Print ISSN: 2790-0207

Online ISSN: 2790-0215

Keywords : Kirkuk

Bacterial neonatal sepsis and outcome in kirkuk city 2021

Jameel Azeez

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 84-100

Sepsis is the commonest cause of neonatal mortality, it is responsible for about (30 - 50% ) of neonatal deaths every year in developing countries.

Two hundred neonates were studied, sepsis was confirmed in 175 neonates (87.5%) by positive blood culture. Preterm neonates in this study were118 (59%), Prolonged rupture of amniotic membranes( > 18-hrs), was reported in 123 (61.5%), history of maternal fever was reported in 130 (65%). incidence in males was 120 (60%) while in females was 80 (40%). Early-onset disease (0-7 days) had occurred in 69 (34.5%), while 131 (65.5%) was the percentage of late-onset disease(8-30 days) . most of the late-onset disease was nosocomial infections 60 (53.57%). The predominant isolates in both early and late-onset diseases were Gram-negative bacteria 138 (78.8%) . the common organism in early-onset sepsis was E.coli 31 (49.20%), while the common organism in late-onset sepsis was Klebsiella 50 (44.64%). The total mortality rate was 82 (41%), in the early neonatal onset was 26 (42.02%) and while in the late neonatal-onset disease was 56 (42.7%) was. Candida albicans and Pseudomonas aeroginosa have high mortality (100%), but there is no death was recorded in pneumococcal sepsis.
Conclusion Neonatal septicemia generally is present in developing countries more common than in developed countries.


Jameel Azeez

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 30-46

Background: Kerosene poisoning is one of the most common accidental poisoning in children in developing countries due common use of kerosene in house-hold and unsafe storage practices
Aim Of The Study: The aim of this study was to identify the demographics, incidence, clinical features, radiological findings and treatment of kerosene poisoning in children in Kirkuk city.
Patients And Methods: Seventy two cases were admitted immediately to the emergency department in Kirkuk pediatric hospitals, Kerosene ingestion during the period from the 1st of june 2020 to the 1st of june 2021. Fifty four cases (75%) were boys and 18 cases (25%) were girls, and age ranges from 10 months to 10 years. Information regarding the history was taken from their parents , by special questionnaire paper (appendix) statistical method is used in this study.

1. It appears clearly that kerosene pneumonia in Iraq is most often of mild to moderate degree of severity with no mortality.

The manifestation of COVID 19 virus in children in Kirkuk city

Shan Nadhmi

Kirkuk Journal of Medical Sciences, 2021, Volume 9, Issue 1, Pages 204-217

The study is dealing with a pandemic and highly infectious disease which is COVID 19, that caused a pandemic in world and affected a huge number of children in Kirkuk city.
The objectives of this study are to assess the different presentations, signs & symptoms of COVID 19 in children in Kirkuk city in order to diagnose these cases as soon as possible and isolate them .
This is a community-based descriptive cross-sectional study done in children presenting to Pediatric hospital in Kirkuk city and privet clinics from the period of June 2020 until July 2021, 120 children infected with COVID 19 virus and diagnosed by PCR from nasal swap were collected using a questionaire, containing details of his condition.
The study had showed that children may present with a variety of symptoms, like: fever, cough, nasal congestion, loss of smell and/or taste, dyspnea or GIT symptoms like: diarrhea, nausea, vomiting, abdominal, others with headache, dizziness, muscle aches and poor feeding.
Children infected with COVID 19 might present with a wide variety of symptoms, like respiratory, GIT, CNS or non-specific symptoms, and it is important to send them nasal swap for PCR for early diagnosis, isolation and start the proper treatment with them

