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issn:2229-340
2.  ARE YOUNG ARAB WOMEN EATING A HEALTHY DIET? A QUALITATIVE DIETARY STUDY AMONG COLLEGE HOSTEL STUDENTS 
Background:
Two recent studies conducted on young College Arab Women showed a trend towards over nutrition. It is well known that good eating habits adopted early in life not only improve health and control obesity in the youthful years but also promote healthy eating behaviours in later life.
Objective:
To investigate the dietary habits of young college women and identify specific areas for nutrition education.
Methods:
A self-administered questionnaire containing 20 items related to qualitative dietary history was distributed to all the college (King Faisal University, Dammam) women residing in the hostel during a one-week period in April 1998.
Result:
Out of a total of 56 women, 50.7% frequently missed out on breakfast and lunch. To satisfy their state of hunger, frequent snacking with deserts/carbohydrate-rich food items (21.4%) and consumption of regular cola drinks (32.1%) was common. Fast food rich in fat and calories from restaurants was popular among a majority (98.2%) of the students. On the other hand, there was a deficient intake of protective foods and nutrients for repair, maintenance and growth, such as fruits (73.2%), vegetables (85.6%), milk and milk products (66.1%) and protein-rich foods (82.1%).
Conclusion:
To decrease the risk of malnutrition among young college women, there is a need to target them for nutrition education and adoption of healthy eating practices within the context of a healthy life style.
PMCID: PMC3437099  PMID: 23008599
Dietary habits; College women; Dammam; Saudi Arabia
3.  THE FUTURE OF ACADEMIC MEDICAL CENTERS IN SAUDI ARABIA: DIFFICULTIES ENCOUNTERED IN A TEACHING HOSPITAL 
Objective:
The objective of this study was to define and analyze the major difficulties experienced and documented in a university teaching hospital.
Methodology:
The academic medical center (AMC) reviewed was the King Fahd Hospital of the University (KFHU), Al-Khobar, Eastern Saudi Arabia. Data sources included student registration figures, budget allocation and the hospital annual reports. The retrospective analysis was restricted to difficulties encountered.
Results:
While numbers of medical students increased, staff positions remained static. There was remarkable budgetary deficiency over 9 years; especially for pharmacy, equipment's and supplies. The number of patients’ visit markedly increased. The difficulties encountered were 237 in 70 sections of KFHU. Other problems included recruitment difficulties and the triple role for the faculty; teaching, researching and service.
Conclusion:
The role of leadership is emphasized to provide answers for the problems; to manage AMC's more efficiently; to find ways of providing medical care more cost-effectively and to generate more funds.
PMCID: PMC3437100  PMID: 23008600
Academic medical centers; teaching hospitals; difficulties encountered; cost-effectiveness
4.  FACTORS AFFECTING CHILD DEVELOPMENT IN MADINAH, SAUDI ARABIA 
Introduction:
This paper addresses an important pre-requisite for promoting child health; namely the promotion of sound child development.
Objectives:
The study aimed at identifying factors affecting child development in Madinah, Saudi Arabia.
Design:
A cross-sectional study with a multi-stage stratified random sample of children.
Setting:
Well-baby clinics of the primary health care centers in urban and rural areas of the Madinah region, North-western Saudi Arabia.
Participants:
A sample of 1219 “normal” children below the age of six.
Intervention:
Tools used for the study were the modified and translated Denver Revised-Pre-screening Developmental Questionnaire (R-PDQ), and the Denver Developmental Screening Test (DDST) kit together with a social questionnaire. Logistic Regression analysis was used to show any significant association(s) between the study variables and the 104 developmental items in the R-PDQ.
Results:
Eight variables were found to be strongly associated with each of the developmental items. Mothers’ education was found to be significantly associated with 21 developmental items. Number of children in the household was next to mothers’ education in its association with child development. Place of residence and gender were found to be significantly associated with seven and one abilities respectively.
