Morphological study for Accipitrid birds (Accipitridforms, Accipitridae) in Iraq; part two.

A part two of Accipitridae Family members that belong to three genera: Circus, Gyps, and Neophron were documented as morphometrics, distribution ranges, and conservation status were reviewed and comprehensively discussed. A total of 29 voucher specimens belong to six species which are conserved in the "Iraq Natural History Research Center and Museum INHM" as follow: Marsh Harrier Circus aeruginosus (Linnaeus, 1758), Hen Harrier Circus cyaneus (Linnaeus, 1766), Montagus Harrier Circus pygargus (Linnaeus, 1758), Pallid Harrier Circus macrourus (Gmelin, 1770), Egyptian vulture Neophron percnopterus (Linnaeus, 1758), and Griffon vulture Gyps fulfus (Hablitz, 1783). The results revealed significant criteria about near threatened NT species IUCN and Birdlife International listed as Pallid Harrier Circus macrourus, and Endangered (EN) species as Egyptian vulture Neophron percnopterus globally decreasing population trend.

Assessment of land degradation susceptibility within the Shaqlawa subregion of Northern Iraq-Kurdistan Region via synergistic application of remotely acquired datasets and advanced predictive models.

Land degradation (LD) is the decline in a land's functional capacity and productive potential, which includes various anthropogenic and natural drivers. This study focuses on three primary manifestations of LD including soil erosion, landslides, and rockfalls, which are the most prevalent in the Shaqlawa district. A set of 22 LD conditioning factors, encompassing curvature, lithology, aspect, river density, soil type, lineament density, river distance, elevation, road distance, length slope (LS), land use land cover (LULC), stream power index (SPI), valley depth, profile curvature, slope, solar radiation, road density, lineament distance, rainfall, topographic wetness index (TWI), plan curvature, and normalized difference vegetation index (NDVI), were integrated into the analysis. Variance inflation factors (VIF) and tolerance (TOL) values from linear regression indicate that most LD factors have acceptable levels of multicollinearity. The Information Gain Ratio (IGR) identified key variables TWI, NDVI, and lithology-as pivotal factors for predicting LD. Additionally, the study evaluated degradation factors using various machine learning (ML) algorithms, including random forest (RF), Naive Bayes, logistic regression, rotation forest, forest penalized attributes (FPA), and Fisher's Linear discriminant analysis (FLDA). This facilitated categorizing the study area into five susceptibility categories. The FLDA model categorized the highest area under very high degradation risk at 26.72%, emphasizing the varied insights each algorithm brought to characterizing the degradation risk. Additionally, the receiver operating characteristic curves (ROC) were employed for model validation, identifying RF as the most successful model in the training dataset with an area under the curve (AUC) of 0.882, while FLDA outperformed in the testing dataset with an AUC of 0.883. The identified LD-prone areas will help land-use planners and emergency management officials apply effective mitigation strategies for similar terrains.

EVALUATION OF PROTEIN C AND S IN Β-THALASSEMIA MAJOR.

Beta-thalassemia major is a genetic disease characterized by formation of little or no beta-globin chain, leading to premature death of red blood cells and hence to ineffective erythropoiesis. Aim of this study to evaluate Protein C and Protein S in patient with beta-thalassemia major and its correlation with haemoglobin, serum ferritin, D. dimer, prothrombin time and liver enzymes. METHOD: Study is a case control, for patients with beta-thalassemia major at Ibn Al-Atheer Hospital in Nineveh Province in Iraq during a period from July 2022 to November 2022. A total of (70) patients diagnosed as ß-thalassemia major, from 5 to 40 years old presented at thalassemia center. A total of (30) normal persons, age and sex matched to the patients. Complete blood count, Protein C, Protein S, Pro-thrombin time, Ferritin, D. dimer, Aspartate aminotransferase, Alanine aminotransferase, done for all patients and control. RESULT: Protein C and protein S were significantly lower in patients with ß-thalassemia major in comparison to control. Prothrombin time was significantly prolonged in patients with ß-thalassemia major. D. dimer was significantly increase in ß-thalassemia major than control. Protein C and protein S level were significantly higher in cases with frequent blood transfusion than in those with non -frequent patient. Prothrombin time and D. dimer also significantly elevated in patients with non-frequent transfusion. CONCLUSION: These findings suggest that patients with ß-thalassemia major may be at a higher risk for coagulation abnormalities and should be closely monitored. Further research is needed to better understand the relationship between ß-thalassemia major and coagulation parameters.

