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   2005| September-December  | Volume 12 | Issue 3  
    Online since June 30, 2012

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Breast infections in non-lactating women
Maha S.A AbdelHadi, Huda A Bukharie
September-December 2005, 12(3):133-137
Background : Breast infection in lactating mothers is a common entity which in the majority of cases can be explained by ascending infections. However, it has been noticed that the number of non lactating women presenting with breast abscesses is rising. This study attempts to explore the sensitivity pattern of organisms and underlying cause of breast infections in non-lactating women. Materials and Methods : This review was undertaken at King Fahd of the University, Alkhobar, Saudi Arabia between 1991-2003. All patients presenting with breast infections were included. Medical records, operative notes, cultures, histopathology reports and outcome were reviewed. Results: The number of patients presenting with breast infections accounted for 179(3.5%) out of the total number of patients 6314 with variable breast complaints. Infection occurred in 136(76%) lactating women (Group I) ,while Non lactating (Group II) breast infections accounted for 43(24%). Age ranged from 24 years to 52 years. Underlying clinical conditions were found in 26 patients(60%) in Group II namely granulomatous mastitis13(50%), duct ectasia4 (15.3%), pregnancy3(11.5%), fat necrosis1(3.8%), diabetes3 (11.5%) and breast cancer 2(7.6%). The pattern of culture results was different in the two groups, from differing causative organisms namely staphylococcus aureus as the commonest organism in both groups, in comparison to such uncommon organisms as Klebsiella pneumonae, Peptococcus magnus, Streptococcus group B, Entro-bacter cloacae, Methicillin resistant staphylococcus aureus (MRSA) and Mycobacterium tuberculosis occurring in group II only. Fortunately, all organisms were sensitive to antimicrobial therapy. Conclusion : Breast infection in non-lactating women is an infrequent but recognized clinical entity that deserves special attention. An underlying clinical condition should always be sought and treated. Indeed, in addition to cultures, radiological modalities such as ultrasonographic imaging may provide specific diagnosis and aid the management.
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Prescribing patterns for acute respiratory infections in primary health care, Aseer Region, Saudi Arabia
Yahia M Al-Khaldi, Mohamed M.A.A. Diab, Khalid S Al-Gelban, Ali S Al-Asmari, Salaheddin Al-Amin, Mesfer S Al-Shahrani
September-December 2005, 12(3):121-126
Objective : The objective of this study was to identify the patterns of prescribing for Acute respiratory infections in patients attending primary health care centers in the Aseer region, southwestern Saudi Arabia . Materials & Methods: This study was conducted at primary health care centers in the Aseer region during November 2003. A master sheet designed by the investigator was distributed to all the working physicians in the primary health care center in the Aseer region. The master sheet included the age, sex, complaints, signs, clinical diagnosis and the type of medications prescribed. Physicians were asked to include all patients attending on 17 th November 2003, and send the master sheet to the Technical Supervision Unit at Primary Care Department, General Directorate of Health Affairs. Data of the master sheet was entered and analyzed by using SPSS. Results: The total number of patients attending with acute respiratory infections(ARIs) was 3000 which represented 25% of the patients attending primary health care centers that day. Children formed 60% of the total number of cases. Regarding symptoms and signs, it was found that 70% had a cough, 59% had a runny nose, and 43% had a sore throat . The common cold was the most common diagnosis (42%). Antipyretics, antihistamines, antibiotics and antitussives were prescribed for 78%, 48%, 45% and 25% respectively. Statistical analysis using logistic regression revealed that the higher the temperature, the more severe the throat congestion and the presence of exudates on pharynx, the higher the likelihood to prescribe antibiotics. Conclusion: In this study, it was found that the prescription of all drugs for ARIs was still high in spite of the fact that these conditions are self-limiting. To rationalize prescribing for ARI, implementation of the national protocol for diagnosis and treatment of ARIs is mandatory. Further studies to explore the physician's knowledge, attitudes and behavior concerning prescribing for ARI is strongly recommended.
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Antibiotic susceptibility patterns of different bacteria isolated from patients with ventilator associated pneumonia (VAP)
Abdulrahman M Alqurashi
September-December 2005, 12(3):139-144
Objective: Ventilator associated pneumonia (VAP) is a frequent complication of mechanical ventilation (MV) and it is a leading cause of death in MV patients. The development of VAP has been demonstrated as being due to aspiration of oropharyngeal secretion, ventilator tubing condensate, or gastric contents that are colonized with pathogenic microorganisms. The aim of the present study is to isolate and identify bacteria that cause VAP and to study antibiotic susceptibility. Material and Methods : This study was carried out on 95 patients who fulfilled the diagnostic criteria for VAP. Quantitative cultures of endotracheal aspirates (EA) using a cut-off point of 10 [6] cfu/ml was done. Results : The microbiological results revealed that gram negative bacilli were the most common bacterial agents responsible for VAP and accounted for 78.8% of all the causative agents. The most common isolated organisms were Klebsiella pnemouniae (30.9 %) followed by Pseudomonas aeruginosa (22.5%), Staphylococcus aureus (21.2%), Eschericia coli (12.8 %), Proteus spp. (9.8%), and Citrobacter spp. (2.8%). Blood cultures were positive in 25.9% of patients with Klebsiella pnemouniae in about 33.3%. Conclusion : From this study, it can be concluded that VAP is an important nosocomial infection. EA is a simple procedure to obtain respiratory samples and perform sensitivity testing in patients with VAP. Also, the commonest cause of VAP is gram negative bacilli.
