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1.
Artigo em Inglês | MEDLINE | ID: mdl-33810092

RESUMO

COVID-19 poses grave challenges for mass gatherings. One of the world's largest annual gatherings, Arbaeen, occurs in Iraq. We studied respiratory symptoms and risk and protective factors using representative sampling of Arbaeen pilgrims in 2019 to inform prevention of COVID-19 transmission. Structured sampling was used to recruit walking pilgrims. A questionnaire asked about respiratory symptoms, risk, and preventive factors, including hygiene-related resources of toilet facilities. The commonest symptom reported by the 1842 participants (63.3% male, 36.7% female) was cough (25.6%). Eating in mawkibs (rest areas) with indoor kitchens and drinking only packaged water were associated with lower risk of cough (AOR = 0.72, CI = 0.56-0.94; AOR = 0.60; CI = 0.45-0.78, p < 0.05). Facemask use was associated with increased risk of cough (AOR = 2.71, CI = 2.08-3.53, p < 0.05). Handwashing was not protective against cough, or against (one or more of) cough, fever, or breathlessness in multivariate analysis. Toilet facilities often lacked running water (32.1%) and soap (26.1%), and had shared hand towels (17%). To reduce risk of respiratory infections including COVID-19 during Arbaeen or other mass gatherings, needs include running water, soap, and hygienic hand drying options or hand sanitiser. Education on proper handwashing and facemask approaches and monitoring around food preparation and eating spaces are needed.


Assuntos
Pandemias , Feminino , Desinfecção das Mãos , Humanos , Iraque , Masculino , Máscaras
2.
Molecules ; 26(4)2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33669881

RESUMO

Ruta chalepensis L. (Rutaceae), a perennial herb with wild and cultivated habitats, is well known for its traditional uses as an anti-inflammatory, analgesic, antipyretic agent, and in the treatment of rheumatism, nerve diseases, neuralgia, dropsy, convulsions and mental disorders. The antimicrobial activities of the crude extracts from the fruits, leaves, stem and roots of R. chalepensis were initially evaluated against two Gram-positive and two Gram-negative bacterial strains and a strain of the fungus Candida albicans. Phytochemical investigation afforded 19 compounds, including alkaloids, coumarins, flavonoid glycosides, a cinnamic acid derivative and a long-chain alkane. These compounds were tested against a panel of methicillin-resistant Staphylococcus aureus (MRSA) strains, i.e., ATCC 25923, SA-1199B, XU212, MRSA-274819 and EMRSA-15. The MIC values of the active compounds, chalepin (9), chalepensin (10), rutamarin (11), rutin 3'-methyl ether (14), rutin 7,4'-dimethyl ether (15), 6-hydroxy-rutin 3',7-dimethyl ether (16) and arborinine (18) were in the range of 32-128 µg/mL against the tested MRSA strains. Compounds 10 and 16 were the most active compounds from R. chalepensis, and were active against four out of six tested MRSA strains, and in silico studies were performed on these compounds. The anti-MRSA activity of compound 16 was comparable to that of the positive control norfloxacin (MICs 32 vs 16 µg/mL, respectively) against the MRSA strain XU212, which is a Kuwaiti hospital isolate that possesses the TetK tetracycline efflux pump. This is the first report on the anti-MRSA property of compounds isolated from R. chalepensis and relevant in silico studies on the most active compounds.


Assuntos
Simulação por Computador , Furocumarinas/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Ruta/química , Ruta/crescimento & desenvolvimento , Rutina/farmacologia , Antibacterianos/química , Antibacterianos/farmacologia , Furocumarinas/química , Furocumarinas/isolamento & purificação , Ligação de Hidrogênio , Iraque , Ligantes , Testes de Sensibilidade Microbiana , Simulação de Acoplamento Molecular , Rutina/química , Rutina/isolamento & purificação
3.
PLoS One ; 16(3): e0249310, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33788835

