Journals
2026 EN
Irfan Bilal · Omeish Ibrahim · Alamrain Abdulwhhab Abu
+17 more
ABSTRACT Gaza's health system has been devastated by a confluence of political determinants that long predated the 2023–25 Israeli military assault and were dramatically intensified during it. Using historical, political economy, ethical, and health systems lenses, this article argues that settler colonialism, military occupation, and a protracted blockade created chronic shortages, workforce erosion, and institutional fragility, leaving services acutely vulnerable to targeted destruction of facilities and personnel. We examine the role and limitations of international medical deployments and field hospitals, which provided lifesaving care but operated under stringent access controls, supply interdictions, and security risks. Short rotations, poor continuity of care, and donor restrictions that discourage engagement with local authorities contributed to parallel systems, fragmentation, and dependency. We then identify four intersecting barriers to reconstruction: ongoing blockade and humanitarian access denials; lack of protection and accountability for attacks on health; governance fragmentation and the sidelining of Palestinian leadership; and donor fatigue amid politicised aid. The article proposes a justice‐centred pathway for recovery that prioritises accountability and reparations, an end to the blockade and occupation, inclusive Palestinian‐led governance, alignment of aid with national plans, avoidance of parallel structures through early transition to local ownership, workforce stabilisation, and long‐term partnerships. Without these political preconditions, reconstruction efforts will remain fragile and inequitable.
Journals
2026 EN
Ibrahim Sazgar Khald · Mosa Rondik Khalid · Sarkees Alaa Noori
+1 more
ABSTRACT Background and Aim Bioelectrical Impedance Analysis is a reliable, noninvasive, objective, and cost‐effective body composition assessment method used in clinical practice. Body composition provides information for precise nutrition intervention in the perioperative period to improve patients' postoperative outcomes. The study evaluates and estimates the nutritional status of patients undergoing surgical intervention. Patients and Methodology A cross‐sectional survey took place from March 2024 to October 2024 to examine the body composition, muscle‐fat analysis, and body‐calculated data of 2368 adult patients (aged 18 years and older) from Erbil Teaching Hospital in Erbil City utilizing a convenience sampling technique from those patients who were admitted to the hospital for surgical intervention. Data were collected using the InBody machine 270, including two parts: the first was related to demographic data, while the second consisted of body composition. Results The analysis showed that men generally had higher levels of total body water, protein, minerals, skeletal muscle mass and fat‐free mass, while women indicated higher levels of visceral fat and percent body fat, as both genders show waist‐hip ratios and levels of obesity above the average. Conclusion The study concluded that gender differences have a significant impact on the presence of gender body composition differences.
Journals
2026 EN
Sarhan Menna · Mohammed Yasmine Adel · Abdulgadir Ayah
+5 more
ABSTRACT Background and Aims Bilateral Wilms tumor (BWT) presents a significant challenge in pediatric oncology, necessitating a delicate balance between achieving oncological control and preserving renal function. While nephron‐sparing surgery (NSS) has emerged as a promising alternative to radical nephrectomy, its overall safety and efficacy profile for BWT remains to be consolidated. This systematic review and meta‐analysis aimed to synthesize the available evidence to evaluate the pooled safety and efficacy outcomes of NSS in children with BWT. Methods Following PRISMA guidelines, a systematic search was conducted across five databases (PubMed, Medline, Web of Science, SCOPUS, Cochrane Library). We included studies reporting on pediatric patients with BWT treated with NSS. A single‐arm meta‐analysis was performed using a random‐effects model to pool estimates for survival, recurrence, and renal function outcomes. Results Thirteen studies comprising 749 patients were included. The pooled overall survival rate was 55.9% (95% CI: 38.2%–73.7%), relapse‐free survival was 51.4% (95% CI: 32.6%–70.3%), and event‐free survival was 38.0% (95% CI: 23.3%–52.7%). The recurrence rate was 14.9% (95% CI: 9.4%–20.5%). Critically, renal function was well‐preserved, with a mean glomerular filtration rate (GFR) of 92.0 mL/min/1.73 m². The need for dialysis (1.7%) and renal transplantation (4.3%) was low. Conclusion NSS provides a viable surgical strategy for BWT, effectively preserving renal function without unduly compromising survival outcomes. The acceptable recurrence and low renal replacement therapy rates underscore its role in mitigating long‐term morbidity. Significant heterogeneity across studies highlights the need for standardized treatment protocols and prospective research to optimize patient selection and outcomes.
