Introduction fatty deposition occurs under the skin in the anterior abdominal wall, buttocks, in the arterial wall, inside the liver (causing fatty liver) and other parts of the body. Metabolic syndrome is a cluster of abnormalities that tend to occur together in some individuals. 1 These include abdominal obesity, insulin resistance, glucose intolerance, dyslipidemia, and high blood pressure. This syndrome is associated with diabetes, cardiovascular disease, and death. 2 Multiple diagnostic criteria have been proposed for detecting MetS. 3 Abdominal obesity is defined as having a waist measurement of at least 40 inches for men and 35 inches for women. Insulin resistance is the inability of the body to use the hormone insulin effectively to regulate sugars and carbohydrates properly. Insulin resistance results in a fasting blood glucose level of 106 mg/dL or higher. High blood pressure is loosely defined as a consistent reading of 130/84 mm Hg or higher. There are often no other signs and symptoms of insulin resistance and high blood pressure for years until complications occur. 4 Hypercholesterolemia or hyperlipidemia is a high level of total cholesterol in the blood. A blood level of triglycerides of 150 mg/dL or higher or a blood level of HDL below 40 mg/dL is considered a symptom of MetS. 2 Modernization, economic development, and technological advances have brought rapid demographic and epidemiological Background and objective: There has been a recent concern about chronic non-communicable diseases in Iraq. The country is undergoing an epidemiological transition with an increasing burden of chronic non-communicable diseases with two-thirds of the people aged 25-65 years old are overweight and one-third are obese. This study aimed to estimate the prevalence of metabolic syndrome with their associated risk factors among a sample of peoples in Erbil city. Methods: This cross-sectional analytic study was carried out in Erbil city and involved a convenience sample of 566 apparently healthy subjects. A structured direct interview using interviewer administered questionnaire was applied. Anthropometric measures, random blood sugar, cholesterol level, triglyceride level, low-density lipoprotein and high-density lipoprotein were investigated. Results: The prevalence of metabolic syndrome in the studied sample was 30.6%. The prevalence was higher in females (45.5%) than males (16.3%). Variables like gender (P <0.001), age (P = 0.008), education and marriage (P = 0.001), family history of diabetes mellitus (P = 0.029), hyperlipidemia (P <0.001), hypertension (P = 0.047) and obesity (P = 0.005) were found to be factors that significantly associated with metabolic syndrome. Conclusions: Metabolic syndrome is prevalent among the studied population. Female gender, old age, marriage, family history of diabetes mellitus, hyperlipidemia, hypertension and obesity may be regarded as risk factors for metabolic syndrome.
Introduction The purpose of this study is to compare the change in the metabolic syndrome prevalence and risk factors between participants who followed a low carbohydrate diet and those who followed a low fat diet for six months in Erbil city/ Iraqi Kurdistan. Methods Out of 289 apparently healthy obese adults who were chosen by a stratified multistage probability sampling method, 94 of them agreed to participate in the study. They were assigned to low carbohydrate and low fat diet groups. Both groups were followed up for 6 months and the data were taken at baseline, after 3 months and after 6 months of intervention. Ninety-four obese adults completed the intervention. One-way repeated measures ANOVA was used to compare differences of metabolic dependent variables between the two independent variables, the low carbohydrate and low fat diet, at baseline, after 3 months and after 6 months of intervention. Results The Participants in low carbohydrate diet group had greater decrease in the prevalence of MetS. At the baseline, according to the ATP III criteria, the prevalence of metabolic syndrome was 44.4% (24/54) in low carbohydrate diet group and 60% (24/40) in low fat diet group. The prevalence of MetS was decreased significantly to 16.7% (9/54) after 3 months and to 3.7% (2/54) after 6 months in low carbohydrate diet (p < 0.001). Moreover, the prevalence of MetS was decreased significantly to 32.5 (13/40) after 3 months and to 22.5% (9/40) after 6 months in low fat diet (p < 0.001). No statistically significant difference was found between low carbohydrate diet & low fat diet at the baseline (p-value = 0.136) and after 3 months and after 6 months of intervention. Conclusions Both low carbohydrate diet and low fat diet have significant effects on reducing the prevalence of MetS in obese adults when followed up for 6 months. Compared to low fat diet, low carbohydrate diet had greater effect in reducing the prevalence of metabolic syndrome. Both diet programs were found to be effective in improving the metabolic state of obese adults. Trial registration The trial is registered retrospectively at the US National Institutes of Health (ClinicalTrials.gov). The registration in the US National Institutes of Health was done in 23/12/2020 with the registration number: NCT04681924.
