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   2016| September-December  | Volume 23 | Issue 3  
    Online since August 25, 2016

 
 
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ORIGINAL ARTICLES
Efficacy of patient discharge instructions: A pointer toward caregiver friendly communication methods from pediatric emergency personnel
Nesrin Al-Harthy, Kavita M Sudersanadas, Mohammed Al-Mutairi, Senthilvel Vasudevan, Ghada Bin Saleh, Malak Al-Mutairi, Lenna W Hussain
September-December 2016, 23(3):155-160
DOI:10.4103/2230-8229.189128  PMID:27625582
Background: Discharge instructions are vital in postemergency patient care to help the caregiver understand the diagnosis and identify symptoms which require prompt readmission. In general, oral or written instructions are provided on discharge. However, there is a dearth of information on the efficacy of discharge instructions provided by physicians in KSA. Objectives: To evaluate the efficacy of discharge instructions for postpediatrics emergency visit. Materials and Methods: This observational cross-sectional survey conducted in the Department of Paediatric Emergency at King Abdul Aziz Medical City, Riyadh, KSA, included 173 literate adult caregivers who had given their consent. Those who had been on admission earlier and been discharged from the emergency department were excluded. Demographic data and variables like knowledge of medicine and treatment follow-up were collected using a structured questionnaire and analyzed using SPSS version 16. Results: Verbal only, written only, or both verbal and written discharge instructions were provided. Written and verbal instructions, when provided together, were the most effective modes of communication with caregivers. The majority of the respondents were unaware of the follow-up plan (64.16%), unable to identify problems that would necessitate a follow-up (58.96%), and unable to identify the signs and symptoms that would require a revisit (62.43%) irrespective of the mode of instruction. However, more attention is necessary because of the 34.68% of the subjects who left the hospital without discharge instructions. Conclusions: Instructions given both verbally and in writing were observed to be more effective than verbal only or written only. The effectiveness of discharge instructions was highly influenced by the level of education of the caregivers. Improved caregiver friendly methods of communication from the pediatric emergency health-care team are necessary for the delivery of discharge instructions.
  12 2,301 323
Risky health behaviors among students in Majmaah University, Kingdom of Saudi Arabia
Tahir Ansari, Talal Alghamdi, Mansour Alzahrani, Fahad Alfhaid, Waqas Sami, Bader A Aldahash, Dukhayel S Aldukhayel, Fahad S Alshanbah, Naif M Almutairi
September-December 2016, 23(3):133-139
DOI:10.4103/2230-8229.189105  PMID:27625578
Introduction: Risky behaviors are those that potentially expose people to harm, or significant risk of harm, which prevent them from reaching their potential in life and which can cause significant morbidity or mortality. Objectives: The objectives of the study were to determine the overall prevalence of risky behaviors among university students; to determine the prevalence of smoking, drifting, fast driving and physical inactivity among university students; and to determine the associations between such behavior and demographic characteristics. Materials and Methods: An observational cross-sectional study conducted in three colleges. The data were randomly collected from 340 students aged 18-30 years from February to March 2015 using a self-administered questionnaire in Arabic. The data were entered using SPSS v 22.0. Mean and standard deviation were calculated for quantitative variables, and frequency and percentages were computed for categorical variables. Chi-square or Fisher's Exact test, as appropriate, were used to test for statistical significance. Results: The overall prevalence of risky behaviors (smoking, drifting, fast driving, and physical inactivity) among students was 47.35%. Overall, 28% of the students were smokers, 25.2% were involved in drifting, 60.9% reported driving fast, and 66.4% were physically inactive. The age between 18-20 years was significantly associated with higher rates of drifting, fast driving, and physical inactivity. Conclusion: The prevalence of risky behaviors among university students was high. Physical inactivity and fast driving were the most common identified risky behaviors. Increasing awareness of these risks in the youth may significantly decrease related morbidities, complications, and even mortalities.
  6 2,114 3,579
Using prefrailty to detect early disability
Miguel A Acosta-Benito, Ignacio Sevilla-Machuca
September-December 2016, 23(3):140-144
DOI:10.4103/2230-8229.189106  PMID:27625579
Introduction: In an aging population, new strategies are required to identify individuals at risk of adverse health outcomes. Frailty syndrome is related to negative health events. This increased risk may be used to identify individuals in which interventions can delay the onset of physical and functional complications. The aim of the study was to determine the relationship between the onset of frailty and the beginning of functional disability. Materials and Methods: This was a cross-sectional observational study with consecutive sampling to analyze 146 patients aged seventy and older who come to the primary care center. The level of frailty was registered according to fatigue, resistance, ambulation, illnesses, and loss of weight scale. Disability for Instrumental Activities of Daily Live dependency, comorbidity, and social risk factors was registered too. Results: The prevalence of frailty and prefrailty was 17.8% and 39%, respectively, and were associated with age, level of disability, and the presence of gastrointestinal disease. Prefrail patients had initial levels of dependency, while those who were not frail were mostly independent. Conclusion: Frailty syndrome is easily detectable. The intermediate stage known as prefrailty is related to the start of the functional disability. The syndrome screening identifies individuals at risk in whom we can potentially intervene to delay the onset of the syndrome and delay functional disability. Control of comorbidity in frail patients must be studied. Screening age could be set in patients between 75 and 81 years old.