RESUMO

Since the World Health Organization (WHO) announced that the coronavirus disease (COVID-19) is a worldwide pandemic, many countries' authorities, including the Iraqi authorities, started responding and taking action to control the spread of the pandemic. The public's knowledge and practices play an important role in curbing the spreading of the virus by following the health guidelines. This study aimed to assess the socio-demographic correlate of knowledge and practices of Iraqi living in Mosul-Iraq towards COVID-19 during its rapid rise. A cross-sectional online survey of 909 participants was conducted among a sample of the Mosul-Iraq population between 20th June to 1st July 2020. The survey included three parts: 1) socio-demographic characteristics, 2) participants' knowledge, 3) participants' practices. T-test, ANOVA, chi-square, and binary logistic regression were used. A p-value less than 0.05 (p < 0.05) was considered statistically significant. The results showed a knowledge and practice mean score of (12.91±1.67) and (21.56± 2.92) with cumulative knowledge and practice of 86% and 76% respectively towards COVID-19. Socio-demographic characteristics such as age, marital status, gender, level of education and employment were statistically related with a higher mean score of knowledge and practice towards the virus as P<0.05. We concluded that the majority of the respondents demonstrate a high level of knowledge and practices towards COVID-19 except for respondents with socio-demographic characteristics such as those who were younger, male respondents, those with lower education and those unemployed as such campaigns that will increase the knowledge and encourage adequate preventive practice towards COVID-19 should be targeted towards this group.


Assuntos
/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Iraque/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
4.
Environ Monit Assess ; 193(2): 107, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33532931

RESUMO

In many parts of the world, groundwater is considered to be a key source of fresh water for both the domestic and non-domestic sectors. Where groundwater extraction is implemented, systems to monitor water quality must ensure a safe and sustainable supply. Over the years, Iraq has suffered from surface water quality and supply problems, necessitating groundwater extraction in many regions. This study investigates groundwater quality in a region of central Iraq around Babylon city, covering an area of 5119 km2. The data gathered for this study included maps, well locations and water quality data and was sourced from the relevant governmental departments. A base map of the focussed region was initially prepared following data collection. The analysed water quality parameters were used as an attribute database to produce thematic maps using a geographical information system (GIS) environment. In this paper, the water quality index (WQI) and the irrigation water quality index (IWQI) were calculated for different groundwater samples using various parameters including the Electrical Conductivity (EC), Cl-, HCO3-, Na+ and pH. Moreover, the groundwater suitability for irrigation purposes has been assessed using indices such as Kelly's ratio (KR), sodium absorption ratio (SAR), residual sodium carbonate (RSC), soluble sodium percentage (SSP) and permeability index (PI). Water quality index maps have been developed using the GIS environment. The obtained results reveal that the groundwater in the study location requires specific treatments to be usable.


Assuntos
Água Potável , Água Subterrânea , Poluentes Químicos da Água , Água Potável/análise , Monitoramento Ambiental , Sistemas de Informação Geográfica , Iraque , Poluentes Químicos da Água/análise , Qualidade da Água , Abastecimento de Água
5.
Mar Pollut Bull ; 165: 112110, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33578187

RESUMO

The otolith length and width of adult teleost Otolithes ruber (Bloch & Schneider, 1801) were used to calculate the fluctuating asymmetry in these two characters. The results displayed that the amount of asymmetry of the otolith width was the highest between the two asymmetry values attained for the otolith of O. ruber. Further, the lowest level of asymmetry in the two otolith characters is at the fish length ranging between 150 and 180 mm and the highest at the fish length ranging between 461 and 2490 mm. The conceivable reason for the asymmetry in this species has been deliberated relative to different pollutants and their presence in the area. A tendency of increase in the asymmetry levels with the fish length was observed for the otolith length and width.


