Breastfeeding attitudes and knowledge among sixth year medical students in Jordan

Previous reports have demonstrated that counseling about breastfeeding can improve the rate and initiation duration of breastfeeding. However, those medical students are ill-prepared for this role. It is unclear whether medical students would provide the knowledge and skills necessary for effective breastfeeding promotion or not in Jordan. The aim of this study was to identify breastfeeding attitudes and knowledge among 6th year medical students in their final year at The Jordan University of Science and Technology [JUST]. A 28-item self-administered questionnaire; containing three sections: knowledge [13 items] attitude [7 items] and demographic [3 items], were distributed randomly to medical students. The random sample consisted of 234 medical students who were in their final year. The questionnaire assessed both breastfeeding attitudes and knowledge. The results were explained taking into consideration gender and being a parent. Mean attitude's score for participants without children was 46.7 as compared to 44.0 for those with children. The results showed similar negative attitude toward breastfeeding among both male and female participants regardless of having children or not [p=0.35]. This means that there were no significant difference in attitudes toward breastfeeding among male and female students whether they are having children or not. On the other hand, the mean knowledge score was 22.9 for male participants while it was 21.55 for female participants, indicating some degree of breastfeeding knowledge among participants [p=0.035]. However, having personal experience with breastfeeding [self or partner] did not increased breastfeeding attitudes and knowledge [p=0.35 vs. p=0.93, respectively]. Medical students have significant educational needs in the area of breastfeeding management and breastfeeding education. Further targeted training is needed to improve both breastfeeding attitudes and knowledge

Early neonatal death at a teaching hospital in Jordan

To estimate the stillbirth and hospital early neonatal death rates at the main referral hospital in the north of Jordan [King Abdullah University Hospital]. All infants born at the King Abdullah University Hospital [KAUH] over a 5-year period from January 1. 2005 to December 31, 2009 were identified retrospectively. Medical records of the patient who were considered stillbirth or died in the first week of life were reviewed. The following data: age. gestational age, birth weight, maternal medical and obstetric history, duration of stay and cause of death were collected and analyzed .The main cause of death was taken from death certificates. A total of 10,030 newborns were included in this study. There were 89 stillbirths and 102 early neonatal deaths. Stillbirth rate was 9.0 per 1000 births and early neonatal mortality rate was 10.3 per 1000 live births. Of the early neonatal deaths, 79.4% were born premature, 77.5% were born with low birth weight, 28.4% of them were born of mothers with hypertensive disorders and 17.6% were born of mothers with diabetes. Almost half of deaths [52.9%] occurred in the first day of life and 20.6% of deaths occurred in the second day of life. The most common cause of early neonatal death was respiratory distress syndrome [50.0%] followed by multiple congenital anomalies [19.6%] and sepsis [12.7%]. The three causes together contributed to 82.3% of deaths. In a referral tertiary center in the north of Jordan, stillbirth rate was 9.0 per 1000 births and early neonatal mortality rate was 10.3 per 1000 births. About half of early neonatal deaths occur in the first day of life. Prevention and treatment of prematurity, prevention of sepsis and better understanding of congenital anomalies may help to decrease early neonatal death. Attention to prevention and treatment of respiratory distress syndrome is warranted

Evidence for the use PET for radiation therapy planning in patients with cervical cancer: a systematic review

In recent years, the role of positron emission tomography [PET] in the staging and management of gynecological cancers has been increasing. The aim of this study was to systematically review the role of PET in radiotherapy planning and brachytherapy treatment optimization in patients with cervical cancer. Systematic literature review. Systematic review of relevant literature addressing the utilization of PET and/or PET-computed tomography [CT] in external-beam radiotherapy planning and brachytherapy treatment optimization. We performed an extensive PubMed database search on 20 April 2011. Nineteen studies, including 759 patients, formed the basis of this systematic review. PET/ PET-CT is the most sensitive imaging modality for detecting nodal metastases in patients with cervical cancer and has been shown to impact external-beam radiotherapy planning by modifying the treatment field and customizing the radiation dose. This particularly applies to detection of previously uncovered para-aortic and inguinal nodal metastases. Furthermore, PET/ PET-CT guided intensity-modulated radiation therapy [IMRT] allows delivery of higher doses of radiation to the primary tumor, if brachytherapy is unsuitable, and to grossly involved nodal disease while minimizing treatment-related toxicity. PET/ PET-CT based brachytherapy optimization allows improved tumor-volume dose distribution and detailed 3D dosimetric evaluation of risk organs. Sequential PET/ PET-CT imaging performed during the course of brachytherapy form the basis of "adaptive" brachytherapy in cervical cancer. This review demonstrates the effectiveness of pretreatment PET/ PET-CT in cervical cancer patients treated by radiotherapy. Further prospective studies are required to define the group of patients who would benefit the most from this procedure