  6 1,834 1,654
MEDICAL EDUCATION
Perceived stress and associated factors among medical students
Abdalla A Saeed, Ahmed A Bahnassy, Nasser A Al-Hamdan, Faisal S Almudhaibery, Anisah Z Alyahya
September-December 2016, 23(3):166-171
DOI:10.4103/2230-8229.189132  PMID:27625584
Background: Stress and its psychological manifestations are currently a major source of concern. Medical education poses challenging and potentially threatening demands for students throughout the world. Objectives: To determine the prevalence and factors associated with perceived stress in medical students in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia. Materials and Methods: This was a cross-sectional study on all medical students of batches 9, 10, and 11, which constituted all the enrolled students. Data were collected using a questionnaire based on the Kessler10 psychological distress instrument with a total score ranging from 10 to 50 points in addition to some sociodemographic characteristics. Appropriate statistical test procedures were used to study the magnitude of stress and its risk factors. Results: Mean stress score of the eighty participants was 26.03 ± 9.7. Students with severe stress constituted 33.8%, and 30% were well. Severe stress was significantly associated with female gender and junior level. Nervousness, feeling hopeless, feeling restless, and depressed were the most important factors affecting students' stress scores. Factor analysis revealed three hidden factors for stress in this group, namely, depression, nervousness, and age. Conclusion: Stress in medical students is prevalent and significantly associated with the female gender and the junior level. Implementation of coping programs is necessary.
  5 2,685 503
ORIGINAL ARTICLES
Attitudes and perceptions towards HPV vaccination among young women in Saudi Arabia
Aneela N Hussain, Abdullah Alkhenizan, Patricia McWalter, Nusrat Qazi, Amal Alshmassi, Samina Farooqi, Ahmed Abdulkarim
September-December 2016, 23(3):145-150
DOI:10.4103/2230-8229.189107  PMID:27625580
Background: Rising incidence of human papillomavirus (HPV) infection and cervical cancer can be reduced by effective vaccination. Saudi Food and Drug Administration approved prophylactic HPV vaccine in 2010 for females of 11-26 years. Objectives: To determine the awareness of HPV infection, its health sequel and the attitude and barriers to the acceptance of HPV vaccine by young women in Saudi Arabia. Dynamics influencing the decision of patients and parents regarding vaccination were assessed to foster effective and strategically focused interventions. Materials and Methods: All patients of Family Medicine department, King Faisal Specialist Hospital and Research Center, Riyadh were invited to participate in this study from January 2012 to June 2014. A culturally sensitive and specially designed questionnaire was administered using an interview-based model to assess the knowledge, perception, and associated sociodemographic factors of HPV. Results: A total of 325 patients participated as per the inclusion criteria: 87.4% were Saudis, 53.5% had university or higher education and 65.2% were adolescents (age 11-19 years). The questionnaire was answered by participants (50.8%) or guardians (49.2%). About 34.5% of the population was aware of HPV infection, and 27.4% were aware of its relation with cervical cancer. However, awareness of the HPV vaccine, perception of its prevention of cervical cancer and other HPV-related disease was relatively low (32.3%), Saudis (29.9%) versus non-Saudis (48.8%) (P = 0.016). More guardians (41.2%) were aware of the HPV vaccine and its impact than participants (27.9%) (P = 0.01). Higher educational background (43.1%) increased the knowledge of HPV compared to less than high school education (24.5%) (odds ratio: 2.33; 95% confidence interval: 1.44-3.76). Nearly 64.3% of participants agreed, and 35.7% refused to receive the HPV vaccine. Conclusion: Knowledge and perception of HPV infection as an sexually transmitted infections and its vaccine was significantly low in this cohort of patients. Higher age and educational levels directly correlated with increased knowledge of HPV infection and its complications. It is recommended that awareness should be raised, and access to HPV vaccination increased to help reduce the health care burden of HPV sequelae in the Kingdom.
  2 2,388 461
SHORT COMMUNICATION
Parents' perception of children's obesity, in Al-Qassim, Saudi Arabia
Abdulrahman A Al-Mohaimeed
September-December 2016, 23(3):179-183
DOI:10.4103/2230-8229.189134  PMID:27625586
Background and Objectives: Although the prevalence of childhood obesity has increased significantly in Saudi Arabia, parents are unable to appreciate obesity in their child. The objective of the study was to identify the percentage of parents who misclassify the status of child's weight, and determine whether there is a difference between those parents whose children are overweight and obese and those with children of normal weight. Materials and Methods: This cross-sectional study included 601 children aged 6-10 years. The children were recruited from the primary schools located in Al-Qassim, Saudi Arabia. The body mass index of the children was assessed in the school, and their parents responded to a self-administered questionnaire which contained questions on parental perception of the children's weight/obesity status. Data were entered and analyzed using SPSS. Results: Parents with overweight/obese children had significantly more misclassification than those with normal weight children. Ninety percent of parents of the 81 overweight children misclassified and reported that their child had normal weight, while 65% of parents of the 61 obese children, misclassified the child's weight status. Conclusions: The level of misclassification of children's weight status by parents is high. Saudi parents with overweight and obese children do not recognize their child's weight status. Parents' awareness of childhood obesity and its negative health impact needs to be improved.
