wisam akram

@mustansiriyahuniversity.edi.iq

Obstetrics and Gynecology Consultant and assistant professor
Mustansiriyah Medical colleg

wisam akram


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https://researchid.co/wisamakram
Consultant and assistant professor

EDUCATION

M.B.Ch.B. 1987
PhD Obstetrics and gynecology 1997

RESEARCH, TEACHING, or OTHER INTERESTS

Biophysics, Music, History and Philosophy of Science, Cancer Research

FUTURE PROJECTS

adrenal gland in the fetus as predictor of post date pregnancy

Still on gooing


Applications Invited
Correlation between fetal AGV and postdate pregnancy
23

Scopus Publications

Scopus Publications

  • Diagnostic performance of HyFoSy versus HSG for tubal patency: accuracy and agreement analysis
    Shaymaa K. Abdulqader, Wassan Nori, Rajaa A. Mohammed, Wisam Akram, Nabeeha N. Akram
    Polish Journal of Radiology, 2026
    Purpose Tubal patency examination is an essential part of the infertility workup; HyFoSy is a recommended substitute for the standard Hystero-Salpingo Graphy (HSG). This study aims to determine the diagnostic concordance of HyFoSy and HSG and to determine impact of uterus position on test performance. Material and methods A prospective observational cohort study enrolled 80 infertile women referred for assessing tubal patency at Al Yarmouk Hospital.Parameters recorded: demographics ( age, parity, uterus position) and tubal patency test interpreted ( patent, unilateral, or bilateral blocked tubes). HyFoSy was performed first, followed by HSG. Results Age and parity were insignificant. HyFoSy showed a high degree of diagnostic concordance with HSG ( 85%) with 0.3 (95% CI: 0.05–0.55) Cohen's kappa coefficient . Gwet's AC1 coefficient was 0.84 (95% CI: 0.74–0.94), indicating strong agreement. McNemar's test revealed significant systematic bias between the methods (P < 0.001), suggesting that HyFoSy and HSG are not interchangeable, which was further confirmed by Bland-Altman analysis showing a mean bias of +0.25 in favor of HyFoSy.The latter has a tendency to overestimate tubal patency among women with a retroverted uterus. Conclusions HyFoSy is a promising tool to be used as a complementary infertility test showing high concordance with HSG. However, it should not be used as a stand-in for HSG without clinical judgment, especially in women with a retroverted uterus. The best of both approaches may be provided by a hybrid strategy that uses HyFoSy as a first-line test and saves HSG for cases that are unclear or high-risk.
  • The implication of chlamydia and bacterial vaginosis among low-risk pregnant women with preterm birth: a prospective multicentric cohort study
    Wassan Nori, Wisam Akram, Rafal Mustafa Murshid, Reia Jaber
    BMC Pregnancy and Childbirth, 2025
    BACKGROUND: Preterm birth (PTB) is a multifactorial pathology that raises feto-maternal morbidity. Infection was associated with higher PTB risk. Earlier studies discussed the inconsistent role of Chlamydia trachomatis (CT) with PTB. To examine the contribution of CT to the overall incidence of PL in our population and to verify the concurrent impact of bacterial vaginosis (BV) on PTB risk. METHODS: A prospective cohort study enrolled low-risk pregnant women attending an antenatal clinic at a gestational age of 24-28 weeks. They were screened for CT and BV using cervical smears and subdivided into two groups: positive CT cases (study group; N = 79) and negative CT cases (control group; N = 235). They were followed until delivery. For each, maternal parameters [Maternal age, parity, socioeconomic class, BV, preterm labor, tocolytic, progestogen drugs, and dexamethasone] and Fetal parameters [Gestational age at delivery, fetal birth weight, admission to intensive care unit for respiratory distress syndrome] were recorded. RESULTS: Positive CT cases had significantly higher PBT; 20/79 (25.3%) vs. 21/235 (9%) among negative CT cases. Stratifying PTB results according to infection status revealed that 6.3% (12/189) of PTB cases were negative for both CT and BV, 12.2% (5/41) had CT alone, and 19.6% (9/46) were positive for BV alone. 