Background: In the context of Iraqi communities, mycosis fungoides (MF) is the main cutaneous T-cell lymphoma that is the most prevalent, but little information is available about it. One of the areas that is still being actively researched is the role that tumor-associated macrophages (TAMs), which are identified by their expression of CD68, play in the course of illness. Objective: is to define the demographic, clinical, and immunohistochemical characteristics of MF in an Iraqi cohort, with a particular focus on identifying relationships that may provide evidence regarding the pathogenesis and course of the illness. Methods: A retrospective review of 22 patients diagnosed with MF at a single dermatology center in Iraq (2020–2025). Data on age, sex, disease duration, clinical subtype, stage, and CD4/CD8/CD68 expression were analyzed using Mann-Whitney U tests, Kruskal-Wallis tests, Fisher's exact tests, and Spearman's correlation. Results: A retrospective review of 22 individuals diagnosed with MF at a single dermatological center in Iraq (2020–2025) was conducted as part of the methodology involved. Mann-Whitney U tests, Kruskal-Wallis tests, Fisher's exact tests, and Spearman's correlation were utilized in order to assess the data pertaining to age, gender, length of disease, clinical subtype, stage, and expression of CD4/CD8/CD68 and other related factors. As a result, the cohort consisted of 14 males and 8 females, with a gender ratio of 1.75:1. In this study, it was discovered that males presented at a considerably older age compared to females (49.2 ± 13.7 years versus 35.5 ± 13.1 years, p = 0.023). This is a novel discovery that has not been discussed in the literature before. There was a positive correlation between the length of the disease and the age at diagnosis (ρ = pokilodermatous -erythrodermic, p = 0.028), which indicates that older patients may have delayed presentation. In addition to lichenoid (18.2%) The least was a female patient 15 years old who had hypopigmented MF. There were two significant associations that were found associated with CD68 expression: Strong CD68 positivity was significantly associated with tumor-stage disease (present in 2/2 tumor-stage patients compared to 3/17 patch/plaque patients; p = 0.048); and patients with strong CD68 expression had significantly longer disease duration than those with weak or negative expression (7.8 ± 3.1 years versus 4.2 ± 3.1 years, p = 0.035). The CD4+ phenotype was the most prevalent (84.2%). Conclusion: This work reveals unexpected findings in an Iraqi MF cohort, including a large age discrepancy between the sexes at the time of diagnosis, a link between age and the length of the disease, and, most importantly, dual associations of CD68 expression with both advanced stage and prolonged disease duration. These findings imply that tumor-associated macrophages have a role in the chronicity and progression of mycosis fungoides (MF), raising the possibility that CD68 could be used as a biomarker for risk classification. It is necessary to do more extensive research in order to verify these discoveries and investigate the consequences they have for prognosis.

Type A interrupted aortic arch is a rare congenital heart disease characterized by a complete loss of continuity between the ascending and descending portions of the aorta; presentation in adults is exceptional due to its high mortality. This article presents the case of a 57-year-old woman with resistant arterial hypertension since the age of 15, treated with multiple therapeutic regimens, presenting long-standing nonspecific symptoms. CT angiography and aortography were performed, confirming the diagnosis of type A interrupted aortic arch. She was referred to a tertiary care center where a left subclavian artery–descending aorta bypass was performed with an extra-anatomic graft, with good clinical evolution; she is currently asymptomatic under follow-up. Interrupted aortic arch is a rare congenital heart disease with low prevalence in adults due to its high mortality, of which type A is the most frequent and is associated with greater survival due to the formation of collateral arteries. Multiple studies have compared imaging methods to evaluate sensitivity, with modalities such as computed tomography and magnetic resonance imaging being superior to echocardiography.

Background: Anticholinergic medications are among the most widely prescribed drug classes in older adults, yet their cumulative burden poses substantial risks for cognitive decline, falls, and functional impairment. The Anticholinergic Cognitive Burden (ACB) scale provides a validated framework for quantifying this risk, with scores ≥3 indicating clinically significant burden. Objective: This quality improvement project (QIP) aimed to identify patients aged ≥65 years with an ACB score ≥3 in a primary care setting and to implement structured medication review interventions, including de-prescribing, switching, or dose adjustment, to reduce anticholinergic burden. Methods: A cross-sectional quality improvement design was employed over a six-month period (January–June 2024) in a GP practice in the United Kingdom. All registered patients aged ≥65 years were systematically screened using the ACB scale. Patients with a total ACB score ≥3 underwent structured medication reviews. Interventions included de-prescribing, therapeutic switching to alternatives with lower anticholinergic activity, and dose reduction. Pre- and post-intervention ACB scores were compared. Results: Of 120 patients screened, 98 were aged ≥65 years and 62 (63.3%) had an ACB score ≥3. The most prevalent anticholinergic agents were amitriptyline (29.0%), oxybutynin (22.6%), and tolterodine (19.4%). Following intervention, the mean ACB score decreased from 4.7 ± 1.1 to 2.9 ± 1.0 (p<0.001), the proportion of patients with ACB ≥3 reduced from 63.3% to 42.9%, and Mini-Mental State Examination scores showed modest improvement. Conclusion: Structured, ACB-guided medication reviews in older primary care patients are feasible and effective in reducing anticholinergic burden. Embedding systematic pharmacological review within routine geriatric care can meaningfully protect cognitive function and reduce fall risk in this vulnerable population.

