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Echinococcosis in Iraq: prevalence of Echinococcus granulosus in stray dogs in Arbil Province.

Of 67 dogs examined in 11 localities in Arbil Province, northern Iraq, 53 (79.1%) were found infected with Echinococcus granulosus. The infection rates in the 11 localities ranged from 66.7% to 100%. Infections were light (1-200 worms) in 37.7% of infected dogs, medium (201-1,000 worms) in 20.8% and heavy (over 1,000 worms) in 41.5%. The heaviest burden was detected in 13 dogs, in which 3,000 to 8,000 worms each were counted. Infection rates were slightly higher in male dogs (81.1%) than in bitches (76.7%).

Animals↗

Epidemiology of hydatidosis and echinococcosis in Theqar Province, southern Iraq.

Ninety-six cases of human hydatidosis caused by Echinococcus granulosus were diagnosed from surgical records of hospitals in Theqar Province, Southern Iraq during 1989. The infection rate was higher in female than in male patients (56 versus 40 cases) and increased with their age (maximum, 25.0% in a female group of 31-40 years and 32.5% in a male group of 41-50 years). Many organs such as liver, lungs, peritoneum and spleen were involved, but the liver was most frequently affected. Of 96 patients, 66 (68.8%) showed single organ-involvement and 30 (31.2%) multiple organ-involvement. In 50 stray dogs surveyed for E. granulosus the prevalence was found to be 56.0% with a mean worm burden of 5,300. The light infection (1-200 worms) was found in 10.7% of the infected dogs, the medium (201-1,000 worms) in 21.4% and the heavy (over 1,000 worms) in 67.9%.

Adolescent↗

Surgical interventions at field hospitals during the Iran and Iraq War (1980-1987).

Surgical treatment of wounded soldiers in the field began in World War II, and the care of the wounded was aided by air, ground, and marine transportation. Even with highly developed facilities, medical care should be started as soon as possible. The Islamic Republic of Iran was under an economic blockade during its war with Iraq. Field hospitals were considered a solution to the problem of transportation shortages. The aim of this study was to assess the surgical interventions of these hospitals. In a descriptive cross-sectional study, data for 7,718 patients admitted to field hospitals (among a total of 173,823 casualties) were analyzed. A checklist was used as the data-collection tool. The data were entered and analyzed by the Statistical Program for the Social Sciences. The type of surgical intervention, duration of the surgery, and frequency of the interventions in each hospital were examined. Laparotomy was the most common and tracheostomy the least common intervention. Shahid Baghaei Field Hospital had the greatest number of admissions. Of all the patients in the Southern Command District who underwent any kind of surgery, 21.53% were operated on in the complex of field hospitals. The surgery time in these hospitals was 156 +/- 69 minutes (mean +/- SD). A great number of the procedures were lifesaving (including laparotomy and chest tube insertion). It seems that these hospitals played a key role in reducing mortality and morbidity during the war.

Cross-Sectional Studies↗

Therapeutic urogenital modalities during the last three years of the Iran and Iraq War (1985-1987).

OBJECTIVE: Research projects in the field of military medicine have a central role in medical logistical planning. Treatment of traumatic lesions (including urogenital system injuries) is an important aspect of military medicine. Triage for urogenital injuries has specific problems and points of concern. The purpose of this study was to evaluate the role and different types of therapeutic modalities in the treatment of urogenital injuries during the final 3 years of the Iran and Iraq War (1985-1987). METHODS: In a descriptive-analytical study, records of 1,094 patients with urogenital injuries hospitalized from 1985 to 1987 were studied. A checklist and the Statistical Program for the Social Sciences (version 6) were used for data collection and analysis, respectively. A chi 2 test interpreted part of the data. RESULTS: The highest incidence of urogenital injuries and the highest rate of surgical interventions for urogenital injuries were in 1986 and 1987, respectively. The total incidence of urogenital injuries was 0.51%. Among all surgical interventions, bladder repair was most frequent and ureteral repair was least frequent. Partial nephrectomy was the second most frequent surgical intervention and was performed more often than total nephrectomy. There was a significant difference between the urogenital surgery rate and the total surgery rate (chi 2 = 148, p = 0.000). CONCLUSION: The results suggest progress in the triage of patients with urogenital injuries. The lower incidence of urogenital injuries, however, should be interpreted cautiously because it may be attributable to different combat field conditions. Follow-up studies in this group of patients are necessary.

