ABSTRACT
Children under 5 years of age in developing countries are particularly vulnerable to malnutrition. Malnutrition affects 50% of hospitalized children and 25–70% of the critically ill children. Malnutrition interferes with the appropriate response of the body to disease and predisposes to infection and to the onset of multiorgan failure, increasing morbidity and mortality, the mean length of hospital stay, and health costs. Aim: A prospective cohort study of children admitted to the tertiary pediatric ICU between January 2009 and January 2014 was carried out. To assess the malnutrition type, and impact of nutritional status on outcomes like mortality rate, disease, complication in critically ill children.To the study were enrolled 138 children admitted to the pediatric intensive care units of the NationalCenter for Maternal and Childrens Hospital. The study protocol was approved by the Ethics Committee of the MNUMS, and written informed consent was obtained from all study participants. Nutritional status was determined using Waterlow criteria.Total participants were 49.3% (n=68) of male, 50.7% (n=70) female. 138 children with a mean age 4.4 months ±3.6/ Std.Er/, min = 1 month, max = 12 months, mode = 1 month. n=70(50.7%) acute malnutrition, n=58(42%) chronic malnutrition by Waterlow criteria. In malnutrition group was assessed patient with ricket n=36 (26.1%), patient with anemia n=56(58.9%)While malnutrition is a major problem in pediatric intensive care units. Acute malnutrition moreoccurred in the pediatric intensive care.Malnutrition more occurring of intrauterine infection, genetic disorder, hematology disease’s patients.
ABSTRACT
Health expenditure towards mental health is only 2% of all other health expenditure allocated to public health. Currently almost 64% of all that fraction xpendituregoesto hospital based care. It means that there is lack of resources or limitation for development of community basedmental health services in this country, where hospital based mental health system is still remain in place. Long term chronic patients occupied most hospital beds are usually homeless, have no caregivers, no family protection or have a families that could not support their mentally ill members. Traditionally National Center for Mental Health has been offering community based rehabilitation scheme in form of developing labor skills but its coverage and accessibility remains short. In other words it is open for those who admitted to an inpatient service only.For last years the center has been forged partnership with international NGO namely AIFO in cooperation to gradually expand its works toward development of community based rehabilitation programs for people with mental health problems. Study basis is a current need for an expansion and coverage of mental health care and services and priority development of community based services over inpatient care.To asses a current situation of long term chronic patients admitted to inpatient service, their inclusion to CBR programs, expansion possibility of mental health servicesTotal 450 cases of history were registered in an inpatient care in 2013. 170 cases of them were belong to long term patients (1 and over years) with 94 male (55.3% )and 76 female (44.7%) patients. From perspective of age: adult (30-49 years old) consists of main percentage (66.4%)of long term patients. 64 (57.1%)of that age group patients have diagnosis of schizophrenia. Age group of 10-19 years old consists of 0.6% with mental retardation diagnosis. Research shows that long term patients mostly have affective disorders, organic psychosis, mental retardation and schizophrenia. Schizophrenic patients consist of most percentage (52.9%) of long termpatients. Inpatient stay duration spans from 1 to 36 years for long term patients and 17 patients of them have been on permanent basis at the center. These inpatient care users usually have been re-admitting after from 2 weeks to 1 month of duration breaks and they all suffer fromschizophrenia.Currently 170 patients out 450 or 1 in 3 admitted to inpatient service department at NCMH are chronic patients. 80.6% of those frequent users consist of labor intensive 20-49 year olds. Need to develop and conduct community based rehabilitation programs at primary, secondaryand tertiary level of public health services, include chronic patients and also need to set up a nursery for chronic mental health patients.
ABSTRACT
In pathopsychology, one branch of mental analysis, recently we are using qualitative analyzing methods for mental phenomena. But improvement of professional methods of study, generalization of the new computer based technology, children’s psychology assessment and many other problems are becoming an urgent issue in this field.Our study involved 45 children from orphanage and the High School Personality Questionnaire (HSPQ) computer based questionnaire is used to measure the personality characteristics of orphan children. Spielberg-Hanin test is used to reveal anxiety. Study is analyzed by SPSS program.In total, 45 children (age from 9 to 18), 22 boys and 23 girls participated in our survey. 8.9% of them measured as a high intelligence, 91.1% measured as a lower and an average intelligence. Interestingly, 60% of children were good at controlling their emotions and behavior. Thus 55.6%had symptoms of flexible mind, imagining and probability of affect illness. Having more stress is due to introverted preference and self-blaming, also a feeling of self-blaming is due to not being bold. 51.1% of them assessed that they have dependent, emulative personality and submissive behavior which was very considerably. The anxiety of condition was high in 34.1% of children andlow in 12.2% of them, thus anxiety of individual was high in 36.6% and low in 7.3% of children. Therefore, it’s essential to help orphan children and consider reducing anxiety and improving their self-independence.
ABSTRACT
Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.
ABSTRACT
Acute lung injury and acute respiratory distress syndrome among children are clinical entities of multifactorial origin requiring intensive care. Pediatric acute respiratory distress syndrome is a devastating lung condition with high mortality being the end result of a wide variety of inciting events. The purpose of this article is to review recent evidence for the epidemiology, clinical signs, diagnosis and treatment of the acute respiratory distress syndrome in chidlren.