PURPOSEThis study aims to describe the pattern of presentation of Iraqi female patients with breast cancer by assessing the grades and stages of their cancers at the time of presentation, to identify patients’ main complaints, and to discover whether there is any difference in presentation between patients in Iraq and those in other countries.PATIENTS AND METHODSThis is a retrospective cross-sectional study that was performed in the National Center of Cancer in 2018. The target population was female patients with breast cancer who came to the Center for treatment and follow-up. A sample of 171 patients was drawn from this population. Self-evaluation forms were used in interviews with the patients to collect personal and sociodemographic data; clinical and histologic characteristics of the patients’ tumors were obtained from their medical records. Ethical approval was obtained.RESULTSForty-five percent of the patients were younger than age 50 years, and 25% were younger than age 45 years. In all, 42.9% of the patients were diagnosed with stage III and 25% with stage IV cancer, and metastasis was diagnosed in 24.1%. In our study population, 53.4% of the tumors were found in the right breast, and 3.9% of patients had bilateral breast tumors. The most common histopathologic type was invasive ductal carcinoma (81.4%) followed by invasive lobular carcinoma (6.9%) and tubular carcinoma (5.9%). The patients’ most common complaints were breast lump (71.3%) and pain (18.9%). No correlation was found between tumor stage and breast self-examination, family history, education, occupation, histopathology, or grade.CONCLUSIONMost of the patients are diagnosed at a late stage when treatment is less effective.

Background: Thalassemia is an autosomal recessive disease common in Iraq with a prevalence of 35.7 per 100000. Beta thalassemia major is a life-threatening condition with many complications which if not managed could cause death at an early age. This cross-sectional study aimed to assess the awareness of parents/caregivers of children with beta-thalassemia major and intermedia, as enhancing awareness is the first and the most important step in all prevention programs Methods: We conducted this study in three thalassemia centers (two in Baghdad and one in Al-Nasiriyah) from July 20th, 2017 to September 20th, 2017. This study involved 193 parents of thalassemic children under the age of 15 who come to the centers frequently for blood transfusion. The study assessed the awareness questionnaire through interviews. Data analysis was performed using the Statistical Package for the Social Sciences program (SPSS) version 24. Results: We found that awareness was low in many aspects. The highest knowledge was for foods that thalassemic patients shouldn't eat and for the early manifestation signs in thalassemic patients which is 94.8% and 86%, respectively. The lowest knowledge was for the consideration of human immune deficiency virus as a transfusion-transmitted disease and for the chance of having an affected child when both parents are carriers which were 37.3% and 11.9%, respectively. Conclusion: Parents have low awareness of thalassemia in many aspects. Thalassemia care centers may need to provide more education for the parents of patients with thalassemia.

Thalassemia is an autosomal recessive disease that is common in Iraq with a prevalence of 35.7 per 100,000. It is the most common type of hereditary anemia registered in 2015. It is a life-threatening condition with many complications which if not managed could cause death in early age. This study aimed to assess the awareness of Iraqi people about thalassemia transmission and prevention and to find their source of information about the disease, as developing good awareness is the first and the most advantageous road to establish a successful prevention program. This cross-sectional study involved 417 participants who were from medical and non-medical fields. It was conducted as an online survey in addition to participants interview using a self-structured questionnaire which was tested for content and face validity, unidimensionality and test-retest reliability in a pilot study of 40 participants. Each participant who had heard about the disease was given a score (0-5) based on their knowledge: 68.8% of the people had heard about the disease previously, those had a mean score of 3 out of 5; 84% claimed that thalassemia is a noncommunicable disease which resembles the highest awareness aspect. The lowest one was about the preventability of the disease. Significant correlation was found between the score of awareness and the age. People awareness about thalassemia was relatively good. A control strategy should be directed to elevate the awareness level about thalassemia in the community with the application of the national program for thalassemia control.

Background: Forensic medicine is the branch of medicine that deals with applying medical knowledge to establish facts in civil or criminal cases, such as investigations into the cause and time of death. In Iraq, people's knowledge about forensic doctors' profiles is unknown, so this study aims to assess the general population's knowledge regarding forensic doctors. Methods: This is a cross-sectional study that involved 644 participants from different provinces in Iraq using a self-administered questionnaire published via social media websites. The survey involved questions about the sociodemographic status of participants and twelve questions about forensic doctor duties, which were listed in the Iraqi constitution. These were tested for internal consistency with an alpha Cronbach value of 0.82. The data was analyzed using Statistical Package for the Social science (SPSS) version 23. Results: The mean number of questions correctly answered was 7.35 with a standard deviation of 3, 9.5% of the sample answered all the questions correctly, 30.4% answered from 9 to 11 questions, 20.5% from 7 to 8, 28% from 4 to 6, 9.4% from 1 to 3 and 2.2% answered all questions wrongly. The highest awareness was about the duty of dissecting bodies, identifying the remnants' identity, and identifying the cause of death. The lowest awareness was about public morality issues as a duty of the forensic doctor. There was a statistically significant association between the number of correctly answered questions and gender, age, marital status, and education level. Conclusion This study shows moderate knowledge and awareness about forensic doctors among Iraq's general population.

