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Background: The objective of this study was to characterize patients with HBeAg-negative chronic hepatitis B in Duhok province.Methods: We recruited all patients with HBeAg negative chronic hepatitis B virus infections who visited viral hepatitis clinic in Azadi Teaching Hospital between September 2015-December 2017. The main evaluation parameters were: serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, serum albumin, total serum bilirubin (TSB), viral load. Few patients were subjected to Fibro-test, Fibroscan, or liver biopsy.Results: There were 251 patients. The mean age of the patients was 35.75±14.40 years. One hundred fifty-seven cases were male and 94 cases were female. The baseline mean of ALT, AST and viral load was 42.09±2.71U/L, 30.26±19.65U/L, and 1421197.08±14436692.04IU/ml, respectively. Compared with women, men have significantly higher values of ALT and AST, serum albumin, and TSB. There were 217 chronic inactive carrier (IC) patients and 34 chronic active hepatitis (AH) patients. ALT, AST, and viral load levels were significantly higher among AH patients.Conclusions: The majority of patients showed nil to mild liver injury. The higher level of ALT in males is a supporting guide to follow the American Association for the Study of Liver Diseases (AASLD) considering 30U/L and 19U/L levels for males and females, respectively. There was preponderance of males in AH, which indicates greater frequency of advanced fibrosis in such patients. There was a greater probability of AH in old aged people. Serum albumin and TSB were not good markers for differentiation between AH and IC state. Twenty-four patients had ALT above twice upper limit of normal level, but 34 patients showed AH based on liver biopsy, firboscan or fibrotest.

Ephedra gerardiana (E. gerardiana,), commonly known as "Ma-huang," is a medicinal plant native to the Himalayan region. Historically, it has a long traditional use in various indigenous systems for medicinal purpose. The current review aims to summarize the present knowledge on the botanical description, phytochemistry, traditional uses, and pharmacological properties of E. gerardiana. This study was thoroughly based on previous literature and was conducted by using electronic databases such as PubMed, Scopus, and Google Scholar. Relevant studies and recently published articles up till 2020 were included in this review. E. gerardiana is a small shrub-like plant characterized by jointed stems, scale-like leaves, and cylindrical cones. It belongs to the family Ephedraceae and is commonly found in arid and semi-arid regions. Phytochemical analysis has revealed the presence of various bioactive compounds in Ephedra gerardiana, including ephedrine, pseudoephedrine, norephedrine, and methyl ephedrine. These alkaloids are primarily responsible for their pharmacological activities. In traditional medicine, Ephedra gerardiana has been used for its bronchodilatory, diaphoretic, diuretic, and thermogenic properties. Additionally, it has been employed for the treatment of respiratory disorders, namely, asthma and nasal congestion, as a stimulant. Its bioactive alkaloids, particularly ephedrine, have been extensively studied for their potential therapeutic applications. However, caution should be exercised due to the potential side effects associated with ephedrine-containing products. Further research can explore its mechanisms of action, optimize dosage regimens, and investigate potential drug interactions to ensure its safe and effective use in clinical settings.