Cross-Sectional Studies↗

Environmental contamination by mercury in Iraq.

Following the outbreak of organomercury poisoning in Iraq, an investigation was carried out during the spring and summer of 1972 to evaluate environmental contamination by organomercury.Analyses were performed on fish of several species (not typical predators) and on a few specimens of aquatic birds (not fish-eating). Most fish samples contained concentrations in muscle ranging from 0.01 to 0.15 mg/kg. These concentrations are within the range found in tropical rivers. Higher figures, 0.3-0.5 mg/kg, were found downstream from a caustic soda plant south of Baghdad. A few cases of very high mercury concentrations (25-30 mg/kg) were reported from an area where fish kills had occurred. Aquatic birds (ducks and waders) contained low concentrations of mercury (900-2750 ng/g). Tail feathers of seed-eating birds were found to contain 13 500-21 000 ng/g of mercury, which is about 10 times higher than values reported from Ethiopia and within the range found in Sweden and Canada. Insect-eating birds contained 1850-5200 ng/g, which is thought to be slightly elevated. Extremely high concentrations of mercury were found in muscle tissue of dead seed-eating birds (15 000-40 000 ng/g), while feathers contained similar concentrations (9000-52 000 ng/g). These extremely high concentrations were found only in the vicinity of storehouses where treated seed was kept. No birds of prey could be caught and analysed.

Animals↗

Epidemiology of organomercury poisoning in Iraq. I. Incidence in a defined area and relationship to the eating of contaminated bread.

A survey was carried out in a defined area in rural Iraq where there had been many cases of organomercury poisoning following the consumption of bread contaminated by mercury, in order to determine the true incidence of the disorder. The results were compared with those obtained from a similar rural area from which few cases had been reported. A questionnaire was used to determine the amount of contaminated bread eaten and the frequency of symptoms; a simple clinical examination was performed and blood and hair samples were collected for estimation of total mercury concentration. Of 700 people over the age of 5 years in the high-exposure area, 66% admitted to having eaten contaminated bread, while none of the 864 persons in the low exposure area had done so. The mean period during which contaminated bread was eaten was 32 days, but some people had eaten it for as long as 3 months. A mean of 121 loaves was eaten, the maximum being 480 loaves. For the mean number of loaves the intake of methylmercury was likely to have been between 80 mg and 250 mg, but the people who had consumed the largest amount of contaminated bread may have ingested up to 1 000 mg of methylmercury over a 3-month period. Of those with signs of alkylmercury poisoning at the time of the survey, 80% had eaten more than 100 loaves, and 53 (71%) out of 75 persons who had eaten more than 200 loaves showed some evidence of poisoning.The incidence rate for poisoning was estimated at 271 per 1 000; this figure includes a mortality rate of 59 per 1 000, 32 per 1 000 cases with severe disability, 41 per 1 000 cases with mild or moderate disability and 138 per 1 000 cases with only subjective evidence of poisoning at the time of the study.

Adolescent↗

Intoxication due to alkylmercury-treated seed--1971-72 outbreak in Iraq: clinical aspects.

