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Introduction: Obstructive sleep apnoea (OSA) is a long-term disorder characterized by frequent blockages in the upper respiratory tract during sleep, often leading to abrupt awakenings, with or without a decrease in oxygen levels. The systematic review and meta-analysis aimed to assess the effect of continuous positive airway pressure therapy (CPAP) on blood interleukin (IL) levels of IL-6, IL-10, IL-18, IL-1β, IL-4, and IL-17 in OSA adults., Materials and Methods: The published databases from PubMed, Scopus, Web of Science, and Cochrane Library were searched from 2003 to 2024, without any restrictions. The Review Manager software 5.3 was employed to compute effect sizes, which were presented as the standardized mean difference (SMD) along with a 95% confidence interval (CI)., Results: In total, 320 records were identified through database searching; ultimately, 42 articles were included in the qualitative synthesis and then the meta-analysis. The CPAP therapy significantly reduces IL-6 levels, as indicated SMD=0.64 [95% CI: 0.35, 0.93] and P<0.0001. CPAP therapy significantly reduced IL-18 and IL-1β levels in adults with OSA, but there is no significant difference in IL-10, IL-4, or IL-17 levels. Age, blood sample, body mass index, ethnicity, and treatment duration for IL-6 and apnoea-hypopnea index with IL-10 levels were effective factors in the pooled results. Experimentally, there was an interaction between IL-18 and IL-1β., Conclusions: CPAP therapy has a positive impact on inflammatory markers in OSA adults; remarkably, it reduces IL-6 and IL-1β levels. Nevertheless, more evidence (such as the role of ethnicity) and understanding of interactions are needed., (Copyright © 2024 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Background: The surveillance of serious and superficial skin fungal infections in Iraq has not been conducted. Limited information exists on their incidence and prevalence., Objectives: This study aimed to analyze, compute and estimate the prevalence and burden of fungal infections, as no previous data is available and no studies has been attempted in Iraq., Methods: In the present study the data were collected and reviewed from published data on epidemiology of fungal infections nationally, internationally, from unpublished postgraduate master and PhD theses, hospital records and private clinic records. External sources of data from other countries were used for diseases which lacked sufficient local data., Results: We estimated 985,628 annual serious infections comprising of 2.26 % of the total population. When including superficial fungal infections group of the skin, this rises to 2,075,113 infections at 4.76 % of the total population. The most common serious and skin infections were recurrent Candida vaginitis, fungal rhinosinusitis and tinea capitis comprising 61.5 %, 21.8 %, and 22.4 % of all infections although the total incidence of superficial fungal infections was also high at 1,071,485. Respiratory fungal disease is also common comprising 14.0 % of infections. We predicted the following annual burden per 100,000; oral candidiasis at 247.9, esophageal candidiasis at 6.04, candidemia at 5.0, Candida peritonitis at 0.75, recurrent Candida vaginitis at 5461, allergic bronchopulmonary aspergillosis at 35, severe asthma with fungal sensitisation at 46, invasive aspergillosis at 7.9, chronic pulmonary aspergillosis at 11.7, chronic fungal rhinosinusitis at 496, mucormycosis at 0.99, fungal keratitis at 14.0, and total dermatophytosis at 1631, the most severe being tinea capitis at 366. Many of these estimates were made with data sourced from other nations, so additional data from Iraq is required to validate or modify these estimates., Conclusion: Recurrent Candida vaginitis, fungal rhinosinusitis, and tinea capitis are considered to be the most frequent fungal diseases present in Iraq., Competing Interests: Declaration of competing interest None of the authors have a conflict of interest with the contents of this manuscript, (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Stem-cell therapy is a revolutionary frontier in modern medicine, offering enormous capacity to transform the treatment landscape of numerous debilitating illnesses and injuries. This review examines the revolutionary frontier of treatments utilizing stem cells, highlighting the distinctive abilities of stem cells to undergo regeneration and specialized cell differentiation into a wide variety of phenotypes. This paper aims to guide researchers, physicians, and stakeholders through the intricate terrain of stem-cell therapy, examining the