services. Keywords: Postpartum Hemorrhage Prevention, Nurses And Midwives Knowledge, Maternal Health Care, Obstetric Emergency Management, Iraq
Copyright (c) 2026 Hadeel Rasheed Seger, Ph.D https://creativecommons.org/licenses/by/4.0
The Impact of Enterobiasis on Some Blood Elements among Children in Tikrit City
General Background: Enterobiasis caused by Enterobius vermicularis is a widespread intestinal parasitic infection that commonly affects children and has been associated with nutritional disorders and hematological abnormalities. Specific Background: The infection may interfere with digestion, absorption, and micronutrient balance, potentially contributing to anemia and deficiencies of essential elements such as ferritin, magnesium, zinc, and vitamin B12. Knowledge Gap: Despite the high prevalence of enterobiasis in developing regions, limited empirical data exist on the variations in hematological and biochemical parameters among infected children in Tikrit City. Aims: This study aimed to examine the relationship between Enterobius vermicularis infection and selected blood elements among children aged 2–10 years in Tikrit City between April 2023 and April 2024. Results: Among 100 examined children, 75% were infected with E. vermicularis. The infection rate was slightly higher in males (78.72%) than females (71.69%), and higher in children aged 6–10 years (80.39%) than those aged 2–5 years (69.38%). Infected children showed significantly lower hemoglobin levels (10.610 ± 1.21 g/dl) compared with non-infected children (11.724 ± 0.767 g/dl). Significant reductions were also observed in serum ferritin (28.5 ± 4.51 ng/ml vs 37.5 ± 5.73 ng/ml), magnesium (1.433 ± 0.180 mg/dl vs 1.992 ± 0.138 mg/dl), zinc (48.77 ± 9.85 mg/dl vs 62.59 ± 8.43 mg/dl), and vitamin B12 (485.0 ± 56.0 pg/ml vs 623.6 ± 33.3 pg/ml). Novelty: The study provides detailed evidence of multiple hematological and micronutrient variations associated with E. vermicularis infection among children in Tikrit City. Implications: These findings highlight the need for early diagnosis, routine monitoring of blood parameters, and strengthened health awareness programs to reduce infection spread and related nutritional complications. Highlights: • High Prevalence of Pinworm Infection Observed Among Examined Children in Tikrit City • Infected Participants Showed Lower Hemoglobin and Multiple Micronutrient Concentrations • Monitoring Hematological and Biochemical Indicators Supports Early Clinical Management Keywords: Enterobius Vermicularis, Enterobiasis, Hemoglobin, Micronutrient Deficiency, Children Health
Copyright (c) 2026 Al-Shaima M. Jasim https://creativecommons.org/licenses/by/4.0
Assessment of Obstetric and Gynecological Nurses' Knowledge Regarding Water Birth in Mosul City
General Background: Water birth has emerged as an alternative childbirth method that utilizes immersion in warm water to provide comfort for mothers and reduce stress during labor while maintaining physiological birth processes. Specific Background: Despite its potential benefits, the successful implementation of water birth in clinical settings largely depends on the knowledge and preparedness of healthcare professionals, particularly nurses working in obstetric units. Knowledge Gap: In Mosul city, limited empirical evidence exists regarding the knowledge level of obstetric and gynecological nurses concerning water birth practices and their clinical considerations. Aims: This study aimed to assess the knowledge level of obstetric and gynecological nurses regarding water birth and examine the relationship between knowledge and selected socio-demographic characteristics. Results: A descriptive cross-sectional study was conducted among 140 nurses working in obstetrics and gynecology departments in Mosul teaching hospitals using a structured questionnaire. The findings indicated that most nurses demonstrated an acceptable overall level of knowledge regarding water birth, while knowledge related to risks and indications requiring mothers to leave the water pool was frequently rated as not acceptable. Statistical analysis showed a significant association between nurses’ knowledge and their educational level as well as access to scientific sources. Novelty: This study provides one of the first empirical assessments of nurses’ knowledge regarding water birth practices in Mosul city. Implications: The findings highlight the need for improved educational programs, professional training, and greater access to scientific resources to strengthen nurses’ competencies in supporting safe water birth practices. Keywords: Water Birth, Nurses Knowledge, Obstetric Nursing, Maternal Care, Mosul Hospitals Key Findings Highlights Majority of participants demonstrated acceptable understanding of hydrotherapy childbirth concepts. Knowledge gaps identified in clinical risk recognition and maternal pool exit indications. Educational attainment and scientific reading associated with higher professional competency levels.
Copyright (c) 2026 Rana Mohammed Jasim https://creativecommons.org/licenses/by/4.0
Identification of Cryptosporidiosis in Preschool Children
General Background: Cryptosporidiosis is a globally distributed parasitic disease that frequently causes diarrheal illness in young children and represents a persistent public health concern. Specific Background: Cryptosporidium parvum is one of the most significant zoonotic protozoa responsible for gastrointestinal infections, and molecular identification methods are increasingly used to clarify epidemiological patterns and genetic diversity of circulating strains. Knowledge Gap: Despite numerous studies on intestinal parasites, molecular data regarding local isolates and subtype distribution of C. parvum in Iraqi children remain limited. Aims: This study aimed to detect C. parvum in diarrheic children using nested polymerase chain reaction targeting the GP60 gene and to analyze the genetic relationships of local isolates through sequencing and phylogenetic analysis. Results: Among 28 fecal samples examined, 12 (42.86%) were positive for C. parvum. Sequencing analysis of positive samples revealed a high genetic similarity (approximately 99%) with global reference strains in the NCBI database, with minimal nucleotide variation. Phylogenetic analysis further classified the detected isolates into two subtype groups, IIc and IIId, with IIc representing the majority of cases. Novelty: This research provides the first molecular confirmation and phylogenetic characterization of these GP60 subtype groups among local Iraqi isolates deposited in the NCBI database. Implications: The findings contribute to the understanding of molecular epidemiology of cryptosporidiosis in Iraq and highlight the importance of expanded genotyping and surveillance studies to clarify transmission pathways and improve disease monitoring. Keywords: Cryptosporidium Parvum, Molecular Epidemiology, Nested PCR, GP60 Gene, Pediatric Diarrhea Key Findings Highlights High proportion of pediatric stool samples contained detectable parasite DNA. Genetic sequencing revealed strong similarity between local isolates and global strains. Two allele groups dominated the detected variants within the sampled population.
Copyright (c) 2026 Baraa Abdulsalam Hraija Hraija, Dhamyaa Kareem Kadhim , Ghasik Aqeele https://creativecommons.org/licenses/by/4.0