Zanco Journal of Medical Sciences (Zanco J Med Sci)

Recording a large number of gall stones from a cholecystectomy specimen, in Kurdistan region-Iraq / a case report study

Saman Taher Barzinjy — 2025-10-22

Cholelithiasis is one of the most common diseases in the Western world and is increasing in the incidence in the Eastern world too. Laparoscopic cholecystectomy is gold standard treatment for cholelithiasis. Some surgeons may even thinking that a very large gallstone is an indication for a classical open cholecystectomy.

Circulating microRNA-1, and IL-18 are associated with inflammation in patients with type 2 diabetes mellitus: A case control study

Lajan Qasim Rahman — 2025-10-22

Background and objective: IL-18 and micRNA-1 can be differentially regulated in cardiomyopathy, nephropathy, and amputation that are among the many micro- and macrovascular issues known to be the complications of type 2 diabetes mellitus (T2DM). Thus, this study aims to detect the association of miRNA-1 and IL-18 with type 2 diabetes mellitus.

Methods: This study included 90 participants including 30 diabetic patients, 30 pre-diabetic patients and 30 healthy controls in Erbil City, Iraq between November 2021 and May 2022. Different parameters were assessed for each participant including levels interleukin-18, high sensitivity C-reactive protein, lipid profile, and miRNA-1 profiling. 200µL of fresh plasma was utilized for the extraction of microRNA, and the extracted RNA was subsequently transformed into cDNA. Utilizing quantitative Real-Time PCR, the miRNA profiling analysis was carried out.

Results: When comparing the mean age of the diabetic patients to the other studied groups, there was a statistically significant difference (P <0.05). Furthermore, there was a greater proportion of males, smokers, obese people, and people with hypertension among DM patients. When compared to the healthy controls, the concentration levels of IL-18 and hsC-reactive protein in both DM and pre-DM patients exhibited a substantial elevation (P <0.01). The expression of miRNA-1 was down-regulated in healthy controls and considerably up-regulated in both diabetes and pre-diabetic patients.

Conclusion: These findings demonstrated that T2DM patients had higher expression of miRNA-1 than did healthy persons. MiRNAs may be very important in the etiology of type 2 diabetes via inducing inflammation. More research is necessary to determine their implications as diagnostic and preventive biomarkers.

A Clinical Feature-Based Validation and Calibration for Diagnosing Hypertension and Cardiovascular Diseases: Integrative Review.

Nahla Abdulrahman — 2025-10-22

Background and objective: Hypertension and Cardiovascular Diseases (CVD) are major global public health issues, leading to a large impact on illness and death rates. Prompt and precise identification of these diseases is essential for efficient management and avoidance of complication. This study aims to examine the significance of clinical characteristics in the diagnosis of cardiovascular diseases and hypertension. Identification and categorization of risk are crucial for prompt interventions and efficient management of these widespread and influential situations. The diagnostic techniques are based on clinical aspects, which include blood pressure measures, lipid profiles, family history, lifestyle choices, and comorbidities.

Methods: The review evaluates the validation and calibration of clinical characteristics, drawing from robust data obtained through extensive cohort studies, risk prediction models, and adherence to defined criteria. It examines the role of measuring blood pressure, lipid profiles, and lifestyle habits in efficiently identifying individuals at risk of developing hypertension and CVD. Additionally, the review explores the incorporation of technology innovations, such as wearable devices, mobile apps, and artificial intelligence, in improving the diagnostic process.

Results: This study shows that measuring blood pressure, lipid profiles, and lifestyle habits may efficiently detect individuals who are susceptible to develop hypertension and CVD. It is crucial to calibrate clinical characteristics in order to guarantee their precision and dependability in predicting the probability of hypertension and cardiovascular disease. This method entails enhancing risk assessment systems to include population-specific attributes and dynamic disease patterns. The incorporation of technology innovations, such as wearable devices, mobile apps, and artificial intelligence, has significantly improved the process of diagnosing clinical features, and the accuracy of predicting clinical parameters, making it easier to measure individualized risk and diagnose hypertension and cardiovascular disease at an early stage.

