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issn:2229-340
1.  DETERMINANTS OF BIRTH SPACING AMONG SAUDI WOMEN 
Background:
High fertility levels are of major concern to planners and policy makers in most countries in the developing world. In Saudi Arabia, the rate of population growth is the third highest of the countries of the Eastern Mediterranean Region.
Objectives:
This study aimed at identifying determinants of birth spacing and attitudes toward family planning among Saudi women.
Methods:
A cross sectional survey of all women who have been married before, aged 15-49 years attending Al Hada armed forces hospital (primary health care and antenatal care clinics), was conducted between 1st February 2005 and 31st January 2006. Data was collected on socio-demographic, biological characteristics, beliefs, attitudes, and utilization of family planning services, pregnancy intervals and medical history
Results:
For the 786 women included in the study, the mean duration of interbirth interval was 2.38±1.24 years. The multivariate Cox regression revealed that a woman's education, work status, husband's work status, a woman's history of chronic diseases, and husband's encouragement of interbirth spacing were the only significant predictors of longer interbirth intervals. Shorter interbirth intervals were independently predicted by lower family income, and presence of female offspring only or equal number of male and female offspring as opposed to presence of more males. The great majority of participating women (98%) had a positive opinion of the effect of birth spacing on the family.
Conclusion:
This study showed that certain factors were significant predictors of interbirth spacing for the Saudi women. This should lead to the encouragement of longer intervals between births. However, further studies are needed to ascertain a cause-effect association.
PMCID: PMC3410152  PMID: 23012155
Saudi; Women; Birth spacing
2.  QUALITY OF PRIMARY CARE REFERRAL LETTERS AND FEEDBACK REPORTS IN BURAIDAH, QASSIM REGION, SAUDI ARABIA 
Objective:
To evaluate the quality of referral letters and feedback reports written according to the standards of Quality Assurance Manual of Ministry of Health from primary health care centers (PHCC's) in Buraidah.
Methodology:
This study was conducted during October and November 2004. A total of 330 referral letters and feedback reports were randomly selected from six PHCCs (20% from PHCCs in Buraidah City). About 55 referral and feedback letters were selected from each PHCC by systematic sampling method. The referral letters and feedback reports were reviewed thoroughly for the main items required in ideal referral letters and feedback reports according to the standard of Quality Assurance Manual of Ministry of Health, and a scoring system was used
Result:
Many of the referral letters lacked such important information as the history in 36%, vital signs in 30%, results of clinical examination in 45%, results of basic investigations in 52%, provisional diagnosis in 50%, and treatment given in PHCCs in 47%. The legibility of referral letters and feedback reports was good in 75%, and 63% respectively, and the quality of referral letters and feedback reports was good in 63% and 39% respectively. The rate of feedback reports received by PHCCs was 30% of total number of referrals to the hospitals. The referral rate was (4%) from total number of patients seen in PHCCs. The most frequent reasons for referrals were for general treatment 36.7%, for general diagnostic evaluation 28%, and for laboratory investigation 18.8%.
Conclusion:
The referral rate from PHCCs in Buraidah fell within the standard set in Quality Assurance Manual. However, the quality of referral letters and feedback reports was poor in 17.6% and 29.7% respectively. The quality of both referral letters and feedback reports should improve to guarantee the quality of patient care..
PMCID: PMC3410153  PMID: 23012156
Referral letters; Feedback reports; Quality; Buraidah; Qassim Region
3.  EFFECTS OF DIETARY FLAVONOIDS INTAKE IN SAUDI PATIENTS WITH CORONARY HEART DISEASE 
Objectives:
The aim of the study was to assess the dietary intake of flavonoids and their effect on serum lipid levels in Saudi patients with coronary heart disease (CHD).
