kufa Journal for Nursing sciences

Background: Sodium lauryl sulfate (SLS) is a detergent that has been used as the major surfactant in most dentifrices and could affect the barrier function of oral mucosa causing enhanced penetration of exogenous antigens.
Objective: The aim of this clinical trial was to compare the effects of an SLS-free dentifrice and an SLS-containing dentifrice in patients suffering of recurrent aphthous ulcers .
Method: This study was achieved in private clinic in 10/1/2015 to 1/6/2015,in this study, 33 volunteers (20 women, 13 men; mean age, 22 years: range, 15-35 years) were included, all have a history of recurrent aphthous ulceration. Two different dentifrices were used in the study. One contained SLS, and the other was SLS free. The patients were randomly allocated to one of the test toothpastes for 8 weeks, Then the patients changed to the other toothpaste for another 8 weeks period. The patients were asked to record on 100 mm visual analogue scales (VAS) the soreness arising of the ulcerated area, as well as the total number of ulcers, t-test was used to determine the statistical difference.
Results: The number of ulcers and baseline soreness scores were significantly less in the group of patients using SLS free tooth paste
Conclusions: This study concluded that using SLS free tooth baste can decrease the number of recurrent aphthous ulcers and the soreness that result of these ulcers regardless of the gender of the patients.
Recommendations: It was recommended to enhance the use of SLS free tooth baste to minimize the number of recurrent aphthous ulcers and the soreness.

Objective: The aim of this study is to identify the relationship between antisocial personality disorder and addiction.
Methodology: A descriptive Case-control study was conducted in AL-Diwanyia Teaching Hospital, Psychiatric Department of 6 May 2015 to 30 of June 2015 on a non-probability (purposive sample) of 20 addicted patients and 20 of healthy person were matched with them of general population. The data were collected through the use of semi-structured interview, the questionnaire prepared by Robert Harry and translation of AL-Saadani, Data was analysis through descriptive and inferential statistic.
Results: The findings of the present study indicate there is relationship between antisocial personality disorder and addiction.
Conclusion: The study conclude that the antisocial personality disorder was more frequent in cases than in the control group.
Recommendations: Use psychotherapy specially social skills through treating of addiction.

Background: Patients' satisfaction has become an established outcome indicator of the quality and efficiency of the health care system.
Objective: The aim of this study was to assess the level of Breast cancer patients' satisfaction toward nursing care in selected hospital of Erbil city in Iraqi Kurdistan Region.
Materials and Methods: A descriptive study was designed at oncology ward of Rizgari Teaching Hospital.
Participants were interviewed and questions were asked. It started in 1st June to 20th September 2014.The
questionnaire included demographical data: gender, educational qualification, history of cancer in the family, family
income, type of hospital room and duration of stay in hospital, and type of treatment and frequency of hospitalization were analyzed by using Rating Scale
Results: 60 patients participated in this study. Likert scale was used to assess the levels of satisfaction. Chi-square
analysis was computed to find the associations between the levels of satisfaction and demographic variables. 30
patients had a scored between 60-80 and considered to have a good level of satisfaction toward nursing care.
However, 30 participants had scoring between 38-59 and are considered to have average level of satisfaction.
Conclusion: The study concluded breast cancer patients had positive attitude toward nursing care. be conducted to
assess the level of breast cancer patients’ satisfaction toward nursing care
Recommendations: Further research including further oncology hospitals.

Background: Widespread use of chemotherapy in the treatment of cancer has lead to higher health hazards among nurses who handle and administer such drugs, so they should know how to protect themselves of effects of chemotherapy.
Objective: to assess knowledge and practices of nurses for safe handling chemotherapy in Erbil City.
Methodology: A cross sectional study design was undertaken on 27 nurses in oncology units in Erbil City in 2015, to collect the data, patients who met the inclusion criteria were selected and questionnaires were filled through interviewing in 20 minutes. The questionnaire including demographic information and safe handling chemotherapy knowledge and practices and barriers of personal protective equipment. data were analysis by descriptive and inferential statistics
Results: The total mean score of knowledge and practices of safe handling chemotherapy was 15.59±1.96, 8.74+1.78 respectively and more than two to third of nurses had no knowledge that chemotherapy enter the body through contaminated foods, about practices more than three quarter no change of personnel protective barriers after contact with chemotherapy . Result of this study showed that was significant negative association between knowledge and practices (r=-0.469, p=0.014). Moreover, It is showed that significant negative association between practices and barriers (r = 0. 475; P = 0. 012).
Conclusion: Most of the study sample had fair knowledge and practices of safe handling chemotherapy.
Recommendation: Chemotherapy Safety protocol should be instituted for all oncology nurses who are working in oncology unit.

Background: Thalassemia major is a prevalent hereditary disease in Mediterranean region, the assessment of physical aspect of school age children, especially in those with chronic illness such as thalassemia is particularly important.
Objectives: this study aims to assess psychosocial aspects of school age children with thalassemia major. And found out the magnitude association between psychosocial aspects and their demographic characteristics and their clinical characteristics.
Methodology: A Non Probability "purposive" sample of (100) school age children with thalassemia major and their parents are included in the present study. The study was conducted in the period of September 2nd 2014 to August2nd2015 in Al Najaf Al Ashraf â„ Al-Zahra Maternal and Child Teaching Hospital / Thalassemia center. Researcher constructed special questioner to achieve objectives of the present study. Validity of the study instrument was determined through the panel of experts and the reliability of the study questionnaire was determined through Alpha correlation coefficient was computed for the determination of the internal consistency reliability which was ±= 0.87 for the standardized alpha of the internal scale of the assessment of child psychosocial aspects and ±= 0.91 for standardized Alpha of the internal scale of the assessment of parents proxy information. Data analyses through use descriptive (frequency and percentage) and inferential statistical analysis procedures (t-test , chi squire, and P- value) were used to data analysis.
Results: The present study results indicated that there was a significant relationship between thalassemia major and their psychosocial aspects. Also non-significant differences between child and their parent's responses regard to the overall psychosocial aspects.
Conclusions:. The study concluded that the majority of the study sample of thalassemic children had negative impact on psychosocial aspects. In addition, the emotional domain is the most affected one, followed by the social domain, and then the school domain.
Recommendations: The study recommends that a psychologist and sociologist in the center thalassemia is a must be present to help in providing a link between patients, school, the families, and the physicians. And health oriented by mass media in providing information to population about thalassemia and other inherited diseases.

