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1.  Pilgrims satisfaction with ambulatory health services in Makkah, 2008 
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.
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).
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.
PMCID: PMC3045102  PMID: 21359024
Ambulatory health services; Hajj pilgrims; Makkah
2.  A review of community-acquired methicillin-resistant Staphylococcus aureus for primary care physicians 
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.
PMCID: PMC3045103  PMID: 21359021
Clindamycin; methicillin; Saudi Arabia; Staphylococcus aureus
3.  E-learning in Saudi Arabia: ‘To E or not to E, that is the question’ 
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.’
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.
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.
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.
PMCID: PMC3045104  PMID: 21359026
Challenges and development of E-learning in Saudi Arabia; E-learning; vision and strategic planning of E-learning
4.  Physicians’ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria 
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.
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.
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.
PMCID: PMC3045105  PMID: 21359022
Compliance; diabetes; doctor-patient relationship; knowledge; skills
5.  Assessment of the effect of health education on mothers in Al Maki area, Gezira state, to improve homecare for children under five with diarrhea 
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.
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 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.
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.
PMCID: PMC3045106  PMID: 21359025
Diarrhea disease; home management and health education
6.  Quality of diabetes care at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, 2006 
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.
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%).
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.
PMCID: PMC3045107  PMID: 21359023
Armed forces hospital; care; diabetes; quality; southern region
7.  Anomalous origin of left coronary artery from pulmonary artery: A rare cause of myocardial infarction in children 
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.
PMCID: PMC3045108  PMID: 21359020
Anomalous left coronary artery arise from the pulmonary artery; anomalous origin of left coronary artery from pulmonary artery; Bland-White-Garland syndrome
8.  Influence of age, gender, and prodromal symptoms on sudden death in a tertiary care hospital, eastern Saudi Arabia 
Sudden death (SD) remains an important worldwide public health problem. The incidence of SD and causes vary in different societies, and these differences are influenced also by demographic and clinical factors such as age, gender and prodromal symptoms and signs. This six-year study describes the influence of these factors on SD.
Materials and Methods:
This is a retrospective study of SD in all age groups undertaken in King Fahd Hospital of the University (KFHU), Eastern Saudi Arabia. All cases of death (1273 total, 1050 expected death and 223 cases of sudden unexpected death) that occurred between January 1, 2000 and December 31, 2005 were investigated and subsequently analyzed on demographic and clinical parameters of the deceased patients. The statistical analysis was performed as appropriate to illustrate any possible association between different demographic variables and SD.
There were 223 cases of SD (17.5%) out of 1273 total deaths in KFHU in the 6-year study period. There was a definite influence of age on the incidence of sudden death (SD) as it increased clearly at the two ends of the age spectrum, 32.2% of the cases were infants (from birth to 12 months), and 31.4% were elderly (> 60 year-old). However, among infantile age group, the highest frequency of SD (22.2% of the cases) was among the neonates. There was also a significant trend of gender influence on the incidence of SD which was higher in men than women (56% vs. 42%). The influence of prodromal symptoms and signs on SD was variable. Dyspnea and cough as major symptoms of cardiovascular and respiratory disease were the most frequent presenting symptoms in 32.3% of the cases, followed by fever as a sign of infections in 11.7%, premature infants in 10.8%, circulatory collapse in 9.4%, and angina in 7.6% of the cases.
The current study indicated a definite influence of age, gender and prodromal symptoms on the incidence of SD. The highest incidence occurred in the two extremes of age scale as compared to other age groups. Incidence was also higher in men than women. Meanwhile, the major prodromal symptoms and signs were dyspnea and cough, fever, premature birth, circulatory collapse, and angina pectoris..
PMCID: PMC3045092  PMID: 21359030
Sudden death; sudden cardiac death; unexpected sudden death; expected death; coronary artery disease; atherosclerotic coronary heart disease; acute myocardial infarction; sudden infant death syndrome
9.  Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea 
Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS) mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.
