Zanco Journal of Medical Sciences (ZJMS)
https://zjms.hmu.edu.krd/index.php/zjms
<p style="margin: 0in; margin-bottom: .0001pt;"><strong>Publisher:</strong> <a href="https://hmu.edu.krd/">Hawler Medical University</a></p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>Journal name:</strong> Zanco Journal of Medical Sciences (Zanco J Med Sci)</p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>Disciplines:</strong> Clinical and basic medical sciences</p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>ISSN: eISSN:</strong> 1995-5596, <strong>pISSN: </strong>1995-5588</p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>DOI:</strong> 10.15218/zjms</p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>Description:</strong> Peer-reviewed, open access</p> <p style="margin: 0in; margin-bottom: .0001pt;"><strong>Frequency:</strong> Three times per year in both hard and electronic copies</p>Hawler Medical Universityen-USZanco Journal of Medical Sciences (ZJMS)1995-5588<p><span style="color: rgba(0, 0, 0, 0.87); font-family: Lato, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the </span>Creative Commons Attribution Non-Commercial ShareAlike License<span style="color: rgba(0, 0, 0, 0.87); font-family: Lato, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> (CC BY-NC-SA 4.0).</span></p> <p> </p>Prevalence and predictors of post-traumatic stress disorder among Yazidi women: a cross-sectional study in the Kurdistan region of Iraq
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1213
<p><strong>Background and objective:</strong> The Yazidi community, an ethno-religious minority in Iraq, was severely affected by the 2014 ISIS attacks, which led to mass killings, abductions, and widespread psychological trauma. This study aimed to assess the prevalence and severity of Post-Traumatic Stress Disorder (PTSD) among Yazidi women in the context of ISIS-related violence.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted, where 300 women were chosen among those who were displaced from Sinjar during the 2014 ISIS attacks and currently residing in Shariya IDP Camp, and 300 women from the long-term residents of Shariya Complex in Duhok Governorate, who were not directly exposed to ISIS violence. Data were collected through structured interviews addressing demographics, socioeconomic characteristics, trauma exposure and conflict-related experiences, mental health history, and support systems. PTSD symptoms were assessed using the Impact of Event Scale–Revised (IES-R).</p> <p><strong>Results:</strong> Severe PTSD symptoms were reported by 73.3% of participants, with significantly higher rates among IDP camp residents (88.7%) compared to non- directly exposed residents (58.0%) (P <0.001). PTSD severity was significantly associated with displacement (P <0.001), captivity (P <0.001), sexual and physical violence (P <0.001), current residence (P <0.001), illiteracy (P <0.001), number of children (P = 0.005) and marital status (P = 0.015). Access to mental health services showed limited impact, with major barriers including unavailability, stigma, and low awareness. Moreover, displacement due to ISIS, low educational level and number of children were identified as predictors of PTSD as analyzed using binary logistical regression among the studied covariates.</p> <p><strong>Conclusion:</strong> PTSD remains alarmingly prevalent among Yazidi women, even 11 years after the 2014 genocide. Prevalence is notably higher among displaced multiparous women and increases with lower levels of education. Elevated symptoms are also observed among women who were not directly exposed to the violence, suggesting the presence of vicarious and intergenerational trauma.</p>Lourd HannaNamir G. Al-Tawil
Copyright (c) 2026 Lourd H. Hanna, Namir G. Al-Tawil (Author)
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2026-08-122026-08-1230229931610.15218/zjms.2026.021Knowledge and practice of community pharmacists about medication use during pregnancy in Erbil city.
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1218
<p><strong>Background and objective: </strong>Community pharmacists, as the most accessible healthcare providers, have an important role in ensuring the safe use of medications during this period; that’s why they must have optimal knowledge. This study aims to assess the knowledge and practice of community pharmacists in Erbil City regarding safe medication use and their relationship with sociodemographic characteristics of the community pharmacists.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted among community pharmacists who work in Erbil City, Kurdistan Region, Iraq. A total of 350 community pharmacists were selected by convenience sampling method for interviews using a structured questionnaire on medication safety during pregnancy. SPSS version 26 was used for data entry and analysis. A P-value of ≤0.05 is regarded as statistically significant.</p> <p><strong>Results:</strong> Out of the total participants (n=350), more than half (51.4%) were between the ages of 26 and 30 years, and 58.6% and 52.3% were female and single, respectively. About 91% of participants held a bachelor’s degree in pharmacy, and 63.7% had less than 5 years of experience. The study found that 49.7% of respondents had good knowledge and 51.7% had safe practices. Age and marital status were significantly associated with knowledge (P-value: 0.009 and 0.005, respectively), and gender was significantly associated with practice level, P = 0.002.</p> <p><strong>Conclusion: </strong>Although approximately half of the pharmacists had good knowledge and safe practice in handling pregnancy medications, the remaining half of them lacked essential skills that may influence the quality of the care received by patients. Therefore, we need special educational interventions to fill in gaps and ensure safer maternal health outcomes.</p>Saya AmeerSamir Mahmood Othman
