Medical Journal of Babylon (Med J Babylon)

The association between serum zinc levels and insulin resistance among polycystic ovary syndrome patients in Duhok City, Kurdistan Region, Iraq Lashkar Abdullah Jasem, Dhia Mustafa Sulaiman Medical Journal of Babylon 2019 16(1):1-4 Background: Polycystic ovary syndrome (PCOS) is a relatively common endocrine and metabolic problem. Patients with PCOS are known to have a higher incidence of insulin resistance. The homeostasis model assessment (HOMA) is an indirect, rapid, accurate, and cost-effective method of assessing insulin resistance based on patient's fasting plasma insulin and glucose concentrations. Several studies have reported a significant correlation between HOMA and the traditional hyperinsulinemic-euglycemic clamp method. Zinc deficiency promotes insulin resistance, and that zinc supplementation can prevent or, at least, alleviate insulin resistance in selected patient populations. Objective: The current study primarily aims at defining the association between insulin resistance and zinc deficiency among both PCOS and selected controls. It also looks at certain risk factors associated with obesity among the study population in Duhok City, Kurdistan Region, Iraq. Materials and Methods: The current case–control study was performed at Azadi Teaching Hospital/Gynecological Outpatient Clinic in Duhok City/Kurdistan Region/Iraq. The study included 80 women (40 cases with PCOS and 40 controls of healthy women). Results: There was no age difference between both groups (Mean = 26.77 years, standard deviation [SD] = 6.42 years for PCOS cases versus mean and SD of 27.57 years and 6.45 years, respectively; P= 0.48). Likewise, there was no difference in the serum zinc levels between cases and controls. However, patients with PCOS had significantly higher Body mass index and HOMA scores compared to the controls (P = 0.005 and 0.007, respectively). Conclusion: Higher serum zinc levels are independently associated with lower HOMA. Patients with PCOS had significantly higher insulin resistance when compared to the controls of similar age and zinc level.

Prevalence of symptomatic urinary tract infections and asymptomatic bacteriuria in Iraqi pregnant women of Babylon Governorate Najlaa Abass Al-Mamoryi, Abdulrazzaq Salman Al-Salman Medical Journal of Babylon 2019 16(1):5-12 Background: Urinary tract infections (UTIs) are the most common infections among pregnant women. It can be lead to poor maternal and perinatal outcomes. Objective: The objective of the study is to determine the prevalence rate of symptomatic UTIs and asymptomatic bacteriuria of pregnant women in the Babylon Governorate and to determine its association with sociodemographic, obstetrical, and other factors. Materials and Methods: Cross-sectional study between March 2018 and June 2018 involves examining 300 pregnant women at primary health centers; Maternity and Pediatrics Hospital of Hilla city, with and without symptoms of UTI were employed for this study. Midstream urine samples were taken, and general urine examination was performed. Results: The results of this study revealed that the overall prevalence of UTI among pregnant was 64.6% which include (symptomatic bacteriuria 8.0%, asymptomatic bacteriuria 6.3%, and UTI 50.3%). The higher rate of UTI was found in lower age, multiparous women, and during the second trimester. Factors such as socioeconomic status, history of UTI, dysuria, and positive laboratory results were found to be significantly associated with UTI. Conclusion: UTI is still the common health problem in pregnant women especially during their second trimester. Urinalyses are essential for all pregnant women during the antenatal period. The screening will be assisted to early detection and treatment of asymptomatic bacteriuria which prevent complication for mother and baby.