Background: Clinical features of celiac disease vary considerably. Intestinal symptoms are common in children whose disease is diagnosed within the 1st 2 years of life. As the age at presentation of the disease shifts to later in childhood, and with the more liberal use of serologic screening tests, extra-intestinal manifestations and associated disorders, without any accompanying digestive symptoms, have increasingly become recognized, including short stature. We aim in this study to determine the percentage of celiac disease among patients with short stature.
Objectives of the Study: (1) to show the percentage of patient with celiac disease in short stature children. (2) to show the effect celiac disease on treatment of short stature children.
Methodology: A cross sectional study that carried out at the Endocrine Pediatrics Clinic at A Zahraa Teaching Hospital for a period in 1st of January 2013 to end of October 2013; a total of 167 children and adolescents, aged range of 2 to 18 years were registered with short stature . 91 children of them only have been enrolled in this study according to inclusion criteria. Enzyme immunoassay (Biosystems, Spain) was used to determine IgA tTG using microplate tests. Samples with concentrations >20U/mL were defined as positive. Patients with positive anti-tTG
serology were referred to the gastroenterology clinic to continue investigation of celiac disease by endoscopy and biopsy. Data were analyzed by SPSS software in IBM version 20 using chi square and paired T-test.
Result: A total of 167 patients were evaluated 91 of them only have been enrolled in our study according to inclusion criteria; 59 (65%) were female and 32 (35%) were male. Median age was 9 years (of 2 - 18 years).The anti-tTG assays were positive in 16.5% of patients (15/91). Out of 15 patient whose diagnosed as anti-tTG positive, 11 (73%) have been diagnosed as celiac disease by endoscopy and biopsy according to modified marsh classification. All children diagnosed to have celiac disease were kept on a gluten-free diet. Patients were followed-up for six months and showed improvement in growth rate.
Conclusion: Celiac disease a cause of short stature that should be included in diagnostic investigations of short stature.
Recommendation: anti-tTG antibody as routine test recommended for all patients with short statures. All patients with idiopathic short statures and anti-tTG test positive with normal IgA level should be subjected to intestinal biopsy to prove the diagnosis of celiac disease.

Objective: is to determine the knowledge of nurses concerning implantation pacemaker for adults patients with cardiac rhythm disorders, to find out the relationship between nurses knowledge concerning implantation pacemaker for adult's patients with cardiac rhythm disorders and demographic characteristics.
Methodology: The study was performed November 2014 to June 2015. A convenience (non-probability) sample of the study consists of (100) nurses choose purposively who are working in Al-Nassirrhyia Heart Center (The data were collected the use of a questionnaire which were consisted of two parts (demographic data, nurses knowledge about pacemaker). Content validity of the questionnaire was determine through a panel of (13) experts. Reliability and validity of questionnaire was determined through test re-test (r= 0.82) of pilot study. The data collection process was performed of 15th of March until the 5th of May 2015.the data was analyzed through the application of descriptive statistical analysis that include (frequency, Percentages [%] and cumulative percent, Mean of scores ), and the application of inferential statistical analysis that included the person correlation coefficient.
Results: The result of study shows that the majority (49%) of the age group was (23-27) years old and most of the study sample (60%) was male. Most of them (52%) were single and (40%) was secondary school nursing and between parley sufficient and insufficient in monthly income their livings (93%) were urban, more of the study sample was working in coronary care unit (21%) and (11%) of them were have training course all of them inside of Iraq and most of the study sample have once course training and (80%) of them were employ in (1-5) years with (1-3) years of experience in cardiac unit (68%), mean of score are moderate on item (1) and high on the remaining items.
Conclusion: Nurse's knowledge was sufficient and good, There is a relationship between nurses knowledge and gender, residential area and work site.
Recommendation: There is a need for an orientation program for all new nurses. There is need for implement an active updated educational activities. Skills training to all the nurses concerning of pacemaker. Farther study is necessary in nurse's practices concerning implantation pacemaker in order to demonstrate more clearly.

Objectives: To know the mothers fearing of caesarean birth in Kirkuk governorate as well as to classified their fearing according to the severity and found the priority of method for treatment.
Methodology: A descriptive study of a quantitative design was carried out at Azadi teaching hospital and Kirkuk general hospital in Kirkuk governorate for women after caesarean birth June 5th2013 to April 31st2014. A convenience sample of (200) women after cesarean from Azadi Teaching Hospital and Kirkuk General Hospital in Kirkuk governorate. Developed questionnaire was constructed for the purpose of the study which consists of (26) items, the first part include the demographic data of the respondent, the second part fearing of mothers. The data were collected through the use of interview. They were analyzed through the application of descriptive statistical analysis (frequency and percentage).
Results: The findings of the study indicated that (29%) of the sample Age group were (20-24) year's old, (37%) were primary school graduated, (82%) were house wives, (25%) were first pregnant and (70%) were never had abortion.
Conclusion: There have been different reasons for mother's fears such as fear of fetus death, the fear of labor pain and fear of fetus harm.
Recommendation: Provide advanced efficient Nursing staff to treat fearing associated with the patient by Caesarean birth, Psychological support to the pregnant women before Caesarean birth and answer all questions of pregnant mothers about Caesarean birth.

