Zanco Journal of Medical Sciences (ZJMS)

Identifying the contributing factors in benign anorectal diseases including acute anal fissure and hemorrhoids

2026-04-22T11:48:34+00:00

Background and objective: Hemorrhoidal disease and anal fissure are the two most frequent entities within benign anorectal diseases, both of which have a negative impact on quality of life. The current study focuses on the potential linkage between various demographic factors and lifestyle and the occurrence of hemorrhoids (HD) and anal fissures (AF).

Methods: This study includes 100 patients (50 HD and 50 AF) and 50 healthy controls. The patients diagnosed based on medical history and physical examination. The participants asked to answer the prepared questionnaire containing toilet choice, dietary choice, hydration status, fecal consistency, anxiety risk, and straining during defecation.

Result: A significant difference was observed in toilet choice between the control group with both HD and AF with P-values of 0.048 (OR = 0.37) and 0.017 (OR = 0.31), respectively. Patients with these conditions were more likely to use a sitting toilet and less likely to use a squatting toilet. Dietary habits differed among the study groups. The difference is significant for the HD group that uses mostly meat (P 0.009) and nearly significant for AF (P 0.070). Whereas anxiety, straining, gender, hydration status, age, and body weight did not show significant differences between groups. However, time spent on the toilet is the risk factor for benign anorectal diseases.

Conclusion: These results suggest that toilet habits and diet may contribute to the development of these conditions. If future research supports this idea, we could say that changing bathroom habits should be recommended to all patients with any degree of HD and AF as part of treatment and as a preventive measure. In addition, spending too much time in the toilet should be avoided, as it could worsen these conditions.

Interleukin-6 as a biochemical marker in patients with acute coronary syndrome: A cross-sectional study at Erbil cardiac center

2025-05-21T06:43:41+00:00

Background and objective: Despite advances in diagnosis and treatment, acute coronary syndrome (ACS) is the leading cause of death globally. Serum interleukin-6 (IL-6) is one of the biomarkers that have been recently identified for the evaluation of ACS. It has been demonstrated to be a predictor of disease severity that is independent of traditional cardiovascular risk factors. This study aimed to evaluate the association between serum IL-6 levels and disease severity and other related clinical parameters in patients with ACS.

Method: This cross-sectional research comprised 180 ACS patients at Erbil surgical specialty Hospital-Cardiac Center. The participants were divided into three groups: Group I (STEMI group, 83 patients), Group II (NSTEMI group, 74 patients), and Group III (UA group, 23 patients). Each group was tested for S.IL-6, total cholesterol, HDL-C, LDL-C, VLDL-C, TG, and troponin T.

Results: The study population included 134 males (74.4%) and 46 females (25.6%), the mean age was 58.66 ± 12.0 years, ranging from 35-90 years. Correlation coefficient of serum IL-6 with other variables indicated a statistically significant positive correlation with total cholesterol, LDL-C, and troponin T among ACS types, with values of (r=0.1, P = 0.05), (r=0.2, P <0.001), and (r=0.4, P <0.001), respectively. IL-6 levels were statistically significant different between types of ACS (P < 0.001). The mean of IL-6 level in STEMI patients was (19.1 ± 0.42) pg/mL, followed by NSTEMI (15.9 ± 0.34) pg/mL and UA (10.0 ± 0.43) pg/mL.

Conclusion: The present study highlights IL-6 as a biomarker for determining ACS severity.

Knowledge, attitudes, and practices of community pharmacists regarding obesity management: A cross-sectional study

2025-05-27T09:50:19+00:00

Background and objective: Obesity is a chronic, multifactorial condition characterized by an excessive accumulation of body fat that presents significant health risks. Community pharmacists, for instance, are highly accessible and often serve as the first point of contact for patients seeking advice on weight management. This study aims to fill a research gap by evaluating community pharmacists’ knowledge, attitudes, and practices related to obesity and weight management.

Methods: A cross-sectional study was carried out among 331 community pharmacists among different pharmacy settings in Erbil city from November 2024 to May 2025. An interview was done with each Pharmacist using a well-designed questionnaire including the socio-demographic characteristics of studied participants and questions related to opinions, knowledge, attitude and practice.

