SM Journal of Family Medicine

Archive Articles

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Prevalence of Critical Bilirubin Results among Neonatal Patients in Windhoek, Namibia

Neonatal jaundice is a frequently encountered paediatric problem in Africa that is associated with sickness and death. The research was undertaken to determine the prevalence of critical jaundice values in neonates in Windhoek, Namibia. Although several risk factors and aetiologies may be attributed to neonatal jaundice, the research focused on establishing the number of neonates with critical bilirubin levels in Windhoek, Namibia. Secondary data of bilirubin tests performed on neonates was obtained from the Namibia Institute of Pathology’s (NIP’s) archived patient records for the years 2013 and 2014. Only neonates that were less than 31 days old were included in the study. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22. The prevalence of critical jaundice values was estimated to be 12.4%. Neonates >3 to ≤6 days of age were noted to be the most affected. It was notable that 9.6% of neonates that were 3 to 6 days old had a potential for developing kernicterus. Males had a higher prevalence of critical values (13.4%) as compared to females (11.5%) and were at greater risk of kernicterus. The critical values and kernicterus cases increased with age. Neonates between 3 to 6 days were most affected as they had bilirubin values depicting risk to kernicterus. The cause of the male preponderance in elevated bilirubin levels is not known. Further studies thus need to be conducted to establish the causes of critical jaundice.

Shilongo SN, Mukesi M¹*, Gonzo M and Moyo SR


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Mirror, Mirror on the Wall: Body Image Disturbance among Qatari Female College Students

Introduction: The transition from high school to college or university is known to be an especially problematic stage in adult development. In order to adapt and find a way of becoming accepted or popular with their peer group, young women become increasingly concerned about maintaining an attractive and culturally acceptable body shape. To reach their often idealistically low weight goals, many female students engage in regular dieting behaviors which are often unsound and extreme.

Objectives: This study aims to estimate the proportion of Body Image Disturbance among first year Qatari female college students and relate it to their BMI distribution. It also assesses the perceptions towards weight and dieting behaviors among first year Qatari female college students.

Methodology: Data were obtained by cross-sectional study design. Three hundred and thirty two first year Qatari female college students were selected using simple random sample. Participants completed a questionnaire that assessed different concepts including feelings towards body appearance, overweight preoccupation, appearance orientation, body areas satisfaction, and potential risky behaviors and after that their height and weight were measured. Pearson Correlation was used.

Results: Our results indicate that 227(68.4%) of participants desire to lose weight. among them, 58% had body image disturbance (BID) ranging between 0-20% of their current weight. On the other hand, 105 (31.6%) of all participants have BID with a desire to gain weight, of these participants 73.3% have a desire to gain between 0-20% of their actual weight. Strong correlation was found between self reported current weight and actual (measured) weight with r=0.783, p<0.001, 55.1% of students dislike their body shape, 61.4% starve themselves, and 52.7% eat binges for no apparent reasons. About eighty percent weigh themselves at least once a day and 28.6% consider surgery as a way of controlling their weight.

Conclusion & Recommendations: Thinness is linked to social desirability among Qatari female college students. A sizable proportion of females with normal BMI have body dissatisfaction and desire to lose weight and potentially risky behaviors are practiced by the students in order to control their weight. The alarming findings of these behaviors among underweight students should raise concerns of possible eating disorders among these students.

Balanced health education messages should be delivered to females in schools and colleges about healthy attitudes and practices towards diet, and body weight.

Nagah Abdel Aziz Selim¹, Kholood Al Mutawaa², Hana Said³ and Mansoura Fawaz Salem⁴*


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Presentation and Outcome of Acute Abdomen in Goba Referral Hospital, Goba, Southeast Ethiopia: Retrospective Study

Background: Surgical acute abdomen is one of the commonly encountered emergencies in the practice of General surgery. However, there was not much study done regarding the presentation and outcome of acute abdomen in Ethiopia, particularly in this study area.

Objective: This study was aimed to assess the presentation and outcome of surgically treated acute abdomen patients who were managed operatively at Goba Referral Hospital, southeast Ethiopia.

Methods: This was Retrospective study conducted on 299 adult patients admitted with acute abdomen in Goba Referral Hospital from September 1, 2012 to August, 30, 2014. Variables analyzed include demographic data, clinical features, and causes of acute abdomen, immediate complications and outcome of the surgical management of acute abdomen. Data were extracted by trained data collectors using data compilation sheet. The collected data were processed using SPSS version 21 software. Descriptive statistics was done. Chi-square test was calculated to identify associated factors of acute abdomen.