Conclusion: Incorporating verified clinical characteristics into risk assessment tools and prediction models, together with advancements in technology, has the capacity to enhance the early identification and individualized treatment of these illnesses. Ongoing research and innovation in this sector are crucial to improve diagnostic methods and increase the accuracy of clinical feature-based diagnosis for hypertension and cardiovascular disease.

Frequency of reported cases of developmental dysplasia of the hip in Kurdistan region/Iraq

Jagar Omar Doski — 2025-10-22

Background and objectives: Developmental dysplasia of the hip (DDH) incidence and prevalence varies with ethnicity and geographic location. In Iraq, especially in the Kurdistan Region, this information is not yet clear. This study aimed to find the total number of reported DDH cases and to estimate the incidence and prevalence.

Methods: This cross-sectional study collected data from three governmental places of national sources of database (child disabilities centers, General Directory of Health, and General Directory of Statistics) in the three governments of Kurdistan Region/Iraq (Erbil, Sulaymania, and Duhok). The data included: the number of reported cases of DDH, live births, and population for each year and each government separately. The incidence was calculated by dividing the number of DDH cases per 1000 live births for each year, and prevalence by dividing all the cases of DDH per 1000 of population for each year. Then the average (mean) incidence and prevalence of each government was calculated. Finally, the average (mean) incidence and prevalence for the whole region (the three governments together) were calculated.

Results: The required data from the determined sources were available for the last 25 years (1998-2022). The total number of reported cases of DDH during this period was 44972 cases. The average incidence of DDH cases in Kurdistan Region/Iraq was 18.2 cases per 1000 live births per year, the highest -22.9- in the Duhok government and the lowest -13.8- in the Erbil government. The average prevalence of DDH cases among the population in the region was 4.65 per 1000 in the last 25 years (the highest -8.93- in the Duhok government, and the lowest -2.35- in the Sulaymania government).

Conclusion: The incidence of DDH cases in the Kurdistan region in the last 25 years was 18.2 cases per 1000 live births per year and the prevalence was 4.65 cases per 1000 of the population. The highest incidence and prevalence were reported in the Duhok government.

Perceptions and practices of community pharmacists towards antimicrobial stewardship program in Erbil City, Iraq: A cross-sectional study

Ali Omar Yassen — 2025-10-22

Background and objective: Antimicrobial resistance is a crucial health concern around the world, giving rise to millions of deaths each year. Despite the existence of recommendations for antimicrobial stewardship programs (ASP), the problem persists, particularly in conflict-affected areas such as the Middle East. The aim of this study is to investigate pharmacists’ attitude and practices towards ASP in Erbil, Iraq.

Methods: A cross-sectional observational study was conducted among community pharmacies in Erbil City, Iraq, from March 2023 to May 2023. 170 Pharmacists completed an electronic questionnaire consisting of three sections: sociodemographic information, perception of ASP, and practices related to ASP. Statistical analysis was performed by using statistical package SPSS version 22 for the social science data.

Results: The questionnaire was completed by 170 participants in total, 85 of whom were female and 85 of whom were male. The majority of participants 65.9% were between the ages of 20 and 30, and 71.2% had bachelor's degrees in pharmacy. The survey indicated 28.2% strongly agreed that “AMS programs improve patient care.” Furthermore, 33.5% strongly agreed that “AMS programs help reduce antimicrobial resistance,” and 31.2% said they frequently administer antibiotics based on complete clinical information. While 24.7% occasionally administered antibiotics in accordance with local guidelines, 33.5% occasionally dispensed antibiotics without a prescription. Notably, 47.6% of those surveyed claimed they would never dispense antibiotics for periods longer than prescribed, even upon patient request.

Conclusion: The study shows that community pharmacists in Erbil have favorable views and are responding appropriately to promote antimicrobial stewardship. However, there is room for improvement, especially when it comes to promoting inter-professional collaboration, incorporating AMS programs into community pharmacies, and addressing the issue of providing antibiotics without a valid prescription. These results highlight the necessity of continued measures for patient awareness, education, and training in order to improve the prudent use of antibiotics and guarantee patient safety.

