Scopus Research — Salim K. Hajwal

Diabetes mellitus (DM) is a globally prevalent metabolic disorder with rising incidence. Diabetic peripheral neuropathy (DPN), the most common microvascular complication in DM, disrupts autonomic nervous system regulation of cardiac and circulatory functions, thereby increasing susceptibility to cardiovascular and cerebrovascular events. Elucidating the relationship between diabetic DPN and cardiovascular complications is critical for optimizing holistic management of diabetic patients. This study aimed to investigate the correlation between DPN and cardiovascular events in patients attending the Diabetes Clinic of Rafsanjan University of Medical Sciences, Iran. In this cross-sectional study, 260 patients with type 2 diabetes mellitus (T2DM), diagnosed per the American Diabetes Association (ADA) 2023 criteria, were enrolled via convenience sampling. The patients with cardiovascular complications group comprised 121 patients with T2DM and documented cardiovascular events, while the control group included 138 patients with T2DM and no cardiovascular history. Data on demographic characteristics, body mass index (BMI), blood pressure, clinical laboratory parameters, and neuropathy severity (assessed via the Michigan Neuropathy Screening Instrument [MNSI]) were collected. Statistical analysis was performed using SPSS version 22. The patients with cardiovascular complications had significantly higher neuropathy scores (p = 0.039), longer diabetes duration (p < 0.05), greater prevalence of hypertension (p < 0.001), and elevated serum creatinine (p = 0.020) compared to those without cardiovascular complications. In multivariable logistic regression, severe diabetic neuropathy (score > 4) was associated with increased odds of cardiovascular complications in the unadjusted model (OR = 1.73, 95% CI: 1.03–2.91) and after adjustment for demographic and lifestyle factors (adjusted OR = 2.07, 95% CI: 1.07–3.97; p = 0.030). A significant crude association was also observed for each one-unit increase in continuous neuropathy score (OR = 1.09, 95% CI: 1.01–1.18; p = 0.021). A significant association was found between peripheral neuropathy and increased odds of cardiovascular disease in T2DM patients. This underscores the potential role of neuropathy as a marker for cardiovascular risk. Further longitudinal studies are warranted to explore the mechanistic interplay between neuropathy progression and cardiovascular outcomes. © The Author(s) 2025.

Atopic dermatitis (AD) is a lifelong inflammatory dermatosis associated with intense itching, scratching, and erythematous dry skin. Conyza canadensis is a medicinal herb enriched in polyphenols and flavonoids and has profound anti-inflammatory and antioxidant actions. To evaluate the anti-eczematous effect of topical flavonoid fraction in a mouse model of 1-chloro-2,4-dinitrobenzene (CDNB)-induced AD. Fifty Swiss albino-type mice were randomly divided into 5 groups of 10 each: control, induction, vehicle, tacrolimus, and flavonoid. The ethanolic extract of Conyza canadensis was evaluated by HPLC. Skin specimens were taken for histopathology, immunohistochemistry, and tissue homogenate analyses. Flavonoids from Conyza canadensis effectively lowered CDNB-exacerbated eczematous manifestations, as seen by diminished general dermatitis scores and scratching behaviors, along with a drop in overall leukocyte, neutrophil, and eosinophil percentages. Further, topical flavonoids profoundly hampered immunohistochemistry grades for IL-4 and IL-13, as well as amounts of IgE, MDA, IL-33, IL-17, IL-1β, and TNF-α in the skin. Isolated flavonoids also suppressed histologic scores, including cutaneous thickening/acanthosis and inflammatory cell penetration. Flavonoids of Conyza canadensis alleviates CDNB-evoked AD-like skin lesions thanks to its strengthening anti-inflammatory and anti-oxidative activities. © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2025.

