Knowledge, Attitude and Practices of Saudi Women Regarding Breast Feeding at Makkah Al Mukkaramah

Background: Breastfeeding (BF) is the normal way of feeding infants and young children. Breast milk has disease-fighting antibodies that can help protect infants from several types of illnesses. Moth­ers who breastfeed have a lower risk of some health problems, including breast cancer and type 2 diabetes. Large percentage of saudi women do not breastfeed their infants despite of the fact that, Islam is very clear in encouraging breastfeeding until a child is two years of age. This study aims to assess knowledge, attitude and practices of Saudi women regarding breast feeding. Subjects and Methods: A descriptive design was used in this study. It was conducted at the post-partum department, Heraa General Hospital,  Makkah Al-Mukaramh. A convenient sample of 120 mothers were involved in this study. Three tools were used in the present study. The first tool was an interviewing assessment sheet, used to collect socio-demographic data, obstetric history and knowledge regarding BF. The second tool was an attitude scale, that ranged from positive, neutral and negative attitude toward breast feeding.. The third tool was an observational checklist to observe mothers during BF and newborn latching on. Results: The results of this study revealed that, less than one fifth of the mothers (17.5%) had poor knowledge regarding breast feeding, less than one half of them (43.3%) had negative attitude and slightly more than one third of them (35.0%) had average to poor latching on practices. Conclusion and recommendations: older (40-50 years old), highly educated and working mothers had excellent knowledge, positive attitude and good latching on practice. It was recommended to, encourage baby–friendly hospital initiative as one of the strategies to support and promote breastfeeding. Intensify breastfeeding education among mothers, with emphasis on the advantages of the early initiation of breastfeeding. Key words: Knowledge, Attitude, Practices and Breast feeding

Does MRI help in the assessment of inflammatory breast disorders?

AbstractObjectiveThe aim of work is to evaluate the role of magnetic resonance imaging in the assessment of different entities of inflammatory breast disorders.Materials and methodsEighty-one non-lactating patients with mastitis had been evaluated by post contrast MR imaging; their ages ranged from 22 to 70years (Average age: 41.6years). MRI data analysis was performed regarding qualitative criteria and parametric color maps for image post processing. Diagnosis was made up regarding resolution in follow up sessions for simple mastitis and biopsy were done for cases with suspicious imaging findings.ResultsMammary interstitial edema with no masses or abnormal enhancement was elicited in 28.4% (n=23/81). T2-weighed and post contrast series were the sequences of choice to rely upon in evaluation. T2 had demonstrated lesions in 64.2% (n=52/81) and contrast uptake was detected in 68% (n=55/81). Quantitative analysis was overlapping.MR imaging had displayed sensitivity, specificity and accuracy of 87.5%, 72.3%, and 75.4% respectively in differentiating benign forms of mastitis from malignant ones.ConclusionIn inflammatory breast disorders, MR imaging can precisely delineate disease extent and monitor response to therapy. Immediate distinction between infectious/non-infectious and malignant mastitis is difficult to be obtained

Residual breast cancer or post operative changes: Can Diffusion-weighted magnetic resonance imaging solve the case?

AbstractObjectiveTo evaluate the ability of Diffusion weighted MR imaging (DWI), as a non-invasive sequence to differentiate between accepted post operative sequel and residual malignancy in breast cancer patients following different surgical procedures.Patients and methodsDWI in addition to the routine post contrast MRI was performed for follow up of 170 post operative breasts (6–24months). DWI acquired using b values: 0, 850, 1000 and 1500. Analysis considered signal intensity (SI) at b 1000 and the ADC map and the mean ADC values.ResultsPost operative changes were: Edema (n=17, 10%), skin thickening (n=25, 15.9%), seroma (n=17, 10%), hematoma (n=5, 3%), fat necrosis (n=13, 7.6%), fibrosis (n=8, 4.7%), and combined (n=83, 48.8%). Residual malignancy found in 16.5% (n=28) of cases.No significant difference was noted between DWI SI at b 850 versus 1000 and b 1000 versus 1500 (P>0.05). Also no difference (P>0.05) was noted between the mean ADC values of residual malignant masses and post operative sequel of fibrosis and fat necrosis. ADC map showed low SI in 30% of cases. Statistical analysis yielded sensitivity, specificity and accuracy of 92.8%, 75.6% and 78% for contrast MRI and 92.8%, 82.6% and 83.4% for DWI respectively.ConclusionDWI enhanced the diagnostic performance of MRI in differentiating residual malignancy from post operative changes

