Endothelial microparticles (EMP) are released from activated or apoptotic endothelial cells (ECs) and can be taken up by adjacent ECs, but their effect on vascular inflammation after engulfment is largely unknown. We sought to determine the role of EMP in EC inflammation. In vitro, EMP treatment significantly reduced tumour necrosis factor-α-induced endothelial intercellular adhesion molecule (ICAM)-1 expression on mRNA and protein level, whereas there was no effect on vascular cell adhesion molecule-1 expression. Reduced ICAM-1 expression after EMP treatment resulted in diminished monocyte adhesion in vitro. In vivo, systemic treatment of ApoE−/− mice with EMP significantly reduced murine endothelial ICAM-1 expression. To explore the underlying mechanisms, Taqman microRNA array was performed and microRNA (miR)-222 was identified as the strongest regulated miR between EMP and ECs. Following experiments demonstrated that miR-222 was transported into recipient ECs by EMP and functionally regulated expression of its target protein ICAM-1 in vitro and in vivo. After simulating diabetic conditions, EMP derived from glucose-treated ECs contained significantly lower amounts of miR-222 and showed reduced anti-inflammatory capacity in vitro and in vivo. Finally, circulating miR-222 level was diminished in patients with coronary artery disease (CAD) compared to patients without CAD. EMPs promote anti-inflammatory effects in vitro and in vivo by reducing endothelial ICAM-1 expression via the transfer of functional miR-222 into recipient cells. In pathological hyperglycaemic conditions, EMP-mediated miR-222-dependent anti-inflammatory effects are reduced.

Background: Iraq was among the first countries invaded by the novel human coronavirus (SARS-COV-2) after China. This study aimed to assess the Iraqi people's knowledge, attitudes, and practices toward COVID-19 during the pandemic.  Methods: A cross-sectional study recruiting an online self-reported survey conducted from 17-31 July 2020. Data of 877 participants have undergone descriptive, univariate, and multivariable regression analyses, respectively, to assess the differences in mean scores and identify factors associated with knowledge, attitudes, and practices (KAP) toward COVID-19. Results: Most of the respondents (78.8%) from the urban region, highly educated (69.7%), aged less than 45 years (61.2%), females (58.3%), married (51.9%), and 74.0% self-ranked health as good. Less than half (45.4%) were employed; however, the average monthly income was USD 400 or more in about 66.8% of them. The mean knowledge, attitude and practice score was 15.57 ± 2.46 (range: 0-20), 38.88 (SD = 3.57, (range: 11-55), and 5.13 (SD = 1.14, range: 0–6), respectively. Findings of regression analysis showed that higher educated (p< 0.001), urban residents (P <0.001), employed (P =0.040), and having an income level of USD 400 or more (P <0.001) were significantly associated with upper knowledge score. Female gender and employed respondents are significantly associated with positive attitude scores, but inversely respondents with an income of USD 400 or more are significantly associated with a negative attitude. Regarding practice score, the female gender and those living in an urban region had better practice, but the young age group (0-44 years) was significantly associated with the weak practice. Conclusion: Although Iraq has adopted a preventive and precautionary plan to control the spread of coronavirus. However, the public's knowledge and attitude toward COVID-19, coupled with the unstable political and security situation, have greatly affected the commitment to preventive measures.

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001),  and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

BackgroundCystatin C (Cys-C) is a marker of renal damage. Higher serum levels of Cys-C were observed in cardiovascular disease. This study aimed to test the null hypothesis that Cys-C levels in newly diagnosed acute myocardial infarction (AMI) may remain high in the survival and the impact of the cardiometabolic risk factors is small.MethodsForty patients with AMI are enrolled in this study. The cardiometabolic factors including the anthropometric measurements, blood pressure and lipid profile were determined. The diagnosis of AMI is based on the electrocardiograph, cardiac enzymes and positive troponin-c (cTn) test. Quantitative determination of serum high sensitive C-reactive protein (hs-CRP) and Cys-C was carried out, at the time of admission and at the time of the discharge, using the enzyme-linked immunosorbent assay (ELISA) technique.ResultsSerum Cys-C levels significantly increased at the time of the admission (1,296 ± 431.8 ng/mL) and at the time of the discharge (1,244.6 ± 482 ng/mL) compared with the reference levels (0.7 ± 0.2 ng/mL) of the healthy subjects. Non-significant differences were found between Cys-C levels in respect to the presence or absence of the cardiometabolic risk factors at the times of admission and discharge. Significant decrease of Cys-C levels was found in patients who have negative cTn at the time of discharge compared with corresponding levels at the time of admission.ConclusionsWe conclude that AMI patients have significant high serum levels of Cys-C at the time of admission and the levels significantly decreased in patients with negative cTn test within few days indicating an association between infarct size and the levels of Cys-C.

Background: Although significant improvement has been achieved in terms of antibiotic care, otitis media (OM) continues to be a worldwide health problem that may develop serious complications. This study aimed to detect the growth of organisms and to find out the most susceptible factors related to OM among the Iraqi population. Methods: A prospective cross-sectional study was conducted at the out-patient department (OPD) of Ear, Nose, and Throat (ENT) at the Baquba teaching hospital at the Faculty of medicine, Diyala University from November 2017 to March 2018. A total of 300 ear samples collected from 87 (29.0%) patients of acute otitis media (AOM), 104 (34.7%) patients of otitis media with effusion (OME), and 109 (36.3%) patients of chronic otitis media (COM). Standard microbiological procedures were recruited to investigate the samples using aerobic and anaerobic culture methods. Results: The highest incidence of OM 218 (72.7%) was observed among the age group of fewer than ten years old. The most common bacteria isolated were Pseudomonas aeruginosa (35.0%), Staphylococcus aureus (25.0%), Proteus spp. (24.0%), Escherichia coli (7.0%), Streptococcus pneumonia (6.0%), Klebsiella pneumonia (2.0%) and Streptococcus pyogenes (1.0%). It was found that upper respiratory infection (URTI), adenoid inflammation with (URTI), adenoid inflammation, the practices of complementary and alternative medicine (CAM), and the accident or trauma are the main factors related to OM in about (42.0%), (31.0%), (11.0%), (10.0%) and (6.0%) of cases respectively. Conclusion: Our findings suggest that OM was effectively related to URTI and adenoid inflammation with (URTI) in about 73.0% of cases. More attention should be given to early diagnosis and treatment of URTI before progressing to undesirable OM.