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   1997| January-June  | Volume 4 | Issue 1  
    Online since July 31, 2012

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Guidelines for the management of diabetic patients in the health centers of Saudi Arabia
Eiad A AI-Faris
January-June 1997, 4(1):12-23
This paper presents general guidelines for the management of diabetic patients within the primary health care (PHC) system in the Kingdom of Saudi Arabia (KSA). It intends to enhance PHC physicians' knowledge and improve clinical practice to ensure better management of people with diabetes mellitus. A step­wise (Algorithm) management approach for different categories of diabetic pa­tients, including diet, exercise, and drugs, is suggested. The peculiarities of Family Medicine, e.g., adopting the biopsychosocial model, the holistic ap­proach, and relations with the hospital are considered.
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Utilization of laboratory investigations in primary health care centers in Al-Khobar, Saudi Arabia
Marwan A Bakarman, Nabil Y Kurashi, Muhammad Hanif
January-June 1997, 4(1):37-45
Objective: The objective of this study was to determine the pattern of utilization of laboratory investigations in the Al-Khobar area of Saudi Arabia. Material and Methods : A two-stage sampling design was used to select a Family Health Records checklist. At the first stage, 5 Primary Health Care Centers were selected out of 9 using a random sampling method. A Family Health Records checklist was selected using a systematic sampling design from each selected Primary Health Care Center at the first stage. Results : The results showed that laboratory investigations were used for 49% of the sample population tested. Of these, 84% recorded a maximum of 3 laboratory tests. In over half of the cases, the tests were inappropriately utilized, 3 7.8% were underutilized and 13.2% were over-utilized. There was no significant difference in the pattern of utilization between males and females and between Saudi and non-Saudi patients. However, laboratory services were utilized more for patients above the age of 40 years, where an average of 2.1 tests per patient was re­corded. Conclusion : There was a significant difference between primary health care centers regarding pattern of laboratory utilization. Respiratory disease ac­counted for the majority of the health problems, followed by diabetes mellitus and hypertension. Microbiology was the most heavily used investigation followed by biochemistry and hematology. Urinalysis was the most frequently requested test followed by blood glucose and complete blood count (CBC). This study high­lighted the problems in the utilization of laboratory investigations and led to a number of solutions and recommendations.
  1,759 196 -
Pattern of HBsAg positivity in selected groups at King Khalid general hospital - hail region, kingdom of Saudi Arabia
Hisham M Mahaba, Abd El Kader A EI-Tayeb, Dahl K EI-Sekibi, Ali F El Gofaei, Hisham S EI-Baz, Nanees A Ismail
January-June 1997, 4(1):30-36
Background : Hepatitis B virus (HBV9 is endemic in the Kingdom of Saudi Arabia. The acquisition of infection occurs early in life. The availability of safe and efficacious vaccines has led to the feasibility of an effective control of HBV infection. This study compares the pattern of HBsAg positivity among se­lected groups of patients with similar groups in other regions in the Kingdom of Saudi Arabia. Objectives : This study is conducted to determine the prevalence of HBsAg positive subjects among selected groups of patients attending the main general hospital in the Hail region. Subjects and Methods : This retrospective study included 14029 subjects that were tested for HBsAg at King Khalid General Hospital, during the period from April 1994 to April 1996. Results and Discussion : The overall prevalence of HBsAg positive subjects was 3.5%. The prevalence for Saudis was about 3.2% for Saudis. Pakistanis had the highest prevalence of 11.8%. The prevalence was 3.02% for blood donors, and 2.1 % among pregnant women. No significant difference was found among different age groups. Hail region had a lower prevalence of HBsAg positive cases compared to that estimated by previous studies in the Kingdom, suggesting success in efforts applied by the Ministry of Health (110H) for prevention of Hepatitis B viral infection. Conclusion : We can conclude that the prevalence of HBsAg positive subjects is declining in the Hail region, Kingdom of Saudi Arabia (KSA). This decline suggests the success of preventive efforts such as vaccination of newborns with the HBsAg vaccine. However, screening of pregnant women for HBsAg scents to be necessary.
  1,726 171 -
Seroepidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) and relationship to alanine transferase (ALT) in Saudi workers at Yanbu industrial city
Rashad H Kashgari, Adel A Mohamad
January-June 1997, 4(1):24-29
Objectives : To study the epidemiology of Hepatitis B virus (HBV) and Hepatitis C virus (HCP) in a relatively new industrial community in Yanbu, and to find out whether any relationship exists between increased serum Alanine Transferase (ALT) and HBV infection. Method : .4 group of Saudi male workers (n=332) (mean age = 32 years) were screened for Hepatitis B core antibody (anti-HBc), Hepatitis B surface antigen (HBsAg), Hepatitis C virus antibody (anti-HCV), and Alanine Transferase (ALT) level and the results were correlated with age and marital status. Results: Overall, the prevalence of anti-HBc, HBsAg, and anti-HCV were 23.2%, 7.7% and 0.6% respectively. Age-related HBsAg carrier rates were 7.8%, 6.4% and 9.4% for age groups 18-20, 21-30 and over 30 years respec­tively. Anti-HBc positivity rates lucre 7.8%, 24.3% and 23.1 M for the same age groups. Anti-HCV was positive in only two cases (0.6%) of all subjects. Con­sidering marital status, HBsAg and anti-HBc positivity rates were 7.8% and 20.5% for single subjects compared wi t h 7.4% and 24.5% for married subjects (P=> 0.5 and > 0.5). Twenty-two percent of all subjects had ALT levels above 35 U/L with no correlation between the increase of ALT and anti-HBc or HBsAg positivity. Conclusions : The findings of this work: (1) Support the notion of relatively low prevalence of HCV in the Saudi Population as compared to HBV. (2) Provide clues regarding possible routes of transmission of HBV in Saudis that may help in vaccination policies for control of HBV infection. (3) Emphasize the fact that ALT level is an independent factor of HBV infection, and (4) Signify the need to screen industrial workers fir non-viral causes of liver disease.
