Baghdad - Prompt medical care is at last on offer in Iraq, for those who can find the dollars for it.
"Why would I want to go to government-run hospitals where there is no care, no functioning instruments, long lines, and in the end the same doctor who treats you there can treat you at a private hospital," says Mohammed Abbas, 35, an employee at Iraq's Ministry of Oil.
Abbas, speaking at the private Saint Raphael Hospital in the Karrada area of Baghdad, wanted treatment on time, and was prepared to pay for it. Like him, many are coughing up money for private treatment. When they have money, that is, in an economy with more than 50 percent unemployment.
For medical care, many scramble to find money somehow. "It is a catastrophe at the government-run hospitals," says Hayder Abud, 30, at the private hospital for a check-up. "When you finally get a doctor to see you there, they are so rushed and sleep deprived, you can't be sure you are getting proper treatment."
Most treatment at government hospitals is free. Getting an x-ray at a private hospital may cost 40 dollars. But at a private hospital the job can get done on time.
"Iraq's Ministry of Health is struggling," said Khaled, administrative manager at the Saint Raphael Hospital, requesting that his last name not be used. "We have had problems with the Ministry of Health because they are angry at us for treating so many more people nowadays."
The state medical system is on its knees. It was one of the best in the region before the U.N.-backed economic sanctions for more than 12 years, followed by the U.S.-led invasion and occupation.
Government hospitals are short of doctors. A small increase in pay over the last three years has lured some doctors back, but what they pay cannot match income in the private sector.
On average, a general practitioner in a government hospital earns about 300 dollars a month; a private hospital pays twice or three times that much. More and more doctors are shifting away from government hospitals.
"I and my family were unable to live on the pay I earned at a government hospital," says Dr. Kubayir Abbas, 34, an anesthetist. "So I decided to come over to the private sector instead, and now it is much better."
Dr. Shakir Mahmood Al-Robaei, another anesthetist, said "It's better for us to work here than in the public sector. We earn more money, it is safer, and we don't have to worry about having the right equipment and supplies. When I worked in the public sector, we were short of everything most of the time."
And so government hospitals continue to run short of doctors, while some private hospitals have a surplus. What has improved since 2007 is that violence against doctors, and even against patients who attend certain hospitals, has dropped notably.
Government hospitals also lack basic supplies such as gauze, rubber gloves, clean needles, surgical instruments and drugs for anesthesia. Non-medical basics such as clean bedding, disinfectants and air-conditioning are often lacking, even in the largest medical complex in the country, the Baghdad Medical City. Iraqis have for years had to buy their own medicines and even oxygen supplies on the expensive black market.
Corruption within the Ministry of Health, and the near total lack of reconstruction that was promised by the U.S. Coalition Provisional Authority in the first year of the occupation have left Iraq's healthcare system depleted of resources.
A report, "Rehabilitation Under Fire," released last year by the health organization Medcat said Iraq has only around 9,000 doctors, after most fled the country. That gives a ratio of six doctors for every 10,000 people. The ratio in Britain is 23 to 10,000.
Given the crisis in government medical care, the business of private hospitals is booming. Raphael hospital, which currently has 35 beds and sees on average over 1,000 patients a day, will soon expand to 90 beds and increase its staff.
Dr. Rhamis Mukhtar, the only surgeon for morbid obesity in Iraq, has been working at this private hospital since 2000, while also working at a state hospital. "I'm thinking of moving here full time," he said. "There are much better supplies, services, and overall care for the patient. This center is the best for laparoscopic surgery in the country."
For complicated emergency cases, government hospitals are still the best, Dr. Mukhtar said. They have special equipment most smaller private hospitals lack. It has to get very bad for someone before they can hope to get the best out of a government hospital.
March 7, 2009
HOMEO DOCTOR FOR YOU
DOCTOR SAJID AZIZ
IF U WANT THEN CONTECT AT THIS NUMBER AND GET FREE HELP ABOUT YOUR PROBLEM............03009684770
IF U WANT THEN CONTECT AT THIS NUMBER AND GET FREE HELP ABOUT YOUR PROBLEM............03009684770
Medical Care - home
Journal Description - Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. All subscribers to the Journal receive copies of supplemental issues along with their regular issue.NEW! Authorship Policy.NEW! Conflict of Interest PolicyVisit http://mdc.edmgr.com for further information. Important Message: Easily submit and review manuscripts online with LWW's Prompt/Editorial Manager. This automated, web-based tool simplifies the manuscript submission and review processes and enables users to electronically submit, review and track manuscripts and artwork online in a few easy steps. We invite contributors and reviewers to begin using the Prompt/Editorial Manager interface today at http://mdc.edmgr.com Important Message: Select articles now feature links to supplemental digital content directly from the article text and are indicated in the Table of Contents. Authors are encouraged to submit supplemental digital content that supports their article text. Please see the journal instructions for authors or go to http://links.lww.com/A142 to read LWW's requirements for submitting supplemental digital content.