Methodology:
A cross-sectional study with a sample of 50 CHD patients and 50 controls. A 24-hour recall method was used to collect data on the dietary intake of macronutrients, flavonoids, and antioxidant vitamins. A food frequency questionnaire (FFQ) was used to collect data on habitual consumption during the year preceding the interview. Baseline data collection included medical history, anthropometric measurements, physical activity, and smoking status.
Results:
CHD patients showed significantly less intake of fruits and vegetables compared to the controls. Serum lipids including total cholesterol (TC), triglycerides (TG), and low density lipoproteins (LDL) were found to be significantly higher in CHD patients than in the controls. The main sources of flavonoids in a typical Saudi diet are tea, fruits (apples), vegetables (onions), and chocolate. The intake of flavonoids and antioxidant vitamins was significantly lower in CHD patients compared to the controls. A negative correlation between the dietary intake of different flavonoids and serum LDL was observed in CHD patients. Significant correlation was found between the intake of flavonol and waist to hip ratio
Conclusions:
The findings of the study support a potential protective effect of dietary flavonoids in relation to CHD. The study showed that consuming more Flavonoids may have positive effect on lowering blood lipids.
PMCID: PMC3410154  PMID: 23012157
Flavonoids; antioxidants; coronary heart disease; lipid profile; Saudi Arabia.
4.  DEVELOPING AN INTEGRATED ORGAN/SYSTEM CURRICULUM WITH COMMUNITY-ORIENTATION FOR A NEW MEDICAL COLLEGE IN JAZAN, SAUDI ARABIA 
Background:
Jazan province is located in the south-west of the Kingdom of Saudi Arabia. The province is offlicted with a wide spectrum of diseases and therefore have a special need for more health services. The Faculty of Medicine at Jazan has been following the traditional curriculum since its inception in 2001. The traditional curriculum has been criticized because of the students inability to relate what they learned in the basic sciences to medicine, thus stifling their motivation. It was felt that much of what was presented in preclinical courses was irrelevant to what the doctor really needed to know for his practice. The College therefore, decided to change to an integrated curriculum.
Design:
The study was conducted in 2004-2005 in the Faculty of Medicine, Jazan University. It began with a literature survey/search for relevant information and a series of meetings with experts from various institutions. A Curriculum Committee was formed and a set of guiding principles was prepared to help develop the new curriculum. A standard curriculum writing format was adopted for each module. It was decided that an independent evaluation of the new curriculum was to be done by experts in medical education before submission for official approval. There were several difficulties in the course of designing the curriculum, such as: provision of vertical integration, the lack of preparedness of faculty to teach an integrated curriculum, and difficulties inherent in setting a truly integrated examination.
Curriculum:
The program designed is for 6 years and in 3 phases; pre-med (year 1), organ/system (years 2 and 3), and clinical clerkship (years 4, 5, and 6). This is to be followed by a year of Internship. The pre-med phase aims at improving the students’ English language and prepare them for the succeeding phases. The organ/ system phase includes the integrated systems and the introductory modules. The curriculum includes elective modules, early clinical training, behavioral sciences, medical ethics, biostatistics, computer practice, and research methods. The curriculum provides active methods of instruction that include: small group discussion/ tutorials, problem-based learning (PBL), case-study/ clinical presentations, seminars, skills practice (clinical skill lab), practical, demonstration, and student independent learning. Methods of evaluating students include continuous and summative assessment.
Conclusion:
The new curriculum adopted by the Jazan Faculty of Medicine is an integrated, organ/ system based, community-oriented, with early clinical skills, elective modules, and innovative methods of instructions.
PMCID: PMC3410155  PMID: 23012158
Community oriented education; Curriculum development/evaluation; Interdisciplinary medical education; Problem-based learning
6.  A COMMUNITY-BASED SCREENING CAMPAIGN FOR THE DETECTION OF DIABETES MELLITUS AND HYPERTENSION IN THE EASTERN PROVINCE, SAUDI ARABIA: METHODS AND PARTICIPATION RATES 
Objective:
To describe a community-based diabetes and hypertension screening campaign, the percentage of screened positive individuals, identified the participation rate, and the factors affecting the participation.
