Ultrasonographic Gallbladder Wall Thickness as a Pathophysiological Predictor of Surgical Outcome in Laparoscopic Cholecystectomy: A Prospective Study
Background: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic gallstone disease. Gallbladder wall thickness (GBWT) is a well-established pathophysiological marker reflecting the degree of mural inflammation and fibrosis, and is an important preoperative predictor of surgical difficulty. Thickened gallbladder walls are frequently associated with higher rates of intraoperative complications and prolonged hospital stays. Objectives: To assess the relationship between preoperative ultrasonographic GBWT and the pathophysiological and clinical challenges encountered during laparoscopic cholecystectomy. Patients and Methods: A prospective study conducted on 144 patients who underwent LC at the Surgical Department of Al-Hussain Teaching Hospital and Al-Nassiriya Teaching Hospital, Nasiriyah, Iraq, from January 2023 to July 2024. GBWT was classified by ultrasonography as normal, mild, moderate, or severe. LC difficulty was assessed based on operative time, intraoperative complications, and the ability to achieve the critical view of safety (CVS). Results: LC was classified as easy in 58.33% and difficult in 41.67% of cases. Difficult LC was significantly associated with male sex (21.67% vs. 3.57%, p=0.001), higher BMI (30.29±3.08 vs. 28.71±3.95, p=0.011), elevated WBC count (p=0.001), pericholecystic fluid (35% vs. 7.14%, p<0.001), and moderate/severe GBWT (p<0.001). Moderate/severe GBWT was present in 18% of cases and was significantly associated with older age (48.19±13.36 vs. 41.62±11.45 years, p=0.011), male sex (p=0.032), hypertension (p=0.002), leukocytosis (p=0.016), pericholecystic fluid (p<0.001), prolonged operative time (p<0.001), adhesions (p<0.001), hemorrhage (p=0.045), and postoperative collection (p=0.010). Conclusions: GBWT is a significant preoperative pathophysiological predictor of LC difficulty. Moderate to severe GBWT is associated with higher rates of intraoperative and postoperative complications. Preoperative identification of GBWT by ultrasonography enables better patient counselling and surgical planning.
Copyright (c) 2026 Hasanain Mazyed Shamkh, Alaa Jamel Hasin (Author) https://creativecommons.org/licenses/by/4.0/
Acute Abdominal Pain in Young Versus Elderly Patients: A Comparative Prospective Study of Clinical Presentation, Aetiology, and Management Outcomes
Background: Acute abdominal pain is a common emergency presentation. Clinical features, aetiology, and outcomes differ markedly between young and elderly patients. Objectives: To compare presentation, diagnosis, management, and outcomes of acute abdominal pain between young (<60 years) and elderly (≥60 years) patients. Patients and Methods: A prospective study of 193 patients at Al-Hussain Teaching Hospital, Nasiriyah, Iraq (January–November 2024). Group A: young (<60 years, n=139); Group B: elderly (≥60 years, n=54). Results: Acute appendicitis predominated in young patients (51.80% vs. 16.67%, p<0.001). Perforated duodenal ulcer (27.78% vs. 7.19%, p=0.018) and intestinal obstruction (24.07% vs. 4.32%, p<0.001) were more frequent in the elderly. Young patients more often had tenderness, right iliac fossa pain, and rigid abdomen, while constipation and distension were commoner in elderly patients. Appendectomy was performed more in young patients (51.80% vs. 11.11%, p<0.001); conservative management predominated in the elderly (72.22% vs. 33.09%, p<0.001). UTI complications were significantly higher in elderly patients (9.26% vs. 0.72%, p=0.012). Conclusions: Elderly patients present atypically with higher rates of serious pathology and postoperative complications. Age-stratified protocols are essential to optimize outcomes.
Copyright (c) 2026 Hayder Hasan Hadi, Abdulhadi Jabbar Sarhan (Author) https://creativecommons.org/licenses/by/4.0/
Povidone-Iodine as a Scolicidal Agent in Liver Hydatid Cyst Surgery: A Prospective Comparative Study with Hypertonic Saline
Background: Hydatid disease caused by Echinococcus granulosus is endemic in Iraq and the Middle East. Surgery remains the definitive treatment for liver hydatid cysts, and the choice of scolicidal agent is critical to minimising intraoperative spillage complications and postoperative morbidity. Povidone-iodine and hypertonic saline are the most widely used scolicidal agents, yet their comparative efficacy and safety in clinical practice require further evaluation. Objectives: To evaluate the effectiveness and safety of 10% povidone-iodine compared with 15–20% hypertonic saline as a scolicidal agent in the surgical management of liver hydatid cysts, with respect to postoperative complications and recurrence rate. Patients and Methods: A prospective single-centre study including 110 patients with liver hydatidosis managed surgically at Al-Nasiriyah Teaching Hospital and Al-Hussain Teaching Hospital, Nasiriyah, Iraq, from January 2022 to December 2024. Patients were divided into two groups: Group A (povidone-iodine, n=91) and Group B (hypertonic saline, n=19). All patients were followed up for up to 24 months with ultrasonography and CT, liver enzyme assays, and clinical assessment for wound infection, collection, and abscess formation. Results: The mean age was 33.24±13.96 years and 65.45% were female. Laparoscopic surgery was performed in 63.64% of patients. The overall recurrence rate was 12.73%. Elevated liver enzymes (9.89% vs. 42.11%, p<0.001), wound infection (8.79% vs. 26.32%, p=0.031), fluid collection (10.99% vs. 31.58%, p=0.021), and abscess formation (4.40% vs. 21.05%, p=0.029) were all significantly less frequent in the povidone-iodine group. No significant differences were found between groups in hospital stay (p=0.567) or recurrence rate (p=0.752). Prolonged hospital stay was the only factor significantly associated with recurrence (p=0.001). Conclusions: Povidone-iodine (10%) is superior to hypertonic saline as a scolicidal agent in reducing liver enzyme elevation, wound infection, fluid collection, and abscess formation following liver hydatid cyst surgery. Both agents have comparable hospital stay and recurrence rates.
