Knowledge of Pharmacy Staff Regarding Over the Counter Medications in Erbil City

Background and objectives: Use of over the counter (OTC) medications is an important area for research within different health care systems. It is also associated with increased risk of abuse and medication addiction. The need to avoid unnecessary exposure to medication is a concern among the health-care community, in which pharmacy staff plays first line of response and their knowledge is critical. In Kurdistan region of Iraq, other medical and to some extend non-medical staff also works in pharmacies which may affect their scientific understanding of medication. The current study aims to determine the knowledge of pharmacies staff regarding OTC medication use in Erbil city. Methods: A cross-sectional study was conducted from 15th- October 2018 to 15th -October 2019. A sample of 187 pharmacies in Erbil city Centre was recruited through a systematic random sampling technique. Data were collected through direct interview with participants, A questionnaire was used for interviewing the pharmacy staff about socio-demographic characteristics and knowledge regarding OTC medications. The validity and reliability of the instrument was checked. Data were analyzed by using the software system of Statistical Package for Social Science (SPSS version 23). Results: The total number of the studied sample was 187 medical and para-medical staff working in Erbil pharmacies. Their mean age + SD were 28.56 + 5.33 years, ranging from 18 to 45 years. Generally only quarter (25%) of the whole sample had good level of knowledge. less than one third (29.4%) of the sample knew the correct definition of the OTC. Only 28.3% of the sample thinks that the OTC medications mostly cause side effects. Good level of knowledge was significantly associated with being female, and being a graduate and with being a specialized pharmacist. Conclusion: There is a limited knowledge about OTC medications among staff working in pharmacies.

Comparative Study of Topical 1% Terbinafine Cream Versus 1% Clotrimazole Cream in The Treatment of Tineapedis

Background:Tinea pedis (athletic foot) is the most common dermatophytic fungal infection of the body. It may last for a short or long time and may recur after treatment. Objective: To assessed and compared the effectiveness and safety of 1% terbinafine cream and 1% clotrimazole cream for the treatment of tinea pedis. Patients and Methods: Randomized control trial was done in the outpatient clinic of dermatology department in Rizgary Teaching Hospital in Erbil. From March, 2019 to January, 2020. Sixty patients with tinea pedis diag-nosed clinically were included in this study. Thirty patients applied 1% terbinafine cream topically twice daily for one week and thirty patients applied 1% clotrimazole cream topically twice daily for four weeks. Scraping for fungi was performed before and after therapy. Efficacy was assessed by clini-cal cure and mycological cure. Clinical and mycological cure measured at weeks one, four and six. Results: Mycological cure rates were 86.7% for terbinafine and 80% for clotrimazole at 4 weeks, 86.7% for terbinafine and 90% for clotrimazole at 6 weeks. At 4 weeks, terbinafine had an 83.3 percent clinical treatment rate and clotrimazole had a 76.67 percent clinical treatment rate; at 6 weeks, terbinafine had an 83.3 percent clinical treatment rate and clotrimazole had an 83.3 percent clinical treatment rate. Conclusion: The study showed that one week terbinafine two times a day is as effective as four weeks clotrimazole two times a day as well as in terms of mycological treatments and efficient therapies

The Prevalence of Parasites in the Domestic Pigeons (Columba livia domestica) in Zakho City, Kurdistan-Iraq

