Background: Oral health is a mirror of general health. During pregnancy, oral health is affected by changes in saliva and oral hygiene measures which may lead to more dental caries. Objective: Assess oral health status in relation to salivary antimicrobial peptides in pregnant women. Subjects and Method: This cross sectional study was carried out in different primary health care centers in Rusafa sectors/ Baghdad city. The total sample included was 80 women (their age range from 21-30). The study group consisted of 40 pregnant women: half of them were in the first trimester and others were in third trimester, while the control group included 40 non-pregnant married females. Dental Plaque was recorded according to simplified oral hygiene index. Dental caries were diagnosed by using WHO (2013) criteria. Unstimulated salivary samples were collected. Chemical analysis of salivary samples was performed for the detection of human β-Defensin 2. Results: The current study revealed that dental caries experiences (decayed surfaces(DS), missed surfaces (MS) and decayed, missing, filled surfaces(DMFS)) were higher among pregnant than non-pregnant females especially in the third trimester, add percentage with no significant differences, while filled surfaces (FS) were higher in the control group with also no significant difference. Regarding plaque index, results revealed that pregnant women had higher plaque index than non-pregnant women, with significant higher per-centage (53.3%) in the third trimester, P value = 0.027. The salivary human β-Defensin 2 was higher among the pregnant group in the third trimester with statistically no significant difference. Conclusion: More plaque accumulation during pregnancy may explain the higher preva-lence of dental caries as the dental plaque considered to be the chief contributing factor in dental caries.
{"title":"Oral Health Status in relation to Salivary Antimicrobial Peptide in Pregnant Women","authors":"S. Hussein, A. Alwaheb","doi":"10.47723/kcmj.v19i1.905","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.905","url":null,"abstract":"Background: Oral health is a mirror of general health. During pregnancy, oral health is affected by changes in saliva and oral hygiene measures which may lead to more dental caries.\u0000Objective: Assess oral health status in relation to salivary antimicrobial peptides in pregnant women.\u0000Subjects and Method: This cross sectional study was carried out in different primary health care centers in Rusafa sectors/ Baghdad city. The total sample included was 80 women (their age range from 21-30). The study group consisted of 40 pregnant women: half of them were in the first trimester and others were in third trimester, while the control group included 40 non-pregnant married females. Dental Plaque was recorded according to simplified oral hygiene index. Dental caries were diagnosed by using WHO (2013) criteria. Unstimulated salivary samples were collected. Chemical analysis of salivary samples was performed for the detection of human β-Defensin 2.\u0000Results: The current study revealed that dental caries experiences (decayed surfaces(DS), missed surfaces (MS) and decayed, missing, filled surfaces(DMFS)) were higher among pregnant than non-pregnant females especially in the third trimester, add percentage with no significant differences, while filled surfaces (FS) were higher in the control group with also no significant difference. Regarding plaque index, results revealed that pregnant women had higher plaque index than non-pregnant women, with significant higher per-centage (53.3%) in the third trimester, P value = 0.027. The salivary human β-Defensin 2 was higher among the pregnant group in the third trimester with statistically no significant difference.\u0000Conclusion: More plaque accumulation during pregnancy may explain the higher preva-lence of dental caries as the dental plaque considered to be the chief contributing factor in dental caries.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42267618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhannad Ghazi AnNasseh, S. Rattan, Didar Sddeq Anwar
Background: It is well-known that silicon oil (SO) injection into the vitreous cavity after pars plana vitrectomy is usually associated with high intraocular pressure. Objectives: To determine the influence of silicon oil (SO) removal on IOP level after pars plana vitrectomy for spontaneous rhegmatogenous retinal detachment (RRD) Subjects and Methods: A prospective study was conducted at Ibn Al-Haitham eye teaching hospital, Baghdad- Iraq. Intraocular pressure (IOP) was measured pre and post SO removal in patients who have underwent retinal detachment surgery with SO injection of 1000 centistokes (cSt) viscosity. Baseline IOP was measured for all the patient before the SO removal. Follow-up was performed at 1, 4, and 8 weeks after SO removal. IOP was measured by Goldman applanation tonometer. Patients with IOP > 21 mm Hg at 8 weeks post-operatively with or without anti-glaucoma mediations were considered as persistent IOP elevation after SO removal. Result: Sixty eyes of 60 patients were included. Twenty eyes had persistent IOP elevation after SO removal on first week postoperative. It decreased to 14 eyes on 4th week after SO removal and further decreased to 12 eyes on 8th week af-ter SO removal. The percentage of persistent IOP elevation following SO remov-al was about 20% on 8th week of SO removal. Conclusion: Persistent IOP elevation sometimes happens after SO removal. Therefore, removing SO does not simply treat the elevated IOP happened during SO injection. Patients after SO removal should be followed up for IOP for several weeks and should be treated medically or surgically as required.
