Mosul Journal of Nursing

Background and Aim: Pregnancy induces some physiological changes in hemoglobin (Hb)
level. In addition, multiple factors are influencing the Hb level such as dietary intake of iron
and folic acid before and during pregnancy, smoking, the amount of caffeine consumption,
body mass index (BMI) and visiting prenatal health centers. The study aimed to determine
the percentage of anemia among third trimester pregnant women and the relation of these
factors with anemia.
Materials and Methods: This cross sectional study was conducted from October 2019 to
February 2020 on 288 pregnant women aged (17- 48 years) with various gestational ages in
third trimester (28 - 42weeks), who attended different primary health centers in Erbil city,
Iraq. The data were collected by face to face interview and the questioner was designed.
Their hemoglobin concentration was measured by testing the peripheral venous blood and
their BMI before and during pregnancy was calculated using the pregnant self-reported prepregnant weight and their weight and height during pregnancy. Data was entered to Microsoft
Excel 2016 then analyzed by the statistical package for the social sciences (SPSS) version 22.
Results: The results showed a significant relationship between Hb level and folic acid
supplementation, caffeine consumption, routine prenatal visits, and smoking. No significant
relationship was found between BMI and Hb level.
Conclusion: This study concluded that anemia was found more in those who were not
consuming folic acid supplementation, smokers, consuming coffee or tea after meals and they
did not visit health center routinely. No significant relationship was found between BMI and
Hb level.
Recommendations: Encourage pregnant women to do routine checkup, consuming folic acid
supplementation before conceiving and during pregnancy, and avoid smoking and caffeine
consumption.

Background and Aims: Nursing diagnosis is consider a guide, direct the nursing care, and the
foundation for goal setting and the basis for nursing interventions. The aim of the present study is to
assess the nurses’ knowledge toward nursing diagnosis.
Materials and Methods: A descriptive study (cross-sectional design) had been done on nurses’
knowledge toward nursing diagnosis which was carried out during the period from the 1st of
December, 2019 to 15th of June, 2020, A random sample comprised of (49) nurses who worked in Al
– Salam, Al- Jamhurry, and Ibn- Sina Teaching Hospitals in Mosul City - Iraq. The data was collected
through constructed Self-administered questionnaire sheet based on literature review. The instrument
validity was determined through the content validity, by a panel of experts. The SPSS (version 20)
was used for the data analysis. The demographic characteristics of the study samples were reported
by using descriptive statistics (frequencies, percentages, mean, and ANOVA test.
Results: The results of the present study showed that less than half of the samples were belonged to
(20-25) years old, most of them were male, majority of them (73.5%) were married. Also, nearly half
of them were had secondary nursing graduate and less than (5) years. And also showed that there are
no significant differences between nursing demographical characteristics and their knowledge at pvalue=0.005.
Conclusions: The study concluded that the general level of the knowledge among the participants
was more than half (55.1%) had poor knowledge, while (16.3%) had good knowledge regarding
nursing diagnosis.
Recommendations: Based on the results, there is strong need for continuing nursing education
program for all nurses in the hospitals under the supervision of qualified staff in order to increase their
ability to use nursing diagnosis and to improve the quality of care.

Background: Domestic violence is now considered as a global health issue. It is defined as a
threat or physical, psychological and/or emotionally violent act.
Methods: An experimental design was used to guide this study. The study was conducted at
three secondary schools for girls from Al-Mahmudiya district. The study included a sample
of 200) secondary school student girls who were randomly selected. The education program
is implemented through three sessions. Each session is scheduled for 45-minutes.
Study instrument
A questionnaire was adopted from Elabani (2015). The behaviors considered as domestic
violence against women scale was used to measure behaviors that women consider them
implying domestic violence against them.
The study results revealed that was a (a priori p = 0.01) significant difference in the domestic
violence as a concept over time for participants in the study group. The omnibus effect
(measure of association) for this analysis is .658, which indicates that approximately 65% of
the total variance in the domestic violence concept values is accounted for by the variance in
the administered intervention.
Conclusion
The implemented program positively affected the values of the domestic violence as a
concept, for the study group by time compared to the control group.