  2 3,030 231
MEDICAL EDUCATION
Patients' attitudes towards the participation of medical students in clinical examination and care in Western Saudi Arabia
Sarah B Aljoudi, Somayah S Alsolami, Fayssal M Farahat, Basim Alsaywid, Wesam Abuznadah
September-December 2016, 23(3):172-178
DOI:10.4103/2230-8229.189133  PMID:27625585
Background and Objectives: Patients are essential for the acquisition and development of medical students clinical skills for their tasks. The study aimed to identify factors that influence patients' attitudes towards the involvement of medical students in clinical examination and care in Western Saudi Arabia. Methods: A cross-sectional study using self-administered questionnaire was conducted among Saudi and non-Saudi patients at two university hospitals in Jeddah, Western Saudi Arabia. Information sought included demographic characteristics (age, gender, educational level, job, income, and marital status); patients' attitude and comfort level towards different types of students' involvement; factors influencing patients' cooperation with medical students (students' level of training, manner, skills, and attire. All these were assessed on a five-point Likert scale. Data was entered and analyzed using SPSS v 19. Results: Four hundred and seventeen adult patients participated. Fifty-one percent indicated a positive attitude towards involving medical students in clinical examination and care. Female and young patients (<45 years old) were more likely to be negative in their attitude and be less comfortable towards involving medical students in their care. The highest overall mean comfort score was with medical students taking history followed by observations and less invasive examination. Patients' mean confidence scores regarding students' attire were the highest for female traditional attire and for scrub suit for males. Conclusion: Of the influential factors that could affect patients' willingness to cooperate with medical students, clinical skills followed by manner and level of training ranked first. Ensuring that students mastered specific procedures before coming into direct contact with patients using patient simulators, for example, would improve patients' acceptance of student participation.
  1 1,579 220
ORIGINAL ARTICLES
Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia
Ayman A Al-Talib
September-December 2016, 23(3):161-165
DOI:10.4103/2230-8229.189129  PMID:27625583
Objectives: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Materials and Methods: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Results: Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7%) were older than 35 years, and were nulliparous (45.5%). The commonest symptom was vaginal bleeding (86.4%) followed by hyperemesis gravidarum (41.0%); Hyperthyroidism was seen in 1 patient (4.5%). Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%). The majority of patients (63.6%) had normal BhCG within 9 weeks (63 days) after suction curettage. The majority of the cases followed a benign course. Conclusion: Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.
  1 1,891 242
Serum Vitamin B12 and thyroid hormone levels in Saudi patients with multiple sclerosis
Fahd A Al-Khamis
September-December 2016, 23(3):151-154
DOI:10.4103/2230-8229.189126  PMID:27625581
Objectives: To determine the relationship between Vitamin B12 levels and thyroid hormones in patients with multiple sclerosis (MS). Materials and Methods: One hundred and ten patients with MS were recruited for this study after Institutional Review Board approval. All patients signed a written informed consent form and donated a single blood sample. Plasma Vitamin B12 levels, triiodothyronine (T3), and thyroxine (T4) hormone levels were measured. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: Analysis of Vitamin B12 levels in 110 patients with MS revealed that 65% had normal levels of Vitamin B12 (200-900 pg/ml), 30% had low levels of Vitamin B12 (<200 pg/ml), and 5% high levels of Vitamin B12 (higher than 900 pg/ml). Further analysis of patients with low levels of Vitamin B12 revealed that this cohort exhibited a significantly high number of patients with low levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) (P < 0.005). Conclusion: This study suggests a relationship between Vitamin B12 levels and thyroid hormones. This opens the possibility that the use of therapies that increase triiodothyronine (T3) and thyroxine (T4) levels might be beneficial to patients with MS.
  1 1,946 293
LETTERS TO EDITOR
Promotion of voluntary blood donation among hospital employees
Nitin Agarwal, Prashant Pandey, Praveen Kumar
September-December 2016, 23(3):184-185
DOI:10.4103/2230-8229.189136  PMID:27625587
  - 1,069 124
Comment on: Social anxiety disorder in Saudi adolescent boys: Prevalence, subtypes, and parenting styles as a risk factor
Manikandan Srinivasan, Pruthu Thekkur, Mahendra M Reddy, Kalaiselvi Selvaraj
September-December 2016, 23(3):185-186
DOI:10.4103/2230-8229.189140  PMID:27625588
  - 1,032 139
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010