Journals
2026 EN
AlObaidi Ahmed Hakim · Ibrahim Marwan Majeed · AlQaseer Abdul Hameed Abdul Majeed
ABSTRACT Background Coronavirus disease 2019 (COVID‐19) is a lethal global pandemic that originated in Wuhan, China at the end of 2019. As with other viral infectious diseases, the introduction of an effective vaccine is crucial for stopping the spread of the pandemic. In Iraq the COVID‐19 vaccination campaign started on March 2, 2021. Aim of the Study To determine the influence of the vaccine on new virus infection in Baghdad in terms of its effectiveness on the illness, hospitalization, and mortality. Methods A prospective observational study of patients with SARS‐CoV‐2 infection who were had a newly positive Real time PCR testing for SARS‐CoV‐2 at Al‐Yarmouk Hospital or Al‐Adel Primary Health Care Center, and correlate their symptoms to their state of vaccination. Results A total of 539 patients tested positive for COVID‐19 via PCR (328 females and 211 males). Among these, 265 patients (49.2%) were vaccinated, while 274 (50.8%) were not. Being vaccinated and receiving the full doses showed the strongest association with decreased disease severity, reduced hospitalization rates, and lower mortality rates ( p < 0.05 for all). The type of vaccination was significantly correlated with disease severity ( p < 0.001), with more severe or critical symptoms reported in patients vaccinated with BBIBP‐CorV compared to those vaccinated with BNT162b2 or ChAdOx1 nCoV‐19 (AZD1222). However, no correlation was found with hospitalization or mortality rates. Conclusion COVID‐19 vaccination, while not preventing infection, markedly reduced disease severity and mortality—especially with full dosing and among high‐risk groups. The differential effectiveness observed among vaccine types highlights the importance of optimizing vaccine strategies based on real‐world outcomes, particularly in resource‐constrained settings like Iraq.
Journals
2026 EN
Moshi Jobran M. · Abdelwahab Siddig Ibrahim · Taha Manal Mohamed Elhassan
+8 more
ABSTRACT Background and Aims Breast cancer is the most commonly diagnosed cancer among women in Saudi Arabia, with early detection playing a critical role in improving survival outcomes. However, screening uptake remains suboptimal, particularly among younger women. To address this gap, this study aimed to evaluate the knowledge, attitudes, and practices (KAP) of young women in the Jazan region and identify key demographic and behavioral predictors influencing breast cancer screening uptake. Methods A cross‐sectional study ( N = 480) was conducted between January and March 2024. A structured, validated questionnaire was used to collect data on demographic characteristics and KAP regarding breast cancer. The primary outcomes assessed were knowledge, attitude, and practice scores. Statistical analysis included descriptive and inferential statistics, Pearson's correlation, and logistic regression to identify predictors of breast self‐examination (BSE). Results Most participants were young, single Saudi students residing in urban areas. The mean scores were: knowledge (3.66 ± 0.66), attitude (4.09 ± 0.58), and practice (3.81 ± 0.73). Moderate‐to‐strong positive correlations were observed between knowledge and attitude ( r = 0.569, p < 0.001) and between knowledge and practice ( r = 0.567, p < 0.001), indicating meaningful associations among the three domains. Age differences were evident, with both the youngest (< 25 years) and oldest (> 45 years) groups demonstrating comparatively higher knowledge scores. Participants in health‐related specializations also showed higher knowledge levels (mean = 3.78 ± 0.66), suggesting a notable effect of academic background. Logistic regression demonstrated that age (26–35 years) substantially increased the likelihood of performing BSE (adjusted OR = 12.422; 95% CI: 1.12–137.95), while having two to three children markedly reduced the odds (adjusted ORs = 0.051–0.065). Additionally, non‐Saudi participants had lower odds of practicing BSE (crude OR = 0.212; 95% CI: 0.06–0.72), highlighting demographic disparities in screening behaviors. Conclusion Age, education, specialization, and family responsibilities significantly influence women's breast cancer knowledge, attitudes, and preventive behaviors, including BSE and screening uptake. Targeted, population‐specific awareness strategies are essential to enhance early detection practices and reduce the breast cancer burden in the KSA.
