Determinants of healthcare utilization and cost among privately insured families in Saudi Arabia

The kingdom of Saudi Arabia is currently restructuring its healthcare system through implementing a number of strategies among which the introduction of insurance coverage for both foreign workers and citizens. The aim of the present study is to assess factors that affect utilization and cost of health services among a group of privately insured families in Saudi Arabia. A six month administrative claims database of employees and their dependents from three different companies covered by a major insurance company was utilized to collect demographic enrollment characteristics, service utilization and services costs. The unit of analysis of the present study was families rather than individuals with a total of 131 families included in the analysis. The study revealed that those covered by the highest class of coverage provided by the insurance company [class VIP and A] had more utilization and higher mean charges per family compared to those covered by class B or C. The study also found that middle aged and older families had more utilization and average charges per family compared to younger families. Families in which women were the primary insured had both lower use and lower average charges. Finally family size seemed not related to any pattern of medical care use. Families with lower insurance class coverage, and families in which women are the primary insured showed lower utilization pattern, but families with older individuals had more utilization. Additional studies are need for a more comprehensive understanding of utilization pattern by the insured population in Saudi Arabia

Effect of growth regulators on growth, essential oils content and anthocyanin accumulation in basil, [ocimum americanum L.] shoot cultures

Shoot tips of aseptically growing seedlings of O. americanum were cultured on plant growth regulators-free culture medium [control] or on media containing 0.25 mg/l IAA and different concentrations [1,2 and 3 mg/l] of BA. The morphogenic response of the cultured shoot tips in the tested media were evaluated. Composition of the volatile oil from both shoot cultures and intact plant leaves of 0. americanum were analyzed by Gas Chromatography-Mass Spectrometry [GC-MS]. The volatile oil content and anthocyanin accumulation were determined. Clear differences between tested treatments of the produced plantlets were observed in terms of growth data after 6 weeks of culture. According to the respective growth indexes, the plantlets grown in free-growth regulators medium was the best in growth. However, Qualitative and quantitative changes in essential oil content and composition of plantlet oil were also observed in response to the effect of BA level in the culture medium. These results also indicated that anthocyanin synthesis was most active in basil shoot cultures grown in medium with BA not more than 1 mg/l with 0.25 mg/l IAA

Physiological response of rosemary plants to some vitamins

The effect of foliar application of nicotineamide, ascorbic acid and thiamine [25, 50 and 75 mg/l] on vegetative growth and chemical constituents of rosemary plants was studied. Most criteria of vegetative growth were significantly affected by application of the vitamins. Foliar application of nicotineamide to rosemary plants significantly promoted plant height, number of branches and fresh and dry weights of herb. Increasing nicotineamide concentration to 75 mg/l caused increase in the growth of the two cuttings. Ascorbic acid treatments significantly increased plant height, number of branches, fresh and dry weights of herb in both cuttings as well as chemical constituents. The highest recorded results were obtained in plants treated with 75 mg/l ascorbic acid. Foliar application of thiamine to rosemary plants significantly promoted plant growth and chemical constituents of the herb. Increasing thiamine concentration to 50 mg/l caused increase in plant growth, while increasing it to 75 mg/l led to a decrease in the growth parameters in the two cuttings. The GC-MS analysis of essential oil extracted from Rosmarinus officinalis L. plants treated with these vitamins revealed that 1,8 cineole, camphor and bornyl acetate are the major constituents [more than 9%] in all treatments, while alpha-pinene and linalool are also dominant in all treatments, respectively, except the essential oil of plants treated with 25 mg/l [NA] that recorded 4.95% alpha-pinene. Plants treated with 25 mg/l [AA] showed that alpha-bisabolol and alpha- humulene recorded the most dramatic changes and reached their maximum values of 11.31% and 4.85%, respectively, which may be at the expense of 1,8-cineole and linalool which decreased dramatically and showed the least value compared with the other treatments

Study of immunogenetic aspect of alpha-one antitrypsin phenotypes in different chest diseases

The relation between alpha 1-antitrypsin and some pulmonary diseases was studied. We studied 66 patients suffering from 3 common chest disease: Bronchial asthma [25 patients], chronic bronchitis [16 patients], bronchiectasis [25 patients] and 15 as control. They all were subjected to chest X-ray, C.B.S, ESR, quantitative determination of serum alpha 1-antitrypsin by radial immunodiffusion method and alpha 1-antitrypsin phenotyping by immunofixation electrophoresis. A second serum alpha 1-antitrypsin after 3 weeks of treatment was carried out. Serum alpha 1-antitrypsin in all patients was significantly higher than normal at initial estimation. After treatment it dropped to normal level. Serum alpha 1-antitrypsin was signifIcantly decreased than normal in bronchial asthma patients. MM phenotype was the commonest, it was found in all control, in 85% of chronic bronchitis, 80% of bronchiectasis. In asthmatic other Pi variants [MS, MZ, SS] known to be alpha 1-antitrypsin deficient in most cases. Among 66 studied 24.6% had other phenotype variant than the PiM. These Pi variants were heterozygous defecient in alpha 1-antitrypsin, and presented as recurrent chest infection or bronchial asthma

