Hawler Medical University

Background and objectives: The in vitro fertilization plays a significant role for human development in last decades. Anti-müllerian hormone level evaluation is indicator of ovarian reserve. The aim of this study was to assess the role of anti-müllerian hormone in assessing the quality of in vitro fertilization outcomes. Methods: It was a retrospective study implemented at in vitro fertilization center of private hospital in Erbil city, Kurdistan region-Iraq in duration of one year from 1st of October, 2022 to 30th of September, 2023 on sample of 50 infertile women underwent in vitro fertilization. The biochemical pregnancy was diagnosed through serum recognition of human chorionic gonadotrophin, while the clinical pregnancy was diagnosed by ultrasonography. The in vitro fertilization outcome was assessed in relation to anti-mullerian hormone level and other variables like demographic and hormonal status. Results: Biochemical pregnancy was positive in 80% of infertile women, while clinical pregnancy was positive in 72% of them; 24 women with ongoing pregnancy and 12 women ended with live birth pregnancy. Mean anti-mullerian hormone level was not significantly different in regard to clinical pregnancy outcome (p=0.4). The means of oocyte retrieved and embryo transferred were significantly higher among infertile women with positive clinical pregnancy (p?0.05). The anti-mullerian hormone level was positively correlated to the count of oocyte retrieved and embryo transferred. Conclusions: The serum anti-mullerian hormone level is not a predictor for in vitro fertilization quality.

Background and objective: Retinopathy of Prematurity is a retinal vascular and capillary proliferation disease affecting premature infants undergoing oxygen therapy—the current study aimed to introduce adjusted screening criteria for children in the Kurdistan region. Methods: A retrospective review of medical records was conducted to analyze patients who underwent Retinopathy of Prematurity screenings in the Kurdistan region (Duhok Eye Hospital) between 01.01.2019 and 30.03.2023. The screening procedure involved pupil dilation using 1.25% phenylephrine ophthalmic solution and 1% tropicamide. Examinations were conducted using indirect ophthalmoscopy. To optimize screening and ensure timely treatment, three criteria were applied to all 500 babies based on gestational age and birth weight: 33-35 weeks and/or 2500-3000 g, 31-33 weeks and/or 2100-2500 g, and ? 31 weeks and/or ? 2100 g. Results: This study demonstrates a noteworthy association between gestational age and retinopathy of prematurity prevalence. Among neonates born at or before 31 weeks, 81.90% developed retinopathy of prematurity, while only 18.10% did not. For neonates delivered at 32-33 weeks, 27.37% experienced retinopathy of prematurity, with 72.63% avoiding it. At 34-35 weeks, 11.11% experienced retinopathy of prematurity, 88.89% did not. The data also reveals a relationship between birth weight and the requirement for retinopathy of prematurity treatment. Among neonates with a birth weight of less than 2100 grams, a substantial 56.27% required treatment, while 43.73% did not. Conclusions: The study underscores the importance of tailored screening and intervention strategies for retinopathy of prematurity, especially in the vulnerable in the Kurdistan region.

Background and objectives: Confronting a serious illness like cancer has the ability to trigger feelings of depression, anxiety, and other mental health challenges in a considerable portion of patients. This study aims to evaluate the prevalence of psychiatric disorders in cancer patients. Methods: The research was carried out as a cross-sectional study to assess Psychiatric morbidity at Rizgary Teaching Hospital-Oncology department and Nanakali Hospital for Hematology and Oncology, in Erbil city, Iraq. The study was initiated in April 2023 until April 2024. General health questionnaire-28 was used as a screening tool to detect psychiatric morbidity among cancer patients. Results: The majority of the patients showed presence of psychiatric morbidity (59.6%) according to the General Health Questionnaire-28 scale. The mean General Health Questionnaire-28 score of the patients were 26.7±10, the mean score for somatic symptoms was 8.5±3.7, the mean score for anxiety and insomnia was 7.5±4.4, the mean score for social dysfunction was 7.6±1.2, and the mean score for severe depression was 3.3±3.9. Younger age is significantly associated with presence of psychiatric morbidity (46±9.52 vs. 51±6.33) (p=0.001). Gender was also significantly associated with having psychiatric morbidity, as females showed the highest prevalence (66.2%) compared to males (40%) (p<0.05). There is a statistically significant association, between type of treatment and presence of psychiatric morbidity(p=0.039). Conclusion: The mental health issues are prevalent among individuals with cancer. Factors such as age, gender, and treatment type play a significant role in determining the likelihood of these issues occurring.