لقد اقترن تواجد الحمام الأليف منذ الأزل مع الإنسان, حيث تم استخدامه كمصدر للطعام وكحيوان داجن وكهواية ورمز ديني.في هذه الدراسة وجدت نسبه مرتفعه من الإصابة بالطفيليات الخارجية ونسبه اقل بالديدان الشريطية  فقط في الطيور المستخدمة.أجريت هذه الدراسة لتقييم مدى انتشار الطفيليات التي تصيب الحمام المنزلي (Columba livia) من تشرين الاول2017 إلى نيسان2018 ،الذي تم شرائه من سوق الطيور في مدينة زاخو ، إقليم كردستان. تم أخذ العينات من 50 حمام بالغ (28 ذكر و 22انثى).  تم نقل الطيور إلى مختبر علم الطفيليات ، فاكولتي العلوم ، جامعة زاخو. في المختبر تم فحص الريش لكل طير ثم تم تشريحها وعلى الفور تم فحص الريش والجلد تحت الأجنحة ، الصدر، للبحث عن الطفيليات الخارجية. ثم جمعت الطفيليات الخارجية و حفظت في70 ٪ من الكحول لإجراء المزيد من الدراسة. تم تشريح الطيور التي تم ذبحها و فحصت الأمعاء للبحث عن وجود الطفيليات الداخلية. أظهرت النتائج عن معدل إجمالي قدره 76٪ (38/50) من العدوى بالطفيليات الخارجية ، والتي تضمنت 3 أنواع من القمل ، وهي: Columbicola columbae (56٪)، Companulotes compar (36 ٪) وHohorstiella lata(10%). فيما يتعلق بالديدان الطفيلية ، كانت الديدان الشريطية هي الديدان الوحيدة الموجودة في هذه الدراسة ، بمعدل 16 ٪ (8/50). تم تسجيل ثلاثة أنواع منالديدان الشريطية وهي:Raillietina cesticillus (14%)،R. echinobothrida (4%) و .(2%) Choanotaenia infundibulumهناك الحاجة إلى المزيد من الدراسات في هذا المجال لتقيم التأثير المرضي للطفيليات التي يتم عزلها من هذا الحيوان الداجن و امكانية انتقالها إلي بقية الطيور أو الإنسان. الكلمات الداله: حمام, الطفيليات الخارجية, الديدان الشريطية, مدى انتشارPigeons have accompanied humans since ancient time because they are used as a source of food, pets, hobby, and religious symbols. Pigeons have shown high prevalence rate of infection with gastrointestinal helminths and protozoan. This study was conducted to evaluate the prevalence of parasitic infections in the domestic pigeon (Columba livia domestica) from October, 2017 to April, 2018, purchased from bird market of Zakho City, Kurdistan region. The samples were taken from 50 adult pigeons (28 males and 22 females). The birds were transferred to Parasitology Laboratory, Faculty of Science, Zakho University. In the laboratory, each bird was sacrificed and immediately the feather and skin of under wings, chest and the rest of the body was examined for ectoparasites. The collected ectoparasites were preserved in 70% alcohol for further study. The sacrificed birds were dissected and their intestine and contained were examined for the presence of parasites. The results revealed a total rate of 76% of infection with ectoparasites, which included three species of lice, namely: Columbicola columbae (56%), Companulotes compar (36%) and Hohorstiella lata (10%). Regarding helminths, cestodes were the only helminths found in this study with a rate of 16% (8/50). Three species of cestodes were recorded, they included: Raillietina cesticillus(14%), Raillietina echinobothrida(4%) and Choanotaenia infundibulum (2%). Further studies are required to evaluate the effect of the recovered parasites on this host and their transmission to other poultry flocks and human. Keywords: Pigeon, Ectoparasites, Cestodes, Prevalence

The impact of organizational values on employee performance, an empirical study on banking industry in Kurdistan Region

The aim of this study was to test the impact of organizational values on employee performance in banking industry in Kurdistan region. Four groups of organizational values are identified in this study based on a study accomplished by Woodcock and Francis (1989) [Woodcock & Francis, 1989).Unblocking organizational values. 1st ed., USA.]; namely managing tasks values, managing environment values, managing organization values, and managing relationship values. These were determined as independent variables and employee performance was considered as a dependent variable. Researchers assumed there is a statistically significant correlation between organizational values and employee performance. The primary data used in this study were collected from a sample of 75 employees in different banks in Kurdistan region. The data were analyzed by using correlation and multiple regression analysis by using SPSS software. The results illustrate that organizational values were significantly and positively associated with employee performance in banking industry in Kurdistan region, and the strength of the correlation coefficient vary from one variable to another. Managing tasks received the highest value, with a correlation coefficient of 0.636 when the level of significant was one percent

P-15 Passive Housing Systems:A Comparative Analysis against Timber Manufacturing and the Feasibility of Implementation in the United Kingdom

Passive Houses are a new sustainable development option that has been appearing more frequently across the UK in the last 25 years. The houses offer huge benefits in terms of energy saving, comfort and host a multitude of sustainable technologies within. The houses use an increased amount of timber in the structure and there is a question on whether this increased use of timber combined with the current UK timber shortage could potentially mitigate the sustainability of the house. The research assesses the problem from both the worker and consumer viewpoints using collected primary data and analyzes the feedback well as this alternate solution Passive Houses are explored and compared and the market for these kinds of technologies is researched to conclude whether these houses could potentially become a widespread product across the UK. This research concludes that making passive houses more widespread is possible, but it would rely on a countrywide push to make it happen. Standards need to be raised and an increased level of continuing professional development in this specialised field would need to be put in place to allow for sustainable innovations to become more common

Natriuretic peptide system expression in murine and human submandibular salivary glands: a study of the spatial localisation of ANB, BNP, CNP and their receptors

The natriuretic peptide (NP) system comprises of three ligands, the Atrial Natriuretic Peptide (ANP), Brain Natriuretic peptide (BNP) and C-type Natriuretic peptide (CNP), and three natriuretic peptide receptors, NPRA, NPRB and NPRC. Here we present a comprehensive study of the natriuretic peptide system in healthy murine and human submandibular salivary glands (SMGs). We show CNP is the dominant NP in mouse and human SMG and is expressed together with NP receptors in ducts, autonomic nerves and the microvasculature of the gland, suggesting CNP autocrine signalling may take place in some of these glandular structures. These data suggest the NP system may control salivary gland function during homeostasis through the regulation of electrolyte re-absorption, neural stimulation and/or blood vessel wall contraction/relaxation. We also show abnormal expression of NPRA in the stroma of a subset of human SMGs resected from patients diagnosed with oral squamous cell carcinoma (OSCC) of non-salivary gland origin. This finding warrants further research to investigate a possible correlation between early OSCC invasion and NPRA overexpression

