Volume 9, Issue 2, Summer 2021, Page 138-300


Cost –Effectiveness of the nurses role in antenatal care programmer Implementation in Mosul city

Yusra Mohammed Isma'el; Mohammed Ataallah Ahmed

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 138-153
DOI: 10.33899/mjn.2021.168460

Pregnancy is not a disease, but it is a normal  physiological  process , it is associated with certain  risks to health . Healthy survival of both the woman and the infant she bears is the aim of good antenatal care.
Antenatal care is a preventive method of care it has been shown to be beneficial and cost effective for a pregnant woman who receives in an adequate antenatal care otherwise more complications and poorer  outcomes of pregnancy will appear. The cost of no A.N.C provided  to a pregnant woman is substantially high with increased  rates of complena complications like pre-eclampsia  low birth weight infants both premature and growth retarded and prenatal deaths.
The present study aims to evaluate the cost–effectiveness of the current antenatal care provided by the nurse . A descriptive  observational study was conducted  in AL-Hadba primary health care center Mosul city from 1st of March to 30 April 2004, The study include 2 groups first (group A) examine by the doctor only ( antenatal care without nursel . The doctor completed all information on the pregnant assessment card and physical examination for (100 women) measuring the time need by the doctor to complete this information in first and follow up visit .While was (2-7) min second (Group B) in antenatal care unit the investigator completed the information of pregnant card, gave advice and prepared (50 pregnant women)  for physical examination. The time needed for the nurse to complete the information of pregnant card was (2-7) min.
Analysis of the information in (pregnancy assessment card) indicate non-significant differences in the information gained by both the doctor and the nurse , but the time spend by nurse could  compensate that needed by the doctors for better services and (full pregnant assessment and healthily education). Aiming at reducing the complications such as hypertension which is most prevalent is one example of the cost –effectiveness of the squeal for missing a case of hypertension that will may be end in caesarean section is presented as (a case study).
In conclusion antenatal care should be appointed to a specialized nursing college  graduate Nurse should be appointed in every antenatal care clinic to fulfill their nursing role during the reception & follow up of pregnant  women who consulted the antenatal care the investigator thinks that it is very cost effectiveness to fulfill

Study of Women's Knowledge and Information about Family Planning at Al-Kansaa and Al-Salam Hospital In Mosul City

Yusra Mohammed Isma'el; Mohammed Ataallah Ahmed

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 154-166
DOI: 10.33899/mjn.2021.168518

Family planning services have potential in China to improve people's lives and economic well-being. Family planning methods have a temporary effect after which the ability to conceive and give birth returns to normal.  Contraception can be used based on the desire of both spouses to delay childbearing and to ensure the health of the mother and the fetus, (2013.http://alghad.com).  The aim of the study was to assess the level of knowledge of women's perceptions about family planning, and a descriptive study was conducted of (100) married women of childbearing at Al-Khansa Hospital and Al-Salam Teaching Hospital in the city of Mosul, the study results were that most of the Tamm were aged 35 years or more.  They forgot about (40%), and female employees the most use of family planning methods by (8%).  The study showed that women's knowledge about the female condom was Btseh (19%) and the condom with ballast (27%) by the official intrauterine device, intramuscular injection and the contraceptive pill got the same percentage (41 96), and this indicates that women do not have information about these  Means and accordingly, the researchers recommend increasing the eastern revolutions for women and the feature of housewives about the importance of family planning, educating women about family planning methods and the importance of each method and the urge to call, and from the periodic review to the Ummah Planning Center and from the scheduled appointments, with the aim of rationing the health risks for mothers that occur in the timetable and frequent work of the bile  Characteristic of very young and old age groups, planning the mortality rate of newborns and providing more opportunity for the mother to remain and breastfeed for a long time

Health Beliefs about Cardiovascular Disease among Elementary School Teachers at AL-Rusafa Side in Baghdad City

Faris Tareq Ahmed; Arkan Bahlol Naji

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 167-174
DOI: 10.33899/mjn.2021.168519

