Journal of Family & Community Medicine|مجلة طب الأسرة والمجتمع
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Item 7TH GCC Medical Colleges Conference, 17-19 November 2009, Dammam, Saudi Arabia(2010) 7TH GCC Medical Colleges ConferenceThe 7 th GCC Medical Colleges Conference was held at the Dammam Campus of King Faisal University, Saudi Arabia from 17 th to 19 th November 2009. The theme of the conference was "Medical Education: Research and Applications" and it was organized by the Medical Education Unit, College of Medicine, King Faisal University-Dammam (KFH-D), Saudi Arabia. The Medical Education Unit at KFU-D is committed to promote faculty development activities that support the mission of KFU-D. It also strives to provide facilities and services of highest order to improve assessment in particular and quality of medical and health professional's education in general. The Journal of Family and Community Medicine has allotted a section for Medical Education. Considering the importance of the conference, our commitment towards medical education, and to the interest of our readers, we have included the abstracts of the scientific presentations of the 7 th GCC Medical Colleges Conference in this issue.Item A bibliometric analysis of global research performance on tuberculosis (2011–2020): Time for a global approach to support high-burden countries(2022) Abdullah, Muhammad; Humayun, Ayesha; Imran, Muhammad; Bashir, Muhammad A; Malik, Ahmad ABACKGROUND: Tuberculosis (TB) is a persistent public health issue requiring consistent global effort for its eradication and control. Research on the subject plays a vital role in combatting the disease, giving future directions, and meeting the sustainable development goals (SDGs). This study aimed to evaluate the global TB research trends and performance from 2011 to 2020. MATERIALS AND METHODS: All the data for TB-related research publications from 2011 to 2020 were extracted from the Web of Science database and a comprehensive analysis was performed on the R-bibliometrix package. RESULTS: An increasing number of publications with an annual growth rate of 6.32% and a plateau in production from 2015 to 2018 was observed. Of 145 countries, the United States of America (USA), China, India, the United Kingdom, and South Africa led and made up half of the global contribution. Out of 91,862 authors, Zhang Y was the most productive with 205 articles and Barry CE had the highest H-index of 45. Only seven of the top 20 authors were from high-burden countries. The University of Cape Town was the leading institutional affiliation, followed by Stellenbosch University and the London School of Hygiene and Tropical Medicine. The most frequent international collaboration was between the USA and South Africa, occurring on 1203 instances. Only five of the top 30 high-burden countries were present in the top 30 collaborations. PLOS ONE, disseminating 2271 articles, was the most productive out of 3500 sources. CONCLUSION: The past decade has seen a steady increase in global TB research. Prominent authors, affiliations, and countries showed collaborative trends, but publications were found to be mostly from developed, low-burden countries except China, India, and South Africa. To meet the goals set by the SDGs and the WHO End TB Strategy, high-burden countries need to explore feasible opportunities and global support to enhance their expected TB-related research contributions.Item A case of Kartagener's syndrome with combined aplasia of frontal and sphenoid sinuses and hypoplasia of maxillary and ethmoid sinuses(2021) Sharma, Sonica; Durgaprasad, BhamidipatyVijayalakshmi, PayalaKartagener's syndrome (KS), characterized by a triad of bronchiectasis, chronic sinusitis, and situs inversus, is a subset of an autosomal recessive hereditary disorder of primary ciliary dyskinesia. We report the case of a 35-year-old male who presented with a history of intermittent episodes of productive cough, breathlessness, and cold since childhood. High resolution computed tomography of chest revealed bronchiectatic changes, dextrocardia, and right-sided aortic arch. Computed tomography (CT) scan of the abdomen revealed situs inversus. CT of the paranasal sinuses revealed combined aplasia of bilateral frontal and sphenoid sinus with sinusitis. Based on these findings, a diagnosis of KS was made. There was no complaint of infertility, which usually accompanies KS, even though an analysis of his seminal fluid revealed reduced count and reduced motility of sperms. The uniqueness of our case is that our patient was a male aged 35 years; besides, the third decade is an unusual age for presentation of combined aplasia/agenesis of bilateral frontal and sphenoid sinuses with hypoplasia of maxillary and ethmoid sinuses. Even though these findings have been reported in children and young adults, there are very few case reports of such a presentation in adults in