In the United States, the pharmaceutical industry is actively devising strategies to improve the diversity of clinical trial participants. These efforts stem from a plethora of evidence indicating that various ethnic groups respond differently to a given treatment. Thus, increasing the diversity of trial participants would not only provide more robust and representative trial data but also lead to safer and more effective therapies. Further diversifying trial participants appear straightforward, but it is a complex process requiring feedback from multiple stakeholders such as pharmaceutical sponsors, regulators, community leaders, and research sites. Therefore, the objective of this paper is to describe three viable strategies that can p

Background: Vitamin D deficiency/ insufficiency is common in different age groups in both genders especially among pregnant women and neonates where it is associated with several adverse outcomes including preeclampsia and preterm delivery.  

Objectives: To assess the extent of vitamin D deficiency/ insufficiency among mothers and their neonates and some factors related to it and identify some adverse outcomes of the deficiency/ insufficiency on neonates (preterm birth and low birth weight).

Subject and Methods: A cross-sectional study was conducted on 88 Iraqi pregnant women and neonates admitted to “Al-Elwiya teaching hospital for maternity” in Baghdad- Al

There is a global shortage of health care providers needed to address all levels of primary and specialty care.  The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases.  In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care.  The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system.  An example of how APPs are utilized to provide both inpatient and outpatient

Background: Cystoid Macular Edema (CME) in its various forms can be considered one of the leading causes of central vision loss in the developed world. It is not a disease itself, It represents a common pathologic sequel of the retina and occurs in a variety of pathological conditions such as, diabetic retinopathy, central or branch retinal vein occlusion(CRVO,BRVO), intraocular inflammation and following cataract extraction. Objective: This study was done to investigate the pattern of CME in patient attending Erbil Teaching Hospitals.Type of the study: Cross- sectional study.Methods and Materials: This is a hospital base cross- sectional study that included 61 patients (75 eyes) conducted at Erbil Teaching Hospitals for six months. All

Metagenomics is a branch of genomics that involves sequencing genetic material directly from environmental samples. Metagenomic data could facilitates evidence-based decisions while providing a more complete view of the microbial ecosystem in a pandemic setting. It would provide critical knowledge for future pandemic preparedness programs

Background: Central serous chorioretinopathy (CSCR) is an idiopathic condition aggravated by exogenous or endogenous glucocorticoids. Vascular deregulation in the choroid is a new hypothesis regarding central serous chorioretinopathy occurrence. The inhibition of choroidal mineralocorticoid receptors has a great role in shortening the duration of CSCR by inhibiting choroidal vasodilatation and leak.

Objective:  To assess the effect of oral spironolactone on subretinal fluid, central macular thickness and visual acuity in patients with acute CSCR compared to observation.

Subjects and Methods:  a hospital based, randomized clinical trial carried out at outpatient clinic in Ibn-Alhaitham Teaching E

Traumatic Brain Injury (TBI) is still considered a worldwide leading cause of mortality and morbidity. Within the last decades, different modalities were used to assess severity and outcome including Glasgow Coma Scale (GCS), imaging modalities, and even genetic polymorphism, however, determining the prognosis of TBI victims is still challenging requiring the emerging of more accurate and more applicable tools to surrogate other old modalities

Background: Malaria remains a leading cause of mortality in sub-Saharan Africa (including Sudan). C-reactive protein (CRP) is useful as   a marker of severity in malaria. African studies have shown that serum CRP levels correlate with parasite burden and complications in malaria, especially falciparum. However, there are no data on CRP levels in Sudanese malaria patients.

This study aims to evaluate the association between CRP levels with comorbidities, species, and complications of severe malaria

Subjects and Methods: A cross-sectional study enrolled 65 severe malaria patients at Khartoum state hospitals during the period from April to June2021. Manifestations of severe

Background: Background : Patients with non-rheumatic atrial fibrillation have high risk of thromboembolism especially ischemic stroke usually arising from left atrial appendage .Transoesophageal echocardiography provides useful information for risk stratification in these patients as it detects thrombus in the left atrial or left atrial appendage. Objective : This study was conducted at Al-Kadhimiya Teaching Hospital to assess the prevalence of left atrial chamber thrombi in patients with chronic non-rheumatic atrial fibrillation using transoesophageal echocardiography and its clinical significance as well as to verify the superiority of transoesophageal over transthoracic echocardiography in the detection of these abnormalities. Type of

Background: Thyroid operation needs very meticulous haemostasis to have minimal morbidity and mortality.

