Kerbala Journal of Nursing and Health Sciences

Background: Due to their underlying cancer, comorbidities, and critical illness, cancer patients admitted to intensive care units (ICUs) encounter particular difficulties.
Objective: Assess the variables affecting the outcomes and discharge status of cancer patients admitted to the intensive care unit (ICU) at Warith International Cancer Institute (WICI) in Karbala, Iraq.
Methodology: A retrospective observational study conducted at WICI involving all cancer patients admitted to the ICU between August 2021 and March 2024. Comorbidities, cancer-related traits, ICU interventions, complications, and outcomes were among the data that were taken from electronic medical records. SPSS was used for statistical analysis. Bivariate analyses were performed to identify factors associated with mortality, and significant factors were entered into a binary logistic regression model. A p-value of less than 0.05 was considered statistically significant.
Results: 24.8% of 113 patients died in the intensive care unit. Higher APACHE II scores, neutropenia, acute renal failure, illness progression, mechanical ventilation, hypotension, tachycardia, and pulmonary aspergillosis were all substantially linked to mortality.
Conclusion: these results emphasize the necessity of early detection of high-risk individuals and targeted interventions to improve outcomes in environments with limited resources.

Background and Objectives: Renal failure is a chronic illness that leads to great psychological suffering of the patients under dialysis treatment. the aim of the current study was to evaluate the degree of psychological suffering among dialysis patients in Yarmouk Teaching Hospital, Baghdad, Iraq and to establish a correlation between the psychological suffering and demographical characteristics of the study sample.
Methodology: The cross-sectional study was done at the Yarmouk Hospital, Baghdad, Iraq on a sample of 50 patients in the haemodialysis unit. The convenience sample was used to collect the sample and the questionnaire was divided into three parts the first part was used to collect demographic data and the second was composed of two standardized measures of anxiety and depression. Pre-existing standardized measures were used to determine the reliability and validity of the research instruments.
Results: The findings identify significant psychological distress in the patient group, which is manifested through the overall scores of mean=1.18 (SD=1.08) in the depression scale and 1.12 (SD=0.92) in the anxiety scale.
Conclusion: The research concluded that patients under dialysis in the Yarmouk Teaching Hospital experience psychological distress, and the distress depends on the social and demographic background of the patients. This would require the combination of psychological evaluation and medication in addition to the conventional medical procedure of addressing this category of patients.

The proliferation of social media has led to widespread worries about its effects on the mind and body. One of the issues that came from it is language like “brain rot” and “worthlessness,” which has now become standard when we talk about how social media negatively affects adults. “Brain rot” describes cognitive experiences including memory fog, mental exhaustion and shorter attention spans, while worthlessness is often a byproduct of social comparison and thin digital connections. This scoping review aims to explore the association of the use of social media among adults, with cognitive health or emotional well-being using as key concepts the idea that social media is brain rot and feeling you are losing your life. The review will collate what is known of this literature and propose potential remedies to ameliorate negative impacts.

Background: Streptococcus mutans is a major cariogenic bacterium implicated in dental plaque formation, gingivitis, and dental caries. Although chlorhexidine (CHX) is widely used as an antimicrobial mouthwash, its long-term use is associated with several undesirable side effects, prompting the search for effective natural alternatives.
Aim: This study aimed to evaluate the antibacterial activity of a cold aqueous pomegranate peel extract (PPE) and to compare its efficacy with 0.2% chlorhexidine against Streptococcus mutans isolated from patients with gingivitis and dental caries.
Methods: A total of 55 clinical isolates of Streptococcus mutans were obtained from patients attending dental clinics. Antibacterial activity was assessed using agar disk diffusion. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill assays were performed using standard broth microdilution methods.
Results: PPE exhibited a larger mean inhibition zone than chlorhexidine (26.0 ± SD mm vs. 24.0 ± SD mm). The MIC and MBC values of PPE (0.78 mg/mL and 1.56 mg/mL, respectively) were lower than those of chlorhexidine (1.25 mg/mL and 2.50 mg/mL). Time-kill analysis demonstrated a rapid and sustained reduction in viable bacterial counts with PPE compared to chlorhexidine.
Conclusion: The cold aqueous extract of pomegranate peel demonstrated significant in vitro antibacterial activity against S. mutans and showed greater efficacy than chlorhexidine in several parameters. These findings suggest that PPE may represent a promising natural candidate for further clinical evaluation in oral healthcare applications.