literature.Item A rare invasive male breast cancer of nonspecific type presenting at a primary care clinic: Importance of early diagnosis and management(2023) Mansoor, Nurulhana S.; Arifin, Farnaza; Kornain, Noor K.M.; Razalli, Mazuin M.Abstract: Male breast cancer is a rare disease with an incidence rate of <1% of all breast cancer cases, and only 1% of all male malignancies. Men tend to present at an older age and with more advanced stages compared to women. We report a case of a 74-year-old man who presented at a primary care clinic with a right subareolar painless breast mass. A mammogram and core biopsy were performed. A diagnosis of right invasive breast carcinoma was rendered. The patient underwent a right total mastectomy with ipsilateral axillary lymph node dissection, which revealed an invasive ductal carcinoma of no special type (NST). Chemotherapy, radiotherapy, and hormonal therapy were included in the adjuvant treatment plan. In this report, we discuss the important role of the primary care physician (PCP) in early diagnosis and referral for definitive management. The PCP also plays an essential role in the holistic care of male breast cancer patients, including the management of physical, psychological, social, and underlying chronic diseases.Item Ability of adult patients to predict absence or presence of fever in an emergency department triage clinic(1999) Al-Almaie, Sameehntroduction: 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 o C or greater, and 38.0 o 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 o C or greater). This means that medical staff should take a complaint of subjective fever in our population more seriously.Item Item Academia and accountability: The importance of role modeling(2004) Al-Sulaiman, AbdulsalamAbstract Not Available(Editorial)Item Academic job satisfaction questionnaire: Construction and validation in Saudi Arabia(2011) Al-Rubaish, Abdullah; Rahim, Sheikh Idris; Abumadini, Mahdi; Wosornu, LadeBackground: Colleges and universities are becoming increasingly accountable for teaching outcomes in order to meet rigorous accreditation standards. Job satisfaction (JS) seems more difficult to measure in the academic field in view of the complexity of roles, duties and responsibilities. Objectives: To compile and determine the psychometric properties of a proposed Academic Job Satisfaction Questionnaire (AJSQ) suitable for university faculty, and amenable to future upgrading. Materials and Methods: A 46-item five-option Likert-type draft questionnaire on JS was distributed for anonymous self-reporting by all the academic staff of five colleges in University of Dammam (n=340). The outcome measures were (1) factor analysis of the questionnaire items, (2) intra-factor α-Coefficient of Internal Consistency Reliability, (3) inter-factor correlations, (4) comparison of psychometric properties in separately analyzed main faculty subgroups. Results: The response rate was 72.9 percent. Factor analysis extracted eight factors which conjointly explained 60.3 percent of the variance in JS. These factors, in descending order of eigenvalue, were labeled "Authority", "Supervision", "Policies and Facilities", "My Work Itself", "Interpersonal Relationships", "Commitment", "Salary" and "Workload". Cronbach's-α ranged from 0.90 in "Supervision" to 0.63 in "Salary" and "Workload". All inter-factor correlations were positive and significant, ranging from 0.65 to 0.23. The psychometric properties of the instrument in separately analyzed subgroups divided by sex, nationality, college and clinical duties produced fairly comparable findings. Conclusion: The AJSQ demonstrated good overall psychometric properties in terms of construct validity and internal consistency reliability in both the overall sample and its separately analyzed subgroups. Recommendation: To replicate these findings in larger multicenter samples of academic staff.Item Acceptance of premarital health counseling in Riyadh city, 1417H(2000) Al-Kahtani, NabilBackground: Health counseling before marriage can be a most worthwhile and satisfying aspect of preventive medicine. It is important in genetic diagnosis and the prevention of hereditary, sexually transmitted and other infectious diseases. Objectives: To determine the acceptance of the concept of Premarital Health Counseling (PMHC), and to identify some factors, which may efect this acceptance among Saudis who attend Primary Health Care Center in Riyadh, Kingdom of Saudi Arabia (KSA), 1417H. Methods: The present study is a cross-sectional one with a selected sample of Saudis who attended the Primary Health Care Centers in Riyadh during the year 1417H. A multistage sampling and equal allocation stratified sampling within was used to select 484 persons comprising an equal number of males and females, married and single above the age of 18 years. A pre-designed pre-tested questionnaire sheet was used to collect the