kufa Journal for Nursing sciences

Background: Miscarriage or spontaneous abortion is one of the prevalent adverse reproductive outcomes, which seriously threatens maternal health around the world. Some demographic features might associate with an elevate risk of spontaneous miscarriage which include cervical incompetence, infection, previous history of miscarriage, maternal passive smoking, age, and body weight.
Objectives: The current study was carried out in order to investigate the association between socio-demographic characteristics of women undergoing miscarriage and their risk for spontaneous miscarriage in Rania city.
Methodology: Quantitative design, a descriptive cross-sectional study was performed to assess the types of miscarriage and associated factors among women in Rania City. Samples of the study are Non probability purposive of (158) sample who attend Rania maternity and pediatric teaching Hospital. Besides two participants induced miscarriage were excluded. The data were collected from 1st June to 15th August 2022 through the utilization of construct questionnaire, data were collected by interview technique face to face approach of the study samples.
Results: The study illustrate socio-demographic characters of miscarried women, the average age was 34.6 years and majority of them have diploma qualification (27.8%), and (61.4%) were house wife, also (48.7%) were in sufficient level of income, furthermore most of the study sample were in normal weight include (50.6%) while only (2.5%) were under weight,( 38.6%) of samples were in passive cigarette of smoking, moreover the samples’ weight and smoking cigarette associated to miscarriage (P= 0.022),(P= 0.003) respectively.
Conclusion: The present study concluded that most common factor where associated with miscarriage was related to sociodemographic features. Excessive focusing on cigarette smoking exposure and maternal weight. Regarding the results of this study, mother’s demographic had relationship to miscarriage.

Background: Nursing is a demanding career that needs strong role models and mentors who can motivate and inspire their colleagues.
Objectives: The study's overarching objective was to conduct a conceptual review of nursing administration.
Methodology: Concept analysis using (Walker and Avant’s, 2005) concept analysis method, and review of the literature was conducted using several databases, “nursing leadership”, “nursing” , “leadership”, “nurse” and “leadership” were searched as keywords. Data sources: PubMed, CINAHL and Google Scholar.
Results: Leadership attributes in nursing were found in this study as self-improvement, teamwork, nursing excellence, creative problem solution, and sway. As with any profession, nursing leadership is predicated on the individual's development, the establishment of trustworthy relationships, and the absolute necessity of the position itself. Many positive outcomes emerged, including higher levels of nursing productivity, the creation of a more cooperative workplace, and increased satisfaction with one has chosen career path.
Conclusion: The findings from this research demonstrate the efficacy of nurse leadership. The results also provide theoretical backing for the contention that nurses of all stripes would benefit from taking leadership training.

Objectives: To assess the pregnant women knowledge toward prevention of urinary tract infection, and find out the relationship between pregnant women knowledge toward prevention UTI and some socio-demographic characteristics.
Methodology: A descriptive study was conducted from 1st of November 2013 and up to the 19th of August 2014 in five typical primary health care centers at Kirkuk City. A non -probability (convenient sample) was used to select the sample of 180 pregnant women aged (15-44) years. A constructed questionnaire format was constructed and comprised (9 items) to assess pregnant woman's knowledge toward prevention of urinary tract infection. Descriptive statistical (Frequency & percentage) and inferential statistics )ANOVA) were used to analyze the data by using SPSS (version 17).
Results: The results of the study revealed that the majority of the study sample within age groups (20-24) and (25-29) years respectively, was primary school graduated, housewife, and living in urban area, and insufficient in socioeconomic status.
Conclusion: The most of pregnant women had adequate knowledge in the most items toward prevention of UTI. In addition, there is a significant difference between the women knowledge toward prevention of UTI and their level of education and occupation.
Recommendations: Implementing an instructional program to raise the knowledge of pregnant women on the causes, symptoms, prevention, and treatments of UTIs as well as distributing scientific journals, booklets, and brochures on the subject.

