Objective : To evaluate the quality of management of hypertensive patients attending Primary Health Care Center (PHC) in Dammam city and to determine factors that possibly affect it. Design : A cross sectional study and direct interview. Setting : Dammam city. Subjects: All doctors and nurses from a randomly selected sample of Primary Health Care Centers during April 1994. Main measures : Measuring the knowledge, attitude and practice of doctors and nurses about hypertension management. Results : Hypertension is regarded as an important health problem in Saudi Arabia in the opinion of majority of doctors (80'0) and nurses (69%). Almost half of the doctors and nurses believe that nurses are sufficiently qualified to measure blood pressure of patients. Most of the doctors (96.7%) and nurses (86%) depend merely on face-to-face education of patients Thirty percent of doctors and 34% of nurses think that the care for hypertensive patients in their Primary Health Care Centers is inadequate. Conclusions and recommendations: Offering on job training of both physicians and nurses on hypertension management. Producing a well planned protocol on the national level. Implementing a total quality management and medical audit system to PHC centers.

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Background: Tobacco consumption is now one of the most serious problems in the world and is receiving renewed attention in the current health promotion. Objectives: This study was carried out to elucidate the psychosocial and behavioural aspects of smokers associated with participation, attrition and outcome in smoking cessation programs. Methodology : This prospective cohort design included three hundred and twenty six smokers from the antismoking center - King Fahd Specialist Hospital, Buraydah, Kingdom of Saudi Arabia. The selected patients were subjected to a history taking, the assessment of causes of smoking, motives for quitting and belief problems arising from quitting; then they were made to join the clinic's antismoking program and were followed up after six months to assess the success of the program, which was measured by the rate of recidivism. Results and conclusion : The results showed that the important psychosocial and behavioural factors affecting the success in quitting smoking were: previous history of an attempt to stop tension, anxiety, anger, health beliefs and attitudes, importance of quitting, duration of smoking, period of last attempt to stop and the method used. These factors can be modified in order to increase the likelihood of success in quitting smoking.

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Objective: To evaluate the prevalence of parasitic and bacterial infestations among food handlers. Design: Retrospective study. Setting: Food handlers working in the Military food serving facilities in Jubail (Eastern Province of Saudi Arabia). Method: The stool samples of 881 food handlers of different nationalities were examined at the Armed Forces Hospital laboratory using the concentration method. Results : A total of 194 (20%) of the workers tested positive for enteric microbial infestation. Helminths were the most prevalent, infecting 93 (10.56%) of the food handlers; followed by protozoa which affected 65 (7.38%) food handlers; and the smallest group was infected with bacteria in 44 (4.9%) of the food handlers. Not only single organism infection was seen (83.94%), but also double (14.51%) and triple (1.55%) infections. Among the Helminths, Ascaris lumbricoides was the most prevalent with 33 (47.14%) cases, Giardia lamblia was the most prevalent Protozoa with 23 (43.40%) cases, and Salmonella was the most prevalent bacteria with 34 (87.18%) cases. Expatriates from South Asia showed a significant rate of infection when compared to expatriates from Arabian countries. The Bangladeshi food handlers were of the greatest prevalence of infection with 151 (17.14%) cases, followed by Indian workers with 17 (1.93%) cases, and Pakistani workers with 11 (1.25%). Conclusion : The study stresses the importance of regular check-ups and prompt treatment of infected food handler .

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The negative effects on health by behavior such as cigarette smoking, lack of physical exercise, non-control of body weight and non-use of seat belts were empirically documented. Available findings of the various studies on lifestyle of the Saudi Arabian community were not encouraging. If the general health status of the Saudi population is to be improved, an enforcement of healthy lifestyles must be considered.

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Objectives.- The aim of the study was to assess the physicians' knowledge, attitude and practice towards laboratory services in the primary health care (PHC) centers at Al-Khobar area. Methodology : Five primary health care centers were selected out of 9 (56%) from the Al-Khobar area. Twenty physicians (33%), in these primary health care centers were included. A questionnaire was given to all physicians to explore the knowledge, attitude and practice. Results: All physicians considered laboratory investigations an essential service that contributed to the management of their patients most of the time. Knowledge and practice of most (80% of them) regarding laboratory investigations was between fair to good but the attitude of 80% of them was poor since postgraduation experience was the only factor which influenced their practice. Conclusions: There has been an increase in number of Saudi physicians working in the Primary Health Care Centers. The quality of the current laboratory services was deficient according to 30% of physicians. They considered that investigations were essential for primary health care centers. And finally the utilization of laboratory tests in the Kingdom of Saudi Arabia was higher than many developing countries.