Background: Healthy lifestyle is the responsibility of person to choice and making smart health through good nutrition, daily exercise, adequate sleep, avoid tobacco smoking and drinking alcohol and engage with family members and friends.
Aim of study: is to identify the lifestyle for clients attending to primary health care centers in Erbil
Methods: descriptive study conducted in Erbil City through the period of July 17, 2014- January to 11, 2015. A convenience method of sample was recruit 248 client age 15 and above without chronic diseases who were attended to primary health care centers during study period for purpose either treatment minor illness or vaccination coverage program for their children. Questionnaire designed by researchers and used to collect data by interview. Chi square test of association (or Fisher's test) was used to compare proportions. A p- value of ≤ 0.05 was considered as statistically significant.
Results: study found that the unhealthy behavior among study sample were: smoker 27.0%, did not practicing physical activities 64.9%, watch TV more than seven hours 70.2%, eat food high in fat 40.7% and there significantly association between age and smoker (P<0.0001), age and number of hours sleeping (P<0.0001), age and going to bed early (P<0.0001), and there was significantly association between r physical activities and gender (P=0.021).
Conclusion: there was proportion of unhealthy lifestyle among sample of study such as watch TV more than seven hours, did not practicing physical activities eating fatty foods, there was significantly association between age and smoking, age and practicing physical activities, and association between gender and practicing physical activities.
Recommendation: study recommended for health policy in governorate to encourage health lifestyle among people through mass media and open more sports club for physical activities.

Background: Ulcerative colitis (UC) is a chronic inflammatory disease of unknown causes. It has involved the inflammatory process of the mucosa and sometimes the submucosa of the large intestinal tract. There are a several theories involve role of the immune mechanisms and cell signals that lead to activation of many intracellular adapter proteins and other markers, which in turn trigger an inflammatory process and death of many colonocytes.
Objective: investigation of serum TNF-alpha, TRAF-1 and TRAF-2 levels in active Ulcerative Colitis and also, identified the diagnostic possibility of the studied parameters in diagnosis of UC patients.
Methodology: A case-control study was conducted at the City of Al-Najaf Al-Ashraf using 56 and 30 individuals of both genders for Patients and Control groups with an overall age range of 18-75 years old. All sera with negative Epstein-Barr Virus (EBV) agglutination test of all subjects were monitored for level of Tumor Necrosis Factor-alpha (TNF), TNF Receptor Associated Factor-1 (TRAF-1), and TNF Receptor Associated Factor-2 (TRAF-2), by ELISA Method. All these Data was analyzed by using spss (T-test) program and also, the receiver operate characteristic curve (ROC) was used to identify their possibility of diagnostic value.
Results: Serum level of TNF-alpha, TRAF-1 and TRAF-2 were significantly higher in UC patients than those in controls (P values were = 0.000). TNF-alpha, TRAF-1, and TRAF-2 shown to have a display to fabulous value in the differentiation of UC patients and control with the area under the ROC curve (AUR) of 0.698–1.000 (P value < 0.001).
Conclusion: In light of the obtained results in current study, we conclude that the serological levels of TNF-alpha, TRAF-1 and TRAF-2 were increased in active UC patients. It seems that the activation of TNF-alpha, TRAF-1, and TRAF-2 may be first events in the development of UC.
Recommendation: Additional genetic and immunological markers, including standardized lymphocytes and other assays, are needed. These are to determine the pro-inflammatory cytokines and monitor the progress of the disease in order to detect the suitable time of a possible intervention.

Background: Osteoporosis is a major public health problem, because it is lead to weakness of the skeleton and increased risk of fractures particularly of the spine and hip, increased morbidity and mortality, and which are a huge burden on the health system due to the high economic costs of those care fractures they produced.
Objective: to identify some factors associated with occurrence of osteoporosis among women in AL-Najaf province
Methodology: A descriptive study was conducted in DEXA unit in radiology department in Al-Sader Teaching Hospital in AL-Najaf Province /Iraq from August 2014 till the end of March 2015.A purposive sample was (150) woman who referred for investigation osteoporosis by using DEXA measurement. Data were gathered by direct interview with the women using especial questionnaire that include questions about socio-demographic characteristics such as age of women, level of education, residency, reproductive variables such as menopausal age, medical history such as hypertension, diabetic mellitus, body mass index (BMI) and physical activities.
Results: The results indicated that the osteoporosis in this study was 45.3%. The most of osteoporosis (75%) within age group (> 60) years, (53.7%) woman at menopause, (67.8%) were smoking, (31.3%) had renal problems. The present study showed that (85%) of women with osteoporosis had normal body mass index, while (31.1%) were obese (30+). In addition to, the study revealed that (60%)of women with osteoporosis were within low physical activities levels.
Conclusion :The study concludes that the osteoporosis was significantly associated with body mass index, current age, renal problems,
Recommendations: the researcher recommended that all women above 50 years to be done DEXA examination yearly or every two years to decrease possibility of osteoporosis

Background: Self-care Practices is a human regulatory functions that is a deliberate action to supply or ensure the supply of necessary materials needed for continued life, growth, development and to maintain of human integrity.
Aim of study: This study aim to enhancing self-care practices for epileptic patients at home.
Methodology: Quasi-experimental study design carried out in 21 January 2014 to 26 April 2015 at Middle Euphrates Neuroscience Center in AL-Najaf City with application of pre\post-test method. Purposive sample consists of (57) patients who are suffering on epilepsy disorder participated in the study. They are divided as (27) patients (study group) who are received educational program they identify and applied of the right self-care practices related to epileptic patients at home after attending to educational program sessions, while (30) patients did not received program (control group). Data was analyzed by using descriptive and inferential statistics which was computerized by using of SPSS (version 21).
Results: The results of the study presented highly significant difference in the self-care practices for the epileptic patients who attended structured educational sessions (study group), while there is no significant difference in self-care practices of control group.
Conclusion: The study concluded that the educational program provided improvement in self-care practices of epileptic patients.
Recommendation: The epileptic patients should be educated by specialist nurse in health care center by structured educational program which includes all aspects of the self-care practices, ongoing assessment should be planned to evaluate the application of instructions and education to maintain the epileptic patients health.

