Background: Acute abdomen is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that a person may seek emergency treatment; it can signal a variety of more serious conditions, some of which require immediate medical care and or surgery. Aim of the Study: The aim of this study was to evaluate the causes of nontraumatic acute abdomen and their presentation in elderly patients within the Emergency Department at Al-Yarmouk Teaching Hospital and their correlation to the final diagnosis and outcome. Patients and Methods: A descriptive study was conducted on 121 elderly patients aged 60 years and above, complaining of acute abdominal pain (traumatic cases were excluded and unknown patients fate), presented to the emergency unit of Al-Yarmouk Teaching Hospital. The study was done for a period of 13 months (February 1, 2015, till April 1, 2016). The data were collected by interviewing questionnaire, reviewing of records, taking some measurements, and physical examinations. Data were analyzed using the SPSS program version 22. Results: Patients with acute abdomen were included in the present study with a mean age of 68.4 ± 7.5 years with a female-to-male ratio of 2.1:1. The most common chief complaint was pain presented in 100 (59%) of patients, 50 patients (41%) presented with a duration of chief complaint in ≤24 h, 56.2% of the studied patients were hyperthermia, 65% were hypertensive, mean pulse rate of studied patients was 110 ± 12 beat/min, 75.3% of them had tachycardia, mean respiratory rate of studied patients was 19 ± 2/min, and 52% of them had tachypnea. The most common site of pain was right iliac fossa (24.8%), Murphy's sign was positive among 19 patients (16%), tenderness was present in 114 of the patients (94%), abdominal guarding was positive in 106 of the studied patients (88%), jaundice was observed in 27 (22%) patients, dehydration was present among 79 (65%) of studied patients, and 76 of the patients (62.8%) had elevated white blood cell. Cardiovascular diseases were the most common associated diseases (47%). Ultrasound findings of studied acute abdomen patients presented to the emergency department revealed that 26 of them (21.5%) had gallbladder abnormality, 24 (19.8%) had no specific ultrasound findings, and the X-ray finding was abnormal among 44 (36.4%). The most common diagnosis was perforated viscus for 18 (14.8%) patients. More than two-thirds (72; 59.5%) were treated surgically with mortality rate was 18 (14.8%). Conclusion: Pain was the most common complaint among the elderly with acute abdomen, and the right iliac fossa was the common site of pain. Most patients attended the hospital late (after 24 h from starting the symptoms). Perforated viscus and cholecystitis appear to be the main causes of acute abdomen among Iraqi elderly people.

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Background: New coronavirus has been isolated in China and is named by the World Health Organization (WHO) severe acute respiratory syndrome-coronavirus-2 as a cause of coronavirus disease-2019 (COVID-19) which progressed to the pandemic. The first COVID-19 case was reported in Iraq on February 24, 2020, which was Iranian student. Objective: This study was conducted to highlight the demographic characteristics of the first 70 COVID-19 patients in a Teaching Medical City in Baghdad. Patients and Methods: This descriptive study involved the first 70 COVID-19 confirmed cases by reverse transcriptase–polymerase chain reaction (RT-PCR) and treated in Al-Shafaa Center–Teaching Medical City from March 1 to April 17. Data were collected from investigation forms which include demographic data, risk factors, outcome, type of laboratory sample, and their result. The definition of a suspected, probable, and confirmed case is that explained by the WHO. Results: The total number of confirmed COVID-19 patients (RT-PCR-positive) was found to be 70 out of 537 suspected cases (13%). The case fatality rate was found to be 6% for those who died within more than 24 h. The recovery rate was 53%. The low rate of occurrence was among children below 14 years, females, and those with no risk factor. The high fatality rate was among those whose ages were more than 60 years, males, those with risk factors, and who delayed in seeking medical advice. The recovery rate was better among those <60 years of age, no risk factors, and early seeking medical advice. Females have high recovery rate and low case fatality rate than males. Conclusions: COVID-19 affects all ages but low occurrence in children <14 years of age and affects males more than females. Fatality increases with old age, male gender, presence of chronic disease, and delay in seeking medical advice.