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************Journal subscribers - please activate your subscription via the Register button on the top menu bar. Your subscriber number is provided on your journal mailing label. Guests - simply create a new account via the Register button on the top menu bar. Once you have established an account you will be able to purchase articles via our pay-per-view service and sign up for additional online services.
March 6, 2009
Sick babies, few choices: a historical geography of medical care and facilities for infants and children.
Imagine that a parent wakes up one morning and finds his/her child having a fever. The parent is likely to call a pediatrician for instructions about how to handle the situation. The pediatrician, in turn, might suggest watchful waiting, or bringing the child to the office or a clinic for an examination or tests. If there is sufficient concern, the pediatrician might instruct the parent to bring the child to the emergency room for hospital admission. Being able to make choices about how and where to treat sick children is a relatively recent phenomenon. Historically, infants and children had poor chances for survival and their access to any type of medical care was sorely limited. Physicians often refused to accept infants or children as patients, refused them access to hospitals, and generally considered them untreatable. We report here on the diffusion of access to medical care for infants and children in selected urban centers of both Europe and the northeastern United States, beginning with the initial concept of providing refuge for abandoned infants in the Middle Ages and ending at the turn of the 20th century. This paper provides a historical geography that should clarify how lucky today's parents are to have a range of options for medical care for their children. Refuge for Infants and Children The decline of feudalism and the rise of cities created massive social upheaval in Europe. Sanitation was abominable and disease ran rampant through densely populated areas that lacked sewers and access to clean water. Hunger and poverty were rampant. Trade routes expanded and they brought more than goods back to European ports they brought rats and disease. During the 14th century alone, the Black Death (bubonic plague) killed more than 25 million people (about 25 percent of the European population). The result was unparalleled social turmoil, with an enormous number of abandoned and orphaned infants and children left to fend for themselves. Their odds of survival were close to nil. One way of solving the problem of abandoned and orphaned infants and children was to create a place of refuge where they could receive basic food, clothing and shelter. The first recognized attempt to provide refuge for abandoned infants is credited to the Archbishop of Milan who, in the year 787, attached a cradle to a revolving exterior church door. An anonymous donor would place an infant into the cradle and ring a bell. The door then revolved, accepting the infant. The Church then took the responsibility of finding a wet nurse for the "little stranger" and offered a monastic life for any that survived. Over time, providing refuge for abandoned and orphaned infants and children in times of stress (such as during a war or after an epidemic) became acceptable. Many foundling homes and orphanages opened in Italy during the 14th and 15th centuries (see Figure 1 for an example from Italy), with more than 80 in operation across the European continent before 1700. As missionaries moved around the globe, they helped to diffuse the concept of refuge with them, creating facilities for abandoned and orphaned infants and children in Jerusalem in 1210, Arabia in 1283, Mexico City in 1524, Lima in 1563, Bogota in 1650, Pernambuco in 1650, and Beijing in 1662. [FIGURE 1 OMITTED] Urbanization and migration, as well as religious and cultural changes created economic, political and social turmoil in Europe. While explorers claimed new lands and opened new trade routes, children of the poor died of cold and hunger in the streets of European cities. The bodies of infants were recovered from the sewers and rivers of European cities in increasing numbers. The Hotel Dieu, the oldest hospital in France, began accepting abandoned children in 1523 so that they would not purposefully be maimed and sold as beggars. By 1547, infanticide was so rife in Paris that the Parliament decreed that nobles must care for foundlings left in their domains. Orphaned and abandoned infants and children and the children of the poor were not the only ones with poor chances for survival during this period. Even children of parents with means were unlikely to survive to adulthood. Diseases ran rampant through urbanized populations. A basic understanding of sanitation did not yet exist and there was no effective treatment for infectious agents. High death rates pushed the social system to its limits. A foundling hospital,...