The impact of WHO triage on mortality rate in an emergency department in Erbil, Kurdistan region of Iraq

Soran Ahmad Khdr — 2025-10-22

Background and objective: Triage is a process that includes categorizing patients according to the severity of their illnesses or injuries. This practice offers the potential to enhance the quality of healthcare and reduce the mortality rate. The Integrated Interagency Triage Tool (IITT) is a recently implemented triage system developed by the World Health Organization (WHO). The study aimed to examine the impacts of implementing the triage methods on the death rates of patients visiting the Rizgary Emergency Department.

Methods: This observational study includes the examination and comparing the mortality rate of any patient admitted to Rizgary emergency department in Erbil between January-June 2022, which was before implementing the triage system, and also during that period in 2023 in which the triage system was implemented. For each month, collected data included the number of deaths, admissions, and reasons for death. Cases related to cancer and major trauma were excluded from the study.

Results: Six months after the triage system was implemented, 26,015 patients were admitted, slightly more than the previous year (25,715 patients). The total number of deaths decreased by 41.7% after implementing the triage system. The mean mortality rate decreased from 6.80 deaths per 1,000 in 2022 to 3.94 deaths per 1,000 in 2023, which was statistically significant (P = 0.010).

Conclusion: Implementing the WHO triage system significantly reduced patient mortality in the emergency department by 41.7%, resulting from correct classification and optimal use of available time and resources.

Identification and Diagnosis of Active and Inactive Hepatitis B Virus among Foreign-Resident Individuals Using Real-Time PCR-Based Assays in Erbil Governorate, Iraq

Ayad Kareem Ali — 2025-10-22

Background and Objective: Real-time Polymerase Chain Reaction's main advantages lie in its high sensitivity and its capacity to develop rapid assays. In regions with high foreign residents, such as Erbil Governorate, effective diagnosis and differentiation of active and inactive HBV infections are of paramount importance for public health management. The present study aims to determine the prevalence of HBV infection among foreign-resident based on Real-time PCR results and providing insights that may have implications for public health strategies.

Methods: In this study, a Real-time PCR was used to detect HBV DNA among 193 foreign-resident individuals with hepatitis B.

Results: Among the clinically diagnosed individuals at the Erbil public health laboratory, a study encompassed 193 HBsAg-positive foreign-resident individuals, comprising 107 males and 86 females, aged between 23 and 47 years. Among males, 60 (56.74%) of them had HBV DNA of (≥ 3.8 IU/ml), whereas among females, 48 (55.8%) of them exhibited HBV DNA of (≥ 3.8 IU/ml). The study is conducted on foreign-resident individuals from seven different nationalities. The minimum viral load was observed among Chinese (0 IU/ml), while the maximum viral load was recorded among Syrians (2,398,805, 400 IU/ml) according to sample size. The study found that among ELISA-positive individuals, 44.04% were categorized as having inactive HBV infections; in contrast, 55.95% of the individuals were classified as active carriers.

Conclusion: Understanding the distribution of HBV infection and their viral loads across different resident nationalities in Erbil governorate is essential for controlling the spread of HBV and tailoring prevention and treatment programs. Detection and quantification of HBV DNA are crucial in diagnosis and monitoring HBV infection and evaluating therapeutic responses.

Cryptosporidiosis among pre-school children in Duhok city, Kurdistan Region, Iraq

Helan Saman Jameel — 2025-10-22

Background and objective: The most prominent intestinal parasite causing watery diarrhea globally is cryptosporidiosis. The objectives of the study were directed to examine the frequency of Cryptosporidium spp. among pre-schoolchildren of age groups (≤5) years presenting with and without diarrhea, and determine associated risk factors related to this infection in children attending different daycare centers and kindergartens.

Methods: This cross-sectional study was conducted to find out the prevalence of cryptosporidiosis among preschool children. Participants examined from October 2022 to ending of February 2023 in the city of Duhok. Overall, (160) stool specimens were collected from children who attended different daycare centers and kindergartens in Duhok, all stool samples were examined microscopically by direct wet mount and modified Ziehl-Neelsen stain methods to detect the oocyst of Cryptosporidium spp.

Results: The infection rate of cryptosporidiosis among the total infected stool children was (11.25%). The parasite infection showed a significant difference between boys and girls at P <0.05, the highest infection rate was found in age group of (3-4) years old (25%), followed by age group (5) years old (10.64%). The Modified Zihel-Neelsen stain test (75%), performed more accurate than the direct wet mount method (25%).

