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   2004| January-April  | Volume 11 | Issue 1  
    Online since June 30, 2012

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Bacterial contamination of stethoscopes
Huda A Bukharie, Hussain Al-Zahrani, Abdullah M Rubaish, Mohammed F Abdulmohsen
January-April 2004, 11(1):31-33
Background: A stethoscope, an essential tool of the medical profession, can become a source of nosocomial infection. Objective: To determine the frequency of bacterial contamination of stethoscopes as well as the practices used for cleaning them. Methods: Cultures were taken from 100 stethoscopes used by different medical personnel in different hospital services. The stethoscopes were collected while the staff filled in a questionnaire. Results: Thirty (30%) out of the 100 stethoscopes surveyed were contaminated with microorganisms. The majority of organisms isolated were gram-positive bacteria (gram positive bacilli 12%, gram-negative bacteria 9%, gram-positive cocci 9%). None of the stethoscopes grew methicillin-resistant staphylococcus aureus. Overall, 21% of the health personnel cleaned their stethoscopes daily, 47% weekly, and 32% yearly. None of the health care workers cleaned their stethoscopes after every patient. Nurses cleaned their stethoscopes more often than physicians and medical students. Conclusion: Stethoscopes may be important in the spread of infectious agents. Their regular disinfection after use on each patient should be considered, particularly in such areas of the hospital, as the critical care units, and oncology units which house many patients with antibiotic-resistant organisms.
  4,387 356 -
Sociodemographic variables affecting the health seeking behaviour of mothers in a Saudi community
Nora Al-Nahedh
January-April 2004, 11(1):3-9
Objectives: Studies have shown that good antenatal care is associated with favorable outcome for both mothers and children. However, there are several factors that influence the utilization of such care even when available. The objective of this paper is to examine maternal demographic variables that influence antenatal care and the desire of mothers to consult a physician when their children aged below two are ill. Methods: This is a cross-sectional study of women living in Riyadh, Saudi Arabia. From a map of residential areas, a multi-stage sampling approach was employed to select a random sample of houses. All women with children aged less than two years were included in a house- to- house survey. A structured questionnaire was used for data collection. Epi-Info was used for statistical analysis. Results: Results show that 96.6% of the mothers had at least one antenatal care visit, while 80.9% had had more than six visits. Delivery under medical supervision was reported by 97.8% of the sample. The use of antenatal care and the number of visits were statistically significantly associated with age, education and marital status. The last two variables were also statistically significantly associated with the place of delivery. Nearly 83% of the mothers reported one or two illnesses in their children within the last two weeks. About 90.5% of these mothers consulted a physician on the illness and there was a 12.4% severe morbidity rate as evidenced by hospital admission. Physician consultation was statistically significantly associated with nationality, education and the occupation of the mother p<0.05. Hospital admission was also statistically significantly associated with age, nationality and occupation of the mother p<0.05. The commonest illness in the children in the last two weeks was diarrhea (34.3%) followed by fever (33.4%) and breathing difficulties (16%), although the highest frequency of episodes of illness was diarrhea and fever. Nevertheless, breathing difficulties followed closely by ear infection constituted the two highest prevalences among children who were brought for medical consultation (94.4% and 93.3% respectively). Conclusion: The study shows a higher proportion of mothers attending antenatal care than has been previously reported for the country. The pattern of reported children's illnesses reflects what has been previously seen from hospital studies. It also shows a high rate of physician consultation. This is probably due to the extensive coverage of free government health services in Riyadh. It will be worthwhile to document other socio-demographic variables affecting health seeking behavior of mothers in other parts of the country. There is a need to educate young illiterate mothers in sound child rearing practices. This will help minimize the distress of childhood diseases.
  2,470 332 -
The validity of clinical criteria in predicting pneumonia among children under five years of age
Samim A Al-Dabbagh, Sinan N Al-Zubaidi
January-April 2004, 11(1):11-16
Background: Pneumonia is a major cause of morbidity and mortality, especially among infant and young children. Early diagnosis and treatment is essential to reduce the risk. To achieve this, physicians require high quality diagnostic indicators. The aim of the present study is to assess the validity of clinical symptoms and signs in predicting pneumonia among children below the age of 5 years. Patients and Methods: This is a case series study for a sample of 103 children aged 4 days-59 months who were admitted to Al-Khanssa Teaching Hospital, Mosul, Iraq, suffering from respiratory symptoms and for whom a chest x-ray was requested. Sensitivity, specificity, predictive values and likelihood ratios were estimated for each clinical criterion. Results: Pneumonia was diagnosed on radiological bases in about 70% of the patients. All symptoms had high sensitivity with very low specificity. The best positive predictive values for symptoms were for fast and difficult breathing. However, the signs of Crackle, Tachypnoea, nasal flarring and chest indrawing yielded the best sensitivity estimates. Moreover, a body temperature of ≥38 °C was the best single predictor of pneumonia with a sensitivity of 67% and specificity of 75.8%. The absence of the 3 signs (nasal flaring, chest indrawing and crackles) ruled out pneumonia effectively. The sensitivity of this combination of signs was 98.6%. Detecting a body temperature ≥38 °C and grunting simultaneously was adequate to confirm the disease. Conclusions: The study suggests that using clinical criteria in combination could improve physicians' prediction of pneumonia among children.
