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1.  Patterns of tobacco consumption in food facilities in Riyadh, Saudi Arabia 
Annals of Thoracic Medicine  2014;9(3):173-178.
AIM:
This study aimed at assessing prevailing patterns and risk factors of tobacco consumption among clients, food handlers and employers of food facilities, in Riyadh, Saudi Arabia.
METHODS:
A cross-sectional approach to a representative sample of food facilities in Riyadh was used. A sample of 3000 participants included clients (75%); food handlers/hospitality workers (20 %) and employers (5 %). Participants were reached at restaurants, food courts or cafes. A modified version of the WHO-CDC-Global Youth Tobacco Survey questionnaire was used for data collection.
RESULTS:
The prevalence of tobacco use at food facilities was found to be 40.3 %, of which 74% were customers, 18.8% were food handlers and 7.2% were managers. The consumption of tobacco was higher at restaurants (39.9%), but lowest at food courts of shopping malls. Water pipe (55.3%) was the main consumption type, followed by cigarettes (42.6%) and chewing tobacco (2.1%). Multivariate analysis showed that gender (male), marital status (single), and type of food facility (Estaraha and café/coffee shop) were independent risk factors associated with tobacco use at food facilities.
CONCLUSION:
Tobacco use is very common in food facilities in Riyadh as reflected by results of our study, especially among single males Saudis. We should build on success encountered in banning smoking in airports, airplanes, shopping malls, market places, educational institutions and healthcare facilities, extending the ban to include food facilities as well. This is important for the health of non-smokers as well as smokers themselves.
doi:10.4103/1817-1737.134075
PMCID: PMC4073576  PMID: 24987478
Food facilities; Riyadh; Saudi Arabia; tobacco use
2.  Home caregivers’ satisfaction with the services provided by Riyadh Military Hospital's home support program 
Annals of Saudi Medicine  2011;31(6):591-597.
BACKGROUND AND OBJECTIVES:
The satisfaction of the family is essential to the success of home care support services. This study aimed to assess home caregivers’ satisfaction with support services and to identify potential factors affecting their satisfaction.
DESIGN AND SETTINGS:
The study was conducted in the Family and Community Medicine Department at Riyadh Military Hospital using cross-sectional design over a period of six months.
PATIENTS AND METHODS:
Two hundred forty participants were recruited by systematic random sampling from the division registry. Data were collected through telephone calls using a designed structured interview form. All research ethics principles were followed.
RESULTS:
The response rate was 76.25%. Most caregivers were patients’ sons or daughters. The duration of patients’ disabling illnesses varied from less than 1 year to up to 40 years. The majority of caregivers agreed that a home care services team provided the proper healthcare-related support to the patients and improved caregivers’ self-confidence in caring for their patients. Overall, on a scale of 100%, the median level of satisfaction was 90%, and 73.2% of caregivers had a satisfaction score of 75% or higher. Increased age, female gender, and more frequent home visits were positive independent factors associated with caregivers’ satisfaction scores.
CONCLUSION:
Although most caregivers are satisfied with the services provided by a home care support program, there are still areas of deficiency, particularly in physiotherapy, vocational therapy, and social services. The implications are that caregivers need to be educated and trained in caring for their patients and need to gain self-confidence in their skills. The program's administration should improve physiotherapy, vocational therapy, social services, and procedures for hospital referral.
doi:10.4103/0256-4947.87095
PMCID: PMC3221130  PMID: 22048504
3.  A validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with real-time RT-PCR for diagnosing influenza A (H1N1) 
Annals of Saudi Medicine  2011;31(4):351-355.
BACKGROUND AND OBJECTIVES:
A new test (Dr. KSU H1N1 RT-PCR kit) was recently developed to provide a less expensive alternative to real-time reverse transcriptase-polymerase chain reaction (RT-PCR). We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to real-time RT-PCR.
DESIGN AND SETTING:
Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh.
PATIENTS AND METHODS:
Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both real-time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms.