Campaign design and methods:
A community-based screening campaign whose main objective was the screening for diabetes and hypertension was conducted in the Eastern Province of Saudi Arabia for three and half months in the year 2004. A structured questionnaire was used. Diabetes mellitus was diagnosed on the basis of repeated detection of a fasting blood sugar equal to or more than 126 mg/dl, and hypertension when the blood pressure was 140/90 mm Hg or more.
Results:
Of the 650,000 target population, 214,381 (33%) participated, and 197,681 questionnaire were completed. Of the number of individuals screened, 31,711 (16%) were positive for abnormal blood pressure and /or glucose, and needed confirmation of their results. Only 17296 (54.5%) of them were referred to health facilities for confirmation of results
Conclusion:
Community screening campaigns for diabetes mellitus and hypertension is extremely efficient in identifying undiagnosed diabetic and hypertensive individuals. The most successful strategy for the screening and confirmation of results was through PHCCs, especially in the rural areas, where there was good organization and strict adherence to guidelines on methodology.
PMCID: PMC3410157  PMID: 23012153
Campaign; screening; Saudi Arabia; diabetes; hypertension.
7.  APPOINTMENT SYSTEM IN PRIMARY CARE: OPINION OF CONSUMERS AND PROVIDERS 
Background:
The appointment system in primary care is widely used in developed countries, but there seems to be a problem with its use in Saudi Arabia.
Objectives:
(1) To explore opinions and satisfaction of consumers and providers of care in Primary Health Care regarding walk-in and the introduction of the appointment system. (2) To examine factors which may affect commitment to an appointment system in PHC.
Subject and method:
Two hundred sixty (260) consumers above the age of 15 years as well as seventy (70) members of staff were randomly selected from 10 Primary Health Care Clinics in the National Guard Housing Area, Riyadh and asked to complete a structured questionnaire designed to meet the study's objectives.
Results:
The majority of consumers and providers of care were in favour of introducing appointments despite their satisfaction with the existing walk-in sysem. Respondents saw many advantages in the appointment system in PHC such as time saving, reduction of crowds in the clinics and guarantee of a time slot. The main perceived disadvantage was the limitation of accessibility to patients especially with acute conditions. The main organizational advantages and disadvantages perceived by providers were related to follow-ups of chronic patients, no shows and late arrivals. The majority of the patients preferred appointments in the afternoon and the possibility of obtaining an appointment over the telephone.
Conclusion:
In this study, both consumers and providers supportted the idea of introducing the appointment mixed system in primary care, but further study is required
PMCID: PMC3410158  PMID: 23012154
Appointment System; Primary Health Care; Consumers/Providers′ Opinion; and Consultation.
9.  THUNDERSTORM-ASSOCIATED BRONCHIAL ASTHMA: A FORGOTTEN BUT VERY PRESENT EPIDEMIC 
Acute episodes of bronchial asthma are associated with specific etiological factors such as air pollutants and meteorological conditions including thunderstorms. Evidence suggests that thunderstorm-associated asthma (TAA) may be a distinct subset of asthmatics, and, epidemics have been reported, but none from Saudi Arabia.
The trigger for this review was the TAA epidemic in November 2002, Eastern Saudi Arabia. The bulk of patients were seen in the King Fahd Hospital of the University, Al-Khobar. The steady influx of acute cases were managed effectively and involved all neighboring hospitals, without evoking any “Major Incident Plan”.
Three groups of factors are implicated as causes of TAA: pollutants (aerobiologic or chemical) and meteorological conditions. Aerobiological pollutants include air-borne allergens: pollen and spores of molds. Their asthma-inducing effect is augmented during thunderstorms.
Chemical pollutants include greenhouse gases, heavy metals, ozone, nitrogen dioxide, sulfur dioxide, fumes from engines and particulate matter. Their relation to rain-associated asthma is mediated by sulfuric and nitric acid.