Knowledge, attitudes, and practice of complementary and alternative medicine among diabetic patients Esraa Kadhum Mehdi, Hadeel Fadhil Farhood Medical Journal of Babylon 2019 16(1):13-19 Background: Complementary and alternative medicine (CAM) is defined as a group of various medical and healthcare systems, practices, and products that are not generally considered part of conventional western medicine. Objective: This study was carried out to estimate the prevalence of CAM use among diabetic patients and to assess knowledge, attitudes, and practice of CAM among diabetic patients. Materials and Methods: This is a hospital-based cross-sectional study done at diabetic center of Merjan teaching hospital on 200 patients. Results: This study estimated that the prevalence of CAM use among diabetic patients at Babylon province was 48.5%; the most common type of CAM used by diabetic patients was Herbal products (24.7%), while nutritional supplements and spiritual healing together used by (18.6%)of (CAM) users, herbal products and nutritional supplements together at rate of (14.4%) and (40.2%) use the 3 types of CAM modalities together. The most common type of Herbal products used by diabetic patients were Garlic which used at (16.9%), while Lemon used by (19.1%) of Diabetic patients, Cinnamon (Darcin) (10.2%), Fenugreek (Helba) (8.8%), (7.3%) bitter gum, and (18.3%) were a mixture of herbs, (7.3%) black seed. (62%)of Subjects had good knowledge about (CAM),(28%) had fair knowledge and (10%) poor knowledge. (66%) of (CAM )users had negative attitudes toward (CAM) and (34%) had positive attitude. Conclusion: Our study estimated the prevalence of CAM use among diabetic patients, revealed good knowledge of the diabetic patients and negative attitudes of CAM users, and showed five significant associations with score of knowledge and attitudes (age, educational level, residence, family history of DM, and follow-up visits), which was consistent with some studies in other eastern and western countries.

Evaluation of the effect of dapagliflozin on atherosclerosis progression by interfering with inflammatory and oxidative stress pathways in rabbits Hajir Karim Abd-Ulhussein, Fadhil Abdul-Jabbar Rizij Medical Journal of Babylon 2019 16(1):20-24 Background: Atherosclerosis is a very common disease in which fat deposition in the inner layers of arteries leading to plaques formation. Dapagliflozin is one of a new class of drugs known as the sodium-glucose cotransporter-2 inhibitors, responsible for lowering of the blood glucose level, and enhancing urinary glucose excretion. Dapagliflozin may lower blood glucose levels and at the same time prevent cardiovascular diseases. Objective: The objective of this study was to assess the effect of dapagliflozin on atherosclerosis through interfering with inflammatory and oxidative pathways. Materials and Methods: Eighteen local domestic male rabbits were used in this study. The rabbits were randomly divided into three groups: Group I rabbits fed normal chow diet for 12 weeks; Group II rabbits fed with 0.5% cholesterol-enriched diet; and Group III rabbits fed with 0.5% cholesterol-enriched diet together with dapagliflozin (1 mg/kg once daily). Blood samples were collected before the study (zero time) and every 4 weeks for the measurement of serum total cholesterol, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very LDL-C (VLDL-C), tumor necrosis factor alpha (TNF-α), and endothelin-1 (ET-1). Results: Dapagliflozin treatment showed insignificant elevation in total cholesterol and LDL-C, significant decrease VLDL-C and TG, and significant elevation of HDL-C level (P < 0.05) compared with the induced untreated group. It was insignificantly decreased inflammatory markers (TNF-α and ET-1), increased aortic total antioxidant capacity, and significantly reduced aortic intima thickness compared with induced untreated group. Dapagliflozin, by slightly interfering with inflammatory and oxidative pathways, may show beneficial effects on atherosclerosis and can attenuate the atherosclerotic lesion formation. Conclusion: Dapagliflozin may have a beneficial effect on atherosclerosis by slightly interfering with inflammatory and oxidative pathways and can reduce the atherosclerotic lesion formation; however, our study needs further clinical studies to be carried out on large population.

Evaluation of the quality of maternal health services in primary health-care centers by using service provision Assessment Wedyan Ibrahim Ismael, Hadeel Fadhil Farhood Medical Journal of Babylon 2019 16(1):25-30 Background: The Service Provision Assessment (SPA) survey is a nationwide facility-based survey that measures the ability of health facilities to provide quality preventive, diagnostic, and treatment services for key maternal and child health and HIV/AIDS programs. Objective: The study was designed to assess some aspects of expressed maternal health services provided at ten primary health-care (PHC) centers in Babylon province, Iraq, using interviews with health service providers and clients and observations of provider–client consultations to obtain information on the capacity of facilities to provide quality services, and the existence of functioning systems to support quality services. Materials and Methods: A cross-sectional study was done in ten Babylon PHC centers from March to August 2018. The study included 165 pregnant women. The questionnaire included sociodemographic factors (age, residence, employment, parity, and education) and data related to Service Provision Assessment questionnaire which include a facility inventory, client exit interviews, and antenatal care (ANC) observation and consultation. Results: The mean age of pregnant women attending ANC was 25.29 ± 5.48, 66.1% came from urban areas, the majority were not employed (83%), their educational level was secondary (38.8%), and 57% were multipara. The findings showed that the majority (89.1%) of patients think that health facility services were good. A sizeable majority (83.0%) of women were satisfied regarding health services including availability of medicines at the facility (91.5%), cleanliness of the facility (100%), privacy (93.9%), charging or payment of fees for services received (0.6%), and discussion of problems related to the pregnancy (93.3%). Conclusion: This study showed a high level of satisfaction with the quality of maternal health services among antenatal attendees and highlighted the need to support interventions that increase the uptake of formal maternal health-care services.

