Human papillomavirus (HPV) genotype prevalence and impact of COVID-19 on the HPV prevention program in Duhok city.

Introduction and aims: Human papillomavirus (HPV) is a sexually transmitted virus that can cause cervical cancer. This study aimed to investigate the prevalence of HPV infection, the prevalent HPV genotypes in women and men with recurrent genital infections, and the impact of the coronavirus disease 2019 (COVID-19) pandemic on the HPV prevention program. Materials and methods: This cross-sectional study was conducted in Duhok city, in the Kurdistan Region of Iraq, between January 2018 and September 2020. We recruited patients from an infectious disease clinic, who were married, were older than 18 years, and agreed to participate in this study. A reverse hybridisation-based assay was used to identify the HPV genotypes prevalent in these patients. Results: Among the patients in the study, 20.9% (67/320) tested positive for HPV infection. The HPV prevalence in females was 18.8% (52/276), which was lower than that in males (34.1%,15/44) (p = 0.21). Thirty-six patients (11.3%) were infected with a single HPV genotype, seventeen (5.3%) with two HPV genotypes, eight (2.5%) with three HPV genotypes, and the remaining six (1.8%) with four or more HPV genotypes. The most common genotypes detected among the patients were HPV-6 (7.2%), -11 (3.8%), and -16 (3.4%). The prevalence of all HPV genotype infections was highest and lowest in the 18-25- and 36-45-year age groups, respectively (X 2 = 8.24; p = 0.041). The number of referred patients substantially reduced from 12 patients per month to 1 patient per month during the COVID-19 pandemic. Conclusion: HPV infection was common in the study population. The most common genotypes were HPV 6, 11, and 16, against which vaccines are available. Further population-based studies are needed to investigate the prevalence of such an infection.

Home management scheme for patients with severe covid-19 in Duhok city, Kurdistan region of Iraq: a possible role for family physicians.

AIM: This study investigated the clinical characteristics and outcomes of patients with severe coronavirus disease 2019 (COVID-19) who were involved in the home management scheme in Duhok city. MATERIALS AND METHODS: This prospective descriptive study enrolled Kurdish patients diagnosed with severe COVID-19 between June 1 and November 1, 2020, and were treated at home. RESULTS: The average age of the patients was 59.77 ± 14 years and 51 (56.04%) of them were males. Seven of these patients (7.69%) were smokers. Most patients (72.52%) had one or more comorbidities. Fever (87.1%) was the most commonly presented symptom in older patients. The case fatality rate was 3/91 (3.29%). This rate was not found to be associated with sex, history of smoking, or comorbidities. The age of deceased patients (40 ± 25 years) was significantly lower than that of cured patients (60 ± 13 years) (p = -0.025). CONCLUSIONS: The case fatality rate of patients enrolled in this scheme was comparable to those who received treatment in hospitals. Therefore, this scheme could provide a good alternative for treating patients with severe COVID-19 and family physicians could lead the scheme through the primary care network.

A sharp increase in the number of COVID-19 cases and case fatality rates after lifting the lockdown in Kurdistan region of Iraq.

With the appearance of first cases of Coronavirus disease (COVID-19), strict control measures were implemented in the Kurdistan Region of Iraq to combat the infection. These measures included the closure of schools and universities, the closure of borders and airports, cancellation of public and religious gatherings, and mandatory quarantine for persons returning from traveling abroad. Such measures have played a major role in the control of COVID-19 spread. However, due to social and economic pressures, the government relaxed the lockdown. After relaxing the measures, a sharp increase in the number of patients was noticed. Besides, there was a significant increase in the number of symptomatic patients and the case fatality rate was doubled. In addition, the outbreak and outbreak response led to the loss of trust and a breakdown in relations between the society and local authority. To minimize the consequences for population health, local authority should have a plan that balances between health imperatives and socioeconomic imperatives. Finally, to be successful in controlling the infection, the government must rebuild public trust in the handling of COVID-19 outbreak and compensate people for lost earnings.

Impact of Covid-19 pandemic on surgical practice in Kurdistan, Iraq: An online cross-sectional survey.

INTRODUCTION: The COVID-19 pandemic is a major challenge to healthcare services in the world. It has negatively impacted surgical practice, and health workers. We aimed to assess the impact of the COVID-19 pandemic on surgical practice in the Kurdistan Region, Iraq. METHODS: An online cross-sectional study using an online survey was performed between 13 April to 29 April, 2020 in the Kurdistan Region, Iraq. An online cross-sectional study using an online survey was performed between 13 April to 29 April, 2020 in the Kurdistan Region, Iraq. A total of 241 surgeons, aged 28-70 years (mean range 22.2 ± 7.9 SD), were recruited to this study. The questionnaire was designed to evaluate the impact of the COVID-19 pandemic on surgeons' practices. Participants completed a self-developed online questionnaire. RESULTS: The majority of participants (44.39%) were general surgeons, followed by urologists (17.01%). Approximately 82.57% of surgeons performed surgeries during the COVID-19 pandemic and 60.31% undertook emergency surgeries only. There was no significant difference between men and women (P = 0.41) and different age groups (P = 0.08). Only 28.22% of surgeons had access to full personal protective equipment (PPE), and 41.18% believed that wearing PPEs severely affected their skills. Results also found that surgeons aged between 28 and 34 years were more pledged to the use of PPEs, than other age groups (P = 0.001). The use of PPEs during surgeries was significantly higher in the Sulaymaniyah province (P = 0.001). The surgical services were also severely impacted in the Sulaymaniyah province than in the other provinces (p = 0.001). CONCLUSION: The COVID-19 pandemic severely affected surgical practice in the Kurdistan Region, particularly in the Sulaymaniyah province. Males, and young surgeons showed a higher commitment level for using PPE. Additional training and precautions are needed to increase awareness about COVID-19 among surgeons, and the importance of using PPE during surgery.

Proliferative Index (Ki67) for Prediction in Breast Duct Carcinomas

Background and objectives: To date, many tumor markers have been used to predict prognosis and therapeutic response in patients with breast cancer. The well established and routinely applied tumor markers are the estrogen-receptor, progesterone-receptor and Her2/neu-receptor. In the current study, we aimed to highlight any association of the proliferation index (Ki67) in breast infiltrative duct carcinoma with the tumor grade, tumor size and nodal status in addition to hormone receptor status. Tissue sections were stained immunohistochemically for Ki67 nuclear antigen, estrogen, progesterone and Her2/neu receptors using an automated Dako machine (Dako Denmark. There was a significant inverse relationship of Ki67 levels with ER and PR, while values were directly proportional to the tumor grade and Her2/neu status. No significant association was found between Ki67 and size of tumor or nodal status. Ki67 immunoexpression may offer an independent predictive tumor marker and for routine application in cases of breast cancer.