Journal of Ideas in Health (JIDHealth)
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Neonatal bacterial colonization of the intestine—Implications for the practitioner
Get PDFBackground: Neonatal intestinal bacterial colony balance has correlations with positive and negative health situations. The understanding of how neonate colonization occurs is therefore extremely important in providing life-extending and holistic care for infants. Certain medical interventions can impede optimal intestinal colonization. However, with proper screening and identification, side effects can be limited and compensated for, and complications can be minimized in an already compromised population. This study aims to identify influences on neonate microbiomes to create best practices for increased health outcomes. Develop mitigations for factors leading to intestinal microbiome conditions linked to negative neonate outcomes and increase opportunities for healthy colonization.
Methods: The research team conducted a literature review via PubMed, Cumulative Index of Nursing and Allied Health Literature, and Academic Search Ultimate to collect data regarding neonatal bacterial colonization of the intestine.
Results: Normal colonization is affected by birth age, birthing method, time spent in direct skin to skin contact with mother and feeding type. Iatrogenic influences include the use of oral and topical antibiotics, proton blockers, and practices that limit direct contact.
Conclusion: The nursing process and policy adaptations can have a positive effect on developing a protective neonate intestinal microbiome. Awareness of risks and early clinical signs can improve positive interventions that may prevent life-threatening complications in susceptible neonates.
 
Assessment of obesity and central obesity among patients with knee osteoarthritis in Al-Sadder Hospital, Baghdad, Iraq
Get PDFBackground: Obese individuals are at increased risk for many chronic and life-threating conditions. The most significant burden on the musculoskeletal system resulted from osteoarthritis, mainly knee osteoarthritis. This study aimed to determine the prevalence of obesity and central obesity among a group of patients with knee osteoarthritis, analyze the effect of demographic variables, and examine the relationship between these two types of obesity.
Methods: A cross-sectional study was conducted in Al-Sadder hospital in Baghdad from June through September 2017. A convenience sample of 200 patients with knee osteoarthritis was collected. Those with body mass index (BMI) equal to or more than (30 kg/m2) considered obese. The cutoff point for central obesity was the waist-hip ratio (WHR) above (0.9) for men and above (0.85) for women. The risk ratio and 95% confidence interval (95% CI) calculated to determine the strength of the relationship. P-value ≤ 0.05 was considered statistically significant.
Results: The number of obese patients, according to BMI, was 163 (81.5%). For central obesity, the men and women with unhealthy WHR were 53 (96.4%) and 131 (10.3%), respectively. No significant difference in the rate of obesity among age groups (p= 0.986). Central obesity is significantly lower in those less than 45 years (p=0.023). In men, the risk of obese to have central obesity is (1.06) with no significant association (95% CI = 0.89 - 1.27, P = 0.481). In women, risk ratio = 1.56 and association is significant (95% CI = 1.03 - 1.36, P = 0.037).
Conclusion: The increasing age was associated with a rise in the rate of central obesity, but not with obesity. The overlap between the two types of obesity was evident and significant only in women
Assessment of malnutrition among the internally - displaced old age people in the Tikrit City, Iraq
Get PDFBackground: With the steady increase in the number of old age people, the prevalence of chronic diseases, and the health expenditures, the importance of preventing malnutrition is becoming more critical than ever. This study aimed to assess malnutrition among the internally- displaced old age people in Iraq.
Methods: A descriptive cross-sectional study conducted between November 2016 and March 2017 at the Dream city camp for the internally - displaced persons in Tikrit city, Iraq. Data was collected using the valid (Arabic) version of the mini - nutritional assessment (MNA) questionnaire. The internally displaced persons (IDPs) interviewed, and the nutritional status assessed via the MNA, body mass index (BMI), mid-arm circumferences (MAC) and calf circumferences (CC) measures.
Results: A total of 142 eligible old age persons, of which 40.2% were malnourished, and 35.2% were at risk of malnutrition. Among those with malnutrition, 40% were males, and 60% were females. Concerning comorbidity, 80% with positive malnutrition, had chronic diseases. DM reported a higher prevalence (46.5%) compared to other chronic diseases.
Conclusion: The prevalence of malnutrition was high among the old age people resident at the displacement camp in Iraq. Both the deteriorating security situation and the lack of proper services have combined to exacerbate the nutritional status of older persons in displacement camps
Iraqi medical students are still planning to leave after graduation
Get PDFBackground: Medical students constitute the backbone of the future human resource for health, and therefore, as much as attention should be given to secure a high level of education, it should also be given to understand their wishes to leave or to stay at home country. This study aimed to find out the prominent factors associated with Iraqi medical students\u27 planning to leave their country after graduation.
Methods: A descriptive cross-sectional study was conducted among clinical medical students (fourth, fifth, and sixth classes) of two medical colleges (the University of Anbar and University of Fallujah) in Anbar Governorate from 1st to 14th March 2018. A total of 183 students (Response Rate: 72,6%.) completed a self-administered questionnaire consisting of 15 close-ended questions related to the socio-demographic factors, economic characteristics, and some other factors inspired from Iraq\u27s situation. Moreover, one open-ended question was designed to explore the main reasons for migration from the student\u27s point of view.