Background: Safe use of infant formula is challenging in developing world settings. Because water and sanitation infrastructure are often suboptimal in these communities, infants who are not breastfed remain at high risk of morbidity and mortality caused by diarrheal pathogens.
Objectives: The study aimed to find out the association between methods of cleaning and disinfecting bottle feeding and culture result, determine most sterilize methods by mothers.
Methodology: A survey study was carried out at Rapern Teaching hospital in Erbil City Iraq/Kurdistan Region of (15-June-2015 to15-September-2015) .A convenience sample of 40 mothers were selected who used bottle feeding,(10) Mothers of each method ( boiling water, salt (Nacl),Detergent) and tap water only),Then the Then the swape was taken in the screw line of bottle after the cleaning and washing by mother and send to laboratory for culture was taken in the screw line of bottle after the cleaning and washing by mother and send to laboratory for culture. A questionnaire was designed that composed of four parts, (Socio-demographic data of mother and their infant, some questions method of cleaning and disinfecting bottle feeing, the data were analysis by using
Frequency, percentage and Chi square (SPSS, 19 ).
Results: The results found (32.5%) of mothers were age (26-30) years old, (37.5%) were illiterate, (45%) of them were at Urban, (82.5%)of infant have history of previous diarrhea (10%) positive culture swap of boiling methods of cleaning and sterilizing the bottle feeding, while (90%) positive pathogen culture swap is seen in detergent method, (100%) was positive culture swap of both methods( tap water and salt). (35%) of bacterial growth was E. Coli, (17.5%) of them was Klepssela. pneumonia, while only (5%) of bacteria were ( Multi bacteria), Regarding the fungi (15%) was positive (Monilia), there is highly significant association between (Culture result, Type of Bacteria, Duration of cleaning and sterilization and Type of bottle) with method of cleaning and sterilization.
Conclusions: The study concludes that method of cleaning and sterilization of bottle feeding were sterilize because there are a lot of pathogen were isolated of bottle after cleaning and sterilization by mothers and Boiling method was the most sterilize method and The study indicate that bottle feeding does not provide a safe feeding.
Recommendations: The study recommend a guideline and an educational program about method of cleaning and sterilization of bottle feeding for mothers and family must be provide to all maternal and child heath care center in Kurdistan region / Iraq, Encourage mother to use breast feeding and use glass bottle feeding instead of plastic one, because its easer to sterilize and clean. Tap water not recommended for cleaning the bottle feeding because of poor sanitation.

Background: Cardiogenic shock resulting of an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively. As this is a type of circulatory shock, there is insufficient perfusion of tissue to meet the demands for oxygen and nutrients. Cardiogenic shock is a largely irreversible condition and as such is more often fatal than not. The condition involves increasingly more pervasive cell death in oxygen starvation (hypoxia) and nutrient starvation (e.g. low blood sugar). Because of this, it may lead to cardiac arrest (or circulatory arrest), Nurses, physicians and others health team need to work together to develop a rapid and well-organized treatment approach to this devastating condition.
Objective: The present study aimed to assess the effectiveness of an educational program on nurse's knowledge concerning management of cardiogenic shock.
Methodology: A quasi-experimental design study was carried out at AL-Mosul teaching hospitals in March 9th 2015 to July 1st of 2015. The program and instruments constructed and developed by the researcher to measure the purpose of the study. Random sample comprised of (50) nurse was divided into two groups, study group consisted (25) nurse exposed to the nursing educational program and control group consisted (25) nurse were not exposed to the program. The measurement of the effectiveness of nursing educational program on nurses' knowledge the researcher use knowledge test includes (44) items concerning with assessment knowledge for nurses related to management of patients with cardiogenic shock. Reliability of instrument tools was determined through the use of test and retest and the instrument validity was determined through a panel of experts. The analysis of data was performed through the application of description statistic (Frequencies, Percentages, and cumulative percent, Mean of Score, Standard Deviation, Relative Sufficiency) and Inferential statistical (Chi-Square test, Fisher Exact Probability test to present the differences between the study and control groups).
Results: The results of the study showed that there is good improvement with highly significant differences in study group between pre and posttests in overall main domains. for the nurses' knowledge.
Conclusion: The study Concluded that that inadequate nurses' knowledge in the medical department (coronary care unit, medical ward and emergency department) toward management of patient with Cardiogenic shock.
Recommendation: The study recommended that an educational program can be designed and constructed for nurses through the program ,an emphasis can be directed and oriented in management of patient with Cardiogenic shock should be included continuous training for all nursing staff who work in medical department(coronary care unit, medical ward and emergency department).

Background: Secondary Polycythemia (SP) mean an elevated of erythrocytes numbers and hemoglobin above
normal levels which as more than 18 g / liter in males or 16 g / liter in females, and the elevated red blood cell
above the normal level lead to many complication as thromboembolisim, hypertension, and gout.
Objective: The study aims to assess find out the effectiveness of instructional program application on secondary
polycythemic clients.
Methodology: A quasi-experimental design study conducted in Iraqi national blood bank in the period of
January, 13th 2015 to September, 1st 2015, the study sample consist of 70 clients have hemoglobin level more
than 18 mg/dl for males and 16 mg/dl for females, divided into two groups (35) case and (35) control groups.
The study instrument was composed of three parts which as socio- demographic information was included; (age
group, gender, marital status, level of education and occupational, and second parts deals medical history which
include (weight, height, Hb level, other diseases, smoking and alcohol drinking). part three consist of 11 domains
concerned to clients knowledge toward the SP which include (general information about SP include (definition,
causes and symptoms), diagnosis, complication, treatment, and treatment plan which include (diet, smoking and
alcohol, exercise, control on blood pressure, blood donation, relaxation and follow. The validity of the instrument
was established through a panel of (10) experts, the reliability of the items was based on the internal consistency of the questionnaire was assessed by calculating Cronbach s' Coefficient alpha which as= 0.75. The data have
been analyzed through the application of: descriptive frequency, percentages; mean of scores; and the inferential
analysis that include: Analysis of variance and the researcher used the SPSS version 20 to analysis of data.
Results: the findings revealed that the 97.1% of the case group were males at age 37-41 years old, 71.4% were
married, 31.4% primary school graduate, 54.3% of the case group have free job, 68.6% of them were cigarettes
smokers, low percent of the case group smoking water pip, and 25.7% of them have drinking alcohol.
Conclusion: the study concluded that the program has a clear impact on improving the knowledge of clients
relating to the definition and symptoms and how to control the disease through the pretest and posttest of the
program.
Recommendation: the study recommends increase health awareness among young people through the
implementation of courses and lectures for youth in coordination with the Ministries of Health and Education and
Higher Education in order to control the causes of disease and their risks.

