Cough-Induced Rib Fracture in a Postmenopausal Woman Without Clinical Evidence of Osteoporosis: A Case Report.

Cough-induced rib fractures are rare conditions and are seldom reported in the medical literature. This case involves a 54-year-old postmenopausal woman who experienced a persistent dry cough lasting 16 days, which progressed to acute, localized chest pain in the right hemithorax. Symptoms started after an initial chest infection.

Tranexamic Acid in Pregnant Women With Placenta Previa: A Double-Blind, Multicenter Randomized Clinical Trial.

Aims: To determine the effectiveness of tranexamic acid (TXA) in reducing vaginal bleeding, extending pregnancy duration, and enhancing perinatal outcomes in pregnant women with placenta previa.

Methods: A multicenter, randomized, double-blind clinical trial was conducted at three maternity teaching hospitals in Iraq's Kurdistan region, Azadi Hospital in the north of Iraq, and Al-Azhar University Hospital in Egypt on 146 women with placenta previa. Participants were randomly assigned to two interventional groups in a 1:1 ratio to receive either TXA or Dextrose 5% water (D5W).

Mode of Presentation of Hypertension in a Group of Hypertensive Patients in Erbil.

Background Hypertension is a major public health problem, and it remains the major preventable cause of cardiovascular and all-cause mortality worldwide. Most cases are asymptomatic and discovered incidentally. Objectives The objective of this study is to identify (i) the proportion of hypertensive patients diagnosed incidentally and those diagnosed due to symptoms, (ii) the most common symptoms among patients that present with symptoms, (iii) the presentation of acute elevations of blood pressure in hypertensive patients, and (iv) hypertension-related symptoms affect compliance with medications.

Students and examiners perception on virtual medical graduation exam during the COVID-19 quarantine period: A cross-sectional study.

Background: With the emergence of the COVID-19 pandemic and lockdown approach that was adopted all over the world, conducting assessments while maintaining integrity became a big challenge. This article aims at sharing the experience of conducting an online assessment with the academic community and to assess its effectiveness from both examiners' and students' perspectives.

Methods: An online assessment was carried out for the final year medical students of Hawler Medical University/Iraq during the lockdown period of the COVID-19 pandemic, June 2020.

Umbilical vein injection of 400 versus 800 μg misoprostol for the treatment of retained placenta: A multicenter, randomized double-blind controlled trial.

Aims: This trial was conducted to determine the efficacy of umbilical vein injection of 400 versus 800 μg misoprostol to deliver retained placenta and to compare both regimens regarding the time of placental delivery and amount of vaginal blood loss.

Methods: A double-blind, multicenter randomized clinical trial was undertaken in four teaching hospitals in the North of Iraq and Al-Azhar University Hospital in Egypt, from March 2016 to May 2019. Group I (274 women) received 400 μg misoprostol and group II (249 women) received 800 μg misoprostol.

Effect of a Formative Objective Structured Clinical Examination on the Clinical Performance of Undergraduate Medical Students in a Summative Examination: A Randomized Controlled Trial.

Objective: To study the effect of formative Objective structured clinical examination (OSCE) on the undergraduate medical students' performance in a subsequent summative-OSCE assessment.

Methods: In a randomized single-blind trial, 130 fifth year medical students at Raparin hospital, Erbil were assigned to intervention (n=61) and control group (n=69). Formative-OSCE was performed for the intervention group in pediatric module with feedback on their performance versus standard pediatric module for the control group.

Screening for depression during pregnancy using the Kurdish version of the Edinburgh Postnatal Depression Scale in Erbil city.

We aimed to determine any difference in the prevalence rate of depression during the three trimesters of pregnancy and its association with certain obstetric risk factors. In total, 1000 pregnant women attending primary health centers in the city of Erbil, Kurdistan, Iraq were assessed for depression using the Edinburgh Postnatal Depression Scale. Women in the first and second trimesters had a significantly higher probability of depression than those in the third trimester.

