Background: Tibial fractures are common, making for 2.2% of all intra-articular fractures. Two age groups are more likely to suffer these fractures: younger patients are more likely to suffer higher-energy fractures, while older patients are more likely to suffer lower-energy fractures due to osteopenia. In the younger population, these injuries are associated with a higher incidence of sequelae such non-union, infection, limited mobility, and post-traumatic arthritis. The main goal of the study was to evaluate the outcomes of locking plate treatment for proximal tibial fractures. Methods: This retrospective clinical research includes thirty-five individuals who had fractures to their proximal tibia. A tibia locking plate system is used to treat each of them. thirty-five patients, fifteen female and twenty males, with an average age of forty-two. fractures classified according to the kind of soft tissue injury and the AO classification. Using VAS, post-operative radiographs, and ROM, patients were evaluated clinically, radiologically, and functionally. Results: A 6-month surveillance period was used to all 35 selected cases. Within a range of 16 to 22 weeks, the average time for fracture union was 18 weeks. There were no instances of non-union or delayed union. Complications included knee pain, valgus, and infection. During the post operative visit, three patients expressed concerns regarding their slight pain. On the basis of discomfort, ADLs, aesthetics, and full weight bearing, all patients were satisfied at their most recent appointment and acceptable knee range of motion of an angle greater than 120° had been reached. Conclusions: By using the proximal tibia plate approach in conjunction with MIPO (minimum intrusive plate osteosynthesis) and ORIF (open reduction and internal fixation), excellent outcomes were obtained in the surgical treatment of proximal tibia fractures. Reduction, stiff fixation to replace articular fragments, and early mobility are the keys to optimal knee function avoiding osteoarthritis after an injury.

Objective: By applying quality by design (QbD) approach towards the development and validation of HPLC method of Clopidogrel Bisulphate (CPD) in Nasal Simulated fluid (NSF). Method: HPLC method was developed for CPD by using NSF as it mimics the nasal mucosa at some extent and developed method was optimised by using Central Composite design (CCD) and validated by using different parameters like accuracy, precision, robustness, and robustness etc. Assay was also performed by using marketed formulation and force degradation studies was carried out. Results: The efficient method was developed by using CCD of Design of Experiment Version 13, consist of two independent key parameters ratio of mobile phase (acetonitrile: NSF) and the PH of NSF. The column Hypersil C-18 with flow rate of 1ml/min with loop volume 20µl at ambient temperature like chromatographic conditions were used to get retention time, Area, and theoretical plates 4.216, 2694.866, and 14214.5 respectively with desirability 0.918. The developed method given by QbD was linear with conc. range 2 to 10 µg/ml. with regression equation and regression coefficient y = 1171.8x-24.667 & 0.9971 with accuracy 0.150%-0.351%. The % RSD for intraday and interday was found 0.141% -0.550% and 0.251%-0.676% with robustness having value less than 2 with LOD and LOQ 0.47 µg/ml and 0.77 µg/ml. respectively. The concentration in assay was 99.351% and the maximum degradation was found in forced conditions of alkali. Conclusion: The QbD approach was successfully utilised to develop HPLC method in NSF. The method was found to be sensitive, cost effective and reproducible.

Anesthesia technology is a critical component of modern healthcare, requiring a rigorous and comprehensive training program to ensure technologists are equipped to support anesthesiologists in providing safe and effective patient care. This study provides a thorough review of anesthesia technology training programs, focusing on the integration of emerging technologies such as artificial intelligence (AI) and simulation-based learning, and the need for standardized curricula across educational institutions. The analysis reveals significant variability in curriculum content, with traditional subjects consistently covered, but emerging areas like AI and crisis resource management often underrepresented. Clinical training experiences also vary, with programs that incorporate high-fidelity simulations and virtual reality (VR) technologies showing higher levels of student proficiency in critical competencies. Surveys indicate that while students are generally satisfied with their theoretical training, many feel underprepared for real-world clinical scenarios. Educators emphasize the need for updated simulation facilities and standardized assessments. The findings suggest that to meet the evolving demands of modern healthcare, anesthesia technology programs must integrate advanced technologies, standardize curricula, and enhance clinical training opportunities. These improvements are essential for preparing anesthesia technologists to operate in increasingly complex clinical environments, ultimately leading to better patient outcomes.

Introduction: Non neoplastic lesions of vocal cord are a spectrum of laryngeal diseases, in which the patients suffer from various symptoms like hoarseness of voice, throat discomfort, pain in the throat. With timely diagnosis and intervention, the prognosis will be good. Methodology: A prospective study with 60 patients clinically diagnosed with nonmalignant lesions of larynx who attended ENT OPD, VMKVMCH, Salem. After history taking, ENT examination, patients with suspected benign lesions of larynx were examined with video laryngoscopy and diagnosis was made and patients were managed accordingly and followed up for a period of 3 months. Results: In our study, mean age was 45.21±6.61 years. 60% of the patients were male, 40% were female.71.7% of the cases presented with hoarseness of voice, 70% of cases had vocal fatigue, 96.7% had foreign body sensation, 48.3% had dysphagia, 28.3% had neck swelling, 45% had history of weight loss.  35% had smoking habit, 35% had habit of alcohol, 45% had habit of chewing pan and betel nut, 58.3% had history of vocal abuse and 55% were having poor oral hygiene. In our study, it was observed that 5% of the cases had chronic laryngitis ,1.7% had contact ulcers, 21.7% had cysts, 5% had granulomas, 1.7% had papilloma, 5% had Reinke’s edema, 1.7% had Tuberculous laryngitis, 15% had vocal nodules, 43.3% had vocal polyp.

 53% of the patients were managed by micro laryngeal surgery and speech therapy, 46% were managed by medical and speech therapy.  The success rate was 89% following micro laryngeal surgery and speech therapy, 85% following medical and speech therapy. Conclusion: Early diagnosis of the non-neoplastic lesions can lead to effective management.   Micro laryngeal surgery and voice rest offer a cost effective, useful and safe method for management of benign laryngeal lesion.

Background: Diabetes melletes, a chronic metabolic disease involves development of severe complications affecting nearly every system in the body^2-4 apart from the basic abnormal blood glucose levels¹. India being the “Diabetic Capital of the world”⁶, has a increasing prevalence rate⁵ , with the age of onset decreasing day by day. Diabetes Mellitus is an important etiological etiological factor for the onset of hearing loss in the elderly population^7,8. The hearing loss is described as bilateral and progressive sensorineural^11,12. Hearing Loss may be related to microangiopathy, neuronal degenerations or diabetic encephalopathy. The Study is conducted to  establish effect  of metabolic control on  subclinical auditory dysfunction related with controlled and uncontrolled  Type 2 DM by utilizing otoacoustic emission. Methodology: A cross sectional prospective study with 30 patients with metabolically controlled diabetes mellitus and 30 patients with metabolically uncontrolled diabetic mellitus between Jan 2020- to-Aug 2020. The patients were separated into two groups according to the HbA1c levels. Group 1 and Group 2 consisted of controlled Type2 DM cases having HbA1c ≤7% and uncontrolled Type2 DM cases with HbA1c >7%. Otoacoustic Emissions were studied in both the groups and compared. Results & Discussion: The present study reports SNHL in 16.66% of Type 2 controlled diabetic patients and 20% of uncontrolled diabetic patients. The majority of them had bilateral mild SNHL. There was a significant difference in the auditory thresholds at all frequencies from 250 Hz to 8000 Hz between Type 2 controlled diabetic patients and uncontrolled diabetic patients, and  a gradual increase in hearing loss from 250 Hz to 8000 Hz. Statistically significant differences were found in the otoacoustic emission measurements of the patients between  metabolically controlled diabetes and uncontrolled groups. Conclusion: The uncontrolled diabetic patients had increased hearing threshold at all frequencies with gradual increase in hearing loss from 250 Hz to 8000 Hz. In DPOAE (DP-gram and DPOAE I/O) measurements we found significant effect of metabolic control in uncontrolled diabetic patients on hearing loss. Summary: Diabetes Mellitus is a highly prevalent disease with age of onset decreasing day by day. In this context it is important to emphasize the importance of long term control of blood sugar levels which influences and prevents onset and progression of hearing loss.

Background: Auditory Brainstem Response has been used as a diagnostic method to detect abnormalities in the respective auditory pathways involving their central connections¹. It is a test to measure the brain wave activity that occurs in response to clicks or certain tones². It is relatively cheap, easy to perform diagnostic method to detect early damage. This study is to correlate changes in brainstem evoked response audiometry parameters in Hypertensive Patients. Methods: The study was conducted between January 2020 to December 2020 on 100 patients attending ENT OPD in Vinayaka Missions Kirupanandha Variyar Medical College and Hospital, Salem. All patients with auditory complaints and known Hypertensives on treatment were seen at the otorhinolaryngology OPD and underwent a complete otorhinolaryngological examination, audiological studies (pure tone audiometry) and electrophysiological assessment BERA. Results: 100 Hypertensive Patients in the Ages between 41 years and 80 years were investigated with BERA. Hypertensive Patients showed significant prolongation of absolute peak latencies of wave I, II, V and interpeak latency of wave III-V indicating involvement of brainstem auditory pathways. Conclusions: The findings of the current study suggest that hypertension does affect the neuronal excitation/conduction in the auditory pathways. Both the peripheral auditory pathway and the central brainstem pathway of transmission are affected. Thu BAER can act as potential marker of neurological damage in Hypertension and emphasizes the requirement for further research in the field.