Conclusion: The study showed Cryptosporidiosis were common health problems in various day care centers of Duhok city and active prevention programs must be considered for the improvement of cleanliness and health education.

Efficacy, cure rate, recurrence rate and complications of Rubber band ligation for treatment of different grades of hemorrhoids in Koya - Erbil - Kurdistan Iraq, Retrospective Study

Saman Taher Barzinjy — 2025-10-22

Background and objective: Hemorrhoids defined as lax fibrovascular cushions which are prolapsed, two main types of hemorrhoids are available, internal and external types, Dietary fiber deficiency, prolonged straining and prolonged use of the toilet, constipation, diarrhea, pregnancy and straining that increase intra-abdominal pressure, sedentary lifestyle, high body mass index and family history are all contributing factors. Hemorrhoids can be treated medically, surgically, and with office-based endoscopic procedures such as rubber band ligation. The aim of this retrospective study is to assess the response and cure rate, complications, and recurrence rate of grades 2 and 3 of Hermorrhoidal Disease treated as out-patient procedure by rubber band ligation in Koya-Erbil –Kurdistan –Iraq.

Methods: This Retrospective study includes 400 patients seeking consultation and treatment at General Surgery Private Clinic between June 2018 and August 2021, who underwent rubber band ligation as out-patient procedure.

Results: (59%) of cases were male and (41%) were female, mean age and SD was 38.42 ± 12.54. The most common chief complaint of the patients on presentation were abdominal distension, perianal itching, and abdominal pain, three Rubber Band Ligation sessions has been performed for (87.5%)of cases, but the remaining other 45 (12.5%) cases only need one or two sessions, Following the intervention, vast majority of the cases developed no complications and they were completely comfortable with the procedure, meanwhile only (15.25%) cases developed minor complications.

Conclusion: Rubber Band Ligationis safe and effective intervention line for second and third grades of hemorrhoids, can be done as out-patient procedure under local anesthesia with minimum side effects and complications in compare to classical surgeries that can be treated conservatively.

Molecular subtypes of breast cancer: distribution and prognostic implications

Shwan Salam Marouf — 2025-10-22

Background and objectives: Breast cancer is a heterogeneous disease complex with various molecular subtypes, each having unique features that significantly affect the disease's course, behavior, treatment response, and prognosis. This study aimed to investigate the incidence of different breast cancer molecular subtypes and to explore the associations between these subtypes and important prognostic characteristics, such as tumor grade and disease stage.

Methods: This study was a retrospective observational analysis of paper-based medical records of 187 female patients diagnosed with breast cancer and registered at the Oncology Center of Rizgary Teaching Hospital in Erbil City in 2021.

Results: Analyzing the records of the 187 confirmed breast cancer patients revealed that luminal-B was the most frequent breast cancer molecular subtype, followed by luminal-A, TNBC and HER2-enriched subtypes in order of decreasing frequency. Additionally, the study found a statistically significant association between breast cancer molecular subtypes and prognostic characteristics such as tumor grade (P <0.001), primary tumor size (P = 0.017) and axillary lymph node status (P = 0.002).

Conclusion: The findings revealed a significant association between different breast cancer molecular subtypes and key tumor characteristics such as tumor grade and TNM disease stage, potentially influencing therapeutic and prognostic outcomes.

Unusual Lightning Strike Causing Death: A Case report

Yasin Kareem Amin — 2025-10-22

In daily autopsies, lightning-related deaths are an uncommon occurrence. Lightning-related deaths are more common in mountainous, wet regions, although they are uncommon in and around Erbil city. Lightning is typically connected to rain, and while lightning-related injuries may be distinguished from electrocution, the latter is also frequently observed. The majority of lightning-related injuries to adults and the elderly are not lethal, but if an individual's strong strike is involved, there may be a tragic outcome. These factors should be investigated in cases of adult fatal lightning deaths. Lightning fatalities are infrequently discussed in medical literature, but since many outdoor workers are implicated, there is a need for more research in this area. Research on lightning deaths in Iraq, a country with a continental, semi-arid, and subtropical climate, needs to focus more on factors of human fatality prevention and treatment. Though more prevalent in adults than in children, an adult death by lightning is documented here. The autopsy results and scene investigation were vital in ascertaining the cause of death.

