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1.  Prevalence of oral mucosal lesions in dental patients with tobacco smoking, chewing, and mixed habits: A cross-sectional study in South India 
A variety of oral mucosal lesions and conditions are associated with the habit of smoking and chewing tobacco, and many of these carry a potential risk for the development of cancer. There have been no studies that report the prevalence of habits and associated oral changes in the population in Dharwad region, of Karnataka, south India.
Materials and Methods:
A hospital–based, cross-sectional study was carried out at SDM Dental College (Dharwad, Karnataka). A total of 2400 subjects (1200 subjects with and 1200 subjects without habits) attending the dental hospital were interviewed and examined by trained professionals to assess any oral mucosal changes.
Oral mucosal lesions were found in 322 (26.8%) subjects who had tobacco smoking and chewing habits as compared to 34 (2.8%) subjects without those habits. Oral leukoplakia (8.2%) and oral submucous fibrosis (OSF) (7.1%) were the prevalent oral mucosal lesions found in subjects who had those habits, while the other lesions (1.7%) namely; oral candidiasis, median rhomboid glossitis, recurrent apthous ulcer, frictional keratosis, and oral lichen planus (0.9%) were frequently reported among individuals without those habits. The odds of developing oral lesions in subjects with tobacco habits was nearly 11.92 times that of abstainers (odds ratio, OR = 11.92, 95% confidence intervals, CI = 10.61-14.59%).
The study showed that the risk of the development of oral lesions associated with tobacco smoking, chewing, or both is quite high. Males who had one or more of these habits showed more frequent oral changes than females. The study reinforces the association of OSF with gutkha and areca nut chewing, and leukoplakia, erythroplakia, and oral cancer with tobacco smoking, chewing, or mixed habits.
PMCID: PMC3748648  PMID: 23983566
Betel quid; gutkha; oral cancer; oral lesions; pre-cancer; tobacco
2.  Fortification with vitamin D: Comparative study in the Saudi Arabian and US markets 
Background and Objective:
Vitamin D deficiency is common among Saudi Arabian population. To evaluate the current status of vitamin D fortification and calcium content of commonly consumed food items by the Saudi population and to compare it to US data.
Setting and Design:
Cross-sectional market survey at markets of Eastern Province of Saudi Arabia and State of Illinois, USA.
A dietary survey was carried out for the content of calcium and vitamin D on the most commonly consumed food products by the Saudi population which are suppose to be fortified by vitamin D. The survey included different brands of fresh milk, yoghurt, powdered milk, cheese, ready-to-eat breakfast cereals and orange juice. Vitamin D content in the products studied from the Saudi marketplace was compared with the suggested vitamin D content in the same products according to US Code of Federal Regulations recommendations.
The overall calcium content in the processed dairy products is generally higher than the content in fresh dairy products. Vitamin D content in the fresh dairy products varied from 40 IU/L to 400 IU/L. None of the cereals or orange juice in Saudi Arabia contain vitamin D supplement. The vitamin D content in the food items from the Saudi marketplace is mostly lower than recommended by the US Code of Federal Regulations.
Most commonly consumed food products by Saudi population which are suppose to be fortified by vitamin D either not fortified or contain an amount less than recommended by guidelines set for US marketplace.
PMCID: PMC3663164  PMID: 23723731
Food; fortification; Saudi Arabia; United States; vitamin D
3.  Profile of morbidity among elderly at home health care service in Southern Saudi Arabia 
This study aimed to determine the profile of morbidity among elderly registered at home health care service in the Armed Forces Hospital of Southern Region, Kingdom of Saudi Arabia.
Materials and Methods:
A retrospective study was conducted (over a period of 6 months during year 2011) and data was collected by reviewing of medical records of all elderly patients of elderly.
The total number of elderly ≥ 60 years were 880. The most prevalent morbidity is hypertension (59.1%) followed by diabetes mellitus (57.3%), stroke (34.9%), dementia (28.5%), osteoarthritis (24.2%) and Alzheimer (21.4%). Females are at higher risks of having many types elderly diseases compared to males. The highest risk was for obesity (OR = 9.1; 95% CI = 3.51- 12.8), followed by osteoporosis (OR = 8.7; 95% CI = 15.10 – 9.13) and fracture neck femur (OR = 3.9; 95 CI = 2.11 – 6.91). In addition, females were also at higher risks of having Osteoarthritis and thyroid disorder. On the other hand, males are more susceptible to hypertension (OR = 1.4; 95 % CI = 1.07 – 1.85), stroke (OR = 1.3; 95 % CI = 1.08 – 1.89) and renal diseases (OR = 2.4; 95% CI = 1.25 – 4.54).
