Abstract: Background: Excessive hair shedding among child-bearing women has been linked to low iron store. Despite this, multi-studies looked at this connection have yield inconsistent results.ferritinAim: To compare hemoglobin and ferritin level of childbearing women with telogen effluvium and those in otherwise good health. To evaluate the link between iron store level and amount of hair shed.Patients and Methods: The case-controlled study included 74 women with telogen effluvium and 22 age matched healthy women recruited from Al-Salam Teaching Hospital in Mosul. Participants underwent an assessment of hair fall count using a standardized hair fall count in 60 seconds. Five ml of blood was drawn to assess the iron status (hemoglobin and ferritin).  Difference in iron status between groups were compared by t-test and their link with amount of hair fall was assessed by Pearson correlation and regression tests. P-value <0.05 is significant.Results: Alopecia patients were 27.81±9.63 years old on average. The difference in hemoglobin levels between Alopecia patients and the control group were not-significantly (11. 83±4.59 gm/dl vs. 12.72±0.88 gm/dl) while differences in ferritin level was highly significant (27.84±22.06 ng/ml vs. 57.75±19.75ng/ml). Strong inverse linear were detected in the number of hair falls and ferritin (r=-0.53, P 0.0001). Regression analysis revealed that changes in hemoglobin accounts for only 9% of variation in the total number of hair falls, while ferritin accounts for 28% of them. Two prediction equations based on hemoglobin and ferritin were created for predicting hair fall count in 60 seconds.Conclusions: The study provides additional evidence for the role of low iron stores reflected by ferritin level in hair fall count in women with chronic telogen effluvium. A nonanemic iron deficiency is probably responsible for unexplained non-specific symptoms like diffuse hair loss. The suggested regression equation provides dermatologists with a tool to predict the amount of hair fall based on estimated ferritin and hemoglobin.

Abstract: Background: Aging is a normal physiological process that causes several changes in all organs, and changes in testicular histology are one consequence of aging that leads to decline in male fertility.The aim of the study: is to examine the impact of aging on the testes and the possible protective role of resveratrol. Method: Twenty-four male of Wistar albino rats were used in the present study, which divided into three groups of eight animals each. A 6-month-old control group A. Group B the 24 month old group. Group C the old age group treated with resveratrol received 25 mg/kg/day dissolved in distilled water given orally by gastric tube. Treatmentwere performed for 3 months. At end of experiment, blood was collected for hormonal assessment, the animals were scarified, and the testes were taken and prepared for histological examination.Results: revealed that the testes had regressive age-related structural alterations  include atrophy and sclerosed seminiferous tubules, arrest of spermatogenesis, decrease in the spermatogenic cells and Sertoli cells, thickening of the tunica albuginea, increase in Leydig cells associated with decrease testosterone and increase in FSH )follicular stimulating hormone) and LH (luteinizing hormone),  increase the oxidative marker MDA (Malonaldehyde ),  in addition to deterioration in sperm analysisThe use of RES (Resveratrol) improve the testosterone, FSH and LH with decrease the MDA and improve the histological changes of aged testes .Conclusion: aging has deleterious effect on testes cause histological changes, reduction in spermatozoa's quality and quantity with aging and increase oxidative stress of aged testes and the use of RES as a preventative and/or  therapeutic drug for  aging-related testicular alterations is possible. 

Abstract: Background: Increasing authentication suggests that olfactory disorder is a prominent symptom of COVID-19 with the inadequacy of data on its recovery patterns in the Middle East.Aim of the study: The primary aim is to identify the different recovery patterns in patients with olfactory dysfunction due to the COVID-19 pandemic in Iraq. While in the second aim, we assess the correlation of olfactory dysfunction to age, gender, and comorbidities.Patients and methods: This online cross-sectional study was conducted at Al-Jumhory teaching hospital, Mosul, Iraq, for a period from January/2021 up to January/2022. This study was done by answering responses using the website online questionnaire and not directly from the patients. After the exclusion of incomplete responses, this study involved 637 patients who were older than 18 years. We included patients with COVID-19 infection which was proved by positive polymerase chain reaction associated with the new-onset olfactory disorder.Results: The current study portrays that 50.9% have a complete recovery, 35.9% with partial recovery, and 13.2% of patients did not recover olfactory function. Earlier recovery (less than 3 weeks) is associated with complete recovery, while later recovery is associated with partial recovery. In the first three weeks, 75.3% and 45.9% of complete and partial recovery occurred respectively.Conclusions: This study declares that most of the participants documented complete recovery of olfactory disorders in the first three weeks following infection. The recovery was not related to age, gender, and comorbidities.

