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   2014| September-December  | Volume 21 | Issue 3  
    Online since October 15, 2014

 
 
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ORIGINAL ARTICLES
The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem
Abdulbari Bener, Mohammad S Ehlayel, Hale Z Bener, Qutayba Hamid
September-December 2014, 21(3):154-161
DOI:10.4103/2230-8229.142967  PMID:25374465
Background: Vitamin D deficiency has been declared a public health problem for both adults and children worldwide. Asthma and related allergic diseases are the leading causes of morbidity in children. The objective of this study was to investigate the potential role of Vitamin D deficiency in childhood asthma and other allergic diseases such as allergic rhinitis and wheezing. Materials and Methods: This cross-sectional study was conducted in Primary Health Care Centers (PHCs), from March 2012 to October 2013. A total of 2350 Qatari children below the age of 16 were selected from PHCs, and 1833 agreed to participate in this study giving a response rate of (78%). Face-to-face interviews with parents of all the children were based on a questionnaire that included variables such as socio-demographic information, assessment of nondietary covariates, Vitamin D intake, type of feeding, and laboratory investigations. Their health status was assessed by serum Vitamin D (25-hydoxyvitamin D), family history and body mass index. Results: Most of the children who had asthma (38.5%), allergic rhinitis (34.8%) and wheezing (35.7%) were below 5 years. Consanguinity was significantly higher in parents of children with allergic rhinitis (48.6%), followed by those with asthma (46.4%) and wheezing (40.8%) than in healthy children (35.9%) (P < 0.001). The proportion of severe Vitamin D deficiency was significantly higher in children with wheezing (23.4%), allergic rhinitis (18.5%), and asthma (17%) than in healthy children (10.5%). Exposure to the sun was significantly less in Vitamin D deficient children with asthma (60.3%), allergic rhinitis (62.5%) and wheezing (64.4%) than in controls (47.1%) (P = 0.008). It was found that Vitamin D deficiency was a significant correlate for asthma (odds ratio [OR] =2.31; P < 0.001), allergic rhinitis (OR = 1.59; P < 0.001) and wheezing (relative risk = 1.29; P = 0.05). Conclusion: The study findings revealed a high prevalence of Vitamin D deficiency in children with asthma and allergic diseases. Vitamin D deficiency was a strong correlate for asthma, allergic rhinitis and wheezing.
  25 4,549 2,868
Metabolic syndrome: Risk factors among adults in Kingdom of Saudi Arabia
Naji J Aljohani
September-December 2014, 21(3):170-175
DOI:10.4103/2230-8229.142971  PMID:25374468
Background: Metabolic syndrome (MetS) is a cluster of established cardiovascular risk factors that collectively increase predisposition to major chronic diseases, including heart diseases and diabetes mellitus. Citizens of developing countries such as Saudi Arabia are at risk for MetS as a result of industrialization and accessibility to fast foods. In this epidemiologic study, the kingdom-wide prevalence of MetS is determined. Materials and Methods: A total of 4578 Saudis aged 15-64 was randomly selected from 20 regions in Saudi Arabia. Anthropometrics were collected, and fasting blood samples collected to ascertain fasting blood glucose and lipid profile. Components of full MetS as defined by the International Diabetes Federation were used for screening. Results: The overall prevalence of MetS is 28.3%. Prevalence was significantly higher in males than in females (31.4 vs. 25.2%; P = 0.001). Prevalence of MetS was the highest in the northern and central region, and showed a parallel increase with age, and inversely with educational status. Region was also a significant contributor to MetS. Conclusion: Despite accumulating evidence of an epidemic, MetS remains largely unresolved in the kingdom. Aggressive public campaign should be launched, and policies implemented to control any future damage of MetS in the kingdom.
  15 2,555 503
The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis
Alsayed A Shanb, Enas F Youssef
September-December 2014, 21(3):176-181
DOI:10.4103/2230-8229.142972  PMID:25374469
Background: Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density (BMD) and health-related quality of life (HRQoL) of elderly patients with osteoporosis. Materials and Methods: Participating in the study were 40 elderly osteoporotic patients (27 females and 13 males), with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL "ECOS-16" questionnaire. Results: T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant. Conclusion: Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis.
  13 6,037 1,063
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.
  6 3,522 9,395
Respiratory health of a population of welders
Sultan T Al-Otaibi
September-December 2014, 21(3):162-165
DOI:10.4103/2230-8229.142969  PMID:25374466
Objective: The aim was to identify respiratory symptoms and respiratory function of welders in comparison to a "nonexposed group." Materials and Methods: Information was collected by means of a questionnaire completed during an interview, and spirometry of all subjects. Results: This study involved 41 welders and 41 comparable nonexposed group. Sixteen (39%) welders reported bringing up phlegm from the chest first thing in the morning, compared with seven individuals (17.1%) in the nonexposed group. The difference is significant (Chi-square = 3.87 odds ratio (OR) 3.11 [1.0-9.9], P = 0.0182). Eleven welders had chronic bronchitis, which they had experienced most days for as long as 3 months, compared with one person in the nonexposed group. The difference was statistically significant, and OR was 1.7 (95% confidence interval 1.19-2.53). On the other hand, the difference in cough, shortness of breath and lung function was statistically insignificant when the welders were compared with the nonexposed group. Conclusion: This study showed more respiratory complaints, particularly chronic bronchitis, among welders compared with the nonexposed group, which is believed to be the result of welding emissions. Spirometry showed no impairment in lung function in both the welders and the nonexposed group.
