Effect of Vitamin D3 Levels on Varicella-Zoster Virus Infection and IFN-Gamma Expression in Children: A Cross-Sectional Study in Iraq

Background: This study aimed to explore the correlation between Vitamin D3 levels and IFN-Gamma expression in children residing in the southern and central provinces of Iraq. Vitamin D3 plays a pivotal role in immune function, and IFN-Gamma is a crucial cytokine involved in antiviral defense. Investigating the connection between Vitamin D3 and IFN-Gamma offers valuable insights into immune responses and potential implications for infectious diseases.Methods: A case-control study was conducted, involving children from various schools and kindergartens in the southern and central provinces of Iraq. The study assessed Vitamin D3 levels and measured IFN-Gamma expression. Statistical analyses were performed to determine the relationship between these variables.Results: The outcomes revealed a significant positive correlation between Vitamin D3 levels and IFN-Gamma expression within the study population (p < 0.05). Children with higher Vitamin D3 levels exhibited elevated IFN-Gamma expression, suggesting a possible immunomodulatory impact of Vitamin D3 on IFN-Gamma production.Conclusion:These findings underscore the importance of maintaining adequate Vitamin D3 levels to support immune function, particularly in relation to IFN-Gamma expression. Improving Vitamin D3 status could potentially bolster antiviral defense mechanisms and reduce susceptibility to viral infections among children in the southern and central provinces of Iraq. Further investigation is warranted to delve into the underlying mechanisms and potential clinical ramifications of this significant association. Additionally, exploring the long-term effects of maintaining optimal Vitamin D3 levels on immune function and the outcomes of infectious diseases in this population would offer valuable insights for preventive and therapeutic strategies.

Effect of electronic health records on doctor-patient relationship in Arabian gulf countries: a systematic review

BackgroundThe electronic health record (EHR) has been widely implemented internationally as a tool to improve health and healthcare delivery. However, EHR implementation has been comparatively slow amongst hospitals in the Arabian Gulf countries. This gradual uptake may be linked to prevailing opinions amongst medical practitioners. Until now, no systematic review has been conducted to identify the impact of EHRs on doctor-patient relationships and attitudes in the Arabian Gulf countries.ObjectiveTo understand the impact of EHR use on patient-doctor relationships and communication in the Arabian Gulf countries.DesignA systematic review of English language publications was performed using PRISMA chart guidelines between 1990 and 2023.MethodsElectronic database search (Ovid MEDLINE, Global Health, HMIC, EMRIM, and PsycINFO) and reference searching restricted to the six Arabian Gulf countries only. MeSH terms and keywords related to electronic health records, doctor-patient communication, and relationship were used. Newcastle-Ottawa Scale (NOS) quality assessment was performed.Results18 studies fulfilled the criteria to be included in the systematic review. They were published between 1992 and 2023. Overall, a positive impact of EHR uptake was reported within the Gulf countries studied. This included improvement in the quality and performance of physicians, as well as improved accuracy in monitoring patient health. On the other hand, a notable negative impact was a general perception of physician attention shifted away from the patients themselves and towards data entry tasks (e.g., details of the patients and their education at the time of the consultation).ConclusionThe implementation of EHR systems is beneficial for effective care delivery by doctors in Gulf countries despite some patients' perception of decreased attention. The use of EHR assists doctors with recording patient details, including medication and treatment procedures, as well as their outcomes. Based on this study, the authors conclude that widespread EHR implementation is highly recommended, yet specific training should be provided, and the subsequent effect on adoption rates by all users must be evaluated (particularly physicians). The COVID-19 Pandemic showed the great value of EHR in accessing information and consulting patients remotely

The way forward to public health in Gulf Cooperation Council (GCC) countries: a need for public health systems and law

Introduction: Public health systems in the Gulf Cooperation Council (GCC) Countries are not well established. The existing systems do not match with the current health challenges and with the use of innovative technology in healthcare (diagnosis, treatment or rehabilitation). This paper is intended to give an overview of the public health situation in these countries. It discusses the need for effective and integrated system of public health laws that plays important role in addressing high priorities in public health. Conclusion: The GCC countries have the infrastructure for estab¬lishing a national public health system. However it needs an effective integrated and organized mechanism to shape this system; based on acceptable guidelines and criteria in such a way that they are institutional and capable of meeting the population needs. This system should be cost- effective and investment in health sector should be looked upon as a sustained investment in human and societal development. Despite the great efforts exerted and achievements made, there are great challenges ahead that can be overcome by exhibiting a strong political will and having a united approach of all stakeholders

Access to person-centered care: a perspective on status, barriers, opportunities and challenges from the Eastern Mediterranean Region