背景:玻璃体切割术后玻璃体腔内注射硅油通常伴有高眼压。目的:探讨硅油(SO)去除对自发性孔源性视网膜脱离(RRD)玻璃体切割术后IOP水平的影响。研究对象和方法:在伊拉克巴格达Ibn Al-Haitham眼科教学医院进行前瞻性研究。在接受视网膜脱离手术的患者中,用1000厘斯托克(cSt)粘度的SO注射,测量去除SO前后的眼压(IOP)。在取下SO之前测量所有患者的基线IOP。随访时间分别为1周、4周和8周。眼压用Goldman眼压计测量。术后8周,有或没有使用抗青光眼药物的患者IOP值为21 mm Hg,被认为是SO去除后的持续性IOP升高。结果:纳入60例患者60只眼。术后第1周摘除SO后,20只眼的IOP持续升高。术后第4周降至14眼,第8周降至12眼。SO去除后第8周持续IOP升高的百分比约为20%。结论:在SO移除后,有时会出现持续的IOP升高。因此,去除SO并不能简单地治疗注射SO时发生的IOP升高。摘除SO后的患者应随访数周,并根据需要进行药物或手术治疗。
{"title":"Persistent Intraocular Pressure Elevation after Silicon Oil Removal in Patients with Post-Pars Plana Vitrectomy","authors":"Muhannad Ghazi AnNasseh, S. Rattan, Didar Sddeq Anwar","doi":"10.47723/kcmj.v19i1.898","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.898","url":null,"abstract":"Background: It is well-known that silicon oil (SO) injection into the vitreous cavity after pars plana vitrectomy is usually associated with high intraocular pressure.\u0000Objectives: To determine the influence of silicon oil (SO) removal on IOP level after pars plana vitrectomy for spontaneous rhegmatogenous retinal detachment (RRD)\u0000Subjects and Methods: A prospective study was conducted at Ibn Al-Haitham eye teaching hospital, Baghdad- Iraq. Intraocular pressure (IOP) was measured pre and post SO removal in patients who have underwent retinal detachment surgery with SO injection of 1000 centistokes (cSt) viscosity. Baseline IOP was measured for all the patient before the SO removal. Follow-up was performed at 1, 4, and 8 weeks after SO removal. IOP was measured by Goldman applanation tonometer. Patients with IOP > 21 mm Hg at 8 weeks post-operatively with or without anti-glaucoma mediations were considered as persistent IOP elevation after SO removal.\u0000Result: Sixty eyes of 60 patients were included. Twenty eyes had persistent IOP elevation after SO removal on first week postoperative. It decreased to 14 eyes on 4th week after SO removal and further decreased to 12 eyes on 8th week af-ter SO removal. The percentage of persistent IOP elevation following SO remov-al was about 20% on 8th week of SO removal. \u0000Conclusion: Persistent IOP elevation sometimes happens after SO removal. Therefore, removing SO does not simply treat the elevated IOP happened during SO injection. Patients after SO removal should be followed up for IOP for several weeks and should be treated medically or surgically as required.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44787190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems. Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommendations. Subjects and Methods: Prospective, interventional, clinical study for 80 hospitalized decompensated cirrhosis patients was conducted at Baghdad Teaching Hospital and lasted for four months, from the first of December 2021 until the last of March 2022. The study involved two phases, the first one was observational to identify drug-related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and the second phase was interventional to increase the awareness of patients and health care providers about those problems and to propose a proper solution for each one. Results: The most frequent pharmacist intervention was proposed to the prescriber (54.7%), followed by speaking to the caregiver (37.7%). Acceptance and full implementation were highly observed in 71.1% of the intervention. There is a significant association between occurring ascites and bleeding in patients and accepting/implementing pharmacist recommendations Conclusions: Patients with decompensated liver cirrhosis have a significant prevalence of drug-related problems. Clinical pharmacists are excellent at recognizing drug-related problems and reducing their incidence, and their interventions were well accepted.