Outbreaks of non-epidemic asthma are associated with high rainfall, drop in maximum air temperature and pressure, lightning strikes and increased humidity. Thunderstorm can cause all of these and it seems to be related to the onset of asthma epidemic.
Patients in epidemics of TAA are usually young atopic adults not on prophylaxis steroid inhalers. The epidemic is usually their first known attack. These features are consistent with the hypothesis that TAA is related to both aero-allergens and weather effects. Subjects allergic to pollen who are in the path of thunderstorm can inhale air loaded with pollen allergen and so have acute asthmatic response. TAA runs a benign course
Doctors should be aware of this phenomenon and the potential outbreak of asthma during heavy rains. A & E departments and ICU should be alert for possible rush of asthmatic admissions and reinforce ventilators and requirements of cardio-pulmonary resuscitation. Scientific approach should be adopted to investigate such outbreaks in the future and must include meteorological, bio-aerosole pollutants and chemical pollutant assessment. Regional team work is mandatory.
PMCID: PMC3410145  PMID: 23012145
Thunderstorm-associated asthma; epidemic
10.  THE APPROACH TO A PATIENT WITH A BLEEDING DISORDER: FOR THE PRIMARY CARE PHYSICIAN 
Normal Hemostasis requires the interaction of platelets and the clotting cascade with normal blood vessels and supporting tissues. Bleeding problems and easy bruising are commonly encountered clinical problems. Assessment of these patients is a multistep evaluation process that involves a complete detailed history, thorough physical examination and relevant laboratory evaluation. Many disorders are usually relatively straight forward to diagnose, but in other disorders, patients may have “hidden” signs and symptoms making diagnosis more difficult. A meticulous approach must be used to plan the first steps of management.
PMCID: PMC3410146  PMID: 23012146
Bleeding disorder; clinical history; laboratory tests
11.  MEDICINE AND CLINICAL SKILLS LABORATORIES 
The main objective of the medical curriculum is to provide medical students with knowledge, skills and attitudes required for their practice. A decade ago, the UK Medical Council issued a report called “Tomorrow's Doctors”1 which called for the reduction in the factual content of the medical course with the promotion of problem-based and self-dedicated learning. This report was the basis for a move toward an extensive reform of the medical and nursing curricula. The new reformed curricula enhanced the integrated medical teaching and emphasized the teaching and learning of clinical skills. However, there were still concerns about the standards and appropriateness of the skills of new medical graduates.2
The changes in the teaching and learning methods, the radical changes in the health care delivery and the rapid growth of technology challenged the traditional way of clinical skills development and led to the emergence of clinical skills laboratories (CSLs) in the medical education of many medical and nursing schools. With the proliferation of the CSLs, it is important to evaluate and introduce the reader to their applications, bearing in mind the paucity of information on this subject particularly over the last couple of years. This article is based on literature review.
PMCID: PMC3410147  PMID: 23012147
Clinical; Skills; Laboratories; Centers; Units
12.  LEVEL AND DETERMINANTS OF INFANT AND UNDER-FIVE MORTALITY IN WAD-MEDANI TOWN, SUDAN 
Aim:
This study aimed to determine the level of infant and under-five mortality rates and to examine the effect of socioeconomic, demographic and environmental factors on the health status of the children under five years.
Methods:
The data for this study were collected by means of a questionnaire addressed to women in Wad-Medani, Sudan. Three hundred women in the reproductive age (15-49) years were chosen randomly for this study. The data were analyzed statistically using the Statistical Package for Social Sciences (SPSS). Frequency distributions and a statistical test based on Chi-square for independence was conducted.
Results:
Infant mortality rate was 77 per 100 and child mortality rate was 67 per 100. The results revealed that immunization, child order, child birth weight, birth interval and contraceptive use had a significant influence on the mortality of children under the age of five. The mother's level of education is highly significant on the mortality of children under five years old.