Background: Access to Person-Centered care is a major area of concern throughout the world including the Eastern Mediterranean Region. Objective: This networking paper reviews current status, barriers, opportunities, challenges and future directions with regards to Access to Person-Centered care in the Eastern Mediterranean Region. Methods: The lead Author from the Working Party on Research of Eastern Mediterranean Region invited members through its ya-hoo group to participate in this networking project. Objectives and work plan were developed by the lead Author and shared with interested contributors. Co-Authors and Advisors were invited to contribute and timelines were set for contributors to submit their report. Submissions were collected by lead authors and put into a draft that was shared with contributors for feedback. After incorporating feedback, the final draft was edited by the Editor before submission for publication consideration. Results: Access to Person-Centered care in the Eastern Mediterranean Region shows extreme variations. At one end there are oil and gas rich countries that offer advanced health care services to the majority of their local population while on the other end are impoverished countries that are unable to provide even minimum required services to their people. Inequalities in health status have been growing since the mid-1990s and have resulted in an increasing gap between the most advantaged and disadvantaged social groups. There are social, cultural, religious and economical barriers that may impede access to healthcare. It warrants a need to address these barriers on a priority basis so that Universal access to Person-Centered care may be made available to the population of the region. Conclusion: A well planned and evidence based approach is the only way forward to ensure universal access to all populations in the Eastern Mediterranean Region. Access to Person-Centered care is the need of the hour in the region. Provision of health care services through a well deined health system with a prime focus on a primary care model delivered by trained family doctors is the single most appropriate step to achieve health for all

Demographics, Risk Factors, and Post-COVID-19 Syndrome Among Patients in the Middle Euphrates Region of Iraq

Background: The COVID-19 pandemic has had a significant impact on global health, requiring a comprehensive understanding of its regional dynamics for effective management and response strategies. This study aimed to explore the demographics, risk factors, and post-COVID-19 syndrome among patients in the Middle Euphrates region of Iraq.Methods: A total of 410 patients were included in the study, with 180 females and 230 males. Demographic characteristics, risk factors (such as smoking, and comorbidities), and post-COVID-19 syndrome manifestations were analyzed. Statistical and machine learning analyses were conducted to predict outcomes.Results: The findings revealed a diverse age range (38-83 years) of COVID-19 patients in the Middle Euphrates region. Smoking was prevalent among 93 patients, while comorbidities such as diabetes, hypertension, and obesity were observed in significant numbers. Post-COVID-19 syndrome symptoms included generalized muscle fatigue, impaired concentration and memory, joint pain, hair loss, and respiratory problems. The prevalence of these symptoms varied across different age groups.Conclusion: This study provides valuable insights into the demographics, risk factors, and post-COVID-19 syndrome among patients in the Middle Euphrates region of Iraq. The high prevalence of smoking and comorbidities highlights the importance of tailored interventions for high-risk individuals. The range of persistent symptoms emphasizes the need for comprehensive healthcare support. These findings contribute to the existing knowledge on the impact of COVID-19 in the region and can inform targeted interventions and resource allocation

Barriers, challenges and way forward for implementation of person centered care model of patient and physician consultation: a survey of patients’ perspective from Eastern Mediterranean countries

Background: Person-Centered Care (PCC) is now considered a mandatory approach in Patient-Physician consultation. The aim of the study was to identify patients’ perception regarding barriers and possible remedies for implementation of PCC in Eastern Mediterranean Region (EMR). Methods: A cross-sectional multi-country study was conducted in six countries of EMR during May 2014 to October 2014. Expert Family Physicians from each country were identified and asked to participate in the study. The Family Physicians then recruited Patients from their own clinics (\u3e18 years). Data analysis was performed on SPSS 19 and results are reported in the form of proportions, odds ratios and 95% confidence intervals. Results: A total of 234 patients were recruited, 60.6% were aged between 20 to 30 years and 36.3% of them were males. 56% of the patients preferred Person-Centered Care model for patient-physician consultation. The major barriers identified by patients in its implementing were; time constraints (73.9%, OR: 1.5; 95% CI: 0.86-2.78), doctors desire to control patient (OR: 2.6; 95% CI: 1.55-4.49), cultural and religious reasons (52.1%), increased cost (50.9%). Patients responded that increased cost related to Person-Centered Care practice would be acceptable (58.1%), if increase proved to be in the interest of better health and care outcomes (40.6%). Conclusion: Person-Centered Care (PCC) is associated with significant barriers in its implementation in Eastern Mediterranean Region. These barriers can be overcome in the interest of better health and care related outcomes

Lessons on the COVID-19 pandemic, for and by primary care professionals worldwide.