Background: An epidemic of metabolic diseases, stress, worry, and a lower standard of living are all associated with obesity. Stress is a major contributor to various metabolic and cardiac diseases. Variability in heart rate (HRV) is indeed a crucial indicator of functional stress and the balance among the sympathetic nervous system and parasympathetic nervous systems. The aim of the study is to assess the impact of yoga treatment on the heart rate variability of obese individuals, as yoga provides a comprehensive approach to restoring the body and mind's normal physiology.

Materials and methods: A total of 150 subjects, whose BMI ≥25kg/m² were selected for the study based on predefined selection criteria. A control group (n=75) and a yoga group (n=75) were assigned to this study, and yoga group had yoga treatment for ten weeks while adhering to a regular diet and lifestyle. On the first day and ten weeks into the yoga intervention, they were evaluated based on their criteria.

Results: Comparing the case and control groups, the yoga practitioners experienced significant improvements in several health indicators. They showed reduced mean weight, BMI, blood pressure, and mean heart rate. Furthermore, their heart rate variability (HRV) increased, as evidenced by higher R-R interval, SDNN, RMSSD, NN50, and pNN50, along with a greater high-frequency (HF) component. Additionally, there was a decrease in mean low frequency (LF) and LF/HF ratio, indicating a shift towards parasympathetic dominance and reduced sympathetic activity.

Conclusion: Heart rate variability is positively impacted by yoga treatment, which suggests that the autonomic nervous system's balancing mechanism is moving in favour of parasympathetic activity.

When a situation of mass casualties develops (MCIs), being reactively strong enough is the only way EMS can cooperate reasonably and deal with the calamity. This piece of writing is a critical analysis of the current response plans to mass casualty incidents. It assesses their preparedness level in dealing with the plans, the mechanisms for organizing the response, and whether the strategy for resilience has been considered. This study intends to examine appropriate literature, find voids in knowledge, and synthesize the findings to broaden the understanding and offer competent insights for MCI responses in EMS.

Including a range of health services involving various healthcare sectors is essential to designing a system that meets these objectives. The paper aims to critically analyze the cross-sector integration between the dental, radiology, pharmacy, emergency, epidemiological, medical secretarial, and medical device professions. By applying an in-depth literature review and empirical data, the research finds the most evident flaws on the subject and suggests future measures. The research strategy combines qualitative and quantitative methods utilizing principal and secondary data sources. Discoveries have shown the advantage of multi-sectional clinical relationships in transforming the health system and achieving the best results. Proposals are policy actions, technology involvement, and the training of professionals to bridge the gaps within the sector and ensure equitable and easy access to healthcare.

Introduction: Embolization of the uterine arteries (UAE) has been approved as a minimally invasive technique for the treatment of uterine fibroid and maintaining fertility; different agents are used in this technique; embospheres have nowadays become widely used in many centers. Aim: assess the effectiveness and safety of Embospheres as Embolizing agents in treating symptomatic uterine fibroids among Iraqi patients. Methods: This was a mixed retrospective-prospective study conducted at Ibn Sina Hospital; the study included 17 patients who were managed and followed up during the period 2018 – 2020 included 17 Iraqi women with symptomatic uterine fibroids and were managed with embolization of uterine arteries using Embosphere as an embolization agent followed for six months by MRI to monitor changes in size & IV contrast enhancement. Results: The mean age of the patients was 39.5 (range: 266-49) years. Single fibroids were reported in 70.6% of the cases and multiple fibroids in 29.4%, the median number of fibroids was significantly reduced after UAE, (P<0.05) and the median size reduced by more than 50%, from 11 cm to 5 cm after UAE, (P<0.05). More than 70% of fibroids decreased in size, and 17.6% disappeared. After UAE, during the follow-up period, 17.6% of women got pregnant safely. Unfortunately, two patients did not get the benefit. Conclusions: Embospheres were safe and effective as an Embolizing agent in treating symptomatic uterine fibroids with good outcomes and no serious adverse effects or complications.

Histone deacetylase (HDAC) enzymes are interesting targets for developing new therapeutic molecules. New sulfonamide derivatives were designed via the implication of docking experiments using Glide software to validate the binding affinity with several HDAC enzymes. Molecules involving sulfonamide moiety exhibit acceptable binding scores and zinc chelation properties. Compounds with acceptable docking scores were nominated for the organic synthesis. The final compounds were synthesized through the amide coupling reaction followed by an amine alkylation reaction to afford final compounds IVa-d. The ADME properties were virtually assessed utilizing QikProp Schrodinger. The virtual ADME results indicated the drug-likeness properties of the final compounds with no major violation of the rule of five. The preliminary cytotoxic activity evaluation showing that compounds Iva and IVb killing colon cancer cells (LS-174T) in $I{C}^{}$ of 0.37 $\mu$M and 0.44 $\mu$M, respectively.

Objective: This study evaluated the efficacy and safety of perioperative intra-articular infiltration with a tranexamic acid and ropivacaine cocktail in patients undergoing bilateral total knee replacement (TKR). Methods: A randomized controlled trial was conducted involving 50 patients scheduled for elective bilateral TKR. Participants were randomly assigned to receive either intra-articular infiltration of a tranexamic acid and ropivacaine cocktail (intervention group) or standard care (control group). Outcome measures included postoperative blood loss, pain scores, range of motion, and adverse events. Results: Among the enrolled patients (n=50), the intervention group demonstrated reduced postoperative blood loss, evidenced by higher hemoglobin levels and lower drain output than the control group. Additionally, the intervention group exhibited consistently lower pain scores at various postoperative time points and greater improvements in range of motion. Conclusion: Intra-articular infiltration with a tranexamic acid and ropivacaine cocktail in bilateral TKR patients showed promising outcomes, including reduced blood loss, improved pain control, and enhanced range of motion. These findings suggest the potential of this adjunctive therapy in optimizing perioperative care for patients undergoing bilateral TKR. However, further research with larger sample sizes is warranted to validate these preliminary results and establish this intervention’s long-term efficacy and safety.

In the present work, the optical properties of Nile blue dye dissolved in ethanol with different concentrations for three cases were studied. The first case is when the dissolved dye is pure. The second case is when the dye is added to the PVP polymer, and finally when gold nanoparticles (AuNPs) are added to the (NB-PVP) blend. It was noticed that the absorption intensity increases with increasing concentrations. The results for the first case found its absorption intensity value (0.35). At the wavelength 655nm and a concentration of (0.5 mM) As for the absorption density for the second case (0.18) At the wavelength 655nm and the same concentration as well as the absorption density for the third case(0.12) at the wavelength 653nm a concentration of (0.5m M).

Background: Postoperative septic arthritis of the knee joint is an uncommon complication with serious consequences following anterior cruciate ligament reconstruction (ACLR). Systemic antibiotics received preoperatively and presoaking the soft tissue autograft with antibiotics result in a lower infection rate. Preoperative intravenous antibiotics may not be sufficient enough to reach minimum inhibitory concentration (MIC) levels due to poor vascularity of hamstring tendons in addition the harvested graft is prone to infection from skin flora.
Aim of the study: To assess the efficacy of local antibiotic (ceftriaxone drug 1g.) solution diluted in (500 mL 0.9% sodium chloride N/S) for invitro interrupted irrigation of harvested soft tissue ACL graft as prophylaxis in reducing the infection rate during knee joint arthroscopic procedure. Patients and Methods: A Prospective comparative study of forty patients fit for arthroscopic anterior cruciate ligament reconstruction were enrolled in the study. The timeline period from April 2022 to July 2023.patients divided into (group A), twenty patients (received local ceftriaxone irrigation 1gm. solution diluted in 500 mL 0.9% NaCl for presoaking soft tissue autograft) and (Group B), twenty patients received (plain NaCl 0.9% ) only for irrigation of harvested graft. All patients in both groups received intravenous ceftriaxone at time of induction of anesthesia. Patients with history of injury more than 2years, open procedure, intravenous drug abuse, alcoholism steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Patients were followed postoperatively by clinical, laboratory, and imaging studies. The chi-square test was used for the comparison of categorical data. A student T-test and ANOVA were conducted to demonstrate the differences in postoperative inflammatory markers. Results: Presoaking of soft tissue autograft with ceftriaxone was performed in 20 patients (the study group), while 20 patients (the control group) were soaked only with plain N/S. In the control group, two patients (10%) developed postoperative infection after 2 weeks postoperatively, while no case developed infection in the study group. There was no statistically significant difference (p >0.05) between the study and control groups in terms of demographic characteristics, type of graft (p = 0.34), associated arthroscopic procedure (p = 0.35), and Lysholm score (p = 0.58). In the study group, there was a significant decrease in ESR (P = 0.01) after 4 weeks, Total lymphocyte count (p = 0.04), and Polymorphonuclear (p = 0.03) after 6 weeks postoperatively. Conclusion: Presoaking of hamstring autograft with ceftriaxone intraoperative may be alternative for other antibiotics in reducing rate of infection following arthroscopic anterior cruciate ligament reconstruction.

