Print ISSN: 0027-1446

Online ISSN: 2309-6217

Main Subjects : Family and Community Medicine

Prevalence of Caesarean Sections in Mosul City Hospitals :A Cross – Sectional Study

Noor Nazar Al-Sanjary; Omaima Abdulrazzaq Zubair; Raida Muhammed Al-Wazzan

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 2, Pages 126-132
DOI: 10.33899/mmed.2020.128879.1059

Background: Caesarean section rates had been increasing markedly in the world and the procedure as it become more safe than before (although it still a major surgical operation) and the objective of this study is to estimate the prevalence of caesarean section in Mosul city hospitals.
Methods: A cross-sectional study was conducted at eight hospitals in Mosul city from both river sides including five governmental hospitals and three private hospitals, (671) women who delivered by caesarean section in Mosul city hospitals during a period of data collection were included from beginning 15th of November 2019 and ending at 15th of April 2020.
Results: Women delivered by caesarean section aged between 20-35 years in (70.6%), (74.8%) of low educational level and (91.8%) were unemployed. The rate of caesarean section during the period of data collection in Mosul city hospitals was (28.8%) while the rate of caesarean section during the period of data collection showed that the highest rate of caesarean section were in private hospital and especially at Al-Zahrawi and Al-Rabee Private Hospitals (100%) while Al-Batool Hospital include (37.6%) from governmental hospitals in spite that the highest numbers of deliveries and caesarean section was in Al-Khansa Teaching Hospital.
Conclusions: Caesarean section rate was higher than WHO recommendation among Mosul hospitals. Further improvement and attention to primary health care should be applied.

Patients satisfaction to quality of health services of family doctors in family medicine centers in left side of Mosul city

Mohammad Yousif Mohammad; firas husam ali; ammar hazim yahia

Annals of the College of Medicine, Mosul, 2020, Volume 42, Issue 1, Pages 76-81
DOI: 10.33899/mmed.2020.126482.1015

Background:Patient satisfaction is related to clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. The aim of study was to assess the level of patients' doctors in family medicine centers in Mosul city.
Patients and Methods: A cross sectional study was conducted in order to achieve the aim of the present study in which the data was taken from the attendants to family medicine centers in left side of Mosul city by direct interview using specially designed questionnaire (The Bulgarian EUROPEP questionnaire) after receiving health services during a period of 8 months started from 1st of May 2018 up to 30th of January 2019.
Results:The study includes 580 participants. More than half of them their ages were between 20 – 40 years from both sexes (male = 175, female = 135) and 38.8% of them were having university graduation. The overall satisfaction to medical services delivered by family doctors was 79.7%, Continuity and confidentiality constituted the higher satisfaction rate in 97%, 96.6%, while Informativeness satisfaction constitute 89.7%. Accessibility and Acceptability had the lowest satisfaction rate compared to other domains
Conclusions:this study revealed high patients’satisfaction rate to doctors delivering health care at the family health centers in left side of Mosul city while there was lower satisfaction rate regarding Accessibility and Acceptability. Further wide scale studies are needed in the future and provision of appropriate infrastructure.
Key words: patient satisfaction, family medicine, health care.

Implementation of Integrated Management of Childhood Illness Strategy's in Al Hadbaa Primary Health Care Center in Mosul City

Ashraf Abdulrahman; Ali M. Saleem

Annals of the College of Medicine, Mosul, 2019, Volume 41, Issue 1, Pages 75-80
DOI: 10.33899/mmed.2019.161297

Background: The World Health Organization (WHO) build up guidelines for the integrated management of childhood illnesses (IMCI) in the health facilities  to improve the recognition and the individual management of the common reasons of death among children under the age of five. The approach used in outpatient clinical settings with restricted diagnostic and therapeutic tools.
Aim of study: To assess the impact of implementation of IMCI strategy, in reducing an inappropriate prescription of antibiotics and raising vaccination coverage.     
Patients and methods: A cross-sectional study design was arranged, where 395 child with age from two months up to below 5 years old attending Al Hadbaa PHCC from 1st of January to 31st of March 2014 suffering from one or more of the following respiratory infection, diarrheal diseases, throat infections, ear infections and fever. The children assessed separately by two clinics, "A" non-adopting IMCI and "B" adopting IMCI guidelines, the Mc-Nemar test was applied and differences  were evaluated.
Results: The attendant children are 239 males and 156 females complaining from fever (39.1%), throat problems (21.4%), ear problems (12.6%), cough (11.6%), diarrhea (11.1%) and pneumonia (4.2%). The overall use of antibiotics is 66.1% in clinic "A" and 21.0% in clinic "B" with p-value 0.000. Regarding the immunization, the outcomes appear to have very high significant difference  54.1% in "A" and 75.7% in "B".
Conclusion: The classification-approach to the sick child using IMCI guidelines has clear effect on decreasing an inappropriate use of antibiotics and raising number of vaccinated children, which justifying the adaptation of this strategy.   

