kufa Journal for Nursing sciences

Background: There is a lack of research in the assessment of autism risk factors affecting children in the Kurdistan Region.
The aim: The present study has been carried out to find the parental perceptions about socio-demographic, prenatal, perinatal and neonatal factors associated with autistic children.
Methodology: A descriptive cross sectional study was conducted in 120 autistic children's families, where their children diagnosed using the diagnostic and statistical manual of development disorder (DSM-5) (either mother or father) attending special school in Sulaimania city during October 2015 to June 2016. Factorial analysis (principal component analysis) was used in order to identify the effective factors affecting autism.

Results: The characteristic of mother's socio-demographic data showed that the mother's mean age were (28.95 years, SD ± 6.320) and father's mean age was (34.10 years, SD ± 6.475). Prenatal factors showed (43.3%) were used medications while they were pregnant with their children. Mor than half (59.2%) of them were living in a very unhappy emotional status, which estimated as a second principle component affecting autism. Regarding the perinatal factors, more than half of the children were delivered through c/s and selected as the most effective factors affecting autism along with a prolong and induce labor.

Background: The age of advanced mothers is still associated with a range of adverse pregnancy outcomes Objective: To assess pregnancy outcome at 40 years and older among women attending to obstetric teaching hospital of Suleiman

Methodology: A descriptive study was applied on mothers in sulaimani governorate from September 25th 2014 to May 11th, 2015. Non-probability sampling of (200) pregnant women 40 years and older who were attended to obstetric teaching hospital of sulaimani for following up their health. A questionnaire was developed for the purpose of the study. It was comprised of two parts; the first part includes the demographic characteristics of women and the second part consists of questions related to maternal health and fetus. A pilot study was carried out for the period from September 11th to 25th, 2014 to determine the questionnaire reliability through the use of (Test- Retest). A panel of (8) experts was involved in the determination of the questionnaire content validity. Data were analyzed through the application of descriptive statistical data analysis approach (frequency and percentage), and inferential data analysis approach (chi-square).
Results: The results of the study revealed that pregnant women more seasoned than 40 years had more chronic diseases, for example, such as hypertension, diabetes mellitus, so they require visit medical and dietetically treatment, likewise mal presentation, fetal demise happened more in women %40 years old, contrasted with women more youthful than 35 years, cesarean section in women %40 years had a more than two times, they required longer remaining in hospital. While placenta abroptia were about four times more in younger mothers compared to old age. Also abortion in younger women occurred more and needed more medical treatment continues check-ups.

Objectives: The study objectives to assess the occupational hazards on nurses in the operational room at Al-Amarah city hospitals, and to find out the relationship between the occupational hazard for nurses and their socio-demographic characteristics

Methodology: descriptive study was conducted in Al- Amarah city during the period from January 2016 to May 2016. It was the use of non-probability sample (purposive) of (80 nurses) working in the operational room. The data are collected through the interview technique by using of constructed questionnaires, which consists of two parts, the first part contains the socio-demographic characteristics, and the second part consists of (5) domain: accidental (8 items), physical (3 items), chemical (4 items), biological (2 items), and psychological hazard (5 items), totally (22 items). The data are describe and analysis through the using of (SPSS program).

Results: The results showed that the occupational hazards are effect on the nurses was moderate level mean of score MS (1.79), also the maximal effect presented by the Biological hazard, followed by accidental hazard. Moreover, there was a high significant relationship between occupational hazard and their socio-demographic characteristics of age, level of education, and years of experience (P <0.01), while non- significant relationship between occupational hazard and their gender (P > 0.05).

Conclusions: The results showed that the majority of exposure to occupational hazards among male nurses (71.3%) more than female nurses, as well as the study confirmed that nurses who do not have more experience in the field of work are more exposed to occupational hazards than others, also the study showed that more than half of the study sample (62.5%) were graduates of medical technician institutes

Objective: This study aimed to determine the relationship between the addition of Glutathione to sperm freezing medium and cryosurvival rate of sperm motility and viability in asthenozoospermic patients.
Methodology: fifty nine semen samples of asthenozoospermic patients were obtained from the male partner of infertile couples attending the fertility center of al-sadder medical teaching city in Al-Najaf during the period 1st October 2016 until 1st March 2017.Each semen sample was divided into four equal parts, volume of each part is 0.5 ml: first part (before activation), second part (after activation), third part (cryopreservation with sperm freezing medium for one month), and fourth part (cryopreservation with sperm freezing medium plus glutathione for one month ) .
Sperm concentration , sperm progressive motility, sperm viability and sperm normal morphology were counted in first two parts, cryosurvival rate of sperm motility, viability was counted in third and fourth parts .Statistical analysis of the study performed by using Independent t-test and paired test to assess the differences between two groups .
Results: After sperm activation by using the swim up technique ,the study results showed significant increase (P < 0.01) of progressive sperm motility, normal sperm morphology and sperm viability, while there were a significant decrease (P < 0.01) of sperm concentration. cryosurvival rate of sperm motility and viability were significant decrease (p < 0.01) after cryopreservation and thawing processes while the results were revealed significant improvement in cryosurvival rate of sperm motility, and viability ( p < 0.01 ) after the addition of glutathione to the sperm freezing medium.
Conclusion: it can conclude from this study that addition of glutathione to sperm freeze medium improves. (p < 0.01) cryosurvival rate of sperm motility and viability during cryopreservation and thawing processes .