Background and Aim: Cancer is one of the major of human problems and prostate cancer is a
popular healthy problem in cancers. In spite of the developing treatment methods, prostate cancer
cannot be treated effectively.Therefore, the identification of novel genes that will be role in the
treatment and diagnosis of prostate cancer is of greatest interestmeg3 (meg3 family tumer suprosser
gene are key regulators of programed death cell .
Objective Although studies have saw that this meg 3 has processes, its usefulness in the treatment
and diagnosis of prostate cancer has not been fully elucidated.At the same time, previous studies
have shown that the meg 3gene is associated with important protein apoptosis triggering proteins
such as HAGLR and TSIX. In this study, by using gene expression level, we aimed to investigate
the relationship between the levels of meg3,and haglrgene which the prognosis and apoptosis
processes of prostate cell line.
Materials and Methods: Collected of the sample from normal and cancer tissue type in the cell
line, RNA isolated from the cell, RNA quantitation, cDNA synthesised, cDNA quantitation ,and
Real -time PCR was performed to see the level between two types of genes.
Results: meg3 tumer supresur level was significantly lessened in regulator molecule tissues of a
cell line with prostate cancer . In contrast to HAGLRprotein, no significant difference was detected
in TSIX expression level. However, Our study also showed that low meg3 expression level is
associated with important clinic characteristics of the patient such as tumor grade, stage and breast
cancer type.
Conclusion: Findings of our study show that meg3 has roles in prostate cancer formation and
might be a novel biomarker for the diagnosis and treatment of cancer.

CAD/CAM dental restoration had become a sequence of digital tool and software to perform best
esthetic with strong material. The effect of only three marginal thickness (0.5,1.0 and 1.5mm) on fracture
strength of feldspathic ceramic (FSC) ceramic have been deal within present project Thirty-six (36) die
model were tested in separate, fracture load has been carried out until catastrophic failure occurred using
low speed video recorder. Range of variation at the values exceed 2000N for all the three sets whereas the
mean value of fracture strength for 0.5,1.0,1.5 mm marginal thickness was 1873,2028 and 1296 N
respectively. Standard deviation and coefficient of variance were calculated for the result. The influence
of these three-finishing line depth on fracture strength of FSC was not so clear. Still applying FSC is
promising for prosthodontic restoration as an alternative to the previous metal ceramic. Future studies
could lead to more precise answer to the most suitable finishing line.

Background and objective: Little is known about paraoxonase1 (PON1) activity and its relation to
Coronary Artery Disease (CAD). This study aimed to assess the association of serum PON1 activity with
myocardial infarction and to found out its possible relationship with serum High density lipoprotein
(HDL-C) in patients with MI. This study had also examined age, gender, lipid profile and evaluate of
PON1 activity by changing the parameters as a risk factor.
Methods: This case-control study was carried out at the College of Medicine-Hawler Medical University,
from 18th February 2019 to 18th September 2020. Blood specimens were obtained from MI patients in
Hawler Cardiac center. A total number of 176 participants were enrolled in this study grouped into 120
patients with MI (36 females and 84 males) diagnosed by consultants and 56 subjects healthy controls (30
females and 26 males). Measurements of serum (PON1, Troponin and lipid profile) were determined in
both MI patients and control group. Statistically SPSS version package 20 is used.
Results: The results revealed significant decrease in serum PON1 activity in patients with MI (3.07±0.18
ng/ml) comparing with controls serum PON1 activity (4.79±0.27 ng/ml) (P<0.01). The levels of serum
Total cholesterol, Triglycerides, LDL-C and Troponin in patients with MI were significantly higher
(P<0.01) when compared to controls. According to gender it was 36(30%) in females, in males 84(70%).
Conclusion: The study concluded that patients with MI had low serum PON1 activity.