Background: Partograph was a first graphic assessment of progress of labor was designed by Friedman It is a cheap instrument designed to provide a constant graphic overview of labor and has been shown to enhance outcomes when used to manage and monitor labor. The purpose of the partograph, also called the partogram, is to help midwives record, interpret, analyze, and use data to make clinical management decisions while labor is in progress. The form (which is an early warning system) provides a graphic overview of the progress of labor and records information about maternal and fetal condition during labor.
Objective: to assess midwives knowledge regarding use of partograph in first stage of labor in delivery room.
Methodology: Quasi experimental design for two groups(study and control) was found to be effective for the present study. In this study the target population was consisted of all midwives working in delivery room in hospitals of a Holy Karbala city. The sampling technique use in this study was non probability convenience method of sampling ; sample were consist of 50 midwives working in delivery room in Karbala hospitals. There were 25 items regarding knowledge of partograph. The data collection were carried out during the period of February 1st to February 28th, 2015.The data analyzed through the use of the descriptive and inferential statistical analysis procedures.
Results: the results of the study reveal that (88%) of midwives have poor knowledge for using partograph in study group and (92%) in control group, 80% of midwives have good knowledge in study group after implementation of teaching program regarding partograph the result revealed that the knowledge of midwives regarding partograph is increased after the intervention these finding shows the group teaching was very effective in improving the knowledge of midwives.
Conclusion: The finding concluded that the teaching program was very effective in increasing their knowledge regarding using of partograph.
Recommendation: Enhance the midwives knowledge regarding partograph by frequency application of teaching program, training course and workshop for all midwives specially in delivery room.

Objective: The objective of this study was to improve certain sperm function parameters in vitro of oligozoospermic patients and other mild male factors using sperm activation techniques such as swim-up and density gradient.
Methodology: The study was carried out between January 2014 and October 2014 including (30) semen samples of oligozoospermic patients who attended the Fertility Center in AL- Sadr Medical City. The liquefied semen was then carefully mixed for few second and the semen was analyzed by macroscopic and microscopic examination. Two method of IUI sperm activation have been used in this study to separate the motile spermatozoa in seminal plasma. Data analyzed using the SPSS version(20)
Results: The results of the study showed that there was statistical significant ( p<0.05) decrease in the sperm concentration, leukocyte concentration, malondialdehyde(MDA) concentration and sperm chromatin maturity after activation by both swim-up and density gradient techniques compared with before activation. Also the results was appeared a significant (p<0.05) improvement in progressive motility (A+B) and normal morphology after activation by both techniques while, there was a significant (p<0.05) improvement in progressive motility (A+B) was noticed by using density gradient technique compared to swim-up technique.
Conclusions: It was concluded that the density gradient and swim-up techniques were appeared clear improvement in the certain sperm parameters of oligozoospermic patients after activation.
Recommendation: The density gradient techniques with intrauterine insemination to treatment Oligozoospermic patients.

Background: Bladder cancer is one of the most common human cancers in Iraq and the world. While smoking, age sex, and occupational exposure to aromatic amines are the most prominent among the risk factors identified, long term Inflammation and chronic infection may largely play some role in urinary bladder cancer (UBC) development. In the present study we worked on urinary bladder cancer and noncancerous Formalin-Fixed Paraffin Embedded (FFPE) Tissue specimens of Iraqi patients, the current study used Acid Fast Stain and Transmission Electron Microscope for detection of Mycobacterium tuberculosis in Urinary Bladder tissues.
Objectives: microscopical detection of Mycobacterium tuberculosis in urinary bladder cancer.
Methodology: The current study used urinary bladder cancer (UBC) formalin-fixed paraffin embedded tissues (FFPET) specimens of Iraqi patients collected of several privet histopathology labs in AL-Najaf province, the specimens were 50 specimens of UBC patients and 25 different noncancerous pathological bladder specimens. Slides of urinary bladder FFPE tissues were stained with Ziehl-Neelsen (ZN) stain. Examining of slides were conducted using Transmission Electron Microscope (TEM) imaging was performed special procedure was used for TEM slides preparation.
Results: FFPE tissues were stained with Ziehl-Neelsen (ZN) stain. Examining of slides showed presence of high number of acid fast bacilli (AFB) in one microscopical field. UBC tissue slides showed the highest percentage comparing to noncancerous patients (76.6% and 23.4%) respectively. For further confirmation and study of ZN stain results, Transmission Electron Microscope (TEM) imaging was performed. The results showed presence of different morphological shapes of acid fast bacilli cells appeared in TEM fields and most cells were observed attaching to the urothelial cell membrane.
Conclusions: high percentage of MTBC and MTB were detected among patients with UBC compared to noncancerous cases.
Recommendations: modern techniques should be used for MTBC and MTB detection in laboratories, and further study for the relationship between chronic MTB infection and UBC are required.