Conclusion:
Findings emphasized the importance of girls and mothers’ education as an aid in stimulating the development of their children and enabling mothers to prepare children for school. Adequate birth interval, and prolonged breastfeeding are recommended to enable mothers to care for their children, communicate with them and foster sound development. Scrutinizing the child's home environment and involving parents in the developmental progress of their children are also considered important. More stimulation and educational play are recommended for rural children and male urban children.
PMCID: PMC3437101  PMID: 23008601
Child development; R-PDQ; Madina; Saudi Arabia
5.  PREDICTIVE FACTORS AND INCIDENCE OF COMPLICATIONS IN APPARENTLY HEALTHY FULL TERM INFANTS OF DIABETIC MOTHERS 
Aim:
To determine the incidence of different complications of the apparently healthy full-term infants of diabetic mothers (IDMs) and whether these complications could be predicted early.
Methods:
A prospective study was performed in the Nursery Unit of King Fahd Hospital of the University in Al-Khobar over an 18-month period. Eligible neonates were those full-term IDMs who were asymptomatic at birth, with birth weight ≥ 2000 g and whose mothers had gestational or pregestational diabetes. AUDMs were routinely observed for at least 2 days. A complete blood count, glucose, bilirubin and calcium serum levels were monitored. The morbidity study group included all IDMs who experienced complications requiring treatment or observation for > 48 hours.
Results:
One hundred and eighty eight infants with a birth-weight of 3411 ± 616 g and with gestational age of 38.5 ± 1.2 weeks were enrolled in the study. Asymptomatic hypoglycemia (31%) was mostly mild and transient. The rate of other complications such as hypocalcemia (4%), polycythemia (13%), hyperbilirubinemia (18%), intrauterine growth retardation (2%) with 30% rate for large gestational age. Using a logistic regression model; maternal insulin therapy, poor diabetic control, birth asphyxia, early neonatal hypoglycemia and polycythemia were found to be highly predictive of morbidity with an odd ratio of 2.41, 2.91, 9.65, 3.88 and 3.74 respectively.
Conclusion:
Complications of apparently healthy IDMs appear to be very mild and transient. These were found to be strongly associated with specific perinatal events.
PMCID: PMC3437102  PMID: 23008602
Infant of diabetic mother; full-term; complications
6.  PATTERNS OF RESISTANCE TO ANTIBIOTICS AT KING FAHD HOSPITAL OF THE UNIVERSITY 
Introduction and Aim:
A sharp worldwide rise in bacterial resistance to antimicrobial agents in both nosocomial and community acquired pathogens has recently been observed. This may complicate treatment of infectious disease or increase the cost of its management. It is, therefore, important to regularly investigate the patterns of resistance to antimicrobial agents at both local and national levels.
Methods:
The antibiograms of organisms isolated over a one-year period in King Fahd Hospital of the University were analyzed.
Results:
Of the 3679 microbial isolates of 35 types of organisms identified, the most common were Streptococcous spp (25.5%), S. aureus (16.1%), E. Coli (12.7%), Psueudomonas spp (9.3%) and Klebsiella spp (7%) High resistance rates (>50%) to ampicillin and to amoxycillin + clavulanate (AMX+CLV) were encountered in Enterobacter spp., and H. influenzae while in E. coli, the resistance was higher to ampicillin (60.0%) than to AMX+CLV (38.1%). With regard to S. aureus, 98.3%, 91.1% and 25.5% of isolates were resistant to penicillin, AMX+CLV and methicillin respectively but all were sensitive to vancomycin. High resistance (53% of 2830 isolates) to tetracycline was also observed especially in H. influenzae (80.5%), Streptococcous spp (72.9%) and E. Coli (54.5%). The same organisms were also highly resistant to trimethoprim/sulphamethoxazole with rates of 75.5%, 80.4% and 48.1% respectively. Moderate resistance (26% of 1567 isolates) to gentamicin was noted but the drug remained very effective against most tested gram-negative organisms. In addition, multiple resistance to gentamicin and AMX+CLV was also detected in 24.3% of 839 isolates.
