Iraq healthcare system: The first year of covid-19 pandemic | Author : Aamir Jalal Al-Mosawi | Abstract | Full Text | Abstract :Background: The year 2020 witnessed the rapid spread of covid-19 pandemic in Iraq and in almost all the countries in the world. This spread has created a serious health crises and a public health emergency in Iraq and throughout the world. Throughout the world, healthcare systems have been negatively influenced by the pandemic and experienced unexpected changes. We have previously provided several descriptions of the Iraq health care system from its evolution. However, little is known about the health care system in Iraq during the first year of the coves pandemic. The aim of this paper is provide a description of the healthcare system in Iraq during the year 2020, the first year of covid-19 global pandemic.
Materials and methods: The available unpublished and published data about the Iraqi healthcare system during the first year of covid-19 pandemic, the year 2020 were examined. The data included more than 100 relevant unpublished and published information documents including journal articles, books, official reports of the Iraqi Ministry of Planning and Iraqi Ministry of Health. In addition, relevant useful data available at internet web sites were also reviewed. The available relevant data were classified into categories including; demographic data relevant to healthcare, Data related to covid-19 disease in Iraq, data related to the organizational structure of the healthcare system, data related to national healthcare policies including national healthcare mission, vision, strategic goals and plans, data related to healthcare system financing, data about healthcare services delivery, data about the workforce in the Iraq healthcare system, data related to child health and maternal, data about notifiable infectious disease, data about chronic disorders and the main causes of morbidity and mortality, and data about medical education and healthcare education. Many relevant healthcare data for three provinces (The Kurdish provinces in the north of Iraq) of the eighteen provinces in Iraq were not available in English or Arabic.
Results: The population of Iraq in 2020 was estimated at 40.150.174 (20.284.823 males and 19.865.351 females). During the year 2020, 595291 cases of covid-19 disease were registered by the Iraqi Ministry of Health. 12813 (2.15%) patients died and 537841 (90.3%) patients experienced recovery. The organizational structure of the Iraq health system, the backbone of the Iraq healthcare system witnessed no important change from the description before covid-19 global pandemic in 2019.
The declared mission and vision of the Iraqi Ministry of Health for the year 2020 were the same mission and vision of the Iraqi Ministry of Health that were declared in 2018. In 2020, the Iraqi Ministry of Health declared a strategic plan which included a vision and mission statements for the health information system. The first year of covid-19 pandemic in Iraq was not associated with an important increase in the number of primary healthcare centers. However, there was little increase in the number of governmental hospitals. Surprisingly, the bed occupancy rate of governmental hospitals during the first year of the pandemic was lower than the bed occupancy rate during the two years before the pandemic. The total number of hospitalized patients in 2020 was lower than the previous four years, but the mortality rate per 1000 hospitalized patients was significantly higher in 2020 than the previous four years.
Conclusion: Covid-19 disease in Iraq was associated with a significant mortality during the year 2020. It actually changed the previously reported national mortality pattern as covid-19 has become the second most common cause of death in Iraq. Contradictory, to the general belief that mortality associated with covid-19 disease was generally restricted to the older age groups, 117 children under the age of ten years died because of covid-19 disease in 2020. This number of childhood deaths suggests the need to consider vaccination of the younger age groups and to perform the relevant research. Covid-19 disease has emerged as a new notifiable infectious disease in Iraq and throughout the world; therefore, it changed the pattern of notifiable infectious diseases in Iraq. |
| A Historical Review of Classic Publications in Web of Science Category of Obstetrics and Gynecology | Author : Yuh-Shan Ho | Abstract | Full Text | Abstract :Classic publications in Web of Science Category of Obstetrics and Gynecology were identified by using bibliometric indicator, TCyear, total citations since publication to the end of the recent year from Web of Science Core Collection. Fourteen classic publications with TC2016 = 1,000 times were analysied. We also applied a citation indicator, the Cyear, total citations in the most recent year only, to assess the recent impact of the classic publications. The results showed that the 14 classic publications were published between 1927 and 2004, and that the most productive journal were American Journal of Obstetrics and Gynecology. Citation histories were applied for impact of the classic publications after their publications. In addition, highlight of each classic articles were presented. A classic article by Sampson in 1927 was found to be the classic Sleeping Beauties in Web of Science category of obstetrics and gynecology. |