Background: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain with diarrhea and/or constipation and defecation with mucus. The etiology of IBS has not been definitively established., The IBS remains a condition that can seriously compromise an individual s’ quality of life.
Objective: The present study aims to identify the effectiveness of an Instructional Program concerning Knowledge on clients with Irritable Bowel Syndrome .
Methodology: A quasi-experimental design study conducted in Liver and Digestive Disease Hospital at Baghdad City of the period of January ,20th 2015 to October, 1st 2015, the study sample consist of 60 clients have IBS, divided into two groups (30) case and (30) control groups. The study instrument was composed of three parts which as socio- demographic information was included 5 items; (age group, gender, marital status, level of education, occupational), and second parts deals medical history which include (4) items BMI, The duration of developing IBS, type of IBS, diseases, smoking and alcohol drinking, other chronic diseases and factors affecting disease). part three consist of 5 domains concerned to clients knowledge toward the IBS which include (definition, causes and symptoms, diagnosis, and treatment plan which include (dietary change, drug therapy, psychotherapy, herbal therapy, and flow up). The data have been analyzed through the application of: descriptive analysis (frequency, percentages; mean of scores; and the inferential analysis that include: Analysis of variance, and the researcher used the SPSS version 21 to analysis of data.
Results: the findings revealed that the 56% of the case group were females at age 33-37 years old, 56% were married at institute & collage graduated, 66.6% of the case group have government employment, 40% of them have IBS of 1-3 years , 50% of the case group have diarrhea prodromal , high percent of them not Smoker, and the results revealed that their effectiveness of instructional program on IBS clients at P≤ 0.05 level.
Conclusion: the study concluded that the program applied by the researchers was a clear impact on improving the knowledge of clients relating to the definition and symptoms and how to control the disease through the pretest and posttest of the program.
Recommendation: the study recommends to increase health awareness among people through the implementation of courses and lectures in coordination with the Ministries of Health and Education and Higher Education in order to control the causes of disease and reduce symptoms of IBS.

Objectives: The study aims to assess the patients' asthma control and find out the association between the gender, age, marital status, educational level, employment, duration of disease.
Methodology: descriptive Design study is starting in 5th January 2014 to the 15th August 2014 was This study was conducted at Al Zahra'a Center consultative for Allergy and Asthma, Clinic consultative for Chest and Respiratory Diseases, in Baghdad city, purposive (non-probability) sample consist of 100 patients, who attending to above centers, Reliability of the questionnaires was determine by calculating Cronbach s' Coefficient alpha = .89. The Descriptive data analysis was done through frequency, percentage mean, standard deviation and relative sufficiency and inferential data analysis was done by chi-square, t-test and contingency coefficient.
Results: The results of the present study showed that the female's patients more than males, most of the sample marriage and college graduated, the findings revealed there were significant association between The patients control of asthma with Emergency admission and employment.
Conclusion: the study show high percentage (67%) of the study samples were uncontrolled, (28%) of samples were partial controlled and (5%) of samples were controlled.
Recommendations: This study provides evidence of poor asthma control According to present findings the researcher recommends to prepare educational program related to implement suitable interventions to improve asthma management according to standard treatment guidelines in the health establishment

Objectives: The study aims to assess the self-care practices of the antenatal mother, and to Identify the demographic characteristics of pregnant mother (Age, Level of education, occupation.. etc. ).
Methodology: A descriptive analytical design study was conducted on non-Probability (convenient sample), Starting in the period December 1st 2014 to August the 3rd 2015. which consists of (150) pregnant women. Were selected of (4) health centers 2 of each sector in the Hilla city as randomly selected of the general population. The researcher used rated on (3- level type Likert scale), by (Lindgren 2005) which is on the other hand the (Health practice questionnaire - II (HPQ-II ). The questionnaire was consisted of (67) items developed and adopted to measure the self-care practices of pregnant women. The current items which were grouped into comprised of two parts which includes the following: Part. I A. Socio-demographic characteristics of mothers, B. Reproductive Information. Part II. Items of pregnant mother practices. A pilot study has been carried out to test the reliability of the questionnaire and content validity has been carried out through the (22) experts in the different fields. The reliability Coefficient through of the calculated (alpha Cronbach's) was (a±= 0.827). The researcher gathered the subjects responses through the questionnaire & face-to face interview as one of the methods of data collection. Statistical analysis was conducted to determine a frequency distribution of responses for each item as reported for the entire sample.
Results: "overall" Results shows of the study showed that the final evaluation of the practice of self-care during the period of prenatal he was a good 50%.The present study demonstrated no statistically significant relationship between the demographic variables and practices of the self- care.
Conclusions: The results achieved in all studied self-care practices among mothers during pregnancy (nutritional, physical activity, personal hygiene, rest and sleep, other practices), it was of a good level of the assessment
Recommendations: The present study recommends the continuation of ministry of health and public mass media which have a great role to play in creating awareness about prenatal care among pregnant women as well as among deprived populations in the other places. Encouraging the pregnant mothers to commitment through dietary programs toward vegetable-based diets rich in a variety of vegetables, fruits and pulses minimally cereals, nuts, fat diets and sweets.

Objectives: To assess of psychological status of orphans in orphanages in Baghdad city.
Methodology: A descriptive correlation analytical study included purposive (non-probability) sample of (50) orphan was selected for the present study. The data had been collection in 9th January 2015 to 20th February 2015.Data were collected through the use of the constructed questionnaire and the process of interviewing to orphans children. Data were analyzed through the application of descriptive statistical analysis (percentage, frequency, mean of score and S.D) and inferential data analysis (Chi-square) with (SPSS, Version 20).
Results: The findings of the study indicate that most of the samples (34%) have both sever, moderate anxiety level and (32%) of the samples have mild anxiety level. There is highly significant relation in anxiety level with sociodemographic data (age, education level, loss of parents), there was significant relation in anxiety level with sociodemographic data (age at admission, financial support).The findings of the study indicate that most (48%) of the samples have mild depression, (30%) of the samples have severe depression level and (22%) have moderate depression level. There is highly significant relation in depression level with sociodemographic data (age, loss of parents), there was significant relation in anxiety level with sociodemographic data (education level).
Conclusion: All orphans affected with the psychological problems in different levels and there are weak relationship between females and males in gender group with psychological problems.
Recommendation: The study recommends that give an educational program to those who were responsible about the orphanage to increase their knowledge toward the psychological problems such as (anxiety, depression). A guidance towards religious and moral education specialist to reduce the conflict between the orphans and development of psychosocial problems.