The chromones found in the dried roots of Saposhnikovia divaricata include cimifugin; in fact, Saposhnikovia divaricata is a main source of cimifugin. Vinpocetine is a synthetic version of vincamine derived from periwinkle; it is characterized by potent anti-inflammatory properties that allow it to reduce immune cell infiltration and suppress the release of pro-inflammatory cytokines. The objective of this study was to investigate the potential influence of a topically-applied combination of cimifugin and vinpocetine gels on a model of a psoriasis-like inflammatory skin reaction. To this end, we divided 48 albino BALB/c mice into six groups. All groups except for the negative control group received imiquimod topically (daily, for 7 days) for the induction of psoriasis-like skin lesions. A group received imiquimod (5%) only (positive control), while four other groups were also treated with a clobetasol (0.05%) cream, a cimifugin (3%) gel, a vinpocetine (3%) gel, or a combination of cimifugin (3%) and vinpocetine (3%) gels, once daily, for 7 days; the aforementioned treatments were first applied 7 days after the pharmacological induction of the lesions. Our findings revealed that the topically-applied combination of cimifugin-and vinpocetine-containing gels had an important anti-psoriatic effect, as seen by the diminishing of the skin levels of tumour necrosis factor-alpha, interleukin-17, and interleukin-23, thereby improving the imiquimod-induced histological changes in mice. We conclude that a topically-applied combination of cimifugin and vinpocetine can exert substantial anti-psoriatic activity. © 2025, ZITA Medical Management. All rights reserved.

Skin aging is a prominent manifestation of human aging, largely driven by oxidative stress and inflammation. D-limonene, a natural monoterpene, possesses strong antioxidant and anti-inflammatory properties that may help counteract these effects. This study aimed to explore the anti-aging and skin-rejuvenating potential of D-limonene in a mouse model of D-galactose-induced skin aging. 60 male mice were divided into 6 groups (n = 10). Group I served as the control. Group II received D-galactose (500 mg/kg) for 42 days to induce aging. Groups III and IV received vitamin C (100 mg/kg) either concurrently with D-galactose or after aging induction, respectively. Groups V and VI received D-limonene (100 mg/kg) either simultaneously with D-galactose or after induction. This design allowed comparison of protective versus therapeutic effects. Both concurrent and post-treatment with D-limonene substantially decreased pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) and the oxidative stress marker MDA, while enhancing antioxidant components (SOD and GPx) and promoting the synthesis of collagen types I and III. Additionally, it improved skin thickness and histomorphological scores, restoring normal skin architecture. D-limonene exerts potent anti-aging and skin-rejuvenating effects by modulating oxidation and inflammatory markers, suggesting its potential as a preventive and curative anti-aging agent. © The Author(s), under exclusive licence to Springer Nature B.V. 2025.

A cytokine storm is a severe and potentially fatal condition resulting from an excessive immune response. Epicatechin and huperzine A have demonstrated anti-inflammatory and antioxidant properties, suggesting their potential utility in mitigating tissue damage and cytokine storm severity. This study aimed to compare the protective effects of huperzine A and epicatechin in a cytokine storm-like murine model. Sixty male Swiss albino mice were randomly allocated into six groups. Except for the control group, all animals received a single intraperitoneal injection of lipopolysaccharide (LPS; 5 mg/kg) in order to induce a cytokine storm. The induction group received LPS without further intervention. The remaining groups were pre-treated for three consecutive days prior to LPS administration as follows: vehicle group (1% dimethyl sulfoxide), methylprednisolone group (50 mg/ kg/day methylprednisolone), huperzine A group (0.2 mg/kg/day huperzine A), and epicatechin group (25 mg/kg/day epicatechin). The histological analysis of lung tissues and the quantification of serum cytokines – interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) – revealed that all pre-treated groups exhibited significant anti-inflammatory effects. Notably, epicatechin conferred a more pronounced protective effect than either methylprednisolone or huperzine A, as evidenced by reduced pulmonary histopathological alterations and lower serum cytokine concentrations. In conclusion, both huperzine A and epicatechin demonstrated protective efficacy against the LPS-induced cytokine storm, with epicatechin showing superior performance in attenuating systemic inflammation and lung injury. © 2025, ZITA Medical Management. All rights reserved.