Aims: This study aimed at assess health beliefs about cardiovascular disease among elementary school teachers at AL-Rusafa Side in Baghdad City.
Methods: A quantitative descriptive research used to test the approach to questionnaire items was conducted on teachers at elementary schools in Baghdad city from September 26th  2020 to May 30th  2021 to examine their health belief model related cardio vascular diseases. A total of 350 primary school instructors were included in the study. They are chosen using non-probability sampling (convenience sample). Data was collection through the use of a questionnaire and self report. Through the application the descriptive statistic, data were analyzed.
Results: Findings reveals that 233(66.6%) of teachers have unhealthy belief about cardiovascular diseases.
Conclusion: Two third of teachers have unhealthy belief Models regarding cardiovascular diseases, unhealthy belief in susceptibility, severity & barriers domain. Initiate training sessions to educate teachers about risk factors, signs and symptoms of CVD.
Key-wards: Health Beliefs, Cardiovascular Disease, Teachers.

Female Sexual Events Referred To Medico-Legal Institute in Erbil

Yasin Kareem Amin; Dilman Azad Hassan

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 175-187
DOI: 10.33899/mjn.2021.168544

Background and Objective:Sexual abuse is a major global problem that impacts millions of women and claims one survivor every 45 seconds, according to the American Medical Association. It is a significant public health issue, and the societal crisis has grown beyond the limits of social and cultural freedom. Indeed, SA survivors live with the aftereffects of the attack for the rest of their lives. This study aimed to look into Female Sexual Events Referred to Medico-Legal Institutes in Erbil.
Methods:The prospective research is conducted; it covers rape, newly-married, and trauma cases (fall from height or on sharp objects, and traffic accidents). The medico-legal institute received the cases at Rizgary teaching hospital in Erbil governorate between 1st December 2013 and 1st July 2014. It includes a total of 110 cases.
Results: These cases were classified as raped in 50 45%% of cases, traumatic in 30 27% of cases, and married in 30 27% of cases. In raped cases, the age ranged from (2-35) years old, with a mean of (17.446.42), among raped group majority of them have no trauma in the body years (76 % ),  and (64%) in non-use of force and weapon, with the consensual sexual act but regarded as a raped case because they are under 18 years old. And the most common site for the tear in the hymen is at 6 o’clock (i.e.) the posteroinferior area of the vagina. Regarding the duration of the tear in raped cases (32%) is new tear while for traumatic is (70%), and for married is (60%). For the type of sexual act, the most common route is both anal and vaginal, which is (58%). Regarding the frequency of anal injury in sodomy cases (56%), of them have an anal injury (dilated or funnel shape), but dilation with tear is about (2%).
Conclusion:We concluded from our investigation that the presence and extent of the tear in the hymen are critical factors in diagnosing cases of rape and trauma.
Keywords: Sexual Violence, Abuse, Female, Erbil

Morphological and Immunohistochemical Changes in Thyroid Gland Due to Exposure of Formalin in Albino Rats

Paiman Jamal Muhammed Ameen; Nali AbdulQader Ma’aroof

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 188-198
DOI: 10.33899/mjn.2021.168545

Background: Formaldehyde is the most widely used chemical in daily life; thus, chronic exposure to formaldehyde has been revealed to have negative effects on different organs in humans and animals.
Objective: This research was designed to investigate variable thyroid changes arising from chronic formaldehyde exposure by measuring different histomorphometry parameters in accordance with estrogen receptor and S-100 protein expression.
Materials & Methods: In this experiment, two hundred (200) rats were used and divided into two groups (100 male and 100 female), each group was subdivided into control and experimental groups each with 50 rats. The rats were exposed to formaldehyde using (20 ml =92.6ppm formaldehyde), 5hrs / d, for 21 days. Animals were sacrificed,  and thyroid sections were examined for histomorphometry using H&E stain and immunohistochemistry for localization of estrogen receptor and S-100 protein Results: Significant decrease obtained in histomorphometrical measurements in the area of the colloids, area of follicles and width, height and number of the follicles in the cells of both experimental groups with no significant effect of gender in both control and experimental groups except in the height of the cells which showed significant decrease in female more than male.  Formaldehyde exposure showed no significant effect on localization of estrogen receptor but significant increase of S-100 protein localization in both male and female groups. Conclusion: Formaldehyde had similar effect on histological structure of thyroid gland in both sexes causing disruption of thyroid follicles. Exposure of Formaldehyde had no effect on estrogen receptor but caused an increase in S-100 protein localization in both sexes.      
 Key words: Formaldehyde, Rat, Estrogen receptor, S-100 protein

