Assement of Severity of Community Acquired Pneumonia By CURB-65

Background:Community-acquired pneumonia. is a disease in which individuals who have not recently been hospitalized develop an infection of the lungs, which can affect people at all ages.  Pneumonia affecting about 2/1000 of the population per year.The initial assessment of the severity of community-acquired pneumonia is important for patient management. Severity assessment is an important early step in the management of patients presenting with community-acquired pneumonia. Various pneumonia-specific scores, generic sepsis scores and predictive biomarkers have been proposed as tools to aid clinicians in key management decisions. Objective:The study was conducted to determine the efficacy of CURB-65 in the management of the Pneumonia. Patients and Methods: 200  consecutive  patients attending   Baquba  Teaching   Hospital  (108 female and 92 male)   at   a median age  of 68 year , male(46%) and female(54%) between April 2017 and November 2018, diagnosed as CAP . Results: CURB65 is useful in the evaluation of patients with CAP and determining the severity of the illness  a  clinical  prediction  rule  suitable for use in busy casualty departments or admission units. Conclusion: Iit include clinical features of  prognostic  importance, which  were  easily measurable at the time of initial assessment

Squatters, Floodplain Occupation And Effects On Rivers:Some Experience From Malaysia.

Malaysia is a rapidly developing country, one of the 'tiger' economies of Asia and on the verge of becoming a developed natio

EFFECT OF FOLIAR APPLICATION OF POTASSIUM SILICATE AND SOME POSTHARVEST TREATMENTS ON GROWTH, PRODUCTIVITY AND STORABILITY OF GARLIC

Two experiments were carried out in the experimental farm of Al-Kanater Research Station at ElQalyubia Governorate, during the two consecutive years of 2016/2017 and 2017/2018 to investigate the effect of potassium silicate foliar application on growth, productivity and some postharvest treatments on storability of garlic ((Allium sativum L.)" clone sids 40". In the field experiment, the treatments comprised of control(water spray),foliar application of potassium silicate at 4000, 6000 and 8000ppm and plants were sprayed at 30, 60 and 90 days after planting. In the storage experiment, cured bulbs were stored at room temperature conditions and subjected to sixteen postharvest treatments included the previous four treatments (the three potassium silicate levels and control). In addition, three spraying treatments of sodium silicate at 6000 ppm, chitosan at 200 ppm and calcium chloride at 3000 ppm both separately and their combinations with potassium silicate (three treatments in field) were done.   The results revealed that, the highest plant length, number of leaves, fresh, dry weight\plant, neck diameter, bulb diameter and chlorophyll content of garlic were achieved from foliar application of potassium silicate at the 4000ppm after 120 days from planting compared to the control. Foliar spray of potassium silicate at 4000 ppm recorded the highest total yield and bulb quality such as bulb diameter, bulb weight/plant, number of cloves, cloves weight, total soluble solids and dry matter of bulbs. Leaf K percentage significantly increased by spraying of potassium silicate at 6000ppm.Further, all potassium silicate treatments recorded higher silicon percentage over the control.   Postharvest results showed that weight loss and shrinking percentages of the bulbs after 7 months of the storage were the least with the foliar application of potassium silicate at 8000ppm plus chitosan at 200ppm in storage followed by chitosan individually, potassium silicate at 8000 ppm and potassium silicate at 6000 ppm combined with calcium chloride as a postharvest treatment. However, the highest total soluble solids after 7 months of the storage was obtained from foliar spraying of potassium silicate at 4000 ppm combined with either sodium silicate or chitosan. Also, bulbs treated with foliar application of potassium silicate at 6000 or 8000 ppm combined with chitosan at 200 ppm, had the highest values of dry matter after 7 months from storage.  In general, foliar application of potassium silicate at 4000ppm was the superior treatment for enhancing plant growth, yield and quality. Also, foliar application of potassium silicate at 8000ppm and sprayed with chitosan at 200 ppm was the most effective for garlic storability seven months at the room temperature conditions

