Background: Azithromycin, a widely used macrolide antibiotic, is associated with dose-dependent hepatorenal toxicity primarily mediated by oxidative stress and inflammation. Rutin, a natural flavonoid, possesses potent antioxidant and anti-inflammatory properties that can mitigate organ damage. This study aimed to evaluate the potential of Rutin to ameliorate azithromycin-induced histopathological alterations in the livers and kidneys of albino rats. Methods: Thirty-six adult male albino rats (180-200 g) were allocated into five groups: a control group (normal saline), groups receiving azithromycin (30 mg/kg) for 7 (T1) or 14 days (T2), and groups receiving concurrent azithromycin and rutin (50 mg/kg) for 7 (T3) or 14 days (T4). After the treatment period, liver and kidney tissues (one kidney per animal) were harvested for histopathological examination using hematoxylin and eosin (H&E) staining. Results: Azithromycin administration induced a significant time-dependent histopathological damage. The T2 group (14-day azithromycin treatment) exhibited severe hepatic injury, including hepatocellular necrosis, sinusoidal dilatation, and inflammatory infiltration, as well as renal damage characterized by glomerular atrophy and tubular necrosis. Cotreatment with Rutin markedly attenuated these effects. The T4 group (14-day cotreatment) showed near-complete preservation of the hepatic architecture and renal histology, with minimal signs of inflammation and cellular damage. Conclusion: Co-administration of Rutin confers significant protection against azithromycin-induced hepatorenal damage, attributed to its antioxidative and anti-inflammatory mechanisms. These findings highlight the potential of Rutin as an effective adjuvant therapy to minimize antibiotic-associated organ toxicity.
Background: Children are especially vulnerable to potentially fatal injuries from illness or accidents. This study aims to examine the circumstances surrounding out-of-hospital cardiac arrest and to evaluate unsuccessful emergency rescue attempts. Methods: This retrospective study reviewed records of patients under 18 years admitted to Iran University of Medical Sciences-affiliated hospitals from March 2013 to March 2024. The study included children who received emergency medical services and were transported during ongoing CPR. Results: Among 134 cases, the mean age was 4.75 years and male-to-female ratio was 1.39:1. While 61.9% were Iranian, 38.1% were Afghans. Mortality was highest in infants under one year (35.1%) and in children aged 1-5 years (25.4%). The leading causes of death were underlying medical illnesses, followed by accidents, notably pedestrian collisions. Conclusion: Cardiac arrest due to medical illnesses at home and pedestrian accidents account for a large share of unsuccessful pre-hospital resuscitations, most of which are preventable. Migrant children have a markedly higher mortality risk, likely due to socio-economic factors. These findings call for targeted injury prevention and policy reforms to address migrant populations and reduce the public health burden.
Background: Precise detection of drugs in urine samples is crucial in both clinical and forensic settings. However, the pre-analytical phase, which encompasses sample handling before testing, can significantly affect results. Additionally, Forensic investigations may involve longer storage periods than traditional clinical scenarios with immediate testing; therefore, proper sample collection and storage are essential to ensure accurate analysis. This study aims to evaluate the impact of temperature and storage duration on the stability of target compounds in urine samples. Methods: Specifically, the research paper analyzes the impact of different storage conditions, i.e., freezing vs. refrigeration, on the detectability of Tramadol. The stability of Tramadol under the following temperatures (room temperature, 40 degrees C, 4 degrees C, and-20 degrees C) with the preservatives in place and without them in place in the presence of urine samples (n= 240) was established. Findings indicate the nature of the interconnection among Tramadol stability, temperature, and storage time. Results: We have determined that the conditions that gave the most stable state with Tramadol were those that provided a reasonable degree of stability over time after one month, mild loss of concentration after three months, and comparative degradation after six months, under storage at-20 degrees C and with the preservative. The reason is that the sample can also be kept in Formaldehyde, as it is an antibacterial agent in addition to carbon, hydrogen, and oxygen. Conclusion: These findings imply that one must be careful when measuring urine temperatures to maintain the integrity of the samples used for proper drug testing. The impact of such a discovery extends widely to health care professionals, toxicologists, and laboratory analysts within the urine drug testing industry. These findings hold significant implications for healthcare professionals, toxicologists, and laboratory analysts involved in urine drug testing. Ultimately, the present research seeks to minimize errors and misinterpretations caused by mishandling during the pre-analytical phase and storage, leading to more reliable drug testing outcomes.
