BackgroundMicroalbuminuria (MAU) is defined as an urinary albumin excretion rate between 20–200 mg/l or 30–300 mg/day. It is a surrogate marker for endothelial dysfunction and is independently associated with atherosclerotis in diabetic and in non-diabetic patients. We assessed the prevalence of MAU in non-diabetic patients who presented with UA/NSTEMI and the relation of MAU to the severity of coronary artery disease in patients at a cardiac care center in Iraq.MethodsSeventy non-diabetic patients referred to the Iraqi Center for Heart Disease, Baghdad, between November 1st 2010 and June 1st 2011 with the diagnosis of UA/NSTEMI were included in this study. Physical examination, ECG and echocardiography were performed on all patients. TIMI (“Thrombolysis in Myocardial Infarction”) risk score was obtained. Urine samples were collected and sent for quantitative determination of MAU. All patients underwent diagnostic coronary angiography. Data are give as mean (quantitative and percent) ± SD.ResultsFifty-three men (76 %) and 17 (24 %) women (mean age 56 ± 12 years) were investigated. Overall 37 (53 %) individuals presented with arterial hypertension and 41 (59 %) with a history of smoking. 58 patients (83 %) had ischemic ECG changes (defined as ST segment depression more than 1 mm from baseline, and/or T wave inversion), 52 (74 %) had echocardiographic findings indicative of ischemia (defined as segmental wall motion abnormalities). Twenty-one (30 %) patients tested positive for MAU. There was a significant correlation of echocardiographic signs of ischemia and MAU, (n = 20 (38 %), p < 0.01). There was a clear relationship between MAU and TIMI risk score. Additionally, MAU was more common in patients with multivessel coronary artery disease (CAD) (p < 0.001). There was no statistically significant correlation between MAU and mean age, sex, smoking, and blood pressure.ConclusionIn this analysis of patients with UA/NSTEMI we found a strong correlation of microalbuminuria with echocardiographic changes and findings in coronary angiography.

Background:The motivations behind why people choose to study medicine in Iraqi medical schools are unknown. Such information could help school pupils to make more informed career decisions and assist medical schools in enhancing the student selection process.Aims:To investigate why people choose to study medicine in Iraq.Subjects and methods:The first-year students admitted on the academic year 2015-2016 to Baghdad College of Medicine, University of Baghdad, were invited to complete a structured questionnaire, which was administered through the college electronic education portal. The data were analyzed using IBM SPSS version 21 software.Results:A total of 152 (50% response rate) students responded. Women constituted 69.1% of respondents. Most students (61.8%) had made their choice by themselves without family pressure. The most frequent reasons that affected this choice were “humanitarian reasons and a wish to provide help to others” as well as “childhood dream,” “positive community appraisal of doctors,” and “ready availability of work for physicians.” About three-quarters (73.6%) of the students made some inquiry about medical school before making their choice, and the people asked were most frequently a medical student or a doctor. Information provided by the consulted parties was regarded as satisfactory by 64.2% of the surveyed students, had a positive value in 47.2%, and affected their decision in 34.9%. The highest proportion (42.2%) of the study sample was thinking about studying medicine since primary school. In addition, students with personal preference made their choice at a significantly younger age.Conclusions:Reasons to apply for medical schools in Iraq are similar to those in many countries. Most of the students who inquired about studying medicine had not contacted the medical school itself.

Objectives The current study sought to evaluate the communication skills of Iraqi physicians from a patient perspective, differentiating between “interpersonal” and “content” components of communication. In the past century, the doctor–patient relationship has changed considerably, shifting from a paternalistic, physician-dominated approach to a more dynamic and patient-centered. In such a context, effective communication skills have become even more crucial for good medical practice and most accreditation organizations urge medical schools to teach and evaluate communication skills. Methods A cross-sectional study was conducted at Baghdad Teaching Hospital's three major departments (Surgery, Medicine, Obs/ Gyne). The final sample included 270 participants. A factor analysis was performed and generated two dimensions ("interpersonal" and "content"). Statistical differences between the groups and between the two dimensions of the questionnaire were analysed through t-tests and ANOVA. In addition, a multiple linear regression model was used to study the effect of some variables on the dependent variable "communication". Results The study showed a significant difference between “interpersonal” and “content” communication, with patients reporting higher satisfaction for the former. Reported satisfaction rates varied amongst the three departments with the Surgery specialty scoring significantly lower than the Medicine and the Obs/Gyne department. The duration of care under the current physician, a higher rank of specialty and the settings (inpatients versus outpatients) were positively and significantly associated with a higher quality of communication skills. Conclusions These findings have significant implications for training institutions.

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Genetic factors will determine the higher variability, which found in response to lipid reduction treatment (statins). However, due to ethnicity the frequency and effect of single nucleotide polymorphisms (SNPs) may differ. The main aim of lipid lowering medical treatment is to eventually prevent the endogenous production of cholesterol through inhibition of HMG-CoA reductase, The resulting decrease in hepatocyte cholesterol concentration triggers up-regulation of low-density lipoprotein (LDL)-receptor expression by inducing sterol regulatory element-binding protein (SREBP) 2 cleavage, as SREBP-2 activates LDL receptor transcription. The aim of this study was to evaluate the effects of low density lipoprotein receptor (LDL-R) gene variants (rs200727689; rs72658860) in response to atorvastatin treatment in atherosclerotic coronary artery disease (ACAD) in a sample of Iraqi patients. The genetic polymorphisms of rs200727689 and rs72658860 were studied in patients undergoing coronary angiography (CAG). One hundred Iraqi patients include 52 patients treated with 20mg/day and 48 patients treated with 40mg/day, In addition, 100 apparently healthy subjects were genotype for these SNP by the thermal profile of allelic discrimination methods used Real Time PCR (RT-PCR) assay. A significant increase in A allele frequency (rs200727689) compared with controls for total ACAD patients (43% vs 23.5%; OR= 2.46; 95% C.I: 1.60-3.77; p=0.000). For (rs72658860) SNP, among total patients the A allele also increased the frequency substantially compared with the controls (40.5% vs 23.5%; P=0.0003; OR= 2.22; 95% C.I: 1.44-3.41). In the patients who were treated with atorvastatin, SNP rs72658860 AA genotype significantly affected the response of atorvastatin in dose 20mg compared with 40mg. The result showed in AA genotype of (rs200727689) SNP a reduction in TC concentrations (277.55±108.38 vs 326.99±63.56) and LDL-C concentrations (198.33±100.0 vs 250.01±62.52) in sera compared with GG genotype in patients treated with 20 mg atorvastatin, although, none in all parameters statistically significant differences.