Conclusions:
The Ministry of Health should give greater attention to improving immunization services and concentrate on health education campaigns for mothers and for the community.
PMCID: PMC3410148  PMID: 23012148
Determinants; Infant; Underfive mortality; Sudan
13.  THE RELATIONSHIP OF BODY WEIGHT TO ALTITUDE IN PRESCHOOL CHILDREN OF SOUTHWESTERN SAUDI ARABIA 
Objectives:
To determine the average weight and height and the prevalence of overweight or obesity and thinness in preschool children of the Southwestern highlands of the Kingdom of Saudi Arabia and compare them with their counterparts living at lower altitudes.
Methods:
A cross-sectional study of 559 preschool children aged 12-71 months born and living permanently at high altitude, and 463 preschool children of comparable age born and living permanently at low altitude. For each child at high and low altitude, age was recorded and weight and height were measured. Weight for height Z-score with WHO standards was used for an assessment of normal weight, overweight or obesity and thinness.
Results:
The highland preschool children were found to be significantly heavier and taller than their counterparts living at low altitude. 92.1% of all highland preschool children and 67.6% of lowland preschool children were found to have normal weight (p < 0.0001). Overweight or obesity was insignificantly greater among preschool children of the highlands (2.3%) compared to the preschool children of the low lying areas (0.9%) (p<0.7). Thinness was significantly more prevalent among preschool children of the lowlands (31.5%) than preschool children of the highlands(5.5%) (p< 0.0001). At both high and low altitude, there were no significant differences in the prevalence of overweight or obesity and thinness between boys and girls.
Conclusion:
The findings of this study indicate that thinness is a major nutritional problem among lowland preschool children. This may be attributed to the prevailing tropical environmental conditions on the health of children at low altitude.
PMCID: PMC3410149  PMID: 23012149
Body weight; Altitude; Saudi Arabia
14.  CLINICO-EPIDEMIOLOGICAL FEATURES OF HYPERTENSIVE SUBJECTS IN KASSALA TOWN, EASTERN SUDAN 
Objectives:
To study the clinico- epidemiological profile of hypertension in a series of hypertensive patients in a town in Eastern Sudan.
Methods:
A sample of 242 hypertensive patients was studied using a structured questionnaire including the clinico-epidemiological features associated with hypertension.
Results:
Two thirds of the sample were females, 73.6% of whom were in the 35-64 year age-range; three-quarters of them had a low level of education. Significant risk factors for hypertension included positive family history of hypertension, and being from the Northern Sudan. Significantly more patients from the eastern and western regions had coronary heart disease (P<0.001). Also, significantly more patients from Western Sudan had left ventricular failure (P<0.02) and congestive heart failure (p<0.0001), while significantly more patients from Southern Sudan had nephropathy (P<0.007).
Conclusions:
The study reveals some clinico-epidemiological characteristics in a series of hypertensive patients in Eastern Sudan. It suggests a low rate of blood pressure control as well as ethnic variation of blood pressure control and complications.
PMCID: PMC3410150  PMID: 23012150
Hypertension; Ethnic variation; Kassala Town
15.  STUDENTS’ VIEWS ON STUDENT-TEACHER RELATIONSHIP: A QUESTIONNAIRE-BASED STUDY 
Aim:
The aim of this study is to assess students’ views on student-teacher relationship and its effect on academic grades.
Methods:
The present cross-sectional study was conducted in the College of Medicine, King Saud University, Riyadh, in 2005. The questionnaires were distributed to 420 students during the examination period in order to obtain a full response. It consisted of items on different aspects of student-teacher relationship for which the responses were measured on a 4-point scale. The response rate was about 83%.