Major Determinants of Maternal Near-Miss and Mortality at the Maternity Teaching Hospital, Erbil city, Iraq.

Objectives: To find out the major determinants of maternal near-miss (NM)and maternal deaths (MDs) in Erbil city, Iraq, by comparative analysis of maternal NMs and MDs.

Methods: We conducted a hospital-based cross-sectional study in the Maternity Teaching Hospital in Erbil city from 1 June to 31 December 2013. All MDs and NMs that occurred in the hospital during the study period were included in the study.

Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria.

Purpose: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disturbances in women and is divided into different phenotypes. The aim of study is to compare the clinical and hormonal parameters among the four phenotypes of PCOS based on the Rotterdam criteria and with control group.

Methods: Women with PCOS (n = 263) confirmed based on the Rotterdam criteria and 263 women with no evidence of PCOS were recruited as controls using observational case-control study.

A qualitative assessment of faculty perspectives of small group teaching experience in Iraq.

Background: Although medical colleges in Iraq started recently to increasingly use small group teaching approach, there is limited research on the challenges, opportunities and needs of small group teaching in Iraq particularly in Kurdistan Region. Therefore, this study was aimed to assess the small group teaching experience in the 4(th) and 5(th) year of study in Hawler College of Medicine with a focus on characterizing the impressions of faculty members about how small group teaching is proceeding in the college.

Methods: A qualitative study based on semi-structured interviews with 20 purposively selected faculty members was conducted.

Bemiparin versus enoxaparin as thromboprophylaxis following vaginal and abdominal deliveries: a prospective clinical trial.

Background: Venous thromboembolism (VTE) is a leading cause of maternal mortality and morbidity, with the highest incidence occurring during the postpartum period. This study compared the ability of two types of low-molecular-weight heparin, enoxaparin and bemiparin, to decrease the incidence of VTE following elective caesarean section, emergency caesarean section, and vaginal delivery in women who had risk factors for thromboembolism.

Methods: In this prospective clinical trial using a sequential group allocation method, 7020 haemodynamically stable women delivered vaginally or abdominally at the Maternity Teaching Hospital, Kurdistan region, Erbil, Iraq, between May 1, 2012, and November 1, 2013.

A case-control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria.

Background: Polycystic ovary syndrome (PCOS) is associated with an increased risk of insulin resistance (IR), metabolic syndrome (MetS), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). Metabolic aspects of the four PCOS phenotypes remain to be fully defined. The aim of this study was to compare metabolic parameters and insulin resistance among the four PCOS phenotypes defined according to the Rotterdam criteria and to determine predictors of these complications.

Ovarian reserve markers and assisted reproductive technique (ART) outcomes in women with advanced endometriosis.

Background: The role of ovarian reserve markers as predictors of the controlled ovarian stimulation (COS) response in intracytoplasmic sperm injection (ICSI) cycles in women with endometriosis has been much debated. The aim of the present study is to assess the predictability of ovarian reserve markers for the number of mature oocytes (MII) retrieved and to assess the pregnancy rate and live birth rate in women with advanced endometriosis.

Methods: Two hundred eighty-five infertile women who had laparoscopy followed by a first ICSI cycle were recruited in this prospective study.

Using Q-methodology to explore people's health seeking behavior and perception of the quality of primary care services.

Background: Information on health seeking behavior and beneficiaries' perception of the quality of primary care can help policy makers to set strategies to improve health system. With scarcity of research on this particular field in Iraqi Kurdistan region, we sought to explore the patterns of health seeking behavior and perception of the quality of primary care services of a sample of population.

Methods: This explorative study was carried out in Erbil governorate, Iraq.

Intimate partner violence against women in the Erbil city of the Kurdistan region, Iraq.

Background: Violence against women is a worldwide problem and serious human rights abuse that occurs among all social, cultural, economic and religious groups. There is a paucity of research on intimate partner violence against women in Iraq, particularly in the Kurdistan region. This study assessed the prevalence of emotional, physical and sexual intimate partner violence against women and the impact of physical violence in Erbil, the main city of the Iraqi Kurdistan region.