Copyright (c) 2026 Saya Ameer, Mahmood (Author)
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2026-08-122026-08-1230231733210.15218/zjms.2026.022Knowledge and practices towards vitamin D sources and insufficiency among healthcare workers in Erbil, Iraq, 2025
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1224
<p><strong>Background and objective:</strong> Vitamin D is an essential fat-soluble vitamin that is produced in the skin depending on sunlight and found in different foods. Its deficiency is a widespread health issue, affecting approximately one billion people and leading to significant health consequences. This study aimed to assess knowledge and practices regarding vitamin D sources and insufficiency amongst healthcare workers (HCWs) in Erbil hospitals.</p> <p><strong>Methods:</strong> A cross-sectional study was carried out at five public hospitals in Erbil city in 2025. A total of 400 HCWs were recruited from the selected hospitals. A structured questionnaire was developed, which included three sections: sociodemographic characteristics, knowledge questions, and practice questions related to sources and insufficiency of vitamin D.</p> <p><strong>Results:</strong> This study revealed that 33 HCWs (8.3%) had poor knowledge, 319 (79.7%) had fair knowledge, and 48 (12%) had good knowledge about vitamin D. Good knowledge levels were significantly higher in older HCWs (55.2%), highly educated HCWs (23.3%), technicians (20%), and HCWs who had 1–13 years of experience (13.3%). Only 28 (7%) exhibited good practice, and the poor practice level was significantly higher among females (56.3%) and technicians (60%).</p> <p><strong>Conclusion: </strong>Most HCWs had fair knowledge and less than half had poor practices regarding vitamin D. Better knowledge was associated with older age, higher education, longer service, and being a technician, while poor practices were more common among females and technicians. Targeted interventions are recommended to improve HCWs’ knowledge and practices for better public health outcomes.</p>Shaymaa Qais SaeedSherzad Abdulahad Shabu
Copyright (c) 2026 Shaymaa Qais Saeed, Sherzad Abdulahad Shabu (Author)
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2026-08-122026-08-1230233334410.15218/zjms.2026.023The Evaluation of serum fucose and fucose related parameters in beta- thalassemia major
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1200
<p><strong>Background and objective: </strong>Beta-thalassemia syndrome is characterized by either absent or lower-than-normal production of the beta-globin chain in hemoglobin, which can cause various health problems. α- L-fucose is a methyl pentose sugar, which is a part of the glycan’s of a significant category of compounds referred to as glycoconjugates; glycoproteins and glycolipids. The major aim of the current study is to evaluate using serum fucose parameters as biomarkers or indicators for beta- thalassemia disease.</p> <p><strong>Methods: </strong>The current study was materialized on 45 Beta-thalassemia major patients and 45 healthy volunteer individuals. Blood sample collections were performed at Thalassemia Center (Akre and Erbil). Serum Fucose and related parameters total fucose (TF), protein bound fucose (PBF), protein bound hexose (PBH), lipid associated fucose (LAF), and free fucose (FF) were measured using UV/VIS spectrophotometry.</p> <p><strong>Results: </strong>Beta-thalassemia major (BTM) patients had a significantly higher serum levels of TF and FF compared to the controls. A significant reduction in serum PBF was observed in patients. However, differences in PBH and LAF were not statistically significant. The PBH mean and standard deviation in patients were 6.421 and 3.085, respectively, compared to 6.817 and 3.758 in controls (P = 0.5858). For LAF, patient values were 3.281 and 2.225, versus 2.452 and 1.960 in controls (P = 0.0640).</p> <p><strong>Conclusion: </strong>The results inferred significant increase in serum TF and FF, and a significant decrease in serum (PBF) in Beta-thalassemia major patients. The results suggest that TF, FF and PBF parameters can be used as diagnostic markers for the disease.</p>Heba Hasan JalalBakhtiar Muhialdin Ahmad
Copyright (c) 2026 Heba Hasan Jalal, Bakhtiar Muhialdin Ahmad (Author)
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2026-08-122026-08-1230234535610.15218/zjms.2026.024Perception of pharmacist about medication adherence among patients in Erbil city
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1199
<p><strong>Background and objective</strong>: Medication adherence stands as a vital public health concern, especially for managing diseases that need prolonged treatment. Pharmacists' functions are crucial as essential healthcare providers who reach patients directly to deliver education and counseling services for improving adherence. The research evaluated pharmacists' views about patient medication adherence in Erbil City through assessments of their knowledge, attitudes, practices, and perceived barriers.</p> <p><strong>Methods</strong>: A descriptive cross-sectional research design included 350 licensed pharmacists who worked in public and private pharmacies throughout Erbil City. The research used a structured self-administered questionnaire based on the Knowledge-Attitude-Practice (KAP) model to gather data. The researcher used SPSS version 29 to perform a statistical analysis of the data, with P ≤0.05 as the significance level.