Vol 28, No 3 (2024)

Background and objective: Symptomatic benign prostatic hyperplasia (BPH) results in several symptoms including the lower urinary tract symptoms. Consequently, BPH may affect the bladder and finally the kidneys. There are various pharmacological options for the treatment of BPH including 5-Alpha Reductase Inhibitors (5-ARIs) (finasteride or dutasteride). Recent researchers have demonstrated that using 5-ARIs for treating BPH may have unfavorable adverse effects. Therefore, this study aimed to compare finasteride and dutasteride in terms of their efficacy, safety, and adverse effects.

Methods: This retrospective cohort study included 170 patients, 77 patients who received finasteride and 93 patients who received dutasteride, the data obtained retrospectively from medical databases and file sheets were reviewed and selected according to inclusion and exclusion criteria followed by the comparison between two groups regarding baseline characteristics, prostate volume and the incidence of adverse effects.

Results: Similarity observed between two groups at baseline characteristics. Statistically, no significant differences were identified between dutasteride and finasteride in the reduction of prostate volume. However, dutasteride and finasteride significantly reduced prostate volume at 1-year follow-up. No significant differences were observed between two agents regarding the incidence of adverse effects.

Conclusion: Finasteride and dutasteride improved lower urinary tract symptoms (LUTS) at one-year follow-up by reducing prostate volume. The incidence rate of adverse effects for finasteride and dutasteride was similar over one year.

Background and objective: The benign renal mesenchymal tumor, angiomyolipoma (AML), consists of smooth muscle, fat and blood vessels, representing (1–3%) of the solid renal tumors. The most common type of benign renal tumors is accounting about (0.3–3%) of all kidney masses. AMLs are asymptomatic in general and found incidentally via routine imaging procedures and are seldom symptomatic. This study aimed to evaluate incidental findings of Angiomyolipoma by ultrasound in relation with CT findings in Erbil province.

Methods: This descriptive cross-sectional study was conducted at the Rizgary Teaching hospital from March 2021 to April 2022. Review of ultrasound reports and CT scans data were collected from 61 patients with renal masses who attended to the public and private hospitals in Erbil province during the study period. The patients were older than 25 years in age.

Results: The results showed that female of middle age were predominant among AML patients in the study. By using CT technique, 92.6% of females scored as hypoattenuating AML, and 88.5% of the AMLs were hyperdense or hyperattenuating by using CT technique. The results also revealed that 93.4% of AML cases were hyperechoic by Ultrasound technique, while 6.6% of the fat-poor were hyperechoic by using the Ultrasound technique.

Conclusion: It can be concluded that female of middle age were predominant among AML patients, and CT technique is more accurate and sensitive in the diagnosis of AML cases.

Background and objective: Idiopathic pulmonary fibrosis (IPF) is a deadly lung illness characterized by progressive lung fibrosis and deteriorating lung function, with the uncertain origin and few therapeutic options. Chemotherapy such as Irinotecan (IRI) is the major antineoplastic agent that produces IPF and induces lung damage. N-acetylcysteine (NAC) has a glutathionepre cursor that protects lung function. The present study was designed to evaluate the protective effects of N-acetylcysteine in Irinotecan induced lung toxicity.

Methods: In total, 18 female Albino rats were divided into three groups, aging from 8-12 weeks and weighing between 180-250 g. The control group G1 received 1 ml intraperitoneal (IP) normal saline for 14 days, G2 Irinotecan group was administered a single high dose of Irinotecan (300 mg/kg) intraperitoneal instillation. And G3 N-acetylcysteine group (500 mg/kg/day) orally one week before Irinotecan (300 mg/kg) injection continued to the end of 21 days of the experimental period. Histopathology, cell counts, cytokine responses in the serum (TGF-β, TNF-α, and IL-6), and weight measurements were studied to evaluate the protective effects.

Results: Histopathological study indicated the Irinotecan–induced pulmonary fibrosis with a significant increase in the levels of inflammatory cytokines, and the protective impacts of N-acetylcysteine administration attenuated the degree of inflammation and fibrosis with a reduced level of cytokines concentrations in serum.

Conclusion: N-acetylcysteine can protect the lungs from both histological alterations and activation of cytokines caused by pulmonary toxicity induced by Irinotecan.

