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

Effect of Consumption Dried Apple Peel and Ginger on Blood Level of Cholesterol

This experiment conducted and applicated in the Budget Clinic in a Rashed district, Baghdad supervised by Dr. Haatum Al-Aithawy in June-August, 2014. This experiment conducted on samples of women who suffering from high blood pressure, cholesterol, triglyceride, and blood sugar. Fifty married and dyewood women were selected randomly with age ranging between 30-60 years. Twenty fife women were given dried red apple peel powder, other 25 women were given dried ginger powder, in a laboratory tablet in dose of 3 tablet /day/for 5-6 weeks. The blood pressure and lipid profile been measured for the studied samples before and after treatment. Medical tests been done statistically analyzed before consuming the suggesting powder of apple peel or rhizomes ginger for 25 ladies, it was found that 56% upon them suffering from high blood pressure (hypertension stage 2 ≥ 160 mmHg), 36% upon them suffering from high blood pressure (hypertension stage 1 range from 139-150 mmHg) and 8% upon them suffering from high blood pressure (prehypertension 120-139 mmHg). After starting our experiment with the same samples and after giving dried apple peel powder, it was found that a high significant differences as the percentage of the women who was suffering from high blood pressure decreased from 56% to 8%, and increase in women percentage to 60% and 24% who suffering from hypertension stage 1(139-150 mmHg) and prehypertension respectively.Lipid profile showed that 100% of women who were suffered from high cholesterol, 96% upon them suffering from triglyceride and 96% upon them suffering from high blood sugar. At the end of our experiment with the same samples who giving dried apple peel powder, it was found that high statistically significant differences as the percentage of the women who was suffering from high cholesterol decreased from 100% to 80%, and from 96% to 80% for triglyceride and from 96% to 64% for high blood sugar.  In addition of that, it was improved the appetite, comfortable feeling and feel painless arrhythmias in elderly ladies in comparison with chemical medicine used and its side effect. Also, for the 25 ladies sample who consummated dried ginger powder tablet daily / for 5-6 weeks, the results showed high statistically significant differences for each blood pressure profile (prehypertension, hypertension stage 1, and hypertension stage 2) and lipid profile (cholesterol, triglyceride, and blood sugar).So we could concluded that, the dried apple peel and the dried ginger almost have the same high positive effect on blood pressure profile and lipid profile, so the possibility of using dietary plants as a tablet instead of chemical drug (medicine) very important for treating human who are suffering from blood pressure and high lipid. So, for all the above facts, this type of studies and researches should be supported and encouraged the National medicine products against the imported chemical medicine.         Keywords: Dried red apple peel flour, Dried Ginger flour, Blood pressure profile (prehypertension, hypertension stage 1, and hypertension stage 2), Lipid profile (cholesterol, triglyceride, and blood sugar)

Effect of Supplementation of Yoghurt with Syrup of Date Palm Pomace on Quality Properties Products

Dates are a popular fruit among the population of Middle Eastern countries, providing a staple food for millions of people around the world. The by-products arising from date processing can be used for different purposes, due to its contents of polyphenols, antioxidants, fibers and minerals. Date palm pomace powder with 2, 4, 6% concentration were used in processing of yogurt. The possible beneficial effects of date palm pomace powder on the rheological, sensory, microbial quality of yogurt-based products were determined. Comparisons were made between the sample yogurts made from different concentration of supplemented date palm pomace yogurt, and controls. The incorporation of date palm pomace reduced product syneresis and improved the texture and sensory characteristics of the supplemented yogurts so that their quality characteristics were similar or more acceptable by the panalists than control yogurt. Pomace of the date palm at low level (2 and 4%) were effective in improving whey retention of the yogurt and its sensory qualities. While, high level (6%) of date palm powder was exert significant improvements of textural characteristics of yogurt but, the color and harchy taste which were un-acceptable by panelists. In addition of that, the microbial contents were diminished and very low in some of these products. So that we could be successfully utilized that by-product of date palm to produce enriched different products, one of them dairy product which is high in dietary fiber, mineras and many antioxidants to modulate the harmful of dairy product. Keywords:Date palm pomace-yogurt supplemented food- sensory properties-physico-chemical analysis-microbial content

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

On the fracture toughness of polymeric nanocomposites: Comprehensive stochastic and numerical studies

