Table of content

IRAQI JOURNALOF COMMUNITY MEDICINE

المجلة العراقية لطب المجتمع

ISSN: 16845382
Publisher: Al-Mustansyriah University
Faculty: Medicine
Language: English

This journal is Open Access

About

Peer reviewed Medical Journal, Issued every four Months, Published by the Iraqi Community Medicine Society and Community Medicine Department Al-Mustansyriah College of Medicine.
The Journal accept original works in the freldi of epidemiology & Communicable non communicable diseases, Primary health care , Social Medicine health administration, health economic, environmental Medicine in addition to basic and clinical sciences.

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jamalrawi58@yahoo.com/gmail.com/hotmail.com
monaalallow@yahoo.com

Table of content: 2017 volume:30 issue:2

Article
Knowledge & Health Seeking Behavior of Newly Delivered Mothers Regarding Neonatal Jaundice
المعارف والسلوكيات لدى الامهات حديثات الولاده حول اليرقان الولادي

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Abstract

Background: Neonatal jaundice is one of the most common diseases globally. It's believed that delays in detection and improper treatment of neonatal jaundice can be responsible for neonatal morbidity and mortality. Knowledge and health seeking behavior of mothers play an important role in the course of this health condition. Objectives: to assess the knowledge and health seeking behavior regarding neonatal jaundice of newly delivered mothers. Determine the influence of some maternal characteristics on knowledge, and health care seeking behavior regarding neonatal jaundice. Methodology: A cross sectional study was conducted on newly delivered mothers at Al-Yarmouk teaching hospital in Baghdad for the period from May to the end of August, 2016. Data was collected via direct interview with the newly delivered mothers using a special questionnaire form to assess the knowledge and health seeking behavior regarding neonatal jaundice. In addition, the data collected comprised some characteristics of the mother. Results: The study included 500 mothers. Only 4% of mothers had good knowledge, while others were between fair and poor knowledge levels. Appropriate health seeking behavior was adopted by only 21% of the study group regarding the management of neonatal jaundice. Cultural beliefs and traditional care practices still have an impact on mothers as (78.4%) of them had used traditional methods for treating their babies. Better education and being employed influenced mothers' knowledge and health seeking behavior. Mothers parity showed its' influence on knowledge level only. Conclusion: There are gaps in mothers' knowledge and health seeking behavior regarding neonatal jaundice. Targeted education during antenatal care by health professionals is needed to help mothers recognize neonatal jaundice, refrain from potentially harmful home interventions and promptly seek healthcare.

Keywords

Knowledge --- Behavior --- Mothers --- Neonatal --- Jaundice


Article
Evaluation of Directly Observed Treatment Short Course(DOTS) Program Implementation in Al-Anbar Governorate ,West of Iraq, for the Years 2008-2012
تقييم تطبيق البرنامج الوطني لعلاج مرض التدرن تحت النظر مباشرة في محافظة الانبار غرب العراق

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Abstract

Abstract: Background:- DOTS program has been adopted by WHO as hopeful strategy for treatment of TB since early nineties ,and it is widely accepted as an essential strategy for achieving (TB) control . Iraqi health authorities started DOTS program implementation since 2001 in Baghdad, Iraq. Objectives:- This study aimed to evaluate DOTS program implementation in Al-Anbar Governorate from 2008-2012 , and to assess the treatment outcomes of this program . Patients and Methods:- This Cross –Sectional Descriptive Study was conducted in consultation clinic in Ramadi city ,Al-Anbar Governorate for the period of October 1 ,2012 to March 31,2013 . Records of (1680) TB patients were studied retrospectively for the years 2008 to 2012 .Data regarding pulmonary cases for positive and negative smears ,extra-pulmonary and relapse cases ,treatment failure and chronic cases , in addition to Socio - demographic features were obtained .Statistical package for social sciences (SPSS)version 17 , and chi- square test were used ,while P values of less than 0.05 considered statistically significant . Results:- A total of 1680 TB patients records reviewed , (919) were males , and (761) were females . Male to female ratio was 1.2:1 .The total of new sputum smear positive( SS+) cases were 541(32.2%),sputum smear negative(SS- ) were 413(24.5%) ,and extra pulmonary( EP) cases were 726(43.2%) .The Cure rate for TB patients for the period (2008- 2012) was 84.7% , 86.8%, 82.7% ,85.6% ,and 91.4% respectively . The treatment success rate of DOTS program for the period from 2008 to -2012 were 89% , 85.6% , 85.6% ,85.8% , 87.7% respectively .The higher death rate was at 2010 (4.5%) ,treatment failure rate was higher at 2012(2.6%) ,while defaulter rate was higher at 2009(10.5%),and transfer out rate was higher at 2010 (1.9%) . Conclusions:- DOTS program is still an important role in improving registration and curing TB cases ,and widely accepted for achieving TB control strategy in AL-Anbar Governorate .Although many results were close to WHO targets,the case detection rate was very low and faraway from its goals .