Female genital mutilation among Iraqi Kurdish women: a cross-sectional study from Erbil city.

Background: Iraqi Kurdistan region is one of the areas where female genital mutilation is reportedly widely practiced but inadequately studied. The aim of this study was to determine (i) the prevalence of female genital mutilation among Muslim Kurdish women in Erbil city, (ii) the patterns and types of female genital mutilation, (iii) the factors associated with this practice and (iv) women's knowledge and attitudes towards this practice.

Methods: A cross-sectional study was conducted in the primary health care centers and the Maternity Teaching Hospital in Erbil city, involving 1987 women aged 15-49 years.

Post-conflict health reconstruction: where is the evidence?

In the context of the CARA Iraq Research Fellowship Programme, staff from Hawler Medical University in Erbil, Iraq and the London School of Hygiene and Tropical Medicine in the UK collaboratively conducted a multimodal research project analysing challenges and opportunities for reform of the primary care system in Iraq. Through a mix of quantitative and qualitative methods a range of challenges were identified, both in terms of services offered and the utilisation of those services. The collaborative study proved positive in terms of direct research outcomes, in boosting academia with skill development and use of new methodologies, and in reengaging displaced Iraqi academics.

The range and diversity of providers' viewpoints towards the Iraqi primary health care system: an exploration using Q-methodology.

Background: The increasingly recognized need for reorganizing the primary health care services in Iraq calls for a comprehensive assessment of the system to better understand its problems and needs for development. As part of such comprehensive assessment and due to the important role of primary health care providers in adopting any change, we ought to explore the range and diversity of viewpoints of primary health care providers towards the Iraqi primary health care system.

Methods: This explorative study was carried out in Erbil governorate, Iraq from May to July 2011.

Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

Background: As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system.

Methods: A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement.

Association of violence against women with religion and culture in Erbil Iraq: a cross-sectional study.

Background: Violence against women by intimate partners is still a public health problem. The study aims at finding out the prevalence of violence among women residing in Erbil city (Muslim culture) and in Ankawa sub-district (Christian culture), finding out the role of religion and culture on the prevalence, and finding out some other factors (like occupation of husband and wife, age at marriage, woman agreement for marriage, illegitimate relations of husband) that might be associated with violence.

Methods: A cross-sectional study was carried out in Erbil during the second half of the year 2011.

Teaching methods in Hawler College of Medicine in Iraq: a qualitative assessment from teachers' perspectives.

Background: Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning.

Methods: A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted.

A qualitative assessment of the Iraqi primary healthcare system.

With the limited availability of empirical and documented knowledge about the Iraqi primary healthcare (PHC) system, this study aimed to identify the main problems facing the Iraqi PHC system and the priorities for change. A qualitative study based on a self-administered questionnaire survey involving 46 primary care managers, public health professionals and academics was conducted in Erbil, Iraq. The questionnaire addressed participants' views on positive aspects, problems, priorities and barriers to change of the PHC system through seven open questions.

Effect of thrombolytic therapy on the incidence of early left ventricular infarct expansion in acute anterior myocardial infarction.

Objectives: To determine the incidence of early left ventricular infarct expansion within five days after first anterior ST-segment elevation myocardial infarction and the effect of early thrombolytic therapy on the incidence of early infarct expansion compared with late thrombolytic therapy.

Methods: In a prospective study of 101 patients (75males and 26 females), with the first attack of acute anterior myocardial infarction, their ages ranged from 40-80 years (mean age: 61.07±10.

Screening for postpartum depression using Kurdish version of Edinburgh postnatal depression scale.

Background: One of the important public health problems affecting maternal and child health is postpartum depression (PPD). It generally occurs within 6-8 weeks after childbirth.

Objectives: To determine the prevalence of postpartum depression (PPD) using a Kurdish version of Edinburgh postpartum depression scale (EPDS) and to analyze the risk factors for postpartum depression in a population of puerperal Kurdish women in Erbil city.