Results: Out of total 331 pharmacists participated in this study, 59.5% of them were females and 40.5% were males. Most of respondents (43.2%), possessed 1–5 years of professional experience with majority worked in community pharmacy environments (77.9%). Less than half (46.5%) of them showed positive attitudes toward obesity management, especially in-patient counseling. A significant association existed between knowledge and attitude (P = 0.001), while no significant association was found between knowledge and practice (P = 0.79), attitudes and practice (P = 0.878).

Conclusion: This study assessed community pharmacists' knowledge, attitudes, and practices regarding obesity and weight management, revealing that the majority of the participants had average knowledge and more than half of the respondents had negative attitude but a very high proportion had an average and good level of practice and that’s why we had significant association between knowledge and attitude which is notably a good outcome of the study. However, practical involvement was limited. The results highlight a gap between pharmacists’ attitudes and their actual practices.

Assessment of the status of advanced glycation end products, oxidative stress, and other biomarker parameters in the sera of diabetic patients in Erbil city

2025-05-13T09:42:29+00:00

Background and objective: Diabetes mellitus (DM) poses a significant threat to human health, especially in developed countries, and is very important for helping us understand advanced glycation end products (AGEs) that contribute to oxidative stress (OS). The purpose of the investigation is to assess the concentration of the serum level of AGE, OS, antioxidants, and lipid profile parameters in diabetic patient.
Methods: This case-control study comprised 90 participants, including 60 subjects with type 2 diabetes mellitus and 30 healthy subjects, encompassing both genders. Demographic information and medication histories were gathered for each participant. The levels of advanced glycation end products (AGE), oxidative stress (OS) markers, antioxidants, and the parameters of lipid profile were evaluated using Randox Imola and enzyme-linked immunosorbent assay (ELISA) methods.

Results: The current investigation demonstrated that serum levels of pentosidine (PEN), peroxynitrite (ONOO•-), and xanthine oxidase (XOD) were significantly elevated, whereas serum levels of glutathione reductase (GR) and vitamin E were significantly reduced in individuals with type 2 diabetes mellitus compared to the healthy group.
Conclusion: Elevated levels of AGEs and oxidative stress are correlated with diabetes mellitus patients. Glutathione reductase and peroxynitrite may serve as effective indicators for diabetes mellitus.

Knowledge, attitudes, and practices towards Sunscreen use among a sample of school adolescents in Erbil city: A cross-sectional study

2025-05-18T07:13:27+00:00

Background and objective: Adolescents are vulnerable to the risks of radiation, yet sunscreen use among this group remains inconsistent globally. This study aims to assess knowledge, attitudes, and practices regarding sunscreen use among adolescents in Erbil city

Methods: The study was conducted in Erbil City, Kurdistan Region, Iraq, from 27th October 2024 to 11th May 2025. This cross-sectional study was conducted on 400 students selected from ten public and private primary and high schools. Data were collected through a self- administered questionnaire. SPSS version 27 was used for the purpose of data analysis. Participants were chosen using stratified random sampling.

Results: Age of the participants ranged from 13-18 years with a mean ± SD of 15.395 ± 1.397 years, 48.2% of the participants reported using sunscreen, 45.2% of the participants applied it once a day, and 32.5% of the participants reporting that their parents influenced their sunscreen use, followed by media.

There was highly statistical significant association (P = 0.001) between age groups of the participants to their knowledge, attitudes, practices, showed that that the age group (15 years and less) had higher (KAP) than the age group (16 years and more).

Conclusion: The findings highlight a gap in knowledge, attitudes, and practices concerning sunscreen use. Educational interventions as school based educational sessions, age and gender-based orientation sessions are recommended to address these gaps by improving knowledge of proper sunscreen practices and correcting misconceptions.

Determinant of breastfeeding practice among mothers in Soran city: a cross-sectional study in 2024–2025

2025-06-11T06:24:21+00:00

Background and objective: Breastfeeding practices are essential for child health and development, yet may be influenced by maternal demographics and feeding behaviors. This study aimed to assess the level of breastfeeding practice among mothers in Soran City and examine its association with sociodemographic characteristics.

Methods: This cross-sectional study was conducted from January 1st to April 12th, 2025, in five primary health care centers in Soran City, using Convenience sampling. The questionnaire included demographic information and a breastfeeding practice assessment tool. Breastfeeding practice levels were determined using a composite score based on type of feeding, duration, frequency, and use of supplementary feeding. Statistical analysis was performed using Stata version 12 (StataCorp LLC, College Station, TX). Chi-square and ordinal regression analyses were conducted to assess the associations between breastfeeding practice levels and demographic variables.