Results:
The current relationship between the student and the teacher was evaluated as very good and good by 61% of the study sample. The responses were associated with their grades as (X2=6.25, p=0.012). Eighty-four point one percent of students with higher and above average grades felt that expulsion from class was an appropriate means of controlling the class. Also (78.2%) students felt that the teachers treated them with respect, and their responses were significantly associated with their grades (X2=11.8, p=0.003). Eight-four percent of the students with higher and above average grades strongly agreed that teacher's performance was affected by students’ attendance or absence and the responses were significantly associated with their grades (X2=4.35, p=0.037). The responses to most of the items by the students were independent of their grades.
Conclusion:
This study concludes that student-teacher relationship was good in a medical school and the views of students on this relationship were independent with their academic grades. Further study which includes from 1st year to 5th year undergraduate students is required to give a broader view of student-teacher relationship in a medical school.
PMCID: PMC3410151  PMID: 23012151
Student-teacher relationship; Undergraduate medical education; Saudi Arabia
17.  PREVALENCE OF ANTIBODIES TO HUMAN PARVOVIRUS B19 IN SAUDI WOMEN OF CHILDBEARING AGE IN MAKKAH 
Objectives:
To determine the seroprevalence rate of immunoglobulin G (IgG) and immunoglobulin M (IgM) to parvovirus B19 in pregnant Saudi women in Makkah.
Subjects and Methods:
Using enzyme-linked immunosorbent assay (ELISA), a total of 1200 serum samples were tested for antibodies to parvovirus B19 known to cause a variety of clinical syndromes in women and newborn infants.
Results:
Parvovirus B19 IgG antibodies detected in 46.6% and IgM antibodies were found in 2.25% of different age groups.
Conclusion:
The previous exposure to parvovirus B19 was determined, and 560 (46.6%) of 1200 pregnant Saudi women tested at their first antenatal visit were seropositive for specific IgG. The rate of maternal infection in susceptible pregnancies was 2.25%. These results were in accordance with previous studies performed in other countries.
PMCID: PMC3410113  PMID: 23012138
Makkah; Saudi Arabia; pregnant women; parvovirus B19; ELISA
18.  ERECTILE DYSFUNCTION AMONG DIABETIC PATIENTS IN SAUDI ARABIA: A HOSPITAL-BASED PRIMARY CARE STUDY 
Objectives:
The aim of the present study was to estimate the prevalence of erectile dysfunction in men with diabetes mellitus attending a primary care clinic in King Khalid University Hospital, Riyadh, Saudi Arabia.
Methods:
A cross sectional study was carried out on men with diabetes mellitus followed in a primary care clinic of King Khalid University Hospital in Riyadh, Saudi Arabia, from 13 November 2005 to 13 June 2006. A total of 186 diabetic patients were interviewed. Data collection forms were completed by a member of the medical staff, a family medicine consultant, during the consultation of diabetic patients in the primary care clinic. Erectile dysfunction was categorized as absent erectile dysfunction (normal function), partial erectile dysfunction, and complete erectile dysfunction. The data was analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p-value of less than 0.05 was considered statistically significant.
Results:
A total of 186 men with diabetes mellitus were interviewed during the study period. The majority of diabetic patients (95%) had type 2 diabetes. Most of the patients (68.8%) were on oral hypoglycemic agents, 24.7% on insulin injection, and 6.5% on diet only. The present study showed that 11.2% of the diabetic patients were suffering from complete and severe erectile dysfunction, while 64% of the patients complained of partial erectile dysfunction which was affecting their marital relationship. The cardiovascular risk factors in the 186 diabetic patients were hypertension 34.9%, smoking 13.4%, obesity 40%, and dyslipidemia 16.6%.
Conclusions:
Complete (severe) and partial erectile dysfunction was quite common among adult diabetic patients in a hospital-based primary care setting in Saudi Arabia. It is important for primary care physicians to diagnose erectile dysfunction in diabetic patients, and to counsel them early, as most patients are hesitant to discuss their concern during a consultation. Further studies are recommended to evaluate the effect of other risk factors on erectile dysfunction in diabetic patients.
