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issn:2229-340
1.  CURRENT SITUATION OF CONTINUING MEDICAL EDUCATION FOR PRIMARY HEALTH CARE PHYSICIANS IN AL-MADINAH AL-MUNAWARAH PROVINCE, SAUDI ARABIA 
Objective:
In the health care system, continuing medical education (CME) is concerned with the maintenance, improvement, and promotion of health care provided by physicians. The objectives of this study are: to assess the knowledge, attitude and practice of Primary Health Care (PHC) physicians of CME, and to analyze the utilization of Continuing Medical Education (CME) program.
Material and Methods:
This is a cross-sectional descriptive study with an analytic component. A two-stage stratified random sampling was done on 189 PHC physicians from 76 PHC centers in the Al Madina, Al Munawarah City. One Hundred Fifteen physicians actually took part in the study.
Results:
Only 3.5% of the physicians were Saudi, 2% had PHC postgraduate qualification in Primary Health Care and 75% had had basic training during their practice. The study showed that: (1) PHC physicians who worked in a group evaluated Medical Education Center (MEC) better than those who worked alone (p =0.0052). (2)Those who were aware of the presence of the MEC gave MEC contribution a better grade in evaluation than those who were not (p=0.0001). (3) PHC physicians who had more experience in medical practice evaluated CME achievement with a better grade than those who had less experience (p = 0.0173). (4) PHC physicians working in groups evaluated CME achievement with a better grade (p = 0.0330). (5) Those who were attached to the hospitals evaluated CME achievement with a better grade (p = 0.0392). (6) Those who attended activities outside PHC centers evaluated CME achievements better than those who did not (p = 0.0202).
Conclusion:
From the results it was concluded that: (1) There are many PHC physicians who were unaware of CME activities in their area of work and therefore tend to be unhappy with MEC contribution. (2) PHC physicians were not satisfied with MEC's contribution and with their CME's achievements. (3) PHC physicians felt the need for utilizable CME. (4) PHC physicians were not fully aware of the use of the internet, distance learning, and emails in CME.
PMCID: PMC3410068  PMID: 23012109
Continuing Medical Education (CME); Primary Health Care (PHC); Medical Education Center (MEC); World Health Organization (WHO)
2.  THE PROFILE OF LONG-TERM CARE PATIENTS IN AL-KHOBAR AND DAMMAM, SAUDI ARABIA 
Objectives.
To find out the profile of patients who stay more than 20 days in hospital in Al-Khobar and Al-Dammam.
Methods.
A cross sectional descriptive study was designed using a questionnaire completed by health care providers (physicians, nurses, physiotherapists, and social workers) of a random sample of 159 patients out of 318 patients identified as having stayed in the hospital for more than 20 days.
Results.
The mean length of stay of the patients were 358.6 ±776 days in government hospitals, and 1014.4 ±1018.3 days in private hospitals. Patients were seen as stable by their doctors, 66.7% in government hospitals and 93.9% in private hospitals (statistically significant different at p<0.001. Physicians agreed that about two thirds of the patients could have been managed at home. 57.2% of the patients had no active problems. Diseases of the nervous system and sense organs accounted for 67.9% of the diagnoses, followed by endocrine, nutritional, and metabolic diseases (37.1%), diseases of the circulatory system (32.7%), and neoplasms (1.9%). Diabetes mellitus was the commonest illness making up 53.2% and 57.1% of the long-term patients in private and government hospitals respectively. The active problems of 25% and 23.5% of the patients was tracheostomy care and ventilation respectively.
Conclusions.
Long-term patients tended to stay longer in private hospitals than in government hospitals, had diseases related to the nervous and endocrine systems and nutritional metabolism, were in stable condition with no active problems, and could thus, be managed at home.
PMCID: PMC3410074  PMID: 23012099
Long-Term Patients; Home Health Care
3.  AUDIT OF DIABETIC CARE IN A SAUDI PRIMARY CARE SETTING 
Objective:
To audit the care offered to diabetic patients attending the Family and Community Medicine Clinic (FAMCO), King Faisal University, Kingdom of Saudi Arabia (KSA).
Design:
A cross-sectional study of medical records of 45 diabetic patients who regularly visited the clinic during a one-year period from June 1997 to May 1998.
Subjects:
Patients who presented at the clinic because of non-insulin-dependent diabetes mellitus (type II).
