About Journal

Mosul Journal of Nursing is an international,quarterly, peer reviewed,open access scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. Journal content includes clinical topics, integrative or systematic literature reviews, research, and practice improvement initiatives that provide nurses globally with implications for translation of new knowledge into practice. The journal welcomes studies that aim to evaluate and understand complex health care interventions and health policies and which employ the...
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The Association of BMI, smoking, caffeine consumption and folic acid supplementation with hemoglobin levels in third trimester pregnant women in Erbil city

Amani Layth Hameed; Nidhal Gorgees Hanna; Feedan Tahseen Mohammed Halmi; Sahar Mohammed Zaki

Mosul Journal of Nursing, 2021, Volume 9, Issue 1, Pages 1-13
DOI: 10.33899/mjn.2021.167591

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 pre-pregnant 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.

Assessment of Nurses' Knowledge Toward Nursing Diagnosis in Mosul Teaching Hospitals

tahsein Muhsin Al_Ali

Mosul Journal of Nursing, 2021, Volume 9, Issue 1, Pages 14-22
DOI: 10.33899/mjn.2021.167892

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 p-value=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.

Effectiveness of an Educational Program Directing toward the Domestic Violence among Secondary School Students

Amena Razzaq Jasim; Arkan Bahlol Naji

Mosul Journal of Nursing, 2021, Volume 9, Issue 1, Pages 23-29
DOI: 10.33899/mjn.2021.167929

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.
Keywords: Domestic Violence; Educational Program

Efficacy of Health Belief Model-Based Intervention in Enhancing Breast Cancer Screening Behaviors among Women who work at Al-Najaf Al-Ashraf City

Alaa Abdul-hadi Kadhim; Arkan Bahlol Naji

Mosul Journal of Nursing, 2021, Volume 9, Issue 1, Pages 30-37
DOI: 10.33899/mjn.2021.167945

Objectives: to determine the efficacy of health belief model-based intervention in enhancing women’s breast cancer screening behaviors,  determine correlation between womens age, family  socioecononmic status, breast cancer screening behavior, and breast cancer screening behavior, and (investigate the  differences  in womens breast cancer screening  behavior between  the groups  of educational  qualification,  familys socioeconomic class, self-related health and family history of breast cancer.
Methodology: A randomized controlled trial(True –experimental pretest-posttest I,Post -test II) was conducted using the health belief model. The study included a systematic random sample of 110 women (55 women for the study group and 55 women for control group).
Women who age 22-68-years were selected from Banks of Al-Raafidyn branch Al-Amir, Al-Guri, and Muslim Bin Aqeel in AL-Njaf AL-Ashraf City for the period from (first OF February to thirteen of April, 2020).
 Data were collected through a self-report instrument that includes
First part: The demographic characteristics of the nursing staff (age, marital status, economic status).
Second part: The Perceived Susceptibility Scale, The Perceived Benefits Scale, Self-Efficacy Scale, Health Motivation, The Perceived Severity Scale, and The Perceived Barriers Scale. The validity of the questionnaire and the educational program were verified by presenting it to (9) experts. The sample has received a pre-test, intervention based health belief model, and post-test I, Post- test II. Descriptive and inferential statistics were used to analyze the results of the study using the Statistical Package of Social Sciences (SPSS) version 26 and Microsoft Excel (2010).
Results: The study results revealed that HBM-based intervention was efficacious in enhancing the Perceived Susceptibility, The Perceived Benefits, Self-Efficacy, Health Motivation, The Perceived Severity, and The Perceived Barriers for women in the study group. The researcher concluded that the HBM-based intervention weas efficacious in enhancing women’s screening behaviors for breast cancer
Recommendations: It is empirically important to conduct similar studies on larger sample size across Iraq. It is necessary to incorporate health belief model-based interventions into the curricula of graduate programs in Iraq. Encourage graduate students to adopt intervention-based studies in their future proposed research

ASSESSMENTS 0F THE APPLICATION OF NURSING PROCESS IN SURGICAL WARDS

Munther Natheer AL-Fattah

Mosul Journal of Nursing, 2019, Volume 7, Issue 1, Pages 50-59
DOI: 10.33899/mjn.2019.162875