Diabetes mellitus is a metabolic non-communicable chronic disease in which the body's ability to process glucose is impaired, resulting in higher blood glucose levels. If not controlled, this disease can lead to severe complications. Various plants with medicinal properties can treat chronic diseases, such as diabetes, due to therapeutically important phytochemicals and bioactive compounds.
This study investigated the effect of antidiabetic medicinal plant leaves in controlling blood glucose levels among Wakhi diabetic patients in the Hunza district of Pakistan. The "Wakhis" are an ethnic group living in the remote region of Pakistan.
The method used in this study was a placebo-controlled study. Leaf powders of Moringa oleifera and Lagerstroemia speciosa were filled in capsules of 1000 mg each. The antidiabetic potential of the medicinal plants was estimated by performing the biochemical blood profiles of diabetic patients before and after the trial. After the intervention, the level of glycated hemoglobin (HbA1c) reduced from 8.3±1.8 to 7.5±1.2% significantly (P = 0.0401). The fasting blood sugar (FBS) in the intervention group reduced significantly from 191±49 mg/dL to 169±41 mg/dL (P = 0.0041) after the trial.
According to the findings of this study, the combined herbal capsules effectively controlled the blood sugar of type 2 diabetic patients.
Conclusively, the combination of M. oleifera and L. speciosa have the potential to lower blood sugar levels supplementary to existing regimens.
Further investigation is warranted to explore the mechanism resulting in the observed reduction in sugar levels in type 2 diabetic patients.

Self-management is one of the effective strategies used to maintain glucose levels and prevent complications associated with diabetes. It is the diabetic's responsibility to manage their chronic condition. The management includes monitoring blood glucose levels, taking diabetic medication as prescribed, adhering to a diabetic diet plan, and focusing on physical activity to maintain a healthy blood glucose level. These practices are necessary for the self-management of the disease; however, patients cannot self-manage their disease due to various obstacles.
This qualitative exploratory study investigated the perceived barriers to diabetes management among the diabetic Wakhi population in District Hunza.
Sixteen participants were interviewed in-depth to gain insight into their perceptions of obstacles that impede diabetes mellitus self-management. Four major themes emerged from the analysis, including sociodemographic and cultural barriers, personal barriers, healthcare system-related barriers, and diet-related barriers. Each central theme had subsidiary themes. Diet-related obstacles, healthcare system issues, and social engagement in rural areas constituted the most significant barrier to the management of diabetes.
This study's findings may assist healthcare providers in educating their patients about self-management practices, designing and developing interventions to educate patients, and conducting awareness sessions involving dietitians to educate patients about culturally and socially appropriate diet plans. In addition, the study's identified barriers may guide relevant authorities toward patient-specific self-care interventions.

Background: Young people who develop good habits will find it simpler to keep them than to subsequently change their ways. Despite their great importance to human-beings’ health, large number still do not consume the recommended amount of whole grains.
Objectives: This study aims to (1) identify university students’ readiness to consume whole grains and (2) investigate the differences in students’ Pros, Cons, and Self-Efficacy for consuming whole grains between the groups of gender, living arrangement, and body mass index categories.
Methodology: A descriptive design was used to guide this study. Data were collected for the period from October 10th, 2022 to December 20th, 2022. The study included a convenience sample of 540 undergraduate students who were recruited from humanistic colleges from four public universities in Baghdad City. The study instrument includes participants’ sociodemographic characteristics and body mass index, The Stages of Change Scale for Whole Grain Consumption, and The Self-Efficacy Scale for Whole Grain Consumption. Data were analyzed using the statistical package for social science for windows, version 26.
Results: The study results revealed that more than a half are in the Contemplation Stage of Change for whole grains consumption, followed by those who are in the Preparation Stage, and those who are in the Maintenance Stage. There is a statistically significant difference in the Self-Efficacy of whole grains consumption between gender groups. There is a statistically significant difference in the Pros of whole grains consumption among the body mass index groups.
Conclusion: More than a half still do not intend to consume whole grains. The higher the body mass index, the greater the Pros of whole grains consumption.