Patients' satisfaction and quality of life after breast augmentation with implants

Suzan Fazil Jabber — 2025-10-22

Background and objective: Breast augmentation surgery is a common procedure worldwide to treat tiny or atrophied breasts that significantly influences women's lives. Thus, we aimed to find the impacts of breast augmentation in women who underwent surgery in concerning to their satisfaction and quality of life.

Methods: A prospective and analytical study was conducted on 40 married women who underwent breast augmentation surgery using smooth silicone-filled implant, from April 2020 to June 2023. The participants completed the breast Q-questionnaire voluntarily. The patient-reported surveys were performed out through the internet, over the cell phone and individually. The data was analyzed using IBM SPSS version 26 software. Then, 3 sections and criteria of the breast Q-questionnaire were reported, including breast satisfaction (17 items), psychosocial well-being (9 items), and sexual well-being (5 items). Statistical analysis was performed at the inter-group and individual levels by t-test. The statistical significance was set at 0.05.

Results: The studied patients stated that breast satisfaction significantly improved from 32.12 ± 0.11 preoperatively to 77.54 ± 0.18 postoperatively (P value <0.0001). Similar significant improvements were also seen for both psychosocial/sexual well-being from 28.5 ± 0.16 preoperatively to 74.65 ± 0.39 postoperatively (P value <0.0001) and 29.9 ± 0.15 preoperatively to 62.3 ± 0.05 postoperatively (P value <0.0001), respectively.

Conclusion: Using smooth silicone-filled breast implants considerably improves women's satisfaction, as well as psychological/sexual well-being following aesthetic breast augmentation.

Maternal and perinatal outcomes of teenage pregnancies: A case control study

Zainab M. Zwain — 2025-10-22

Background and objective: Teenage pregnancies are widely distributed in developing countries. Different adverse outcomes are reported for early marriage and teenage pregnancy. This study aimed to assess the maternal and neonatal outcomes of teenage pregnancy in Erbil city-Kurdistan region/Iraq.

Methods: From January 1 to June 30, 2024, 200 delivered women were participants of a case-control study at the Maternity Teaching Hospital in Erbil, Kurdistan region, Iraq. Of the 200 women, 100 were teenage cases and the remaining 100 were adult control participants. Both groups' maternal and perinatal outcomes were assessed.

Results: There was a significant difference between the teenage and adult delivered women in relation to age, body mass index, parity, miscarriage history and educational level. Intrauterine growth restriction and emergency cesarean section were significantly different. Gestational diabetes and preeclampsia were more prevalent in teenage pregnancies. Preterm labor, low birth weight and low APGAR scores after 1 and 5 minutes were more in teenage deliveries.

Conclusion: Teenage pregnancy is more likely to be accompanied by multiple adverse maternal and neonatal outcomes.

Estimation of serum zinc and electrolytes in end-stage renal disease patients on hemodialysis Erbil city

Kamaran M. AMIN — 2025-10-22

Background and objective: End-stage renal disease (ESRD), particularly in patients undergoing haemodialysis (HD), often results in altered serum mineral and electrolyte levels, which can lead to additional health complications. This study aims to assess serum zinc levels, electrolyte concentrations, and renal function markers in HD, providing a comprehensive analysis of these parameters for the first time in this population.

Methods: This cross-sectional study, which included a comparison group, enrolled 65 ESRD patients undergoing regular HD at the Erbil Dialysis Centre and 65 healthy control subjects individuals from Erbil City. Information on dietary intake, medication use, and demographic factors was gathered through structured interviews, medical record reviews, and serum analysis, which measured kidney function biomarkers, serum zinc levels, and electrolyte levels.

Results: Serum zinc levels were significantly lower, and potassium concentrations were notably higher in HD patients compared to the control group. Zinc depletion was more pronounced in HD patients with hypertension than in those without. These alterations showed a negative correlation with estimated glomerular filtration rate (eGFR) levels among HD patients, with hyperkalaemia being significantly associated with lower eGFR values.

Conclusion: Monitoring serum zinc levels and electrolyte balance is crucial in HD patients, as zinc deficiency appears independently linked to hypertension. Addressing this deficiency may improve patient outcomes, through larger sample-size studies.

