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CASE REPORTS
A forgotten complication of diaper dermatitis: Granuloma gluteale infantum
Nadya A Al-Faraidy, Sahar H Al-Natour
May-August 2010, 17(2):107-109
DOI:10.4103/1319-1683.71994  PMID:21359035
Granuloma Gluteale Infantum (GGI) is a rare condition of unclear etiology, [1] presenting as asymptomatic cherry red nodules in the diaper area appearing in the setting of primary irritant contact dermatitis. [2] A 50 day old infant with GGI is presented to emphasize that the condition may be easily missed, and that it may result from the misuse of fluorinated topical steroids used to treat a rash in the diaper area. This is the first case reported from Saudi Arabia.
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ORIGINAL ARTICLES
Primary care physicians' knowledge and perceived barriers in the management of overweight and obesity
Abdulaziz M Sebiany
September-December 2013, 20(3):147-152
DOI:10.4103/2230-8229.121972  PMID:24672270
Objectives: To determine the level of knowledge of primary health care physicians and the barriers perceived in the management of overweight and obesity in the Eastern Province of Saudi Arabia. Setting: Primary health care centers in Dammam and Al-Khobar cities, Saudi Arabia. Design: A cross-sectional study. Materials and Methods: One hundred and forty-nine physicians were surveyed. Data were collected with a specially made anonymous, self-administrated, structured questionnaire with a Cronbach alpha reliability of 0.85, and content validity by five experts was used to measure the knowledge and barriers from several different aspects of care provided by primary health care centers to the overweight and obese. Results: One hundred and thirty (87%) physicians responded. More than two-thirds of the respondents considered themselves as key players in the management of obesity. However, only one-third believed that they were well prepared to treat obesity. Eighty-three per cent of the respondents had a negative attitude toward the concept of overweight and obesity. It was noted that 76.9% of physicians advised patients to control their weight with sport and exercise together with low calorie diet. Sixty percent of the respondents used body mass index to diagnose obesity. Seventy-two percent of respondents did not use weight reduction medications to treat obesity. Lack of training, poor administrative support, and time constraints were identified as barriers in managing overweight and obesity. Conclusion: Respondents were aware of the magnitude of overweight and obesity as a major public health problem in Saudi Arabia, and they were also aware of the correct definition of overweight and obesity, as well as its effect in increasing mortality. Better training is required to improve some areas of awareness and management of the conditions.
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Favorable impact of Nigella sativa seeds on lipid profile in type 2 diabetic patients
Huda Kaatabi, Abdullah O Bamosa, Fatma M Lebda, Abdulmohsen H Al Elq, Ali I Al-Sultan
September-December 2012, 19(3):155-161
DOI:10.4103/2230-8229.102311  PMID:23230380
Background and Aim: The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus (DM) has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa (NS) seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients. Patients and Method: A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered orally in a dose of 1, 2, and 3 g/day for 12 weeks. All patients were subjected to measurement of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) before treatment and 4, 8, and 12 weeks thereafter. Results: Patients receiving 1 g/day NS seeds for 12 weeks (group 1) showed nonsignificant changes in all the parameters except for a significant increase in HDL-c after 4 weeks of treatment. However, patients ingested 2 g/day NS displayed a significant decline in TC, TG, and LDL-c, and a significant elevation in HDL-c/LDL-c, compared with their baseline data and to group 1 patients. Increasing NS dose to 3 g/day failed to show any increase in the hypolipdemic effect produced by the 2 g/day dose. Conclusion: NS supplementation at a dose of 2 g/day for 12 weeks may improve the dyslipidemia associated with type 2 diabetic patients. Therefore, NS is a potential protective natural agent against atherosclerosis and cardiovascular complications in these patients.