Copyright (c) 2026 Ahmed Ali Ismael, Abdul-Hussein Segeel Ashour Al-Jaberi (Author) https://creativecommons.org/licenses/by/4.0/
Outcomes and Predictors of Unfavorable Outcome after Decompressive Craniectomy for Severe Traumatic Brain Injury in Thi-Qar Province
Background: The widespread use of personal earphones and AirPods as audio devices has increased significantly, particularly among university students. Thus, the concerns about their potential role in carrying microbial contaminants have increased. When the students who share these devices can allow growth of pathogenic microorganisms, particularly when basic hygiene is neglected. Materials and Methods: About 60 Earphones were gathered from students at Al-Qadisiyah University for both male and female participants. Sterile swabs were used to collect samples from the inner and outer surfaces of the devices. A questionnaire on hygiene practices and sharing habits was performed by participants. The isolates and detection of Staphylococcus aureus of methicillin resistance were confirmed using PCR targeting the nuc and mecA genes as molecular confirmation. Results: The contamination with microorganisms was distinguished in 93.3% of the samples. S. aureus was the most common isolate (68.3%), also with methicillin-resistant S. aureus (MRSA) found in 8.3% of samples, followed by Pseudomonas aeruginosa (30%), Escherichia coli (25%), and Candida albicans (20%). While mixed growth of bacterial and fungal was present in 28.3% of devices. The identity of Staphylococcus aureus isolates and the presence of methicillin-resistant S. aureus (MRSA) were confirmed by polymerase chain reaction (PCR). Conclusion: Earphones that are regularly used by students can lead to opportunistic pathogens. For this reason, routine cleaning and proper hygiene practices may reduce microbial contamination and minimize potential health risks.
Copyright (c) 2026 Amjed Hassan Sahib (Author) https://creativecommons.org/licenses/by/4.0/
Evaluation of the Relationship Between H. Pylori Infection and Hyperemesis Gravidarum
Background: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy with significant maternal health implications. Helicobacter pylori (H. pylori), a gram-negative bacterium associated with gastric conditions, has been proposed as a contributing factor through gastric mucosal inflammation, hormonal interactions, and immune responses. Aim: To assess the relationship between H. pylori infection and hyperemesis gravidarum. Methods: A prospective case-control study was conducted at Bint al-Huda Hospital, Thi Qar City, from December 2023 to December 2024. Ninety-eight first-trimester pregnant women were enrolled: 50 with HG (cases) and 48 without HG (controls). Serum H. pylori IgG levels were measured using ELISA. Statistical analyses were performed using SPSS version 26 (p ≤ 0.05). Results: Mean age was comparable between groups (29.08 ± 3.4 vs. 28.9 ± 2.8 years; p = 0.053). Most participants were housewives residing in rural areas, with no significant inter-group differences. H. pylori IgG seropositivity was significantly higher in HG cases than controls (72% vs. 29%; p < 0.001). Infected women demonstrated more severe clinical manifestations, including dehydration and electrolyte imbalances. Conclusions: A significant association between H. pylori infection and hyperemesis gravidarum was identified, suggesting H. pylori may exacerbate gastrointestinal symptoms. Routine screening and eradication therapy may improve maternal outcomes. Further research exploring pathophysiological mechanisms is warranted
Copyright (c) 2026 Wasan Shareef Hameed, Nadia Saddam Fahad (Author) https://creativecommons.org/licenses/by/4.0/
Antimicrobial Prophylaxis Before Urodynamic Studies and Post-Procedure Urinary Tract Infection: A Critical Synthesis
Background. Urodynamic study (UDS) is a low-pressure outpatient investigation widely used in the workup of lower urinary tract symptoms (LUTS), neurogenic bladder, and incontinence. Whether routine antimicrobial prophylaxis (AMP) reduces clinically meaningful post-procedure urinary tract infection (UTI) remains contested, and major guidelines disagree. The European Association of Urology (EAU) recommends against routine AMP for low-risk patients, while older American Urological Association (AUA) statements list UDS among procedures where AMP may be considered. Objectives.This work synthesizes the contemporary evidence (2018–2025) on AMP before UDS, distinguishes asymptomatic bacteriuria (ASB) from symptomatic UTI, and proposes a risk-stratified prophylaxis framework consistent with antimicrobial stewardship priorities. Methods.A structured narrative review was conducted across MEDLINE, Embase, and the Cochrane Library for randomized controlled trials (RCTs), prospective and retrospective cohort studies, and systematic reviews evaluating AMP versus placebo, no prophylaxis, or active comparator before UDS. Outcomes of interest were symptomatic UTI within 7–30 days, ASB, antimicrobial-related adverse events, and reported resistance signals. A risk-stratification scheme was synthesized inductively from study-level inclusion criteria. Results. Across pooled estimates, AMP reduced post-UDS bacteriuria but produced only a small and frequently non-significant reduction in symptomatic UTI in low-risk adults. Higher-risk subgroups neurogenic lower urinary tract dysfunction (NLUTD), recurrent UTI, immunosuppression, and indwelling-catheter dependence howed larger and more consistent benefits. Conclusions.Universal AMP before UDS is not justified for low-risk outpatients. A risk-stratified approach focusing prophylaxis on defined higher-risk groups, combined with pre-procedure dipstick screening and clear counselling on UTI symptoms, balances patient safety with stewardship objectives.
