The quality of life (QOL) has emerged as an important parameter for evaluating the quality of health-care for patients with renal failure. The literature suggests that many factors impact QOL. The QOL of dialysis patients in the United Arab Emirates (UAE) has not been studied before. This research examined the QOL of patients in the UAE on dialysis using two QOL tools.
Materials and Methods:
A descriptive comparative survey design was used to study 161 dialysis patients. The participants completed the 36-Item Short Form Health Survey (SF-36) and the QOL index dialysis version tool. Comparative analyses of the results for both tools were done using descriptive statistics. Multiple linear regression analysis determines the effect of the variables on the QOL scores.
The questionnaires return rate was 93%. The overall QOL for dialysis patients was rated low when self-assessed using the SF-36 (58.9) compared to QOL index (77.2). The multiple regression analysis revealed that having a chronic illness had the strongest impact on the total scores of both tools. The comparison between the statistically significant variables for both samples revealed contradictory results from the two tools used. This meant that the two tools measured QOL differently.
The two QOL tools scores impacted very differently on most socio-demographic variables on the two samples. More studies are required to explore the concept of QOL in the Arab dialysis population.
Dialysis; Islamic religion; quality of life; United Arab Emirates
Discharging patients against medical advice is a problem of every age-group. However, because of their physiological vulnerability, the risk for the neonatal population is greater when discharged against medical advice (DAMA). This article is a study of the prevalence of the problem, the possible causes and/or risk factors.
Materials and Methods:
A retrospective review of 10 years of medical records of neonates discharged against medical advice from a Neonatal Intensive Care Unit (NICU) at a university hospital.
The overall prevalence of DAMA was 1.6%. Most of the 51 infants who were taken out of hospital against medical advice (AMA) were term (72.5%) with a mean gestational age of 37.78 ± 2.5 weeks, of normal birth weight, with a mean of 2736 ± 661 g, Saudis (96%), those delivered vaginally (69%), and those that were provisionally diagnosed with transient tachypnea of newborn (TTN) and/or query sepsis (49%). There was no difference between males and females (M/F = 1.2). There was an association between DAMA and the timing of DAMA (27.5% of DAMA at weekends and 67% of DAMA from May to October).
DAMA of neonates is particularly critical. The causes and risk factors are many and difficult to predict. In addition to several other factors, its prevalence is influenced negatively by some socio-cultural beliefs.
Discharge against medical advice; neonatal; neonatal intensive care unit
Students who perceived their learning environment positively are more likely to develop effective learning strategies, and adopt a deep learning approach. Currently, there is no validated instrument for measuring the educational environment of educational programs on respiratory care (RC). The aim of this study was to develop an instrument to measure students’ perception of the RC educational environment.
Materials and Methods:
Based on the literature review and an assessment of content validity by multiple focus groups of RC educationalists, potential items of the instrument relevant to RC educational environment construct were generated by the research group. The initial 71 item questionnaire was then field-tested on all students from the 3 RC programs in Saudi Arabia and was subjected to multi-trait scaling analysis. Cronbach's alpha was used to assess internal consistency reliabilities.
Two hundred and twelve students (100%) completed the survey. The initial instrument of 71 items was reduced to 65 across 5 scales. Convergent and discriminant validity assessment demonstrated that the majority of items correlated more highly with their intended scale than a competing one. Cronbach's alpha exceeded the standard criterion of >0.70 in all scales except one. There was no floor or ceiling effect for scale or overall score.
This instrument is the first assessment tool developed to measure the RC educational environment. There was evidence of its good feasibility, validity, and reliability. This first validation of the instrument supports its use by RC students to evaluate educational environment.
Educational environment; instrument; perception; respiratory care; Saudi Arabia
“Off-service” clinical rotations are part of the necessary requirements for many residency training programs. Because these rotations are off-service, little attention is given to their structure and quality of training. This often leads to suboptimal educational experience for the residents on these rotations.
The aim of this study was to assess medical residents’ perceptions, opinions, and levels of satisfaction with their “off-service” rotations at a major residency training site in Saudi Arabia. It was also to evaluate the reliability and validity of a questionnaire used for quality assurance in these rotations. Improved reliability and validity of this questionnaire may help to improve the educational experience of residents in their “off-service” rotations.
