Objectives Early-onset myocardial infarction constitutes nearly one third of cases of myocardial infarction among Iraqis, which is rather higher than the proportions reported in many Western countries. Thus this study was initiated to investigate the role of some genetic polymorphisms, as well as acquired risk factors in this condition. Results A total of 102 Iraqi patients with first myocardial infarction aged 50 years, and 77 matched controls were enrolled. The DNAs of participants were screened for nine polymorphisms, namely: β-Fibrinogen (− 455G > A), Factor XIII (V34L), Plasminogen Activator inhibitor-1 (PAI-1, 4G/5G), Human Platelet Antigen-1 (HPA1a/b), 5,10-Methylenetetrahydrofolate Reductase MTHFR (C677T) and MTHFR (A1298C), Angiotensin-Converting Enzyme (ACE) 287 bp insertion/deletion (I/D), Apolipoprotein-B (ApoB: R3500Q), and Apolipoprotein-E (Apo E: E2/E3/E4), using PCR and reverse hybridization technique. Among traditional risk factors, univariate analysis revealed that smoking (OR 2.86 [95%CI 1.53–5.34]), hyperlipidemia (OR 5.23 [95%CI 2.66–10.29]), and diabetes mellitus (OR 4.05 [95% CI 1.57–10.41]) were significantly higher among patients compared to controls (P<0.001, <0.001 and 0.002 respectively), while none of the nine genetic polymorphisms reached significance. Multivariate Logistic regression, however, revealed that only smoking and hyperlipidemia retained significance (P of < 0.001 each). The need to initiate further studies on larger cohorts is paramount to understand the higher than expected frequency of early-onset myocardial infarction in our population.

Hemoglobinopathies are major health problems among Iraqi Kurds, who are a distinct ethnic group inhabiting North and Northeastern Iraq. We reviewed published literature on these disorders in this part of the world, and it was revealed that the most prevalent is β-thalassemia with carrier rates of 3.7-6.9%. Alpha thalassemia is less prevalent with carrier rates of 0.03-1.22%, while the sickle cell gene is variably distributed with carrier rates of 0.06-1.2%. Other structural hemoglobinopathies and δβ-thalassemia are sporadic. Twenty-seven different β-thalassemia mutations were identified, with seven constituting 82% of 1039 chromosomes characterized, namely: IVS-II-1 (G>A), IVS-I-6 (T>C), IVS-I-I (G>A), codon 8 (−AA), codon 8/9 (+G), IVS-I-110 (G>A), and codon 5 (-CT). There were notable regional variations in the distribution of β-thalassemia mutations, with Cd44 being mainly prevalent in the North, while IVS-I-110 is mainly prevalent in the East. In relevance to α-thalassemia, ten different mutations were detected, with the four most frequent constituting 92.4% of 262 alleles characterized being: −α 3.7 , -MED , α −5nt α, and α PolyA1 α. In relevance to sickle cell gene, it is seen in the northern part of the region bordering Turkey, with comparable prevalence rates, and is associated, similar to Turkey, mainly with the Benin haplotype, unlike that in Southern Iraq where it is associated with the Arab-Indian haplotype, similar to Eastern Arabian Peninsula. Given the high prevalence of hemoglobinopathies in the region, and the high rates of consanguineous marriages, a preventive program was initiated in 2008, and results of its first 5 years were promising, though there are still many outstanding challenges that require addressing.

No abstract

Background: Epstein Barr virus (EBV) has been linked to the etiology of several malignancies, including Hodgkin's Lymphoma (HL). However, the degree of this association varies between different geographical regions and age of EBV exposure. No study has addressed such an association in Kurdistan, northern Iraq, and thus this study was initiated. Patients and methods: A total of 91 patients diagnosed as HL over a 10 year period were studied. These patients had their records and slides reviewed and the additional immunohistochemistry, including that for LMP1 as well as in situ hybridization for EBER performed. Results: The patients had a mean age (SD) of 28.8 (16.2) years and had a male to female ratio of 1.7:1. They included 3.3% with Nodular Lymphocyte Predominant HL (NLPHL) and 96.7% Classical HL (cHL). The most common 2 subtypes of the latter were nodular sclerosis (NS) and mixed cellularity (MC) at 52.7% and 36.6% respectively. It was found that 40 cases (44.0%) were latent membrane protein 1 (LMP1) and/or EBER positive. The positivity was significantly higher in males (P=0.009), mixed cellularity subtype (P<0.001) and in the ages ≥45 and ≤15 years when compared to those 16-44 years (P=0.004). Conclusion: HL in Iraqi Kurdistan demonstrates a frequency of EBV virus infection that approaches the levels seen in Western countries and is coupled with a changing histological pattern of classical HL from MC to NS. This is likely to be a reflection of the improving socioeconomic status of the population of the region.