Introduction: Non-adherence to antiseizure medications is one of the main reasons for treatment failure and seizure recurrence. Objective: Evaluation of adherence and association with belief about antiseizure drugs in patients with epilepsy were examined. Materials and methods: This was a prospective, cross-sectional study of patients with epilepsy in the neurology department for six months. Patient adherence and persistence in long-term treatment continuation were assessed using the Modified Morisky Adherence Scale and Beliefs about Medicines questionnaire scale. Results: A total of 100 patients were enrolled out of which (46%) of the patients were adherent, 54% were non adherent to their medications. GTCS was the commonest seizure (58% ), followed by partial seizures (41% ) and unclassified seizures (1% ). Levetiracetam(37% ) was the commonest drug prescribed, followed by valproic acid(24% ), carbamazepine(19% ), oxcarbazepine(14% ), phenytoin(5% ), phenobarbitone (1% ). Male patients were found to be more adherent to drug therapy as compared to females. $(p<0.05).$ Participants with higher education were highly (73% ) adherent to antiepileptic drugs, followed by high school (37% ) and primary school 33% ). The specific necessity score was significantly higher in the adherent group than the nonadherent group. Patients who believed that antiepileptic drugs do more harm than benefit were significantly more in the nonadherent group. Conclusions: Patient with high educational status, positive attitude, and belief toward therapy were found to be more adherent to their medication. Assessment of adherence to medication and counseling should be a routine part of management for better health care and quality of life.

Background: A cataract distorts the eye’s lens, which at first impairs vision and later leads to blindness if untreated. Increased light sensitivity, poor night vision, seeing double pictures, and eventual utter blindness are the results. Objectives: The study aims to assess older adults’ knowledge and attitude toward cataracts and identify the relationship between the sociodemographic characteristics of older adults’ knowledge and attitude toward cataracts. Methods: descriptive study design among 200 older adults selected by convenience sample. The study tool is a questionnaire comprising 3 parts (sociodemographic characteristics, knowledge, and attitude). The data was collected by the interview method. Result: The finding indicated that (60%) of older adults at age (60-65) years, (64.5%) are males, (29.5%) have secondary school graduates, and 71(35.5%) are housewives. The grand mean and standard deviation of knowledge are (1.550.22). The grand mean and standard deviation of attitude are (2.06$\pm$0.46). There is a significant difference between the mean score of older adults’ knowledge with age and education at p-value (0.000 & 0.03), respectively. Also, there is a significant difference between the mean score of older adults’ attitudes with age at p-value (0.000). Conclusion: It is essential to check the vision health status of old age people. Enhance the awareness about cataract risk factors, prevention, and treatment.

ackground: Casting, open plate fixation, minimally invasive plate osteosynthesis, intramedullary nailing, and external fixation are some treatment options for tibial fractures. The aim of treatment is anatomical alignment with sufficient stability to permit early motion. The least invasive and most popular techniques are intramedullary nailing, external fixation, and minimally invasive plate osteosynthesis. Aim of Study: To compare the clinical and functional outcome between Intramedullary nailing and external fixation and minimally invasive plate osteosynthesis in treating tibial shaft fracture. Patients and Methods: A randomized clinical trial study was conducted at Al-Yarmouk Teaching Hospital and other private hospitals in Baghdad, Iraq, during a period of 17 months from September 2020 to January 2022, including a period of one year for follow-up. Patients were selected according to certain inclusion criteria and divided into two groups, each with 20 patients. IMN was treated by intramedullary nailing, and the MIPO group was treated by minimally invasive plate osteosynthesis. Patients were followed up radiologically and clinically using the JETTS Lower Extremity Trauma Scale score. Result: The difference was significant (P< 0.05) regarding partial and full weight bearing, union time, and return to work. Ankle stiffness, implant irritation, and knee pain revealed significant differences. Conclusion: Intramedullary nailing and external fixation and minimally invasive plate osteosynthesis are effective methods for the treatment of extra-articular tibial shaft fracture. They provided rigid fixation, preventing major complications and good functional and anatomical outcomes.

Patients on hemodialysis (HD) are usually anemic because of defective erythropoiesis. Hepcidin is a polypeptide that regulates iron homeostasis and could indicate functional iron deficiency in patients with end-stage renal disease (ESRD); this may also aid in assessing a patient’s response to erythropoietin (EPO). The present study was directed to investigate serum levels of hepcidin, iron status, and inflammation markers such as C-reactive protein (CRP) in patients with ESRD on maintenance HD and to observe the correlation of serum hepcidin with conventional iron and inflammatory markers. Forty-two patients of both sexes on maintenance HD and EPO therapy were enrolled; 42 age and sex-matched healthy subjects were included as controls. Laboratory tests were performed, including complete blood count, serum hepcidin, total iron binding capacity (TIBC), serum ferritin, serum iron, and CRP. Serum hepcidin levels were significantly higher in patients with ESRD than in the control group (18.2 $\pm$ 2.8 ng/mL and 8.5 $\pm$ 2.3 ng/mL, respectively P = 0.000). The hemoglobin, hematocrit, serum iron, TIBC, and transferrin saturation levels in the patient group were significantly lower than in the control group. Higher hepcidin levels were found in EPO non-responders (19.6 $\pm$ 2.4 ng/mL), while lower levels (16.9 $\pm$ 2.5 ng/mL) were seen in responders (P = 0.001). A positive and significant correlation was observed between the values of serum hepcidin and CRP. Our study indicates that higher hepcidin levels are found in ESRD patients on HD and in those not responding to EPO. Our findings suggest that hepcidin might play a role in the pathophysiology of anemia associated with chronic diseases and EPO resistance.

Background and Purpose: Osteopenia (OP) is a chronic and advanced condition that is often described by diminished bone mineral density (BMD), deteriorated bone tissue microarchitecture, and an elevated risk of fracture. The low molecular weight antimicrobial peptides known as Human Defensin (HBD-2) proteins are produced locally by keratinocytes in various tissues, including skin, mucosa, and bones. Osteocalcin, often called bone gamma-carboxyglutamic acid-containing protein (BGLAP), is a tiny (49 amino acids) noncollagenous protein hormone in bone and dentin. It was initially discovered to be a calcium-binding protein. Material and Methods: Prospective study to evaluate the osteoblast’s ability to produce and release osteocalcin makes it a noncollagenous protein, and has primary physiological roles include calcium ion homeostasis, maintaining an average rate of bone mineralization, preventing the aberrant development of hydroxyapatite crystals, and participating in bone remodeling via a negative feedback loop. In menopausal women with osteopenia, this study evaluates the osteocalcin and human beta-defensin 2 for their diagnostic potential. A small amount of venous blood, about 5 ml, was added to the tube and centrifuged for five minutes at a speed of 3 $\times$ 103 rpm. The serum was put into an Eppendorf tube and stored in a freezer at -20 ${}^{\circ }$C before being tested. With the help of the specified equation, the body mass index is determined. Findings and Conclusion: Increasing serum HBD 2, osteocalcin levels in postmenopausal women with osteopenia plays an essential role in developing osteopenia to osteoporosis. Differences in serum levels of alkaline phosphatase were seen among patients (as a sample) and controls; serum levels of HBD2 and osteocalcin were considerably lower in controls than in patients (p 0.01).

Introduction: Alopecia is a benign hair condition that causes reduced hair growth on the scalp and has afflicted populations worldwide. Aim: The present study is designed to formulate and characterize submicron emulsion-based topical gel containing an anti-hypertensive drug like minoxidil to overcome the adverse effects of conventional oral dosage forms & to provide an improved, targetted therapy for the treatment of alopecia. Methods: The minoxidil-loaded submicron emulsion was prepared by aqueous titration method using a suitable combination of Clove oil (oil phase), Tween 20 (surfactant), and Transcutol P (co-surfactant). Results: The maximum submicron emulsion area obtained after constructing pseudo-ternary phase diagrams was found in S${}_{\text{mix}}$ ratio 4:1. The optimized submicron emulsion formulation (M5) exhibited a pH of 5.4 $\pm$ 0.17, in vitro release of 95.08 $\pm$ 0.36%, ex vivo permeation of 79.36 $\pm$ 0.18%, the particle size of 181.3nm with an uniform particle size distribution $(<1)$ and optimum zeta potential (-8.80 mV). The optimized formulation (M5) was then converted to intogel formulation by adding different concentrations (1%, 1.5%, and 2% w/v) of gelling agents like Carbopol 934. Among them, M5 ${}_{2w/v}$was considered to be the optimized gel formulation based on different evaluation studies. The optimized submicron emulsion-based gel formulation also showed an inherited anti-oxidant potential and remained stable for three months at $4^{\circ }$. Conclusion: The minoxidil-loaded submicron emulsion-based topical gel formulation could be considered a beneficial nano-approach in contrast to other traditional topical dosage forms for treating alopecia.

Objectives: The aim of the study was to compare between the effects of two most common iron chelating agents (Deferasirox and Deferoxamine) used in the management of beta-thalassemia major. Materials and Methods: A Cross section study conducted in Thalassemia and hereditary blood Diseases Center of Kut hospitals in September 2022, all the included patients were of $\beta$-thalassemia major type those treated with blood transfusion and iron chelating agents. Patients were divided into two groups. First group included 20 patients receiving Deferasirox (Exjade) Novartis Europharm Basil, Switzerland and another group included 20 patients receiving Deferoxamine (Desferal) Novartis Europharm Basil, Switzerland as iron chelating agents. Both of them manufactured from Novartis Europharm- Basil, Switzerland. Results: The results showed that serum ferritin levels were significantly lowered in Exjade group compared to deferoxamine group indicating that, Exjade was more effective in reducing iron overload compared to deferoxamine. There were no significant differences for other laboratory investigations between the chelating agent groups. Conclusion: our study indicated that exjade is more effective than deferoxamine in treatment of iron overload so should using of exjade lead to decrease effects of iron on vital organs and minimized mortality rate of thalassemia.