Keywords

DOTS --- TB --- Cure rate --- Defaulter rate --- Transfer out rate


Article
Relation between thyroid disorders and polycystic ovary syndrome
العلاقه بين اضطرابات الغدة الدرقيه ومتلازمة تكيس المبايض

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Abstract

Abstact: Background: Polycystic ovarian syndrome which is the most common endocrinopathy of women at their reproductive age seems to be associated with thyroid dysfunction, but it’s true patho¬genesis is far from being elucidated. Both have independent risks of ovarian dysfunction and pregnancy related complications. Objective: To evaluate the association between thyroid dysfunction and polycystic ovary syndrome (PCOS).Study Design: Prospective Case-Control Study. Setting: Department of Obstetrics and Gynecology/ AL-Elwiya Maternity Teaching Hospital, Baghdad - Iraq Patients and Methods: The study included 100 women at reproductive age, 50 of them were defined as having polycystic ovary syndrome (study group), another 50 healthy women served as control group. Thyroid function and morphology were evaluated by measuring serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), anti thyroperoxidase antibody (anti TPO Antibody) and anti-thyroglubulin antibody (anti-TG Antibody) and by clinical and ultrasound examination of thyroid gland. Results: The study revealed statistically higher prevalence of autoimmune thyroiditis in patients with PCOS (12% vs. 4% of control) as evidenced by raised anti-TPO antibody levels (means125.91±333.39 and 88.19±316.18 respectively; P =0.563). PCOS patients were found to have higher mean TSH level than that of the control group (3.14±2.74and 2.24±1.81respectively; P value < 0.05). There was high prevalence of goiter among PCOS patients (10.0%vs. 4% of control, P value > 0.001). On thyroid ultrasound, a significantly higher percentage of PCOS patients (10%; controls 2.5%) had hypoechoic ultrasound pattern which also compatible with diagnosis of autoimmune thyroiditis. Conclusions: Higher prevalence of thyroid disorders in the form of autoimmune thyroiditis in patients suffering from PCOS (12%) compared with control group (4%).


Article
Knowledge about Tuberculosis among Secondary School Students in Baghdad City
معلومات طلاب المدارس الاعدادية حول مرض التدرن في بغداد

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Abstract

Abstract: Background: Community awareness in general and in young generations in particular is of vital importance in combating tuberculosis which is a leading cause of morbidity and mortality in developing countries. Tuberculosis is still a prevalent disease in our country. Objective: To assess the knowledge of secondary school students regarding tuberculosis. Methods: This descriptive cross-sectional study was conducted in Al-Karkh district of Baghdad during the period from November 2015 to April 2016. The sample size was determined at 1000 students from the total number of 63464 students. A simple random sampling technique was adopted to select schools from each of the ten sectors; this resulted in collecting a total of 20 schools (ten schools for males and ten for females). The students were randomly selected from those schools, 500 male &500 Female, using a systematic random sampling technique by choosing every other student from the selected classes. The study instrument included multiple choice questions about the cause of the disease, the route of transmission, vaccination, symptoms, availability of treatment, transmission and prevention. The questionnaire was developed by the researcher making use of previous studies and WHO standards. Results: On average, 42% of the questions were answered correctly, only 27.2% knew that TB was caused by bacteria, 40.8% knew that TB’s first symptom was a cough of more than 3 weeks, 56.5% knew that TB is associated with loss of appetite & weight loss, 39.8% knew that TB is associated with fever & night sweats, only 38% of students knew that it is transferred by respiratory droplets, 60.6% knew that the first organ most commonly affected by TB is the lung, 44% knew that the TB vaccine is BCG, only 23.1% knew that sputum examination is used to help identify TB, 56.3% knew that covering your mouth during coughing & sneezing helps prevent disease spread, only 33.4% knew that TB treatment is available in all primary health care centers(PHCC). Conclusion: Only about one third of the student sample had good knowledge regarding Tuberculosis, also female students had a higher level of knowledge than male students.