PMCID: PMC3045093  PMID: 21359029
Diarrhea; childhood; oral rehydration salts; zinc; rota vaccine
10.  A forgotten complication of diaper dermatitis: Granuloma gluteale infantum 
Granuloma Gluteale Infantum (GGI) is a rare condition of unclear etiology,[1] presenting as asymptomatic cherry red nodules in the diaper area appearing in the setting of primary irritant contact dermatitis.[2] A 50 day old infant with GGI is presented to emphasize that the condition may be easily missed, and that it may result from the misuse of fluorinated topical steroids used to treat a rash in the diaper area. This is the first case reported from Saudi Arabia.
PMCID: PMC3045094  PMID: 21359035
Granuloma gluteale infantum; fluorinated steroids; diaper dermatitis
11.  Psuedomyxoma peritonei secondary to adenocarcinoma of the cecum 
Pseudomyxoma peritonei is a rare progressive disease. Patients commonly present with a picture of acute appendicitis or with increasing abdominal girth. We present a case of a 71 year old man who presented with right iliac fossa pain, fever and vomiting. His abdominal examination revealed right iliac fossa mass which was confirmed radiologically. Diagnostic laparoscopy showed jelly like material along with a right iliac fossa mass. The aspirate was negative for malignancy initially. Due to persistance and progression of his disease he underwent right hemicolectomy. Histopathological diagnosis showed moderately differentiated adenocarcinoma of the cecum Duke’s C2.
PMCID: PMC3045095  PMID: 21359034
Pseuomyxoma peritonei; mucinous adenocarcinoma
12.  A practical discussion to avoid common pitfalls when constructing multiple choice questions items 
This paper is an attempt to produce a guide for improving the quality of Multiple Choice Questions (MCQs) used in undergraduate and postgraduate assessment. Multiple Choice Questions type is the most frequently used type of assessment worldwide. Well constructed, context rich MCQs have a high reliability per hour of testing. Avoidance of technical items flaws is essential to improve the validity evidence of MCQs. Technical item flaws are essentially of two types (i) related to testwiseness, (ii) related to irrelevant difficulty. A list of such flaws is presented together with discussion of each flaw and examples to facilitate learning of this paper and to make it learner friendly. This paper was designed to be interactive with self-assessment exercises followed by the key answer with explanations.
PMCID: PMC3045096  PMID: 21359033
Pitfalls; assessment; student
13.  Developing questionnaires for students’ evaluation of individual faculty’s teaching skills: A Saudi Arabian pilot study 
The National Commission for Academic Accreditation and Assessment is responsible for the academic accreditation of universities in the Kingdom of Saudi Arabia (KSA). Requirements for this include evaluation of teaching effectiveness, evidence-based conclusions, and external benchmarks.
To develop a questionnaire for students’ evaluation of the teaching skills of individual instructors and provide a tool for benchmarking.
College of Nursing, University of Dammam [UoD], May-June 2009.
Materials and Methods:
The original questionnaire was “Monash Questionnaire Series on Teaching (MonQueST) - Clinical Nursing. The UoD modification retained four areas and seven responses, but reduced items from 26 to 20. Outcome measures were factor analysis and Cronbach’s alpha coefficient.
Seven Nursing courses were studied, viz.: Fundamentals, Medical, Surgical, Psychiatric and Mental Health, Obstetrics and Gynecology, Pediatrics, and Family and Community Health. Total number of students was 74; missing data ranged from 5 to 27%. The explained variance ranged from 66.9% to 78.7%. The observed Cornbach’s α coefficients ranged from 0.78 to 0.93, indicating an exceptionally high reliability. The students in the study were found to be fair and frank in their evaluation.
PMCID: PMC3045097  PMID: 21359032
Student evaluation of teaching effectiveness; student evulation of faculty teaching skills; academic accreditation; faculy personal portofolio; Saudi Arabia
14.  Metabolic syndrome and cardiovascular risk 
The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol), elevated blood pressure, impaired glucose tolerance, and central obesity is now classified as metabolic syndrome, also called syndrome X. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria for use in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general, they include a combination of multiple and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics, commonly manifest a prothrombotic state as well as and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB), increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C). The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of atherosclerotic cardiovascular disease (ASCVD) risk factors, that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to the components of the syndrome present as well as the other, non–metabolic syndrome risk factors in a particular person.
