Iranian Journal of War and Public Health
Volume:14 Issue: 55, Spring 2022

Diabetic nephropathy is one of the consequences of type 1 and type 2 diabetes and one of the main causes of End-Stage Renal Disease (ESRD) as well as an important risk factor for cardiovascular morbidity and death. The aim of this study was to identify the risk factors for diabetic nephropathy in diabetic patients.

In this cross-sectional descriptive study, 121 patients (66 females and 55 males) with type 2 diabetes in Karbala, Iraq from October 2019 to April 2021were studied. In the first stage, a complete history of the patients was taken and then a physical examination was performed. After that, 5 ml of aspirated blood and 100 ml of urine were collected from each patient and both were sent to the laboratory for biochemical tests and urinalysis. The collected data were statistically analyzed using SPSS 22 software and Chi-square test.

Out of 121 diabetic patients, 77 (63.6%) had diabetic nephropathy. The incidence of diabetic nephropathy was higher in men than women. There was a significant relationship between age, persistent hyperglycemia, obesity, and duration of diabetes with diabetic nephropathy (p<0.05).

Age, persistent hyperglycemia, obesity and duration of diabetes are involved in the development of diabetic nephropathy in diabetic patients.

COIVD-19 Patients suffering from other diseases such as diabetic mellitus, asthma and obstructive pulmonary disease have increased morbidity and mortality rates resulting in more hospitalization and intensive therapy unit admissions. The study aimed to characterise and investigate the clinical pattern and the severity of symptoms in COVID-19 patients and to study its relationship with the coexisted morbidities.

The data was collected from COVID-19 patients (N=202) who attended the Al-Shefaa center in Al-Najaf city, Iraq, during the period from 6 September 2020 to 20 January 2021. Demographical features, comorbidities, chronic diseases, and more prevalent symptoms were studied. The data was collected anonymously and processed using IBM SPSS 25 software. The descriptive statistics were performed.

121 patients (59.9%) had a body mass index (BMI) of less than 18, while 38 patients (18.8%) have BMI ranged 18.5 to 24.9. Furthermore, 16 patients (7.9%) have BMI between 30-34.9 and only 6 (3%) have a BMI of 35-39.9. Patients with hypertension 9 (4.5%), respiratory diseases 7 (3.5%), atherosclerosis 6 (3%), diabetic Mellitus 6 (3%). Patients with moderate Covid-19 symptoms account for 54% of the cases while only 2% of the patients developed severe manifestations. Hair fall happened in 105 patients (52%), the severity can range from mild (43.6%) to severe (2.5%), and fever 61 (30%). Eighty-five patients (42.1%) of admitted patients with an incubation period of 2 weeks while 6 (3%) for 4 weeks. The requirement for artificial oxygen therapy was seen in 19 (10%) of cases, whereas 183 patients (90%) recovered without artificial oxygen support. Obesity was observed in more than 10% of infected patients, whereas more than 40% of cases have coexisted chronic diseases such as hypertension, diabetes mellitus, respiratory tract disorders and other chronic diseases. The duration of the disease ranged from a few days (15.3%) to 2 weeks (41%) to 4 weeks (3%).

The study highlights the possible role of obesity and concurrent chronic diseases on the magnitude and duration of COVID-19 illness

The study's purpose was to evaluate the serious risk factor for the neuropathy disease in patients with diabetes

This research was done on 120 subjects classified into 40 with DPN T2DM and 40 with T2DM and 40 healthy considered as a control. As the conditions of the Iraqi Ministry of Health to evaluate the thesis clinically, that the number of samples examined should be at least 120 samples. The collection period was from 1 October 2021 to 1 December 2021. All patients and control groups were collected from medical City Al-Imamian, Al-Kadhmiyain-Baghdad-Iraq. Regression analysis was used to investigate potential risky factorize lead for the DPN in T2DM patients.