Copyright (c) 2026 Hasan Ali Salmam Alhusseini, Hayder Hakim Saleh (Author) https://creativecommons.org/licenses/by/4.0/
Microbial Contamination and Antibiotic Resistance Patterns of Personal Earphones Among University Students in Al-Qadisiyah, Iraq
Methicillin-resistant Staphylococcus aureus (MRSA)
Copyright (c) 2026 Sura A. Al-Ganahi, Saja Mahdey Jaber, Hanaa Neamah Abdullah, Robeena Farzand (Author) https://creativecommons.org/licenses/by/4.0/
C-Reactive Protein and White Blood Cell Count at Pre / Post Cervical Cerclage Predict Early Preterm Labour
Background and Aim: Preterm birth affects over 15 million infants annually worldwide, with cervical insufficiency being a major contributing factor. This study evaluates CRP and WBC levels in pregnant women undergoing cervical cerclage to predict Early Preterm Birth (EPTB) risk. Methods: A prospective observational study conducted at Bint al-Huda Hospital, Thi-Qar, Iraq, from December 2023 to December 2024. Fifty-four pregnant women with singleton pregnancies and cervical insufficiency (cervical length <25 mm) were enrolled. CRP and WBC levels were measured pre-cerclage and on days 1 and 2 post-cerclage, with follow-up until delivery. Results: Mean participant age was 30.2 years. Cervical length improved from 20.6 mm pre-cerclage to 23.8 mm post-cerclage. Mean gestational age at cerclage was 20.6 weeks, with delivery occurring at a mean of 35.3 weeks. Only 18.5% delivered before 34 weeks, while 81.5% delivered at or beyond 34 weeks. Elevated pre-cerclage CRP and WBC levels were significantly associated with increased EPTB risk. Post-cerclage monitoring identified persistent inflammation correlating with adverse outcomes. Conclusions: CRP and WBC are reliable biomarkers for predicting EPTB in women undergoing cervical cerclage. Elevated pre-cerclage levels indicate higher risk, necessitating close monitoring and early intervention. Post-cerclage trends provide critical insights into inflammatory responses, enabling targeted management to improve maternal and neonatal outcomes. Further research is recommended to refine predictive models and explore therapeutic strategies.
Copyright (c) 2026 Nawar Hasan Jaaz, Alaa Hussein Ali Nasser (Author) https://creativecommons.org/licenses/by/4.0/
Inhibitory Effects of Cardamom Seed Extract on Streptococcus mutans: A Study on Gum Infection Isolates from Al-Muthanna, Iraq
Background: S. mutans is one of the most bacterial pathogens causing periodontal disease worldwide. Aim: This study aimed to evaluate the effectiveness of cardamom seed extract concentrations in inhibiting the growth of clinically isolated bacteria from patients with gingivitis caused by Streptococcus mutans, given the traditional use of cardamom seeds in Iraqi folk medicine for oral and dental health. Methods: S. mutans bacteria were clinically isolated from patients with periodontal disease in Al-Muthanna Governorate and identified using the VITEK system. The effect of cardamom seed extracts on the bacterial growth activity of Streptococcus mutans was then evaluated. Results: The study showed that ethanolic extracts of cardamom seeds (Elettaria cardamomum) have strong antibacterial effects against Streptococcus mutans (S. mutans), and the larger inhibition zones (12-16 mm) observed in the ethanolic extract indicate better efficacy than the aqueous extract. Conclusion: The properties of ethanolic cardamom extract have demonstrated its ability to inhibit bacterial cell membrane enzymes, thus controlling bacteria. Furthermore, it is necessary to determine safe concentrations for human use and assess their suitability for use without the appearance of side effects.
Copyright (c) 2026 Bushra Hussein Alwan, Aseel Talib Hashem, Hadeel S. Almaliki, Yousif Sinan Alhamadani, Haider S. Almnehlawi, Anfal AL-Dalaeen, Nawar Jasim Alsalih, Ali Mosa Rashid Al-Yasari, Mohenned Alsaadawi (Author) https://creativecommons.org/licenses/by/4.0/
Prevalence, Virulence Regulation, and Resistance Mechanisms of Clinical Staphylococcus aureus Isolates: The Role of the agr System and Mobile Genetic Elements in Al-Diwaniyah, Iraq
Background: Infections by Staphylococcus aureus are continued as a real issue especially in hospital-acquired disease. It can produce virulent factors that can be controlled by the accessory gene regulator (agr), and it can be affected by mobile genetic elements (MGEs). It should be known their mechanism in local isolates as it is crucial for monitoring infections and treatment approaches. Objectives: To evaluate S. aureus prevalence in clinical samples and to discover the consequence of the agr system and MGEs in regulating virulence. Methods: Microbiological procedures were used to gather clinical samples. Also, molecular assays were accomplished to determine agr types, key virulence-associated genes, and MGEs. The data of this study was evaluated to estimate the association among agr function, virulence gene distribution, and resistance traits. Results: Most clinical samples contain active agr system, with major of agr group I. Virulence factors like enterotoxins, hemolysins, and adhesion-associated genes were extensively spread. MGEs such as pathogenic islands and plasmids were detected and cause antimicrobial resistance and virulence expression. Interestingly, in the isolated samples, active agr systems present a significant association with toxin production more than those with dysfunctional variants. Conclusion: S. aureus samples show high dominance and genetic variant. Virulence measurements are strongly affected by the agr system and MGEs. Molecular monitoring is important step to display these influences and support active therapeutic and infection-control measures.
Copyright (c) 2026 Hanaa Neamah Abdullah, Nada Ahmed Fairooz, Bushra Hamad Obaid, Sura A Al-Ganahi, Robeena Farzand (Author) https://creativecommons.org/licenses/by/4.0/
Assessment Sleep Pattern among Patients undergoing Hemodialysis in Al-Diwaniyah Teaching Hospital
Background: Kidney failure is a condition in which one or both of the kidneys can no longer work on their own. Sometimes, kidney failure is temporary and comes on quickly. Other times, it is a chronic condition that can get worse slowly over a long time. Objectives: The aims of the existing study were to identify sleep patterns for patients undergoing hemodialysis and to find out the association between sleep patterns for patients undergoing hemodialysis and their socio demographic variables. Methodology: A descriptive cross-sectional study was conducted in in Al-Diwaniyah Teaching Hospital. Data were collected from (15 January to 15 February 2024) through the self-report questionnaire and analyzed through the descriptive and inferential statistical (SPSS) method. Results: The study revealed that hemodialysis patients are predominantly middle-aged males, with many reporting poor sleep qualities, including daytime dysfunction, insufficient restoration after sleep, and difficulties falling or staying asleep. Despite these challenges, most patients expressed general satisfaction with their sleep pattern but experienced disruptions, such as noise and waking during sleep. The findings highlight the need for targeted interventions to improve sleep quality and overall health in this population. Conclusions: 60% of participants were classified as having low overall sleep quality. This underscores the widespread nature of sleep disturbances within the hemodialysis population and highlights the critical need for targeted interventions to improve sleep quality, which may in turn enhance patients' overall health and well-being. Recommendations: Given the widespread impact of poor sleep on daily functioning, further clinical attention should be given to improving sleep hygiene, minimizing nocturnal disruptions, and addressing underlying health issues that contribute to poor sleep quality in hemodialysis patients.