Background: Cerebral ischemia/reperfusion (CI/R) is a separate feature of ischemic stroke that occurs when blood perfusion is restored following a period of ischemia. Despite the beneficial effects of reperfusion, it can cause even more harmful outcomes than persistent ischemia. Objectives: This study was conducted to assess perindopril’s neuroprotective ability in (CI/R) and to conceptualize its molecular underpinnings. Materials and Methods: The 28 Sprague-Dawley male rats weighing 200-300 g were randomly divided into four groups, each with seven rats: Sham (undergo general anesthesia without bilateral common carotid artery occlusion (BCCO)), Control (30 min. of BCCO followed by reperfusion 60 minutes), Vehicle (7 days of distilled water then as control group), and Perindopril-treated group (7 days of Perindopril-treated then as control group). After reperfusion, the brain’s tissues were extracted in order to evaluate the levels of biochemical, and total antioxidant capacity in addition to the extent of the infarct and histological investigation. Results: Cerebral infarct size, as well as levels of inflammatory marker were significantly higher in the control and vehicle groups compared to the sham groups, although overall anti-oxidant capability was significantly lower. Perindopril therapy increased IL-10 and overall antioxidant capacity while decreasing IL-6, TNF-$\alpha$, NF-kB p65, and ICAM-1 significantly. Histopathological, both control and vehicle rats had severe ischemia damage, which was significantly alleviated by perindopril therapy. Conclusions: The perindopril neuroprotective effect in rats exposed to cerebral ischemia/reperfusion injury may be attributed to the anti-inflammatory and anti-oxidative effect of perindopril.

Background: Cerebral ischemia is reason of death and disability worldwide with 11.6% of all death and 5.7% of the total disability. Thrombosis and embolism of a major cerebral artery, mainly the middle cerebral artery, account for over 70% of stroke cases. The other major type of stroke is cerebral hemorrhage either intracerebral or subarachnoid hemorrhage. The oxygen requirements of the nervous tissue are excessively high bringing the brain highly susceptible to ischemia. The subsequent reperfusion after brain ischemia can precipitate more brain injury. Objectives: Assess the neuroprotective effects of perindopril and coenzyme Q10 in combination, as well as to speculate on their mechanism. Method: A total of forty-nine adult male Sprauge-dawley rats weighing between 200 and 300 g were randomly assigned to 7 groups: sham (no Bilateral common carotid artery occlusion (BCCAO)), control group (BCCAO for 30 minutes followed by reperfusion for an hour), vehicle-1 group (rat were pretreatment with oral 1% carboxymethylcellulose for seven days followed by control group), vehicle-2 group (seven days of oral distilled water pretreatment then as control group), perindopril group (rat were pretreatment with perindopril for then as control group), coenzyme Q10 group (rat were pretreatment with coenzyme Q10 for seven days then as control group), and combination group (rat were pretreatment with perindopril plus coenzyme Q10 for seven days then as control group). The brain tissues were separated in order to measure the size of the brain infarction, assess the histology, and measure the levels of cerebral IL-6, IL-10, TNF-\(\alpha\), ICAM-1, NF-\(\kappa\)B p65, and total antioxidant capacity. Results: The brain levels of IL-6, IL-10, ICAM-1, TNF-\(\alpha\), NF-\(\kappa\)B p65, and the cerebral infarct size were substantially increased in control and vehicle in relation to sham groups, while the total anti-oxidant capacity was considerably reduced. Perindopril and coenzyme Q10 treatment alone and in combination resulted in marked elevation in IL-10 and the total antioxidant capacity, with significant decrement in IL-6, ICAM-1, TNF-\(\alpha\), and NF-\(\kappa\)B p65 in respect to vehicle and control group. There was severe histopathological ischemic damage in control and vehicle groups which was remarkedly decreased by perindopril and coenzyme Q10 treatment alone and in combination pretreatment. Conclusions: Due to their anti-inflammatory and anti-oxidative characteristics, perindopril and coenzyme Q10, either separately or in combination, exhibit neuroprotective benefits in male rats that have been treated to cerebral ischemia/reperfusion injury.

Background: When a patient has an upper gastrointestinal disorder-which frequently manifests as dyspepsia-upper gastrointestinal endoscopy is considered the preferred diagnostic procedure. Without a biopsy, endoscopy cannot be considered complete, and the most reliable method for diagnosing lesions seen during endoscopy is histopathology. Methodology: This retrospective study was conducted in the Department of Pathology at A.C.S Medical College and Hospital for one year duration from July 2022 to July 2023. A total of fifty-five endoscopic biopsy specimens were obtained; they were preserved in 10% formalin and regularly stained with hematoxylin and eosin. Results: The majority was found to be 45.4% (25/40) of those aged 61-70, 36.3% (20/55) of those aged 51-60, and 18.1% (10/55) of those aged 40-50.Thirty patients (18.7%) had duodenal lesions, 80 cases (50%) had stomach lesions, and 50 cases (31.2%) had oesophageal lesions. Most upper gastrointestinal tract endoscopic biopsies came from the stomach. Conclusion: Endoscopy is insufficient without biopsy, and the gold standard for diagnosing lesions seen during an endoscopy is histopathology. The particular location of mucosal lesions can be seen with the use of upper gastrointestinal tract endoscopy. Therefore, we may draw the conclusion that using these two approaches together offers a potent diagnostic tool for improved patient care.

Introduction: Diabetes mellitus and thyroid disorder constitute the commonest endocrinal disorders worldwide. These two diseases affect each other resulting in worsening the condition of each other and making it difficult to control the patients’ condition. Aim of the Study: The aim of the current study to assess thyroid disorders among T2DM patients from Iraq. Subjects and Methods: The current study included a randomly selected 100 diabetic patients. All included patients were subjected to anthropometric measurements, blood glucose assessment and thyroid profile assessment. Results: Among the included diabetic patients, clinical hypothyroidism was diagnosed in 4 patients, subclinical hypothyroid status was detected in 8 patients, clinical hyperthyroidism in 2 patients while subclinical hypothyroid status was detected in 4 patients. Conclusion: The current study revealed statistically significant high prevalence of thyroid dysfunctions-mainly clinical hypothyroidism-among included diabetic patients.

Background: Nephrolithiasis, also known as kidney stones, is the third most prevalent issue affecting the urinary tract, following urinary tract infections and prostate illnesses. Approximately 12% of the global population experiences this condition at some point, encompassing individuals of all ages, genders, and races. Regrettably, the current medical landscape lacks a pharmacological intervention that can effectively treat or prevent the recurrence of kidney stones. Consequently, people turn to herbal medicine as a viable option. Aim: Evaluate the use and perception of herbal medicine among patients residing in Karbala, documenting their herbal products and evaluating patients’ knowledge, practice, and attitude toward herbal remedies and possible factors behind using herbal remedies as an alternative to conventional medications. Method: Two-hundred and sixty-six patients diagnosed with kidney stones in Karbala joined this survey, a cross-sectional design between October 2022 and March 2023, using a questionnaire administered to patients. In face-to-face meetings, participants completed a multicomponent questionnaire comprising 26 items in three parts. The data acquired were analyzed using a statistical package for social sciences; Chi-square was used to correlate some variables, and P-values of <0.05 were considered significant. Results: A significant proportion of individuals aged 20 to 49 exhibited a high level of education, with 50.8% possessing a university degree. Conversely, 9.4% of patients were illiterate. Most individuals within the sample were employed, with only 7.5% identified as students and 4.5% classified as jobless. Most participants, precisely 76.3%, were found to be married, while a smaller proportion, approximately 18.4%, were identified as unmarried. A mere 5.3% of the individuals under consideration were identified as widows, whereas there were no instances of divorce among them. The present study evaluated patients’ knowledge, attitudes, and practice (KAP) outcomes, revealing suboptimal levels of knowledge, neutral attitudes, and poor practice toward herbal therapy. Moreover, the data analysis revealed a noteworthy association between educational attainment and knowledge score, as well as gender and attitude toward herbal products. The findings additionally documented twelve herbal medicines used by patients, with Zea mays and Barley emerging as the most often employed remedies among the remaining options. Conclusion: Most patients lack proper knowledge regarding herbal remedies, and most seek herbal products due to their low cost, relative recommendation, and belief that herbal medications are safe. The most used treatments were Zea mays and barley, which were reasonably priced and famous for their use.

Background: Inflammatory Bowel Disease (IBD) is a chronic gastrointestinal disease, Crohn’s disease (CD) and ulcerative colitis (UC) are two distinct kinds of IBD. Recent researches have linked between Escherichia coli which produce the toxin microcin B17 (E. coli/+mB17) and the development of inflammatory bowel disease (IBD). Objective: This study aimed to demonstrate the relationship between these E. coli isolates and the emergence of IBD in an experimental animal models. Materials and Methods: Twenty female rats, five-weeks-old were divided in to four groups; first group, were orally given E. coli/+mB17 isolated from crohn’s patients stool, the second group rats were orally given E. coli/+mB17 isolated from patients stool with ulcerative colitis, in the third group were orally given E. coli non-producing microcin B17 (E. coli/-mB17) isolated from patients stool with IBD, and the last group received normal saline orally, as control. After fifteen weeks of administration, Blood was drawn for serological tests which include interlukin-10 (IL-10) and tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and the rats sacrificed for evaluation of histological changes in their intestine. Results: All groups that were administrated bacteria, whether they were toxin producer or not, showed a decrease in their weights with a reduction of appetite. Serological changes observed included an increase in IL-10 level and an increase in TNF-$\alpha$ level in their sera. Regarding the histological examination, there were noticeable histological changes in the large intestines of all rats given bacterial suspension but not in small intestine. Conclusion: All E.coli isolates which were isolated from IBD patients stool (whether it was microcin B17 producing or not) were able to induce inflammatory responses and histological changes in the intestines of rats . Accordingly, other virulence factors (in addition to Microcin B17) may play role in the pathogenesis of IBD.