Results: A total of 400 mothers participated in the study. The mean breastfeeding practice score was 4.65 ± 2.21, indicating an overall moderate level of practice. The majority of mothers (373 out of 400; 93.3%) delivered in health facilities, and 328 mothers (82.0%) reported breastfeeding as the primary feeding method. Significant associations were found between breastfeeding practice levels and both socioeconomic status (χ² = 11.72, P = 0.02) and household size (χ² = 11.64, P = 0.01). However, ordinal regression analysis showed that no single demographic factor independently predicted breastfeeding practice levels, with all P-values exceeding 0.05 in the model.

Conclusion: The study demonstrated that mothers in Soran exhibited moderate levels of breastfeeding practice. Policymakers and healthcare providers should design targeted educational programs to promote optimal breastfeeding behaviors and address barriers related to socioeconomic and household conditions.

The cytokine milieu orchestrates the Th1/Th2/Th17 and Treg cells roles in acute lymphoblastic leukemia patients

2025-06-18T06:40:23+00:00

Background and objective: T cells perform a crucial role in mediating immune responses to a diversity of pathogens. Different types of T cells play a great role in immune response, including T helper cells 1 (Th1), T helper cells 2 (Th2), T helper cells 17 (Th17), and T regulatory cells (Treg cells). Each of these cells produces different types of cytokines, and irregularities of their levels have been linked to various malignancies.

Methods: In this case-control study, demographic information was collected from patients suffering from acute lymphoblastic leukemia (ALL), and then concentrations of C-reactive protein (CRP) and total white blood cell (WBC) count, beside interleukins 2,4,10,13,17 and 22(IL-2, IL-4 IL-10, IL-13, IL17, IL22), tumor necrosis factor alpha (TNF-α) and interferon gamma (INF-γ) cytokines were tested in their sera.

Results: Th-associated pro-inflammatory cytokines IFN-γ, IL-2, TNF-α, IL-4, IL-13, IL-17, and IL-22 were significantly decreased in ALL patients compared to healthy controls. On the other hand, immunosuppressive cytokine IL-10 associated with Treg cells was markedly elevated in the patient group. Elevated CRP and WBC levels were also observed in ALL patients, indicating systemic inflammation.

Conclusion: The cytokine profile in ALL patients is indicative of a shift to immunosuppressive status that could facilitate leukemic development. The reduction in pro-inflammatory cytokines and elevation of IL-10 levels point towards suppressed anti-tumor immunity. These findings highlight the significance of Th1/Th2/Th17/Treg cell interactions in ALL and suggest that manipulation of cytokine disbalance could yield new diagnostic or therapeutic avenues.

The onset of puberty in adolescents with type 1 diabetes mellitus in comparison to a group of non-diabetic teenagers in Erbil City: A cross-sectional comparative study

2025-06-01T07:37:26+00:00

Background and objective: Puberty and type 1 diabetes (T1DM) have a complex relationship. This study aims to determine the prevalence of delayed puberty among a sample of type 1 diabetes adolescents and compare it to a non-diabetic group.

Methods: A cross-sectional comparative study design was used to compare the data between January 1st, 2024, and July 31, 2024, included 380 participants, a convenient sample of 134 type 1 diabetic adolescents aged 9-16 years who were enrolled in Galyawa Specialized Diabetic Center and outpatient endocrinology at Rapareen Teaching Hospital in Erbil City, and 246 healthy adolescents in the same age range who attended Brayaty and Shady primary health care. Pubertal stage was determined by Tanner criteria. Anthropometry, BMI Z-score, and HbA1c were recorded.

Results: Mean age was 13.3 ± 1.7 years in both groups. Delayed puberty (Tanner stage < II at ≥13 y in girls or ≥14 y in boys) occurred in 53.7 % of diabetics versus 11.8 % of non-diabetics (P <0.001). The prevalence of delayed puberty among diabetic girls and boys (65.7% and 40.6%) was significantly higher than among the non-diabetic group (13.4% and 9.3%). Diabetic adolescents had significantly lower height-for-age Z-scores (< –2 SD) than non-diabetics (P <0.001). HbA1c level was not associated with pubertal delay.