Physicians' Perception at College of Medicine/ University of Mosul Regarding Relationship with Drug Industries

Nadia Saeed

Annals of the College of Medicine, Mosul, 2019, Volume 41, Issue 1, Pages 11-17
DOI: 10.33899/mmed.2019.161255

Context: Physicians experience a conflict of interest related to appropriate interaction to the current industries' practices of gifts provision as a marketing strategy.
Aim of the study: The study aims to explore physicians' insight about dealing with drug promotion activities of pharmaceutical industries.
Subjects and methods: A cross- sectional study design was conducted in the College of Medicine /University of Mosul during the academic year 2018-2019. Medical faculty staffs in the College of Medicine/ University of Mosul in the clinical departments including department of: (Medicine, Surgery, Pediatrics and Obstetrics and Gynecology). In addition to academic physicians in non-clinical departments who have privet clinic who agreed to participate were involved. A modified standardized questionnaire form was used.
Results: From 71 participant physicians 61 (85.92%) had no previous teaching regarding ethical principles of interaction with drug representatives. Forty percent of the participants had personal friendship with a medical representative; meanwhile 63.38% had previous dealing with pharmaceutical companies. Only 16.9% of participants trust the information that delivered from drug companies. More than one fifth of participants supposed that gift provision from drug companies will influence drug prescription manners. Physicians considered drug sample appropriate gift to be accepted followed by conference registration fees, textbooks and travel to conference.
Conclusion and recommendations: Considerable proportion of academic Physicians at College of Medicine /University of Mosul had interaction with pharmaceutical company representatives. Academic physicians' responses attempted to minimize gifts provision on their professional behavior. However, pharmaceutical promotional activities should be monitored and controlled through physicians' self- regulation and legislations.

Association between Anxiety and Depression with Irritable Bowel Syndrome in Mosul

Firas Husam Ali; Samim Al–Dabbagh

Annals of the College of Medicine, Mosul, 2019, Volume 41, Issue 1, Pages 63-68
DOI: 10.33899/mmed.2019.161288

Background: Irritable Bowel Syndrome (IBS) is the most common disorder seen in gastroenterology practice.  It is also a large component of primary care practices.
Aim: To determine the association between anxiety and depression and Irritable bowel syndrome.
Methods: A case – control study design was adopted to achieve the aim of the present study. This study was conducted in Mosul city and sample was taken from the inward and outward patient department of Al-Zahrawi, Ibn-Seena teaching hospitals and Al-Salaam general hospital. The actual period of data collection has been extended between (20th of December 2006 – 31st of July 2007). A total of 150 cases diagnosed to have IBS by Rome II criteria. Another 150 control group was diagnosed as Rome II negative of apparently healthy individuals which were relatives of patients other than IBS matched according to age (+ 5 years) and sex with cases. A specially designed questionnaire form has been used to help in diagnosing IBS cases according to Rome II criteria. To assess anxiety in cases and controls, ICD- 10 checklist was used and its variables have been planned to be assessed as risk factors and For the diagnosis of depression the international diagnostic checklist for ICD – 10 ( IDCL) has been used.
    A questionnaire form filling is through direct interviewing with cases and controls. Chi – square test for contingency tables was used to test for the presence or absence of statistical association or differences between cases and controls, Z – test for the differences between two proportions was used. During statistical analysis P – value of Results: present study shows that the majority of cases (93.3%) were below 55 years. Female to male ratio among cases was 1.9:1. The majority of cases had a mild symptom. Anxiety was found to be a significant risk factor in the development of IBS, this study showed that 64.8% were females with anxiety in comparison to 35.2% males and this study showed that those with depression had a very highly significant risk to develop IBS (OR=4.50) and those with both anxiety and depression have 5 times risk to develop IBS in    comparison to those with   anxiety or depression or none (OR=5.21, P<0.001).
Conclusion: In this study, IBS patients appeared to have a significant association with anxiety, depression and these factors maybe played a causative role in the development of IBS.