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Abstract : Even with advent of modern diagnostic tools, misdiagnosis of appendicitis has remained more or less constant. Percentage of misdiagnosis is higher among women than men and children than adults. We aimed to validate importance of AIR score in diagnosing acute appendicitis and comparing it with Alvarado score. This case series study was done in emergency and surgical department of Al- Kindy Teaching Hospital- Baghdad-Iraq during a period extended from second of January /2016 to 30/July/2017 were convenient sample of patients attended emergency unit suffering from acute abdominal pain with suspicion of acute appendicitis. Appendicitis inflammatory score (AIR) (at score>4) in comparison with Alvarado score (at score >4) shows that former has good statistical points of discrimination for diagnosing patient with acute appendicitis, with a sensitivity of 91%, and outclass Alvarado score, with a sensitivity of 83%. AIR versus Alvarado score former outperform result obtaining by later one in children below 12 year old with a sensitivity and specificity of 88% and 61%s respectively for AIR score (score >4), and a sensitivity and specificity of 41% and 61% respectively for Alvarado score (score >4). White cell count can be normal or low as a result of lymphopenia or sepsis. C - reactive protein (CRP) concentrate is a powerful indicator of appendicitis particularly complicated cases. CRP demonstrates a sensitivity of 85% and specificity of 69%. Rebound tenderness was demonstrated in 63% individuals in present study. This study validates AIR score in diagnosing acute appendicitis and exceeds Alvarado score.

Abstract : Sodium-glucose co-transporter two inhibitors (SGLT2) present a growing area in the treatment of heart failure. In the literature, the primary focus has been given on the treatment of heart failure in patients with reduced ejection fraction (HFrEF) in other words, (LVEF <40). Several exploratory trials assess the efficacy of SGLT2 inhibitors in the treatment of heart failure with preserved ejection fraction (HFpEF), that is LVEF ≥ 40. We aimed to systematically analyze the effect of SGLT2 inhibitors on HFpEF patients including the primary and secondary outcomes of this therapy. A systematic review and meta-analysis of randomized controlled trials on SGLT2 inhibitors in HFpEF patients has been performed. MEDLINE, EMBASE, PubMed, SCOPUS, and Cochrane databases were searched for trials published up to March 31, 2022. Data was extracted from published studies, and quality assessment was performed as per Cochrane recommendations. Standard mean differences and risk ratios were calculated using the Cochrane handbook for a pooled analysis of the trials. Out of the identified 9,982 database results, 10 randomized trials were included in this meta-analysis. Primary outcomes measured included increased exercise endurance from baseline, the change in the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) responses and outcomes from baseline, all-cause mortality, and the risk of adverse effects. The pooled analysis revealed a standard mean difference of -0.51[-0.60, -0.41], -0.36[-0.78, 0.05], respectively, for exercise endurance and KCCQ-12 responses. Pooled analysis of the risk ratios of 0.97[0.88, 1.07] revealed a minimal reduction of all-cause mortality in the SGLT2 treatment intervention group compared to placebo. A documented risk ratio of 0.97(0.87, 1.08, CI,95%) posed concerns about the safety levels of SGLT2 inhibitors. Heterogeneity across the analysis was insignificant, P<1. The review noted a significant association between SGLT2 inhibitor therapy and improved exercise endurance and KCCQ-12 response. Overall, SGLT2 inhibitors can remarkably reduce heart failure-related hospitalization and urgent hospital visits in HFpEF patients.

Abstract : Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause serious illness and even death. L. monocytogenes mainly affects people who are predisposed due to an underlying immune system condition, such as cancer or AIDS, as well as other susceptible people like the elderly, pregnant women, newborn babies, or foetuses. The condition has flu-like symptoms, but it can lead to serious complications such meningitis, septicaemia, abrupt abortion, or neonatal listeriosis .L. monocytogens remains of great public health concern due to its high mortality rate and lack of accurate detection and identification methods used in the laboratories. However, the VITEK® 2 analyzer system was previously used for biochemical identification of many bacterial strains. Also, the ability of PCR-based method to identify the high-risk L. monocytogenes is an important strategy that could help in diagnostic of such pathogen in the laboratories. Therefore, in this study, the VITEK® 2 analyzer system and a PCR-based method for rapid and sensitive detection of L. monocytogenes in twenty samples of stool collected randomly from diarrhea patients were used. Our results detected the presence of L. monocytogenes in twelve stool samples, which conformed by VITEK® 2 analyzer system and PCR based-method. In more details, the results of VITEK® 2 analyzer system showed that twelve samples gave 91% matching to L. monocytogenes. In addition, the PCR results of the twelve samples gave clear bands with 320 bp in size (Amplicon length). We concluded that the VITEK® 2 analyzer systems is very important method for biochemical identification of L. monocytogenes, and the PCR technique is very specific and useful molecular method in diagnosis of L. monocytogenes infections.

Abstract : The coronary artery wall consists of three coats differently developed: tunica intima, tunica media, and tunica adventitia. The intima consists of a lining of endothelial cells, and a subendothelial layer. The intima is separated from the media by the internal elastic lamina, while the media consists of multiple layers of smooth muscle cells, collagen and elastic fibers. An external elastic lamina, considerably thinner than the internal elastic lamina and composed particularly of elastin, separates media from adventitia. Tunica adventitia consists of a significant amount of fibrous tissue, particularly collagen and elastic fibers oriented longitudinally. The current study aims to describe the histological structure of the coronary artery among different ages in Kirkuk governorate. Twenty hearts of twenty normal Iraqi adults, with age ranged from 40-70 years were taken from the forensic medicine department of Kirkuk Teaching Hospital in the Azadi region during the period from September 2021 to June 2022. Histological study showed that the inner diameter in left coronary artery was 3.4±0.5 mm and in right coronary artery was 2.9±0.6 mm. The tunica intima was made up of one layer of endothelial cells and was supported by the internal elastic lamina. Thickness of tunica intima of left coronary artery was 95.6±46.4 μm and of right coronary artery was 52.0±29.1 μm. The tunica media consisted of multiple layers of smooth muscle cells and connective tissues (elastic fibers, collagen and proteoglycans). Thickness of tunica media of left coronary artery was 129.8±49.4 μm and of right was 100.3±35.2 μm.

Abstract : Menstrual irregularities pose serious problems for women's quality of life and contribute to anxiety in reproductive age group and many underlying reasons responsible for this and the most important one changes in the BMI so this study aim to found if menstrual irregularities effected by BMI. In a cross-sectional study, 91 women who were admitted to an outpatient clinic served as the participants. The three categories employed in this study were: underweight (<18.4kg/m2), normal weight (18.5-22.99kg/m2), overweight (23-27.49kg/m2), and obese (over27.50kg/m2). To analyze the effects of various factors on these groups, estimates of the number, percentage, proportion, and chi-square were used. P-values less than 0.01 were considered to be very significant. According to our data, 12 women were underweight, while 7 women had a BMI under 30, making up the smallest category. A total of 46 women had an overweight body mass index. According to our findings, the age group of 18–29 years had the highest BMI (severe obesity). All age groups had low body weights (BMI 18.5) in equal percentage. Body mass index (BMI) and various age groups did not have a statistically significant association, p-value (0.536). With a p-value of 0.18, the association between BMI and dysmenorrhea was not statistically significant. There is no relationship between the various body mass index (BMI) categories and irregular menstrual cycles. Our data also revealed that there is no connection between BMI and menstrual cycles including (duration, amount of blood loss and dysmenorrhea) or between BMI and age of the various groups.