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   2011| May-August  | Volume 18 | Issue 2  
    Online since July 30, 2011

 
 
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ORIGINAL ARTICLES
Breastfeeding practices: Positioning, attachment (latch-on) and effective suckling - A hospital-based study in Libya
Ram C Goyal, Ashish S Banginwar, Fatima Ziyo, Ahmed A Toweir
May-August 2011, 18(2):74-79
DOI:10.4103/2230-8229.83372  PMID:21897915
Purpose/Objective: To assess the correct position, attachment and effective suckling in the breastfeeding of infants as practiced by mothers attending hospitals at Benghazi. Materials and Methods : An observational, descriptive, cross-sectional study was done at AlJamahiriya and AlFateh Hospital in Benghazi, Libya, from November 2009 to February 2010. One hundred ninety-two mother-neonate units were observed for mother's and baby's position, attachment and effective suckling using WHO B-R-E-A-S-T- Feed observation form. Grading of positioning, attachment and suckling was done according to the score of various characteristics. Data thus collected were analyzed using software SPSS 11.5 version. Results: About 15% of the infants were about a week old (early neonatal period) and 85% were in the late neonatal period. There was poorer positioning among primipara (24.0%) than multipara (8.9-12.5%)mothers. Poorer attachment was also more evident among primipara (30.0%) compared to multipara (20.9%) mothers. Parity was significantly associated with poor position (P = 0.028) and attachment (P = 0.002). Poor attachment was related to cracked nipples and mastitis. Preterm and low birth weight were significantly associated with poor attachment and poor effective suckling. Poor suckling was more (42.8%) in the early neonatal period than late neonatal period (32.9%). Conclusions and Recommendations: Young (<20 years) and primipara mothers were more in need of support and guidance for appropriate breastfeeding techniques. It is recommended that each mother should be observed for mother's and infant's positioning and attachment at the onset of breastfeeding and if needed subsequent counseling should be given on correct positioning and attachment.
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CASE REPORT
Breast abscess caused by penicillin resistant Pneumococci
Boppe Appalaraju, Anila A Mathews, Appolo C Bhaskaran, Pavai Arunachalam
May-August 2011, 18(2):85-86
DOI:10.4103/2230-8229.83375  PMID:21897917
Breast abscess is mostly caused by Staphylococcus aureus. A 26-year-old immunocompetent lady was admitted with breast abscess. Incision and drainage (I/D) was done and Pneumococci were isolated from the drained pus. The patient was earlier treated with Augmentin which was later changed to linezolid after testing for antibiotic susceptibility. This strain showed a high level of resistance to penicillin. It had been noticed that there was a slow increase in the number of penicillin resistant Pneumococci isolated in our hospitals. The increase in penicillin-resistant Pneumococci correlates with the intensive use of beta-lactam antibiotics. Hence, antibiotics should be used judiciously, avoiding their use particularly in mild self-limiting upper respiratory infections. Attention therefore, should focus on monitoring resistance in Pneumococci to prevent mortality and morbidity associated with this organism, which continues to take a heavy toll on children and the elderly.
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ORIGINAL ARTICLES
Smoking pattern among female college students in Dammam, Saudi Arabia
Manal R Koura, Ahlam F Al-Dossary, Ahmed A Bahnassy
May-August 2011, 18(2):63-68
DOI:10.4103/2230-8229.83370  PMID:21897913
Background: Smoking is the most important avoidable cause of premature morbidity and mortality in the world. The estimated annual death rate of 4.9 million people in 1999 is expected to rise to 10 million by the 2020s and 2030s, 7 million of which will occur in developing countries. Aim: The aim of the present study was to estimate the prevalence of smoking and assess its pattern among non-medical female college students in Dammam, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted of 1020 female students selected from the literature and science colleges by multi-stage stratified random sampling technique with proportional allocation. Data were collected using a self-administered modified WHO Global Youth Tobacco Survey questionnaire. Results: Results revealed that occurrence of smoking among female college students was 8.6%. It was significantly higher among literature college students (12.1%) than among Science College students (3.4%). The mean age at which smoking started was 16 ± 2.4 years, with a minimum of 11 years. More than half of the students who smoked were cigarette smokers, while 43.2% were shisha smokers. There was a strong relationship between parents who smoked and daughters who smoked. The main motive for smoking was curiosity (44.3%), followed by relief of tension (26.1%). Conclusions: It may be concluded that smoking is increasing among female college students in Saudi Arabia. Accordingly, it is recommended that a preventive comprehensive health education program on smoking be initiated for females in middle schools, that stricter tobacco control measures be adopted by the government, and that anti-smoking clinics be established in colleges.
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Was there a change in the body mass index of Saudi adolescent girls in Al-Khobar between 1997 and 2007?