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age and is often associated with hormonal imbalance, insulin resistance, and metabolic disturbances. Recently, vitamin D deficiency has been proposed to play a potential role in the pathophysiology of PCOS through its effects on ovarian function and reproductive hormones.This study aimed to evaluate the relationship between serum vitamin D levels and reproductive hormones, including luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratio, in women diagnosed with PCOS.
Objective: to evaluate the relationship between serum vitamin D levels and reproductive hormones, including luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratio, in women diagnosed with PCOS.
Methods: This case-control study was conducted at Gynecology and Obstetrics Teaching Hospital in Kerbala City, Iraq from January 2025 to May 2025. A total of 100 women aged 20–40 years were included and divided into two groups: 50 PCOS patients with vitamin D deficiency (Group A) and 50 PCOS patients with normal vitamin D levels (Group B). Serum vitamin D, LH, and FSH levels were measured using standard biochemical methods, and the LH/FSH ratio was calculated. Statistical analyses were performed using SPSS version 26, with significance set at p < 0.05.
Results: Polycystic ovary syndrome women with vitamin D deficiency showed significantly higher LH levels and LH/FSH ratios compared to those with normal vitamin D levels (p < 0.05). FSH levels did not differ significantly between groups. A negative correlation was found between vitamin D levels and LH/FSH ratio, suggesting that lower vitamin D is associated with greater hormonal imbalance.
Conclusion: Vitamin D deficiency is associated with hormonal deregulation in women with PCOS, particularly by elevating LH and LH/FSH ratio. These findings highlight the potential benefit of maintaining adequate vitamin D status in improving reproductive and endocrine profiles in PCOS patients.

Background: One of the most important causes of child death in the world is preterm birth (PTB), especially in developing and low-income countries. Therefore, identifying socioeconomic factors may contribute to supporting targeted measures to reduce its incidence.
Objective: To determine the relationship between family socioeconomic factors, preterm and full-term birth among mothers in Holy Karbala city, Iraq.
Methods: A quantitative (comparative) analytical study was conducted in three hospitals in the Holy city Karbala, Iraq, during the period from September 19, 2024, and July 9, 2025. The study sample included 150 mothers who had preterm births and 150 mothers who had full-term births. individuals were selected via non-probability convenience sampling., data were collected through face-to-face interviews with mothers using a standardized questionnaire that covered sociodemographic and health-related variables. Binary logistic regression and chi-square tests were used to analyse the data.
Results: Various socioeconomic factors, including: mother age (p=0.035), living in rural region (p=0.004), having a low level of education (p=0.000), and having an insufficient monthly income
(p=0.014), were significantly correlated with PTB.
Conclusion: PTB risk in Holy Karbala strongly correlates with family socioeconomic conditions especially low mother education, insufficient income, and rural residence. In similar populations, the burden of PTB may be minimized by efforts that improve maternal awareness and access to antenatal care services.

Background: Endotracheal suctioning is a common procedure in mechanically ventilated patients to maintain airway patency. The use of normal saline instillation prior to suctioning remains controversial due to its potential impact on arterial blood gas (ABG) values. Objective This quasi-experimental study aimed to evaluate the effect of endotracheal suctioning with and without normal saline on arterial blood gas values in mechanically ventilated adult patients and determine which of the two methods (with or without saline) is more effective in improving oxygenation and reducing airway resistance.
Methods: A quasi-experimental design was used in the study. This study was initiated from 19th September 2024 to 30th July 2025 at the ICU at Imam Al-Hussein Medical City and the ICU unit of Imam Al-Hassan Al-Mujtaba Teaching Hospital in Holy Kerbala, Iraq. In Kerbala, purposive sampling was used to select the participants. A total of patients receiving mechanical ventilation in the intensive care unit (ICU) were enrolled. Patients were divided into two groups: one group received endotracheal suctioning with normal saline instillation, and the other without saline. Arterial blood gas parameters (PaO₂, PaCO₂, and pH) were measured before and after the procedure. Statistical analysis was conducted using SPSS version .
Results: The results showed no statistically significant differences between the two groups in demographic characteristics, except for shorter ICU stay in the saline group (p = 0.037). This group achieved significant improvements in arterial blood gas values, with PaO₂ increasing and PaCO₂ decreasing as pH stabilized. Effect sizes were large for respiratory volume and ventilation pressures. In contrast, the untreated group recorded limited changes, with small effect sizes. The study also demonstrated a significant effect of some demographic factors, such as age and medical diagnosis, on physiological responses at a significant rate within each group.
Conclusion: Endotracheal suctioning with normal saline instillation resulted in more favorable outcomes in terms of gas exchange compared to suctioning without saline. The use of N/S appears to improve secretion clearance, ventilation efficiency, and oxygenation, supporting its clinical utility in mechanically ventilated patients.
Recommendations: The use of saline prior to tube suctioning is recommended in the presence of thick secretions or inadequate gas exchange, and its routine use should be avoided without necessity. Standardized suction protocols should be developed, supported by ongoing training and close monitoring of vital signs. The use of humidification or inhaled saline is also recommended to improve secretion fluidity. Finally, future studies are needed to evaluate the effect of the suctioning with normal saline instillation on infection and quality of care.

