Journal of General Practice

Cervical inlet patch is an ectopic gastric mucosa in upper end of oesophagus. They are generally asymptomatic, few may present with oropharyngeal symptoms due to acid secretion from the patch like odynophagia, dysphagia, globus sensation, cough etc. Here we present a symptomatic case with complains of odynophagia, dysphagia and globus sensation who responded remarkably with the acid suppression. High dose PPI with H2 blocker was prescribed for 8 weeks which resulted in long term remission of symptoms. Patient was followed for 5 years. There were no recurrence of symptoms neither developed any other complications of acid secretion. 

Background: Antenatal care is comprehensive care that pregnant women receive from organized health care services to promote and maintain optimal health of the mother throughout the pregnancy, labor and puerperium. High quality antenatal care is important to safeguard their health help women maintain normal pregnancies and reduce the rate of maternal and infant morbidity and mortality. Studies conducted to assess quality of antenatal care service which describes the components of antenatal care that the woman receive during her pregnancy and do not describe the factor that affects quality service and also they do not illustrate the quality service. Therefore this study tried to fill the gap which was not address by previous studies.
Objective: To assess quality of Antenatal care service and associated factors in Harar town governmental health facilities Harar, Ethiopia from January 30 to February 30.
Methods: Facility based cross sectional study that employed quantitative method supplemented with qualitative method was used. Exit interview was conducted on clients who had ANC follow up. Observation on the health care provider was performed while providing antenatal care. In-depth interview was conducted on one purposively selected antenatal care provider. Facility infrastructure, supplies and equipment and health care practices during Antenatal clinic was assessed. Collected and checked data were entered in to Epi Data software version 3.02 and exported and analyzed using SPSS version 21. Both Bivariate and multiple logistic regressions were used to observe the association between the outcome variable and associated factors.
Result: Among the Focused Antenatal Component personal history, Blood pressure measurement, Laboratory evaluation and provision of supply were provided for majority of the clients. The overall prevalence of quality of ANC service was 24.3%. Women who had history of still birth 2 times more likely (AOR=2.936, 95% CI: 1.177-7.320) Women who had more than four visit were 4.5 times more likely (AOR=4.592, 95% CI: 1.318-12.996), women whose privacy maintain while counseling were 4 times more likely (AOR=4.110, 95% CI: 1.753-9.637) having quality of antenatal care services than their encounters.
Conclusion and Recommendation: Generally, the studies showed that majority of clients were not received quality Antenatal care service. Consultation room for keeping privacy should have to maintain for providing quality Antenatal care service by the health facilities.

Objectives: To determine the prevalence of internet addiction and some of the associated factors among medical students of the University of Kufa, and find its effect on academic performance.
Subjects & Methods: A cross sectional study was conducted on 218 medical students selected throughouta systematic sampling method. A self- administered questionnaire was used for collection of data, its include three parts (demographic data, computer and internet use data, and Young Internet Addiction Test). The analysis of data was carried out using the Statistical Package for Social Sciences (SPSS). Chi square test (X2-test), T-test, and binary logistic regression were used to investigate variables. The level of significance was considered as p-value ≤ 0.05.
Results: According to the results of Young Internet Addiction Test score, 44.5% of the participants had a mild internet addiction, 119 (54.6%) had a moderate internet addiction, and only 2 (0.9%) had a severe internet addiction. Further analysis using binary logistic regression revealed that spending time online for studying related purpose was a significant protective factor from internet addiction among participants (P<0.001,OR=0.975, 95% C.I=0.963-0.987).
Conclusions: High prevalence of internet addiction among medical students of Kufa University. Students who spend more time on the internet for educational purposes are protected from internet addiction. There is no significant association between internet addiction and academic performance of students.

Thyroid disorders and diabetes mellitus are one of the most common duo in endocrinology. The existence of both conditions in patients seems sometimes inevitable.
Aim: To estimate the prevalence of thyroid dysfunction in type 2 diabetics in Bahrain; also to examine and compare some clinical, biometric and biochemical parameters between hypothyroid and normothyroid diabetic patients.
Methods and Material: This is part of cross sectional study that took place in 2012 and examined the prevalence of vitamin D3 in diabetics. 268 Type 2 diabetic patients’ medical records were examined for history of thyroid disease. Other parameters included BMI, waist circumference, and history of hypertension, hyperlipidemia, vitamin D3 levels, glycated hemoglobin and total cholesterol.
Results: 7.83% (21/268) patients of this diabetic population had history of thyroid disease. Twenty patients out of 268 (7.46%) had history of hypothyroidism treated with thyroid replacement therapy while 1/268 (0.03%) had history of hyperthyroidism treated with antithyroid therapy. Total cholesterol levels, BMI and C-peptide levels were significantly higher in the hypothyroid population of diabetics compared to the normothyroid diabetics.
Conclusion: Hypothyroidism in diabetics is common problem that should be addressed and managed to avoid further complications of both endocrinological problems. This study calls for further more elaborate studies to meticulously estimate the prevalence of thyroid dysfunction in the general population and the diabetic population as well in Bahrain. Also the study reinforces the impact of thyroid dysfunction in diabetics especially in relation to cardiovascular morbidity and mortality.

Misdiagnosis, which most common due to recommend of appropriate test/diagnostic procedure, fails to interpret test results accurately or propels examine of the patient or referring to the rights specialist Misdiagnosis and inappropriate therapeutic decision all result in worse of the patients conditions rather than improve it. In addition, the factors that result in medications errors include inadequate therapeutic training or knowledge/experience, physical and psychological issues of the healthcare professional, complex clinical cases.