Results: Although 109 students (60%) felt that serving their citizens and country is a priority, however, the vast majority of 133 (73%) of the surveyed students had a plan to leave Iraq. About two thirds (69 %) of students intended to migrate as soon as they manage to: obtain their graduation certificate (49%); have enough money (34%), and the remaining 18% when they get parents’ permission.
Conclusion: Our results suggest that living environments and work-related variables are significantly associated with medical students\u27 intention of migration; however, social reasons and inspiring academic achievement were the main factors triggering students to leave Iraq
Predictors of emotional exhaustion among physicians from Iraq - a descriptive cross-sectional multicentre study
Get PDFBackground: Doctors and paramedics in countries suffering from long-acting conflicts, including Iraq, are working in severe and exceptional conditions, putting them under severe physical and psychological pressure, therefore examining burnout is important when dealing with the quality of care and working conditions. This study aimed to assess the point prevalence and to explore factors associated with emotional exhaustion (EE) among medical doctors in Iraq.
Methods: Descriptive and a cross-sectional study was conducted (January to June 2014) among a randomly selected sample of medical doctors (n=576, 87.3% response rate) working in twenty large general hospitals and medical centers. In addition to EE, the self-administered questionnaire used was consisting of questions on sociodemographic, work-related characteristics, conflict-related variables, and job satisfaction. EE was measured using the emotional exhaustion subscale of the Maslach Burnout Inventory (MBI).
Results: The prevalence of EE reported by 60.0% of the respondents. In multiple linear regression analysis, the emotional burnout was higher among doctors who were married, female, bearing children, being threatened, displaced internally, non-specialist doctors, working more than 40 hours per week, experienced unsafe medical practice, disagreed with the way manager handle the staff and those who reported that the doctor-patient relationship as not excellent.
Conclusion: Our findings suggest that job dissatisfaction, conflict, and violence-related factors were significantly associated with a high level of emotional exhaustion among Iraqi physicians
Upper respiratory tract infection and otitis media are clinically and microbiologically associated
No full textBackground: Although significant improvement has been achieved in terms of antibiotic care, otitis media (OM) continues to be a worldwide health problem that may develop serious complications. This study aimed to detect the growth of organisms and to find out the most susceptible factors related to OM among the Iraqi population.
Methods: A prospective cross-sectional study was conducted at the out-patient department (OPD) of Ear, Nose, and Throat (ENT) at the Baquba teaching hospital at the Faculty of medicine, Diyala University from November 2017 to March 2018. A total of 300 ear samples collected from 87 (29.0%) patients of acute otitis media (AOM), 104 (34.7%) patients of otitis media with effusion (OME), and 109 (36.3%) patients of chronic otitis media (COM). Standard microbiological procedures were recruited to investigate the samples using aerobic and anaerobic culture methods.
Results: The highest incidence of OM 218 (72.7%) was observed among the age group of fewer than ten years old. The most common bacteria isolated were Pseudomonas aeruginosa (35.0%), Staphylococcus aureus (25.0%), Proteus spp. (24.0%), Escherichia coli (7.0%), Streptococcus pneumonia (6.0%), Klebsiella pneumonia (2.0%) and Streptococcus pyogenes (1.0%). It was found that upper respiratory infection (URTI), adenoid inflammation with (URTI), adenoid inflammation, the practices of complementary and alternative medicine (CAM), and the accident or trauma are the main factors related to OM in about (42.0%), (31.0%), (11.0%), (10.0%) and (6.0%) of cases respectively.
Conclusion: Our findings suggest that OM was effectively related to URTI and adenoid inflammation with (URTI) in about 73.0% of cases. More attention should be given to early diagnosis and treatment of URTI before progressing to undesirable OM
Medical students carry more virulent microorganisms at their throat than that of patients\u27 accompaniers
Get PDFBackground: Transition of medical students from a non-clinical to a clinical situation carries a considerable risk that needs further investigation. This study aims to detect and compare the throat bacterial colonization between medical students and patients\u27 accompaniers in a tertiary hospital.
Methods: Across-sectional descriptive study was conducted at the outpatient clinics of the Baquba Teaching Hospital at the Faculty of Medicine, Diyala University, Iraq. A total of 120 throat swabs collected from a sample of 70 medical students (fifth stage) and 50 volunteers as a control group who were selected conveniently during their outpatient visits over September 2018. Aerobic and anaerobic culture methods were recruited to investigate the samples following the standard microbiological procedures.
Results: Finding of this study indicate a high rate of bacterial throat colonization among medical students compared to the control group. Male gender showed high susceptibility for infection than females. The most common bacteria isolated among medical students were Staphylococcus aureus, and Escherichia coli 26 (37.1%), followed by Streptococcus pneumonia appeared in 23 samples (32.8%), Viridians streptococci 19 (27.1%), Acinetobacter spp.14 (20%), Enterobacter spp. 4 (5.7%), Candida spp. 3 (4.2%), Pseudomonas aeruginosa 2 (2.8%) respectively.
