Application of Predictive Modelling to Improve the Discharge Process in Hospitals / 대한의료정보학회지

Objectives@#To find out the factors influencing discharge process turnaround time (TAT) and to accurately predict the discharge process TAT. @*Methods@#The discharge process of cardiology department inpatients in a tertiary care hospital was mapped over a month. The likely factors influencing discharge TAT were tested for significance by ANOVA. Multiple linear regression (MLR) was used to predict the TAT. The sample was divided into testing and training sets for regression. A model was generated using the training set and compared with the testing set for accuracy. @*Results@#After a process map was plotted, the significant factors influencing the TAT were identified to be the treating doctor, and pending evaluations on the day of discharge. The MLR model was developed with Python libraries based on the two factors identified. The model predicted the discharge TAT with a 69% R2 value and 32.4 minutes (standard error) on the testing set and a 77.3% R2 value and 26.7 minutes (standard error) on the overall sample. @*Conclusions@#This study was an initiation to find out factors influencing discharge TAT and how those factors can be used to predict discharge in the hospital of interest. The study was validated and predicted the TAT with 77% accuracy after the significant factors that affect the discharge process were identified.

Impact of morning and rotational duties on physical health of nurses working in tertiary care hospitals of karachi

Background and Objectives: In the system related to health care, shifting duties are considered essential and obligatory to make sure the stability of care in hospitals. Scheduling and shifting are the key uniqueness of shift work and nurses are mostly bounded into different schedules that facilitate 24-hour care. Our objective was to identify the impact of morning and rotational duties on physical health of nurses working in tertiary care hospitals

Methods: A total of 154 nurses from two tertiary care hospitals in Karachi were included in this study. Data were collected through the Short Form Health Servay-26 between May to June 2017. Questionnaire form consisted of five domains including Physical functioning, Role limitations due to physical health, Energy/ Fatigue, Pain and General health

Results: Most of the study participants were staff nurses [66.9%] and few were head nurse and assistant head nurses 13.6% and 8.4% respectively. Nurses' characteristics such as gender, age, educational level, designation and monthly income were found significant with duty shift with p-values 0.049, 0.007, <0.001 and 0.017 respectively. Energy/Fatigue was only domain of SF-26 which showed significant mean difference [p-value <0.001] between morning and rotational duties

Conclusion: This research concludes that nurses working in rotational duties were more prone to develop physical problem as compared to morning duties. Energy/Fatigue showed significant mean difference

Primary cutaneous anaplastic large cell lymphoma with lung metastasis

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is relatively a rare tumour of head and neck region. Without histopathological confirmation, it appears and behaved as like malignant epithelial tumor of the head and neck region as will be illustrated in the present case. Cutaneous involvement of the tumor with distant metastasis has made the prognosis unfavorable. This isolated case of head and neck PC-ALCL was highlighted as it has a tendency to behave aggressively and early diagnosis and treatment is crucial to avoid poor survival outcome.

Pterygium excision with suture less, glue free conjunctival auto graft

Objective: To find out outcomes of pterygium excision with sutureless, glue free conjunctival auto graft

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the Ophthalmology Department Unit-I, Dow University of Health Sciences, Civil Hospital Karachi from June 2011 to May 2015

Materials and Methods: Either gender patients above 25 years of age enrolled for primary pterygium excisionfollowed by limbal to limbal orientation of conjunctival auto graft without suture or adhesive glue. Recurrent pterygia, pseudo pterygia, ocular surface disorders, vascularized cornea, dry eye and patients already on topical anti metabolites were not included. Follow up was scheduled on 1[st] day, 1[st] week, 1[st], 3[rd], and finally 6[th] months. Chi square test was applied to check significance of recurrence with age, gender, occupation and graft size or graft application time

Results: Out of 382 participants, 303 [79.3%] were males. Majority of patients [77.7%] were young between 25 to 45 years of age. Mean time required for graft application was 16.89 +/- 2.58 [std] minutes. Recurrence of pterygium was found in 32 [8.4%] cases. No significant relationship of recurrence of pterygium was found with other variables like gender, age, occupation, graft size or graft application time

Conclusion: Natural healing tendency of vascularized conjunctiva allow graft to adhere underlying scleral bed while well aligned autograft margins and limbal to limbal orientation do not allow overgrowth of fibrovascular conjunctival tissue thereby prevent recurrence of pterygium

Cycloplegic refraction in children with cyclopentolate versus atropine

Objective: The aim of this study is to evaluate the effectiveness of two cycloplegic drugs used in cycloplegic refraction in hyperopic children