Conclusion: more than half of the diabetics had delayed puberty, but there was no significant relationship between HbA1c and delayed puberty. Individuals with type 1 diabetes are shorter than non-diabetics. This study raised the importance of that the health practitioners, adolescents with type 1 diabetes and their caregivers should be informed about the possible outcomes of type 1 diabetes in adolescents.

Assessment of pharmacists’ knowledge, attitude, and practice toward over-the-counter medications in Erbil city: A cross-sectional study

2025-05-20T08:09:36+00:00

Background and objective: Over-the-counter (OTC) drugs are those that are available to the general population without a prescription from a physician. Analyzing pharmacists' knowledge, attitudes, and practices about over-the-counter (OTC) medications in Erbil was one of the study’s objectives, in addition to establishing a connection between the knowledge, attitude, and practice of pharmacists and their sociodemographic characteristics.

Methods: Descriptive cross-sectional study was conducted among 350 pharmacists. The convenience sampling method was used for sampling and data were collected to assess pharmacists' knowledge, attitudes, and behaviors regarding OTC medications in Erbil city through using a standardized, self-administered questionnaire.

Results: Pharmacists' positive attitude and practice level were 46.3% and 49.1%, respectively, also about two thirds (66%), lacked sufficient knowledge. Training participation was low, only 28% of pharmacists received OTC medication-specific training in the previous year. Age and attitude were significantly associated (P = 0.05). There were statistically significant correlations between knowledge and practice (P = 0.014), knowledge and attitude (P = 0.038), and attitude and practice (P = 0.001).

Conclusion: The findings underscore a critical need for targeted continuing education programs to improve pharmacists’ competencies in OTC medication counseling and ensure patient safety.

Molecular analysis of Giardia lamblia using small subunit ribosomal RNA gene isolated from food handlers’ people in Erbil city

2025-05-21T06:14:35+00:00

Background and objective: Giardia lamblia is the intestinal flagellated protozoan parasite causes giardiasis, a gastrointestinal illness, by living and multiplying in the small intestine of humans and other mammals. Giardiasis is most commonly transmitted in underdeveloped nations due to a lack of infrastructure for sanitation and hygiene education, as well as the fact that affected individuals often consume tainted food and drink that has mature cysts. The purpose of this research was to identify human giardiasis among food handlers as well as to perform sequencing, and phylogenetic analysis of small subunit ribosomal RNA (ssurRNA) gene.

Methods: A total of 540 fecal samples from food handlers were screened at the central laboratory in Erbil City, including both symptoms and asymptomatic individuals. General stool microscopy is the gold standard for primary diagnosis using saline and iodine wet mount technique. Molecular testing was carried out for samples that tested positive for Giardia lamblia, nucleic acid extracted from stool samples using specialize kit for that purpose. A 550 bp fragment of the ssu rRNA gene was amplified by PCR analysis targeted through a specific primer set. The amplified PCR products were sent to a sequencing facility in South Korea to determine the sequence of the ssu rRNA gene in Giardia lamblia.

Results: The study did not find any correlations between infection rates and socioeconomic status or demographic variables. Microscopic examination identified (50) positive cases, of which (21) were also confirmed as positive through PCR. The ssu rRNA gene reported variation, and (21) different sequences of the gene show changing in one nucleotide which changes one amino acid. Following aligning of ssu rRNA gene sequences using NCBI-BLAST homology analysis, the samples showed the following percentages of identity with Giardia lamblia isolates from various countries: 99.59% and 100% with isolates from Australia, 100% with those from USA, 99.38% from Iraq, 99.59% from Sweden, and 99.59% from Spain.

Conclusion: Polymerase Chain Reaction (PCR) is a very dependable tool for identifying Giardia lamblia. The pathogenicity of Giardia lamblia may be impacted by the variations in sequencing alignment of ssu rRNA documented through bioinformatics and single nucleotide mutations.

Effect of breathing exercise during labour on delivery outcome: an interventional study cardiotoxicity

2025-06-18T06:48:11+00:00

Background and objective: Labor is a physically and emotionally demanding process, often accompanied by pain, anxiety, and physiological stress. Lamaze breathing techniques are evidence-based, non-pharmacological methods that promote maternal control, reduce labor discomfort, and improve delivery outcomes. This study aimed to evaluate the effect of Lamaze breathing exercise on maternal and fetal outcomes among primigravida women.