The spread of DPN in Type 2 diabetic patients was 50% of the multiple logistic transformations revealed in diabetic peripheral neuropathy. The mean value of Duration was significant (p<0.05) for DPN compared with T2DM. The mean value of fasting glucose, HbA1c, and hypertension, for DPN participants, were significantly higher than in T2DM and control groups (p=0.0001). The analysis of variance for vitamin B12 and vitamin D was significant (p=0.0001) for DPN it was lower than for T2DM and control. The mean value of lipid profile was non-significant (p>0.05) between the three groups.

Diabetic peripheral neuropathy had a high risk of a decrease in their vitamin B12 and vitamin D levels. On another hand, patients with T2DM should follow up on their vitamin levels periodically.

Klebsiella pneumoniae can be defined as one of the virulent pathogens with a high level of antibiotic resistance. The goal of the presented work was to see if Capsicum annuum L. juice has antibacterial activity against K. pneumonia, a bacteria seen in respiratory tract infections.

Fifty respiratory tract infections have been collected that include such bacterium’s resistance to some antibiotics, the qualitative detection of C. annuum L. juice effective groups, the minimal inhibitory concentration of C. annuum L. juice, and the inhibition activity against the growth of K. pneumoniae, and its cytotoxicity was studied.

The cultural results showed that 12 (24%) isolates were related to K. pneumonia, and the associated virulence factors with K. pneumonia pathogenicity are capsule, hemolysin, urease, biofilm production, and β-lactamase production. All isolates showed resistance to 100% Ampicillin and indicated that juice contained high percentages of active compounds. The minimal inhibitory concentration value of C. annuum L. was 6.25mg/mL for the bacterial isolates related to K. pneumoniae. There has been a considerable difference at p≤0.050, while the cytotoxicity shows that Juice C. annuum L. has no cytotoxic activity against human red blood cells.

Antibacterial activity of C. annuum L. juice increases with the increase of its concentration, and it is possible to use it as an adjunct treatment to eliminate or reduce the growth of some pathogens.

The aim of the present study was to investigate the causal modeling of death anxiety in veterans with post-traumatic stress disorder based on cognitive emotion regulation strategies and experiential avoidance with the mediating role of coping self-efficacy.

The research method was descriptive and structural equations. The statistical population of the present study consisted of all veterans with PTSD who were admitted to Isar Psychiatric Hospital in Ardabil in 2019, from which 200 people were selected by the available sampling method. Data collection tools included Templer Death Anxiety Scale, Cognitive Emotion Regulation Questionnaire- a short 18-item version, Acceptance and Action Questionnaire and Coping Self-Efficacy Scale. Data were analyzed using structural equation modeling.

Based on the results, cognitive emotion regulation strategies, experiential avoidance and coping self-efficacy have a direct effect on the death anxiety in veterans with post-traumatic stress disorder; also, cognitive emotion regulation strategies and experiential avoidance have an indirect effect on the death anxiety in veterans with post-traumatic stress disorder through coping self-efficacy (p<0.05).

Therefore, cognitive emotion regulation strategies, experiential avoidance and coping self-efficacy play an important role in the death anxiety in veterans with post-traumatic stress disorder and targeting these three components by psychological therapies can be effective in reducing the death anxiety in veterans with post-traumatic stress disorder.

The aim of the current research was to investigate the effect of aluminum exposure on humoral immunity (immunoglobulin G and immunoglobulin M serum levels), function enzymes, and histological alterations in the liver of rats.

Sixteen albino male rats at fifteen weeks were grouped into four groups, and administered with aluminum chloride at 35g/Kg of body weight for 8, 12 and 16 weeks, while the control group was fed with a normal diet for 16 weeks. The rats were anesthetized, blood was collected, and serum separated for estimation levels of immunoglobulin G, immunoglobulin M, alanine aminotransferase (also called transaminase) and alkaline phosphatase, then rats were sacrificed, livers isolated and divided into two parts; the first was used for micronucleus (MN) assay, and the second was subjected to histopathological examination.