Taking Care Of Baby’S Health- Tips And Tricks
When new baby is born, all things from a little one to the biggest are changed. All aspects in life are completely changed after the arrival of the baby. The responsibility of taking care of baby is on the head of the parents after the birth of the baby. There are several aspects on which parents have to pay attention. There is a long list of the things that baby wants from you other than just love that you often show towards the baby. The health of the baby is one of the most important aspects that parents can't ignore. Parents should be as serious as possible about the health of the baby. The baby's health includes many things such as medical care, dental care, skin care etc. In this article you will find the tips that will be helpful in the health care of your baby. You can use the tips in your practical life for better experience.
Be serious about the health of the baby. Don't ignore little things for the baby and always try to keep your baby safe. The skin care of the baby is important one. The skin of the baby is delicate and needs to be treated gently and appropriately. Use proper and trusted products for the baby. Know the type of the skin of the baby and use products according to the type. Use the products that are recommended by most of the doctors. Baby's cosmetic products should take good care of the skin of the baby. All baby clothes should be washed with a special detergent. Skin care includes good care of the head also. The shampoo for the head of the baby should b chosen carefully. Also, the body wash products should be chosen well. There are a lot of baby skin care products in the market; you can pick up the best one for you.
Food is another important thing in a baby's life. Little babies may be feed more than four times a day as they can hold a little amount of food and that amount is not enough for them to carry out whole day. You must be caring about the food of your little one. Give him food as per need and whenever required. One or two years old babies should be feed only milk, either from mom or from bottle. More than two years old children should be feed more that that of the little ones. They should be given food three or four times a day.
Baby is healthier if he sleeps appropriately. But, how to know about the right time of baby's sleep? It depends upon the age of the baby. Your baby should be sleeping nine to ten hours if he is less then of two years. But it is not written on the stone. Sleeping time varies baby per baby. If your baby is having difficulty with sleep, then you should seek medical help.
The three important aspect of the baby's health have been discussed in this article. Hope that you will use the tips in the development of your baby.
Taking Care Of Baby’S Health- Tips And Tricks
Taking Care Of Baby’S Health- Tips And Tricks
When new baby is born, all things from a little one to the biggest are changed. All aspects in life are completely changed after the arrival of the baby. The responsibility of taking care of baby is on the head of the parents after the birth of the baby. There are several aspects on which parents have to pay attention. There is a long list of the things that baby wants from you other than just love that you often show towards the baby. The health of the baby is one of the most important aspects that parents can't ignore. Parents should be as serious as possible about the health of the baby. The baby's health includes many things such as medical care, dental care, skin care etc. In this article you will find the tips that will be helpful in the health care of your baby. You can use the tips in your practical life for better experience.
Be serious about the health of the baby. Don't ignore little things for the baby and always try to keep your baby safe. The skin care of the baby is important one. The skin of the baby is delicate and needs to be treated gently and appropriately. Use proper and trusted products for the baby. Know the type of the skin of the baby and use products according to the type. Use the products that are recommended by most of the doctors. Baby's cosmetic products should take good care of the skin of the baby. All baby clothes should be washed with a special detergent. Skin care includes good care of the head also. The shampoo for the head of the baby should b chosen carefully. Also, the body wash products should be chosen well. There are a lot of baby skin care products in the market; you can pick up the best one for you.
Food is another important thing in a baby's life. Little babies may be feed more than four times a day as they can hold a little amount of food and that amount is not enough for them to carry out whole day. You must be caring about the food of your little one. Give him food as per need and whenever required. One or two years old babies should be feed only milk, either from mom or from bottle. More than two years old children should be feed more that that of the little ones. They should be given food three or four times a day.
Baby is healthier if he sleeps appropriately. But, how to know about the right time of baby's sleep? It depends upon the age of the baby. Your baby should be sleeping nine to ten hours if he is less then of two years. But it is not written on the stone. Sleeping time varies baby per baby. If your baby is having difficulty with sleep, then you should seek medical help.
The three important aspect of the baby's health have been discussed in this article. Hope that you will use the tips in the development of your baby
Getting Medical Care After Cancer Treatment
Getting Medical Care After Cancer Treatment
All cancer survivors should have follow-up care. Knowing what to expect after cancer treatment can help you and your family make plans, lifestyle changes and important decisions.
Some common questions you may have are:
Should I tell the doctor about symptoms that worry me?
Which doctors should I see after treatment?
How often should I see the doctor?
What tests do I need?
What can be done to relieve pain, fatigue or other problems after treatment?
How long will it take for me to recover from treatment and feel more like myself?
Dealing with these issues can be a challenge. Yet many say that getting involved in decisions about their future medical care and lifestyle was a good way for them to regain some of the control they felt they lost during cancer treatment. Research has shown that people who feel more in control feel and function better than those who do not. Being an active partner with your doctor and getting help from other members of your health care team is the first step. What Is Follow-up Care? Follow-up care means seeing a doctor for regular medical checkups. Your followup care depends on the type of cancer and type of treatment you had, along with your overall health. It is usually different for each person who has been treated for cancer.