Background: Epstein Barr virus (EBV) has a unique association with several human malignancies,
especially lymphoproliferative disorders.
Objective: The aim of the present study was to estimate the levels of EBV serum antibodies in children
with ALL.
Material and Methods: Thirty-one children with acute lymphoblastic leukemia who were
attending Nanakali oncology -hematology department in Erbil City. were subjected for antibody
detection of Epstein-Barr (EBV) virus with age ranged (2-12) years. A second group comprised of 30
children with non-malignant condition age ranged (2-12) years regarded as control group.
Both groups were tested for Epstein-Barr virus antibodies assays (EBV-VCA (IgG, IgM), EBV-EA (IgG,
and IgM) by enzyme -linked immunosorbent assay (ELISA).
Results: Regarding the patient groups (ALL) twenty-five (25;80.7%) patients had raised antibody levels
while in the control healthy group, thirteen (13;43.3%) child had raised antibody levels. Regarding the
patients group the numbers and percentages of VCA-IgM (4;12.9%), VCA IgG (12;38.7%), EA IgM
(3;9.8%), and EA IgG (6;19.4%) were higher when compared with the control group. The mean values of EBV (VCA IgG) in ALL group increase in a highly significant manner (p≤0.01) when compared with
the control group, While no significant difference between ALL and control in the mean values of VCA
IgM. There was a significant increase in the mean of EA IgG in ALL than in control group (p≤0.05),
whereas, no significant differences were noticed in EA IgM between the two groups.
Conclusion: The current study shows evidence of active EBV replication in a significant number of
Acute ALL patients.

The study aims to evaluate nurses’ practices toward using Aseptic Techniques, and to identify the
relationships between nurses' demographics including (age, gender, education level, and years of
experiences in kidney transplantation units) and their practices toward aseptic techniques. A quasiexperimental study, quantitative design (One-group) was conducted on nurse’s practice toward aseptic
techniques in kidney transplant units. It was carried out in order to achieve the early stated objectives with
the application of pretest and posttest. A non-probability (purposive) sample of (30) nurses who are
working in kidney transplant unit, that’s selected based on the study criterion, and after obtaining oral
consent from them, those nurses were distributed in kidney transplant units at Medical City complex. The
study Instrument was composed of two Parts: The First Part is concerned with the socio-demographic
characteristics, and the second Part includes Nurses' Practices. Content validity of the instrument was
established through a penal of (12) experts. Reliability of the instrument scales determined the internal
consistency by using test-retest approach through the computation of Pearson correlation coefficient of
the scale which was r=0.83 for nurse' practices. Results have been analyzed through the use of SPSS
"Statistical Package for Social Sciences" model 24.0 by using descriptive and inferential statistical
methods. Findings of the present study revealed that most of the samples were within the age of (40 - 49)
years who were accounted (40%). It has been presented that there were significant differences in the
mean of the study sample between the pre and post test procedures, revealing a significant improvement
in nurses' practices regarding using of Aseptic Techniques. Moreover, a high significant difference was
also presented among the whole study sample at pre and post-test practices, t-test value (8.462) at p value
(.000). The study recommended that nurses should be committed to follow and apply standards of using
the personal protective equipment, sharing in training sessions, improve practices through self-learning
and training, and establishing future studies to measure nurses’ practices toward using personal protective
equipment at all healthcare settings in Iraq