There was a significant increase (p<0.01) of sera immunoglobulin G and immunoglobulin M amongst all treated groups compared with the control group. There was a significant elevation in alanine aminotransferase and alkaline phosphatase levels among all case groups as compared with the control. The results of the histopathological examination showed different alterations according to the period of aluminum chloride administration, such as decomposition and degeneration of hepatocytes, presence of fibroblast and lymphocytes infiltration with thickening wall of the blood vessel, increase kupffer cells, necrotic foci, haemosiderin in hepatocytes sinuses, congestion with polymorphonuclear leukocyte infiltration within central.

The aluminum chloride administration causes significant histological alteration in immunoglobulin G, immunoglobulin M, liver tissue rates, and an increase in micronucleus frequency as well as changes in levels of liver function enzymes such as alanine aminotransferase and alkaline phosphatase.

Chronic diseases strongly affect the severity of infection and mortality in patients with COVID-19. High levels of ferritin also indicate the severity of the disease and may indicate the presence of secondary infections among patients. The aim of this study was to compare ferritin levels in diabetic patients with COVID-19 and non-diabetic patients with COVID-19 based on age and gender groups.

This descriptive cross-sectional study was conducted on 64 patients with COVID-19 and 26 people without COVID-19 referred to the Najaf Hospitals, Najaf, Iraq. Samples were selected by available sampling method. Clinical tests and laboratory diagnosis were used to investigate the subjects.

In diabetic patients with COVID-19, the highest level of ferritin was in the age group of 51-65 years and the lowest level of ferritin was in the age group of ≤20 years. In non-diabetic patients with COVID-19, the highest level of ferritin was in the age group of 66-80 years and the lowest level was in the age group of ≤20 years. In diabetic patients with COVID-19, ferritin levels were higher in women than men. However, in non-diabetic patients with COVID-19, ferritin levels were higher in men than women. There was no significant difference between the disease groups in terms of ferritin production based on age groups and gender (p>0.05).

Serum ferritin levels increase in diabetic patients with COVID infection than in non-diabetic COVID-19 patients, and the elderly produce higher levels of ferritin. Also, in diabetic patients ferritin levels increase in women more than men with COVID-19.

 Today, pension funds have a key role in providing living expenses and improving the level of social welfare of the elderly. This study aimed to investigate the status of insurance coverage and support for the elderly in the Iranian provinces using developmental indicators and investigate the level of providing insurance and pension for the elderly in the provinces based on the level of development in infrastructure and technical, economic, production, cultural and social dimensions. 

 The research method is a secondary analysis, which examines the status of insurance and supports pension coverage for the elderly in Iran and compares it with provincial development indicators in infrastructure and technical, economic and production, and cultural and social areas.

 Kohkiluyeh and Boyer-Ahmad Province ranked first in providing insurance coverage and pension support for the elderly. Kohkiluyeh and Boyer-Ahmad had 28th, 20th, and 8th ranks in development, infrastructure and technology, and economic and production indicators. Sistan-Baluchestan and Lorestan provinces had the second and thirsty ranks in insurance coverage and pension support for the elderly. The ranks of Sistan & Baluchestan in terms of infrastructure and technical, economic and production, and cultural and social indicators were 26, 26, and 9, respectively. The ranks of Lorestan in terms of infrastructure and technical, economic and production, and cultural and social indicators were 24, 19, and 30, respectively.

 There are many differences between the provinces of Iran in terms of pension coverage, insurance, and support according to development indicators. Lack of access to social services and support is an obstacle to economic and social development. The distribution of development resources in the provinces does not follow a unique pattern, and the provinces' situations are different. Therefore, development in the country's spatial structure cannot be expected to be uniform.

The main purpose of this study was to investigate the leveling of barriers to the development of sports volunteering for the disabled in Iran using a structural-interpretive model.

It was performed based on the purpose of applied research and in terms of data collection by the exploratory mixed method. Participants included professors of sports management, managers, and specialists in the field of the disabled and volunteering in the country. Data collection tools were semi-structured interviews and structural self-interaction matrix questionnaires. In the first part, the data were organized using the thematic analysis method and in the form of basic, organized and comprehensive themes. Also, using the interpretive structural model, the identified obstacles were classified.