39.5% (15/38) of PTB cases screened positive for CT and BV, thus highlighting a potential synergistic effect between the infection and PTB risk. Positive CT cases had higher BV incidence; 38/79 (48.1%), and higher use of tocolytic; 21/79 (26.6%), progestogen; 20/79 (25.3%), and dexamethasone drugs; 24/79 (30.4%); (P = 0.03, 0.006, 0.02, 0.009, and 0.01, respectively). Multiple logistic regression showed that positive BV cases had an increased risk of adverse outcomes, OR = 3.78. Overall model fit confirmed CT contribution to overall PTB 3-7%. Cochran-Mantel-Haenszel test discussed a BV synergistic role in PTB; OR = 2.55; 95%CI:1.44 to 4.51; P = 0.002. CONCLUSION: The current findings suggest that CT infection, especially when combined with BV, may significantly increase the risk of PTB even when both infections are appropriately treated during pregnancy. The observed synergistic interaction highlights the potential role of screening for co-infection during pregnancy and reinforces an integrated management approach beyond treatment.
  • Exploring zinc-α2-glycoprotein as a mediator of infertility in polycystic ovarian syndrome: a comparative study from a metabolic perspective
    Dina Akeel Salman, Wassan Nori, Wisam Akram
    Przeglad Menopauzalny, 2025
    Introduction: Polycystic ovarian syndrome (PCOS) is a leading cause of infertility linked to insulin resistance and obesity.Zinc-2-glycoprotein (ZAG) is an adipokine involved in lipid metabolism and insulin sensitivity.We hypothesized that reduced ZAG serum levels among PCOS cases could predict fertility odds.The aim is to examine ZAG's relationship with fertility parameters and to test its role as a predictor for fertility potential.Material and methods: A comparative cross-sectional study recruited PCOS cases into two groups: the infertile and fertile group; n = 60 for each.Women's anthropometric (age, body mass index -BMI, waist circumference) hormonal (follicle-stimulating hormone, luteinizing hormone, anti-Mllerian hormone (AMH), total testosterone, and prolactin) metabolic parameters and ZAG serum levels, estimated via ELIZA/ELISA were recorded.Results: Body mass index was significantly high in infertile cases; ZAG levels were significantly lower among the infertile group (37.08 3.885 vs. 54.25 14.71 g/ml; p < 0.0001).Zinc-2-glycoprotein was inversely and significantly correlated to BMI, waist circumference (r = -0.81,-0.78; p < 0.0001), and all hormonal and metabolic parameters.Zinc-2-glycoprotein cut-off value of > 42 g/ml predicted fertility potential in PCOS, with 67% sensitivity, 97.50% specificity, and p < 0.0001, but it did not surpass AMH.Conclusions: Zinc-2-glycoprotein is a potential biomarker for fertility that links metabolic and reproduction dysfunction in PCOS women.It mediates 13.5% of obesity's inverse effect on fertility.Restoring normal ZAG levels may improve fertility odds and can have prognostic value in following the therapy in those populations.Further longitudinal, larger-sized studies are recommended to explore newer diagnostic and prognostic avenues to improve reproduction potential among PCOS cases.
  • Predicting Late-Term Pregnancy: The Role of Corrected Fetal Adrenal Gland Volume in Low-Risk Pregnants
    Wassan Nori, Wisam Akram, Shaymaa Khalid Abdulqader, Taghreed Al-Haidari
    Reproductive Sciences, 2025
  • The impact of stress on menstrual cycle changes around examination time among medical college students: a multicentric study
    W. Nori, B.H. Hameed, R.M. Murshid, W. Akram
    Italian Journal of Gynaecology and Obstetrics, 2025
    Objective.Stress was linked to many menstrual cycle (MC) abnormalities, especially during stressful periods like exams.Medical students are known to experience higher stress levels compared to other disciplines.This study primarily examined the impact of stress on MC parameters.Secondly, to verify predictors linked to stress and successful stress-coping strategies among students to mitigate stress-related MC changes. Materials and Methods.A cross-sectional study enrolled medical college students via an online survey by Google Forms.Three data sets were collected: demographics, menstrual history, and socio-behavioral factors.