Results and Conclusions:
The level of care for diabetic patients was relatively inappropriate, and some important parameters were under-recorded. Specific measures to improve and promote diabetic care in FAMCO clinics need to be undertaken. These include formulating and using protocols for diabetes management and better training of health-care providers.
PMCID: PMC3437105  PMID: 23008605
Saudi Arabia; medical audit; diabetes mellitus; primary care
4.  UTILIZATION OF LABORATORY INVESTIGATIONS IN PRIMARY HEALTH CARE CENTERS IN AL-KHOBAR, SAUDI ARABIA 
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, 37.8% 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.
PMCID: PMC3437132  PMID: 23008564
Laboratory utilization; sampling; primary health care; diagnosis
5.  UTILIZATION OF LABORATORY INVESTIGATIONS: STUDY OF KNOWLEDGE, ATTITUDE AND PRACTICE AMONG PRIMARY CARE PHYSICIANS 
Objectives:
The aim of the study was to assess the physicians’ knowledge, attitude and practice towards laboratory services in the primary health care (PHC) centers at Al-Khobar area.
Methodology:
Five primary health care centers were selected out of 9 (56%) from the Al-Khobar area. Twenty physicians (33%), in these primary health care centers were included. A questionnaire was given to all physicians to explore the knowledge, attitude and practice.
Results:
All physicians considered laboratory investigations an essential service that contributed to the management of their patients most of the time. Knowledge and practice of most (80% of them) regarding laboratory investigations was between fair to good but the attitude of 80% of them was poor since postgraduation experience was the only factor which influenced their practice.
Conclusions:
There has been an increase in number of Saudi physicians working in the Primary Health Care Centers. The quality of the current laboratory services was deficient according to 30% of physicians. They considered that investigations were essential for primary health care centers. And finally the utilization of laboratory tests in the Kingdom of Saudi Arabia was higher than many developing countries.
PMCID: PMC3437159  PMID: 23008553
Utilization; Knowledge; Attitude; Practice; Primary Health Care; Sampling
6.  Utilisation of Health Services by the Primary Health Care Centres-Registered Elderly People in Burraidah City, Saudi Arabia 
Objective:
To assess the pattern of and factors associated with geriatrics′ utilisation of health services.
Design:
A cross-sectional, study involving a random sample of 266 elderly subjects registered in the primary health care centres in Burraidah city, Saudi Arabia.
Setting:
The primary health care centres in Qassim Region, Saudi Arabia.
Methods:
Data was collected from PHC centres-registered elderly subjects at their homes. Information including utilisation of primary health centres, hospital admissions and duration of hospital stay were recorded.
Results:
The response rate was 96.7%. Twenty percent of the sample had not used any health services facility during the previous year. Two-thirds of subjects made visits to the primary health care centres, majority of them having made 6 visits or less. Significant factors positively associated with those visits were female, advancing age, and having a family. Three-quarters of the sample did not have hospital admissions. Significant factors positively associated with admissions were diabetes mellitus, hypertension, paralysis, advanced age, and living with a family.
Conclusions:
Geriatric health services utilisation by the study sample is affected by family ties and the high prevalence of chronic diseases. Subjects living alone or crippled by immobility may not be able to utilise available health services properly. Community based geriatrics services can help this vulnerable group.
PMCID: PMC3437139  PMID: 23008543
Geriatrics; Health services utilisation; Saudi Arabia
7.  Survival After Stroke in Saudis : A Hospital Based Study 
Background:
Prognosis of stroke has been studied in various population. Factors adversely affecting short term survival include impaired consciousness, leg weakness and increasing age.
Aim of the Study:
In this study, the prognostic effects of age, sex, hypertension, diabetes mellitus and presentation in coma on the survival pattern of stroke patients presenting to a referral hospital, are reviewed.
Methodology:
The medical records of all patients hospitalized with definite stroke at King Fahd Specialist Hospital, Buraidah, for the period between June 1986 and June 1991, were reviewed. The Cranial CT Scans were also reviewed.
Results:
One hundred and seventy four patients, 106 males and 68 females, with a mean age of 64 years who had definite stroke were studied to estimate overall survival and the various risk factors influencing it. The case records and cranial CT scans were reviewed.
Conclusion :
The factors adversely affecting survival in this study, were age above 60 (P<0.04), presentation in coma (P<0.003) and pre-existing heart disease (P<0.0009). There was no significant effect on survival due to sex, hypertension and/or diabetes mellitus.
PMCID: PMC3437144  PMID: 23008548
Stroke; Saudis; hospital

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