Materials and Methods:
A close-ended questionnaire was developed, Pilot tested and distributed to 110 off-service residents in training programs of different specializations at King Fahad Naitonal Guard Hospital and King Abdulziz Medical City, Riyadh, Saudi Arabia, between September 2011 and December 2011.
A total of 80 out of 110 residents completed and returned the questionnaire. Only 33% of these residents had a clear set of goals and educational learning objectives before the beginning of their off-service rotations to direct their training. Surgical specializations had low satisfaction mean scores of 57.2 (11.9) compared to emergency medicine, which had 70.7 (16.2), P value (0.03). The reliability of the questionnaire was Cronbach's alpha 0.57. The factor analysis yielded a 4-factor solution (educational environment, educational balance, educational goals and objectives, and learning ability); thus, accounting for 51% variance in the data.
Our data suggest that there were significant weaknesses in the curriculum for off-service clinical rotations in KAMC and that residents were not completely satisfied with their training.
Knowledge attitudes and perception; needs assessment; off-service rotations; residents; validity of questionnaire
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.
Betel quid; gutkha; oral cancer; oral lesions; pre-cancer; tobacco
Mycetoma is an uncommon chronic granulomatous infective disease of the skin, dermis and subcutaneous tissues predominantly seen in tropical countries. A patient presented to our hospital with the swelling of the left foot with a healed sinus and a painful nodule. He gave a history of sinuses in the left foot from which there was discharge of yellow granules. Culture of the ultrasound guided fine needle aspiration cytology of the nodule revealed growths of Nocardia species. The patient was treated with a multi-drug therapy along with debridement of the painful nodule. He experienced symptomatic relief and a regression of the swelling within the three months of follow-up so far. Due to the relatively slow progression of the disease, patients are diagnosed at a late stage. Hence, emphasis should be placed on health education and the importance of wearing footwear.
Actinomycetoma; grains; Madura foot
Diabetes mellitus (DM) requires continuous medical care, patients’ self-management, education, and adherence to prescribed medication to reduce the risk of long-term complications. The aim of this study was to assess the benefits of an education program on diabetes, patient self-management, adherence to medication, anxiety, depression and glycemic control in type 2 diabetics in Saudi Arabia.
Materials and Methods:
This was a prospective study, conducted among 104 diabetic patients at a major tertiary hospital in Riyadh, Saudi Arabia, between May 2011 and October 2012. Education materials given to diabetic patients included pamphlets/handouts written in Arabic, the national language. Special videotapes about DM were made and distributed to all participants. In addition, specific educational programs through the diabetes educators and one-on-one counseling sessions with the doctor were also arranged. Patients were interviewed using a structured interview schedule both during the baseline, and after 6 months of the program. The interview schedule included, socio-demographics, clinical characteristics, diabetes self-management, adherence to medication, anxiety, and depression. Glycemic control was considered poor, if hemoglobin A1c (HbA1c) was ≥ 7%.
The mean age of the study population was 57.3 ± 14.4 years. Seventy one were males (68.3%) and 33 (31.7%) were females. After six months of the diabetes education program, there were significant improvements in patients’ dietary plan (P = 0.0001), physical exercise (P = 0.0001), self-monitoring of blood glucose (SMBG) (P = 0.0001), HbA1c (P = 0.04), adherence to medication (P = 0.007), and depression (P = 0.03).
Implementation of education programs on diabetes among type 2 diabetic patients is associated with better outcomes such as their dietary plan, physical exercise, SMBG, adherence to medication, HbA1c and depression.
Anxiety; depression; diabetes education; diabetes self-management; Saudi Arabia
There is little information on the association between watching Television (TV) and obesity in the Arabian Peninsula.
Aim of the Study:
The aim of this study was to explore the association between the watching of television and obesity in Saudi children of school-age.
Materials and Methods:
A case-controlled study was conducted with students between the ages of 9 and 14 years who attended the school health clinic in King Abdulaziz Housing for National Guard (Iskan), Riyadh, Saudi Arabia, during the study period (February to April 2012). During each clinic, children were selected by simple random sampling (five obese and five non-obese). For data collection, two trained physicians interviewed the participants using a 20-item Arabic questionnaire. Well-trained nurses collected the anthropometric measurements of weight and height.