Article
Evolution of the Effectiveness of Peremetherin and Trimethoprim/ Slfomethoxazole on Pediculosis Capitit and some Bacteria Isolated from its Complication
تقييم تاثير البيرميثرين وترايمثوبريم مثاكسوزول على قمل الراس وبعض الابكتريا المعزوله من مضاعفاتها

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Abstract

Abstract: Background:Head lice infestation caused by Pediculus humanus var. Capitis, is the most prevalent human ectoparasitic disease worldwide, head lice are haematophagous, frequent among children 3-11 years. Traditional pharmacological therapies, have focused on 1 or 2 courses of various ovicidal and pediculicidal topical therapies. Objectives: To compare the effectiveness of permetherin and trimethoprim/sulfamethoxazole on 1 or 2 courses of various ovicidal and pediculicidal topical therapies. Methods; Seventy five females patients with pediculosis capitis , their ages ranged from 3 to 60 years. In 40 patients the pediculosis was complicated by secondary bacterial infection. The patients were divided in to three groups, Group 1 :-The patients were treated by 5% permetherin solution . Group 2 :-Was treated by trimethoprim /sulfamethoxazole tablet or solution according to the age .Group 3:- Was treated by combination of 5% permetherin solution and oral trimethoprim /sulfamethoxazole . Swabs were taken from patients with bacterial infection. Results:The study revealed that 23(92%) patients of the first group, was cleared, 20(80%)patients from the second group, also cleared and all the patients in the third group 25(100%). Of those who were complicated by secondary bacterial infection 40(60%), 30(75%) the cultures show bacterial growth. The cultures which were tested by 5% permetherin shows no inhibition zone but those cultures which were tested by trimethoprim /sulphamethoxazol shows significant inhibition zone. Conclusion:It was concluded that permetherin was ineffective as antibacterial agent but it was highly effectivas pediculocidal agent and it was more effective when combined with oral trimethoprim/ sulfamethoxazole.


Article
Evaluation use of Ultrasound guided Transverses Abdominal Plane Block and Paracetamol for Post-operative Analgesia in Appendectom Patients
تقنية كبح العضله البطنية المستعرضه باستخدام موجات فوق الصوتيه بالمقارنة مع الباراستامول لضمان التسكين بعد عملية استئصال الزائدة الدودي

Authors: layla khalil ليلى خليل
Pages: 83-87
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Abstract

Background: A lot of pain relieve techniques were use postoperatively the transverses abdominal plan block is new regional anesthesia technique and paracetamol infusion one of these. Objectives: the aim of this study to evaluate the effectiveness of the two methods in patients undergoes appendectomy. Methods: Non- randomized clinical trial, started in the 1stfeb 2016 to 1st Feb. 2017 at Al-Jarah hospital Iraq –Baghdad, A 180 patients ASA I, undergone appendectomy. Age matched, 80 Patients were on ultrasound guided transverses abdominis plane block and 100 toke paracetamol .after wound closure 20 ml of 0.5% bupivacaine was infiltrated in to transverses abdominis neuro facial plan by posterior approach. 1000 mg of paracetamol (parol) were administered after induction of anesthesia as infusion in 20 min and pain score was assessed in postoperative period in 0 hr, 1 hr, 2hr, 3hr, 4hr by numerical rating scale (NRS) and visual analogue scale (VAS). Results: Transverses abdominal plane block (TAP) under ultrasound guidance had significantly lower postoperative pain score according NRS and VAS in comparison to paracetamol (P-value less than 0.001) at 4hr post-operative after appendectomy. Conclusion: Ultrasound-guided transverses abdominis plane block was easy, safe, reliable and effective analgesic postoperative appendectomy than paracetamol.