Background: Tinea capitis is a common pediatric dermatophytosis involving the scalp, hair shafts, and follicles, most frequently caused by Trichophyton, Microsporum, and Nannizzia species. Although most cases are non-inflammatory, a subset progresses to kerion celsi. While appropriate antifungal therapy typically leads to resolution, persistent inflammation may occur despite microbiological clearance, suggesting additional pathogenic mechanisms. We report a 7-year-old male presenting with a chronic pseudoalopecic plaque on the scalp following inflammatory tinea capitis, with negative mycological studies but histopathological evidence of granulomatous dermatitis. Dermoscopic-guided removal of keratin plugs and ingrown hairs resulted in clinical improvement. This case highlights a novel mechanism of persistent inflammation in kerion celsi associated with hair shaft fragmentation, aberrant follicular penetration, and retention of keratinous debris acting as endogenous foreign bodies, triggering a chronic granulomatous response.

The vertebral column begins at the occipital bone and concludes with the coccyx, collectively forming the structure referred to as the Ṣulb, or spine. The vertebrae are relatively small in size and extend from the cervical region down to the coccyx, with the spinal cord being distinct from the brain. The cervical vertebrae are essential for facilitating a range of movements while maintaining stability, and their cavities are designed to be spacious, allowing the spinal cord to reside within them comfortably. The vertebrae have a distinctive thorn-like form, with each featuring two foramina located on its right and left sides. From each foramen, two processes extend; one connects to the upper vertebral foramen, while the other connects to the lower vertebral foramen. The closure of these foramina has enhanced stability and strength within the vertebral structure. Each vertebra is characterized by three analogous processes: one that extends upward and two that project laterally. A vertebra typically features four processes, with two located on the right and two on the left of the foramen. The processes serve the essential function of establishing articular connection between adjacent vertebrae, utilizing the cavities of some processes and the condyloid projections of others. They also provide protection, support, and resistance to impact, as well as facilitate the attachment of ligaments. The structures located at the posterior aspect of the vertebrae are referred to as spinous processes, while those situated laterally on the right and left are known as transverse processes. These processes serve to safeguard the nerves, blood vessels, and muscles that are situated deeper within the body along its length. The spinal cord's gradual reduction in thickness from top to bottom mirrors natural patterns found in rivers and trees, allowing for the emergence of nerve pairs from the intervertebral foramen. The cervical region comprises five cervical vertebrae, each characterized by four processes that extend both upward and downward. The twelve vertebrae of the spine are arranged such that each joint produces two upwardly extending processes, while two additional processes descend into corresponding pits that interlock with adjacent vertebrae. The research aims to conduct a comprehensive analysis of the complex anatomical framework of the vertebral column, as described by various esteemed scholars and notable philosophers from both Greek and Arab civilizations.

Background: The vaginal microbiota consists primarily of Lactobacillus species, which help maintain microbial balance through acid production and antimicrobial activity. The disruption of balance causes vaginal dysbiosis and infection. Objective: The aim of this study was to analyze the association of vaginal infection with the distribution of Lactobacillus species, vaginal pH, and antimicrobial activity. Methods: The study was designed as a case-control study. A total of 100 subjects, including 50 healthy subjects and 50 infected subjects, were included. Vaginal swabs were collected to assess pH, microbial isolation, and identification using the standard microbiology technique. The antimicrobial activity of Lactobacillus isolates was assessed using the agar well diffusion technique and peroxide production was assessed qualitatively. Chi-square test and independent t-test were used for the statistical analysis of the results. Results: The isolation of Lactobacillus was 90% in healthy women and 40% in infected women, with a statistically significant difference (p < 0.001). Infected women had increased vaginal pH (5.6 ± 0.5) as compared to healthy women (4.3 ± 0.3) (p < 0.001). Lactobacillus crispatus was the most frequent in healthy women and Lactobacillus iners was the most frequent in infected women. Pathogenic organisms, especially Gardnerella vaginalis, were statistically significantly more common in the infected group. The isolates taken from healthy women had the highest hydrogen peroxide production and antimicrobial activity. Conclusions: An increase in vaginal pH, a decrease in antimicrobial defenses, and overgrowth of pathogens are associated with the loss of functionally active Lactobacillus species. Composition and functional capacity are critical factors in determining vaginal health.

The purpose of the study was to examine the impact of a low-intensity aerobic fitness program on the chosen physiological and biochemical markers of kidney activity, the parameters of physical fitness in physically active elderly men of 55 60 years. A one-group pretest- posttest design was used as the experimental method. The sample was chosen as 12 physically active elderly men, who were carefully chosen out of elderly population of Misan Governorate in Iraq. The training had a duration of 12 weeks and it had four sessions in a week. It was composed of walking workouts, stationary bicycle, and bodyweight trainings whereby intensity and duration were increased gradually. Physiological measurements were done in heart rate and systolic and diastolic blood pressure. Measures of physical fitness included cardiorespiratory endurance, muscular endurance and body mass index (BMI). The findings showed statistically significant differences in the post-test measures in favor of most variables, which means that the training program is effective in improving the functioning of kidney and blood pressure regulation as well as physical fitness in general. The research suggests the implementation of such low-intensity aerobic exercises programs as one of the safe and effective preventive measures aimed at maintaining physiological health among older adults.