Mosul Journal of Nursing

The study to estimate of nurses' practice regarding pulmonary rehabilitation to take away secretions from the lungs of a person infected with covid-19 and to conclude the association between nurses’ practice and their socio-demographic characteristics. Methodology: A descriptive study was carried out at isolation units of Al-Hussein teaching hospital started from June 1st ,2022 to January 27th, 2023. A non-probability (purposively) sample of 41 nurses who were working in isolation units were selected from Al-Hussein teaching hospital located in Thi-Qar, Iraq. The data were collected through the use of observational checklist, which consists of two parts (1) Demographic data form that consists of a (8) items and (2) nurses practice checklists that consists of (3) parts contain (19) procedures, by mean of direct observational technique with isolation units nurses. The validity of the checklists was determined through presenting it to (13) specialist expert and its reliability were determined through a pilot study which was carried out through the period from April 1st, 2022 to April 28th, 2022. The data was analyzed through the use of descriptive and inferential statistical analysis approaches. Results: The results of the study show that the majority of the study sample are within the age group of (20-30) years, female, married, have Bachelor in nursing, working for 6-12 hours, with 1 to 5 years of experience, and 56.1% (23/41) who did not participate in training sessions related to COVID-19. Also nurses' practice were insufficient, where the evaluation shows a clear fail in most responses for 19 procedures regarding pulmonary rehabilitation for patient with COVID-19. Conclusions: The study concluded that the nurses' practice toward pulmonary rehabilitation for patients with COVID-19 is inadequate during evaluation, also there is not statistical association between the nurses' practice and socio-demographic characteristics. Recommendations: The study recommend for the conduction of health intervention programs to raise nurses' practice and skills about pulmonary rehabilitation for patients with COVID-19.

Background: Laparoscopic cholecystectomy is one of the most commonly performed general surgical procedures worldwide, especially in Arab countries. About 35%–60% of patients' experience shoulder pain after laparoscopy.Objective(s): To compare the effects of vibration and Standard exercises on shoulder pain in patients after laparoscopic cholecystectomy.Methodology: A Comparative Study was carried out at the surgical wards of Al-Kindi Teaching Hospital and Baghdad Teaching Hospital. It started from 16th November, 2022 to 20th June, 2023. Seventy patients participated in this study to achieve the study objective. The interview method was chosen to collect the data.Results: The results of the data showed that all of the seventy patients with shoulder pain after laparoscopic cholecystectomy had a severe pain level in the pre-test, while the results of the post-test of the application were at a statistically significant high level through the application of vibration and exercise, which effectively decreased shoulder pain. Conclusion: In this application, both vibration and exercises had a positive relationship in decreasing the intensity of shoulder pain, but vibration had a more significant and obvious role in relieving shoulder pain compared to exercises.Recommendations: The researcher recommended generalizing the results of the experiment to hospitals and surgical wards by applying the vibration and exercise trial to all patients after laparoscopic cholecystectomy.

This descriptive evaluative study aimed to assess the knowledge of diabetic patients about preventive measures for diabetic retinopathy in the Diabetic and Endocrine Centre in Al-Nasiriya City, covering the period from 9th March 2022 to 1st December 2022. The study employed a constructed questionnaire based on an extensive literature review and guidance from the supervisor. The questionnaire was divided into three parts, covering socio-demographic characteristics, clinical information, and an assessment of diabetic patients' knowledge related to retinopathy prevention. Data was collected using interviews, and both descriptive and inferential statistical analyses were conducted. The results revealed that the majority of the study sample were males (68.3%) and most patients were aged 50 years and above (41.7%). Regarding education, the majority were high school or high institute graduates (25.0%), and a significant proportion were government employees (46.7%). The duration of diabetes for most patients ranged from 6 to 10 years (38.3%), and approximately 30.0% did not have any diabetes-related complications. Visual impairment due to diabetic eye problems was reported by 48.3% of the patients. Monitoring blood glucose weekly was the most common practice among the study participants (58.3%), and the majority (73.3%) did not have a history of hypertension. Furthermore, 55.0% of the patients had a history of dyslipidaemia. The study revealed a mean knowledge score of 0.238 (SD=0.0672) out of a maximum possible score of 0.46, indicating a poor to intermediate overall level of knowledge regarding preventive measures for diabetic retinopathy among diabetic patients. However, no significant relationships were found between patients' knowledge and their age, gender, education, diabetes duration, history of hypertension, or history of dyslipidemia conclusion, the study highlighted those diabetic patients had poor knowledge regarding diabetic retinopathy, despite being aware of its impact on eye health. As a recommendation, the study suggests implementing an intensive and comprehensive national-level educational program targeting a large population of diabetes mellitus patients to improve their knowledge about preventive measures for diabetic retinopathy. Health professionals, mass media, and illustrated posters in diabetic clinics and hospitals could play an effective role in this educational initiative.

