Kufa Medical Journal
type: channel
description: Kufa Medical Journal (KMJ) ISSN (Print) : 1993-517X ISSN (Online) : 2709-4464 KMJ: is a peer-reviewed journal that publish original articles to advocate changes in, or illuminate aspects of medical and health sciences. It accept submission of State of the art full length research papers\articles, Review articles, Case reports, and Communication articles. KMJ considers the double-blind peer-review system to assure the quality of the publication and tests plagiarism at two stages, at submission and after considering the reviewers comments. KMJ is issued biannually (2 issues per year) by the Faculty of Medicine, University of Kufa, Iraq. considering that the first hard copy of the first issue was printed at 1999. Indexed in: Directory of Open Access Journals (DOAJ), EBSCO, Google scholar, Iraq Academic Scientific Journals (IASJ), Crossref, Dimensions, Internet archive, LOCKSS, CLOCKSS, PKP PN Contact Details: Editor in Chief : Prof. Dr. Arafat Aldujaili Editorial Manger: Asst. Prof. Dr. Wijdan Rajh Al-Kraity E-mail: kufamed.journal@uokufa.edu.iq Address: Faculty of Medicine, University of Kufa, P.O Box 21, Kufa, Najaf Governorate, Iraq.
publisher: Faculty of Medicine - University of Kufa
language: en
publication name: Kufa Medical Journal
issn: 1993-517X
copyright: which allows users to copy, create extracts, abstracts, and new works from the Article, alter and revise the Article, and make commercial use of the Article (including reuse and/or resale of the Article by commercial entities), provided the user gives appropriate credit (with a link to the formal publication through the relevant DOI), provides a link to the license, indicates if changes were made and the licensor is not represented as endorsing the use made of the work. The authors hold the copyright for their published work on the KMJ website, given that KMJ is responsible to appreciate citation for their work, which is released under CC-BY-4.0 enabling the unrestricted use, distribution, and reproduction of an article in any medium, provided that the original work is properly cited.
items: Gene Expressions of CTLA-4 and CCL2 in Patients with Rheumatoid Arthritis
items: Prevalence of Severe Acute Bronchiolitis in Al-Ramadi Maternity and Children's Teaching Hospital
items: Avascular Necrosis of Femoral Head Following Closed Reduction in Cases of Developmental Dysplasia of the Hip Among Infants
items: A Quasi-Experimental Study of the Effectiveness of Evidence-Based Practice Education Sessions on Nurses’ Knowledge and Attitude Regarding Evidence-Based Practice
items: LEPR Q223R Variant and Its Role in Type 2 Diabetes Susceptibility Among Iraqi Individuals
items: Analysis of Some Demographic, Hematological, and Immunological Parameters among Chronic Hepatitis B Patients with Coronary Artery Disease in Iraq
items: Cryptosporidium Detection in Pediatric Diarrheal Cases: Microscopic, Immunological and Molecular Approaches in Kirkuk, Iraq
items: Tirzepatide Protects the Kidney by Modulating Oxidative Stress, Inflammation, and Apoptosis in an Induced Ischemia-Reperfusion Rat Model
items: Elevated Serum Cathepsin D Correlates with TNF-α, Insulin, and Myocardial Infarction in Type 2 Diabetes
items: Effects of Pirfenidone on Renal Ischemia-Reperfusion Injury in a Mice Model: Reno-protective Effect
items: Pattern of Patient Referrals from Family Healthcare Centers to Tertiary Centers in Erbil City
items: Case-Control Study on KCNJ11 Gene Polymorphism and Type 2 Diabetes Mellitus
items: Pattern of Abnormal Uterine Bleeding among Perimenopausal Women in Erbil City
items: Assessment of Paediatric Antibiotic Prescriptions Practice Among Hospitalized Children Using WHO AWaRe Guidelines in Sulaimani City, Iraq
items: Vitamin D Status among Women of Childbearing Age Attending Primary Health Care Centers in Al-Najaf Governorate, Iraq
items: Evaluation of Lymphocyte Activation Gene 3 Activity with Hepatitis C Virus Infection in Beta Thalassemia Major Patients
items: The Assessment of Serum Interleukin-18 (IL-18) Level and Its Role as a Biomarker for Psoriasis in Najaf Province
items: The Role of Matrix Metalloproteinase-3 as a Biomarker for Diagnosis and Disease Activity Assessment in Patients with Ankylosing Spondylitis
items: High Prevalence of blaNDM and blaOXA Carbapenemases in Multiple Antibiotic Resistant Acinetobacter baumannii from Iraqi Hospital
items: Identification of Bacterial Isolates from Urine Samples of Patients with Ascending Pyelonephritis at Al-Sadder Teaching Hospital
items: Prevalence of Resistance Genes Gyr B, Ade-B and NDM-1 in Acinetobacter baumannii from Asthmatic Children
items: Evaluation of IGA And IGE In Atopic Dermatitis Paediatric Patients in Relation to the Type of Feeding
items: Exploring the Relationship of Thalassemia Major and Gingival Health: A Narrative Review
items: The TCF7L2 rs7903146 Variant as a Predictor of Type 2 Diabetes Susceptibility in the Iraqi Middle Euphrates Region
items: The impact of kangaroo Mother care on the Newborn Health Outcome of A preterm Infant at Al-Zahraa Teaching Hospital in Al-Najaf AL-Ashraf City 2024
items: Comparative Accuracy of Automated Upper Arm and Wrist Blood Pressure Devices: A Comparison with Intra-arterial line
items: Attitude of Dental Students towards the Specialty of Oral Pathology: A Questionnaire-Based Survey
items: Detection of Monocyte Chemotactic Protein-1 (MCP-1) among Patients with Celiac Disease
items: Evaluation of Cathelicidin (LL-37) Serum Levels Among Iraqi Psoriatic Patients and Its Association with Disease Severity and Complications
items: Assessment of Interleukin-2 and Vitamin D Status in Vitiligo Patients Compared to Healthy

Gene Expressions of CTLA-4 and CCL2 in Patients with Rheumatoid Arthritis
type: item
description: Background: Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune system erroneously targets the body’s own tissues, primarily causing chronic inflammation in the synovial joints (inflammatory arthritis) and potentially affecting other organs and systems (extra-articular manifestations). RA pathogenesis is complicated and it includes genetic predispositions, environmental factors, and dysregulation of the immune system. The aim of this study is to evaluate the correlation between CTLA-4 and CCL2 gene expressions in RA patients. Methods: A total of 120 subjects were involved in a case-control study, including 60 patients with RA and sixty apparently healthy volunteers as a control group. Measurement of the expression levels of CTLA-4 and CCL2 genes was conducted utilizing the real-time PCR methodology. Results: The mean of expression level of the CTLA-4 and CCL2 genes was considerably higher in patients with RA compared with healthy controls (P<0.001), with a significant negative correlation between CTLA-4 and CCL2 gene expressions (R= -0. 248, P=0.04) in patients with RA. Conclusion: This study concluded that CTLA-4 and CCL2 genes have an associated role in the pathogenesis of RA. The balance between the immune-inhibiting CTLA-4 and the inflammation-promoting CCL2 reduces severity of chronic inflammation and tissue damage.
subject: Original Articles
  topic: section
subject: Rheumatoid Arthritis
  topic: keywords
subject: CTLA-4
  topic: keywords
subject: CCL2
  topic: keywords
creator: Zahraa Falah AL-Fatlaawi
creator: Raad Abdulameer Alasady
rights: Copyright (c) 2025 Zahraa Alfatlawi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 228
ending page: 241
doi: 10.36330/kmj.v21.i2.21933