Objectives: to assess nurses' practice level toward care of fracture treated with external.
Methodology: A descriptive study was carried out at orthopedic wards in Al-Zhrawi Surgical Hospital -Missan Governorate. The study started in November 11th, 2014 to June15th, 2015. A non-probability sample of (50) orthopedic nurses (male & female) who were working in orthopedic wards. The data were collected through the use of questionnaire, which consists of three parts, part (1) Demographic data form that consists of (8) items, part (2) concerning nurses' practices level toward patient treated with external fixation consist of (25) items, part (3) consist of (9) items concerning with external fixation device care. Checklist was used to collect data for orthopedic nurses. The validity of the checklist was determined through presenting it to (15) specialist expert and its reliability were determined through a pilot study which was carried out through the period of (22 Jan to 10th Feb, 2015). Descriptive statistical analysis procedures inferential analysis procedures were used for the data analysis.
Results: Discussions of the study result indicated that the majority of items had low M.S (less than1.66)
Conclusion: the results show that it conclude that the orthopedic nurses have inadequate or deficit in some aspects related to postoperative care for patient undergoing external fixation surgery in orthopedic wards.
Recommendations: The researcher recommend a special training sessions should be designated and presented to all orthopedic nurses that include specific training programs about nurses' intervention concerning care of fracture treated with external fixation. Authorizing and distributing a manual handbook or pamphlet to all nurses who work in orthopedic wards including nursing interventions in postoperative.

Objectives: To identify nurse's knowledge concerning Braden scale.
Methodology: A descriptive study was conducted in three teaching hospitals in Baghdad and for the period of Feb 1st 2015 to the 28th Feb 2015 and these hospitals is Ghazi Hariri Hospital for specialist surgery, and Baghdad teaching hospital, al-kindey teaching hospital. In order to identify the knowledge of nurses concerning of Braden scale in critical care unit in teaching hospitals. Selected sample intentional (not probability) of (50) and nurse working in the critical care unite in teaching hospitals. Prepared the questionnaire to depending on the objectives of the study, and consisted of two parts, one dealing with public information and the second deals with the knowledge of nurses concerning application of Braden scale. Reliability of the instrument by a group of experts, data were analyzed by using descriptive statistics (frequencies and percentages) in addition to statistics deductive using Pearson Correlation.
Results: The results indicate that most of the sample of nurses have moderate knowledge about the of Braden scale.
Conclusion: The study concluded that there is a relationship between knowledge of nurses with some variables such as level of education, year of experiences in nursing, and experiences in CCU. In general, the study concluded that the nurses had moderate knowledge about the Braden Scale.
Recommendations: The provision of Training Courses for nurses inside and outside of Iraq

Objective(s): The objective of the study to assess the nurse manager performance of planning in hospitals.
Methodology: A descriptive study was carried out to determine the quality of nurse manager role performance of staffing in middle Euphrates governorates hospitals. Non-probability sampling was performed. Convenient sampling of (62) nurse manager was selected of the middle Euphrates governorates hospitals. The study was conducted for the period of 2nd June, 2013 through 30th June, 2013. Through extensive review of relevant literature, a questionnaire was constructed for the purpose of the study. A pilot study is conducted in order to determine the reliability of the study instrument which was used for measuring the determination of quality of nurse manager administrative role performance in middle Euphrates governorates hospitals. Data were analyzed through the application of the descriptive statistical data analysis approach (frequency, percentage, mean) and inferential statistical data analysis approach (t-test, person correlation coefficient, stepwise logistic multiple regression, Spearman-Brown, chi-square).
Results: The findings of the study indicated that through the course of data analysis more than one half of the study sample are in Babylon governorate, the most hospitals are distributed in the city center rather than in the city side or in rural areas, the males nurses are more attend to working as an administrative nurse than the female nurses, the study sample responses to overall evaluation for the majority of the administrative nurse managers' role and duties is highly significant, study subject's responses to the basic components to determine the quality of management performance staffing are at all items a non-significant correlation between the basic components to determine quality of management performance staffing and the different demographic data at p-value more than 0.05.
Conclusion: The study concludes that the nurse managers have a good opportunity to continue their education, because they are to the top working side by management, The nurse managers have a good level of performance relative to their managerial roles and duties, and Working as managers in teaching hospital increases their knowledge about the staffing function determine the quality of nurse manager performance.
Recommendations: The study recommended that the Further studies should be conducted to involve a larger geographical area in Iraq, apply a continuing education courses for the nurse managers to increase their knowledge and performance about the managerial roles and duties especially in the non-teaching hospitals, and Management courses should be developed and improved to increase students' managerial knowledge and performance.

Objectives: To assess the demographic data to the mothers and their hemophilic children and to assess practices of mothers with hemophilic children
Methodology: Non- probability (purposive) sample of 100 mothers with hemophilic children revision to blood disease center in Babylon for maternity and pediatric hospital in AL. Hilla city. The data collected in January 24th until March 1st 2015. A structured interviewing constructed with mothers who were attended blood disease center by questionnaire. The questionnaire form is consisted of five parts which included mother demographic data and child demographic data, and mother's practice questionnaire. The response scored as Likert rating scale (never, sometime and always), The data analyzed by using descriptive statistical measures and inferential statistical measures.
Results: Concerning mothers practices related to care, follow up and nutrition the arithmetic mean was (1.64) which was less than the mean premise (2) this finding indicate poor practices of mothers in care in their care of hemophilic children.
Conclusion: The practices of mothers provided to hemophilic children regarding care, nutrition and follow up was below the required level.
Recommendations: The suggested recommendation. Establish a regularly training program in blood disease centers to new mothers with hemophilic children who were newly diagnosis was essential to improve their practices regarding the care of their children with hemophilia.