Nada A Abahussain
May-August 2011, 18(2):49-53
DOI:10.4103/2230-8229.83367  PMID:21897910
Background and Objectives: Special concern is focused on the nutritional status of adolescent girls in order to avoid future health problems. The aim of this study was to determine the change in body mass index (BMI) among adolescent Saudi girls living in Al-Khobar between 1997 and 2007. Materials and Methods: A cross-sectional sample of adolescent Saudi girls, 15-19-years-old, living in Al-Khobar, Saudi Arabia, was analyzed through two data sets. The first data set (n = 400) was collected in 1997 and the second (n = 321) was collected in 2007. Both data sets used the same sampling method. Anthropometric measurements were made and the BMI was used to determine participants' nutritional status. Statistical analysis was performed. Results: There was an increase in the median weight of Saudi adolescent girls from 1997 to 2007, but the change was not statistically significant. There was a statistically significant change, however, in adolescent girls' height during the 10-year interval. Using BMI to determine the nutritional status of the sample, no statistically significant difference was found. Overweight and obesity remain prevalent in about 30% of the adolescent girls, and about 3.5% of the girls in both sets were underweight. Conclusions: This study concluded that there was no change in BMI among Saudi adolescent girls living in Al-Khobar during the 10-year span. Underweight is of low prevalence, and overweight and obesity are the critical nutritional problems that are faced by this population. Further research using time span comparisons is important to assess changes in maladaptive overweight and obesity.
  6,089 477 3
Overweight and obesity among school-going children of Lucknow city
Rajaat Vohra, Pankaj Bhardwaj, Jyoti P Srivastava, Shekhar Srivastava, Anusha Vohra
May-August 2011, 18(2):59-62
DOI:10.4103/2230-8229.83369  PMID:21897912
Background: Childhood obesity is increasingly being observed with changing lifestyles of families. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges from 1% to 12.9% among Indian children. Objectives: The present study was undertaken to study the magnitude of overweight/obesity and its determinants among children in Lucknow city. Materials and Methods: A list of government and private school was procured from Office of Basic Shiksha Adhikari. Three government and three private schools were selected by Simple Random Sampling. Students of 5th to 12th grades available at the time of study were included as study unit. Predesigned and pretested questionnaire was used to elicit the information on family characteristics and individual characteristics. Height and weight were measured and BMI was calculated. Children with BMI of 25 and above were considered overweight and children with BMI more than 30 were considered obese. Results: Overweight and obesity was found to be 4.17% and 0.73%, respectively; they together constitute 4.91% for overweight/obesity. The study revealed that the important correlates of overweight/obesity were father's education, father's occupation, class, children playing outdoor games for less than 30 min, and those consuming fast foods. Conclusions : Children of higher classes (above 8th standard) belonging to higher socioeconomic group with less outdoor activities and consuming fast foods were more predisposed to overweight/obesity. As a preventive strategy, there is a need to apply health and nutritional education programs for inculcating healthy life styles, and incorporating more outdoor activities in Physical Education Department of school curriculum.
  5,019 864 17
Quality of hypertension care in the family practice center, Aseer Region, Saudi Arabia
Yahia M Al-Khaldi
May-August 2011, 18(2):45-48
DOI:10.4103/2230-8229.83366  PMID:21897909
Introduction: Hypertension (HTN) is a common health problem in Saudi Arabia. Good control depends on the quality of care, which should be supervised and monitored regularly through clinical audit. Aims: The objective of this study was to assess the quality of HTN care at Al-Manhal Family Practice, Aseer Region, Saudi Arabia. Settings and Design: This study was conductedin 2009 at Al-Manhal Family Practice, Aseer Region, Saudi Arabia. Materials and Methods: Medical records of all hypertensive patients were extracted and reviewed using master sheets. Assessment of processes and outcomes of HTN care were based on the standards of quality assurance manual issuedby the Ministry of Health. Statistical Analysis Used: Data were entered and analyzed by SPPS, version 15. Relevant statistical tests were used accordingly and the P-value was considered significant when it was less than 0.05. Results: A total of 295 medical records were reviewed and assessed. Most patients were Saudi, married, and about 50% were educated. Two-hundred and thirty-one records were assessed for processes and outcomes of HTN care. Weight measurement and physical examination were carried out for 99% and 97% of the patients, respectively. For 53% of the patients, blood was checked for glucose and kidney function and a lipid profile was done. More than two-thirds of the patients were overweight and obese while 46% had diabetes. Less than one half of the patients had good control of HTN. Conclusions: By most standards, quality of HTN care in Al-Manhal Family Practice was unsatisfactory. Most of the patients had comorbidities and poor HTN control. Essential facilities should be provided to the practice to optimize HTN care and to improve the degree of control.