The nursing process is a  problem-solving framework that enables the nursing staff to plan their care for a patents and clients as an individual  or  group basis . This requires nurses to be accountable for the care that they prescribe with care deliver and to keep clear and accurate records of the discussions .Today, one’s ability to use the nursing process is governed by the standards for pre-registration  for any nursing education as outline.
The present study aimed at utilize the nursing process in Mosul teaching hospitals
The initial sample consisted of  (42) nurses  whose were   selected randomly  from surgical and emergency  units at Mosul teaching Hospitals .
the period of data collection for this  study was carried out  from 20-1-2019 until  20-2-2019 . in Ibn-Sina and AL-Jamhuori teaching hospitals.
The results shows a highly significant of all assessment for applications of nursing process at p. value (0.05) 
In conclusions of this study The nursing process it's very important to enhancing the quality of care especially at surgical field and The highly significant number for all elements of nursing process. Furthermore, the nursing staff cant not be able to make any management without nursing process.
Thus the researcher put some recommendations for the current study such as ;the nursing process case sheet should be putting in patient case folder  , to evaluate the patient and his health status systematically, the nursing staff  and health care team  must be educating to how could they using  nursing process and updating, surgical wards should be formulate a time table for all clients to guide them about their care as a schedules .The head of nursing staff  as a adviser must be enrolled with conferences and educations centers to discuss the implementation of nursing process .
Keywords: nursing care plan, recommender system, data mining.

Assessment of Nursing staff’s Knowledge and Practice regarding Care of Premature Babies in Mosul Teaching Hospitals

Qusay Norry Mohammed; Bakir Faris Alsawaf

Mosul Journal of Nursing, 2016, Volume 4, Issue 2, Pages 70-73
DOI: 10.33899/mjn.2016.160039

Background and aim: Premature is a live born infant delivered before 37 weeks from the first day of last menstrual period .It accounts for the largest number of admissions to neonatal intensive care unit (NICU) . Premature infants can develop a range of problems because their organs are not mature enough. The proper nursing care of premature baby should be established by good nursing performances . The purpose of this study is to assess of nursing staff knowledge and practice regarding care of premature babies in Mosul Hospitals in the (Premature babies units).
Materials and method: A descriptive design carried throughout the period 2nd of December 2013 to March 2nd 2014 employing quantitative research methods to attain the results. The sample of the study was a non-probability purposive sampling which included all the nurses working in the premature units in these four Hospitals the sample consisted of (60) nurses (females).The data were analyzed using the statistical package for social science (SPSS) program version 17 throughout the application of descriptive statistic (frequency, mean, standard deviation and percentage) and inferential statistics (t-test and ANOVA-one way test).
Results: The findings of the study the Having diploma degree, being 40-49 years old, and more clinical experience Nurses in the Premature babies units increase neonatal nursing knowledge and practices.
Conclusions: There are significant differences between knowledge and practice of nursing staff about nursing care for premature babies with regard to age, level of education, and duration of work. Having diploma degree, being 40-49 years old, and more clinical experience in premature babies units increase neonatal nursing knowledge and practices. Recommendation: The study recommends preparing, Nurses should update their knowledge and practice through training courses and training programs for nursing care for premature baby in order to improve their skills and performing statistics by ministry of health of Iraq on the number of premature births in the country in order to reduce this phenomenon and finding appropriate solutions to the problems.

BLOOD TRANSFUSION KNOWLEDGE AND PRACTICES AMONG NURSES IN KIRKUK CITY HOSPITALS

Shelan Qahraman Shakor; Hewa Sattar Salih

Mosul Journal of Nursing, 2020, Volume 8, Issue 1, Pages 14-24
DOI: 10.33899/mjn.2020.164622

