Midwives’ Clinical Reasons for Performing Episiotomies in the Kurdistan Region : Are they evidence-based?

Objectives: An episiotomy is one of the most common obstetric surgical procedures and is performed mainly by midwives. The decision to perform an episiotomy depends on related clinical factors. This study aimed to find out midwives’ reasons for performing episiotomies and to identify the relationship between these reasons and the demographic characteristics of the midwives. Methods: This cross-sectional study was conducted between 1st July and 30th September 2013 in three governmental maternity teaching hospitals in the three main cities of the Kurdistan Region of Iraq. All of the midwives who had worked in the delivery rooms of these hospitals for at least one year were invited to participate in the study (n = 53). Data were collected through interviews with midwives as well as via a questionnaire constructed for the purpose of the study. The questionnaire sought to determine: midwives’ demographic characteristics; type of episiotomy performed; authority of the decision to perform the procedure, and reasons for performing episiotomies. Results: The main clinical reasons reported by midwives for performing an episiotomy were: macrosomia/large fetus (38, 71.7%), breech delivery (31, 58.5%), shoulder dystocia (29, 54.7%), anticipated perineal tear (27, 50.9%) and fetal distress (27, 50.9%). There was a significant association between the frequency of these reasons and midwives’ total experience in delivery rooms as well as their levels of education. Conclusion: Most of the reasons given by the midwives for performing episiotomies were not evidencebased. Age, years of experience, specialties and level of education also had an effect on midwives’ reasons for performing episiotomies

Nutritional Characteristics of Pregnant Women and its Relation with Anemia during Pregnancy in a Sample of Kurdish Women/Iraq

Anemia in pregnancy is a major public health problem, especially in developing countries. This study aimed to assess the nutritional characteristics of pregnant women and find out its relationship with anemia during pregnancy. A descriptive, cross-sectional study was conducted on 600 pregnant women who attended four primary health-care centers which randomly selected according to the geographical area. A specially designed questionnaire was prepared by the researcher after extensive review of relevant literature. The severity of anemia is determined according to Alene and Dohe. Estimation and calculation of dietary characteristics was done according to food frequency questionnaire, frequencies and percentage, mean and standard deviations, and Chi-square test of association and regression analysis. There was a highly statistically significant association between anemia with eating vegetables and chicken, and a high significant relation of anemia with eating beef and eating nuts. Furthermore, there was a highly significant association between severity of anemia with eating nuts, and a significant association with eating vegetables, while there was no significant association with other variables. Logistic regression analysis revealed that eating less than normal of vegetables, beef, and nuts were indicated risks of anemia. Eating less than normal of vegetables, beef, and nuts were indicated risks of anemia during pregnancy

Prevalence and Associated Factors with Attending Antenatal Care in Akre City, Iraq

Background and Objectives: Antenatal care is essential for protecting the health of women and their unborn children. Antenatal care utilization is a key intervention in problem detection and treatment, promoting health-seeking behavior, and preparing pregnant women for birth. The present study aimed to investigate the prevalence and associated factors that affect attending and utilizing antenatal care in primary health care centers among pregnant women in Akre city. Methods: A cross-sectional study was conducted in the Maternity Hospital of Akre City from November 21 to February 21, 2022. Data were collected through interviews with 400 women who attended the hospital for delivery and via a questionnaire constructed for the study. The questionnaire included women's socio-demographic characteristics, socio-economic status, obstetrical and reproductive history, and factors affecting antenatal care. Frequency, percentage, and chi-square tests were used to analyze the data. Result: The rate of attending antennal care was 20%. The study findings showed a statistically significant association between attending antenatal care in the last pregnancy with residency, type of family, parity, and previous mode of delivery. Conclusion: The prevalence of women who attend antenatal care is few. Effective media and providing special health care in primary health care centers and services are required to improve the level of awareness of pregnant women for utilizing antenatal care

Postoperative complications of laparoscopic cholecystectomy among women in Permam hospital