Introduction: The paper examined the effects of the extended use of the internet on cardiovascular symptoms, sleeping habits, appetite, and musculoskeletal wellbeing. The survey was a cross-sectional survey of 185 adult subjects, which measured daily screen time and pre-sleep exposure, sleep quality, physical complaints, changes in appetite, and cognitive symptoms. The results showed that widespread long-term internet usage, exposure to it just before going to bed, insomnia, low sleep quality, and morning fatigue were common. The complaints that were regularly mentioned were fatigue, palpitations, appetite disregulation, neck, shoulder, and back pain. Additionally, there was a great effect on the heart rate of the participants, and many of them claimed that their resting heart rate was high and they experienced tachycardia occasionally, which was likely due to the enhanced sympathetic activity. To conclude, the idea of chronic internet use appears to be a major behavioral stress factor in need of the implementation of healthier digital habits and additional longitudinal research.
Methods: Our research design was A cross-sectional quantitative survey, which entailed 185 adult internet users to investigate the effects of a long-term internet use on physiological and behavioral consequences. The respondents completed a questionnaire, which contained questions on their daily internet use, exposure to screens before sleep, cardiovascular responses to online actions, sleeping disturbances, appetite alterations, musculoskeletal symptoms, and cognitive symptoms, including eyestrain and loss of concentration. The analysis of the data was performed by the descriptive statistics that covered frequencies and percentages and were presented in the tables and in Figure. The method helped to determine the common trends of internet use over a long period of time and its association with autonomic, musculoskeletal and neurocognitive outcomes.
Results: The findings part includes the distribution of the responses of the participants in the case of daily internet. Use, sleep patterns, behaviors about the appetite, and musculoskeletal symptoms. Findings are recorded in frequencies and percentages and presented in the form of graphical figures.
Conclusion According to this study, there are physiological, behavioral, and cognitive effects of the effects of long internet use. Excessive use can disrupt sleep causing difficulty in falling asleep, staying asleep, morning drowsiness and circadian rhythm disturbance. The alterations in eating habits might cause metabolism problems, whereas cognitive and neurological stress would cause headaches, stress, and overload especially during disconnections or interruptions. The effects vary depending on personal usage patterns, lifestyle and physiological strength. These findings represent the relevance of both deliberate and moderate internet use in duration and timing. Additional longitudinal studies are encouraged in order to study causal correlations and preventive measures.

Tomato is Significant for Iraq\\'s food security and agricultural economy. Primarily serving regional and national markets, the Al-Sharia agricultural area in Karbala Governorate serves as a major production hub. Most especially bacterial spot brought on by Xanthomonas gardneri, phytosanitary problems always threaten the viability of this sector. This pathogen causes extreme defoliation and fruit damage, which results in major financial losses. Certain unique environmental conditions make disease control in Iraq more challenging. The region is defined by calcareous soils and summer temperatures typically exceeding 40°C. These conditions not only help the pathogen to spread through irrigation but also make some of the commercially available biocontrol products from temperate regions less effective. These products usually have trouble surviving in such challenging environments. The reliance on copper-based bactericides has raised concerns about environmental pollution and the development of resistant pathogen strains. Consequently, biological control using endophytic bacteria looks to be a wise choice. This study aimed to find local endophytic bacteria fit for these circumstances and determine their capacity to ward off other bacteria. Sixty bacterial isolates were obtained; seventeen different endophytes selected for characterization were discovered. Koch\\'s postulates supported confirmation of the local X. gardneri isolate\\'s pathogenicity. On the basis of phenotypic and biochemical characteristics, the promising isolates were distributed among the Bacillus and Pseudomonas genera. Significantly, isolates KSH-04 and KSH-07 (Pseudomonas sp.) were quite resilient; they grew at 5% NaCl concentrations and 42°C. In vitro studies revealed significant antagonism against X. gardneri linked to siderophore production. Greenhouse studies showed that, in comparison to the control, pre-treating with these stress-tolerant isolates reduced disease severity by more than 50%. According to this study, selecting ecologically friendly strains is vital as it offers a sustainable means of tomato production in dry and salty agroecosystem .