</p> <p><strong>Results</strong>: The survey revealed that 91.7% of pharmacists understood adherence concepts, yet 43.1% chose 80% as the proper adherence threshold. The survey revealed that 94.0% of pharmacists recognized their essential function in adherence promotion, yet only 26.3% stated they counsel patients in every instance. The survey showed that 72.9% of participants considered adherence very important, yet 44.6% rated patient adherence as average and 34.0% rated it as poor. Knowledge levels demonstrated significant relationships with gender, ethnicity, and education status (P <0.05), and practice levels showed a significant relationship with attitude (P = 0.004). The analysis revealed no meaningful relationships between patient demographic characteristics and their scores on attitude or practice.</p> <p><strong>Conclusion</strong>: The pharmacists of Erbil show strong knowledge and favorable perspectives about medication adherence, yet they face challenges in actual practice and knowledge comprehension. We must establish specific interventions and professional training programs to enhance adherence-related practices.</p>Shayan Othman AbdulkareemAbubakir M. Saleh
Copyright (c) 2026 Shayan Othman Abdulkareem, Abubakir M. Saleh (Author)
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2026-08-122026-08-1230235737110.15218/zjms.2026.025Role of liraglutide and probiotics in managing chronic kidney disease induced in rats
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1221
<p><strong>Background and objective:</strong> Chronic kidney disease (CKD) is an incurable disorder involving widespread inflammation and gut dysbiosis, which facilitates disease progression via the gut-kidney axis. Current therapies can only decelerate the course of the disease and may cause adverse effects. This study aimed to investigate the potential reno-protective effects and modulation of gut integrity by the glucagon-like peptide-1 receptor agonist liraglutide and probiotics, separately and in combination, in a rat model of CKD.</p> <p><strong>Methods:</strong> CKD was induced in male rats (n=40) by intraperitoneal injection of high-dose folic acid. Animals were randomly distributed into five equal groups: control negative, control positive, liraglutide group, probiotics group, and combination group. Serum levels of creatinine, blood urea nitrogen, cystatin-C and C-reactive protein were measured. Histological assessment of the kidney and colon was also performed.</p> <p><strong>Results:</strong> High-dosefolic acid significantly increased markers of impaired kidney function and systemic inflammation. Treatment with liraglutide, probiotics, and their combination significantly reduced these markers’ levels. Histopathological analysis revealed improved renal and gastrointestinal integrity in all treatment groups, with the combination treatment group demonstrating the most substantial recovery.</p> <p><strong>Conclusion:</strong> The combination therapy effectively protected renal and intestinal tissues from the damage of high-dose folic acid. The current findings suggest potential additive or synergistic benefits of combining liraglutide with probiotics and support its use as a novel strategy for managing CKD via gut and renal regulation.</p>Zeineb Adel Faleeh AlamriNidhal Abdulkader Mohammed Ali
Copyright (c) 2026 Zeineb Adel Faleeh Alamri, Nidhal Abdulkader Mohammed Ali (Author)
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2026-08-122026-08-1230237238510.15218/zjms.2026.026Assessment of community pharmacists’ knowledge, barriers, and practices in detecting antibiotic prescribing errors in Erbil city
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1220
<p><strong>Background and objective: </strong>Antibiotic prescribing errors are one of the major contributors to antimicrobial resistance and treatment failure, especially in low-resource places like Erbil, Iraq. This study sought to assess community pharmacists' knowledge in detecting antibiotic prescribing errors, identify the most common types of errors encountered in practice, and explore key barriers that hinder error detection and prevention.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in community pharmacies in Erbil city between November 2024 and March 2025. A structured, self-administered questionnaire was used to collect data from 342 pharmacists selected via convenience sampling. The questionnaire assessed demographics, knowledge, factors that affect prescription errors detection, and types of prescription errors in antibiotics prescription.</p> <p><strong>Results: </strong>Data from 342 graduated pharmacists indicated that the workforce is predominantly young, with 74.4% under the age of 30, and largely female (66.8%). The majority were employed in private pharmacies. Only 7.9% demonstrated high knowledge scores regarding antibiotic prescribing errors, the most commonly incorrect responses were related to dosage-related questions. Additionally, 31.2% of participants had received training in antimicrobial stewardship. Statistical analysis showed a significant association between knowledge level and belief in the effectiveness of automated prescribing systems (P = 0.004). A higher proportion of older pharmacists were found in the high knowledge category.</p> <p><strong>Conclusion: </strong>The study highlights significant knowledge gaps and limited formal training among community pharmacists regarding antibiotic prescribing errors. Strengthening pharmacist education and implementing structured antibiotic stewardship programs are essential to improving prescribing safety and reducing antimicrobial resistance.</p>Awaz Zero AbbasKameran Hassan Ismail
Copyright (c) 2026 Awaz Zero Abbas, Kameran Hassan Ismail (Author)
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2026-08-122026-08-1230238639810.15218/zjms.2026.027Knowledge, attitudes, and practices of healthcare workers on antimicrobial resistance and antibiotic use in Erbil city, Iraq: a cross-sectional study