Background: Benefits of minimally invasive or laparoscopic procedures include less post operative discomfort. Objective: This study aimed to identify the early postoperative complications of laparscopic cholecystectomy and their association with age, occupation and previous laparatomy. Patients and Methods: 60 female patients  diagnosed with having symptomatic gallstone underwent laparscopic cholecystectomy in Pirmam General Hospital,  during the period from Jan 2015 to Jul 2015. Surgery done by researchers and after 10 days, the patient interviewed and examined for finding the complications, the patient then reexamined after 30 days for the presence of other complications.   Results: Postoperative complications among study sample were as following: shoulder pain (25%), serous discharge from port (3.3%), stone spillage (1.7%), and hernia (18.3%). There was no statistically significant association between postoperative complications and age groups, occupation and history of previous laparatomy(mostly lower abdominal operations ). Conclusion: Laparoscopic cholecystectomy is associated with few and low rate complications the most common distressing complication is shoulder pain

Prevalence and severity of anemia among pregnant women in primary health centers/Erbil City

Anemia in pregnancy is a major public health problem, especially in developing countries. Nutritional anemia is the most common type of anemia worldwide and mainly includes iron, folic acid, vitamin B12 and vitamin C deficiencies. Iron deficiency contributes to half of the burden of anemia globally. The objectives of this study were to find out the prevalence and severity of anemia among pregnant women. A descriptive study was conducted on 600 pregnant women, during the period October 2015 to November 2016 at four primary health care centers in Erbil city. Data gathered through interview with study sample and filling questionnaire format and reviewing their antenatal records. Blood hemoglobin level was measured to assess the severity of anemia. Chi-square test and regression were used to analyze the data. Prevalence of anemia was 46.2%, and 67.1% of the anemic women had mild anemia. There was a significant association of severity of anemia with wife education and occupation, smoking, the number of abortions and cesarean section, ante partum hemorrhage, taking tablets of iron and folic acid per month. The study concluded that prevalence of anemia considered high in Erbil city, the highest percentage had mild anemia

Effect of Lupin (Lupinus albifrons) Flour on Microbial and sensory properties of local Yoghurt

This study conducted and implicated in the General State Company for Dairy Products, Abu-Ghraib/ Baghdad/Iraq in February to April /2014. Two different sweet lupin seed (Jordanian, Egyptian) origin were used for this study which been imported from the local markets. Soaking and boiling process (de- bittering process) of lupin seeds was used to destroy thermo-labile anti-nutritional factors, such as trypsin inhibitors, phytic acid and to soften the seed. It was been found that, the concentration (2, 4, 6)% of lupin seed supplementation for each origin (Jordan and Egypt) are the best in dairy product supplementation after conducting many different tests to see the best degree of agreement by the specialized panelists in the dairy company. The physicochemical analysis of the supplemented yogurt with different concentration (2, 4, and 6) % of Jordanian and Egyptian lupin flour showed that, it does not affect the percent of fat content statistically. But, there were clear positive statistical significant differences in the total solid. Also, there were statistically positive correlation between lupin flour concentration addition and total solid of the yogurt product which does affect directly the texture of the yogurt. There were statistically positive correlation between lupin flour concentration supplement and the pH of the yogurt product which does affect directly the flavor and taste of the yogurt product by the consumers. Thus, increasing the concentration of the supplementation with lupin flour lead to decrease the acidity and increase the pH in yogurt products significantly. Sensory evaluation of the supplemented yogurt product were showed that the 2 and 4% of lupin flour for both origin were the highest positive effect on physicochemical and sensory scores (flavor, taste, acidity, texture and consistency, appearance, and the total properties). Also, it was found that, the period of storage (1-14 days) did not affect the physicochemical and sensory evaluation clearly of the supplemented lupin dairy product. Therefore, we recommended the possibility of supplementation of yogurt with sweet lupin flour for its healthier and structural effect on human health to these kind of products. Keywords: Dairy product, Supplementation, Lupin flour, Physicochemical properties, Sensory evaluation, microbial content. 