Background and objective: GATA3, an emerging immunohistochemical marker, is a zinc finger transcription factor that is expressed in normal urothelial epithelium and its corresponding neoplasms, and it has been recognized as a reliable urothelial related immunohistochemical marker. This study aimed to detect the frequency of GATA3 expression in urothelial carcinoma of urinary bladder and determine its association with some clinicopathologic parameters.

Methods: Seventy-nine formalin fixed paraffin embedded blocks of urothelial carcinoma cases were randomly selected from a private laboratory in Erbil city during October 2019 to October 2021. In this study, GATA3, a Rabbit monoclonal antibody was applied on urothelial carcinoma cases and its expression was assessed.

Results: GATA3 was expressed in 94.9% of the study cases. It was expressed in all non-invasive and low-grade urothelial carcinoma cases and 97.1% of papillary urothelial carcinoma cases, while it down-expressed in high-grade, invasive and non-papillary urothelial carcinoma cases. A significant association was noted between GATA3 expression and tumor pattern (P = 0.034), while no significant association was noted between GATA3 expression and other clinicopathologic parameters like age, gender, tumor grade, lympho-vascular invasion and tumor stage.

Conclusion: GATA3 is a useful diagnostic immunohistochemical marker for urothelial carcinoma, as this marker was expressed in 94.9% of urothelial carcinoma cases with a significant association with tumor pattern. Further studies are required to evaluate GATA3 expression in association with urothelial cancer progression and metastasis.

Background and objective: Renal transplantation for patients with end-stage renal disease gives better long-term survival results and a better quality of life in comparison with maintenance dialysis. However, some general and urological complications may occur following kidney transplantation. One of those complications is ureteral stricture, but the harm of renal transplant can be avoided when treated in an accurate and timely manner. This study is carried out to determine the incidence of ureteral stricture of renal transplantation, and to appropriately diagnose and treat the conditions.

Methods: A retrospective study extended from July 2011 to February 2021. In this period, 1840 renal transplant performed by our team in Rizgary teaching and Zheen international hospitals, all from living donors.

Results: Among 1840 kidney transplant surgery, 17 patients were only admitted as ureteral stricture post-transplant operation (0.92%) that diagnosed by high serum creatinine in association with hydroureteronephrosis. Hydronephrosis subsided and renal function tests nearly normalized after drainage of transplanted kidney with percutaneous nephrostomy tube. Anastomosis site stricture was observed in 16 patients (94.1%), they were treated by ureteral re-implantation. DJ-stenting and upper ureteric stricture was observed in only one patient (5.9%) that treated through pyeloplasty technique.

Conclusion: Surgical treatment is the best choice of patients with ureteral stricture, post renal transplantation. For low grade stricture, endoscopic treatment may be offered although the rate of success is not high.

Background and objective: Accurate estimation of the fetal gestational age is the cornerstone for the management of all pregnancies. This study aims to assess the accuracy of Trans cerebellar diameter in comparison with the other previously established fetal biometric parameters in the second and third trimesters.

Methods: This is a prospective study conducted on 237 pregnant women who attended Erbil Maternity Teaching Hospital and a private clinic from January 2021 to July 2022.

The ultrasound of selected cases was performed on GE Voluson E6 and E8 ultrasound machines with a 3.5 MHz probe sector transducer.

Trans cerebellar diameter measurement was obtained by placing the electronic calibers from the outer portion of the proximal end of the cerebellum to the inner portion of the distal margin. Biparietal diameter, femoral length, head circumference, and abdominal circumference were measured using the standard technique by Hadlock tables. Data were tabulated and all the statistical analyses were done using SPSS version 26.

Results: The mean trans cerebellar diameter during different gestational ages was 19.95 (±1.2) mm between 18-22 weeks gestation, 25.45 (±1.7) mm between 23-28 weeks gestation, 29.79 (±1.15) mm between 29-32 weeks gestation, 34.29 (± 1.13) mm between 33-36 weeks gestation and 36.79 (±1.7) mm above 37 weeks gestation respectively. Differences between the estimated gestational age and the gestational age assessed by trans cerebellar diameter ranged from -7 to 6 days irrespective of the gestational age.

Conclusion: Even in the third trimester trans cerebellar diameter is a fairly accurate and better predictor of gestational age in comparison to other ultrasound parameters such as biparietal diameter, head circumference, abdominal circumference, and femoral length.