Background: Red blood cell transfusions are commonly used in palliative care to treat anemia or symptoms caused by anemia. In patients with advanced disease, there is little evidence of benefit to guide treatment decisions in the face of increased risk of harms. Objectives: To assess the level of knowledge and practices of nurses about blood transfusion for adult patients in Kirkuk city hospitals.
Methods: A purposive study design was conducted in the period from 1st June 2019 to 15th November 2019. the sample includes (80) nurses who were working at (Gynecology and obstetrics, General medicine, General surgery, intensive care unit, Oncology at Azadi teaching hospital, and Kirkuk general hospital.
Results: The number of nurses’ who included in the study was (35%) worked in Gynecology and obstetrics, (25%) worked in General medicine, General surgery, (10%) worked in the intensive care unit, (5%) Oncology, generally nurses had a low level of knowledge but showed best practice level.
Conclusions: The findings showed that the nurses' knowledge of blood transfusion was insufficient which could be detrimental to patient safety, also practice Was optimal in Kirkuk city hospitals
Recommendation: Nurses have the responsibility to update their knowledge and skills in carrying out blood transfusion. The tool developed in this study may be useful for educators and managers to identify gaps in knowledge and inform decisions to address them.
Keywords: Blood transfusion, Knowledge, Practice.

Nurses’ Knowledge about Cardio-Pulmonary Resuscitation in Mosul City

Mahmoud Mohammed Ahmed; Nasir Mufaq Youns; Ahmed Ali Hussein

Mosul Journal of Nursing, 2017, Volume 5, Issue 1, Pages 49-53
DOI: 10.33899/mjn.2017.160051

Background and Objectives: Resuscitation in hospitals and health care facilities, refers to prompt actions aimed to prevent death and providing the best possible chances for human survival. The study aims to assess the nurses' knowledge towards cardiopulmonary resuscitation and to identify the relationship between nurses' knowledge about cardiopulmonary resuscitation and some demographic variables (age, gender, educational level, work place and years of experience).
Material and method: A descriptive study design was adapted to assess the knowledge of the nurses regarding CPR. The sample of the study consist of (122) nurses, (26) female, and (96) male who works in Iben-Sena and Al-Zahrawe teaching hospitals in Mosul City. The sample of the study was selected in the simple random method. Data were collected by using a questionnaire throughout an interview technique. The questionnaire consists of two parts, Part one consists of (5 items) includes some demographic data including age, gender, educational level, work place and previous experience. Part two consists of (23 items) include questions that assess the nurses' knowledge towards cardiopulmonary resuscitation. Data were analyzed and calculated by using SPSS program.
Results: The nurses' knowledge score regarding cardiopulmonary resuscitation record low, (27.942%), and standard deviation (0.609).
Conclusion: The present study reveals that the nurses have poor knowledge regarding the CPR techniques and there are no significant difference between nurses' knowledge about cardio pulmonary resuscitation with demographic characteristics except work place and gender.

Effect Of Job Stress On Job Satisfaction Among Nursing Staff In Sulimani Mental Health Hospitals

Kamal Jummah Ameen; Saman Anwar Faraj

Mosul Journal of Nursing, 2019, Volume 7, Issue 2, Pages 109-119
DOI: 10.33899/mjn.2019.164132

Background: Job stress is regarded as a harmful factor for both employees and organizations, which negatively affects the effectiveness of employees and the efficiency of organizational performance.
Many occupations are exposed to different types of stress in the workplace environment. One of these occupations is nursing, which occupies essential roles and vital parts of the effectiveness of the health care system.
Objective: To investigate the relationship between the effect of job stress on job satisfaction for nurses.
Method: A descriptive study was conducted among nursing staff in mental health hospitals in Sulaimani. The process of the necessary data collection began from 25th May - 10th July 2016 and was obtained through a self-report convenient sample of (75) nurses. They distributed in three hospitals Soz Mental Hospital, Shahid Salahi Muhandis Hospital, and Mental Health Center / Teaching Hospital by using questionnaires were divided into three parts: First, socio-demographic characteristics consisted of eight items. Second, Expanded Nursing Stress Scale (ENSS). This consisted of (57) items ranged in nine subscales. Third, Job Satisfaction Survey (JSS), which included 36 items in nine subscales. Descriptive data and inferential data were used for analysis. the validity of the questionnaire was determined through a panel of (11) experts in the different fields and work settings.
Results: The analysis of the data figured out that total average job stress among nursing staff at the mental hospitals was "Occasionally stressful- frequently stressful". The subscale death and dying from job stress took the highest level. Nursing staff had job satisfaction, subscale payment (salary) from job satisfaction took the lowest level. There were significant statistical relationships between the level of job stress subscales and demographic characteristics except for the training course dimension. There was no statistically significant correlation between total ENSS and total JSS.
Conclusions: The death of the patients played an important role in perceiving job stress. The lack and delay in salary were a major factor in decreasing job satisfaction, although the level of job stress among nurses does not highly record. Also, most of the nurses were satisfied with their work.
Keywords: Stress level, Job Satisfaction, Nursing Staff In Mental Health center

