Kirkuk Journal of Medical Sciences

Background
Iraq's health-care system has faced tremendous obstacles in its recovery from the Islamic State's conflict. Iraq has set targets to prevent and control noncommunicable diseases (NCDs) such as diabetes, but safety confrontation and governmental insecurity have made these objectives difficult to achieve. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications.The goal is to identify the roadblocks to better glycemic management.The participants in this cross-sectional study were recruited from a diabetes out-patient clinic at Baba Gurgur diabetic facility. From April to December 2019, K1 hospital – North oil company in Kirkuk city. A validated questionnaire was used to interview those with an uncontrolled glycemic index (AIC7%). Patients were asked to name the primary causes of inadequate glucose control and to select more than one response based on their opinion.The mean A1C was 8.3 2.1 percent, with 256 (22.5 percent) patients having an A1C less than 7% and 880 (77.5 percent) having an A1C equal to or greater than 7. Poor glycemic control is caused by a lack of medication and/or a lack of drug supply from PHC in 51.1 percent of cases. Diet and medication non-compliance, as well as illiteracy,. Glycemic regulation is greatly influenced by one's financial situation. However, security issues and political instability play a significant impact.Conclusion: Diabetic patients confirmed poor glycemic control, with the majority of cases being linked to Iraq's current health situation.
key words :- Diabetes Mellitus, Management, and Iraq are.

Background: The most common functional gastrointestinal disorder is irritable bowel syndrome (IBS). food can act a function in stimulation presentations. Using the Rome IV criteria, we calculated the prevalence of irritable bowel syndrome and it’s types amidst Iraqi inhabitance.
Method and patient: A descriptive cross-sectional treatise carried out in the outpatient clinics at two prime Kirkuk infirmary. Between November 2019 and February 2022, a total of 2638 people (1412 men and 1226 women) completed a questionnaire with three sections (sociodemographic, Rome IV, and food constraints). We used appropriateness sampling.

Result: irritable bowel syndrome was documented in 208 people (7.90%), with 52 percent of them having IBSM (mixed) type. Women had a higher prevalence than men (4.90 versus 3.00 %; P value = 0.006). There was a presumed link inter alia having Irritable bowel syndrome presentation and having a minimal revenue (P value = 0.0100) and idle (P value= 0.0001).

Conclusions: Irritable bowel syndrome is less prevalent in Iraqi society. The highest correlations with IBS are female genus, minimal family revenue, plus occupational situation. outlook society treatises can provide a chance to discuss educational varies and diet priorities.

for estimation the prevalence of osteoporosis and osteopenia amidst Iraqi postmenopausal females turning up the Azadi Teaching Hospital's Diabetes and Endocrinology clinic, as well as the relevant venture agents. A descriptive cross-sectional treatise was carried out in a diabetic and endocrinology clinic in Kirkuk, Iraq. An aggregate of 1085 Iraqi postmenopausal females at age 45 to 84 years old were enrolled in this study, which took place between April 2019 and April 2021. The bone mineral density of all patients was measured using a dual-energy X-ray absorptiometry (DEXA) scan. According to World Health Organization recommendations, the DEXA scan was explicated in idioms of T score. Osteoporosis and osteopenia were found to be prevalent in 37.5 percent and 44.6 percent of the population, respectively. The lumbar spine had the highest incidence of osteoporosis (32.40 %), chased via the left femoral neck (14.40 %), and the left femoral neck had the highest frequency of osteopenia (56.10 %), the lumbar spine (41.30 %). Extended menopausal scope, ordinary or overweight BMI, elevated parity, corporal inactivity, affirmative family history of osteoporosis, inconvenient sun exposition, elevated diurnal cafe utilization, low diurnal utilization of calcium, with delayed menarche age were whole linked to osteoporosis. Females with type 2 diabetes, on the other hand, had a decreased incidence of osteoporosis. Iraqi postmenopausal females have a significant frequency of osteoporosis and osteopenia. More generic instruction plus a better publicizing of knowledge about osteoporosis and its prohibition are required