To preserve the patients' equipment and therapy, such as endotracheal tubes, central lines, and arterial lines, nurses in critical illness settings typically use physical restraints. Due to changes in their level of awareness while a patient in a critical care unit, a high percent of critically ill patients admitted to various types of critical care units may require the use of physical restraints. The nursing care offered to constrained patients and the prevention of its problems depend heavily on the knowledge and practice of nurses about physical restraints. The study was done to evaluate nurses’ knowledge and practices toward physical restraint at critical care unit and to identify the relationships between demographic characteristic and nurses’ knowledge and practices toward physical restraint at critical care unit. Fifty nurses, who were selected by a non-probability (convenient) sampling method, participated in this descriptive study. The instrument of the study was knowledge parts of the questionnaire were initially developed by Janelli et al., (1991) in the U.S.A for nursing homes; in 2006 they were adopted for all hospital units by the original developers (Janelli et al., 2006). The knowledge section of the questionnaire consisted of 20 items, which were used to measure knowledge of nurses towards the definition, indications and contraindications, proper application and legal and ethical considerations of physical restraint use. A three- point ordinal scale (Agree, Uncertain and Disagree) was applied to determine nurses’ responses to the items; it contained negative and positive sentences. Positive items, if answered with “agree,” were considered correct; if answered with “disagree,” items were considered incorrect. To evaluate the nurse's practices with respect to physical restraint, the researcher observes and checks for correct or incorrect performance. The practices checklist for nurses is composed of (94) items divided into six content domains. The result of this research showed that 90% of nurses had low knowledge about physical restraint, and 80 % of the participants had unsatisfactory performance. The study recommended Development of local policies for physical restraint use including detailed descriptions of conditions requiring its use is mandatory.

Background: Infants born at full term consistently had better hematologic and iron status in the short- and long-term when the umbilical cord clamping was delayed for at least 2 minutes after birth. Aim: In this study, the bilirubin serum, hemoglobin, and hematocrit levels of term newborns who underwent early cord clamping versus delayed cord clamping following a typical vaginal delivery were compared. Material and Method: A true experimental study involving (160) pregnant women from the labor ward who were in the second stage of labor. Participants were randomly assigned between the 1st of July 2021 and the 1st of February 2022, samples were selected by using a simple random sampling technique through the Structured Interviewing Questionnaire and the neonatal outcome, hematological parameters (Hemoglobin and Hematocrit), and total serum bilirubin level at the 72 hours after birth, and the participants were randomly divided into two groups early cord clamping (< 1 minute), and delayed cord clamping (more than 1 minute). Descriptive and inferential statistics were applied to the data analysis. A structured interviewing questionnaire; includes two parts socio-demographic characteristics of the pregnant women with early and delayed cord clamping on neonatal outcomes (Hemoglobin, Hematocrit, and Total Serum Bilirubin). Result: Among the 160 participants who completed the study 80 were control group (early cord clamping) and 80 were study group (delayed cord clamping) group. Delayed cord clamping was associated with higher hemoglobin, and hematocrit among newborns after 72 hours. Neonatal hemoglobin ranged from 16.8 ± 1.99 g/dl and there was a statistical reduction in early when compared to the late cord clamping group (17.9± 1.33 respectively). Serum bilirubin ranged from 6.28± 2.89 and there was a significant reduction in early when compared to the late-cord clamping group (8.27± 3.52 respectively). Conclusion: The use of a delayed cord clamp is helpful because it is a quick, easy, and safe maneuver. Delaying cord clamping in term newborns resulted in higher hemoglobin and hematocrit levels without having an unfavorable impact on neonatal characteristics, and significantly higher newborn hematocrit and neonatal hemoglobin levels. In addition to a large rise in blood volume and red cell volume in newborns, it reduces anemia.

Objectives : The research aimed to: evaluate the hemodialysis complications in the dialysis unit at Al-Hussein Teaching Hospital, Nasiriyah city.. Methodology:- A descriptive study approach was used throughout the current investigation, which lasted from 20 October 2018 to February 2019: 80 patients (non-probability) were carefully examined. AL-Hussein Hospital educates at the AL-Nasiriyah Hemodialysis Unit in the city of AL-Nasiriyah. Data were acquired utilizing a self-reported questionnaire for the administrative reporting procedure. The questionnaire has three components: socio-demographic characteristics of the parents (age, gender, educational level, jobs, monthly income and residence). The questionnaire's second portion includes questions concerning chronic hemodialysis complications. The material validity of the instrument was determined by panel experts, and the instrument's internal correctness was determined by pilot study and the Alpha correlation coefficient (r = 0.870). Descriptive and inferential statistical approaches were used to examine the data., using the Social Science Statistical System (IBM SPSS)20.0.Results :- The results showed that the bulk of the sample was in the 7-11 year old age group. The majority of the study sample is male, Level of education, the greater number of students not reading and writing (32.0 %) were accounted for by surveys, job status and the findings showed that the largest proportion of the survey were (unemployed and research subjects are inadequate and accountable (49.0 % ).Much of the study population is rural living. Study findings indicate the highest rate of infection with hemodialysis.Recommendations :- The research advised that family members of hemodialysis patients get instructional health education to raise their understanding of chronic hemodialysis complications..