The results showed that barriers to the development of sports volunteering for the disabled as a comprehensive theme include 54 basic themes and 8 organizing themes which were classified into 3 levels and based on the results of lack of material and spiritual support for disabled volunteering, poor management of sports organizations, Ignorance of laws and macro-politics, non-compliance of sports facilities with the disabled are in the first level and are considered the most important obstacles. Also, in the second level, there is inappropriate media coverage, and in the last level, there are individual restrictions, inappropriate position of volunteering in Iranian sports, and a negative attitude towards the abilities and competencies of the disabled.

By focusing on removing the identified barriers, we can help a lot in the development of social capital as well as the effectiveness of the performance of sports organizations.

The link between Acute Lymphoblastic Leukemia (ALL) susceptibility to Human Leukocyte Antigen (HLA) may reveal information about the development of leukemia in combination with other risk factors. This study aimed to compare the most frequent -DQA1 and -DQB1 alleles in ALL patients with healthy individuals.

In this case-control study conducted during 2020-2022, 50 children with ALL aged between 1-15 years and 50 sex and age-matched controls were investigated. Patients were diagnosed by a specialist physician in the Oncology Unit of Basrah Children's Hospital, Iraq. Blood samples were collected from patients and controls for DNA extraction and further work with HLA-DQA1 and –DQB1 genotyping and sequencing.

Out of 50 patients with ALL, the highest percentage was B-ALL (92.0%) and the lowest percentage was T-ALL (8.0%). Two alleles of DQA1 including the 0201 allele and 040101 allele showed high frequency. One allele among HLA-DQA1 alleles appeared in IMTG/HLA as a new variant (03*new). Regarding DQB1, two alleles showed significant association with ALL but in the opposite way. The allele 030201 showed high frequency (33.33%) in controls, while 060301 indicated high frequency (20%) in ALL patients. Among the results of DQB1, two alleles showed new variants and were present in both patients and controls (03*new and 06*new).

By The HLA-DQA1 alleles (0201 and 03*new) and the HLA-DQB1 allele (060301) have a high frequency in ALL Patients. Also, new variants have appeared in all patients and controls during HLA-DQB1 typing (03*new and 06*new).

Breast cancer is the most common type of cancer among women worldwide, that Because of their lengthy life expectancy, these individuals are at increased risk of having second primary malignancies in their lifetime. The aim of this study was to compare the concentrations of trace elements in women with breast cancer and lung cancer and healthy women.

In this descriptive study, women with breast cancer (n=44), lung cancer (n=44) and healthy individuals (n=80) were sampled in Najaf city, Iraq. Blood samples were taken from the subjects, then copper, zinc and nickel levels were assessed.

Serum Cu levels in women with lung cancer and healthy women were significantly lower than women with breast cancer (p<0.05). Furthermore, serum Cu levels in women with lung cancer were significantly lower than healthy women (p<0.05). Healthy women had the highest levels of zinc and nickel compared to the groups of women with breast cancer and lung cancer (p<0.01). Moreover, serum zinc and nickel levels were significantly higher in women with lung cancer compared to women with breast cancer (p<0.05).

Serum concentrations of trace elements increase in some groups and decrease in others, and there is a link between some elements that can be used as a means of early detection.

Inflammatory conditions are probably implicated in the pathophysiology of diabetic retinopathy. This study aimed to investigate the levels of monocytes chemoattractant protein-1 and interleukin-8 in patients with diabetes mellitus and diabetic retinopathy and to indicate whether these chemokines can predict diabetic retinopathy or not.

One-hindered fifty individuals were recruited in this study from Najaf city, Iraq. They were divided into three groups 50 diabetes mellitus diabetes mellitus patients, 50 non-proliferative diabetic retinopathy patients, and 50 healthy control. Enzyme-linked immunosorbent assays were used to assess monocytes chemoattractant protein-1 and interleukin-8 along with other spectrophotometric methods for determining other biomarkers.