Breast Cancer Risk Factors among Women Getting Mammogram Screening at Azadi Hospital and Private Mammographic Clinics in Kirkuk City

Safiya Ibrahim Mohammed; Ala’a Hassan Mirza Hussain

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 199-206
DOI: 10.33899/mjn.2021.168564

Background: Breast lesions form a heterogeneous group of illnesses that affect epithelial and stromal tissues of breast. There are many factors such as demographic, social and biomedical hazard act as breast lesion development; generally, these factors can be grouped into hazard factors that can be altered (modifiable) and hazard factors that cannot be altered (non-modifiable).
Objectives: To identify breast cancer risk factors of breast among women attending to mammographic clinics in Kirkuk City.
Methods: A descriptive study design carried out in Kirkuk City among (100) women getting mammogram screening, selected by purposive (non-probability) sample. The study initiated from (September 26 th , 2020 –June 27th , 2021).
Results: Fifty-one percent of women who visited the mammogram clinics were belong 40-49 years old with average age 44±9 years. Only 9% of women were smoking. While 21% of them were reporting that they were ex-smokers and 55% of them were some one smoked around. Only 6% of women were playing sport as running (3%) and daily walk (3%) that showed significant difference at p-value= 0.041.And the findings showed that 38% of them were eating a lot of sweet, but that was statistically insignificant. Most of women were eating a lot of fat and carbohydrate (84%) that showed significant difference at p-value = 0.029. Meanwhile only 34% of women were eating red meat, 56%, eating white meat, and 71% eating fresh fruit and vegetable but all that were statistically insignificant appeared.
Conclusion: Age and unhealthy physical and dietary behaviour may associate with breast health problems.
 Key words: Risk Factors, Breast Lesions, Women.

Impact of Serum Prolactin and Testosterone Levels on Male Infertility in Sulaimanyah City

hadeel Abdulelah ibrahim; Zhian Salah Ramzi

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 207-214
DOI: 10.33899/mjn.2021.168676

The appropriateness of the interactions between Prolactin, gonadotrophins and testicular hormones ensures that normal spermatogenesis takes place in the male. So this study is an attempt to classify male infertility depending on WHO criteria of seminal changes and to evaluate serum Prolactin, Testosterone FSH and LH levels in the participants, also determine the association between serum Prolactin, Testosterone levels and  subtypes of male infertility. This study involved three hundred  infertile males having infertility more than one year (cases group) and three  hundred  age-matched fertile males with definite paternity in past two  years (control group) were included to the study from Jan  2018 -Dec 2020 at Shahid Ali Qader  consultant clinic in the Sulaimanyah city. Serum levels of hormones were measured by electrochemiluminescense immunoassay technique. Approximately half of patient's age ranged between 30- 39 years. Sixty eight percentage of cases complained from primary infertility. About 71.3% of patients had infertility duration between 1 - 5 years. This percentage decreased with increasing the infertility years. Most common infertile group was Asthenospermia (34.3%). A higher significant levels of serum Prolactin, FSH and LH found in cases than controls (p<0.001). However, the serum Testosterone levels was significantly lower in cases than controls (p<0.05). Moreover, serum Prolactin levels were found significantly elevated in all infertile subgroups (except Normospermic subgroup) compared to control group, while serum Testosterone levels were significantly decreased in all infertile subgroups (except Normospermic subgroup) compared to control group (p<0.05). So we conclude that; Poor spermatogenesis is associated with high serum Prolactin, FSH,LH levels and low serum Testosterone levels in patients with male infertility. Moreover, elevated serum Prolactin levels and decreased serum Testosterone levels were significantly associated with A, AT, OAT, Azoo and OA infertile males.
Keywords: Male infertility, primary and secondary infertility, Prolactin, Testosterone, spermatogenesis.