Copyright (c) 2026 Ismael Mohammed Alsaadi, Haider Abbas Hadi Al-Mhanaa, Widad Abd Aljabbar Mozzan, Fatima Kamil Salman, Saad Mardi Muhammad (Author) https://creativecommons.org/licenses/by/4.0/
Global Longitudinal Strain (GLS) by 2D speckle tracking echocardiography to predict and diagnose coronary artery disease
Background: Non-invasive cardiac imaging is increasingly used nowadays to predict and diagnose structural and functional diseases of coronary arteries with improved efficacy, safety and cost. Objective: To evaluate the ability of two-dimensional (2D) global longitudinal strain (GLS) by speckle echocardiography to predict the presence of significantcoronary artery disease (CAD), disease severity and its’ reproducibility in the stratification of coronary disease risk in suspected patients. Patients and methods: An observational study that was conducted at Al Nasiriya Cardiac Hospital and included 75 patients with suspected CAD who were admitted for elective diagnostic coronary angiography. They divided into 3 groups according to presence of coronary artery stenosis andthe degree of significance. 2D speckle tracking echocardiography was performed for all and its’ ability in the prediction and diagnosis of CAD was studied. Results: Study showed that 60% of patients had significant stenosis, while 30.67% had no stenosis and 9.33% had a non- significant stenosis by coronary angiography. There was a significant variance regarding gender preference and hypertension with no significant variance regarding age,diabetes and smoking status. GLS had significant associations with the degree of coronary stenosis and culprit vessels, having a cut of value of -16.5% for discrimination of significant, non-significant and no stenosis with 83% sensitivity and 84% specificity. GLS had a significant positivecorrelation with the ejection fraction, r = 0.511 at a p-value <0.001. Conclusions: 2D speckle tracking echocardiogram GLS has the potential to improve the value of echocardiography in identifying high-riskpatients, detecting CAD and CAD severity (degree of stenosis) which provides more information for the clinical physician.
Copyright (c) 2026 Hyder Mejeed Rustum Hussona, Nazar Essa Hasan (Author) https://creativecommons.org/licenses/by/4.0/
Emerging RNA Viruses: Epidemiology, Pathogenesis, and Challenges for Vaccine Development: Review
"For decades, emerging RNAviruses have continued to multiply and diversify constantly for humanity. Many regulations have been issued regarding different strains of coronavirus to combat human infection, and they do not cause the deaths of millions of people around the world.". Emerging RNA viruses, including coronaviruses, flaviviruses, and filoviruses, have demonstrated the ability to cause pandemics and outbreaks with devastating health and economic impacts. Their high mutation rates and zoonotic potential complicate public health responses. This review provides a detailed overview of the epidemiological trends of major emerging RNA viruses, their mechanisms of host infection and immune evasion, and the current challenges in vaccine development. Key obstacles include antigenic variability, cross-species transmission, and limited duration of immune protection. Advances in mRNA vaccine technology, vector-based vaccines, and universal vaccine strategies are also discussed. Proactive surveillance, rapid vaccine platforms, and global collaboration are emphasized as critical components for future preparedness.
Copyright (c) 2026 Zahraa Hussein Obaid, Ahmed Saleem Abbas, Lubna Abd AlmuttalibAl- Shalah, Ghazi Mohamad Ramadan (Author) https://creativecommons.org/licenses/by/4.0/
Human Beta-Defensin-3 and Di-Aminoimidazole as Antimicrobial Adjuvants Against Multidrug-Resistant Acinetobacter baumannii
Background: Multidrug-resistant (MDR) Acinetobacter baumannii is a major cause of hospital-acquired infections with high morbidity and mortality. Resistance has quickly grown, making it harder to find effective treatments. This has led to the need for new approaches, like antimicrobial adjuvants that make existing antibiotics work better. Objective: This study assessed the efficacy of human beta-defensin-3 (hBD-3) and di-aminoimidazole (2-AI) as antimicrobial adjuvants in conjunction with conventional antibiotics against multidrug-resistant A. baumannii. Methods: We evaluated three MDR clinical isolates and one reference strain (ATCC19606). Used broth microdilution to find the minimum inhibitory concentrations (MICs) of hBD-3, 2-AI, and four antibiotics: ampicillin-sulbactam, imipenem, ceftazidime, and ciprofloxacin. A sub-MIC quantity of 50 µg/mL of hBD-3 and 2-AI was employed in combinatorial experiments. Experiments three times and used the paired t-test and Wilcoxon signed-rank test to look at the results. Results: A notable decrease in MIC occurred when ampicillin-sulbactam was administered in conjunction with either hBD-3 or 2-AI across all isolates. There was also a big improvement with imipenem+ hBD-3, however imipenem + 2-AI had no impact. No substantial synergy was seen for combinations of ceftazidime or ciprofloxacin with either adjuvant. Conclusion:hBD-3 and 2-AI showed potential, as antimicrobial adjuvants, especially; when combined with β-lactam antibiotics. However, due to the limited number of isolates examined, these findings must be considered preliminary, and further studies with larger sample sizes are required.