Assuntos
Membrana dos Otólitos , Perciformes , Animais , Peixes , Iraque
6.
Environ Monit Assess ; 193(3): 148, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33638037

RESUMO

Land use/land cover (LULC) change is an important indicator used for assessing the function and health of ecosystems. Understanding the patterns of LULC change assists in managing natural resources effectively, especially for regions where there are minimal or no reported data on the status of LULC. In this study, remotely sensed Landsat satellite imagery from 5 years (i.e., 1988, 1996, 2002, 2008, and 2017), geographic information systems (GIS), and the hybrid cellular automata (CA)-Markov model were used to (i) quantify the past and present LULC changes and (ii) model the future changes in Sulaimani Province in the Kurdistan region of Iraq (KRI). To accomplish these objectives, five LULC maps with various class categories were generated using the maximum likelihood classifier (MCL). The classified maps for 1996, 2002, 2008, and 2017 were used in the hybrid model to simulate LULC maps for 2017 and 2037. The map simulated for 2017 was validated with the classified 2017 LULC map. The change analysis demonstrated that between 1988 and 2017, the built-up areas and agricultural fallow land increased by 419% and 226%, respectively. In the future predictions for 2037, built-up areas and agricultural fallow land showed increasing trends of 5.5% and 26.5%, respectively. In contrast, agricultural land, plantation land, and sparse vegetation areas were predicted to decrease by 29.4%, 65.8%, and 36.9%, respectively. In addition, in 2008, waterbodies shrank by 43.36% in comparison with their status in 1988, suggesting that 2008 was a severe drought year. These findings provide invaluable baseline information with which conservation biologists, agricultural engineers, urban planners, and decision makers can better manage natural resources and monitor environmental changes. Based on these results, sustainable development actions and an early warning system can be established.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Agricultura , Monitoramento Ambiental , Iraque , Imagens de Satélites
7.
Artigo em Inglês | MEDLINE | ID: mdl-33430219

RESUMO

The construction industries' unsafe conditions require increased efforts to improve safety performance to prevent and reduce accident rates. Safety performance in the Iraqi construction industry is notoriously poor. Despite this condition, safety research has so far been neglected. Implementing a safety program is a proven initial step to improve safety. Therefore, the aim of this study is to identify the key elements of a safety program in the Iraqi construction industry. To verify and validate a list of safety program elements identified in the literature review, a mixed method approach was used by using interviews and questionnaire surveys. A final list of 25 elements were then analyzed using exploratory factor analysis. The analysis found that these elements can be grouped into four interrelated dimensions: management commitment and employee involvement, worksite analysis, hazard prevention and control systems, and safety and health training. This study contributes to the body of knowledge on safety in the Iraqi construction sector, a research area which has not been adequately investigated previously. They also help decision-makers focus on key elements that are needed to start improving safety performance in this context.


Assuntos
Indústria da Construção , Saúde do Trabalhador , Iraque , Gestão da Segurança , Local de Trabalho
8.
Environ Monit Assess ; 193(1): 49, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33415539

RESUMO

Heavy metal pollution in the environment has gained interest in the past few decades, as it has been found to accumulate in soil and water, as well as in the human body. Heavy metals present a serious health risk to humans when the concentration level and exposure time are increased. Although they have been extensively studied in the environment and food, little is known regarding their occurrence in the Kurdistan Region of northern Iraq. To fill this gap, we investigated the occurrence of some metals and heavy metals, namely aluminium (Al), barium (Ba), mercury (Hg), manganese (Mn), lead (Pb), vanadium (V) and zinc (Zn), in the blood of crude oil workers (40 men) who have worked in crude oil fields for at least 3 years-exposed group. In addition, a control group of 40 men was selected who have never worked or been close to crude oil fields. There is a significant correlation of metal concentrations between exposed and control groups, especially for Al, Ba, Hg, Mn and V (significant for all metals). Even though the correlation for Pb and Zn was weak, the concentrations were higher by 2-folds in the exposed group compared to the control group. Thus, the exposure caused an increase in the concentration of heavy metals by at least 1-fold in the blood of the exposed group compared to the control group. The environmental and ecotoxicological relevance of heavy metals in humans and the environment in areas with industrial activities have yet to be assessed.


