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   2010| September-December  | Volume 17 | Issue 3  
    Online since December 29, 2010

 
 
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REVIEW ARTICLES
A review of community-acquired methicillin-resistant Staphylococcus aureus for primary care physicians
Huda A Bukharie
September-December 2010, 17(3):117-120
DOI:10.4103/1319-1683.74320  PMID:21359021
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among young people without healthcare-associated risk factors have emerged during the past decade. Reported prevalence rates of CA-MRSA vary widely among studies, largely because of the different definitions employed and different settings in which the studies have been performed. Although the majority of CA-MRSA infections are mild skin and soft tissue infections, severe life-threatening cases have been reported. CA-MRSA infections have mostly been associated with staphylococcal strains bearing the staphylococcal cassette chromosome mec type IV element and Panton-Valentine leukocidin genes. These strains are more frequently susceptible to a variety of non-beta-lactam antibiotics. Clinicians must be aware of the wide spectrum of disease caused by CA-MRSA. Continued emergence of MRSA in the community is a public health problem, and therefore warrants increased vigilance in the diagnosis and management of suspected and confirmed staphylococcal infections.
  12 4,996 958
MEDICAL EDUCATION
E-learning in Saudi Arabia: 'To E or not to E, that is the question'
Ali M Al-Shehri
September-December 2010, 17(3):147-150
DOI:10.4103/1319-1683.74333  PMID:21359026
Background: The Kingdom of Saudi Arabia (KSA) has witnessed unprecedented growth in higher education and E-learning in recent times. In the last five years, one university and five colleges have been commissioned every month; 800 scholarships have been awarded every month for overseas study; a national center for E-learning has been established; and E-units or departments have been set-up in almost every university. E-learning has become important for discussion to quote Shakespeare 'To E or not to E that is the question.' Objectives: To examine current and future developments and challenges of E-learning in KSA. Materials and Methods: A qualitative approach was used to explore views of 30 senior academicians involved in E-learning during their attendance at a two-week course on the subject. Results: All participants considered themselves as decision makers on E-learning in their units or departments. They felt that E-learning had come to stay, but acknowledged challenges in respect of resources, organization, management, and information technology. Conclusion: The fast development of E-learning poses many challenges. Clear vision and strategic planning with prospective E-learners in mind are essential to make E-learning programs cost effective.
  11 4,091 579
REVIEW ARTICLES
Anomalous origin of left coronary artery from pulmonary artery: A rare cause of myocardial infarction in children
Amer A Lardhi
September-December 2010, 17(3):113-116
DOI:10.4103/1319-1683.74319  PMID:21359020
Anomalous origin of the left coronary artery from pulmonary artery is a rare congenital heart anomaly. It presents predominantly in infancy with clinical features of myocardial ischemia and/or congestive heart failure. It poses a clinical diagnostic challenge to family physicians and pediatricians as it may present in a way similar to common pediatric conditions such as infantile colic, food intolerance, gastroesophageal reflux, and bronchiolitis. Awareness of this condition is essential for prompt diagnosis and referral to a cardiac center for early surgical intervention and improved prognosis. This article reviews this rare but serious disease in children.
  8 6,269 621
ORIGINAL ARTICLES
Physicians' therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria
Nahla Khamis R Ibrahim, Saeid G Attia, Sunny A Sallam, Ebtisam M Fetohy, Fatihey El-Sewi
September-December 2010, 17(3):121-128
DOI:10.4103/1319-1683.74325  PMID:21359022
Objectives: The objectives of the study were to investigate physician's therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient's knowledge and skills, patient's compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3%) of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient's knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c) revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient's compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient's compliance should be improved by conducting educational and training programs.
