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When Patients Say No: Rethinking Refusal in Bedside Medical Education
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ABSTRACT<sec> <title>Background

Bedside clinical teaching is a fundamental part of the medical education that offers invaluable opportunities for the students to build and improve their clinical and communication skills. However, there is a growing concern about the increasing refusal of patients to participate in clinical sessions, especially in certain settings where there are sensitive cultural traditions and decreased trust in institutions.

Aim

This paper discusses patient refusal during bedside clinical teaching and views it from three aspects, that of the medical student, the clinical educator and the patient, and proposes culturally sensitive strategies that balance patient autonomy with educational needs.

Perspective

Patient refusals reduce the students' chances of hands‐on learning, placing the educator under ethical strain and emotional fatigue. These refusals are not simply uncomfortable incidents, but they signal underlying systemic gaps such as lack of transparent communication with the patients, failure to adapt to the social development and deep cultural dissonance. While simulation offers partial relief, it cannot fully replace the human dimensions of real patient interactions.

Conclusion

Patients' reluctance is a meaningful message that needs to be heard. A thoughtful reform including coordinated efforts at the level of patient education, faculty support, student preparation and institutional policy is needed. Without reform, we risk graduating doctors who have never truly encountered the human side of medicine.

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Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Detection of active human cytomegalovirus in patients with multiple myeloma
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Abstract:<sec><title>BACKGROUND:

Human cytomegalovirus (HCMV) infection is ubiquitous and successfully reactivated in patients with immune dysfunction as in patient with multiple myeloma (MM), causing a wide range of life-threatening diseases. Early detection of HCMV and significant advances in MM management has amended patient outcomes and prolonged survival rates.

OBJECTIVES:

The aim of the study was to estimate the frequency of active HCMV in MM patients.

MATERIALS AND METHODS:

This is a case–control study involved 50 MM patients attending Hematology Center, Bag

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Conservative Treatment of Closed Fracture Shaft Humerus in Adult Patients
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Background: Fractures of the humeral shaft
accounting for approximately 3% of all
fractures. There is a wide array of good
options for their treatment and controversy
over the best methods. Although good
techniques of osteosynthesis are available, the
aim of this article is toemphasize on the benefit
and good outcome of conservative treatment
for properly selected cases to decrease the cost
and avoid the complications of surgery.

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Determination of Enzymatic Antioxidant in Iraqi Patients with Chronic Gastritis
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Infection of the gastric mucosa with Helicobacter pylori is strongly associated with chronic gastritis, peptic ulcer and gastric cancer. Helicobacter pylori virulence factors include a variety of proteins that are involved in its pathogenesis, such as VacA and CagA. Another group of virulence factors is clearly important for colonization of H.pylori in the gastric mucosa. These include urease, motility factors (flagellin), and Superoxide dismutase (SOD). Because of this organism's microaerophilic nature and the increased levels of reactive oxygen in the infected host, we expect that other factors involved in the response to oxidative stress are likely to be required for virulence. Superoxide dismutase is a near

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and AMH in Iraqi Patients with Chronic Kidney Disease
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This study was conducted to investigate thyroid function and Anti-Müllerian hormone (AMH) in (Chronic kidney disease) CKD patients by evaluating their levels in CKD patients, 50 patients were diagnosed to have CKD stage-5, their ages ranged between 20-50 years (25 males and 25 females) who attended the Nephrology and Transplant Center in Medical City of Baghdad- Iraq, they were recruited from April 2018 to July 2018 and were enrolled into the study. The control group consisted of 20 healthy individuals, their ages ranged between 20-48 years (10 males and 10 females). The study showed non-significant (p>0.05) increase in AMH level in CKD patients compared to the control group. On the other hand, TSH was recorded a highly significant (

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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
Pulmonary CT findings in Patients Recovered from COVID-19 Pneumonia
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Background: The COVID-19 infection is a more recent pandemic disease all over the world and studying the pulmonary findings on survivors of this disease has lately commenced.