{"title":"Pharmacist Intervention to Address Drug Related Problems in Patients with Decompensated Liver Cirrhosis","authors":"Ameer A. Khazal, Mohammed Y. Jamal","doi":"10.47723/kcmj.v19i1.888","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.888","url":null,"abstract":"Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.\u0000Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommendations.\u0000Subjects and Methods: Prospective, interventional, clinical study for 80 hospitalized decompensated cirrhosis patients was conducted at Baghdad Teaching Hospital and lasted for four months, from the first of December 2021 until the last of March 2022. The study involved two phases, the first one was observational to identify drug-related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and the second phase was interventional to increase the awareness of patients and health care providers about those problems and to propose a proper solution for each one.\u0000Results: The most frequent pharmacist intervention was proposed to the prescriber (54.7%), followed by speaking to the caregiver (37.7%). Acceptance and full implementation were highly observed in 71.1% of the intervention. There is a significant association between occurring ascites and bleeding in patients and accepting/implementing pharmacist recommendations\u0000Conclusions: Patients with decompensated liver cirrhosis have a significant prevalence of drug-related problems. Clinical pharmacists are excellent at recognizing drug-related problems and reducing their incidence, and their interventions were well accepted.\u0000 \u0000 \u0000 \u0000 ","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42415862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients. Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder center in al-Najaf Governorate/Iraq which include hyperthyroid group and healthy group, the hyperthyroid patients were diagnosed by specialist and under treatment with carbimazole. The clinical examination of periodontal health status assessment was performed according to WHO (2013) in addition to evaluation the Plaque and gingival condition. The Saliva was collected to evaluate IL-6 concentrations. Results: The plaque index (PLI) in the study group was more than the control with a significant difference (P<0.05). The gingival index (GI) in the study was more than the control but with no significant difference (P>0.05). Both periodontal pocket depth (PPD) and clinical attachment loss (CAL) were higher in the study group than in the control group, with a significant difference. IL-6 was higher in the study group than in control with a significant difference. There was a positive non-significant correlation between PPD and CAL with IL-6 in hyperthyroid patients.
{"title":"Estimation of Salivary IL-6 Level in relation of Periodontal Status in Patients with Hyperthyroidism","authors":"E. H. Kadhom, N. Radhi","doi":"10.47723/kcmj.v19i1.909","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.909","url":null,"abstract":"\u0000\u0000\u0000\u0000Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients.\u0000Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder center in al-Najaf Governorate/Iraq which include hyperthyroid group and healthy group, the hyperthyroid patients were diagnosed by specialist and under treatment with carbimazole. The clinical examination of periodontal health status assessment was performed according to WHO (2013) in addition to evaluation the Plaque and gingival condition. The Saliva was collected to evaluate IL-6 concentrations.\u0000Results: The plaque index (PLI) in the study group was more than the control with a significant difference (P<0.05). The gingival index (GI) in the study was more than the control but with no significant difference (P>0.05). Both periodontal pocket depth (PPD) and clinical attachment loss (CAL) were higher in the study group than in the control group, with a significant difference. IL-6 was higher in the study group than in control with a significant difference. There was a positive non-significant correlation between PPD and CAL with IL-6 in hyperthyroid patients.\u0000\u0000\u0000\u0000","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45946684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although severe epistaxis is uncommon, it is serious. The systematic endoscopic nasal examination is an essential step in identifying the bleeding point and aiding electrocauterization. Currently, the S-point, which is located in the superior part of the nasal septum behind the septal body and corresponding to the axilla of the middle concha, is identified in about 30% of cases with severe epistaxis. Cauterization of this point has an excellent rate of controlling the bleeding and preventing its recurrence. We aimed to highlight the significance of the S-point in the management of severe cases of epistaxis.
