Risk factors of hepatitis B virus infection among blood donors in Duhok city, Kurdistan Region, Iraq

Background: Hepatitis B virus (HBV) infection is a public health problem. The lack of information about the seroprevalence and risk factors is an obstacle for preventive public health plans to reduce the burden of viral hepatitis. Therefore, this study was conducted in Iraq, where no studies had been performed to determine the prevalence and risk factors of HBV infection. Methods: Blood samples were collected form 438 blood donors attending blood bank in Duhok city. Serum samples were tested for HBV core-antibodies (HBcAb) and HBV surface-antigen (HBsAg) by ELISA. Various risk factors were recorded and multivariate analysis was performed. Results: 5/438 (1.14%) of the subjects were HBsAg positive (HBsAg and HBcAb positive) and 36/438 (8.2%) were HBcAb positive. Hence, 41 cases were exposed to HBV and data analysis was based on that. Univariate analysis showed that there were significant associations between history of illegitimate sexual contact, history of alcohol or history of dental surgeries and HBV exposure (p<0.05 for all). Then, multivariate analysis was conducted to find HBV exposure predictive factors. It was found that history of dental surgery was a predictive factor for exposure to the virus (P=0.03, OR: 2.397). Conclusions: This study suggested that the history of dental surgery was predictive for HBV transmission in Duhok city. Further population-based study is needed to determine HBV risk factors in the society and public health plan based on that should be considered

The pathogenesis of Helicobacter pylori associated diseases in Kurdistan region, Iraq

Helicobacter pylori is regarded as the most important risk factor for peptic ulcer disease and gastric cancer. In Kurdistan region, northern Iraq, gastric cancer is rare (5/100,000). To investigate some possible reasons for this, the prevalence of H. pylori infection, gastric mucosal histopathological changes in H. pylori infected subjects, and virulence factor genotypes (especially dupA) of colonising strains were studied. The immune response to H. pylori infection, focusing on genes associated with T-helper (Th) and regulatory T-cell (Treg) cells, was also investigated. It was found that 79% of 163 adults and 37% of 120 children were seropositive for H. pylori (p<0.0001). For infected people, gastric lymphocyte infiltration was more prominent in the antrum (p=0.01). 71% of Iraqi H. pylori strains were positive for cagA and its presence was significantly associated with peptic ulcer disease (PUD) (p<0.01). cagA genes encoding four or more tyrosine phosphorylation motifs could not be found in any of the Iraqi strains. Isolates possessing the i1 form of vacA were significantly associated with GU (p<0.02). 32% of Iraqi H. pylori isolates were dupA-positive and presence of this gene was associated with PUD (p<0.01). The levels of IFNγ, IL-12 p35, IL-10, IL-4 and FOXP3 mRNA were found to be elevated in gastric mucosal samples from H. pylori-infected patients compared to those from H. pylori-negative patients (median increase 7-fold p=0.001; 17-fold p=0.002; 1320-fold p=0.001; 1184-fold p=0.001; and 3-fold p=0.01, respectively), indicating a predominant IL-4 and IL-10 (Th2) response. Interestingly, IFNγ mRNA levels were 16-fold higher in tissues taken from 17 infected smokers than found in tissues taken from 18 infected non-smokers (p=0.009). IL-4 mRNA levels in tissues from 20 infected females were 40-fold higher than in tissues from 15 males (p=0.005). Nucleotide sequencing of the dupA 3' region from 32 strains showed that dupA commonly had additional single base insertions or deletions that either truncated or extended the open reading frame (ORF). We have therefore classified dupA into two main groups: the common extended ORF within jhp0917-19 (dupA1), and dupA with an early stop codon to truncate the ORF (dupA2). ELISA performed on supernatants from H. pylori-infected gastric epithelial cell lines found no significant differences in IL-8 production between strains that possessed or lacked dupA. In comparison to wild-type H. pylori, disruption of dupA significantly reduced IL-12, IFNγ, TNFα and IL-8 production by peripheral blood mononuclear cells (PBMCs) in 2/4 strains. For the remaining 2 strains, where gene sequencing revealed a frame shift resulting in truncated dupA in the wild-type, the level of these cytokines was unchanged by dupA mutation. H. pylori infection is common in Kurdistan region and acquired at a young age. The low cancer rate may be partially explained by a predominant lymphocyte infiltration in the antrum rather than the corpus, which has been reported to be associated with reduced risk of gastric adenocarcinoma. An absence of the more toxic cagA genotype with four or more tyrosine phosphorylation motifs in the Iraqi strains, and the predominance of Th2 cytokine expression rather than a more pro-inflammatory Th1 response to H. pylori could also contribute to a reduced incidence of cancer. dupA1 appears to play an important role in promoting the inflammatory response of leukocytes to H. pylori