Evaluation of Referral System Patterns in Azadi - Teaching Hospital/ Kirkuk

Eman N. Mohammad; Taghlub H. Ryhan; Saad S. Mustafa

Kirkuk Journal of Medical Sciences, 2020, Volume 8, Issue 1, Pages 44-53

Background: Referral system constitutes a key element of health system and one of the strategies for ensuring the best use of hospital resources and health care services.. Aim and objectives: a) Causes behind of direct attendance of patients to hospital. b) Find out the main reasons of patients referral to hospital. c) Patients' opinion about the hospital services. d) Assess consultants view about referral system. Methods: A cross sectional study was carried out since 1st of March 2018 till end of September 2018. 1000 patients attending seven consultation units in Azadi teaching hospital were involved in the study. Anevaluation of main causes of direct attendance was done, review of the information on the referral form, patient satisfaction with referral was inquired and specialist doctors' evaluation of the referral was obtained. Results: The rate of referral with referral form was (81%). Main cause of direct attendance was that patients don’t trust the Primary health care center (PHCC) doctor. The provisional diagnosis,a reason for the referral and name of the referring doctor were absent or unclear on (94.6, 84.1 and 61.9 %) of referral forms..Patient satisfaction with the services of secondary health care facilities was (80.1%), and the highest rates of dissatisfaction were because of drug unavailability in hospitals. Specialist doctors considered (55.1%) of all referrals as inappropriate and the need for further treatment was the main reason for indicated referrals. Conclusion: The rate of patient’s referral with referral form was high. The main cause of directly attending hospital with no referral form is that patients do not trust doctors in PHC level. Patients are generally satisfied with the services of secondary health care facilities. More than half of referred cases not need referral from the specialists’ point of view.

Breast Conservative Surgery vs. Modified Radical Mastectomy: The Commonest Surgical Practice to Treat Breast Cancer Patients among Surgeons in Kirkuk City

Isam A. Ali; Alaa Othman sedeeq; Hazim S. Ahmed

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 117-124

Background: Worldwide breast-conserving surgery (BCS) became more common than mastectomy in treating breast cancer patients after the National Institutes of Health Consensus Statement in 1990. Objective: To evaluate the preferred surgical procedures used by surgeons in Kirkuk city. Methods: A total of 104 patients with breast cancer underwent surgery (BCS vs. Mastectomy) collected from Kirkuk General Hospital, Azadi Teaching Hospital and Kirkuk Oncology Center from June 2015 to August 2017. Results: Mean age of patients with breast cancer in this studied were 47.3±9.2 years. Two thirds of patients were premenopausal and a third was postmenopausal. The presenting stage at diagnosis of breast cancer patients was (17.3% stage I, 36.6% stage II, 42.3% stage III, and 3.8% stage IV). Three quarter of patients with breast cancer underwent mastectomy and only one quarter underwent Breast Conservative. Mastectomy rate per staging was: (10.5% stage I, 21% stage II, 36% stage III, and 2.8% stage IV), while BCS rate per staging was: 7.7% stage I, 17.3% stage II, 2.8% stage III, and 1.9% stage IV). Conclusions: Mastectomy is most common surgical procedure in treating breast cancer patients regardless to disease staging among surgeons in Kirkuk city.

Normal Spleen Size in Adults in Kirkuk Population Using Ultrasound Scan

Israa Mohammed Sadiq; Saman Anwer Nooruldeen; Zahraa Ahmed Hasan; Mohammed Mustafa