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Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia
Ataur R Khan, Zaki N Al-Abdul Lateef, Mohammad A Al Aithan, Montaser A Bu-Khamseen, Ibrahim Al Ibrahim, Shabbir A Khan
January-April 2012, 19(1):26-32
DOI:10.4103/2230-8229.94008  PMID:22518355
Purpose: The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia. Materials and Methods: A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant. Results: The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 - 72.02%). The non-compliance of males (69.34%) was higher than females (65.45%, P = .003). The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023) in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57),level of education (Illiteracy) (OR = 5.27, CI = 4.63 - 7.19), urban population (OR =5.22, CI= 3.65 - 8.22), irregularity of the follow-up (OR = 8.41, CI = 4.90 - 11.92), non-adherence to drug prescription (OR = 4.55 , CI = 3.54 - 5.56), non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 - 6.), insulin (OR = 1.29, CI = .71 - 1.87), and insulin with oral Metformin (OR = 1.20, CI = .65 - 1.75). Conclusion: The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need for improvement in the healthcare system, health education, and training of diabetic patients.
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Academic job satisfaction questionnaire: Construction and validation in Saudi Arabia
Abdullah M Al-Rubaish, Sheikh Idris A Rahim, Mahdi S Abumadini, Lade Wosornu
January-April 2011, 18(1):1-7
DOI:10.4103/1319-1683.78630  PMID:21694952
Background: Colleges and universities are becoming increasingly accountable for teaching outcomes in order to meet rigorous accreditation standards. Job satisfaction (JS) seems more difficult to measure in the academic field in view of the complexity of roles, duties and responsibilities. Objectives: To compile and determine the psychometric properties of a proposed Academic Job Satisfaction Questionnaire (AJSQ) suitable for university faculty, and amenable to future upgrading. Materials and Methods: A 46-item five-option Likert-type draft questionnaire on JS was distributed for anonymous self-reporting by all the academic staff of five colleges in University of Dammam (n=340). The outcome measures were (1) factor analysis of the questionnaire items, (2) intra-factor α-Coefficient of Internal Consistency Reliability, (3) inter-factor correlations, (4) comparison of psychometric properties in separately analyzed main faculty subgroups. Results: The response rate was 72.9 percent. Factor analysis extracted eight factors which conjointly explained 60.3 percent of the variance in JS. These factors, in descending order of eigenvalue, were labeled "Authority", "Supervision", "Policies and Facilities", "My Work Itself", "Interpersonal Relationships", "Commitment", "Salary" and "Workload". Cronbach's-α ranged from 0.90 in "Supervision" to 0.63 in "Salary" and "Workload". All inter-factor correlations were positive and significant, ranging from 0.65 to 0.23. The psychometric properties of the instrument in separately analyzed subgroups divided by sex, nationality, college and clinical duties produced fairly comparable findings. Conclusion: The AJSQ demonstrated good overall psychometric properties in terms of construct validity and internal consistency reliability in both the overall sample and its separately analyzed subgroups. Recommendation: To replicate these findings in larger multicenter samples of academic staff.
  10,860 1,588 5
Isolation and identification of microbes associated with mobile phones in Dammam in eastern Saudi Arabia
Amira H.A Al-Abdalall
January-April 2010, 17(1):11-14
DOI:10.4103/1319-1683.68783  PMID:22022665
Objective: This study was conducted to determine microbial contamination of mobile phones in the city of Dammam, in the eastern region of Saudi Arabia, and identify the most important microbial species associated with these phones in order to take the necessary remedial measures. Materials and Methods: The analysis of a total of 202 samples was done to identify fungal and pathogenic bacteria isolates. Sterile swabs were firmly passed on the handset, the buttons and the screens of mobile phones, then inoculated into media of bacteria and fungi. Frequency distribution of isolates were calculated. Results: There were 737 isolated of the following bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Neisseria sicca, Micrococcus luteus, Proteus mirabilis, Bacillus subtilis, and Enterobacter aerogenes at the rate of 56.58, 13.57, 8.01, 7.73, 6.51, 3.66, 2.85 and 1.09% respectively. There were fungal isolates as follows: Alternaria alternata, Aspergillus niger, Cladosporium sp., Penicillium spp., Aspergillus flavus, Aspergillus fumigatus, Rhizopus stolonifer, Aspergillus ochraceus at the rate of 29.07, 26.74, 20.93, 10.47, 6.98, 2.33, 2.33, 1.16%, respectively. Conclusions: The study showed that all mobile phones under consideration were infected by several microbes, most of which belonged to the natural flora of the human body as well as airborne fungi and soil. This means that it is necessary to sterilize hands after contact with a phone since it is a source of disease transmission.