Enhancement Mechanical Properties of Polyvinly Alcohol by adding Methyl Cellulose using ultrasonic technique

Some of physical properties of polyvinyl alcohol dissolves in distilled water had been studied at different concentrations (0.1%, 0.2%, 0.3%, 0.4%, 0.5% , 0.6%, 0.7%, 0.8%) gm./ml) before and after adding (1and 2 ) gm of MC for all concentrations , the mechanical properties such as ultrasonic velocity had been measured by ultrasonic waves system at frequency 25 KHz, other mechanical properties had been calculated such as absorption coefficient of ultrasonic waves, relaxation time, relaxation amplitude, specific acoustic impedance, compressibility and bulk modules. The results show that all these properties are increasing with the increase of the polymer concentration except compressibility is decreasing with increase the concentration; results show that when adding MC these properties are increasing except compressibility is decreasing. Results also shows that adding MC polymer to PVA enhances these properties as a result of high values after addition. Keywords: PVA solution, MC solution, mechanical properties, ultrasound technique

Enhancement Rheological and Electrical Properties of Polyvinyl Alcohol by adding Methyl Cellulose

In this study the effect of methyl cellulose on the properties of aqueous solutions including density, viscosity and electrical conductivity have been investigated at (293K.), different type of viscosity and electrical properties were measured for polyvinyl alcohol dissolved in distilled water of different concentrations (0.1%, 0.2%, 0.3%, 0.4%, 0.5%, 0.6%, 0.7% and 0.8%)gm./ml  before and after adding (1and 2 ) gm. of methyl cellulose for all concentrations. The shear viscosity, relative viscosity, specific viscosity, reduced viscosity, intrinsic viscosity and Viscosity Average Molecular weight  are measured, all the viscosities depend on density and concentration, The results show that all these properties are increasing with the increase of the polymer concentration before and after adding MC , Results also shows that adding MC polymer to PVA enhances the conductivity, the conductivity measured at room temperature (293 K.), then the molar conductivity and degree of dissociation were calculated and it depending on the values of density, concentration and type of solute_ solvent . Keywords: Polyvinyl Alcohol solution, Methyl cellulose solution, Rheological properties, Electrical properties

The pathogenesis of Helicobacter pylori associated diseases in Kurdistan region, Iraq

Helicobacter pylori is regarded as the most important risk factor for peptic ulcer disease and gastric cancer. In Kurdistan region, northern Iraq, gastric cancer is rare (5/100,000). To investigate some possible reasons for this, the prevalence of H. pylori infection, gastric mucosal histopathological changes in H. pylori infected subjects, and virulence factor genotypes (especially dupA) of colonising strains were studied. The immune response to H. pylori infection, focusing on genes associated with T-helper (Th) and regulatory T-cell (Treg) cells, was also investigated. It was found that 79% of 163 adults and 37% of 120 children were seropositive for H. pylori (p<0.0001). For infected people, gastric lymphocyte infiltration was more prominent in the antrum (p=0.01). 71% of Iraqi H. pylori strains were positive for cagA and its presence was significantly associated with peptic ulcer disease (PUD) (p<0.01). cagA genes encoding four or more tyrosine phosphorylation motifs could not be found in any of the Iraqi strains. Isolates possessing the i1 form of vacA were significantly associated with GU (p<0.02). 32% of Iraqi H. pylori isolates were dupA-positive and presence of this gene was associated with PUD (p<0.01). The levels of IFNγ, IL-12 p35, IL-10, IL-4 and FOXP3 mRNA were found to be elevated in gastric mucosal samples from H. pylori-infected patients compared to those from H. pylori-negative patients (median increase 7-fold p=0.001; 17-fold p=0.002; 1320-fold p=0.001; 1184-fold p=0.001; and 3-fold p=0.01, respectively), indicating a predominant IL-4 and IL-10 (Th2) response. Interestingly, IFNγ mRNA levels were 16-fold higher in tissues taken from 17 infected smokers than found in tissues taken from 18 infected non-smokers (p=0.009). IL-4 mRNA levels in tissues from 20 infected females were 40-fold higher than in tissues from 15 males (p=0.005). Nucleotide sequencing of the dupA 3' region from 32 strains showed that dupA commonly had additional single base insertions or deletions that either truncated or extended the open reading frame (ORF). We have therefore classified dupA into two main groups: the common extended ORF within jhp0917-19 (dupA1), and dupA with an early stop codon to truncate the ORF (dupA2). ELISA performed on supernatants from H. pylori-infected gastric epithelial cell lines found no significant differences in IL-8 production between strains that possessed or lacked dupA. In comparison to wild-type H. pylori, disruption of dupA significantly reduced IL-12, IFNγ, TNFα and IL-8 production by peripheral blood mononuclear cells (PBMCs) in 2/4 strains. For the remaining 2 strains, where gene sequencing revealed a frame shift resulting in truncated dupA in the wild-type, the level of these cytokines was unchanged by dupA mutation. H. pylori infection is common in Kurdistan region and acquired at a young age. The low cancer rate may be partially explained by a predominant lymphocyte infiltration in the antrum rather than the corpus, which has been reported to be associated with reduced risk of gastric adenocarcinoma. An absence of the more toxic cagA genotype with four or more tyrosine phosphorylation motifs in the Iraqi strains, and the predominance of Th2 cytokine expression rather than a more pro-inflammatory Th1 response to H. pylori could also contribute to a reduced incidence of cancer. dupA1 appears to play an important role in promoting the inflammatory response of leukocytes to H. pylori