Assuntos
Metais Pesados , Petróleo , Poluentes do Solo , China , Monitoramento Ambiental , Humanos , Iraque , Masculino , Metais Pesados/análise , Medição de Risco , Poluentes do Solo/análise
9.
Mil Med ; 186(Suppl 1): 316-323, 2021 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-33499492

RESUMO

INTRODUCTION: Rapid sequence intubation of patients experiencing traumatic hemorrhage represents a precarious phase of care, which can be marked by hemodynamic instability and pulseless arrest. Military combat trauma guidelines recommend reduced induction dose and early blood product resuscitation. Few studies have evaluated the role of induction dose and preintubation transfusion on hemodynamic outcomes. We compared rates of postintubation systolic blood pressure (SBP) of < 70 mm Hg, > 30% drop in SBP, pulseless arrest, and mortality at 24 hours and 30 days among patients who did and did not receive blood products before intubation and then examined if induction agent and dose influenced the same outcomes. MATERIALS AND METHODS: A retrospective analysis was performed of battle-injured personnel presenting to surgical care facilities in Iraq and Afghanistan between 2004 and 2018. Those who received blood transfusions, underwent intubation, and had an Injury Severity Score of ≥15 were included. Intubation for primary head, facial, or neck injury, burns, operative room intubations, or those with cardiopulmonary resuscitation in progress were excluded. Multivariable logistic regression was performed with unadjusted and adjusted odds ratios for the five study outcomes among patients who did and did not receive preintubation blood products. The same analysis was performed for patients who received full or excessive versus partial induction agent dose. RESULTS: A total of 153 patients had a mean age of 24.9 (SD 4.5), Injury Severity Score 29.7 (SD 11.2), heart rate 122.8 (SD 24), SBP 108.2 (SD 26.6). Eighty-one (53%) patients received preintubation blood products and had similar characteristics to those who did not receive transfusions. Adjusted multivariate analysis found odds ratios as follows: 30% SBP decrease 9.4 (95% CI 2.3-38.0), SBP < 70 13.0 (95% CI 3.3-51.6), pulseless arrest 18.5 (95% CI 1.2-279.3), 24-hour mortality 3.8 (95% CI 0.7-21.5), and 30-day mortality 1.3 (0.4-4.7). In analysis of induction agent choice and comparison of induction agent dose, no statistically significant benefit was seen. CONCLUSION: Within the context of this historical cohort, the early use of blood products conferred a statistically significant benefit in reducing postintubation hypotension and pulseless arrest among combat trauma victims exposed to traumatic hemorrhage. Induction agent choice and dose did not significantly influence the hemodynamic or mortality outcomes.


Assuntos
Militares , Afeganistão , Humanos , Escala de Gravidade do Ferimento , Iraque , Indução e Intubação de Sequência Rápida , Estudos Retrospectivos , Ferimentos e Lesões/complicações , Ferimentos e Lesões/terapia
10.
Sci Total Environ ; 754: 141978, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32919315

RESUMO

Covid-19 was first reported in Iraq on February 24, 2020. Since then, to prevent its propagation, the Iraqi government declared a state of health emergency. A set of rapid and strict countermeasures have taken, including locking down cities and limiting population's mobility. In this study, concentrations of four criteria pollutants, NO2, O3, PM2.5 and PM10 before the lockdown from January 16 to February 29, 2020, and during four periods of partial and total lockdown from March 1 to July 24, 2020, in Baghdad were analysed. Overall, 6, 8 and 15% decreases in NO2, PM2.5, and PM10 concentrations, respectively in Baghdad during the 1st partial and total lockdown from March 1 to April 21, compared to the period before the lockdown. While, there were 13% increase in O3 for same period. During the 2nd partial lockdown from June 14 to July 24, NO2 and PM2.5 decreases 20 and 2.5%, respectively. While, there were 525 and 56% increase in O3 and PM10, respectively for same period. The air quality index (AQI) improved by 13% in Baghdad during the 1st partial lockdown from March 1 to April 21, compared to its pre-lockdown. The results of NO2 tropospheric column extracted from the Sentinel-5P satellite shown the NO2 emissions reduced up to 35 to 40% across Iraq, due to lockdown measures, between January and July, 2020, especially across the major cities such as Baghdad, Basra and Erbil. The lockdown due to COVID-19 has drastic effects on social and economic aspects. However, the lockdown also has some positive effect on natural environment and air quality improvement.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Betacoronavirus , Cidades , Monitoramento Ambiental , Humanos , Iraque , Dióxido de Nitrogênio/análise , Material Particulado/análise
11.
Zootaxa ; 4894(2): zootaxa.4894.2.10, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33311089

