Abstract: Background: Chronic inflammation is responsible for low insulin sensitivity, making obesity a major risk factor for developing insulin resistance, type 2 diabetes mellitus, and metabolic syndrome. Increased expression of inflammatory cytokines activates several signaling pathways, consequently leading to the accumulation of fats in adipocytes and contributing to the pathogenesis of insulin resistance. Aim: The review aimed to provide an overview of the potential molecular correlation between the insulin signaling pathway and the inflammatory process in addition to their linkage to the development of insulin resistance and other metabolic diseases, with an exploration of the possibility of using drugs that target inflammation in the management of diabetes. Results: Based on the obtained data from the latest literature, the source of cytokines in insulin-resistant states is the insulin targets themselves including the adipose tissue and liver, but to a greater extent the activated macrophages. Prolonged inflammation in these tissues may result in systemic insulin resistance via endocrine signaling and localized insulin resistance by paracrine/autocrine cytokine signaling. Conclusion: Inflammation is involved in the pathogenesis of insulin resistance and diabetes type 2, consequently, in the management of insulin resistance, anti-inflammatory agents may benefit, and the risk assessment may benefit from the use of inflammatory biomarkers in such disorders.

Abstract: Background and objectives: To evade anti-tumour responses, tumour cells expressed programmed death ligand 1 (PDL1), which play a role in suppressing the adaptive arm of immune systems. It has been disputed, meanwhile, whether PDL1 expression in Renal cell cancer (RCC) has any predictive value. Anti-PDL1 can decrease tumour size, inhibit immunological checkpoints, and improve overall RCC survival. In our study, our primary objective was to evaluate the statement of PDL1 immunostain in RCC. Methods: Fifty samples of primary RCC were used in a prospective and retrospective case series research. From Formalin-fixed and paraffin-embedded (FFPE) blocks, hematoxylin and eosin (H and E) stained glass slides were prepared, and the diagnosis was updated. PDL1 immunohistochemical stain (PDL1 IHC) was conducted for all cases, using the EnVision FLEX visualization system on Autostainer Link 48 with PDL1 IHC 22C3 pharmDx (Dako) monoclonal mouse anti-PDL1. Results: PDL1 is found to be expressed in (56 %). The mean age of patients was (54.8±13.52) years, most of them were in their 50s and 60s year old, with male to female ratio of 1.94:1. Clear cell RCC consists of (78%), and most common in stage 1 and stage 3 with statistically significant p–value. Clear cell carcinoma was statistically significant with stage 1 and 3 and grade 2 was the most frequent. The majority of instances of clear cell RCC were on the left side. Conclusion: PDL1 provide an excellent template for confirming the diagnosis of RCC.

Abstract: Background: As a key regulator of bone metabolism, parathyroid hormone (PTH) also modulates the homeostatic response to changes in plasma calcium concentrations. PTH values are often used in patients with “chronic kidney disease (CKD)” as a surrogate for assessing bone and mineral disease associated with CKD. Objectives: The present study sought to evaluate the PTH level alongside measured serum electrolytes and renal function in CKD patients. Method: This study was based on a cross-sectional comparative study which considered the sample size of 120 individuals who were divided into two groups, the control group (n=30) which had apparently healthy individuals, and the second group which consisted of (n=90) patients diagnosed with CKD, and associated medical conditions including hypertension and diabetes. Parathyroid hormone, calcium, phosphate, fasting blood sugar, creatinine, blood urea, serum sodium were measured. Results: The results summarize that the levels of PTH, FBS, phosphate, urea, and creatinine were significantly increased in the patients with CKD as compared to the healthy individuals. However, no marked differences were found in the values of Na, K, and Ca. Conclusion: PTH should be considered as a marker for CKD and outlined in the investigation and follow-up of the prognosis of these patients.

Abstract: Background: The prevention of drug-induced cardiotoxicity is a complicated challenge facing healthcare providers during the last few decades. This challenge is raised from the unclear definition of the term “cardiotoxicity”, the overlapping of the symptoms of heart dysfunction due to the underlying diseases and the used drugs or using a combination of drugs which makes it difficult to distinguish between the side effects of each drug. Objective: This review discusses the most causative agents of cardiotoxicity, and their mechanisms to induce cardiac muscle damage, and finally focuses on the most applicable methods to deal with these dangerous heart problems. Methods: The search method involved electronic databases, including PubMed, Web of Science, Springer, Google Scholar, and others to resume relevant trials of heart disease published in the period between 2010-2023. Conclusion: Cardiotoxicity is a common substantial adverse effect of many drugs including anticancer drugs and others. The prevention methods may include medications, such as (Enalapril or carvedilol), supplementation with antioxidants, or cardioprotective natural products.

Abstract: Background: The use of tobacco products among adolescents is a global health concern with reduced available information about the driving cause enhancing smoking in school-age adolescents and the synchronised role of friends, school, and parents in initiating the adolescent quitting. Aim: This study aims to examine smoking behaviours, beliefs, knowledge, and attitudes among male secondary school students in Duhok City (Iraq). Methods: A descriptive study of 420 students was conducted from October to December 2022. A cluster stratified systematic random sample was used. Results: The smoking frequency was 36.4%. Most students had a moderate level of knowledge regarding smoking's harms. Attitudes ranged from neutral to negative regarding smoking's health and social impacts. Smoking behaviours are prevalent among these students, but knowledge deficits and social norms sustain this behaviour. Student attitude revealed that there are agreement (>50%, p50%, p