full pdf of issue - Middle East Journal of Family Medicine

More documents

Recommendations

Info

ORIGINAL CONTRIBUTION AND CLINICAL INVESTIGATION16. Howie JGR, Heaney DJ,Maxwell M. Measuring quality ingeneral practice. London: RoyalCollege of General Practitioners,1997(Occasional paper 75.)17. Howie JGR, Heaney DJ, MaxwellM, Walker JJ, Freeman GK, RaiH. Quality at general practiceconsultations: cross sectional survey.Br Med J 1999; 319: 738-743.18. Statistical package of socialscience, SPSS7.5. SPSS Inc., 1996.19. Deveugele M, Derese A, vanden Brink-Muinen A, Bensing J, DeMaeseneer J. Consultation lengthin general practice. Cross sectionalstudy in six European countries. BMJ2002 Aug 31: 325-472.20. Britt HM, Valenti L, MillerG. Length of general practiceconsultation in Australia. Aust. Fam.Physician, 2002 Sep: 876-880.21. Freeman G, Hjortdahl P. Whatfuture for continuity of care in generalpractice? Br Med J 1997; 314: 1870-1873.22. Kotic M, Bdak A, IvankovicD, Mastilica M, Lazic D, Babic A,Matkovic V. Patients views on theprofessional behavior of familyphysicians. Family practice, vol 18(1), oxford university press 2001: 42-47.23. Anderson SO, Matteson B,Length of consultation in generalpractice in Sweden: views of doctorsand patients. Fam. Pract. 1989 Jan.:.130 -134.24. Campbell S., Hann M, HackerJ, and Roland M.. Identifyingpredicators of high quality carein English general practice:observational study. BMJ, 2001; 323:784.24 MIDDLE EAST JOURNAL OF FAMILY MEDICINE VOLUME 10 ISSUE 7MIDDLE EAST JOURNAL OF FAMILY MEDICINE • VOLUME 7, ISSUE 10
MEDICINE AND SOCIET YApproach to Febrile Infants in the Southern PeripheralHospitals of the Royal Medical Services, JordanAbdallah M. GhanmaCorrespondence:Abdallah M. Ghanma, M.D.Senior specialist in Pediatrics.Royal Medical ServicesP.O. Box 855038Amman, JordanMobile phone 00962 795578777Email: farrisghanma@yahoo.comAbstractObjectives:The aim of this studywas to help pediatricians andfamily doctors to triage younginfants presenting with fever tothe Emergency department, intoserious and dischargeable patients.This will help in decreasingthe unnecessary use of potentantibiotics, the number of admissions,as well as the unnecessaryinvasive and noninvasive laboratoryinvestigations.Methods: Specially designedmedical records abstract formswere filled with data collectedfrom 200 infants (over a period of12 months) who presented withfever more than 38.2ºc rectally tothe pediatric emergency room attwo peripheral hospitals in thesouthern part of Jordan (PrincessHaya Hospital in Aqaba, andPrince Ali Hospital in Al-Karak).Full detailed medical historyand physical examination wereperformed. Laboratory tests wereperformed including CompleteBlood Count, C-reactive protein,chest X-ray, urine analysis andculture, stool analysis and culture(if diarrhea is present), in additionto Blood culture and Cerebrospinalfluid sampling in seriously illadmitted infants.All candidates were closely followedup daily over the next twodays if discharged from the emergencyroom, otherwise, they wereadmitted.The final diagnosis was correlatedwith the preliminary findingsand tests to define significanceand possibility of depending onfuture assessment of similarpatients.Results: Significant correlationwas noticed between positiveBlood Cultures and/or positivechest X-ray findings with thesymptoms of poor feeding, hypoactivity,convulsion and attacks ofcyanosis.The most important signs wereabdominal distension, irritability,respiratory distress and bulginganterior fontanel.The significant laboratory findingsthat we depended upon foradmission were:White Blood Cells count of morethan 14.000, with more than 40%Neutrophils, urine analysis withWhite Blood Cells more than6/High power field, positive C-reactive protein, and chest X-rayfindings.Conclusion: It can be concludedthat poor feeding, hypo-activity,convulsion and cyanosis are consideredindicators of serious illnesses,necessitating admissionand treatment. Simple Laboratoryinvestigations are very helpful topediatricians and family doctorsto spot the serious cases, andspare many young infants theunnecessary admissions to thehospital.Key words: Fever, CompleteBlood Count, CRP, Chest X-ray,Urine AnalysisMIDDLE MIDDLE EAST EAST JOURNAL JOURNAL OF OF FAMILY MEDICINE VOLUME • VOLUME 10 ISSUE 7, ISSUE 7 10 25
Page 1 and 2: 1819ISSN 1839-0188 August 2012 - Vo
Page 3 and 4: TABLE OF CONTENTSOriginal Contribut
Page 5 and 6: ORIGINAL CONTRIBUTION AND CLINICAL
Page 23: ORIGINAL CONTRIBUTION AND CLINICAL
Page 27 and 28: MEDICINE AND SOCIET YTable 1: Popul
Page 29 and 30: MEDICINE AND SOCIET Ylaboratory inv
Page 31 and 32: EDUCATION AND TRAININGlearning capa
Page 33 and 34: EDUCATION AND TRAININGpragmatism wh
Page 35 and 36: EDUCATION AND TRAINING(Simonson, 19
Page 37 and 38: EDUCATION AND TRAININGthe media as
Page 39 and 40: CASE REPORTCerebral venous sinus th
Page 41 and 42: CASE REPORTweaned off. Facial nerve
Page 43 and 44: CASE REPORTTurk J Pediatr 1989; 31(
Page 45 and 46: TECHNOLOGY AND FAMILY MEDICINEseeki
Page 47 and 48: TECHNOLOGY AND FAMILY MEDICINEFigur
Page 49 and 50: TECHNOLOGY AND FAMILY MEDICINEFigur
Page 51 and 52: MIDDLE EAST JOURNAL OF FAMILY MEDIC

full pdf of issue - Middle East Journal of Family Medicine

Create successful ePaper yourself

Delete template?

Save as template?