In this work, it was evaluated the wear resistance, hardness, and surface roughness values of resin-based composites that applied in dentistry as restorative materials. The resin composites were made from six types of resin matrixes (A, B, C, D, E, and F) and each one of them has contained different types and ratios of monomers as well as the inorganic nanofillers (SiO2, ZrO2, HA, and Al2O3). For each test, thirty specimens were prepared, which were classified into six groups depending on the types of the resin matrix and fillers used in the composites. The results prove that the nanocomposites that have the lowest rate of wear were the group E which was derived from the resin matrix of the group E that has monomers are (BIS-GMA, meth acrylamide, methacrylic acid, and 1-6 hexanediol methacrylate) with values range from 8.11 to 6.11 mm 3 /mm depending on the filler type material. All prepared composites resin materials (A to F) showed an increase in their hardness values as regards the reference, group D showed the highest hardness value followed by group B while group C was the lowest. The highest mean roughness was shown in groups A and F with 0.82 and 0.79 μm respectively, while the smoother surfaces among all groups were groups B and D which had significantly fewer roughness values of 0.16 and 0.19 μm respectively.

The objectives of this study were to determine presenting symptoms, risk factors, echocardiographic and angiographic findings in patients with Left bundle branch block (LBBB), who underwent coronary angiography in Duhok heart center. All patients with symptomatic complete LBBB who attended Duhok cardiac heart center from September 15, 2007 to September 1, 2009 were included. Demographic profile such as age and sex, presenting symptoms, risk factors, echocardiographic and coronary angiographic findings were studied. The study included 75 patients, 41 patients (54.7%) were males and 34 patients (45.3%) were females with a mean age of 56 years. Male patients with LBBB have more incidences of both abnormal coronary angiography (70.3%) and three vessels disease (70%) than female patients. In our study 57.4% of patients with LBBB had hypertension. Patients with 2 or more risk factors showed a higher percentage (47.7%) of having abnormal angiography. Based on echocardiography findings, WMA constitutes the major finding (24, 32%). In the patients with CAD, there were normal ejection fraction (EF) in 7 patients (26%) and depressed EF in 20 patients (74%). In conclusion, hypertension was a major risk factor for LBBB. left anterior descending artery (LAD) artery was the most common vessel disease. Males show an overall higher degree of affection than females in regards with three vessels disease. Patients who had 2 or more risk factors had a higher percentage of having abnormal angiography. Left ventricular EF was lower in LBBB patients who had CAD.

Background: There is a growing interest in studying the effects of arthritis on a person's work productivity using a growing variety of outcome indicators. Objectives:To develop a valid and reliable shortened version of the Workplace Activity Limitation Scale 12 (WALS-12) for assessing work productivity limitations in rheumatoid arthritis (RA) patients. Methods:A cross-sectional study involving 277 RA patients was conducted. An exploratory factor analysis on WALS-12 was used for item reduction on the first sample. Then confirmatory factor analysis (CFA) was run to establish the best fit indices of the reduced version. On the second sample, CFA and linear discriminant analysis were performed to assess the diagnostic performance and discriminant ability of the reduced form. A Bland-Altman method was used to find the agreement between the WALS-12 and the reduced one. Results:The WALS-12 was reduced to 5 items. The Cronbach α was 0.817, with a composite reliability of 0.715. The Spearman rho correlation coefficient ranged between 0.675 and 0.795 for WALS-5, which was higher for the scale items with their domains than the correlation of WALS-5 with the domains of Work Limitations Questionnaire-25. Also, the root square of the average variant extracted from WALS-5 was 0.802. WALS-5 showed excellent discriminant ability with an area under the curve of 0.98 (P < .001), sensitivity of 97%, specificity of 82%, and accuracy of 94%.The reduced version WALS-5 was in agreement with the original version WALS-12.Conclusions: WALS-5 is a valid and reliable tool to assess the work productivity limitations in RA patients.

Breast cancer is a common malignancy worldwide. It is considered top cancer in women and about 13% of women in the general population will develop breast cancer sometimes during their lives, with a gradual increase in incidence as survival increases. Primary prevention of breast cancer is directed toward promoting a healthy lifestyle and reversing modifiable risk factors; these factors include smoking cessation, physical activity, alcohol, and dietary modification. Imaging plays an important role in the diagnosis and management of breast cancer, it is also considered the most valuable tool in screening breast cancer. Mammogram is the most widely used method; it is recommended by many societies and committees as a useful method for early detection of breast cancer. False-positive and over-diagnosis constitute a problem in using screening mammogram. The implementation of a screening program faces many issues that may adversely affect its success such as personal factors, social factors, and accessibility issues. These issues should be identified as the initial step in program implementation. The role of Magnetic Resonance Imaging and Ultrasound is mainly in high-risk patients. The introduction of Artificial Intelligence in Mammogram may add beneficial effects in time and efforts improving its efforts.