Polymeric nanocomposites (PNCs) are considered for numerous nanotechnology such as: nano-biotechnology, nano-systems, nanoelectronics, and nano-structured materials. Commonly , they are formed by polymer (epoxy) matrix reinforced with a nanosized filler. The addition of rigid nanofillers to the epoxy matrix has offered great improvements in the fracture toughness without sacrificing other important thermo-mechanical properties. The physics of the fracture in PNCs is rather complicated and is influenced by different parameters. The presence of uncertainty in the predicted output is expected as a result of stochastic variance in the factors affecting the fracture mechanism. Consequently, evaluating the improved fracture toughness in PNCs is a challenging problem. Artificial neural network (ANN) and adaptive neuro-fuzzy inference system (ANFIS) have been employed to predict the fracture energy of polymer/particle nanocomposites. The ANN and ANFIS models were constructed, trained, and tested based on a collection of 115 experimental datasets gathered from the literature. The performance evaluation indices of the developed ANN and ANFIS showed relatively small error, with high coefficients of determination (R2), and low root mean square error and mean absolute percentage error. In the framework for uncertainty quantification of PNCs, a sensitivity analysis (SA) has been conducted to examine the influence of uncertain input parameters on the fracture toughness of polymer/clay nanocomposites (PNCs). The phase-field approach is employed to predict the macroscopic properties of the composite considering six uncertain input parameters. The efficiency, robustness, and repeatability are compared and evaluated comprehensively for five different SA methods. The Bayesian method is applied to develop a methodology in order to evaluate the performance of different analytical models used in predicting the fracture toughness of polymeric particles nanocomposites. The developed method have considered the model and parameters uncertainties based on different reference data (experimental measurements) gained from the literature. Three analytical models differing in theory and assumptions were examined. The coefficients of variation of the model predictions to the measurements are calculated using the approximated optimal parameter sets. Then, the model selection probability is obtained with respect to the different reference data. Stochastic finite element modeling is implemented to predict the fracture toughness of polymer/particle nanocomposites. For this purpose, 2D finite element model containing an epoxy matrix and rigid nanoparticles surrounded by an interphase zone is generated. The crack propagation is simulated by the cohesive segments method and phantom nodes. Considering the uncertainties in the input parameters, a polynomial chaos expansion (PCE) surrogate model is construed followed by a sensitivity analysis

An efficient optimization approach for designing machine learning models based on genetic algorithm

Machine learning (ML) methods have shown powerful performance in different application. Nonetheless, designing ML models remains a challenge and requires further research as most procedures adopt a trial and error strategy. In this study, we present a methodology to optimize the architecture and the feature configurations of ML models considering a supervised learning process. The proposed approach employs genetic algorithm (GA)-based integer-valued optimization for two ML models, namely deep neural networks (DNN) and adaptive neuro-fuzzy inference system (ANFIS). The selected variables in the DNN optimization problems are the number of hidden layers, their number of neurons and their activation function, while the type and the number of membership functions are the design variables in the ANFIS optimization problem. The mean squared error (MSE) between the predictions and the target outputs is minimized as the optimization fitness function. The proposed scheme is validated through a case study of computational material design. We apply the method to predict the fracture energy of polymer/nanoparticles composites (PNCs) with a database gathered from the literature. The optimized DNN model shows superior prediction accuracy compared to the classical one-hidden layer network. Also, it outperforms ANFIS with significantly lower number of generations in GA. The proposed method can be easily extended to optimize similar architecture properties of ML models in various complex systems

Effect of consumption supplemented strained yoghurt with vegetables on reducing weight of obese women samples

Obesity during adulthood is a public health problem in modern society, and increasingly universal disease that is turning into an epidemic one. The main cause of the excessive deposition of fat is the destruction of the systems controlling the expenditure of energy. Pathological increase of mass fat leads to disorders of the body, and lipid-carbohydrate parameters, raise the development of vascular diseases and increases the risk of morbidity and mortality. A substantial body of data has elicited over the last five years to show  that dairy foods especially low-fat yogurt modulate weight loss and has some unique properties that may enhance its role in maintenance of healthy weight. Regular physical activity is an important as what we eat for losing, maintains weight and keeping our heart healthy. Being active helps burn calories, tone our muscles and control our appetite.  The aim of this study is to demonstrate the impact of diet which was restricted in its energy by consuming concentrated yogurt daily and physical activity changes in the body weight, body mass index, and in the parameters lipid- cholesterol of women's adulthood.  Low-fat yogurt, restricted energy consumption with at least three times exercises weekly inversely associated with body weight, BMI, and WC (all p< 0.05). Also, consumption of low-fat yogurt and exercising daily was associated inversely with blood glucose, cholesterol and lipid parameter (all p< 0.05). Within a sample of obese adults women, consumption of low-fat dairy product and increases the physical activity with restricted energy ingestion  was associated with more favorable body composition. Keywords: Obesity, diet-yogurt, physical activity,  BMI-blood lipid, parameter

Evaluation of Inhibitory Activity of Cordia Myxa Fruit Extract on Microorganisms that Causes Spoilage of Food and Its Role in the Treatment of Certain Disease States