PMCID: PMC3045098  PMID: 21359028
Metabolic syndrome; risk; cardiovascular
15.  The relation of age to the severity of Type I diabetes in children 
To study the relationship between the age and severity of Type 1 diabetes in children 0 - 5 years and more than 5 years of age admitted to Aseer Central Hospital, Southwestern Saudi Arabia over a 7-year period.
Materials and Methods:
A retrospective review of children less than 13 years of age with Type 1 diabetes admitted to the Pediatric Department, between 1st January 2000 to 31st December 2006.
A total of 181 children with Type1 diabetes were admitted to the hospital during this period. Of these, 27.6% were children 5 years or less, while 72.4% were more than 5 years of age. The duration of symptoms was longer in younger children compared to older patients. Diabetic ketoacidosis was present in 31.4% of the younger children, and in 15.3% of the children more than 5 years old. Hospital stay was also longer in children less than 5 years of age. Most significant differences were in the younger children’s group and affected the biochemical test results.
The present study showed that more younger children present to the hospital late, and in a state of diabetic ketoacidosis compared to older patients. Efforts should be directed at improving the knowledge and skills of the primary health care personnel to be able to diagnose and refer these cases earlier.
PMCID: PMC3045099  PMID: 21359031
Type 1 diabetes; children; severity; biochemical; laboratory
16.  Mobile eye services: Literature review with special reference to the experience of Al-Basar International Foundation 
To evaluate the concept of quality assured mobile eye services (MES) in implementing the vision 2020 initiative.
Materials and Methods:
Literature review as well as the medical records of Al-Basar International Foundation (BIF) on MES. Emphasis was focused on the causes of blindness, objectives, operation, management and the benefits of MES, a critical appraisal of MES, training for MES and the relationship with other organizations and concerned government agencies.
More than 38 countries have been included in this exercise during which more than 620 eye camps have been conducted. More than two million people have benefited from the services provided including medicines and glasses in these eye camps and about 180,000 sight restoring surgeries performed for cataract, glaucoma etc.
Quality assured MES are a very important means of tackling the problems of blindness and implementing the vision 2020 initiative. The adoption of this concept by major stake-holders in the prevention of blindness (e.g. WHO, IAPB) will bring an additional momentum to the achievement of this noble goal.
PMCID: PMC3195066  PMID: 22022671
Al-Basar International Foundation; eye camps; mobile eye services
17.  Simulation-based medical teaching and learning 
One of the most important steps in curriculum development is the introduction of simulation- based medical teaching and learning. Simulation is a generic term that refers to an artificial representation of a real world process to achieve educational goals through experiential learning. Simulation based medical education is defined as any educational activity that utilizes simulation aides to replicate clinical scenarios. Although medical simulation is relatively new, simulation has been used for a long time in other high risk professions such as aviation. Medical simulation allows the acquisition of clinical skills through deliberate practice rather than an apprentice style of learning. Simulation tools serve as an alternative to real patients. A trainee can make mistakes and learn from them without the fear of harming the patient. There are different types and classification of simulators and their cost vary according to the degree of their resemblance to the reality, or ‘fidelity’. Simulation- based learning is expensive. However, it is cost-effective if utilized properly. Medical simulation has been found to enhance clinical competence at the undergraduate and postgraduate levels. It has also been found to have many advantages that can improve patient safety and reduce health care costs through the improvement of the medical provider's competencies. The objective of this narrative review article is to highlight the importance of simulation as a new teaching method in undergraduate and postgraduate education.
PMCID: PMC3195067  PMID: 22022669
Clinical skills; medical education; medical simulation; simulators
18.  Isolation and identification of microbes associated with mobile phones in Dammam in eastern Saudi Arabia 
This study was conducted to determine microbial contamination of mobile phones in the city of Dammam, in the eastern region of Saudi Arabia, and identify the most important microbial species associated with these phones in order to take the necessary remedial measures.