Molecular Characterization of Fasciola Spp. Isolated From the Gallbladder of Infected Cattle in Duhok Province, Kurdistan Region Iraq

Fascioliasis caused by the liver flukes of the genus Fasciola is considered as the most significant Trematodes infection of ruminants in both temperate and tropical countries. In the present study fifty adult Fasciola flukes (Platyhelminthes: Trematoda: Digenia) were collected from the bile ducts and gallbladder of infected bovine hosts (cattle) slaughtered at Duhok abattoir, Kurdistan region, Iraq.  Genomic DNA extraction was performed using a Genomic DNA Extraction kit. ITS-1 and ITS-2 ribosomal DNA sequences have been used to characterize these liver flukes as a specific marker. The PCR products were separated by electrophoresis in 1.5% agarose gel, visualized by staining with ethidium bromide, and photographed. ITS-2 marker for F. hepatica was amplified successfully and the length of produced band for ITS-2 was 330 bp. The present study is the first trail for molecular characterization of F. hepatica in cattle in Duhok, Kurdistan Region, Iraq  using the ITS-2 rDNA as a reliable genetic marker

The Prevalence of S. Aureus Nasal Colonisation and its Antibiotic Sensitivity Pattern amongst Primary School Pupils

Staphylococcus aureus is one of the most adaptable human pathogens. Nasal Staphylococcus aureus is the main cause of community-associated staphylococcal infections. This project aimed to study the prevalence of nasal carriage of Staphylococcus aureus and community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) and evaluate their antibiotic susceptibility tests among primary school children at Zakho city, Kurdistan region, Iraq. Nasal swabs were taken from a total of 300 primary school pupils aged 8-12 years. Collected nasal swabs were processed according to the standard bacteriological culture and isolates were identified using mannitol fermentation, Gram stain, catalase test and coagulase test. Antimicrobial susceptibility test was carried out on Muller-Hinton agar (MHA) to determine the susceptibility of S. aureus and CA-MRSA towards antibiotics. 30% (90/300) of the primary school children carried S. aureus. The nasal carriage of MRSA was 4% (12/300) among participants. All MRSA isolates were sensitive to vancomycin, doxycycline, amikacin and ciprofloxacin. This study showed that the incidence of S. aureus and CA-MRSA is comparable with reports from elsewhere. Measures are needed to keep the emergence and transmission of these pathogens to a lowest. Antimicrobial susceptibility testing of all S. aureus isolates is crucial for treatment of MRSA. Further studies are required to detect the risk factors of the acquisition of MRSA

GIS Visualization of Solid Waste Disposal Sites and Environmental Impacts in Kurdistan Region-Iraq

The increase in the quantity of municipal solid waste (MSW) has made environmental problems in the Kurdistan Region (KR)-Iraq. Current study illustrated components and generation rates (GR) of MSW in seven different cities of KR. Geographic information system (GIS) was applied to locate MSW disposal sites, components, and generation rate in the cities. The study reported the maximum GR for MSW in Sulaymaniyah City which was 1.20 Kg/Capita/day and the minimum GR for domestic solid waste in Erbil City was 0.65 Kg/Capita/day. In-addition, the amount of organic waste component (OWC) in Erbil, Halabja, Sulaymaniyah, Semel, Duhok, Qaladize, and Ranya Cities were 79.34 %, 58 %, 65 %, 65 %, 79 %, 75.1 %, and 67.05 %, respectively. The average GR and OWC were calculated to be 0.972 Kg/Capita/day and 71.91%, respectively. Consequently, all MSW disposal sites had great impact to the surrounding areas resulting in air, water, and soil contamination

Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019 : results from the Global Burden of Disease Study 2019

BACKGROUND: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. METHODS: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4-B97.6, J09-J15.8, J16-J16.9, J20-J21.9, J91.0, P23.0-P23.4, and U04-U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. FINDINGS: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18-1·42) male deaths and 1·20 million (1·07-1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16-1·18) and 1·31 times (95% UI 1·23-1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4-131·1]) and deaths (100·0% [83·4-115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (-70·7% [-77·2 to -61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7-61·8] in males and 56·4% [40·7-65·1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6-35·5] for males and PAF 25·8% [16·3-35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4-25·2) in those aged 15-49 years, 30·5% (24·1-36·9) in those aged 50-69 years, and 21·9% (16·8-27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5-27·9) in those aged 15-49 years and 18·2% (12·5-24·5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2-15·8) of LRI deaths. INTERPRETATION: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. FUNDING: Bill & Melinda Gates Foundation