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

Adopting western retinopathy of prematurity screening programs in eastern countries, are we screening properly?

To describe retinopathy of prematurity [ROP] among Jordanian preterm infants and evaluate the efficacy of applying current Western screening guidelines for Jordanian preterms. In this retrospective, descriptive hospital based study, we collected data on preterm infants who were referred by their neonatologist for ROP screening at King Abdullah University Hospital between July 2006 and June 2007. Guidelines suggested by the American Academy of Pediatrics were followed. Additionally, older preterms considered at risk for ROP by the neonatal intensive care unit were screened. Any neonate with stage 1 ROP or higher in either eye was considered a positive case of ROP. Ninety-one preterms were included in the study. The median birth weight was 1390 gm [range,730-1980 gms] and the gestational age ranged from 26 to 35 weeks with 64.8% of preterms /= 32 weeks. Six patients [6.6%] required laser treatment, two with low birth weight greater than 1250 gm and one was 33 weeks of age. Consanguinity was identified in 19.2% of infants with ROP while consanguinity in infants who did not develop ROP was 1.9%. This difference was statistically significant [P<0.05]. ROP occurs in premature infants in Jordan with gestational age above 32 weeks and birth weight above 1250 gm. Future guidelines for screening should incorporate the current study outcomes. A prospective, population-based is required to set national guidelines for ROP screening in the Jordanian population and similarly for different populations worldwide. Consanguinity may play a role in ROP development and further genetic studies may aid in elucidating the pathogenesis of ROP

Surgical treatment of hip dislocation in children with arthrogryposis multiplex congenita

Arthrogryposis multiplex congenital [AMC] is a rare disease with multiple joint contractures. In unilateral hip dislocation surgical treatment to reduce the hip is recommended to prevent pelvic obliquity and scoliosis. It is commonly believed that bilaterally dislocated hips should not be reduced because movement is satisfactory and open reduction leads to poor results. The purpose of this study is to report our clinical and radiological outcome of the surgical treatment of unilateral and bilateral hip dislocation in 5 patients [8 hips] having AMC. During the period 2006 to 2010, we operated on 8 hips of 5 children with AMC [3 patients had bilateral hip dislocation and 2 patients had unilateral hip dislocation]. Open reduction with capsular plication without any bony procedure was performed on 2 hips. Open reduction combined with Salter osteotomy of innominate bone was performed on 2 hips. Open reduction combined with Salter osteotomy of innominate bone and femoral shortening with varus derotational osteotomy was performed on 5 hips. In addition to that, open adductor tenotomy was done in all cases through a separate medial incision. The mean age at surgery was 16.6 months [range: 9-22 months] and the average follow up period was 2.3 years [range: 1-3 years]. At the final follow up, two children were able to walk independently. One child had a unilateral dislocation and required a long leg brace and support for walking. One child had a unilateral dislocation and required a short leg brace for walking. One child was unable to walk because of severe contractures in all four limbs, and one child required revision surgery for a re-dislocation of the hip joint. The clinical results were good in 5 hips, fair in 1 hip, and poor in 2 hips. According to the Severin classification, all 8 hips were rated as good [5 hips in class I and 3 hips in class II]. There was a low incidence of avascular necrosis where only one hip was in grade 1 according to Kalamchi classification, while 7 hips did not show any evidence of avascular necrosis. We believe that open reduction combined with bony procedures should be performed for unilateral and bilateral dislocation of the hip in children with AMC, and it should be done at an earlier age to achieve the best functional outcome

effect of neonatal sepsis on platelet count and their indices

To study the effect of neonatal sepsis on the platelets' counts and sizes. Also, our study aims to verify if there are significant differences in the platelet's indices between gram-positive or gram-negative sepsis or being full term or premature. This study was conducted prospectively over a one year period starting from January 2006 at Princess Rahmah Teaching Hospital. The study included all neonates who were admitted to neonatal intensive care units with a clinical diagnosis of sepsis. Only neonates who had positive blood culture results were included in the study, else were excluded from the study. All neonates included in the study had full septic work up including the platelet's number and size. Other serological and radiological investigations were selectively done when needed. Neonatal sepsis was diagnosed in 105 cases. Sepsis caused by gram-positive microorganisms was seen in 50 [47.6%] with Staphylococcus coagulase negative microorganism being the commonest accounting for 44 [41.9%]. Gram-negative microorganism was seen in 55 [52.4%], with klebsiella pneumonia accounting for 42 [40%]. Full term babies' account for 59 [56.1%] while premature babies account for 46 [43.9%]. Thrombocytopenia was present in 45[42.8%] of the all cases of neonatal sepsis, of which 27 [60%] were found among gram negative sepsis. The remaining 18 [40%] cases were due to gram-positive microorganisms. 19 [42.2%] of the cases of thrombocytopenia are premature babies and 26 [57.8%] are full term babies. The mean platelet volume was found to be high in 29 [27.6%] of all cases. Nineteen [65.5%] were found to be attributed to gram negative sepsis and the remaining 10 [34.4] of cases were gram positive microorganism. Low platelets count and high mean platelets volume was present in nearly quarter of children with neonatal sepsis. There is no statistical significance difference in these indices and gram negative or positive sepsis, neither being premature or full term baby. [MPV] Mean Platelet Volume, [PWD] Platelet Distribution Width, [PRTH] Princess Rahmah Teaching Hospital, [SCBU] Special Care Baby Unit