Immunological and cytokine profile (IL-25 and IL-35) in patients with Entamoeba histolytica infection in Southern Iraq.

Amoebiasis is an intestinal disease caused by a unicellular parasite called Entamoeba histolytica. Interleukin-35 (IL-35) is the youngest specific member of the IL-12 family that plays a major role in the inhibitory function of regulatory T cells (Tregs) to curb inflammatory responses. IL-25 of the IL-17 family, which is widely released by Th2 cells and epithelial cells, is a warning signal produced upon cell or tissue injury to activate immune cells. The present study aimed to determine the cytokine profile (IL-25 and IL-35) in patients with E. histolytica infection in southern Iraq. This hospital-based study was conducted from August 2022 to May 2023. The study participants were patients with E. histolytica infection admitted to the infection department of general hospitals in Thi-qar province, southern Iraq. Initially, E. histolytica amebiasis was detected in the patients by nested multiplex PCR. All collected sera were tested with the Human Interleukin 35 (Biotech, China, Cat.RD-IL35-Hu) and IL25 (Biotech, China, Cat.RD-IL25-Hu) ELISA kits according to the instructions of the manufacturer. A total of 80 patients, including 50 patients with E. histolytica infection and 30 subjects in the control group without E. histolytica infection, were enrolled in the present study. The results showed a significant difference (p<0.001) in the serum level of IL-25 in patients with E. histolytica infection (4275.19 pg/mL) compared to individuals in the control group without E. histolytica infection (2186 pg/mL). Statistical analysis showed that there was no significant difference in the serum levels of IL-35 patients with E. histolytica infection compared with individuals in the control group without E. histolytica infection. The results of the present study show that the level of IL-25 is high in patients with E. histolytica infection. This indicates the important role of IL-25 in the activation of the immune system during intestinal inflammation. Therefore, this cytokine can be used as a diagnostic marker for E. histolytica infection.

Prevalence of Trichomoniasis and Vulvovaginal Candidiasis among Married Women in Duhok City, Kurdistan Region, Iraq.

Trichomonas vaginalis and Candida spp. are the most common causes of vaginal infections among reproductive-age women. T. vaginalis is a sexual protozoa parasite that causes trichomoniasis. Candida spp. are fungal and cause infection in the female genital tract named candidiasis. Both microorganisms if not treated correctly may lead to various complications, such as abortion, premature delivery, disorders of menstrual cycle, and infertility. The current study aimed to study the frequency of infections with T. vaginalis and Candida spp., including C. albicans, C. krusei, and C. glabrata, among females with vaginal infection in Duhok City, Kurdistan region, Iraq. A total of 400 vaginal swabs were collected from women with vaginal infections that attended the Vin Private Laboratory (n=250) and Arveen Private Laboratory (n=150). Out of these 400 vaginal swabs samples, 24 samples were recorded positive for T. vaginalis by direct smear and 100 samples for candidiasis by culturing on the CHROMagarTM Candida. Three species of Candida were isolated, namely C. albicans, C. krusei, and C. glabrata, and their prevalence rates were obtained at 60.9%., 28.25, 7.3%, and 3.6%, respectively. Vaginal infection was commonly found in the age group of 25-35 years (49.6%), followed by the age group of 35-45 years (36.4%). Moreover, 3.2% of samples were found to have a mixed infection with trichomoniasis and candidiasis. Because these two causative agents cause numerous complications in women, it is highly recommended proper controlling measures, such as health education, personal hygiene, and treatment of infected women, be implemented to prevent or decrease vaginal infection.

A study of prevalence and risk factors for Helicobacter pylori infection among adults in Duhok Province, Kurdistan Region, Iraq.

