ABSTRACT
Background and objective: Evidence-based medicine, by guiding medical care towards meaningful outcomes to patients, has a significant worldwide impact on medical care and education. It is important that medical students, whom are the future physicians, keep themselves updated with recent advancement in medical knowledge and health care. The aim of this cross-sectional study was to determine the attitude, knowledge and barriers among students towards evidence-based medicine and making them familiar with the concept and advantage of evidence based medicine
Methods: A cross-sectional study was conducted on 163 sixth year students of the College of Medicine at Hawler Medical University during the period from October 2012 to May 2013. The response rate was 86.5%. Knowledge towards evidence-based medicine, accessing and interpreting evidence and perceived barriers to practice evidence-based medicine among participants were the main outcome measures
Results: Of 141 of participants that filled the questionnaire, only 69.5% had heard about evidence-based medicine. Around 82% stated that they had knew evidence-based medicine and only 23.5% had knew steps of evidence-based medicine. Around 65% of respondents welcomed the promotion of evidence-based medicine and 74.4% agreed with that finding from the current study in which it would be helpful in daily management of patients. Furthermore, 31.6% of students reported that standard textbook as a frequent source used for medical knowledge. Around 91% of students did not know the strongest evidence in the hierarchy of evidence and only small proportion of students reported that they understand the common epidemiological concepts that are used in evidence-based medicine
Conclusion: Evidence-based medicine is relatively a new concept among students at the College of Medicine in Erbil. Although the students appeared interested in learning and implementing evidence-based medicine in clinical practice, they need more guidance and training to ensure the correct use of evidence-based medicine ideals
ABSTRACT
Stroke is the third most common cause of death. The objective of this study was to find out the case fatality rate of first-ever stroke in Erbil city. This cross-sectional study included 228 first-ever stroke patients hospitalized to teaching hospitals in Erbil city from January, 1[st] 2009 to August, 31st 2009. Stroke was diagnosed by the consultant internist or neurologist and confirmed by brain CT-scan. Patients were followed-up and one month case-fatality rate was calculated. The one month case-fatality rate was 23.7% with a higher proportion of deaths occurred in females [26.4%] than in males [21.2%] [P= 0.358]. The case-fatality increased with age [P= 0.019]; around 75% of deaths occurred in the 7[th] and 8th decades of life and more than 95% occurred among those 60 years and more. More deaths occurred from haemorrhagic [31.3%] than ischaemic [20.7%] strokes [P= 0.093]. The mean +/- SD ages of dead and alive were 68.56 +/- 11.52 and 61.32 +/- 12.91 years, respectively [P=0.001]. Multiple logistic regression revealed significant association of stroke outcome with age [P= 0.037] and atrial fibrillation [P=0.001]. The one month case-fatality rate was relatively comparable to that reported in other developing countries
ABSTRACT
Stroke is a worldwide health problem. This study was carried out to find out the risk factors associated with stroke in Erbil city. A hospital based case-control study was carried out in Erbil city from January, 1[st] 2009 to June, 30[th] 2009. The sample included [173 cases and 173 controls] cases admitted to Erbil teaching hospitals with first-ever stroke diagnosed by the consultant internist or neurologists and confirmed by brain CT-scan. Sex and age-matched [ +/- 5 years] patients admitted to the same hospital, who do not have stroke, were taken as a control group. The mean +/- SD ages of cases and controls were 62.2 +/- 13.4 and 61.54 +/- 13.16 years, respectively with a male: female ratio of 1.1:1. Nearly 70% were ischaemic and 30% were haemorrhagic. A slightly more than half [51.45%] of strokes occurred in the 7[th] and 8[th] decades of life. Multiple logistic regression analysis revealed statistically significant association between smoking [P<0.001], exercise [P<0.001], hypertension [P=0.001], family history of stroke [P=0.004], BMI [P=0.012] and PCV% [P<0.001] with stroke. However multiple logistic regressions of risk factors for ischaemic and haemorrhagic strokes separately revealed that diabetes was significantly associated with ischaemic stroke [P=0.025] while body mass index was significantly associated with haemorrhagic stroke [P=0.001]. Majority of stroke patients were of older age. The most frequent risk factor among stroke cases were lack of exercise, overweight and obesity and hypertension