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1207
<p><strong>Background and objective: </strong>Antimicrobial resistance (AMR) is a growing global health threat, with predictions of a substantial rise in AMR-related deaths over the coming decades. Healthcare workers (HCWs) are central to the fight against AMR through their prescribing and counselling practices. This study assessed the knowledge, attitudes, and practices (KAP) regarding antibiotic use and AMR among HCWs in Erbil City, Iraq, and examined how these vary across professions.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted in five government hospitals in Erbil City, Iraq: Erbil Teaching Hospital, West Emergency Hospital, Rizgary Teaching Hospital, Raparin Hospital, and Gynecology and Maternity Hospital. Physicians, pharmacists, dentists, and nurses were recruited using a convenience sampling approach. A total of 408 healthcare workers were interviewed face-to-face using a standardized questionnaire between September 2024 and March 2025. Data were analyzed using SPSS version 27.</p> <p><strong>Results: </strong>Participants' ages ranged from 19 to 99 years (mean 34.0 ± 8.6 years), and years of professional experience averaged 10.3 ± 8.1 (range 1–35). Males comprised 46.3% of the sample and females 53.7%. Physicians (38.5%) and nurses (30.1%) were the most represented professions, and most participants (83.8%) held permanent positions. Knowledge of AMR was inconsistent: although 82.4% correctly identified prevention of post-operative infection as an appropriate use of antibiotics, misconceptions about antibiotic use remained common. Adherence to prescribing guidelines, discussion of antibiotic use with patients, and knowledge scores all differed significantly across professions (P <0.001), with physicians scoring highest and nurses lowest.</p> <p><strong>Conclusion: </strong>There are substantial gaps in the knowledge, attitudes, and practices of healthcare workers in Erbil City regarding antibiotic prescribing. Targeted interventions, particularly among nurses, are needed to strengthen antimicrobial stewardship and curb the emergence and spread of AMR.</p>Mahdi Mohammed Saleh Abdelkarim Haitham Issa Al-Bana
Copyright (c) 2026 Mahdi Mohammed Saleh Abdelkarim , Haitham Issa Al-Bana (Author)
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2026-08-122026-08-1230239941310.15218/zjms.2026.028Dual-strategy; complexation-based solid dispersion for enhancing the solubility and dissolution rate of candesartan cilexetil
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1225
<p><strong>Background and objective:</strong> Candesartan cilexetil (CC), an angiotensin II receptor blocker indicated for hypertension and heart failure, is classified as a BCS Class II drug which is characterized by low aqueous solubility (0.963 ± 0.062 µg/mL) and limited oral bioavailability (14%–40%). Both factors significantly undermine its therapeutic efficacy and present challenges in formulation development. This study aimed to improve the solubility and dissolution properties of CC through two formulation techniques of solid dispersion with PVPK30 by rotavapor and inclusion complex with HPβCD by kneading.</p> <p><strong>Methods:</strong> In this study, solid dispersions and inclusion complexes were formulated at drug to polymer ratios of 1:1, 1:3, and 1:6, with corresponding physical mixtures at a 1:6 ratio. A study on saturated solubility was performed in distilled water. The best formulations—SD3 (solid dispersion with PVP K30) and IC3 (inclusion complex with HPβCD)—were subjected to further characterization. The characterizations consisting of percent drug content, in vitro drug release, Fourier Transform Infrared Spectroscopy, and Powder X-ray Diffraction were performed.</p> <p><strong>Results:</strong> SD3 and IC3 improved the solubility of CC by 21.19-fold (20.40 ± 0.139 µg/mL) and 12.22-fold (11.76 ± 0.202 µg/mL), respectively. Both exhibited high drug content—98.47% (SD3) and 98.21% (IC3)—and accomplished over 90% drug release within 15 minutes. FTIR confirmed hydrogen bonding and non-covalent interactions, however PXRD revealed diminished crystallinity and enhanced amorphization.</p> <p><strong>Conclusion:</strong> Both PVP K30-based solid dispersion via rotavapor and HPβCD-based inclusion complexation through kneading significantly improved the solubility and dissolution rate of Candesartan cilexetil, with solid dispersion demonstrating superior efficacy for enhancing oral bioavailability.</p>Saya Latif Abdullah Huner Kamal Omer
Copyright (c) 2026 Saya Latif Abdullah , Huner Kamal Omer (Author)
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2026-08-122026-08-1230241443510.15218/zjms.2026.029The status of apoproteins b100 and a1 in type 2 diabetes in Erbil city
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1222
<p><strong>Background and objective: </strong>Type 2 diabetes mellitus (T2DM) originates from the body's incapacity to react to insulin. Hypoglycemic medications and lifestyle modifications can help control it. The aim of this study was to compare the serum Apolipoprotein B100/Apolipoprotein A1 Ratio (ApoB100/ApoA1) between T2DM patients and controls.</p> <p><strong>Methods</strong>: This case-control study was conducted in the Galiawa Teaching Center for Diabetes and Endocrinology in Erbil City from October to December 2024. The blood samples were taken from 45 patients with T2DM and 45 healthy control subjects. Two types of tubes were used to collect blood samples: one for serum separation (gel tube) and another for plasma (tri-potassium ethylene diamine tetra acetic acid) (K3EDTA) tube. The samples have been left at room temperature for fifteen minutes and then put in a centrifuge for ten minutes at 4000 rpm to get the serum of the blood. The separated serum was subjected to laboratory analysis to analyze the biochemical tests (ApoA1, ApoB100, fasting serum glucose, hemoglobin A1C (HbA1C), and lipid profile).