  7 5,313 632
Assessment of the effect of health education on mothers in Al Maki area, Gezira state, to improve homecare for children under five with diarrhea
Huda M Haroun, Mohamed S Mahfouz, Mohamed El Mukhtar, Amani Salah
September-December 2010, 17(3):141-146
DOI:10.4103/1319-1683.74332  PMID:21359025
Introduction: Home care of under-five children is one of the most important interventions in the control of diarrheal diseases. It has a significant impact in reducing childhood mortality and morbidity. Objective: This study was conducted to evaluate the effect of health education on home care of under- five children with diarrheal disease. Materials and Methods: This is a quasi- experimental study, held in Al Maki neighborhood, which is located in Greater Wad Medani locality, Gezira State, Central Sudan. The study targeted a random sample of 118 mothers who have at least one child under- five years of age with diarrhea needing home management. The study was conducted in three phases. Phase one was a base line survey for the mothers. Intervention phase including different health education approaches, home visits, group sessions and distribution of mother cards through community volunteers and researchers. Post intervention survey using the same pre-intervention questionnaire, and observation of mothers managing their children. Results: Results showed that knowledge of mothers about definition of diarrhea, its danger, when to seek medical help and the three rules of home management which was found to be 35,28,13 and 29% improved significantly after intervention to 91, 94,92 and 93% respectively with a very high significant level. Recommendations: We recommended that volunteers are effective health education provider especially on household based intervention. Health services should support the community based interventions to reinforce the knowledge and practices of mother towards the sick children.
  4 4,371 648
Quality of diabetes care at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, 2006
Ibrahim S Al-Arfaj
September-December 2010, 17(3):129-134
DOI:10.4103/1319-1683.74328  PMID:21359023
Objective: The aim of this study was to assess the current status of care provided by the Diabetes Center at Armed Forces Hospital, Southern Region. Materials and Methods : A total of 260 patients were randomly selected from the diabetic patients attending the Diabetes Center. Study tools comprised patients' data sheets and patients' interview questionnaire. Results : Two-thirds of the patients were aged 50 years or more. Half of patients had had the disease for less than 10 years. Diet therapy alone was followed by 2.3% of diabetic patients. More than half of patients (56.5%) were on insulin. Most of the diabetic patients were tested for HbA1c at least once per year (88.1%), and 71.5% had their lipid profile done at least once within two years. Low indicators included having a dilated eye examination (35.4%), assessment for nephropathy (28.8%), and having a well-documented foot examination (12.7%). Highest risk HbA1c level (>9.5%) was reached by 38.8% of patients, 48.8% had a low-density lipoprotein level of <130 mg/dl, and 36.5% of patients had controlled blood pressure (≤130/80 mmHg). Most patients were satisfied with their interaction with the treating doctor, 41.5% were satisfied with access to treatment. Hypertension was found to be the most frequent comorbidity (38.5%). Conclusion : The quality of services as regard to process and outcome are low at the Diabetes Center. The overall diabetic patients' satisfaction was high, whereas their satisfaction was low as regards to access to treatment or health professionals.
  2 3,867 541
Pilgrims satisfaction with ambulatory health services in Makkah, 2008
Ibrahim A Al-Hoqail, Abdelshakour M Abdalla, Abdalla A Saeed, Nasir A Al-Hamdan, Ahmed A Bahnassy
September-December 2010, 17(3):135-140
DOI:10.4103/1319-1683.74331  PMID:21359024
Objective: The main objective of this study was to assess the level and correlates of patients' satisfaction with ambulatory health services provided for pilgrims during Hajj period in 2008. Materials and Methods: This was a facility-based, cross-sectional study conducted in the Makkah region during the Hajj season in December 2008. A two-stage technique was used to select 500 patients from those who attended the ambulatory health services. One hundred subjects were selected by systematic random sampling (every fifth) from each of the five hospitals included in the study and asked to fill in a pilot-tested self-administered questionnaire. A total of 487 questionnaires were analyzed. Descriptive statistics and t-test, Mann Whitney test and ANOVA, or Kruskal-Wallis test was used as appropriate after checking for normality. Level of significance level was set to be <0.05 throughout the study. Results: From 478 subjects analyzed, 390 (81.6%) were man, 345 (72.2%) were married, 28.9% had either intermediate or high secondary school education, and 2.4% were skilled laborers. The total satisfaction score for health facilities was 20.45 ± 4.03 of 25. The satisfaction scores were 20.15 ± 4.7 of 25 for patient satisfaction with physicians and 21.35 ± 4.5 for patient satisfaction with paramedical personnel. The overall satisfaction score was 61.5 ± 4.5 of 75 points. There were significant relations between total satisfaction of health facilities with education level and with occupation (P = 0.012, 0.001, respectively). The total satisfaction of patients with physicians was significant only with education level. The overall satisfaction score had a significant relation with occupation (P = 0.03), but a borderline relation with the education level (P = 0.056). Conclusion: Satisfaction with ambulatory Hajj health services is acceptable. Some physicians and waiting area services need special attention to improve satisfaction levels with ambulatory health in the subsequent Hajj seasons.
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010