The study included 397 students. Higher (body mass index) BMI was associated with a higher number of televisions at home (P < 0.001), watching TV for more than three hours per day at the weekend (P = 0.047), eating more than three snacks per day (P = 0.005), watching TV at night (P = 0.026), and siblings’ decisions on how much TV to watch (P = 0.025). The prevalence of childhood obesity was significantly lower among those whose mothers determined how much TV they could watch (P = 0.03). In logistic regression analysis, the increase in the child's age, the presence of more than one TV at home, having his or her own TV, and an increase in the number of hours of watching TV over the weekend were significantly associated with an increased risk of childhood obesity. Personal computers and the Internet were not significantly associated with an increased risk of childhood obesity.
The present investigation revealed that watching TV represents an important risk factor for obesity in children of school-age.
Obesity; Saudi Arabia; school-age children; television
Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children.
Materials and Methods:
A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards.
A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = −0.095, P = 0.037) was negatively associated with DBP.
BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.
Blood pressure; body mass index; cross-sectional survey; obesity; school children; waist circumference
Adverse events are frequent in clinical practice, but only a few studies in Saudi Arabia have addressed them. The current study was designed to review the lawsuits against healthcare professionals by analyzing records of the cases dealt with by the Medico-legal Committees (MLC) in various provinces in Saudi Arabia, in order to determine the pattern of medical errors and litigations in the country.
Materials and Methods:
A pre-designed data sheet was used to collect data from the records of the Medical Violation Committee (MVC) and the Medical Jurisprudence Committee (MJC). The data sheets consisted of information on details of the cases, details on where the error had occurred, and details of the errors.
The review of records revealed 642 cases, most of which were from hospitals run by the Ministry of Health (MOH). The operating room was where most of the errors (20.4%) had occurred, followed by the emergency room (18.1%). Surgery was at the top of the specialties (25.1%). Most of the deaths occurred in surgery and obstetrics (about 25% for each), followed by other medical specialties (17%). About half of the lawsuit cases studied (46.5%) involved patients belonging to a relatively young age group (20–50 years).
Most of the medical error litigations involved surgeons and obstetricians especially in MOH hospitals. The process of litigations and documentation need to be improved, and access to the records for research and education need to be made easier. In addition, there is a need for more prospective field studies.
Litigations; medical errors; patient safety; Saudi Arabia
Diabetes imposes a large economic burden on the individual, national healthcare systems, and countries.
To determine the economic impact of diabetes mellitus on Saudi healthcare system, both now and in the future.
Materials and Methods:
This research study uses a prevalence-based approach that combines the demographics of the population (classified by nationality, sex and age group) with and without diagnosed diabetes in 1992 and 2010. The economic impact of diabetes is estimated in this study, using secondary sources of information provided by Ministry of Health, Ministry of Finance and Central Department of Statistics and Information databases.
People diagnosed with diabetes, on average, have medical healthcare expenditures that are ten times higher ($3,686 vs. $380) than what expenditures would be in the absence of diabetes. Over 96% of all medical healthcare expenditures attributed to diabetes are incurred by persons of Saudi nationality, with the remaining 4% incurred by persons of non-Saudi nationality. The population age 45-60 incurs 45% of diabetes-attributed costs, with the remaining population under age 15 incurs 3.8%, age 15-44 incurs 27.5%, and age 60 and above incurs 23.8%.
The actual national healthcare burden because of diabetes is likely to exceed the $0.87 billion estimated in this study, because it omits the indirect costs associated with diabetes, such as absenteeism, lost productivity from disease-related absenteeism, unemployment from disease-related disability, lost productivity due to early mortality by disease. The social cost of intangibles such as pain and suffering and care provided by non-paid caregivers as well as healthcare system administrative costs, cost of medications, clinician training programs, and research and infrastructure development is also omitted from this research study. Further studies are needed to confirm the present findings and to improve our understanding of economic costs of diabetes and its related complications.
Diabetes mellitus; economic costs; healthcare system; Saudi Arabia
Effective reduction of malaria morbidity and mortality in Nigerian children under the age of five depends to a large extent on family biosocial factors. Although, the awareness of insecticide treated bed nets (ITNs) is reportedly high and increasing in Nigeria there remain large gaps between awareness, possession and use by families with children under the age of five in Nigeria.