Background: Multiple sclerosis (MS) is a chronic, inflammatory progressive demyelinating
disease of the central nervous system. MS is one of the main causes of disability among young adults, and
its management is a serious challenge for the healthcare system. And it is a debilitating disease that can
partly be controlled with long-term use of disease-modifying therapy (DMT). Adherence of treatment in
MS is essential for the benefits of therapies. However, although neurologists are aware of the
consequences of non-adherence, they generally spend limited time discussing the importance of treatment
adherence with their patients. Treatment for MS focuses on disease management to prevent and treat
relapses, manage symptoms, and slow disease progression.
Objective: The aim of this study is to find out the rate and causes of non-adherence to disease modifying
therapy (DMT) in relapsing multiple sclerosis patients recorded in Sulaimani city multiple sclerosis clinic.
Methods: cross-sectional study was conducted, in which about 350 MS patients with relapsing MS
recorded in Sulaimani Shar teaching hospital Multiple Sclerosis clinic and 124 patients have been
interviewed and evaluated by questionnaires regarding demoFigureic (age, sex, occupation and etc.),
clinical data (type of DMT, duration of illness, side effects, missed injection, clinical course of patients,
disease progression, missing dose and etc.), causes and barriers of non-adherence to treatment. During the
interviews the questionnaire was filled out by the researcher. Data analyzed was performed using SPSS
software version 22.0 and P- value.
Result: The mean age was 36.8±9.89 years. The majority of the gender was female (66.1%) and 64.5% of
participant were married. The of the total respondents using (Betaferon) (41.1%). there were statistically
significant differences between adherent and non-adherent group in type of DMT. However, patients
taking (Betaferon) are more belonged to non-adherent group. The main cause for non-compliance was
memory problem. The overall adherence was 72.5% according to the first criterion (missed $1 injection or tablet). The degree of adherence among MS patients treated with immunomodulatory drugs are high;
however, some patients do not take medications regularly.
Conclusion: The adherence rate is acceptable. It is widely known that treatment satisfaction is related to
adherence. In our study, patients’ level of satisfaction was higher with oral treat¬ments. However, oral
administration showed a greater lack of adherence. The main cause of lack of adherence was memory
problem. In relation to other variables, Side effects of medication, Fear of needles and Tired of taking my
medication showed a positive correlation with treatment adherence.

Back ground and objective: Myocardial infarction is sudden blockage of coronary artery,
result in damage to the surrounding heart muscle. Quality of life it’s a situation with wide
variety, which is influenced Physical wellbeing, psychological condition, in a nuanced way,
personal beliefs, social relations and relations with other persons in the environment. The aim
of the study was to assess quality of life domains in patients with Myocardial Infarction.
Method: A literature search and selection of peer-reviewed and professional journal
publications were conducted, Eastern Mediterranean Health Journal, Zanco J. Med. Sci, The
Medical Journal of Basrah University, Medico-legal Update, Arch Argent Pediatr. Were
found in PubMed, and Google Scholar databases to capture a comprehensive list of peerreviewed studies published between 2007 and 2020.
Results: The present article review concluded that the study showed most of the participant
age were (53-65) years, and more than half of them were males, illiterate, married and mostly
came from urban with half of the patients were retired.
Most of the patients were smoker, have family history of myocadiac infarction with high level
of cholesterol, mostly have hypertension and diabetes mellitus.
The present study revealed that quality of life affected in patient with myocardial infarction.
There were very highly significant association between patients age, education, occupation and Quality of Life Domains.
Conclusion: significant relationship between myocardial infarction and age groups (53-65)
years, males, illiterate, married, smoker, have family history of myocardial infarction with
high level of cholesterol, mostly have hypertension and diabetes mellitus.