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 34-40

Background: Splenomegaly is a clinically important finding, particularly for physicians required to make decisions on variety of disease status including infectious, storage diseases and malignant disorders. Objective diagnostic measures have been proposed as a useful step in making decisions in those patients using ultrasonography, as it‘s a noninvasive, established, safe, quick and accurate method for measurement of spleen size. There are racial differences in normal splenic size, as previous ultrasound data have been suggested. These differences in splenic size result in improper interpretation of splenic measurements. Objectives: To develop standards of normal range of splenic length (as indicator for splenic size) for our adult population based on gender, age and body mass index using ultrasound scan. Material and Methods: A cross-sectional study conducted in the department of Radiology in Azadi Teaching Hospital, Kirkuk, Iraq within a period from May 2013 to April 2016. The study was conducted among 303 adult individuals (120 males and 183 females), they were healthy individuals more than 18 years old not suffering from diseases affecting the spleen, the exclusion criteria were individuals not willing to participate; history of medical disorders affecting spleen, such as blood, metabolic and connective tissue diseases, portal hypertension, high body temperature within the last month of examination, malignancy, and pregnancy. Maximum splenic length in centimeters was assessed at level of splenic hilum on the longitudinal view using 5 MHz sector curvilinear transducer probe for trans-abdominal Ultrasonography. 2-tailed t test was used to assess the differences between continues variables. The Relationship of length of spleen with age, and body mass index (BMI) were assessed with the Pearson‘s correlation coefficient (r). Results: The mean age of the study sample was 38.05±15.58 years for male and 37.23±13.98 for female, their mean body height was 173.1±46 cm for male and 159.70±4.88 cm for female, their body weight was 83.42±16.70 kg for male and 73.19±15.90 Kg for female and mean BMI were 27.86 ±5.42 for male and 28.58±6.27 for female. Mean spleen length were 10.65±1.41 for male and 9.52±1.25 for female. There was significant correlation between spleen length and gender (p< 0.05). There was weak negative correlation with age, and weak positive relation between the splenic length and BMI. Conclusion: This study provides the values of normal splenic size by ultrasonography in adults‘ for both genders at Kirkuk city. The splenic size had weak positive correlation with body mass index (BMI), and weak negative correlation with age.

Study the Relation of Drug –Non Adherence with Some SocioEconomic Factors among Diabetic Patients in Kirkuk City

Zahraa Gh. Abdullah; Ali Akram Ismaeel; Waleed Mohammed Ali

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 103-110

Background: Poor & non-adherence to medications are serious issues in the management of chronic diseases such as diabetes mellitus. Amounting body of evidence indicates that decreased medication adherence is associated with increased rate of hospitalization and total costs of care. Objective: For studying the prevalence of drug non-adherence & poor/ partial adherence among adults and its associated risk factors totaling with causes. Patients and Methods: Prospective descriptive cross sectional study was carried out in Azadi Teaching Hospital at Kirkuk Governorate of Iraq. Based on the inclusion and exclusion criteria 500 patients were enrolled into study, which had Diabetes Mellitus. Results: Five hundred adult patients participated in this study. Estimated mean prevalence rate of drug non-adherence were: (1) self-perceived adverse effect of medicines (16.67); (2) complicated medicine regimens (7.07); (3) inadequate knowledge about medicines and diseases(1.01);(4) frightening from dependency and addiction (3.54); (5) the stigmatization (4.54); (6) drugs not present in health centers (16.67); (7) considering disease is transient and not lifelong (8.58); (8) considering the drug is not effective (18.18); (9) the cost of medications (21.71); (10) the forgetfulness (2.02). Conclusion: The drug non-adherence is an important concern or problem in a patient management. Medication regimens should be simplified as more as possible, in particular to avoiding cutting pills or using of different dosages at a different timing. Patients should be encouraged to voice out their perceived drug adverse effects. Further worksare needed to determine the prevalence and causes of patients, non-adherence to medication in Kirkuk Governorate.

Prevalence of Anemia during Pregnancy in Kirkuk Province

Hassan Y. Hassan; Abdulhadi M. Jumaa M. Jumaa; Fadheelah S. Azeez S. Azeez

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 66-70

Background: Anemia is defined as a state of decreased blood concentration of hemoglobin which can by too few red blood cells, too little hemoglobin in red blood cells or both. Worldwide, anemia is considered as one of the major nutritional deficiency disorders. In developing countries, almost two thirds of pregnant ladies are anemic. Most of the studies suggest that there is a significant rise in perinatal mortality rate when hemoglobin of pregnant woman becomes pregnant below 11.0 g/dl. The aim of study is to estimate prevalence of anemia during pregnancy in Kirkuk province. Subjects and methods: This study was conducted at the beginning of May to the end of September 2017. 100 females, whose ages were between 18-35 years, were collected randomly in Kirkuk province (50 pregnant females and 50 nonpregnant females at childbearing age as control). The mean and standard deviation of our sample ages were 27.72+5.38 years (23.39+4.1 years for nonpregnant females and 31.9+2.3 years for pregnant females). Among pregnant females, the mean and standard deviation of ages were 28.17+1.2 for 1st trimester, 32.2+2 for 2nd trimester and 32.9+1.4 for 3rd trimester. 68 of our sample were from urban areas and 32 from rural areas. 3 ml of blood drawn from the cubital vein by using disposable needles and syringes. CBC (complete blood count) was estimated by using same automated analyser in same laboratory. 5 parameters (Hemoglobin (Hb), hematocrit (Hct), Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC)) have collected for each woman in this study. Results: In this study, it has been seen that the changes in all parameters during pregnancy becomes more obvious in last two trimesters of pregnancy. Conclusions: Regarding results of present study, prevalence of anemia during pregnancy in Kirkuk province is high and type of anemia is mild anemia