Objectives: To assess of health protective behavior for clients with stable angina through use three domains' of dietary habits ,physical activity, and Health follow-up, and also to determine the relationship between health protective behaviors and demographic characteristics.
Methodology: Descriptive study between November 26, 2014 to July 8, 2015 conducted health protective behavior for clients' at out-patient clinics in Al- Nasiriyah city on. A non-probability (purposive sample) of (N=130) clients were matched with them of general population. The data were collected through the use of interview by questionnaire, which consists of two parts (1) divide, section A. Socio-demographic data which consists of 7-items, and part (2) health protective behaviors questionnaire consists of 39-items distributed to seven dimensions include, domains, dietary habits ,physical activity ,and Health follow-up. All the items were measured on scale of (3) Always, (2) Sometimes, and (1) Never. Content validity of the questionnaire was determine through a panel of (17) experts. Reliability and validity of questionnaire was determined through the implicated the cronbach alpha=87
technique of pilot study, and the data was analyzed through the application of descriptive statistical of inferential statistical analysis
Results: The study results showed that the stable angina can occur between the age group (60-69) for clients at outpatient in Al- Nasiriyah city. Most of the study sample (60.8%) is male. (84.6%) of the sample are married. With regard to educational level (25.4%) of the study participants are illiterate, (42.3%) of the study sample of a sufficient income to some extent, and (69.2%) live in rural areas, and (56.9%) of them are unemployed (including housewife). As well, the study indicates the presence of a statistically significant relationship between health protection behaviors and marital status, occupation and level of education of the study.
Conclusion: Stable angina can happen to elderly of clients at out-patient clinics in Al- Nassirya city. The majority of health protective behaviors for clients with stable angina were adequate and good, except physical activity domain was inadequate and need to improvement due to the aging process, which means that they overall experience health behaviors which increase their ability for self-management of illness.
Recommendation: Health education programs should be towards the elderly clients or patients with stable angina for purposes of protect , maintain and promote health especially regarding physical activity domain in all out-patient clinics of the hospitals and the specialized centers. A nation-wide study can be done to add extra of health protective behaviors and can be carried out on large sample size and this characteristics can be used as data base for further research in this is area.

Objectives: The present study aims to assess health promotion behavior of teenage students in Baghdad city and to identify the relationship between students healthy behavior and some characteristics , such as : age, gender , level of education .
Methodology: A descriptive study is carried out in February 4th (2012) to May 5th (2012), Non probability (purposive) sample of (100) teenage students are selected of the intermediate and secondary school in Baghdad city. The data are collected through the use of constructed questionnaire, which consists of seven parts. The analysis of data was preformed through the application of descriptive statistic (frequency, percentage)
Results: The findings of the study indicate that the teenage demographic characteristics has depicted that half of them are age group of (16-18) years (50%) of the sample have acquired better level of knowledge the Nutrition and its patterns and exposure to persecution (30%) , and male more than female in the study sample (60%) have Psychological and mental was more positive answer for boys by (68%) than Girls .Regarding to their education, almost (22%) of them are his forth class in secondary school graduates have better level of knowledge with regard to all domains of health The promoting behaviors.
Conclusions: study concluded that there is a (Sexual behavior) respondent's domain is the best, then followed by (Dietary patterns), (Exposure to persecution) all these domains are pass
Recommendations: The study recommended that all teenagers should take into account the promotion of health behaviors in school. There must be a lesson for Health Education in the science class, or the allocation of a few minutes to explain the importance of healthy behaviors within the prescribed curriculum.

Background: depression is the most psychological distress experienced by patients with cancer and are associated with poorer treatment outcome, increased periods of hospitalization and higher mortality rates.
Objective: To assess the level of depression in patients with different types of cancer and identify the relationship between depression level with some Sociodemographic and Clinical characteristics.
Methodology: purposive (non- probability) sample of 100 cases selected of cancer patients in Merjan medical city /Babylon oncology center. The data collected in January 2nd 2015 to February 28th 2015. A structured interviewing questionnaire constructed with cancer patients through using the depression scales. The data analyzed by using descriptive statistical measures and inferential statistical measures.
Results: Most of cancer patients have severe levels of depression (70%).Most of them were (46-60) age group, females, married, illiterate, lived in the urban and they were housewives. Most of the sample complaining in breast cancer, all of them under surgical and chemotherapy and other types of treatment
Conclusion: The study concluded that most of cancer patients have depression.
Recommendations: Improving the psychological and emotional status for cancer patients of all types by nursing staff, especially after taking chemotherapy treatment. Also coordination between oncology center and the Department of Psychiatry in the hospital to reduce depression level. And educate all government institutions to conduct periodic tests for early detection of cancer, especially breast cancer to reduce spread.

Background: breast cancer is the most commonly diagnosed cancer among women worldwide, although breast screening with Mammography can reduce mortality in breast cancer. Women perceived fear, barriers, benefit, and self-efficacy can affect their decision to participation in Mammography screening.
Objectives: The major objectives of this study were to assess the levels of women's perceived Mammography screening, and to find out the relationships between women's perceived Mammography screening and some women's demographic variables such as age, marital status socioeconomic status, and family history of breast cancer, to Find out the correlation between entire perceived Mammography variables, and to predict the effect of perceived barriers on fear.
Methodology: A Descriptive analytical study was carried out in April 1, 2013 to June 20, 2013.A purposive (non-probability) sample of 100 women who were attending the outpatient clinic at National Center for Early Detection of Cancer in Medical City. Data was collected through the use of the Health Belief Model HBM scale questionnaire and the process of the self- administrative report for each woman as a method for collections data. The questionnaire was modify to achieve the objectives of the study, which consisted of two parts; the first part is concerned with the demographic characteristics of the women and ; the second part consist of four subscales measure four concepts including perceived benefits, perceived self -efficacy, perceived barrier, and perceived fear
Results: Results of the study indicate that most of the women at high level of perceived fear. There were significant relationships between women's perceived Mammography screening and their socioeconomic status, there were significant relationships between perceived benefits with barriers, self-efficacy, and there were significant
relationships between Perceived barriers and self- efficacy, and there were a significant relationship between perceived fears on barriers
Conclusions: work at increase health awareness for women about Mammography screening throughout increase educational programs in all media types and elevate awareness levels for all health providers to play an important roles for women's' awareness to attending the Mammography screening centers.
Recommendation: Health providers who work with women in Mammography screening units need to assess women perception of Mammography screening in order to plan, implement, and evaluate psychological health education programs. And public health education should promote awareness of breast cancer and emphasize the advantages of earlier presentation and diagnosis of this disease.