Results: There were 299 patients of which 211 (67.2%) were males and 98 (32.8%) were females. About 58.2% of patients visited the hospital after 2 days of onset of symptoms. Abdominal pain (100%) and vomiting (99.3%) were the most common complaints. Acute appendicitis was the most common cause accounting for 49.2% of the patients, followed by acute intestinal obstruction (39.1%). Wound infection (15.7%) and septicemia (8.0%) were the most common postoperative complications. The overall case fatality rate was 16%. Conclusion: Acute appendicitis was the most common cause for acute abdomen. The overall case fatality rate of acute abdomen found was unacceptably high. Wound infection and sepsis were the most common postoperative complications. Early diagnosis, adequate preoperative and postoperative care may help to reduce the observed high mortality.

Bizuayehu Tassew¹, Mekonnen Tegegne Haile², Tomas Benti Tefera², Semere Sileshi Balda³, Kebebe Bekele Gonfa⁴ and Khan Mubashir⁴*


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Medical Resident Alumni Perspectives Regarding Preferred Pharmacotherapy Rotation Format

Introduction: Pharmacy integration into a Family Medicine Residency (FMR) curriculum is beneficial to the professional development and education of medical residents. While pharmacist involvement in FMR programs is well-documented, the ideal means of incorporating pharmacotherapy education as a standardized component of a residency curriculum is unknown. This study was conducted to determine the need, impact, and best approach to incorporate pharmacy experiences into a FMR curriculum, while secondarily identifying the medication-related content medical residents preferred to be taught by pharmacists.

Materials and Methods: A cross-sectional study was conducted via online survey sent to alumni of the Saint Joseph Regional Medical Center’s (SJRMC) FMR in order to assess their perception of the pharmacy curriculum within the residency program, which has been delivered in a variety of formats since its inception.

Results: Of 113 alumni invited to participate, 51 (41%) completed the survey. Developing a required, longitudinal pharmacy experience was well-received, as most alumni believed that it would improve patient care (98%), increase confidence in medication choices (100%), and increase retention of pharmaceutical knowledge (96%). Seventy-two percent believed pharmacotherapy rotations should be a required component of the FMR curriculum, with 96% preferring longitudinal exposure throughout the residency compared to a single month rotation. Finally, the subjects identified as most preferred for pharmacists to teach were quantified, with diabetes, hypertension, pain management, heart failure and anticoagulation cited most commonly.

Conclusions: The majority of FMR alumni believed a pharmacy experience should be a required component of the residency program and would prefer it be delivered longitudinally throughout the residency.

Kirk E Evoy¹*, Katelyn M Harsh², Elizabeth C Langton², Grace C Lee¹, Edward N Battjes³ and Hanna Raber⁴


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Family Medicine Specialism Training in Family Health Center in Bursa Integrated with the University Medical Faculty Department of Family Medicine, in Line with European Union Criteria

Introduction Family Medicine is a rapidly growing medical discipline in Turkey. This area of specialism, which is drawing attention in almost every developed country in the world and through training given in European Union (E.U.) countries, is a branch of clinical medicine which is wide-ranging in its scope. In 2002, the European branch of the World Organisation of National Colleges, Academies and Academic Associations of General Practitioners (WONCA Europe) gave the following definition: Family Medicine/General Practice is an academic and scientific discipline with training, investigation, peculiar to itself based on investigation and proof along with clinical application, directed at primary health care.

Göktaş Olgun*


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Fables of Family Medicine: A Collection of Clinical Fables that Teach the Principles of Family Medicine

The conceptual systematization in the speciality of Family Medicine has not matched with practice. As it has been renewed and extended its practice, its conceptual foundation was forgotten. Therefore, it is necessary to achieve more meaningful representations of the fundamental concepts of Family Medicine, and facilitate the transfer of these to clinical practice. But, these concepts can be difficult to understand and explain, even for experienced physicians in the specialty. The fable is an adult education method that can serve to intuitively understand abstract concepts by linking them to specific situations, for facilitating their assimilation. In this book -Fables of Family Medicine: A collection of clinical fables that teach the Principles of Family Medicine-, its short fables present animals, plants, minerals and things that think and speak as if they were human beings; beings or objects that are given the opportunity to think, feel and speak, and they are “patients” who come to the consultation with the family doctor. Each fable is a “great lesson” about “a fundamental concept of Family Medicine”. These concepts, elements or fundamental dimensions of Family Medicine, presented by fables in the book are, among others: comprehensiveness, panoramic view, circular causality, context and contextualization, uncertainty, complexity, coordination, variability, clinic interview, relationship doctor-patient, companion of the patient, empathy-assertiveness, biopsychosocial model, functional vs organic, continuity of care, symptoms of the disease vs experience of the pathology, diagnosis, anticipatory care, prevention, epidemiology, medicalization, technology, resources, family, community, treatment, strategic planning, co-development and co-treatment, multimorbidity, healing, participation, empowerment, focusing on the process, prognosis, terminal care, mental health, health and sickness.

Jose Luis Turabian*


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Maternal Age and Infertility

The incidence of female infertility is growing worldwide, reaching rates from 10 to 20%. It has been reported diverse risk factors associated with this medical complication.

Mar Nohales Córcoles*