Prevalence of text neck syndrome among Iraqi medical students: a cross-sectional study

Background: Excessive use of portable electronic devices causes neck flexion and the emergence of text neck syndrome (TNS). This study aims to explore the prevalence of TNS among medical students during the COVID-19 lockdown in Iraq. Methods: A prospective cross-sectional web-based study was conducted from 1st to 20th March 2021 at the faculty of medicine, Diyala University, Iraq. A self-administered questionnaire was distributed among the medical students using Google Form through social media (WhatsApp group). The semi-structured questionnaire included the sociodemographic, the valid smartphone addiction scale-short version (SAS-SV), and the neck disability index (NDI). Univariate, bivariate, and multiple logistic regression were used to analyze the data. SPSS version 16. The statistical significance is considered at less than 0.05. Results: Out of 273 medical students included in the study, 59.3% were males, unmarried (88.3%), and from the 1st year (21.6%). The mean age of students was 21.27 ± 1.74 years. The prevalence of text neck syndrome was 64.5%. About two-thirds (61.5%) of students were addicted to their smartphones and used them more than five h/daily (63.7%). Factors associated with neck disability were the students who did not warm up neck muscles before using the smartphone (OR = 8.796, 95% CI: 1.724 to 24.884), addicted to the smartphone (OR = 6.803, 95% CI: 3.455 to 13.397), experienced increase in daily hours using the smartphone during the COVID-19 related quarantine (OR = 5.370, 95% CI: 2.523 to 11.427), maintained smartphone use five hours and more daily (OR = 2.818, 95% CI: 1.422 to 5.587), had neck pain (OR = 2.876, 95% CI: 1.356 to 6.098), the female gender (OR = 2.756, 95% CI: 1.221 to 6.221), and those who did not have a frequent break when using the smartphone (OR = 2.693, 95% CI: 1.329 to 5.454). Conclusion: In conclusion, the prevalence of neck disability was high among the surveyed medical students. Addiction and excessive smartphone use with a lack of attention to warm up the neck muscles before usage was the most prominent predictors of neck disability

Genotyping of Hepatitis C Virus Isolates from Iraqi Hemodialysis Patients by Reverse Transcription-PCR and One Step Nested RT-PCR

Background: Hepatitis C virus (HCV) infection is a major health problem among dialysis patients in developing countries. Geographical distribution of various genotypes of HCV is useful for understanding the epidemiological status, detection of mode and source of infection, designing the program of control, evaluating the response to treatment and development of diagnostic methods and vaccine production. Aim: To investigate the prevalence of HCV genotypes and subtypes (1a, 1b, 2a, 2b, 3a, 3b, 4, 5a & 6a) among hemodialysis patients. Materials and Methods: The prevalence of anti-HCV antibody was determined by Enzyme Linked Immunosorbent assay (ELISA). Then, HCV specific RNA was detected in those anti-HCV seropositive and seronegative dialysis patients, utilizing reverse transcriptase-polymerase chain reaction technique (RT-PCR), Furthermore, Genotyping the HCV-RNA positive samples by one step nested RT-PCR technique. Results: Genotyping analysis was performed in 29 HCV-RNA positive patients. Genotypes 1a, 1b, 3a and 4 were found in (34.48%), (13.79%), (3.45%) and (41.38%) patients, respectively. In addition, two patients (6.90%) had mixed infected with both 4 and 1b. Conclusion: The genotype distribution in our study is comparable to that for non haemodialysis patients. Further analyze relatedness of HCV isolates by sequence analysis are required to trace the source of infection

Influence of Mobile Phone Electromagnetic Field Exposures on Pseudomonas Aeruginosa and Staphylococcus Aureusinvitro