In general, survivors usually return to the doctor every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that. At these visits, your doctor will look for side effects from treatment and check if your cancer has returned (recurred) or spread (metastasized) to another part of your body.
At these visits, your doctor will:
Review your medical history
Give you a physical exam
Your doctor may run follow-up tests:
MRI or CT scans – These scans take detailed pictures of areas inside the body at different angles.
Endoscopy – This test uses a thin, lighted tube to examine the inside of the body.
Blood tests
Follow-up care can also include home care, occupational or vocational therapy, pain management, physical therapy, and support groups.
Back To Top Keep In Mind In this document, the term cancer survivor is used to include anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of his or her life. You may not like the word, or you may feel that it does not apply to you, but the word survivor helps many people think about embracing their lives beyond their illness
Aetna Members: If you are a female member of an HMO-based plan and would like more information about breast cancer and breast cancer prevention, please call (888) 322 8742.Miembros de Aetna: Si tiene un plan HMO y desea más información sobre el cáncer de seno y la prevención del cáncer de seno, por favor llame al 1-888-322-8742.
All cancer survivors should have follow-up care. Knowing what to expect after cancer treatment can help you and your family make plans, lifestyle changes and important decisions.
Some common questions you may have are:
Should I tell the doctor about symptoms that worry me?
Which doctors should I see after treatment?
How often should I see the doctor?
What tests do I need?
What can be done to relieve pain, fatigue or other problems after treatment?
How long will it take for me to recover from treatment and feel more like myself?
Dealing with these issues can be a challenge. Yet many say that getting involved in decisions about their future medical care and lifestyle was a good way for them to regain some of the control they felt they lost during cancer treatment. Research has shown that people who feel more in control feel and function better than those who do not. Being an active partner with your doctor and getting help from other members of your health care team is the first step. What Is Follow-up Care? Follow-up care means seeing a doctor for regular medical checkups. Your followup care depends on the type of cancer and type of treatment you had, along with your overall health. It is usually different for each person who has been treated for cancer.
In general, survivors usually return to the doctor every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that. At these visits, your doctor will look for side effects from treatment and check if your cancer has returned (recurred) or spread (metastasized) to another part of your body.
At these visits, your doctor will:
Review your medical history
Give you a physical exam
Your doctor may run follow-up tests:
MRI or CT scans – These scans take detailed pictures of areas inside the body at different angles.
Endoscopy – This test uses a thin, lighted tube to examine the inside of the body.
Blood tests
Follow-up care can also include home care, occupational or vocational therapy, pain management, physical therapy, and support groups.
Back To Top Keep In Mind In this document, the term cancer survivor is used to include anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of his or her life. You may not like the word, or you may feel that it does not apply to you, but the word survivor helps many people think about embracing their lives beyond their illness
Aetna Members: If you are a female member of an HMO-based plan and would like more information about breast cancer and breast cancer prevention, please call (888) 322 8742.Miembros de Aetna: Si tiene un plan HMO y desea más información sobre el cáncer de seno y la prevención del cáncer de seno, por favor llame al 1-888-322-8742.
Medical Care and Your 8- to 12-Month-Old
Medical Care and Your 8- to 12-Month-Old
As your baby becomes more independent and mobile, your questions for your child's doctor may have more to do with bumps, bruises, and behavior than with anything else.
You can't protect your baby from every knee-bump suffered while learning to walk. But you can make sure poisons and medicines are kept where kids can't possibly get to them and provide a safe environment for exploration.
Your baby is probably hearing "no" a lot these days while exploring boundaries; soon, you'll hear that word back from your little one! Be consistent but loving while teaching the difference between acceptable and unacceptable behavior.
When Will We See the Doctor?
Doctors often have their own schedules for well-baby visits, but most will generally see a baby twice during this stage, once at 9 months and again at 12 months. If you have missed any immunizations, or if a problem has been detected that needs special attention, additional visits may be scheduled.
What Will Happen During the Office Visit?
The well-baby visits at 9 and 12 months are pretty similar to the exams that have taken place so far, although your discussions with your doctor about behavior and habits may become more frequent.
Expect these common procedures and questions:
Measurement of your baby's length, weight, and head circumference. Growth will be plotted on the growth chart and you will be advised of your little one's progress.