Study Design: Hospital based cross sectional study

Place and Duration of Study: This study was carried out at the Out-patient department of Ophthalmology Dow University of Health Science [Ohja campus], Karachi Pakistan from January 2011 to June 2011

Materials and Methods: We instilled cyclopentolate 1% drops and refracted the patient followed after a few days with atropine eye drops 1% instillation and the results of both drugs were compared. The data are presented as mean and standard deviation [SD]. Statistical analysis was performed using the SPSS software 19. A P-value of lessthan0.05 was considered statistically significant

Results: The total refractions were recorded after cycloplegia with atropine 1% and cyclopentolate 1% eye drops. Atropine refraction [mean4.05 D] was statically insignificantly comparing with cyclopentolate refraction [mean 3.315 D; P>0.05]

Conclusion: There is no significant difference in the cycloplegic refraction values between the two drugs hence cyclopentolate is a safe and effective drug to be used in cycloplegic refraction

Screening of hepatitis B and C viruses in patients before ocular surgical procedures

Objective: To screen and see the incidence of hepatitis B and C among patients before ocular surgical procedures

Study Design: Prospective / Observational Study

Place and Duration of Study: This study was conducted at the Department of Ophthalmology, Dow University Hospital [ojha campus] of Dow International Medical College, Karachi, Pakistan from May 2014 to December2014

Patients and Methods: 223 patients above the age of 18 years were screened for hepatitis B and C before going ocular surgery by immune-chromatographic method [ICT].The patients who were positive for hepatitis were further confirmed by Enzyme LinkedImmunosorbent Assay [ELISA]

Results: Total number of patients screened was 223. 11 [4.93%] patients were positive for hepatitis B and C, out of which 2[0.9%] were hepatitis B positive and 9[4%] were hepatitis C positive. Prevalence among male patient was 6.97% while among female was 2.12%

Conclusion: The eye patients show high incidence of hepatitis B and C. Therefore, it is mandatory for all patients who need ocular surgery to be screened by serological test for hepatitis B and C preoperatively

Prevalence of different refractive errors and their relation to age and sex in patients presenting in the outpatient department of ophthalmology at Dow University of Health Sciences

To see the prevalence of different refractive errors and their relation to age and sex in patients presenting in the Outpatient department of Ophthalmology at Dow University of Health Science. Cross sectional study This study was carried out at the out-patient department of Ophthalmology Dow University of Health Science [OJHA campus], Karachi Pakistan from January 2011 to June 2011. Total of 691 patients were included in the study. The testing and examination protocol included visual acuity measurement using Snellen and E chart after auto refraction, cycloplegic retinoscopy in children and examination of anterior segment and fundus in all patients. Mean age was 42.11 +/- 17.35 years. Males were 323 and females were 368 in number. The most frequent refractive error was Myopia which was found in 153 [22.1%] patients and the second frequent refractive error was Myopic Astigmatism at a frequency of 148[21.4%]; p value was 0.037. Thus Myopia and myopic astigmatism were the most frequent refractive error in age group ranging from 05-75 years. In our study we found Myopia to be the most common refractive error [n=153 22.1%] followed by Myopic Astigmatism [n=148 21.4%]. Myopia and Myopic Astigmatism were seen in males more than females while hypermetropia, hypermetropic astigmatism and mixed astigmatism were seen in more in females as compared to males

Comparison between the measurements of intraocular pressure readings taken by pascal dynamic contour tonometry and goldmann applanation tonometry

To compare the measurements of Intraocular Pressure readings taken by Pascal dynamic contour tonometry and Goldmannapplanation tonometry. Clinical Observational Study. This study was carried out at the Outpatient Department of Ophthalmology, Dow University hospital [Ojha Campus] of Dow University of Health Sciences, Karachi from July 2010 to September 2010. In a prospective single center study, 282 eyes from 141 subjects were examined by three experienced clinicians. The IOP measurements were obtained with PDCT and GAT and difference in intraocular pressure measured by PDCT and GAT was compared. IOP measurements by PDCT [mean +/- SD, 18.66 +/- 4.68 mmHg] were significantly [P<0.001] higher than GAT measurements [mean +/- SD, 17.84 +/- 4.21 mmHg] correlating significantly with each other [r[2] = 0.842, Pvalue< 0.001] PDCT allows the suitable and reliable IOP measurements. IOP measurements by PDCT are highly concordant with IOP readings from GAT. PDCT seems to be an appropriate method of tonometry for routine clinical use