Methods: A quasi-experimental design was used with a purposive sample of 118 primigravida women, who were equally divided into a study group and a control group (n = 59 each). The study group received Lamaze breathing intervention during the first and second stages of labor, while the control group received routine care. Data were collected through structured questionnaires, the perceived stress scale, and observation checklists for maternal and neonatal outcomes.

Results: Results from the post-intervention revealed that the study group's stress levels had significantly decreased. (66.1% low stress vs. 0% in the control group; P <0.001), shorter second-stage labor (<30 minutes in 59.3% vs. 10.2%; P<0 .001), and higher first-minute APGAR scores (93.2% normal vs. 61.0%; P <0.001). No statistically significant differences were found in fifth-minute APGAR scores, NICU admissions, newborn weight, or maternal complications, although trends favored the intervention group.

Conclusion: Lamaze breathing exercises significantly reduced maternal stress and second-stage labor duration, and improved neonatal condition at birth. Integrating such interventions into antenatal education is recommended for enhancing birth outcomes in primigravida women.

Evaluation of genotoxic effect of different smoking habits by detecting micronucleus frequency in university students, A case control study

2025-04-27T06:39:02+00:00

Background and objective: Cigarettes, shisha, and e-cigarettes are significant etiologic factors of oral cancers. Buccal mucosa is the first tissue that faces the pollutants and might reflect unhealthy processes in the body. Micronuclei are chromosomal fragments generated in interphasic cells. The present study was undertaken to investigate the association of cigarette, shisha, and e-cigarette use and micronucleus induction in the buccal mucosa.

Methods: The present study was carried out on 120 healthy volunteers (56 males and 64 females) aged 18–30 years old and divided into four groups: e-cigarette consumers, cigarette smokers, shisha smokers, and non-smokers. After filling out the questionnaire, participants were asked to rinse their mouths with water, and then oral mucosa samples were taken, processed, and stained for micronucleus detection.

Results: The frequency of micronucleus (mean ±SD) was 34.3±6.5 vs 16.76±4.27 (P <0.001), 37.1±8.31 vs 16.76±4.27 (P <0.001), 39.1±3.25 vs 16.76±4.27 (P <0.001) in cigarette vs control, shisha vs control, and e-cigarette vs control, respectively. Among the studied tobacco-related habits, and in respect to genotoxicity, e-cigarette revealed highest significant impact (P <0.001). In respect to the gender, no significant (P >0.05) differences were observed between male and female students who use tobacco related habits.

Conclusion: The rate of exfoliated buccal epithelial cells with micronuclei in the buccal mucosa of e-cigarette, shisha, and cigarette users was significantly higher compared with the non-smokers group, which might lead to undesired clinical consequences. However, further studies concerning the association of genetic aberrations on the nucleotide level and tobacco-related habits are recommended.

Altered serum fucose and its diagnostic relevance in newly diagnosed leukemia patients

2025-05-15T06:18:05+00:00

Background and objective: Altered fucosylation patterns have been implicated in cancer progression and immune evasion. This study aimed to evaluate serum fucose and specific fucose-related parameters in newly diagnosed leukemia patients and assess their diagnostic potential.

Methods: A case-control study was conducted on 65 males (33 leukemia patients, 32 healthy controls), aged 20–75. Blood samples were collected at Nanakali Hospital (Erbil) and analyzed by spectrophotometry to determine levels of Total Fucose (TF), Protein-Bound Fucose (PBF), Lipid-Associated Fucose (LAF), Protein-Bound Hexose (PBH), and Free Fucose (FF). Statistical analysis was performed using GraphPad Prism with a significance level of P* <0.001. Diagnostic performance was assessed using ROC analysis.

Results: Leukemia patients had significantly elevated serum TF (median: 173.3 mg/dl), PBF (10.17 mg/dl), FF (161.1mg/dl), and LAF (mean: 3.347± 1.076), while PBH levels were decreased (18.97mg/dl). ROC analysis showed strong diagnostic performance for TF (AUC = 0.989, sensitivity = 96.97%, specificity = 90.63%) and FF (AUC = 0.986, sensitivity = 93.94%, specificity = 90.63%).

Conclusion: Fucose-related parameters, particularly TF and FF, are significantly altered in male leukemia patients and may serve as useful non-invasive diagnostic biomarkers.