A physical examination checking for normal function of the eyes, ears, heart, abdomen, hands and feet, reflexes, etc. The doctor may check your baby's soft spot (the fontanel), which may be closed or much smaller (the size of a fingertip). The doctor will check your baby's mouth for new teeth and signs of others to come.
A review of your baby's physical and emotional development through both observation and your report: Can your baby sit up alone? Pull up on things to stand? Recognize his or her own name and the names of family members? Enjoy games like "peekaboo"? Your doctor may ask you these questions and others.
You may be asked how you're doing with your baby and how the rest of the family is functioning. Your doctor may review safety with you: Have you babyproofed your home? Is your baby in an appropriate car seat while riding in the car?
A discussion of eating habits: Is your baby eating more table foods? Interested in finger foods on the tray of the highchair? Able to use a cup? Being weaned from the breast or bottle? Most doctors advise a switch from bottle to cup by the first birthday to be sure the bottle doesn't interfere with normal tooth development and to avoid struggles with a determined toddler later. By age 1 year, most babies can be given foods that were off-limits before, such as cow's milk, citrus fruits, and eggs. Your doctor can discuss these dietary additions with you.
Advice on what to expect in the coming months.
Your baby will receive immunizations during some visits (see below).
Depending on where they live and the potential risk of tuberculosis, sometimes babies at about 1 year of age undergo a tuberculin skin test. You'll be given instructions on how to monitor the test and asked to return to the office for the nurse or doctor to check the results of the test. Discuss possible vaccine reactions with your doctor and when to call with unusual problems.
During appointments, raise any questions or concerns you have and jot down any instructions the doctor gives you about special baby care. Keep updating your child's permanent medical record, listing information on growth and any problems or illnesses.
What Immunizations Will My Baby Receive?
If your baby missed immunizations at previous visits because of illness or scheduling problems, he or she will probably be brought up-to-date now. Because your baby is becoming more and more mobile and is in contact with other kids more often, you'll want to make sure immunizations are given as close to the recommended times as possible. This is especially true if your baby goes out of your home for childcare.
Because more immunizations than ever are given to kids by 2 years of age, doctors are spacing vaccinations so that they won't need more than three to four shots per well-baby visit.
From the Recommended Childhood Immunization Schedule of the American Academy of Pediatrics (AAP):
At the 12-month visit, your baby may receive the first measles, mumps, and rubella (MMR) vaccine (it's given between 12-15 months of age).
The chickenpox (varicella) vaccine is given as a single injection between 12-18 months of age.
The fourth pneumococcal conjugate vaccine (PCV) is given between 12-15 months of age.
The fourth Haemophilus influenzae type B (Hib) vaccine is given between 12-15 months of age.
Your baby also may receive:
the third hepatitis B vaccine (Hep B), which can be given at any time during 6-18 months of age
the third polio vaccine (IPV), which can be given at any time during 6-18 months of age
This immunization schedule can vary depending on what combined vaccines your doctor uses.
When to Call the Doctor
You should feel comfortable enough with your doctor to call with questions and concerns that can't wait until the next scheduled visit. If your questions can wait, write them down so you don't forget. Of course, call the doctor immediately if your child has an injury or illness that needs attention.
Call the doctor right away if your baby seems especially sluggish, is refusing food or drink, is vomiting or has diarrhea, or has a temperature of 102° Fahrenheit or higher.
At this age, developmental delays may cause concern, so contact your doctor if you suspect your child is not developing within the range of normal. Kids have their own timetable for crawling, talking, and walking, so keep that in mind when checking for these signs of developmental progress by the first birthday. Make sure your child:
has said a first single word (mama, dada)
uses gestures (waves bye-bye, shakes head no)
responds to familiar pictures or toys
stands when supported and pulls up on things to stand
Again, the absence of any of these signs may or may not be cause for concern. Share them with your doctor, though, because problems caught early can be treated more successfully
As your baby becomes more independent and mobile, your questions for your child's doctor may have more to do with bumps, bruises, and behavior than with anything else.
You can't protect your baby from every knee-bump suffered while learning to walk. But you can make sure poisons and medicines are kept where kids can't possibly get to them and provide a safe environment for exploration.
Your baby is probably hearing "no" a lot these days while exploring boundaries; soon, you'll hear that word back from your little one! Be consistent but loving while teaching the difference between acceptable and unacceptable behavior.
When Will We See the Doctor?
Doctors often have their own schedules for well-baby visits, but most will generally see a baby twice during this stage, once at 9 months and again at 12 months. If you have missed any immunizations, or if a problem has been detected that needs special attention, additional visits may be scheduled.