Longevity life expectancy, mortality rates, and causes of deaths of elderly rural population, Egypt, 1996

It is a descriptive analytical study utilizing death records of aged ones after 60 years and its causes, together with using available data from national vital statistics. The results showed that the age of deaths is increasing from [65-70] years reaching the age groups 85 + years in the last [3-5]years [1989-l 996]. The death causes are statistically different from combined to rural health units, which uncontrolled and not guided by WHO's international classification of diseases and causes of death. It was done on 521 cases and the age of death reached 85+ years mostly due to heart failure

effect of television watching on child diet and physical activity

The present study was conducted by questionnaire involving the mothers of 600 children aged from 8-12 years chosen from Maadi district. This questionnaire include the child personal data, family data, data about telvision watching and any other mother's notes. Analysis of the obtained data revealed that a long period of time is spent by children watching television. More than 90% of children look at television almost each day. More than 95% of children eat meals while watching the television. The food that children requested was greatly affected by food ads advertised on television. The physical activity of the children is inversely related to television viewing time. Girls are more affected by television food ads than boys. Playing with video games is much more common among boys than girls. All children [8-12 y] of the district were included. In conclusion, evaluation of the impact of television watching on diet and physical activity of the children is very important in order to develop strategies to prevent obesity and sedentary life style in children

Plasma B-Endorphin Levels in patient with chronic low back pain treated with needle acupuncture

This study is carried out to evaluate the therapeutic role of needle acupuncture in chronic low back pain and to find out its effect on plasma B-endorphin. Thirty patients with chronic low back pain with and without sciatica and ten apparently healthy subjects were included. Patients were divided into two groups. In the first group [20] patients were treated with needle acupuncture for one month, while patients in the second group [10] were treated by placebo. Clinical evaluation was carried out before and after treatment. Plasma B-endorphin immunoreactivity level was determined by radioimmunoassay. The plasma B-endorphin level was significantly [P<0.001] higher in normal subject than in the chronic low back pain patients. However, there was a significant [P<0.001] increase in plasma B-endorphin in chronic low back pain patients after one month treatment with needle acupuncture. There was a statistically significant reduction [P<0.001] of low back pain after one month of acupuncture treatment. There was a significant increase [P<0.001] in the range of movement of the lumbar spine. Also there was a significant improvement in straight leg raising [SLR] [P<0.001].From these results we could conclude that needle acupuncture is effective in management of patients with chronic low back pain and this therapeutic effect is accompanied by a significant increase in plasma -endorphin level

Fibrinolytic activity in rheumatoid arthritis

This study was carried out to investigate whether there is a defective fibrinolytic activity or not in patients with rheumatoid arthritis [RA]. 15 patients with RA, and 10 apparently healthy controls were included. In RA, various clinical and laboratory criteria were used to assess disease activity. Fibrinolytic activity in the blood was assessed using: plasma fibrinogen, fibrinogen/fibrin degradation products [FDPs] and euglobin clot lysis time [ECLT]. Patients with RA were found to have an enhanced fibrinolytic activity manifested by a significant shortening of ECLT [P > 0.01] and a significant increase in FDPs concentration [P> 0.01]. Disease activity as measured by a composite activity index [CAl] showed an inverse correlation [rs = 0.74, P > 0.001] with ECLT and a positive correlation with FDPs [rs = 0.71, P > 0.001] and fibrinogen[rs = 0.77, P > 0.001], in RA patients a significant correlation was found between plasma fibrinogen and morning stiffness [rs = 0.88, P > 0.001], grip strength [rs = 0.63, P > 0.02], articular index [rs = 0.78, P > 0.001], and functional status[rs = 0.78, P > 0.001], ESR[rs = 0.87, P > 0.001]. the increased fibrinolytic activity observed in RA patients may be due to an increased fibrinolytic activity observed in RA patients may be due to an increase in disease activity. Therefore, enhanced fibrinolytic activity in RA might be considered as one of the body defence mechanisms. In conclusion : We have demonstrated enhanced fibrinolytic activity with increased disease activity in RA therefore, disease activity should be considered during the assessment of fibrinolytic activity in RA patients