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Background: The problems of medical education in Saudi Arabia emanate from its high course content and a lack of proper integration, exacerbated by the language barrier. Objective/Proposal: To encourage good lasting learning habits, it is envisaged the need to establish training courses for learning skills. This training would include the development of positive attitude and reliable approaches to learning, learning styles, and emotional skills. It would also develop specific skills such as the setting and achievement of objectives, self assessment, group work, accessing sources of knowledge, note-taking, reading skills, retention skills, examination techniques and computer literacy. Teaching techniques, the organization of the course, assessment procedure, and the use of resources also affect learning. However, changes in these areas can be beneficial only if students have the appropriate learning skills. Recommendations. Research needs to look at the specific ways of teaching learning skills, and the effect of the application of such skills.

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Objective : The objective of the study is the identification of the specialty intentions, the reason behind that choice and the preferred practice location of the study population. Methodology: A cross sectional study was conducted using a self administered questionnaire distributed at the end of the academic year 1994. One hundred and forty nine (149) male and 104 female graduating medical students representing the four medical colleges in Saudi Arabia were included Results : The four major clinical specialties were selected by more than half of the students; Internal Medicine (17%), Surgery(16%), Paediatrics (14%) and Obstetrics (11%). Twenty seven percent were not sure of their future career choice. Primary health care was chosen by only 1.6% of the students. More men chose Surgery but more women chose Obstetrics and Ophthalmology. Discussion : "Financial incentives", "no night duties", "social reasons" and "less responsibilities" were the less frequently mentioned reasons for career choice. The qualifications in view were mostly Canadian Board for 49% of the students and Arab Board for 48% of them. The most frequently preferred locations for postgraduate training were Saudi Arabia (56%) and Canada (40%). The majority intended to practice in hospitals (90%) and in cities (85%). Conclusion : The current drastic deficiency of trained Saudi Family Physicians will continue unless targeted strategies to produce more generalists are undertaken.

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Introduction: Training of primary health care (PHC) staff, at Hail region, is conducted as a part of a national program for training all PHC staff all over the Kingdom of Saudi Arabia. The program started in Hail region during the year 1412H. The objective of the program was to train all PHC staff, or at least a doctor and a nurse or a midwife in every health center, on Maternity and Child Health (MCH) services. This objective was achieved at Hail region by the end of the year 1414H. Objectives : The objective of this study is to evaluate the impact of training of PHC staff on maternal and child health services in Hail region. Materials and Methods : Collection of data about MCH services was done by using structured forms, pre-tested and distributed at the end of each year studied to all Primary Health Care Centres (PHCCs). These forms were collected, data were encoded into the computer and analyzed by using SPSS for Windows statistical package. Results : Evaluation of the program, at the end of the year 1415H, showed improvement in utilization of MCH services, and improved quality of care provided for mothers and children. This improvement was manifested by reduction of percentage of home deliveries without medical supervision, and increased numbers of risk factors discovered among pregnant mothers and children. However, the percentage of deliveries conducted at PHCCs were not increased, and pregnancy outcome showed slight reduction of S.B. rate. Discussion: Improvement in the knowledge of the trainees was marked. Also intellectual skills e.g., using growth charts were markedly improved. However, because of the short duration of the courses, manual skills were not improved significantly. So increased frequencies of risk factors discovered among registered pregnant mothers and children was evident, however, deliveries at PHCCs were not increased. Conclusion : Training of PHC staff had a positive impact on maternal health services at Hail region. However, more time must be allowed to the practical part of training at the hospitals.

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Objectives : To verify whether the first national campaign for poliomyelitis vaccination achieved its objectives. Setting : Al-Khobar area in the Eastern Province of the Kingdom of Saudi Arabia. Materials & Methods : Randomized samples have been obtained using the Bowleg's proportional allocation scheme. At the first stage, housing blocks of 8­10 houses were selected using random sampling procedure. At a second stage, 2 houses from each block were selected in a 1 or 4 order. Both Saudi and non­Saudi nationals living in these households were screened using pretested questionnaire administered at a face-to-face by trained interviewers. The questionnaire covered areas that included number of children vaccinated, reasons for non vaccination, whether or not the vaccinated child has received certificate of vaccination as well as placement of stickers on the door of the vaccinated households. Result : A total of 107 households were surveyed in Al-Khobar. The total populations surveyed was 527 people including 213 adults and 314 children (152 of the children were aged 5 years or less). In all the households surveyed, all eligible children age 5 years or less were vaccinated. All of the vaccinated children obtained a vaccination certificate. Conclusion : The overall percentage coverage in Al-Khobar was 100%. This denotes the success of the campaign. A nationwide survey is suggested to corroborate these findings.

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