{"title":"Importance of S-point in the Management of Severe Epistaxis","authors":"Raid M. Al-Ani","doi":"10.47723/kcmj.v19i1.929","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.929","url":null,"abstract":"Although severe epistaxis is uncommon, it is serious. The systematic endoscopic nasal examination is an essential step in identifying the bleeding point and aiding electrocauterization. Currently, the S-point, which is located in the superior part of the nasal septum behind the septal body and corresponding to the axilla of the middle concha, is identified in about 30% of cases with severe epistaxis. Cauterization of this point has an excellent rate of controlling the bleeding and preventing its recurrence. We aimed to highlight the significance of the S-point in the management of severe cases of epistaxis.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46673149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Azzam, Shaza Abdul Basset Abdul Basset, Heba Khaled, Neveen Refaey, Ahmed Atta Ahmed Ali, Saad Abdelrahim saad shoulah, Mohammed Saleh Al Saifi, Mahmoud s.Meleha
Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells. Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing plasma/serum IL-23 levels between patients with RA and controls and examined correlation coefficients between circulating IL-23 levels and disease activity Subjects and Methods: Using the following keywords: lenterleukin-23, IL-23, and rheumatoid arthritis, a comprehensive literature search was carried out in the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed, and the review was registered in the PROSPERO International prospective register of systematic reviews with registration number CRD42022345901. Results were reported as standardized mean differences (SMDs) with a 95% confidence interval. All statistical analysis was performed using StatsDirect statistical software version 3.0.0 (StatsDirect Ltd., Cheshire, UK). A sensitivity analysis was conducted using the leave-one-out approach to test the robustness of the results. Results: The total sample size for the RA group included in our review was 408 cases, while the control group sample size was 244 cases. The serum IL-23 level in the RA group was significantly higher than the control group (pooled SMD = 3.5, 95% CI; 2.1: 4.8, P < 0.0001) as compared to the control group. There were 8 studies with a total sample size of 402 that reported the correlation between IL-23 and DAS28-based RA activity. According to our findings, a significantly positive correlation between IL-23 and DAS28-based RA activity was found, with a weighted mean correlation of 0.57 (95% CI; 0.4: 0.75, P < 0.0001). Conclusion: Our meta-analysis has shown that IL-23 circulatory levels are higher in RA patients and that there is a significant positive correlation between IL-23 and disease activity. Our findings emphasize the role that IL-23 may have in RA. More studies may be required to fully comprehend the involvement of IL-23 in RA.
背景:类风湿性关节炎(RA)是一种慢性全身性自身免疫性疾病,其特征是严重的滑膜炎症、软骨侵蚀、骨质流失和全身性血管病变。尽管RA的免疫机制尚不清楚,但现在认为它主要是由th17驱动的疾病。与其他因素一起,IL-23刺激原始CD4+ T细胞中Th17细胞的扩增。目的:本研究的目的是评估类风湿关节炎(RA)的循环白细胞介素(IL)-23水平,并确定血浆/血清IL-23水平与疾病活动度的相关性。因此,我们采用meta分析方法对RA患者和对照组的血浆/血清IL-23水平进行了系统评价,并检测了循环IL-23水平与疾病活动度之间的相关系数。研究对象和方法:以lenterleukin-23、IL-23和类风湿关节炎为关键词,在PubMed、Scopus、谷歌Scholar和Web of Science数据库中进行了全面的文献检索。遵循系统评价和meta分析的首选报告项目标准,并在普洛斯彼罗国际前瞻性系统评价注册中注册,注册号为CRD42022345901。结果以标准化平均差异(SMDs)报告,置信区间为95%。所有统计分析均使用StatsDirect统计软件3.0.0版(StatsDirect Ltd., Cheshire, UK)进行。采用留一方法进行敏感性分析,以检验结果的稳健性。结果:我们纳入RA组的总样本量为408例,对照组的样本量为244例。RA组血清IL-23水平显著高于对照组(合并SMD = 3.5, 95% CI;2.1: 4.8, P < 0.0001)。共有8项总样本量为402的研究报道了IL-23与基于das28的RA活性之间的相关性。根据我们的研究结果,IL-23与基于das28的RA活性之间存在显著的正相关,加权平均相关系数为0.57 (95% CI;0.4: 0.75, p < 0.0001)。结论:我们的荟萃分析显示,RA患者循环中IL-23水平较高,IL-23与疾病活动性之间存在显著正相关。我们的发现强调了IL-23在RA中的作用。可能需要更多的研究来充分了解IL-23在RA中的作用。