Background: Those with polycystic ovarian syndrome, which is a marker of the illness, can develop gestational diabetes mellitus. The frequency of gestational diabetes mellitus in women with polycystic ovaries varies greatly today. The aim of this study was to investigate the concurrent occurrence of gestational diabetes mellitus due to the fact that a variety of additional variables have been associated with the incidence of the condition in women with polycystic ovarian syndrome.
Objectives: this study aims to assess a sizable community-based sample of pregnant women with PCOS and GDM to assess the distinct risk of diabetes depending on the severity of the GDM.
Methodology: a case control study, was conducted on women during their pregnancy, (40 women) non-diabetic and (20 women) diabetic, who participated in kewarash health care center, Raparin health care center and maternal and pediatric hospital in Rania city, from November 1st, 2018 to March 13th 2019. The assessment instrument was created as a questionnaire. It consisted of two parts: sociodemographic data and reasons associated with occurrence of gestational diabetes among women.
Results: Both descriptive statistical analysis (frequency and percentage) and statistical test for data analysis were used to assess the results. It demonstrates that 66.67% The Prevalence of prenatal diabetes mellitus in Rania City/ women with polycystic ovaries. Findings indicated that there is a real correlation between them, which is significant at the 0.0001 level. The results of our study demonstrate a high incidence of gestational diabetes mellitus among pregnant women with polycystic ovarian syndrome in the city of Rania.
Conclusion: According to our study in Rania gestational diabetes mellitus is a major for expectant mothers with polycystic ovary syndrome. Therefore, education of mothers, implementing a nutritious diet and taking part in consistent physical activity, as well as prenatal, perinatal, and postpartum care are initiatives and procedures to decrease the incidence of gestational diabetes mellitus among pregnant women with polycystic ovary syndrome.

The oral cavity is habitat to a wide variety of commensal flora, which may act as a reservoir of factors that influence drug resistance. Bacteria in the oral cavity create biofilms, which makes it easier for horizontal gene transfer to result in the accumulation of antibiotic resistance genes. Methicillin-resistant Staphylococcus aureus (MRSA) carriage rates in the oral cavity are high, according to recent studies. The widespread use of antibiotic prophylaxis among at-risk dental procedure applicants may facilitate MRSA establishment in the mouth. These modifications in the epidemiology of MRSA have significant ramifications for clinical practice, methodological approaches to MRSA carriage studies, and MRSA prevention efforts.

Background: A pressure ulcer (PU), also known as bedsore, pressure injury, or decubitus ulcer, is a localized injury brought on by sustained pressure applied to the skin and underlying soft tissue over an extended length of time.
Aim: This study aimed to identify the outcome and challenges of the application of pressure ulcer prevention project.
Methodology: This is a retrospective hospital-based study, which monitored the pressure ulcer prevention project's (PUPP) results from 2019 to 2021 for 3 years. Data on 21400 patients were gathered from several departments of a hospital in the northern region of Saudi Arabia. The project's main goals were the installation of a wound care team, hospital staff education, ongoing data monitoring, and follow-up visits for inpatient units.
Results: This current study showed that the pressure ulcer prevention project was successful showing a statistically significant reduction of hospital-acquired pressure ulcers (HAPUs) from 1.97% in 2018 to 1.4% in 2019 to 0.53% in 2020 to 0.14% in 2021.
Conclusion: The research concluded the percentage of cases of pressure ulcers was successfully decreased by the PUPP. The project can be expanded and carried out in additional hospitals.