Background : status epilepticus (SE) is a serious complications of cerebral venous thrombosis (CVT). the risk factors associated with SE occurrence and the out come is a debate issue .
Aim of study : To estimate predictives of development of SE in CVT patient, and compare the relative risk of SE in determining death and disability compared with those patients without SE.
Methods : this is a Comparative case sires study of 29 CVT patient were admitted to Al-Yarmook teaching hospital from January , 2019 to march , 2021. Patients were followed up and re-assed at 3 months and 6 months after discharge and outcomes were classified on the basis of modified rankin scale .
Results : of 29 patient with CVT admitted to Al-yarmook teaching hospital 11 Patients (37.9%) had SE . presence of decrease conscious level (GCS ≤8) (p=0.0001) , motor weakness (p= 0.003 ) and supra tentorial brain lesion on MRI (p= 0.0001) specially Hemorrhagic type (p=0.003) all were risk factors to development of status epilepticus and disability were higher in status epilepticus group 3 months after discharge (p=0.006) but after 6 months both status epilepticus and without SE group all had good recovery (p=0.345) .
Conclusion: predictives of SE development were decreased level of consciousness , motor weakness and supratentorial lesion on brain mri specially hemorrhagic type . The presence of SE were associated with higher rate of disability 3 months after discharge but after 6 months all patients achieved good recovery

Abstract

Background: The new coronavirus disease 2019 (COVID-19) pandemic outbreak resulted in millions of co-morbidities and mortalities all over the world. The hyperglycemia with or without diabetes mellitus is prevalent in COVID-19 disease.
Aim of study: To identify the prevalence of hyperglycemia in COVID-19 patients and to evaluate the relationship between hyperglycemia and severity of COVID-19 disease.
Patients and methods: This study is a descriptive cross sectional study conducted in AL-Shifaa 14 Hospital in Kirkuk city-Iraq for duration of six months during the period from 1st of January till 30th of June, 2021 on convenient sample of 250 non-diabetic COVID-19 patients. The diagnosis of COVID-19 disease was confirmed by the supervisor according to clinical symptoms and signs, RT-PCR finding and CT-scan finding. The severity of COVID-19 disease was categorized by the supervisor according to Iraqi Ministry of Health guidelines.
Results: The prevalence of hyperglycemia among COVID-19 patients was (8%). The COVID-19 severity of patients was classified into; mild (27.2%), moderate (13.6%) and severe (59.2%). The means of random blood sugar and HBA1c were significantly increased among patients with severe COVID-19 disease (p

Abstract
Background: Obesity is a recognized risk factor for severe COVID-19, possibly related to chronic inflammation that disrupts immune and thrombogenic responses to pathogens as well as to impaired lung function from excess weight. Obesity is a common metabolic disease; approximately two in three Iraqi adult participants were overweight/obese.
Aim of Study: The aim of this study is to investigate the association between COVID-19 disease severity and obesity among sample of Iraqi patients.
Patient and methods: A prospective observational study included 609 patients with confirmed Covid-19 infection carried out in Azadi and alShifaa14 hospitals and on outpatient cases in Kirkuk city from 1st November2020 to 30 April 2021 through which BMI was calculated for each patient and correlated with severity.
Results: The study showed that majority of patients (77.9%) were overweight or obese., majority of patients (63.5%) were in sever condition, (24.5%) patients were in mild state, and only 2 patients were critical ill. The males gender were associated with more severe cases (p=0.018). The age was associated with more severity (p=0.0001). BMI showed an association with viral disease severity, in which over weight and obese categories were had more severe symptoms (p=0.0001).
Conclusions: BMI showed an association with COVID-19 Disease status, in which overweight and obese categories were had more severe symptoms (p=0.0001). The study revealed that males gender were associated with more severe cases of COVID-19 disease status (p=0.018).