Prevalence of Severe Acute Bronchiolitis in Al-Ramadi Maternity and Children's Teaching Hospital
type: item
description: Background: Acute bronchiolitis is a common respiratory illness in infants and young children with variable clinical severity, sometimes leading to serious complications or death. Objectives: To evaluate the prevalence, risk factors, and outcomes of severe acute bronchiolitis in children. Methods: A cross-sectional study was conducted over six months at Al-Ramadi Maternity and Children Teaching Hospital, involving 511 children aged ≤ 2 years with their first episode of bronchiolitis. Cases were categorized into mild, moderate, or severe. Results: Out of the 511 cases, 109 (21.3%) as severe bronchiolitis. The majority were infants aged 1-6 months, with a slight male predominance. Most patients resided in rural areas, and overcrowded households were common. Significant associations (P-value < 0.05) were found between disease severity and factors such as young age, cesarean delivery, lower parental education, overcrowding, use of oil-based heating, and lack of maternal supplementation during pregnancy. Bottle feeding was the most prevalent type, but feeding method and parental smoking showed no significant association (P-value > 0.05) with disease severity. Pneumonia was the most frequent complication (22.5%), followed by apnea (8.8%), and respiratory care unit admission (11.7%). The observed mortality rate 3.1%. Conclusion: Acute bronchiolitis remains a significant cause of infant morbidity and mortality. Early identification of risk factors and improved supportive care are essential, especially in resource-limited settings.
subject: Original Articles
  topic: section
subject: Bronchiolitis; Acute severe bronchiolitis; Severity
  topic: keywords
creator: Bara’a Nouri
creator: Mohammed Maher Al-Ani
creator: Raid M. Al-Ani
creator: Asfar Alshibib
rights: Copyright (c) 2025 Bara’a Nouri , Mohammed Maher Al-Ani , Raid M. Al-Ani, Asfar Alshibib https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 217
ending page: 227
doi: 10.36330/kmj.v21.i2.21754

Avascular Necrosis of Femoral Head Following Closed Reduction in Cases of Developmental Dysplasia of the Hip Among Infants
type: item
description: Background: Avascular necrosis (AVN) of the femoral head is a serious complication following treatment for developmental dysplasia of the hip (DDH) in infants. Although several risk factors have been proposed, there remains uncertainty regarding the role of patient age, sex, hip side, and treatment technique in AVN development. This study aimed to determine the incidence and associated risk factors for AVN in infants undergoing closed reduction for DDH. Methods: A retrospective descriptive study was conducted on 124 infants (5–12 months old) treated for DDH at two specialized centers in Duhok City, Iraq, between January 2019 and December 2023. Patients underwent closed reduction with or without adductor tenotomy and with or without pre-reduction traction. All were followed clinically and radiographically for at least two years. AVN diagnosis was based on Salter criteria and graded using the Bucholz–Ogden and Kalamchi–MacEwen classifications. Categorical variables were compared using the Chi-square test, with p < 0.05 considered statistically significant. Results: The overall incidence of AVN was 18.5%. AVN rates did not differ significantly between the 5–8 month group (18.3%) and the 9–12 month group (18.8%, p = 0.06), nor by sex or side of involvement. Adductor tenotomy was associated with a significantly lower incidence of AVN (11.2% vs. 46.1% without tenotomy, p = 0.001). Pre-reduction traction also reduced AVN risk (9.1% vs. 41.6% without traction, p = 0.001). Conclusion: In this cohort, age, sex, and side were not significant predictors of AVN after closed reduction for DDH. The use of adductor tenotomy and pre-reduction traction markedly reduced AVN incidence, highlighting the importance of soft-tissue management and gentle, tension-free reduction techniques.
subject: Original Articles
  topic: section
subject: Developmental dysplasia of the hip
  topic: keywords
subject: Avascular necrosis
  topic: keywords
subject: Closed reduction
  topic: keywords
subject: Tenotomy
  topic: keywords
subject: Traction
  topic: keywords
subject: Infants
  topic: keywords
creator: Kaidar AL-Hassawi
rights: Copyright (c) 2025 Kaidar AL-Hassawi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 210
ending page: 216
doi: 10.36330/kmj.v21.i2.21204

A Quasi-Experimental Study of the Effectiveness of Evidence-Based Practice Education Sessions on Nurses’ Knowledge and Attitude Regarding Evidence-Based Practice
type: item
description: Background: Nursing activities are no longer accepted without Evidence-Based Practice (EBP). For that reason, nurses should have a positive attitude toward EBP. They should acquire good knowledge for enhancing their practices. This study aims to increase EBP knowledge and attitude among nurses in clinical practice. Materials and Methods: a quasi-experimental design was used to involve nurses in different private hospitals in Sulaimani city. A total of 37 nurses participated after giving a verbal consent, by convenient sampling. Knowledge and attitude levels were observed at baseline and after an intervention. Two EBP sessions were presented, and a modified questionnaire for assessing knowledge and attitude of EBP was used. SPSS version 25.0 was used for data analysis. Results: The mean age was (31 ± 7.7), they had administrative positions like head nurse (13.5%) and ward in charge (62.2%). The attitude levels were the same before and after the intervention as (97.3%) had a positive attitude. The proportions of the nurses with a good level of EBP knowledge were improved from 51.4% at baseline to 97.3% following the sessions. A statistically highly significant association was found between working area and level of attitude meanwhile, other variables did not represent any significant relationships p (0.02). There was a highly significant correlation between pre-and-post attitude scores at the p (0.002) meanwhile, no correlation was found between pre-and-post knowledge scores at the p (0.6).Conclusions: Evidence-Based Practice sessions can have positive impact on the nurses’ knowledge to consider in their daily practice.
subject: Original Articles
  topic: section
subject: EBP, Attitude, Evidence based nursing and Nurses’ Knowledge
  topic: keywords
creator: Omar Hussein Shareef
rights: Copyright (c) 2025 Omar Hussein Shareef https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 202
ending page: 209
doi: 10.36330/kmj.v21.i2.21152

LEPR Q223R Variant and Its Role in Type 2 Diabetes Susceptibility Among Iraqi Individuals
type: item
description: Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and impaired β-cell function. Recent studies have highlighted the contribution of genetic polymorphisms, particularly in the leptin receptor (LEPR) gene, to T2DM susceptibility. The LEPR rs1137101 (A>G) polymorphism, which leads to a Q223R amino acid substitution, may influence leptin signaling and insulin sensitivity, thereby affecting T2DM pathogenesis. Methods: A case-control study included 300 participants (150 T2DM patients and 150 healthy controls) recruited from Najaf, Iraq. Genotyping of LEPR rs1137101 was performed using allele-specific PCR, while biochemical parameters, including fasting blood glucose (FBG), insulin, lipid profile, HOMA-IR, and serum leptin levels, were measured using standard methods. Data were analyzed under different genetic inheritance models with adjustment for age, sex, and BMI. Results: The LEPR rs1137101 G allele was significantly associated with an increased risk of T2DM. Individuals with the GG genotype had a 4.9-fold increased risk (p < 0.0001; OR = 4.96, 95% CI = 2.26–10.90), and AG carriers had a 3.7-fold increased risk (p < 0.0001; OR = 3.70, 95% CI = 2.19–6.26) compared to AA homozygotes. The G allele also showed a strong association in dominant (OR = 3.95), over-dominant (OR = 2.47), and recessive models (OR = 2.48), indicating its robust link to T2DM susceptibility. Furthermore, GG carriers exhibited significantly elevated insulin, HOMA-IR, and leptin levels, suggesting a relationship with increased insulin resistance and altered leptin signaling. However, no significant differences were observed in BMI, FBG, or lipid profile between genotypes. Conclusion: The LEPR rs1137101 (A>G) polymorphism is strongly associated with T2DM in the Iraqi population.
subject: Original Articles
  topic: section
subject: LEPR Q223R, rs1137101SNP, T2DM.
  topic: keywords
creator: Noor Najah Mohsin Fakhreldeen
creator: Abdulhussein Alwan Aljanabi
creator: Zahraa Najah Fakhreldain
rights: Copyright (c) 2025 noor mohsin fakhreldeen https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 181
ending page: 190
doi: 10.36330/kmj.v21.i2.20822