Aim: To determine the relation of conflict management with work productivity among the nursing staff in Babylon educational hospitals. Background: Nursing organizations are particularly prone to conflict; work may be difficult and stressful. power struggles are a significant cause of stress in nursing units. For nursing organizations to function well, early conflict management training is essential
Method: A Descriptive analytic study research the relation of conflict management with work productivity among the nursing staff in Babylon educational hospitals.
Result: there was a direct and significant relationship between conflict management in nurses with work productivity scores in terms of working conditions. (r = 0.028 p= 0.128) and job perceptions (r=0/139,p=0.15).
Conclusion: After gathering data from 306 participation that came from Babylon educational hospitals. Most of the nurses are ¬under 30 years old (75.5 percent) Conflict management was according to the results that appeared in the middle category in this study the researcher determined that relation between conflict management and work productively among nursing staff shows a positive significant relationship between the conflict management score in nurses and their work productivity score.

Background: Adolescents' growth, cognitive development, learning, and general well-being are all affected by sleep, which is both a physiological phenomenon and a behavioral process. Adolescents' physiological and psychological development has a negative effect on their sleep, but it is also possible that access to electronic media and other outside variables like early school starts and the bedroom's surroundings also contribute to bad sleep.
Methodology: A descriptive design was used to guide this study. Data were collected for the period of October 10th, 2022, to December 20th, 2023. The study was carried out through different secondary schools in Holy Kerbala city to assess the effect of excessive use of electronic media on sleep disturbances among adolescents. The samples were selected non-randomly (a convenience sample) from separate areas of the center of Kerbala Holy Governorate, where the samples were chosen from the population only because they were available to the researcher. A sample of 382 total students was chosen to obtain the data. The sample of the study includes 139 females and 243 males.
Results : The study results reveal that the mean of hours students spend in internet is less than a half spend 2-5-hours in internet use (47.4%), followed by those who spend 6-10-hours in internet use (36.3%), those who spend 11-15-hours (9.2%), those who spend less than hour in internet use (5.8%), and those who spend 16-20 hours in electronic media use (1.3%). The study results reveal that the number of hours students spend on electronic media use every day and sleep hours positively predict excessive use of electronic media (p-value = .000, .024) respectively. The study results reveal that the sleep hours negatively predict sleep disturbance (p-value .004). On the other hand, excessive use of electronic media positively predict sleep disturbance (p-value = .000).
Conclusion : The majority of participants in the current study believe that sleep disturbances are strongly correlated with excessive use of electronic media and that the more excessive use of electronic media, the higher the incidence of sleep disturbances.

Background: Because low-grade inflammation may play a role in the pathogenesis of coronary heart disease, and pro-inflammatory cytokines govern inflammatory cascades leading to atherosclerosis, and then to ischemic heart disease.
Objectives: To evaluate the role of two cytokines IL-6 and IL-12+p40 in the etiology of IHD, as well as to observe the relationship of IL-6 , IL-12+p40 and two chronic diseases diabetes mellitus and hypertension in IHD patients.
Methodology: A total of 70 (55 males and 15 females) patients with ischemic heart disease were included in the study. They were admitted to the Coronary Care Unit (CCU) at Ibn Al-Betar Hospital (Baghdad) for a surgical operation during the period July 2022 - April 2023. In addition to the patients, a total of 20 apparently healthy individuals (control group). Serum levels of IL-6 and IL-12+p40 were quantitatively determined in patients and control subjects by means of indirect sandwich Enzyme Linked Immuno Sorbant Assay (ELISA) test.
Results: Serum levels of IL-6 for total patients are (404.8 pg/ml), diabetic (480.3 pg/ml), non-diabetic (250.8 pg/ml), hypertensive (451.6 pg/ml) and non-hypertensive (322.2 pg/ml), patients showed a significant increased serum level of IL-6 as compared to controls (155.7 pg/ml). The diabetic patients also showed a significantly higher level than non-diabetic patients (480.3 vs. 250.8 pg/ml), as well as, hypertensive patients (451.6 pg/ml) versus non-hypertensive patients (322.2 pg/ml). Serum level of IL-12+p40 for total patients (410.2 pg/ml), diabetic (357.7 pg/ml), non-diabetic (458.1 pg/ml), hypertensive (270 pg/ml) and non-hypertensive (420.5 pg/ml) patients showed a significant decreased level of IL-12+p40 as compared to controls (649.3 pg/ml). In contrast, the non-diabetic patients showed a significantly higher level than diabetic patients (458.1 vs. 357.7 pg/ml), as well as, non-hypertensive patients (420.5 pg/ml) versus hypertensive patients (270.0 pg/ml).
Conclusion: proinflammatory cytokine cascades play crucial roles in the onset and progression of IHD.