What Will Happen During the Office Visit?
The well-baby visits at 9 and 12 months are pretty similar to the exams that have taken place so far, although your discussions with your doctor about behavior and habits may become more frequent.
Expect these common procedures and questions:
Measurement of your baby's length, weight, and head circumference. Growth will be plotted on the growth chart and you will be advised of your little one's progress.
A physical examination checking for normal function of the eyes, ears, heart, abdomen, hands and feet, reflexes, etc. The doctor may check your baby's soft spot (the fontanel), which may be closed or much smaller (the size of a fingertip). The doctor will check your baby's mouth for new teeth and signs of others to come.
A review of your baby's physical and emotional development through both observation and your report: Can your baby sit up alone? Pull up on things to stand? Recognize his or her own name and the names of family members? Enjoy games like "peekaboo"? Your doctor may ask you these questions and others.
You may be asked how you're doing with your baby and how the rest of the family is functioning. Your doctor may review safety with you: Have you babyproofed your home? Is your baby in an appropriate car seat while riding in the car?
A discussion of eating habits: Is your baby eating more table foods? Interested in finger foods on the tray of the highchair? Able to use a cup? Being weaned from the breast or bottle? Most doctors advise a switch from bottle to cup by the first birthday to be sure the bottle doesn't interfere with normal tooth development and to avoid struggles with a determined toddler later. By age 1 year, most babies can be given foods that were off-limits before, such as cow's milk, citrus fruits, and eggs. Your doctor can discuss these dietary additions with you.
Advice on what to expect in the coming months.
Your baby will receive immunizations during some visits (see below).
Depending on where they live and the potential risk of tuberculosis, sometimes babies at about 1 year of age undergo a tuberculin skin test. You'll be given instructions on how to monitor the test and asked to return to the office for the nurse or doctor to check the results of the test. Discuss possible vaccine reactions with your doctor and when to call with unusual problems.
During appointments, raise any questions or concerns you have and jot down any instructions the doctor gives you about special baby care. Keep updating your child's permanent medical record, listing information on growth and any problems or illnesses.
What Immunizations Will My Baby Receive?
If your baby missed immunizations at previous visits because of illness or scheduling problems, he or she will probably be brought up-to-date now. Because your baby is becoming more and more mobile and is in contact with other kids more often, you'll want to make sure immunizations are given as close to the recommended times as possible. This is especially true if your baby goes out of your home for childcare.
Because more immunizations than ever are given to kids by 2 years of age, doctors are spacing vaccinations so that they won't need more than three to four shots per well-baby visit.
From the Recommended Childhood Immunization Schedule of the American Academy of Pediatrics (AAP):
At the 12-month visit, your baby may receive the first measles, mumps, and rubella (MMR) vaccine (it's given between 12-15 months of age).
The chickenpox (varicella) vaccine is given as a single injection between 12-18 months of age.
The fourth pneumococcal conjugate vaccine (PCV) is given between 12-15 months of age.
The fourth Haemophilus influenzae type B (Hib) vaccine is given between 12-15 months of age.
Your baby also may receive:
the third hepatitis B vaccine (Hep B), which can be given at any time during 6-18 months of age
the third polio vaccine (IPV), which can be given at any time during 6-18 months of age
This immunization schedule can vary depending on what combined vaccines your doctor uses.
When to Call the Doctor
You should feel comfortable enough with your doctor to call with questions and concerns that can't wait until the next scheduled visit. If your questions can wait, write them down so you don't forget. Of course, call the doctor immediately if your child has an injury or illness that needs attention.
Call the doctor right away if your baby seems especially sluggish, is refusing food or drink, is vomiting or has diarrhea, or has a temperature of 102° Fahrenheit or higher.
At this age, developmental delays may cause concern, so contact your doctor if you suspect your child is not developing within the range of normal. Kids have their own timetable for crawling, talking, and walking, so keep that in mind when checking for these signs of developmental progress by the first birthday. Make sure your child:
has said a first single word (mama, dada)
uses gestures (waves bye-bye, shakes head no)
responds to familiar pictures or toys
stands when supported and pulls up on things to stand
Again, the absence of any of these signs may or may not be cause for concern. Share them with your doctor, though, because problems caught early can be treated more successfully
Medical Care and Your Newborn
Medical Care and Your Newborn
By the time you hold your new baby in your arms for the first time, chances are you've already chosen one of the most important people in your little one's early life — a doctor. You and your baby will probably visit the doctor more often during the first year than at any other time.
You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.