RESUMO

Genus Saga Charpentier, 1825 along with four other genera (Clonia Stål, 1855; Cloniella Kaltenbach, 1971; Emptera Saussure, 1888 and Peringueyella Saussure, 1888) comprises the tettigoniid subfamily Saginae. These genera are distributed throughout three separated biogeographical zones; in the South-Southeast of Africa, genus Emptera in India and genus Saga in Palaearctic region (Kolics et.al., 2012 Sirin et.al., 2019). The predatory bush crickets of the genus Saga are the largest Palearctic orthopterans, with 16 species, of which ten inhabit Asia (Azerbaijan, Armenia, Caucasus, Turkey, Syria, Palestine, Lebanon, Jordan, Israel, Iran, and Iraq), the rest occur in Europe (one of them ranging to Western Siberia) (Kaltenbach, 1964, 1967, Bader Massa, 2001, Sirin et.al., 2019 Cigliano et al. 2020). Six of these species are endemic to Turkey (Saga beiri, S. capadocica, S. hakkarica, S. longicaudata, S. puella and S. rhodiensis) (Sirin et.al., 2019), while the six European taxa are (S. natoliae, S. pedo, S. campbelli, S. gracilis, S. hellenica and S. rammei) (Kolics et.al., 2012). In the East Mediterranean countries S. ledereri occur in Syria and Lebanon, S. ornata in Israel, Jordan, Lebanon, Palestine and Syria (Kaltenbach, 1964, 1967 Cigliano et al. 2020). Among the non-European Saga species, S. ephippigera has the broadest geographic range, extending from Israel, Jordan, Lebanon, Palestine and Syria to Turkey, Iraq, Iran, Caucasus, Transcaucasus and Karabagh, while S. syriaca is found in Syria, Lebanon, Turkey and Iraq (Kirby,1906, Kaltenbach, 1967, Bader Massa, 2001, Arsalan Candan, 2019, Sirin et.al., 2019 Cigliano et al. 2020).


Assuntos
Ortópteros , Distribuição Animal , Animais , Iraque
13.
PLoS One ; 15(12): e0243293, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332375

RESUMO

The main cause of problematic soil failure under a certain load is due to low bearing capacity and excessive settlement. With a growing interest in employing shallow foundation to support heavy structures, it is important to study the soil improvement techniques. The technique of using geosynthetic reinforcement is commonly applied over the last few decades. This paper aims to determine the effect of using geogrid Tensar BX1500 on the bearing capacity and settlement of strip footing for different types of soils, namely Al-Hamedat, Ba'shiqah, and Al-Rashidia in Mosul, Iraq. The analysis of reinforced and unreinforced soil foundations was conducted numerically and analytically. A series of conditions were tested by varying the number (N) and the width (b) of the geogrid layers. The results showed that the geogrid could improve the footing's bearing capacity and reduce settlement. The soil of the Al-Rashidia site was sandy and indicated better improvement than the other two sites' soils (clayey soils). The optimum geogrid width (b) was five times the footing width (B), while no optimum geogrid number (N) was obtained. Finally, the numerical results of the ultimate bearing capacity were compared with the analytical results, and the comparison showed good agreement between both the analyses and the optimum range published in the literature. The significant findings reveal that the geogrid reinforcement may induce improvement to the soil foundation, however, not directly subject to the width and number of the geogrid alone. The varying soil properties and footing size also contribute to both BCR and SRR values supported by the improvement factor calculations. Hence, the output complemented the benefit of applying reinforced soil foundations effectively.