Objective: This study aimed to assess the knowledge levels and skills regarding care bundle guidelines among nurses in Mosul hospitals.
Methodology: A descriptive study was conducted at pediatric teaching hospitals in Mosul City from November 1, 2022, to May 1, 2023. A purposive sample of 60 nurses working in pediatric teaching hospitals was selected for the study. A questionnaire consisting of three parts was used, including demographic information, nurses' knowledge regarding care bundle guidelines (with four sections), and nurses' skills regarding care bundle guidelines (with four sections). The validity of the questionnaire was established through an expert panel review, and its reliability was assessed using a pilot study with a Pearson's correlation coefficient of r=0.786 (p≤0.05) for test-retest reliability.
Results: The knowledge results for nurses' understanding of care bundle guidelines indicated that 53.3% (32) of them had an unacceptable level of knowledge regarding infection prevention and control. There were no significant relationships between knowledge results and demographic variables, except for the general employment period (p≤0.05).
Recommendations: Based on the findings, it is recommended to provide training courses and workshops for nurses in the pediatric departments of Mosul hospitals regarding care bundle guidelines.

Background: Clinical nursing education is a valuable element of any nursing program and leads to better prepare nursing with the required skills to provide safe and high quality care.
Objectives: This study aims to assess the level of undergraduate nursing students' satisfaction toward their clinical learning in Duhok City.
Material and Methods: A cross-sectional descriptive study design used. A convenient sample of 197 male and female undergraduate nursing students from three nursing stages including second, third, and fourth class at the University of Duhok/ College of Nursing. The researchers of the current study adopted the clinical learning environment inventory (CLEI) questionnaire to investigate nursing students' satisfaction of their clinical learning environment (CLE) for the purpose of data collection. The statistical calculations were performed by John's Macintosh Project Product (JMP Pro) 14.3.0. The general characteristics of nursing students were presented in mean and SD. The comparisons of satisfaction score and its dimensions among students with different characteristics were examined in an independent t-test or ANOVA one-way. The null hypothesis was determined in a two-sided p-value <0.05.
Results: The majority of the participants (64.97 %) were female and most of them (36.04 %) were the third class students. Regarding the clinical training and supervision, 64.98 % of them responded that they had one training session a week with their supervisors, 40.61% their last clinical placement was pediatric teaching hospital.
Conclusion: The current study concluded that nursing students were relatively satisfied and responded positively with their CLE based on their experiences from clinical placements.

Background: The second most frequent site for face bone fractures is the zygomatic arch. Because of its anatomical prominence, zygomatic bone fractures are becoming more common. Since the fracture lines cannot be seen clearly in closed reduction, the fragments are clinically repositioned using digital exploration and crepitus noise or traditional radiography imaging as a guideline.
Aim: The aim of this study to evaluate the accuracy of zygomatic arch reduction by using of portable wireless dental X-ray with an intraoral sensor.
Methods and Materials: This study comprised 15 patients who had isolated zygomatic arch fractures. The study was conducted between February 2021 and September 2022 in the department of oral and maxillofacial surgery at Alwasity Teaching Hospital, with patients ranging in age from 21 to 43. All cases were treated by closed reduction with the use of portable wireless dental X-ray with an intraoral sensor to ensure the reduction intraoperatively.
Results: Three months postoperatively all patients were sent for a new CT scan, we found excellent reduction and bone healing at the fracture site, except only one case was reveal slight depression at the fracture site but was esthetically accepted.
Conclusions: intraoperative use of portable wireless dental X-ray with an intraoral sensor is considered a safe, relatively easy, reliable method in the treating of zygomatic arch fracture.