Background and objective: Neural tube defect is a serious congenital anomaly associated with lifelong disability, mortality and morbidity; it consists of heterogeneous group of disorders affecting brain and spinal cord. This study aimed to test the efficacy and accuracy of the intracranial translucency (fourth ventricle) in diagnosing open spina bifida.

Methods: A diagnostic prospective convenient study of intracranial translucency and open spina bifida was conducted in the Maternity Teaching Hospital / Erbil city, Kurdistan region /Iraq from the Feb 2021 till June 2022. The study included 200 pregnant women attended maternity teaching hospital for routine first trimester scan (11 wk -13 wk+6d) using a convenience method. Ultrasound examinations were performed using general electric (GE) ultrasound machine. The fetuses were classified into two groups; those fetuses which have clear visible intracranial translucency on ultrasound examination by the radiologist, and in the other group, the intracranial translucency was not clearly seen.

Results: The two studied groups were comparable in crown-rump length, number of pregnancies, number of children, maternal age, and maternal weight. Intracranial translucency was seen in 196 out of 200 (98%) and was not visible in 4 cases out of 200 (2%).

Conclusion: The intracranial translucency was considered a good sonographic marker with high accuracy and sensitivity in diagnosing cases of OSB among 11-13⁺⁶ weeks pregnant women.

Background and objective: Since the beginning of the medical practice, headache was considered both a therapeutic and a diagnostic challenge. According to the ranking that was made by the global burden of diseases collaborative network for causes of disabilities, headache was considered the fourth for both males and females. The aim of the study was to evaluate the findings of MRI among headache patients.

Methods: A cross-sectional study was conducted from 1^st of Nov. 2021 till the 1stof June 2022. A convenient sample was collected from referred patients to outpatient clinic in Rizgary Teaching Hospital. The cases were diagnosed by a specialist in internal medicine and then referred for further MRI evaluation. The data analyzed using IBM SPSS (statistical package of social science) version 25. The data was summarized by descriptive statistics. The measures of central tendency and dispersion were calculated. The mean of age differences was calculated by t-test. The associations between categorical variables were found by Chi-square test. The P value was considered significant if it was ≤ 0.05.

Results: Out of 150 patients, 70% were females and only 30% were males with male to female ratio of. 0.43:1.73.3% of females in primary group had normal MRI findings and 84.4% of males had abnormal findings in the secondary group. The difference was statistically significant (P-value <0.001). The mean age ± SD for males was 45.2 ± 9.3 and the mean age for females was 37± 9.8. The difference between means was significant (P = 0.018). In MRI findings 56% (84 out of 150) of patients were normal, followed by sinusitis (28%), (3.3%) cerebral tumor,0.6% had pituitary mass and 0.6% diagnosed as meningitis.

Conclusion: The low rate of positive findings in our study supports the need for an evidence-based guideline for neuroimaging in this health care setting. Future studies are recommended to investigate other physicians’ reasons for using neuroimaging techniques as a routine investigation for headache patients.

Background and objective: commonest fracture of pediatric elbow is the fractures of supracondylar of humerus. Gartland type II and type III Management is preferably operation, either with closed reduction and K. wire pinning or with open reduction and K. wire fixation. Some of the patients will get post-operative complications including Malunion. The aim of this study is to sort out the incidence of malunion in management of fractures of supracondylar in children by closed reduction and K. wire pinning versus open reduction-lateral approach and K. wire pinning.

Methods: Forty nine children were included, who had Gartland type II and Type III Supracondylar fractures and underwent operative management, been enrolled using convenient sampling method. Patients are followed up after 12 weeks. During the review, assessment of the patient done for possible complications postoperatively and measured any possible change of degrees of carrying angle and movement loss at the elbow considering malunion complication.

Results: 12% of the patients who are treated with close reduction and K. wire pinning developed malunion, while none of the patients who are treated with open reduction-lateral approach and K. wire pinning developed malunion.

Conclusion: Incidence of malunion after treatment of supracondylar fracture of humerus in children with close reduction and K. wire pinning is more than the incidence by open reduction-lateral approach and K. wire pinning.