Aim: This research was conducted to determine whether or not a recently formulated intraocular lens (IOL) with an extended depth of focus (EDOF) successfully treats cataracts. Different Techniques: After performing phacoemulsification cataract surgery on a total of 36 eyes belonging to 25 patients ranging in age from 51 to 82, the LUCIDIS EDOF IOL, which was produced by SAV-IOL SA and is situated at Route des Falaises 74 in Neuchatel, Switzerland, was successfully implanted. The patients’ ages ranged from 51 to 82. SAV-IOL SA, located at 74 Route des Falaises in Neuchatel, Switzerland, served as the location for the surgical procedure. Switzerland is home to the city in question. During the course of the three-month follow-up period, the patients’ uncorrected near vision (UNVA), distance-corrected near vision (DCNVA), uncorrected and corrected distance vision (UDVA and CDVA), monocular defocus curves, and refractive outcomes were evaluated. Result: “The postoperative mean values for UDVA, UNVA, and DCNVA were 0.10 $\pm$ 0.19, 0.16 $\pm$ 0.24, and 0.39 $\pm$0.38, respectively. The average distance-corrected visual acuity was over 0.30 between +1.02 and 1.52 D defocus. After cataract surgery, the Synthesis + EDOF IOL provides functional far, intermediate, and close vision. A micro-monovision method might boost this new IOL’s near-visual performance. Clinical investigations should confirm this pilot study’s findings.

Heavy alcohol consumption is linked to the development of type 2 diabetes. Alcohol’s effects on the function of cells are not completely known at this time. This investigation looked into the relationships that exist between all of these different characteristics. All of the males who participated in this study were of Indian descent, and their ages ranged anywhere from 25 to 80 years old. Participants were categorized as abstainers, teetotalers, light drinkers (drinking between 0.1 and 20 grams of alcohol per day), moderate drinkers (consuming between 21.0 and 40 grams of alcohol per day), or heavy drinkers (consuming more than 41 grams of alcohol per day). Light drinkers consumed between 0.1 and 20 grams of alcohol per day. Moderate drinkers consumed between 21.0 and 40 kilos of alcohol per day. Heavy drinkers used more than 41 grams of alcohol per day. After that, the participants were separated into two groups: those with a body mass index (BMI) of less than 25 kilograms per square meter and those with a BMI of 25 kilograms per square meter or more. A number of parameters, such as age, smoking status, body mass index (BMI), waist circumference, blood pressure, lipids, and serum uric acid levels, were taken into consideration. In comparison to individuals who refrained from alcohol use, those who drank alcohol had a lower HOMA- score, and this was the case independent of their body mass index. In the group with a BMI of less than 25 $kg/m^2$, both past and current alcohol use were substantially connected with HOMA-IR. However, this association was not seen in the group with a BMI of more than 25 $kg/m^{2.}$ According to the results of multiple research, drinking alcohol is associated with -cell dysfunction in boys of Indian heritage, independent of the BMI of the participants in the studies.

Background: Children living in countries with moderate income levels, such as India, who are born with untreated refractive abnormalities continue to face significant challenges. Despite the availability of low-cost remedial techniques like eyeglasses, uncorrected refractive defects cause vision loss for many children in India. This persists even though glasses may correct the problem.
Aim: The aim of the present study is to investigate whether children from middle-income families exhibit any refractive errors.
Materials & methods: The researchers conducted the present study after receiving approval from the institution’s ethics board. The research was carried out at Gautam Budha Chikitsa Mahavidyalaya, Jhajra, Dehradun, India. The study enrolled children from middle-income groups in and around the Dehradun city area.
Results & Conclusions: The study revealed that refractive errors are the leading cause of visual impairment among school-age children, particularly those from middle-income families. Given that most refractive defects can be corrected with glasses, there is a need for cost-effective strategies to safeguard children’s eyesight. Such disabilities might impede a child’s development and education. There is compelling evidence supporting this treatable cause of blindness.

Introduction: To date, there is no systematic review dedicated to the study of inventions that have not yet been introduced into clinical practice, but are devoted to the diagnosis, prevention, modeling and treatment of fetal intrauterine hypoxia. Hypoxic damage to fetal brain cells still remains an unsolved problem of obstetrics and gynecology.
Methods: 27 inventions were found from the beginning of the 21st century to 26.08.2023 in databases such as EAPATIS, BYPATENTS, DWPI, DEPATISnet, PATENTSCOPE, Espacenet, RUPTO, USPTO, CIPO, CNIPA, KIPRIS, PatSearch, J-PlatPat, Google Patents and TPO. Due to the small number of inventions, methodological heterogeneity, and differences in the content of their claims, a quantitative meta-analysis could not be performed.
Results: Prospects for innovative obstetric care proposals aimed at improving fetal viability in hypoxia during pregnancy and delivery were analyzed. Results of the included studies were presented only qualitatively (descriptively).
Conclusion: Fetal resistance to impending labor hypoxia has not been previously investigated, so values of low fetal resistance to intrauterine hypoxia are still not among the indications for the use of excess oxygen and the choice of Cesarean section to exclude stillbirth and neonatal encephalopathy. The first systematic review of published inventions shows innovative ways of assessing fetal adaptive reserves to hypoxia, oxygen and apnea administration, and selecting the optimal timing and type of delivery to prevent stillbirth and neonatal encephalopathy.

Background: Choking is a leading cause of morbidity and mortality among children. Food, coins, and toys are the primary causes of choking-related injury and death. Certain characteristics, including shape, size, and consistency, of certain toys and foods increase their potential to cause choking among preschool children. It’s largely preventable with a little knowledge and by following proven guidelines. So this study aimed to investigate the effect of Supportive strategies regarding chocking prevention and first aid maneuver among preschool children. Research Design: A quasi-experimental design was utilized. Study settings: the study conducted at four governmental nursery schools in Al Kut city Research Subject: included 200 preschool children selected by stratified sample from the previously mentioned settings. Tools of the data collection: A predesigned questionnaire sheet, Observational Checklists were used pre and post supportive strategies implementation Results: Revealed that, there was a statistical significant difference (p value < 0.001) between child's knowledge and practice pre and post supportive strategies for chocking prevention Conclusion: Supportive strategies had significant effect on children’s’ knowledge and practice regarding chocking prevention and first aid maneuvers among preschool children. Recommendations: it could be recommended that, implement the designed Supportive strategies for controlling chocking to children at all nursery schools in Kut City.

The present work consists of synthesizing a five-decorated aromatic amine derivatives. The decoration involves aromatic derivatives nano-platelets through an electric process using aromatic amine derivatives such as Sulfamethoxazole, $2$-Amino-$6$-chloro benzothiole, Trimethoprim, $2$-Amino benzoic acid, and $4$-Amino phenol. This process occurs in an electric cell containing platinum electrodes with a voltage of $1.6$ volts, resulting in the production of compound $(R1,R5)$. These compounds were characterized and diagnosed using physical and spectroscopic methods, including infrared spectroscopy (FT-IR), $X$-ray diffraction (XRD), electron microscopy (FESEM), atomic force microscopy (AFM), and $H1$-NMR.

Background: Clexane is used in pregnant women (PW) to minimize placental blood clotting (PBC) and fetal danger. Standard coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) are critical for anticoagulant medication optimization. As a result, the study’s goal was to evaluate the efficacy of clexane as well as adherence to the American Heart Association’s recommended limits for routine coagulation tests. Methods: The study included forty normal PW as controls and forty PW with PBC as patients from Al-Mafraq Hospital in Jordan. Patients were administered daily subcutaneous injections of 40 mg of clexane as an anticoagulant, in conjunction with a daily 75 mg aspirin regimen. During the first trimester, 5 ml of venous blood were drawn from each participant. The PT, INR and APTT were measured. This assessment also considered variables including plasma fibrinogen concentration (PFC), age, body mass index (BMI), blood type, and fetal gender. Results: The mean age $\pm$ SD were 29.6 $\pm$ 6.2 for the patient group and 28.3 $\pm$ 5.9 years for the control group. The changes in PT, INR, APTT and PFC between the control and patient groups were statistically significant independent of mother’s age, BMI, baby gender, or blood type. Patients displayed inadequate anticoagulation with an INR of 0.8, falling below the recommended therapeutic range of 2-3 for anticoagulant treatment. Surprisingly, by the end of the clinical study, all patients under investigation had safely delivered their babies without difficulties. Conclusion: The observed rise in fibrinogen levels among patients may contribute to PBC formation, necessitating further investigation. Evaluation of the safety and efficacy of a combined 40 mg Clexane and 75 mg aspirin regimen in PW from the Al-Mafraq region, Jordan, is warranted.