{"title":"Circulating Interleukin-23 Levels in Rheumatoid Arthritis and its Relationship to Disease Activity: a Systematic Review with Meta-Analysis","authors":"A. Azzam, Shaza Abdul Basset Abdul Basset, Heba Khaled, Neveen Refaey, Ahmed Atta Ahmed Ali, Saad Abdelrahim saad shoulah, Mohammed Saleh Al Saifi, Mahmoud s.Meleha","doi":"10.47723/kcmj.v19i1.946","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.946","url":null,"abstract":"Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells.\u0000Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing plasma/serum IL-23 levels between patients with RA and controls and examined correlation coefficients between circulating IL-23 levels and disease activity\u0000Subjects and Methods: Using the following keywords: lenterleukin-23, IL-23, and rheumatoid arthritis, a comprehensive literature search was carried out in the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed, and the review was registered in the PROSPERO International prospective register of systematic reviews with registration number CRD42022345901. Results were reported as standardized mean differences (SMDs) with a 95% confidence interval. All statistical analysis was performed using StatsDirect statistical software version 3.0.0 (StatsDirect Ltd., Cheshire, UK). A sensitivity analysis was conducted using the leave-one-out approach to test the robustness of the results.\u0000Results: The total sample size for the RA group included in our review was 408 cases, while the control group sample size was 244 cases. The serum IL-23 level in the RA group was significantly higher than the control group (pooled SMD = 3.5, 95% CI; 2.1: 4.8, P < 0.0001) as compared to the control group. There were 8 studies with a total sample size of 402 that reported the correlation between IL-23 and DAS28-based RA activity. According to our findings, a significantly positive correlation between IL-23 and DAS28-based RA activity was found, with a weighted mean correlation of 0.57 (95% CI; 0.4: 0.75, P < 0.0001).\u0000Conclusion: Our meta-analysis has shown that IL-23 circulatory levels are higher in RA patients and that there is a significant positive correlation between IL-23 and disease activity. Our findings emphasize the role that IL-23 may have in RA. More studies may be required to fully comprehend the involvement of IL-23 in RA.\u0000 ","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47316265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
May Abdullah Mohammed, Muna Atallah Khaleefah Ali, A. A. Marzook, M. Albayaty
Background: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome. Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews. Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative approach (triangulation) was used. Quantitative method used self-administered questionnaires of Maslach Burn out Inventory. Qualitative approach used an open-ended question modified from Copenhagen Burnout Inventory by face-to-face interviews. An ordinal logistic regression used in the analysis phase to overcome confounders. Results: The percentages of emotional exhaustion, depersonalization, and feeling of inefficacy were 72.5%, 31.9%, and 12.7% respectively. Total burnout syndrome was 56.4%. Being single and hospital workers were significantly associated with emotional exhaustion (p=0.006, 0.001 respectively) and total burnout syndrome (p=0.017, 0.016 in sequence). In addition to emotional exhaustion and burnout syndrome, singles suffered from depersonalization (p=0.010). Administrative responsibilities made physicians less liable for emotional exhaustion but more prone to feeling of inefficacy (p=0.038, 0.017 respectively). Less than 40-year age group had a relation with depersonalization, p=0.003, and total burnout syndrome p=0.013. Being male was significant with total burnout syndrome, p=0.008. All Violence types were associated significantly with burnout syndrome and its dimensions, p=0.001 (except feeling of inefficacy in which only threat was significant with it, p=0.054). In qualitative part, the response rate was 80%. It was formulated from 3 themes. Highest percentages in these themes were gained by female and graded physicians. Conclusion: Burnout affects over half of Baghdad’s doctor. Violence was significant to burnout syndrome but job title was not. In qualitative part female and graded physicians were most groups to be affected.