Conclusions and Recommendations:
It is concluded that the alarmingly high pattern of bacterial resistance to antibiotics may reflect the extent of use of each antibiotic in the eastern province of Saudi Arabia. It is recommended that hospital antibiotic policies (purchasing, prescribing and dispensing) be based on, and regularly reviewed in accordance with hospital antibiogram results. A center for infectious disease control should also be established in each region of the Kingdom to disseminate information and coordinate antibiotic policies among hospitals.
PMCID: PMC3437103  PMID: 23008603
Antibiotics; resistance; pathogenic organisms; Saudi Arabia
7.  KNOWLEDGE, ATTITUDE AND SMOKING PATTERNS AMONG NURSING AND LABORATORY TECHNOLOGY STUDENTS, DAMMAM, SAUDI ARABIA 
Objective:
To study the reported practices of knowledge about and attitude towards smoking among nursing and medical laboratory technology (MLT) students, College of Medicine, King Faisal University at Dammam and Al-Khobar.
Setting:
College of Medicine, Dammam and King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
Methods:
A cross-sectional approach involving a sample of 266 students and interns (152 nursing and 114 MLT), which included all enrolled students in the academic year (1998/1999). A self-administered questionnaire was used to collect data covering knowledge, practice and attitude to smoking. SPSS was used for statistical analysis.
Results:
The overall smoking prevalence was low (5.6%), slightly higher among nursing (6.6%) versus MLT (4.4%) students. Knowledge of and attitude towards smoking was generally satisfactory in both groups, although deficient in some key areas, such as the addictive nature of smoking, some of its consequences on health, and difficulty of quitting.
Conclusion and Recommendations:
The prevalence of smoking among nursing and MLT students is generally low but their knowledge and attitude need improvement. Health education on facts, dangers and consequences of smoking should start as early as the primary school, and should continue throughout the education of future health professionals (role models for the community).
PMCID: PMC3437104  PMID: 23008604
Smoking; tobacco consumption; university students; nursing; laboratory technology; knowledge/attitudes/practice (KAP); Saudi Arabia
8.  AUDIT OF DIABETIC CARE IN A SAUDI PRIMARY CARE SETTING 
Objective:
To audit the care offered to diabetic patients attending the Family and Community Medicine Clinic (FAMCO), King Faisal University, Kingdom of Saudi Arabia (KSA).
Design:
A cross-sectional study of medical records of 45 diabetic patients who regularly visited the clinic during a one-year period from June 1997 to May 1998.
Subjects:
Patients who presented at the clinic because of non-insulin-dependent diabetes mellitus (type II).
Results and Conclusions:
The level of care for diabetic patients was relatively inappropriate, and some important parameters were under-recorded. Specific measures to improve and promote diabetic care in FAMCO clinics need to be undertaken. These include formulating and using protocols for diabetes management and better training of health-care providers.
PMCID: PMC3437105  PMID: 23008605
Saudi Arabia; medical audit; diabetes mellitus; primary care
9.  ATTITUDES OF SAUDI MEDIA TOWARDS WORLD HEALTH EVENTS 
Introduction:
Mass media are very important in health education programmes. Health promoters rely on them to play a crucial role in their campaign.
Aim:
The aim of the study was to study the patterns of contribution of the Saudi daily newspapers on two international health occasion during the year 1416H (World AIDS Day 1995 and World Health Day 1996).
Material and Methods:
The study was retrospective, carried out by reviewing eight daily Saudi newspapers including all issues covering three months before and extending three weeks after each occasion. All newspaper materials concerning the two occasions were specified, and data obtained from them included types of materials, topics and characteristics of the paper.
Results:
The study revealed that the newspapers gave more coverage to World AIDS Day than on World Health Day. This meant that journalists considered that AIDS was more interesting to the readers than the environmental topic of World Health Day. Most of the materials especially in World Health Day were published in the inner pages. These findings are in consonance with previous work, which showed that Saudi journalists had little interest in environmental issues. Nearly two thirds of the materials were news items about ministerial and activities of other organizations. Informative articles on health education and readers’ participation were minimal.