  10,687 1,267 11
The prevalence of smoking and its associated factors among military personnel in Kingdom of Saudi Arabia: A national study
Hesham I Al-Khashan, Fahad S Al Sabaan, Hifa S Al Nasser, Ahmed A Al Buraidi, Ahmed D Al Awad, Ghalib B Horaib, AlJoharah H Al Obaikan, Adel M Mishriky
September-December 2014, 21(3):147-153
DOI:10.4103/2230-8229.142966  PMID:25374464
Aim: The aim was to measure the prevalence of smoking and identify its potential predictors among military personnel in Kingdom of Saudi Arabia (KSA). Materials and Methods: This cross-sectional study was carried out among military personnel in the five military regions of KSA between January 2009 and January 2011. The sample of 10,500 military personnel in the Saudi Armed Forces was equally divided among the five regions with a ratio 3:7 for officers and soldiers. A multistage stratified random sampling was used to recruit participants in the four services of the armed forces in the five regions. Information on sociodemographic characteristics with a detailed history of smoking was collected by means of a self-administered questionnaire. Bivariate analysis was used to identify the factors associated with smoking, and multiple logistic regression analysis to discover its potential predictors. Results: About 35% of the sample was current smokers, with higher rates among soldiers. The eastern region had the highest rate (43.0%), and the southern region the lowest (27.5%). Navy personnel had a higher risk of being current smokers (40.6%), and the air defense the lowest risk (31.0%). Multivariate analysis identified working in the navy, and low income as positive predictors of current smoking, while residing in the southern region, older age, years of education, being married, and having an officer rank were negative (protective) factors. Conclusion: Smoking is prevalent among military personnel in KSA, with higher rates in the Navy and Air Force, among privates, younger age group, lower education and income, and divorced/widowed status. Measures should be taken to initiate programs on smoking cessation that involve changes in the environment that is likely to promote this habit.
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The pattern of medical errors and litigation against doctors in Saudi Arabia
Jamal S AlJarallah, Norah AlRowaiss
May-August 2013, 20(2):98-105
DOI:10.4103/2230-8229.114771  PMID:23983561
Background: Adverse events are frequent in clinical practice, but only a few studies in Saudi Arabia have addressed them. The current study was designed to review the lawsuits against healthcare professionals by analyzing records of the cases dealt with by the Medico-legal Committees (MLC) in various provinces in Saudi Arabia, in order to determine the pattern of medical errors and litigations in the country. Materials and Methods: A pre-designed data sheet was used to collect data from the records of the Medical Violation Committee (MVC) and the Medical Jurisprudence Committee (MJC). The data sheets consisted of information on details of the cases, details on where the error had occurred, and details of the errors. Results: The review of records revealed 642 cases, most of which were from hospitals run by the Ministry of Health (MOH). The operating room was where most of the errors (20.4%) had occurred, followed by the emergency room (18.1%). Surgery was at the top of the specialties (25.1%). Most of the deaths occurred in surgery and obstetrics (about 25% for each), followed by other medical specialties (17%). About half of the lawsuit cases studied (46.5%) involved patients belonging to a relatively young age group (20-50 years). Conclusion: Most of the medical error litigations involved surgeons and obstetricians especially in MOH hospitals. The process of litigations and documentation need to be improved, and access to the records for research and education need to be made easier. In addition, there is a need for more prospective field studies.