Effect of risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites with angiographical data of local population: Number, site, severity of coronary lesion

The aim of this study was to determine the effect of major risk factors like age, gender, hypertension, diabetes, smoking, dyslipidemia on coronary artery disease in Karachiites and highlighted the angiographic data of local population like number of vessels involvement, site and severity of coronary lesions. This was a cross sectional analytical prospective study which was carried out at Abbasi Shaheed Hospital Karachi from August 2004 - July 2014. We included five hundred [500] consecutive patients [188 female and 312 male] between 26-80 years old, who came for coronary angiography with suspecting ischemic heart disease clinically or otherwise proven by relevant tests like ETT, ECHO, and Thallium stress test. Post PCI and CABG patients were excluded from study. During this study variables like age, gender, hypertension, diabetes, smoking and dyslipidemia were taken into account in relation to coronary artery disease in Karachiites. In addition we also assorted some important findings of coronary angiography like: number of vessels involved, site and severity lesions in our population and compared them with existing literature. Our study revealed that in our local population not only old age and male gender are potential threat for an early coronary artery disease but other variables like hypertension, diabetes, smoking, and dyslipidemia are also playing important role in coronary artery disease. It is also concluded that our population is more prone to multiple vessels involvement with almost involvement of LAD in majority of population

Simultaneous repair for complicated/ complex vesicovaginal fistula

To determine the outcomes of repair of complicated/complex vesicovaginal fistulae [VVF] by simultaneously abdominal and vaginal approach. Prospective descriptive study. This study was conducted at PUMHS, Nawabshah from Jan. 2008 to Dec. 2012. After routine clinical examination and investigation, patients having complicated/complex vesicovaginal fistulae were selected for repair. The patients having associated with colonic involvement or with preexisting malignant pelvic pathology were excluded from the study. Follow up was carried out weekly basis for 03 to 06 months. Our study comprises of only 12 cases having complicated/complex VVF. The mean age was 35 SD +/- 3.5 years. The mean size of fistula was 3.9 SD +/- 1.2 cm. The ureter and urethra were adjunct with fistula in 03 [25%] and 02[%] cases respectively. all cases were treated with aforementioned method and auto-cystoplasty was carried in 08 [66.5%] cases. The uni-lateral and bilateral ureteric re-implantation was attempted in 01 [8.5%] and 02 [16.5%] cases respectively and double J stent were kept in all these cases. The success was achieved in 09 [75%] cases. The short and long term complications like frequency/dysuia/urgency of micturation, urinary stress incontinence and dyspareunia that had occurred in 04 [33.5%], 02 [16.5%] and 05[41.5%] cases respectively. Simultaneously abdominal and vaginal approach should be considered as complementary add-on to improve the access in difficult instances from 02 sides. It authorizes the surgeon to excise the fistulous tract

Ureteroscopic lithotripsy: a day-surgery procedure

Objective: To ascertain patient's safety and efficacy of ureterolithotripsy as a day-surgery procedure

Study Design: An interventional study

Place And Duration: At Citi Medical Center Larkana, Ghulam Mohammed Mahar Medical College and Hospital Sukkur Peoples University of Medical and Health Sciences for Women Nawabshah between Dec: 2007 to Dec: 2012

Methodology: All the patients of either sex having ureteral stone less than 1.5 cm in diameter were selected on the basis of routine clinical examination, laboratory investigation like complete blood count and biochemistry, Ultra-sound and x-rays like intravenous urography [IVU] etc for ureteral lithotripsy. The Semi-rigid UreteroscopicG.O Fr with Swiss Lithoclast lithotripter was used

Results: Our study comprises 320 selected patients. Male to female ratio was 1.6:1. Average age of patients was 30.5 year. The mean stone diameter was 1.2 cm. The stones were successfully disintegrated and completely pulverized in 95% [n=304] cases. In remaining 5%[n=16] cases, the procedure was deferred. Among them, ureteric catheter or J J stent in 3% [n=9] and 2%[n=7] cases respectively had been left. Of them, former cases were due to failure of access to stone and ureteroscope did not negotiate at all and in later cases stone was presented in upper ureter and inadvertently floated up into the kidney [P< 0.05]. The operative complications like simple mucosal injury occurred in 11%[n=35] and minor bleeding which did not cloud the field of vision occurred only in 13%[n=42] cases. The Mean operating time was 27[ranged from 22 to 55] minutes. Postoperative complications like urinary tract infection [sepsis] with fever and persisting haematuria had occurs in 5.5%[n=18] cases 9%[n=29] respectfully. The hospital stay was merely a day in all except 15% [n=47] cases who developed post-operative complications [P< 0.05]. In 03 week follow-up, residual fragments were noted only in 6%[n=19] cases. These patients were managed conservatively except 2%[n=7] cases that underwent repeat ureteral catheterization for manipulation of fragments which were jammed together, remit

