Medical waste management is of crucial importance in health care facilities (HCF). In the present study, we assessed the knowledge, attitude and practices of medical waste management in an HCF of Sulaimani city, Kurdistan Region of Iraq. Using a self-administered questionnaire, we collected information on waste management practices from health care professionals (HCP) in 14 public and private hospitals and 10 primary health care centers of the city. Based on answers, total knowledge score on a 10-point scale was established. A total of 406 HCPs (of those, 261 women), average age 37.3 (SD ± 9.4) years participated. Just 20.3% have been trained on medical waste management. The total knowledge score ranged from 0 to 9 with a mean of 4.7 (SD ± 1.8).  Factors which were significantly associated with the better knowledge score was male gender, having a high educational degree, being trained in waste management and has been in service for more than 5 years. 68% of HCPs followed the color coding system, 91% always/frequently disposed used sharps/needles to safety boxes, 79% always or frequently recapped needles, 49% reported experiencing at least one needle prick injury during their work but only 37% of them had reported the injury to a supervisor and only 4% of those injured had filled an injury form. There is a low average level of knowledge and the unsafe risky practices are quite prevalent in HCFs. Provision of appropriate training on dealing with medical waste is essential to promote safe practices among HCFs.

Resistance to antibiotics is rapidly increasing in our community and burn wounds are frequently infected by these multidrug resistant organisms. Careful antibiotic selection and effective control of these strains can be translated into lower morbidity and mortality for these patients.

Background General anesthesia and intravenous anesthetic drugs influence the leukocytes. The study designed to assess the effects of intravenous anesthetics and anesthesia technique on leukocytes which are the important human immune cells. Methods The prospective study was performed on 100 patients undergoing surgery in Sulaimani Teaching and Shar Teaching Hospitals from November 2021 to March 2022. First blood sample were collected from the patients before induction and second sample were collected 6 hours after operation. Complete blood counts were done for all samples to find out the rates of leukocytes pre- and post-operative. Results In general, the mean of lymphocytes, monocytes, eosinophils and basophils counts were decreased after operation, but the mean of neutrophils counts were increased. General anesthesia was more effective to leukocytes than other types. All hypnotic anesthetic drugs were affecting the level of leukocytes except Pentothal. Patients who given analgesics had obvious effect on leukocytes than other who were not received analgesics. Also, leukocytes changes were shown for muscle relaxant, they decrease the level of lymphocytes, monocytes, eosinophils and basophils count, but increase the level of neutrophils. According to the leukocytes count, significant changes were found for most of the intravenous anesthetics (p < 0.05). Conclusion All hypnotic, analgesic, and muscle relaxant except Pentothal can decrease leukocytes especially, Lymphocytes. While, by using all the intravenous anesthetic drugs neutrophil counts elevation may occurs.

The gram-negative, especially rod shapes vary in the frequencies that they cause the most frequent types of hospital-acquired infection: pneumonia, surgical site infection, urinary tract infection, diabetic infection, burn and bloodstream infection. The presented study determined the microbial spectrum and antimicrobial susceptibility of gram-negative bacteria isolated from various infection sites in hospitalized patients in Sulaimani city. This study included 735 patients who underwent surgical and wound treatment admitted to the hospital. A microbiological standard technique was used for Identification, isolation and antimicrobial susceptibility. The data in this job were scaled into excel sheets and transferred to SPSS (Statistical Package for Social Sciences) version 24.0 software. The significance of associations between variables and predictor done by Chi-square (χ2). P-value of <0.05 was regarded significant. Male was the most common cases 52.5%. Patients less than 18 years-old were the most frequently affected 54.3%. Gram negative infection is the most common and most serious complication of burn injuries and it is the majority suspected clinical finding nearly to 60%. The most common bacteria separatedd from wound and sepsis were Pseudomonas aeruginosa 91.91%. Individual pathogens’ incidence differ significantly between location of infection p<0.001. Pseudomonas aeruginosa, only resistant stabled at the lowest rates for Colistine and Imepenim (0.1% and 7.8%) and significant finding was confirmed p<0.001. But highly resistance to Ticarcillin/Clavulanic Acid, Cefepime, Tobramycin, and Gentamicin (85.6%, 80.8%, 79.3%, 79.2%) .In conclusion, these population-based study gram-negative infections predominate in burn wounds. Microbial resistance to the confirmed drugs leads to repeated antimicrobial treatment modifications and long-time of treatments.