Sixty-six hospitalized patients suffering from chronic methylmercury poisoning were examined in Baghdad during 1972. The poisoning was attributed to consumption of home-made bread prepared from seed wheat treated with mercurial fungicide. The age incidence ranged between 4 and 70 years.Of the various clinical features encountered, neurological symptoms and signs were predominant and included muscular weakness, numbness, unsteady gait, paraesthesia, dysarthria, mental disturbances and, in severe cases, blindness, partial deafness, stupor, coma, and death. Involvement of the cardiovascular, urinary, gastrointestinal and haemopoietic systems, which was commonly encountered in ethylmercury poisoning in the 1960 outbreak in Iraq, was unusual.The severity of symptoms and signs was, broadly speaking, dose-dependent; high exposure led to severe clinical manifestations, but variations existed. Criteria, based on the clinical manifestations, were set for grading the severity of cases. The series included 2 asymptomatic cases, 20 mild, 20 moderate, 14 severe, and 10 very severe. In the latter group 5 patients died from failure of the central nervous system.The severely poisoned patients died irrespective of the medical treatment received. After 2 years of observation, most patients graded as mild or moderate cases lost their symptoms completely. Severe cases improved slowly, although ataxia, diminution of visual field and acuity and paraesthesia were still present. Thus, the previously accepted view that neurological signs were irreversible has been disproved.

Adolescent↗

Restrictions cancelled in Iraq.

The Office of the President of Iraq has cancelled Health Ministry regulations banning female sterilization and the taking of oral contraceptives without a doctor's prescription, according to a report in the Middle East Economic Digest of May 23, 1980.

Asia↗

Incidence of Rhesus isoimmunization in Rhesus-negative mothers in Ramadi, Iraq, in the mid-1990s.

This work was carried out in Ramadi, Iraq over the period 1993 to 1997. Of 487 rhesus (Rh)-negative mothers tested and followed up, 172 were primigravida, 1.7% of whom were Rh-isoimmunized. The frequency of isoimmunization increased with increasing number of pregnancies (4.9% for second pregnancies to 45.4% for fifth pregnancies). Comparison of our results with other earlier studies shows that the incidence of Rh-isoimmunization in our study was considerably greater than the others.

Female↗

Knowledge and use of contraception in rural and urban Iraq.

"This paper investigates variation in birth control knowledge and practices in Iraq as reported in the 1974 National Fertility Sample Survey. The descriptive and inferential statistical analysis indicated the existence of significant rural-urban differentials in knowledge and use of contraceptive methods by ever-married women. With the continuation of the war with Iran, the Iraqi government has adopted pro-natal policy to spur population growth. Whether such a policy achieves its goals is a matter deserving further investigation."

Asia↗

Spatial diffusion of the population of Al-Jazirah region in Iraq.

"The aim of this study is to illustrate the picture of the spatial diffusion of the population in Al-Jazirah in the north-west of Iraq....The region was studied in the light of the 1977 census and compared with the data of the 1987 census to determine the extent of change in population diffusion during the period between the two censuses."

Asia↗

About veterinary education in Iraq.

The cons and pros of veterinary education in Iraq are described. Started as a small institution, with few students and with foreign staffs, then expanded to enroll more than hundred students each year, with all Iraqi staff. The graduates of the Veterinary College played an important role in monitoring animal health, supervising research projects involving animal welfare, some served as educators of various veterinary science specializations, others worked as private practitioners or recruited in the army. Veterinary education was very vital, as other sciences for progress of the country.

Education, Veterinary↗

Bilharziasis survey in south-western Asia; covering Iraq, Israel, Jordan, Lebanon, Sa'udi Arabia, and Syria: 1950-51.

This paper describes a limited survey of bilharziasis and its vectors carried out during 1950 and 1951 in some countries of south-western Asia. Lack of time and of full facilities prevented the survey from being as comprehensive and systematic as would have been wished, but enough data were obtained to provide a general estimate of the situation.Information already available from the literature was supplemented by collecting unpublished records, questioning the inhabitants, examining random samples of stools and urine, and investigating rivers, wells, and springs. Bilharziasis haematobia is already heavily endemic in the irrigated areas of Iraq and is also present, in comparatively smaller foci, in northern Syria, Israel, and Sa'udi Arabia. In the opinion of the senior author (M. A. A.), the envisaged extension of irrigation is likely to create a serious health problem in Mesopotamia and to introduce the disease into the Jordan region unless the spread of the molluscan vector, Bulinus sp., is checked. Intensification of infection and further spread are possible in Israel and in the Syrian Jezire, while the remainder of Syria and Lebanon are not considered to be endangered. Bilharziasis mansoni is widespread in the fertile areas of Sa'udi Arabia and also occurs in one minor focus in Israel. The industrialization of Sa'udi Arabia which is planned to exploit its oil resources, with its inevitable concentration of population, equally presents a danger in the intensification of bilharziasis. It is considered that, unless prompt measures are undertaken to break the link between the agricultural and industrial expansion and the spread of the disease, the debilitation of large groups of the population and the economic loss which may well result over most of the inhabited parts of the area discussed will be significant.