To determine the family biosocial variables that influence the use of insecticide treated nets for children in Eastern Nigeria.
Materials and Methods:
A descriptive hospital-based study was carried out from June 2008-June 2011 on a cross-section of 415 mothers with children under the age of five, who were treated for confirmed malaria, and met the selection criteria were interviewed using a pretested, structured researcher-administered questionnaire. The questionnaire tool elicited information on family socio-demographic variables, inter-spousal discussion, communication, concurrence and participation in the use of insecticide treated bed nets; and reasons for non-utilization. The period of usage in the previous 6 months was assessed and graded using a scoring system of 0-4. Scores of 1-4 indicated usage while score of 0 meant non use.
The rate of ITNs use was 53.0%. The family variables that significantly influenced utilization were secondary education and above of parents (mother: P = 0.009; father: P = 0.001), monogamy (P value = 0.024), family size of 1-4 (P value = 0.016) and parents living together (P = 0.001); others included parents’ occupation (mother: P = 0.003; father: P = 0.04) and inter-spousal discussion (P value = 0.001), communication (P value = 0.001), concurrence (P = 0.000) and participation (P = 0.000). The commonest reason for non- use was inconvenience during sleep (P = 0.04).
This study shows that the rate of ITN use was marginally good. Specifically, this rate was significantly influenced by some family variables. The families of children under the age of five should, therefore, be the focus of intensive health promotion campaign to influence the use of ITNs to produce ITN family friendly communities.
Children; family biosocial variables; hospital; ITNs-use; malaria; Nigeria
Antimicrobial resistance of urinary tract pathogens has increased worldwide. Empiric treatment of community-acquired urinary tract infection (CA-UTI) is determined by antimicrobial resistance patterns of uropathogens in a population of specific geographical location.
This study was conducted to determine the prevalence of CA-UTI in rural Odisha, India, and the effect of gender and age on its prevalence as well as etiologic agents and the resistance profile of the bacterial isolates.
Materials and Methods:
Consecutive clean-catch mid-stream urine samples were collected from 1670 adult patients. The urine samples were processed and microbial isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed on all bacterial isolates by Kirby Bauer's disc diffusion method.
The prevalence of UTI was significantly higher in females compared with males (females 45.2%, males 18.4%, OR = 2.041, 95% CI = 1.64-2.52, P ≤ 0.0001). Young females within the age group of 18-37 years and elderly males (≥68 years) showed high prevalence of UTI. Escherichia coli (68.8%) was the most prevalent isolate followed by Enterococcus spp. (9.7%). Amikacin and nitrofurantoin were the most active antimicrobial agents which showed low resistance rate of 5.8% and 9.8%, respectively.
Our study revealed E. coli as the pre-dominant bacterial pathogen. Nitrofurantoin should be used as empirical therapy for uncomplicated CA-UTIs. In the Indian setting, routine urine cultures may be advisable, since treatment failure is likely to occur with commonly used antimicrobials. Therefore, development of regional surveillance programs is necessary for implementation of national CA-UTI guidelines.
Antimicrobial; community-acquired urinary tract infection; Escherichia coli; prevalence; resistance
The objective of the study was to examine maternal complications that occur during the third trimester and their neonatal outcome in Arab women residing in Qatar.
This is a prospective hospital-based study.
The survey was carried out in women's hospital.
Materials and Methods:
The study was based on the log book of the women's hospital, from which we recruited women in their third trimester of pregnancy between the first week of January 2010 and April 2011. Of the 1 824 Arab women who were approached to participate in the study, 1 432 (78.5%) consented. Face-to-face interviews were conducted with the pregnant women in the third trimester attending routine antenatal clinics at a women's hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Medical records of the patients were referred to collect the clinical variables.