  2,617 282 -
Severe malaria in sudanese children: Clinical aspects and prognosis in hospitilized patients
Zeidan A Zeidan, Elkhir M Kojal, Ali B Habour, Kamal A Nowary, Fatih H Mohammed, Mohammed A Awadelkareem
September-December 2005, 12(3):127-132
Objective : To asssess the epidemiology, clinical presentations, disease mangement, outcome and risk factors associatted with severe malaria in children in four hospitals in Sudan. Methods : Follow-up prospective design was used to fulfil the objectives of the study in four hospitals: Omdurman paediatrics hospital, located in the capital (Khartoum) compared to Madani, Gadarif and Sennar hospitals located in other states. The results: Total admission of severe malaria was 543 children representing 21% of all paediatric admissions, and 12% of malaria outpatient cases. Median age of children with severe malaria was 48 months. 93% of children with severe malaria died before the age of 9 years. Case fatlality rate was 2.6%. The risk of dying because of delay was four times more than when there was no delay , 95% CI (1.5 - 14.3). Other risks of death were severe malaria associated with coma, inability to sit or eat and hyperpyrexia. Omdurman hospital in Khartoum State in the capital, had the highest case management performance percentage compared to other regional hospitals. Conclusions: In view of this, it can be argued that deaths due to severe malaria could be reduced by improving health management and planning with the redistribution of resources (including consultants) at the central and regional levels and the conduct of proper training programs on the management of severe malaria at all levels. Raising the awareness of parents about seeking treatment for malaria early in order to avoid unnecessary deaths is vital.
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Prevalence and risk factors of Asthma among Wad Medani basic school children, Gezira State, Sudan
Salwa E Hussein, Mohammed A Ahmed
September-December 2005, 12(3):145-148
Objectives: Childhood asthma is said to be under-estimated and under-diagnosed in tropical countries including Sudan. The prevalence of asthma worldwide is increasing. The objective of this study was to determine the prevalence and the trigger factors of asthma among Wad Medani basic school children. Methods: A cross-sectional study was conducted during school year 2000-2001. The study group was selected by stratified proportional random sampling according to their age, sex and localities.Data was collected utilizing a pre-tested questionnaire addressing the history of asthma and its trigger factors (sample-2, 2002). Results: The results revealed that asthma is the ninth of the most common diseases among the school children, having a prevalence of 9.2% (sample 1) and 17.9% (sample 2), the main trigger factors of which are dust, cold bats, exercise and smoke respectively. Conclusion: Asthma among school children is a common problem that should be considered when planning preventive school health programmes.
  2,060 219 -
Health care professionals' knowledge on home health care in Al-Khobar and Al-Dammam
Ali M Al-Hazmi, Nabil Y Al-Kurashi
September-December 2005, 12(3):115-119
Objective: To survey self-reported knowledge of home health care (HHC) services of health care professionals in Al-Khobar and Al-Dammam. Methods: A specially developed questionnaire was used to conduct a cross-sectional study to find out how knowledgeable 11 hospital administrators, 16 PHHC medical directors, and 637 health care team were of HHC services. Results: When asked whether they knew of HHC services, 90.9% of medical directors, 62.5% of primary health care center directors, 83.1% of physicians, 92.9% of nurses, 98.6% of physiotherapists, 95.9% of social workers, and 57.6% of the health team members replied that they did, although this knowledge was very scanty. Health care workers' source of information on HHC services was hospital work (65.0%) while administrators' sources were journals (65.0%). Only 11.1% of the administrators and 30.3% of the health team members indicated having had HHC training from university, and 3.7% of administrators and 20.4% of health team members indicated having attended a HHC lecture or symposium. The only finding with significant difference of responses (p<0.001) was on the knowledge of HHC services among health care professionals. All other responses showed no significant differences between them. No significant differences in the responses were found between the two groups of administrators. Conclusions: Health professionals and administrators showed little knowledge of HHC services. The main source of HHC information for health professionals was from their hospital experience while administrators learned more about HHC services from medical journals. Recommendations: HHC training centers must be set up in Saudi Arabia. Home health care concepts and skills should be part of the regular health science undergraduate curriculum.
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Professional attitudes and career choices of female medical laboratory technology students and graduates: Experience from Eastern Saudi Arabia
Layla A.M. Bashawri
September-December 2005, 12(3):149-155
Objectives: To conduct a survey of the medical laboratory technology senior students, interns and graduates in King Faisal University to gather descriptive data on what students and graduates felt about their chosen profession and their career goals for the next five years. Material and Methods: The study design was a survey. A questionnaire was specially designed for this purpose in order to gather information on the professional attitudes and career choices of the participants. The study period was one year, from January I, 2004 to December 31, 2004. A stratified random sample with proportional allocation was selected and a self-administered 17-item questionnaire was distributed. A 5-point Likert scale ranging from 1, strongly agree to 5 strongly disagree was created for the questions as well as two multiple-choice questions. 115 questionnaires were distributed to the available senior students, interns and graduates, 111 were returned completed. Statistical analysis was performed using the statistical package for the social sciences (SPSS) PC + Software program. Results: Respondents indicated a high level of satisfaction with their chosen profession as indicated by the ratings on the different questions relating to the profession of MLT. Their career goals were mainly working in a hospital laboratory as medical technologists (57.7%), and continuing their postgraduate education (38.7%). Conclusion and Recommendations: MLT students and graduates expressed satisfaction with their chosen profession as evidenced by their responses assessing professional attitudes. Their career goals were mainly working at the bench level as Medical Laboratory Technologists in a hospital laboratory and postgraduate education.
  1,906 169 -
Avian influenza: Reasons for concern and the challenges ahead
Tariq A Madani
September-December 2005, 12(3):113-114
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010