Copyright (c) 2026 Ruqayah Taher Habash, Dhuha Mahdi Jabir (Author) https://creativecommons.org/licenses/by/4.0/
Two-Dimensional Ultrasonographic Nomograms of the Fetal Cerebellar Area in aCohort of 150 Normal Singleton Pregnancies: A Prospective Cross-Sectional Study
Objective: The study aims to set reference ranges for the cerebellar area, across gestation. The fetal cerebellar area is measured in 150 low‑risk pregnancies. The fetal cerebellar area is measured with 2D ultrasonography (2D‑US). Methods: This a prospective cross-sectional study was carried out at specialized gynecology and obstetric center in south of Iraq . We enrolled one hundred fifty women who had a single baby and who had accurate pregnancy dates. Healthy pregnant women were, between 18 and 38 weeks of gestation. We manually tracing ,the outline of cerebellar area in the transverse view of the cerebellum. We performed regression analysis to model the relation between the measured cerebellar area and gestational age (GA). We built reference tables. Results : Women mean age in this study, was 28.7 plus or minus 4.5 years. The mean gestational age at the scan was 27.8 plus or minus 5.1 weeks. We found that the fetal cerebellar area had a linear correlation, with the advancing gestational age. We recorded the correlation coefficient as r = 0.95 and the p value as than 0.001. I derived the regression equation for the area: Cerebellar Area (cm²) = -2.481. 0.257 × GA[weeks]). We created nomograms that show the 95th percentiles, for each gestational week from 18 to 38 weeks. We did not find a correlation between the area and the maternal Body Mass Index (BMI). The correlation was (r = 0.08 p = 0.32 The study provides 2D‑US nomograms, for the cerebellar area from a cohort of 150 patients. The 2D‑US nomograms are a simple tool. The 2D‑US nomograms serve as a tool in prenatal screening, for posterior fossa anomalies.
Copyright (c) 2025 Firas Abdullah AlBaghdadi (Author) https://creativecommons.org/licenses/by/4.0/
Integrated Ultrasound Assessment of the 'Placenta-Brain Unit': Correlating Uteroplacental Doppler with Fetal Neurosonography Findings in Diabetic Pregnancies
Objective:To investigate the relationship between utero-placental Doppler indices and detailed fetal neurosonographic findings in pregnancies complicated by pre-gestational and gestational diabetes mellitus (GDM). Methods:A prospective cohort study was conducted on 150 diabetic pregnancies (75 pre- gestational, 75 GDM) and 75 matched healthy controls between 28-32 weeks of gestation. All participants underwent pulsed-wave Doppler assessment of the uterine arteries (UtA) to determine the pulsatility index (PI) and the presence of an early diastolic notch. Subsequently, a dedicated fetal neurosonography was performed to measure the transcerebellar diameter (TCD), Sylvian fissure depth, and lateral ventricle width, and to assess the development of the corpus callosum and cortical sulcation. Results: The diabetic cohort, particularly the pre- gestational subgroup, demonstrated significantly higher mean UtA-PI values and a higher prevalence of bilateral notching compared to controls (p < 0.01). Neurosonography revealed significant alterations in the diabetic groups, including a larger transcerebellar diameter (p < 0.05), abnormal Sylvian fissure maturation, and delayed opercularization compared to the control group (p < 0.01). A significant inverse correlation was observed between UtA-PI and transcerebellar diameter (r = -0.45, p < 0.001), and a positive correlation with Sylvian fissure depth (r = 0.52, p < 0.001) in the pre-gestational diabetes group. Conclusion: This study demonstrates a significant correlation between impaired utero-placental hemodynamics and alterations in fetal brain development in diabetic pregnancies, supporting the concept of a "placenta-brain unit". Integrated ultrasound assessment of this unit may serve as an early biomarker for identifying fetuses at risk for neurodevelopmental morbidity, enabling potential early intervention strategies.
Copyright (c) 2025 Riyadh Adel Jaed (Author) https://creativecommons.org/licenses/by/4.0/
Molecular and Clinical Perspectives on Cytokine Storms and Seasonal Influenza Infections
Background: Seasonal influenza may cause severe complications in case of cytokine storm, a hyperinflammatory reaction that increases tissue damage and dysfunction of multiple organs. Objective: The research aims were to determine the correlation between seasonal influenza and cytokine storm through clinical and molecular investigations. Methods: A cross-sectional observational study was carried out on 120 patients with RT-PCR-confirmed seasonal influenza in December 2023-March 2024. ELISA was used to determine serum levels of IL-6, TNF-α, IFN- g, IL-1, and IL-18. Demographics and clinical information, such as ARDS, coagulopathy, acute kidney injury, CNS manifestations, etc., were documented. Statistical significance of p = 0.05 was used to test statistical significance with SPSS v26.0 (t-test, Mann- Whitney, Pearson/Spearman correlation). Results: The patients with cytokine storm (n = XX) had much more serum cytokines than their uncomplicated influenza counterparts (IL-6: 142 ± 35 vs. 18 ± 6 pg/mL, p < 0.001; TNF-α a: 96 ± 22 vs. 15 ± 5 pg/mL, p < 0.001). The incidence of coagulopathy (70% vs. 5%), AKI (40% vs. 5%), and CNS (confusion 45% vs. 10%) was significantly higher. High IL-6 levels were greatly associated with ARDS (r = 0.68, p < 0.01). Conclusion: In seasonal influenza, cytokine storm is related to hyper-release of IL-6, TNF-α, IFN- gamma, IL- 1 8, and IL-1α, which cause dysfunction of multiple organs and increased complications. The timely identification of the signs of cytokine storm would enhance the outcome of patients and inform the use of specific immunomodulatory treatment.
