Because of the enormous changes in the lifestyle of Saudis in the last three decades, the risk factors of coronary heart disease (CHD), including physical inactivity, are increasingly becoming prevalent in the society. This paper provides an overview of the importance of physical activity in health promotion and disease prevention, and discusses the public health burden of physical inactivity in Saudi Arabia. Available evidence clearly indicates that physical inactivity is extremely prevalent in the different ages and sex of the Saudi population. This high prevalence of inactivity in Saudi society presents a major public health burden, as evidenced by the high risk in the Saudi population as a risk of physical inactivity compared with the populations of United States and the United Kingdom. Unless concrete steps are taken to reduce physical inactivity in the Saudi population, the future public health cost would be enormous. It is well known that physical activity is associated with numerous health benefits and plays a major role in modifying many other CHD risk factors. Finally, several recommendations for reducing physical inactivity and promoting active life in the Saudi population have been discussed.

Background: Diabetes mellitus associated with high prevalence and incidence of CHD is a common problem in Saudi Arabia. Objectives: To assess the percentage of major modifiable risk factors for CHD among diabetic patients. Methods: This is a retrospective study conducted on 495 diabetic patients (292 males and 203 females) attending the Miniclinic at Al-Rabwah PHC center in Riyadh. Their records for the months of April and May 2001 were reviewed. Data collected from the patient's files included body mass index (BMI), blood pressure, total cholesterol, triglyceride, and smoking status. In addition, information on the duration of diabetes was obtained and fasting blood sugar was done. Results: The percentage of overweight males was 43.2% as against 22% females, the figure for males being highly significant (p<0.0001). Obesity which was 27.9% in males and 64.1% in females, was highly significant in females (p<0.0001). For cholesterol ( > 5.2 mmol/l) was 49.5% in males versus 68.5% in females (p=0.0036). High triglyceride ( > 1.7%) was 50% in both genders. 13.4% of males were hypertensive as against 44.3% female hypertensives which was highly significant in females (p<0.0001). 19.5% of the males smoked. There was no significant difference between risk factors for CHD and duration of diabetes except that there were more smokers among those who had had diabetes for less than 10 years. Most of the diabetics with poor glycemic control (FBS> 8.3mmol/l) tended to be smokers, were more obese, had high triglyceride and high total cholesterol. Conclusion: The findings indicated that diabetic patients have high percentage of risk factors for CHD and more females than males are at risk. Therefore, early intervention is required if the incidence of CHD among diabetic patients is to be reduced.

Objective: To describe the pattern of childhood poisoning in the Emergency Room (ER) of the Pediatrics Department in Aseer Central Hospital (ACH), in order to suggest possible causes and preventive measures. Methods: This is a retrospective study of cases of childhood poisoning or ingestions attending the pediatric emergency room of Aseer Central Hospital or those admitted to the Pediatric Department of same hospital in Abha, Kingdom of Saudi Arabia, during the period of January 2000 to December 2003. Children aged 12 years and below were included. Review of records was done to collect data on clinical information such as age, sex, type of poison, clinical condition on admission as well as the time, place and date of exposure to the offending agent. Results: In this study, 114 poisoned children aged 12 years and below were studied. It was found that children from 2-4 years were more liable to poisoning (81%, p<0.001). Males were (68%) while females were (32%), with a sex ratio of 2.2:1. Medical drugs offended the most (72%, p<0.001). As regards clinical condition on admission, drowsiness, nausea and vomiting as well as abdominal pain represented (82%) of the cases. Daytime was when 80% of poisoned cases were admitted (p<0.001). The peak months were from June to August (71%, p<0.01). As regard the place of exposure to offending agent, living rooms and bedrooms accounted for 58% of the cases(p<001). Conclusion: The peak age for poisonings in children is before the age of four with significantly high diurnal frequency, significant seasonal variation in favor of summer. Medical drugs were the most common agents of poisoning, and living rooms and bedrooms the places where most poisoning occurred. Good and continuous supervision by parents is essential, especially from the age 1-5 years. There should also be legislation for the use of child resistant containers for home medicines and household agents.