Abstract: Purpose: Renin-angiotensin-aldosterone-system activation associated with heart failure is one of the main determinants of  health condition deterioration of the patients with heart failure. The aim of this study is to compare the effectiveness of the metallo-endopeptidase inhibitor Sacubitril alone and in combination with azilsartan in ameliorating syndromes of heart failure in rats.Materials and Methods: twenty four rats were divided into 4 groups, each of 6 rats. The first group served as the normal control group. Heart failure was induced in the rats of the other three groups with isoproterenol 5 mg/kg/day for one week, 2nd group rats served as appositive control group, rats in the 3rd, and 4th groups were administered daily oral doses of sacubitril, and sacubitril-azilsartan combination respectively for two weeks.Results: Heart failure induction in rats with isoproterenol showed a statistically significant increase in plasma concentration of NT-proBNP, MMP9, Renin, Troponin I, and CK-MB. A significant decrease in mean blood pressure, urine flow, glomerular filtration rate was observed.Administration of sacubitril-azilsartan combinations showed a significant fall of MMP9, NT-proBNP, serum urea, Troponin I and creatinine.  Rats that have received Sacubitril alone did not show significant changes in the mentioned parameters except for NT-proBNP and serum creatinine.Combining sacubitril with azilsartan showed a significant increase in urine flow, glomerular filtration rate, and renin plasma level, whereas Sacubitril alone failed to show a significant change in the mentioned parameters.Conclusion: Combination of sacubitril with azilsartan showed better efficacy to sacubitril monotherapy in improving plasma levels of cardiac biomarkers: NT-proBNP, MMP9, and troponin I levels. It has ameliorated compromised renal function through increasing glomerular filtration rate, urine flow, creatinine clearance, and urea clearance. Results revealed that the combination (azilsartan-sacubitril) showed better ameliorating impacts on syndromes of heart failure induced by isoproterenol in rats. 

Abstract: Background: the anterior cruciate ligament (ACL) is the knee joint ligament that is the most frequently injured and necessitate knee joint MRI secondary to trauma.Aim of the study: to assess the benefit of adding T2W-coronal oblique sequence to the standard MRI knee protocol in detecting and grading the ACL tears.Patients and methods: Seventy patients participated in this cross-sectional study between July 2021 to December 2021, 54 were males and 16 were females with an age ranged from 18-45 years (mean age 33.4±8.6). Three well-trained general radiologists interpreted the results; each radiologist assessed all the patients in the standard sequences alone (method A), then randomly re-assessed them using the standard and oblique sequences together (method B).Results: the results showed a considerable degree of variability in interpretation between the 3 radiologists in method A, while there was a relative decrease in the degree of variability in interpretation between the 3 radiologists in method B. There was a statically significant difference between the results for each radiologist in both methods (P-value 0.0001). The results showed an overall increment in Cohen's Kappa score for radiologists no. 2 and 3 in method B compared to method A, Cohen Kappa for (Radiologist 2: in method A 0.800 became 0.808 in method B) and (Radiologist 3: in method A 0.801 became 0.936 in method B), while for radiologist 1, there was substantial agreement in both methods.Conclusion: addition of oblique coronal sequence in assessing ACL injury revealed an improved detection and appropriate grading of the ACL tears.

Abstract: Background: Coronavirus  disease 2019 (COVID-19) is an emerging, rapidly evolving situation that leads to unprecedented demand for health care services.Objectives: Underscoring the clinical manifestations of SARS-CoV-2 infection in children in Iraq by highlighting a new configuration of health care services without any boundaries in the future provided to pediatric patients via telemedicine.Patients and methods: An ongoing prospective cross-sectional telemedicine-based study with data gathering and analysis of many variables of 62 patients in Iraq via remote consultations between July 2020 and May 2021.Results: The male-to-female sex ratio was 0.8:1. The most frequently observed symptoms in infants less than 1 year of age have been coughing (66.6%) and fever (55.5%). In children aged 1-9 years, fever (61.1%) and rhinorrhea (55.5%) were the most commonly observed symptoms with additional clinical findings, including one case (2.7%) presented with bloody diarrhea and another case (2.7%) presented with chest pain. In children and Adolescents aged 10-<18 years, headache (64.7%) with a significant P-value (0.000) and fever (58.8%) were the most frequently observed symptoms. Only one patient (1.6%) requires hospital admission, and the vast majority of the patients are treated at home (98.4%). Hopefully, the case fatality rate was zero percent.Conclusions: The COVID-19 trajectory in children has a good prognosis, even in cases with underlying chronic diseases, and most of the cases are treated at home using telemedicine-healthcare services. 