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Analysis of diarrhea episodes in children reported at a primary health care center in Abha city in the year 2002
Mohammed Alshehri, Ismail Abdelmoneim, Hussah M Gilban
January-April 2004, 11(1):35-38
Objective: To determine the incidence, characteristics and the different factors associated with diarrhea events reported at the Primary Health Care (PHC) level in children under five years of age. Material and methods: All reported cases of diarrhea in children under 5 in the primary health care (PHC) center of Wasat Abha, Abha city during the year 2002. The medical records of patients were reviewed for name, sex, date, duration of diarrhea and character of stool, type of feeding, degree of dehydration, the treatment received and the outcome. Results: The overall incidence /child/year 2002 was 1.2 episodes. The total number of diarrhea episodes in that age group was 573 cases giving an incidence rate of 9.9% for the year 2002.Two thirds of the episodes of diarrhea (64.6%) occurred in females, and 60.9% of the episodes affected 7-12-month olds. The majority of diarrhea episodes (89.4%) lasted less than 7 days and only 3.7% of cases were moderately dehydrated. Ninety four percent of the cases improved and only 1.7 % were admitted to the hospital. Conclusion: The incidence of diarrhea episodes in the under fives in the year 2002 was lower than the national rate reported in 1993. Female children had about twice the incidence of diarrhea in male children and the highest incidence was observed in the 7-12-month olds. The majority of cases were acute. It is recommended that studies on the incidence of diarrhea in all PHC centers be done in order to monitor the progress of diarrhea in children and implement suitable preventive measures.
  2,048 206 -
Frequency of depression among patients with acute coronary syndrome, eastern region, Saudi Arabia
Mohammed F Abdul-Mohsen
January-April 2004, 11(1):23-29
BackgroundThree decades ago, Epidemiologists began to report a strong association between depression and cardiovascular disease - morbidity and mortality, and in the last decade, many large-scale studies have identified depression as an important risk factor for Coronary Artery Disease (CAD) and its morbidity and mortality. Objectives: To determine the frequency of clinical depression among patients admitted with Acute Coronary Syndrome (ACS) to the Coronary Care Unit (CCU) at King Fahd Hospital of the University (KFHU), and to find out if there is any relationship between depression and the traditional risk factors for CAD. Methods: One hundred and two patients admitted consecutively with ACS completed the self-rated Beck Depression Inventory (BDI) in their native language. The patients were classified into two groups: Group A comprising patients with no symptoms of depression and patients with subclinical or borderline depression, scored less than 21 points on BDI score scale; and Group B composed of those who scored 21 points and above. Various statistical tests were used whenever appropriate. Results: One hundred and two patients completed the BDI. Ninety-Two (90.2%) were males, with a mean age of 52.14΁12.14 years. Of these, 37.3% were Saudis, 25.5% Non-Saudi Arabs, 31.4% from the Indian subcontinent and 5.9% were other Asians. Patients from the Indian Subcontinent were significantly younger than the Saudis (p<0.0001). The evidence of clinical depression was found in 20.6% of all patients, 13.2% of Saudi patients, 19.2% of Non-Saudi Arabs and 34.4% of those from the Indian subcontinent. There was a significant difference in the frequency of clinical depression between Saudi patients and the Indians (p=0.035). Smoking and dyslipidemia were the only strong predictors of clinical depression in our study. Conclusion: Depression is unquestionably associated with CAD. Its frequency in our patients with ACS was 20.6%, and the highest frequency was recorded among patients from the Indian subcontinent (34.4%). Smoking and dyslipidemia were the strongest independent risk factors for depression.
  1,687 194 -
Hypertension care in al asyah primary health care center, Al Qassim, Saudi Arabia: An audit of structure, process, and outcome
Atef M Surour, Mahmoud A Saleh, Mohammed A Al-Alfi, Abdullah M Al-Saigul, Mohammed A Riyadh
January-April 2004, 11(1):17-22
Objectives: The objective of this study is to assess the quality of hypertension care in Al-Asyah primary health cares (PHC) center, Al Qassim Region, Saudi Arabia through an auditing of structure, process, and outcome. Subjects and methods: All files of registered hypertensive patients in the PHC center were reviewed as recommended by WHO, National Quality Assurance protocol, protocol of management of hypertension and criteria in the Sixth report of Joint National Committee on detection, evaluation and treatment of high blood pressure (JNCVI), to evaluate the structure, process, and outcome of hypertension care. Result: All hypertensive patients registered in Al Asyah PHC center ( 201 patients ) were included in this study. The prevalence of HTN among adults (≥15 years) was7.4% and increased with age. Patients were mostly Saudi (94.5%) with a mean age of 58.6 ΁ 13.9 years. Most of the patients were diagnosed as essential HTN (98.5%) at Al Asyah PHC center (87.1%). The mean duration of the HTN was 7.7 years, and 48.8% had a family history of HTN and 35.3% had diabetes mellitus. Most patients were obese or overweight (53.7% and 31.3% respectively), blood pressure of 79.6% of the patients was well controlled, and 45.3% of these patients had at least one complication. Ischemic heart disease, left ventricular hypertrophy, stroke, and myocardial infarction were the most common recorded complications. Conclusion: This study proves that all essential resources needed for hypertension care are available, but the results of process and outcome indicators show the need for the improvement of the referral system as well as good continuous constant health education programs to encourage the patients, their families and the community to observe more healthy lifestyles.
  1,572 193 -
Academia and accountability: The importance of role modeling
Abdulsalam A Al-Sulaiman
January-April 2004, 11(1):1-2
  1,198 157 -


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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010