  5 1,893 1,100
SHORT COMMUNICATION
Obesity and gastric balloon
Mohammed I Yasawy, Abdulaziz A Al-Quorain, Anas M Hussameddin, Zakia M Yasawy, Raid M Al-Sulaiman
September-December 2014, 21(3):196-199
DOI:10.4103/2230-8229.142977  PMID:25374473
Background: The obesity epidemic, which is among the most common nutritional disorders, is rising rapidly worldwide. It leads to several health problems such as metabolic disorders, stroke, and even cancer. Efforts to control obesity with exercise and diet have a limited value in obese patients and different approaches to do this have been tried. In this paper, we share our experience with bioenteric intragastric balloon (BIB) in treating obesity: Its safety, tolerability, and its efficacy in weight reduction. Materials and Methods: From January 2009 to September 2012, a total of 190 gastric balloons was inserted on patients at the endoscopy unit in King Fahd Hospital of the University, Al-Khobar. This is an evaluation of the first 100 patients. All the patients had a body mass index of over 30 kg/m 2 and were within the age range of 17-55 with a mean age of 32 years. After consent, preballoon investigation tests and anesthesia evaluation, BIB was inserted under monitored anesthesia care sedation in the endoscopy suite. The balloon was filled with 500-700 mls of stained saline. All patients' were given an analgesic and antiemetic for a week and antisecretory proton pump inhibitor's for 6 months. Diet and the importance of the exercise were part of the preballoon insertion phase and protocol. The balloon was removed after 6-12 months. Results: The weight loss response to BIB in the 100 patients are classified into four groups: In the uncooperative, noncompliant patients - the maximum weight loss was 7 kg, while in the most compliant patients the weight loss reached up to 39 kg. In addition, there was significant improvement into diabetes mellitus, hypertension, dyslipidemia, and fatty liveras. Its safety and tolerability were extremely acceptable. Conclusion: Our data indicates that in well-selected patients, BIB is an effective device, which with minimum complications helps to achieve body weight loss and resolve many obesity related morbidities in cooperative and dedicated obese patients.
  3 2,100 531
CASE REPORT
An unusual case of chronic prostatitis caused by Haemophilus influenzae in an elderly Saudi patient: A case report and literature review
Maha M Al-Mohizea, Fawzia E Alotaibi
September-December 2014, 21(3):193-195
DOI:10.4103/2230-8229.142975  PMID:25374472
Haemophilus influenzae has been reported on rare occasions as the cause of prostatitis and urinary tract infections. Here, we report a rare case of chronic prostatitis in a 52-year-old male with benign prostatic hypertrophy and discuss the possible underestimation of the true incidence of H. influenzae in genitourinary infections. This organism was identified only by its growth on chocolate agar, a medium that is not commonly used for urine cultures.
  2 1,994 285
ORIGINAL ARTICLES
Suitability assessment of health education brochures in Qassim province, Kingdom of Saudi Arabia
Saulat Jahan, Abdullah M Al-Saigul, Ali M Alharbi, Muzamil H Abdelgadir
September-December 2014, 21(3):186-192
DOI:10.4103/2230-8229.142974  PMID:25374471
Background: Health education is the cornerstone of primary health care. Health education materials distributed to the community should, therefore, be suitable and effective. The purpose of this study was to evaluate the health education brochures, designed and disseminated by Ministry of Health institutions in the Qassim province. Materials and Methods: The study was a cross-sectional review of health education brochures. We used a structured evaluation form, comprising general information on the brochures and a modified Suitability Assessment of Materials (SAM) score sheet. The SAM consisting of 22 criteria in six groups, includes content, literacy demands, graphics, layout/typography, learning stimulation/motivation, and cultural appropriateness. SAM criteria categorize written material into "superior," "adequate" and "not suitable." Two qualified consultant family physicians evaluated the brochures. Data were analyzed using Epi Info version 3.4 statistical package. Results: We evaluated 110 brochures, the majority of which addressed chronic health conditions such as mental health, diabetes mellitus and hypertension. Seventy-four (67.3%) brochures were evaluated as "adequate," 34 (30.9%) as "not suitable" and 2 (1.8%) as "superior." "Cultural appropriateness" was the highest scoring factor, with 92 (83.6%) brochures falling into either the "superior" or "adequate" category. With regard to "content," 88 (80.0%) brochures fell into either the "superior" or "adequate" category. This was the second highest scoring factor. Graphics was the factor that scored the least. Seventy-five (68.2%) brochures were rated in this factor as "not suitable." Conclusions: Although two-thirds of our brochures were considered "adequate," the majority needed improvement to their graphics and learning stimulation factors. We recommend that guidelines for designing health education brochures should be formulated to improve the quality of health education brochures.