Osteoarthritis (OA) is a chronic degenerative joint disease influenced by genetic, environmental, and immunological factors. Vitamin D exerts immunomodulatory and anti-inflammatory effects through the vitamin D receptor (VDR), and genetic variation in the VDR gene may influence susceptibility to OA. However, data from Middle Eastern and Kurdish populations remain limited. This study aimed to evaluate the association between serum vitamin D status and four common VDR gene polymorphisms (FokI, ApaI, TaqI, and BsmI) in Kurdish adults with knee osteoarthritis. A hospital-based case-control study was conducted, including 100 OA patients and 100 healthy controls recruited in Erbil, Iraq. Serum vitamin D levels were measured biochemically, and VDR polymorphisms were genotyped using PCR-RFLP and sequencing. Association analyses were performed for polymorphic loci using univariate logistic regression. No allelic or genotypic variation was detected at the FokI (rs2228570), ApaI (rs7975232), or TaqI (rs731236) loci, indicating allele fixation in this population. In contrast, the BsmI (rs1544410) polymorphism exhibited significant variability. The AA genotype was significantly more frequent among OA patients than controls and was associated with increased odds of OA (OR = 2.26, 95% CI = 1.21-4.23; p = 0.006). The findings indicate that the VDR BsmI polymorphism is associated with knee osteoarthritis in the Kurdish population, whereas FokI, ApaI, and TaqI loci were non-polymorphic. These results highlight population-specific genetic variation within the VDR gene and underscore the need for larger studies incorporating functional validation to clarify the biological relevance of BsmI variation in osteoarthritis.

Introduction: This study investigates the quality of life among civilians with acute conflict-related extremity injuries sustained in Syria and Iraq, comparing Negative-Pressure Wound Therapy (NPWT) to standard treatment. Methods: Data were derived from a randomized controlled trial. Quality of life was assessed using the Self-Reporting Questionnaire 20 (SRQ-20) (range: 0–20) and the Wound-QoL (range: 4–7) questionnaires, with baseline and follow-up measurements. Statistical analyses compared NPWT to standard treatment, examining total scores as well as improvements. For the SRQ-20 results, the number of patients with a total score above the screening cut-off value was compared. For the Wound-QoL results, individual item responses were analyzed. Student’s t-test was used. Results: The median number of days between baseline and follow-up was eight (IQR: 4–21) for SRQ-20 and four (IQR: 4–7) for Wound-QoL. No differences were found between standard treatment and NPWT for the SRQ-20 scores at baseline or at follow-up, nor in the number of patients with scores above the screening cut-off value. For Wound QoL, patients receiving NPWT had better total scores at baseline than patients who received standard treatment (means of 10.3 vs. 13.1, 95% CI: 1.45–4.15), but there were no differences at follow-up (means of 7.2 vs. 7.4, 95% CI: -1.08–0.77). When comparing individual items at baseline, patients receiving NPWT had better scores on questions assessing unpleasant smell, poor sleep, and disturbing discharge compared to those receiving standard treatment, with mean differences of 0.45 (95% CI: 0.21–0.69), 0.65 (95% CI: 0.23–1.1), and 0.88 (95% CI: 0.69– 1.1), respectively. Conclusion: The results indicate that NPWT offers early benefits for symptoms of unpleasant smell, poor sleep, and discharge compared to standard treatment. However, these differences did not persist. The possible short-term gains in quality of life with NPWT should be weighed against the technique’s associated costs, especially in low-resource settings.

Introduction: Stroke is a leading cause of long-term disability worldwide, and rehabilitation strategies remain essential to optimize recovery. Electrical stimulation has been increasingly used alongside with exercise to enhance motor function and functional independence. Objective: This study aimed to evaluate the impact of combining electrical stimulation with range of motion (ROM) exercises on health-related outcomes among stroke patients compared with ROM exercises alone. Methods: A total of 100 stroke patients were recruited and randomly assigned into two equal groups: one received electrical stimulation combined with ROM exercises, while the other performed ROM exercises only. Functional outcomes were assessed across upper and lower limb joint movements, balance, swallowing, facial control, and cognitive orientation at three time points. Results: The combined therapy group demonstrated significantly greater improvements in motor recovery, joint mobility, postural balance, and functional independence compared to the ROM-only group. Additionally, faster recovery was observed in swallowing function, facial symmetry, and memory orientation among patients receiving combined therapy. Conclusion: Electrical stimulation combined with ROM exercises provides superior benefits over ROM exercises alone in stroke rehabilitation. These findings support its integration into physiotherapy practice to enhance neuroplasticity, accelerate functional recovery, and promote independence in daily life. Further large-scale and long-term studies are recommended to confirm these outcomes.