Of the pregnant women studied, 39.8% were less than 30 years of age. The risk of maternal complications was higher in housewives (60.8%) and women with a low monthly household income (38.2%). Most of the pregnant women (77.6%) had antenatal care. Normal delivery (69.7%) was more common in expatriate Arab women, whereas caesarean was more prevalent in Qatari women (22.2%). Women aged 35 years or older had a significantly higher risk of maternal complications such as gestational diabetes (20.8% vs 13.4%; P < 0.01), gestational hypertension (21.6% vs 15.2%; P = 0.003), and ante-partum hemorrhage (17.9% vs 13.7%; P = 0.042) than younger women. Gestational diabetes increased the risk of caesarean delivery (25.1%) and macrosomia (42.3%). The frequency of caesarean delivery (22.1%) was higher in women with gestational hypertension. Neonatal complications such as Apgar score (<7) 1 minute (33.1% vs 21.2%; P < 0.001), 5 minutes (13.1% vs 8.2%; P = 0.005), and congenital anomalies (2.9% vs 0.9%; P = 0.007) were significantly higher in newborns of older women. Low birth weight (11.1%) and Apgar 1st minute < 7 rate (28.2%) were higher in newborns of mothers with ante-partum hemorrhage.
The study findings revealed that maternal complications such as gestational diabetes, gestational hypertension, ante-partum hemorrhage, and maternal anemia were significantly higher in older pregnant women. Similarly, neonatal complications were higher in the newborns of older women. Gestational hypertension was the leading maternal complication observed in Arab women.
Arabs; gestational; maternal complications; pregnant women; prevalence
Background and Aim:
Hepatitis C virus (HCV) infection is a major health problem worldwide. Genotype-4 is the most common genotype in Saudi Arabia. The response to treatment with pegylated interferon-α combined with ribavirin in chronic HCV infection varies. This study aimed at investigating the pre- and on-treatment predictors of sustained virologic response (SVR) in patients with chronic hepatitis C (CHC) infection.
Patients and Methods:
Clinical data of 48 patients with CHC treated with standard HCV antiviral combination therapy, between January 2005 and December 2010, at a Saudi University hospital, were retrospectively reviewed for age, sex, body mass index, liver enzymes, HCV-RNA viral load, liver biopsy, and response to treatment. The primary end point was SVR defined as undetectable HCV-RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Univariable logistic regression was used to explore the association between the different variables and SVR. These independent predictors of SVR were then analyzed with multivariable logistic regression analysis.
Of the 48 treated patients, 25 (52%) were females and 27 (56%) were Saudi. The mean age was 43 years (43 ± 10 years). Twenty-four (50%) had genotype-4, and 26 (54%) had liver biopsy. The overall SVR rate was 75% (36/48) and was 83.3% (20/24) among genotype-4 patients. Baseline factors associated with SVR identified by univariate logistic regression were genotype-4 and early viral response (EVR), defined as a drop of ≥2 log in serum HCV viral load after 12 weeks of initiation of combination therapy (P = 0.001). However, in stepwise regression analysis, the independent factor associated with the effect of antiviral therapy was genotype-4. When on-treatment variables were included, EVR (P = 0.003) and low baseline viral load (P = 0.048) were highly predictive of SVR.
Of our HCV-treated patients, 75% had SVR. HCV genotype-4, EVR, and low baseline viral load were predictive of SVR.
Chronic hepatitis C; Saudi; sustained virologic response; treatment response predictors
The aim of the study was to evaluate the prevalence of oral mucosal lesions (OML) in adult patients reporting to the dental outpatient department at the Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India. The purpose was to determine the priorities in oral health education, preventive measures, and identify the group in urgent need of treatment.
Materials and Methods:
The study was conducted over a period of 6 months in 2010, when 8866 subjects were offered structured interviews and standardized extraoral and intraoral examinations according to the World Health Organization (WHO) guidelines.
Overall prevalence of OML was 1736 (16.8%), the most prevalent being smoker's palate (10.44%) followed by leukoplakia (2.83%), oral submucous fibrosis (1.97%), oral candidiasis (1.61%), recurrent aphthous stomatitis (1.53%), oral lichen planus (0.8%) and others (0.78%). The highest prevalence of the tobacco habit in both forms was recorded in the group aged 40–44 yearsand those aged between 60 and 64 years who wore dentures. Lesions were most prevalent in those aged 40–44 years with a significant predominance of males at 3:1 (M = 12.6% and F = 4.3%). Patients who consumed tobacco in any form or wore dentures had a significantly higher prevalence of OML (P < 0.001). The highest number of lesions were on the palate (59.7%) followed by buccal mucosa (19.9%). Various normal mucosal variants were recorded. Fordyce's granules (0.13%), fissured tongue (3.3%), leukoedema (1.47%), and lingual varices (2.73%) were also recorded. The tongue showed the highest number of variants (64.4%). Patients were grouped according to the treatment needed under the WHO criteria. One hundred and ninety-seven patients were given oral hygiene instructions only, whereas 1422 patients were advised on change of habit and a follow-up and 674 patients needed definitive treatment.