Background and objective: Salmonella typhi is the causative agent of enteric fever while Salmonella enteritidis causes gastroenteritis. Lytic bacteriophages can be applied as biocontrol agents to prevent Salmonella infections. The purpose of this study was to prepare a proper Salmonella phage therapy candidate to be used against pathogenic Salmonella enteritidis and Salmonella typhi.

Methods: We used clinical isolates of Salmonella typhi and Salmonella enteritidis as host bacteria, to isolate Salmonella-specific phages from raw sewage water in four locations (Bahrka, Farmnbaran neighborhoods, Korey and Shaqlawa towns) in Erbil district. We assessed the efficacy of this phage as a biocontrol agent against Salmonella enteritidis in-vivo using four groups of 8 pathogen-free duck chicks. A group was kept as uninfected control while the other three groups were artificially infected with a clinical strain of Salmonella enteritidis. Two of the infected groups were treated by oral administration of phage suspension using two different doses of Salmonella enteritidis phage (7 and 12 Log10 Plague Forming Unit respectively). To compare the bacterial growth dynamics among the infected groups, one group was kept untreated.

Results: We found that the four sewage samples contained bacteriophages for the two bacterial isolates with different plaque diameters and morphology. Salmonella enteritidis phage isolates collected from the Farmanbaran neighborhood showed the best lysing efficacy in-vitro hence it was selected to be tested in-vivo experiment. Phage-treatment significantly reduced the colonization burden of Salmonella enteritidis in feces and cecum contents of the experimentally infected chicks.

Conclusion: These results suggest that using Salmonella phage could be a good agent to control Salmonella.

Background and objective: Many physiological, hematological, biochemical and metabolic changes can be associated with pregnancy. Changes in carbohydrate and lipid metabolism occur during pregnancy to ensure a continuous supply of nutrients to the growing fetus. The present study was undertaken to evaluate the influence of duration of pregnancy in term of trimester on glucose and lipid metabolism.

Methods: This study was cross – sectional study comprised 62 women. The study population was classified into four groups, non-pregnant (14), first trimester (16), second trimester (16) and third trimester (16). The resulting Sera were analyzed at the same day of sampling for the determination of FBS and serum lipid profile in DNA medical lab.

All data are expressed as mean ± SD. Differences between mean levels of fasting blood sugar and lipid profile of the four groups were evaluated statistically using students’ t-test. A value of P <0.05 was considered statistically significant.

Results: Mean of BMI, FBS, TG, TC and LDL in the 3^rd trimester pregnant group were significantly higher than non-pregnant group (P = 0.002), (P = 0.025), (P <0.001), (P = 0.021) and (P = 0.034) respectively. Mean of TG in the 3^rd trimester group was significantly higher than that in 1^st and 2^nd trimester groups (P <0.001) respectively.

Conclusion: Lipid profile and blood glucose is variable during each trimester of a normal pregnancy. Total cholesterol, triglycerides and LDL-cholesterol increased in both second and third trimester. The estimation of lipid profile is highly recommended during pregnancy.

Background and objective: The burden of morbidity and mortality caused by the complications of acute and chronic hyperglycemia is rising along with the prevalence of diabetes mellitus in the world. About 50% of diabetic patients will eventually develop neuropathy. In particular, the abducens, oculomotor, and trochlear nerves, which supply the extraocular muscles, are affected by the most common diabetic cranial mononeuropathies. This study is to determine the prevalence, risk factors, and main treatment options for ocular motor nerve palsy in diabetes individuals.

Methods: During the period from 1^st of August 2021 to 31^st of March 2022, a cross-sectional study was conducted in the Ophthalmology Department/ Rizgary Teaching Hospital and Erbil Teaching Hospital. A convenient sample of 500 patients who were diagnosed with diabetes was enrolled in the current study.

Results: Out of the 500 patients, 6 (1.2%) had oculomotor nerve palsy, of them, 2 (33.3%) had ptosis, 4 (66.6%) had diplopia, and 2 (33.3%) had pain. Trochlear nerve palsy was diagnosed in 2 (0.4%) of the patients. Of them, 2 (100%) had diplopia. Only one patient was diagnosed with abducent nerve palsy and presented with diplopia. Diabetic retinopathy was diagnosed in 31.3%.