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Background: The low survival rates of breast cancer in less developed countries such as Iraq are mainly attributed to a lack of awareness programs, resulting in a high proportion of women presenting in late stages, in addition to the limited capacity for early diagnosis and effective multimodality treatment. Objectives: The objective of the study was to compare the outcome of clinical breast examination with breast light device use. Patients and Methods: This descriptive hospital-based cross-sectional study was conducted on a sample of 305 women attending a breast examination clinic in Al-Yarmouk Teaching Hospital-Baghdad, from January 1, 2015 to July 30, 2015. Study tools included “The Breast light” which is a handheld device that transilluminates the breast with a red light that is absorbed by hemoglobin yielding dark shadows in areas of high vascularity (including malignancy). The breast-light device was used for breast examination, together with a clinical breast examination. Results: The study showed moderate agreement in the detection of breast abnormalities between clinical breast examination and breast light examination (kappa 43%). Neither breast mass size nor its location showed significant differences when comparing the results of the two methods. Moreover, mastalgia appeared to be the most frequent presentation in the examined women. Conclusion: Detecting ability of breast abnormalities could be raised, when integrating clinical breast examination with breast light. In addition, breast light could be a valuable aid for family doctors at the primary health care level, as it is easy to use, portable, and not invasive.

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Background: Insulin resistance (IR) is a risk factor for ischemic heart disease and myocardial infarction. It often manifests in myocardial infarction and is regarded as an independent predictor of in-hospital mortality, which can provide early risk stratification for recurrent acute coronary events. Objective: The aim of this study was to assess the levels of apolipoproteinsA1, E with IR in Iraqi male patients with acute myocardial infarction (AMI). Patients and Methods: Forty-five male patients with AMI were enrolled in this study. Their age range was 40–55 years and they are compared with 45 healthy male as a control group. All patients with AMI were checked up by a cardiologist in Iraqi Centre for Cardiovascular Diseases/Al-Hariry Hospital/Baghdad. Fasting venous blood samples were collected from all the subjects. Laboratory evaluations consisted of fasting serum glucose (FSG), glycated hemoglobin (HbA1c), serum insulin, and lipid profile. Furthermore, apolipoproteinsA1 and E levels were determined in this study. Results: There was a significant increase in FSG and insulin levels in patients group as compared to the controls. In addition, there was an elevation in HbA1c and homeostasis model assessment for IR in those patients, but they were not significant. There was a significant increase (P = 0.001) in serum total cholesterol, triglyceride, and low-density lipoprotein cholesterol, while there was a significant decrease in serum high-density lipoprotein cholesterol in patients group as compared to the controls. Moreover, there was a significant increase (P = 0.001) in apolipoprotein E, while a significant decrease (P = 0.001) in apolipoproteinsA1in patients group as compared to the controls. Conclusions: Dyslipidemia, along with insulinemia and glycemia, is one of the most significant IR risk factors in the acute and early recovery phases of myocardial infarction.

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Background: Hyperuricemia is associated with a diversity of other illnesses comprising increased alcohol and purine-rich food ingestion and obesity. Hyperuricemia is deliberated to be a lifestyle condition interrelated with obesity. Objective: The aspire of this revision was to assess the occurrence of hyperuricemia and its association with obesity among Iraqi adults. Subjects and Methods: Ninety participants with hyperuricemia participated in this study; their ages ranged from 35 to 50 years. They were classified into two groups: obese (n = 45) and nonobese (n = 45) from January 2019 to July 2019 at Medical City Hospital/Baghdad. Results: There was a substantial rise (P < 0.05) in body mass index (BMI), fasting serum glucose (FSG), total cholesterol (TC), triacylglycerol (TAG), and low-density lipoprotein cholesterol, while there was a substantial reduction in serum high-density lipoprotein cholesterol (HDL-C) in obese subjects as paralleled to nonobese. Furthermore, there was an elevation in serum lipid ratios, but they were not significant. A substantial rise in serum uric acid was found in obese subjects as paralleled to nonobese. An elevation in serum uric acid level was found in males as paralleled to females, but it was not substantial. Furthermore, there was a substantial positive correlation between serum uric acid and BMI, waist circumference, waist-to-hip ratio, FSG, TC, TAG, and low-density lipoprotein cholesterol, while there was a significant negative correlation between serum uric acid and HDL-C in obese subjects. Conclusions: Outcomes of this data designate a substantial positive correlation between hyperuricemia and obesity among Iraqi adult subjects. Thus, routine measurement of serum uric acid is suggested in obese persons to avoid hyperuricemia and its associated problems.