Conclusion: Our findings suggest that medical students may contribute significantly to the transmission and dissemination of nosocomial pathogens among patients and vice versa
Simultaneous versus two stage surgical treatment of developmental dislocation of the hip with excessive femoral anteversion in children under the age of three years
Get PDFBackground: Delayed diagnosis and improper treated cases of developmental dysplasia of the hip (DDH) in the presence of excessive anteversion of femoral head may lead to undesirable consequences, including more extensive interventions with severe complications and functional disability. This study aimed to compare the clinical, radiological, and complication outcomes of simultaneously versus two-stage surgical procedures (open reduction and proximal femoral derotation osteotomy) in the treatment of DDH with excessive femoral anteversion among a sample of Iraqi children aged less than three years old.
Methods: A total of 26 DDH cases were treated in two groups (GI, GII) at Al-Wasity Teaching Hospital (Baghdad, Iraq) from January 2014 to March 2015. GI (15 hips) in 13 patients subjected to simultaneous open reduction (with/without salter osteotomy) and proximal femoral derotation osteotomy. GII (18 hips) in 13 patients operated in two stages procedure; open reduction (with/without salter osteotomy) followed by proximal femoral derotation osteotomy six weeks later.
Results: At the time of operation, the average age was 21.79±3.51months (range: 18-30). The mean follow-up period was 10.36 ±1.45 months (range, 8 -12). Statistically, the postoperative clinical, radiological, and complication findings were not significantly different between the two groups. However, in post-operative clinical assessment (McKay\u27s criteria), the satisfying results (excellent and good) were 93% in GI and 88% in GII, respectively. Moreover, in radiological assessment (Severins classification), the satisfying results (excellent and good) were 94% in GI and 83% in GII, respectively. Two cases of re-dislocation and avascular necrosis (AVN) were reported in GII.
Conclusion: When the clinical and radiological findings of one and two-stage open reduction and proximal femoral derotation osteotomy procedures are similar, the one-stage is more likely to overcome the two-stage in terms of minimizing the cost, length of stay and the risk of AVN of the femoral head
Impact of conflict related and workplace related violence on job satisfaction among physicians from Iraq - a descriptive cross-sectional multicentre study
Get PDFBackground: During the last decade, the events of violence against healthcare providers have been escalated, especially in the areas of conflicts. This study aimed to test the impact of conflict-related and workplace-related violence on job satisfaction among Iraqi physicians.
Methods: A cross-sectional study with a self-administered survey was conducted among medical doctors in Iraq from January to June 2014. Participants (n=535, 81.1% response rate) were selected at random from 20 large general and district hospitals using a multistage sampling technique.
Results: The mean (+SD) value on the total job satisfaction score was 42.26 (+14.63). The majority of respondents (67.3%) experienced unsafe medical practice; however, the conflict- related violence showed no significant difference in job satisfaction scores. In backward regression analysis, two socio-demographic variables (age, gender), and three work-related variables (being a specialist, working less than 40 hours per week, working in both government and private sector) were positively related to job satisfaction, while the workplace violence variables were negatively related. It was found that increases in physical attack, verbal abuse, bullying, and racial harassment brought about decreases in job satisfaction scores of 6,087, 3.014, 9,107, and 4,242, respectively.
Conclusion: Our results suggest that work-related variables and workplace violence do affect job satisfaction. Specifically, when physicians have been physically attacked, verbally abused, bullied, and racially harassed, their job satisfaction decreases significantly
Impact of training on practical skills of Iraqi health providers towards integrated management of neonate and child health - a multicentre cross- sectional study
No full textoai:ojs.pkp.sfu.ca:article/2Background: This study aims to assess the mandatory practical skills of caregivers towards the implementation of the Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy in primary health care (PHC) centers of Salah al-Din governorate in Iraq.
Methods: A cross-sectional comparative study was conducted from January to May 2014. An equal sample of 42 trained and 42 non-trained caregivers who are working in 20 PHC centers in Tikrit city and other districts of Salah al-Din governorate of Iraq were included. The study tool was a semi-structured questionnaire with 20 questions covering different required practical skills that caregivers should have. The total score was 100 and in a range of 4- 6 points for each question. An independent sample t-test was used to compare the means of numerical variables.
Results: The mean age of total respondents were (33.18 ± 5.82Years), and the vast majority (63, 75.0%) were females. More than two-third (58, 69.0%) were paramedical compared to 26 (31.0%), who were doctors. Trained caregivers had statistically significant better practice (73.48 ± 13.46) compared to non- trained caregivers (63.95 ± 17.44). Trained doctors had statistically significant better practice (88.15 ± 2.70) compared to trained paramedical staff (66.90 ± 10.84). Trained caregivers from Tikrit city had statistically significantly better practice (80.26 ± 7.38) compared to trained caregivers from districts (67.89± 14.85). The highest proportion (97.5%) of trained caregivers felt the child for fever or body hotness appropriately, and the lowest proportion (59.5%) of them recorded age, height, and weight correctly.
Conclusion: This study showed that training has a positive influence on the implementation of IMNCI interventions. IMNCI-trained caregivers were more likely to correctly classify illnesses than non-trained caregivers