Background: Medical waste puts nurses at a greater risk than others. Nurses visit the ward more than anyone which increases their chance of being exposed to hazards. It is important that they ensure the rest of the team and the community are not at risk of waste matters. The attitudes of nurses toward medical waste management are crucial for ensuring effective waste segregation, handling, and disposal practices. Positive attitudes can enhance compliance with established protocols, while negative perceptions may lead to unsafe practices, increasing the likelihood of infections and environmental contamination. Thus, the main objective of this study is to assess the level of nurse’s attitudes towards medical waste management and to find out the relationship between nurses’ attitudes and key sociodemographic characteristics such as age, sex, qualifications in nursing, years of experience, attending training courses and department they work in.
Methods: A descriptive cross-sectional design was employed; 318 nurses were taken from various departments. Data were collected using a specially developed questionnaire encompassing demographic characteristics and attitudes toward medical waste management.
Results: The findings revealed more than half of the sample %59.8 have a moderate level of attitudes towards medical waste management in the hospital under study. The results showed a statistically significant relationship between the sample\'s attitudes and their educational level, years of experience, and participation in training courses, respectively, at a significance level of 0.05%.
Conclusion: The study highlights the critical role of nurses in effective waste management and underscores the need for targeted training programs to enhance compliance and safety practices.

Introduction: There is an urgent requirement to develop novel antimicrobial agents that can counter the rising problem of antibiotic-resistant disease-causing microorganisms. The actinobacteria are a prolific source of natural products, and most of the known antibiotics are produced by these mycelial bacteria. Studies of rare actinobacteria can enhance the chances of new compounds with new chemical structures.
Methods: This review relates to intensive isolation and screening procedures of rare actinobacteria of understudied environments. The natural habitats like sandy, beach, desert and forest soils were viewed as potential harvest for collecting the less-represented genera in the past. The importance was also put on the assessments of ecological conditions, such as microbial interactions, which might trigger the expression of antibiotics.
Results: Natural discovery libraries and the probability of natural bioactive discovery are enhanced as a result of the screening of rare actinobacteria in unexploited natural habitats. It has been indicated that some antibiotics are solely expressed in some conditions of environmental or microbial interaction and there is a necessity to conduct research in other ecological niches such as soil, dry and marine ecosystems.
Conclusion: The rare actinobacteria can also be used as a good source of novel antimicrobial drugs. Increasing bio-discovery initiatives by focusing on isolating, screening, and ecologically discovering new antimicrobial agents can empower scientific capacity to discover new, desperately required antimicrobial agents.

Background: Among the barriers that nurses encounter in their practices include work overloads, working at night and odd hours, which do not allow them to be able to practice health and wellness-promoting behaviors despite understanding what they need to do about health and wellness.
Methods: This study utilized a cross-sectional design to identify barriers perceived by nursing staff (???? = 300) regarding their health-promoting behaviors and to explore associations with various personal and professional variables. Data were gathered using a structured questionnaire adopted by previous research, encompassing demographics and determinants of health-promoting behaviors. Cronbach\\'s alpha coefficient was used to determine the reliability of the questionnaire.
Results: The findings revealed that participation in health-promoting activities had a robust inverse relationship with perceived barriers (r = –.296, P = .001), implying that higher engagement in such activities was associated with lower perceived barriers. Notably, other factors such as sex, age, marital status, qualifications, income, experience, and prior surgeries did not exhibit significant associations.
Conclusion: The study concluded that nursing staff confronts moderate barriers, primarily due to logistical challenges like the lack of nearby activity centers and insufficient information about available programs. Further obstacles recognized included environmental aspects like bad weather and personal barriers, such as time constraints from family responsibilities, alongside a lack of motivation. Interestingly, physical limitations were not common barriers among participants.