Abstract: Background: Vitamin D and zinc deficiency have been the most common nutritional deficiency worldwide. There is conflicting evidence about the potential link between serum vitamin D levels and serum zinc and semen quality. The aim of this study is to examine how serum zinc and serum vitamin D affect the fertility of males by evaluating the quality of their semen.Materials and Methods: The cross-sectional study was carried out for 18 months from May 2021 to December 2022 on 103 men who were referred to an infertility clinic center at Kalar, As-Sulaymaniyyah city for their wife's fertility problems. They divided into two different groups of normal sperm parameters and abnormal sperm parameters (55 normal) and (48 abnormal).Results: The mean values of the semen volume, total sperm concentration, total sperm motility percentage,  and normal morphology percentage as well as serum vitamin D and serum zinc were significantly higher in the group with “normal sperm parameter” (55) as compared to subjects (48)  “abnormal sperm parameters” group. The serum vitamin D and serum zinc levels were significantly high in men with “normal sperm parameters”; 35.21±10.18 (ng/dL), and, 76.46±12.02 (ng/dL), respectively. Compared with "abnormal sperm parameters" 17.64±10.01 (ng/dL) and 54.14±15.64 (ng/dL)  (mean ± SD) with  p-value < 0.0001.Conclusion: A significant decrease in serum vitamin D and serum zinc concentrations has a negative association on semen quality, leading to decrease sperm parameters as well as fertilization rate. 

Abstract: Background :   Methotrexate (MTX) is one of the most effective drugs in cancer chemotherapy, as well as in the treatment of non-oncologic conditions such rheumatoid arthritis and psoriasis. It is one of the folic acid antagonists. However, The efficacy of MTX is often limited by it’s severe side effects on the renal and liver tissue which may  limit its use.Aim of Study:  The purpose of this study was to examine the histological alterations in the rat liver and renal structure after treatment with (MTX), as well as the potential protective impact of vitamin C.  METHODS: An experimental study of eighteen (18)  male albino rats which were randomly distributed into three groups. Each group consists of six animals. Group I was the control group.  In Group II rats received a daily IM injection of MTX (5mg/kg b.w.) for seven days. Group III: For seven days, the animals were given MTX at the same doses, periods and modes of administration as before with concomitant vitamin C in a dose of (100 mg/day) was given. The mice were euthanized after blood samples were taken from the retroorbital venous plexus for biochemical tests of liver enzymes and renal function. Light microscopic examinations were performed on liver and kidney specimens.Results: The current study found that (MTX) therapy caused significant damage to the rat liver and kidney, as seen by elevated liver enzyme levels and altered renal function tests. The central and portal veins were severely dilated and congested in sections of the liver, with patches of fatty degeneration readily visible. The kidney segment revealed glomerular atrophy, tubular dilatation, and degeneration. Rats given vitamin C concomitantqqq2ly with MTX, on the other hand, showed minor histological alterations.Conclusion: Vitamin C appeared to have some protection against MTX poisoning by reducing earlier degenerative alterations.

Abstract: Aim of the study: To explore any differences in weight-loss outcomes between rural versus urban citizens in patients who underwent laparoscopic sleeve gastrectomy (LSG).Design: A retrospective study.Patient and methods: A sample of 270 patients (108 rural, 162 urban) who underwent (LSG) over a 1 year of follow-up.Data collected included age, gender, pre-and postoperative body mass index (BMI) and percentage of total body weight loss (% TWL) at 3, 6 and 12 months.Results: Patients from rural areas showed a greater (% TWL) at 3 months (p = 0.018) but there were no significant differences between groups at 6 and 12 months (p > 0.05).Conclusion: Residence status is not a predictor of weight-loss outcomes at 12 months after (LSG). 