Purpose: To evaluate the prescription pattern and utilization of drugs used by glaucoma patients with comorbidities including hypertension and diabetes mellitus type 2.
Methods: This study was conducted at Al-Shifa trust eye hospital, Rawalpindi Pakistan from April 2021 to October 2021. Data regarding patient demographics, disease profile, medications & side effects were recorded. Percent utilization of total ophthalmic, antiglaucoma, antihypertensive, and antidiabetic drugs was calculated. Comparative utilization of antiglaucoma drugs in hypertensive and diabetic patients and in pre and post-visit to glaucoma specialists was also calculated.
Results: Out of 876 glaucoma patients, majority had primary open-angle glaucoma, 58.3 were males, >50 belonged to the 50-70 years age group, and 27 and 18.8 were hypertensive and diabetic respectively. In the majority of cases, 1 or 2 eye drugs were prescribed and mostly in the topical dosage form. Fixed dose combinations (33.39) mainly were prescribed in all groups and Dorzolamide + Timolol was given in almost 80 of the time. Prostaglandin analogs (29.09) were 2nd most prescribed drugs. Beta-blockers were the least prescribed in all groups. Burning of the eyes was the most common side effect of ophthalmic drugs (28). Systemic beta-blockers were most commonly utilized by hypertensive patients while sulfonylureas by diabetic patients. No prominent change was noted in pre- and post-visit utilization of antiglaucoma drugs except brinzolamide.
Conclusion: This study highlights the need for rational prescribing of antiglaucoma drugs in multimorbid patients and the importance of creating awareness of pharmacological actions, drug interactions, and side effects among physicians.

Background: Around the world, doctors frequently prescribe antimicrobial agents (AMAs). However, irrational and inappropriate use of AMAs results in several negative outcomes, including antimicrobial resistance, connected health issues, lengthened hospital stays, and increased treatment costs. Antimicrobial resistance (AMR) is becoming a more serious global challenge in hospitals and communities. Hence, Drug Utilization Evaluation (DUE) studies are created primarily to evaluate and improve prescribing procedures and enhance the rational use of pharmaceuticals to address this significant condition. Materials and methods: A prospective observational study was conducted in a tertiary care hospital’s in-patient department of medicine. Analyses were done on the antibacterial agent drug usage patterns. Using Defined Daily Doses (DDDs) and Anatomical Therapeutic Chemical (ATC) Classification. The cost of the AMA therapy was estimated using the government’s approval rate for generic drugs. Results: Sixty-seven of the 100 patients were women, and 33 were men. Throughout the research period, 432 medications were prescribed, of which 39.8% were antibiotics and 77 % of patients had their AMA prescriptions based on data from bacteriological culture and sensitivity tests. The National List of Essential Medicines (NLEM) of India and the state essential drug lists were followed for prescribing the antimicrobial drugs by their generic names, respectively. In 27% of prescriptions, there was evidence of polypharmacy, and 70% of the combinations were logical. The patient spent 3.47 days in the hospital on average throughout their stay. It was discovered that antibiotics cost an average of Rs 200.17 per patient every day. Conclusion: Hospital antibiotic policy according to the ASP (Antibacterial Stewardship Programme) is essential for the optimization of antimicrobial therapy in this institution to ensure rational use of AMAs and to fight antimicrobial resistance.

Background: Specialist ambulatory care Nursing is a complicated, diverse profession that includes solitary and group practice. Young children who experience febrile seizures, often known as fits or convulsions, are affected by fever. Aim: It aimed to assess ambulatory nursing care for young children suffering from febrile convulsions. Design: Descriptive research design is used. Sample: A convenient sample for all ambulatory nurses they were 100 nurses. Setting: Study conducted at all outpatient clinics at Central Children’s Hospital, Al-zahrawi ( Ibn Al-Baladi.) Teaching hospital and Welfare children teaching hospital Two tools: 1st Structural interviewing questionnaire composed of two parts (demographic characteristics, ambulatory nurse knowledge about febrile convulsions), second tool: observation checklist of ambulatory nurse practice. Results: Regarding ambulatory nurses’ knowledge about Febrile Convulsions, 65% of nurses have satisfactory knowledge, 35% of them have unsatisfactory knowledge regarding febrile convulsions, Also, 70% of nurses done practice, and 25.0% of them not done practice and 5% of them do not know regarding measurement young children body temperature under axillary, While, 65% of nurses done practice, and 20.0% of them not done practice and 15% of them do not know regarding the right way to make tap compresses and 70.0% of nurses done practice, and 20.0% of them not done practice and 10% of them do not know regarding the right way to give oxygen therapy. Conclusion: there was a positive relation between nurses’ total knowledge and total practice regarding the right way to measure body temperature, the measurement of young children’s temperature under axillary, and the right way to give oxygen therapy with statistical significance difference between nurses’ knowledge and practice regarding febrile convulsions (p< 0.001). Recommendations: Continuous health education and training programs for the nurses about febrile convulsions.

Background: Fine Needle Aspiration Cytology (FNAC) has emerged as the primary approach for the initial assessment of thyroid nodules, followed by ultrasound scanning and a thyroid profile analysis. This study aims to analyze the prevalence of solitary thyroid nodules and investigate the factors contributing to malignancies in patients with solitary thyroid nodules. Methods: The study encompassed a total of 50 cases. In all instances, a neck ultrasound was performed to exclude multinodular goiter. Fine Needle Aspiration Cytology (FNAC) served as the primary diagnostic procedure for assessing the solitary nodule in every case. Additionally, clinically diagnosed thyroid cases were subjected to further evaluation in accordance with the provided proforma. Results: The male-to-female ratio was 1:4, with the highest occurrence observed in the second and fourth decades of life. Approximately 30 patients exhibited nodules in the right thyroid lobe. Fine Needle Aspiration Cytology (FNAC) demonstrated a sensitivity of 64% for benign lesions and 100% for malignant ones. The most frequently encountered histopathological findings were colloid goiter and follicular adenoma. The malignancy rate was 16%, with six cases experiencing hypocalcemia and seven patients encountering wound dehiscence. Conclusion: Besides determining the cystic or solid nature of the clinically palpable nodule, ultrasonography is valuable for characterizing the rest of the thyroid gland, thereby distinguishing between a true solitary nodule and a dominant nodule within a multinodular goiter. Fine Needle Aspiration Cytology (FNAC) and thyroid profile assessments are pivotal diagnostic tools. Hemi-thyroidectomy emerges as the most suitable and cost-effective surgical intervention for its treatment.

Background: Osteoarthritis (OA) of the knee, including bilateral varus deformity, presents unique challenges for treatment. This comparative study evaluates clinical and radiological outcomes of conventional total knee replacement (TKR) and robotic-assisted TKR in patients with bilateral varus deformity knee OA within the Eastern population. Methods: A prospective study was conducted on 84 bilateral varus deformity knee OA patients treated with two different surgical approaches: Group A (Conventional TKR) and Group B (Robotic-assisted TKR). Clinical outcomes, including pain relief, functional improvement, and patient satisfaction, were assessed using Visual Analog Scale (VAS), Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quality of life measures. Radiological outcomes, including alignment and component positioning, were evaluated. Statistical analyses compared outcomes between groups. Results: Both groups demonstrated significant improvements in clinical and radiological outcomes. Robotic-assisted TKR showed advantages with reduced pain (p < 0.001), superior knee function (p < 0.001), better pain relief and function (p < 0.001), higher patient satisfaction (p < 0.001), and improved quality of life (p < 0.001) compared to conventional TKR. Radiologically, robotic-assisted TKR exhibited superior alignment (p < 0.001) and component positioning (p < 0.001). Implant survivorship remained excellent in both groups, with no revisions reported. Conclusion: Robotic-assisted TKR offers significant benefits in pain relief, functional improvement, and radiological outcomes for patients with bilateral varus deformity knee OA within the Eastern population. While both approaches are effective, the advantages of robotic assistance should be considered in surgical decision-making. Further research is needed to assess cost-effectiveness and long-term outcomes.

Background: Repairing a recurrent hernia is a challenging endeavor due to the pre-existing weakened tissues and altered anatomy. Among the available approaches, the open posterior preperitoneal approach has demonstrated significantly better outcomes compared to the anterior approach. Additionally, the laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair represents an evolving technique with the advantages of minimally invasive surgery. The objective of our study is to perform a comparative analysis of these three approaches for the repair of recurrent inguinal hernias, focusing on complications and the occurrence of early recurrences. This research aims to provide valuable insights into the most effective and safe approach for managing this challenging surgical condition. Methods: In our study, we conducted a randomized allocation of 200 patients into three equal groups: Group A, Group B, and Group C. Patients in Group A underwent the open posterior preperitoneal approach, while those in Group B received transinguinal anterior tension-free repair. Group C patients underwent the laparoscopic transabdominal preperitoneal (TAPP) procedure. The primary endpoint of our study was to assess the recurrence of inguinal hernias following the respective surgical approaches. Results: Our study yielded several noteworthy findings. The mean hospital stay, time to return to work, and time off from work were all shorter in Group C when compared to Groups A and B. Chronic postoperative pain was observed in 13.33% of patients in Group A, 30% of patients in Group B, and 10% of patients in Group C. Notably, the overall complication rate was lower in both Groups A and C at 19.7%, while Group B had a higher complication rate of 34.36%. Conclusion: In the context of recurrent inguinal hernia repair, our study findings suggest that the laparoscopic and open posterior approaches are equally effective in terms of operative outcomes. The open preperitoneal hernia repair stands out as a cost-effective option with a low recurrence rate. Patients undergoing this procedure experience a relatively short postoperative recovery period and report minimal postoperative pain. This approach has demonstrated significantly better outcomes compared to the commonly used anterior approach.