Nurses' Performance for Patient Undergoing Bariatric Surgery

Context: Bariatric surgery is currently considered the most effective treatment option for morbid obesity; it results in more significant improvement in weight loss outcomes and obesity-related co-morbidities when compared with non-surgical interventions. The performance of bariatric nurses is very relevant for the quality and outcome of surgery.Aim: The study aimed to assess nurses' performance for a patient undergoing bariatric surgery. Methods: A descriptive exploratory design was followed to achieve the aim of this study. The study was conducted at surgical units at Ain Shams University hospital Cairo-Egypt. A purposive sample of 30 nurses recruited in this study worked in bariatric surgery units at Ain Shams University hospital. Tools of data collection were structured self-administered knowledge assessment questionnaire and evaluation practice checklist used to collect data of this study. Results: This study showed that 73.3% of studied nurses had inadequate knowledge, and 70.0% had poor practice regarding managing the patient undergoing bariatric surgery. Furthermore, there was a statistically significant correlation between total knowledge and total practice of the studied nurses.Conclusion: The current study concluded that more than two-thirds of the studied nurses had a reduced level of knowledge and practice. The study emphasized implementing an educational training program to improve nurses' performance regarding caring for bariatric surgery patients

Challenges Facing Nursing Profession in Saudi Arabia

Saudi Arabia, like many areas of the world, is challenged by a nursing shortage. The World Health Organization (2004), reported that there is only 40 nurses for every 10,000 of the Saudi Arabia population. In 2010, it was found that there is a chronic nursing shortage of 30% that is worsened by heavy migration of nurses. The Saudi literature links the shortage in Saudi nurses to socio-cultural factors found to influence the prevailing negative images and perceived low status of nursing. Community image, family disagreement, cultural and communal values, long working hours, mixing with members of the opposite gender, and the worry of not being a "marriageable" prospect were the main reasons why Saudi females did not choose nursing as a career (Miligi & Selim 2013). The Saudi Arabian government has committed  enormous resources to improve health care, with the ultimate goal of providing free and accessible healthcare services for every Saudi national and expatriate working within the public sector (Al-Dossary et al., 2008). However, the nursing needs of Saudi Arabia far exceed the supply of Saudi nurses. Despite continued efforts to increase the number of Saudi nurses, by 2010, expatriate nurses still constituted 74% of the total nursing workforce in Saudi Arabia (Ministry of Health Annual Report 2010).  In Saudi Arabia, nursing is a less desirable career choice for Saudi nationals in comparison to other professions. There are a number of challenges facing nurse practitioners (Tumulty 2001). Keywords: Challenges, Nursing professio

Castor Oil Safety and Effectiveness on Labour Induction and Neonatal Outcome

Background: Castor oil is one of the most popular methods for  labour induction. The use of castor oil to induce labor is controversial. The irregular, painful contractions of castor oil-induced labor can be stressful on the mother and fetus. The use of castor oil may stimulate passage of meconium, and thus, neonatal respiratory distress that may result from meconium aspiration. So, the aim of this study was to assess safety and effectiveness of castor oil on labour induction and neonatal outcome. Subjects and Methods: a quasi-experimental design was used. The study was conducted in a private hospital at Makkah Al Mukaramah. One hundred pregnant women who attended the hospital for giving birth was selected from the previously mentioned setting. The sample was divided as follow: 50   women already took castor oil and 50   women didn't take castor oil at the time of birth. Results: there were a lot of maternal complications that had been occurred among castor oil group in comparison with control group such as fatigue (12.0%), nausea & vomiting (20.0%) and excessive uterine activity (12.0%) compared to (8.0%, 4.0% ,4.0%) from the control group respectively. About one fifth 18 % of castor oil group had amniotic fluid mixed with meconium. In addition, a highly statistical significant difference was found between the two groups at the first minute APGAR score (t=2.65 at p=0.009). Conclusion: It can be concluded that, the probability of labour initiation increases during the first 24 hours after using castor oil. In addition, taking castor oil increases the chances of meconium stained amniotic fluid. Most side effects caused by taking castor oil are fatigue, nausea, vomiting and diarrhea. Also, castor oil affected newborn's APGOR score at the first minute. Key words: Castor oil, labour induction, neonatal outcom

Detection and diagnosis of breast lesions: Performance evaluation of digital breast tomosynthesis and magnetic resonance mammography

AbstractObjectiveTo assess the impact of digital breast tomosynthesis (DBT) and magnetic resonance mammography (MRM) in enhancing the performance of digital mammography (DM) in the detection and evaluation of different breast lesions.Patients and methodsIn this retrospective study, 98 patients with 103 breast lesions were assessed by DM, DBT and MRM. Mammography images were acquired using the “combo mode", where both DM and DBT scanned in the same compression. MRM was performed by 1T open system. Each lesion was assigned a blinded category in an individual performance for each modality. The resultant BI-RADS categories were correlated with reports of the pathology specimens or outcome of 18-month follow-up.ResultsBoth DBT and MRM showed equivalent sensitivity of 92%. The specificity for DBT and MRM was 80.7% and 89.7% respectively. The efficacy of DM was raised from 61% to 83.5% with DBT and 90.2% with MRM. The results of the three modalities and the final diagnosis revealed a significant correlation (p=0.035).The association between the results of DBT and those of MRM showed statistically significant difference between DBT and MRM for diagnosing breast lesions (p=0.001).ConclusionBoth MRM and DBT provide better performance than classic DM. Adding either of these modalities to the classic examination enhances diagnosis and precise disease distribution

