Volume 39, Issue 1, Winter and Spring 2021

National Health Systems Response to COVID-19 Outbreak, Iraq an Example

Alaa Hussein Abed; Dhurgham A. Abdulwahid; Haider A. Jassim

The Medical Journal of Basrah University, 2021, Volume 39, Issue 1, Pages 1-6
DOI: 10.33762/mjbu.2021.130218.1071

This article describes chronologically the development of COVID-epidemic in Iraq, mainly Basra Province, and the response of the national and provincial health system response to control this crisis. It points some strengths and weaknesses of this response. In addition, it mentions some of the opportunities that need to get benefit from, including following an evidence-based approach in epidemic control management. Some of the international assessments' results showed that the performance of Iraqi health system come at the tail of the sorted list of international health systems. This necessitates conducting a scientific systematic evaluation to the national performance to precisely quantify structural and process strengths and weaknesses.

Intrauterine vertical transmission of COVID-19 during pregnancy: A systematic review

Jasim Al Asadi; Sadiq M Mousa

The Medical Journal of Basrah University, 2021, Volume 39, Issue 1, Pages 7-20
DOI: 10.33762/mjbu.2021.128851.1045

Background: COVID-19 infection in pregnancy raised concerns about the risk of intrauterine vertical transmission of the SARS-CoV-2 from mother to fetus.
Objectives: to review the current evidence on the possibility of intrauterine vertical transmission potential among COVID-19 infected pregnant mothers.
Methods: Eligible studies published from December 2019 until August 1, 2020, were searched for from PubMed, PubMed Central, Google scholar, medRxiv, and bioRxiv collection databases using MeSH-compliant keywords including COVID-19, pregnancy, intrauterine vertical transmission, Coronavirus 2019, SARS-CoV-2, 2019-nCoV, and maternal-fetal transmission.
Results: The initial search yielded 152 articles. After elimination of duplicates, review, commentaries, and articles from media, 78 articles were deemed relevant and comprised neonatal outcome data for 1231 neonates whose mothers were infected with COVID-19. Of these 78 articles, 24 articles that fulfilled the inclusion criteria were eventually selected for analysis yielding 517 neonates from 514 pregnancies (3 sets of twins). Most of the women (64.4%) were delivered by cesarean section. Vaginal delivery was reported in 31.7%, and in 20 women (3.9%), the mode of delivery was not reported. Of the total 517 neonates reported in the 24 analyzed articles, 51 neonates (9.9%; 95% CI, 7.4-12.8) were tested by positive by at least one of the investigation tools, and 38 neonates (7.3%; 95% CI, 5.3-9.9) were found positive for SARS-CoV-2 by RT-PCR nasopharyngeal swab.
Conclusions: The risk of intrauterine vertical transmission of SARS-CoV-2 in late pregnancy is possible but rare. However, the potential risk of vertical transmission in early pregnancy is not yet assessed.

Overview of Iraqi experience in management of acute promyelocytic leukemia

Waseem Al-Tameemi; Zahra’a S. Shakir

The Medical Journal of Basrah University, 2021, Volume 39, Issue 1, Pages 21-30
DOI: 10.33762/mjbu.2021.129847.1068

Background & Objectives
In Iraq, leukemia is the 4th most common cancer, Acute promyelocytic leukemia contributes to 2.83%, and 3.18% of leukemia in Iraqi males and females respectively. This study is to review of acute promyelocytic leukemia patients presentation and management outcome in Iraq
Patients and Method
A hospital based case series study was conducted over a period of 15 months in different hematology centers. A total of 58 acute promyelocytic leukemia patients were enrolled in this study (53 newly diagnosed and 5 relapsed cases). Diagnosis based on of morphology with or without cytogenetic study.
The mean age was 33.1±13.8 years, with slight female predominance. Most cases presented at winter season (39.7%). Sanz severity scoring classification as; (25.9%) low risk, (53.4%) intermediate risk, and (20.6%) high risk disease. Induction protocol consist of chemotherapy plus ATRA in (58%) while (36.2%) received only ATRA plus ATO. At the end of induction, 86.2% of patients have complete remission, while only 13.8% have failure of induction due to death. Induction mortality was higher in those who have received chemotherapy based regimens. At relapse, a second complete remission has been achieved in 4 out of 5 cases (80%).

There is a predilection of acute promyelocytic leukemia to young age group and winter season presentation. The choice of non-chemotherapy regimens, especially for the low and intermediate risk group, showed no drawback in complete remission rate. Disease outcome in Iraq has improved over several years due to increasing experience with using different regimen