</p> <p><strong>Results</strong>: Based on the research findings, diabetic patients had substantially higher levels of serum glucose, HbA1C, lipid profiles, and ApoB100/ApoA1 ratio than the healthy individuals. The case group had a mean serum ratio ApoB100/ApoA1 of (0.84±0.06), while the control group had a ratio of (0.66±0.02) g/L (P = 0.037). While HbA1C and serum glucose with all lipid profile results were significantly higher in T2DM than the control group, high-density lipoprotein (HDL) was lower in T2DM.</p> <p><strong>Conclusion: </strong>The study found that patients with T2DM had a high ApoB100/ApoA1 ratio. Compared to the control group.</p>Avin Salih KhalndLeweza Bilal Abbas
Copyright (c) 2026 Avin Salih Khalnd, Leweza Bilal Abbas (Author)
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2026-08-122026-08-1230243644510.15218/zjms.2026.030Prevalence of trichomonas vaginalis infection and evaluation of diagnostic methods in women attending maternity teaching hospital in Erbil city, Iraq
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1235
<p><strong>Background and objective: </strong><em>Trichomonas vaginalis</em>, an anaerobic, extracellular flagellated protozoan parasite, widespread sexually transmitted infection (STI). The objectives were to determine the prevalence of <em>Trichomonas vaginalis </em>in women attending to Erbil Maternity Teaching Hospital by different methods using microscopy, rapid and culture methods.</p> <p><strong>Methods:</strong> In this cross-sectional study from October of 2024 to June of 2025, 400 high vaginal swab (HVS) samples and urine samples were taken from women attending Maternity Teaching Hospital to detect the prevalence of <em>Trichomonas vaginalis</em> infection by different methods such as direct wet mount, rapid and culture methods.</p> <p><strong>Results: </strong>In this study, <em>T. vaginalis</em> was detected in 12 cases (3%) by culture and 9 cases (2.25%) by direct wet mount among 400 high vaginal swab samples. Of these, 120 were also tested by rapid diagnostic test, yielding 3 positives (2.5%). From the same patients, 400 urine samples were examined, with 4 positives (1%). Infection occurred only in married women, with the highest prevalence in the 18–29 age group (5.88%). No significant differences were found by age or residence, but significant associations were observed with clinical symptoms, whiff test results, vaginal discharge colour, and vaginal pH.</p> <p><strong>Conclusion: </strong><em>Trichomonas vaginalis</em> infection was significantly linked to elevated vaginal pH and was most common in symptomatic women with pruritus and dyspareunia, particularly in the 18–29 age group. Culture detected more cases than wet mount or rapid tests, supporting the use of multiple diagnostic methods and targeted screening for early intervention.</p>Hero Hussein AbbasAhmed Akil Al-Daoody
Copyright (c) 2026 Hero Hussein Abbas, Ahmed Akil Al-Daoody (Author)
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2026-08-122026-08-1230244646010.15218/zjms.2026.031T cell subsets and their signature cytokines in infertile women prepared to undergo in vitro fertilization (IVF)
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1245
<p><strong>Background and objective:</strong> This study aimed to explore the immunological profile, particularly the balance between T helpers 1 (Th1), Th2, Th17, and regulatory T (Treg) cytokine responses, in women undergoing in vitro fertilization (IVF), and how these responses correlate with reproductive outcomes. It investigated the systemic levels of specific cytokines to evaluate their roles in implantation success and potential immunological barriers to fertility.</p> <p><strong>Methods:</strong> A case-control study was conducted at private IVF centers in Erbil city, Iraq. Peripheral blood samples were collected and analyzed using the Human Th1/Th2/Th17/Treg Multiplex Enzyme Linked Immuno-Sorbent Assay (ELISA) Kit to quantify interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), IL-4, IL-13, IL-17, IL-22, and IL-10 levels.</p> <p><strong>Results:</strong> Significant elevations were found in Th2 cytokines (IL-4 and IL-13) and Treg cytokine (IL-10) in IVF patients compared to healthy controls (P <0.01). Th1 (IFN-γ, TNF-α, IL-2) and Th17 (IL-17, IL-22) cytokines were modestly reduced, but these differences were not statistically significant (P >0.05). Notably, anti-Müllerian hormone (AMH) levels were significantly higher in smokers, and luteinizing hormone (LH) levels were significantly elevated in women with prior IVF attempts.</p> <p style="font-weight: 400;"><strong>Conclusion:</strong> The cytokine profile suggests an immune shift toward a Th2/Treg-dominant environment in IVF patients, supporting tolerance and embryo implantation. However, excessive skewing could impair local immune readiness. The findings highlight the immunological complexity of IVF outcomes and suggest potential benefits of targeted cytokine modulation to improve reproductive success.</p>Safin Tahsin HaiasZahra A. Amin
Copyright (c) 2026 Safin Tahsin Haias, Zahra A. Amin (Author)
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2026-08-122026-08-1230246148210.15218/zjms.2026.032Ras Homolog Family Member A Regulates Interleukin-6 Expression in Streptozotocin-Pretreated Mice with Relevance to Alzheimer’s Disease-Related Inflammation
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1253