Background: Suicide among university students is a growing concern that sits at the intersection of public health and forensic science. Many students face intense academic pressure, emotional burden, and social instability, all of which can contribute to suicidal thoughts and actions. One particularly troubling aspect is the "copycat" phenomenon, where exposure to another person's suicide, whether through media, social networks, or personal connections. Those all can lead to imitative behavior, especially among young people. Although this effect is recognized worldwide, there is a lack of detailed forensic documentation in Southeast Asia. Case Presentation: This report examines the case of a 20-year-old female undergraduate who died after a fail. The external examination revealed multiple healed scars on her forearm, indicating a history of self-harm, and severe head injuries consistent with a high-impact fall. Friends reported that she had recently sent messages that sounded like farewells, and there were rumors of a previous suicide at a nearby institution. The presence of similar stressors, a history of self-harm, and contextual similarities suggest that the possibility of a copycat effect should not be overlooked, even if a direct link cannot be confirmed. Conclusion: This case highlights the urgent need for thorough forensic investigations and stronger mental health support systems on university campuses. Preventing suicide contagion among students requires not only careful documentation but also responsible media reporting and targeted interventions for those at risk. By addressing these factors, we can work towards reducing the spread of suicide and protecting vulnerable students.
Background: Ammonia is toxic at high concentrations, and those who handle corpses should be cautious about the ammonia produced by decomposition. However, there is a dearth of reports showing an appropriate index for the ammonia level of corpses. Methods: The progression of decomposition was divided into four stages based on easily visible changes in appearance, namely, skin discoloration and soft tissue destruction. Ammonia was quantified in the liquid decomposition products on the surface of the corpse and in the air surrounding it. Results: During moderate to severe decomposition, ammonia concentrations rose to levels that could cause serious damage to the respiratory system and ocular mucosa due to chemical irritation. However, as decay progressed and bone became exposed, ammonia concentration decreased. Conclusion: This study revealed that ammonia levels can be predicted from the visual stage of corpse decomposition. We believe that these results can guide the safe handling of bodies.
Background and Aim: Bupropion, a monocyclic phenylethylamine antidepressant, is the only FDA-approved synthetic cathinone, commonly prescribed as monotherapy or adjunctive therapy for major depressive disorder, seasonal affective disorder, and smoking cessation. Case Presentation: Although traditionally considered non-serotonergic, bupropion overdose has been associated with serotonin syndrome (SS), particularly when combined with other serotonergic agents like fluoxetine. Bupropion overdose may cause tachycardia, QRS widening, and QTc prolongation, but these effects are usually transient and resolve within a few days. Co-ingestion with other drugs can worsen toxicity. Sodium bicarbonate shows inconsistent benefit, and while most patients recover fully, severe cases can occasionally result in fatal arrhythmias. The management of bupropion toxicity encompasses administration of activated charcoal for recent ingestion, stabilization of cardiovascular and neurological function, and continuous cardiac monitoring due to the potential for arrhythmias and QT interval prolongation. Sodium bicarbonate may be considered in cases of QRS complex widening despite lack of evidence. Benzodiazepines represent the primary therapy for seizure activity and agitation. Supportive care measures-including intravenous fluid administration, correction of electrolyte imbalances, and temperature regulation-are crucial, especially in addressing delayed complications associated with extended-release bupropion formulations. This case describes a young woman with depression who overdosed on bupropion while taking fluoxetine. She developed recurrent seizures, QT prolongation, ventricular tachycardia, and cardiovascular collapse, ultimately requiring ECMO. Extubation failed on day four, and she died on day seven. Conclusion: The case underscores the risk of severe complications from bupropion-fluoxetine toxicity, stressing the importance of close monitoring and prompt intervention.