Cigarette smoking and age of menopause

Ishraq Mahmood Shakir Imarah — 2025-10-22

Background and objective: To identify the effect of cigarette smoking on women's age of menopause. Earlier time at menopause increased women morbidity and mortality rates. Unhealthy lifestyle had a negative impact on women's age at menopause.

Methods: Present study was a retrospective cross-sectional study implemented at outpatients' clinics of Maternity Teaching hospital in Erbil city, Kurdistan region-Iraq in period of six months from 1^st of January to 30^th of June 2024on sample of 280 women experienced menopause. The menopause of studied women was confirmed by absence of menstrual cycle for at least one year with experiencing menopause symptoms.

Results: Mean age at menopause was (46.8 years); premature menopause was recorded in 10% of women and early menopause was present in 21.4% of them. A highly significant association was observed between current smoking status of women and earlier menopause (P <0.001). Longer smoking duration of women with positive smoking history was related significantly to earlier menopause (P <0.001).Single marital status and nulliparity may play role in developing early menopausal age.

Conclusion: The prevalence of premature menopause in women experienced menopause is high. The smoking and duration of smoking are risk factors for earlier age at menopause.

Infection prevention knowledge and practice among health care workers in Primary Health Care centers of Erbil city

Shelan Mustafa Ali — 2025-10-22

Background and objective: Infection prevention is the practice of making barriers between susceptible microorganisms and hosts and is crucial for the supply of quality health services and safety at the level of facility. This study aimed to determine the knowledge on infection prevention and practices among health care workers working in primary health care centers in Erbil city.

Methods: A cross-sectional study carried out in 20 primary health care centers in Erbil city from 5^th September 2023 to 4^th October 2024. A convenience sampling method was used to recruit the sample of (291) health care workers. An electronic questionnaire form (Google form) used for data collection. SPSS version 25 was used for data entry and analysis. P value ≤ 0.05 was regarded as a statistically significant.

Results: A total of 291 health care staffs attended the selected primary health centers were involved in this study. About 35% of the participants were in the age group 41-50 years old. Most of health care workers 173 (59.5%) were females and 118 (40.5%) were males. More than one third (36.1%) of them joined in infection prevention and control training and majority (78%) of them has medium level of knowledge. A statistically significant highest percentage (82.4%) of nurses had medium knowledge about infection prevention control in comparison to other professions (Physicians, Biologist/chemist and radiologist (74.8%), (66.7%) and (80.0%) respectively, P value <0.001.

Conclusion: The knowledge about infection prevention and control among health care workers was medium. Nurses are more knowledgeable compare to other professions.

An investigation of self-esteem perceived by university students undergone Rhinoplasty surgery in Sulaimani city

Araz Mohammed Abdulkarim — 2025-10-22

Background and objective: This study investigates self-esteem among university students who underwent rhinoplasty surgery to assess its impact on their perceived self-worth and explore associations with personal and demographic factors.

Methods: A qualitative descriptive cross-sectional design was employed. A purposive sample of 100 undergraduate students from the old campus of the University of Sulaimani participated. Data was collected using a self-reported questionnaire consisting of sociodemographic questions and the Rosenberg Self-Esteem Scale (RSES). Data analysis was performed using SPSS version 23, applying descriptive and inferential statistics.

Results: The findings indicated that 83% of participants had normal self-esteem, 13% reported high self-esteem, and 4% experienced low self-esteem. No significant associations were found between self-esteem and demographic factors such as gender, age, marital status, or economic status (P >0.05). However, the participants' academic year showed a statistically significant relationship with self-esteem (P = 0.034).

Conclusion: Rhinoplasty may improve self-esteem for some individuals, but its influence varies across demographic profiles. These results underscore the importance of psychological assessments before and after cosmetic surgeries and highlight the need for interventions to foster positive body image beyond physical alterations.

The role of pulmonologist in patient education on asthma control using the asthma control test in Erbil city

Zahir Salih Khoshnaw — 2025-10-22

Background and objective: Asthma is a disease characterized by chronic airway inflammation and variable expiratory airflow limitation that is under-controlled globally. This study aimed to show the role of pulmonologists in patient education on asthma control in Erbil city, Iraq.