Background: The placenta is feto-maternal organ. It arises from the trophoblastic layer of the fertilized egg. It works closely with the mother's circulatory system to perform functions that cannot be performed by itself while the foetation is in the womb. The placenta is a separate, distinct organ made up of both maternal and fetal components . Aim: To evaluate the effectiveness of educational programs of the placenta examination, on nurses'/midwives' level of performance. who were taking care of maternal during and after deliveryResearch Design: Quasi-Experimental study was applied at a Maternity Teaching Hospital in Sulaimani City, from August 2021 to December 2021Material and Method: A purposive convenience sample consists of (87) nurses/ midwives who were working in the delivery room, Postpartum ward, and theater room (emergency – cold cases) with different qualifications, and years of experience. A structured interviewing questionnaire; it includes three parts socio-demographic characteristics, professional background of the participants and an Observation checklist of Nurses/Midwives’ performance regarding the placental examination.Result: The findings shows that (90%) of study sample performed poorly on the pretest, but after implementing the education program the majority of them (94.3%) improved their performance and had good practice on the posttest. The result indicate that majority of N/M are above 40 years old, they have skills, but they apply their care in a traditional way, after receiving the program their practice improved.Conclusion: The study concluded that the participants have poor practice regarding the examination of the placenta after delivery, as well as they, follow traditional performance, also the finding indicates that there was a significant association between Nurses/ Midwives `s age with their overall practice.

Background: Osteoporosis is one of the top five illnesses that lead to lengthy hospital stays and disability, but it is still underdiagnosed globally, particularly in developing nations. Consequently, the purpose of this study was to ascertain the awareness of this condition among female employees in Sulaimani city. Methods: A cross-sectional study of female employees at the University of Sulaimani old campus was done from October to December 2022. The convenience sample size was used to enroll 100 female workers in total. The Osteoporosis Knowledge Assessment Tool (OKAT) was used to present a self-administered structured questionnaire to gather information about sociodemographic factors and female awareness of osteoporosis. Results: The age range of the study's participating employees was between 35 and 45 years old, with a mean age and a standard deviation of 35.1 and 12.9 years, respectively. The majority of them (50 percent, 64 percent, and 58 percent, respectively) were unmarried, urban dwellers, barely surviving, and highly educated. According to the participant's knowledge score, 56% had fair awareness about osteoporosis, 38% had strong knowledge, and only 6% had poor knowledge. Age and economic level had a statistically significant relationship with knowledge of osteoporosis (p-value = 0.001), as did knowledge score. Conclusions: The majority of participants scored fairly well on knowledge about osteoporosis. Nonetheless, there was a sizable knowledge gap with relation to the same risk factors. In the current study, the good knowledge score was much lower than the global average. The quality and trustworthiness of information about osteoporosis must therefore be improved through educational efforts

Background:mniotic membrane dressing is the most effective for burn wounds. It was lessexpensive and reduced the level of pain and duration of wound healing due to a burning wound. Objectives To evaluate an Amniotic Membrane in the dressing of second-degree burn. the main objective of this study is to identify the Amniotic Membrane mention its medical advantages, and clarify the roles and benefits in the management and healing of different kinds, and degrees of burn wounds. MethodsA quasi-experimental study was conducted at the Maternity Teaching Hospital in Sulaimaniyah/ Iraq. Participants were 101patients with 2nd-degree burns divided purposively divided into an experimental group that applied Physiological dressing with human amniotic membrane and a control group that followed traditional way or routine hospital care prospectively followed their wound pain level and the number of dressings for both groups, from 3rd April to the end of September 2022. Descriptive and inferential statistics were used for data analysis.ResultThe mean age of the burn case in the control group was 29.7 ± 20.7 years, while the mean age of the study group was 25.6 ± 17.3 years. The study group was composed of 39.6% female patients and 60.4% male patients. There was no significant difference between the two groups regarding gender. 34% of the study group were employed and 62.0% of the study group were housewives. The findings show that statistically significant variations are present between the groups regarding the pain score. There was a significant difference regarding the pain without a dressing change. Conclusion This quasi-experimental study found a significant effect of the Amniotic Membrane in the Dressing of Second Degree Burn To decrease the pain and healing duration.

Parents' attitudes and degree of information surrounding child immunization may have an impact on how they practice. Deficiency of information about vaccinations, low levels of awareness or unfavorable attitudes about vaccinations, and false beliefs or rumors about the safety of vaccinations is major barriers to achieving high vaccination rates in children. To assess the level of knowledge about immunization among parents and to assess the role of an educational program in improving the knowledge of a selected group of parents with low level of knowledge. A quasi-experimental study (pre and post educational program) was carried out on 50 women who were selected from urban and rural areas of Erbil governorate, Kurdistan, Iraq to participate in the educational program. The questionnaire was developed by the researcher. The data were analyzed by SPSS, version 26, software. A p-value of ≤ 0.05 was considered, statistically significant. Chi square test of association (or Fisher’s exact test) was used to compare proportions. The majority (88.6%) of the mothers mentioned that family, mother, or mother-in-law are the source of first information about vaccination. Mothers in Erbil governorate had medium knowledge score before the program. There was development in the knowledge level of them after the implementation of health education program and all of them had high knowledge after the program. There was improvement in the knowledge level of them after the implementation of health education program, and all of them had high knowledge after the program therefore, consistent health education sessions and reminders among mothers will solve the problems of immunization.