<p><strong>Background and objective: </strong>Alzheimer's disease (AD) is a slowly worsening brain disorder linked to ongoing inflammation, with interleukin-6 (IL-6) playing a significant role in its progression. Ras Homolog Family Member A (RhoA) regulates inflammatory signaling and may influence IL-6 expression in AD. This research aimed to investigate the impact of RhoA inhibition on IL-6 expression and neuropathology in a streptozotocin (STZ)-induced AD mouse model.</p> <p><strong>Methods: </strong>A total of 15 male Swiss albino mice, aged 8–9 weeks and weighing 25–30 g, were randomly assigned into three groups (n = 5 per group): Control (control), STZ-pretreated (diabetes-associated cognitive impairment like Alzheimer’s diseasemodel), and Y-27632+STZ (RhoA inhibitor-treated). The treatment group received 5 mg/kg Y-27632 before STZ administration. ELISA measured IL-6, amyloid beta 42 (Aβ42), and tau levels in brain and serum. Histopathological analysis assessed neuroinflammation and neuronal damage.</p> <p><strong>Results: </strong>STZ significantly increased Aβ42, tau, and IL-6 levels (P <0.05). Y-27632 treatment reduced these markers, indicating neuroprotection. Histological analysis revealed severe neuroinflammation and neuronal damage in the STZ group, while Y-27632 reduced inflammatory cell infiltration and brain injury scores (P <0.05).</p> <p><strong>Conclusion: </strong>RhoA inhibition attenuates IL-6-mediated neuroinflammation, decreases tau and amyloid plaque pathology, and mitigates neurodegeneration in AD. Targeting RhoA may offer a promising therapeutic approach for AD management.</p>Kanyaw AbdulrahmanRundk Hwaiz
Copyright (c) 2026 Kanyaw Abdulrahman, Rundk Hwaiz (Author)
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2026-08-122026-08-1230248349710.15218/zjms.2026.033Human papillomavirus genotypes in cervicitis and atypical squamous cell of undetermined significance lesions among women in Erbil, Iraq
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1204
<p><strong>Background and objective: </strong>Human papillomavirus infection is known to be the primary reason for cervical carcinoma. Steady infection with high risk (HR)-HPV strains is behind most abnormal cervical lesions, this studyaims to investigate the prevalence and genotype distribution of HPV in cervical samples from women between 20 to 50 years old with different cervical lesions, including cervicitis and atypical squamous cells of undetermined significance (ASC-US) cases.</p> <p><strong>Methods:</strong> Cervical smears of 113 patients diagnosed with atypical squamous cell of undetermined significance and cervicitis were included in the study and examined for HPV detection used reverse transcription polymerase chain reaction and hybridization method, followed by HPV genotyping assay specimens</p> <p><strong>Results:</strong> Out of the total 113 cases, 24.74% were positive for HPV infection, and 75.22% were negative for HPV infection. Most of the patients diagnosed with cervicitis were within 35-39 age group, accounting for 26.3% of the total cases. In contrast, most patients with ASCUS were in the 30-34 age group, representing 29.7%. The majority of patients exhibit a single serotype (60.7%), while multiple serotypes were found in 39.3%. HR-HPV16 and multiple genotype HPV (31,35,39,51,52,56,58,59,66, and 68) were the most frequently identified genotypes.</p> <p><strong>Conclusion:</strong> The detection of both low- and HR- HPV genotypes were reported and not uncommon among patients with cervicitis and a typical squamous cell of undetermined significance. High risk (HR)-HPV16 and multiple genotypes were the most frequently diagnosed by PCR test. Consequently, it is highly advisable to create a program for cervical cancer screening and prophylactic HPV vaccination for early diagnosis and prevention of cervical abnormalities and neoplasia in Iraq.</p>Dashty Hamad ameenTavga Hushair Salim
Copyright (c) 2026 Dashty Hamad ameen, Tavga Hushair Salim (Author)
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2026-08-122026-08-1230249851010.15218/zjms.2026.034Serum magnesium levels during pregnancy and their correlation with maternal demographic characteristics: A cross-sectional study
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1203
<p><strong>Background and objective:</strong> The rate of low magnesium levels in pregnancy varies significantly between regions, shaped by dietary practices, socioeconomic factors, and healthcare access. This study aimed to determine the prevalence of hypomagnesaemia in pregnant women attending a tertiary public hospital and any maternal associated factor in relation to magnesium levels.</p> <p><strong>Methods</strong>: A cross-sectional study was conducted on 930 pregnant women across all trimesters at Maternity Teaching Hospital, Erbil, Kurdistan Region, Iraq, from 3<sup>rd </sup>January 2023 to 3<sup>rd </sup>January 2024. Serum magnesium concentrations (mg/dL) were determined using the Cobas Integra analyzer. These levels were correlated with demographic characteristics and weight.</p> <p><strong>Results:</strong> The mean serum magnesium level was 1.86±0.22 mg/dL (median 1.88, range 0.47-2.7 mg/dL). Hypomagnesemia was observed in 4.3% (n=40) and hypermagnesemia in 3.3% of participants. Serum magnesium levels showed a trend towards decreasing with advancing gestational age, although differences between trimesters were statistically significant. No significant association was found between hypomagnesemia and educational level or occupation.</p> <p><strong>Conclusion: </strong>Hypomagnesemia was infrequent in pregnant women at the studied hospital and was not linked to education, socioeconomic status, or body weight.</p>Rose Burhanedin MeeranyShayma Abd EzatShelan Omer JaafarNazar P. ShabilaShahla Kareem Alalaf
Copyright (c) 2026 Rose Burhanedin Meerany, Shayma Abd Ezat, Shelan Omer Jaafar, Nazar P. Shabila, Shahla Kareem Alalaf (Author)