Background: Troponin has been widely recognized as a key prognostic biomarker for predicting mortality in patients with severe COVID-19. This study aimed to assess the relationship between troponin concentration and mortality in patients infected with the Delta variant of COVID-19. Methods: This retrospective, single-center study included 40 hospitalized COVID-19 patients aged 18 to 65 years, classified as having moderate or severe disease. Patients with pre-existing cardiovascular or muscular disorders, prior use of anticoagulants, or non-standard treatment protocols were excluded to reduce confounding. All participants had documented serum troponin levels measured at admission (troponin 0) and repeated six hours later (troponin 6). Data on demographics, comorbidities, laboratory findings, and clinical outcomes were extracted from medical records. Statistical analyses were performed to assess correlations between troponin levels and disease severity. Results: Serum troponin levels showed a significant positive correlation with age (r = 0.482, P = 0.002) and were notably higher among retired individuals (H = 6.45, P = 0.040). No significant association was found between troponin levels and clinical symptoms (P > 0.05). A significant negative correlation was observed between diastolic blood pressure (DBP) and troponin (r = -0.421, P = 0.008). Patients who died had significantly elevated troponin levels (U = 0.62, P = 0.001). A troponin cutoff value of 15.5 ng/L predicted mortality with 70.6% sensitivity and 90.9% specificity. Conclusion: The findings of this report indicate that elevated troponin concentrations were more frequently observed in older individuals and in patients with lower DBP. Moreover, higher troponin levels were significantly associated with increased mortality, likely due to direct cardiac damage from SARS-CoV-2 or the body's inflammatory response to the infection.
Background: Since type-2 diabetes mellitus (T2DM) is becoming more common, it is crucial to implement an appropriate care plan for these patients' hyperglycemia to lower the risk of complications. While Sliding Scale Insulin (SSI) has been the traditional approach, Basal-bolus insulin (BBI) therapy is a promising strategy and is increasingly recommended. We aimed to compare the efficacy of SSI versus BBI regimens in hospitalized patients with T2DM. Methods: The demographics, complications, and type of insulin therapy for type 2 diabetic hospitalized patients were recorded from patients' archived documents. Results: We observed that 59.7% of the patients were treated for SSI accompanied by macrovascular complications. While 37.8% of patients treated with BBI had macrovascular complications, the difference between the BBI & SSI groups was statistically significant. For microvascular complications, also, a statistically significant difference was detected between the BBI & SSI groups (P-value = 0.001). Only 18.6% & 17.2% of the patients developed hypoglycemia in the BBI group & SSI group, respectively. We evaluated the efficacy of both treatments on daily random blood glucose (RBG) in our patients for 1 week; a slight decrease in RBG was observed between the first & the seventh days of treatment in the SSI group. An obvious improvement was observed in the BBI, indicating that BBI was more effective at controlling RBG than SSI. Conclusion: Our study demonstrated that BBI therapy was superior to SSI therapy in achieving ideal blood glucose levels, with fewer hypoglycemic episodes and cardiovascular events.
Background: Zinc is an essential trace element for humans, although its excessive and prolonged ingestion or inhalation can cause harmful health problems. Case Presentation: We report the clinical case of a 25-year-old male patient from Yambrasbamba, Amazonas, Peru, who carried out agricultural and livestock activities in an area adjacent to a zinc oxide mining project closed in 2007 and 2008. The patient was admitted to the Lambayeque Regional Hospital with initial symptoms of decreased muscle strength, low back pain, nausea and vomiting, vesicular skin rash and polydipsia. Supporting tests revealed a notable increase in transaminases and total creatine phosphokinase and abdominal radiological image with multiple metallic calcifications along the colon. The history of consuming spring water with unusual organoleptic characteristics suggested environmental exposure to heavy metals. Analysis confirmed the diagnosis of chronic zinc poisoning. Compared with poisonings by other metals, such as mercury, zinc showed distinctive cutaneous symptoms and a favourable response to supportive measures. Conclusion: This case underlines the importance of considering environmental exposures in the differential diagnosis of patients with non-specific symptoms and highlights the need to raise awareness of the risks associated with zinc and other heavy metal poisoning in rural settings.
Background: A cornerstone of forensic practice is determining the postmortem interval to resolve suspicious deaths and assist in criminal investigations. The work aims to estimate the postmortem interval (PMI) using oxidative stress markers, and to Assess Molecular, histopathological, and immunohistochemical changes in the spleen, pancreas, and heart of adult albino rats. Methods: 30 adult albino rats were divided into five groups. All rats were sacrificed and kept at room temperature. Dissection of the spleen, pancreas, and heart was done at 0 (control), 6, 24, 48, and 72 hours. The following parameters were measured: malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), hypoxia-associated factor (HAF), apoptosis-inducing factor (AIF), and B-cell lymphoma 2 (BCL2) immunostaining. Results: MDA, GSH, and SOD showed strong positive correlations with PMI in the pancreas, whereas in the heart, GSH showed a fair positive correlation with PMI.SOD showed a strong positive correlation with PMI in the spleen, while GSH showed a strong negative correlation with PMI. HAF showed a strongly significant positive association with PMI in the heart and the spleen, whereas in the pancreas, it showed a fair correlation. AIF showed a significant negative correlation with PMI in the heart. Histological changes showed time-dependent changes. BCL2 immunohistochemical expression showed a significant decrease over time in all organs. Conclusion: Oxidative stress markers, Molecular, histopathological, and immunohistochemical changes can help estimate PMI. Four novel equations were developed to estimate PMI using the studied parameters across different organs.