Prevalence of obesity and physical activity among primary school children in Erbil City/Iraq

Saad Jbraeil Sulaiman; Mouroge Hashim AlAni

Mosul Journal of Nursing, 2020, Volume 8, Issue 1, Pages 1-13
DOI: 10.33899/mjn.2020.164353

Background: As inactive lifestyles and a tendency for having a more comfortable life rise in the Iraqi population, obesity prevalence has become a major public health concern particularly among children in the Kurdistan Region Iraq. Moreover, obesity can result in an enormous burden to the economy and public health. Conducting educational programs of physical activity and modifying nutrition patterns among primary school children can be a preventive strategy. The present study was aimed at identifying the obesity prevalence rate and its risk factors among primary school children in Erbil, the Kurdistan Region of Iraq.
Patients and methods: In a cross-sectional descriptive study, 400 children who were 6 to 13 years old were selected from primary schools in Erbil and studied from 2017 to 2019. A researcher-designed questionnaire was employed to gather required socioeconomic and sociodemographic data. For this purpose, face-to-face interviews were carried out with the children’s parents. Moreover, the UNICEF calibrated digital scale was used to measure the children’s weight, a portable stadiometer for their height, and their height and weight for their body mass index. Statistical Package for the Social Sciences (version 22) was used to analyze the collected data.
Results: It was seen that 26% of the students were obese. All age groups and grades had an almost equal prevalence of obesity. Obesity was more prevalent among those students who were males, had child ranking of 1st or 2nd, whose parents lived together, whose parental education was illiterate or primary, whose mother was retired, and whose father was retired. Having an obese mother or father, eating more than 3 main meals per day, physical inactivity, and low socioeconomic status was found to be effective factors in causing children’s obesity. There was a significant relationship between children’s daily physical activity and nutritional status (p=0.000).
Conclusion: Obesity prevalence was higher among inactive primary school children who had an obese mother or father, ate more than 3 main meals per day and had low socioeconomic status. Daily physical activity of children was directly associated with a decrease in obesity prevalence in children.

Assessment of Patients Knowledge about Gastritis at General Kirkuk Hospital in Kirkuk City

Qasim Hussein Mohammed

Mosul Journal of Nursing, 2015, Volume 3, Issue 1, Pages 49-54
DOI: 10.33899/mjn.2015.160020

Background and aim: Gastritis (inflammation of the gastric or stomach mucosa) is a common GI problem. Gastritis may be acute, lasting several hours to a few days, or chronic, resulting from repeated exposure to irritating agents or recurring episodes of acute gastritis). The aim of the study to assessment of patient Knowledge regarding gastritis at General Kirkuk Hospital in Kirkuk city.
Materials and method: descriptive study was carried out on gastritis patients at General Kirkuk hospital in Kirkuk city from the beginning from (10th of June 2013 to5th May 2014) in order to assess knowledge concerning gastritis ,non- probability sampling convenience sample of (50) patients .The data was collected through the application of constructed questionnaire with consist of three parts and were used (SPSS). The Data were analyzed by using descriptive and inferential statistical the frequencies (F), percentage (%), and mean of score.
Results : (74%) of the samples (35>) years old, (76%) of them were male, (54%) of the samples were illiterate, (62%) of them were house wife, (88%) of the samples were married, 40%) of them were (4-6) Working hour per day , 32%) of them have history of hypertension,(72%) of the sample had no family history of gastritis, (66%) of them no smoker, (78%) of them had continuous stress.
Conclusion: type of the patients gender the highest age that having gastritis is (female), almost highest rate of the sample revealed illiterate of the patient. Majority of the sample show housewife occupational of patient. Almost majority of the sample showed that most of patient was married, The highest rate of patient who having gastritis was complain from chronic disease. The majority of samples were having continuous stress, The highest rate of patient was having good knowledge about medical treatment instruct the people about avoiding taking any medication without physician order.
Recommendation: Advice the people to take healthy diet and avoid irritant food, and decrease stress.