processes, applications, and challenges inherent in utilizing stem cells across diverse medical disciplines. The historical journey from foundational contributions in the late 19th and early 20th centuries to recent breakthroughs, including ESC isolation and iPSC discovery, has set the stage for monumental leaps in medical science. Stem cells' regenerative potential spans embryonic, adult, induced pluripotent, and perinatal stages, offering unprecedented therapeutic opportunities in cancer, neurodegenerative disorders, cardiovascular ailments, spinal cord injuries, diabetes, and tissue damage. However, difficulties, such as immunological rejection, tumorigenesis, and precise manipulation of stem-cell behavior, necessitate comprehensive exploration and innovative solutions. This manuscript summarizes recent biotechnological advancements, critical trial evaluations, and emerging technologies, providing a nuanced understanding of the triumphs, difficulties, and future trajectories in stem cell-based regenerative medicine. Future directions, including precision medicine integration, immune modulation strategies, advancements in gene-editing technologies, and bioengineering synergy, offer a roadmap in stem cell treatment. The focus on stem-cell therapy's potential highlights its significant influence on contemporary medicine and points to a future in which individualized regenerative therapies will alleviate various medical disorders., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Coronavirus disease 2019 (COVID-19) first appeared in Iraq, including the Iraqi Kurdistan region governorates, in March 2020., Methodology: 48,494 samples were collected from public hospitals in the Kurdish governates from February 2021 to May 2022. Viral RNA was extracted, and real time quantitative polymerase chain reaction (RT-PCR) was used to detect the COVID-19 variants. Statistical analysis of patients' clinical data was performed., Results: The RT-PCR results identified the Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529) variants in the Kurdistan governorates. Young adults (20-39 years) had significantly higher rate of infection than children (1-11 months) and older adults (80-89 years). The Delta wave was more contiguous, spread more easily, and more fatal than the Alpha and Omicron waves. The highest number of COVID-19 cases was reported in Sulaymaniyah and Duhok; and the highest death rate was reported in Sulaymaniyah. The death rate in males was higher than in females, especially among older people. Fatigue, cough, and fever were common symptoms among the three variants. The phylogenetic tree revealed that the L-type of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was a descendant of the S-type at an early stage of evolution. The L-type could spread faster in Kurdistan. Multiple sequence alignment (MSA) confirmed that all L-type variants in different countries were 100% similar in sequence, and all were mutated in the regions 8782: ORF1ab and 28144: ORF8 703., Conclusions: This study described the COVID-19 waves, pathogenesis, and evolution of the virus in the Iraqi Kurdistan region., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Sevan O Majed, Rande Dzay, Raya Kh. Yashooa, Suhad A Mustafa.)

Alzheimer's disease (AD) is a neurological, age-related condition that causes cognitive decline and memory loss; it induces dementia in the elderly. Telomerase is a reverse transcriptase ribonucleoprotein that adds nucleotides to the end of DNA. This study aimed to compare human telomerase reverse transcriptase (hTERT) and telomerase RNA component (TERC) expression in different phases of AD and healthy cohorts. Sixty participants were divided into 30 who had dementia and 30 who did not. After collecting blood samples, total RNAs were extracted from the plasma. Screening for hTERT and TERC gene expression was carried out by quantitative reverse transcriptase real-time polymerase chain reaction (RT-qPCR) using the relative quantification method to estimate the expression changes in hTERT and TERC. The RT-qPCR results show that hTERT and TERC gene expression was significantly down-regulated in Alzheimer's patients compared to the health subjects (P-value= <0.0001,0.005), respectively. The area under curve AUC was 0.773 for hTERT and 0.703 for TERC. The Mini-Mental State Examination scores revealed a significant difference between dementia and non-dementia subjects (P=<0.0001). We conclude down-regulations in both hTERT and TERC gene expression in AD patients, which supports our hypothesis that the telomerase expression gene in the blood of AD patients can serve as a non-invasive, early, and novel diagnostic marker of AD.