PMCID: PMC3410114  PMID: 23012139
Erectile dysfunction; diabetes; primary care
19.  CARE-SEEKING BEHAVIOR FOR FEVER IN CHILDREN UNDER FIVE YEARS IN AN URBAN AREA IN EASTERN SUDAN 
Background:
Early diagnosis and prompt treatment are the basic elements of malaria control. The mother's perceptions about the cause of the fever, duration of sickness, accessibility and the anticipated cost of treatment, frequent use of traditional medicine, and judgement of the severity of the fever are the most important determinants for effective treatment of fever in children.
Subjects and Methods:
This cross-sectional study was conducted in Kassala city, in Eastern Sudan to investigate the caregivers’ care-seeking behaviour related to fever among children < 5 years. Data was collected by trained social workers using a structured questionnaire and was analysed by means of SPSS.
Results:
Three-hundred fifty housewives were interviewed. The majority (85.7%) had had at least basic education and 244 (69.7%) were full-time housewives. A total of 237 (67.7%) mothers were found to have adequate knowledge about malaria. Malaria was perceived by only 143 (40.9%) of the respondents as a cause of low grade fever and this percentage was almost doubled in the case of high fever. There were similar findings with respect to the selection of treatment sources and the use of antimalarial drugs. High fever urged 319 (91.1%) to seek advice from health workers and 281 (80.3%) to take drugs other than chloroquine.
Conclusion:
The intensity of fever (low/ high) governed the respondent's perceived causes of fever, decision about available treatment options and the type of antimalarial drugs they used. Health education programmes should focus on the importance of seeking early advice, compliance with prescribed treatment and awareness and handling of danger signs before presenting at health facility.
PMCID: PMC3410115  PMID: 23012140
Malaria; Fever; Treatment-seeking behaviour; Sudan
20.  AN OUTBREAK OF FOODBORNE DIARRHEAL ILLNESS AMONG SOLDIERS IN MINA DURING HAJJ: THE ROLE OF CONSUMER FOOD HANDLING BEHAVIORS 
Objective:
An investigation of the outbreak was initiated as a result of the number of cases of gastroenteritis reporting to a general hospital in Mina during the pilgrimage to Makkah (HAJJ). This study was conducted to identify the source of the outbreak, assess its extent, and make recommendations to prevent similar outbreaks in the future.
Methodology:
A case was defined as any individual who developed diarrhea with or without abdominal pain after eating at the camp in Mina on 3rd January 2006. A retrospective cohort study was conducted to identify food items and circumstances responsible for this outbreak. Laboratory tests included stool cultures of all diarrhea patients, and rectal swabs from all food handlers were cultured for enteric pathogens.
Results:
A total of 50 Saudi Male Soldiers were interviewed. Out of these, 16 (39%) had developed gastroenteritis, most commonly manifested by diarrhea (100%), and abdominal colic (87.5%). The mean incubation period was 12.6 ± 4.9 hours and the epidemic curve suggested a common point source outbreak. Out of three served meals, lunch was found to have a statistically significant association with illness (p=0.0230). Out of five food items served, rice was the only food item found to have a statistically significant association with illness (p=0.0230). No food remnants were found for sampling. All results of stool cultures of all diarrhea patients, and rectal swabs from all food handlers were inconclusive.
Conclusions:
This outbreak was most likely caused by eating contaminated rice served at lunch on 3rd January. The most likely organisms were Bacillus cereus, and/or Clostridium perfringens. Consuming food that was kept at an unsafe temperature wihout being reheated was the most probable important factor leading to this outbreak.
PMCID: PMC3410116  PMID: 23012141
Foodborne Outbreak; Saudi Arabia; Hajj; Consumer behaviors
21.  PREVALENCE OF HERPES SIMPLEX VIRUS TYPES 1 AND 2 AND ASSOCIATED SOCIODEMOGRAPHIC VARIABLES IN PREGNANT WOMEN ATTENDING KING FAHD HOSPITAL OF THE UNIVERSITY 
Objectives:
The risk factors associated with herpes simplex virus (HSV) seropositivity in pregnant women in Saudi Arabia are not known. This study was aimed at identifying the sociodemographic variables associated with seroprevalence of HSV-1 and HSV-2 in pregnant women in a Saudi hospital.