In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.
What Happens Right After Birth
Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:
Weight, length, and head circumference will be measured.
Temperature will be taken, and your baby's breathing and heart rate will be measured.
The doctor or nurse will monitor skin color and your newborn's activity.
Special eye drops will be given to ward off infection.
A shot of vitamin K will be given to prevent the possibility of bleeding.
Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.
The Doctor's Visit
The hospital or birth center where you deliver will notify your child's doctor of the birth. If you have had any medical problems during pregnancy, if any medical problems for your baby are suspected, or if you are having a C-section, a pediatrician or your baby's doctor will be alerted of the impending birth and be standing by to take care of the baby.
The doctor you have chosen for your newborn will probably give your baby a full physical examination within 24 hours of birth. This is a good opportunity to ask questions about your baby's care.
Find out when the doctor would like to see your newborn again. Most healthy newborns are routinely examined at the doctor's office at about 1 to 2 weeks old.
The First Office Visit
During the first office visit, your doctor will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:
measurement of weight, length, and head circumference to assess how your baby's been doing since birth
observation of your newborn's vision, hearing, and reflexes
a total physical examination to check for any abnormalities of the body or organ function
questions about how you are doing with the new baby and how your baby is eating and sleeping
advice on what you can expect in the coming month
a discussion of your home environment and how it might affect your baby's health (for example, smoking in the house can negatively affect your baby's health in many ways)
Also, if the results of screening tests performed on your newborn after birth are available, they may be discussed with you. Bring any questions or concerns to the doctor at this time. Jot down any specific instructions given regarding special baby care. Keep a permanent medical record for your baby that includes information about growth, immunizations, medications, and any problems or illnesses.
Immunizations Your Baby Will Receive
Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases. Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.
At birth or shortly after, some infants receive their first artificial immunization, a hepatitis B vaccine (HBV) that is given in three doses. There are combination vaccines, however, that include HBV and are given at the 2-month visit. So other babies will receive no immunizations until 2 months of age.
In either case, it's wise to familiarize yourself with the standard immunization schedule.
When to Call the Doctor
Since small problems can indicate big problems for newborns, don't hesitate to call your doctor if you have concerns. Some difficulties to be aware of during this first month:
Excessive drowsiness can be hard to spot in a newborn since most sleep so much. But if you suspect your infant is sleepier than normal, call the doctor. Sometimes this could be a sign of infection.
Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their own before too long, but sometimes they remain clogged, which can cause mucus-like tearing of the eyes. The white discharge can crust up on the eyes and make it difficult for your baby to open them, and the blockage can lead to infection. If you suspect a serious infection, such as pinkeye (conjunctivitis), call your doctor immediately. If your baby has an infection, the doctor will need to perform an exam and may prescribe antibiotic drops.
Fever in a newborn (rectal temperature above 100.4° Fahrenheit or 38° Celsius) should be reported to your child's doctor right away.
Extreme floppiness or jitters
By the time you hold your new baby in your arms for the first time, chances are you've already chosen one of the most important people in your little one's early life — a doctor. You and your baby will probably visit the doctor more often during the first year than at any other time.
You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.
In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.
What Happens Right After Birth
Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:
Weight, length, and head circumference will be measured.
Temperature will be taken, and your baby's breathing and heart rate will be measured.
The doctor or nurse will monitor skin color and your newborn's activity.
Special eye drops will be given to ward off infection.
A shot of vitamin K will be given to prevent the possibility of bleeding.
Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers provide personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.
The Doctor's Visit
The hospital or birth center where you deliver will notify your child's doctor of the birth. If you have had any medical problems during pregnancy, if any medical problems for your baby are suspected, or if you are having a C-section, a pediatrician or your baby's doctor will be alerted of the impending birth and be standing by to take care of the baby.
The doctor you have chosen for your newborn will probably give your baby a full physical examination within 24 hours of birth. This is a good opportunity to ask questions about your baby's care.
Find out when the doctor would like to see your newborn again. Most healthy newborns are routinely examined at the doctor's office at about 1 to 2 weeks old.
The First Office Visit
During the first office visit, your doctor will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:
measurement of weight, length, and head circumference to assess how your baby's been doing since birth
observation of your newborn's vision, hearing, and reflexes
a total physical examination to check for any abnormalities of the body or organ function
questions about how you are doing with the new baby and how your baby is eating and sleeping
advice on what you can expect in the coming month
a discussion of your home environment and how it might affect your baby's health (for example, smoking in the house can negatively affect your baby's health in many ways)
Also, if the results of screening tests performed on your newborn after birth are available, they may be discussed with you. Bring any questions or concerns to the doctor at this time. Jot down any specific instructions given regarding special baby care. Keep a permanent medical record for your baby that includes information about growth, immunizations, medications, and any problems or illnesses.