Conclusion: Although, our study has documented high success rate and low morbidity with merely a day hospital stay but is dependent on many potentially modifiable and process-related factors

values of CA-125, progesterone, beta-HCG and estradiol in the early prediction of ectopic pregnancy

To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone [P], beta-HCG, and estradiol [E2] in the early diagnosis of ectopic pregnancy. Serum levels of CA-125, progesterone, beta-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay [ELISA] techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011. The mean +/- SEM serum levels of CA-125, progesterone, beta-HCG, and estradiol in patients with ectopic pregnancies [16.51 +/- 2.39U/ml; 2.54 +/- 0.47ng/ml; 72.75 +/- 12.27mIU/ml; 13.4 +/- 2.14pg/ml; respectively] were significantly lower than the levels in normal intrauterine pregnancies [74.25 +/- 18.5U/ ml; 28.36 +/- 3.7ng/ml; 249.54 +/- 18.0mIU/ml; 112.7 +/- 23.6pg/ml; respectively]. When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7%, specificity 100%, the positive predictive value was 100% and the negative predictive value 71.4%. The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations

Comparison of surgical with nonsurgical treatment for fractured mandibular condyle - a study

Condylar fractures are the second most-common fractures of the mandible. The purpose of this study was to compare the surgical [open reduction+internal fixation] and nonsurgical [closed reduction+immobilization] treatment of mandibular condylar fracture in terms of occlusion and maximum mouth opening[inter-incisal distance of the jaws] after these two procedures. The study followed a prospective comparative design and was carried out at the Department of Oral and Maxillofacial Surgery, King Edward Medical University/ Mayo Hospital, Lahore on sixty patients with uni-lateral condylar fractures [neck and /or subcondylar]. Thirty patients were treated by nonsurgical method and thirty by surgical method. At different intervals of their post-operative visits, patients were evaluated in terms of occlusion and maximum mouth opening to assess the difference between the two groups. Patients treated by nonsurgical treatment i.e. closed reduction had greater percentage of malocclusions [44%] at the final post operative visit i.e. one year, as compared with patients treated by surgical treatment i.e. open reduction and internal fixation [8.3%] p=0.005. Similarly patients treated surgically exhibited better improvement in maximum inter incisal opening [46mm+4.50] than patients treated non-surgically [37mm+5.50] at the final post operative visit i.e. one year [p=<0.05]. Based on this study, more consistent occlusion and better improvement in maximum mouth opening can be expected when fractures of the condyle are treated by surgical technique

Closure of elective abdominal incisions with monofilament, non-absorbable suture material versus polyfilament absorbable suture material

Background: Closure of abdominal incisions with different suture materials has been a matter of great controversy. Polypropylene and Polylactide with Polyglycolide are among the commonest suture materials used for closure of abdominal incisions. Objectives of this study were to assess optimal suture material used for closure of elective abdominal incisions and to see complications associated with these suture materials. Methods: This prospective, comparative, randomised study was conducted at public and private sector hospitals of Nawabshah and Hyderabad from 1st Jan 2005 to 31st October 2009. All patients who underwent abdominal surgery under the investigators' supervision were included in the study. Patients were divided into 2 groups on even or odd numbers. In group-A patients' incision was closed with monofilament, non-absorbable Polypropylene [Prolene] No. 1 suture material and in groupB incision was closed with Polyfilament, absorbable, co-polymer of Polylactide with Polyglycolide [Vicryle] No. 1. Results: A total 274 patients were finally analysed for closure of elective abdominal incisions, with 138 [50.4%] patients in Group-A and 136 [49.6%] patients in Group-B. Vicryle was found superior in knot security and suture handling. Superficial wound infection was found in 5.79% patients of Group-A and 6.61% of Group-B. Discharging sinus was found in 3.62% of Group-A vs 0.73% of Group-B. Burst abdomen was seen in 2.17% patients in Group-A and 1.47% in Group-B. Incisional hernia was present in 4.34% of Group-A and 0.73% patients of Group-B. No patient in Group-B developed persistent pain at incisional site while it was found in 8.69% patients of Group-A. Conclusion: Polylactide is an optimal suture material in closure of elective abdominal incisions. Keywords: elective, incisions, monofilament, polyfilament, suture, postoperative, complications