The COVID-19 pandemic has modified organisation and processes of primary care. In this paper, we aim to summarise experiences of international primary care systems. We explored personal accounts and findings in reporting on the early experiences from primary care during the pandemic, through the online Global Forum on Universal Health Coverage and Primary Health Care. During the early stage of the pandemic, primary care continued as the first point of contact to the health system but was poorly informed by policy makers on how to fulfil its role and ill equipped to provide care while protecting staff and patients against further spread of the infection. In many countries, the creativity and initiatives of local health professionals led to the introduction or extension of the use of telephone, e-mail and virtual consulting, and introduced triaging to separate 'suspected' COVID-19 from non-COVID-19 care. There were substantial concerns of collateral damage to the health of the population due to abandoned or postponed routine care. The pandemic presents important lessons to strengthen health systems through better connection between public health, primary care, and secondary care to cope better with future waves of this and other pandemics

New leadership model for family physicians in the Eastern Mediterranean region: a pilot study across selected countries

Background: Family Medicine is growing rapidly across the Eastern Mediterranean Region. However, it needs support in terms of overall health system development. This will require strong leadership in family medicine to implement the change required to improve current conditions. Objective: To collect data that will support the development of a leadership program for the future family physicians in the region. Methods: A cross-sectional study was conducted from July 2016 to September 2016 in eight countries of the Eastern Mediterranean Region, (Bahrain, Egypt, Iraq, Jordan, Kuwait, Qatar, Pakistan, and Saudi Arabia). These countries were selected to obtain perceptions of Family Physicians (FPs) regarding the current leadership model and to explore the need for a new future innovative model in Family Medicine (FM) across the region. Results: The information of 68 family physicians was included in the final analysis. The majority of the FPs was females as compared to males (71% vs. 29%). Forty-four percent of the FPs had 10 to 19 years of experience. Almost all of the FPs (96%) had completed some training in family medicine after graduation. About three fifths of the FPs had completed postgraduate qualifications and out of those, 64% had passed Board or Membership Examinations. Twenty-one percent of them are currently in a leadership role and 45% who were not in any leadership role responded that the current situation of FM in their country is poor. All of the leaders believed that it is important to develop strong leadership in FM to take the specialty forward. Almost similar proportions (67% and 64%) of leaders and non-leaders thought that establishing regional associations would enhance the FM practice model. Approximately two thirds of leaders (67%) responded that the current role of decision makers in the Ministry of Health (MOH) regarding capacity building in FM is not effective. The majority of the FPs (54% and 38%) considers that the existing postgraduate curriculum does not address leadership skill development in FM. Eighty-eight percent of the FPs both from leadership and non-leadership groups agreed that academic institutions and practicing FPs can play an effective leadership role in taking FM forward. Conclusion: The Family Medicine specialty will have to develop leadership capabilities in line with today’s fast-moving changes in healthcare for it to obtain the due recognition in the healthcare delivery system

Health promotion, disease prevention and periodic health checks: perceptions and practice among family physicians in Eastern Mediterranean region

Introduction: The aim of this study was to identify the current practices and perceptions of family physicians regarding health promotion, disease prevention including periodic screening and health checks in Eastern Mediterranean Region. Methods: A multi-country cross-sectional study was conducted in six countries of EMR, from September 2014 to March 2015. Family Physicians who were currently practicing in different countries of EMR were invited to participate in the study through email. A pre-tested structured questionnaire was used for data collection. Data was entered and analyzed on SPSS 19 and logistic regression analysis was performed. Results: A total of 100 physicians’ data was included in the final analysis. The majority were female physicians (76%): 63% were 25 to 35 years of age. Approximately 53% of Family physicians always recommend periodic screening and health checks to their patients. The common screening question asked to patients in medical history was related to their blood pressure (86%). Almost all (99%) of the Family physicians believe they should conduct periodic health checks. Those who had postgraduate training in Family Medicine (OR: 0.5; 95% CI: 0.39-1.67) and attended CME sessions regularly (OR: 0.11; 95% CI: 0.01-0.93), are more likely to recommend periodic screening and health checks to their patients. Conclusion: Periodic screening and health check is an important strategy to prevent disease and maintain health. It is an underutilized practice and a great need exists for its implementation in family practice

Primary care healthcare policy implementation in the Eastern Mediterranean region; experiences of six countries: Part II

Background: Primary healthcare (PHC) is essential for equitable access and cost-effective healthcare. This makes PHC a key factor in the global strategy for universal health coverage (UHC). Implementing PHC requires an understanding of the health system under prevailing circumstances, but for most countries, no data are available. Objectives: This paper describes and analyses the health systems of Algeria, Kuwait, Morocco, Saudi Arabia, Jordan and Iraq to PHC. Methods: Data were collected during a workshop at the Wonca East Mediterranean Regional Conference in 2018. Academic family physicians (FP) presented their country; using the Wonca framework of 11 PowerPoint slides, with queries of the country demographics, main health challenges, and the position of PHC in the health system. Results: The six countries had achieved a significant improvement in populations’ health but currently face challenges of health financing, a small number of certified FPs, difficulties in accessing services and bureaucratic procedures. Primary concerns were the absence of a family practice model, brain drain and immigration of FPs. Countries differed in building a coherent policy. Conclusion: Priorities should be focused on: developing PHC model in Eastern Mediterranean region with advocacy for community-based PHC to policymakers; capacity building for strengthening PHC-oriented health systems with FP specialty training and restrict practising to fully trained FPs; engage communities to improve understanding of PHC; adopt quality and accreditation policies for better services; validation of the referral and follow-up process; and, develop public–private partnership mechanisms to enhance PHC for UHC