Abstract: Background: The controversy of pediatric septoplasty exists. Septoplasty is an uncommon procedure in pediatric populations. Still, there is a lack of consensus about the age and extent of septoplasty in this age group. Moreover, delayed surgical correction of septal deviation may adversely affect normal nasal and facial growth. There is a recent trend toward major cartilage work in pediatric patients with severe septal deviation.The aims of this study are to evaluate the health-related quality of life in pediatric patients after septoplasty and to assess the early as well as the long-term outcomes of surgery.Ethical Approval: The Collegiate Committee for Medical Research Ethics approved the study with approval code CCMRE-MED-22-1 on 17/01/2022. It aligns with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.Patients and methods: This case series study was conducted on 25 children (24 males and one female) who underwent septoplasty for severe symptomatic septal deviation. This assessment was done three months and 1-year post-operatively to assess the operation's effect on the quality of life and overall patient satisfaction. The follow-up was done utilizing NOSE and VAS scales and they were compared with pre-operative ones. In most cases, the cartilage was delivered, remodelled, and reinserted.Results: The mean age of patients was 8.5±3.8 years. There were 24 (96.31%) males and 1 (3.69%) females. The current study reveals significant differences in postoperative NOSE and VAS scores compared to pre-operative ones at three months and one year post-operatively with P-values <0.001. Synechia, infection due to crust formation, and residual deviation were the common complications in this study.Conclusion: The significant improvement in quality of life and the low complication rate justifies septoplasty in the pediatric age group in indicated cases, even if considerable cartilage work was needed.

Abstract: Background: Ruptured ovarian cysts are common gynaecological presentation to health institutions most commonly presented with abdominal pain.Objective: Describe the clinical profile of cases diagnosed to have ruptured ovarian cysts.   Methodology: The current study is a case series study conducted in Al-Jumhory and Al-Salam Teaching Hospitals in Mosul.  During the period from 1st Jan. to the end of October. 2021. The study subjects include 64 females' presented to the involved hospitals and diagnosed to have ruptured ovarian cysts.Results: About 70% of participants were in the age group 11-26 years. More than half of the study population reports primary school education compared to only 15% of cases who report university level of education. Also, it has been found that  27 patients (41.67 %) were married. The majority of cases were diagnosed to have right ovarian cyst, moreover, 70.31% of patients presented with right Iliac fossa pain. Nausea, and vomiting was reported by 85.94% and 60.94% of study population respectively. on the other hand, vaginal bleeding was observed among only 15.63%.Conclusion: The frequency of ovarian cyst rupture is relatively high among younger women, and in lower educational levels women, whereas positive family history of ovarian cyst rupture was infrequent.

Abstract: Melatonin (MLT) "N-acetyl-5-methoxytryptamine"; a pineal hormone; has a diurnal variation and may be necessary for the suprachiasmatic nucleus (SCN) and peripheral tissue's molecular circadian clocks to be synchronized, has powerful receptor-dependent and receptor-independent effects on a number of cardiovascular (CV) variables, including endothelial cells function, thrombus formation, blood pressure (BP), and heart rate (HR). MLT possesses antioxidative, anti-inflammatory, chronobiotic, and perhaps epigenetics regulatory characteristics. Low blood concentrations of MLT have been found in persons who have coronary artery disease (CAD), arterial hypertension (HT), and congestive cardiac failure. The physiological function of endogenous MLT and its circadian rhythm in the human CV system is reviewed in this article.

Abstract: Type one diabetes mellitus (T1DM) is an autoimmune condition wherein islet cells of pancreas are damaged, necessitating extrinsic insulin therapy for the remainder of life. T1DM affects kids and teenagers and accounts for roughly 5-10% of diabetes cases. Cytokines are low-molecular-weight extracellular molecules that serve as immune modulators which cause β cells impairment in T1DM patients by generating nitric-oxide. Comprehending and controlling autoimmune inflammatory factors, on the contrary, may aid in treating or even avoiding disease advancement. Interleukin-6 (IL-6) is a versatile mediator that have an influential purpose in inflammation besides autoimmune conditions and one of variables implicated in autoimmune inflammation. This cytokine, however, was demonstrated to play a significant function in metabolic control, notably homeostasis of glucose.Objective of this review is to demonstrate the contribution of interleukine-6 in T1DM etiology.

Abstract: Background: The World Health Organization led a program to eliminate smallpox, which was validated 40 years ago. According to estimates, most nations have stopped vaccinating their citizens against the disease on a regular basis. Cross immunity has been affected as a result, and a sizable section of the world's population no longer possesses protection to orthopox viruses that are directly connected to one another, such monkeypox and smallpox. These data raise the possibility that emerging or re-emerging human would fill the epidemiological gap left by smallpox, along with occasional instances of human pathogens with many orthopox viral infections.Aim of this study: This review focused on the disease caused by the monkeypox virus and its significant modes of transmission, which has recently reemerged in some nations globally, as well as how to prevent the disease from spreading.Conclusion: The monkeypox virus can spread in a variety of methods, all of which need intimate contact with ill people or infected animals. Small mammals are occasionally able to carry the virus without showing any symptoms. Monkeys, hedgehogs, rodents, anteaters, prairie dogs, dogs, and squirrels are just a few of the many animal species that can contract the monkeypox virus. Viral transmission between humans is less frequent than with infected animals, however, close contact either exposure to respiratory droplet, mouth contact to mouth or to skin, or skin contact with mucosal skin lesions of an infected person are the methods of transmission. Good personal hygiene and vaccination is recommended to build immunity against monkeypox. Further research is needed to clarify the role of host as well as viral components in the pathogenesis of serious and lethal infection, as well as to gain a better understanding of their risks, genes, and natural histories. This will enable global healthcare strategists to develop effective protection plans.

