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   2008| September-December  | Volume 15 | Issue 3  
    Online since June 16, 2012

 
 
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ORIGINAL ARTICLES
Breast cancer management delay - time for improvement: A reflection from the eastern province of Saudi Arabia
Maha S.A Abdelhadi
September-December 2008, 15(3):117-122
PMID:23012177
Objective: Breast cancer is the commonest international malignancy among women. Its increased prevalence over recent years in our part of the world has prompted women to randomly seek medical advice. Many patients are delayed for weeks to months prior to receiving medical treatment. This review explores the causes of delay and proposes possible solutions. Materials and Methods: This review was undertaken at King Fahd Hospital of the University, a tertiary care center with the capacity of 420 beds. It accommodates a large number of referrals from the Eastern Province, other regions of the Kingdom, in addition to many walk-in patients. Most of the patients referred with breast cancer are directed to the breast clinic for treatment. There was random re-tracing of patients' steps from the discovery of the suspicious breast mass to the delivery of care. Results: The total number of diagnosed breast cancer cases at this center between 1997-2007 was 303, with a total number of 975 registered visits. Random retracing of these patients' records identified three points of delay: community related, primary heath care and tertiary care. It was found that the patients spent 6-15 weeks and around 32-38 hand offs before receiving the final care. Conclusion: This unnecessary delay creates anxiety and mistrust of the operating health system leading patients to seek alternative medicine or treatment abroad. A multidisciplinary one-stop breast oncology clinic may be the solution to the above problem. It may allow the fast tracking of breast cancer patients through a highly specialized and well-trained multidisciplinary team that offers the highest quality of care, thereby optimizing the chances of cure with the least delay and possible morbidity.
  4,220 258 -
CASE REPORTS
Ovarian dysgerminoma in two sisters
Bander F Aldhafery
September-December 2008, 15(3):127-131
PMID:23012179
Although rare, dysgerminomas are important irrespective of incidence because they affect women of reproductive age (i.e., <45 years). Dysgerminomas make up two thirds of all malignant ovarian neoplasms in women younger than 20 years. All dysgerminomas are considered malignant, but only one third of dysgerminomas behave aggressively. Their exact etiology has not been determined. Few reports are found in the review of the literature on the incidence of dysgerminoma and other germ cell tumors in families. Some of these reports focus on the genetic abnormalities associated with germ cell tumor and the responsible gene. Two cases of dysgerminomas diagnosed in two sisters aged 14 and 19 years old are presented here with their radiological studies.
  4,143 298 -
ORIGINAL ARTICLES
Stages of change in physical activity, self efficacy and decisional balance among Saudi university students
Ensaf S.A. Gawwad
September-December 2008, 15(3):107-115
PMID:23012176
Background : Determining the stages of change in physical activity (PA) helps to determine effective promotion of PA interventions. The aim of the study was to assess the readiness of students of King Saud University (KSU) to be more physically active and relate this to their self efficacy, perceived benefits and perceived barriers to PA. Method : A cross-sectional descriptive study was conducted at KSU, Riyadh, between March and May 2007, using a self-administered questionnaire. The total sample size was 302 randomly chosen male and female students. Results : More than half of the students (55.3%) reported that they participated in PA in the action (for <6 months) and maintenance (for > 6 months) stages. The remaining students did not engage in PA as they were in precontemplation, contemplation, preparation and relapse stages. More males were found in the maintenance stage, but more females were found in the inactive stages (precontemplation, contemplation and preparation). Only 24.4% of the students were engaged in PA as much as three times or more/week and 9.9% engaged in PA regularly through out the year. About 39% of which, significantly, more were males did vigorous PA for 20 minutes or more. However, 4.6% described themselves as hyperactive. More females used the stairs, did house work and considered themselves moderately active. Nearly 50% had a low total score of perceived barriers while 85% had high perceived benefits and 63.6% had moderate self efficacy of PA. The main barriers perceived were time and resources. The score relating to barriers decreased significantly across stages of change, but the pattern was reversed with regard to the perceived benefits and self-efficacy (p<0.05). Conclusion : Physical inactivity is common among KSU students. A considerable proportion of them was not ready to become more physically active. The study highlights the need to adapt PA promotion programs to states of readiness for PA. University and public policies as well as environmental changes are necessary to encourage active living within the context of Islamic rules and Saudi culture.
  2,753 407 -
CASE REPORTS
Primary synovial sarcoma of the abdominal wall: A case report and review of the literature
Alsaif H Saif
September-December 2008, 15(3):123-125
PMID:23012178
Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in the extremities of adults, in close association with joint capsules, tendon sheaths, bursae and fascial structures. Only a few cases of synovial sarcoma occurring in the abdominal wall have been reported. A case of a primary synovial sarcoma arising from the anterior abdominal wall fascial aponeurosis is presented.