Effect of obesity on immune response against covid-19

Rasul Jameel Ali; Hangaw Omar Haji; Sahar Mohammed Zaki; Zhilia yassin aziz; Rayan sarbaz anwar; Hawren sarnger fars; Shahban fars salh; Muhamad saleem aziz

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 215-220
DOI: 10.33899/mjn.2021.169026

Abstract
Background and Aim: In Wuhan, Hubei Province, China, a new coronavirus, now known as SARS-CoV-2, produced a series of acute atypical respiratory diseases in December 2019. A number of studies have investigated for risk factors in attempt to provide prevention and treatmentoptions for the general public. Obesity, along with other comorbidities such diabetes, hypertension, coronary artery disease, and heart failure, has been recognized as a risk factor for catastrophic outcomes in patients with COVID-19 infection. Thus, the present study aimed to determine the association between the incidence of COVID-19 infection and BMI according to the demographic data.
Materials and Methods: This cross-sectional was conducted in the Iraq-Erbil city between 15th October 2020 to 5th of February 2021. Inclusion criteria were participants that tested positive for SARS-COVID-2. The patients classified according to their weight into 6 classes. The semi‐quantitative analysis of IgG and IgM anti‐SARS‐CoV‐2 antibodies was carried out for 200 enrolled participants by ELISA and also vitamin and ferritin level measured for the patients.
Results: The incidence of COVID-19 infection was higher among male by 4% than female. The highest percentage of COVID19 infection reported among the age group of (30-39) years old. The prevalence of the mentioned infection was higher among class 1 obesity group. A total of 200 IgG and IgM tests revealed that the underweight and class 3 obese patients had the highest percentage of positive cases in IgG testing by (100 %) while the obese patient class 1 reported highest percentage of positive IgM cases (47.36 percent). Furthermore, the highest number of underweight people (100%) had vitamin D3 deficiency among patients and the highest percentage of iron deficiency anemia was among class 3 obese patients (25%).
Conclusions: The present study concluded gender balance in COVID19 incidence. The infection of COVID-19 was found in all age groups. However, middle age group appears to be more susceptible. The highest IgG and IgM reported among obese patients. The highest number of underweight people had vitamin D3 deficiency. In contrast, the highest percentage of iron deficiency anemia was reported in class 3 obese patients
Keywords: Age, Body Mass Index, COVID-19, Gender, Vitamin D.

Hospitalization-related Stress and Its Impact on the Monitored Vital Signs of Adult Patients with Corona Virus Diseases-19 In Respiratory Isolation Wards: A Repeated-Measure Study

Marwan Thamer Hajem; Sadeq AL-Fayyadh

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 221-231
DOI: 10.33899/mjn.2021.169849

Background: Psychological stress has an obvious effect on vital signs of patients with covid-19 The body responses to psychological stress includes tachypnea, pulse rate, blood pressure, and temperature. which will lead to increasing the respiratory rate and increase the length of hospitalization therefore, this study was endeavored to examine the causal relationship between hospitalization-related Psychological stress and change vital signs among the targeted subjects.
Aims (s): Examining the impact of psychological stress on the vital signs prognosis of hospitalized adult patients with Covid-2019 in respiratory isolation wards This can be done by  determining  the difference between the prognosis of stressed & non-stressed patients.
Design: A longitudinal design was used to accomplish the above-mentioned goals.
Methods: A purposive sample of 140 patients with Covid-19 who were hospitalized in respiratory isolation wards in two public hospitals, in Baghdad city. The data collection process started December 25th - 2020 – April 15th  2021. Two measures were conducted at seven-days intervals. The Depression Anxity Stress scales (DASS) was the selected tool to examine the study main variables.
Result: There is a statistically significant difference of respiratory rate in response to psychological stress between the 1st and 2nd measures (P=0.004, Sig=0.001 ).
Concluation: The study show, There is a statistically significant difference of respiratory rate in response to psychological stress between the 1st and 2nd measures (P=0.004, Sig=0.001 ).
Recommendation: mointoring vital signes, Provide psychological support to the patient with covid-19.   And all adult age groups must be careful of infection with the virus.
Keywords: Covid-19, vital signs, prognosis, psychological stress.