Abstract: Background   and   objective: It is well known that infection with SARS-CoV-2 (COVID-19) has pulmonary and extra-pulmonary manifestations including renal system. Understanding the bidirectional impact and correlation between severity of COVID-19 and renal function impairment is crucial in managing the complications of COVID-19 and drug prescription accordingly. This study aimed  to  assess impairment in renal function at mild, moderate and sever cases of covid-19.Methods: A study focused on COVID-19 cases was carried out in Erbil, Iraq. The sample consisted of 253 individuals who tested positive for the virus through PCR (135 females and 118 males) aged 18 or older and were obtained through convenience sampling from various clinics and hospitals in the city. The data collection took place from July 1, 2020 to October 2021 and involved gathering the medical history, physical examination results, laboratory tests, and imaging of the cases to assess their health status, the severity of their illness, and their renal function.Results: The patient's gender did not play a major role in the intensity of COVID-19 illness (p=0.744), however, factors such as smoking, hypertension, and diabetes were found to be significant contributors (p<0.0001). The kidney function measurement, GFR, revealed a significant difference among all groups (p<0.0001) and showed a strong negative relationship with CRP (r=-0.751, p<0.001) and a moderate positive connection with SpO2 (r=0.646, p<0.001).Conclusion: The severity of COVID-19 was found to have a strong negative correlation with kidney function, which was represented by GFR. 

Abstract: Background: Giardiasis, is a disease caused by the Giadia lambilia, found in many regions of the world, including Iraq. It affects different age groups of people, especially children and causes symptoms, including abdominal pain, diarrhea and weight loss.The aim of this review is to find the prevalence of giardiasis among many cities and governorates in Iraq and the extent of the influence of age, sex, area of residence and seasons of the year on its spread.Conclusion: Numerous previous studies indicated the spread of giardiasis in many cities and governorates in Iraq and the young age group showed a higher rate of prevalence than the other groups. Males are also recorded higher infection rate than females. Also, the infection rate in rural areas was higher than in urban areas. It is also evident that the seasons had an effect on the parasite's existence and, consequently, the spread of this sickness.

Abstract: Background: Exercise or physical activity is considered of key importance in the clinical management of patients with type 2 diabetes mellitus T2DM and has therefore been included inthe guidelines for diabetes prevention and treatment,Aim: this study aims to evaluate the relationship between energy expenditure and T2DM parameters during the evaluation of functional exercise capacity.Materials and Methods: the case series study was included 100 individuals with type 2 diabetes mellitus   T2DM.  The patients with physical or cognitive disabilities, uncontrollable cardiovascular disease, heart failure, arrhythmia, pulmonary disease, liver failure, kidney failure, cancer, neurological and orthopedic diseases were excluded from this study. Informed consent was obtained from all individuals participating in the study. Data were analyzed with SPSS software (version 25, IBM., NY, U.S.A.) Results: The patients included in the study were clinically stable. When the visceral adipose index ( VAI)  values of individuals according to age are examined, 29.4% had no adipose tissue dysfunction, 5.9% had mild, 35.3% moderate, 29.4% had severe adipose tissue dysfunction. The mean PCI was 0.37 ±0.18 (beats/m). When individuals are classified according to the physiological expenditure index, Physiological cost index (PCI ) values are below 0.23 beats/m in 23.5% of individuals, between 0.23-0.42 beats/m in 29.4%, and 0.42 beats/m in 47.1% of individuals. It was above.  The six-minute walk test 6MWT values of 47.1% of individuals were below 82% and above 82% of 52.9%. Considering the relationships between clinical parameters and 6MWT job; Height, PCI, total cholesterol, 6MWT distance, 6MWT percentage, and during 6MWT with PCI Conclusions: Although the correlation between exercise capacity and (FBG). is modest, it may have accounted for these people's poor functional exercise ability