Fasting during Ramadan is a spiritual and religious practice. Fasting increases the risk of complications in people with diabetes, including hypoglycaemia and hyperglycaemia. There is a lack of evidence-based medicine in the field of managing diabetes during Ramadan. In fact, a variety of recommendations are based more on expert opinion than on clinical evidence.Objectives: To evaluate the effectiveness of applying Ramadan education and awareness program on blood glucose profile among Type 2 Diabetes Mellitus patients who fast during Ramadan. Methods: This is a quantitative design of a quasi-experimental study which involved 84 type 2 diabetic patients, recruited one week before Ramadan at the Diabetes and Endocrine Center in Sulaimani city. The Enrolled patients were divided in to two groups 43 patients were in the first group, Group A, who participated in a 1-hour education program with repeated follow up throughout the month of investigation. The control group, Group B, was made up of 41 patients who were invited but did not enter in the program.Results: After Ramadan, there was a mean weight reduction of 0.9 kg in intervention group. A considerable improvement observed in the Mean of blood glucose among the intervention group, it declined from (182.3 mg/dl) to (171.3 mg/dl). In the intervention group (74.4%) of patients reported not experiencing any symptoms. whereas, in the control group this proportion is (53.7%).Conclusions: This Ramadan-focused educational program supported type 2 diabetic patients in weight loss, improved glucose control, and safer fasting during Ramadan.

Background: Poor medication adherence is associated with social support the difficulty of the regimen, socio-economic status, mental health issues, and drug side effects especial with elderly type 2 diabetic mellitus (T2DM).Objective(s): to evaluate the application of social support scale for patients with type 2 diabetes.Methodology: The quantitative study used a descriptive study design in Baghdad Teaching Hospital / Medical City Department, and Imam Ali A.S. Hospital / Rusafa Health Department. It was conducted on patients with type 2 diabetes. It started from the 5th of January 2023 to the May 15th, 2023. A non-probability sampling technique (110) patients was chosen to achieve the objectives of the study. After that, a checklist was drawn up consisting of two parts: the first part: the demographic characteristics of the patients, and the second part: it consists of a global scale examined to know the social support for patients with type 2 diabetes.Results: The results of the study showed that there is little social support for most items of evaluated scale and the patients' non-adherence to refilling medication with an average higher than the cut-off point (16), which is (27.93).Conclusion: The study concludes that the social support for patients with type 2 diabetes was mild (weak).Recommendations: The researcher recommends encouraging medical counseling units to conduct educational workshops and seminars for patients about social support and its importance for patients with type 2 diabetes.

ABSTRACT Her2 single nucleotide polymorphism is known to be associated with the risk of breast cancer in women. The distribution of mutations in the Her2 gene differs from one geographic location to another. This study aimed to find two risky genotypes of Her2, Ile/Val Val/Val, in different geographical regions of Sulaimani province. For this purpose, 272 blood samples were collected from healthy women and women who have breast cancer for genetic analysis. The detecting alleles were performed by PCR amplification of the her2 gene and then digestion of the DNA by enzyme BsmAI to find different fragments of DNA representing different genotypes of Ile/Val, Val/Val. Among 272 cases, it was found that the highest rate of single nucleotide polymorphism was in Sulaimani City, 38.9% and the lowest rate of mutation of Her2gene was found in Raparin, 1.8%. The distribution of Ile/Val and Val/Val in other regions was as follows: Garmyan, 6.6% and Halabja, 2.2%. At the same time, the correlation between chronic diseases with breast cancer and with her2 single nucleotide polymorphism was studied. It was found that there were no significant relationships between chronic diseases and Her2 mutation. It concluded that risky genotypes, Ile/Val Val/Val, exist in Sulaimani province, and the highest rate was detected in Sulaimani city.

Background: The recommended respectful maternity care (RMC) developed by WHO and effective communication (EC) between mothers and health staff have a direct positive effect on women’s childbirth experience and satisfaction. This study aimed to examine the effect of RMC and EC on mothers' satisfaction with childbirth by considering women’s demographics and obstetric characteristics. Methods: The study used an interventional design and was conducted at the Shahid Doctor Khalid Teaching Hospital in Koya/Iraq. One hundred women (50 control, 50 intervention) were recruited for this study. Fifty labouring women were randomly selected and enrolled for WHO standard RMC and EC. The control group intervened only in routine hospital care. Sociodemographic, obstetric and childbirth satisfaction data were collected during all stages of labor. The 30-item Birth Satisfaction Scale (BSS) was used to measure childbirth satisfaction. The Mean of BSS was found for intervention and control groups according to sociodemographic and obstetric factors. Results: The Mean of BSS was significantly higher in the intervention group (103.10±9.93) compared to the control group (86.54±10.04) (p. value was 0.001). The mean of BSS was significantly low in the younger age group, primipara, episiotomy, long hospitalization, delayed cervical dilatation, and longer duration of labour. Conclusions: This study found that RMC and EC are highly efficient in improving satisfaction. In the intervention group, low-level education, low perceived economic status, long hospitalization, longer cervical dilation, and the first stage of labor do not significantly affect childbirth satisfaction. Primipara and episiotomy were the main fundamental causes for low childbirth satisfaction in both groups