Background : Health care that meets patient's expectations inevitably leads to a high level of patient satisfaction and in turn to an improved compliance of the patient with the prescribed management. Accordingly, health care services are more likely to improve. Numerous factors have been associated with patient satisfaction and studies have been done to investigate this relationship. However, not much work has been done in the field of dermatological service. Objective : This study was designed to investigate the experience, satisfaction and expectations of adolescents of the dermatological services provided in the outpatient ambulatory facilities. Methods : A cross-sectional study was conducted on 700 male and female secondary school students in Riyadh in Saudi Arabia. A self-administered questionnaire was used to collect data from the students. Data were related to the perception, expectation and satisfaction of a specific group of students. The overall and different items of satisfaction with the dermatological service including satisfaction with the physician providing the service, and satisfaction with the setting of the care were estimated. Results : The age range was 15-29 years with a mean of 18.1 + 1.8 years. Of the 517 (74%) respondents, 267 (51.6%) males and 250 (48.4%) females, 457 (88.4%) were Saudis. With regard to expectation and preference, 385 (73.9%) would like to have dermatologists at each PHC center; 310 (59.5%) preferred a government setting for treatment. Statistically significant gender preference was observed (p<0.001); males preferred male dermatologist and females preferred female dermatologist, 142 (52.8 %) and 167 (66.5%), respectively. Only 14 (2.7 %) had no preference. As far as the experience with dermatological service was concerned, 273 (52.4%) had had one or more consultations, 225 (82.4%) had used the services for curative purpose, 91 (33.3%), 104 (38.1%) and 78 (28.6%) had used governmental, private and both facilities, respectively. Overall, 188 (68.9%) patients were satisfied, but of those who had availed themselves of the government services, 36 (42.3%) were not satisfied and 68 (24.9%) considered the waiting time too long. Conclusion : Dermatological services at the governmental facilities do not meet the expectations of the adolescent. Well-designed operational research studies on the appropriate sample, focusing on patients' expectation and satisfaction with appropriate sample is required. Such studies will facilitate the work of the policy makers and service implementers and help them to develop appropriate human and other resources in order to tailor dermatologic services to the clients' expectations.

Acute appendicitis is a common cause of acute abdomen. However, it is a rare cause of pneumoperitonium. In this report the surgical diagnoses and management will be discussed in detail.

Objective : To assess the feasibility and acceptability of using objective structured clinical examination (OSCE) for a large number of medical students. Methods : All medical students (291) who had completed the basic surgical course were examined by objective structured clinical examination (OSCE) at the College of Medicine, Riyadh, for the first time. A 5-scale questionnaire was filled by the examiners at the end of the examination each day. Another questionnaire was filled by the students as a feedback. Results: All students agreed that the organizational aspect of the examinations was smooth and the time for each station was adequate. 86% of the students agreed that the stations were within the content of the course, 82% agreed that the examination was fair and objective and 93% wanted this method to be followed in the assessment of third year medical students, instead of the traditional examination (written and single long case). Similar responses were received from the examiners who were involved in the exams. Conclusion: OSCE is a practical and acceptable method for assessing medical students' basic surgical skills, even for a large number of candidates, if facilities are available in the examination center. Replacing written exams with OSCE depends on the design of stations to test knowledge adequately in scope and depth probably at problem solving level.

Objectives: Exams are known to be strong external motivators for study. In this study, this observation was utilized to increase the attendance and attention of students in lectures. Methodology: Tests were conducted at the end of every lecture, on the material covered in that lecture. A total of 12 tests on renal physiology, consisting of 4 MCQs each, were done. Students (137 male & female) were requested to fill a questionnaire of 18 items, rated on a 5-point scale in addition to some open questions. Results: Analysis of the 137 questionnaires showed that students who had participated had found it enjoyable. However, some students pointed out certain disadvantages in the practice. Conclusion: It is concluded that end-of- lecture quizzes are an extremely useful stimulus for motivation provided they are random, answers are given, and cheating is minimized.