Evaluation of serum level of soluble lectin-like oxidized low-density lipoprotein receptor-1 and its relationship with severity of preeclampsia and birth weight Hiba Ghassan Rajab, Mohammed A.M Ali, Hala Abdulqader Al-Moayad Medical Journal of Babylon 2019 16(1):31-35 Background: Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is one of the pattern recognition receptors that plays a critical role in vascular diseases and host immune response, LOX-1 can induce endothelial dysfunction through pathways implicated with oxidative stress and inflammation that ends with vascular lesions. Objective: The objective of the study is to evaluate the serum level of soluble LOX-1 (sLOX-1) in preeclampsia (PE) and normal pregnancy to study its relationship with the severity of PE and birth weight. Materials and Methods: A total of 56 patients with PE were allocated to the study together with 28 healthy pregnant women as normal controls. PE patients divided into 28 mild and 28 severe PE. Levels of serum sLOX-1 were measured by sandwich enzyme-linked immunosorbent assay technique. Results: Results showed a significant increase in the serum sLOX-1 in preeclamptic patients (P < 0.01) compared to normal controls. The significance increased in serum levels of sLOX-1, was noted in mild (P = 0.001) and severe patients (P = 0.001), compared to normal controls. There was a significant decrease in fetal birth weight in severe PE as compared to mild and control groups which was correlated with sLOX-1, furthermore, logistic regression of the variables for the presence of low birth weight <2.5 kg. Conclusion: High level of serum sLOX-1 is associated with the occurrence and severity of PE, which provides additional information for predicting of PE and preventing its complications and for better understanding pathogenesis of PE and the results highlight the involvement of innate immunity molecules and inflammation in pathogenesis of PE through binding to apoptotic cells and angiogenic process.

Study the relation between internet usage and the occurrence of depression among Kirkuk technical students Wafa Mahmood Jasim Medical Journal of Babylon 2019 16(1):36-40 Background: Internet is regarded as one of the most indispensable parts in our life, and majority of young and adolescent people interested in the usage of it, but in some cases, these uses are become out of the control which later on lead to a condition called internet addiction in which it will be the predominant life activity. Objective: A descriptive cross-sectional study was conducted on Kirkuk Technical Institute students from January 1, 2017, to May 30, 2017 to study, if there is any relation between the occurrence of depression and internet usage. Materials and Methods: The total number of students included in the study was 550 from different scientific departments after distributing a special questionnaire form prepared for that purpose, and face-to-face interview was conducted after receiving the written consent from them. Results: The study results show that 60.8% of technical study students and 47.3% of students from administrative departments used internet daily, while 46.0% of students of health department used it weekly. In addition to that 72.1% and 67.8% male students from technical and administrative departments used internet daily, while female students from all departments (technical, administrative, and health) used the internet monthly; in addition to that 53.1% of students from administrative departments have a depressive attempts which affects daily activity and work in comparison to 18.5% of students from technical departments. Conclusion: The study concluded that the time spent for internet was about 7–9 h/daily with the presence of a suggestive depressive symptom which affects daily activity and work. Recommendations: The study recommended that further advanced educational programs about the main adverse effects of the internet and the main possible ways to control its usage.