Nurse/Midwives' practices during labor and delivery in Maternity Teaching Hospital in Erbil City

Background and objective: Labor is a life-changing event and is a high-risk time for both the fetus and the mother which affects them physically and emotionally, so proper care during labor and delivery is important. The study assessed the quality of the labor and delivery care by nurse/midwives. Methods: A study was carried out to observe nurse/midwives’ practices during the stages of labor and delivery. The study was conducted in the delivery room of the Maternity Teaching Hospital in Erbil City, during the period 28th February 2013 to 20th May 2013. The non-probability sample included 15 midwives who gave care to mothers during labor. Data were collected through a questionnaire format and observation checklist. Results: Midwives did not perform the following practice during labor and delivery: pre-paring the mother (84%), checking vital signs (93.3%), using aseptic technique for fixing a cannula (96.6%), providing privacy for the mother (84%), and using sterile technique for vaginal examination, catheterization, and episiotomy (91.6%) (91.7%) (92.5%) respectively, monitoring uterine contraction (98.3%), checking the progress of labor (93.4%) and se-lecting a suitable position for delivery (93%). Conclusion: Nurse/midwives did not provide proper care during labor and delivery. Improvements in their practice through training courses and changing hospital and delivery room policies is recommended

Prevalence of Urinary Incontinence and Probable Risk Factors in a Sample of Kurdish Women

Objectives: The most common manifestation of pelvic floor dysfunction is urinary incontinence (UI) which affects 15–50% of adult women depending on the age and risk factors of the population studied. The aim of this study was to determine the probable risk factors associated with UI; the characteristics of women with UI; describe the types of UI, and determine its prevalence. Methods: A cross-sectional study was conducted between February and August 2011, in the Maternity Teaching Hospital of the Erbil Governorate, Kurdistan Region, northern Iraq. It included 1,107 women who were accompanying patients admitted to the hospital. A questionnaire designed by the researchers was used for data collection. A chi-square test was used to test the significance of the association between UI and different risk factors. Binary logistic regression was used, considering UI as the dependent variable. Results: The overall prevalence of UI was 51.7%. The prevalence of stress, urgency, and mixed UI was 5.4%, 13.3% and 33%, respectively. There was a significant positive association between UI and menopause, multiparity, diabetes mellitus (DM), chronic cough, constipation, and a history of gynaecological surgery, while a significant negative association was detected between UI and a history of delivery by both vaginal delivery and Caesarean section. Conclusion: A high prevalence of UI was detected in the studied sample, and the most probable risk factors were multiparity, menopausal status, constipation, chronic cough, and DM

Inexpensive organic dyes-sensitized zinc oxide nanoparticles photoanode for solar cells devices