Methods: This study was done on 100 patients with asthma from the 1st of September 2023 to the 31st of August 2024. Demographics, asthma control status, causes of uncontrolled asthma, and the state of asthma control were assessed using the asthma control test tool questionnaire. Educational interventions given by the face-to-face method include knowledge about asthma symptoms, triggers, inhaler technique, inhaler of adherence, medication side effects, rescue drug instructions, a written asthma action plan, self-monitoring, and regular review. For reevaluation of the impact of educational intervention on asthma control, an appointment was given to the patients after three months for reevaluation by using ACT.

Results: The mean age ± SD of the patients was 33.23 ± 13.5 years (ranging from 15 to 70 years) with a female-to-male ratio of 1:1. Most of the studied patients (61%) are below 35 years old. Overall, the level of asthma control was 12% at presentation and increased to 45% post-education, which is statistically significant. There was no statistically significant association between gender and age group with the level of asthma control (P-value = 0.811 and P-value = 0.072, respectively) at presentation and post-education. According to the results of the study, there was a statistically significant association between the effect of education given by pulmonologists about asthma self-management and the level of asthma control by measuring the mean difference between pre and post-education, which is - 4.21 (15.2 - 19.41 pre-education and post-education, respectively).

Conclusion: The study concluded that there was a statistically significant association between pulmonologists' asthma educational interventions and the improvement of asthma control levels.

Effect of mental illness stigma upon the quality of life among families with schizophrenic patients in Mental Health Centre, Sulaimaniyah, Iraq

Araz Mohammed Abdulkarim — 2025-10-22

Background and objective: Family caregivers of members with schizophrenia are subjected to stigmatization that significantly affects the quality of life. And causes delays in caregiving and treatment seeking for schizophrenic patients. The objective is to assess the stigma of mental illness and QoL levels and to determine its association among family caregivers of schizophrenic patients.

Methods: A quantitative cross-sectional study was performed on 100 family caregivers with schizophrenia in 100 patients selected at the Mental Health Center, General Teaching Hospital in Sulaimaniyah, Iraq, from December 2022 to February 2023. A questionnaire used for data collection by interviewing the caregivers was composed of three parts; socio-demographic characteristics of family caregivers and patients, the stigma of mental illness scale, and QoL-BREF.

Results: Most family caregivers of patients with schizophrenia were males (72%) and siblings (49%). Moderate prevalence of stigma (78%) and low level of life (91%) were observed among caregivers. The likelihood ratio test results indicated that stigma was significantly associated with QoL (LR=4.912, P <0.05). The multinomial logistic regression model analysis showed that family caregivers with a high level of stigma were significantly four times lower QoL (P <0.05, odds ratio=4.43).

Conclusion: Family caregivers experienced a moderate level of stigma and low QoL that reflects a failure to use practical approaches to prompt and satisfy their needs in the community.

Prevalence of thyroid dysfunction in the general population in Erbil city

Khoshawi Mousa khaleel — 2025-10-22

Background and objectives: Thyroid diseases are worldwide endocrine disorders in clinical practice. Risk prevalence is higher in females than males with significant clinical adverse effects among these cardiovascular diseases. Prevalence is high among diabetic patients; with subclinical hypothyroidism categorized as the most common endocrine disorders. The aim of the present study was to screen the prevalence of thyroid dysfunction among apparently healthy adults, with special reference to diabetic patients.

Methods: 300 apparently healthy adults’ thyroid free disorders were screened included 200 females &100 males individuals of different age & BMI. Blood samples were collected & subjected to. thyroid profiles test included TSH, FT3 &FT4.Thyroid dysfunction-were further categorized according to the tested thyroid profiles.

Results: The results revealed 7.3 % prevalence of sub-clinical hypothyroidism followed by overt hypothyroidism (1.7%) & subclinical hyperthyroidism (0.7%). Among diabetic patients subclinical hypothyroidism predominate (12.5%) followed by clinical hypothyroidism (7.5%).

Conclusion: The results delineated the fact that among thyroid free subjected, screening in of paramount importance especially diagnosis of subclinical hypothyroidism that might linked with significant clinical complication especially female during pregnancy & as a cardiovascular diseases risk factor.