Background and objectives: Neonatal hyperbilirubinemia is the most common medical condition in the neonates. About 60% of term and 80% of preterm infants develop jaundice during 1st week of life. The objectives of the study were to assess knowledge and attitude of nurses toward hyperbilirubinemia , and to find out whether there were any relationships between nurses knowledge and attitude with sociodemographic data. Subjects and methods: A descriptive, cross sectional study was done all nurses (n=166) working in the neonatal intensive care units and different departments in governmental hospitals in Duhok governorate has been recruited to the study during the period started from 1 st May to 1 st August 2019. Results: The study revealed that the majority of nurses had fair knowledge about concepts, definition of phototherapy 98 (59%), causes 78 (47%), Intervention of bilirubin level and steps of management 125 (75.3%), side effects 106 (63.9). While 98.8% of nurses had good knowledge regarding clinical manifestations 164 (98.8%), Investigations 137 (82.5%), complications 78 (47.0%) and Nursing care 159 (95.8%). It also found that there was a significant relationship between demographic data and nurses' knowledge. Moreover, 145 (87.3%) of nurses held neutral attitude toward neonatal hyperbilirubinemia. Finally, the study found a significant relationship between attitude and demographic factors. Conclusions: The study concludes that nurses working in Neonatal intensive care unit (NICU) and pediatric wards had fair knowledge regarding concepts, causes, steps of management, side effects of phototherapy and good knowledge regarding clinical manifestations, investigations, complications and nursing care. Furthermore, nurses held neutral attitude towards neonatal hyperbilirubinemia.

Background: Neonatal sepsis is a major cause of death all over the world. Risk factors represent an interaction between maternal immunity and the defense mechanisms of the neonate. epidemiological, clinical and laboratory profiles of neonates with sepsis in relation to outcome and to determine the predictors of outcome. Subject and Methods: A prospective study included neonates with sepsis admitted to neonatal care unit. 126 neonates with features of sepsis were included with age ranged from (1-30) days. From each patient, neonatal and maternal data were collected and clinical features as well as laboratory test results of hemoglobin, platelets count. total white blood cell and absolute neutrophil count , C statistically analyzed. Results: of 126 neonates, 32 (25.39%) died while others survived. Age < 7 days was in 61.9% of all cases, 69.84% had respiratory distress syndr encephalopathy, 60.31% were preterm, 61.9% were born vaginally and male to female ratio was 1.73:1. There is a significant relation of mortality to respiratory distress syndrome and hypoxic ischemic encephalopathy, preterm d Vomiting, apnea, sclerema, cyanosis and tachypnea were significantly related to the mortality. Eschericia coli were mortality is with Acenatobacterbaumani relation. The C reactive protein was>10 mg/dl was in higher number of neonates with sepsis who died by comparison to those who survived, with a significant relation. Conclusions: Neonatal sepsis is still a c the pattern of causative organisms and this requires more monitoring and periodic surveillance. There is a real need to find out the local antibiotic sensitivities of pat establish an optimal empirical treatment before the results of culture and sensitivity are available.

Background: Magnesium has an important role in the metabolism of carbohydrate so that it may affect the release and activation of insulin which is the hormone that controls levels of blood glucose. Different studies all over the world have found a low serum Magnesium in diabetic children with poor glycemic control reflected mainly by glycated hemoglobin (HbA1c) level. Our aim was to evaluate the serum magnesium status in children with type 1 diabetes and to assess its relation to glycemic control. Methods: A case control study included 50 diabetic patients whose ages were between 1 and 18 years and 50 controls who were age-and sex-matched chosen from the siblings of the patients who visited the center during the study period. Serum Magnesium was assayed and acut off point equal to and above 1.7 mg/dl considered as normal level. The glycemic control of patients was classified according toHbA1c % as good <7.5%, poor 7.5-8.5% and very poor >8.5%.Data were statistically analyzed using SPSS 22.A P value of <0.05 was considered significant. Results: of the total patients 32% had Hypomagnesemia compared to 10% of controls. Serum magnesium level was significantly lower in diabetic children as compared to controls (p<0.007). The diabetic patients in the first quartile had the lower value of serum magnesium. The remaining values, including duration of diabetes and HbA1 were comparably nonsignificant. A significant inverse correlation was found between serum magnesium and glycated hemoglobin level(r=-0.302, p =0.033). Conclusion:Serum magnesium level is frequently low in children with type 1 diabetes mellitus. There is a significant correlation between serum magnesium level and the glycemic control. Therefore we recommend doing regular monitoring of serum magnesium in type 1diabetic children and appropriate supplement of low levels.

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Background Asthma is an increasingly common disease over the last century. It is caused by chronic inflammation of lung airways with increased airway responsiveness and airflow obstruction. Magnesium is the fourth most common cation in the body and the major intracellular divalent cation. Mg+2 in extracellular fluid is crucial for normal neuromuscular activities. Magnesium deficiency is associated with increased contractility of smooth muscle cells including bronchiolar resulting in bronchospasm. Objectives To detect the prevalence of hypomagnesemia among asthmatic children and to find out any significant correlation of hypomagnesemia with asthma in children. Patients and Methods A case control study conducted in Duhok, North of Iraq in the period between January the 1st 2014 and January  the 1st 2015. One hundred asthmatic patients aged between 1 and 15 years were examined. All patients had acute asthmatic attacks with features of respiratory distress for which they were admitted to Heevi Pediatric Teaching Hospital. Those with fever, dehydration, localized wheezing, pneumonia, cardiac, renal, or hepatic dysfunction were excluded. They were all studied in terms of age, gender, duration of asthma, drugs used for treatment, severity of asthma and the patients’ growth as measured by Body Mass index. Control group included 100 children who were healthy non asthmatic and visited the hospital with their parents. Samples of blood were taken to measure serum magnesium level.Statistical analysis were performed by using the SPSS 19 where P<0.05 is significant. Results The mean serum magnesium in patients group was 1.91± 0.33 mg/dl while in the control group it was 2.03± 0.33 mg/dl. Serum magnesium levels were lower in the asthmatic patients than controls P= 0.01. Male gender predominated in both groups (68% , 61%) and the most common age among cases was 1- < 3 years and controls 5- <10 years. Serum magnesium level indirectly correlated with duration of asthma but not significantly (P=0.1). Serum magnesium level was not significantly related to body mass index P=0.3.Serum magnesium level decreased with increasing severity of asthma symptoms P= 0.05. Serum level is slightly lower in asthmatics on steroids and bronchodilators than those who were not P=0.7, P=0.9 respectively.  Conclusion Serum magnesium level is significantly lower in asthmatic children as compared to the control group. Serum Mg+2 level decreases as the duration of asthma is longer but not significantly. There is an inverse relation between serum Mg+2 and the severity of asthma. No significant change in serum Mg+2 develops when steroids and bronchodilators are used.