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.

Safety and immunogenicity following co-administration of Yellow fever vaccine with Tick-borne encephalitis or Japanese encephalitis vaccines: Results from an open label, non-randomized clinical trial.

Background: Flavivirus infections pose a significant global health burden underscoring the need for the development of safe and effective vaccination strategies. Available flavivirus vaccines are from time to time concomitantly delivered to individuals. Co-administration of different vaccines saves time and visits to health care units and vaccine clinics.

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.

Prevalence of Premenstrual Syndrome Levels and Its Management Among Female Students of Medical and Non-Medical Colleges in Riyadh.

Objective The purpose of this study is to measure the prevalence of premenstrual syndrome (PMS), its management, and its possible association with depression, anxiety, and stress among female medical and non-medical students. Methods A cross-sectional study was conducted at King Khalid University Hospital and King Saud University Female Campus. A self-administered questionnaire following the American College of Obstetricians and Gynecologists (ACOG) criteria was used to measure levels of PMS.

Safety and immunogenicity of the live attenuated intranasal pertussis vaccine BPZE1: a phase 1b, double-blind, randomised, placebo-controlled dose-escalation study.

Background: Long-term protection and herd immunity induced by existing pertussis vaccines are imperfect, and a need therefore exists to develop new pertussis vaccines. This study aimed to investigate the safety, colonisation, and immunogenicity of the new, live attenuated pertussis vaccine, BPZE1, when given intranasally.

Methods: This phase 1b, double-blind, randomised, placebo-controlled, dose-escalation study was done at the phase 1 unit, Karolinska Trial Alliance, Karolinska University Hospital, Stockholm, Sweden.

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.

PET Molecular Imaging of Phosphodiesterase 10A: An Early Biomarker of Huntington's Disease Progression.

Background: Changes in phosphodiesterase 10A enzyme levels may be a suitable biomarker of disease progression in Huntington's disease.

Objectives: To evaluate phosphodiesterase 10A PET imaging as a biomarker of HD progression using the radioligand, [ F]MNI-659.

Methods: The cross-sectional study (NCT02061722) included 45 Huntington's disease gene-expansion carriers stratified into four disease stages (early and late premanifest and Huntington's disease stages 1 and 2) and 45 age- and sex-matched healthy controls.

Substance use among high school students in Erbil City, Iraq: prevalence and potential contributing factors.

Background: Substance use among adolescents, especially smoking and alcohol consumption, has become a public health concern in the Kurdistan Region, Iraq, in the past 10 years.

Aims: This study aimed to determine the prevalence of substance use and certain associated factors among high school students in Erbil City, Kurdistan Region, Iraq.

Methods: A cross-sectional study was conducted using a multistage cluster sampling technique to collect a sample of 3000 students.

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.

Impact of an education intervention on knowledge of high school students concerning substance use in Kurdistan Region-Iraq: A quasi-experimental study.

Background And Aims: Substance use among adolescents especially smoking, is becoming a public health problem in the Kurdistan region of Iraq. School-based health education is an appropriate approach for improving students' knowledge regarding substance use in an attempt to prevent or reduce such problem The purpose of the study was to examine the effect of an educational intervention for high school students to improve their knowledge for substance use and its negative consequences, which will, in turn, motivate students to take protective measures against substance use.

Methods: This quasi-experimental (one group; pre, and post-test) design was carried out in Erbil city from January 2017 to June 2017.

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.

Revisiting the Logan plot to account for non-negligible blood volume in brain tissue.

Background: Reference tissue-based quantification of brain PET data does not typically include correction for signal originating from blood vessels, which is known to result in biased outcome measures. The bias extent depends on the amount of radioactivity in the blood vessels. In this study, we seek to revisit the well-established Logan plot and derive alternative formulations that provide estimation of distribution volume ratios (DVRs) that are corrected for the signal originating from the vasculature.

Effects of intranasal kinetic oscillation stimulation on heart rate variability.

Background: Kinetic oscillation stimulation in the nasal cavity (KOS) has been shown to have positive symptomatic effects in subjects with non-allergic rhinitis and in patients with migraine.

Methods: To evaluate the effect of KOS on autonomic function, we assessed heart rate variability (HRV) in this small exploratory study in 12 healthy subjects. KOS treatment was performed using a minimally invasive system with a single-use catheter inserted into the nasal cavity.

Patterns of age related changes for phosphodiesterase type-10A in comparison with dopamine D receptors and sub-cortical volumes in the human basal ganglia: A PET study with F-MNI-659 and C-raclopride with correction for partial volume effect.

Phosphodiesterase 10A enzyme (PDE10A) is an important striatal target that has been shown to be affected in patients with neurodegenerative disorders, particularly Huntington´s disease (HD). PDE10A is expressed on striatal neurones in basal ganglia where other known molecular targets are enriched such as dopamine D receptors (D R). The aim of this study was to examine the availability of PDE10A enzyme in relation with age and gender and to compare those changes with those related to D R and volumes in different regions of the basal ganglia.

In vivo measurement of PDE10A enzyme occupancy by positron emission tomography (PET) following single oral dose administration of PF-02545920 in healthy male subjects.

Phosphodiesterase 10A (PDE10A) is an enzyme highly enriched in the striatal medium spiny neurons. It is involved in the regulation of cytoplasmic levels of cAMP and cGMP and signaling within the basal ganglia. This study with PDE10A radioligand [F]MNI-659 was designed to measure the enzyme occupancy of PF-02545920 in 8 healthy male volunteers (48 ± 4 years) after a single oral dose (10 mg or 20 mg) and to evaluate safety and tolerability.

Bemiparin for thromboprophylaxis after benign gynecologic surgery: a randomized clinical trial.

Background: Venous thromboembolism (VTE) is the leading cause of mortality and morbidity in women following gynecologic surgery.

Objectives: To determine the efficacy of a second-generation low molecular weight heparin (bemiparin) for thromboprophylaxis after benign gynecologic surgery.

Methods: We performed a single-blind randomized controlled trial including women in the moderate-risk, high-risk and highest-risk groups for developing VTE after benign gynecologic surgery.

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.