It is concluded that there is a great need for preventive, curative and rehabilitative program in order to introduce high quality of health care services to elderly.
PMCID: PMC3663165  PMID: 23723732
Elderly population; morbidity; South of Saudi Arabia
4.  Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors 
The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia.
Materials and Methods:
The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals.
The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The “before go-live training”, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011.
The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other areas. As a result of the pilot project, NGHA developed a list of CSFs to increase the likelihood of project success for the expansion of the system to other clinics and hospitals. The authors recommend a future study for the CPOE implementation to be done that covers the implementation in all the four NGHA hospitals. The results of the study can then be generalized to other hospitals in Saudi Arabia.
PMCID: PMC3237203  PMID: 22175042
Computerized physician order entry; critical success factor; health information systems; Saudi hospitals
5.  Propolis and its direct and indirect hypoglycemic effect 
Propolis means a gum that is gathered by bees from various plants. It is strongly adhesive resinous substance, collected, transformed, and used by bees to seal holes in their honeycombs. Bees use it to seal holes in their honeycombs, smooth out internal walls, as well as to cover carcasses of intruders who died inside the hive in order to avoid their decomposition. Propolis also protects the colony from diseases because of its antiseptic efficacy and antimicrobial properties. It also has been reported to possess various biological activities, namely anticancer, antioxidant, anti-inflammatory, antibacterial, antifungal, and hypolipidemic. The aim of this review is to evaluate the hypoglycemic effect of propolis since a little number of researches studied this effect when we compare with the huge number of papers that reported many other biological activities.
PMCID: PMC3237204  PMID: 22175043
Anticancer; antioxidant; anti-inflammatory; antibiotic; antifungal and antihepatotoxic; bees; propolis
6.  HIV/AIDS knowledge among first year MBBS, Nursing, Pharmacy students of a health university, India 
To determine level of HIV/AIDS knowledge among first-year MBBS, nursing and pharmacy students of a health university.
Materials and Methods:
A pre-designed, pre-tested, anonymous self-administered, semi-structured questionnaire was circulated among available 129, 53 and 55 first-year MBBS, nursing and pharmacy students during Oct’ 09. Data entry, management and analysis were carried out using MS excel and software statistical package.
Out of the total 237 students, there were 123 (51.9%) female and 103 (44.0%) students from rural native place. A majority of students were able to correctly write the full form of AIDS (95.8%) in comparison to HIV (72.6%) and the difference between two terminologies were known to 87.6%, 81.1% and 70.9% of MBBS, nursing and pharmacy students, respectively. All four common routes of transmission of infection and methods of prevention were known to majority of the lot. However, injecting drug users (IDU) and truck driver as a risk category was correctly reported by 67.5% and 55.3% students, whereas 35.9% incorrectly mentioned that smoking is a risk factor for acquiring infection. A statistically significant (P <0.05) proportion of MBBS followed by nursing and pharmacy students were aware that infection neither spreads by social activities like handshake/playing nor by mosquito bite. However, low level was ascertained with regard to items related to non-curability of infection (57.4%) and availability of anti-retro viral therapy (27.4%).
Overall high level of knowledge was recorded in the present study with a difference noted among students in three professional streams.
PMCID: PMC3237205  PMID: 22175044
Aids; HIV; knowledge; university students
The teaching of communication skills is gaining increasing attention. However, the opportunities for faculty development are limited. This study highlights an attempt by the Medical Education Unit, King Fahd Hospital of the University, Al-Khobar, to raise the awareness of faculty to this vital area by organizing a one-day workshop.
A one-day workshop was organized to improve the awareness of the participants to the role of communication skills such as doctor-patient interaction, breaking bad news, counseling and conflict management. In all, 168 participants consisting of faculty members, interns and students, both male and female participated. The sessions included interactive lectures, video demonstrations and role play.
The feedback from the participants indicated that the objectives of the workshop were largely realized. The presentations by speakers were of high quality. However, the participants wanted more small group activities and video-demonstrations that were relevant to the local environment.