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Knowledge, attitude, and practice of general practitioners in Dammam, Saudi Arabia towards Vitamin D supplementation to infants
Afrah I Babli, Kasim M AlDawood, Ammar H Khamis
September-December 2015, 22(3):135-139
DOI:10.4103/2230-8229.163025  PMID:26392792
Background: With the report of high prevalence rate of Vitamin D deficiency in the literature since the 1980s, the condition can be considered an epidemic in Saudi Arabia. However, no specific steps have been taken by the Ministry of Health to tackle the problem. Moreover, little is known about general practitioners' (GPs) knowledge, attitude, and practice (KAP) of Vitamin D supplementation for infants. Objectives: To measure the KAP of GPs, of Vitamin D supplementation for infants in Dammam, Saudi Arabia. Materials and Methods: This was a cross-sectional study of GPs practicing in primary healthcare centers in the Dammam area of Saudi Arabia. All the 110 GPs working in primary health centers (PHCs) in Dammam were invited to participate in the study. Data was collected with the help of a self-administered questionnaire. Data was analyzed using SPSS 20.0. Statistical analysis included descriptive analysis of all the variables, expressed as the mean (standard deviation [SD]) or the median if not normally distributed. Results: Ninety-three GPs working in the Dammam area participated in the study. Thirty percent had excellent knowledge of Vitamin D. Ninety two percent had a positive attitude toward Vitamin D supplementation and sixty percent regularly prescribed Vitamin D supplementation for infants. Conclusion: The majority of GPs had a positive attitude toward Vitamin D supplementation for infants. However, their knowledge and practice need improvement.
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The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia
Abdulaziz F Alkabba, Ghaiath M. A. Hussein, Adnan A Albar, Ahmad A Bahnassy, Mahdi Qadi
January-April 2012, 19(1):1-6
DOI:10.4103/2230-8229.94003  PMID:22518351
Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: "What top ten ethical challenges are Saudis likely to face in health care?" The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts' meeting. Results: The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1) Patients' Rights, (2) Equity of resources, (3) Confidentiality of the patients, (4) Patient Safety, (5) Conflict of Interests, (6) Ethics of privatization, (7) Informed Consent, (8) Dealing with the opposite sex, (9) Beginning and end of life, and (10) Healthcare team ethics. Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.
  9,650 1,200 6
SPECIAL COMMUNICATION
Role of government in public health: Current scenario in India and future scope
Subitha Lakshminarayanan
January-April 2011, 18(1):26-30
DOI:10.4103/1319-1683.78635  PMID:21694957
The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.
  9,710 1,032 5
ORIGINAL ARTICLES
Breastfeeding practices: Positioning, attachment (latch-on) and effective suckling - A hospital-based study in Libya
Ram C Goyal, Ashish S Banginwar, Fatima Ziyo, Ahmed A Toweir
May-August 2011, 18(2):74-79
DOI:10.4103/2230-8229.83372  PMID:21897915
Purpose/Objective: To assess the correct position, attachment and effective suckling in the breastfeeding of infants as practiced by mothers attending hospitals at Benghazi. Materials and Methods : An observational, descriptive, cross-sectional study was done at AlJamahiriya and AlFateh Hospital in Benghazi, Libya, from November 2009 to February 2010. One hundred ninety-two mother-neonate units were observed for mother's and baby's position, attachment and effective suckling using WHO B-R-E-A-S-T- Feed observation form. Grading of positioning, attachment and suckling was done according to the score of various characteristics. Data thus collected were analyzed using software SPSS 11.5 version. Results: About 15% of the infants were about a week old (early neonatal period) and 85% were in the late neonatal period. There was poorer positioning among primipara (24.0%) than multipara (8.9-12.5%)mothers. Poorer attachment was also more evident among primipara (30.0%) compared to multipara (20.9%) mothers. Parity was significantly associated with poor position (P = 0.028) and attachment (P = 0.002). Poor attachment was related to cracked nipples and mastitis. Preterm and low birth weight were significantly associated with poor attachment and poor effective suckling. Poor suckling was more (42.8%) in the early neonatal period than late neonatal period (32.9%). Conclusions and Recommendations: Young (<20 years) and primipara mothers were more in need of support and guidance for appropriate breastfeeding techniques. It is recommended that each mother should be observed for mother's and infant's positioning and attachment at the onset of breastfeeding and if needed subsequent counseling should be given on correct positioning and attachment.