Background: In traumatic forensic cases, road accidents represent an essential percentage of morbidity and mortality. The majority of these are unintentional incidents that have the same manner of death. Case Presentation: A 42-year-old man, was admitted to the regional hospital in Pazardzhik with symptoms of epigastric pain, vomiting, and weight loss. Following a physical examination, additional ultrasound tests, laboratory tests, and gastroscopy, which included a biopsy, the results indicated a malignant tumor in the stomach with the morphological characteristics of middle-grade adenocarcinoma. On the fourth day of the diagnostic and treatment process, the patient voluntarily left the hospital without notifying the medical staff. Conclusion: Road traffic injuries are a significant cause of increasing mortality rates among young and middle-aged individuals globally. While suicide is less common among traffic-related fatalities, both accidents and suicides can contribute to road traffic deaths. Suicides continue to be a significant cause of mortality and morbidity worldwide. Understanding the issues surrounding these cases, especially the rarer forms of suicide, is crucial for preventing this negative social phenomenon.
Background: Forensic anthropology relies on skeletal analysis to establish a biological profile in medicolegal cases, including age and sex estimation. While the skull and pelvis are considered the most reliable indicators, they are not always available due to fragmentation or postmortem changes. The sternum, being centrally located and relatively resistant to damage, offers an alternative skeletal element for forensic identification. Methods: A cross-sectional descriptive-analytical study was conducted using 200 thoracic CT scans from Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia. The samples consisted of 100 males and 100 females, distributed across four age categories. Morphometric parameters measured included Manubrium Length (ML), Manubrium Width (MW), Corpus Length (CL), Manubriocorpus Length (MCL), Corpus Width 1 (CW1), Corpus Width 2 (CW2), and the Sternal Index (SI). Statistical analyses were performed using the Kruskal-Wallis and Mann-Whitney U tests, followed by multivariate modeling to assess age-and sex-related differences. Results: Significant sexual dimorphism was observed, with males showing larger sternum dimensions compared to females, except for SI, which was higher in females. Age-related changes were evident, with sternal dimensions increasing until early adulthood before plateauing. Minimal ethnic variation was found, with notable differences limited to CL among young adult Toraja males. Conclusion: Three-dimensional CT-based sternal morphometry provides reliable markers for age and sex estimation, supporting its role as a complementary tool in forensic anthropology, particularly when traditional skeletal elements are unavailable.
Background: Forensic examination of child victims of sexual abuse mainly prioritizes the identification and documentation of physical findings for legal purposes. As a result, psychosocial problems may remain underrecognized during the initial assessment. A brief and practical screening instrument is therefore needed to support early detection in clinical forensic services. To assess the agreement between Pediatric Symptom Checklist-17 (PSC-17) screening results and clinical psychological evaluation findings in child victims of sexual abuse. Methods: This analytical observational study used a cross-sectional design and was conducted from April to September 2025 at a forensic referral hospital. A total of 101 child victims of sexual abuse aged 1-17 years underwent PSC-17 screening. Clinical psychological evaluation was subsequently completed for 51 respondents, depending on the referral pathway and service availability. Agreement between PSC-17 classification and clinical psychological evaluation was assessed using a 4 & times; 4 contingency matrix and Cohen's kappa coefficient. The 95% confidence interval was estimated using bootstrap analysis with 1,000 replications. Results: Of the 101 respondents, 39 children (38.6%) were classified as having severe psychosocial problems based on the PSC-17 classification applied in this study. Among the 51 respondents who underwent clinical psychosocial evaluation, 26 children (51.0%) were classified as having severe psychosocial problems. Classification accuracy was 86.27%, with a Cohen's kappa of 0.778 (95% CI [0.606, 0.908], p < 0.001), indicating substantial agreement between PSC-17 screening and clinical psychological evaluation. Conclusion: PSC-17 showed good agreement with clinical psychological evaluation in identifying psychosocial problems among child victims of sexual abuse. These findings support its potential use as an initial screening tool to facilitate early detection and psychosocial triage in cliup06nical forensic settings.