Helicobacter pylori is known to increase the risk of developing gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric lymphoma in adults across the globe. The present study aimed to determine the prevalence of H. pylori infection and its associated risk factors. This cross-sectional study was conducted among the adult population in Duhok Province, Kurdistan Region, Iraq. A total of 259 subjects over the age of 18 who visited the hospitals were included in the study from 2018 to 2020. An enzyme-linked immunosorbent assay was utilized to determine H. pylori seropositivity. A standardized questionnaire was administered to all study participants through face-to-face interviews. The H. pylori immunoglobulin G (IgG) antibody data were analyzed using the Chi-square test. The prevalence of anti-H. pylori IgG antibody was present in 40.02% of adults. Among the studied variables, the following risk factors were significantly associated with the presence of anti-H. pylori IgG antibodies: male gender (P<0.043), level of education (P<0.025), history of gastrointestinal diseases (P<0.001), smoking status (P<0.001), and more siblings (P<0.001). This study supports the hypothesis that H. pylori infection in adults is highly related to poor hygiene and smoking status, low level of education, and crowded conditions. Therefore, in order to reduce the prevalence of H. pylori infection among adults, it is crucial to implement effective strategies aimed at enhancing fundamental sanitary conditions, as well as improving educational and socioeconomic status.

Morphological and molecular identification of freshwater eutardigrade Dactylobiotus parthenogeneticus (Bertolani, 1982) in the Greater Zab River of Kurdistan Region - Iraq.

Dactylobiotus parthenogeneticus is one of the widespread species of tardigrade all over the world. Tardigrades of this species were collected from the Greater Zab River in Erbil City-Iraq by filtering water of the river through a plankton net with a mesh of 45 µm pore. The samples were mounted on a slide with a cover slip and examined under the microscope to determine morphological characteristics and measurements. Based on these characters the species identified to be D. parthenogeneticus. To support this diagnosis, DNA barcoding techniques were applied to do molecular analysis and sequencing on the cytochrome oxidase subunit I (COI) gene. The sequence was subjected to the GenBank database of NCBI and recorded with the accession number PP140905. The result of the sequencing and molecular analysis of the cytochrome oxidase subunit I (COI) gene confirmed to be the same species diagnosed by relying upon morphological characters. This study represents one of the pioneer researches and documents on tardigrades and found D. parthenogeneticus for the first time in the Greater Zab River in Kurdistan, North of Iraq. Tardigrades play a magnificent role in different trophic levels and can be utilized as an indicator of ecosystem health.

Acute renal injury among seriously ill Iraqi children: risk factors, management, and outcome.

OBJECTIVE: To determine the frequency of acute kidney injury in seriously ill young patients, and to find out the risk factors linked to renal impairment. METHODS: The cross-sectional study was conducted from June 1 to December 1, 2019, at the Central Child Teaching Hospital, Baghdad, Iraq, and comprised patients of either gender aged from >28 days to <18 years who presented to the emergency department with any critical acute illness who had to undergo hospitalisation. Kidney Disease Improving Global Outcomes criterion was used to identify patients having acute kidney injury. Such patients were followed up during their hospitalisation and their follow-up data was collected daily till discharge... Data was analysed using SPSS 25. RESULTS: of the 485 critically ill paediatric patients, 113(23.3%) had acute kidney injury; 57(50.9%) females and 56(49.1%) males. The overall mean age was 18.68±25.8 months (range: 1.5-120 months). There were 46(40.7%) patients with stage 3 disease. The incidence of acute kidney disease was not significantly associated with either age or gender (p>0.05). Diarrhoea and vomiting were the only complaints that had a significant association with acute kidney injury (p=0.001). Sagwa was consumed by 40(8.2%) cases, and 35(87.5%) of them developed acute kidney injury (p=0.001). Ventilator was used in 12(10.6%) cases, Of the total 65(13.4) cases of mortality, 21(18.6%) had acute kidney injury compared to 44(11.8%) of the rest (p=0.014). CONCLUSIONS: Acute renal impairment was found to be prevalent in seriously ill paediatric patients and was linked to increased mortality. Sagwa poisoning, diarrhoea and vomiting as presenting complaints had a significant association with acute kidney disease in such patients.

The psychological impact of COVID-19 pandemic on Iraqi health workers.