Evaluation of serum levels of visfatin and resistin alongside other biochemical indicators in breast cancer

2025-05-21T07:01:40+00:00

Background and objective: One important modifiable risk factor for breast cancer is obesity. The pathophysiology and advancement of breast cancer are facilitated by the release of chemicals from obese adipose tissue, including proinflammatory and adipocytokines. The two adipocytokines that are the subject of this study are Resistin and Visfatin. To compare breast cancer patients' blood and tissue levels of Resistin, Visfatin, and other biochemical markers to those of healthy controls.

Methods: a case-control study involving breast cancer patients and healthy individuals. The study included 30 women patients with breast cancer before treatment, the same number (30) of women with breast cancer on treatment, and also 30 women in a healthy group, totally collected 90 female blood sample from patients that diagnosed with a breast cancer and healthy control, the level of serum Visfatin and Resistin with biochemical parameters was performed for all participants.

Results: The mean ± SE Visfatin levels in the patients (pre-treatment and post-treatment) were elevated (4.44 ± 0.807, 7.79 ± 1.802) relative to the control (3.53 ± 0.214). With a P-value of 0.025. There was a significant difference in the mean ± SE of serum Resistin levels between the cases and the control group with (P = 0.013).

Conclusion: According to our study, women with breast cancer had significantly greater levels of Visfatin and Resistin than those in good health. This implies that the genesis and progression of breast cancer may be influenced by these adipocytokines.

Alteration in cardiac biomarkers associated with breast cancer therapy-induced cardiotoxicity

2025-05-21T07:32:49+00:00

Background and objective: Breast cancer medications, including chemotherapy, radiation, and targeted treatments, are linked to increased cardiovascular risk, frequently leading to early cardiac dysfunction. This study examines cardiac and lipid biomarker alterations throughout breast cancer chemotherapy and their correlation with cardiovascular problems.

Methods: A case-control study involved 90 females, 60 breast cancer patients (30 before and 30 after treatment), and 30 healthy controls. Serum levels of lipid profile (Total Cholesterol, Triglycerides, HDL-C, LDL-C, VLDL-C), the tumor marker CA 15-3, and cardiac biomarkers Brain Natriuretic Peptide (BNP), Troponin T, CK-MB, Gamma-Glutamyl Transferase (GGT), and C-reactive Protein (CRP) were assessed.

Results: The mean age was 44±1.64 for the controls and 46.53±1.14 in patients. The BMI was significantly higher in breast cancer patients (P <0.001). Troponin T levels significantly rose (95% confidence intervals post-treatment were (2.46 to 2.70, P <0.001). Triglycerides, VLDL, and atherogenic index increased significantly P-values (0.011, 0.011, 0.014). CA 15-3 concentrations were significantly elevated in both pre-treatment and post-treatment groups as compared to controls (P-value = 0.016). Post-treatment BNP (95% CI: 52.7 to 131.7) levels were elevated, but lacked statistical significance (P-value 0.081).

Conclusion: Elevated Troponin T and BNP levels after breast cancer treatment, indicating early cardiac stress, which supports the need for routine monitoring of cardiac biomarkers in patients undergoing therapy. Early detection of subclinical cardiotoxicity could allow for timely intervention and help reduce long-term cardiovascular complications.

Chemical constituents and anti-gastric ulcer activity of quercus infectoria galls in an ethanol-induced gastric ulcer model

2025-05-15T06:48:23+00:00

Background and objective: Quercus infectoria galls (Q.infectoria), rich in polyphenols, have been traditionally used to treat gastric disorders. This study aimed to evaluate their phytochemical composition, antioxidant capacity, anti-inflammatory, anti-gastric ulcer efficacy, and safety in an ethanol-induced gastric ulcer model.

Methods: Ethanol extracts were obtained using ultrasonic and reflux methods. Quantitative estimation of phenols, flavonoids, and tannins, and antioxidant activity (DPPH assay) were performed. HPLC analysis was conducted to identify major phenolic constituents. Anti-ulcer efficacy was assessed in rats with ethanol-induced gastric ulcers, followed by measurement of cytokines (TNF-α, IL-1β) and biochemical safety parameters.