Materials and Methods:
The analysis of a total of 202 samples was done to identify fungal and pathogenic bacteria isolates. Sterile swabs were firmly passed on the handset, the buttons and the screens of mobile phones, then inoculated into media of bacteria and fungi. Frequency distribution of isolates were calculated.
There were 737 isolated of the following bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Neisseria sicca, Micrococcus luteus, Proteus mirabilis, Bacillus subtilis, and Enterobacter aerogenes at the rate of 56.58, 13.57, 8.01, 7.73, 6.51, 3.66, 2.85 and 1.09% respectively. There were fungal isolates as follows: Alternaria alternata, Aspergillus niger, Cladosporium sp., Penicillium spp., Aspergillus flavus, Aspergillus fumigatus, Rhizopus stolonifer, Aspergillus ochraceus at the rate of 29.07, 26.74, 20.93, 10.47, 6.98, 2.33, 2.33, 1.16%, respectively.
The study showed that all mobile phones under consideration were infected by several microbes, most of which belonged to the natural flora of the human body as well as airborne fungi and soil. This means that it is necessary to sterilize hands after contact with a phone since it is a source of disease transmission.
PMCID: PMC3195068  PMID: 22022665
Microbial of mobile phones; pathogenic bacteria; Pseudomonas; Staphylococcus
19.  Perceptions of secondary technical schools students in Assiut, upper Egypt, about AIDS: Effect of an educational intervention 
Background and Purpose:
Acquired Immunodeficiency Syndrome (AIDS) is a great threat to the youth. The aim is to assess the knowledge of secondary technical schools students on AIDS, identify related misconceptions, and measure the effect of a short health education program on their level of knowledge.
Materials and Methods:
This quasi-experimental study was done on 575 secondary technical schools students in Assiut City, recruited through a two-stage stratified cluster sampling. A self-administered anonymous questionnaire was used to collect data. A health education program was implemented, and its effect assessed through pre-post testing.
The age range of the students was 16 to 20 years, with more girls (57.0%). Only 30.8% had satisfactory knowledge about AIDS in the pretest. Statistically significant improvements in knowledge were revealed after program implementation (P<0.001). Students who were Muslim, of urban residence, and had mobile phones had significantly higher scores (P=0.037, 0.004, 0.038 respectively). The most common misconceptions were the definition of AIDS according to transmission, and phobias related to transmission, which decreased after the intervention. Multivariate analysis showed that the statistically significant independent predictors of the change in knowledge score after the intervention were age, religion and the health education program.
Secondary technical schools students in Assiut city have a major deficiency in knowledge and many misconceptions regarding AIDS. The educational intervention had a positive impact on their knowledge, but a less marked effect on misconceptions. Knowledge was affected by age and religious belief. It is recommended that more health educational efforts tailored to needs and with approaches suitable to community cultures and values be introduced.
PMCID: PMC3195069  PMID: 22022664
AIDS; health education; technical secondary school students; upper Egypt
20.  Awareness of cardiovascular disease in eastern Saudi Arabia 
To estimate the awareness of cardiovascular disease (CVD) and their determinants in a screening campaign in the eastern province of Saudi Arabia.
Materials and Methods:
All national residents in the eastern province of Saudi Arabia aged 30 years and above, were invited to participate in a screening campaign for the early detection of diabetes and hypertension at more than 300 examination posts throughout the eastern province. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart attack, angina, arterial disease, stroke, and transient ischemic attack. Weight, height, blood pressure, and glucose concentration were measured.
Out of 197,681 participants, 5372 (2.7%) were aware of a history of a CVD. The prevalence correlated well with age. It was higher in women, widows, and subjects with lower level of education. More than 75% of affected subjects had two or more risk factors.
A substantial proportion of those with a history of CVD had multiple risk factors, necessitating an effective, focused policy for the prevention and treatment. Increased effort is required to promote an awareness of cardiac disease and also probably target primary care providers involved in the screening process.