Background: The Javanese and Chinese ethnic groups are the most predominant in Indonesia. Saliva presents a major advantage over serum as it may be obtained non-invasively by persons with minimal training. However, there are 13 CODIS loci; hence, it requires more resources and time. This research utilized an observational comparative study design. Methods: The CODIS system has been validated as an identifying tool in forensics. CODIS was developed to compare target DNA records with those in the database, utilizing software for identification matching. Results: Saliva from 12 participants aged 17 to 21 was divided into two groups: Javanese and Chinese. Each group comprises six members. The saliva was analyzed using Short Tandem Repeat (STR) and Polymerase Chain Reaction (PCR) at three loci: D13S317, D5S818, and D3S1358. In comparison to the standard DNA K562, variations in base pairs were observed in bands between the Javanese and Chinese races at three loci: D5S818: Javanese alleles are 10, 11, 12; Chinese alleles are 11, 12, 13.D13S317: Javanese 9, 11; Chinese 9, 12. D3S1358: Javanese 16, 17; Chinese 16, 17, 18 Utilizing the three loci from saliva, we can distinguish between the Javanese and Chinese races for forensic identification. Conclusion: This research successfully demonstrated that the analysis of Short Tandem Repeat (STR) alleles at three loci (D5S818, D13S317, and D3S1358) can distinguish between the Javanese and Chinese populations in Indonesia using saliva samples. Significant differences in allele frequencies were found between the two populations at all three loci, making this method effective for ethnic forensic identification. In addition, the use of saliva as a non-invasive biological sample demonstrates practical advantages in the forensic context, allowing for easier and faster sample collection compared to invasive methods.
Background: The vast Chinese synthetic drug market has given rise to numerous illicit drug production groups; empirical research on these groups remains limited. Methods: In this study, the author collected data on 96 cases of illicit drug production from 2010 to 2020 through a website established by the Supreme Court of China. Results: The findings revealed that the majority of these groups were located in Sichuan Province and Guangdong Province, both of which suffer from serious drug epidemics. Methamphetamine and ketamine were identified as the primary substances manufactured by these groups. Ephedrine and phenyl-2-propanone are commonly used as precursors in methamphetamine production, while hydroxyimide chloride is frequently utilized in the synthesis of ketamine. Conclusion: To effectively combat such criminal activities, governments should enhance interregional cooperation to jointly address crimes related to drug production.
Background: Excessive drinking can cause liver damage and even liver fibrosis and cirrhosis. This study aimed to investigate the influence of alcohol and its related mechanisms on the transformation of growth factor-(31 (TGF-(31) and the loss of epithelial phenotype in hepatocytes. Methods: In the present study, HepG2 cells (2 & times; 105 cells/ml) were co-cultured with K562 cells (2 & times; 105 cells/ml) and treated with 50 mM, 100 mM, and 200 mM alcohol for 24 hours. Cell morphology, as well as the expression of endothelial markers E-cadherin, Desmoplakin, CK18, and TGF-(31, were detected. Results: The study showed that alcohol induced the loss of epithelial phenotype, considerably decreasing the mRNA levels of E-cadherin, Desmoplakin, and CK18, as well as E-cadherin protein expression. In contrast, alcohol increased the mRNA levels and concentrations of TGF-(31 in the cultured media of co-cultured HepG2 cells in a concentration-dependent manner. These results demonstrated that alcohol attenuated the epithelial phenotype in HepG2 cells co-cultured with K562 cells; meanwhile, K562 cells played an essential role in enhancing the expression of TGF-(31 in HepG2 cells. Conclusion: Our research has established an in vitro model of alcohol-induced epithelial phenotype loss in hepatocytes and partly explained the mechanisms of alcohol-induced liver fibrosis.