Background: Advanced surgical procedures for axillary staging of early breast cancer are less invasive. Many patients, however, continued to experience side effects such as infections, hematomas, seromas, paresthesia, shoulder stiffness, and arm swelling, which delayed adjuvant therapy and lowered and degraded their overall health.Aim: The research aimed to assess complications and arm morbidity post-axillary and breast surgery when treating early breast cancer.Patient and method: A prospective observational study was carried out on 110 women undergoing sentinel lymph node biopsy, or sentinel lymph node biopsy plus lower axillary sampling, who underwent ductal carcinoma in situ surgery and invasive carcinoma from March 1, 2021, to April 1, 2022, at Smart Health Tower Hospital and Soma General Surgical Hospital in Sulaimani, Iraq. The study tools included a structured interview questionnaire and an observational checklist. It includes seven parts. Socio-demographic features, history of present illness, clinical examination of the breast and axilla, investigations (breast screening), surgical and non-surgical treatments, and surgical technique to obtain a sentinel lymph node biopsy. The following items are on the observational checklist: wound infection, seroma, hematoma, paresthesias, limited upper extremity range of motion, and lymphedema.Results: The complication rates (infections, hematomas, seromas, paresthesia) in patients with sentinel lymph node biopsy plus lower axillary sampling were higher than in patients with sentinel lymph node biopsy alone. A significant association exists between decreased shoulder range of motion and axillary surgery (p = 0.03). ALND and lymphedema have a very strong correlation (p = 0.001).Conclusion: Despite improvement in axillary surgery for axilla staging in early breast cancer, some patients experienced such complications, which delayed adjuvant therapy and decreased their life quality of life.

Background: The use of complementary and alternative medicine (CAM) has increased globally. It is essential to properly regulate them to guarantee reasonable quality control, ensure consumers' safety, and integrate them into modern medicine. This study was conducted to determine the prevalence of CAM use among the universities in Ninevah Province -Iraq, to their awareness, attitudes, and beliefs.Method: A cross-sectional study was conducted between (2 October-6 December) 2022 in four leading universities (Mosul, Ninevah, Al-Hamdani, and Tal-Afar) in Ninevah Province-Iraq. Data were collected face-to-face via an interviewer-administrated structured questionnaire from a multi-stage sampling of employees. Information was gathered using a data collection form and sent to a Microsoft Office Excel® (2010) spreadsheet. Microsoft Office Excel was used to do statistical analysis and make tables. Statistical significance was determined using a chi-squared test, with a p-value of less than 0.01 representing a significant finding.Results: Our results showed that n= (73.7%) of the sample used complementary and alternative medicines. However, we identified a statistically significant correlation between the female gender and herbal medicine use (p 0.001). Females were shown to have more knowledge regarding the origin of herbal remedies than males, and this difference was statistically significant (p 0.05). Furthermore, there was a statistically significant difference between the percentage of those with no medical problems and those with chronic diseases who used herbal medicines (p 0.001).Conclusion: When writing prescriptions and delivering medications to patients, doctors, nurses and pharmacists should ask the patients for their use of any alternative and herbal medicines and take care to inform patients about the adverse effects of HMs evidence-based information on the body when used with a combination of conventional medicine. Patient counselling, CAM information, and education are necessary to increase patients' awareness of pharmaceutical use.

Background: Type 1 diabetes, also known as DM1, is a chronic disease caused by the destruction of beta cells in the pancreas that produce insulin by the immune system. Insulin deficiency is the direct consequence of the destruction of beta cells.Aim: The main objective of this study is to identify the sociodemographic characteristics of the study samples. The main purpose of this research is to explore the associated factors between children's diabetes mellitus type 1 during the previous year.Methods: A cross-sectional study had been carried out in the Raparin Administration unit for chronic diseases care in Rayna city and Qaladza city and the Raparin administration. non-probability / purposive sample sampling technique used for selection of 70 children who will have chronic type1 diabetes Miletus. The data was collected through structured interviews with mothers and method contact phone numbers. using a special designed questionnaire, During the period of 25 April 2022 up to 30 August 2022. A Statistical Package for Social Sciences (SPSS v.25) was used for statistical analysis.Results: 70 samples of patients had chronic type1 diabetes Miletus. Patient relationships between Associated Factors with DM1 From this study, family history of type 1 diabetes type1 and maternal risk factors (gestational diabetes, infectious diseases during the first trimester of pregnancy, and maternal habits of much drinking tea, coffee during pregnancy. Those risk factors are significant with DM1 because p-values < 0.05. and neonatal risk factors, history of jaundice and neonatal infectious diseases important with DM1 because p-values < 0.05. and nutritional factors cow's milk used before 1 year has a low rate of exclusive breastfeeding, vitamin D- with DM1 because p-values < 0.05.Conclusions: In conclusion, in Raparin children with T1DM From this study it can be concluded had wide range of maternal, and neonatal, nutritional Factors. Risk factors that may have contributed to the development of T1DM.