required data, which were then tabulated and statistically analyzed. Results: The study indicated that 364 (75.2%) of the study population accepted the concept of Premarital Health Counseling. PMHC was positively affected by the advancing age, experience of marriage, educational level and well-understood Islamic-health related issues. Out f those who accepted the concept, 273 (75%) agreed on the exchange of PMHC certificates between couples to be married and 152 (42%) agreed on the implementation of legislation on PMHC. Also, 298 (82%) of them wanted PMHC to be confidential and 168 (46%) agreed to the concept despite its cost. As regards the location of PMHC, most of participants who agreed to PMHC would prefer it to be given at governmental establishments. Recommendations: The study recommended the implementation of PMHC in Saudi Arabia, since it was accepted by the study population. However, further studies should be carried out to determine the details to be incorporated in the PMHC, their implementation and legislation on demographic basis of the Saudi community. Also, a community health education program for PMHC has to be devised in collaboration with Islamic leaders.Item Accidental ingestion of hairpin in an adolescent girl(2019) Almarhabi, AhmedIngestion of headscarf pin is a particular type of foreign body ingestion sometimes experienced by adolescent girls and even older women while putting on their headscarf. We report on a 13-year-old girl who presented at the emergency unit at our hospital within 48 hr after accidentally swallowing a headscarf pin. The pin was successfully retrieved from the ascending colon through colonoscopy. Headscarf pin ingestion is a serious problem among women who wear headscarves for various reasons. However, the retrieval of such pins from the colon through colonoscopy has been infrequently reported.Item Accuracy of body mass index compared to whole-body dual energy X-ray absorptiometry in diagnosing obesity in adults in the Eastern Province of Saudi Arabia: A cross-sectional study(2023) Alqarni, Amani M.; Aljabr, Abdullah S.; Abdelwahab, Moataza M.; Alhallafi, Ahmed H.; Alessa, Mustafa T.; Alreedy, Abdullah H.; Elmaki, Sara A.; Alamer, Naheel A.; Darwish, Magdy A.BACKGROUND: Obesity is a major health concern that requires accurate diagnosis and management. Body mass index (BMI) commonly used to diagnose obesity, has limitations in accurately assessing body fat. Body fat percentage (BF%) from whole-body dual energy X-ray absorptiometry (DEXA) scans is gaining popularity as a more accurate method in diagnosing obesity. MATERIALS AND METHODS: This cross-sectional study included 319 adult patients who underwent whole-body DEXA scans in the Eastern Province of Saudi Arabia from May 2016 to December 2021 were recruited from three medical centers, where data for whole-body DEXA were available. Body fat percent was obtained from the whole-body DEXA scan reports and were compared to BMI to evaluate prevalence of obesity. Data was extracted by reviewing patients’ records using a structured data collection tool. BMI was defined using WHO criteria, and diagnostic performance was assessed by estimating specificity, sensitivity, likelihood ratios, and predictive values, and by constructing receiver operating characteristic (ROC) curves for BMI to detect obesity by age group. RESULTS: The gender-specific BF% cutoff points revealed a higher prevalence of obesity than BMI cutoff points. BMI misclassified 40.6% of participants, and optimal cutoff points yielding highest area under the curve were 24 kg/m2 and 24.3 kg/m2 for males and females, respectively. CONCLUSION: The study underscores the importance of using accurate and comprehensive diagnostic tools such as whole-body DEXA scans to assess obesity.Item Acne vulgaris: Perceptions and beliefs of Saudi adolescent males(2017) Al-Natour, SaharIntroduction: Although acne vulgaris is common in adolescents, information on their understanding of acne is minimal. Objectives: To evaluate the perceptions and beliefs of Saudi youth on acne. Materials And Methods: Three hundred twenty-nine male students (aged 13-22 years) from 6 secondary schools in the Eastern Saudi Arabia completed a self-reported questionnaire on knowledge, causation, exacerbating and relieving factors of acne. Data were analyzed by SPSS version 15.0. Results of subjects with acne, a family history of acne, and parents' educational levels were compared. Differences between the analyzed groups were assessed by a Chi-square test; p ≤ 0.05 was considered statistically significant. Results: Over half (58.9%) of the participants considered acne a transient condition not requiring therapy. Only 13.1% knew that the proper treatment of acne could take a long time, even several years. Over half (52%) thought acne can be treated from the first or after few visits to the doctor. Popular sources of information were television/radio (47.7%), friends (45.6%), and the internet (38%). Only 23.4% indicated school as a source of knowledge. Reported causal factors included scratching (88.5%) and squeezing (82.1%) of pimples, poor hygiene (83.9%), poor dietary habits (71.5%), and stress (54.1%). Ameliorating factors included frequent washing of the face (52.9%), exercise (41.1%), sunbathing (24.1%), and drinking of mineral water (21%). The correlations of these facts are discussed. Conclusion: Results of this study point out that misconceptions of acne are widespread among Saudi youth. A health education program is needed to improve the understanding of the condition.Item Acute abdomen with Pneumoperitoneum(2004) Matar, ZaferAcute appendicitis is a common cause of acute abdomen. However, it is a rare cause of pneumoperitonium. In this report the surgical diagnoses and management will be discussed in detail.Item Acute abdominal pain in women of child-bearing age remains a diagnostic dilemma(2001) Abdelhadi, MahaAbdominal pain is perhaps the most challenging of all the presenting complaints in the emergency department. It is estimated that it accounts for 5%-10% of all visits. Causes of abdominal pain range from the inconsequential to the life threatening. In addition, it nearly always poses a greater degree of diagnostic uncertainty in women of child-bearing age as compared to males. Such difficulties become more pronounced in pregnant women where the unwritten policy seems to be: If she is pregnant blame the pregnancy. This policy is justified by the favorable clinical outcomes. However, in a small but significant number of patients, this policy has the potential of creating delays and increasing the risk of unwarranted complications. Delays in management may lead to emotional trauma, loss to the society, and the potential for serious liability. This review was undertaken at King Fahd hospital of the University, Eastern Province of Saudi Arabia, with a literature search covering a period of over twenty years. It mainly highlights the diagnostic difficulties in young women presenting with acute onset abdominal pain, and possible solutions. It also suggests a policy which includes a careful clinical approach with liberal consults between the surgeon and the gynecologist reinforced by a judicious use of the available diagnostic aids leading to potentially favorable outcomes.Item Acute epiploic appendagitis: A rare cause of acute abdomen and a diagnostic dilemma(2016) Almuhanna, Afnan; Alghamdi, Zeead; Alshammari, EimanAcute epiploic appendagitis is a relatively rare cause of lower abdominal pain that clinically mimics other acute abdomen conditions that require surgery such as acute diverticulitis or appendicitis. Here, we report a case of a 50-year-old lady who presented with an unusual lower abdominal pain. Awareness of such a clinical condition with its characteristic imaging findings is important to avoid costly hospitalization, unnecessary antibiotic courses, and the morbidity and mortality associated with surgical procedures.Item Acute life-threatening asthma in Asir central hospital(1997) Al-Ghamdi, Badr; Taklu, BayuAim: This study was conducted to analyze the severe acute asthma admissions in Asir Central Hospital (ACH) in Abha, Saudi Arabia. In particular, it aimed to identify risk factors and final outcome of acute life-threatening asthma. Method: All patients admitted to the Intensive Care Unit (ICU) with acute bronchial asthma from June 1989 to :May 1995 were analyzed. Total admissions to the ICU were obtained to determine the prevalence of asthma admission to the ICU. Results: There were 13 admissions for 8 patients. Three patients died and five were discharged in good condition. All patients received almost similar modes of therapy. Late presentation was the main cause of death. No patient died of asthma outside the ICU. Asthma constituted 0.42% of total ICU admissions. Several risk factors for admission to ICU were identified, including: poor compliance, previous requirement of systemic steroids, history of previous intubation, and psychiatric illness. Conclusion : Asthma continued to be a cause of death despite the availability of treatment. Late presentation is the main cause of death. With proper management the outcome for a majority of patients could be good even in acute life-threatening asthma.Item Acute plasmodium vivax malaria presenting with pancytopenia secondary to hemophagocytic syndrome: Case report and literature review(2009) Albaker, WaleedPancytopeni,a as an initial manifestation of acute plasmodium vivax malaria is extremely rare and mainly reported with plasmodium falciparum. We report a 37- year old Nepali patient who recently came to Saudi Arabia and presented with a three-week history of intermittent fever, chills and rigor. She was found to have spleenomegaly, pancytopenia, hyperferrtinemia, and hypofibronogenemia with positive peripheral blood smear for plasmodium