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The association between watching television and obesity in children of school-age in Saudi Arabia
Sameer H Al-Ghamdi
May-August 2013, 20(2):83-89
DOI:10.4103/2230-8229.114767  PMID:23983559
Background: There is little information on the association between watching Television (TV) and obesity in the Arabian Peninsula. Aim of the Study: The aim of this study was to explore the association between the watching of television and obesity in Saudi children of school-age. Materials and Methods: A case-controlled study was conducted with students between the ages of 9 and 14 years who attended the school health clinic in King Abdulaziz Housing for National Guard (Iskan), Riyadh, Saudi Arabia, during the study period (February to April 2012). During each clinic, children were selected by simple random sampling (five obese and five non-obese). For data collection, two trained physicians interviewed the participants using a 20-item Arabic questionnaire. Well-trained nurses collected the anthropometric measurements of weight and height. Results: The study included 397 students. Higher (body mass index) BMI was associated with a higher number of televisions at home (P < 0.001), watching TV for more than three hours per day at the weekend (P = 0.047), eating more than three snacks per day (P = 0.005), watching TV at night (P = 0.026), and siblings' decisions on how much TV to watch (P = 0.025). The prevalence of childhood obesity was significantly lower among those whose mothers determined how much TV they could watch (P = 0.03). In logistic regression analysis, the increase in the child's age, the presence of more than one TV at home, having his or her own TV, and an increase in the number of hours of watching TV over the weekend were significantly associated with an increased risk of childhood obesity. Personal computers and the Internet were not significantly associated with an increased risk of childhood obesity. Conclusion: The present investigation revealed that watching TV represents an important risk factor for obesity in children of school-age.
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Impact of an education program on patient anxiety, depression, glycemic control, and adherence to self-care and medication in Type 2 diabetes
Ayman A Al Hayek, Asirvatham A Robert, Mohamed A Al Dawish, Marwan M Zamzami, Asirvatham E Sam, Aus A Alzaid
May-August 2013, 20(2):77-82
DOI:10.4103/2230-8229.114766  PMID:23983558
Background: Diabetes mellitus (DM) requires continuous medical care, patients' self-management, education, and adherence to prescribed medication to reduce the risk of long-term complications. The aim of this study was to assess the benefits of an education program on diabetes, patient self-management, adherence to medication, anxiety, depression and glycemic control in type 2 diabetics in Saudi Arabia. Materials and Methods: This was a prospective study, conducted among 104 diabetic patients at a major tertiary hospital in Riyadh, Saudi Arabia, between May 2011 and October 2012. Education materials given to diabetic patients included pamphlets/handouts written in Arabic, the national language. Special videotapes about DM were made and distributed to all participants. In addition, specific educational programs through the diabetes educators and one-on-one counseling sessions with the doctor were also arranged. Patients were interviewed using a structured interview schedule both during the baseline, and after 6 months of the program. The interview schedule included, socio-demographics, clinical characteristics, diabetes self-management, adherence to medication, anxiety, and depression. Glycemic control was considered poor, if hemoglobin A1c (HbA1c) was ≥ 7%. Results: The mean age of the study population was 57.3 ΁ 14.4 years. Seventy one were males (68.3%) and 33 (31.7%) were females. After six months of the diabetes education program, there were significant improvements in patients' dietary plan (P = 0.0001), physical exercise (P = 0.0001), self-monitoring of blood glucose (SMBG) (P = 0.0001), HbA1c (P = 0.04), adherence to medication (P = 0.007), and depression (P = 0.03). Conclusions: Implementation of education programs on diabetes among type 2 diabetic patients is associated with better outcomes such as their dietary plan, physical exercise, SMBG, adherence to medication, HbA1c and depression.
  8,011 1,588 10
CASE REPORT
Breast abscess caused by penicillin resistant Pneumococci
Boppe Appalaraju, Anila A Mathews, Appolo C Bhaskaran, Pavai Arunachalam
May-August 2011, 18(2):85-86
DOI:10.4103/2230-8229.83375  PMID:21897917
Breast abscess is mostly caused by Staphylococcus aureus. A 26-year-old immunocompetent lady was admitted with breast abscess. Incision and drainage (I/D) was done and Pneumococci were isolated from the drained pus. The patient was earlier treated with Augmentin which was later changed to linezolid after testing for antibiotic susceptibility. This strain showed a high level of resistance to penicillin. It had been noticed that there was a slow increase in the number of penicillin resistant Pneumococci isolated in our hospitals. The increase in penicillin-resistant Pneumococci correlates with the intensive use of beta-lactam antibiotics. Hence, antibiotics should be used judiciously, avoiding their use particularly in mild self-limiting upper respiratory infections. Attention therefore, should focus on monitoring resistance in Pneumococci to prevent mortality and morbidity associated with this organism, which continues to take a heavy toll on children and the elderly.