The results indicate a significant difference (p<0.0001) in monocytes chemoattractant protein-1 and interleukin-8 between patients and healthy control and only monocytes chemoattractant protein-1 was a significant difference (p<0.0001) between diabetes mellitus and non-proliferative diabetic-retinopathy group. A correlation study revealed a significant positive correlation between chemokines and duration of illness (monocytes chemoattractant protein-1: rho=0.684, p<0.0001, interleukin-8; rho=0.704, p<0.0001). besides these chemokines also showed a significant direct correlation with HbA1c. Regression analysis showed a large effect size of these chemokines in predicting inflammatory conditions and diagnosis of diabetes mellitus. In addition, the level of monocytes chemoattractant protein-1 appears to predict patients with non-proliferative diabetic retinopathy.

Elevated levels of monocytes chemoattractant protein-1 and interleukin-8 in patients with diabetes mellitus suggest the implication of these chemokines in the pathophysiology of the disease and one of the contributors to developing complications such as diabetic retinopathy. Besides monocytes chemoattractant, protein-1 may predict the early stage of diabetic retinopathy.

Osteopenia describes a decrease in bone mineral density below normal reference values, yet not low enough to meet the diagnostic criteria for osteoporosis. The aim of this study was to compare the levels of vitamin D, vitamin D receptor and vitamin D binding protein in women with osteoporosis and osteopenia.

This descriptive study was conducted on 110 postmenopausal women aged 52 to 73 years who referred to Baghdad Medical City Hospital from January 2021 to October 2021. Subjects were divided into three groups based on T-score

control, osteopenia, and osteoporosis. Blood samples were collected from each participant to assess biochemical tests and dual energy X-ray absorptiometry used to diagnose osteoporosis.

There was no significant difference in vitamin D and vitamin D receptor levels between the groups (p>0.05). Vitamin D binding protein level in healthy group was significantly higher than osteoporosis group (p=0.005), and DBP level in osteopenia was significantly higher than osteoporosis (p=0.001), but there was no significant difference between healthy and osteopenia groups (p=0.53). Differences between groups were significant in terms of bone mineral density (p<0.001).

Comparison of levels of vitamin D, vitamin D receptor, and vitamin D-binding protein among women with osteoporosis and osteopenia, despite differences between the two groups in bone mineral density, does not show a significant difference.

Colorectal cancer was currently the most frequent malignant cancer of the gastrointestinal system, accounting for 13% of all malignant tumors, and it is the second most common cause of death from cancer worldwide. Aim of study was to clarify the relationship between β-catenin levels in sera, some clinical and pathological variables in Colorectal cancer patients, as well as explore the link between this biomarker and disease diagnosis and progression.

The current study included (55) Colorectal cancer patients and (35) healthy subjects. ELISA was used to calculate serum β-catenin in order to study the relationships between this biomarker and gender, age, histological type, stages, grades, tumor site, and body mass index.

Results showed a significant increase in the levels of β-catenin of Colorectal cancer patients in comparison with the control group (p<0.05). In parallel, no significant correlations have been found in β-catenin levels with all clinical parameters covered by the study (p>0.05).

β-catenin is a less sensitive marker for Colorectal cancer in the detection and prognosis of the advanced stages of cancer.

Adiponectin is associated with obesity and unregulated diabetes, although it may be useful considering the consequences of glycemic control and obesity on Adiponectin. This study investigated the association between Adiponectin, Adiponectin Receptor, and Obesity for Diabetic Female Type II.

In this research, 54 female patients with type 2 diabetes and 36 non-diabetics participated, individuals from two groups, obese and non-obese, compared with apparently healthy control. The Adiponectin and Adiponectin receptor were measured by ELISA sandwich and Colorimetric methods were used for calculating fasting blood glucose. Blood samples were collected and drawn (5 ml) for each individual. For statistical analysis, SPSS 26.0 by ANOVA and Pearson's correlation coefficients were used.

Adiponectin and the Adiponectin receptor were measured, and the values of both were decreased in patients with type 2 diabetes who have the highest FBG, and also decreased for obese females, which have the highest BMI, where the positive significant values were observed when correlated body mass index (r=-0.57, p=0.001), and fasting blood glucose (r=0.291, p=0.0.06), while a negative correlated observed between Adiponectin receptor (r=-0.59, p=0.203) and Adiponectin (r=-0.201, p=0.158).