Transfusion-Related Infections in Thalassemia Major Patients: Kirkuk Thalassemia Center Experience

Jamal Qassim Welli; Majed Najii Agha; Mohammed Saleem Mohammed

Kirkuk Journal of Medical Sciences, 2015, Volume 3, Issue 1, Pages 22-28

Introduction: Thalassemia Major is one of the commonest causes of hereditary anemia in Iraq. Patients usually require frequent blood transfusion. This study tried to estimate the problem of transfusion-related infections among β-thalassemia major patients in Kirkuk governorate-Iraq.
Patients and Methods: The study involved 254 multi-transfused thalassemia major patients attending the Thalassemia Center at Kirkuk governorate over twoyears periodstarting from January 2010 to January 2012. Blood samples were tested for HBsAg, anti HCV antibodies, and HIV antibody using an enzyme-linked immunosorbent assay. A control group of 150 Thalassemia minor with nearly matched age and sex to thalassemia major patients was included.
Results: Anti-HCV antibody was positive in 85 out of 254 thalassemia major patients (33.5%), while HBsAg was positive in only one out of 254 patients (0.4%). HIV infection was not found in any thalassemia major patients. The rate of positive anti-HCV antibodies was significantly higher in comparison with the control group (P value <0.000) while it was not significant for HBsAg (P value=0.9). Age categorization for thalassemia major patients with positive HCV test shows that more than three quarters of them are above 10 years old.
Conclusion:HCV is the current major problem in multi-transfused children with thalassemia major and more careful pre-transfusion screening of blood for anti-HCV must be introduced in blood bank centers.

Lipid Abnormalities among Type II Diabetic Patients in Kirkuk City

Dilshad Sabir Mohammed

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 2, Pages 1-7

Background: Lipid abnormalities are common in diabetic patients and associated with accelerated atherosclerosis and increased risk of coronary artery disease, this study was carried out to determine the degree of lipid abnormalities among type II diabetic patients in Kirkuk City. Patients and Methods: One hundred twenty patients with type II diabetes and (120) control group (non-diabetic) who attended Azadi Teaching Hospital in Kirkuk City from November 2012 to October 2013 were included in the study. Demographic features recorded and the level of fasting: blood sugar, total cholesterol, triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and very low density lipoprotein (VLDL) was measured. Results: Patients with type II diabetes mellitus (DM) showed statistically significant lipid abnormalities when compared with the control group. Overall lipid abnormalities were detected in (55%) of patients with type II DM. Those with poor glycemic control showed significantly higher lipid abnormalities than patients with fair glycemic control. We found no statistically significant difference in lipid abnormalities in relation to the duration of diabetes mellitus. Conclusion: Outcome of this study showed that a high proportion of patients with type II DM have some forms of derangement in their lipid profile and is correlated with poor glycemic control.

Premenstrual Syndrome among Kirkuk University Students

Mohammed Mustafa Mohammed

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 2, Pages 51-55

Background: Premenstrual syndrome (PMS) is a common menstrual disorder precipitated by stress and tensions either at home or at work and particularly affect women during their reproductive live mostly in their reproductive live mostly in their twenties and thirties. Objective: To estimate the prevalence of PMS among Kirkuk University Students and its effect on their activities and learning process. Patients and Methods: This cross-sectional study was conducted during the period 10th/11/2010-10th/3/2011 among 224 Kirkuk University students; by using a special questionnaire form which includes information about: name of the college, age of the student, marital status and physical and psychological symptoms of PMS. Results: Majority of the students included in the study complained from more than one symptom of PMS; and PMS affect their activities. Conclusion: PMS symptoms affect the study and training of the students during their academic year. Recommendation: Advice the girls to take prophylactic drugs and avoid consumption of food and beverage that are high in sugar content or taking sweets which might aggravate menstrual symptoms