The Seroprevalence of HBV and HCV Infection in Newly Recruited Police in Duhok city, Kurdistan Region, Iraq

In develop?ng countries such as Iraq, hepatitis B (HBV) and C virus (HCV) are leading health care problems. The aim of this paper was to evaluate the frequency of HBV and HCV in healthy individuals selected for the recruitment in police services in Duhok city. In the study, blood samples from 566 candidates of police recruitment were collected and tested for HBV surface antigen (HBs Ag) and HCV antibody (AB) positivity by ELISA. It was found that 41/566 (7.2%) subjects were positive for HBs Ag. None of the recruited subjects was positive for HCV AB. To conclude, the prevalence of HBs Ag positivity was high in newly recruited police officers. Further study recruiting larger sample size is needed to confirm such a result

The Efficacy and Safety of Heterologous Immunization with Pfizer-BioNTech (Pfizer) to Individuals Who Have Completed A Primary Vaccination Schedule with Sinopharm (BBibp-CorV)

The aim of this study was to examine the effectiveness and potential adverse reactions when providing a different Pfizer-BioNTech booster shot to 235 volunteers who had previously received the BBIBP-CorV Sinopharm primary vaccination series. Between February and December 2022, a questionnaire-based cross-sectional study was conducted in Duhok, located within the Kurdistan Region of Iraq. The individuals included in the study were adults aged 18 and above, who had received a Pfizer-BioNTech booster shot following the completion of a two-dose vaccination regimen with Sinopharm (BBIBP-CorV). The findings revealed that among those vaccinated with BBIBP-CorV, there were breakthrough infections at a rate of 4.26%, and no significant correlation was identified between post-vaccination infections and factors such as demographics or medical history. Furthermore, individuals who had a Pfizer booster dose experienced breakthrough infections at a rate of 5.73%, and similarly, no link was discovered between this rate and demographic or medical factors. Additionally, the study uncovered that participants commonly experienced side effects, primarily consisting of mild effects at the injection site. The study implies that both the Sinopharm and Pfizer vaccines demonstrate satisfactory safety profiles. It also suggests that giving a heterologous booster dose to individuals who have finished their primary vaccination with the BBIBP-CorV vaccine offers a significant level of protection against infection

False Beliefs About Diabetes Mellitus in the Kurdistan Region of Iraq: A Population-Based Study

Background. Diabetes mellitus (DM) is a chronic, non-transmissible health condition distinguished by high blood glucose levels caused by faulty insulin secretion and impaired insulin activity. People play an essential role in preventing and managing their illnesses. Thus, the misconceptions may negatively influence the prevention and management of DM. The aim of this study was to gauge the extent of knowledge among the general population concerning DM, to determine the prevalence of misconceptions about DM in the community, and to find the factors influencing them. Methods. A population-based study was conducted in Duhok Province, the Kurdistan Region of Iraq. A total of 2,305 adults were enrolled in the study. The study data were collected by face-to-face interview. The survey questionnaire comprised two sections: the first section included basic demographic characteristics of participants, while the second section consisted of ten questions to identify common misconceptions about DM among participants. Results. Among the participants, there were 1,406 (61.0%) females. Participants’ age ranged from 18 to 90 years (the mean age: 54 ± 13.69 years). The most common misconceptions positively responded to were “Will I become addicted to insulin if I start taking it?”, followed by“ Does DM occur because of increased sugar intake?”. Male gender was associated with higher level of misconceptions. In addition, the misconceptions were more prevalent among diabetics as they might seek treatment from non-professionals. There was a significant association between education status and the prevalence of misconceptions. Healthcare workers were found to have a better knowledge about DM compared to the general population. Surprisingly, certain myths were prevalent even among healthcare workers. Conclusions. Certain myths and misconceptions have been pervasive in our society. Actions must be taken to dispel these misconceptions as they lead to an avoidable burden of disease. Therefore, people’s knowledge of DM needs to be enhanced through educational programs, social media, television, newspapers and campaigns

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