(361) Participants were grouped into 2: Group A, who experienced no change in MC, and Group B who did.Chi-square and odds ratio (OR) compared groups.Results.87.7% of participants were 22-24 years old.MC history and menstrual changes at the exam were all statistically significant across groups.In contrast, sleep and diet were not.Stressful life events and asking for medical advice were statistically significant.Reduced blood loss had highest odds for exams-related stress; OR:10.85;95%CI 5.41 to 21.75, followed by reduced MC length; OR:9.91;95%CI 4.91 to 4.29.Most reliable coping strategy was asking for medical advice; OR:2.68;95%CI 1.68 to 4.29.Conclusions.Exam-related stress was more evident in students with abnormal menstrual history manifested as dysmenorrhea and reduced cycle length.Most reliable stress predictors were reduced blood loss and cycle length.Identifying students most likely to suffer exam-related stress and the most effective stress-coping strategies are vital to support female students and help them achieve academic success.
  • The Utility of Maternal Adiponectin and Triglyceride-Glycemic Index for Gestational Diabetes Mellitus Screening: A Cross-Sectional Study
    Hala Zghair Rawi, Wassan Nori, Dina Akeel Salman, Abdulkareem H. Issa, Wisam Akram
    Clinical and Experimental Obstetrics and Gynecology, 2024
    Background: Gestational diabetes mellitus (GDM) is one of the most prominent diseases seen in pregnancy that adversely affects materno-fetal welfare. It is usually screened by an oral glucose tolerance test (GTT), which has some limitations. Adiponectin and triglyceride-glycemic (TyG) index were two biomarkers examined in the GDM context with inconclusive effectiveness. This study aimed to examine both markers' performance in screening for GDM among Iraqi women. Methods: An observational cross-sectional study recruited gestational age and body mass index (BMI) matched pregnant at 26–28 weeks into two groups: healthy controls (n = 44/88) and GDM cases (n = 44/88). Participants' demographics, biochemical [FBS (fasting blood sugar), 2hr_GTT (2-hour glucose tolerance test), HDL (high-density lipoprotein), LDL (low-density lipoprotein), total cholesterol, TG (triglyceride), and TyG index], and hormonal (adiponectin) were recorded. Results: Serum adiponectin was significantly higher among healthy pregnant (8.44 ± 1.12 ng/mL vs. 5.28 ± 0.89 ng/mL); p &lt; 0.0001. In contrast, the TyG index was significantly higher among GDM cases (4.02 ± 0.04 vs. 3.96 ± 0.02; p &lt; 0.0001). Adiponectin showed strong inverse links with FBS, 2hr_GTT with r = (–0.76, –0.80); p &lt; 0.0001, respectively. TyG index was moderately, inversely, and significantly linked to serum adiponectin as r = –0.58; p &lt; 0.0001. Adiponectin and TyG index reliably predicted GDM with a high area under the curve of 0.83 vs. 0.88; p &lt; 0.001, respectively. Conclusions: Both biomarkers correlated well to GDM parameters and showed high sensitivity and specificity in screening for GDM. Their efficiency, easy integrations in practice, and promising therapeutic application suggested by researchers warrant further studies.
  • Three-dimensional modelling of the umbilical artery Doppler and its applications in preeclampsia assessment: a case-control study
    W. Akram, W. Nori, M.A.G. Zghair
    Italian Journal of Gynaecology and Obstetrics, 2024
    Ultrasound and Doppler indices were implemented to screen high-risk pregnancies as preeclampsia, a unique pregnancy syndrome that imposes many challenges on the mother and her unborn child. Since there is currently no conscience of what parameter is best for screening, this study was designed to examine if a 3-dimensional re-modeling of a 2-dimensional Doppler wave will perform better in PE screening and evaluating its severity. A case-control study enrolled 90 eligible primigravida’s age and body mass index-matched screened and followed till 34 weeks, where they were re-grouped into controls; and preeclampsia (PE) cases (45/90) each. Demographic, biochemical, and hematological parameters were tested; followed by ultrasonic parameters [amniotic fluid index, estimated fetal weight, resistance, and pulsatility index (RI and PI)].
  • Biochemical versus radiological screening for osteoporosis in menopause; will Irisin help?
    Wisam Akram, Alaa Ibrahim Ali, Hind Hadi Majeed
    Journal of the Pakistan Medical Association, 2024
