Karbala Journal of Medicine

Knowledge, Attitude and Practice Regarding Antibiotics Misuse among attendants of Primary Health Care Centers: Descriptive Cross Section Study in Basra Center

fatema khaleel — 2024-12-01

Abstract

Background: Antibiotics are the communal drugs used in developing countries. The irrational use of antibiotics (Abs) is a huge problem on the national health care system which lead to development of antimicrobial resistance (AMR).

Objectives: To assess the knowledge, attitude and practice regarding misuse of antibiotics by attendants of primary health care centers (PHCCs) in Basra center and studying the factors contributing to this problem.

Method: A descriptive cross-sectional study conducted in 20 out of 40 PHCCs in 1^st, 2^nd and 3^rd sectors of PHC in Basra city center /Iraq between 1^st of February and the 31^st of July 2023.The target population was attendants of PHCCs, then the collected data was analyzed by using Statistical Package for the Social Sciences program version 26.

Results: Data of the study showed a relatively good knowledge score 77.71% regarding the proper use of Abs and AMR for the participants. 90% of the participants knew about side effects of Abs. 76.29% of the participants in the study showed good attitude about the problem of AMR and risk factors leading to it, however 2.29% of the participants had good practice which was a very low percentage and these results caused by many factors related to the persons themselves, sociodemographic features, doctors-patients and pharmacists-patients relationships, the results of current study showed that 25.7% of participants using self-prescription strategy in using of Abs.

Conclusions: - Final results of statistical analysis of data collected in this study showed a relatively good knowledge about the uses of Abs and good attitude regarding misuse of Abs and risk of AMR, but despite of that there was a higher percent of bad behaviors and unproper usage of these medications. Age and educational level had strongest effects on the degree of knowledge, believes and behaviors. Despite of high percent of information sources was from educational programs in health care institutes, but some of them need to increase works on the methods of health education strategies.

Keywords: knowledge, attitude, practice, antibiotics, misuse, primary health care (PHC), Basra city, Iraq

Knowledge, Attitude and Practice of Facial Cosmetic Procedure Among Females in Karbala Governorate,2022-2023

Yusur Sameer Kadhim — 2024-12-01

Background: Currently, facial cosmetic procedures is among the most popular procedures performed worldwide, including in Iraq. The number of individuals requesting this type of care is rising. Both surgical and non-surgical procedures are referred to as cosmetic procedures. Rhinoplasty, surgical face-lift, and blepharoplasty are referred to as surgical procedures, while dermal filler, botox, and other minimally invasive cosmetic procedures are referred to as non-surgical procedures. This study is aimed to assess knowledge, attitude, and practice of facial cosmetic procedures among women in Karbala.

Methods: A cross-sectional descriptive study among 307 women participants in Karbala. College students and teachers were used as sample sources who were aged between 18 and 61 years. The study was conducted from April 2023 to March 2024 using a self-administered questionnaire.

Results: The mean age of the participants was 27.93. The study findings indicate about 98.7% of the participants have heard about facial cosmetic procedures and the main information source was the Social Networks account 87.3%. They reported that filler, rhinoplasty, and botox were the main three types of facial cosmetic procedures available in Karbala City. Two-thirds (66.1%) of the participants agreed that low self-esteem makes people undergo this procedure. About 20.5% of the participants reported that they had practiced facial cosmetic procedures. Personal desire was the primary source of motivation to undergo such procedures formed about 49.2%.

Conclusions: The majority of the participants revealed good knowledge about facial cosmetic procedures. More than a quarter of participants had a neutral attitude about such a procedure.

Quality of Life among Patients with Systemic Lupus Erythematosus and its Association with Sociodemographic and Clinical Parameters in Karbala Governorate

Rand Saad Mohammed — 2024-11-28

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with a variety of clinical symptoms that primarily affect women of childbearing age causing a significant patient burden.

Objectives: To assess health-related quality of life (HRQOL) among patients with SLE and to evaluate its association with different sociodemographic and clinical characteristics of SLE patients.

Patients and methods: Seventy five patients with SLE who attended the rheumatology outpatient clinics of Imam Al-Hassan Al-Mujtaba Teaching Hospital, were enrolled in a cross-sectional study. Lupus quality of life (LupusQoL) was used to assess disease-specific health related quality of life; and SLE disease activity index (SLEDAI) was applied to evaluate disease activity.

Results: The mean age of the studied patients was 38.12±11.70 years and were 97.3% female. All LupusQoL domains were reduced. Intimate relationship accounted for the highest QoL score with a median of 50, and IQR of 25-100, whereas fatigue represented the lowest score with a median of 25, and IQR of 6.2-50. LupusQoL was positively correlated to address, education, disease duration, occupation, and impact on job especially in physical health domain with r equal (0.277, 0.342, 0.137, 0.240, 0.314respectively). LupusQol was negatively correlated with age (r= -0.461), and with disease activity (r= -0.292), with p- values of all were >0.05. Renal and neuropsychiatric involvement of the disease did not statistically correlate with HRQOL.