Assessment of Nurses Knowledge Regarding Delirium in Adult Critical Care Units in Baqubah

Maryam AAyd Ismail; Iman Abbas Fadhil

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 232-247
DOI: 10.33899/mjn.2021.169850

Research Question: What is the knowledge of nurses in assessing patients with delirium in critical care units in Baqubah?
Aim of this study: An evaluation of nursing knowledge regarding delirium assessment in adult Critical care units.  
Method:  A quantitative descriptive survey was carried out among 36 staff nurses working in Critical care units in Baqubah teaching hospital. A self-reporting questionnaire was used to collect data to answer the research question
Sample: All qualified nursing staff meeting outlined criteria and working in the Critical care clinical areas in the selected hospital were invited to participate in the study. A response rate of 80% (n=36) was achieved.
Findings: More than half of the nurses reported that they don’t using validated tools to assess for delirium during their practice. However, critical care clinical practice in Baqubah lacks established protocols to screen for delirium resulting in non-adherence to clinical practice guidelines. Barriers and poor perceptions were identified in this survey in relation to delirium screening. This information can inform future care planning and care to be used to improve standards and quality of care in intensive care units.
Keywords; Nurse, Nurse Knowledge, Delirium, Critical care units, Adults.

The Effect of Sertraline on Oxidative Stress in Patients with Depression

Rahma Ahmad Saadaldin Alkasso; Kassim Salih Abdullah Al Neaimy

Mosul Journal of Nursing, 2021, Volume 9, Issue 2, Pages 148-156
DOI: 10.33899/mjn.2021.169851

Background: There is effect of sertraline on oxidative stress in patients with depression.
Objective: To assess the oxidative stress and total antioxidant capacity in patients with depression, and  evaluate the effect of antidepressant (sertraline) on the oxidative stress and total antioxidant status.
Design: comparative case-series study. 
Setting: The study was conducted in consultatory clinic outpatient departments  of psychiatry physicians.
Methodology: The study period between Nov.1st, 2020 and April.1st, 2021. Thirty female patients newly diagnosed with depression and thirty, sex and age-matched healthy volunteers as control group were participated in the study. Malondialdehyde (MDA) and total antioxidant status (T-AOC) were measured control group and also measured in patients with depression before and after taking sertraline therapy for two months duration.
Results: Depressed patients have higher MDA values than that of the control group (9.191 ± 2.796 and 3.21 ± 0.94 nmol/ml respectively) (P-value = 0.001) and lower level of T-AOC (9.44 ± 3.210 U/ml)  in depressed patients than that of control group (11.26 ± 2.98 U/ml) P-value = 0.027)
MDA values of newly diagnosed patients(9.191 ± 2.796 nmol/ml) were significantly higher than that of patients taking sertraline treatment for 2 months (6.123 ± 1.889 nmol/ml) (p<0.001). The T-AOC values of newly diagnosed patients (9.444 ± 3.210 U/ml) were significantly lower than that of patients taking sertraline treatment for 2 months (10.142 ± 2.362 U/ml) (p<0.122).
Conclusion:  The present study demonstrated that depressed patients have increased level of malondialdehyde and decreased level of total antioxidants capacity than the control group while depressed patients treated with sertraline for two months  have decreased level of MDA and increased levels of T-AOC than their levels before treatment. This result may give a new insight that sertraline may exhibit its effect in the management of depression by acting as an antioxidant.
Keywords: Depression, Oxidative Stress, Sertraline.