Background: Human rotaviruses, particularly of group A are the most important cause of severe dehydrating diarrhea in young children worldwide in both developed and developing countries. Although rotavirus accounts for up to 50% of hospitalizations for severe diarrhea in infants and children, it has been underestimated within the public health community, particularly in developing countries.
Across sectional study was carried out to evaluate the feeding pattern of malnourished children and to study the association between their demographic and nutritional variables. The study was conducted on 157 infants and children aged 2-36 months (65 males and 92 females) attending Nutritional Rehabilitation Center In Basrah General Hospital during the period from November 2007 till the end of May 2008. Selected demographic variables, feeding pattern, age of administration and type of different complementary foods and frequency of these food items were recorded. Measurement of weight and height or length by standard procedures was done for all infants and children recruited in the study. Anthropometric data were applied to appropriate charts: weight for length Z score, weight for age Z-score and height for age Z-score which were estimated according to CDC/WHO charts. all studied children were underweight; (93.6%) wasted and (87.3%) were stunted, (9.5% and 90.5%) were with severe and moderate wasting respectively, (38% and 62%) with severe and moderate stunting respectively, (45.9%, 54%) with severe and moderate underweight respectively. Study of feeding pattern of malnourished children has revealed that (28.7%) were on breastfeeding; (36.9%) formula feeding & (34.4%) with mixed feeding. Regarding the duration of breastfeeding; (75.8%) were breastfed less than 12 months. The age onset of complementary feeding; 71(65.1%) of children had their complementary feeding at age of 4-6 months. Malnourished children consume mainly cereals & rice in high proportion (38.9%, 56.1%) and least for fish and meat (3.8%, 4.5%) respectively. Children were given complementary food on daily bases in order of frequency of administration; (7%) were given rice, (5.7%) vegetables, (3.2%) cereals, (2.5%) eggs and (1.9%) fruits. Other foods were never on daily bases or even occasionally (> 1/wk) including meat, fish, legumes; they were never given in (95.5%, 96% & 88.5%) respectively. In conclusion: there was a significant positive correlation between age of onset of complementary feeding and underweight.
Aim: A retrospective descriptive study was carried out to evaluate and address some selected variables of admitted children with severe acute malnutrition to five selected nutritional rehabilitation wards in Basrah, three central Hospitals, and two district hospitals. As well as to assess the extent of implementation of world health organization guidelines for management of severe acute malnutrition. Methods: The data registries of the selected nutritional rehabilitation wards are reviewed from 1 st of January till 31 st of December 2015. The following information were reviewed: date of birth, sex, Z score (weight for length), weight on admission and discharge, weight gain, oedema, days of hospitalization, clinical diagnosis on admission and the outcome on discharge. Result: Total number of registered patients are 530 with males and females percentage of (53.2% and 46.8%) respectively. Sixty six percent of admitted patients were aged below 12 months. Clinical presentation of admitted patients reveals that more than 50% of patients had diarrhoea followed by pneumonia (21%) and poor weight gain (13%). Facilities of studied hospitals were limited regarding allocated wards, beds and nursing staff, only Basrah General Hospital has isolated nutritional rehabilitation ward with 12 beds and 7 trained staff, other wards are just a room within paediatrics wards with 4-6 beds and only 2 nursing staff. Although high percentage of severe wasting, underweight and stunting reported in nutritional rehabilitation wards with statistically significant result P-value 0.001 still moderate malnutrition reported in (27%) of admitted patients. Poor weight gain was reported in 48% of total studied patients, with higher percentage of good weight gain in nutritional rehabilitation ward of Basrah General Hospital (93.7%) and least recorded percentage was (9.3%) in Al-Zubair Hospital. The outcome of the studied patients reveals that; (56.8%) of patients recovered with improvement of clinical symptoms and weight gain, the higher percentage was in the nutritional rehabilitation ward of Basrah General Hospital(85.5%) and the least one was in Basrah Maternity and Children's Hospital (38.3%). Short hospitalizations period is obvious from registered data approximately 59.4% of patients stayed for (1-5) days and only 4.9% stayed for (11-15) days. Days of hospitalization, weight gain and clinical presentation can be regarded as dependent risk factors associated with good outcome in malnourished patients. Conclusion: This study concludes that management of severe acute malnutrition was not satisfactory and incomplete with faulty recording of the registered data of admitted patients. Current study recommended that the documentation of all data and records seriously will result in better understanding of the reality of nutritional rehabilitation wards.
Introduction: Communication skills “CS” have no clear curriculum in most Iraqi medical colleges. This shortcoming of education is reflected in a doctor-centered approach in Iraq. Aim: To identify challenges facing introduction of CS into medical education in Iraq. Methods: Feedback form including the main challenges on introducing CS was distributed online to healthcare professionals who have participated in training of CS courses. Results: Ninety-three healthcare professionals responded; 55 males and 38 females; 46 faculty members and 47 practitioners with part-time teaching. Doctors constituted 92 % of the respondents from different disciplines, and 75.2% had more than 15 years’ experience in practice. Frequency of educational and practical challenges were 40% and 44% respectively. Lack of appropriate curriculum constitutes 42% of educational challenges. Challenges include doctors' training in western models which are difficult to transform the interview into a dialogue that harmonizes Iraqi culture and social barriers (16% of respondents). A biomedical approach (22%) and lack of resources (22%) presented other challenges, while 14% of the participants mentioned high proportion of students to faculty members. Challenges related to practice includes a doctor-centered approach (47%) and neglect of patients' psychosocial needs (30%). Factors related to patients revealed that 46% of the challenges were related to health literacy and 26% to patients’ behavior for seeking medical advice. The presence of more than one person at interview was the most difficult factor for successful interview (14%), in addition to the passive role of the patient during interview (13%). There is no significance statistical difference in challenges in relation to specialty, workplace, sex and years of practice. Conclusion: Multiple levels of challenges facing introduction of CS into medical education were revealed which need systematic review in the educational curricula and practice of medicine.
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