Recommendations: the study recommended to addition 50 microliter of glutathione to sperm freezing media in concentration 1 mM .

Background: Iraq witnessed numbers of wars and invasions since 2003. The last worst trigger is the invasion of the criminal (ISIS) gangs in the end of 2013 and the beginning of 2014. These problems caused millions of displacement and migrants of the Iraqi people. People who experienced the migration and displacement are considered to be diagnosed with a difference of mental disorders because of losing their homes, belongings, habitual residence, and their normal life. In addition to what they have experienced through their displacement, several studies reported that posttraumatic stress disorder (PSTD) is the most common disorder among displaced people.
Objective: the present study aims to estimate the prevalence of posttraumatic stress disorder among internal displaced people in Iraq.
Methodology: This study was based on a cross-sectional design using a structured questionnaire conducted in 97 of displaced people in the Al-Jada's camp, which located in the Qayarah Township, Nenavah governorate, Iraq. The period of the present study was from 1st December 2016 to the 30th of May 2017. A Standard Statistical Package for Social Sciences (SPSS version 22) was used to analyze the collected data.
The results: the study resulted that 59.8 % of the participants were aged between (18 - 29) years old. 57.7% of the participants were male. 60.8 % of them were displaced from Salahudeen governorate. The results illustrated that 67.0 % have a PTSD. Finally, the findings of indicates a high significance at (. 003) in independent t-test between the gender and PTSD. While the one-way ANOVA analysis indicates no significant impact between PTSD and (age, marital status, educational level, residential Governorate, displaced Period, and mental disorders history) on PTSD which indicate sequentially (.292, .762, .370, .370, .110, .448, .610)

Conclusion: the study concludes that there were no actual mental and psychological support and treatment in the camp although that most of the displaced people have diagnosed with post traumatic stress disorder due to the displacement.

Background: Intravenous medication administration practices errors are the most common errors among hospitalized children.
Objectives: to assess intravenous antibiotic medication administration errors by nurses.
Methodology: An exploratory study conducted at Raparien pediatric teaching hospital in Erbil City of Iraqi Kurdistan region from December 17th 2012 to December 17th 2013. A purposive sample consists from 35 nurses working in three shifts of work, each nurse was observed during five procedures of intravenous antibiotic medication administration to hospitalized children. A questionnaire format consist from two parts the first part for socio-demographic data collection and the second part was an observational checklist concerning intravenous antibiotics medication administration procedure used for observing the nurses. The data was analyzed through using descriptive and inferential statistical analysis.
Results: The study findings had revealed that the highest percentages of nurse's errors were in the intravenous medication administration phase and most of nurses have errors of; inappropriate medication calculation, not washing hand, not monitoring patient before and after medication administration. There was significant relationship between nurses characteristics, professional background and intravenous antibiotic medication administration errors.
Conclusion: Majority of nurses practice intravenous antibiotic medication administration incorrectly in regarding to right dose and right documentation. Most of nurses weren't washing their hands before and after each procedure.

Recommendations:Researchers recommended establishment of training course for nursing staffs for improving their knowledge and practices that will help avoid medication errors. Having standard guidelines of intravenous medication administration in each unit .Provide medication preparation rooms with adequate guideline as posters in order to revitalize nurse's knowledge regarding appropriate medication preparation.

Back ground: Iron is required by most organisms as an essential cofactor in many important biological processes. There are controversies regarding the role of nutrients especially iron in respiratory tract infections in childhood. Furthermore, iron deficiency is also associated with impaired immunocompetence and therefore can lead to increased morbidity.
Objective: the aim of this study was to testthe possibility of using the iron profile as a laboratory and diagnostic tests for pneumonia in children.
Methodology: Case-control study was designed to hypothesize that lower iron, ferritin, and TIBC would be associated with a greater risk of pneumonia in children. The study was performed on 150 children with ages between (6 - 72) months, 100 children with pneumonia (57% male) and (43% female,) and 50 control (54% female) and (46% female) in pediatric department of Samarra general hospital from September 2015 till March 2017. The data were analyzed through the SPSS V.20 application, descriptive data analysis was done through frequency, percentage, mean, standard deviation in addition to T-test to compare results.

Results: The results showed there was a significant decreased in the levels of Iron, ferritin, and
hemoglobin when compared to control group(66.48±15.9, 3.99±2.06 and 9.4±1.10 vs 75.86±1.87,
5.79±1.66 and 12.23±1.07 respectively), while there was no significant difference of TIBC in study group
when compared to control group(390.93±47.78 vs 393.74±34.64, respectively).
Conclusion: The results of this study were concluded that the pneumonia in children lead to significant
decrease on iron levels, hemoglobin and ferritin while don't effect on TIBC.
Recommendations:The use early and accurate measurements of iron profile that which includes iron,
ferritin and certain compound which contain iron such as hemoglobin as a laboratory diagnostic tests add
to the diagnostic tool for pneumonia in children.