This study thus highlights diagnostic criteria, multifactorial risk factors to make standard measurements of OML a basis for planning and evaluating oral health programs for data collection.
Epidemiology; mucosal variants; oral mucosal lesions; prevalence; treatment; World Health Organization
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.
Food; fortification; Saudi Arabia; United States; vitamin D
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.
Elderly population; morbidity; South of Saudi Arabia
To determine the prevalence, the nature, and the possible socio-demographic risk factors involved in the development of common transmissible skin disorders (TSD) among the studied population.
Materials and Methods:
A cross-sectional consecutive survey was carried out from November 15, 2008 to May 14, 2009 in Al-Ahsa governorate. This study included 1337 male primary school children. Data were collected using the following tools: Socio-demographics and hygienic habits according to pre-established forms and a thorough dermatological examination of all the included children.
The prevalence of TSD was 27.15% with a statistically significant difference according to rural/urban locations (33.74% vs. 22.27%). Fungal infections were the leading diseases (9.1%) followed by bacterial infections (8.9%), parasitic infestations (4.3%), and viral infections (4.1%). TSD were significantly more frequent in students whose fathers have a primary or preparatory educational status and in the students having the habit to play barefooted.
Our study found that TSD was relatively frequent among male primary school students in Al-Ahsa. Our study has several limitations. One major limitation is that female primary school students were excluded from the study. Despite this major limitation, we hope the findings may be useful in planning health care programs for Saudi children with the hope of reducing the prevalence of TSD in the future.
Childhood; skin infections; skin parasitic infestations
The Journal of Family and Community Medicine (JFCM) is the official peer reviewed scientific publication of the Saudi Society of Family and Community Medicine. Unlike many peer medical journals, the contents of JFCM, have never been analyzed. The objective of this study was to perform an analysis of the contents of the JFCM over a 16-year period to discern the study designs and statistical methods used with a view to improving future contents of the journal.
Materials and Methods:
All volumes of the JFCM, from 1 January 1994 to 31 December 2010 were hand searched for research articles. All papers identified as original articles were selected. For every article, the study designs and the statistical methods used were recorded. Articles were then classified according to their statistical methods and study designs. The frequency of study designs was calculated as a simple percentage of the total number of articles, while the frequency of statistical methods was calculated as a percentage of articles that used those statistical methods.
A total of 229 articles were analyzed. Of these, 66 (28.8%) either reported no statistics or reported simple summaries. The cross-sectional design was used in 175 (76.4%) of all analyzed articles. Statistical methods were used in 163 (71.2%) articles. Chi-squared test was used in 111 (68.1%) articles, and t-test used in 48 (29.4%) articles. Other common statistical tests were: Regression, which was used in 35 (21.5%) articles, ANOVA used in 23 (14.1%) articles, and odds ratio and relative risk tests which were used in 22 (13.5%) articles.
The JFCM has a wide range of study designs and statistical methods. However, no article on experimental studies has been published in the JFCM since its inception.
Community medicine; family medicine; research methodology; Saudi Arabia
Background and Aim:
The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus (DM) has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa (NS) seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients.
Patients and Method:
A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered orally in a dose of 1, 2, and 3 g/day for 12 weeks. All patients were subjected to measurement of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) before treatment and 4, 8, and 12 weeks thereafter.
Patients receiving 1 g/day NS seeds for 12 weeks (group 1) showed nonsignificant changes in all the parameters except for a significant increase in HDL-c after 4 weeks of treatment. However, patients ingested 2 g/day NS displayed a significant decline in TC, TG, and LDL-c, and a significant elevation in HDL-c/LDL-c, compared with their baseline data and to group 1 patients. Increasing NS dose to 3 g/day failed to show any increase in the hypolipdemic effect produced by the 2 g/day dose.