Epidemiological Data of Drug Abuse in Kirkuk Governorate; A Descriptive Study

Saadoun Dawood Ahmed Al-Jiboori

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 2, Pages 43-50

Background: Drug abuse is the self-administration of any drug in a manner that diverts from approved medical or social patterns within a given culture. Legal or licit drugs and substances are socially accepted and their use does not constitute any criminal offence. Objective: To determine types of drugs which are abused, to demonstrate the sociodemographic profile of the abusers, the sources of starting drugs consumption and the associated psychiatric disorders among them. Patients and Methods: A descriptive study of (372) patients with drug abuse consisting of (285) males and (87) females. The study was done in Kirkuk city between December 2012 and January 2014. Diagnosis of drug abuse was made according to the Diagnostic Statistical Manual of diseases-Fourth Text Revised (DSM-IVTR). Results: The majority of the patients were singles (56.4%), (83.6%) with the age range of (17-38) years, (64%) were illiterate and primary school educate, (72%) were unemployed, (70%) from urban area. (17%), (16%), (13%), of the patients abused, Tramadol, poly drugs, and Alprazolam respectively. (18%) of the patients were diagnosed anxiety disorders, and (3.7%) of the patients were diagnosed with somatoform. Conclusions: Drug abuse is a growing problem in Iraq. Unaware of medical professional of some drugs with potential risks of abuse, unsupervised prescription and easy access of these drugs, in addition to the characteristic groups of high risks of abuse, such as young males, poorly educated, unemployed, those who were exposed to stressful factors and psychiatric patients. All these need to be addressed by medical, legal and social authorities.

Preferences of Teachers and Students for the Type of Exam Questions in Kirkuk Medical College

Osama Hassan Othman; Mohammed Mustafa Al-Taweel; Summer Saad Abdul-Hussein

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 1, Pages 55-62

Background: Types of questions means a lot for every school in the world starting from primary schools till the end of one‘s professional life. Medical college is among one of the top colleges due the level of the students accepted in the college to be future young physicians and their teachers work mostly as both doctors and teachers at the same time. Objective: This study was performed to assess the preferred types of assessment questions among medical students and teachers in Kirkuk medical college to pinpoint what is ideal for both and to compare it with the results of studies conducted by other colleges published in the literature. Subjects and Methods: Subjects included in this cross-sectional study ware 37 teachers (in basic and clinical teachings), and 181 students starting from the 3rd, up to the 6th year in Kirkuk medical college during 2011-2012 by proposing questions to both students and teachers and asking them to spot their preferences and other wanted data on the prepared questionnaire sheets by researchers. Results: Among 181 students consisting of 120(66.3%) female students and 61(33.7%) male students, Single choice questions (best of five) are the first choice for 56 students due to easy memorisation. Among 26 teachers whose data is included, single choice questions (best of five) is the first choice for 11 teachers. Covering wider subjects is the most common cause behind the teacher's preference for a particular question type. Conclusion: Single choice questions and essays are the most preferred question by the students. Teachers mostly preferred single and multiple choice questions for reasons of covering wider subjects, testing students concentration, and the presence of less factor of chance. Oral exams are preferred by many teachers.

Correlation of Handedness with High Cerebral Function

Osama Hassan Othman; Mohammed Mustafa Mohammed; Summer Saad Abdulhussain

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 74-80

Background: Handedness in human kind means a lot apart from social impact. It gives a hint to localization of dominant hemisphere. This study was done on Kirkuk University students & well concluded that activities other than only hand writing are well correlated to high cerebral function like learning & memory, speech & language. Family history is important in this aspect. Objective: To explore correlation of handedness to candidate performance & other daily activities which need high cerebral function. It's relation to family history is well addressed. The patterns of speech fluency were studied. Subjects and methods: Subjects included in this cross sectional study were selected randomly from students in different colleges in Kirkuk University from Jan. 2012 – Jan. 2013. Proposing sheets of information & asking candidates directly by researchers about wanted data & the result were fixed in appropriate boxes and then analyzed properly. Results: Among 242 students 148 (61.15%) were using right hand during writing while 94 (38.85%) using left hand during writing. Some of them were in forced by their parents to change handedness during early childhood. Handedness were different during other activates, correlated well with performance & got family history. Conclusion: Handedness correlated with many parameters other than hand writing. Important daily activities, performance at college, ability in mathematics, drawing, quality of hand writing were all observed.