Journals
2026 EN
Parsa Hossein · Maghsoudi Leila Haji · Mohammadzadeh Alireza
+1 more
ABSTRACT Background and Aims Emerging therapies such as autologous platelet‐rich plasma (PRP), which delivers a supraphysiological concentration of growth factors including but not limited to PDGF, VEGF, and TGF‐β have shown promise in enhancing tissue regeneration and healing. This study compares two treatments for diabetic foot ulcers: the standard method (normal saline washing and routine debridement) and the PRP method (autologous platelet‐rich plasma). It evaluates PRP's effectiveness in accelerating healing compared to standard care in diabetic patients, specifically in terms of wound area reduction over a 6‐week period, the proportion of patients achieving complete healing, and the average time to healing. Methods In this double‐blind randomized clinical trial conducted on patients referred to Velayat Hospital, 50 eligible type I and II diabetic patients aged 40–70 were randomly allocated to two groups using color‐coded sealed envelopes, ensuring allocation concealment. One group received PRP and the other standard treatment. Double‐blinding was maintained by using identical syringes for both treatments, and independent assessors unaware of group assignments evaluated wound healing weekly. Results There was no significant difference between the two groups regarding gender and HbA1c levels. However, a significant difference was observed in wound healing rates between the PRP method and the standard method across the two groups. Additionally, a meaningful relationship was found when comparing the average age of patients treated with both methods. There was no significant difference between the two groups regarding gender and HbA1c levels. Conclusions Ultimately, our research indicates that the PRP method is a more effective alternative to the standard method alone for the treatment of diabetic foot ulcers. Additionally, younger patients demonstrated a faster rate of diabetic foot ulcer healing. PRP's superior efficacy may justify its moderate upfront costs given potential long‐term savings from reduced complications.
Journals
2026 EN
Dahir Hana Mahdi · Korse Ayan Husein · Mohamed Farduus Ibrahim
+2 more
ABSTRACT Background Tuberculosis (TB) remains a significant public health challenge, necessitating accurate forecasting methodologies to support effective control and prevention strategies. This paper explores the application and comparative performance of single and hybrid time‐series models for forecasting TB incidence trends specifically in Somalia. Methods Annual TB incidence data from 2000 to 2022 were sourced from the World Bank to train and evaluate a comprehensive suite of 14 time‐series models. This included five single models—ARIMA, ETS, TBATS, Theta, and NNAR—and nine hybrid model combinations (e.g., ARIMA‐ETS, ARIMA‐TBATS, ARIMA‐ETS‐TBATS). Model performance was assessed using Theil's U statistic, Mean Absolute Percentage Error (MAPE), Symmetric Mean Absolute Percentage Error (SMAPE), and Root Mean Square Error (RMSE). Results Among the single time‐series models, the TBATS model demonstrated the best fit. However, the comparative analysis revealed that the hybrid ARIMA‐ETS‐TBATS model outperformed other hybrid configurations. The study highlights that hybrid modeling offers enhanced forecasting accuracy compared to single models. Conclusion The resulting forecasts provide valuable insights into future TB incidence trends in Somalia. These findings underscore the importance of hybrid modeling in generating accurate data to aid informed public health decision‐making and the development of targeted intervention strategies for TB control.
Journals
2026 EN
Hassan Mohamed Said · said Abdirahman Ibrahim · Nadarajah Saralees
+2 more
ABSTRACT Background and Aims Vitamin A deficiency (VAD) is a pressing public health issue for young children in low‐ and middle‐income countries like Somalia, significantly increasing risks of morbidity, mortality, and impaired development. High‐dose Vitamin A supplementation (VAS) is a crucial preventative intervention, yet data on its coverage in Somalia's complex humanitarian context are scarce. This study aims to assess the prevalence of VAS and identify its sociodemographic determinants among Somali children aged 6–59 months. Methods This study utilized a quantitative, cross‐sectional design, analyzing data from 15,456 children aged 6–59 months from the nationally representative Somalia Demographic and Health Survey (SDHS) 2020. The outcome was maternal report of a child receiving a Vitamin A supplement in the preceding 6 months. To ensure the results were nationally representative, weighted descriptive statistics and multivariate logistic regression were performed in Stata to account for the complex survey design. Results The prevalence of VAS receipt was critically low at 11.2%. Multivariate analysis revealed significant and unexpected disparities. Contrary to expectations, compared to children of mothers with no education, those with primary (AOR = 0.453, p < 0.001), secondary (AOR = 0.302, p < 0.001), or higher education (AOR = 0.327, p < 0.001) had significantly lower odds of their child receiving VAS. Children in nomadic households had significantly lower odds than those in rural households (AOR = 0.626, 95% CI: 0.549–0.714, p < 0.001). Compared to mothers aged 15–19, older mothers (≥ 35 years) had significantly lower odds of their child receiving VAS. Children of divorced mothers also had lower odds than those of married mothers (AOR = 0.799, p = 0.028). Conclusion VAS coverage among young Somali children is alarmingly inadequate. The counterintuitive finding regarding maternal education suggests that conventional assumptions about health‐seeking behaviors may not apply in this context. Targeted interventions and strengthened health system delivery are urgently needed to address these disparities.