{"title":"Prevalence of Burnout Syndrome and its Association with Job Title and Violence among Physicians in Baghdad: A Triangulated Methodology Study","authors":"May Abdullah Mohammed, Muna Atallah Khaleefah Ali, A. A. Marzook, M. Albayaty","doi":"10.47723/kcmj.v19i1.882","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.882","url":null,"abstract":"Background: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome.\u0000Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews.\u0000Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative approach (triangulation) was used. Quantitative method used self-administered questionnaires of Maslach Burn out Inventory. Qualitative approach used an open-ended question modified from Copenhagen Burnout Inventory by face-to-face interviews. An ordinal logistic regression used in the analysis phase to overcome confounders.\u0000Results: The percentages of emotional exhaustion, depersonalization, and feeling of inefficacy were 72.5%, 31.9%, and 12.7% respectively. Total burnout syndrome was 56.4%. Being single and hospital workers were significantly associated with emotional exhaustion (p=0.006, 0.001 respectively) and total burnout syndrome (p=0.017, 0.016 in sequence). In addition to emotional exhaustion and burnout syndrome, singles suffered from depersonalization (p=0.010). Administrative responsibilities made physicians less liable for emotional exhaustion but more prone to feeling of inefficacy (p=0.038, 0.017 respectively). Less than 40-year age group had a relation with depersonalization, p=0.003, and total burnout syndrome p=0.013. Being male was significant with total burnout syndrome, p=0.008. All Violence types were associated significantly with burnout syndrome and its dimensions, p=0.001 (except feeling of inefficacy in which only threat was significant with it, p=0.054).\u0000In qualitative part, the response rate was 80%. It was formulated from 3 themes. Highest percentages in these themes were gained by female and graded physicians.\u0000Conclusion: Burnout affects over half of Baghdad’s doctor. Violence was significant to burnout syndrome but job title was not. In qualitative part female and graded physicians were most groups to be affected.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49278086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasan Raid Fadhil, A. A. Al-Jumaili, Nizar Abdulateef Al Ani
Background: Ankylosing spondylitis is a chronic inflammatory disease that mostly involves the spine and sacroiliac joints. It is associated with a decreased quality of life. Biological medicines such as infliximab and its biosimilar are the mainstay treatments for active ankylosing spondylitis. Objective: The study objective was to conduct a pharmacoeconomic study comparing the cost-effectiveness of the reference infliximab with its biosimilar in ankylosing spondylitis patients visiting public hospitals. Subjects and Method: This is a two-center pharmacoeconomic study performed at two large teaching governmental hospitals in Baghdad, Iraq, which supplied infliximab to outpatients with ankylosing spondylitis. The outcome data were obtained from patient’s medical records and face-to-face interviews with the patients from December 2021 through April 2022. The Independent T-Test was used to measure the differences in areas of utility, and quality of life, between the two infliximab groups. Results: The study recruited 62 patients with ankylosing spondylitis who received infliximab (31 received Remicade, and 31 received Remsima) for at least 12 weeks at two public teaching hospitals. The mean age of the patients was 37.85 years and 83.9% were men. In general, both reference infliximab and its biosimilar were successful in increasing the quality of life. Their importation costs were different from 2019 to 2021. The incremental cost-effectiveness ratio of reference infliximab versus biosimilar was $ 40,909/quality-adjusted life year (QALY) according to 2019 pricing. In contrast, in 2021 reference infliximab (Remicade) was less expensive and yielded slightly better quality of life improvement than biosimilar (Remsima) making Remicade more cost-effective (dominant). Conclusion: Remicade was slightly superior to Remsima in quality of life improvement. However, it was difficult to determine whether the reference or its biosimilar was more cost-effective in 2019 because the health officials did not specify a willingness to pay per quality-adjusted life year. Compared to Remsima, Remicade was more cost-effective in 2021 because it was less expensive and more effective in terms of quality of life improvement.