  3,676 651 2
Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia
Salih A Bin Salih, Mohammed S Showlag, Mohammed A Al-Qahtani, Ahmad Taha, Muhammad Yousuf, Mohammed Abdullah
May-August 2011, 18(2):80-84
DOI:10.4103/2230-8229.83374  PMID:21897916
Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF) in a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Results: Documented acute and chronic AF was present in 157 (21.8%) and 563 (78.1%) patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems (chest infection, bronchial asthma, and pulmonary embolism) were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus (DM) in 68.8%, hypertension (HTN) in 59.3%, chronic lung diseases (bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease) in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease (IHD) in 23.1%. In 9 (1.3%) patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF (P<0.01). Conclusions : Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control
  3,590 447 2
Attitudes of Saudi medical students toward the disclosure of information on cancer in eastern Saudi Arabia
Ali M Al-Amri
May-August 2011, 18(2):54-58
DOI:10.4103/2230-8229.83368  PMID:21897911
Objective: To assess the attitude of future physicians regarding the disclosure of diagnosis, prognosis, benefits, and adverse effects of therapeutic intervention if they happen to have cancer. It also examined the differences if any between regions or gender. Materials and Methods: A total of 332 medical students from University of Dammam, in the Eastern Province of the Kingdom of Saudi Arabia were surveyed using a self-administered questionnaire. The questionnaire consisted of nine questions on the attitudes to disclosure of information on cancer. This self-administered questionnaire was completed by the students in the presence of an investigator. Results: The vast majority of Saudi medical students stated that they would like to know about diagnosis of cancer (92.8%) and only 7.2% wanted information withheld from them. Further, 67% of the males and 74.1% of the females wanted family members to know (P = 0.01), but one-third (33%) did not want their family to know. Only 24.1% of the male and 21.1% of female students wanted their friends to know. In addition, -97% of the males and 98.8% of the females wanted to know the diagnosis, and 97% and 95.8% of females and males, respectively, would like to know the side effects of the therapy. Almost 95% of male and 93.4% of female students wanted to know the prognosis. Also, 98% of medical students from the Eastern Region would want the diagnosis of cancer to be disclosed compared to 73.6% of those from other regions (P = 0.01). There is no difference between the genders in attitudes toward the disclosure of the diagnosis, 94.6% and 92.2% (P = 0.38). Conclusions: There was a consensus among Saudi medical students on the knowledge of the benefits of treatment, adverse effects of therapy, and prognosis. Female students significantly more than males would like their families to be informed. Significantly more medical students from the Eastern Region than those from other regions would like the diagnosis of cancer to be disclosed.
  3,267 476 4
Toward smoke-free homes: A community-based study on initiatives of rural Indian women
Srabani Mittal, Samiran Das
May-August 2011, 18(2):69-73
DOI:10.4103/2230-8229.83371  PMID:21897914
Context: Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Aims: Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. Materials and Methods: A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. Results: A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Conclusions: Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.
  2,775 447 5
LETTER TO EDITOR
An epidemiological study of obesity in a rural area
Prashant R Kokiwar
May-August 2011, 18(2):91-91
DOI:10.4103/2230-8229.83377  PMID:21897919
  2,351 371 -
SHORT COMMUNICATION
A cross-sectional study of the sociodemographic profile of juveniles under institutional care in the city of Mumbai
Achhelal R Pasi, Ratnendra R Shinde, Ravindra S Kembhavi, Dilip D Kadam
May-August 2011, 18(2):87-90
DOI:10.4103/2230-8229.83376  PMID:21897918
Objectives: To study the sociodemographic profiles of children under institutional care, identify the characteristic features of the families prone to have destitute children, and suggest measures for prevention of destitution of children in the community. Material and Methods: A questionnaire-based cross-sectional study was conducted in a population of 507 boys and girls from 6 to 18 years admitted to four different institutes for care and support. A sample of 170 children was selected using systematic random sampling technique. A survey was done to study the health status of the children. Data was analyzed using SPSS software. Frequency and proportion were calculated and chi square test was used. P value of >0.05 was considered significant. Results: 65.9% of children were in the 6 to 12 age group. 63.5% were Hindu by religion. The majority i.e., 80.9% of the boys and 80% of the girls were urban in origin, 82.4% of the juveniles were from nuclear families, 40.0% of boys and 62.3% of the girl juveniles were from lower socioeconomic status. 75% of boys and 25% of the girls had been child laborers just before institutionalization. Only 12.7% of juveniles were from large families, the rest, the majority (87.3%) were from medium to small sized families. Conclusions: Nuclear families of medium to small size which belong to the lower socioeconomic status and of urban origin were found to be unable to provide care and support to their children putting them at the risk of becoming destitute.
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OBITUARY
Prof. Barbara Starfield
Sameeh A Al-Almaie
May-August 2011, 18(2):92-92
  1,654 357 -
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010