Thalassemia is a well-known inherited hematologic disorder caused by a decrease or an absence of globin production. Patients with thalassemia suffer from chronic hemolytic anemia and its sequelae. A descriptive study was undertaken in Sulaimani Thalassemia and Congenital Blood Disease Center. The self-administered questionnaire was used to 140 patients who had thalassemia and visited to the hospital during the study periods to assess the patients’ characteristics and parent’s relative’s relation to thalassemic patients.  Data were entered into spreadsheets and analyzed in Statistical Package for Social Sciences (SPSS) version 22. Descriptive analysis was performed and frequencies and percentages were reported. Associations between categorical variables were checked using Chi-squared test. Out of 140 patients 50.0% of patients were males and 50.0% were female; the mean age was 12.8 years-old. The most frequent thalassemic patents were come from rural area 95.0%. Majority of patients have major type of thalassemia 84.3%. Most of the patients cannot continue to the study accounted 66.4%. About number of children most of the patient’s family had more than 3 children 99.3%. Majority of patient’s parents is carrier for thalassemia and accounted with 90 (65.0%), from those patients with major thalassemia are 77 (85.6) and few cases with minor thalassemia 4 (4.4%). These relations are statistically significant at (p<0.05). Majority of patients who have major type of thalassemia were from rural area followed by urban area 113 (95.8%) vs. 7 (5.0%), these differences are statistically significant at (p≤0.01), from major types of thalassemic patients; 85 (94.4%) of them were both father and mother are carrier of thalassemia. Statistically significant relation was found at (p<0.05). In conclusion, thalassemia is an important cause of morbidity among thalassemic patients. In our community, thalassemia is more frequent in rural population. Therefore, it is a crucial for monitoring and examination of those who are carriers. Moreover, the lack of health education on thalassemia was the major problems related with awareness of families.

Background: One of the most effective ways to decrease the burden of communicable diseases such as COVID-19 is vaccination but these days despite the availability of vaccine services the hesitancy of the vaccine and the delay of acceptance or rejection of vaccine from most developing countries remain as protection to initiate effective antibody. The aim of this study to assess nurses’ knowledge and attitude regarding COVID-19 vaccination before and after the training course of the health care centers in Sulaimani city. Materials and Methods: we have done a descriptive quantitative design study with a non-probability purposive sample of 74 nurses, The reliability instrument was decided using the internal consistency (Split half) approach. The collection of the data was revealed by using the interview technique, then presenting the training course to the participants and on the last day of the training the post-test was performed. Results: Most of the participants aged between 31-40 years old and were governmental employee’s female which graduated from the institute of nursing, had not been vaccinated yet; and were not trained regarding COVID-19 vaccination (82.4%, 81.1%, 54%, 91.9%, and 97.3%) respectively. (95.9%) of the participant’s knowledge and attitude before the training course regarding COVID-19 vaccination was low level, whereas after the training course the knowledge and attitude of them reach to the highest level 100%. Conclusion: The participant’s level of knowledge before the training course regarding COVID-19 vaccination was low levels, whereas after the training course their knowledge reach the highest level because of that the researchers recommended focusing on more training courses regarding COVID-19 vaccination by the Ministry of health/infection control department to develop their level of knowledge and attitude. Keywords: effect, simulation-based training course, covid-19 vaccine, nurse’s staff, knowledge, attitude

Hepatitis C infection is one of the most common causes of chronic liver disease. It is growing threat and main burden on public health. Globally more than 170 million people are infected with hepatitis C virus (HCV), up to 4 million new infections annually and each year more than 350000 dies of HCV related complications, including cirrhosis and hepatocellular carcinoma (HCC). Thus this descriptive case-series study was conducted in five health facilities in Sulaimani city, from 23rd December 2015 to 10th of June 2016. The data were collected from 180 HCV infected patients by face to face interview; they were interviewed privately by using a structured questionnaire. P-values of ≤0.05 were considered statistically significant. Out of 180 patients, 45% were males and 55% were females, the mean age of the cases was 33.18 years, regarding marital status 55.5% of the cases were single. The majority of the cases were diagnosed by routine screening. Most of the patients (70.7%) had no signs and symptoms at the time of diagnosis. In each patient at least two identifiable risk factors for getting HCV infection were reported. Among the patients that had genotype test, 67.2% of them infected with genotyope1. More than threequarters of the participants had elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST). More future studied parameters and practical skills should be performed to significantly reduce the risk of HCV infection in Sulaimani.

The playbook is more directed towards states than it is towards municipal public health, and indicates what the state should be thinking about as they build out their vaccination program plans. It is not a listing of expectations of municipal public health, but will inform what the state asks of local public health partners.Planning Assumptions for Jurisdictions.