Background—Smoking is a risk factor for mucinous ovarian cancer, but its effects on other
ovarian cancer subtypes and on overall ovarian cancer risk are unclear.
Methods— This study was a case control study; it was conducted in Hiwa hospital for
oncology in Sulaimani city. This study conducted from the 1st of June, 2019 to 1st of April
2020, involving 100 ovarian cancer patients and 100 female appeared normal without
ovarian cancer as a controls. All subjects who agreed to participate signed a consent form,
answered a data collection sheet about personal information as age, education, marital state
,education, economic status , physical activity and special habits especially exposure to
passive smoking .
Results— The mean age of the examined subjects wss 44.9 ± 13.9 and 37.9 ± 13.7 for both
cases and control groups respectively, with a significant difference (p< 0.001) Most cases
were house wife 65% and 32% were illiterate with high significant difference (p< 0.001). 40
% of cases were Sufficient economic state . About cigarette smoking (5% , 3%)of women
were active, (2%, 0%) quit, and (31%, 16%) passive smokers and the remaining( 62%, 81%)
were never smokers in case and control groups respectively . So passive women more prone
to ovarian cancer with a significant difference p =0.02 Especially those with > 5 years
passive smoker (87.1%) comparing with 5 years and less in cases group and compared to
control groups p< 0.001.
This study revealed that passive smoking was associated with serous ovarian cancer(15.5%).
Majority of the patients complained from abdominal pain and abdominal distension (76%) as
the first presenting symptom.
Conclusions— the mean age of Ovarian cancer woman was 44.9 ± 13.9 and most of the age
of patients had ovarian cancer were between 40-50 Years. Passive smoker women more prone
to ovarian cancer especially those with > 5 years passive smoker . Passive cigarette smoking
may be associated with serous ovarian cancer .

We aimed to explain the implementation of a caring framework for teaching excellence in nursing
education, especially leadershipin a developing-country context such as the University of Sulaimani
(UoS)/ Iraqi Kurdistan. According to Adams and Valiga, excellence in nursing teaching is a
“complex, multifaceted, multidimensional concept that challenges nurse educators to reflect on
expectations they hold for themselves, students, stakeholders, and all those involved in the
educational process. Caring Framework for Excellence in Nursing Education conceptualises teaching
excellence in three dimensions: excellence in teaching practice, in teaching scholarship and teaching
leadership. This project emphasises teaching leadership including the academic leadership of leaders
(nurse educators) who play a central role in teaching students, and leaders work as designers of
curriculums or courses and who monitor novice faculty members. It is necessary for the leadership
teaching to manifest caring, as nursing education has embraced a philosophical movement that
encourages incorporating caring into nursing curricula.

In human life, organ donation and transplantation is one of the most significant importance to extend
functional life and support quality of life. Also, this process is not related exclusively to medical
teams, but relates to general society because the sources for this process are only human due to ethical
and legal issues. The process requires ethical and legal consideration, because it presents many
challenges and risks to society and the medical community. The aim of this paper is to consider the
advantages of transplantation for human life. It considers the controversy surrounding the ethical and
legal considerations, from the concept of brain death (brain-dead donor) and the market for human
organs (living donor). The operation of organ donation and transplantation are very complex and
sensitive because it directly relates to human life. There should be more careful observation and
diagnosis by the medical team during the donation process and the transplantation process.

Background : Anemia is one of the most common diseases of childhood and it is a health problem
globally, particularly in developing regions. anemia during childhood is strongly associated with
neurological development, and cognitive and immune function, and can lead to mental impairment and
poor motor development.
Aims of the study: The aim of this study was to evaluate the prevalence and risk factors of anemia among
children aged 5 months -12 years in Haditha City.
Methodology: A descriptive quantitative study is carried out at General Haditha Hospital and out clinic in
Haditha City from January 15th 2020 to June 18th 2020 in order to assess prevalence and risk factors
of anemia among children aged 5 months - 12 years . A structured questionnaire was used to collect data
on the characteristics of the children and members of their families. Hemoglobin (Hb) levels were
measured by using a micro chemical reaction method.
Results: In total, 340 children were included in this study. The prevalence of anemia was 82.4% . The
results show that diarrhea and fever in the previous two weeks (23.2%, 52.4%) respectively, and 19.1%
caregivers could identify the optimum timing of complementary feeding but only 20.9% could identify the
first complementary food which should be consumed by infants .
Conclusions: The prevalence of anemia among children 5 months to 12 years of age was 82.4% .The
feeding practice of caregivers was associated with anemia and the caregiver nutritional knowledge was
low . Nutrition improvement projects are needed to reduce the burden of anemia among children .