OBJECTIVE: To explore the psychological impact of coronavirus disease-2019 on frontline healthcare workers in Iraq. METHODS: The cross-sectional study was conducted from November 2020 to September 2021 after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised doctors and nurses from 4 teaching hospitals and 8 primary healthcare centres in Baghdad. Psychological sequels, like anxiety, depression, fear and insomnia, were assessed along with exposure to coronavirus disease-2019. The study questionnaire was based on the Patient Health Questionnaire Anxiety and Depression Scale. Data was analysed using SPSS 26. RESULTS: Of the 400 participants, 288(72%) were doctors and 112(28%) were nurses. Overall, 215(53.7%) subjects had had a coronavirus disease-2019 infection, 192(48%) reported having anxiety, 148(37%) fear, 100(25%) depressive symptoms, and 51(12.8%) complained of insomnia. Doctors were more likely to have anxiety than nurses (p<0.05), but the difference in terms of depression was not significant (p>0.05). CONCLUSIONS: The mental health of the frontline healthcare workers was found to have been affected by the coronavirus disease-2019 pandemic, with anxiety and fear being the main symptoms.

Does body surface area of children affect the oral health?

OBJECTIVE: To evaluate relationship between oral health and body surface area among children. METHODS: The observational, cross-sectional study was conducted from January to February /2022 after approval from the ethics review committee of the College of Dentistry, University of Baghdad, Baghdad, Iraq, and comprised children of either gender aged 6-8 years who were randomly selected from primary schools in the city. Body surface area was calculated geometrically using different formulas, and the DuBois formula was used to make the intervals. The estimated body surface area values were broadly divided into four intervals: 0.8-0.9, >0.9-1.0, >1.0-1.1, >1.1. Dental caries was examined using the World Health Organisation criteria related to decayed, missed and filled teeth and surfaces for primary and permanent teeth. Dental plaque and gingival health status were measured using plaque and gingival indices. Data was analysed using SPSS 22. RESULTS: There were 240 subjects. There was no significant difference in terms of mean body surface area intervals of decayed, missed and filled teeth and surfaces for primary and permanent teeth (p>0.05). The mean values of gingival index showed significant differences across body surface area intervals (p<0.05). Mean plaque index values showed no significant differences (p>0.05). CONCLUSIONS: No relationship between body surface area and caries experience of primary and permanent teeth was found. However, increasing the body surface area increased gingival inflammation.

Neutrophil gelatinase-associated lipocalin as a biomarker for detection of early renal impairment in Iraqi patients with multiple myeloma.

OBJECTIVE: To evaluate the serum neutrophil gelatinase-associated lipocalin levels in multiple myeloma patients as an indicator of disease progression. METHODS: The case-control study was conducted at the Clinical Biochemistry Department of the National Centre of Haematology, Mustansiriyah University, Baghdad, Iraq, from October 2020 to July 2021, amd comprised diagnosed multiple myeloma patients and healthy controls of either gender aged 40-60 years. Neutrophil gelatinaseassociated lipocalin and renal functions were measured for all patients in addition to obtaining a complete history and physical examination. Data was analysed using MedCalc. RESULTS: Of the 60 sujects, 30(50) were cases with mean age 64±2.1 years and 30(50%) were controls with mean age 60 ±3.2 years. There were 18(68%) males among the cases and 17(55%) among the controls. In the cases group, mean levels of creatinine, urea and neutrophil gelatinase-associated lipocalin were 1.62±0.85mg/dl, 55.56±28.05mg/dl and 389.39±116.12pg/mL, respectively. The corresponding values for the controls were 0.9518±0.1623mg/dl, 30.17±8.47mg/dl and 120.82±68'52pg/ml. The neutrophil gelatinase-associated lipocalin cutoff level >190pg/ml in multiple myeloma patients was strongly associated with renal impairment (p<0.001). CONCLUSIONS: Neutrophil gelatinase-associated lipocalin was found to be an accurate indicator of early kidney disease in patients with de novo multiple myeloma.

Assessment of growth status in children and adolescents with type 1 diabetes mellitus in Baghdad: a case-control study.

