Patient satisfaction with health services at medical ward in Al-Kindy teaching hospital

Patient satisfaction is generally considered as extend to which the patient feel that their needs and expectations are being met by services provided. Satisfied patient are more likely to maintain consistent relationship with their care provider leading to improved compliance and better health outcomes. To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction. Cross sectional study of 60 patients who were interviewed using a questionnaire that includes information under six main heading; 1] Patient general information; 2] Satisfaction about physician; 3] Satisfaction about nurses; 4] Satisfaction about pharmacy; 5] Satisfaction about laboratory services ;6] Satisfaction about ventilation and cleanliness. More than half of satisfied patients were among those of >/= 50 years old, female, and the majority of satisfied patients were among un-employed and those with single reason for admission. Statistical analysis showed a significant association between the reason for admission and patients satisfaction. The satisfaction of elderly was high and more in female, un- employed and less with those who admitted for more than one reason

Knowledge, attitude and practice regarding obesity management among family and non family physicians working in primary health care centers in Baghdad

The rising level of obesity has been called the most urgent challenge to public health for the 21st century. While many social institutions should be involved in addressing this problem, family physicians have an important role in identifying and managing obesity. To assess and compare the knowledge, attitudes and practice regarding obesity management among family and non family physicians working in primary health care centers. A cross-sectional survey has recruited a randomly selected sample of primary health care physicians working in primary health care centers in Baghdad in 2010. A structured self-administered questionnaire was used to collect data from 232 physicians. These include family medicine board certified and other non-family medicine certified physicians. The questionnaire had four main parts: personal data, knowledge, attitude and practice. The majority of the respondents depend on the waist circumference to diagnose obesity with 100% among the family physicians and [74.2%] among non-family physicians. The majority of the respondents think that obesity is a major health problem in Iraq with 49 [96.08%] among the family physicians and132 [72.93%] among non family physicians. About [84.3%, 72.5% and 41.2%] of family physicians agreed to prescribe Weight reduction medication when BMI>30, Patient not on diet and on patient request respectively. Almost all family physicians [92.1%] agreed that is it better to have a training course in obesity management compared to 49.46% among non-family physicians. Both the family and non-family physicians working in the primary health centers need to improve their knowledge and skills regarding obesity management

Knowledge and preference of mothers delivering at Al Kadhumyia teaching hospital regarding caesarean section and normal vaginal delivery

Caesarean section rates are progressively rising in many parts of the world. One suggested reason is increasing requests by women for caesarean section in the absence of clear medical indications. To determined the medical and non medical reasons behind the caesarean section. To identify the mothers preference to the mode of delivary and reasons behind this preference. Across sectional study of 480 mothers was interviewed.The data was collected using a questionnaire form includes information under two main headings: 1] Information related to the mother; these include demographic and some obstetrical information, obstetrical 2] Knowledge of mothers regarding reasons behind their caesarean section.3] Information related to mother preference. The majority of mothers 317[66%] were delivered by Caesarean section ,the majority of Caesarean section mothers [41%] were of [36-45] years of age, [47.3%] completed primary education, [89%] of them reported medical reasons behind their Caeserean section, [25.9%] of mothers with medical reasons reported a history of Caeserean section as the main medical reason.Regarding the non medical reasons the majority of mothers [45.7%] reported Fear of vaginal delivery as the main non medical reasons. The majority 384[80%] of mothers prefer NVD while only [20%] reported their preference to C-section The caesarean section rate was high, history of Caeserean section were the main medical reason behind caesarean section, fear of vaginal delivary was the main non medicval reason behind caesarean section. Majority of mothers prefer NVD than C-section

VCAM-1 is another ugly face of IFN-gamma in women with recurrent spontaneous abortion

The Th-1 cytokines were well implicated in adversely affecting pregnancy and the mechanism by which they cause pregnancy loss was suggested to be mainly vascular by activation of mediators of inflammation like certain adhesion molecules. To study the pathological effect of IFN- gamma and VCAM-1 in recurrent pregnancy loss. The study included three groups of women; Group A: patients had recurrent abortion [n=24], Group B: patients had spontaneous abortion for the first time [n=10], Group C: women with elective pregnancy termination [n=6]. Curate samples obtained from these women were subjected for in situ hybridization technique to determine the in. situ expression of IFN- gamma, and immunohistochemistry analysis to detect the expression of VCAM-1. The in situ expression of IFN- gamma was significantly higher in women with RSA as compared with normal pregnant and first abortion groups [p=0.000 and 0.002] respectively, and the expression of VCAM-1 was also significantly higher [p=0.005] in women with RSA as compared with those who had abortion for the first time, with a positive correlation between the expression of IFN- gamma and VCAM-1 [r=0.418; p<0.05] in women with RSA. The data of this study strengthen the possibility that type-1 immune response may have the upper hand in the pathology of RSA on multidirectional bases including up regulation of the surface expression of VCAM-1