Analysis of Some Demographic, Hematological, and Immunological Parameters among Chronic Hepatitis B Patients with Coronary Artery Disease in Iraq
type: item
description: Background: Hepatitis B is a major global health problem. It is an infection of the liver caused by the hepatitis B virus. The infection can be acute or chronic. Purpose: To assess and compare demographic, hematological, and immunological parameters among chronic hepatitis B patients and identify significant clinical patterns and associations. Methods: A cross-sectional study of 200 hepatitis B patients with coronary artery disease (117males, 83 females) was conducted at Al-Sader Teaching Hospital, Najaf, from November 1, 2023, to December 1, 2024. Serum Blood samples were analyzed for hematological and immunological parameters were measured using ELISA. Results: Among 200 patients, most were from Al-Najaf (75.5%). Unstable angina was most common (35.5%). Males showed higher hematological values than females, including lymphocytes ( p=0.008), RBC (p=0.003), PLT (p=0.006), HB (p<0.001), and WBCs (p=0.002). Diabetic patients had reduced lymphocytes, PLT, HB, and WBCs (all p<0.05) and elevated RBC (p<0.001). Caspase-3 and -9 were significantly higher in asthma, TB, and bronchial allergies compared to those without comorbidities (p<0.001). Smokers had higher caspase-3 (14.2±3.5 vs. 8.9±2.8, p=0.008) and caspase-9 (28.6±4.2 vs. 19.3±3.6, p<0.001) than non-smokers. Conclusion: Chronic hepatitis B in Iraqi patients with coronary artery disease predominantly manifests as unstable angina, with hematological and immunological changes, especially elevated apoptotic markers determined by sex, diabetes, blood group, comorbidities, and smoking. These findings underscore the importance of integrated monitoring and targeted management strategies in this population.
subject: Original Articles
  topic: section
subject: caspase -9, HBV, Cardiovascular
  topic: keywords
creator: Rana Talib Fakher Al-Nafakh
creator: Saif Jabbar Yasir
rights: Copyright (c) 2025 Rana Al-Nafakh https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 191
ending page: 201
doi: 10.36330/kmj.v21.i2.20875

Cryptosporidium Detection in Pediatric Diarrheal Cases: Microscopic, Immunological and Molecular Approaches in Kirkuk, Iraq
type: item
description: Background: Cryptosporidium is a protozoan parasite that causes digestive issues in children and is a major contributor to the increasing burden of waterborne parasitic infections. It is recognized as one of the primary causes of diarrheal disease among children. In low-resource settings like Iraq, poor sanitation significantly elevates the risk of outbreaks, thereby threatening child health and adding to the economic burden. Objective: This study aimed to assess and compare the diagnostic performance of four distinct techniques: direct smear microscopy stained with modified Ziehl-Neelsen (MZN), concentration (formalin-ether sedimentation), rapid immune-chromatography, and molecular-PCR techniques for the detection of Cryptosporidium among diarrhoeic children in Kirkuk City, Iraq. Methods: A total of 150 stool samples were collected from diarrhoeic children across multiple hospitals between September 2024 and March 2025. These samples were analyzed using four diagnostic approaches. Results: Out of 150 samples, 91 (60.7%) tested positive using MZN, 96 (64%) via concentration, 103 (68.7%) through rapid immune-chromatography, and 111 (74.0%) using PCR. Compared to PCR, the sensitivity for MZN, concentration, and rapid immune-chromatography was 62.16%, 63.96%, and 74.86%, respectively; specificity was 43.59%, 35.89%, and 48.72%, respectively. Statistical analysis revealed no significant agreement for MZN and concentration (p = 0.527, 0.988), while rapid immunochromatography showed significant concordance (p = 0.007). Conclusion: While MZN, concentration, and rapid tests are useful, PCR remains the most sensitive and specific, offering genotyping capability, batch processing suitability, and high diagnostic accuracy, PCR is considered a valuable tool for future diagnostic and molecular epidemiological studies.
subject: Original Articles
  topic: section
subject: Cryptosporidium, diarrhoeic children, rapid immuno-chromatography, Molecular-PCR.
  topic: keywords
creator: Chawan Khalil Nori
creator: Younis Sabir Abdullah
rights: Copyright (c) 2025 chawan khalil https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 167
ending page: 180
doi: 10.36330/kmj.v21.i2.20782

Tirzepatide Protects the Kidney by Modulating Oxidative Stress, Inflammation, and Apoptosis in an Induced Ischemia-Reperfusion Rat Model
type: item
description: Renal ischemia-reperfusion (I/R) injury is major cause of acute kidney injury (AKI), driven by oxidative stress, inflammation, and cell death, and no effective pharmacological therapy available. Tirzepatide, a dual GIP/GLP-1 receptor agonist, has shown metabolic and anti-inflammatory benefits that may offer renal protection. This study investigate its effect against acute renal I/R injury in rats. Twenty-four male Sprague-Dawley rats were assigned to four groups: sham, I/R control, I/R + DMSO, and I/R + tirzepatide (1.35 mg/kg). Drug or vehicle was administered 24 hours and 1 hour before 40 minutes of bilateral renal ischemia followed by 2 hours of reperfusion. I/R markedly increased serum urea, creatinine, NGAL, oxidative stress markers, TNF-α, caspase-3, and tubular injury. Tirzepatide significantly improved renal function, reduced NGAL, oxidative stress, inflammation, apoptosis, with histological damage. These findings indicate strong renoprotective effect of tirzepatide, that support its potential as a therapeutic option for AKI associated with ischemic insults.
subject: Original Articles
  topic: section
subject: Tirzepatide
  topic: keywords
subject: Ischemia Reperfusion
  topic: keywords
subject: Acute Kidney Injury
  topic: keywords
subject: Apoptosis
  topic: keywords
subject: Inflammation
  topic: keywords
creator: Layla Ameen Rasheed Alfatli
creator: Thu-Alfeqar Razzaq Tweij
rights: Copyright (c) 2025 Layla Ameen https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 152
ending page: 166
doi: 10.36330/kmj.v21.i2.20688

Elevated Serum Cathepsin D Correlates with TNF-α, Insulin, and Myocardial Infarction in Type 2 Diabetes
type: item
description: Background: Cathepsin D, a lysosomal enzyme, has a clear role in the metabolic and inflammatory processes associated with conditions such as type 2 diabetes mellitus and myocardial infarction (MI), particularly in the context diabetic complications. Objective: To evaluate serum cathepsin D levels in T2DM patients with MI and assess associations with TNF α, insulin, and other metabolic/inflammatory parameters. Methods: Case-control study: This study included 120 participants divided into three equal groups (40 participants): 40 control groups, 40 individuals with type 2 diabetes and insulin resistance, and 40 individuals with diabetes who had suffered a MI. Results: Cathepsin D levels were significantly elevated in G3 (374 ± 118 ng/L) vs. G2 (291 ± 41.6 ng/L) and G1 (233.6 ± 55.8 ng/L; p < 0.001). Strong positive correlations existed between cathepsin D and TNF-α (r = 0.514, p < 0.05) and insulin (r = 0.554, p < 0.05). ROC analysis indicated high diagnostic accuracy for MI in diabetics: cathepsin D (AUC 0.94, sensitivity 88%, specificity 88%) and TNF-α (AUC 0.93, sensitivity 92%, specificity 80%). All metabolic (RBS, HbA1c%, insulin) and inflammatory markers (CRP, TNF-α) were significantly higher in G2 and G3 vs. G1 (p < 0.001). Conclusion: Serum cathepsin D is significantly elevated in T2DM patients with MI and correlates strongly with TNF-α and insulin resistance. These findings support its potential as a biomarker for cardiovascular risk stratification in diabetic populations.
subject: Original Articles
  topic: section
subject: Cathepsin D, type 2 diabetes, myocardial infarction, inflammation, TNF-α
  topic: keywords
creator: Mohammed H. Hassan
creator: Ferdous A. Jabir
rights: Copyright (c) 2025 Mohammed H. Hassan, Ferdous A Jabir https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 144
ending page: 151
doi: 10.36330/kmj.v21.i2.20678

Effects of Pirfenidone on Renal Ischemia-Reperfusion Injury in a Mice Model: Reno-protective Effect
type: item
description: This study look to the nephroprotective properties of pirfenidone in adult male mouse model with renal ischemia-reperfusion injury (IRI). Adult mice (12-15 weeks age and weigh 25-35 g) were separated at random to four groups: sham, ischemia, vehicle (DMSO), and pirfenidone (300 mg/kg orally, 30 minutes preceding to ischemia). Renal IRI produced by 30 minutes of bilateral ischemia and 2 hours of reperfusion. In order to assess renal function and oxidative stress, serum urea, creatinine and F2-isoprostane was checked. TNF-α as well as NF-κB levels in renal tissue also was checked for reactions related to inflammation. Histopathological grades evaluated structural kidney injury. When compared to sham group, the ischemia and vehicle groups revealed significant higher levels of renal function, oxidative stress, and inflammatory markers. Pirfenidone lowered all biochemical indicators dramatically, while improving histological damage scores, resulting in near-normal architecture. The study found that pirfenidone provide significant nephroprotection in renal IRI by acting as anti-inflammatory and antioxidant.
subject: Original Articles
  topic: section
subject: Pirfenidone,IRI, F2 Isoprostan
  topic: keywords
creator: Liqaa Ali Ahmed Almusawi
creator: Bashaer M. Muhammad-Baqir
rights: Copyright (c) 2025 Liqaa Ali Ahmed Almusawi, Bashaer M. Muhammad-Baqir https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 127
ending page: 143
doi: 10.36330/kmj.v21.i2.20623