Conclusion:
It was concluded that newspapers took not much interest on health matters especially health education.
PMCID: PMC3437106  PMID: 23008606
Health occasions; health education; newspapers; AIDS; environment; Saudi Arabia
11.  IMPACT OF HEALTH EDUCATION PROGRAM ON KNOWLEDGE ABOUT AIDS AND HIV TRANSMISSION IN STUDENTS OF SECONDARY SCHOOLS IN BURAIDAH CITY, SAUDI ARABIA: AN EXPLORATORY STUDY 
Background:
Accurate information about Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) is important for their prevention.
Objectives:
This study is intended to assess knowledge on AIDS in students of secondary schools in Buraidah city and to measure the effect of a health education program on their knowledge about AIDS in general, modes of HIV transmission and the degree of their misperception about the transmission of the disease through casual contact.
Methodology:
A well-designed health education program using personal communication and visual media techniques was conducted for 483 secondary school students in Buraidah secondary schools during the year 1997. Pre and post-tests were done to examine their knowledge about AIDS.
Results and recommendations:
The results of this study pointed out that a health education program on AIDS for students of secondary schools greatly and significantly improved their scores on general knowledge on AIDS views on its transmission and misperception of AIDS (p<0.01). Continuous in-service programs for secondary students are recommended.
PMCID: PMC3437069  PMID: 23008592
AIDS; Knowledge; Transmission; Misperception; Students
12.  PEAK EXPIRATORY FLOW RATE IN A SAMPLE OF NORMAL SAUDI MALES AT RIYADH, SAUDI ARABIA 
Objective:
To find out the normal peak expiratory flow rate for adult Saudi males and to compare our standards with British standards.
Methods:
A cross-sectional study was carried out in five primary health care centers representing Riyadh city in the period between 15th November through December 1993. Six hundred and eighty Saudi men who satisfied stringent criteria of normality were included in the study.
Results:
The mean and standard deviation of the subjects’ age and height were 28.4 ± 13 and 167.6 ± 6.4 respectively. Linear regression analysis was performed through step-wise procedure to determine the form of regression of peak expiratory flow on age and height. Regression curves were obtained and it was found that peak expiratory flow rate did not begin to decline until about the age of 25 years; and as height increased the peak expiratory flow rate increased in a linear relationship.
Conclusion:
It was demonstrated that our study group had lower peak expiratory flow rate compared with British people. These findings will serve as a basis for preparing flow rate values for our population.
PMCID: PMC3437070  PMID: 23008593
Peak expiratory flow rate; Bronchial asthma; Saudi Arabia
13.  ABILITY OF ADULT PATIENTS TO PREDICT ABSENCE OR PRESENCE OF FEVER IN AN EMERGENCY DEPARTMENT TRIAGE CLINIC 
Introduction:
Fever is the most appreciated manifestation of disease which usually raises high therapeutic expectations. Patients seek medical advice because they think they are sick and feverish. If they feel that they are sick but not feverish, they may not seek medical advice. Subjective fever may also be an important clue to further evaluation of the patient.
Objective:
The aim of this study was to assess the reliability of adult patients to predict absence or presence of fever in Emergency Department triage clinic.
Methods:
A prospective study of 1241 ambulatory adult patients (above 12 years of age) was carried out over a three-week period. All patients were asked whether or not they had fever or felt they had fever or were running a temperature before oral temperature was taken with an IVAC digital machine. Two sets of temperature readings were taken to define fever as 37.8°C or greater, and 38.0°C or greater.
Results:
The sensitivity and specificity of detecting fever by subjective means was 89.6% and 94.5% for male and 90.0% and 94.8% for female. The accuracy rates were 93.9% and 94.6% respectively. The prevalence of objective fever was 8.7% yielding general positive and negative predictive values of 80.9% and 98.9% with an accuracy rate of 94.2%.