  2 2,712 366
Prevalence and pattern of lipid disorders in Saudi patients with angiographically documented coronary artery disease
Abdullah M Al-Shehri
September-December 2014, 21(3):166-169
DOI:10.4103/2230-8229.142970  PMID:25374467
Objective: The aim of the study was to assess the prevalence and patterns of dyslipidemia in Saudi patients with angiographically documented coronary artery disease (CAD). Materials and Methods: This is a cross-sectional, hospital-based study, which was conducted on all Saudi patients who underwent coronary angiography under the author's personal care and were found to have > 50% coronary stenosis. Fasting lipid profile was measured in all patients during the admission for the coronary angiography. Results: Two hundred and ninety-five patients were included in the study. The mean age (±Standard deviation) was 55.1 ± 11, ranging from 17 to 86 years. The majority of patients were males: 229 (77.6%). Mean total cholesterol was 175.6 ± 47.6 mg/dl, mean low-density lipoprotein cholesterol (LDL-C) was 111.3 ± 40.3 mg/dl, mean high density lipoprotein cholesterol (HDL-C) was 38.27 ± 9.5 mg/dl and mean triglyceride level was 141.8 ± 74.8 mg/dl. 21 (7.1%) patients had normal coronary arteries, 107 (36.3%) had one vessel disease, 78 (26.4%) had two vessel disease and 89 (30.2%) had three vessel disease. There was a significant correlation between the extent of CAD and age (P = 0.003), sex (P = 0.0002), total cholesterol (P = 0.02) and low HDL-C (P < 0.001. 21 (7.1%) patients were asymptomatic, 110 (37.3%) had stable angina, 127 (43.1%) had none ST elevation acute coronary syndrome, 20 (6.8%) had ST elevation myocardial infarction and 17 (5.7%) had heart failure. There was also a significant correlation between age (P = 0.03), sex (P < 0.001), LDL-C (P = 0.005) and low HDL-C (P < 0.001) and the severity of CAD. Conclusion: Dyslipidemia is a very prevalent risk factor in Saudi patients with CAD. Low HDL-C was the most frequent lipid abnormality, which significantly impacts on the extent of the CAD.
  2 1,980 325
LETTER TO EDITOR
Cleanness of the public restroom in a rural municipality, Thailand
Wasana Kaewla, Viroj Wiwanitkit
September-December 2014, 21(3):200-200
DOI:10.4103/2230-8229.142978  PMID:25374474
  - 1,057 205
ORIGINAL ARTICLES
Prevalence of suspected tuberculosis in the Kingdom of Saudi Arabia according to conventional and molecular methods
Ali Z Al Watban, Ali A Al Salamah, Mohamed G El Faki
September-December 2014, 21(3):182-185
DOI:10.4103/2230-8229.142973  PMID:25374470
Background: Although the prevalence of suspected tuberculosis (TB) in the Kingdom of Saudi Arabia remains high, there has been a modest decrease in recent years. In this multi-center cross-sectional study, the prevalence of TB was determined by various techniques with the aim of identifying differences and indicating where there is uniformity in findings. Materials and Methods: A total of 3404 samples were collected from Saudi TB patients from different regions in Saudi Arabia: Riyadh, Dammam, Jeddah, Madinah, Hail, Qassim, Jazan, and Taif. Different techniques including Ziehl-Neelsen (ZN), Mycobacteria growth indicator tube (MGiT), Lowenstein-Jensen (LJ), and polymerase chain reaction (PCR) were used to screen for the presence of Mycobacterium tuberculosis (MTB). Results: ZN stain showed that Riyadh and Dammam had the highest prevalence of MTB with 22% and 21%, respectively, while prevalence was lowest in Jazan and Hail with an incidence of 2% and 3%, respectively. MGiT culture showed that Riyadh, Dammam, and Jeddah had the highest prevalence with a rate of 26%, 22%, and 22%, respectively. LJ culture showed the highest prevalence in Riyadh and Dammam with 22% and 21%, respectively. Of all the techniques, the highest detection rate was by PCR which was 10.46% while ZN stain technique was 6.64%, for MGiT culture it was 8.34%, and for LJ culture it was 7.7%. Conclusion: This study is the first in which different methods have been used for detection in the various regions of Saudi Arabia. Collected data are important not only for patients and physicians but for future epidemiological studies to monitor the spread of MTB infection in Saudi Arabia.
  - 3,596 458
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010