Article
Bacteriological Study on Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Patients
دراسة بكترية على التحول الحاد لمرضى متلازمة الانسداد الرئوي المزمن

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Abstract: Background and Aims: COPD characterized by sputum production, bacterial colonization, neutrophilic bronchial airway inflammation and poor health status, and this lead to cause morbidity and mortality worldwide. This study was designed to find out the most common bacteria that responsible for acute exacerbation of COPD, determine the antimicrobial sensitivity against the bacteria isolated. Patients and Methods: This study is done on patients admitted with acute exacerbation of COPD to hospital. The selection process of Patients was depending on clinical examination, the radiological test and pulmonary function test. The ages of patients were from 40 years and up. 80 patients, 48 males and 32 females. 80 patients with stable COPD serves as controls. A morning specimen of sputum was collected after appropriate preparation and physical character of the sputum were noted. Sputum was immediately sent to microbiology lab for culture. Sensitivity patterns in potentially pathogenic microorganisms (PPMs) were also investigated. Results: Fifty-two patients (65%) had positive sputum cultures, Indicating the presence of bacterial infection. Streptococcus pneumoniae (26.25%), Escherichia coli (7.5%) , Klebsiella pneumoniae (7.5%), Pseudomonas aeruginosa (5%) ,Acinetobacter baumannii (3.75%),Staphylococcus aureus(3.75%) , Stenotrophomonas maltophilia (2.5%) , Enterobacter cloacae (1.25%), Leclercia adecarboxylata (1.25%), Moraxella catarrhalis (1.25%) and Raoultella ornithinolytica (1.25%).The majority of bacterial pathogens isolated in this study were susceptible to Imipenem, Meropenem, Doxycycline and Chloramphenicol. Conclusions: Our results show Incidence of bacterial infection during acute exacerbations of COPD is about 65%. Streptococcus pneumoniae has been the most Pathogen frequently isolated; Bacterial airway infections play a great role in many, but not in all, of the cases of AECOPD. So there is the need to do a sputum bacterial culture examination on each patient with AECOPD, And with appropriate antibiotics to contribute to curing of them.


Article
Frequency of Otitis Media with Effusion in Children with Adenoid Hypertrophy
مدى الاصابة بالتهاب الاذن الوسطى مع انثقاب الطبله عند متضخمي العقد اللمفاويه للتجاويف

Pages: 95-100
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Abstract

Abstract: Background: Otitis Media with Effusion (OME) is a chronic accumulation of mucous within the middle ear , and sometimes the mastoid air cell system . Objective: To study the frequency of otitis media with effusion in relation to the effect and size of adenoid hypertrophy as an aetiological factor , in addition to others like presenting symptoms, risk factors and the changes of tympanometry in otitis media with effusion. Patients and methods: A cross sectional study for 12 months (January 2011-january 2012) in Al-Yarmouk Teaching Hospital, ENT department. One hundred children with adenoid hypertrophy aged (3-12years) were included. All of them were evaluated by clinical ENT examination, tympanometry and lateral plane x-ray of nasopharynx to assess the size of hypertrophied adenoid and classified into 3 grades (I, II and III) and asses the frequency of otitis media with effusion in each grade. Results: Only 38 children out of one hundred (38%) were diagnosed as having otitis media with effusion; with 26 patients were bilaterally involved (68.5%) and 12 patients were unilaterally involved (31.5%). According to adenoid grade, the incidence of otitis media with effusion was as follow: grade I: 19 patients (38ears) only 7 ear with effusion (18%) , grade II : 47 patients (94ears)only 26 ear with effusion (27%) and grade III : 34 patients (68 ears) only31 ears with effusion (45%). Type B tympanometry was more in grade III adenoid hypertrophy 47%. Conclusion and Recommendation: The frequency of otitis media with effusion is directly proportional to the size of adenoid. It is recommend that early diagnosis and proper management of adenoid hypertrophy to reduce the incidence of otitis media with effusion and its sequels of hearing loss and poor speech development in children .