Peptic ulcer disease (PUD) is a chronic condition of the digestive system that can lead to serious complications, increasing both morbidity and mortality and adversely affecting patients’ quality of life. This study aimed to assess the sociodemographic characteristics of the sample and to evaluate patients’ responses to known risk factors associated with PUD. A descriptive study was conducted in hospitals located in Al Hilla, Iraq. A purposive sample of 100 patients diagnosed with PUD was selected based on predefined inclusion criteria. Data were collected using a structured questionnaire and were analysed using descriptive statistics. Frequencies and percentages were used in order to categorize responses, while the mean and standard deviation were calculated in order to assess central tendency and variability. The findings revealed that patients reported high levels of exposure to several risk factors, including psychological stress, consumption of spicy foods, and intake of caffeinated beverages such as tea and coffee. The highest mean score was observed for the use of non-steroidal anti-inflammatory drugs, whereas the lowest scores were recorded for alcohol consumption, tobacco smoking, and rapid ingestion of food. In conclusion, the study highlights that dietary habits and lifestyle factors play a significant role in the development and exacerbation of PUD. © 2025, ZITA Medical Management. All rights reserved.

Cytokine storm is a life-threatening hyperinflammatory condition that can result from infectious diseases, including COVID-19, as well as from non-infectious autoimmune disorders. This study has investigated the potential of glutathione to mitigate a cytokine storm in mice, particularly when administered in combination with prednisolone; a synthetic glucocorticoid. Fifty male albino mice were randomly assigned into five groups. The negative control group received 1% dimethyl sulfoxide (DMSO) intraperitoneally (i.p.), while the positive control group received a single i.p. dose of lipopolysaccharide (LPS) at 5 mg/kg. The treatment groups received either glutathione (200 mg/kg i.p.), prednisolone (5 mg/kg i.p.), or a combination of both drugs, each administered as a single dose, 1 h prior to the LPS injection. After 24 h, blood samples were collected in order to assess the serum interleukin-6 (IL6) levels, and lung tissues were harvested for histopathological analysis. The results demonstrated that glutathione, prednisolone, and their combination can significantly reduce the LPS-induced elevation of IL-6 levels (p<0.05) and can ameliorate the LPS-induced histopathological damage in the lung tissues of mice. In conclusion, pre-treatment with glutathione, prednisolone, or their combination can effectively attenuate both the systemic IL-6 elevation and the pulmonary histopathological alterations associated with cytokine storm. Notably, the combined administration of glutathione and prednisolone exhibited synergistic protective effects, suggesting their potential utility as prophylactic agents against cytokine storm syndromes. © 2025, ZITA Medical Management. All rights reserved.

Background: Diabetes mellitus (DM), in particular type II, has lately become a serious medical condition with elevated probability of increasing comorbidity, because it is a lifelong illness that needs both good self-care and a person with sufficient knowledge about the disease. Objectives: The aim of this study to find the association between the patients' knowledge on type II diabetes and self-care outcome. Materials and Methods: The study was carried out using a descriptive research approach. To achieve the objectives of the study, the researcher created the questionnaire. A descriptive study design from 50 patients was chosen. The validity of the instrument was assured by 11 experts, and the instrument’s reliability was established through making a pilot study. The data were analyzed through using descriptive and inferential statistics by using of SPSS version 20.0 for analysis of questionnaire, The level of Cronbach’s alpha for patient knowledge (20 items) is (0.82), while self-care (30 items) is (0.81). Results: The study findings indicated a significant association between the patient knowledge and self-care at P value (0.008) < 0.05. Conclusion: The majority of patients with DM have a significant association between the patients knowledge and self-care outcome. © 2025 Medical Journal of Babylon | Published by Wolters Kluwer - Medknow.

Background: Metabolic syndrome (MetS) is a recognized risk factor for coronary artery calcification (CAC), a subclinical marker of atherosclerosis associated with elevated cardiovascular risk. However, the prevalence and determinants of CAC in individuals with MetS have not been comprehensively synthesized. This systematic review and meta-analysis aimed to estimate the pooled prevalence of CAC and identify associated factors among adults with MetS. Methods: A comprehensive search was conducted in PubMed, LILACS, Web of Science, Embase, Scopus, AJOL, and gray literature through December 2024, following PRISMA 2020 guidelines. Eligible studies included adults (≥ 18 years) with MetS, defined by established criteria, and reported CAC scores via validated CT imaging techniques. Observational studies and RCTs were included. Study quality was assessed using the Joanna Briggs Institute checklist. Pooled estimates were derived using a random-effects model, and heterogeneity was assessed with the I2 statistic. Results: In total, 17 studies comprising 20 745 individuals were included. The pooled prevalence of CAC in adults with MetS was 39.8% (95% CI: 28.4%–52.5%), with wide variation across study design, geography, and imaging modality. Males had a higher CAC prevalence (RR: 2.00), and MetS was linked to increased CAC scores (SMD: 0.10) and odds of calcification (OR: 1.34–1.50). Subgroup analyses showed variability by region and CT modality. High CAC scores were associated with elevated cardiovascular event rates. Conclusion: CAC affects ~40% of adults with MetS and is associated with higher cardiovascular risk. These findings support the integration of CAC screening in MetS management strategies. © 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.