Conclusion: The prevalence of ocular motor nerve palsy was low among diabetic patients in the current study but it was higher than recorded in other studies. Many factors including occupation, smoking, alcohol, hypertension, hyperlipidemia, cerebrovascular disease, Aspirin use, duration of diabetes, and presence of diabetic retinopathy can affect the prevalence of ocular motor nerve palsy.

Background and objective: Infertility is defined as not getting pregnant after 12 months of unprotected sex for women under 35 or 6 months for those over 35. Ten to fifteen percent of couples struggle to conceive. All cases of infertility are evaluated; however, evaluations should be conducted sooner if there is a male factor or if the female has endometriosis, tubal illness, oligomenorrhea, or amenorrhea. Investigation includes an assessment of ovulatory function, ovarian reserve, uterinecavity, tubalpatency, and a semen analysis, diagnostic laparoscopy, hormone levels estradiol, the number of ovarian antral follicles have role in successful pregnancy in IVF cycles. It is generally known that a particular quantity of estradiol per follicle is necessary for pregnancy to occur. The purpose of this study was to evaluate the effects of IVF on the normal level of E2 in follicular day (12.5-166 pg/ml) and ovulation day (85.5-498 pg/ml) in relation to the estradiol level.

Methods: Because it depended on a few indications (questionnaire), the retrospective study of 50 infertile women at the YAD infertility center in Erbil, Kurdistan Region, Iraq, was analyzed.

Results: In this research the median age was 33 years, and their mean age (SD) was 32.6 (5.9) years. Their average body mass index was ≥ 30 at 28%, although their rate was 34%.Over 38% of women have no history of pregnancy, which is also more common in multigravidas than in primigravidae. In contrast, 23% of nulliparous women are infertile, and 46% of infertile women are nulliparous compared to primiparous and multiparous women. While the success rate was highest for the type of oocyte (M II) (89.7%) compared to 65% for the other types, the mean estradiol level on day 2 of the cycle was 46.9%, and the mean estradiol level on the day of HCG administration was also higher among women with successful biochemical pregnancies than those with failed pregnancies.

Conclusion: The estradiol 2^nd day of cycle and the trigger day was found to have influence on IVF success.

Background and objective: Changes in peripheral blood parameters are commonly seen in physiological, stressful and pathological conditions. The aim of this research was to study the abnormalities in hematological parameters of the blood donors in Duhok blood banking center.

Methods: This study was carried out at Duhok blood banking center, from 20th February, 2022, to July 1, 2022. The study included 1168 adult blood donors of both genders. A Complete blood count was performed by a three-part hematology analyzer and hematological parameters (Hb, HCT, PLT, WBC) were obtained from 1168 random blood donor samples. Open Epi program was used for data analysis; statistical significance was set at P <0.05 and 95% CL was accepted.

Results: Out of 1168 donors, 243 donated for the first time and 925 donors were repeated donors and 1148 (98.29%) were male with females constituting only 20 (1.71%) of all donors. The donors’ age was between 18 and 68 years. Age is generally divided into five groups G1= (< 20 years) and G2= (20-29 years), G3= (30 -39 years), G4= (40- 49 years) and G5= (> 50 years). Most of the donors (31.21%) were in the age group (30 – 39 years) meanwhile the deferral rate was higher in this age group.

Conclusion: It is evident from this study that abnormalities in hematological parameters are frequently seen amongst the blood donor population and frequently contributed to donor deferral and there is a need to maintain and keep hematology analyzer in the donor acceptance criteria.

Background and objective: Pseudoexfoliation syndrome is a systemic disorder related to age mostly affects the anterior structures of the eye. It is characterized by increased production and accumulation of abnormal fibrillar material inextraocular and intraocular tissues. There was a variation in the prevalence of pseudoexfoliation syndrome in diabetic patients compared with non-diabetic patients. The aim of the study is to estimate the prevalence of pseudoexfoliation syndrome among diabetic patients in a sample of the Iraqi population and evaluate the impacting factor that affects this prevalence

Methods: A cross-sectional study was conducted in the Ophthalmology Department/ Erbil Teaching Hospital during the period from 1st of August 2021 to 31st of March 2022. A convenient sample of 100 patients with an age of ≥50 years old and who were diagnosed with type 2 diabetes were enrolled in the current study. The questionnaire included sociodemographic characteristics of the patients (age, gender, smoking, and alcohol state), past medical history and investigations (duration of diabetes mellitus and HbA1c), and the results of the ophthalmologic history and examination including intraocular pressure, presence of diabetic retinopathy, and the presence of pseudoexfoliation syndrome