Copyright (c) 2025 Wurood Kadhim Abed (Author) https://creativecommons.org/licenses/by/4.0/
A Review on Photocatalysts for Water Pollutant Removal
Photocatalytic water filtration technology has been developed as an effective and sustainable method for removing a variety of water contaminants, including organic pollutants, heavy metals, and emerging compounds. Recent research has focused on improving the effectiveness of photocatalysts, particularly through the development of doped forms of titanium dioxide (TiO2), zinc oxide (ZnO), and nanocomposites, with the aim of enhancing light absorption, particularly in the visible spectrum. Furthermore, advances in photocatalytic reactor designs and hybrid systems that combine photocatalysis with conventional methods, such as adsorption and biological treatment, have significantly improved the efficiency of pollutant degradation.Despite these advances, the transition from laboratory-scale to industrial applications still faces several challenges, due to factors such as catalyst stability, light penetration efficiency, and economic feasibility. This study highlights current advances in photocatalyst development, reactor design, and hybrid treatment systems, while discussing key challenges and future research paths toward expanded water treatment applications.
Copyright (c) 2025 Hiba R. Kazem, Hadeer Mohammed Subhi, Zaynab faleh Al-janahi, Hazim Y. Al- gubury (Author) https://creativecommons.org/licenses/by/4.0/
An integrated view of bacterial resistance in the antibiotic era: efflux pumps biofilms and plasmids
Antibiotic resistance is a widespread problem that reduces the effectiveness of antibiotics, leading the rise of multidrug resistance (MDR). Efflux pump, biofilm formation and plasmid based gene transfer together form the basis of co-adaptive mechanisms providing fleeting tolerance resistant overtime. Genes encoding efflux systems are alternative efflux-pumping systems that remove some antimicrobial agents, so that over extremely low intracellular concentrations are required for the bacterium to survive in the biofilm matrix.These, in turn, contribute to the structural and functional coherence of biofilms, which serve as protected niches favoring horizontal gene transfer and the propagation of plasmid-mediated resistance genes. In this review, we combine recent data from molecular and omics-based studies to demonstrate how these systems are co-regulated to control resistance in bacteria, with an emphasis on cross-talk between regulatory pathways including quorum-sensing, stress-response signalling and global transcriptional regulators. Insights into this interplay can pave the way for innovative therapeutic strategies, such as efflux pump inhibitors, biofilm dispersal agents and plasmid-curing strategies. Comprehensive knowledge of these interrelated processes may influence the development of future antimicrobial agents and their use, and may reduce the emergence of pan-resistant species of bacterial pathogens.
Copyright (c) 2025 Zahraa Mohammed (Author) https://creativecommons.org/licenses/by/4.0/
Isolation and Characterization of a High-Efficiency Bioflocculant-Producing Strain of Pseudomonas fluorescens
This study aimed to thoroughly explore, optimize, and characterize a Bioflocculant produced by a novel Pseudomonas fluorescens PF-1 strain isolated from active sewage sludge. When examined under refined culture conditions, including an incubation temperature of 36°C, a neutral pH of 7, and the use of sucrose and yeast extract as the most effective carbon and nitrogen sources, respectively, this strain exhibited promising flocculating capabilities. An inoculum volume of 5% (v/v) further amplified Bioflocculant manufacturing. Under these conditions, the strain demonstrated remarkably high flocculating activity, reaching 87.4%. Biochemical composition analysis revealed that the extracted Bioflocculant principally comprised carbohydrates at 76.3% and proteins at 17.2%, indicating a polysaccharide-protein complex nature. FTIR spectroscopy supported the existence of functional groups, including carboxyl, hydroxyl, and amide, crucial for flocculation mechanisms. SEM imaging depicted a dense, interwoven fibril matrix perfectly suited for trapping and aggregating suspended particles. The Bioflocculant also manifested high thermal resilience up to 80°C and retained activity across a wide pH range from 4 to 8. Wastewater treatment tests employing genuine effluents showed outstanding pollutant removal proficiencies, with reductions in chemical oxygen demand (COD) and biological oxygen demand (BOD) achieving an impressive 90.2% and 88.6% respectively. These conclusions demonstrate strong potential as a Bioflocculant created by P. fluorescens PF-1 as an eco-friendly and highly effective replacement for conventional chemical flocculants in wastewater treatment applications.
Copyright (c) 2025 Worood Younis Azawi, Imad Ahmed Rashid, Ezz El-Din Thabet Mahdi (Author) https://creativecommons.org/licenses/by/4.0/
Emerging Efflux Pump-Mediated Cefiderocol Resistance in Pseudomonas aeruginosa Clinical Isolates from Nasiriyah, Iraq A Molecular and Phenotypic Study
Background: The thalassemia syndromes are a group of inherent hemolyticanemias characterized by the decrease or absence of the synthesis of one or more globin chains of hemoglobin. Elevated levels of NOD-like receptor protein 3 (NLRP3) and ferritin, along with oxidative stress markers such as malondialdehyde (MDA) and catalase activity, have been linked to thalassemia disease progression and prognosis. Aim: This study aims to investigate the relationship between serum levels of NLRP3, ferritin, MDA, and catalase activity in beta-thalassemia patients compared to healthy controls, providing insights into potential diagnostic and prognostic biomarkers. Materials and Methods: (75) patients with beta-thalassemia major aged 6-18 years who were selected at the Al- Zahra Teaching Hospital/ALNAJAF AL ASHRAF CITY along with (45) normal people of the same age without any history of hematological diseases, chronic diseases, acute illness, or infection. Patients who met the selection criteria were included in the study. All subjects were enrolled in this study between November 2024 and January 2025; Serum levels of NLRP3, ferritin, MDA, and Catalase were analyzed using enzyme-linked immunosorbent assay (ELISA) and spectrophotometric methods. For data collection and statistical analysis, Microsoft Office Excel 2013 and GraphPad Prism 9.2.0 were utilized. Results: The study found elevated levels of NLRP3 in thalassemia patients (7.006 ± 1.014) compared to the healthy group (1.35 ± 0.2868), with a P value of 0.0003. Ferritin levels were also higher in patients (1576 ± 85.09 ng/ml) compared to the healthy group (73.1 ± 13.67 ng/ml), with a P value of <0.0001. MDA levels increased in patients (0.157 ± 0.01964) compared to the healthy group (0.06813 ± 0.0149), with a highly significant P value of 0.0007. In contrast, catalase activity was significantly lower in the patient group (0.5321 ± 0.07339) than in the healthy group (0.8746 ± 0.1104), with a P value of 0.0129. These findings suggest that an increase in NLRP3, ferritin, and MDA levels and a decrease in catalase activity are associated with an increased risk of thalassemia disease. Conclusion: Elevated NLRP3, ferritin, and MDA levels, alongside reduced catalase activity, are associated with thalassemia disease progression. These biomarkers could serve as valuable tools for early detection and monitoring therapeutic responses in thalassemia patients.