OBJECTIVE: To assess growth parameters in adolescents and children with type 1 diabetes mellitus, and the factors influencing their growth. METHODS: The case-control study was conducted from February to December 2020 at the Endocrine Outpatient Clinic of the Central Child Teaching Hospital of Paediatrics, Baghdad, Iraq, and comprised patients aged 2-16 years who had type 1 diabetes for at least a year. The patients formed group A, while healthy controls matched for age and gender from different schools and kindergartens formed group B. Weight, height and body mass index of all the subjects in both groups were measured and worked out, and the values were compared. Data was analysed using SPSS 25. RESULTS: Of the 192 subjects, 96(50%) were in each of the 2 groups; 50(52.1%) girls and 46(47.9%) boys in group A, and 58(60.4%) girls and 38(39.6%) boys in group B. The overall mean age was 9.66±3.26 years. Group A children had significantly lower mean height, weight and body mass index Z scores compared to group B (p=0.001). The height Z score of group A children was significantly inversely associated with age, duration of disease, and glycated haemoglobin level (p=0.001), while the weight Z score was significantly inversely correlated with age and glycated haemoglobin (p=0.001). The body mass index Z score of group A was significantly inversely associated with age and glycated haemoglobin level (p<0.05). CONCLUSIONS: Children with type 1 diabetes mellitus had significantly lower mean height, weight and body mass index Z scores compared to their counterparts in the control group. Pubertal age group, poor glycaemic control, longer disease duration, and using conventional insulin regimen were the factors affecting growth parameters.

Association of nuclear factor-kappa B1 (NF-κB1) Ins/Del gene polymorphism with Hepatitis C virus outcomes.

OBJECTIVE: To explore the association of nuclear factor-kappa B1 polymorphism in the promotor area of the gene with hepatitis C virus infection outcomes. METHODS: The case-control study was conducted at the Hepatology and Gastroenterology Teaching Hospital, Baghdad, Iraq, from Dec 1, 2020, to Aug 30, 2021, and comprised individuals ages 20-68 years. Group 1 had patients with persistent hepatitis C virus infection, group 2 had subjects with spontaneous hepatitis C virus clearance, group 3 had subjects treated with direct-acting antiviral drugs, and group 4 had healthy controls. Venous blood was collected for polymorphism genetic analysis of nuclear factor-kappa B1 insertion/deletion ATTG (Adenine-Thymine- Thymine-Guanine) at rs28362491 using a high-resolution melting technique. Data was analysed using SPSS 27. RESULTS: Of the 88 subjects, there were 22(25%) in each of the 4 groups. Overall, there were 55(62.5%) females and 33(37.5%) males, and 40(45.45%) were aged 20-39 years while 48(54.54%) were aged 40-68 years (p>0.05). The Ins allele of rs28362491 was significantly more frequent in the patients than in controls (p=0.0053). The carriage of rs28362491 insertion/insertion and insertion/deletion genotypes, compared to wild-type homozygous deletion/deletion, had a significantly higher risk of developing hepatitis C virus infection (p=0.0013). No association was found between rs28362491 and spontaneous hepatitis C virus clearance (p>0.05). CONCLUSIONS: The insertion allele of rs28362491 was found to be associated with increased susceptibility to developing hepatitis C virus infection.

Evaluation of serum level of MicroRNA323-3p, MicroRNA517a and MicroRNA519d in Ectopic pregnancy: a comparative study.

Aim: To assess the role of serum micro ribonucleic acids 323-3p, 517a and 519d in the diagnosis of ectopic pregnancy. METHODS: The case-control study was conducted at the Gynaecology Department of Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from June 1, 2020, to May 1, 2021, and comprised women with ectopic pregnancy in group A, and those with a viable intrauterine pregnancy in group B. Serum samples were taken for beta human chorionic gonadotropin measurement and for micro ribonucleic acids 323-3p, 517a and 519d testing using polymerase chain reaction. Data was analysed using SPSS 24. RESULTS: Of the 100 women with mean age 26.8±5.29 years, 50(50%) were in each of the 2 groups. There was no significant difference between the groups in terms of age, gravida, parity, abortion, and gestational age (p>0.05). The mean beta human chorionic gonadotropin in group B was significantly greater than group A (p=0.001). In group A, micro ribonucleic acid 323-3p expression was significantly higher, mean micro ribonucleic acid 517a expression was significantly lower and mean micro ribonucleic acid 519d expression was significantly lower compared to group B (p<0.05). At micro ribonucleic acid 323-3p cut-off point 2.415, the test accurately distinguished between ectopic and viable pregnancy with 92% sensitivity, 100% specificity and total area under the curve 0.994 (p=0.001). CONCLUSIONS: Serum micro ribonucleic acid 323-3p, 517a and 519d might be helpful biomarkers in the diagnosis and follow-up of patients with ectopic pregnancy.

Prevalence of breakthrough COVID-19 infection among healthcare workers in Baghdad.