Background: Perforated peptic ulcer (PPU) is relatively rare, but life threatening with the mortality varying from 10% to 40%. While common causes of peptic ulcer disease are H. Pylori, increased inadvertent use of NSAIDS, smoking and stress of modern life, the specific etiologic agent cannot be incriminated in the causation of its perforation.
Objective: The aim of this study is to evaluate the effect of perforated peptic ulcer in fasting Muslims.
Methods: This prospective analysis was conducted for the risk factors associated with perforated peptic ulcer (PPU) in patients attending Surgical Emergency hospital & Sulaimaniyah Teaching Hospital on 312 cases (246 male & 66 females) during the period of one month before Ramadan (Shaban), holy Ramadan and one month after Ramadan (Shawal) for ten successive years from 2006 to 2015. Descriptive analysis and Chi square test was used to find an association between studying variables.
Result: The number of PPU per month was higher in Ramadan, 16.6 patients per month vs. 7.3 patients per each other month and also high among group 1 fasting patients. Predisposing factors played a major role in these differences.
Conclusion: This study found that the incidence of PPU is relatively high among people who have predisposing factors, including young adults age, but earlier in non-fasting people , male gender, but no difference between the two groups in those using non -steroidal anti-inflammatory drugs, history of dyspepsia. Those patients have previous peptic ulcer disease diagnosed on esophagogastroduodenoscopy more prone to perforation. Long period day after day fasting, but not daytime length duration may increase PPU.
Recommendations: This study recommends that the people with these risk factors must be well informed and need special care to avoid such complications. This study also suggests further studies regarding this subject.

Introduction: Overweight and obese persons are at increased risk for heart failure. A direct effect of isolated obesity on cardiac function is not well established.
Objective: To assess the independent effect of increased body mass index on the left ventricular diastolic function. Methodology: cross sectional study to measure of the left ventricular diastolic function was carried out on (175) apparently healthy persons from both sex (68 female and 107 male) aged between 26-49 years (37.5±9.5). Personnel without any other pathological condition were studied. The study sample was divided into 3 groups according to their body mass index (kg/m²): [normal (18.5-24.9), overweight (25-29.9) & obese ( % 30)]. Echocardiographic indices of left diastolic function were obtained, and dysfunction was assumed when at least two values differed by % 2 SD from the normal weight group.
Results: Diastolic dysfunction was significantly higher in overweight and obese groups compared to the normal body mass index group. The deceleration time was with significant P-value (<0.01) and left atrial diameter (p< 0.01) was more in obese persons, while other diastolic variables were unchanged. No differences were found between obesity subgroups. Body mass index correlated significantly with indices of left ventricular diastolic function.
Conclusions: Subclinical left ventricular diastolic dysfunction was noted in all grades of obesity which correlates with body mass index, and more significant in males than females.
Recommendations: people who are suffering from obesity are recommended for follow up and assessment, also they are in need for encouragement to active participation in weight reduction programs.

Background: Clinical environment is all that surrounds the nursing student within clinical areas, such as places, resources, staff skills, patients, peer group and nursing tutors.
Aim: to assess the clinical learning environment and the influential factors from nursing students perspectives.
Methodology: A descriptive study is carried out in Faculty of Nursing, Sohag University at the end of 1 stsemester (2015-2016). The samplecomprised of (183) out of the total number of 2nd year nursing students. Data was collected using the Clinical Learning Environment Inventory, Obstacles to Learning Clinical Skills tools and analyized by using a descriptive statistics in the form of frequencies, percentages, mean and standard deviation and independent t-test using (SPSS v.16).
Results: The average score of total clinical learning environment scale was (112.3 ±14.0) from the total score (168), and about from 50% to 86% of the students' had a negative opinionstowards theirclinical learning environment, and majority of them 72.2% were moderately satisfied. Although the mean scores of clinical learning environment domains were higher in some domains, nostatistical differences were found between the respondents viewpoints depend on age groups (p>0.05). Moreover,it was found that the mean scores of clinical learning environment domains were higher in females than males but no statistical differences were found between the students opinions based on gender except in the following domains: task orientation and teaching innovation only (17.2±3.4,16.1±4.0;15.7±3.1,15.3±3.9) respectively. The most significant obstacles which faced the students during clinical learning were lack of educational facilities (69.3%), and the least was interference between the training schedule with other trainers (36.6%).
Conclusion: There are significant obstacles and challenges that facenursing students in clinical learning environment, all of which could influence their learning and competencyafter graduation.

Recommendations: Educational authorities at Sohag University and nursing educators in the faculty should pay special attention to the issues and take assertive action to overcome the learningobstacles in order to create a desirable clinical climate.