This study aimed at evaluating the performance of school health providers at primary health centers in Al-Hilla City (Hillah) through the application of a quality assurance framework. A descriptive evaluation study was conducted from October 5, 2024 to March 25, 2025. A purposive sample of 63 individuals was selected using a non-probability sampling technique from 15 primary healthcare centers, drawn from two health sectors within the Al-Hilla City Center under the Babylon Health Directorate in Iraq. The sample comprised 20 members of the medical staff and 43 members of the nursing staff. A panel of thirteen experts participated in a pilot study in order to assess the reliability of the evaluation instrument through content validity and internal consistency metrics. The findings indicate a growing demand and a diminishing supply of workforce in primary health care. The quality assurance assessment of school health activities performed by medical and nursing staff revealed a fair overall performance. However, health education services provided to teaching staff and students were found to be suboptimal. © 2025, ZITA Medical Management. All rights reserved.

Antimicrobial resistance (AMR) represents one of the most pressing challenges in contemporary public health. Neonates and children are among the most vulnerable populations, not only by being at heightened risk of developing AMR, but also for being among the ones most frequently being prescribed antibiotics, particularly for respiratory tract infections (RTIs). This study aimed at examining the relationship between antibiotic overuse and resistance in paediatric patients with recurrent RTIs. A descriptive cross-sectional design was employed from 10 December 2023 to 10 March 2024, targeting children in the Babil Province (Iraq) that were selected through a non-probability convenience sampling method. Findings revealed a high prevalence of antibiotic prescription errors: 62% of the cases involved inadequate course duration, 69% of the patients received duplicate therapy, and 61% were prescribed antibiotics with insufficient dosing frequency. A significant association was observed between these prescription errors and a history of recurrent RTIs. Such errors appear to contribute to the development of AMR, not only in children but potentially extending to adult populations. Given the potentially fatal consequences of antibiotic misuse, both paediatricians and parents must exercise rigorous caution when administering antibiotics to children. © 2025, ZITA Medical Management. All rights reserved.

Triage refers to the placement of patients in the appropriate setting at the appropriate time in order for them to receive the appropriate level of care, along with the allocation of resources tailored to their medical needs. A descriptive study was conducted in order to assess nurses’ knowledge of medical triage between October 15, 2023, and April 1, 2024. A non-probability convenience sample comprising 50 nurses working in the Emergency Unit of the Al Hillah Teaching Hospital was included. The study utilized a questionnaire developed through a comprehensive review of the relevant literature and modified as necessary. Its content validity was established through evaluation by a panel of five experts. Data were collected using a researcher-developed, self-administered questionnaire in Arabic, employing both interview and self-report formats. Data analysis was performed using the SPSS software, version 24. The general level of nurses’ knowledge regarding medical triage, as assessed in this study, was found to be fair to good. It is recommended to appoint qualified registered nurses so as to enhance the quality of care provided in medical triage settings. © 2025, ZITA Medical Management. All rights reserved.