{"title":"Comparison between Reference Infliximab (Remicade) and its Biosimilar (Remsima) in Patients with Ankylosing Spondylitis: A Field-based Pharmacoeconomic Study","authors":"Hasan Raid Fadhil, A. A. Al-Jumaili, Nizar Abdulateef Al Ani","doi":"10.47723/kcmj.v19i1.908","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.908","url":null,"abstract":"Background: Ankylosing spondylitis is a chronic inflammatory disease that mostly involves the spine and sacroiliac joints. It is associated with a decreased quality of life. Biological medicines such as infliximab and its biosimilar are the mainstay treatments for active ankylosing spondylitis.\u0000Objective: The study objective was to conduct a pharmacoeconomic study comparing the cost-effectiveness of the reference infliximab with its biosimilar in ankylosing spondylitis patients visiting public hospitals.\u0000Subjects and Method: This is a two-center pharmacoeconomic study performed at two large teaching governmental hospitals in Baghdad, Iraq, which supplied infliximab to outpatients with ankylosing spondylitis. The outcome data were obtained from patient’s medical records and face-to-face interviews with the patients from December 2021 through April 2022. The Independent T-Test was used to measure the differences in areas of utility, and quality of life, between the two infliximab groups.\u0000Results: The study recruited 62 patients with ankylosing spondylitis who received infliximab (31 received Remicade, and 31 received Remsima) for at least 12 weeks at two public teaching hospitals. The mean age of the patients was 37.85 years and 83.9% were men. In general, both reference infliximab and its biosimilar were successful in increasing the quality of life. Their importation costs were different from 2019 to 2021. The incremental cost-effectiveness ratio of reference infliximab versus biosimilar was $ 40,909/quality-adjusted life year (QALY) according to 2019 pricing. In contrast, in 2021 reference infliximab (Remicade) was less expensive and yielded slightly better quality of life improvement than biosimilar (Remsima) making Remicade more cost-effective (dominant).\u0000Conclusion: Remicade was slightly superior to Remsima in quality of life improvement. However, it was difficult to determine whether the reference or its biosimilar was more cost-effective in 2019 because the health officials did not specify a willingness to pay per quality-adjusted life year. Compared to Remsima, Remicade was more cost-effective in 2021 because it was less expensive and more effective in terms of quality of life improvement.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43057232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Hamied, Hasanain Hafid Kudeir, Dena Nadhim Mohammad, Ban Falih Ibraheem, Balkees Taha Garib
Background: Few updated retrospective histopathological-based studies in Iraq evaluate a comprehensive spectrum of oro-maxillofacial lesions. Also, there was a need for a systematic way of categorizing the diseases and reporting results in codes according to the WHO classification that helps occupational health professionals in the clinical-epidemiological approach. Objectives: to establish an electronic archiving database according to the ICD-10 that encompasses oro-maxillofacial lesions in Sulaimani city for the last 12 years, then to study the prevalence trend and correlation with clinicopathological parameters. Subjects and Methods: A descriptive-analytical study included the archived records from three major histopathological centers in Sulaimani (College of Dentistry, Shahid Saifaldeen, and Shorsh Hospitals), related to surgical biopsies of oro-maxillofacial lesions performed between 2008 and 2019 in Sulaimani. Data were tabulated in an excel sheet and analyzed. Results: This study involved 2100 oro-maxillofacial lesions, male: female ratio was 1:1.2, and a mean age of 41.03±19.51 years old. The most frequently involved sites were; the lip (14.5%), followed by the gum and alveolar ridge (14.2%). 69.4% of cases were non-neoplastic lesions. The neoplastic lesions were significantly (P=.000) observed in old patients with a mean age of 46.1±21.09, mostly epithelial tumors (39.1%), followed by connective tissue tumors (19.5%). Malignant connective tissue tumors were more frequently seen than benign ones (52.5% versus 47.5%). The non-neoplastic lesions revealed predominate soft tissue lesions (45.2%), followed by salivary gland diseases (13.8%), with a mean age of 38.26±18.8. Squamous cell carcinoma was the most common epithelial tumor, while haemangioma was predominant among connective tissue tumors Conclusions: ICD-10 classification of oro-maxillofacial lesions in Sulaimani city helps establish a standardized coding database system for clinicopathological distribution. However, the majority of recorded lesions were non-neoplastic especially diagnosed as soft tissue lesions. Still, neoplastic lesions with their minor distribution deserve great attention as they threaten patients’ lives.