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2026-08-122026-08-1230251152010.15218/zjms.2026.035Impacts of low dose gamma rays on hematological parameters in Wistar albino rats: In-vivo
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1180
<p><strong>Background and objective</strong>: The effects of gamma radiation dosages on the hematological parameters of albino rats were examined through in-vivo exposure methodologies.</p> <p><strong>Methods</strong>: Cesium-137 was utilized as a source of ionizing radiation, and various doses were administered via appropriate irradiation collimators. The subjects comprised 30 female albino rats, each with a mass of 200±10 grams, with the duration of exposure for each irradiation source calibrated individually. The principal hematological components (including white blood cells, red blood cells, and platelet counts) of the female rats were assessed employing direct exposure methodologies for low radiation doses.</p> <p><strong>Results</strong>: The results indicated that variations in the optimum time of exposure were 15 minutes. High doses of ionizing radiation have a considerable effect on the primary blood components. The radio-sensitivity and physiological properties of each kind of blood component determined the optimal irradiation dosages that resulted in high WBC, RBC, and PLT densities. Radiation doses had a substantial impact on PLT density, reduced with 42% compare to the control value (P-value < 0.05).</p> <p><strong>Conclusion</strong>: Ionizing radiation had a relatively small effect on the density of the main blood components after a limited amount of exposure. The type of blood components determined the optimal radiation doses with high efficiency on component density. Furthermore, high impacts (very significant) concentrated on PLT density.</p>Sardar Pirkhider Yaba
Copyright (c) 2026 Sardar Pirkhider Yaba (Author)
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2026-08-122026-08-1230252153310.15218/zjms.2026.036Serum leucine as a potential biomarker of insulin resistance in diabetic, prediabetic, and leucine-supplemented individuals
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1256
<p><strong>Background and objective</strong>: Diabetes Mellitus type 2 (T2DM) represents a serious risk to public health known as hyperglycemia. High levels of serum leucine a branched chain amino acid have been associated with early insulin resistance and metabolic imbalances. This study investigates the relationship between serum leucine levels and insulin resistance, and to evaluate its potential as a biomarker alongside standard blood sugar markers in diabetic, prediabetic, and leucine-supplemented individuals undergoing training.</p> <p><strong>Methods</strong>: A cross-sectional study, conducted at the (Galiawa hospital for diabetes and endocrinology and (AKA Fitness) center)/ Erbil city / Iraq. A total of 155 participants, aged between 30 and 69, were included, composed of 46 with T2DM, 38pre-diabetic patients, 36 non-diabetic and 35 healthy young active training individuals who received leucine supplementation. Data was collected by interview questionnaire about; sociodemographic, life style and results of biochemical tests.</p> <p><strong>Results</strong>: High levels of serum Leucine were significantly increase with age, obesity (OR=2.4, 95% CI. 1.7 - 2.8) and increased risk of high fasting blood sugar (OR=1.14,95% of CI 1.09-1.18), HbA1c (OR=1.24, 95% of CI 1.12-1.37), and insulin resistance (OR= 1.06, 95% of CI 1.02-1.1) in diabetic and prediabetic. Excessive supplementation caused excess serum leucine levels and increase potential insulin resistance (OR=1.3, 95% CI I,07-1.6) with advancing age.</p> <p class="s3"><strong>Conclusion:</strong> High serum leucine levels can cause insulin resistance in elderly, obese, prediabetic, and diabetic patients, suggesting its potential use as a biomarker for early diagnosis. A low dose of leucine supplementation should be considered in individuals undergoing training.</p>Asmaa Ahmed OmarJwan Ibrahim Jewzali
Copyright (c) 2026 Asmaa Ahmed Omar, Jwan Ibrahim Jewzali (Author)
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2026-08-122026-08-1230253455310.15218/zjms.2026.037Macrophage polarization induced immune dysregulation in rheumatoid arthritis
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1297
<p><strong>Background and objective:</strong> Rheumatoid arthritis (RA) is one of the most prominent inflammatory autoimmune illnesses, causing polyarticular synovitis. The precise causes of RA are still unknown; however, chronic inflammation patterns are influenced by a combination of immunological, environmental, and epigenetic factors. Anti-CCP antibodies are a particular biomarker for RA diagnosis and severity. Alterations of complement components and pro- and anti-inflammatory cytokines are critical to the pathogenesis of RA. The current study intended to compare and examine the immunological properties of anti-CCP, IL-10, IL-17, and C5a antibodies in samples from RA patients and healthy individuals. The study evaluated medication exposure and various immune markers simultaneously to enhance immunological profiling, clinical accuracy, and classification of patients with RA</p> <p><strong>Methods:</strong> The Cobas e 411 analyzer was used to measure the anti-CCP antibody levels in the serum of 60 RA patients and 40 healthy individuals. Enzyme-linked immunosorbent assay (ELISA) technique from the BioTek ELx800 was used to estimate the levels of IL-17, IL-10, and C5a in the sera of participants. Both groups were matched in age and ethnicity. An unpaired T-test was used to analyze data statistically using the GraphPad Prism 8 program. The ANOVA test was used for more than 2 groups.