Background: Mechanism underlying the lethal effect of microwave radiation on microorganisms are yet to be discovered. Some researchers hypothesized that electromagnetic waves can increase the target temperature and destroy life. Objectives: The aim of this study was to determine the impact of cell phone radiation on bacteria that cause otitis media. Materials and Methods: Two bacterial isolates were selected from cases of inflammation of the middle ear (otitis media). Pseudomonas aeruginosa and Staphylococcus aureus, isolates were exposed to electromagnetic waves emitted from mobile. After the incubation period, the absorbance was measured to determine the degree of turbidity by using spectrophotometer on the wavelength 400nm. Results: It was found that is no effect of mobile radiation up to six minutes of exposure to both bacterial Species, but influence began after the six minutes and increased influence directly proportional to the time. Effective dose 50 of Staphylococcus aureus was 11.5 minutes while for Pseudomonas aeruginosa was 14.2 minutes. Conclusions: The radiofrequency of cell phone effects on the bacteria depend on the following factors: the exposure time to mobile radiation, water content and increasing temperature, breaking protein molecule

Performance of Recombinant rK39 antigen in the diagnosis of Leishmaniasis

Background: Recombinant K39 antigen test is one of the recent experiences in rapid diagnosis of Visceral Leishmaniasis ,it consist  of 39 amino acid which represent the main component of the protein of the Leishmania  parasite and that the reaction occurs between the antibodies in the serum and antigens blotted in the rK39 strip test.                                                                                       Objective: Find out possible reaction of rK39 antigen test on other diseases than visceral leishmaniasis, as well as to compare the test results on both serum and urine of same patients. Patients and Methods: A total of 65 blood and urine samples were included in the study; 25 patients with cutaneous leishmaniasis attended Baquba Teaching Hospital, and 40 apparently healthy controls.  All serum and urine samples were tested with rK39 strip test. 15 serum samples were randomly selected and Indirect Fluorescent Antibody Techniques for diagnosis of Leishmaniasis for the purpose of comparison of rK39 strip test. Results: There was highly significant differences when using the rK39 strip test in urine and serum in patients infected with cutaneous leishmaniasis  (P <0.05), and no significant difference between the sexes, as well as age group , as well as the absence of a significant difference between the rK39 strip test and Indirect Fluorescent Antibody Techniques. Conclusion: rK39 strip antigen test gives positive results, may be due to greater phylogenetic proximity between Leishmania species, or due to mixed infection with Visceral Leishmaniasis

Echocardiographic Assessment Of Left Ventricular Systolic Function Among Patients with Chronic Kidney Disease Managed In Ebn Sena Dialysis Center In Diyala

Background: Cardiovascular diseases are prevalent in patients with chronic  kidney disease and represent the major hazard for mortality in this population . Left ventricular hypertrophy is a cardiovascular complication in patients with chronic kidney disease and end-stage renal disease. Left ventricular hypertrophy in dialysis patients has generally a bad prognostic value, because it represents a risk factor for the development of cardiac arrhythmias, ischemic heart disease, heart failure and sudden death. Objective: To study  left ventricular systolic functions by Echocardiography in patients with chronic renal failure on hemodialysis  program and their relation with some risk factors. Patients and Methods: 100 patients with end stage renal failure on dialysis were studied  by echocardiography, the patients were divided into two groups, the first group   with normal echo study , while the second group consisted of patients with left ventricular  systolic dysfunction. Risk factors  including age , sex , duration of dialysis , hypertension, DM, and hemoglobin levels were compared between the groups. Results: Left Ventricular  disorders occurred in 65% , 34% of patients showed left  ventricular  systolic dysfunction , , older age  group, longer duration of dialysis  , hypertension ,DM, and anemia were found to be significantly associated  with  left ventricular systolic dysfunction. Conclusion: Our study concluded that large numbers of end-stage renal disease patients have hypertension and diabetes as the etiology of their disease, which could be prevented by better approach in controlling blood pressure and blood sugar.         Anaemia is a major problem and as a predictor of cardiovascular risk factor for those patients. Echocardiographic Left Ventricular Study are prognostic predictors in chronic kidney disease patients, which suggest that echocardiography may play a vital role in assessing cardiac morphology and functions in those patients