Results: About 52% of the patients were aged 50-59 years, while 9% had an age of ≥70 years. The prevalence of pseudoexfoliation syndrome was 9%. While diabetic retinopathy was presented in 37%. The prevalence of glaucoma was 12%. There was a significant association between pseudoexfoliation syndrome incidence and increasing the age of the patients, the highest prevalence was among patients with ≥70 years (P = 0.001). The pseudoexfoliation syndrome was significantly associated with diabetic retinopathy, the presence of glaucoma, and diabetic duration (P-values were 0.001, 0.001, and 0.026, respectively). In addition, the mean intraocular pressure was significantly higher among those with pseudoexfoliation syndrome than patients without pseudoexfoliation syndrome (P = 0.001)

Conclusion: The prevalence of pseudoexfoliation syndrome in diabetic patients was 9%. The duration of diabetes, diabetic retinopathy, glaucoma, and the age of the participants significantly impacted the prevalence of pseudoexfoliation syndrome.

Background and objective: The Schiff base compound is formed by the condensation reaction of a primary amine with aldehydes or ketones to form the azomethine group RCH=N-R. This study aims to synthesize some new compounds as Schiff bases from amlodipine derivatives and study their biological activity.

Methods: Ether derivatives of benzaldehyde were synthesized using the Williamson ether synthetic method to react with 3-O-ethyl 5-O-methyl 2-(2-aminoethoxymethyl)-4-(2-chlorophenyl)-6-methyl-1,4-dihydropyridine-3,5-dicarboxylate (amlodipine). Another type of Schiff bases was synthesized from some derivatives of benzaldehyde without the ether group.

Results: The series of Schiff base compounds (6a–k) were obtained from the reaction of benzaldehyde derivatives (5a–k) with amlodipine (4). IR, ¹H-NMR, and ¹³C-NMR spectroscopy were used for the characterization of the synthesized compounds. The antibacterial activities of both types of Schiff base compounds against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli were compared.

Conclusion: All of the synthesized ether derivatives (6a–f) showed more antibacterial activity than the derivatives of benzaldehyde (6g–k), and all of the synthesized compounds were more active against Gram-negative bacteria (Escherichia coli) than Gram-positive Staphylococcus aureus.

Background and objective: Prostate cancer is the third most common cancer in men in Iraq. We aimed to study the epidemiology, clinical and histopathological characteristics of prostate cancer in Erbil city.

Methods: The research was performed retrospectively at Nanakali Teaching Hospital and the Oncology Department of Rizgary Teaching Hospital in Erbil city, covering the period from 2016 to 2021. Comprising 212 people diagnosed with prostate cancer.

Results: The median age of the patients was 71 years. The proportion of patients who present with urinary tract symptoms, no symptoms and other were 81.6%, 4.7% and 13.7% respectively. Two hundred eight prostate cancer patients with available histopathological data had adenocarcinoma and two patients had neuroendocrine carcinoma and one patient had urothelial cancer. The proportion of patients with high grade tumor, intermediate and low grade were 61%, 29% and 10% respectively. While, the percentage of patients with TPSA level > 20 ng/ml, TPSA >100 ng/ml were 80% and 35% respectively. Furthermore, the proportion of patients with stage IV, III, II and I were 62.7%, 17.9%, 17.9% and 1.4% respectively. And, the percentage of high-risk groups, intermediate and low risk were 90.1%, 8% and 1.9% respectively. After correlation of TPSA with stage of disease and grade of tumor there was statistically positive correlation between them.

Conclusion: Patients diagnosed with prostate cancer in our region are more likely to belong to the high-risk category, exhibiting aggressive disease and advanced stage at the time of diagnosis. Nevertheless, they exhibit comparable demography and epidemiology as shown in the recent international literature about the global population and the Middle East region.

Background and objective: The quickest growth in the field of ophthalmology are intravitreal injections. Age-related macular degeneration, diabetic retinopathy and occlusive venous disease associated macular oedema include the most frequent indications of injections. Antiangiogenic agents are the most common injections. The aim of this study is to determine intraocular pressure changes following intravitreal injections between phakic and pseudophakic eyes.