Objective: To determine the prevalence and severity of breakthrough coronavirus disease-2019 infection among health workers, and to assess health workers' post-vaccination adherence to preventive guidelines. METHODS: The cross-sectional study was conducted from December 2021 to March 2022 at 2 major hospitals in Baghdad, Iraq, and comprised physicians, pharmacists, dentists and paramedical staff present at time of data collection. The participants were classified according to vaccination status with history of infection. Unvaccinated meant infected before vaccination; partially vaccinated meant infected after the first dose; and fully vaccinated meant breakthrough infection after the second dose. Data was analysed using SPSS 28. RESULTS: Of the 506 participants aged 20-59 years, 327(64.6%) were females, 247(48.8%) were physicians, 72(14.2%) were smokers, and 21(4.1%) had asthma. All the 506(100%) participants had been infected after vaccination; 430(85%) after the second dose, and 76(15%) after the first dose. In 445(88.6%) cases, the infection was mild to moderate, while admission was required in 21(4.1%). With respect to adherence to preventive guidelines, 229(45.3%) subjects were always wearing masks before the vaccination, but 119(23.7%) continued doing that after receiving the second dose of the vaccine. CONCLUSIONS: The majority of the participants had fallen victim to breakthrough coronavirus disease-2019 infection. Adherence to preventive guidelines was found to be reduced after the second dose of the vaccination.

Pre and postnatal effect of maternal environmental tobacco smoke exposure on infant's growth parameters.

OBJECTIVE: To determine the association between environmental tobacco smoke exposure and growth parameters of infants. METHODS: The observational, comparative study was done in rural areas of the Al-Karkh sector of Baghdad, Iraq, from December 2021 to March 2022 after approval from the ethics review committee of the College of Dentistry, University of Baghdad, and comprised mothers aged 20-35 years having infants aged up to one year. Those exposed to environmental tobacco smoke were in group A, while non-exposed mothers were in group B. Along with sociodemographic data, a second-hand smoke exposure scale was used. Weight-for-height, height-for-age and weightfor- age indices, as well as head circumference values, were used to measure growth parameters. Data was analysed using SPSS 22. RESULTS: Of the 150 mothers, 67(44.7%) were in group A with mean age 27.8±4.7 years and 83(55.3%) were in group B with mean age 26,1±4.6 years. The mean age of the children was 9.4±3.1 years in group A and 9.2±2.3 years in group B. Husband was the primary source of smoking at home 55(82.08%). When it came to exposure duration, 58(86.57%) had been exposed for years and 9(13.43 %) for months. The mean Z-score for all growth measurements was higher in group B infants compared to group A (p<0.05) except weight-for-height (p>0.05). CONCLUSIONS: Mothers' exposure to environmental tobacco smoke was found to have a significant harmful effect on the growth parameters of infants.

Factors affecting the level of parental knowledge about their children's congenital heart diseases and their care.

OBJECTIVE: To assess parental knowledge about their children's congenital heart disease using a newly-designed scale. METHODS: The cross-sectional study was conducted from June 2020 to May 2021, at Alkhansaa maternity and child hospital, Mosul Iraq; after approval from the ethics review committee of Ninevah Medical College, Ninevah University, Iraq, and comprised parents with children having congenital heart disease. Data, including age, gender, type of congenital heart disease as well as parents' educational and socioeconomic levels, residence, internet use and knowledge of the disease with respect to type, burden, bacterial endocarditis, outcome, etc. was noted. Parental knowledge levels were measured using a self-designed scoring scale, having a total score of 18 and 4 categories; <6 = some knowledge, 7-12 = good knowledge, 13-17 = very good knowledge, and 18 = full knowledge. Data was analysed using SPSS 26. RESULTS: There were 364 children with mean age 83.72±47.4 months and a male-female ratio of 0.98. The mean age at diagnosis was 12.1±8.32 months. The overall mean parental knowledge level was 8.41± 3.88, with 126(34.6%) parents having some knowledge, 178(48.9%) having good, 58(16%) having very good, and 2(0.5%) having full knowledge about their children's health condition (p<0.001) There was a significant association of parental knowledge with educational level, socioeconomic status and the type of doctor caring for the child (p<0.05). The duration of the illness showed a significant correlation with knowledge level (p=0.021). CONCLUSIONS: Heart Defects, Congenital, Endocarditis, Bacterial, Social Class.