Pattern of Patient Referrals from Family Healthcare Centers to Tertiary Centers in Erbil City
type: item
description: Background: Family medicine provides personal, comprehensive, and ongoing care for individuals within the context of their family and community. There is little information on referral status in Middle Eastern countries. Purpose: In this regard, we aimed to investigate the reasons for patient referrals from family healthcare centers (FHCs) to tertiary health facilities within Erbil City. Methods: A cross-sectional study was conducted in five FHCs in Erbil City from October 1st 2024 to September 1st 2025. This study included patients who attended these FHCs and subsequently received referrals to tertiary health centers. Results: Of the 400 patients, one-third (36.3%) were male, and more than two-thirds (63.7%) were female. The mean age was 33.21 (SD: 18.18 years). More than two-thirds (65.8%) of the referrals were indicated, and 34.3% were self-request referrals with no significant difference in genders (p=0.941). The main reasons for referral were insufficient investigation (44%), non-existence of a specialty in the hospital (34.3%), non-diagnosis (13%), and non-availability of medicine (8.8%). Internal medicine (13.5%), ENT (13.8%), skin (11.8%), and obstetrics and gynecology (10.3%) were the main areas to which patients were referred. Pediatric and orthopedic services had equal representation (8.8%). Conclusions: Research revealed that medical professionals sent a significant number of patients to Family Health Centers (FHCs). Patients frequently self-referred because they perceived family care centers to be inadequate. Such a trend of self-referral could add a strain on the already scarce resources of the specialized healthcare institutions.
subject: Original Articles
  topic: section
subject: Management
  topic: keywords
subject: primary health system
  topic: keywords
subject: referral system
  topic: keywords
creator: Vian Fareq Obaid
creator: Lana Adil Bakir
rights: Copyright (c) 2025 vian fareq Obaid, Lana Adil Bakir https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 116
ending page: 126
doi: 10.36330/kmj.v21.i2.20259

Case-Control Study on KCNJ11 Gene Polymorphism and Type 2 Diabetes Mellitus
type: item
description: Background: Type 2 diabetes mellitus (T2DM) it is a complex metabolic condition marked by insulin resistance and dysfuction of pancreatic β-cells. Genome-wide association studies (GWAS) indicate that multiple genes, notably potassium inwardly-rectifying channel, subfamily J, member 11 (KCNJ11), have a major role in susceptibility to type 2 diabetes mellitus (T2DM). Aim of study: To estimate the risk of KCNJ11 gene polymorphism (rs5215) in the development of type 2 diabetes. Methods: A case-control research was done involving 300 participants, including 150 individuals with Type 2 Diabetes Mellitus and 150 healthy controls. Genotypic data was obtained by allele-specific Polymerase Chain Reaction (AS-PCR), while biochemical measurements involved fasting blood glucose, serum insulin levels, and lipid profiles. Results: genotyping of the SNP rs5215 under codominant model show highly significant variation between diabetic and control group with T/C genotype (OR = 0.48, 95% CI = 0.29 – 0.78, P = 0.006),dominant model (T/C-C/C) show statistically significant result (OR = 0.56, 95% CI = 0.35 – 0.89, P = 0.013), The minor allele frequency (C) was decreased in T2DM patient compared to controls(OR = 0.79, 95% CI = 0.89 – 1.77, P = 0.19), the association did not reach statistical significance Conclusion: Single nucleotide polymorphism of the KCNJ11 gene (rs5215) is insignificantly linked to susceptibility of type 2 diabetes mellitus in the AL-Najaf population.
subject: Original Articles
  topic: section
subject: KCNJ11
  topic: keywords
subject: rs5215
  topic: keywords
subject: T2DM
  topic: keywords
creator: Raghad Aabdulmahdi
creator: Hasanat Aljabery
rights: Copyright (c) 2025 Raghad abdulmahdi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 108
ending page: 115
doi: 10.36330/kmj.v21.i2.20215

Pattern of Abnormal Uterine Bleeding among Perimenopausal Women in Erbil City
type: item
description: Background: Abnormal uterine bleeding (AUB) is an epidemic, painful condition among perimenopausal women and an indicator of the quality of life with reproductive health problems. The pattern and precipitating factors should be defined to guide early diagnosis and treatment. The objective of this study was to determine the pattern of abnormal uterine bleeding and precipitating demographic and clinical factors among perimenopausal women in Erbil city based on the FIGO PALM-COEIN classification system. Methods: In this cross-sectional study, Four hundred perimenopausal women aged between forty and fifty five years old, attending gynecology clinics in Erbil, were investigated. The data were collected with structured interviews and clinical examination. The etiologies of AUB were divided according to the PALM-COEIN classification. Statistical tests applied were chi-square tests and multinomial logistic regression to detect associations between patterns of bleeding and some variables. Results: Mixed bleeding (23.3%) was the most prevalent AUB type, followed by metrorrhagia (20.8%) and polymenorrhea (12.0%). Based on the FIGO classification, endometrial disorders (36.5%), leiomyomas (24.0%), and ovulatory dysfunction (16.0%) were the main etiologies. Bleeding patterns had no significant correlations with factors like age, BMI, marital status, education level, parity, gravidity, and use of contraceptives (p < 0.05). Multinomial logistic regression determined BMI, gravidity, and use of IUD as independent predictors of bleeding type. Conclusion: Perimenopausal women of Erbil with abnormal uterine bleeding are controlled by various reproductive and sociodemographic factors. Early diagnosis and standardized evaluation according to FIGO criteria are the keys to proper management and prevention of the gynecological disease burden.
subject: Original Articles
  topic: section
subject: abnormal uterine bleeding, perimenopausal women, PALM-COEIN classification, Reproductive health, Erbil city
  topic: keywords
creator: Intisar Shahab Mohammed
creator: Jwan Muhammad Zangana
rights: Copyright (c) 2025 Intisar Mohammed https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 93
ending page: 107
doi: 10.36330/kmj.v21.i2.20214

Assessment of Paediatric Antibiotic Prescriptions Practice Among Hospitalized Children Using WHO AWaRe Guidelines in Sulaimani City, Iraq
type: item
description: Background: Inappropriate antibiotic use among hospitalised children is a growing concern, particularly in low- and middle-income countries. Objective: The study aims to evaluate the rationality of antibiotic prescription practices among hospitalized children in a major referral hospital in Sulaimani, Iraq, using the World Health Organisation AWaRe classification as a benchmark. Methods: A cross-sectional study with a convenience sampling method was conducted on 600 patients from January to April 2025 at Dr Jamal Ahmad Rashid Paediatric Teaching Hospital. Data were collected from inpatients on wards, in the Intensive Care Unit, and in the Neonatal Intensive Care Unit using the interview method, medical record reviews, and a structured questionnaire aligned with WHO standards. Statistical analyses were performed using SPSS version 25. Results: Out of 600 patients, 435 (72.5%) received antibiotics. The most prescribed antibiotics were Ceftriaxone (31.4%) and Cefotaxime (16.7%). According to WHO, AWaRe classification, 65.8% of prescriptions were from the Watch group, 33.7% from Access, and 0.4% from the Reserve group. Only 8.9% underwent culture and sensitivity testing. Modifications to the antibiotic regimen were implemented in 70% of positive culture cases. Patients prescribed antibiotics had a higher discharge cure/stable rate (86.1%) but also accounted for all reported mortalities (3.9%). Conclusion: Antibiotic prescribing practices at the hospital show substantial reliance on Watch group antibiotics and limited microbiological guidance, highlighting potential misuse. Strengthen antimicrobial stewardship programs, increase microbiological testing, promote prescriber education, and encourage adherence to WHO guidelines to ensure rational antibiotic use and curb resistance.
subject: Original Articles
  topic: section
subject: Antibiotic,
  topic: keywords
subject: Paediatric,
  topic: keywords
subject: WHO AWaRe Classification,
  topic: keywords
subject: Antimicrobial Stewardship
  topic: keywords
creator: Haidar Hamakhan M. Amin
creator: Zhian Salah Ramzi
rights: Copyright (c) 2025 Haidar Muhmmad, Prof. Dr. Zhian Salah Ramzi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 82
ending page: 92
doi: 10.36330/kmj.v21.i2.20181