Methods: A hospital based prospective cross-sectional study involved 50 patients divided into two groups; 27 phakic patients marked as group A, while 23 pseudophakic patients as group B. The study conducted in ophthalmology department of Erbil Teaching Hospital in Erbil city from July 2021 till April 2022. The participants were recruited from the outpatient clinic and planned for intravitreal anti-VEGF / aflibercept (EYLEA®) injection.

Results: The mean intraocular pressure difference pre-injection and six hours after single injection was -0.59 ± 1.21 and -0.65 ± 1.19 mmHg (higher in the post injection period) for group A and B respectively. This difference was statistically significant (P value was 0.018 and 0.015) for both group A and B respectively. The intraocular pressure levels reduced slightly after twenty-four hours following injection; the difference in intraocular pressure level between 6 hours and twenty-four hours was statistically significant for the phakic group (P value of 0.29) but insignificant for the pseudophakic group (P value of 0.056).

Conclusion: The status of the lens either being phakic or pseudophakic has no implication on intraocular pressure after intravitreal anti-VEGF injection. There was a statistically significant short-term increase in intraocular pressure in both groups after six hours of intravitreal injection.

Background and objective: The Sub-fecundity and infertility are both enhanced by obesity. Regardless of the method of conception, obese women have less favourable reproductive results, and poorer fertility prognosis. One of the main reasons for infertility is polycystic ovarian syndrome (PCOS). The purpose of this study is to determine how obesity and polycystic ovarian syndrome affect fertility in women of reproductive age.

Methods: A cross-sectional study was performed at a maternity teaching hospital in Erbil, Kurdistan Region, Iraq. It comprises 400 women: 200 with a BMI of 30 or above and 200 with a BMI between 18 and 24. From January 1, 2021, until December 31, 2021.

Results: The average age of the enrolled women was 29.9 years. The majority (81.5%) were under 30 years of age, and (70.6%) were classified as overweight. In the obese group, 55% of women had never experienced pregnancy. A greater percentage of the obese group had no history of miscarriage in comparison to the non-obese group. The obese group exhibited a significantly higher prevalence of hirsutism (59%) compared to the non-obese group (39.5%). Infertility rates varied from 84% in the obese group to 38.5% in the non-obese group. In contrast to 44.5% of non obese women, the ultrasonographic findings indicated that 60% of obese women displayed PCOS morphology.

Conclusion: Obesity has effect on the occurrence of sub-fertility and polycystic ovary syndrome at all reproductive ages.

Background and objective: Toxoplasmosis is a zoonotic disease that can cause a wide spectrum of clinical diseases. This study aimed to investigate the association between toxoplasmosis and rheumatoid arthritis among patients, besides, to confirm the role of Toxoplasma gondii in the enhancement and modulation of autoimmune diseases such as rheumatoid arthritis.

Methods: A cross-sectional study was implemented from August 2021 to February 2022, in which blood samples were taken conveniently from a total of 180 patients from both genders and different ages (15-60 years). These patients attended Zakho General Hospital and some private clinics suffering from symptoms related to rheumatoid arthritis. All samples were tested for Toxoplasma gondii immunoglobulins G and M (IgG, IgM) antibodies, C- reactive proteins (CRP), rheumatoid factor (RF), and erythrocyte sedimentation rate (ESR).

Results: The total seropositivity of anti-Toxoplasma gondii IgG and IgM Abs using ELISA were 13.9% and 3.9%, respectively. Furthermore, the highest rate (16.4%) of IgGAbs was recorded among the male group, while, the highest rate (4.8%) of IgMAbs, was recorded among the female group. Furthermore, the highest rate of IgG, and IgM Abs were recorded among the age group 46-60 in both genders (20%, 5.7% respectively). In addition, the statistical analysis demonstrated the presence of significant relationship between IgG Abs with CRP and RF test results (P = 0.027, 0.039 respectively). Whereas, concerning ESR only seropositive IgM Abs results were statistically significant (P = 0.049).

Conclusion: Toxoplasmosis may influence the immune system and act as a contributing factor in the exacerbation of autoimmune illnesses, including rheumatoid arthritis. Subsequent investigations will be essential to delineate the risks of T. gondii within the human population.