Zinc oxide nanoparticles (ZnO NPs) were synthesized using a hydrothermal route. The prepared ZnO NPs were characterized by x-ray diffraction (XRD), high-resolution transmission electron microscopy (HR-TEM), UV–vis spectroscopy, and photoluminescence (PL) spectroscopy. The XRD patterns confirmed the standard hexagonal wurtzite structure of ZnO NPs, and the calculated value of the average particle size was 23.34 nm. HR-TEM micrographs of ZnO NPs showed semispherical particle morphologies and their sizes lie between 10 and 40 nm. The estimated average size distribution of ZnO NPs was 21.35 6.01 nm. UV–vis spectrum of ZnO NPs revealed the highest absorption band at 360.5 nm, and the Eg was 3.70 0.01 eV. The PL spectrum emission was deconvoluted by eight peaks into two regions [near-ultraviolet (NUV) and visible that caused from the defects]. Two groups of dye-sensitized solar cells (DSSCs) thin film devices based on ZnO NPs were sensitized in different concentration solutions of 0.1, 0.32, and 0.5 mM of eosin B (EB) and eosin Y (EY) dyes. The sensitized DSSCs device with 0.32-mM dye of EY displayed higher efficiency and its performance parameters are much better among all other fabricated DSSCs devices. The short current density (Jsc) increased from 1.59 to 4:97 mA∕cm2 and the Voc enhanced from 0.36 to 0.46 V. The conversion efficiency from light to electricity showed a significant improvement from 0.29% to 0.94%. The transient open circuit photovoltage decay (TOCPVD) was measured to estimate the apparent electron lifetime or response time (τn) or the electron recombination rate (krec), using the double exponential function for first time to fit the experiment data of TOCPVD. The results revealed that the EY dye can be used as an efficient and an inexpensive dye for DSSCs.This research activity carried out between Gaza and Cairo-Egypt was financially supported by Qatar Charity IBHATH Project grant funded by the Gulf Cooperation Council for the Reconstruction of Gaza through the Islamic Development Bank.Zinc oxide nanoparticles (ZnO NPs) were synthesized using a hydrothermal route. The prepared ZnO NPs were characterized by x-ray diffraction (XRD), high-resolution transmission electron microscopy (HR-TEM), UV–vis spectroscopy, and photoluminescence (PL) spectroscopy. The XRD patterns confirmed the standard hexagonal wurtzite structure of ZnO NPs, and the calculated value of the average particle size was 23.34 nm. HR-TEM micrographs of ZnO NPs showed semispherical particle morphologies and their sizes lie between 10 and 40 nm. The estimated average size distribution of ZnO NPs was 21.35 6.01 nm. UV–vis spectrum of ZnO NPs revealed the highest absorption band at 360.5 nm, and the Eg was 3.70 0.01 eV. The PL spectrum emission was deconvoluted by eight peaks into two regions [near-ultraviolet (NUV) and visible that caused from the defects]. Two groups of dye-sensitized solar cells (DSSCs) thin film devices based on ZnO NPs were sensitized in different concentration solutions of 0.1, 0.32, and 0.5 mM of eosin B (EB) and eosin Y (EY) dyes. The sensitized DSSCs device with 0.32-mM dye of EY displayed higher efficiency and its performance parameters are much better among all other fabricated DSSCs devices. The short current density (Jsc) increased from 1.59 to 4:97 mA∕cm2 and the Voc enhanced from 0.36 to 0.46 V. The conversion efficiency from light to electricity showed a significant improvement from 0.29% to 0.94%. The transient open circuit photovoltage decay (TOCPVD) was measured to estimate the apparent electron lifetime or response time (τn) or the electron recombination rate (krec), using the double exponential function for first time to fit the experiment data of TOCPVD. The results revealed that the EY dye can be used as an efficient and an inexpensive dye for DSSCs

Prevalence and Risk Factors of Episiotomy and Perineal Tear in the Maternity Teaching Hospital of Erbil City, Iraq

Background and Objectives: During childbirth, women are at risk for experiencing perineal trauma to the genitalia resulting in a tear of the perineum or the surgical process of an episiotomy. Knowing the prevalence and the risk factors associated with perineal trauma may help in the reduction of episiotomy and prevention of occurrence of tear. The aim of the study was to find out the prevalence and risk factors associated with perineal trauma among women ages 15-48. Methods: A cross-sectional study was conducted in the Maternity Teaching Hospital of Erbil, Kurdistan region, Iraq. All records of mothers (n = 1500) who had been admitted to the delivery room for vaginal delivery during the month of May (2015) were reviewed. Chi-square test of association and binary logistic regression were used to interpret the data. Results: The overall rates of episiotomy, tear, their combined presence, and an intact perineum were: 47.8%, 7.2%, 26.1% and 18.9%, respectively. Incidence of having an episiotomy, tear, or combination of both, were significantly associated with women of young ages and women who were primigravida parity. There was a statistically significant association between high birth weight and the occurrence of perineal trauma. There was no association between perineal trauma and residency (urban/rural), occupation, gender of baby and time of delivery. Binary logistic regression analysis showed that having an episiotomy increased the risk of a tear by more than 30%. Conclusions: The prevalence of episiotomy was found to be 73.9% which is much higher compared to the World Health Organization recommendation which is 10%. Perineal trauma were associated with factors such as age, parity, and birth weight. Episiotomy is a risk factor for a vaginal tear. We recommend further research to inform the development and implementation of restrictive episiotomy policies to reduce and prevent occurrences of perineal trauma