Materials and Methods:
This is a hospital-based cross-sectional study that included all pregnant mothers who delivered at King Fahd Hospital of the University (KFHU) over a period of two years (November 2002 to October 2004). Anti-HSV-1 and anti-HSV-2 IgG and IgM antibodies were determined using type-specific ELISA. Each subject completed a structured questionnaire. Relevant sociodemographic variables were analyzed.
Results:
A higher prevalence of HSV-1 IgG antibodies (93.2%) was found in those mothers who were not educated (illiterate or read and write only) in comparison with pregnant women with formal school education (p = 0.021). This was confirmed by using multiple regression analysis (p = 0.027). The prevalence of HSV-2 IgG was higher among civil servants and teachers (40.0 % and 14.7 % respectively) than in unskilled labourers, professionals, or housewives (p = 0.0001). Using multiple regression analysis, the prevalence of HSV-2 IgG was found to increase in older mothers (p = 0.037). No statistically significant association was found between HSV seroprevalence and other socio demographic variables.
Conclusions:
Identifying the sociodemographic factors associated with HSV infection will help in understanding the epidemiology of HSV infection in Saudi women and may help in designing preventive measures.
PMCID: PMC3410117  PMID: 23012136
HSV-1; HSV-2; pregnant women; IgG; IgM; sociodemographic variables
22.  MORBIDITY PATTERNS AMONG KING FAISAL UNIVERSITY STUDENTS, AL HASSA, KINGDOM OF SAUDI ARABIA 
Objectives:
To explore the prevalent morbidity problems among students at King Faisal University. To identify the nature of referred cases and assess the efficiency of the referral system.
Subjects and Methods:
This was a retrospective, records-based descriptive study, involving the examination of the health records of students at King Faisal University, who attended the Medical Center for Primary Health Care services in a five-year period. A pre-tested compilation sheet was used for data collection.
Results:
Out of 2472 consultations, about 58 % of the diagnosed morbidity conditions were of infectious nature, mostly affecting the respiratory (62%), dental (14%), gastrointestinal (7%), and skin infections (5 %), with more prevalence among males. The non-infectious morbidity conditions were recorded more among females and included muscle and joints problems (16 %), allergic conditions (15 %), gastrointestinal (8 %), and trauma (5 %). Some of the encountered morbidity demonstrated seasonal variation. Case referrals were about 6 %, more in the non-infectious conditions, with a deficient feedback system.
Conclusion:
Quality improvement of the medical records and the establishment of a proper referral system are necessary. Health education on preventable morbid conditions should be organized and implemented.
PMCID: PMC3410118  PMID: 23012142
Morbidity; Medical Records; University students
23.  A STUDY OF MATERNAL DIETARY INTAKE DURING PREGNANCY IN RIYADH, SAUDI ARABIA 
Objective:
This study was carried out to evaluate the dietary nutrient intake of pregnant women. The relationship between dietary intake and pregnancy outcome was also studied.
Method:
A total of 114 pregnant women were studied, using systematic random sampling.
Results:
The percentages of the mean nutrient intake below the recommended dietary allowances (RDA) for pregnant women were as the follows: 51.8%, 93.9%, 82.5% and 98.2% for energy, vitamin B1, calcium and iron, respectively. Moreover, 13.2% of the women experienced some form of pica. Using height and mid-arm circumferences, about 2.8% and 4.4% were seen to be undernourished respectively.
Conclusion:
Saudi pregnant women need guidance in selecting nutrient dense foods to reduce maternal and outcome health hazards.
PMCID: PMC3410119  PMID: 23012137
Dietary intake; Pregnant women; Saudi Arabia

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