Background: Caesarean sections are a surgical procedure used when vaginal delivery is not possible or safe, and the global rate has been increasing. Elective caesarean sections are planned for non-medical reasons and carry risks such as bleeding, infection, and organ injury. The study aimed to assess the indications for elective and indicative caesarean sections at teaching hospitals in Mosul City.Method: A descriptive, cross-sectional study design aimed to investigate the indications for caesarean sections and women's reasons for choosing the procedure. Conducted from the 25th of February 2023 to the 1st of June 2023, a simple random sampling method selected a sample of 175 individuals from Mosul hospitals. A structured questionnaire gathered demographic data and information on caesarean section indications and preferences. The data was then analyzed using SPSS version 26.Results: During the study period, the incidence rate for elective and indicative caesarean sections was 31.4% and 68.6%, respectively. Among the reasons for choosing a caesarean section, 9.1% preferred the painless method, 9.1% cited the baby's safety, 12.7% believed it was more satisfying, 7.3% chose it for cosmetic reasons, and 10.9% for emotional health. Interestingly, 23.6% selected caesarean section for a combination of reasons, while 1.8% feared episiotomy and chose it for preserving sexual function. Indications for planned, urgent, and emergent caesarean sections included hypertensive disorders of pregnancy (5.8%), obstructed labor (10%), and fetal distress (15%), respectively.Conclusion: Planned caesareans were often due to previous caesareans, while urgent and emergent ones resulted from obstructed labor and fetal distress. Mothers chose caesareans for the baby's safety, emotional health, and episiotomy fear.Recommendation: the study recommends promoting patient education on delivery options, monitoring and analyzing caesarean section trends, and investing in research to understand long-term consequences and minimize risks.

Background: Healthcare-associated infections (HAIs) are a major public health problem that can affect a patient's health and quality of life. All healthcare providers should be concerned about patient safety and use standard precautions to minimize infection.Aim: The present study aims to evaluate nurses’ Knowledge regarding infection control standard precautions at Shar Teaching Hospital in Sulaimani City.Methods: A descriptive observational design used in this study includes 212 nurses in all departments of Shar Teaching Hospital in Sulaimani city. A probability, the stratified random sampling method is used and the data were collected from 15th March 2022 to 20th September 2022 using a related questionnaire; the questionnaire was composed of three parts, including sociodemographic data, information about the setting of the study, and information related to Knowledge of standard precautions. The data were analyzed by SPSS, version 24. Results: The result of this study indicates that 12.3% of the nurses had poor Knowledge, 30.2% had fair Knowledge, and 57.5% had good Knowledge regarding infection control standard precautions. Conclusion: The present study concludes that the majority of the nurses had good Knowledge regarding infection control standard precautions, and there was a significant association between the level of Knowledge of the nurses and their level of education. Therefore, it is recommended to provide training programs on standard precautions for newly employed nurses at regular intervals, and guideline posters are available for nurses to follow.

Background: Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication and repetitive behaviours, highly restricted interests and/or sensory behaviours beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries.Objectives: The study aimed to develop standards for quality assurance of the educational programs provided to students with children with autism spectrum disorders in the centres of the three cities (Misurata, Zlatan and Elkhoms).Methodology: The study focused on the following problem: To what extent are educational programs and services provided to children with autism committed to quality standards? The study sample consists of (22) centres for Autism Spectrum Disorder in the three cities of Misurata, Zliten and Elkhoms). In order to achieve the study objectives, a scale was developed to assess the quality assurance of the educational programs provided to students with children with Autism Spectrum. This scale consists of (9) dimensions, which cover eighty-seven sub-indicatorsResults: The study results concluded the following: A Proposed Model to develop standards for quality assurance of educational programs provided to children with autism spectrum disorder was built. This proposed model consists of (9) Criteria (Strategic Planning, Management and personnel, The educational environment, Methods and Strategies of Teaching, Services and Programs, professional ethics, family participation and support, Merger and Transition Services, measurement and evaluation. The level of applicability of all quality standards was found to be low, with a relative weight of 47%. The standard of management and employees has obtained the highest level of applicability with a relative weight (55%) (Medium), and the standard of Strategic Planning was found to be the lowest one among all the educational programs and services provided to children with autism spectrum disorder with a relative weight (32%).Conclusion: Standards have been proposed to ensure the quality of educational programs and services provided to people with autism spectrum disorder in Libya, represented in nine dimensions, which are (strategic planning, management and personnel, educational environment, teaching methods and strategies, services and programs, professional practice, family participation and support, integration and transitional services, measurement and evaluation It covers (87) sub-indicators. The level of applicability of all criteria as a whole was low, with a relative weight of (50%)Recommendations: Directing the attention of officials to the need to adopt standards to control the quality of educational programs and services provided to people with autism spectrum disorder. Coordination between the agencies that supervise the services provided to the autism spectrum disorder category at the level of Libya. Finding specialized supervisory oversight bodies and working on training and developing them to supervise and follow up in the field.