  1,644 161 -
Acute life-threatening asthma in Asir central hospital
Badr R Al-Ghamdi, Bayu G Taklu
January-June 1997, 4(1):62-65
Aim: This study was conducted to analyze the severe acute asthma admissions in Asir Central Hospital (ACH) in Abha, Saudi Arabia. In particular, it aimed to identify risk factors and final outcome of acute life-threatening asthma. Method: All patients admitted to the Intensive Care Unit (ICU) with acute bronchial asthma from June 1989 to :May 1995 were analyzed. Total admis­sions to the ICU were obtained to determine the prevalence of asthma admis­sion to the ICU. Results: There were 13 admissions for 8 patients. Three patients died and five were discharged in good condition. All patients received almost similar modes of therapy. Late presentation was the main cause of death. No patient died of asthma outside the ICU. Asthma constituted 0.42% of total ICU admissions. Several risk factors for admission to ICU were identified, including: poor compliance, previous requirement of systemic steroids, history of previous in­tubation, and psychiatric illness. Conclusion : Asthma continued to be a cause of death despite the availability of treatment. Late presentation is the main cause of death. With proper man­agement the outcome for a majority of patients could be good even in acute life-threatening asthma.
  1,602 181 -
Glanzmann's thrombasthenia-spectrum of clinical presentation on Saudi patients in the eastern province
Sahida K AI-Barghouthi, Abdullah AI-Othman, Amer Lardhi
January-June 1997, 4(1):57-61
Introduction : Glanzmann's thrombasthenia is a rare inherited hemorrhagic disorder characterized by abnormal platelet function. It usually presents with subcutaneous bleeding and bleeding from the mucous membranes. Objectives : The aim of the study is to find out the clinical presentation of Glanzmann's thrombosthenia in Saudi patients, Eastern Province. Methods: In this report we have reviewed the clinical presentation of sixteen Saudi patients suffering from this disorder presented at King Fahd Hospital of the University in AI-Khobar over a period of eleven years. Results: We have noticed similarity in the frequency of the various symptoms with those reported in the literature except for the apparently more frequent hemarthrosis in our patients which mimics hemophilia. Conclusion : The spectrum of clinical presentations with Glanzmann's throm­bosthenia appears to be wide and the occurrence of the various symptoms var­ies. Moreover, some of the presenting features tend to mimic those of hemophilia, a situation which, in some cases, has resulted in unnecessary treatment with Factor VIII-containing blood components.
  1,528 184 -
The second campaign for poliomyelitis vaccination in the eastern province: Different strategy with similar success
Abdulsalam A Al-Sulaiman, Yagob Y Al-Mazrou, Adnan A Al-Bar, Ahmed A Al-Ali
January-June 1997, 4(1):53-56
Purpose: To determine whether the change from the door-to-door strategy of administering the Oral Polio Vaccine (OPV) to designated vaccination points has led to less than optimal vaccination coverage. Methods : The Second Bi Annual Poliomyelitis Vaccination ended on 28 Rajab 1417N (9 December 1996G). To minimize the high cost in terms of staff and fi­nancial resources, the local authority in the Eastern Province offered the vacci­nations at various primary health and commercial centers, schools and private hospitals. The WHO cluster sampling technique was used to conduct a survey in the Al-Khobar and Qatif areas to verify the percentage coverage using the new strategy. Results : A total population of 1399 including 644 adults and 755 children (317 Al-Khobar, 438 Qatif) was surveyed. There were 153 children aged less than 5 years in Al-Khobar and 179 in Qatif Of these, 148 (96.7%) in Al-Khobar were vaccinated compared to 179 (100%) in Qatif. Only 5 of the eligible children were not vaccinated, two of whom were Saudis and three non-Saudis. Conclusions : The study shows an overall percentage coverage of 98.4 in the Eastern Province which is well above the WHO's minimal 80% target for success. This method of vaccination at assigned points may be used in areas where the lit­eracy rate is high and public cooperation is at a maximum.
  1,537 172 -
Factors associated with patient's care during consultation in ministry of health facilities, Jeddah city, Saudi Arabia
Omar M Balbaid, Kasim M Al-Dawood
January-June 1997, 4(1):46-52
Objective: To assess the factors affecting health care and patient's satisfaction during the consultation. Design: A cross-sectional study was conducted using a structured questionnaire form on a random sample of outpatient clinic attendants. Setting: The Outpatient Department clinics at King Fahad and King Abdulaziz Hospital in addition to eleven Primary Health Care Centers (PHCCs) in Jeddah. Subjects: A sample of 340 subjects attending clinics of two hospitals and eleven PHCCs. Methods : Direct interviewing of subjects using a structured questionnaire was carried out. Information collected was basic demographic data regarding satis­faction with aspects of outpatient health care. Results : The rate of patients' satisfaction in all facilities was 76.5% with no significant variation between hospitals and Primary Health Care Centers. The study showed aspects of poor patient care, such as short consultation time and incomplete physical examination of patients. Other factors correlated with mean consultation time and completeness of physical examination were stressed. Conclusion : There was a low rate of patients' satisfaction in all Ministry of Health (MOH) facilities studied. Aspects related to patient care need to be im­proved. Practical recommendations on this were stressed
  1,509 179 -
Viral hepatitis, the battle continues
Hussein M AI-Freihi
January-June 1997, 4(1):9-11
  1,241 168 -


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