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ORIGINAL ARTICLES
Economic costs of diabetes in Saudi Arabia
Abdulkarim K Alhowaish
January-April 2013, 20(1):1-7
DOI:10.4103/2230-8229.108174  PMID:23723724
Background: Diabetes imposes a large economic burden on the individual, national healthcare systems, and countries. Objective: To determine the economic impact of diabetes mellitus on Saudi healthcare system, both now and in the future. Materials and Methods: This research study uses a prevalence-based approach that combines the demographics of the population (classified by nationality, sex and age group) with and without diagnosed diabetes in 1992 and 2010. The economic impact of diabetes is estimated in this study, using secondary sources of information provided by Ministry of Health, Ministry of Finance and Central Department of Statistics and Information databases. Results: People diagnosed with diabetes, on average, have medical healthcare expenditures that are ten times higher ($3,686 vs. $380) than what expenditures would be in the absence of diabetes. Over 96% of all medical healthcare expenditures attributed to diabetes are incurred by persons of Saudi nationality, with the remaining 4% incurred by persons of non-Saudi nationality. The population age 45-60 incurs 45% of diabetes-attributed costs, with the remaining population under age 15 incurs 3.8%, age 15-44 incurs 27.5%, and age 60 and above incurs 23.8%. Conclusion: The actual national healthcare burden because of diabetes is likely to exceed the $0.87 billion estimated in this study, because it omits the indirect costs associated with diabetes, such as absenteeism, lost productivity from disease-related absenteeism, unemployment from disease-related disability, lost productivity due to early mortality by disease. The social cost of intangibles such as pain and suffering and care provided by non-paid caregivers as well as healthcare system administrative costs, cost of medications, clinician training programs, and research and infrastructure development is also omitted from this research study. Further studies are needed to confirm the present findings and to improve our understanding of economic costs of diabetes and its related complications.
  7,334 1,401 21
BRIEF REPORT
Tips on searching the internet for medical information
Ibrahim Mansoor
January-April 2002, 9(1):57-61
PMID:23008664
Searching for references is part of everyday life in medicine. Since the arrival of the Internet, it has provided great promise for clinicians because of its ready provision of access to large amounts of knowledge and information. But because of the overload of information, searching for particular information has now become a tedious time-consuming and frustrating task. This article describes effective ways, tips, tools, detailed search techniques and strategies for searching for medical information. It also lists some useful resource and database sites that can help in the search for accurate information.
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CONFERENCE ABSTRACTS
7TH GCC Medical Colleges Conference, 17-19 November 2009, Dammam, Saudi Arabia

January-April 2010, 17(1):50-67
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ORIGINAL ARTICLES
Dynamics of doctor-patient relationship: A cross-sectional study on concordance, trust, and patient enablement
Amitav Banerjee, Debmitra Sanyal
January-April 2012, 19(1):12-19
DOI:10.4103/2230-8229.94006  PMID:22518353
Background:The rapid pace of medical advances coupled with specialization and super-specialization, is eroding the traditional doctor-patient relationship. Objective:(a) To study the determinants of core dimensions, such as, concordance, trust, and enablement in a doctor-patient relationship; (b) to explore associations, if any, among these core dimensions. Materials and Methods: A cross-sectional study design with both quantitative and qualitative methods was employed. One hundred and ninety-eight outdoor patients were interviewed as part of the quantitative study. Three dimensions of the doctor-patient relationship, that is, physician patient concordance, trust in physician, and patient enablement were assessed using validated tools. Focus group interviews using an open-ended format among few physicians was carried out as part of the qualitative study. Results: In the quantitative analysis most of the sociocultural factors did not show any significant association with the doctor-patient relationship. However, gender was significantly and strongly associated with trust in the physician. Female patients showed a much lower trust in the physician (50%) as compared to male patients (75%) (OR = 0.33, 95% CI 0.17 - 0.64, Chi Sq = 12.86, P = 0.0003). A qualitative study revealed language and culture, alternative medicines, commercialization of medicine, and crowding at specialist and super-specialist clinics as barriers to a good doctor-patient relationship. Better concordance was associated with improved trust in the doctor (OR = 5.30, 95% CI 2.06 - 13.98, Chi Sq = 14.46, P = 0.0001), which in turn was associated with improved patient enablement (OR = 3.89, 95% CI = 1.60 - 9.64, Chi Sq = 10.15, P = 0.001). Conclusion:Good doctor-patient concordance (agreement) leads to better trust in the physician, which in turn leads to better patient enablement, irrespective of the sociocultural determinants.