Immunizations Your Baby Will Receive
Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases. Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.
At birth or shortly after, some infants receive their first artificial immunization, a hepatitis B vaccine (HBV) that is given in three doses. There are combination vaccines, however, that include HBV and are given at the 2-month visit. So other babies will receive no immunizations until 2 months of age.
In either case, it's wise to familiarize yourself with the standard immunization schedule.
When to Call the Doctor
Since small problems can indicate big problems for newborns, don't hesitate to call your doctor if you have concerns. Some difficulties to be aware of during this first month:
Excessive drowsiness can be hard to spot in a newborn since most sleep so much. But if you suspect your infant is sleepier than normal, call the doctor. Sometimes this could be a sign of infection.
Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their own before too long, but sometimes they remain clogged, which can cause mucus-like tearing of the eyes. The white discharge can crust up on the eyes and make it difficult for your baby to open them, and the blockage can lead to infection. If you suspect a serious infection, such as pinkeye (conjunctivitis), call your doctor immediately. If your baby has an infection, the doctor will need to perform an exam and may prescribe antibiotic drops.
Fever in a newborn (rectal temperature above 100.4° Fahrenheit or 38° Celsius) should be reported to your child's doctor right away.
Extreme floppiness or jitters
February 27, 2009
Journal Description
Journal Description - Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. All subscribers to the Journal receive copies of supplemental issues along with their regular issue.NEW! Authorship Policy.NEW! Conflict of Interest PolicyVisit http://mdc.edmgr.com for further information. Important Message: Easily submit and review manuscripts online with LWW's Prompt/Editorial Manager. This automated, web-based tool simplifies the manuscript submission and review processes and enables users to electronically submit, review and track manuscripts and artwork online in a few easy steps. We invite contributors and reviewers to begin using the Prompt/Editorial Manager interface today at http://mdc.edmgr.com Important Message: Select articles now feature links to supplemental digital content directly from the article text and are indicated in the Table of Contents. Authors are encouraged to submit supplemental digital content that supports their article text. Please see the journal instructions for authors or go to http://links.lww.com/A142 to read LWW's requirements for submitting supplemental digital content.
************Journal subscribers - please activate your subscription via the Register button on the top menu bar. Your subscriber number is provided on your journal mailing label. Guests - simply create a new account via the Register button on the top menu bar. Once you have established an account you will be able to purchase articles via our pay-per-view service and sign up for additional online services.
************Journal subscribers - please activate your subscription via the Register button on the top menu bar. Your subscriber number is provided on your journal mailing label. Guests - simply create a new account via the Register button on the top menu bar. Once you have established an account you will be able to purchase articles via our pay-per-view service and sign up for additional online services.
February 26, 2009
PROFESSIONAL MEDICAL PUBLICATIONS
INTRODUCTION: PAKISTAN JOURNAL OF MEDICAL SCIENCES (Pak J Med Sci) is a peer reviewed journal. It is published quarterly and we practice open peer review system. It has controlled circulation.Objective: The journal aims at promoting the art and science of medicine to improve healthcare besides being a useful source of CME for healthcare professionals offering healthy, balanced and constructive debates on controversial issues that effect medicine, keeping up the professional ethics in medical journalism. We accept original research, review articles, guest editorials, case reports, short communications, drug trials and letters. Complimentary copies are sent to all the medical libraries, teaching institutions and otherimportant medical centres in the country. Others can have the copy by sending a crossed Bank Draft/Money Order for Rs. 400/- in the name of “PAKISTAN JOURNAL OF MEDICAL SCIENCES”. Minimum publication charges for articles, manuscripts is Rs.3,000/- (in case of overseas US$ 100/- ) up to 4 printed pages in the journal. Rs.500/- extra will be payable for each additional page. Charges for photograph, films and illustrations are additional. Publication charges are payable in advance once the manuscript has been accepted for publication by the Editorial Board after peer review. Those who cannot afford to pay the publication charges can request for financial assistance and the management will manage it from the special fund created for this purpose. Main author will be sent one copy of the journal. Additional reprints can be obtained from online edition which contains all the published manuscripts in PDF format. Authors and coauthors can order additional copies at a concessional price of Rs.300/- per copy at the time of returning computer print out after proof reading. (For detailed instructions to authors visit our website pjms.com.pk)
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