Objectives: Assessment of harmonic knife in open thyroid surgery as anew haemostatic procedure .

Type of the study: Cross-sectional study.

Methods: This study had been conducted at Alkindy teaching hospital in Baghdad city from the 1^st of May 2013 to the 1^st of January 2017  on 229  goiterous patients who needs thyroidectomy(36 males,193 females),divided in 2 groups according to the haemostatic procedure used during their operations, Group A (15 males,85females)using the usual conventional surgery(

Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms

Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD)

There is limited data and evidence about the effects of COVID-19 on Maternal health, especially when new information is emerging daily, through pregnancy, child birth and post natal period, women are vulnerable to have the infection, this article, aimed to show the suitable measures that should be applied for women at reproductive age who are suspected /confirmed with COVID -19 infection,

During pregnancy it is advisable to continue the antenatal care schedule, although reducing face to face visit is recommended (unless the pregnant condition required that ),and prioritize ANC at health facilities for high-risk pregnancy and during second half of pregnancy with adequate infection prevention control  measures.

Regardi

ackground: Escherichia coli is one of the most
important bacterial pathogen that can cause several
disease to human being . In our study we try to
investigate the sensitivity resistance pattern of
Escherichia coli against three antibiotics ( Amikacin,
Nalidixic acid and Cephalexin).
Methods: For this purpose we collected 51 clinical
isolates of Escherichia coli from stool and urine of
outpatient and inpatient patients from different wards
of AL-SADER Teaching Hospital in AL-NAJAF
AL-ASHRAf, IRAQ, and tested by culture and
sensitivity test .
Results: The results appeared that Amikacin show
the highest percentage of sensitivity ( 66.66 % ) ,
while Cephalexin show the lowest percentage of
sensiti

Background: Diabetes mellitus is a metabolic disorder affecting people worldwide, which require constant monitoring of their glucose levels. Commonly employed procedures include collection of blood or urine samples causing discomfort to the patients. Necessity arises to find alternative non invasive technique is required to monitor glucose levels. Saliva is one of most abundant secretions in the human body and its collection is easy, noninvasive and painless technique. Objective: The aim of this study was to determine the efficacy of saliva as a diagnostic tool by study the correlation between blood and salivary glucose levels and glycosylated hemoglobin (HbA1c%) in diabetes and non diabetes, and the comparison of salivary glucose level

Background: Toxoplasmosis is a very common infection caused by the obligate intracellular protozoan parasite. This parasite is called Toxoplasma gondii widely distributed around the world . Toxoplasma gondii can be vertically transmitted to the fetus during pregnancy and may cause wide range of clinical manifestations in the offspring.

Objective: To determine seroprevalence Immunoglobulin G (IgG) and Immunoglobulin M  (IgM ) to toxoplasma gondii among pregnant women and to identify the risk factors.

Type of the study: A cross-sectional study.

Methods: A total of 110 blood samples of pregnant women were collected from

Thyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.

Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because

Background: Autism is a complex developmental disability that typically appears during the first three years of life. Autism affects the normal development of the brain in the areas of social interaction and communication skills.Objectives: To identify risk factors for Autism among a sample of autistic children in Baghdad city. Type of the study: this is a case – control, study. Methods: This study was conducted during the period of data collection extended from first of November 2010 until the first of April 2011,The total number of children involved was 100children with diagnosis of autism. Handred children who are free from autism were taken as the control sample. Results: there was a significant association between paternal age and

Background: Primary Health care (PHC) is unanimous to be the cornerstone of a person-centered health system. While the adoption of a well-function, two-way, and organized referral system is the mainstay in the development of an efficient healthcare delivery system.  

