Assessment of acceptance, concerns and side effects towards COVID-19 vaccination among the community: A cross-sectional study from Baghdad, Iraq.

Introduction: The newly developed and marketed vaccines along with concerns about vaccine safety and long-term side effects has been raised an alarming in the general population. The aim of this study was to assess the rate of acceptance, perceptions and concerns towards receiving COVID-19 vaccines and to explore the incidence of vaccines' side effects among Iraqi population in Baghdad province, Iraq. Method: This was a descriptive, cross-sectional study conducted via direct interviews among a convenient sample size of Iraqi population using a structured validated questionnaire consisting of using 24-item questionnaire to assess acceptance, concerns and the incidence of vaccines' side effects towards receiving COVID-19 vaccines. Results: A total of 500 participants with an average age of 27.8 ± 3.7 years were included. Majority were females (70.6%). 43.4% had a history of COVID-19, and 46% received the Pfizer BioNTech vaccine. 73.4% (P < 0.0001) agreed about the importance of receiving the vaccination to protect the community against the COVID-19.46.8% (P < 0.0001) were unsure about the adverse effects and long-term vaccine safety. 72.8% reported that transmission of COVID-19 infection to family members is the main concern for accepting vaccination. Fatigue (60%), injection site reactions (55.8%) were the most common vaccine's side effects. Young age (P = 0.001), females (P < 0.0001), and university educational (P < 0.0001) were the most significant determents for accepting vaccination. Conclusion: This study highlights that the Iraqi population showed a considerable acceptance rate for the COVID-19 vaccines. However, vaccine safety is considered a high priority concern associated with the willingness of the population to vaccinate.

A Cross-Sectional Study of Patients' Practices, Knowledge and Attitudes of Antibiotics among Iraqi Population.

INTRODUCTION: The misconception and misuse of antibiotics among the public has been widely outlined to be one of the main reasons for bacterial resistance. The aim of the present study was to assess the practices, level of knowledge and attitudes regarding the rational and self-medication use of antibiotics in the general public in different districts of Baghdad province, Iraq. METHODOLOGY: A descriptive, cross-sectional study conducted among 384 participants through an interview using a structured 3-parts questionnaire, consisting of 24 items assessing the demographic characteristics, practices, level of knowledge and attitude towards rational antibiotics use. RESULTS: 45.8% of the study participants reported self-medication of antibiotics without prescription. Flu/common cold and sore throat represented the majority of medical conditions for antibiotics intake without prescription (44.9%, 31.3%) respectively. Oral amoxicillin (34.1%) was the most common non-prescription antibiotic. 50.3% had education about the rational use of antibiotics. 41.4% reported intake of antibiotics after having medical advice, 44% suggested their antibiotics not to be used by other members, and 52.9% stated the importance of antibiotic education among the public. However, 57% of the respondents had negative attitudes regarding antibiotics use for sore throat/fever, the effectiveness of antibiotics for cold/flu (54.7%) and cough (49.2%), to keep antibiotics for future use (40.9%) and not completing the antibiotic course after feeling well (49.2%). CONCLUSIONS: A widespread use of antibiotics without prescription was reported, providing some crucial gaps and a lower level of practice, knowledge and attitudes regarding the use of antibiotics among a sample of the Iraqi population.

Current topical trends and novel therapeutic approaches and delivery systems for oral mucositis management.

Oral mucositis (OM) is an extremely serious and challenging complication of chemoradiotherapy, which may limit the efficacy of cancer treatment. Complications related to OM include potential nutrition impairment, high economic burden, and negative impacts on patients' quality of life. Current therapeutic options with local traditional pharmaceutical formulations are largely focused on controlling symptoms, and only few agents are available for treatment. Several local supportive and palliative agents are used for the prevention of OM; however, a standard treatment for the disease has not been confirmed yet. The efficacy of treatment could be improved through the introduction of new medical agents with updated dosage forms that can enhance and optimize local drug delivery and create greater therapeutic effects with fewer side effects. The focus of this review was to provide clear and direct information about the currently available topical therapeutic agents in clinical practice used to cure and/or reduce the incidence of ulcerative symptoms of OM, excluding the associated pain and other coexisting complications such as bacterial and fungal infections. The review also provides recent evidences regarding agents that could be used as promising novel therapies in updated local delivering systems. This will support further encouraging options and approaches for the management of OM and will improve compliance that could be translated in better disease control and survival.

Evaluation of goserelin effectiveness based on assessment of inflammatory cytokines and symptoms in uterine leiomyoma.