Conclusion: patients with SLE had low scores of all LupusQoL domains. There was significant positive correlation between LupusQoL domains and address, education, disease duration, occupation, and impact on job and significant negative correlation with age, and disease activity.

Key words: SLE, health related quality of life, LupusQoL

Comparative Analysis of C4d Deposition with the Severity, Laboratory Tests and Histopathologic Scores in Lupus Nephritis

Ghadeer Salih Noah — 2024-12-01

Background: Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) and evident in 60% of patients. Complement system and its product, complement component 4 degradation (C4d), plays an important role in the pathogenesis of LN. The aim is to determine the prognostic value of C4d detection in different classes of LN and correlation with laboratory results and histopathologic activity score.

Methods: Thirty-five patients with LN were collected between January to September 2023. Blood levels of anti-nuclear antigens (ANA), anti-double stranded DNA antibody (Anti-dsDNA), C3, C4, and 24hr urine protein were measured. Renal tissue biopsy was examined regarding glomerular C4d antibody immunohistochemical staining and Classes of LN according to International society of nephrology/Renal Pathology Society (ISN/RPS).

Results: Glomerular C4d was expressed in 40% of LN patients and was significantly correlated with urinary protein excretion (p=0.001) and Anti-dsDNA antibody (P=0.048), but not with LN classes or activity score or low complements.

Conclusions: Glomerular C4d deposition of LN does not indicate the present disease activity but may help to identify a subset of patients with worse renal prognosis, providing insights about the therapeutic approaches for SLE with LN.

Keywords: Lupus nephriti, glomerular C4d, proteinuria, Anti-double stranded DNA Antibody.

Association of SOX10 Immunohistochemical Expression with Triple Negative Breast Cancer in Karbala city

Maryam Mahdi Salman — 2024-11-28

Abstract

Background: The term triple-negative breast cancer (TNBC) refers to a particular class of aggressive, poorly differentiated neoplasms that show the absence of estrogen (ER), progesterone (PR), and human epidermal growth factor receptor2 (HER2) antibodies. The aim of this study is to assess the immunohistochemical expression of SOX10 in TNBC, its correlation with tumor grade and other clinicopathologic characteristics.

Materials and methods: A Cross sectional study which included thirty paraffin blocks of primary (TNBC) , that were collected from Karbala teaching centre of histopathology in the period (from Jan. 2023 to Dec. 2023). For each of the collected block, two sections were taken. One stained by hematoxylin and eosin and the other was stained by immunohistochemical method for SOX10.

Results: SOX10 reported positive in 43% (13) positive cases versus 57% (17) negative cases, this positivity was significantly correlated with pathological grade (p value =0.012) and the pathological stage (p value =0.038). A particular statistical significance was found in association with the lymph node group and distant metastasis. (p value 0.039 and 0.037) respectively. No significant statistical difference between SOX10 expression and the patient’s age, tumor size, presence of Ductal carcinoma in situ (DCIS) and lymphovascular invasion.

Conclusion:

The study suggested that SOX10 expression is a prognostic biomarker for TNBC. It also highlighted the clinical significance of targeting SOX10 as a promising potential therapeutic target gene for TNBC therapy.

Keywords: SOX10; triple negative breast cancer; immunohistochemistry.

Assessment of the Satisfaction of Pregnant Women with Antenatal Care Services in Primary Health Care Centers in Karbala Province

Mena Muneer — 2024-12-01

Background: Antenatal care (ANC) is the care that the pregnant woman receives from health professionals during the pregnancy. This care was given while pregnancy occurred to make sure the pregnant and her baby were in good health. Patients’ use of health care is affected by the quality of care. Pregnants who are not satisfied with their providers may be less likely to continue with treatment. The study aimed to assess the satisfaction of pregnant women with ANC services in Primary Health Care Centers (PHCC) in Karbala province.

Methods: A descriptive study was conducted from January to October 2023 to assess the satisfaction of pregnant women with ANC services in Karbala province. The sample consisted of 400 women randomly selected from four (PHCCs) that provide antenatal daily care services.

Results: The results showed that 87.25% of the pregnant women were satisfied, whereas 12.75% were unsatisfied. The results concluded that there was a significant difference in satisfaction levels between the four PHCCs (p<0.001). Regarding education, pregnant women with college and higher education satisfaction levels to other educational levels (p=0.008). Also, pregnant women in rural residences had a higher satisfaction level in comparison to urban or slum areas (p<0.001).

Conclusion: Most of the pregnant women were satisfied with the ANC services in Karbala province.

Prevalence of Substance Use among Medical and non-Medical Students in the University of Kufa

Aiser R. Maeh — 2024-12-01

Background: Substance use involves psychoactive drug consumption (both legal and illegal), including alcohol, tobacco, heroin, cocaine, and medically restricted drugs. It's a global public health issue, with over 275 million people (over 5% of the global population aged 15-64) using substances, with a 22% increase since 2010. In Iraq, substance use is a major concern, especially among males. This study aims to assess the prevalence of substance use among students in the University of Kufa, and to identify its associated factors.