Caesarean Section is commonly known as Caesarean birth or C-section, it is a life-saving medical surgery in which the fetus is delivered through an incision in the abdominal wall and womb of the mother for health of both the mother and her embryo. The aim of this study is to evaluate post-Caesarean sections complications among pregnant women who attending the governmental and private hospitals in Sulaimani city. It is a cross-sectional study that conducted in Sulaimani city, Kurdistan Region of Iraq. The samples were collected from 1st October 2021 to 1st February 2022, which involved a convenient sample of 474 pregnant women who admitted to the maternity wards of Sulaimani Maternity Teaching Hospital, Baxshin and Harem Private Hospitals who delivered by Caesarean Section. The data were collected by using a validated questionnaire form that filled in by the researcher with each participant who was agreed for the participation, and after 10-21 days, the researcher asked the delivered women for the post Caesarean section complications if they had through their contact numbers. The findings showed that 428(90.2%) of the participants had no complications. However, 46(9.8%) of the women have had post-Caesarean section complications, and the most frequent complications were wound infection 31(67.5%), followed by bleeding 8(17.3%) and womb lining infection 7(15.2%). In the conclusion, despite of being aware of the post-Caesarean section complications, but most of them are still preferred Caesarean section without any medical reasons, due to influences by the social factors such as relatives or friends, and peer pressure.

The workplace should be a clean and safe place to support the health status of workers. However, there are many potential risks and dangers associated with working in the workplace. The purpose of this study is to determine the type of risks to which workers are exposed in gas power plants.A cross-sectional study was conducted among workers at a gas power plant station in Sulaymaniyah Governorate. Of the 160 workers, 49 participants took part in this study. A questionnaire with structured interview methods was used to obtain data. Workers were selected intentionally according to study criteria. A pilot study was conducted to determine the internal consistency of occupational hazard questions, and reliability was measured using Cronbach's alpha method.The study indicated that workers are exposed to different types of hazards that are classified into physical, radiological, biological, chemical, psychosocial, and ergonomic hazards at the workplace with low and medium levels of risk. Awareness arising from the application of safety rules is essential to reduce the risks of occupational hazards in the workplace.

Background and objectives: GDM (Gestational Diabetes Mellitus) is a growing epidemic that affects pregnant women and their offspring. Medical nutrition therapy (MNT) is the first line of gestational diabetes mellitus management. The study aimed to compare eating habits and food consumption in women with and without Gestational Diabetes Mellitus.Methods: This comparative cross-sectional study was conducted using a questionnaire distributed over 85 pregnant women with the gestational diabetes mellitus and 85 pregnant women without gestational diabetes mellitus visiting Maternity Teaching Hospital at 24 to 40 weeks of gestation from April 1st 2022 to September 1st 2022. With the participants' verbal informal consent, basic data and anthropometric measures were collected. Result: the result showed that the mean age for the gestational diabetes mellitus group was 34.8 ± 5.19 vs. 30.89 ± 5.93 for non-gestational diabetes mellitus group. In terms of medical, obstetric history and anthropometric shows that the following variables (Family history of diabetes, family history of gestational diabetes mellitus, history of gestational diabetes mellitus, para, gravida, pre pregnancy BMI, Hb) there was a statistically significant association between both groups, according to this study only there are significant association between both groups in these food items ((fruit fresh juice, sweetened soft drink, beef, egg, bread, pasta, rice, potato, yogurt, fruit and vegetables, adding sugar, chocolate, pastries and cake, ice cream).Conclusions: there was a statistically significant association between both groups of study regarding eating habit and food consumption. This study will assist in increasing awareness about healthy and balanced nutrition throughout pregnancy, as well as define special nutritional tips for pregnant women.

This study was carried out to isolation of different type of co-infections bacteria from ICU patients with COVID-19 enter through the respiratory tract. The study was conducted in sputum samples were also obtained from treated patients in (Rozhawa hospital emergency - Erbil), in Department of Microbiology. Identify and antimicrobial sensitivity (AST) was done by Vitek 2 apparatus. Entire of sputum samples of Streptococcus pneumonia (41.6%), Acinetobacter baumanni (37.5%), Staphylococcus aureus (8.3%), Sphingomonas paucimobilis (4.2%), Pseudomonas aeruginosa (4.2%) and Klebsiella pneumonia (4.2%). Acinetobacter baumanni bacteria due to its universal antibiotic resistance and widespread proliferation among the study models' patients, the bacterial isolate displayed greater threat.