Background: Organophosphate poisoning is a major public health issue in many low and middle-income countries. Paraquat, a widely used herbicide, can often cause severe, usually fatal poisoning in humans. Dual poisoning involving both organophosphates and paraquat is rare. Case Presentation: A 17-year-old male who ingested both substances was admitted to the emergency department intensive care unit. He was treated with four sessions of hemoperfusion, along with intravenous atropine and pralidoxime. After the fourth hemoperfusion, the patient developed respiratory distress due to acute cholinergic syndrome secondary to organophosphate poisoning, requiring endotracheal intubation. By day five, his clinical condition improved, and he was extubated. Six hours after extubation, he developed sudden respiratory distress and was re-intubated with a 7.5 mm endotracheal tube and connected to a mechanical ventilator. The patient was diagnosed with intermediate syndrome secondary to organophosphate poisoning, and atropine infusion was restarted. By day seven, his condition improved and he was successfully weaned off ventilation. He was discharged hemodynamically stable on day 10. Conclusion: This mixed organophosphate-paraquat poisoning case was clinically complex and challenging. Management involved a combination of mechanical ventilation and hemoperfusion, which had to be carefully titrated. Further studies are needed to improve treatment protocols and outcomes for mixed poisoning cases.
Background: Drowning remains a significant cause of unintentional mortality, requiring comprehensive forensic investigation to determine the mechanism and circumstances of death. Case Presentation: This case report is about a 30-year-old person whose name is not known and who was found in a freshwater river. After that, they were examined on the outside, inside and in other ways. The external findings included fine, frothy fluid coming from the airways, livor mortis that made the skin look pale, rigor mortis of the upper extremities, signs of hypoxia, and maceration of the hands. An internal examination found the Nile sign, no structural problems with the major organs, and stomach contents that were consistent with recent eating. Ancillary tests showed apositive diatom test with Pennales diatoms found in over 10 fields, which supports the idea of freshwater drowning. Conclusion: However, the lung fluid study had a chance of false positives because the body had been preserved for a long time. This case underscores the persistent necessity for comprehensive forensic evaluation encompassing diatom analysis, organ examination and contextual interpretation to ascertain drowning as the cause of death.
Background: This study examines the concentration of touch DNA on various surfaces using analysis of the amelogenin locus to identify the donor's gender. Touch DNA, which is transferred through contact, was collected from masks, iron door handles, plastic, and glass. DNA extraction and amplification were performed using PCR. Methods: Touch DNA samples were collected from masks, iron door handles, plastic, and glass using sterile swabs after contact by male and female donors. DNA extraction was performed using the Chelex method, followed by PCR amplification targeting the amelogenin locus. DNA concentration was measured and compared across different surface types to evaluate variations in DNA transfer. Results: The findings indicate that masks provided the highest DNA concentration, while plastic and glass had the lowest. Factors such as surface type, individual activity, and environmental conditions significantly influence DNA concentration. Additionally, male donors consistently left more DNA than female donors, consistent with previous studies. The study highlights the importance of surface roughness and porosity in DNA retention, with rougher surfaces generally retaining more DNA. Conclusion: This research offers valuable insights for forensic investigators by demonstrating the utility of touch DNA in linking individuals to crime scenes. However, more extensive studies with larger sample sizes are needed to confirm these results and strengthen conclusions.
Background: A serious public health issue in Iraq is diabetes mellitus (DM), which is becoming more common due to demographic and lifestyle factors. The purpose of this research is to examine the association between smoking behaviors, body mass index (BMI), and age in Iraqi patients with diabetes mellitus. Methods: A cross-sectional study was conducted at the National Diabetes Center, Al-Mustansiriya University, between September and December 2016. A total of 300 diabetic patients aged 30-84 years were enrolled and classified into five groups based on age and gender. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body mass index (BMI), and daily cigarette consumption were measured. Results: Among patients aged 50-59, males had the highest mean FBG (462.0 +/- 96.3 mg/dl) and BMI (35.7 +/- 29.4 kg/me). Across all age groups, female patients' BMI remained elevated, and patients aged 50-69 years had the highest HbA1c readings. Male and female patients showed the most significant positive relationships between FBG and HbA1c (r = 0.631 in Group E). There was little correlation between smoking and FBG, except for a moderately positive correlation in middleaged women, and a weak and erratic correlation between BMI and FBG. Conclusion: In Iraqi diabetic patients, age and BMI have a significant impact on glycemic control, especially in middle-aged people. Poor glycemic control is more consistently associated with BMI in female patients. In some subgroups, smoking may exacerbate glycemic indices, although its impact seems to be limited. It is advised to implement focused weight-control and smoking cessation strategies to improve diabetes outcomes.