RESULTS:
The outcomes of the two tests were highly correlated (kappa=0.85; P<.0001). The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally (96%-100%) by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms (100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day). The specificity of the new test also increased with increasing body temperature.
CONCLUSION:
The new test seems to provide a cost-effective alternative to real-time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities.
doi:10.4103/0256-4947.83212
PMCID: PMC3156509  PMID: 21808109
4.  Characteristics of pandemic influenza A (H1N1) infection in patients presenting to a university hospital in Riyadh, Saudi Arabia 
Annals of Saudi Medicine  2010;30(1):59-62.
BACKGROUND AND OBJECTIVES:
A national plan of management for flu-like illnesses was developed by the Saudi Ministry of Health after the first outbreak in Saudi Arabia in June. We describe the clinical presentation of the H1N1 cases attending King Khalid University Hospital (KKUH) between July through September 2009 and identify the high-risk age groups.
METHODS:
All patients presenting with influenza-like illnesses (ILI) in the H1N1 clinics during the specified period were clinically examined and tested using reverse transcription polymerase chain reaction (RT-PCR). Those who were clinically diagnosed and confirmed positive for novel influenza A (H1N1) were included in the study.
RESULTS:
Over a 6-week period, 117 cases of laboratory-confirmed cases were reported in KKUH with a mean (SD) age of 19.6 (16.7) years, of whom 72 (62.1%) were males. Most reported cases were Saudis (n=99, 85.3%); 94 (81%) had no travel history outside the country; 100 (86.2%) had had no contact with an H1N1-identified patient; 33% were aged 5-14 years and 28.4% were aged 15-29 years. The most commonly reported symptoms were fever in 99 (85.3%), cough in 9 (81%), runny nose (33.6%) and sore throat (21.3%). All 117 cases were confirmed positive using real time RT-PCR testing. Thirty-one cases (26%) were admitted and 22 of those (71%) recovered after receiving oseltamivir. Two deaths were attributed to the 2009 pandemic. One patient died of chronic pulmonary disease. The other cause of death was unknown.
CONCLUSION:
These findings indicate indigenous influenza A (H1N1) transmission, and confirm the urgent need for prevention strategies which specifically target children and young adults, who appear to have a higher risk of infection and hospitalization. Such measures include immunization, improved personal hygiene, and increased ventilation in habitations.
doi:10.4103/0256-4947.59377
PMCID: PMC2850183  PMID: 20103959
6.  ASSESSMENT OF THE ACCURACY OF DEATH CERTIFICATION AT TWO REFERRAL HOSPITALS 
Background:
Death certification is a vital source of information used in mortality statistics worldwide to assess the health of the general population. This study focuses on the consistency of information between the death reports and the clinical records (files) of deceased patients in two hospitals: the King Khalid University Hospital (KKUH) and King Fahad National Guard hospital (KFNGH) in Saudi Arabia.
Methods:
A random sample of the records of 157 deceased patients’ registered in 2002 in the two hospitals was retrospectively reviewed independently to determine the underlying cause of death and compare them with death reports. It was also to check the accuracy of the translation from English in to Arabic.
Results:
It was found that the underlying cause of death was misdiagnosed in 80.3% of the death reports. When the two hospitals were compared, no significant difference was observed (p>0.05). In addition, 81.8% of the accurate (correct) death reports in both hospitals were of patients who had died of a malignant disease. However, the translation of the underlying cause of death in KFNGH was correct in 86.1% of the death reports, while in KKUH it was only 25%, which is highly statistically significant (p<0.0001).
Conclusion:
With the limitation of studying only a small number of cases, these results indicate a discrepancy between the file and death reports in relation to the cause of death. Also, the translation of the cause of death was inconsistent in the two hospitals. Hence, there is a real need to adopt suitable measures to improve the quality of death certification.
PMCID: PMC3377056  PMID: 23012166
Death certification; Accuracy; Assessment & Death reports

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