vivax. The patient had a full recovery from pancytopenia with oral chloroquine.Item Adjustment disorder among first year medical students at King Saud University, Riyadh, Saudi Arabia, in 2020(2023) Alhussain, Fahad A.; Onayq, Abdulhakim I. Bin; Ismail, Dawood H.; Alduayj, Mohammed A.; Alawbathani, Turki A.; Aljaffer, Mohammed A.Abstract: BACKGROUND: The general health and well-being of medical students has become a matter of concern, as medical students have higher levels of stress than their nonmedical peers. Long-standing stress may lead to serious outcomes, such as depression, anxiety, poor quality of life, or adjustment disorders. This study aimed to estimate the proportion of first year medical students who have adjustment disorder and explore possible risk factors. MATERIALS AND METHODS: This cross-sectional study was conducted among all first-year medical students at King Saud University, College of Medicine, Saudi Arabia. The adjustment disorder-new model 20 (ADNM-20) was used to assess adjustment disorder with the stressor and item lists. The item list scores were summed and a cutoff point >47.5 was designated as a high risk of developing the disorder. Descriptive analysis included computing mean and standard deviation for continuous variable while frequency and percentages for categorical variables. Chi-square test and logistic regression analysis determined risk factors for having an adjustment disorder and the stress of attending a medical school. RESULTS: The study enrolled 267 students but only 128 completed the ADNM-20 survey. Out of 267 students, the most commonly reported recent stressor was too much/too little work, and 52.8% reported having difficulty in meeting deadlines. The most common core symptom expressed by the medical students was avoidance behavior with a mean score of 10.91 ± 3.12, followed by preoccupation with stressors with a mean score of 10.66 ± 3.10. The factors significantly associated with having adjustment disorder were being female, younger age, recent illness of a loved one, having family conflicts, and having too much or too little work. CONCLUSION: First year medical students are at increased risk of adjustment disorder. Screening and awareness programs may be considered for preventing adjustment disorder. Increased student-staff interactions may provide support to adapt to their new environment and help reduce social adjustment difficulties.Item Admissions for drug-related problems at the Emergency Department of a University Hospital in the Kingdom of Saudi Arabia(2015) Alghamdy, Mastour; Randhawa, Mohammad; Al-Wahhas, Mohye; Al-Jumaan, MohammadBackground and Aim: Medication Errors can result in drug-related problems (DRPs). Insight into the frequency, type, and severity of DRPs could help reduce their incidence. The aim of the present study was to estimate the prevalence of admissions as a result of DRPs at the Emergency Department (ED) of a university hospital in the Kingdom of Saudi Arabia. Materials and Methods: Files of suspected cases of DRPs reporting to ED in the year 2012 were scrutinized. Suspicion arose from the hospital record system based on Diagnosis Code Numbers (ICD-9-CM, Professional 2010) and from triggers, such as some drugs, laboratory tests, and signs and symptoms pointing to DRPs. Results: Of 5574 admissions, 253 (4.5%) were DRPs and were categorized as: Overdose toxicity and side effects of drugs 50 (19.8%), drug-interactions 29 (11.5%), accidental and suicidal drug ingestions 26 (10.3%), drug abuse 18 (7.1%), drug allergy 10 (4%), super-infections 8 (3.2%), and noncompliance to treatment 112 (44.3%). About 70% of DRPs were preventable; 67 (26.5%) required hospital admission for 7-102 days and 10 (4%) died. Conclusions: Noncompliance to treatment, overdose toxicity, drug interactions, and drug abuse are important causes of hospital admissions as a result of DRPs. Awareness of prescribers to the problem and their education would help to prevent them and improve patient care.Item Adolescents and cancer: A survey of knowledge and attitudes about cancer in eastern province of Saudi Arabia(2000) Hashim, TalalObjective: To determine the knowledge and attitudes of adolescents in the Eastern Province of Saudi Arabia towards cancer. Methodology: A pre-structured tested and revised questionnaire was administered to a randomly selected sample from four high schools (two males and two females) in Dhahran, Saudi Arabia. Results: Data were obtained from 572 adolescents. There was a marked variability in knowledge across informational items, particularly about the possible causes and how to avoid developing cancer. Conclusion: Students possess some knowledge of cancer, although this knowledge was not uniform. There were misconceptions about cancer and its pervention. The researcher concludes that the development and implementation of school health education programs on cancer are needed in this population.