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Smoking pattern among female college students in Dammam, Saudi Arabia
Manal R Koura, Ahlam F Al-Dossary, Ahmed A Bahnassy
May-August 2011, 18(2):63-68
DOI:10.4103/2230-8229.83370  PMID:21897913
Background: Smoking is the most important avoidable cause of premature morbidity and mortality in the world. The estimated annual death rate of 4.9 million people in 1999 is expected to rise to 10 million by the 2020s and 2030s, 7 million of which will occur in developing countries. Aim: The aim of the present study was to estimate the prevalence of smoking and assess its pattern among non-medical female college students in Dammam, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted of 1020 female students selected from the literature and science colleges by multi-stage stratified random sampling technique with proportional allocation. Data were collected using a self-administered modified WHO Global Youth Tobacco Survey questionnaire. Results: Results revealed that occurrence of smoking among female college students was 8.6%. It was significantly higher among literature college students (12.1%) than among Science College students (3.4%). The mean age at which smoking started was 16 ± 2.4 years, with a minimum of 11 years. More than half of the students who smoked were cigarette smokers, while 43.2% were shisha smokers. There was a strong relationship between parents who smoked and daughters who smoked. The main motive for smoking was curiosity (44.3%), followed by relief of tension (26.1%). Conclusions: It may be concluded that smoking is increasing among female college students in Saudi Arabia. Accordingly, it is recommended that a preventive comprehensive health education program on smoking be initiated for females in middle schools, that stricter tobacco control measures be adopted by the government, and that anti-smoking clinics be established in colleges.
  6,993 806 11
Blood pressure and its associated factors among primary school children in suburban Selangor, Malaysia: A cross-sectional survey
Chandrashekhar T Sreeramareddy, Wai F Chew, Veronica Poulsaeman, Nem Y Boo, Kong B Choo, Sook F Yap
May-August 2013, 20(2):90-97
DOI:10.4103/2230-8229.114769  PMID:23983560
Background: Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children. Materials and Methods: A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards. Results: A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = −0.095, P = 0.037) was negatively associated with DBP. Conclusion: BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.
  6,683 1,022 2
Knowledge, attitude, and behavior among Saudis toward cancer preventive practice
Kandasamy Ravichandran, Nasser A Al-Hamdan, Gamal Mohamed
September-December 2011, 18(3):135-142
DOI:10.4103/2230-8229.90013  PMID:22175041
Objective: To examine self-reported knowledge, attitude, and preventive practices on cancer among Saudis. Materials and Methods: Data was collected from Saudis aged 15 years or more, who attended one of the randomly selected 20 Primary Health Centers (PHC) or the four major private hospitals located in the Riyadh region, either as patients or their escorts. The association between the variables was evaluated by the Chi square test. Results: The study population consisted of 618 males and 719 females. Among the female respondents 23.1% reported that they practiced breast self-examination (BSE); 14.2 and 8.1%, respectively, had clinical breast examination (CBE) and mammography. However, 10.0 and 16.1% of the females, aged 40 years and older, reported having had mammograms and CBE, respectively. The BSE performers were more educated, knew someone with cancer, and had heard of the cancer warning signal. Both educational level and 'heard of cancer warning signal' were significantly related to CBE. Cancer information was received from television / radio by 65.1% and from the physician by 29.4%. Even though 69.4% believed that cancer could be detected early, a vast majority (95.8%) felt early detection of cancer was extremely desirable and 55.1% said their participation was definite in any screening program. A majority of the respondents (92.6%) insisted on the need for physician recommendation to participate and 78.1% expected that any such program should be conducted in the existing hospitals / clinics. Conclusion: Culturally sensitive health education messages should be tailored to fulfill the knowledge gap among all population strata. Saudis will benefit from partnerships between public health educators and media to speed up the dissemination of cancer information.