| How Fibrinolysis was Defeated by PCI | Author : Victor Gurewich | Abstract | Full Text | Abstract :Fibrinolysis refers to the natural enzymatic system responsible for dissolving a blood clot or thrombus. Since an intravascular thrombus is responsible for almost all heart attacks and most strokes, interest in fibrinolysis, the only medical treatment, dominated medical interest in the 60’s-90’s. Since that time, the incidence of heart attacks and strokes has not changed much, but interest in fibrinolysis has faded. Instead, interest has shifted to catheter removal of clots, called percutaneous coronary intervention (PCI) which is a time-consuming that delays reperfusion considerably, and is much more costly than fibrinolysis. It is also a cruder treatment that can only remove clots larger than the catheter, but it is very well reimbursed. |
| Contact Principles and TCM‘S Management on Post-Syndromes of Covid-19 | Author : Dan Jiang | Abstract | Full Text | Abstract :The coronavirus disease 2019 (COVID-19) has still been spreading around the world, causing an outbreak of acute infectious pneumonia, even a multiple systematic inflammatory disorders following with varied virus. From World Health Organizations (WHO) weekly report in 16th Aug 2021, more than 2 hundred millions (206 693 357) of infected cases and more than 4 million (4 352 488) of deaths are confirmed in the world [1]. The daily report In UK in 18th Aug 2021, there are more than 6 million of infected cases (6 295 613) and 130 thousands of died cases (130 979) are confirmed, fluctuating figures on daily recently on infected and died cases with Covid-19 are reported although the severe case rates, hospitalized rates and died rate have decreased in UK [2].
Due to such bigger amount of patients’ appearance, some post-syndrome of Covid-19 are unavoidably leaving after they are self-healed or treated in the hospitals or anywhere else, they have not recovered completely, still remain some unwanted symptoms, some of them can be quite serious which are possible to disturb them for the rest of their life. We should do and be able doing some significant helps for them with Chinese herbal medicine (TCM). I will discuss these common occurrences of post- syndromes which I have treated: inferior function of lungs, dysfunction of gastrointestinal system, Psychiatric disorder, Post-virus-Chronic-fatigue syndrome, post inflammation of Sexual organs and how manage these post syndromes of Covid-19 with TCM here. TCM should play more effect for helping post-syndromes of Covid-19 after reopening clinics with full of our treating technologies. |
| Association of Serum Osteocalcin and Neutrophil-Lymphocyte Ratio with Bone Mineral Density for the Diagnosis of Osteoporosis | Author : Mesbah Uddin Ahmed | Abstract | Full Text | Abstract :Introduction: Osteoporosis is often under diagnosed, under treated and imposed a considerable economic burden on the health system. About two fifth of the post-menopausal women of Bangladesh are affected. Early diagnosis is necessary to halt the disease process. Serum osteocalcin, neutrophil-lymphocyte ratio (NLR) increases and bone mineral density (BMD) decreases in osteoporosis. There is no specific diagnostic test for osteoporosis except BMD. It is costly, has radiation hazard and not available in all laboratories in our country. On the other hand, serum osteocalcin and NLR are easily available and a promising marker which can be done as routine blood test for the diagnosis of osteoporosis.
Objective: The objective of the study was to evaluate the association of serum osteocalcin and NLR with BMD for the diagnosis of osteoporosis.
Materials and methods: This cross-sectional study was conducted in the Department of Laboratory Medicine and the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from March, 2020 to February, 2021. A total 50 diagnosed patient of osteoporosis, who fulfil the inclusion and exclusion criteria were selected as study population. They were grouped as normal, osteopenia and osteoporosis according to T-score of BMD report. Serum osteocalcin and NLR evaluated from routine blood test. Statistical analysis was done by statistical package for social science (SPSS) software windows version 22.
Results: Negative Pearson’s correlation was found between serum osteocalcin with T-score of BMD (r=-0.812, p=0.002) and between NLR with T-score of BMD (r=-0.826, p=0.001). In receiver operating characteristic (ROC) curve analysis, cut off value of serum osteocalcin was 18.65 ng/mL having sensitivity 67.0% and specificity 70.0% with a cut off value of NLR was 4.54 with sensitivity 72.0% and specificity 75.0%.
Conclusion: Serum osteocalcin and NLR has significant negative correlation with T-score of BMD. Because of high sensitivity and specificity, serum osteocalcin and NLR may be used to diagnosis of osteoporosis |
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