Objective: We aimed to estimate the cumulative percentage of whole radiological resolution after 3 months from recovery and to define the residual chest CT findings and exploring the relevant affecting factors.

Subjects and Methods: Patients who had been previously diagnosed with COVID-19 pneumonia confirmed by RT-PCR test and had radiological evidence of pulmonary involvement by Chest CT during the acute illness were included in the present study. The radiol

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and Leptin in Iraqi Patients with Chronic Kidney Disease
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The present study aims at assessing the effects of chronic kidney disease (CKD) on thyroid hormone and leptin by evaluating the level of: leptin hormone along with thyroid hormone in CKD patients. The study has been conducted on  70 subjects, 50 patients with an age range between 20-50 years (25  males and 25 females) who were diagnosed to have CKD stage-5, and 20 normal controls whose ages ranged between 20-48 years (10  males and 10 females), who attended  the Nephrology and Transplant Center in Medical City of Baghdad- Iraq from April  2018  to July  2018. The study showed a highly significant (P<0.01) increase in TSH level in CKD patients in comparison with controls. While T3 and T4 levels observed highly significant decrea

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Community Medicine
Clinico-epidemiological and Histopathological Study of Syringoma in Iraqi Patients
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KE Sharquie, HA Hassan, AA Noaimi, IRAQI JOURNAL OF COMMUNITY MEDICINE, 2010

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Publication Date
Sat Jan 17 2015
Journal Name
Iraqi Journal Of Science
Dissemination of Carbapenem resistant Pseudomonas aeruginosa among burn patients in Karbala Province\IraqDissemination of Carbapenem resistant Pseudomonas aeruginosa among burn patients in Karbala Province\Iraq
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In this study, 158 clinical samples were collected from hospitalized burn patients during the period from December 2012 to June 2013 in Karbala province\ Iraq. Bacterial isolates were identified using conventional biochemical tests and then identification was confirmed by using Vitek-2 compact system. Pseudomonas aeruginosa recovery was 60 isolates in this study. These isolates were analyzed for antibiotic susceptibility by the disk diffusion test (DDT) according to Kirby Bauer's method using seven clinically important antipseudomonal agents: carbapenems (Imipenem and Meropenem), pencillins (Piperacillin), cephalosporins (Ceftazidim), monobactam (Aztreonam), quinolones (Ciprofloxacin) and aminoglycosides (Gentamicin). The results of resista

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Publication Date
Fri May 01 2020
Journal Name
مجلة بحوث الشرق الأوسط
دراسة مقارنة لمستوى التمکین الإداری بین مشرفی التربیة الریاضیة (الاختصاص والفنی) لمدیریات التربیة فی محافظة بغداد A Comparative Study of the Level of Administrative Empowerment between the Physical Education Supervisors (Specialization and Technical) of Education Directorate in Baghdad Governorate
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Publication Date
Wed Jan 02 2019
Journal Name
Indian Journal Of Public Health Research & Development
Correlation of Protein Tyrosine Kinase with Thyroid Hormones in Type 2 Diabetes Mellitus Patients and those with Diabetic Nephropathy Iraqi Patients.
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Diabetes mellitus is a metabolic disorder categorized hyperglycemia resulting from defects in insulin secretion, insulin action or both. Protein tyrosine kinase (PTK) is an enzyme that catalyzes the transfer of phosphate groups from ATP to the tyrosine residues of many important proteins resulting in proteins phosphorylation. The aim of current study was to evaluate serum levels of protein tyrosine kinase enzyme and thyroid hormone (T3, T4and TSH) and to find the correlation between them in type 2 diabetes mellitus and diabetic nephropathy Iraqi patients. Methods: This study was conducted at The National Diabetes Center, Al-Mustansiriya University, Baghdad, Iraq and included 150 patients divided into three groups the first group included 50

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