Deferoxamine vs. Deferasirox in the Treatment of Thalassemia Major with Iron Overload: Retrospective Study in Thalassemia Center, Kirkuk, Iraq

Jamal Qasim Weli; Mohammed Saleem Mohammed

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 2, Pages 30-36

Background: Iron overload is a major problem in patients with Thalassemia major. An effective and safe iron chelator protocol with high compliance rate plays an important role deciding the best treatment option in these patients. This study was done to assess the efficacy and safety of both Deferoxamine and Deferasirox in Thalassemia major patients in Kirkuk province, Iraq. Patients and methods: In this retrospective study we have included serum ferritin records of 280 Thalassemia major patients treated with two types of iron chelating therapy at Thalassemia center, Azadi teaching Hospital, Kirkuk province, Iraq. The study started since March 2012 till December 2012 and they were categorized in to two groups; First group Thalassemia major patients who had been treated with subcutaneous (SC infusion) Deferoxamine, while second group had been treated with oral Deferasirox (Exjade) with serum ferritin records of both base line and 9 month later had been compared. Most patients with relatively high serum ferritin had been treated with SC Deferoxamine. As a secondary end point, side effect profile had been analyzed in the two studied groups. Results: 173 Thalassemia major patients (mean age 11 year) treated with oral Deferasirox (Exjade) had mean decrease in their serum ferritin after 9 month was 840 ng/ml while the mean decrease in the 107 patients (mean age=17 year) treated with SC infusion Deferoxamine was (1527 ng/ml) with very significant difference between the two studied groups and (p-value = 0.0005). Abdominal cramp, nausea and vomiting, skin rash were more with oral Desferosix (Exjade) than SC Deferoxamine treated patients [52 (30%), 62 (35%), 13 (7%) versus 23 (21%), 11 (10%), 0 (0%) consecutively]. Renal impairment especially elevation of serum Creatinine to a degree requiring dose modification were found in 15 patients treated with oral Deferasirox (Exjade) while it has not been noticed in patients treated with Deferoxamine. Conclusion: In spite of less side effects and more compliance of Thalassemia Major Patients treated with Deferasirox than Deferoxamine; Deferoxamine still is more effective treatment modality than Deferasirox in decreasing serum ferritin level.

A Study on Sexually Transmitted Diseases in Kirkuk City

Mohammed Abdul-Aziz Kadir; Suheila Shamse-El-Den Tahir

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 1, Pages 74-80

Objective: The study was planned to show the prevalence of sexually transmitted disease (STD) among women and neonates attending some private clinics in Kirkuk City. Patients and methods: A cross sectional study was performed on 425 women and neonates attended private clinics in Kirkuk city. The period of study was from 1 st of January 2004 to 31 st of December 2004. Results: It was found that the highest rate of symptoms was vaginal discharges followed by lower abdominal pain, genital ulcers, ophthalmia neonatorum and inguinal bubo respectively. Patients with more than one symptom were also detected. Among patients with discharge, Candida albicans (53.42%) and Trichomonas vaginalis (80.82%) were observed. In addition to symptoms, several genital problems were seen, such as Molluscum contagiosum, warts, Herpes simplex and Tenia cruris. The VDRL positive cases were detected among patients enrolled the study. Conclusion: The prevalence of STD symptoms is common among patients attending the private clinics. The highest rate of symptoms was vaginal discharge followed by lower abdominal pain and genital ulcers. More than one symptoms was detected among patients in the studied groups. Several genital problems were found in association with STD symptoms.