Objective: To Assess the practice & opinion of doctors in the hospitals toward the referral system.  to determine the doctors in the hospital's commitment to referral system instructions and guidelines.

Subjects and Methods: A cross-sectional study with analytic elements was conducted in nine Iraqi governorates. Eight doctors from each health directorate, resulting in a tot

Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).

Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.

On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogr

Background: In the present study used device jet plasma needle with atmospheric pressure which  generates non thermal plasma jet to measure treatment potent with plasma against pathogenic bacteria  founded  in UTI  was inactivated with plasma at 10 sec,

Objective:. This work included the application of the plasma produced from the system in the field of bacterial sterilization , where sample of Gram- negative bacteria (Escherichia coli) were exposed to intervals (1-10)second . Midstream Urine samples swabs were obtained from patients with urinary tract infections.

Type of the study: Cross -sectional study.

Methods: The work were used i

Background: Acute urinary tract infection is a common bacterial infection causing illness in infants and children. At age of seven, 8% of girls and 2% of boys will have at least one episode. Although drinking water and using home remedies are known to help to flush away bacteria and keeps them from sticking to the bladder wall, researches to test the efficacy and safety of hydrochlorothiazide's diuretic effect as adjuvant to the antibiotics in pediatric age groups are lacking, and so this research was to address this subject.

Objectives: To assess the effectiveness   and  the safety of hydrochlorothiazide as adjuvant therapy to the antibiotics in treating acute urinary tract infect

Background: Kinesiologists, Physical Anthropologists, and Anatomists have all long been captivated by the structure and development of the superficial forearm flexor, the Palmaris longus.

Objective: To study the effect of Palmaris Longus on certain handwriting skills.

Subjects and Methods: Three Palmaris Longus occurrence tests were conducted on 200 students (100 males and 100 females) affiliated to Colleges of Medicine of Baghdad University then the participants were tested for certain handwriting skills to correlate the presence of Palmaris Longus in the dominant side with handwriting.

Results: 89% of all subject

Background : Coronary artery disease is theunderlying cause in approximately two thirds of
patients with systolic heart failure ;
Coronary artery angiogriphy may be useful to
define the presence ,
Anatomical characteristics ,and functional
significance of Coronary artery disease in
selected heart failure patients with or without signs
and aymptoms of Coronary artery disease.
Objectives: to verify the clinical usefulness of
coronary angiography (CA) in congestive heart
failure (CHF) patients with no history of ischemic
heart disease and to identify predictive factors for
performing coronary angiography to patients with
congestive heart failure with no obvious ischemia.
Methods :this is a cross-ses

Background: Diabetes mellitus (DM) is a significant cause of visual impairment; many diabetics do not have regular eye examinations, although it is known that early diagnosis and reduces the risk of blindness. There were many barriers that prevent diabetics from attending eye clinics.

Objectives: To assess knowledge, and practice about ocular complications among diabetic patients and to determine barriers preventing the diabetic patients annual visual checking

Methods: A cross-sectional study involving the interview was conducted among 300 diabetic patients attending out patient in Ibn Al Haitham Teaching Ophthalmology Hospital between November 2017 and June 2018.

Background: The effect of garlic extracton fungal
growth and keratinolytic activity was studied in
Trichophytonmentagrophytes as one of the major
etiologic agents of human and animal dermatophytosis
in Baghdad and other parts of the World.
Objective: To investigated an alternative
antidermatophyte with minimum side effects which is
plant based and biodegradable natural product
Methods: Culture conditions for 30 isolates of T.
mentagrophytes isolated from human dermatophytosis
from both sexes with ages of 5-63 years in Central
Medical city for the period July 2009 to October 2009
were cultured on specific solid medium.
Results: The aqueous extract of garlic at various
concentrations inhibited the

Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Background: Sustainability in healthcare is a relatively new concept that aims to integrate environmental, financial, and social factors. Diabetes care in low socioeconomic communities relies on disposable medical supplies, leading to increased waste. This study aims to propose the application of the (reduce, reuse and recycle) framework in diabetes care to enhance sustainability

Subjects and Methods: This study used a mixed-methods approach, including both a literature review and a pilot survey. The literature review included fi