Vitamin D Status among Women of Childbearing Age Attending Primary Health Care Centers in Al-Najaf Governorate, Iraq
type: item
description: Background: Vitamin D is crucial for metabolism and various health consequences, including immune function and bone mineralization. Adequate vitamin D levels are critical throughout pregnancy and lactation. Purpose: To determine vitamin D status and its associated determinants among childbearing age women in Al Najaf, Iraq. Methods: A cross-sectional study was conducted from April 1, 2024, to May 1, 2025. This study was conducted among women of reproductive age attending primary healthcare centers. Ninety women who attended primary health care centers were involved in this study if they fulfilled the inclusion criteria and agreed to participate. Information was gathered through same-day interviews and blood draws. Data on age, body measurements, smoking status, and duration of breastfeeding were collected using a questionnaire. Vitamin D levels in the blood were assessed using an immunofluorescence assay. Results: The results were considered significant if the P-value was equal to or less than 0.05. Implications: It was found that 61 women (67.8%) and 23 (25.6%) were 25(OH) D deficient and insufficient, respectively, whereas only 6 (6.7%) were sufficient. Vitamin D deficiency was found in 45.9% of pregnant women and 44.3% of lactating women. 25-hydroxyvitamin D deficiency was more common in obese individuals (40.6%) (p<0.001), urban residents (59%) (p=0.013), older than 25 years (59%) (p=0.013), and those with lower educational levels (49.2%) (p=0.012). Conclusion: Vitamin D deficiency and insufficiency are more common among pregnant and lactating women. Low educational levels, older age, obesity, and living in urban areas are all significant factors for vitamin D deficiency.
subject: Original Articles
  topic: section
subject: 25-hydroxyvitamin D
  topic: keywords
subject: Lactation
  topic: keywords
subject: Pregnancy
  topic: keywords
subject: Vitamin D
  topic: keywords
creator: Shaymaa Abdul Lateef Alfadhul
creator: Taqwa Bayan Talib
rights: Copyright (c) 2025 Shaymaa Abdul Lateef Alfadhul, Taqwa Bayan Talib https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 70
ending page: 81
doi: 10.36330/kmj.v21.i2.20175

Evaluation of Lymphocyte Activation Gene 3 Activity with Hepatitis C Virus Infection in Beta Thalassemia Major Patients
type: item
description: Background: An infection with the hepatitis C virus can be contracted directly through transfusions or indirectly through contaminated materials (unsafe injections and surgical procedures). The hepatitis C virus (HCV) is the cause of hepatitis C. When the virus gets beyond the host's innate and adaptive immune systems, 60–80% of people with acute hepatitis C go on to acquire the chronic form. Seven significant clades, known as genotypes 1–7, have been identified in the revised HCV categorization based on phylogenetic analysis of several nearly full-length genomes. 86 subcategories have been identified from these genotypes. Purpose: The goal is to study the association of immunological checkpoint activity of lymphocyte activation gene 3 (LAG3) in thalassemia patients infected with the Hepatitis C virus. Methods: 200 participants that was cross-sectional. 69 patients positive HCV and 131 negative participants their ages range between (2-49) years. The samples were collected using fresh blood and serum samples. The sample consisted of 106 females and 94 males in both the patient. Samples were gathered between November 1, 2024, and the end of January 2025. from Center of Al-Batoul Hospital in Wasit, Kut Governorate, Iraq. The level of serum HCV (IgG-IgM) was employing an enzyme-linked immunosorbent assay (ELISA) to measure it. The enzyme-linked immunosorbent assay (ELISA) was also used to evaluate immune checkpoint LAG3. Results: There is no statistically significant correlation between LAG-3 levels and any of the hematological parameters (WBC, lymphocytes, platelets, or hemoglobin) in the study, and LAG-3 levels do not substantially correlate with either age or sex (p >0.05). P-values are more than 0.05. There is no discernible relationship between HCV-specific humoral immune responses (IgG or IgM) and LAG-3 expression. P-values are more than 0.05. When comparing HCV-positive and HCV-negative patients, LAG-3 levels are noticeably higher in the former. The P-value < 0.0…
subject: Original Articles
  topic: section
subject: Hepatitis C Virus, LAG3 , thalassemia
  topic: keywords
creator: Noura Alwan Mahdi
creator: Saif Jabbar Yasir
rights: Copyright (c) 2025 Noura Noura Alwan Alwan Mahdi, Saif Jabbar Yasir https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 62
ending page: 69
doi: 10.36330/kmj.v21.i2.19998

The Assessment of Serum Interleukin-18 (IL-18) Level and Its Role as a Biomarker for Psoriasis in Najaf Province
type: item
description: Background: Psoriasis is a common and chronic autoimmune disorder that predominantly impacts the skin. Its development involves genetic susceptibility and immune system activation. The disease affects roughly 2–3% of the world's population. Objective: This study aims to evaluate the IL-18 levels in serum of Iraqi patients suffering from psoriasis and compare it to control groups as a diagnostic biomarker. Material and Methods: A total of 130 people were included in this study. Of these, 65 had psoriasis (43 males and 22 females) and 65 were controls (apparently healthy individuals); 42 were males and 23 were females. The age range of both the psoriasis patient group and the control group was 18 to 70 years. The sandwich Enzyme-Linked Immunosorbent Assay test (ELISA) was used to determine the serum levels of IL-18 in both (patients and controls). Results: Serum concentration of IL-18 was significantly markedly elevated in the patients group compared to controls (P < 0.001). ROC analysis indicated that IL-18 has an acceptable diagnostic accuracy in distinguishing psoriasis patients from healthy individuals. There was no significant difference in IL-18 levels between patients with a family history of psoriasis and those without. Additionally, IL-18 levels showed no significant variation between patients with moderate and severe psoriasis. Conclusion: Serum IL-18 levels were significantly higher in psoriasis patients, indicating its potential as a diagnostic marker.
subject: Original Articles
  topic: section
subject: Psoriasis, Interleukin-18 (IL-18), Biomarker, Serum levels, Diagnostic accuracy, Comorbidities, Autoimmune skin disease
  topic: keywords
creator: Noor Saeed Abd Mohammed
creator: Hawraa Ameer Mubark
rights: Copyright (c) 2025 Noor Saeed Abd Mohammed, Hawraa Ameer Mubark https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 54
ending page: 61
doi: 10.36330/kmj.v21.i2.19978

The Role of Matrix Metalloproteinase-3 as a Biomarker for Diagnosis and Disease Activity Assessment in Patients with Ankylosing Spondylitis
type: item
description: Background: Ankylosing spondylitis (AS) is a chronic, inflammatory, systemic disease, mainly affects the spine and sacroiliac joints, causing low back pain, stiffness, and spinal fusion. Matrix metalloproteinase-3 (MMP-3) is known to be an essential protease in cartilage and joint destruction due to it can cleave many ECM proteins. purpose: The purpose of this study is to assess whether MMP-3 plays an effective role in the diagnosis and evaluation of AS activity. Methods, Subject, and Methods: A case-control study included 30 patients with ankylosing spondylitis (AS), 30 patients with chronic back pain (CBP), and 28 apparently healthy persons. Furthermore, MMP-3 and CRP levels were assessed for the three groups using an ELISA technique. The study also measured the CBC and ESR levels. Results: The MMP-3 levels in AS, CBP, and healthy groups were 221.92 pg/ml±68.10, 193.29 pg/ml±25.02, and 279.17 pg/ml±80.44, respectively, with a non-significant difference between AS and CBP groups (P=0.699) and between AS and healthy groups (P=0.587). Based on ASDAS-ESR, there was a significant difference in the MMP-3 level (P=0.005). The diagnostic performance of MMP-3 for AS with the healthy group showed an AUC of 0.396, 61.8% sensitivity, and 62.5% specificity. While the diagnostic performance of MMP-3 for AS with CBP revealed an AUC of 0.400, 54.2% sensitivity, and 52.8% specificity. Implications: the findings support ASADAS-ESR as a tool for guiding treatment and highlight the need for further research on its long-term impact. Additional materials: this paper contains 18 references, 8 tables, and 7 figures. Conclusion: The findings showed that MMP-3 plays a significant role in evaluating disease activity in patients with AS based on the ASDAS-ESR index; however, it does not have a diagnostic value and is not involved in the initial diagnosis of the disease.
subject: Original Articles
  topic: section
subject: ankylosing spondylitits
  topic: keywords
subject: chronic back pain
  topic: keywords
subject: MMP-3
  topic: keywords
subject: ASDAS-ESR
  topic: keywords
creator: Noor Alaa Jasim Halboos
creator: Raad Abdulameer Alasady
rights: Copyright (c) 2025 Noor Alaa Jasim Halboos, Raad Abdulameer Alasady https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 42
ending page: 53
doi: 10.36330/kmj.v21.i2.19919