Mineral Derangement and Bone Diseases in Uremic Patients on hemodialysis in Ibn-Sina Hemodialysis Center / Diyala

  Background: Chronic kidney disease is an international public health problem affecting 5–10% of the world population. As kidney function declines, there is a progressive deterioration in mineral homeostasis, with a disruption of normal serum and tissue concentrations of phosphorus and calcium, and changes in circulating levels of hormones. Objective: To determine the severity of bone and mineral disease in chronic renal failure and how efficiently controlled by drugs and hemodialysis procedure in Ibn sina dialysis center. Patients and Methods: A case control study was carried out among 75 patients with chronic kidney disease (stage5) on regular hemodialysis in Ibn Sina dialysis center. Blood was taken before dialysis session and measurements of serum calcium, phosphorus, serum alkaline phosphatase, .protein and albumin levels, Serum parathyroid hormone and VIT D3   were determined.  and another group of 25 normal peoples from surrounding area. Results: The mean parathyroid hormone level was 145.62pg/ml, with 57.33% having normal acceptable rang of parathormone level, 41% of patients having hyperparathyroidism and 1.33% having hypoparathyroidism. There was no significant correlation between serum PTH and dexa scan. Hypocalcemia was found in 52% of patients, 33% with hypercalcemia patients . There was a significant correlation found between Hypocalcemia and dexa scan results. Majority of patients had high serum phosphate levels (54.6%).and normal phosphate level in 40% while the hypophosphatemia result 5.33% and mean phosphate level is2.24 mmol/l.Total serum protein mean is 61.51 a 37.33% of them had hypoproteinemia and 62.66 %of them had normal serum protein. Also our results show 97, 33%of uremic patients have low vit D While 2.33% have normal level of serum vit D. There was a significant correlation between dexa scan and vit D level, calcium, alkaline phosphatase, female gender, smoking and body mass index. Conclusion: The current study demonstrated that we can predict the chronic kidney diseases- Metabolic bone disorder from mineral scores before potentates the diagnosis by dexa scan

Attitude and intention of Iraqi healthcare providers to get vaccinated against COVID-19: a cross-sectional study

Background: International efforts to confront the COVID-19 pandemic are joining forces by accelerating the pace of vaccination. This study aims to explore the attitude and the intent to get vaccinated against COVID-19 among healthcare providers (HCPs) in Iraq. Methods: A cross-sectional survey was conducted in January 2021 using web-based facilities to access the respondents. The data were collected through a semi-structured and self-administered questionnaire, including sociodemographic and close-ended questions related to attitude and intention toward COVID-19 vaccination. Bivariate and multivariate logistic regression were recruited to predict variables. The statistical significance is considered at less than 0.05. Results: Data of 209 HCPs with a mean age of 45.12 (± 6.37) years have undergone final analysis. Most of the HCPs were males (112, 53.6%) and nurses (110, 52.6%), who had close contact (64.6%) with COVID-19 patients, and forty percent have been infected with COVID-19. Overall, 115 HCPs (58.0%) reported intention to get vaccinated compared to 94 (42.0%) who declined vaccination. Variables associated with intention to get vaccinated among HCPs were high attitude toward COVID-19 vaccination (odds ratio (OR) =  1.740, 95% confidence interval (CI): 0.799, 3.786), aged less than 45 years (OR = 3.713; 95% CI: 1.647, 8.367), married (OR = 2.155; 95% CI: 0.984, 4.720), highly educated (OR = 2.657; 95% CI: 1.202, 5.871), doctors (OR = 3.153; 95% CI: 1.428, 6.963), contracted with COVID-19 (OR = 4.119; 95% CI: 1.623, 10.455), directly engaged in management of COVID-19 patients (OR = 3.962; 95% CI: 1.569, 10.005), and had lost a close relative due to COVID-19 (OR = 5.698; 95% CI: 1.506, 12.564). Conclusion: The urgent need to improve the COVID-19 vaccine uptake rates among Iraqis requires a positive attitude and a high vaccination rate among HCPs