Article
Effects of green laser therapy on healing of infected wound in mice.
ثاثير العلاج بالليزر الاخضر على التهام الجروح عند الفيران

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Abstract: Background: Little studies focused on stimulation of healing process of infected wound in mice. The predominant pathogens that infected wound were gram positive such as Staphylococcus aureus and gram negative such as P. aeruruginosa and Acinetobactor Baumannii. A. baumannii cause wide range nosocomial infections. Objective: study the influence of green laser 532nm at constant power density (irradiance) at different exposure times (5, 15) on healing of wound infected by Acinetobacter Baumannii created on BALB/C mice. Methods: An elliptical full thickness skin wound was created aseptically on a back of 45 adults, females BALB/C mice. The wounds were infected by Acinetobacter Baumannii and the mice were randomly divided into two sets, first one was infected ( non-irradiated controls)15 animals (five in each subgroup)dividing according to the days of irradiation, second set was infected(irradiated groups)randomly divided in to two groups, first group irradiated for 5 mints and second group irradiated for 15 minutes. Both irradiated groups subdivided according to follow up period 3, 5, 10 days. Animal killed on day 3, 5, and 10 after treatment and control group killed also on 3,5,10 after contamination. Cold laser therapy (CLT) achieved by semiconductor diode laser 532nm, output power =40mw, continuous wave laser, power density =5.71 mw/cm2 and doses 1.7J/cm2, 5.14J/cm2. The output of green laser fitted with beam expander to irradiate a circular area of diameter 7cm2. CLT started after surgery and repeated for 3, 5, and 10 days. Wound healing studied by calculating the percentage of wound closure and histopathological evaluation. Conclusion: the present study showed that green laser therapy had obvious influence on healing of infected wound especially with a dose 5.14 J/cm2.


Article
Evaluation of Thyroid Function in Sera of Acute and Chronic Leukemic Patients
تقييم وظائف الغده الدرقيه في مصل مرضى السرطان الدم اللمفاوي الحاد والمزمن

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Abstract Background: This study aims to compare thyroid function between patients with acute and chronic leukemia, through measurement of triiodothyronin, tetraiodothyronin (thyroxin), free triiodothyronin, free tetraiodothyronin, thyroid stimulating hormone, antithyroglobulin, and antithyroperoxidase . Material and Methods: One hundred twenty subjects collected from the Hematological Center / AL-Mustansiriya University, This subjects divided into two groups depending on the lineage of the original mutated cell: forty patients of chronic lymphocytic leukemia and forty patients of acute lymphocytic leukemia and forty healthy control for comparison with two groups. Complete blood count of each subjects was evaluate by using Hemolyzer 5 instrument, and Hormonal tests which include: triiodothyronin, tetraiodothyronin (thyroxin), free triiodothyronin, free tetraiodothyronin, thyroid stimulating hormone, were measured by using Minividas. antithyroperoxidase and antithyroglobulin were measured by using Enzyme Linked immunosorbent assay. Result: The result indicated a presence of highly significant increase (P<0.001) of red blood cell and platelet among patients with acute lymphocytic leukemia when compared with control groups, while highly significant decreased (P<0.001) of red blood cell in chronic lymphocytic leukemia when compared with control groups and highly significant increase (P<0.001) of platelets were found in chronic lymphocytic leukemia when compared with control groups. A significant increase (P<0.05) of thyroid stimulating hormone, free triiodothyronin, antithyroglobulin, and antithyroperoxidase in sera of both acute lymphocytic leukemia and chronic lymphocytic leukemia patients in comparison to that of the control group. A significant positive correlation (p˂0.05) was observed between antithyroperoxidase and free tetraiodothyronin in sera of acute lymphocytic leukemia patient while, in contrast with chronic lymphocytic leukemia group there was no significant correlation. A significant negative correlation (p˂0.05) between antithyroperoxidase and RBC was observed , while a significant positive correlation (p˂0.05) between antithyroperoxidase with platelet was observed in sera of chronic lymphocytic leukemia patient. Conclusion: Increase of antithyroglobulin, and antithyroperoxidase with the increase of thyroid stimulating hormone levels of both groups (acute lymphocytic leukemia and chronic lymphocytic leukemia) indicate an autoimmune thyroid disorder, and the free tetraiodothyronin is an important test and it may be used with antithyroperoxidase as a marker for diagnosis of leukemia.

Table of content: volume:30 issue:2