NS supplementation at a dose of 2 g/day for 12 weeks may improve the dyslipidemia associated with type 2 diabetic patients. Therefore, NS is a potential protective natural agent against atherosclerosis and cardiovascular complications in these patients.
Black seeds; diabetes mellitus type 2; dyslipidemia; HDL; LDL; Nigella sativa; total cholesterol; triglycerides
To formulate all intervention strategies for hypertension in the community, it is essential to quantify the magnitude of the disease and its risk factors. The patterns of physical activity have not been studied in terms of their being a risk factor or a predictor of hypertension in Saudi Arabia.
Materials and Methods:
This was a community-based cross-sectional study using the STEP-wise approach of adults and a multistage, stratified, cluster random sample. Data were collected using a questionnaire which included sociodemographics, blood pressure, patterns, levels and duration of physical activity.
Of a total of 4758, 1213 (25.5%) were hypertensives. Hypertension was significantly negatively associated with total levels and duration of physical activity in leisure, transport, and work. Significant predictors of hypertension included lower levels of work involving a moderate physical activity for 10 min, walking/cycling for 10 min continuously, and vigorous activity during leisure time.
Hypertension is prevalent among adults; physical inactivity is a significant risk factor and predictor. Targeting this modifiable risk factor can help in prevention, early diagnosis, and control.
Adults; hypertension; physical activity; Saudi Arabia
Maternal obesity is associated with menstrual disorders, infertility and sporadic miscarriages. Recurrent miscarriage (RM) affects at least 1% of couples trying to conceive. In over 50% of cases, the cause of the loss of pregnancy remains unexplained. The aim of this study was to determine the relationship between maternal Body Mass Index (BMI) and future outcomes of pregnancy in couples with “unexplained” RM.
Methods and Results:
All couples referred to the specialist recurrent miscarriage clinic at St. Mary's Hospital, London, were investigated for an underlying cause. Those with unexplained RM were eligible. Demographic and clinical data were retrieved from a computerised database and medical records. The World Health Organisation (WHO) classification of BMI was used. Univariate analysis demonstrated that BMI, maternal age, number of previous miscarriages and ethnicity were significantly associated with pregnancy outcome. Logistic regression demonstrated that maternal obesity (BMI ≥ 30 kg/m2) significantly increased the risk of miscarriage in couples with unexplained RM (OR 1.73; 95% CI 1.06 – 2.83). Asian women with a BMI similar to Caucasian women had a higher risk of a further miscarriage (OR 2.87, 95% CI, 1.52 – 5.39).
Maternal obesity is an independent factor associated with an increased risk of miscarriage in couples with RM. All women with RM should have their BMI recorded at their first clinic visit. The potential effect of weight loss on the outcome of subsequent pregnancies should be assessed in future studies. The increased risk of miscarriage in Asian women needs to be explored further.
BMI; miscarriage; obesity; recurrent miscarriage; weight loss
Background and Aim:
Health reforms that tend to increase the participation of clients in decision-making requires them to be health-literate; hence, the importance of health education. However, not much research has been done to investigate the differences in health education needs according to demographic characteristics of the clients. The aim of this study was to find out any possible gender differences there may be in health education needs and preferences.
Subjects and Methods:
This cross-sectional study was conducted at Riyadh Military Hospital, Saudi Arabia, on a convenience sample of adult Saudis attending its clinics. Data was collected from April 2009 to May 2010 using a self-administered questionnaire covering demographic data, history and needs of health education, methods, and preferred educator.
Of the 1300 forms distributed, 977 were returned completed (75.2% response). Most men (74.0%) and women (77.9%) had had health education, but more women reported that it had been helpful (P = 0.014). More men mentioned health education needs relating to primary prevention (P = 0.027), and unhealthy practices (P = 0.003), and considered the different language a barrier (P = 0.002) even after adjustment for age and education. The one-to-one method was the most preferred health education method for men (72.7%) and women (67.9%). More women preferred group health education (P = 0.02) after adjustment for age and education. Significantly more men preferred pharmacists and dietitians as health educators.
The results point to a few significant differences between men and women regarding their health education needs, barriers, and preferences. These must be taken into consideration when planning health education programs.
Gender; health education; needs; preferences