Vesico-vaginal fistula abdominal repair versus repair via vaginal route

To evaluate the outcome of Vesico-vaginal Fistulae [VVF] repair by abdominal and vaginal route. Interventional / clinical trial. Department of Urology, Chandka Medical College Teaching Hospital and Almas Medical Centre Larkana. Feb; 2005 to Nov; 2010. After routine clinical examination and investigation, patients having Vesico-vaginal Fistulae [VVF] were selected for repair. All patients had under gone examination those anesthesia [EUA] and cystoscopy. The patients having complex fistulae or associated with urethral, ureteric and colonic involvement or with preexisting malignant pelvic pathology were excluded from the study. Patients were divided in to 02 groups on the basis of the site of the fistula and the method of repair. Group-I comprised of those patients who had low type or uncomplicated fistulae and were operated by vaginal approach. Group-II consisted of those patients who had high type or large fistulae and were operated by abdominal approach. Postoperative follow up was carried out on weekly basis for 03 to 06 months. Our study included 32 cases. Group-I and II comprised of 18 and 14 patients respectively. The mean age was 34 years [ranged from 22 to 45 years]. The main cause of vesico-vaginal fistulae was obstetrical in 28[87.5%] and iatrogenic gynecological [hysterectomy] in 04 [12.5%] patients. No major difficulty was experienced except in 01[0.83%] case in group-1 who had a previous failure history of repair. The mean operative time was 95 minutes [range 80 to 125 minutes] and 145 minutes [range 110 to 175 minutes] in group-1 and group-2 respectively. Peroperative blood transfusion was required in 06 [33.33%] and 13 [93%] patients of group-1 and group-II respectively. Statistically significant difference was found between these two groups [P< 0.05]. Postoperative complications like wound infection occurred in 01[7.15%] of group- 1 and haematuria was present for few days in o4 [22.22%] and 05[35.5%] in group-1 and group-2 respectively. The mean hospital stay was 07 [range 5-10] days. Foleys catheter was removed at 02 week time in all cases. The success rate was achieved 15[83.33%] and in all 14 [100%] cases for group-1 and group-2 respectively and statistically no significant difference was found between two groups [P=NS]. All the patients were followed up regularly except 03 [16.5%] and 05 [35.5%] patients of group-1 and group-II respectively. Long term complications like urinary stress incontinence was observed in 2 [11.1%] patients of group-I, where as small capacity bladder and stone formation was observed in 02[14.3%] of group-11 cases. Birth trauma is still a major cause of vesico vaginal fistula in our region. Although, there is no significant difference in outcome of different technique but interposition of tissue between suture lines have a vital role to achieve a high success rate. Further more, best chance of success achieved with first attempt of repair. Strategic approach and proper training of medical and paramedical staff is recommended

Serum gamma-glutamyltransferase as oxidative stress marker in pre-and postmenopausal Iraqi women

The primary role of gamma-glutamyltransferase is to metabolize reduced glutathione by assimilating and utilizing precursor amino acids for intracellular glutathione synthesis. The aim of this study is to investigate the exact role of gamma-glutamyltransferase enzyme in the oxidative stress associated with menopause. This study was carried out at the Chemistry and Biochemistry department, Al Nahrain University from October 2009 to January 2010. The study participants were categorized into two groups; premenopausal group [n=17] and postmenopausal group [n=16]. Blood specimens were collected from each participant by vein puncture procedure. The g-glutamyltransferase enzyme was measured by kinetic spectrophotometric method while glutathione and malondialdehyde were measured by spectrophotometric methods. Serum glutathione levels in pre- and postmenopausal women were 0.62 +/- 0.17 and 0.47 +/- 0.11 mmol/L respectively. Serum g-glutamyltransferase levels increased significantly in the postmenopausal women group [p=0.025] compared to the premenopausal women group. Serum malondialdehyde levels were 1.04 +/- 0.06 and 1.32 +/- 0.05 mmol/L in pre- and postmenopausal groups respectively. Serum g-glutamyltransferase may be considered as an index of oxidative stress associated with menopause

