Mosul Journal of Nursing

Background and Aim: Pregnancy induces some physiological changes in hemoglobin (Hb) level. In addition, multiple factors are influencing the Hb level such as dietary intake of iron and folic acid before and during pregnancy, smoking, the amount of caffeine consumption, body mass index (BMI) and visiting prenatal health centers. The study aimed to determine the percentage of anemia among third trimester pregnant women and the relation of these factors with anemia. 
Materials and Methods: This cross sectional study was conducted from October 2019 to February 2020 on 288 pregnant women aged (17- 48 years) with various gestational ages in third trimester (28 - 42weeks), who attended different primary health centers in Erbil city, Iraq. The data were collected by face to face interview and the questioner was designed. Their hemoglobin concentration was measured by testing the peripheral venous blood and their BMI before and during pregnancy was calculated using the pregnant self-reported 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.

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 1^st of December, 2019 to 15^th 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.

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

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

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

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

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

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

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

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

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

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

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

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