Background: Healthcare workers (HCWs) in Iraq have endured significant psychological burdens throughout the COVID-19 pandemic. Despite the prolonged impact of the pandemic, studies evaluating the long-term mental health consequences among HCWs remain scarce. To our knowledge. Objective: To assess the psychological impact of the COVID-19 pandemic on HCWs four years after the pandemic. Methods: A cross-sectional study was conducted between May and December 2024. The Patient Health Questionnaire-9 (PHQ-9) was utilized to evaluate depression. Multiple logistic regressions were performed to identify factors independently associated with depression. Results: 948 HCWs were included in this study. 60.3% of them were female, with a mean age of 28.81 years. We found a high level of depression, with 69.4% of HCWs being affected. Younger and single HCWs had a higher depression rate, with a prevalence of 67.4% and 74.3%, respectively. Higher levels of depression were associated with lower educational attainment (84.1%). Also, those with a history of medical, psychological, or family psychological conditions were strongly associated with higher depression levels. Depression affected 72.9% of individuals who had experienced COVID-19 infection before. Medical staff working on the frontlines showed particularly high depression rates at 80.3%. The mild and moderate depression symptoms were most common, since they affected 28.9% and 28.1%, respectively. Conclusions: For the first time in Iraq, this study revealed that 69.4% of healthcare workers (HCWs) suffered from depression four years after the COVID-19 pandemic. Depression was more prevalent among doctors or nurses and those with lower educational attainment. © 2025 The Author(s).

Tobacco use remains one of the most pressing global health challenges. Approximately 80% of smokers worldwide reside in low-and middle-income countries, where the burden of tobacco-related morbidity and mortality is disproportionately high. Cigarette smoking is notably prevalent among university students. This study aimed at investigating and evaluating the awareness and determinants of smoking status within a university student sample, and at examining the association between awareness levels and smoking-related determinants. A descriptive-analytical cross-sectional study was conducted involving 230 university students who smoke, recruited from Baghdad City. Data were collected using a structured questionnaire designed to assess participants’ awareness of smoking-related harms and the factors influencing their smoking behavior. The majority of the participants were male and aged between 18 and 23 years. Most reported smoking cigarettes and hookah, and demonstrated awareness of the harmful effects of smoking, including its role as a major cause of lung cancer, heart disease, and respiratory conditions. The lowest level of agreement was recorded for the statement linking smoking to road traffic accidents. Nearly half of the participants acknowledged that smoking negatively affects family income. Statistical analysis revealed a significant association between students’ awareness and the determinants of smoking status, as well as with their sociodemographic characteristics. © 2025, ZITA Medical Management. All rights reserved.

Ginkgo Biloba is a potential medicinal plant used traditionally to treat various diseases. The present study aimed to evaluate the protective effect of Ginkgo Biloba against Genotoxicity Induced by Hyroxyurea in Mice. Forty male albino mice were randomly divided into 4 groups of ten animals. The first group received hydroxyurea (80mg/kg B. W) orally daily for 30 days, while second and third group received Ginkgo Biloba (100 mg/ kg.BW) and omega3 (150 mg/kg.BW) orally daily for two weeks of HU administration as protective and 4th group (C-ve) were considered as control negative group was given distilled water orally. After therapy by removing the bone marrow from the animal’s bone after anesthesia with ketamine+xylazine and slide preparation with Giemsa stain, experimental animals’ chromosomal abnormalities, mitotic index, and blast index were examined. In order to ascertain the protective activity of the plant extract, the mitotic index and blast index are also assessed. The results showed that the exposed group (T1) had a significantly lower mitotic index (the number of cells in mitosis per 1000 bone marrow cells) than the control group (which only drank distilled water). These results showed a significant decrease (p>0.05) of the mitotic index of (the T1) group that received hydroxyurea orally compared with the control group that received distilled water alone. On the other hand; (T2 and T3) groups that received Ginkgo Biloba and omega 3 respectively, revealed a significant increase (P<0.05) in the mitotic index compared with the T1 group that received hydroxyurea alone. The chromosomal aberrations results recorded a significant increase (P<0.05) in a group (T1) that was exposed to HU alone that suggested to be attributed to the genotoxic effect of the drug. On the other hand, a significant decrease (P>0.05) in the mean of chromosomal aberration in both groups (T2 and T3) that pretreated with GB extract and omega3 respectively. HU treatment caused serious CAs formations such as dicentric chromosome, Acentric, deletion, ring, and a high rate of breaks in bone marrow cells. As a results, GbE would be good candidates for administration as a supplement to decrease the Geno-toxicity side effects of a lot of chemotherapeutic agents. © 2023 by the authors. Licensee ResearchersLinks Ltd, England, UK. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).