Back ground: The most frequent skin ailment in children younger than 12 months is shown to be diaper dermatitis.
Objectives: The objectives of the research were to determine the level of mothers’ awareness about diaper dermatitis for children under two years .
Material & Methods: 90 moms who had children under the age of two years were selected through a non-probability purposive sample and used in a descriptive study. The study began during the time frame of 1 January to 15 May 2023. The researcher collected the data, respecting the privacy and anonymity of the information. Primary health centers in Baghdad city, including Bab Al-Moadem Health Center and New Iraq Health Center, were visited as part of the study to gather replies to the subjects’ questionnaires. The information gathered between the 2nd of February and the 2nd of March 2023 using a built-in questionnaire and a direct interview method. SPSS version 22.0 was used to analyze the data. Statistical significance was determined by the p-value. Results: According to the study’s findings, only 43.3% of samples of mothers at primary health care centers showed good levels of awareness regarding diaper dermatitis, while 56.7% had poor levels. Conclusions: This study is the first to document the prevalence of diaper dermatitis in Iraq for children under 2 years. The majority of moms do not have a job, and their families have a modest degree of socioeconomic status. Additionally, most mothers learn about diaper dermatitis through their relatives, therefore this and other factors contributed to the low level of awareness.

Background: For quite some time, cholecystectomy has been perceived as a safe surgical procedure, often with limited attention given to potential secondary effects. It’s worth noting that the gallbladder plays a significant role as a regulatory component in coordination with vital metabolic pathways responsible for maintaining equilibrium in the body. When the gallbladder is removed, bile from the liver flows directly into the upper portion of the intestine. Therefore, this study aims to evaluate the impact of laparoscopic cholecystectomy on the serum lipid profile of patients. Material and methods: A total of 60 patients diagnosed with gallstones were enrolled in this study. Preoperative blood samples were collected from all patients under sterile conditions, two hours prior to their scheduled surgery, to evaluate their lipid profile. Results: The preoperative mean Total Cholesterol (TC) levels were measured at 160.5 mg%, while postoperatively, they showed a slight decrease to 150.8 mg%. Similarly, the mean High-Density Lipoprotein Cholesterol (HDL-C) levels before surgery were 42.1 mg%, and they decreased to 40.8 mg% after the procedure. In contrast, the mean Triglyceride (TG) levels saw an increase from 180.8 mg% preoperatively to 200.8 mg% postoperatively. Notably, the comparison of mean TC and TG levels before and after the surgery yielded significant results, indicating changes in these lipid parameters following laparoscopic cholecystectomy. Conclusion: Patients undergoing laparoscopic cholecystectomy experience noteworthy changes in their serum lipid profile.

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors. Many people may be unaware of their risk for MetS. The prevalence of patients with chronic metabolic and cardiovascular multi-comorbidities has been increasing steadily over the course of the last decades. Objective: To identify critical care nurses’ knowledge level concerning metabolic syndrome. Methodology: A cross-sectional, descriptive study was conducted among critical care nurses at Al-Diwaniyah teaching hospital and the specialized center for cardiac surgery and catheterization for the period from November 1, 2022, to April 30, 2023. A non-probability purposive sample consisting of 118 nurses who work in critical care units. The study instrument consists of two parts: The first part: socio-demographic characteristic, which includes (6) variables, and the second part: consists of twenty-five questions to evaluate the knowledge of the participant about cardiometabolic syndrome. Results: The result of the current study showed that (62%) of the study participants had a moderate level of knowledge about metabolic syndrome, while only one-third of nurses had a poor knowledge level. It also demonstrated there is a statistically significant relationship between the nurses’ knowledge and their educational level and years of experience in nursing. Conclusion: The study concluded that nursing has a moderate level of knowledge concerning metabolic syndrome, while a few numbers of them have poor knowledge.

Background: The occurrence of anastomotic leakage following intestinal surgery stands as a significant contributor to postoperative complications and fatalities. This prospective study was conducted with the aim of assessing different factors associated with the risk of anastomotic leakage. Methods: This study was carried out within the Department of Surgery over the course of one year. It encompassed patients who underwent intestinal anastomosis, whether in emergency situations or as part of routine surgical procedures. The study encompassed a total of 150 patients. Results: Anastomotic leakage was identified in 18.02% of cases, with a higher incidence among males and individuals from a lower socioeconomic background. However, age, gender, and socioeconomic status were not found to be significant risk factors for anastomotic leakage. The incidence of leaks was elevated in patients with chronic illnesses such as malignancy, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and those on chronic corticosteroid therapy. Additionally, malnourished patients and those with sepsis, as indicated by their blood investigation reports, had a notably higher leak rate. After conducting logistic regression analysis, several independent predictors for anastomotic leaks were identified, including peritonitis ($p<\mathrm{0.05)}$ odds ratio $2.156$), bowel obstructions ($p<\mathrm{0.05)}$; odds ratio $2.864$), receiving more than 2 units of blood transfusion ($p<0.05$; odds ratio $2.334$), serum albumin levels $<3.0$ gm/dL ($p<0.001$; odds ratio $8.873$), corticosteroid therapy ($p1.2$ mg/dL ($p<0.001$; odds ratio 11.785), surgery duration exceeding 4 hours ($p<0.01$; odds ratio 3.0251), and ASA Grading (III & IV) ($p<0.01$; odds ratio 3.707). Conclusion: This study has successfully identified key risk factors that influence the occurrence of anastomotic leakage. The findings from this research are expected to be valuable in efforts to mitigate the incidence of anastomotic leakage following surgery.

Background: Varicose vein (VV) is a common problem that mostly occurs in legs. This medical condition can influence the quality of life and working condition of nurses.
Aim of the study: To estimate the prevalence of lower limbs varicosity and its associated risk factors among nurses. Methods: This a cross-sectional descriptive study was carried out among 100 nurses working Baghdad Teaching Hospital, Surgical Specialties Hospital, and Al- Kidney Teaching Hospital, Baghdad, Iraq from January 1st to May 10th, 2022. The participants were recruited in the study using systematic random sampling. The Occupational Sitting and Physical Activity and Aberdeen Varicose Vein Questionnaires were used for data gathering. Results: The prevalence of varicose veins was estimated to be (48%) of the sample. There are a significant association between (age, prolonged standing, body mass index and varicose vein. Conclusion: The prevalence of VV among the nurses working in Baghdad teaching hospitals was high, and many factors showed a significant relation with this problem. Nurses should be informed about preventive measures and treatments for this medical condition.

The prevalence of inguinal hernias varies globally, likely influenced by factors such as the age distribution of the population, access to surgical care, and the risk of complications from hernias. Worldwide, inguinal hernias contribute significantly to mortality, with more than 60,000 people succumbing to hernia-related complications each year.Patients displaying clinical signs of inguinal hernias were admitted and underwent a comprehensive evaluation, including a detailed medical history and physical examination, as well as standard diagnostic tests such as complete blood count, blood sugar assessment, serum creatinine measurement, chest X-rays, and ECGs.Among the cases included in this study, approximately 50% presented with a noticeable swelling within 2 to 6 months after its initial onset. Roughly 25% sought medical attention between 6 to 12 months after the onset of symptoms, while around 15% delayed seeking medical care for over a year after the swelling first appeared. In terms of hernia types, indirect inguinal hernias accounted for 72.67% of the total cases in the study, with the remaining 27.33% classified as direct inguinal hernias.

Background: Fluoroquinolones like Ciprofloxacin are broad-spectrum antibiotics. They act on targeted bacteria by interfering with DNA replication, leading to the generation of free radicals which ultimately contribute to bacterial death. Conversely, dietary antioxidant supplements are commonly prescribed during the course of infection treatment. Co-administration of a multivitamin preparation alongside fluoroquinolones might play a role in fluoroquinolone treatment failure. Objectives: Thus, the present study aimed to investigate the effect of antioxidants like vitamin E, vitamin C, and vitamin B12 on the action of ciprofloxacin against various standard bacterial strains and ciprofloxacin-sensitive clinical isolates. Methods: The antibacterial activity of ciprofloxacin in the absence and presence of these antioxidants was assessed using the Kirby-Bauer disc diffusion method and by determining the minimum inhibitory concentration. Results: All strains tested in the study demonstrated sensitivity to ciprofloxacin alone. However, when vitamin C, E, or B12 was incorporated into the test medium, all strains exhibited significantly smaller zones of inhibition and elevated MIC ranges compared to ciprofloxacin alone. Conclusion: The generation of reactive oxygen species during the antibacterial action of ciprofloxacin on bacterial cells was either diminished or attenuated after supplementing the media with vitamin C, E, or B12. These antioxidants acted as free radical scavengers, protecting bacterial cells from the effects of generated free radicals. As the presence of antioxidants in the environment modulates the action of ciprofloxacin, the ingestion of these antioxidants should be closely monitored during the treatment course.