PMCID: PMC3195070  PMID: 22022666
Awareness; campaign; cardiovascular disease; Saudi Arabia; screening
21.  Professionalism today 
PMCID: PMC3195071  PMID: 22022663
23.  Medical students’ evaluation of their exposure to the teaching of ethics 
The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students.
(1) To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). (2) To explore the perception of medical students on the different components of the course.
Materials and Methods:
The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course.
Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics.
The students provided valuable comments that were supported by the literature reviews. Medical Students’ views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum.
PMCID: PMC3195073  PMID: 22022670
Bioethics; bioethics curriculum; bioethics learning; bioethics teaching; professional development
24.  Outbreak of food borne Salmonella among guests of a wedding ceremony: The role of cultural factors 
In response to a large number of cases of gastroenteritis reporting to Sulyyel hospital, an outbreak investigation was conducted to identify its source, to assess its extent and to make recommendations on the prevention of such outbreaks in the future.
Material and Methods:
A case was defined as any individual who developed diarrhea with any of the following symptoms: Abdominal pain, fever or vomiting within three days of eating at the wedding ceremony. A retrospective cohort study was conducted to identify food items and circumstances responsible for this outbreak.
A total of 283 individuals were interviewed, 88 of whom developed gastroenteritis, most commonly manifested by diarrhea (100%), abdominal pain (94.3%) and fever (86.4%). The majority of persons interviewed were Saudis (89.1%) and 21.6% were males. The median incubation period was 20.6 ± 2.77 hours and the epidemic curve suggested a common point source outbreak. Out of 9 food items and drinks served at the wedding ceremony, 3 food items were significantly associated with illness: meat ranked first (RR=16.7, 95% CI=2.37-115.8), followed by rice (RR=13.6 95% CI=1.95-93.61), and restaurant made sweets (RR=1.9, 95% CI=1.35-2.58). Out of 62 stool samples collected from cases, 40 (64.5 %) grew Salmonella group C non-typhoid.
Salmonella was considered the causative agent of this food-borne outbreak. Meat and rice served at the wedding party were the food items incriminated. Time, temperature misuse, inadequate heat treatment, and unhygienic handling were the most important factors causing this outbreak.
PMCID: PMC3195074  PMID: 22022668
Food borne; outbreak; Salmonella; Saudi Arabia; wedding
25.  Mothers’ knowledge of child health matters: Are we doing enough? 
Child care is mostly the responsibility of mothers. Several studies have revealed that the mothers’ education has a positive impact on their knowledge and practice in child health matters.
The study was undertaken to assess the level of mothers’ knowledge on certain aspects of child health care and whether there is any correlation between their level of knowledge and the number of years of formal education they have had.
Materials and Methods:
A two-part questionnaire was distributed. The first part comprised information about mother's nationality, age, work, level of education and number of children, in addition to sources of health information and the role of school education in child health matters. The second part contained 40 statements about different aspects of child health matters. A structured interview with the mothers who attended with their children at the pediatric outpatient clinic of King Khalid University Hospital in Riyadh during July and August 2007, was conducted by a trained non-medical research assistant using the items and statements of the questionnaire as a base. A knowledge score was calculated from the number of correct answers. The maximum score was 40. An arbitrary cut-off score of 25 was considered satisfactory.
Three-hundred-seventy-three questionnaires were completed. The mean score of the total sample was 25 (out of 40) and the minimum score obtained was 14, and the maximum 36. Fifty-eight percent scored 25 or more. Scrutiny of individual items on the questionnaire revealed significant and serious gaps in mother's knowledge. No statistically significant correlation was evident between mothers’ knowledge of child health related matters and level of education, age, or number of children.
Mothers’ knowledge of child health related matters is deficient. At present, knowledge on child health matters taught in schools in the Kingdom is inadequate. Health care institutions play a limited role in health education. There should be proper effective practical means of disseminating information on child health matters among mothers in our community.
PMCID: PMC3195075  PMID: 22022667
Child health matters; health care professionals; mothers’ knowledge; school education

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