    Objective: To verify the discriminative power of irisin in osteoporosis patients. Method: The comparative case-control study was conducted at the University Teaching Hospital, Baghdad, Iraq,from March 2020 to June 2021 after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, and comprised post-menopausal women. After being scanned by dual-energyX-ray absorptiometer, the subjects were divided into groups based on T-scores; healthy controls with T-score &gt;-1in group 1, and osteoporosis patients with T-score Less than -2.5 in group 2. Participants' sera were tested for Irisin, 25-hydroxy vitamin D, and carboxyl-terminal telopeptides of type I collagen levels. T-score and bone mineral densitywere recorded as radiological markers. Correlation of irisin was determined with T-score and bone mineral density,cut-off value for serum irisin was worked out for osteoporosis prediction. Data was analysed using Medcalic 17. Result: Of the 142 women, 71(50%) were in group 1 with mean age 58.4±3.5 years, and 71(50%) were in group 2with mean age 58.7±3.4 years (p=0.87). Levels of irisin, 25-hydroxy vitamin D, carboxyl-terminal telopeptides of typeI collagen, bone mineral density and T-scores were significant between the groups (p&lt;0.001). Serum irisin correlateddirectly with bone mineral density (r=0.97, p&lt;0.001) and inversely with T-score (r= -0.95, p&lt;0.001). The cut-off valueof serum irisin was 31.4ng/ml with 84% sensitivity and 100% specificity (p&lt;0.001). Conclusion: Strong serum irisin correlation to osteoporosis radiological markers and its good discrimination ofosteoporosis implied its utility as a good serological marker of osteoporosis. Key Words: Bone Density, Fibronectins, Collagen, Post menopause, X-Rays, Osteoporosis, Vitamin D
  • Predictors for Successful Pregnancy Following Hystro-Laparoscopic Intervention among Infertile Females: A Cohort Study
    Rafal Mustafa Murshid, Wasan Nori, Reshed Zeki Obaid, Wisam Akram
    Al Rafidain Journal of Medical Sciences, 2024
    Background: Infertility is a major medical and sociopsychological problem that impacts a couple's life. Investigations help guide therapeutic intervention by exploring underlying causes. Hysteroscopy can identify and treat intrauterine pathologies such as adhesion, septum, and endometrial polyps. Laparoscopy has a diagnostic and therapeutic role in the pelvic cavity, including tubal blockage, pelvic adhesions, endometriosis, and polycystic ovaries. Objective: To evaluate the value of combined hystro-laparoscopic interventions in managing female infertility and to explore predictors for a successful pregnancy. Methods: A retrospective cohort study enrolled (142) eligible females who underwent hystro-laparoscopy. Participants' demographic criteria were recorded. Additionally, intraoperative interventions (hysteroscopic removal of the polyp and septum) and laparoscopic removal of pelvic adhesions, removal of the chocolate cyst, ovarian drilling and laparoscopic chromotubation). All patients were followed up for six months. Logistic regression and odd ratio were used to assess the intervention's reliability in predicting pregnancy. Results: Clinical pregnancy was reported in 48/142, with a success rate of 33.8%. Pregnant women had significantly lower ages and lived in urban areas. Laparoscopic adhesion removal and tubal block correction reliably predicted clinical pregnancy, with adjusted odds ratios (AOR) of 0.25; 95% CI (0.08–0.78) and 0.40; 95% CI (0.16-0.98), respectively. None of the hysteroscopic interventions was statistically significant. Conclusions: Because hystero-laparoscopic procedures improve the chances of getting pregnant and are minimally invasive, they are an important part of fertility workups and can be used to diagnose and treat fertility problems.
  • Unveiling Systemic Immune Inflammation Index Correlations in Women with Polycystic Ovary Syndrome: A Cross-sectional Study
    Wisam Akram, Amenah Fadhil, Wassan Nori
    Al Rafidain Journal of Medical Sciences, 2024
    Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy of reproductive-age women that imposes metabolic and cardiovascular risks. Systemic immune inflammation index (SII), an inflammatory biomarker calculated from a complete blood count, was linked to many metabolic and cardiovascular illnesses. Objective: To evaluate the SII correlation with clinical, biochemical, and hormonal parameters characteristic of PCOS cases for screening and diagnostic values. Methods: For fifty PCOS patients who were eligible, we did a cross-sectional study and collected three types of information on each person: demographic information like age, menstrual cycle length, and body mass index (BMI); hormonal information like LH/FSH ratio, testosterone, and fasting insulin; and biochemical information like the homeostasis model assessment of insulin resistance (HOMA-IR), serum cholesterol, serum HDL, and serum LDL. The systemic inflammatory index (SII) was calculated from a complete blood count. Results: We found a strong positive correlation between SII and BMI, LH/FSH ratio, testosterone, fasting serum insulin, HOMA-IR, cholesterol, and LDL. However, the correlation between SII, HDL and menstrual cycle days was negative. Regarding the other parameters (HOMA-IR, testosterone, cholesterol, BMI, and LH/FSH ratio), the best subset regression model figures out how strongly SII is linked to each one. Conclusions: SII was strongly and significantly correlated to PCOS clinical, biochemical, and hormonal parameters, which makes it recommendable for screening. Its feasibility, affordability, and meaningful correlation inspired therapeutic and prognostic applications in practice.
  • Prediction of Placenta Previa from Serial Reading of Serum Human Chorionic Gonadotropin Late in the First Half of Pregnancy
    Shatha Sami Hussein, Manal Madany A. Qader, Wisam Akram
    Journal of Obstetrics and Gynecology of India, 2024
  • Area under the curve of carotid artery Doppler as a sensitive marker of insulin sensitivity among Iraqi women with polycystic ovarian syndrome: a cross-sectional study
    W. Akram, W. Nori, M.A.G. Zghair
    Italian Journal of Gynaecology and Obstetrics, 2023
  • Evaluating the Academic Performance of Mustansiriyah Medical College Teaching Staff vs. Final-Year Students Failure Rates
    Wassan Nori, Wisam Akram, Saad Mubarak Rasheed, Nabeeha Najatee Akram, Taqi Mohammed Jwad Taher, Mustafa Ali Kassim Kassim, Alexandru Cosmin Pantazi
    Al Rafidain Journal of Medical Sciences, 2023
  • The dilemma of COVID-19 diagnosis in pregnancy
    Wassan Nori, Roaa Mokram Hamed, Wisam Akram, Maha Chasib Munshid
    Immunopathologia Persa, 2023
  • Fertility outcomes following bariatric surgery
    Wassan Nori, Wisam Akram, Eham Amer Ali
    World Journal of Experimental Medicine, 2023
  • The Value of Serum Fibrinogen/Uric Acid Ratio as a Novel Marker of Fetal Growth Restriction in Preeclampsia at 34 Weeks
    Wassan Nori, Alaa Ibrahim Ali, Wisam Akram Ismael
    Current Women S Health Reviews, 2023
  • Effect of gender on the reliability of COVID-19 rapid antigen test among elderly
    Wassan Nori, Wisam Akram
    World Journal of Clinical Cases, 2022
  • The efficiency of 17a hydroxyprogesterone in the prevention of preterm labour irrespective of administration route: Systematic review metanalysis
    Journal of the Pakistan Medical Association, 2021
  • Alpha-1antitrypsin in pre-eclampsia; from a clinical perspective
    Journal of the Pakistan Medical Association, 2021
  • The value of neutrophils/lymphocyte ratio in predicting foetuses that need urgent delivery in post-term pregnancies: A prospective study
    Journal of the Pakistan Medical Association, 2021
  • Will the area under the curve of the umbilical artery Doppler predict fetal growth restriction at 34 weeks of gestation among pre-eclamptic women?
    Wassan Nori, Najlaa Hannon Fleeh, Wisam Akram
    Aip Conference Proceedings, 2021
  • To operate or to wait? Doppler indices as predictors for medical termination for first trimester missed abortion
    Wassan Nori, Muna Abdulghani, A. Roomi, W. Akram
    Clinical and Experimental Obstetrics and Gynecology, 2021
  • Platelet indices as predictors of fetal growth restriction in pre-eclamptic women
    Wassan Nori, A. Roomi
    Revista Latinoamericana De Hipertension, 2020

GRANT DETAILS

Consultant

RESEARCH OUTPUTS (PATENTS, SOFTWARE, PUBLICATIONS, PRODUCTS)

Matlab Mathcad Mathematica
Medcalc Minitab statsdirect centurion statographics

CONSULTANCY

In Obstetrics and Gynecology

Industry, Institute, or Organisation Collaboration

Mustansiriyah Medical College

INDUSTRY EXPERIENCE

30 years and Assistant professor and consultant in Obstetrics and Gynecology

STARTUP

Medical Statistics

SOCIAL, ECONOMIC, or ACADEMIC BENEFITS

second peer reviewer
Researcher
Statistician