Background Rheumatoid arthritis is a complex multifactorial chronic disease, the importance of human leukocytic antigen (HLA) as a major genetic risk factor for rheumatoid arthritis was studied worldwide. The objective of this study is to identify the association of HLA-DRB1 subtypes with rheumatoid arthritis and its severity in Kurdish region. Methods A case–control study recruited 65 rheumatoid arthritis patients and 100 healthy individuals as control group all over the Kurdistan region/Iraq. Both patient and control groups are genotyped using polymerase chain reaction with sequence specific primer. Anti-CCP antibodies were measured by ELISA test. Rheumatoid factor, C-reactive protein, and disease activity score 28 which measured by DAS-28 values were calculated. The DAS-28 was used to assess the clinical severity of the patients. Results HLA-DRB1-0404 and HLA-DRB1-0405 frequencies showed a strong association with disease susceptibility (P < 0.001). The frequency of HLA-DRB1-0411 and HLA-DRB1-0413 were significantly higher in control group (P < 0.001). The frequency of rheumatoid factor and Anti-CCP were significantly higher among shared epitope-positive patients compared to shared epitope-negative patients (P < 0.001). Regarding the disease activity by DAS-28, rheumatoid arthritis patients didn’t show significant difference between the shared epitope-positive and shared epitope-negative patients. Conclusions HLA-DR0404 and HLA-DR0405 alleles are related to RA, while HLA-DR1-0411 and HLA-DRB1-0413 protect against RA in the Kurdistan region in the North of Iraq.
Background and objectives: The burden of tuberculosis on public health is staggering and has become of growing concern to stakeholders in recent times worldwide. Patients delay in seeking care increases the transmission of pulmonary tuberculosis and hence the burden of the disease. The aim of this study was to investigate the patterns and determinants of patients delay in seeking treatment among pulmonary tuberculosis cases attending the chest and respiratory consultation center in Salahadin governorate. Methods: This descriptive cross-sectional study included 50 tuberculosis cases attending the chest and respiratory consultation center in Salahadin governorate. A questionnaire was used to collect the data that by face to face interview with the patient including25 questions divided into two sections of identification information, socio-demographic characteristics and health seeking history. Results: The median patient delay was 3.9 weeks. The median health system delay was 3.0 weeks. The median total delay was 8.9 weeks. The highest percentage of patients’ first health seeking places was the private clinic 72%. Conclusions: The major cause of delay in seeking treatment among pulmonary tuberculosis cases was attributed to patient and the health system. Decentralization of the treatment is fundamental for earlier diagnosis. Involvement of private sectors in the treatment program will result in a decrease in the delay of tuberculosis patients.
Background and objectives: Influenza virus really became a challenge throughout the world. Erbil, the capital of Kurdistan, Iraq, is likely to face increasing challenges of preventing communicable diseases including influenza and outbreaks. This study aims to investigate the clinical profile & outcome of (H1N1) pandemic 2009 influenza virus infection referred influenza center in Hawler teaching hospital in Erbil city. Objectives of this study include: determining the frequency of positive cases of H1N1 among suspected cases, by demographic features, and finding out the outcome of positive cases of H1N1in terms of case fatality rate. Methods: This is a case series study, carried out in Erbil city, using medical charts of 365 suspected a (H1N1) pandemic 2009 cases referred to influenza center in Hawler teaching hospital during pandemic 2009. Positive cases diagnosed by polymerase chain reaction. The Statistical Package of Social Science software, version 19.1was used for data entry and analysis; P-value ≤ 0.05 was regarded as statistically significance. Results: The H1N1 positive cases are found during epidemic 2009; by viral culture, out of 365 suspected cases, only %12.6) 46) cases found to be positive and affected both sexes equally. Commonest symptoms are including fever (%1.9), sore throat & cough (%1.4) and rhinorrhea (%1). Case fatality rate of H1N1 was %6.5, (p value=0.007). Conclusions: H1N1 positive cases are found during epidemic 2009. Patients had minimum symptom of the disease at presentation. Only %2.17 of patients intubated and mechanically ventilated. The death rate was only %6.5. Crowded sectors inside big city may be regarded as a risk factor for disease transmission.
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