Results: Q.infectoria galls showed high levels of phenolics, flavonoids, and tannins, and exhibited vigorous DPPH scavenging activity (IC₅₀: 43.88 µg/mL). HPLC confirmed gallic acid, chlorogenic acid, and kaempferol as major constituents. The extract significantly reduced ulcer index, gastric acidity, and inflammatory markers, with effects comparable to esomeprazole and no observed toxicity.

Conclusion: These findings indicate that galls of Q.infectoria possess anti-ulcer potential, mediated by their antioxidant and anti-inflammatory properties. It may serve as a safe, natural alternative for managing gastric ulcers.

Evaluation of community pharmacists' knowledge gaps and dispensing errors related to isotretinoin use in Erbil city

2025-06-12T08:40:43+00:00

Background and objective: Isotretinoin, a potent treatment for severe acne, must be administered with caution due to the possibility of serious side effects. Community pharmacists play an important role in ensuring the safe dispensing of medications and providing patient counseling. However, dispensing errors may occur due to pharmacists' current knowledge gaps, particularly in Erbil City. Therefore, this study aims to evaluate the knowledge gaps and dispensing errors among community pharmacists in Erbil City regarding isotretinoin use, to improve safe dispensing practices and patient safety.

Methods: A cross-sectional study consisted of 350 community pharmacists in Erbil City who were selected using a convenience sampling method. Data were collected using a self-administered questionnaire divided into three sections: sociodemographic information, isotretinoin knowledge, and dispensing practices. The data was analyzed using statistical package for the social sciences (SPSS) version 25.

Results: The mean age of the participants was 28.32 ± 5.80 years, and the mean duration of working experience was 5.10 ± 4.60 years. A significant percentage of pharmacists demonstrated a lack of knowledge about isotretinoin treatment. Many people were unaware of its proper use, potential side effects, and the need for counseling. Approximately 67.1% of the participants were classified as having poor knowledge, and only 16.3% of the participants demonstrated good knowledge. This study indicated that the younger, female, and single pharmacists tended to have more knowledge. These findings indicate a significant knowledge gap among pharmacists, emphasizing the importance of more comprehensive educational initiatives to improve isotretinoin-related patient counseling and safe dispensing procedures.

Conclusion: A significant knowledge gap in isotretinoin therapy was identified among Erbil City's community pharmacists. Many pharmacists were not familiar with its proper use, side effects, and safety precautions, emphasizing the need for more comprehensive training and educational initiatives to increase pharmacists' level of knowledge in this area.

Effects of antihypertensive agents on Alzheimer’s disease biomarkers in hypertensive rats with experimentally induced Alzheimer’s

2025-05-28T09:13:08+00:00

Background and objective: The most common cause of dementia in the elderly is Alzheimer's disease (AD). Numerous research studies have demonstrated a connection between hypertension (HTN) and the risk of developing AD. An increasing amount of evidence indicates that cognitive function significantly declines in HTN patients due to pathogenic pathways such as atherosclerosis, arteriolosclerosis, stroke, and cerebral ischemia. This study aims to investigate the effects of antihypertensive drugs on AD onset and levels of AD biomarkers in a rat model of HTN–AD. Oral N-nitro-L-arginine methyl ester hydrochloride (L-NAME HCl) and intraperitoneal injections of scopolamine were used to induce HTN and AD, respectively.

Methods: Forty-two female Wistar albino rats were split into seven groups of six rats. Group I represented the negative control group. The six experimental groups received scopolamine (2 mg/kg) and L-NAME HCl (40 mg/kg), administered intraperitoneally. Group II represented the positive control. The rats in Groups III, IV, V, VI, and VII received a daily oral dose of donepezil (10mg/kg), telmisartan (10mg/kg), amlodipine (5mg/kg), bisoprolol (10mg/kg), or bumetanide (20mg/kg), respectively. Differences for all parameters were assessed using one-way analysis of variance, including for BP, between the control and drug-treated rats using the Statistical Package for Social Science (version 27). Statistical significance was assessed using the P-value<0.05

Results: Inducing HTN and AD in rats significantly elevated the levels of all serum parameters compared to the control group, alongside a noticeable rise in brain parameters. The largest statistically significant decreases—in serum tumor necrosis factor alpha, interleukin-6, and C-reactive protein—were noted in telmisartan-treated rats. The most statistically significant decrease in brain acetylcholinesterase was seen in bumetanide-treated rats. On the other hand, donepezil-treated rats showed the largest statistically significant decreases in brain amyloid-β 42, β-secretase, phosphorylated microtubule-associated protein tau, malondialdehyde, nitric oxide, serum total tau protein, and serum amyloid-β 42. Bumetanide-treated rats showed the greatest performance on the spontaneous alternation (73.66%) and total arm entry tests (57.66) compared those in the other treatment groups, while donepezil-treated rats spent more time (5.42 minutes) in the novel arms compared to those of the other groups.