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Background: Family planning programs represent a chance for family size control, development, and good planning for future. Objective: We aimed to assess the prevalence of usage of family planning methods, to evaluate client knowledge about these methods, and to determine the most common family planning used. Methods: A cross-sectional study was conducted in Bab Al-Moatham Primary Health Care catchment area. One hunderd and forty-one married women aged 15–49 years were given a structured questionnaire developed mainly from the Family Planning WHO guidelines, ten experts' opinions were taken into consideration. And also, a pilot study of 14 married women was done. Data analysis was done by using SPSS ver. 23. Frequency, percentage, and Chi-square tests were used. P < 0.05 was considered significance. Answer scoring was done for knowledge. Results: Sixty-three women (44.7%) aged 29–39 years, with 56% complete primary school, 92.2% homemakers, 34% married, 68.1% with good obstetric history, 87% of them used family planning methods, and 58% using it now, the most method used is CCP. 66.7%, studied women had good knowledge in the withdrawal method (65.2%), CCP (55.3%), and poor/no knowledge in vasectomy. A significant association between educational level, working, year of marriage, and previous use of family planning while only working state has significant with recent use of family planning. Conclusions: Low rate using of family planning methods, and the most method used is CCP, followed by withdrawal method with good knowledge in both and poor/no knowledge in vasectomy.

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Background: Hypertension is a major public health problem worldwide. It is a risk factor for most coronary heart diseases and cardiovascular diseases. Strategies to prevent and treat hypertension in younger age groups and adolescents, including medical students, have been applied and evaluated by the World Health Organization. Objectives: The objective of the study is to determine the prevalence of both hypertension and prehypertension among medical students in medical colleges and to study the association of different factors with hypertension disease. Methodology: A descriptive cross-sectional study was conducted in medical colleges of Al-Anbar University, Iraq. The study period was from January 1 to March 10, 2019. A total of 273 undergraduate medical group students, both female and male, participated in this study from three colleges: medicine, pharmacy, and dentistry colleges. Blood pressure, height, and weight were measured using standardized instruments. SPSS Statistics for Windows, Version 24.0 was used to analyze data. Both cross-tabulation and Chi-square tests of significance were done. Results: The prevalence rate of hypertension in this research study was 9.9%, of them 18.0% and 3.3% were male and female, respectively. Prehypertension was 17.2% of the total sample. Risk factors highly associated with hypertension (P = 0.0001) were male gender, stress, high salt intake, smoking habits, and increased body mass index. However, there was no significant association between dietary risk factor and hypertension in our study. Conclusion: The high overall prevalence of hypertension (9.9%) and prehypertension (17.2%) with overall prevalence of hypertension and prehypertension together (27.1%) represents a call for the establishment of screening system for early detection at primary health-care level. Community-based health education programs on the importance of the examination and follow-up processes for early detection of hypertension and prehypertension are recommended.

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Introduction: Primary health care is still underutilized for obesity counseling and adequate training may increase physician involvement in overweight prevention and treatment, exploring physicians' awareness is important for the design of special training programs to manage deficiencies in knowledge and practices. Objectives: The objective is to assess the knowledge of primary health care centers' physicians about obesity. Subjects and Methods: A cross-sectional descriptive study was carried out for 4 months: A Convenient sample of 129 primary health-care physicians were included, assessment of knowledge consisted of 15 questions, and their answers may be one of 3 (”Yes,” “No” or “I don't know”) according to knowledge of participants. For knowledge assessment, if a participant had 7 or less correct answers, it was considered poor knowledge, and if more than 8 correct answers out of the 15 questions then it considered adequate knowledge. Results: From the 129 study sample, only 11 had training in obesity courses. There were 82.9% of participants identify obesity as a disease, and 75.2% agreed that primary health care physicians playing a dominant role in assessing and managing obesity. In the current study, 98.4% of participants answered correctly about obesity relation to chronic conditions, 40.3% of physicians had incorrect information about low social class can predispose to obesity. In this study, only 50.4% of physicians used body mass index for obesity classification in all health conditions. Conclusions: Most of the physicians who were involved in the study had an adequate knowledge about obesity (92.2%).

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