Efficacy of chloroquine monotherapy against plasmodium vivax malaria

To determine the in vivo efficacy of chloroquine monotherapy against Plasmodium [P.] vivax and frequency of relapse/reinfection. Quasi-experimental study. Place and duration of study: Department of Medicine, Combined Military Hospital, Quetta Balochistan, from July 2006 to February 2007. One hundred and ninety one subjects with positive plasmodium vivax slide were included in the study. Mean, median, minimum and maximum values along with standard deviation of age and parasite clearance time were calculated. Frequency of relapse/reinfection was estimated and significance was determined by applying test of significance. Of the 191, 21 developed P.vivax relapse/reinfection in the six months follow up. Mean duration of relapse/reinfection was 37.76 days while mean parasite clearance time was almost 30 hours in both initial infection and relapse. Chloroquine monotherapy is still effective in the management of P.vivax malaria in our set up and antirelapse therapy is not routinely indicated

Door to needle time of streptokinase and ST segment resolution assessing the efficacy of reperfusion therapy at Karachi Institute of Heart Diseases

Early start of treatment including coronary revascularisation has been recognised as crucial variable in the outcome of acute ST-segment Elevation Myocardial Infarction [STEMI]. Objectives of the study were to determine the magnitude of ST-segment resolution after thrombolytic therapy predicts short- and long-term outcomes in patients with an Acute Myocardial Infarction [AMI]. The duration of quasi experimental study was 3 years, from July 2006 to June 2009, conducted at Karachi Institute of Heart Diseases. Total 1,023 patients of STEMI treated with streptokinase [SK] were enrolled in the study. Of the total 1023, 689 [67.3%] patients were males and 334 [32.6%] were females. Six hundred and twenty-nine [61.5%] were successfully resolved after thrombolytic therapy while in 395 [38.5%] patients ST-segment could not resolve into 3 conventional ST-segment resolution categories at 60 minute and 90 minute after thrombolysis. Three hundred and twelve [30%] and 444 [43.4%] with complete resolution, 344 [33.62%] and 325 [31.76%] with partial resolution, 367 [35.8%] and 491 [19.29%] were with no resolution at 60 and 90 minutes respectively. Shock, congestive heart failure, and recurrent angina and ischemia occurred more often in patients with partial or no ST resolution as compare to complete resolution

Biotechnology Time of initiation of Breastfeeding

mother milk is the best and complete food for babies till six months of age, besides other benefits initiation of mother milk within first hour of delivery and exclusive breast feeding decrease mortality up to 13% in children. To determine the 'time of initiation of breastfeeding after birth. this is a descriptive research, and we used a special questionnaire designed for this proposes and patients file. during this research we found that 50.4% of neonate received their first mother milk within first hour after delivery and 54.2% of mother was able to give mother milk as first food to their babies, 39% of mother weren't able to give mother milk to their children due to cultural barriers. 31.6% of children were exclusively breast feed. In this study we found that initiation of breath feeding as first food after birth is still major concern in the families and about 50% children do not receive mother milk as first food after birth. Suggestion: Increasing awareness about mother milk and exclusive breast feeding through mass media and establishing local council to support breast feeding

Iron body status, ceruloplasmin levels and oxidative stress in pre- and postmenopausal women at baghdad city

Estimatiorfof different iron body status markers, ceruloplas-min and oxidative stress in pre- and postmenopausal women at Baghdad city. This study was performed at the Chemistry and Biochemistry Department, College of medicine, AI-Nahrain University, Baghdad, Iraq from January 2009 to October 2009. The study consisted of 42 healthy women categorized into two groups premeno-pausal women [n= 22] aged 29.71 +/-8.92 years and postmenopausal women [n=20] aged 53.33 +/- 4.61 years. Iron, total iron binding capacity [TIBC] were measured colorimetrically, ferritin levels were measured by enzyme linked immunosorbent assay [ELISA], ceruloplas-min level was estimated by radial immunodiffusion technique whereas malondialdehyde was quantified colorimetrically. Non-significant increase [P>0.05] in iron, ferritin levels, transferrin saturation percents in sera of postmenopausal women and non- significant increase [P>0.05] in total iron binding capacity [TIBC] transferrin, iron stores in sera of premenopausal women. Malondialdehyde increased non- significantly [P=0.44] in premenopausal women whereas ceruloplasmin increased significantly [P=0.000] in postmenopausal women group. On the other hand ferritin was correlated positively and significantly with body mass index [BMI] [r= 0.696; P < 0.05] and with ceruloplasmin levels [r=0.725; P<0.05] in pre- and postmenopausal women. Hormonal changes which usually associated with menopause may be the cause of increased oxidative stress and consequent rise in ceruloplasmin levels, as an antioxidant response