Stress in postgraduate trainee doctors of public and private Universities of Karachi

To evaluate and compare stress level of Postgraduate trainee doctors in public and private sector Medical Universities. A comparative cross sectional study was conducted at Dow University of Health Sciences and Agha Khan University Hospital Karachi among Postgraduate Medical trainee who are doing FCPS, MCPS, and DCPS from Jan. 2008-Dec. 2008. A total of 207 doctors were selected by non-probability convenience sampling technique. Main outcome was major stress level of Medical trainees or resident. Out of the total 207 trainee doctors 62.3% were found to be under stress. Proportion of females with stress was 66.3%. Most of the married PGs 67.2% had high stress level. A large proportion almost 69.7% of doctors who were in stress belongeds to low income group. This study did not find any statistical significance of stress with respect to different demographic and socioeconomic variable that were age, gender, monthly income, specialty and university. The stress level of Postgraduate trainees in both the universities was found to be high. The stress was found to be high among female trainees but no risk factor showed significant association with stress. Every effort should be made to help the future healers in understanding the symptoms of stress and ways to deal with it effectively and safely

expression of EBV versus apoptotic index in breast cancer

Disruption of the balance between proliferation and apoptosis is considered to be an important factor in the development and progression of tumors. To investigate EBV expression in breast tumors and compare it to the extent of apoptosis. Paraffin-embedded tissue blocks from 45 female patients with breast tumors were retrieved. The cases were grouped into two categories: * Group [A]: included 30 cases with breast cancinoma [four in situ and 26 invasive]. * Group [B]: included 15 cases with benign breast diseases [nine fibroadenomas and six flbrocystic changes with epithelial hyperplasia] as a control group. The expression of EBV proteins was examined immunohistochemically. The extent of apoptosis was estimated using TUNEL assay. Twelve [40%] of the 30 breast cancer cases [group A] were reported as positive for EBV expression, Interestingly, the current study demonstrated an increase in the mean apoptotic index [AI] in parallel with the biological aggressiveness of the breast lesion, being the lowest [0.24%] in fibroadenomas and the highest in invasive carcinomas [1.8%]. Also, the mean AI was significantly higher in malignant [1.72%] than benign [0.38%] breast lesions [P < 0.01]. A statistically significant difference in mean AI was noticed between EBV positive and BV negative breast cancer cases [p=0.025]. The results of the current study might refer to the significance of high apoptotic counts in breast carcinogenesis and that EBV positive breast cancer cases being associated with high AI. Therefore, long follow up studies based on larger group of patients are recommended to shed more insight on their role in breast cancer

Determinants of acute otitis media in infants

To describe the relationship of acute otitis media with mode of feeding [bottle-or breast-fed] and with different positions of infant during feeding. Study dcsign:Case control study. Babies aged up to 24 months [62 cases, 66 controls] were selected from the OPD of Abbasi Shaheed Hospital and the Aga Khan Hospital, Karachi. The variables considered were the gender of the infant, mother's educational level and occupation, mode of feeding and the different positions during feeding. SPSS version 11.5 was used for descriptive and inferential analysis. There was a significant association of otitis media with lying position of baby during feeding [OR 37.7, 95% CII 3,34106.43, p< 0.001]. bottle feeding [OR 3.0. 95%CI I .43-6.25, p=0.003], working mother [OR 3.8, 95% Cl 1.3810.34. p=0.007] and education of mother [OR 2.1, 95% CI 1.01.4.24, p=0.044]. Babies with acute otitis media were more likely to be bottle fed and having a lying posture during the feeding than babies without having acute otitis media

Up-regulation of the in situ expression of NF-kB and IFN- gamma in women with recurrent spontaneous abortion

Estimation of the in situ expression of NF-kB and IFN-gamma in women with unexplained recurrent spontaneous abortion [RSA]. A technique utilizing in situ hybridization was performed to detect and determine the in situ expression of NF-kB and IFN- gamma mRNA using paraffin embedded sections of curettage samples obtained from 40 women, who were divided into three groups: 24 women with RSA, 15 women with abortion for the first time, and 6 women with induced abortion. The levels of the in situ expression of both IFN- gamma and NF-kB were found to be significantly up-regulated in group 1 as compared with group 2 [P=0.002, P=0.003 respectively], and group 3 [P=0.001, P=0.01 respectively], with a highly significant positive correlation between these two parameters [P<0.001, r=0.858]. The transcriptional factor NF-kB might play a role in up-regulating the expression of the Th1 cytokine IFN-gamma, participating in the pathogenesis of RSA