Objective: To compare the diagnostic performance of the Modified Alvarado and RIPASA scoring systems in patients presenting with RIF pain. Methods: A cross-sectional study was conducted at Zakho Emergency Hospital between October 2022 and May 2023. A total of 195 consecutively admitted patients with RIF pain were evaluated using both scoring systems. Histopathology (when available) served as the reference standard. Statistical analysis included descriptive statistics, two-tailed independent t-tests, ANOVA, chi-square tests, logistic regression, and receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, predictive values, accuracy, and area under the curve (AUC) were calculated with 95% confidence intervals (CI). Results: Histopathology confirmed appendicitis in 141 patients (72.3%). Using a cutoff ≥7, the MA score showed sensitivity 67.4%, specificity 61.1%, PPV 83.3%, NPV 41.8%, and accuracy 65.6%. The RIPASA score (cutoff ≥10) demonstrated sensitivity 75.9%, PPV 86.3%, NPV 45.8% and accuracy 72.3%, with identical specificity (61.1%). Logistic regression confirmed both scores as significant predictors (p < 0.001). ROC analysis demonstrated acceptable discrimination for both systems. Conclusion: Both scoring systems demonstrated moderate diagnostic performance. RIPASA showed higher sensitivity and overall discrimination; however, the difference was not statistically significant. These findings suggest that RIPASA may provide incremental diagnostic benefit, but neither score should replace imaging in equivocal cases.

Background and Objectives: One of the significant complications of the surgery is surgical site infections. The aim of this study was to focus on the prevalence of surgical site infection, demonstrate the commonest encountered bacteria for a proper postoperative antibiotic coverup and identify some key risk factors. Methodology: a cross-sectional, descriptive study on the cases undergoing surgical procedure was done. The study was conducted during a period of one-year interval from March 2024 until March 2025. A total of 382 cases were included in the study. All cases were assessed properly pre and post operatively with cases suspected to have an infection were sent for culture and sensitivity report. Results: The mean age of participants was 34.9 ± 17.9 and the mean of duration of Hospitalization for cases was 21.4 ± 27.5 hours. The prevalence of postoperative wound infection was 31/382 cases accounting for 8.1% and 100% culture positive. Relation of SSIs to the duration of operation, type of surgical wound, and emergency degree of operation was statistically significant , P value = 0.044, < 0.001 and 0.013, respectively. While the duration of post-operative hospitalization was not related to the risk of infection, P value = 0.069. Conclusion: - The commonest responsible bacteria isolated from infection were Staphylococcus spp, Klebsiella spp and Streptococcus spp. Additionally, the risk of infection increased according to the contamination degree of the wound, 1 in every 3 cases of dirty infected wound develop infection and 1/3, of the samples for cases lasting > 120 minutes in operation developed infection.

Objectives: The aims of this study were to determine the prevalence of HBV infection and investigate the HBV-related risk factors in the Kurdistan region of Iraq. Methods: Sera samples were collected from 3423 patients visiting three centers and tested for HBV positivity by enzyme-linked immunosorbent assay. A questionnaire was prepared and used by the volunteers who collected data, including age, marital status, and different HBV-related risk factors, through face-to-face interviews. Results: The mean age of the recruited participants was 28.94 ± 11.17 years. In addition, 873/3423 (25.47%) were males, and 3024/3423 (88.34%) were married. Furthermore, HBV infection had a prevalence of 1.37% (47/3243). Multivariate analysis was conducted to identify the predictive factors of HBV infection, which revealed that a history of tattoos and age were predictive factors (p<0.05). We then stratified our data according to sex. No association was found between the various factors and HBV positivity in males. On the other hand, in females, a significant association was found between the history of tattoos or age and HBV positivity (p<0.05). Conclusions: In conclusion, the prevalence of HBV infection was low. Our study showed that a history of tattooing and older age were predictive of HBV infection. Our results could be used as a basis for local elimination programs.

Background Hepatitis C virus (HCV) is a public health issue. Successful treatment of HCV infection results in sustained virologic response (SVR) in the majority of subjects. Subsequent recurrence of HCV, either from late relapse or reinfection, may occur. The aim of this study was to assess the recurrence rate of HCV in Iraqi patients. Methods In this study, 113 patients who completed anti-HCV therapy successfully were recruited. While 23 patients received a classical regimen of peg-interferon plus ribavirin, 90 patients received direct-acting antiviral therapy. Those patients were followed up for three years. HCV recurrence rate was calculated using events/person years of follow-up (PYFU). Results Among the recruited patients, HCV RT-PCR was positive in 1 (0. 88%) patient giving a recurrence rate of 2. 95 per 1000 PYFU. When the data were stratified according to the treatment regimen, the recurrence rate was 14. 49 per 1000 PYFU in patients who received the classical regimen of interferon and ribavirin. Conclusions The overall recurrence rate was low in Iraq. No recurrence was recorded in patients received direct-acting antiviral therapy. Further studies are needed with a larger sample size and longer follow-up to determine the relapse rate in Iraq.

Background: Perforation of peptic ulcer is regarded as one of the common abdominal surgical emergencies. The objective of this study was to describe the clinical features and potential risk factors among patients with perforated duodenal ulcer in Duhok city. Subject and Methods: This is a prospective descriptive study done at the Emergency Teaching Hospital in Duhok city, over a period of one year (1st of January, 2015-31st of December, 2015). The study included 35patients who were operated upon for perforated duodenal ulcer. The clinical findings and probable risk factors for perforation of the duodenal ulcer were studied. Results: Age of the patients ranged from 15-80 years; the commonest age group affected was the 20-39 years old (54.2%). Twenty-eight (80%) were males. Helicobacter pylori antibodies were positive of in 26 patients (74.2%) while history of ingestion of non-steroidal anti-inflammatory drugs