The study of chemical content and aqueous and alcoholic extracts of Aplomb's  fruit and then detect the chemical components effective it aggregates and also, studying the effectiveness of inhibitory to extracts toward isolates bacterial different: E.coli, Pseudomonas flurscence, Salmonella, Shegilla and Staphylococcus aureus, where the results showed that the fruit Alpmbr containing 63.9% carbohydrate, 8.6% protein, 6.7% ash and 9.9% fat, so that the fruit Alpmbr high content of carbohydrates and fat shows that fat contains a high percentage of saturated fats, such as fatty acid, lauric acid ratio was 48.3% and Myristic acid was 15.8%, as well as that it contains a significant proportion of unsaturated fatty acid such as oleic by 12.4%, which is an important and basic nutrition and health for human. The fruit Alpmbr of mineral content was high proportion of potassium 29 ppm and sodium element was 13 ppm. It was found that either metallic zinc and calcium were accepted by Iraqi Standard. Heavy metals such as Cadmium, chromium and copper were not diagnose which is toxic elements, so it may be considered the fruit of Alpmbr is a safe fruits to-use and useful for health. To test the activity of the functional chemical components, it was found that high content of alkaloids, Saponin, Comarines, and Gums, and a reasonable rates of resins and Steroid, multiple phenols, flavonoids and Glycosides, tannins and oily nitrogeneous materials oily with low content. The pH of the aqueous extracts is 7.0 and alcoholic extract was 6.5 that means the fruits is neutral acidity. As for the inhibition  activity toward the bacterial isolates were higher effective inhibitory concentration 200mg / ml of aqueous extracts a diameter of 26mm against Pseudomonas flurscence and 25 mm for the both of Salmonella and E.coli. While, it decrease significantly to 19mm towards both Shegilla and Staphylococcus aureus. But with alcoholic extract concentration 200mg / ml has decreased significantly to 25 mm diameter towards Staphylococcus aureus and 20mm in E.coli and Shegilla.  Also the same significant decreases towards the Salmonella 19mm and 16mm towards the bacteria Pseudomonas flurscence. The sensitivity of the bacterial isolates for the  antibiotics inhibition diameters was 20 mm, of Erthromycin against Salmonella.  And the diameter of Oxacillin was 17 mm against Staphylococcus aureus, but Optimdex T was a very highly effective against all bacterial isolates. Keywords: Cordia myxa-Chemicals content-Minerals-Bacterial inhibition activet

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. 

Strukturna i električna svojstva tankih slojeva kalkogenida CuSbTe2, CuSbSe2 i CuSbS2

The ternary chalcogenides CuSbTe2, CuSbSe2 and CuSbS2 were synthesized by the direct fusion technique. The thin films of these compounds were prepared by thermal evaporation under vacuum of about 1.3 mPa (10−5 Torr) and the rate of deposition was 30 nm/min. The structural properties of CuSbTe2, CuSbSe2 and CuSbS2 in powder and thin film forms were investigated by X-ray diffraction (XRD) and transmission electronmicroscopy. Microprobe analysis technique was used to investigate the composition of the three alloys and of their films. The electrical conductivity σ and the thermoelectrical power Q have been measured for all asdeposited and annealed thin films, as a function of temperature in the range from 80 to 500 K. It was found that the electrical conductivity σ, the carrier concentration P, the mobility µ and the thermoelectric power Q increase when increasing the annealing temperature for CuSbTe2, CuSbSe2 and CuSbS2 thin films. The increase of σ, P, µ and Q, and also the decrease of the activation energy ∆E with increasing temperature for the as-deposited CuSbTe2, CuSbSe2 and CuSbS2 thin films, can be attributed to the change in the structure of these films from the amorphous to the crystalline state.Trokomponentne smo kalkogenide CuSbTe2, CuSbSe2 and CuSbS2 pripremili metodom talenja. Tanke smo slojeve tih spojeva pripremali isparavanjem u vakuumu od oko 1.3 mPa, brzinom nanošenja oko 30 nm/min. Strukturna svojstva tih kalkogenida, kako praškova, tako i tankih slojeva, istraživali smo difrakcijom rendgenskog zračenja i prolaznom elektronskom mikroskopijom. Pomoću mikroprobe odredili smo kemijski sastav spojeva i njihovih tankih slojeva. Izmjerili smo električnu vodljivost, σ, i termoelektričnu snagu, Q, svih svježe naparenih i opuštenih legura i njihovih tankih slojeva u ovisnosti o temperaturi u području 80 do 500 K. Električna vodljivost, gustoća nositelja, P, mobilnost, µ, i termoelektrična snaga, Q, povećavaju se ako se tanki slojevi opuštaju na višim temperaturama. Povećanje σ, P, µ and Q, a također smanjenje aktivacijske energije, ∆E, u tankim slojevima CuSbTe2, CuSbSe2 i CuSbS2 tumače se promjenama strukture tih slojeva od amorfnog u kristalinično stanje