Haemophilia care in Iraq; a multi-centre study.

OBJECTIVE: To evaluate the level of care available for haemophilia patients. METHODS: The descriptive, retrospective analytical study was conducted from December 15, 2020, to March 1, 2021, after approval from the Mustansiriyah University, Baghdad, Iraq, and comprised data from 3 haemophilia treating centres in Iraq participating in the World Bleeding Disorders Registry. The data collected related to patients with haemophilia A and B enrolled in the registry since March 2018, and included age at diagnosis, type of haemophilia, disease severity, age at first bleed and at first joint bleed, type of replacement therapy and outcome. Data was analysed using statistical package of social sciences (SPSS) version 20. RESULTS: Of the 638 patients with mean age 16.2±4.3 (range: 9-29 years), 581(91%) had haemophilia A, 57(8.9%) had haemophilia B, 385(60.5%) had severe haemophilia, 126(19.8%) moderate and 125(19.7%) mild. Further, 259(41%) patients had been diagnosed for <1 year. There were 1354 bleeding events, and haemarthrosis accounted for 959(70.8%) of them. The mean annualised bleeding rate for severe patients was 2 ± 0.6(range 0-4), while the mean annualised joint bleeding rate was 4 ± 1.3(range :2-8). There were 256(32.3%) patients who were tested for inhibitors, and 62(24.3%) were positive. Among 426(73.3%) haemophilia A patients with a treatment history, 248(58%) were on prophylactic therapy, and the corresponding value among 37(65%) haemophilia B patients was 17(46%). CONCLUSIONS: Access to treatment was found to be limited, and patients were found to be suffering from high bleeding rates and joint damage.

A profile of emergency departments in Baghdad hospitals.

OBJECTIVE: To assess the structure as well as availability of essential equipment and medicine at emergency departments in Baghdad hospitals. Method: The descriptive, cross-sectional study was conducted from March to June 2021 after approval from the ethics review committee pf the College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised emergency departments of general and teaching hospitals in the city. Evaluations were done using the World Health Organisation checklist and the guidelines of the Australasian College for Emergency Medicine related to Emergency Department Design. Results: Of the 26 secondary care hospitals in Baghdad, 13(50%) were evaluated. Triage was not available in 8(62%) hospitals, resuscitation room in 10(77%) and waiting room in all the 13(100%). An obvious shortage of medicines and vaccines was noted in 11(85%) hospitals. Coronary care unit and intensive care unit were not close to the emergency department in 7(54%) hospitals, and liaison psychiatry and social work links were not available in all 13(100%) hospitals. CONCLUSIONS: There is a need to improve service delivery at emergency departments functioning at hospitals in Baghdad.

Factors affecting symptom duration and recovery among home-treated COVID- 19 patients in Baghdad-Iraq: a cross-sectional study.

OBJECTIVE: To determine the prevalence of Long COVID among home-treated coronavirus disease-2019 cases, and the factors that may influence the duration of symptoms. METHODS: The cross-sectional study was conducted from February to July 2021 at 20 primary healthcare centres in 10 health districts of Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad. Those included were adults of both genders who previously had coronavirus disease-2019 infection as diagnosed through on polymerase chain reaction test, and received supportive treatment during isolation at home. Data was collected through direct interview using a questionnaire which consisted of demographic characteristics, comorbidities, smoking history and symptoms of coronavirus disease-2019 along with their duration. Measurement of weight and height was also done for each subject. Data was analysed using SPSS 27. RESULTS: Of the 400 participants, 248(62%) were males and 152(38%) were females. The overall mean age was 40.8±12.8 years (range: 18-71 years). Of the total, 121(30.25%) subjects had persistent symptoms for >4 weeks. The mean duration of illness was 4.2±3.6 weeks (range: 1-16 weeks). The symptoms that lasted for >4 weeks were fatigue 94(23.5%), loss of smell or taste 59(14.75%), and cough 8(2%). Age, smoking status, comorbidities and the total number of initial symptoms showed a significant association with the duration of illness (p<0.05). CONCLUSIONS: A substantial number of mild to moderate coronavirus disease-2019 cases suffered from persistent symptoms. The duration of illness could have been influenced by age, comorbidities, smoking status and total number of initial symptoms.