Assuntos
Materiais de Construção , Solo , Argila/química , Materiais de Construção/análise , Fenômenos Geológicos , Iraque , Areia/química , Solo/química
14.
N Z Med J ; 133(1527): 51-70, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33332328

RESUMO

AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.


Assuntos
Nível de Saúde , Estilo de Vida/etnologia , Atenção Primária à Saúde/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , Adulto , África ao Sul do Saara/etnologia , Idoso , Idoso de 80 Anos ou mais , Ásia Sudeste/etnologia , Butão/etnologia , Índice de Massa Corporal , Criança , Pré-Escolar , Colômbia/etnologia , Comportamento Contraceptivo/etnologia , Comportamento Contraceptivo/tendências , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/etnologia , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Infecções por HIV/etnologia , Infecções por Helicobacter/etnologia , Helicobacter pylori , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etnologia , Lactente , Recém-Nascido , Enteropatias Parasitárias/etnologia , Iraque/etnologia , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Doenças Sexualmente Transmissíveis/etnologia , Uso de Tabaco/etnologia , Tuberculose Pulmonar/etnologia , Deficiência de Vitamina D/etnologia , Adulto Jovem
16.
PLoS One ; 15(10): e0239969, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33017408

RESUMO

BACKGROUND: Traumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers. METHODS: Care providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring. RESULTS: The care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible. CONCLUSION: The HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future.


Assuntos
Pessoal de Saúde , Trauma Psicológico/fisiopatologia , Transtornos Psicofisiológicos/fisiopatologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Adulto , Idoso , Feminino , Alemanha , Humanos , Iraque/etnologia , Islamismo , Masculino , Pessoa de Meia-Idade , Trauma Psicológico/etnologia , Transtornos Psicofisiológicos/etnologia , Pesquisa Qualitativa , Transtornos de Estresse Pós-Traumáticos/etnologia , Inquéritos e Questionários , Adulto Jovem
18.
Ann Parasitol ; 63(3): 295-302, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33128446

RESUMO

Visceral leishmaniosis is one of the most fatal old-world neglected disease with estimated 90 thousand worldwide cases emerge each year. In Iraq, the cutaneous and visceral form are endemic but available chemotherapies are either toxic with diverse side effects, expensive available drugs or parasite resistant is arising. Artemisinin (ART) is a semi-synthetic compound which proved its effectiveness against protozoan parasites, such as malaria and Leishmania. In this study, the efficacy of different concentrations of pure artemisinin was screened in vitro against promastigotes and axenic amastigotes by MTT assay after 24, 48 and 27 hours follow up. In addition, the infectivity ability and number was investigated of intra-cellular Leishman bodies in treated murine peritoneal macrophages after 24 and 48 hours ART treatment. The results verified ART efficacy against the promastigotes and axenic amastigotes viability with IC50 measured after 24, 48- and 72-hours treatment. Infectivity percentage of murine macrophages and parasite burden were significantly reduced in treated cells. These findings indicate the leishmanicidal activity of ART against the Iraqi isolate of L. donovani and further in vivo study is recommended for assigning ART as a natural anti visceral leishmaniosis compound.


Assuntos
Antiprotozoários , Artemisininas , Leishmania donovani , Leishmaniose Visceral , Animais , Antiprotozoários/farmacologia , Antiprotozoários/uso terapêutico , Artemisininas/farmacologia , Artemisininas/uso terapêutico , Iraque , Leishmaniose Visceral/tratamento farmacológico , Macrófagos , Camundongos
19.
BMC Med Genet ; 21(1): 203, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059634