High Prevalence of blaNDM and blaOXA Carbapenemases in Multiple Antibiotic Resistant Acinetobacter baumannii from Iraqi Hospital
type: item
description: Background: Acinetobacter baumannii is a critical nosocomial pathogen with escalating antimicrobial resistance, particularly to carbapenems. Its ability to survive in hospital environments and acquire resistance genes poses a significant challenge in clinical settings. Carbapenem-resistant A. baumannii (CRAB) has been prioritized by the WHO for urgent research because of its association with high morbidity and mortality. Objective: This study aimed to evaluate antibiotic susceptibility profiles and characterize carbapenem resistance genes (blaOXA-23, blaOXA-48, blaOXA-51, blaNDM, blaVIM) in A. baumannii isolates from Iraqi hospitals. Materials and Methods: A cross-sectional study was conducted in Babylon and Al-Najaf hospitals (August and November 2024). Of the 125 clinical specimens, 50 A. baumannii isolates were identified using Vitek-2 and biochemical tests. Antibiotic susceptibility was assessed using the Kirby-Bauer disc diffusion method (CLSI 2024 guidelines). PCR was performed to detect carbapenemase genes. Results: High rates of resistance were observed: 100% for ampicillin, 90% for imipenem, 84% for meropenem, and 93% for blaNDM. The following resistance genes were prevalent: blaOXA-51 (86%), blaNDM (93%), blaOXA-48 (81.3%), and blaOXA-23 (76.7%). All the isolates tested negative for blaVIM. Multidrug resistance (MDR) and extensive drug resistance (XDR) were detected in 38% and 62% of the isolates, respectively. Conclusion: The high prevalence of carbapenem resistance genes, particularly blaNDM and blaOXA-48, highlights the genetic complexity that drives CRAB in Iraqi healthcare settings. These findings highlight the urgent need for robust infection control measures and antibiotic stewardship to curb the spread of XDR A. baumannii.
subject: Original Articles
  topic: section
creator: Ali Ahmed Kadhim Alkhawaja
creator: Zainab Jabber Hadi
rights: Copyright (c) 2025 Ali Ahmed Kadhim Alkhawaja, Zainab Jabber Hadi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 30
ending page: 41
doi: 10.36330/kmj.v21.i2.19906

Identification of Bacterial Isolates from Urine Samples of Patients with Ascending Pyelonephritis at Al-Sadder Teaching Hospital
type: item
description: Background: Pyelonephritis is a sever type of upper urinary tract infection (UTI) that impact the renal parenchyma and pelvis. The common causative factor is migration of the bacterial infections from the lower urinary tract. Gram-negative bacteria are involved in higher incidences of infection in acute and chronic pyelonephritis cases than are Gram-positive bacteria. Therefore, the entire study was aimed at determining the type of bacterial pathogens responsible for causing the incidence of pyelonephritis. The urine samples were collected from patients clinically diagnosed to have pyelonephritis at Al-Sadder Teaching Hospital. Of the 60 cases, urine samples showing significant bacterial growth were taken and cultured using standard microbiological procedures. Identification of bacterial isolates was done by physical performance, biochemical tests, and the VitecK2 system. It was shown that Gram-negative bacteria, most commonly Escherichia coli (20.0%), cause pyelonephritis. Other Gram-negative bacteria include Klebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, and Enterobacter cloacae. On the other side, Staphylococcus saprophyticus is the ultimate Gram-positive pathogen (11.7%), which is then followed by Staphylococcus aureus, Streptococcus agalactiae, Enterococcus faecalis, and finally Staphylococcus epidermidis. Conclusion: This study demonstrated that pyelonephritis can be caused by both Gram-positive and Gram-negative bacteria; however, Gram-negative organisms, particularly E. coli, were found to be more prevalent than Gram-positive bacteria such as S. saprophyticus.
subject: Original Articles
  topic: section
subject: Pyelonephritis, Urinary Tract Infections, Bacteria
  topic: keywords
creator: Mariam Ahmed Abdulsahib Al-Najafi
creator: Khawlah Abdallah Salman
rights: Copyright (c) 2025 Mariam Ahmed Abdulsahib Al-Najafi, Khawlah Abdallah Salman https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 20
ending page: 29
doi: 10.36330/kmj.v21.i2.19696

Prevalence of Resistance Genes Gyr B, Ade-B and NDM-1 in Acinetobacter baumannii from Asthmatic Children
type: item
description: Background: Acinetobacter baumannii is an opportunistic pathogen associated with hospital acquired infections in AL-Zahraa Educational Hospital in Najaf, Iraq. All samples are being collated during the period from November 2024 to the April 2025 including 250 clinical samples from sputum collected from Asthmatic childhood patients with respiratory infections in Najaf/ Iraq. The present study is designed to detect Gyrase B, AdeB and NDM-1, genes strain. Aim of study: To isolate and identify bacterial species isolated from sputum samples of children with asthma and respiratory infections for the purpose of determining the bacterial types associated with or contributing to asthma conditions. As well as to perform molecular detection of housekeeping genes and antibiotic resistance genes such as (NDM-1), which are known to play a major role in carbapenem resistance in Acinetobacter baumannii, also to identify the housekeeping gene (gyrB and Ade-B), and use it as a molecular reference for bacterial identification and comparative genetic analysis among isolates. Results:Thirty-six of A. baumannii were diagnosed using the VITEK system and molecular detection (PCR) revealed that most isolates of A. baumannii were positive results to the gyrB gene and Ade-B gene (36/36, 100%). The specific primer (gyrB) gene for A. baumannii bacteria was designed in this study by using bioinformatics programs with NCBI website. NDM-1 gene was positive result in 42% of isolates. Conclusion: Presence of multidrug-resistant A. baumannii in childhood asthma patients, with detection of key resistance genes (Ade-B, NDM-1, and gyrB). These findings highlight the serious treatment challenges and the importance of molecular diagnostics and antimicrobial stewardship.
subject: Original Articles
  topic: section
subject: KEYWORD: Acinetobacter baumannii, Gyr B gene, Ade-B gene, NDM-1 gene, and Fluoroquinolone Resistance
  topic: keywords
creator: Adian Maytham Kazam Al-Khafaji
creator: Hawraa Natiq Kabroot AL-Fatlawy
rights: Copyright (c) 2025 Adian Maytham Kazam Al-Khafaji, Hawraa Natiq Kabroot AL-Fatlawy https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19690