Knowledge, attitudes and practices for dialysis nursing staff regarding personal protection means from hospital acquired in Mousl hospital

Aayed ali Bny Uoda

Mosul Journal of Nursing, 2019, Volume 7, Issue 2, Pages 91-99
DOI: 10.33899/mjn.2019.163661

Background: This study intended to assess knowledge, attitudes, and practices regarding standard precautions concerning Hospital acquired protection (HAIs) among hemodialysis nurses in hemodialysis centers in Mosul
Methods: A descriptive study was carried out during the period from 18th  of February 2019until 14th of February 2019. A non – probability purposive sample consisting of 25 nurses.
Results: there were a total of 25 hemodialysis nurses in hemodialysis centers in Mosul. All agreed to participate in the study. Although72% of the nurses knew that their hands could be a source of infection associated with health care, only 36% of the nursing staff washed their hands before contacting another    used 92% by the nursing staff when contacting the patient in the dialysis unit and 40% of nursing staff also wore masks when contacting patient.
Gloves were actually used by 98% of the nurses. 46% of the nurses were usually wearing masks when contacting a patient. Books and journals were the main source of information about (HAI) among 52% of the nurses.
conclusions: The nurses' knowledge of healthcare-related illnesses did not fulfill this purpose because some of the nursing staff did not adhere to personal hygiene practices.
Recommendations: the necessary training programs for nurses in hemodialysis centers on the promotion of hygiene standards and optimal use of personal protection against hospital infection .
Keyword: Knowledge, attitude , practices , nursing staff, dialysis, hospital acquired, infections

ASSESSMENTS 0F THE APPLICATION OF NURSING PROCESS IN SURGICAL WARDS

Munther Natheer AL-Fattah

Mosul Journal of Nursing, 2019, Volume 7, Issue 1, Pages 50-59
DOI: 10.33899/mjn.2019.162875

The nursing process is a  problem-solving framework that enables the nursing staff to plan their care for a patents and clients as an individual  or  group basis . This requires nurses to be accountable for the care that they prescribe with care deliver and to keep clear and accurate records of the discussions .Today, one’s ability to use the nursing process is governed by the standards for pre-registration  for any nursing education as outline.
The present study aimed at utilize the nursing process in Mosul teaching hospitals
The initial sample consisted of  (42) nurses  whose were   selected randomly  from surgical and emergency  units at Mosul teaching Hospitals .
the period of data collection for this  study was carried out  from 20-1-2019 until  20-2-2019 . in Ibn-Sina and AL-Jamhuori teaching hospitals.
The results shows a highly significant of all assessment for applications of nursing process at p. value (0.05) 
In conclusions of this study The nursing process it's very important to enhancing the quality of care especially at surgical field and The highly significant number for all elements of nursing process. Furthermore, the nursing staff cant not be able to make any management without nursing process.
Thus the researcher put some recommendations for the current study such as ;the nursing process case sheet should be putting in patient case folder  , to evaluate the patient and his health status systematically, the nursing staff  and health care team  must be educating to how could they using  nursing process and updating, surgical wards should be formulate a time table for all clients to guide them about their care as a schedules .The head of nursing staff  as a adviser must be enrolled with conferences and educations centers to discuss the implementation of nursing process .
Keywords: nursing care plan, recommender system, data mining.