{"title":"Clinicopathological Features and ICD-10 Categorization of Oro-maxillofacial Surgical Biopsies from Sulaimani","authors":"M. A. Hamied, Hasanain Hafid Kudeir, Dena Nadhim Mohammad, Ban Falih Ibraheem, Balkees Taha Garib","doi":"10.47723/kcmj.v19i1.871","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.871","url":null,"abstract":"Background: Few updated retrospective histopathological-based studies in Iraq evaluate a comprehensive spectrum of oro-maxillofacial lesions. Also, there was a need for a systematic way of categorizing the diseases and reporting results in codes according to the WHO classification that helps occupational health professionals in the clinical-epidemiological approach.\u0000Objectives: to establish an electronic archiving database according to the ICD-10 that encompasses oro-maxillofacial lesions in Sulaimani city for the last 12 years, then to study the prevalence trend and correlation with clinicopathological parameters.\u0000Subjects and Methods: A descriptive-analytical study included the archived records from three major histopathological centers in Sulaimani (College of Dentistry, Shahid Saifaldeen, and Shorsh Hospitals), related to surgical biopsies of oro-maxillofacial lesions performed between 2008 and 2019 in Sulaimani. Data were tabulated in an excel sheet and analyzed.\u0000Results: This study involved 2100 oro-maxillofacial lesions, male: female ratio was 1:1.2, and a mean age of 41.03±19.51 years old. The most frequently involved sites were; the lip (14.5%), followed by the gum and alveolar ridge (14.2%). 69.4% of cases were non-neoplastic lesions. The neoplastic lesions were significantly (P=.000) observed in old patients with a mean age of 46.1±21.09, mostly epithelial tumors (39.1%), followed by connective tissue tumors (19.5%). Malignant connective tissue tumors were more frequently seen than benign ones (52.5% versus 47.5%). The non-neoplastic lesions revealed predominate soft tissue lesions (45.2%), followed by salivary gland diseases (13.8%), with a mean age of 38.26±18.8. Squamous cell carcinoma was the most common epithelial tumor, while haemangioma was predominant among connective tissue tumors\u0000Conclusions: ICD-10 classification of oro-maxillofacial lesions in Sulaimani city helps establish a standardized coding database system for clinicopathological distribution. However, the majority of recorded lesions were non-neoplastic especially diagnosed as soft tissue lesions. Still, neoplastic lesions with their minor distribution deserve great attention as they threaten patients’ lives.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43548862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Osteoporosis is denoted by low bone mass and microarchitectural breakdown of bone tissue, directing to increased fracture risk and bone fragility. Fractures may lead to a decreased quality of life and increased medical costs. Thus, osteoporosis is widely considered a significant health concern. Objective. This study aimed to compare quantitative computed tomography (QCT) and dual-energy X-Ray absorptiometry (DXA) to detect osteoporosis in postmenopausal women. Subjects and Methods. We measured spinal volumetric bone mineral density (BMD) with QCT and areal spinal and hip BMD with DXA in 164 postmenopausal women. We calculated the osteopenia and osteoporosis detection rate for the two methods. The difference between these rates for DXA versus QCT was analyzed using the chi-square test. Results. The detection rate of osteoporosis was 57.9% for QCT and 50.6% for DXA (significant difference, p=0.002). At the same time, the detection rate of osteopenia was 36.6% for QCT and 31.7% for DXA (significant difference, p=0.002). Conclusions. Quantitative CT bone densitometry is an excellent tool for the evaluation of BMD. It is more sensitive than DXA for detecting osteoporosis in postmenopausal women.
{"title":"Comparison between Quantitative Computed Tomography and Dual-Energy X-Ray Absorptiometry in the Detection of Osteoporosis in Postmenopausal Women","authors":"Abdulsattar Hameed Hammood, Sahar Basim Ahmed, Q. Hassan","doi":"10.47723/kcmj.v19i1.864","DOIUrl":"https://doi.org/10.47723/kcmj.v19i1.864","url":null,"abstract":"Background: Osteoporosis is denoted by low bone mass and microarchitectural breakdown of bone tissue, directing to increased fracture risk and bone fragility. Fractures may lead to a decreased quality of life and increased medical costs. Thus, osteoporosis is widely considered a significant health concern.\u0000Objective. This study aimed to compare quantitative computed tomography (QCT) and dual-energy X-Ray absorptiometry (DXA) to detect osteoporosis in postmenopausal women.\u0000Subjects and Methods. We measured spinal volumetric bone mineral density (BMD) with QCT and areal spinal and hip BMD with DXA in 164 postmenopausal women. We calculated the osteopenia and osteoporosis detection rate for the two methods. The difference between these rates for DXA versus QCT was analyzed using the chi-square test.\u0000Results. The detection rate of osteoporosis was 57.9% for QCT and 50.6% for DXA (significant difference, p=0.002). At the same time, the detection rate of osteopenia was 36.6% for QCT and 31.7% for DXA (significant difference, p=0.002).\u0000Conclusions. Quantitative CT bone densitometry is an excellent tool for the evaluation of BMD. It is more sensitive than DXA for detecting osteoporosis in postmenopausal women.","PeriodicalId":34748,"journal":{"name":"mjlh klyh Tb lkndy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43246000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}