By and large, the one-day workshop was found to be a practical model for an initial attempt to raise awareness. Further work is needed to organize more intensive workshops on specific issues related to communication skills.
PMCID: PMC3377044  PMID: 23012202
Communication Skills; Faculty Development; Health Professional Education
The increased prevalence of breast cancer in recent years characterized by young age and delayed presentation has alerted women to randomly seek medical advice randomly. Breast cancer awareness programs are scarce and when available function on a very limited scale. In an attempt to increase cancer awareness among women, school teachers were targeted as missionaries to the community. The purpose of this study was to assess the efficiency of the breast cancer awareness campaign mounted by the author.
Material and Methods:
This survey was undertaken in 2005 with school teachers in Al Khobar district, Eastern Province of Saudi Arabia as the target. A breast cancer campaign was designed with lectures and workshops and delivered to school teachers in seven separate sessions. Each session was attended by 100-150 female teachers selected by their administration. Pre and post workshop questionnaires were distributed to assess knowledge of cancer symptoms, risk factors, attitudes towards breast self-examination (BSE), mammography, and common misconceptions.
The majority demonstrated minimal basic background knowledge on breast cancer, methods of conducting BSE or the need for mammography. The pre workshop questionnaires showed that 5% agreed and performed BSE, 14% thought that mammography may be needed, while 81% did not think any of these modalities were necessary. Post workshop questionnaire demonstrated positive results, 45% agreed to perform BSE, 45% agreed to the need of mammographic screening while 10% still did not see the necessity of these procedures and refused the knowledge or the search for asymptomatic lesions.
In order to succeed, breast cancer programs should be structured and implemented on a wide scale preferably tailored to fit individual communities. School teachers as educators help to convey the message to a large sector of the population by enhancing the knowledge of the younger generation on the necessity and the importance of early detection of cancer.
PMCID: PMC3410058  PMID: 23012130
Breast cancer; awareness
Despite the dearth of allied health professionals in the Kingdom of Saudi Arabia (KSA), the demand for them has increased. Like any other geographic location, KSA, has its own pattern of diseases. Therefore, the curriculum of the health professionals should be appropriately designed to meet the health needs of hospitals and clinics.
To demonstrate that changes in the curriculum of Allied (Applied) Health Sciences in KSA are necessary, and how these changes should be implemented. This paper also recommends that these changes must: (1) be based on the current needs of the community, (2) satisfy the health requirements of the Saudi community as well as the realities of its health practices. The Allied Health Colleges must: (1) undertake a long-term review of the curriculum, (2) ensure that the curriculum reform is continuous, (3) target faculty development, (4) target student evaluation.
PMCID: PMC3430186  PMID: 23008673
Allied (Applied) Health; Format of teaching; Continuous evaluation
Hospitals are important sites for the generation of hazardous waste. Each hospital has its own profile for the generation and transportion of waste according to its location. It is extremely important to manage hospital generated waste properly in order to avoid health and environmental risks.
This article reports the plan designed and used by the hospital waste management committee in King Fahad Hospital of the University , Alhkobar, Saudi Arabia, for the safe management of hospital generated waste starting from the collection areas to the final disposal procedure. The plan was in four stages: background information, identification of problems, intervention and monitoring. The possible solutions for problems encountered are suggested.
This plan which was efficient and cost effective can be used in other medical establishments.
PMCID: PMC3430187  PMID: 23008674
Hospital waste; healthcare waste; medical waste; hospital management; environmental services
Searching for references is part of everyday life in medicine. Since the arrival of the Internet, it has provided great promise for clinicians because of its ready provision of access to large amounts of knowledge and information. But because of the overload of information, searching for particular information has now become a tedious time-consuming and frustrating task. This article describes effective ways, tips, tools, detailed search techniques and strategies for searching for medical information. It also lists some useful resource and database sites that can help in the search for accurate information.
PMCID: PMC3430177  PMID: 23008664
Internet Search; search tools; World Wide Web
To verify whether the first national campaign for poliomyelitis vaccination achieved its objectives.
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 8-10 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 non-Saudi 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.
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.
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.
PMCID: PMC3437165  PMID: 23008559
Poliomyelitis; Vaccination; Saudi Arabia

Results 1-12 (12)