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Bulletin of National Institute of Health Sciences
Title : Risk factors of Gestational diabetes mellitus among pregnant women in Karbala city
Abstract :To determine the risk factor of gestational diabetes mellitus among pregnant women and compare them with the control group. The sample was gathered using (non-probability-convenient-sampling) and the sample size was 200 in Karbala city (Al-Hyndia hospital and The typical health center in Al-hyndia) (with 100 GDM patients and 100 non-GDM controls). The study started on 1 September 2019 to 1 April 2020. The data was gathered through a direct interview with a special questionnaire that included (age, education, occupation, parity, gravidity, diabetes mellitus history, etc.). According to the findings, the majority of cases of were (24.5 percent) for the age group (20-29) years. It was discovered that various essential characteristics, such as age, education level, and family history of diabetes mellitus, are connected with gestational diabetes mellitus. However, one factor that is not associated with gestational diabetes mellitus is smoking habit. The factors showed significant association with GDM are age, previous history of gestational diabetes, family history of diabetes mellitus, gravidity, parity, previous history of abortion, previous history of stillbirth, previous history of macrosomia, polycystic ovarian, type of previous delivery and previous history of hypertension. And factor not have significant associated with GDM is previous history of hypertension and smoking habit. All pregnant women should visit the hospital/clinic health post for antenatal check - ups and Screening for GDM must be performed compulsory to all pregnant mothers.
Title : The efficacy and safety of primary Retrograde Intrarenal Surgery (RIRS)
Abstract :Retrograde Intrarenal Surgery (RIRS) is an emerging minimally invasive method in the surgical treatment of kidney stones. It has rapidly become a preferred surgical technique owing minimally invasive surgical modality gap for small stones. The technique requires the simultaneous and effective use of laser energy, fluoroscopy, access sheaths, fiberoptic and digital technologies. The increasing experience with RIRS has created a tendency to simplify this complex process. There are several studies revealing that RIRS can be performed safely and effectively without these complex processes. Therefore the primary aims are to detect the safety and efficacy of the primary RIRS. From January 2022 to September 2022, the medical records of 58 patients who underwent RIRS for renal stones at Duhok hospitals prospectively evaluated. RIRS cases with stone sizes less than 25 mm and adult age group > 18 years with prior unstented ureters were included. Pediatric age patients, multi-stage procedures, documented ureteral strictures were excluded. Stone clearance rate; at the first session were 40 cases (68.97%) and at the Second session were 18 cases (31.03%). Complication rates; urosepsis 8 cases (13.79%), Ureteral contusion 4 cases (6.90%), and gross hematuria 4 cases (6.90%). The use of primary RIRS in unstented prior ureter is generally effective and safe and is not associated with higher complication rate.
Title : Molecular Diagnosis of Theileria spp. in Camels in Al-Diwaniyah province
Abstract :This study was conducted for detection of Theileria spp. in camels in different areas of Al-Diwaniyah province during period from September 2019 to February 2020. A total of 150 from blood samples and 25 lymph samples from camels were collected from both sexes and different ages. Theileria spp. in camels were detected by staining using Giemsa stain, Pathological changes of lymph nodes and molecular diagnosis. The parasite was found in forms ring, round and rod form inside the RBCs and macroschizonts (Koch's blue bodies) within lymphocytes in blood smears stained with Giemsa stain. the results of microscopically examination of blood smears showed that49 (32.6%). The results of microscopically examination of lymph smears stained by Giemsa stain observed which 7(28%) from total 25 camel's lymph node samples, that show the circular appearance of schizonts in shape. The histopathological changes of infected lymph nodes with Theileria spp. which showed increase number of lymphocyte, hyperplasia of lymphoblast with increase number of macrophage. According to the molecular study, out of 26(53.06%) of examined blood sample were positive result in conventional PCR technique. Sequencing of fragment of the of (18S rRNA) gene (592bp) separated from Al-Diwaniyah province referred to there are three species of Theileria from twenty PCR positive samples confirmed in camel including 17(85%) samples diagnosed as T. annulata, 2(10%) samples as T. equi and 1(5%) sample as T. lestoqaurdi. with highly significant difference at (P>0.01). T. lestoqaurdi. firstly reported in Iraq.
Title : The value of ultrasound examination at day of trigger in determining endometrial thickness and its role in predicting positive pregnancy test in a group of Iraqi infertile couples subjected to “intracytoplasmic sperm injection (ICSI)”
Abstract :Ultrasound examination at day of triggering is preferred to assess endometrial thickness since it’s a non invasive procedure. It has been found in various studies that thin endometrium is correlated to poor results in cycles of “intracytoplasmic sperm injection”. Nevertheless, the issue that endometrial thickness greater than certain cutoff value association with better ICSI outcome is still controversial and need further deep research work both clinically and experimentally. The goal of the current research is to evaluate the correlation of endometrial thickness evaluated by ultrasound examination to the outcome of ICSI cycles in a sample of Iraqi infertile women. The current cross sectional study included 290 infertile women undergoing ICSI cycles in a single fertility center in Iraq. We retrieved the clinical reports of those women from the archival pool present in this center. The following variables were reported: age of women, infertility duration, body mass index (BMI), type of infertility and thickness of endometrium estimated by ultrasound at day of trigger and result of pregnancy test. At the end of the study, positive pregnancy test was reported in 98 women out of 290 participants making the pregnancy rate at 33.8 %. Type of infertility, duration of infertility, body mass index and age were not significantly associated with pregnancy outcome (p > 0.05). Mean endometrial thickness in those with a pregnancy test that is positive was higher significantly than that of those with pregnancy test that is negative. The analysis of Receiver operating characteristic has been utilized to determine endometrial thickness cutoff value, figure 2 and table 3. The cutoff value was > 9.3 mm with 74.4 % accuracy level. Our study revealed that ultrasound examination at day of trigger of women undergoing ICSI is a valuable mean in determining positive pregnancy outcome by defining the thickness of endometrium and that endometrium thickness greater than 9.3 mm is the best predictor of positive ICSI outcome.
Title : The impacts of Health Insurance on Catastrophic Health Expenditure: A Systematic Review and Meta-analysis
Abstract :The medical insurance system has been designed to protect against catastrophic health expenditure (CHE) by reducing out-of-pocket health expenditures over the last few decades, but the protective effect has remained unknown. The purpose of this review was to examine the impacts of health insurance on CHE. The systematic review was carried out in accordance with the Cochrane Handbook and reported in accordance with PRISMA. From January 2000 to September 2022, we searched English literature databases such as PubMed, EMBASE, and Science Direct for empirical studies on the relationship between health insurance and CHE. Two reviewers were responsible for study selection, data extraction, and quality assessment. Meta-analysis and subgroup analysis were used to examine comparisons between articles with different types study design. A total of 710 citations were obtained, and finally 7 eligible studies with 37882 participants were included. The overall odds of CHE rate was lower (AOR= 0.41; 95% CI= 0.28-0.58; p< 0.0001) for people with health insurance compared with people without health insurance. To some extent, the existing health insurance plan has reduced the rate of CHE. More effort is required to control excessive medical demand and rising costs.
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