Conclusion: All the antihypertensive medications examined in this investigation effectively reduced the majority of plasma and brain biomarkers and therefore show great therapeutic potential, particularly bumetanide and telmisartan. According to this study, telmisartan and bumetanide, either alone or in combination with donepezil, may be effective medication options for neurodegeneration and risk mitigation in AD patients who also have HTN.

Adverse childhood experiences and their impact on mental and physical health among university students in Erbil city

2025-05-27T07:54:35+00:00

Background and objective: Adverse childhood experiences (ACEs) have been linked to a broad spectrum of long-term health and behavioral consequences. Despite growing global research, limited evidence exists from Middle Eastern and conflict-affected settings such as Iraq.

This study aimed to determine the prevalence and types of ACEs among university students in Erbil City, and to examine their associations with mental and physical health outcomes, as well as selected sociodemographic characteristics.

Methods: A cross-sectional study was conducted among 400 undergraduate students from Salahaddin University and Hawler Medical University between November 2024 and February 2025. Eight colleges were randomly selected, and convenience sampling method was used to recruit participants. Data were collected using a culturally adapted version of the WHO ACE-International Questionnaire and a modified CDC Health Appraisal form. ACE scores were grouped into low (0–1), moderate (2–3), and high (≥4). Descriptive statistics, chi-square tests, and multivariable logistic regression were applied.

Results: The mean ACE score was 3.5 (SD = 2.39), with 94.5% of students reporting at least one ACE and 42.8% reporting four or more. The most commonly reported ACEs were community violence (85.8%), bullying (56.8%), and witnessing domestic violence (51.7%). Significant associations were observed between ACE exposure and a range of health outcomes. Students with ≥4 ACEs had significantly higher odds of depression (AOR = 4.94), fatigue (AOR = 3.02), headaches (AOR = 2.53), and indigestion (AOR = 2.55). Male students reported higher rates of childhood physical abuse and bullying, while ethnic minority and rural-background students experienced disproportionately greater exposure to several ACE categories.

Conclusion: The high prevalence of ACEs and their strong associations with adverse health outcomes highlight a significant public health concern among university students in Erbil. These findings underscore the need for trauma-informed interventions in educational and healthcare settings and for policies addressing early-life adversity.

Association between glycine levels and insulin resistance in women with polycystic ovary syndrome: A case-control study

2025-06-15T06:07:31+00:00

Background and objective: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder with multi-factorial origins characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Its pathogenesis is complex, but one of the leading contributors to hyperandrogenism is insulin resistance (IR) which leads to a greater likelihood of developing type 2 diabetes mellitus (T2DM). This study aims to analyze the association between PCOS and T2DM, with a focus on IR and the potential moderating role of glycine.

Methods: This case-control study included 100 women (50 PCOS and 50 controls) aged 18–35 years. Women with PCOS showed significantly higher glycated hemoglobin (HbA1c) (6.014% ± 0.042 vs. 4.372% ± 0.071), fasting blood glucose (FBG) (97.25 ± 0.285 vs. 85.48 ± 0.755 mg/dL), insulin levels (20.24 ± 0.581 vs. 4.624 ± 0.087 µU/mL), and HOMA-IR (4.929 ± 0.125 vs. 0.982 ± 0.026) compared to controls (all P <0.001). Glycine levels were significantly lower in PCOS (125.76 ± 1.868 vs. 294.28 ± 8.754 µmol/L, P <0.001).

Results: COS women also had significantly higher insulin, fasting glucose, homeostasis model assessment for (HOMA-IR), and HbA1c levels but lower glycine levels compared with controls. Glycine was negatively correlated with insulin and HOMA-IR, while there were significant positive correlations between insulin and HOMA-IR (P <0.001).

Conclusion: These findings demonstrate that IR is a key factor in the metabolic dysfunction associated with PCOS and the potential development of T2DM.