Copyright (c) 2025 Bushra Hamad Obaid (Author) https://creativecommons.org/licenses/by/4.0/
Advances in the Molecular Pathogenesis of Acute Myeloid Leukemia
Acute Myeloid Leukemia comprises a heterogeneous group of clonal disorders that result from the abnormal accumulation of immature myeloid cells within the bone marrow and peripheral blood. This study aims to detect Advances in the Molecular Pathogenesis of Acute Myeloid Leukemia. This has been elucidated by recent molecular studies that identified crucial mutations in FLT3, NPM1, and DNMT3A genes and epigenetic changes that contribute to leukemogenesis. Deregulated pathways besides PI3K/AKT and MAPK have also asserted themselves in disease progression and resistance to therapy. Hence, the review presents an extensive discussion of contemporary molecular perspectives of AML pathogenesis and their relevance to diagnosis and treatment. The rise in targeted therapies and precision medicine thus paints a promising clinical picture for a better prognosis. Knowledge of the biological compromise unleashed by mutations in genes and their interplay with the bone marrow microenvironment is key to forging newer therapies.
Copyright (c) 2026 Rusul Ahmed Mohammed, Nada Khazal K. Hindi, Mustafa Hussein Mohammed, Zahraa I. J. Shubber, Abdolmajid Ghasemian (Author) https://creativecommons.org/licenses/by/4.0/
Impact of Endocrine Disruptors on Neural Tube Development in Mammalian Embryos
Neural tube defects (NTDs) are severe congenital malformations with multifactorial etiologies, including environmental exposures. This study investigates the effects of prenatal exposure to endocrine-disrupting chemicals (EDCs), specifically bisphenol A (BPA) and phthalates, on neural tube closure in a murine model. Pregnant mice were exposed to low doses of EDCs during critical gestational periods. Morphological assessment and molecular analysis revealed increased incidence of NTDs and dysregulated expression of genes involved in neural patterning. These findings underscore the vulnerability of embryonic development to environmental toxicants and the need for regulatory measures to limit human exposure.
Copyright (c) 2026 Sadiq Salam H. Al-Salih, Ahmed Saleem Abbas, Hussein Kadhim Hussein, Tiba Al Temimi, Yusra Al Nasiri (Author) https://creativecommons.org/licenses/by/4.0/
Infantile Systemic Hyalinosis (ISH): A Comprehensive Review of Its Genetic Basis, Clinical Spectrum, and Therapeutic Challenges
Background: Infantile Systemic Hyalinosis (ISH) is a very rare and severe autosomal recessive disease, in which amorphous hyalineaceous material is deposited extensively in different tissues and presents a multisystemic clinical manifestation. This debilitating disease, based on a biallelic mutation of the ANTXR2 gene, is typically characterized by a course of infancy and progressive joint contractures, painful papules and macules on the skin, gingival hypertrophy, gastrointestinal dysfunction, and failure to thrive. Despite such melodies' effects on people who are affected and it is a poorly-known disease that has few known therapeutic options. This systematic literature review seeks to summarize the knowledge on ISH, including acrylic-based knowledge, genetic foundation, molecular pathophysiology, etc., various clinical expressions, diagnostic and treatment implementations. The study will be going to explore the specific characteristics that separate ISH and its allele Juvenile Hyaline Fibromatosis (JHF), which is a counterpart and speaks of the problems in diagnosis and early intervention, which is vital, through pooling together information based on the case reports and literature reviews in the short term.ISH is a strong reminder of how complicated rare things can be genetic disorders. Increased sensitization among health professionals, as well as Speedy and precise diagnosis, plays the utmost role in maximizing supportive care, enhancing the lives of the affected infants.
Copyright (c) 2025 Maha Mashrq AlBayati, Wurood Kadhim Abed, Thualfakar Hayder Hasan (Author) https://creativecommons.org/licenses/by/4.0/
Study The Sensitivity of Bacteria Isolated From Sputum of Different Antibiotics Using Kirby-Bauer Method
Background: Respiratory tract infections caused by bacterial infections are among the most common health problems, exacerbated by antibiotic resistance. The aim of the study is to isolate and identify pathogenesis bacteria that responsible to respiratory system diseases from 35 samples of sputum and determine bacterial sensitivity to various antibiotics. Materials and Method: A cross-sectional study was conducted in Almuthanna Governorate-Iraq on 35 patients (26:35 male and 9:35 female) age ranged from 15 - 50 years old, the bacteria were diagnosed by physical examination, bacterial dyes and AIP examination in order to reach a final result for the diagnosed bacterial race. Antibiotics sensitivity testing was performed to determine the bacterial sensitivity using 30 different antibiotics by Kirby-Bauer disk diffusion method. Result: The study showed that there are four different species of bacteria, Streptococcus pneumonia (3:35), Mycoplasma Pneumoniae (8:35), Escherichia colli (1:35), staphylococcus aureus (23:35). As for examining of bacterial sensitivity of the isolated bacteria used in this study, showed different sensitivity to each antibiotic, Strept. pneumonia showed sensitivity to (16:30) of antibiotics and the beast effect of antibiotics is Amikacin it was 100%. M. Pneumoniae showed sensitivity to (7:30) of antibiotics and the beast effect of antibiotics is Doxycycline it was 100%. E. colli showed sensitivity to (3:30) of antibiotics and the beast effect of antibiotics are Amikacin, Imipenem and Meropenem it was 100%. S. aureus showed sensitivity to (19:30) of antibiotics and the beast effect of antibiotics is Nitrofurantionit was 100%. The results of this study can be used by assist clinicians to determine the sensitivity of bacteria to antibiotics and prescribe the appropriate antibiotic for treatment of respiratory tract infections caused by bacterial infections.