Conclusion:
The reliability of adult patients attending triage clinic in assessing subjective fever was found to be good. Four out of five of our patients who believed they had a fever were actually found to have an objective temperature increase (38.0°C or greater). This means that medical staff should take a complaint of subjective fever in our population more seriously.
PMCID: PMC3437071  PMID: 23008594
Fever; subjective fever; adult patient; emergency department and reliability
14.  KNOWLEDGE, ATTITUDE AND PRACTICE OF PRIMARY HEALTH CARE DOCTORS AND NURSES IN HYPERTENSION OF PREGNANCY 
Objective:
To assess the status of knowledge, attitude and practice (KAP) of doctors and nurses in Primary Health Care (PHC) centers with regard to hypertension in pregnancy and to identify factors associated with KAP in Al-Khobar, Saudi Arabia.
Methodology:
Using a self-administered comprehensive questionnaire, all available doctors and nurses in PHC centers of the Al-Khobar area were approached to determine their knowledge, attitude and practice in hypertension during pregnancy. Questionnaires were validated and pilot tested. Each section of the questionnaire was scored and the mean scores calculated. Factors affecting each section were identified by means of multiple regression analysis.
Results:
A total of 36 doctors and 91 nurses were enrolled in the study. Saudis formed 22.2% of the doctors and 47.3% of nurses. Mean years of practice after graduation were 12.6 and 8.7 years for doctors and nurses, respectively. Saudi nurses spend only 3 weeks in the obstetrics ward during the whole period of their internship. All Saudi nurses hold only diplomas and not many courses on the hypertensive disorder are offered to both doctors and nurses after graduation. The practice of doctors particularly in the management of patients after reaching a diagnosis and educating them on diet and salt intake was poor. Furthermore, their knowledge was also poor. Though their level of knowledge was poor, the nurses’ practice was satisfactory, particularly in taking history and physical examination. The attitude of both doctors and nurses towards hypertensive disorders was in general, positive and satisfactory towards health education. Nurses’ nationality and duration of post-internship training were the factors that influenced their attitude and scores on knowledge.
Conclusion and recommendation:
The study revealed that both doctors and nurses working in the PHC lacked training and knowledge in this area of their work. It is therefore necessary to give PHC doctors and nurses refresher courses on common and serious problems like hypertension. A longer period of training in action management is needed to improve the knowledge and practice of doctors and nurses working in antenatal clinics in this area.
PMCID: PMC3437072  PMID: 23008595
Pregnancy hypertension; knowledge and practice; Antenatal care; Primary Health Care
15.  AN UNUSUAL PRESENTATION OF TUBERCULOUS SPLENIC ABSCESS 
A 55-year-old male presented with painful lobulated mass on the left lateral lower chest and upper abdomen. Evaluation revealed the mass as a subcutaneous abscess originating from and communicating with a splenic abscess. The patient was treated by incision and drainage of the subcutaneous abscess along with splenectomy, and antituberculous therapy. Histopathological examination of the spleen confirmed the diagnosis of splenic tuberculosis. Postoperatively, the patient improved, and was discharged ten days later on antituberculous drugs. One year later, the patient remains asymptomatic and shows progressive improvement.
PMCID: PMC3437073  PMID: 23008596
Tuberculous; Spleen; Abscess
16.  FACTITIOUS DISORDER IN SAUDI ARABIA: A REPORT OF TWO CASES 
Factitious disorders are characterized by physical or psychological manifestations that are intentionally produced or feigned with no apparent external incentives in order to assume the sick role. These disorders are rarely reported or may be under-reported in Saudi patients. We describe here two male and female Saudi cases of such disorders. Both presented predominantly with features of Munchausen's syndrome. Like most psychiatric patients both had sought help from traditional healers prior to their reporting to the hospitals. Inspite of the socio-cultural factors, it is clear that doctors’ awareness and acceptance of the possibility of factitious disorders is a prerequisite to making the diagnosis.
PMCID: PMC3437074  PMID: 23008597
Factitious disorders; cultural factors

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