RESUMO

BACKGROUND: HbH disease results from dysfunction of three, less commonly two, α-globin genes through various combinations of deletion and non-deletion mutations. Characterization of the mutations and the underlying genotypes is fundamental for proper screening and prevention of thalassaemia in any region. The aim of this study was to explore the genetic arrangements of HbH disease and to correlate the genotypes with the clinical phenotypes. METHODS: A total of 44 HbH disease patients were enrolled in this study. They were clinically and haematologically assessed. The patients were tested for 21 common α-globin gene mutations using multiplex PCR and reverse hybridization. According to the genotype, the patients were categorized into two separate sub-groups, deletion and non-deletion types HbH disease. RESULTS: Within the studied HbH disease patients, eight different α-globin gene mutations were detected in nine different genetic arrangements. The --MED and -α3.7 deletions were the two most frequently encountered mutations (37.5 and 35.2% respectively). Patients with deletion genotypes constituted 70.4%. The most common detected genotype was --MED/-α3.7 (59.1%), followed by αpoly-A1α/αpoly-A1α (13.6%). For the first time, coinheritance of two relatively mild mutations (-α3.7/ααAdana) was unpredictably detected in a 1.5 year-old child with Hb of 7.1 g/dL. CONCLUSION: The HbH disease patients' clinical characteristics were variable with no ample difference between the deletion and non-deletion types. These results can be of benefit for the screening and management of thalassaemia in this region.


Assuntos
Estudos de Associação Genética/métodos , Hemoglobina H/genética , Mutação , alfa-Globinas/genética , Talassemia alfa/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Estudos de Associação Genética/estatística & dados numéricos , Genótipo , Humanos , Lactente , Iraque , Masculino , Pessoa de Meia-Idade , Fenótipo , Adulto Jovem , Talassemia alfa/diagnóstico
20.
BMC Infect Dis ; 20(1): 645, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873242

RESUMO

BACKGROUND: During the outbreak of cutaneous leishmaniasis in the Kurdistan Region of Iraq that started in 2015, the course of the disease and the treatment were not consistent with the available literature. Physicians, particularly dermatologists, faced challenges with treating the cutaneous leishmaniasis lesions with high rates of treatment failure and resistance to treatment. We used Q-methodology to understand the range and diversities of opinions and the practical experiences of dermatologists about the treatment difficulties of cutaneous leishmaniasis. METHODS: This Q-methodology study was carried out in Erbil, Kurdistan Region of Iraq, and involved 37 dermatologists. A set of 40 statements related to different aspects of difficulties and uncertainties of treating cutaneous leishmaniasis was prepared. The dermatologists were requested to distribute the 40 statements into a scaled grid of nine piles from least agree to most agree. We applied by-person factor analysis using PQMethod 2.35 for the data analysis. RESULTS: The analysis revealed two different viewpoints about the treatment of cutaneous leishmaniasis and a consensus viewpoint. The first viewpoint emphasized the use of sodium stibogluconate-based combination therapy, concerns with treatment failure, and lack of compliance with the treatment. The second viewpoint emphasized the lack of standard treatment and advances in the treatment of cutaneous leishmaniasis. There was a consensus between both groups of respondents about many aspects of the treatment of cutaneous leishmaniasis, including considering sodium stibogluconate the first drug of choice for cutaneous leishmaniasis treatment. CONCLUSIONS: This study revealed a diversity of viewpoints and uncertainties about the effectiveness of the available treatment modalities and treatment difficulties and failure. Interrupted supply and poor quality of the available drugs and lack of a standard and advanced treatment are the main problems facing the treatment of cutaneous leishmaniasis. More research is required to determine the best treatment modalities for the different types of cutaneous leishmaniasis. There is a need for the development of treatment guidelines specific to the Iraqi context with a particular focus on the treatment of the resistant and atypical cases of cutaneous leishmaniasis.


Assuntos
Gluconato de Antimônio e Sódio/uso terapêutico , Atitude , Consenso , Dermatologistas/psicologia , Leishmania , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/epidemiologia , Adulto , Terapia Combinada , Análise Fatorial , Feminino , Humanos , Incidência , Iraque/epidemiologia , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Falha de Tratamento
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