CAN LOW DOSE OF ISOTRETINOIN CAUSE DEPRESSION

Kasim S. Al-Chalabi; Haitham B. Fathi; Mohammed N. Al-Mallah

Mosul Journal of Nursing, 2020, Volume 8, Issue 1, Pages 60-67
DOI: 10.33899/mjn.2020.164621

Background: Depressive symptoms may associate with the daily recommended dose of Isotretinoin for nodulocystic acne. Does reduce the dose will reduce the incidence of depressive symptoms is still not clearly understood.
Study objective: To compare the types and frequency of depressive symptoms among patients with nodulocystic acne receiving three different low doses of isotretinoin (10mg daily, 20mg every other day, and 20mg daily).  
Study design: Open randomized clinical trial.
 Study setting: Dermatology clinic at Ibn Sina teaching hospital
Patients & methods: 169 patients with severe nodulocystic acne were randomly assigned to one of three isotretinoin regimen groups as follows: 10 mg daily (n=46), 20mg alternate day (n=58), and 20 mg daily (n=65). After a month of treatment, the patient assessed for degree of improvement of acne and incidence of depressive symptoms
Results: The frequencies of depressive symptoms irrespective to the group were as follows: crying in 36 (21.3%), anger in 35 (20.7%), sleep disturbance in 32 (18.9%), isolation in 29 (17.1%), and sadness in 20 (11.8%) of patients. The frequency of crying, anger, and sadness was significantly rose with an increased dose of isotretinoin from 10mg to 20mg daily (p-value equal to 0.02, 0.02, and 0.001 respectively). The summated depressive symptoms rose from (0.52 symptoms) in 10 mg daily to (1.19 symptoms) in 20 mg daily dose and the difference was statistically significant.
Conclusion: Depressive symptoms increased gradually with an increased dose of isotretinoin and reducing the dose to the least effective dose is mandatory.
Key Words: isotretinoin, dose regimen, depression, nodulocystic acne.

The relationship between biofilm formation and presence of fimH and mrkD genes among E. coli and K. pneumoniae isolated from patients in Mosul

Mohammed taha Mahmood; Basima ahmad Abdullah

Mosul Journal of Nursing, 2015, Volume 3, Issue 1, Pages 34-42
DOI: 10.33899/mjn.2015.160018

Background and objectives: Biofilms have a major medical significance as they decrease susceptibility to antimicrobial agents. The decreased susceptibility to microbial agents within a biofilm arises from multiple factors, including physical impairment of diffusion of antimicrobial agents, reduced bacterial growth rates, and local alterations of the microor-ganisms (M.O) that may impair activity of the antimicrobial agent. The aim of the study was to investigate the biofilm formation among coliforms and study the relationship between biofilm formation and the presence of fimH and mrkD genes among E. coli and K. pneumonia isolates respectively .
Materials and method: One hundred and seventy three clinical samples were collected from both gender who visited or admitted to AL- Salam General Teaching Hospital and AL- Wafa’a center for diabetic patients in Mosul city from April 2013 to February 2014, (110) urine samples from patients suffering from urinary tract infections (UTIs) and (63 ) from patients with diabetic foot infections (DFIs). All samples were cultured on selective media as MacConkey and blood agar aerobically. Coliform isolates are identified to species level depending on biochemical and physiological tests and using Rapid ™ ONE panel kit to be conformed to the diagnosis. The ability of coliforms spp. for biofilm formation was assessed using qualitative and quantitative assay. The Congo red agar (CRA) method was used in the qualitative biofilm assay.
Results: Out of (85) bacterial spp. , 44(51.8%) species were biofilm producers. The tissue culture plate (TCP) method was used in the quantitative biofilm formation assay. The results showed that 46(54.1%) spp. produced biofilm strongly. All biofilm producing E. coli and K. pneumoniae spp. which gives strong biofilm formation by CRA method and non-biofilm producer spp. were subjected to PCR for determining the relation between biofilm formation and the presence of fimH gene in E. coli isolates and mrkD gene in K. pneumoniae isolates. The results revealed that all biofilm producing E. coli 15(100%) isolated from UTI samples were positive for fimH gene. While all biofilm producing K. pneumoniae 9(100%) and 5(100%) isolated from UTIs and DFIs respectively were positive for mrkD gene.