There are a few studies that discuss the medical causes for diabetic foot (DF) ulcerations in Iraq, one of them in Wasit province. The aim of our study was to analyze the medical, therapeutic, and patient risk factors for developing DF ulcerations among diabetic patients in Baghdad, Iraq.

A Feasibility studies include recognizing and analyzing the power and the flaws of the project, in conjunction, also defining the chance and intimidations external the company within the construction industry. There are a number of problems of the feasibility study as it regards overlooked part in Iraqi construction industry and the problems of feasibility studies abuses. Misinterpretation of study stages and also having incorrect idea of the goal of the feasibility studies. Other factors that affect directly and negatively in the Iraqi industry such as delay, cost, and other issues that affect quality of the construction projects The aim of this paper Assess the awareness level of the feasibility study in construction projects and to determine the effects of feasibility study in construction industry and to identify the causes of abuses of feasibility study in construction industry. The methodology of the paper includes survey and formulation of the questionnaire to identify the factor the cause the feasibility study to fail and then use system dynamic to analysis the impact of these factors. The results show that the feasibility study is neglected part in Iraqi construction project due to the fact that its neglected, the were abuse in use the abuse of the feasibility study lead to cost and time over runs, and system dynamic technique approved to be a significant in the analysis of the impact of the.

The pharmacist's role in the community is currently directed towards providing drug information and patient care rather than drug compounding and dispensing. Patient counseling is an essential skill for pharmacists. So as to improve the pharmacist role in the community and enhance the patient's education and counseling skills, many continuing education programs are established. The aim of this study is to assess the perceptions and tendency of community pharmacists in Iraq regarding patients counseling and continuing pharmacists' educational programs. A cross-sectional survey was performed on a convenience sample of community pharmacists' from different governorates of Iraq from January 2017 to April 2018. Data were collected using a pretested questionnaire specifically designed from a previous study with some modification to reflect the work nature in Iraq. The majority of pharmacists gave counseling to the patients and spent from one to five minutes in order to dispense a prescription. Approximately (53%) concentrated on the dose of the drug during dispensing more than the duration of use (19%) or drug indication (21%) while approximately half of the patients, on the other hand, asked mainly on the indications of their medications also less than (32%) asked about drug dose. Almost (47%) of participants indicated that attending continuous pharmacist education programs can help them to improve the counseling practice furthermore, the majority of them have an optimistic attitude toward the importance of these programs for the future of their career. Most participants declared that these programs are very rare in Iraq. This study provided a clue that the majority of community pharmacists in Iraq had an optimistic perception towards patients counseling and continuing pharmacy education programs.

The avoidance of failure in construction projects is not an easy task, which makes the failure of the construction project to achieve its objectives a major problem experienced by all countries in the world, especially Iraq. Where nearly two-thirds of the construction projects in the world have been suffered by significant problems as an increase in the cost of the project, delay in the specified duration for execution, and stopping the project. Therefore it is required to study and apply new methods for managing the construction project to ensure its success and achieve its objectives. The aim of this study is to study the Agile project management method and its impact on the construction project. In addition, to identify the values and principles of Agile project management, which can be applied in the Iraqi construction industry to be adopted it as a new method to manage the construction projects in Iraq. The researcher reviewed the relevant literature to define the method of Agile project management and its methods and impact on the construction project. Then, the researcher conducted a questionnaire survey of a sample of engineers' experts who work in four main parties in the construction project: (beneficiary, supervising, designer, and contractor). The results of this survey showed that it is possible to apply the four values of Agile project management for managing the Iraqi construction projects, and can apply eleven of the twelve principles of Agile project management for managing the Iraqi construction projects.

Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept. Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reaction amplification of the extracted deoxyribonucleic acid, sequencing by Sanger method was performed to identify the polymorphism at the TNF-α promoter region. Results: In the responder group, the GG genotype of (-308G/A) and the AA genotype of (-863C/A) were both significantly present. The CC genotype of (-863C/A) was significantly present in the non-responders group. The CC of (-863C/A) SNP was the only genotype that appeared to increase the likelihood of being resistant to etanercept. The GG genotype of (-308G/A) was negatively correlated with the likelihood of being a non-responder. The (-857CC) and (-863CC) genotypes were significantly more prevalent in the non-responders group. Conclusion: The presence of the (-863CC) genotype, alone or in combination with (-857CC), is linked to an increased likelihood of becoming a nonresponder to etanercept. The GG genotype of -308G/A and the AA genotype of -863C/A significantly increase the likelihood of becoming responder to etanercept.

Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept. Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patients were divided into two groups: responders and non-responders. After polymerase chain reaction amplification of their DNA, the amplified DNA was sequenced by Sanger method to determine the polymorphisms at the positions -376G/A, -806 C/T, and -1031T/C. The results of this study found that equally Phi correlation and binary logistic regression analysis revealed a non-significant association for all genotypes in the three polymorphic sites with the tendency for being non-responder. Moreover, there was no significant difference in TNF-α mean level or the change in disease activity score for 28 joints (DAS28) after six months of etanercept therapy between all genotypes for each polymorphic site. The present study concludes that there was no correlation between the polymorphisms in the TNF-α promoter region at -376G/A, -806 C/T, and -1031T/C with the tendency for being non-responder to ETN.

Objectives:Adverse drug reactions (ADR‎s) can lead to many complications associated with the use of medications .In Iraq where a wide range of medications misused widely due to different reasons, the Iraqi pharmacovigilance program started out few years ago to collect information about adverse drugs reactions and since the success of this program depends on the effective participation of all medical staffs including pharmacists in this program. This study aimed to assess the knowledge, attitude, and degree of awareness of Iraqi pharmacists in Baghdad community toward adverse drugs reactions monitoring and pharmacovigilance program.Methods: This study was a cross-sectional descriptive survey based on individual questionnairethat administered in the English language to a convenience sample of 150 pharmacists working in 3 colleges of pharmacy, 20 community pharmacies and 3 hospitals situated in different areas of Baghdad which are the capital of Iraq. The questionnaire consists of three parts that collect demographic data on the ‎participants and their knowledge, attitudes toward Pharmacovigilance‎. Results: Although about (62%) of pharmacists have observed ADRs in their practice‎ only half of the respondents have heard about the term pharmacovigilance, 48% were aware of the national PV program ‎‎.Moreover , (‎47.33%‎) of the respondents mentioned that ADRs associated with herbal ‎products should not be reported. Although ‎79% of the respondents thought that reporting ADRs is a pharmacist’s duty nevertheless 82% of them  ‎thought that ADRs reporting in Iraq is not widely promoted by the relevant authority .The study showed a high tendency for participation in an adverse drug reaction  monitoring program. Interestingly,‎ 60% of respondents report that their workplace ‎doesn’t encourage them for reporting ADRs, while 48% of respondents indicated that they don’t ‎have enough time for reporting ADRs and 38% of them declared their fearing of facing ‎legal problem from that .  ‎Conclusion: Iraqi pharmacists although have a high tendency in participation in ADR monitoring  program but have  a poor knowledge about pharmacovigilance practices; they lack ‎understanding of the details about the national PV system and ADRs ‎reporting process and may need more information on how ADRs ‎reporting are performed. Keywords: Knowledge, Attitudes, Adverse drug reactions, Pharmacovigilance.

Objective: Rheumatoid arthritis (RA) is a common inflammatory disease associated with many extraarticular features. The aim of the study was to evaluate the effects of pentoxifylline (PTX) as adjuvant therapy to etanercept in moderately to highly active RA. Methods: A single center randomized double-blind placebocontrolled trial of 8 weeks duration was performed. Disease activity was measured via calculating the disease activity score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) and by simplified disease activity score in 28 joints using hsCRP (SDAI-CRP). 40 Patients who were using etanercept (ETN) were randomly allocated to receive each day either pentoxifylline 400mg tablet twice daily or capsules prefilled with glucose as placebo also twice daily and were evaluated at baseline and at week 8 for clinical and hematological parameters. Results: Tumor necrosis factor (TNF), high sensitive C-reactive protein (hsCRP), duration of morning stiffness, and cardiovascular risk were significantly more reduced in pentoxifylline group than placebo group after 8weeks. Non significant changes were observed in clinical parameter like swelling joints counts (SJC),tender joints counts(TJC),visual analogue scale(VAS),evaluator global assessment (EGA),DAS28-ESR, SDAI-CRP and hematological parameter like hemoglobin (Hb) amount, erythrocyte sedimentation rate (ESR) and white blood cells (WBC) count between groups. Conclusion: PTX significantly decreased pro-inflammatory markers (TNF, hsCRP), duration of morning stiffness and cardiovascular risk. This suggests that pentoxifylline may be a promising and useful strategy to reduce the systemic inflammation and cardiovascular morbidity and mortality observed in RA patients.