Quality of Life Among of Menopausal Women

Background: The transition through menopause is a life event that can profoundly affect quality of life. More than 80% of women report physical and psychological symptoms that commonly accompany menopause, with varying degrees of severity and life disruption. Studies find that most women experience at least one or more of these symptoms as they transition through the postmenopausal stage of life. The aim of this study was to assess the menopause related symptoms and their impact on the women’s quality of life. Subjects and methods: A descriptive design was carried out in Obstetrics and Gynecological department at maternity and children hospital in Makkah Al Mukkarrmah..  Convenient sample composed of 90 women at range of from 40-60years were recruited in the study. Interviewing sheet that was designed by the investigators and Menopause Specific Quality of Life Questionnaire (MENQOL) were used to collect the data. Results: The present study showed that the most severe symptoms in vasomotor, psychosocial, physical and sexual domains were, hot flushes (29%), experiencing poor memory (48.3%), being dissatisfied with their personal life (44.8%), Low backache (41.9%), and change in your sexual desire (36.8%). The overall scores of menopausal quality of life for each MENQOL domain are indicated that the highest mean score in sexual domain (3.19± 1.99), following by psychosocial (2.94± 1.45) then vasomotor (2.55± 1.53) and finally physical symptoms (2.28± .749). Conclusion: The present study concluded that most severe symptoms in vasomotor, psychosocial, physical and sexual domains were, hot flushes, experiencing poor memory, being dissatisfied with their personal life, low backache, and change in your sexual desire. The mean scores of physical and vasomotor domain were significantly more in postmenopausal (PM) group then menopausal transition MT group. While the mean scores of each domain suggest that menopausal symptoms were associated with decrease in women quality of life. The current study recommended that: Health care providers need to play a more visible and instrumental role in continuously assessing menopausal women's needs as well as implement appropriate health educational programs. Also further research addressing women's health needs is also essential for improving the quality of life of menopausal women in Saudi Arabia Keywords: Menopause – Menopausal symptoms- Quality of life - MENQOL

Effects of Reciproc, Mtwo and ProTaper Instruments on Formation of Root Fracture

Introduction: The aim of this study was to compare the formation of dentinal crack and craze lines in the root dentin during root canal preparation with three different NiTi endodontic systems, naming Reciproc (RCP), ProTaper Universal (PTU) and Mtwo. Methods and Materials: One hundred extracted mandibular premolars with single canals were selected and decoronated. The teeth were randomly divided into four groups of 25 each (n=25). In groups 1, 2 and 3 the teeth were prepared using Mtwo, PTU and RCP, respectively. While in group 4 (control group) the samples were left unprepared. After preparation, all specimens were sectioned perpendicular to the long axis of root at 3, 5 and 9-mm distances from the apex. The sections were then individually observed under 12× magnification using stereomicroscope. The data was analyzed using the chi-square and Fisher’s exact tests. The level of significance was set at 0.05. Results: No cracks were observed in the control group. All engine-driven systems caused dentinal cracks. Mtwo and PTU caused cracks significantly more than RCP (P<0.05). There was no significant difference between RCP and control group (P>0.05). Conclusion: All three engine-driven systems created dentinal defects. Reciproc caused less cracks than Mtwo and ProTaper Universal.Keywords: Cracks; Craze Lines; Dentin; Nickel-Titanium Instruments; Root Canal Preparation; Tooth Root; Vertical Root Fractur

Consensus recommendations on lymphedema in Phelan-McDermid syndrome

Phelan-McDermid syndrome (PMS) is a neurodevelopmental disorder caused by deletions 22q13.3 or pathogenic variants in the SHANK3 gene. Lymphedema can be a clinical feature in 10–25% of individuals with PMS due to a deletion 22q13.3, but is not observed in those with a SHANK3 variant. This paper forms a part of the European consensus guideline for PMS and focuses on what is known regarding lymphedema in PMS in order to present clinical recommendations. The mechanism causing lymphedema in PMS is unknown. Lymphedema can be suggested by pitting oedema of the extremities or, in later stages, non-pitting swelling. It can occur already at a young age and be progressive if untreated, impacting daily functioning. Lymphedema can be treated using existing general multidisciplinary management guidelines, taking the functioning of the individual with PMS into account. Furthermore, well-known risk factors for the development of lymphedema as lack of physical activities and weight gain/obesity should be addressed. Diagnosis and treatment are best performed in a multidisciplinary centre of expertise.</p