  2,507 233 -
ORIGINAL ARTICLES
Hypertension in the eastern province of Saudi Arabia: Results of a screening campaign
Khalid A Al-Turki, Nadira A Al-Baghli, Aqeel J Al-Ghamdi, Ahmad G El-Zubaier
September-December 2008, 15(3):95-101
PMID:23012174
Objective: To estimate the prevalence of hypertension through a screening campaign in the Eastern Province of Saudi Arabia, and examine its association with lifestyle factors. Research Design and Methods: In 2004, all Saudi residents in the Eastern Province, aged 30 years and above were invited to participate in a screening campaign for the early detection of diabetes and hypertension. Blood pressure was recorded by trained nurses using a mercury sphygmomanometer, based on the recommendations of (JNC- VII). A positive screening test for hypertension was defined as systolic and/or diastolic blood pressure of ≥ 140 and 90 mm Hg, respectively. Subjects who had positive screening tests were asked to come on the following day for a confirmation of the reading. Hypertension was considered if there was a persistent reading of systolic and/or diastolic blood pressure of > 140 and 90 mmHg after confirmation, or when there was history of a previous diagnosis. Results: 21% of the sample was positive from previous history or screening. After confirmation, the prevalence of hypertension dropped to 15.6%, pre-hypertension was 3.7%, whereas the prevalence of undiagnosed hypertension was 2.8%. The prevalence rose with age. It was higher in women than in men of all age groups and in all sectors of the eastern province, although the mean systolic and diastolic BP was higher in men than women. It was higher with lower education, in widows and divorcees than others (P<0.0001). Conclusion: The yield of the screening for abnormal blood pressure was high. Systematic follow-up of subjects with abnormal screening results is vital.
  2,039 290 -
Foot care among male diabetics in family practice center, Abha, Saudi Arabia
Yahia M Al-Khaldi
September-December 2008, 15(3):103-106
PMID:23012175
Objective: This study aims to assess the behaviors of diabetic males towards their foot care at Al-Manhal Center of Family Practice, Aseer Region, KSA. Methodology: A cross-sectional study was conducted for male diabetics in the Aseer region, KSA, during the first quarter of the year 2004.A questionnaire and physical examination of the foot were used to assess their behaviors towards foot care. Results: All the male diabetic patients (107) who attended during the study period were assessed. Mean age was 58 years, mean duration of DM was 10 years. Good diabetic control was 24%, 37% did not know the negative effect of DM on the feet,9-22% had different symptoms of diabetic foot ,53% checked their feet regularly ,31% had fungal infection while an absence of pulse was detected in 7%. Conclusion: This study revealed that many diabetics had negative behaviors towards foot care. There is a need for intensive health education and regular assessment in order to detect ,prevent and manage diabetic foot as early as possible.
  1,897 301 -
MEDICAL EDUCATION
Evaluation of three instructional methods of teaching for undergraduate medical students, at King Saud university, Saudi Arabia
Eiad A Al-Faris, Hamza M Abdulghani, Khalid A.B. Abdulrahman, Norah A Al-Rowais, Abdulaziz A.B. Saeed, Shaffi A Shaikh
September-December 2008, 15(3):133-138
PMID:23012180
Background: There is an international move from traditional curriculum towards the learner - centered, and patient-oriented curriculum. In spite of its advantages, problem-based learning requires a larger number of teaching staff and space. This study was done to compare the problem-based learning (PBL), lectures and modified PBL methods. Methods: Thirty-three fifth year medical students who were taking the Family Medicine rotation participated in the study at the College of Medicine, King Saud University. Three instructors participated in the teaching of three topics to the three groups of students. Students acted as control for themselves across the three instructional methods, namely; lectures, PBL and modified PBL. The main outcomes were students' recall of knowledge, problem solving skills and topic comprehension. Results: In the initial assessment, there was a significant difference in favor of PBL and the modified PBL regarding comprehension of the topic as tested by the short answer questions (p = 0.0001), problem solving skills as tested by the modified essay question (p = 0.002). Non- significant results were observed at the second stage of assessment. The modified PBL method was the preferred one for 39% of the students, followed by the PBL (36%) and lastly the lectures (25%). Conclusion: This empirical study suggests some advantages for the PBL method and the modified PBL over the lecture method. Larger studies are needed to confirm our results of this important issue as the modified PBL is an affordable option for schools that can not meet the staff and space requirements of the PBL curriculum.
  1,651 248 -
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010