The adipo levels, which consider a pro-inflammatory marker for obesity enhance complications such as metabolic syndrome, insulin resistance, ischemic heart disease, and diabetic renal disease for women obese diabetes patients compared with non-obese diabetes patients.

This study aimed to investigate the role of Interleukin-6, C-reactive protein, and Nitric oxide synthase in obese, diabetic, and sub-fertile men.

The current study was conducted in some health centers in Misan province, Iraq, from December 2020 to July 2021. The whole sample included 80 men aged 35-45 years, divided into four groups (20 men/group). Eight to ten milliliters of venous blood samples were drawn at 9 - 11 am, using a disposable needle and plastic syringes for each man. The blood was left at room temperature for 15 minutes for coagulation, centrifuged at 3000rpm for 5 minutes, then serum and plasma were separated and transferred for storage. Statistical analysis was performed by IBM SPSS 23 using ANOVA.

Results revealed: Interleukin-6 increased significantly (p<0.05), except in the diabetic group, in different groups in comparison with the control, C-reactive protein increased significantly (p<0.05) in different groups in comparison with the control, Nitric oxide synthase decreased significantly (p<0.05), except in sub-fertility group, in different groups in comparison with the control.

The Interleukin-6 and C-reactive protein increment and Nitric oxide synthase reduction in different groups might be indicated a pro-inflammatory action and low fertility in obesity, diabetic and sub-fertility groups.

Bone defect repair is still a serious clinical orthopedic issue. To preserve skeletal integrity, bone is a highly vascularized tissue that relies on a close spatial and temporal interaction between blood vessels and bone cells. The aim of the study was to see if the local application of vitronectin protein /angiopoietin-like 4 protein as an autoinducer could help with bone repair.

In this study, 48 albino male rats weighing 300-400 grams and aged 6-8 months were employed under temperature, drinking, and food consumption control conditions. The animals were subjected to a surgical procedure on the medial side of the tibiae bone. In the control group, the bone defect was treated with a local application of an absorbable hemostatic sponge, whereas in the experimental group, which was divided into three subgroups, a group I the bone defect was treated with a local application of 1mg vitronectin protein, group II with a local application of 1mg angiopoietin-like 4 protein, and group III with a local application of a combination of the two (0.5mg vitronectin protein and 0.5 mg of angiopoietin-like 4). The absorbable hemostatic sponge was used to fix all of the experimental groups. 14 and 28 days following surgery, the rats were slaughtered (six rats for each period).

In comparison to other groups, bone defects treated with local application of both vitronectin and angiopoietin protein exhibit new bone formation with a high bone cell count and high bone architectures in terms of trabecular number, bone marrow area, and bone marrow space.

The findings of this investigation revealed that a combination of vitronectin and angiopoietin-like proteins exhibited potential efficacy in boosting bone defect healing.

Some trace element concentrations could also influence the development of lung cancer. This study aimed to identify certain trace minerals in serum in Iraqi patients with lung cancer and investigate the distribution of these elements compared to healthy people.

This study was carried out on 100 subjects, including the healthy group (n=35) and the lung cancer patient group (n=65), whose blood samples were kept in the Imam Hussein Center for Cancerous Tumors in Karbala Governorate, Iraq, in 2021. The samples were selected using a simple random sampling method. The level of zinc, copper lead, and cadmium were measured using the Flame Atomic Absorption Spectrophotometer 6300. The data was analyzed using SPSS 20 software through independent T, ANOVA, Pearson, and Tukey HSD tests.

There was a significant difference between the serum concentration of Pb, Cu, Cd, and Zn between the healthy males with lung cancer males, and in Cd, and Zn between the healthy females with lung cancer females (p<0.05). Whereas, no significant difference was found between the Pb and Cu serum in healthy and lung cancer females (p<0.05). The results of ANOVA showed a significant difference in the serum concentration of minerals between the healthy and lung cancer subjects (p<0.05).

Serum zinc levels are lower in lung cancer patients than in healthy subjects, whereas serum lead, cadmium, and copper are higher in lung cancer patients than in healthy subjects.