Copyright (c) 2025 Yousif Alhamadani (Author) https://creativecommons.org/licenses/by/4.0/
Effects of Hypoxia on Cardiomyocyte Metabolism: An In Vitro and In Vivo Comparative Study
Hypoxia significantly alters cardiomyocyte metabolism, contributing to myocardial injury during ischemic events. In this study, cardiomyocytes cultured under hypoxic conditions were compared to cardiac tissues from rats subjected to experimental myocardial infarction. Both models demonstrated a metabolic shift from oxidative phosphorylation to anaerobic glycolysis, upregulation of hypoxia-inducible factor 1-alpha (HIF-1α), and increased lactate production. The in vivo model also revealed structural changes and fibrosis. Understanding these metabolic adaptations is crucial for developing therapeutic strategies aimed at preserving cardiac function during ischemia and reperfusion.
Copyright (c) 2025 Zaman S. Hamza, Ruqaya Munther Jalil Ewadh, Raad Habeeb Al-Asadi (Author) https://creativecommons.org/licenses/by/4.0/
CRISPR-Cas9 Mediated Knockout of Apoptotic Genes in Human Stem Cells: A Functional Study
Gene editing technologies such as have opened new avenues for studying the role of specific genes in cell survival and differentiation. In this study, we employed CRISPR-Cas9 to knock out the pro-apoptotic genes BAX and CASP3 in human induced pluripotent stem cells (hiPSCs). The edited cells were evaluated for viability, proliferation, and differentiation capacity using flow cytometry, qPCR, and lineage-specific markers. Results demonstrated enhanced cell survival under stress conditions and altered differentiation patterns favoring mesodermal lineage. These findings suggest that modulating apoptotic pathways in stem cells can significantly impact regenerative medicine strategies and improve cell-based therapies.
Copyright (c) 2025 Zaman S. Hamza, Tiba Al Temimi, Ghadah Ali Al-Oudah, Kadum A. AlShareffi (Author) https://creativecommons.org/licenses/by/4.0/
CRISPR-Cas9–Knockout of PD-L1 Gene in Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) remains a challenging malignancy due to its immunosuppressive microenvironment. Here, we employed CRISPR-Cas9 to knockout PD-L1 in TNBC cell lines and evaluated changes in immune recognition and T cell activation. PD-L1 ablation resulted in increased expression of antigen-presenting machinery and enhanced sensitivity to T cell-mediated cytotoxicity. Our findings suggest that CRISPR-mediated PD-L1 disruption could potentiate immunotherapy efficacy in TNBC.
Copyright (c) 2025 Ashwaq MS Al-Jbouri, Asmaa Sami Jawad, Zainab Adil Ghani Chabuck, Saad Mardi Muhammad (Author) https://creativecommons.org/licenses/by/4.0/
Development of 3D Bioprinted Vascularized Cardiac Tissues Using Patient-Derived Stem Cells: A Preclinical Study
Regenerative therapies for myocardial infarction require viable vascularized cardiac tissues. We report the development of 3D bioprinted cardiac patches using patient-derived induced pluripotent stem cells (iPSCs) and endothelial progenitor cells. Bioprinted tissues exhibited spontaneous contraction, vascular network formation, and appropriate electromechanical coupling. In a rat myocardial infarction model, transplanted patches improved cardiac function and reduced scar size significantly. This work paves the way for personalized cardiac regenerative therapies.
Copyright (c) 2025 Mohammed R. Abd Ali, Mohammed Malih Radhi, Hussein Assak Al-Hachami, Nada Nada Khazal K. Hindi, Rusull Hamza K. AL-Jubori, Wamidh H. Talib (Author) https://creativecommons.org/licenses/by/4.0/
Women's Awareness and Knowledge of Breast Self-Examination: A Study at the Obstetrics and Gynecology Teaching Hospital in Karbala City
Breast cancer is the most frequent malignancy of women worldwide. The objective of this study is to explore the socio-demographic profiles of women attending the hospital and evaluate their understanding and awareness of breast self- examination practices. Methodology: A descriptive study design was employed at the Obstetrics and Gynecology Teaching Hospital in Karbala City. The study aimed to assess Women's Awareness and Knowledge toward breast self- examination from 1st February 2024 to 1st February 2025. The study included a convenient sample of 100 women from the Obstetrics and Gynecology Teaching Hospital in Karbala City, specifically from the outpatient department. Result: The age distribution showed that most participants were between 20 and 26 years old, while fewer were in the older age categories. However, no significant association was found between age and breast cancer knowledge (p = 0.120). Regarding the age of first menarche, the majority of women experienced it at age 12 and again, no significant relationship was found with knowledge (p = 0.085). A highly significant correlation was observed between education level and knowledge (p = 0.001), with women holding higher education (39.0% with college and higher education) demonstrating better knowledge about breast cancer. Marital status also showed a significant association (p = 0.005), with single women making up the largest group (51.5%). Regarding occupation, a highly significant relationship was found (p = 0.001), with the majority of participants being housewives (40.0%), followed by government employees, private sector employees, and unskilled workers. Economic status also played a role, with 53.5% of women stating their economic situation was sufficient to some extent, and this factor had a significant impact on their knowledge (p = 0.05). Conclusion: Overall, education, marital status, occupation, economic status, menstrual history, and family history of breast cancer were key factors influencing women's knowledge in this study.
Copyright (c) 2025 Ismael Mohammed Alsaadi, Nada Khazal K. Hindi, Huda Mohammed Reda, Sarmad Salih Jawad, Noor Fadhil Al Maamouri, Rehab Flieh Hassan (Author) https://creativecommons.org/licenses/by/4.0/