Background: The right ventricular infarction occurs frequently in association with inferior myocardial infarction and occurs separately in rare patterns. It is related to higher morbidity and mortality rates.
Aim of study: To measure the prevalence of right ventricular infarction among patients with inferior wall myocardial infarction and identifying the characteristics related to right ventricular infarction.
Patients and methods: A cross sectional study carried out in Coronary Care Unit of Azadi Teaching hospital in Kirkuk through the period from 1st of January to31st of October, 2017 on convenient sample of 150 inferior wall myocardial infarction patients. The data were collected by publisher through direct interview and filling of a prepared questionnaire.
Results: Right ventricular infarction was present among 39.3% of patients with inferior wall myocardial infarction. There was a highly significant association between older age of self-employed patients with inferior wall myocardial infarction and right ventricular infarction (p

Aim of the study: To estimate the prevalence of triglyceride and high density lipoprotein cholesterol ratio among 100 acute coronary syndrome patients and compared to among a sample of 100 control persons.
Methodology: Blood samples were taken from sample (n=100) of acute coronary syndrome inpatients from coronary care unit, and control (n=100) of non acute coronary syndrome outpatients recorded during the period from 1/7/2013 to 30/11/2013 at Baghdad Teaching Hospital.

The mean triglycerides showed a significant differences in different type groups of patients; the unstable angina patients had the lower triglyceride levels than patients with ST-elevation myocardial infarction and non ST-elevation myocardial infarction types, the mean triglyceride was 187.6 ± 62 mgdl in unstable angina patients , 218.8 ± 63.3 in ST-elevation myocardial infarction patients and it was 219.5± 62.3 in non ST-elevation myocardial infarction patients, P=0.031.The percentage of triglyceride/high density lipoprotein cholesterol ratio (≥5 ) in acute coronary syndrome patients was 58% , while in control persons was 10%.
Conclusion: Hypertriglyceridemia has been found to be an associated risk factor for the development of acute coronary syndrome. Lower concentrations of serum high density lipoprotein cholesterol, has been found to be an associated risk factor for the development of acute coronary syndrome. The ratio of triglycerides to high density lipoprotein cholesterol was found to be an associated risk factor for the development of acute coronary syndrome.

Background: Diabetic retinopathy is one of the main causes of preventable blindness, so early detection and diagnosis play a great role in the management of Diabetic retinopathy.
Aim: To determine the prevalence and risk factors of diabetic retinopathy among diabetic patients.
Method: A descriptive cross-sectional study was conducted among diabetic patients at Baba Gurgur Diabetic Center_K1 Hospital in Kirkuk city from November 2019 to May 2020. The study included 750 patients.
Result: A total of 750 diabetic participants were involved in this study, with 55 years mean of age ranging from 23 to 80 years, 412 (54.9%) were male, and 338(45.1%) were female. A 115 (15.3%) patients were found with signs of Diabetic Retinopathy (Group A ) and 635 ( 84.7% ) with no signs of Diabetic Retinopathy( Group B ), there was no significant relationship between male and female ratio and DR increases significantly with age.
There was a significantly high level of mean HbAc1 (10.3 ) among the DR group in comparison to (8.5) in the non-DR group. Also, hypertension and smoking play a role in developing DR.
We noticed significant relation between type I diabetes and the prevalence of Diabetic Retinopathy.
Conclusion: Affair prevalence of Diabetic Retinopathy among Iraqi diabetic patients. High levels of HbA1c, hypertension and, smoking are strongly correlated with diabetic retinopathy. Our findings support enhanced governments' and healthcare providers' efforts in Iraq to ensure DR diagnosis and treatment and greater control of variables correlated with it.

Background: acute myocardial infarction (acute MI) in young age population is characterized by bad prognosis. Many modifiable risk factors for acute myocardial infarction in young age population are reported.
Aim of study: To measure the prevalence of acute MI among young age population and identifying the common risk factors related to acute MI in young patients.
Patients and methods: This study is a clinical follow up prospective study conducted in Coronary Care Unit (CCU) of Azadi Teaching Hospital and Kirkuk General Hospital in Kirkuk city through the period from 1st of June to 30th of November, 2018 on convenient sample of 250 patients with acute MI . The patients were categorized into two groups; young age (