Background Uterine leiomyoma is a benign tumour of the uterine smooth muscles associated with an elevated level of inflammatory cytokines. Goserelin, a synthetic gonadotropin-releasing hormone analogue, suppresses the production of sex hormones and release of inflammatory cytokines in uterine leiomyoma cells. Objective The primary objective of this study was to find out the effectiveness of subcutaneous goserelin therapy on lowering serum levels of inflammatory cytokines and improving uterine leiomyoma-related symptoms in female patients diagnosed with uterine leiomyoma. The secondary objective was to assess the tolerability to goserelin therapy used in the management of this tumour. Setting Outpatient gynaecological clinic of the medical consultation department of Baghdad Teaching Hospital, Baghdad province, Iraq. Methods A single centre, prospective, longitudinal, cohort study was carried out on female patients diagnosed with uterine leiomyoma. Goserelin 3.6 mg subcutaneous injection was given in a consecutive monthly dose for the total time duration of three months. Serum levels of inflammatory cytokines, tumour necrosis factor-α and monocyte chemotactic protein-1 were detected before and after goserelin therapy in a consecutive monthly assessment. The study also assessed the improvement in uterine leiomyoma-related symptoms, including pelvic pain alongside the incidence of goserelin-related side effects during therapy schedules. Main Outcome Measures Assessment of serum levels of tumour necrosis factor-α and monocyte chemotactic protein-1 alongside uterine leiomyoma-related symptoms, including pelvic pain and goserelin-related side effects. Results There was a significant decrease in serum levels of tumour necrosis factor-α and monocyte chemotactic protein-1 compared to the baseline level over the 3-month duration of goserelin therapy (0.11 ± 0.02 vs. 0.74 ± 0.19) pg/mL; (0.07 ± 0.00 vs. 0.44 ± 0.18) pg/mL respectively. Patients showed a clinical improvement regarding uterine leiomyoma-related symptoms following each of the consecutive monthly doses of goserelin therapy (n = 11, 55%, P < 0.0001; n = 15, 75%, P < 0.0001; n = 18, 90%, P < 0.0001) respectively. This also includes a significant decrease in the intensity of leiomyoma-related pelvic pain before and after goserelin therapy (7.2 ± 1.43 vs. 3.05 ± 1.14, P < 0.0001). The majority of patients reported vaginal dryness (60%) as the main goserelin-related side effect. Conclusion Goserelin therapy reduces serum levels of inflammatory cytokines, tumour necrosis factor- α and monocyte chemotactic protein-1, improving leiomyoma-related symptoms with good tolerability in patients with uterine leiomyoma.

Potential Confounders and a Modified Framingham Risk Score for the Prediction of Pregnancy-related Medical Conditions Occurrence among Pregnant Women: A Retrospective Study from Baghdad, Iraq.

BACKGROUND: The incidence of pregnancy-related medical conditions relied on a set of potential factors that could be available even before the term of pregnancy and may be associated with poor outcomes later in life. This study aimed to investigate the association between some potential predictive factors related to maternal, gestational, and clinical parameters and the incidence of pregnancy-related medical conditions in a sample of Iraqi pregnant women. MATERIALS AND METHODS: A retrospective, observational, single-center study was carried out on 92 pregnant women during their routine visit to the obstetric clinic in a certain distinct of Baghdad province, Iraq. Demographic, gestational, and clinical records of the participants were collected and analyzed to detect the predictive factors for pregnancy-related medical conditions. RESULTS: 56.5% of the participants were at a gestational age of 25-37 weeks. 32.6% complained of pregnancy-related medical conditions, mainly gestational hypertension and diabetes mellitus. Pregnant women with pregnancy-related medical conditions were significantly correlated with a family history (P < 0.0001), previous gestational medical conditions (P < 0.001), diastolic blood pressure (P = 0.0011), different lipid panels (P = 0.0001), and maternal blood phenotype O (P = 0.0001). CONCLUSION: Some predictive factors related to maternal, gestational, and health characteristics are correlated with the incidence of pregnancy-related medical conditions. Interventions to adjust and recognize these confounders are essentials even before pregnancy which could improve maternal health and reduce the overall risk of pregnancy-related medical conditions.

Clinical Characteristics of Pregnant Women on the Use of Daily Low-dose Aspirin in Different Hypertensive Pregnancy Disorders: A Retrospective Comparative Study.

BACKGROUND: Hypertensive disorders represent major causes of maternal and fetal complications. It includes a range of conditions, most notably preeclampsia. Aspirin is a well-accepted therapy for the primary and secondary prevention of cardiovascular events. The indications for the use of aspirin during pregnancy are, however, the subject of much concern. This study aimed to assess the clinical characteristics from the benefits of daily low-dose aspirin administration alongside antihypertensive in pregnant women with different hypertensive disorders. MATERIALS AND METHODS: A retrospective observational study was carried out on pregnant women during their routine visit to the obstetric clinic at Baghdad Teaching Hospital. Patients diagnosed during pregnancy with different hypertensive disorders on the prescription of antihypertensive medication with or without daily low-dose aspirin administration were selected. Data were collected to structure a detailed assessment regarding the patients' demographic, gestational, and medical records. RESULTS: Methyldopa was the main antihypertensive agent (98%). Among pregnant women with daily aspirin use, 68% had gestational hypertension, 24% had preeclampsia alongside proteinuria (P = 0.0001), the frequency of daily dose intake of methyldopa (250 mg) tablet (two vs. three times) was significant (P = 0.0001). All pregnant women within the group of daily low-dose aspirin were safe from the incidence of eclampsia (P = 0.0001). CONCLUSION: This study provides intriguing evidence for the benefits of daily low-dose aspirin use during pregnancy as it is considered as a simple protective measure from serious maternal complications of hypertensive disorders, where these complications continue to affect maternal health long after delivery.