Evaluation of IGA And IGE In Atopic Dermatitis Paediatric Patients in Relation to the Type of Feeding
type: item
description: Background: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disorder associated with elevated serum immunoglobulin E (IgE) and skin barrier dysfunction, influenced by genetic, environmental, and immunological factors. IgE is a central mediator in allergic inflammatory processes triggered by allergens. Immunoglobulin A (IgA) is the second most abundant serum immunoglobulin and the predominant antibody at mucosal surfaces, playing a crucial role in defending against pathogens and maintaining mucosal homeostasis. Objective: To investigate the relationship of serum IGA and IGE with the haematological parameters in AD patients and to assess how different types of feeding (exclusive breastfeeding versus formula feeding) influence their immunological profiles. Methods: This cross-sectional study included 60 pediatric patients (aged 3 month –13 years) of both genders, divided into two groups: 30 exclusively breastfed and 30 bottle-fed children. Serum IgA and IgE levels were measured, and haematological parameters, including (neutrophil counts, HB, MPV, platelets count), were analysed. Results: Breastfed children had significantly higher serum IgA levels (median = 129 mg/dL, IQR = 71.8) compared to bottle-fed children (median = 86.4 mg/dL, IQR = 39.1; p = 0.0001). IgE levels showed no significant difference between the two groups (p = 0.9). A significant positive correlation was identified between IgE levels and neutrophil count (r = 0.432, p = 0.017). Conclusion: Exclusive breastfeeding in early infancy is associated with higher serum IgA levels, supporting its protective role in mucosal immunity and its potential to reduce allergic sensitization. The positive correlation between IgE and neutrophil count highlights a possible link between allergic markers and innate immune activation.
subject: Original Articles
  topic: section
creator: Eshraq Haider Hussain Albalaghy
creator: Fouad Shareef Dleikh Aljanabi
rights: Copyright (c) 2025 Eshraq Haider Hussain Albalaghy, Fouad Shareef Dleikh Aljanabi https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 10
ending page: 19
doi: 10.36330/kmj.v21.i2.19563

Exploring the Relationship of Thalassemia Major and Gingival Health: A Narrative Review
type: item
description: Background: Periodontal disease is characterized by the inflammation of the tooth’s supporting tissues, and its etiology is multifactorial. Defense against pathogens depends on the host's immune response, since both innate and adaptive immune cells contribute by releasing their substances and modes of action to preserve harmony in periodontal tissues. Bacterial persistence and immune system dysregulation, characterized by an exaggerated response, can exacerbate periodontal disease. Thalassemia major is an autosomal recessive genetic disorder caused by a mutation in the gene responsible for the β-globin component of the hemoglobin molecule, resulting in either absent or reduced synthesis of this protein in erythroid cells. Individuals with thalassemia major exhibit significant immunological impairments, increasing susceptibility to infectious and inflammatory conditions. The current review aims to explore the relationship between this systemic disease and its effect on the gingival health. The details about gingival health and disease, as well as thalassemia major-associated complications and therapy, have been discussed in this review. Conclusion: Patients with thalassemia major exhibit a greater likelihood of gingival inflammation compared to systemically healthy individuals.
subject: Original Articles
  topic: section
subject: thalassemia major, gingival inflammatio, iron overload, ineffective erythropoiesis
  topic: keywords
creator: Ruaa Riyadh Al-Hamdani
creator: Maha Shukri Mahmood
rights: Copyright (c) 2025 Ruaa Riyadh Al-Hamdani, Maha Shukri Mahmood https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19565

The TCF7L2 rs7903146 Variant as a Predictor of Type 2 Diabetes Susceptibility in the Iraqi Middle Euphrates Region
type: item
description: Background: Type 2 Diabetes Mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance and pancreatic β-cell dysfunction. Certain populations have identified the TCF7L2 gene, particularly the rs7903146 single nucleotide polymorphism (SNP), as a major genetic risk factor. In this study, we aim to investigate the impact of the TCF7L2 rs7903146 polymorphism on T2DM in Middle Euphrates region of Iraq. Methods: A case-control study design was conducted with 300 total participants, 150 T2DM patients and 150 healthy controls. Genotypic data was collected using tetra-primer Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR) and biochemical parameters included fasting blood glucose, serum insulin levels, lipid profiles, and HbA1c. Statistical Analysis incorporated Hardy Weinberg Equilibrium, logistic regression, Bayesian statistics, and Bayesian analysis. Results: In our research, it seems that the rs7903146 SNP had no impact on the risk of developing T2DM in the participants. There was no significant difference in the T-Allele frequency of the polymorphism where case T2DM patients and controls T2DM (23 % vs. controls 20 %, p = 0.45). There were no significant differences on the studied diabetic and control groups regarding the allelic and genotypic distributions under all genetic models. Moreover, no significant difference in insulin resistance or lipid metabolic profiles was observed among the different genotypes of rs7903146, indicating that this SNP polymorphism may have limited impact on this local population. Conclusion: The information obtained about the middle Euphrates people suggests that rs7903146 polymorphism within TCF7L2 gene is not one of the main candidates factors for the development of T2DM and its associated disorders in this population. The results emphasize the need to focus on specific features of the population of the patients being studied, including the genetic and environmental factors when investi…
subject: Original Articles
  topic: section
subject: TCF7L2, rs7903146, Type 2 Diabetes Mellitus, genetic association, Middle Euphrates, metabolic profile.
  topic: keywords
creator: Ahmed Kaftan
creator: Hind Abdul Hussain
rights: Copyright (c) 2025 Ahmed Kaftan, Hind Abdul Hussain https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19497

The impact of kangaroo Mother care on the Newborn Health Outcome of A preterm Infant at Al-Zahraa Teaching Hospital in Al-Najaf AL-Ashraf City 2024
type: item
description: Background Preterm neonates are the most critical cause of death in infants, Kangaroo Mother Care is an important early distinctive care with the least expensive piece of equipment to permit the health and well-being of infants born, by holding neonates on the mother's naked chest with skin-skin contact and exclusive breastfeeding involved with early home discharge. WHO recommended KMC for all neonates, especially preterm. Methods: A prospective cohort, observational design study of preterm infants, the study included a sample of 100 neonates (50 of them subjected to kangaroo groups, the remaining 50 were control group) delivered in AL-Zahraa teaching hospital with birth weight of less than 2000gm and gestational age of 28–35 weeks of both group, Consecutive sample was used to collect the data, all mothers of preterm babies were involved and interviewed with a predesigned questionnaire to take information about her and the neonates, after discharge home each preterm neonates were followed-up for six months age, comparison have been occurred between preterm admitted to kangaroo mother care unit and preterm neonates who didn’t admit. Result: KMC infants as opposed to control group demonstrated Weight gain by (90%) RR 1.55(95%CI 1.2-1.99). and (90%) length increment RR 2.50(95%CI 1.7-3.5), (100%) exclusively breast fed, infant's developmental activities revealed (100%) RR 2.77(95%CI 1.9-4.0), the mean duration of hospital admission of Kangaroo group was (7.47±1.05) while, the case group (11.28±5.05), a P-value of all these follow up variations are statistically significant (<0.001). Conclusion: Results yield that KMC is one of the essential, inexpensive methods; it has the potential effects that significantly improve the newborns' physiological outcomes, increase neonatal survival, improve maternal-infant attachment, and encourage early hospital discharge.
subject: Original Articles
  topic: section
subject: Kangaroo Mother Care
  topic: keywords
subject: Newborn
  topic: keywords
subject: Mother Health
  topic: keywords
creator: Worood Noaman Hadi
creator: Ali Abdul Ridha Abutiheen
creator: Alaa Jumaah Manji Nasrawi
rights: Copyright (c) 2025 Worood Noaman Hadi, Ali Abdul Ridha Abutiheen, Alaa Jumaah Manji Nasrawi https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19515

Comparative Accuracy of Automated Upper Arm and Wrist Blood Pressure Devices: A Comparison with Intra-arterial line
type: item
description: Background: Accurate measurement of blood pressure is crucial for the diagnosis and treatment of the cardiovascular system diseases. Automatic non-invasive blood pressure devices are now widely for the measurement of blood pressure patients at home and even by the doctors in emergency room in Iraq due to their ease of use. However, the accuracy of these devices had been a matter of debate. Aim of the study: Our study aimed to evaluate the accuracy of the automated wrist and upper arm devices in blood pressure measurement. Methods: The study was a cross sectional study involved 75 patients who were undergoing cardiac catheterization. Blood pressure was measured using two types of automated devices, Rossmax upper arm and wrist devices. Their readings were compared simultaneously with the readings of an intra-arterial catheter to assess their accuracy. Results: The automated upper arm and wrist devices measured a higher value of systolic, diastolic and mean arterial pressures than those measured by intra-arterial catheter with mean of differences of 6.11 mmHg, 6.79 mmHg and 6.57 mmHg respectively, regarding the upper arm device. The mean of differences of the readings of systolic, diastolic and mean arterial blood pressures measured by wrist device were 11.32 mmHg, 18.30 mmHg and 15.98 mmHg, respectively. Both devices exhibited good reproducibility. Conclusion: Rossmax upper arm and wrist devices overestimate blood pressure. They are inaccurate and should not be relied upon for critically ill patients and in the emergency room.
subject: Original Articles
  topic: section
subject: Blood pressure
  topic: keywords
subject: Rossmax
  topic: keywords
subject: automated blood pressure devices
  topic: keywords
subject: upper arm
  topic: keywords
subject: wrist
  topic: keywords
creator: Ahmed Abdulwahid
rights: Copyright (c) 2025 Ahmed Badr Abdulwahid https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.18997