  6,683 998 27
Mothers' knowledge of child health matters: Are we doing enough?
Ibrahim H Al-Ayed
January-April 2010, 17(1):22-28
DOI:10.4103/1319-1683.68785  PMID:22022667
Background: Child care is mostly the responsibility of mothers. Several studies have revealed that the mothers' education has a positive impact on their knowledge and practice in child health matters. Objectives: The study was undertaken to assess the level of mothers' knowledge on certain aspects of child health care and whether there is any correlation between their level of knowledge and the number of years of formal education they have had. Materials and Methods: A two-part questionnaire was distributed. The first part comprised information about mother's nationality, age, work, level of education and number of children, in addition to sources of health information and the role of school education in child health matters. The second part contained 40 statements about different aspects of child health matters. A structured interview with the mothers who attended with their children at the pediatric outpatient clinic of King Khalid University Hospital in Riyadh during July and August 2007, was conducted by a trained non-medical research assistant using the items and statements of the questionnaire as a base. A knowledge score was calculated from the number of correct answers. The maximum score was 40. An arbitrary cut-off score of 25 was considered satisfactory. Results: Three-hundred-seventy-three questionnaires were completed. The mean score of the total sample was 25 (out of 40) and the minimum score obtained was 14, and the maximum 36. Fifty-eight percent scored 25 or more. Scrutiny of individual items on the questionnaire revealed significant and serious gaps in mother's knowledge. No statistically significant correlation was evident between mothers' knowledge of child health related matters and level of education, age, or number of children. Conclusion: Mothers' knowledge of child health related matters is deficient. At present, knowledge on child health matters taught in schools in the Kingdom is inadequate. Health care institutions play a limited role in health education. There should be proper effective practical means of disseminating information on child health matters among mothers in our community.
  6,778 863 6
Knowledge regarding risk factors of hypertension among entry year students of a medical university
Rizwana B Shaikh, Elsheba Mathew, Jayadevan Sreedharan, Jayakumary Muttappallymyalil, Shatha Al Sharbatti, Shaikh A Basha
September-December 2011, 18(3):124-129
DOI:10.4103/2230-8229.90011  PMID:22175039
Context: Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. Aims: To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables. Materials and Methods: A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. Results: Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. Conclusions: The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.
  5,935 1,281 5
Quality of life in dialysis patients from the United Arab Emirates
Abdelbasit M Ayoub, Kamal H Hijjazi
May-August 2013, 20(2):106-112
DOI:10.4103/2230-8229.114772  PMID:23983562
Background: The quality of life (QOL) has emerged as an important parameter for evaluating the quality of health-care for patients with renal failure. The literature suggests that many factors impact QOL. The QOL of dialysis patients in the United Arab Emirates (UAE) has not been studied before. This research examined the QOL of patients in the UAE on dialysis using two QOL tools. Materials and Methods: A descriptive comparative survey design was used to study 161 dialysis patients. The participants completed the 36-Item Short Form Health Survey (SF-36) and the QOL index dialysis version tool. Comparative analyses of the results for both tools were done using descriptive statistics. Multiple linear regression analysis determines the effect of the variables on the QOL scores. Results: The questionnaires return rate was 93%. The overall QOL for dialysis patients was rated low when self-assessed using the SF-36 (58.9) compared to QOL index (77.2). The multiple regression analysis revealed that having a chronic illness had the strongest impact on the total scores of both tools. The comparison between the statistically significant variables for both samples revealed contradictory results from the two tools used. This meant that the two tools measured QOL differently. Conclusion: The two QOL tools scores impacted very differently on most socio-demographic variables on the two samples. More studies are required to explore the concept of QOL in the Arab dialysis population.
  6,139 979 10
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010