Background and objective: The identification of victims and an anthropological examination of mass graves are essential steps toward the documenting of scientific findings and the pursuit of justice. Exhumation, anthropological analysis, and individual victim identification were the primary objectives of this research project, which was conducted in a mass grave in Busaya which is located in the Muthanna governorate.Methods: The inquiry involved the uncovering of the bodies of the victims as well as the excavation of their graves. After interviewing witnesses and collecting their testimony, researchers finally got out into the field to begin their investigation. After locating the locations, excavations were carried out on them using the protocols that are well accepted in the scientific community. In the laboratory of the medico-legal institution in Erbil, the leftover skeletons were examined in order to establish the gender of the individual, as well as their age and other details.Results: The grave included 100 bodies, 100 (100%) were males. The results of age estimation reported that the number of young adult bodies 20-30 years old were 40 cases (40%), while 17 cases (17%) was 30-40 aged victims, 10 (10%) was for 40-50 and 50-60 years ages. The rest included 2 (2%) for 15-20 years, and 1(1%) for 60-70 years age group of victims.The results of stature revealed that all cases had stature more than 166-170 cm. All the remained bones were recorded in detail for more documentation.Conclusion: These findings presented the results of an anthropological investigation into a vast Barzanian cemetery located in the Muthanna Afif-2 desert in the southern area of Iraq. Males at the age between 20-30 made up the vast majority (if not all) of those who lost their lives.

Introduction: the importance of recognizing the unknown deceased individual have been well documented. However, generally long bones from sub adult cases are used to estimate age and sex, still in some cases, stature is also helpful or even critical for identification. In fact, few published regression equations are known for consultation in such cases. Materials and methods: All measurements through present investigation were taken in Centimeters. Forearm length and the Maximum Femoral Length were estimated by distance from most proximal to the most distal point of left femur and Forearm bones. Results: the left Femur length mean was 31.40 (SD± 11.91) cm, and 24.02 (SD± 9.12) cm these differences statistically significant (t-test, P< 0.001). In males, the femur length was 37.16 (SD± 10.82) cm. In females was 31.91 (SD± 10.20) cm. regarding forearm length, in males, length was 27.63 (SD± 7.84) cm. In females was 24.69 (SD± 8.59) cm. Conclusions: current study is the first attempt to estimate the sex and age by depending only on long bones in Kurdistan even whole Iraq. Determination of sex, age and identification of human being of deceased person may be the study showed that possible and be practiced by using aforementioned Forensic bone procedures.

Objectives: To assess the effectiveness of the instructional program on knowledge for breast cancer patients undergoing chemotherapy.Methods: A quantitative/Quasi-experimental study was conducted among 118 breast cancer patients, (59 study group, 59 control group) the 59 study group has been exposed to the instructional program while the 59 control group has not been exposed to the instructional program. The instrument used in this study Breast Cancer and Chemotherapy Questionnaire (BCCQ).Results: The study finding shows, a deficit of knowledge among breast cancer patients in the pre-test before the instructional program about breast cancer and chemotherapy, but after the program in the post-test, the knowledge improved, which means that the effectiveness of the instructional program in increasing patients’ knowledge about breast cancer and chemotherapy.Conclusions: The majority of the sample in both the study and control group were answered incorrectly for most items, which means had poor knowledge about breast cancer and chemotherapy for both groups at this point in a pre-test. The patients who were exposed to the instructional program noticed improved knowledge, unlike the patients who were not exposed to the program and still have no information about breast cancer and chemotherapy.Recommendations: The study recommended conducting continuous educational workshops by the Ministry of Health and health institutions to increase women's knowledge about breast cancer and chemotherapy, as well as encourage them to early detection of breast cancer.

Introduction: Nephrotoxicity caused by medicine is a prevalent side effect of many drugs. It can occur as an inpatient or outpatient condition and range in severity from a minor, treatable injury to a severe kidney disease. Symptoms of drug-induced nephrotoxicity include proteinuria, acid-base abnormalities, abnormal urine tests, electrolyte imbalances, hematuria, pyuria, and, most frequently, a decrease in the glomerular filtration rate. Pharmaceuticals or pharmacologic classes have several causes of drug-induced nephrotoxicity, and these reasons are typically categorized based on the histology of the injured kidney. Examples of drug-induced nephrotoxicity include aminoglycoside drugs, radiocontrast material, amphotericin B, selective cyclooxygenase-2 inhibitors, angiotensin-converting enzyme inhibitors, and selective cyclooxygenase-2 inhibitors. This review explores both the clinical signs and underlying processes of drug-induced nephrotoxicity.Aim: The present study concentrates on the reasons and mechanisms of the nephrotoxicity caused by medicines.Methods: The Iraqi Virtual Scientific Library, Google Scholars, and PubMed are the main sources that were relied upon to complete this review.Results: The review demonstrates that different kinds of renal disease can be caused by regular drug use via multiple pathways.Conclusion: Investigation into the crucial problem of drug-induced nephrotoxicity is necessary in order to fully comprehend the mechanisms causing renal damage and how to avoid it. To avoid the negative effects of nephrotoxicity, it is advantageous to maintain proper and consistent hydration, replenish lost electrolytes, and refrain from taking concurrent medications.