Attitude of Dental Students towards the Specialty of Oral Pathology: A Questionnaire-Based Survey
type: item
description: Background: As the dental specialty dealing with the causes, processes, and effects of illnesses impacting the oral and maxillofacial regions, oral and maxillofacial pathology plays a crucial role in bridging the gap between dentistry and medicine. Dental students do not make up a harmonious class; there will always be a mix of some with higher curriculum understanding than others. Aim of this study: Given the rising incidence of oral cancer, this study was carried out to identify dental students' attitudes toward oral pathology and how to improve the likelihood of them choosing it as their future specialty. Methods: This study was carried out at the College of Dentistry, University of Baghdad; it involved 240 dental students. Data were collected and analyzed using descriptive statistics and thematic analysis. Results: The results showed that 66.9% of students faced difficulties in understanding the topics in pathology classes, and only 22.3% of them are interested in being a pathologist. In conclusion, studying oral pathology presents various challenges for dentistry students.
subject: Original Articles
  topic: section
creator: Layla Sabri Yas
creator: Lubna Mohammed Ismail
creator: Fatimah J. Ismael
creator: Shahad Yousif Rashid
creator: Mina Ayad Taha
rights: Copyright (c) 2025 Layla Sabri Yas, Lubna Mohammed Ismail, Fatimah Jalil, Shahad Yousif Rashid, Mina Ayad Taha https://creativecommons.org/licenses/by/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 1
ending page: 9
doi: 10.36330/kmj.v21.i2.19376

Detection of Monocyte Chemotactic Protein-1 (MCP-1) among Patients with Celiac Disease
type: item
description: Background: Celiac disease (CD) is a persistent autoimmune disorder stimulated by gluten consumption in genetically susceptible people. Several studies have focused on the importance of monocyte chemoattractant protein-1 (MCP-1) in the development of CD. MCP-1 is a chemokine that has a crucial effect in attracting monocytes, dendritic cells, and memory T-cells to the inflammation site. In CD, elevated MCP-1 levels have been detected in the intestinal mucosa, contributing to immune cell infiltration and tissue damage. Monocyte chemotactic protein-1 has been linked to the amplification of inflammatory responses, promoting cytokine production and perpetuating mucosal injury. Methods This is a case control study, comprised 128 participants, divided into 64 cases with celiac disease apparently and 64 healthy individuals. The study was conducted at Al-Husainyah Hospital, Al-Hassan Al-Mojtaba Hospital, and Imam Al-Husain Medical City. After taken the consent, all participants in this study donated a five mL of venous blood, which was then deposited in 6 mL gel tubes. Then, this blood is centrifuged for ten minutes at 3000 rpm. By the enzyme-linked immunosorbent assay (ELISA), we estimated the serum level of MCP-1. The Patient's information was collected using questionnaires. People with concurrent other immunological or GIT problems were eliminated from the present study. Results: The findings of the current study indicated elevated levels of serum MCP-1 in celiac disease patients compared to the control group, Also, patients who following a diet have lower levels of MCP-1. The males group has higher levels of MCP-1 than the Females group. Conclusion: The current study results showed that, the serum level of MCP-1 is increased among patients’ group of CD more than controls, Also, greater levels of MCP-1 are showed in males more than in females. Patients who do not follow a strict diet free from gluten possess more levels of MCP-1 than treated patients.
subject: Original Articles
  topic: section
subject: celiac disease
  topic: keywords
subject: monocyte chemotactic protein-1
  topic: keywords
subject: ELISA
  topic: keywords
creator: Yasser Abdul Hamza Ali Al-Timimi
creator: Dhefaf Hameed Abdul Sahib
rights: Copyright (c) 2025 Yasser Abdul Hamza Ali Al-Timimi, Dhefaf Hameed Abdul Sahib https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19317

Evaluation of Cathelicidin (LL-37) Serum Levels Among Iraqi Psoriatic Patients and Its Association with Disease Severity and Complications
type: item
description: Background: Psoriasis is a chronic skin condition distinguished by inflammation and the rapid proliferation of skin cells, leading to scaly, red patches. Methods: A case-control study was executed on 110 individuals, the patient’s group, which included 60 psoriatic patients with a mean age of (37.23 ± 8.26) years old, and 50 volunteers without psoriasis were control group, with a mean age of (35.32 ± 7.53) years old. Study was implemented at Merjan Teaching Hospital in Hilla City, Babylon Province. The data were collected from October 2024 to January 2025.Blood specimens were obtained from all research participants after acquiring verbal permission. ELISA measured the concentration of LL-37 in serum from (Bioassay Technology Laboratory Co/ China). Results: the mean levels of LL-37 were significantly elevated in psoriasis individuals compared to that of control subjects (p=0.001). Also, the mean levels of LL-37 were significantly associated with psoriatic severity (p=0.026). In contrast, the mean levels of LL-37 were non-significantly associated with complications. Conclusion: Serum level of LL-37 was significantly elevated in psoriasis patients and significantly associated with the severity; therefore, it could be used as a predictor of psoriasis progression and severity.
subject: Original Articles
  topic: section
subject: LL-37,
  topic: keywords
subject: Psoriasis,
  topic: keywords
subject: Disease severity
  topic: keywords
creator: Rasool Moussa Bader Al-asade
creator: Suaad Mohammed Hassan
rights: Copyright (c) 2025 Rasool Moussa Bader Al-asade, Suaad Mohammed Hassan https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19315

Assessment of Interleukin-2 and Vitamin D Status in Vitiligo Patients Compared to Healthy
type: item
description: Background: Vitiligo is a chronic skin disorder characterized by the loss of pigment, resulting in white patches on the skin. This condition occurs due to the destruction or dysfunction of melanocytes, the cells responsible for producing melanin, pigment that gives skin its color. Purpose: To assess and compare the serum levels of interleukin-2 and vitamin D3 between patients with vitiligo and healthy individuals, in order to investigate their potential role in the pathogenesis of vitiligo. Method: Case-control study was conducted on 120 subjects, divided into two groups: the patient group included 60 individuals diagnosed with vitiligo, and the control group consisted of 60 healthy volunteers. Blood samples were collected from all participants after obtaining verbal consent. Serum level of interlukin-2 and vitamin D3 was measured using ELISA (Bet Lab/China). Results: In this study) I found that the mean level of interleukin-2 was significantly higher in vitiligo patient (0.66044±0.039136) compared to healthy controls (0.96919±0.125146) with a statistically significant difference (P- value =0.020) However the two clinical types of vitiligo the clinical types of vitiligo (localized and generalized), no statistically significant difference was observed. The mean level in localized vitiligo was (0.56941±0.032243) and in generalized vitiligo was (0.72113± 0.059873) (P-value =0.057), also This study, according linear scatter plot showed no statistically significant relationship between the duration of vitiligo and the level of IL-2. Vitamin D3 levels no statistically significantly between patients of vitiligo compared to controls, the mean levels (0.85717±0.041315) for patients with vitiligo, while the control (1.01195±0.115793), was (p-value= 0.211). Statistically significant difference was found between localized (075233±0.042477) and generalized (0.92706±0.060467) types of vitiligo (p-value =0.037). Conclusion: The study showed a significant increase in interleukin–2 …
subject: Original Articles
  topic: section
subject: Interleukin - 2
  topic: keywords
subject: vitamin D
  topic: keywords
subject: releation with vitiligo
  topic: keywords
creator: Dakhil Ibrahim Sahib Aljbory
creator: Thikra Abdullah Mahmood
rights: Copyright (c) 2025 Dakhil Ibrahim Sahib Aljbory, Thikra Abdullah Mahmood https://creativecommons.org/licenses/by/4.0
date: 2025-06-16
publication date: 2025-06-16
doi: 10.36330/kmj.v21.i1.19299