Methods: A cross-sectional study conducted in the University of Kufa during the period from February 15th till March 15th, 2023. Socio-demographic data was collected using a specially designed questionnaire and a total of (396) participants from four different colleges were randomly selected.

Results: The study enrolled (396) participants with almost equal proportion from each of the included colleges. Mean age was (21.4 ± 2.2) years. More than half of the participants were females. Tobacco use was the most common used substance within recent year (19.9%) which was significantly higher among males (P-value < 0.001). Pain killers use was the second most common (10.1%) with a significantly higher prevalence among females (P-value = 0.002).

Conclusion: This study concludes that substance use is present among college students, mainly of tobacco and pain killers. Peer pressure was one of the important factors that influence substance use, especially among the vulnerable age group of 20-24 years.

Electrodiagnostic evaluation of autonomic dysfunction in patients with multiple sclerosis

Mays Albaiaty — 2024-12-01

Abstract

Background: Autonomic dysfunction frequently affects multiple organs and systems in people with multiple sclerosis (PwMS), including the heart, bladder, and bowels, as well as sudomotor and sexual functions, and can have a significant negative impact on the quality of life.

Aim: to assess the effect of MS on autonomic nervous system (ANS) functions by electrodiagnostic measures and investigate the relationship of these measures with different demographic and clinical factors such as age, sex, duration of disease, type of treatment, the Expanded Disability Severity Scale (EDSS) score, and the Composite Autonomic Symptom Score-31 (COMPASS-31) score.

Methods: forty patients with a definite diagnosis of relapsing-remitting MS and 35 age- and sex-matched controls. The EDSS to assess disease severity and the COMPASS-31 questionnaire to test for degree of clinical autonomic disability, Ewing’s cardiovascular autonomic tests, and sympathetic skin response (SSR) as electrophysiologic tests for autonomic dysfunction were done.

Results: The heart rate during normal (HRNB), HR response to deep breathing (HRDB), and systolic blood pressure (BP) drop from supine to standing position were significantly different in the PwMS relative to the controls. Moreover, PwMS exhibited prolonged palmar SSR latency and reduced plantar SSR amplitude. Disease duration was negatively correlated with HRNB, HRDB, and heart rate during the Valsalva manoeuvre (HTVals). EDSS is also negatively correlated with HRNB and HRDB. Furthermore, COMPASS-31 also shows a negative correlation with HRDB. On the contrary, systolic PB drop and planter SSR amplitude were positively correlated with EDSS.

Conclusion: In MS, cardiac autonomic dysfunction affects both the parasympathetic and sympathetic NS. Alongside the cardiovascular system, the sympathetic sudomotor system is also impacted. The length and severity of the disease were correlated by parasympathetic abnormalities. No correlation was observed within the patient group between any autonomic function tests and age, sex, treatment type, or family history of MS.

Keywords: Multiple sclerosis, EDSS, autonomic function tests, COMPASS-31

The Impact of Orthodontic Therapy on the Periodontal Health and Oral Microbiome

Zainab Mousa Kadhom — 2024-12-01

The demand for dental treatment with multiple orthodontic appliances has recently increased for aesthetic purposes. Still, these appliances are not free from some negative influences that may affect the teeth and gingiva, especially periodontium, due to the accumulation of Plaque during the treatment period. Therefore, special recommendations must be given to orthodontic patients, and they must be encouraged to take care of oral and dental hygiene during the orthodontic treatment period. So, this review aimed to identify and summarise the different effects of the various orthodontic appliances on the periodontium and the composition of the microbial community.

Artificial Intelligence Role in Improving in Vitro Fertilization and Embryology

sahbaa hafedh — 2024-12-01

Abstract:

For the past decade, the success rate of IVF has been constant. Many studies aim to enhance the existing success rate of IVF, which is around 30%. Artificial intelligence (AI) has the liability to improve medical results. Embryo evaluation and choice represent the total manifestation of the in vitro fertilization (IVF) procedure. The goal is to choose the "best" embryos from a wide pool of fertilized oocytes, as many may not be viable owing to aberrant development or chromosomal abnormalities. This essay explores whether AI has the ability to improve fertility results in IVF.

Role of D-Dimer as a Marker of Severity and Long COVID-19

Sura Al-Shamma — 2024-12-01

D dimer is a soluble byproduct of fibrin degradation. It’s well known for its role in exclusion of VTE and other thromboembolic disorder. Recently with the emergence of COVID 19,D- dimer used as indicator of disease severity and outcome in acute phases. However there are limited data regarding significance of D dimer in long term COVID 19 .This literature review tried to elaborate the significance and mechanism of prolonged D dimer in long term COVID 19 .