Background: In Iraq, breast tumor is the greatest prevalent form of female malignancy. Increasing research in the past ten years shows that many human malignancies, including breast tumors, are associated with Human Cytomegalovirus and high-risk Human Papilloma Virus. Objectives: The aim of this research was to determine the role of HPV and HCMV in benign and malignant breast tumors. Methods: This retrospective research used 140 chosen formalin-fixed, paraffin-embedded pieces of breast specimen taken from 100 patients of breast tumor (70 cases of ductal mammary, 15 patients of lobular cancer, five persons mixed from ductal and lobular cancer and ten persons of medullary cancer) and 20 patients infected with benign epithelial lesion As well as 20 pieces of normal breast tissue as control groups. The range of age was 16-72 years. The study was conducted in hospitals and private laboratories in Kirkuk and Tikrit city from 15th January 2022 to 15th December 2022 using the in situ hybridization (ISH) technique. Results: The archival samples collected were related to breast cancer patients ranging from 16 years to 70 years of age, with a maximum age of 73 years in breast cancer and 60 years in healthy women. ISH found that CMV was positive in (25 percent) breast cancer tissues (25 / 100) according to the control group were negative. While in HPV demonstrated (45%) 45/ 100 breast cancer tissues compared to the control group were negative. Of these, The findings revealed that the spreading of HPV-DNA genotypes in malignant and benign cancer groups were as follows: HPV16 10 (20.8%), HPV 18 10 (20.8%), and HPV 31 28 (58.33%). These results suggest that HPV genotype 31 appeared at a greater rate than other genotypes (16 and 18). In 25 (55.6 percent) cases, the largest ratio of co-infection with several high-risk genotypes of HPV 16 + 18 + 31 was observed. Co-infection in the malignant group with other high-danger HPV genotypes was as follows: HPV 16 +18 6(13.33%), HPV 16 + 31 6(13.33), and HPV 18+31 8(17.8%). Positive signs suggesting high-risk HPV infection were detected for 1/1 (100 percent) of benign breast tumor tissues; 30(66.7 percent) mixed HPV infection was found in 45 cases of malignant breast tumors. Conclusion: The results of this study showed a connection between HCMV and high-oncogenic genotypes of HPV in breast cancer patients.

Background: The primary reason for lower extremity amputations predominantly arises from diabetic foot conditions. This study’s objective was to explore the clinical features and influencing factors associated with amputation among patients presenting with diabetic foot ulcers in emergency departments. Methods: This study was conducted through a retrospective examination of the medical records of 60 patients referred to the Emergency Unit due to diabetic foot ulcers. Results: Out of the 60 patients in this study, 34 (53.4%) were male, and 26 (46.6%) were female. The average age was 61.4311.584 years, with an age range of 41 to 85 years. Notably, extremity amputation was not necessary for 34 patients (58.6%), whereas 24 patients (41.4%) did undergo amputation. Factors influencing the need for extremity amputation included the duration of the disease, the presence of coronary artery disease, the length of hospital stay, and the presence of osteomyelitis. Among the laboratory findings, factors associated with extremity amputation were levels of albumin, hemoglobin, leukocytes, neutrophils, neutrophil-to-lymphocyte ratio, hemoglobin A1c, and elevated erythrocyte sedimentation rate. Conclusion: The findings of our study indicate that in addition to classification systems, factors such as comorbidities, levels of albumin, hemoglobin A1c, sedimentation rate, and results from complete blood counts are pivotal in predicting the necessity for amputation in patients with diabetic foot ulcers seeking care in emergency units.

Cecal ligation and puncture (CLP) is one of the most widely utilized models for rat experimental polymicrobial sepsis. In this work, we examine how the anti-oxidant and anti-inflammatory drug Etanercept (ENT), which has been FDA-approved, might lessen the damaging effects of sepsis on renal tissues. In this study, rats were divided into four groups: the control group, which received just CLP; the solvent group, which received DMSO intravenously before CLP; and the treatment group, which received ENT intraperitoneally before CLP, might possibly reduce the risk of sepsis-induced renal tissue damage. According to our results, ENT reduced NF-kB, TNF-$\alpha$, and TLR levels compared to the solvent alone group or control group. A positive tissue integrity was found in the ENT-pretreated group as compared to the solvent-only group or control group during a histopathological evaluation of the renal tissues. The findings indicate that ENT could potentially lower the risk of renal tissue damage due to CLP.

Background: Gallstones represent a prevalent gastrointestinal ailment often necessitating hospitalization. The preferred surgical approach for most patients is laparoscopic cholecystectomy. Instances where the procedure is converted to an open cholecystectomy typically result from factors such as adhesions, complex anatomy at Calot’s triangle, or injury to the common bile duct [1]. This study focused on patients admitted to the surgery department to identify the factors leading to the shift from laparoscopic to open cholecystectomy within a tertiary care center. Secondary objectives encompassed assessing age, gender, and etiological factors associated with cholelithiasis. Methods: This prospective observational study involved 200 admitted patients after obtaining informed consent and ethical clearance from the Institutional Review and Research Committee (IRRC). Those diagnosed with cholelithiasis through imaging techniques like ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and/or endoscopic retrograde cholangiopancreatography (ERCP) were planned for laparoscopic cholecystectomy [2]. The study investigated the factors linked to the conversion of laparoscopic cholecystectomy to an open procedure. Results: Among the 200 patients included in the study, 18 required conversion to an open cholecystectomy. The primary reason for conversion was adhesions, accounting for the highest proportion at 8%. Other reasons included CBD injury (2%), bleeding of the cystic artery (2%), bowel injury (1%), and unclear anatomy (3%). Conclusion: Laparoscopic cholecystectomy is a secure and minimally invasive procedure characterized by a low conversion rate. In this study, the primary reason for conversion was the significant presence of dense adhesions in Calot’s triangle, underlining its importance as a common factor leading to a shift from laparoscopic to open cholecystectomy.

Inflammation and oxidative stress are critical factors leading to sepsis-induced severe lung injury (ALI). This study investigates the regulatory effects of Etanercept (ENT) in an animal model of sepsis-induced ALI. We established a cecal ligation and puncture (CLP) model for ALI in adult rats under anesthesia. Sepsis amplifies pathological lung tissue damage, lung endothelial permeability, serum inflammatory factor production, and the number of inflammatory cells in bronchoalveolar lavage fluid. Furthermore, it enhances the expression of phosphorylated NF-$\kappa$B p65, reduces lung superoxide dismutase due to CLP, and elevates lung malondialdehyde levels due to LPS-induced inflammatory factor production. This cascade of events exacerbates the expression of several genes, including TNF-$\alpha$ and cytokines. LPS-induced inflammatory factor production also enhances the formation of reactive oxygen species in mitochondria. In summary, our current research provides evidence that ENT acts as a novel regulator of inflammation in sepsis-induced ALI in rats. The control of oxidative stress and the modulation of the inflammatory response are two key underlying mechanisms for the effects of ENT.

Backgroud: Gallbladder diseases typically present as gallstones, inflammation, and cancer. Cholecystectomy has long been the established surgical approach for treating cholelithiasis and cholecystitis. The Critical View of Safety (CVS) technique is employed to identify key anatomical structures precisely, namely the cystic duct and the cystic artery. As such, this study aims to evaluate the effectiveness of the CVS method in laparoscopic cholecystectomy for preventing bile duct injuries. Material and methods: The study encompassed a cohort of 70 consecutive patients diagnosed with gallbladder disease. Thorough demographic information for each patient was meticulously collected. Preoperatively, a comprehensive hematological and biochemical profile analysis was conducted. Proficient and seasoned surgeons executed all surgical procedures. Subsequently, a post-operative evaluation was carried out for all patients. Results: In our study, aberrant anatomy was identified in two patients, while 68 patients exhibited typical anatomical structures. Notably, we achieved a 100 percent success rate in obtaining the Critical View of Safety for all patients in our study. However, aberrant anatomy was encountered exclusively in those two cases, necessitating a conversion to open cholecystectomy. Conclusion: The Critical View of Safety method for ductal identification is an effective technique.

A versatile and simple spectrophotometric technique has been presented for the detection of Ganciclovir (GANCICLOVIR) in pharmaceutical formulations. The oxidation method included mixing an excessive amount of N-bromosuccinimide (NBS) with Ganciclovir in an acidic solution, then calculating the amount of unreacted NBS using methyl blue at \(\lambda\) 610 nm. With a superior molar absorption of \(3.39 \times 10^{-3}\) L mol\(^{-1}\) cm\(^{-1}\), the amount of NBS interacting with the colorant is equal to the amount of the drug. The Sandell's sensitivity index was 0.169 g cm\(^{-2}\), the Beer-Lambert law scale was 1-35 \(\mu\)g mL\(^{-1}\), and the recovery of the concentration was 99% with a relative standard deviation of 0.01%. The technique was successfully used to measure the drug content in pharmaceutical formulations. The precise quantification of Ganciclovir, a highly effective antiviral medication, is of considerable significance in the fields of pharmaceutical analysis and clinical practice. The objective of this study was to establish a dependable and effective approach for the quantification of Ganciclovir via an oxidation reaction employing N-bromosuccinimide (NBS) as the oxidizing agent.

Background; Aim; Correlation Between Nephropathy and Anemia in Patients with Type 2 Diabetes in Tertiary Care Hospital. Material and methods; The current study was a five-month cross-sectional investigation carried out in an Indian tertiary care hospital (January to May 2024). The Institutional Ethics Committee approved the project. One hundred and sixty male Type 2 diabetics between the ages of thirty and seventy were involved in the study. Results; Ninety of the 160 research participants had DPN, and 70 did not. Eighty of the 160 patients in total were anemic, while the remaining 65 were not. In the anemia group, 25 people lacked DPN and 59 had it. Of the non-anemic group, 25 had DPN and 40 did not. It was discovered that participants with DPN had longer diabetes durations and higher mean ages than those without DPN. Conclusion; The current study's findings indicate that diabetics with anemia have declining motor and sensory nerve conduction velocities. According to the research, anemia in diabetics is a condition that is often ignored and puts them at risk for problems like neuropathy. Therefore, to prevent long-term consequences, anemia in diabetics needs to be examined. Participants in the study and staff providing support are acknowledged.