Arabia↗

Paediatric trauma in northern Iraq: the Kurdish refugee crisis.

In May 1991 a team of five doctors and two nurses from Edinburgh hospitals were flown to Northern Iraq to assist in the Kurdish refugee relief effort. The two surgical members of the team helped to re-establish surgical services in a small hospital in the Iraqi town of Zakho. During an 8-day stay in the hospital, frequently in extremely difficult circumstances, the surgical team undertook 19 major and 15 minor surgical procedures in 25 patients; 11 major and eight minor procedures were undertaken in 15 children under the age of 16 years. The largest group of children treated had suffered bomb-blast injuries from unexploded ordinance; injuries sustained were primarily to the hands, face and upper trunk. Road traffic accidents and burns were also common. Two children requiring postoperative intensive care were evacuated by military helicopter at night to hospital facilities in Turkey.

Adolescent↗

Rebuilding an empire. Once a crown jewel of healthcare in the Middle East, Iraq's system needs a complete overhaul, everything from equipment to staff.

As work begins to rebuild Iraq's infrastructure, hospitals and primary-care facilities are major priorities. While security concerns have prevented some U.S. civilians from traveling there to lend their assistance, hospital executives soon could participate in exchange programs to educate their Iraqi counterparts. James Haveman, left, is senior U.S. adviser to the Iraqi Ministry of Health.

Delivery of Health Care↗

Land mine injuries: a study of 708 victims in North Iraq and Cambodia.

OBJECTIVE: The aim of this study was to explore the effect of low-cost prehospital trauma systems on trauma outcome in land mine victims and to study prehospital risk indicators for better triage of land mine injuries. METHODS: A 5-year prospective study of the effect of in-field advanced life support provided by local paramedics was conducted in mine-infested areas in North Iraq and Cambodia. RESULTS: After implementation of a rural rescue system, there was a significant reduction in trauma mortality from 26.2% in 1997 to 11.8% in 2001 (95% confidence interval for difference, 5.1%-23.6%). The mortality rate was significantly higher in fragmentation mine victims, 25.2%, as compared with blast mine victims, 5.7% (95% confidence interval for difference, 14.4%-24.6%). The severity of associated fragment injuries in patients with traumatic amputations is a solid risk predictor (area under the curve in receiver operating characteristics plots > 0.9). CONCLUSIONS: Low-cost prehospital trauma systems improve trauma outcome in land mine victims where prehospital transit times are high. The fragment wounds represent the main challenge for trauma care providers.

Adolescent↗

[The 7th Field Hospital of the Army of the Czech Republic (ACR) in southern Iraq: statistics of professional activity and aspects of a foreign mission].

The short communication informs about the work of the field hospital in Iraq. From 3rd June till 10th September 2003 there were 123 patients operated on, 184 patients were hospitalized. The hospital exerted 1,194 bed-days, 131 of them at the intensive care unit. The outpatient department treated 6,953 patients. There were 824 X-ray and ultrasonographic examinations and the laboratory performed 7,941 tests. In their practice the physicians encountered a wide spectrum of surgical and non-surgical diagnoses. Other humanitarian activities (material, organization of transport of children to specialized care in the Czech Republic, blood donor activity) were an integral part of the work. The work in non-standard conditions was significantly complicated by the extreme climate and the high safety risk.

Czech Republic↗