Cytogenetic effects of gestogens on women with threatened miscarriage in Duhok Province, Kurdistan Region, Iraq Hayat S Ahmed, Dian J Salih, Iman Yousif Abdulmalek, Asaad A Alasady Medical Journal of Babylon 2019 16(1):41-46 Background: Gestogens have been recommended to have a place in the prevention of threatened miscarriage and spontaneous pregnancy loss during the first 3 months of pregnancy. Certain studies consider that this steroid hormone has genotoxic effect because they directly involved in the change of DNA structure. Objectives: This study aims to investigate the cytogenetic effects of gestogens on peripheral blood lymphocytes of pregnant women, by damaged cells and chromosomal aberrations, as well as evaluate the models for hormonal therapy in vivo. Materials and Methods: Blood sample from 30 women with threatened miscarriage, who received gestogen therapy in the first 3 months, Were taken. Cytogenetic analyses and karyotyping were performed for Each patient Before and after therapy. Results: The numerical chromosomal aberrations which found in blood lymphocytes of women before taking gestogens were 44,XX and 48,XX. The same result was observed after taking gestogens. The percentage levels of structural chromosomal aberrations were ring chromosome (2.06%), chromatid breaks (12.47%), chromatid gaps (1.65%), dicentric (0.55%), acentric chromosome (4.02%), and interchange chromosome (12.5%). Whereas, the abnormalities after treatment with gestogens were ring chromosome (5.31%), chromatid breaks (42.19%), chromatid gaps (20.86%), dicentric (7.50%), acentric chromosome (17.75%), and interchange chromosome (43.97%). Conclusion: Gestogens as hormonal substitute therapy do not induce numerical chromosomal aberrations but have a significant increase of structural chromosomal aberrations Gestogens have genotoxic effects on human lymphocyte chromosomes at wide range of concentrations. So the potential benefits and side effects of it must be weighed up against the deleterious effects.

Correlation of bilirubin and alkaline phosphatase in infantile patients with cholestasis Mostafa M Al-Bassam, Hassan H Al-Saeed, Hala Sameh Arif Medical Journal of Babylon 2019 16(1):47-50 Background: Early and successful individualized management of infantile cholestasis depends on the time of diagnosis. Objective: The objective of the study is to assess the clinical value of serum total bilirubin, direct bilirubin, and alkaline phosphatase in children with cholestasis. Materials and Methods: Sixty patients with diseases and 25 healthy controls distributed into three groups – total/direct bilirubin, and alkaline phosphatase were measured for all case and control studies by enzyme-linked immunosorbent assay. Results: The results showed serum total, direct bilirubin, and alkaline phosphatase have a highly significantly elevated in intra- and extra-hepatic cholestasis groups when compared with control (P < 0.001). There was a significantly elevated serum total and direct bilirubin when compared the extrahepatic cholestatic group with intrahepatic cholestatic group (P = 0.002 and 0.017), and there was no statistical difference between the intrahepatic cholestatic patients and extrahepatic cholestatic group when serum alkaline phosphatase measured (P = 0.610). Conclusion: From these findings, it was concluded that the level of direct bilirubin in sera of extrahepatic cholestasis group when compared with intrahepatic cholestasis group is elevated, serum total bilirubin, and alkaline phosphatase levels are good markers in determining the poor prognosis of cholestasis disease.

Effect of Vitamin D deficiency on pulmonary function test in a normal population Hemin Khalid Saber, Hamanejm Faraj Jaff, Media Qader Hasan Medical Journal of Babylon 2019 16(1):51-54 Background: During the past years, the role of Vitamin D on wide biologic processes has received the attractiveness. Moreover, the role of Vitamin D in the prevention and treatment of respiratory infections has already been confirmed. Objective: In the present study, the pulmonary functions, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) ratio, and FEV1/FVC ratio were compared between healthy individuals with and without Vitamin D deficiency. Materials and Methods: In the current case–control study, the pulmonary functions of healthy individuals with normal Vitamin D (control = 51) and with Vitamin D deficiency (cases = 57) were compared through statistical analysis. The individuals recruited in the study were screened from the outpatient clinic of medicine department of a public hospital purposively. The Vitamin D level <50 nmol/L was considered deficient. The reference values of pulmonary functions were considered as follows: FVC between 80% and 120% as normal and <80% as reduced; FEV1 ≥75 as normal and <75 as reduced; FEV1/FVC between 80% and 120% as normal. Results: The present study showed that individuals with normal level of Vitamin D (control) and those with deficient level of Vitamin D (case) were comparable in age (39.09 vs. 41.33 years; P= 0.393), and body mass index (27.48 vs. 28.39; P= 0.475), respectively. In addition, both case and control groups were similar in FVC (93.98 vs. 93.12; P= 0.653), FEV1 (90.88 vs. 89.39L; P= 0.752), and FEV1/FVC (95.94 vs. 95.01%; P= 0.777) respectively. Conclusion: The study did not show a significant difference in baseline characteristics and of those spirometry functions (FVC, FEV1, and FEV1/FVC) between the healthy individuals with normal and deficient Vitamin D levels.