</p> <p><strong>Results:</strong> The current study indicated that patients with rheumatoid arthritis (RA) had a significantly lower concentration of IL-10 serum levels as compared to the healthy controls, yet with increased levels of IL-17, C5a, and anti-CCP antibodies. Some of the causes of the decrease in IL-10 might be chronic inflammation and the suppressive action of the pro-inflammatory cytokines on its production and signaling. Further, RA patients under corticosteroid treatment had reduced levels of IL-17, C5a, and anti-CCP antibodies compared to untreated patients, showing corticosteroid therapy lowers the inflammatory mediators without restoring the IL-10 levels.</p> <p><strong>Conclusion: </strong>It can be concluded that macrophages from rheumatoid arthritis patients shifted from anti-inflammatory (like IL-10) to pro-inflammatory (like IL-17) properties. Patients with rheumatoid arthritis had lower levels of anti-inflammatory cytokine markers like IL-10 and greater levels of pro-inflammatory cytokines like IL-17, inflammatory markers like C5a, and rheumatoid arthritis markers like anti-CCP.</p>Rezan Mahmood Kaka SurRamiar Kamal Kheder
Copyright (c) 2026 Rezan Mahmood Kaka Sur, Ramiar Kamal Kheder (Author)
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2026-08-122026-08-1230255457510.15218/zjms.2026.038Molecular detection of Trichomonas Vaginalis using 5.8S rRNA gene in reproductive-age women in Erbil city
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1384
<p><strong>Background and objective: </strong>Trichomoniasis is a parasitice infection that impacts the human reproductive and urinary systems, constituting a significant non-viral sexually transmitted infection globally. The study evaluated the 5.8S rRNA gene as a molecular target for diagnosing <em>T. vaginalis</em> infection among reproductive-age women in Erbil city.</p> <p><strong>Methods: </strong>Vaginal swabs and urine samples from 800 women were examined microscopically and by PCR targeting a 368 bp fragment of the 5.8S rRNA gene.</p> <p><strong>Results: </strong>Thirteen samples (1.63%) tested positive microscopically and were all confirmed by PCR, demonstrating 100% sensitivity and specificity.</p> <p>All patients with positive microscopic identification were confirmed using the amplification of a 368bpfragment of 5.8S rRNA gene, acquisition of the accession number from the gene bank (NCBI) under accession numbers (PV935463, PX147457, PX147458, PX147459, PX147460, PX147461, PX147462, PX147463, PX147464, PX147465, PX147466, PX147467, PX218319).</p> <p><strong>Conclusion: </strong>Molecular detection targeting the 5.8S rRNA gene offers a highly sensitive and specific diagnostic tool for <em>Trichomonas vaginalis</em>, supporting its use alongside microscopy to improve detection accuracy in clinical settings.</p>Hawri M. JabbaryZuber Ismail Hassan Hero Mohammad Ismael
Copyright (c) 2026 Hawri M. Jabbary, Zuber Ismail Hassan , Hero Mohammad Ismael (Author)
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2026-08-122026-08-1230257658610.15218/zjms.2026.039Seroprevalence study of IgG anti CagA& IgA anti H.Pylori and their relationship to blood groups in Erbil city
https://zjms.hmu.edu.krd/index.php/zjms/article/view/1401
<p><strong>Background and objective: </strong><em>Helicobacter pylori</em> is a worldwide bacterial pathogen that associated with increasing risk of gastritis peptic ulcer and gastric adenocarcinoma. Especially strains harbor cytotoxin associated gene A (CagA) which classified by WHO in the category of class 1 carcinogen. The study designed to assess seroprevalence of anti-Cag A IgG & anti-<em>H.pylori</em> IgA antibodies among asymptomatic GIT free manifestations among adult & children in Erbil /Kurdistan region. Linkage between seropositive <em>H.pylori</em> infection & ABO blood group, age, gender & smoking, were also verified.</p> <p><strong>Methods:</strong> A total to 369 blood samples were collected from adult & child participant free of Gastrointestinal diseases. The sera were screened for anti- CagA IgG & anti -H pylori IgA antibody using ELISA assay. Further, the samples were subjected to ABO blood grouping using hemagglutination test. The result was statistically analyzed using chi-square test.</p> <p><strong>Results: </strong>Seroprevalence of IgG anti-cagA positivity was 41.5% among adult which was significantly (P <0.001) higher than the frequency among children (22.1%). For IgG anti-<em>H pylori</em>, the prevalence was significantly (P <0.001) higher among adults than children (44.9% vs 14.4% respectively). The seroprevalence of mixedpositive IgG & IgA anti- <em>H pylori</em> antibodies was 28.7% among adults and 13.5% among children (P = 0.002). The rate of IgG & IgA seropositivity was higher among adult & children with Blood-group (O) although no significant association was detected.</p> <p><strong>Conclusion: </strong>The findings of the present study suggest that anti-CagA IgG & Ig A seropositivity may correlate with infection by CagA-positive <em>H. pylori</em> strains, based on serological data alone. Therefore, this marker can be considered a useful non-invasive screening tool when molecular characterization of the CagA gene is unavailable, though direct genotyping the gold standard. Blood group type O was predominant among participant seropositive for anti- CagA IgG antibodies. The alarming finding in this study was the very high titers of anti-CagA IgG (>150) among the screened participant, which might be a risk factor for increased risk of gastric cancer.</p>Khoshawi Mousa KhaleelKani Rast ShawaisSaeed Ghulam Hussain
Copyright (c) 2026 Khoshawi Mousa Khaleel, Kani Rast Shawais, Saeed Ghulam Hussain (Author)
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2026-08-122026-08-1230258760010.15218/zjms.2026.040