Journals
2026 EN
Skaineh Zeinab · Hammoud Razane · Chaaban Ahlam
+2 more
ABSTRACT Background and Aims Familial Mediterranean Fever (FMF) is a monogenic autoinflammatory disease caused by mutations in the MEFV gene, resulting in recurrent inflammatory episodes and a risk of developing amyloidosis. Although its pathophysiology is well described, FMF still lacks specific biomarkers and personalized treatment strategies. MicroRNAs (miRNAs), which regulate gene expression posttranscriptionally, have emerged as promising diagnostic, prognostic, and therapeutic biomarkers. Given their complex expression patterns, bioinformatics approaches are essential for their identification and interpretation. Hence, this review aims to summarize current bioinformatics tools used in FMF‐related miRNA research and highlight additional platforms employed in other inflammatory diseases that may advance FMF research. Methods A narrative review was conducted by examining published FMF studies that applied miRNA‐focused bioinformatics analyses, including miRWalk, TargetScan, and machine learning pipelines. To identify tools with potential relevance to FMF, platforms widely used in rheumatoid arthritis, systemic lupus erythematosus, Crohn's disease, and psoriasis, such as miRDeep2, miRTarBase, DIANA‐miRPath, miEAA, and MAGPIE, were evaluated for their analytical strengths and applicability to autoinflammatory pathways. Results Most FMF studies rely on a narrow set of tools, primarily miRWalk or TargetScan for target prediction. Emerging machine learning approaches have also been utilized to classify patients and explore candidate biomarkers. Other inflammatory diseases use more advanced platforms enabling miRNA discovery, validated interaction mapping, pathway enrichment, and multi‐omics integration. Tools such as miRDeep2, miRTarBase, DIANA‐miRPath, miEAA, and MAGPIE remain underutilized in FMF. Key limitations include small cohorts, patient heterogeneity, and limited experimental validation. Conclusion Broadening the bioinformatics toolkit for FMF miRNA research could significantly enhance biomarker identification and mechanistic insight. Larger datasets, integrated analysis pipelines, and cross‐disciplinary collaboration are essential to advancing precision diagnostics and targeted therapies for FMF.
Journals
2026 EN
Pirker Thomas · AlBusaidi Ibrahim S.
ABSTRACT Background and Aims The COVID‐19 pandemic exposed critical gaps in healthcare preparedness globally, including in Aotearoa New Zealand (NZ). This study explored healthcare workers' experiences during the initial COVID‐19 wave, identifying key areas to inform future policies and practices. Methods Frontline HCWs at Christchurch Hospital, NZ, who participated in an online survey on COVID‐19 awareness and preparedness, were invited to answer an open‐ended question about improving pandemic preparedness and response. Responses were analyzed using reflexive thematic analysis. Results Six major themes were identified, encompassing communication and information dissemination, training and preparation, resource availability, clear protocols and planning, staff engagement and support, and consistency and standardization. Participants highlighted the importance of transparent, regular updates through both email and face‐to‐face meetings, alongside simulations and standardized online modules to strengthen infection‐control training. They also emphasized the need for adequate resources such as PPE, negative pressure rooms, and ICU capacity, supported by clear guidelines for PPE use and patient management. Furthermore, healthcare workers underscored the value of inclusive decision‐making to enhance morale, as well as the need for uniform practices across regions and departments to ensure a cohesive and coordinated pandemic response. Conclusion The findings highlight the need for robust communication, comprehensive training, resource allocation, and inclusive planning to strengthen healthcare resilience. Addressing these areas can improve pandemic preparedness and response, protect HCWs, and ensure better patient outcomes.