PubMed-based quantitative analysis of biomedical publications in the SAARC countries: 1985-2009

To conduct a geographical analysis of biomedical publications from the South Asian Association for Regional Cooperation [SAARC] countries over the past 25 years [1985-2009] using the PubMed database. A qualitative study. Web-based search during September 2010. A data extraction program, developed by one of the authors [SFS], was used to extract the raw publication counts from the downloaded PubMed data. A search of PubMed was performed for all journals indexed by selecting the advanced search option and entering the country name in the 'affiliation' field. The publications were normalized by total population, adult illiteracy rate, gross domestic product [GDP], secondary school enrollment ratio and Internet usage rate. The number of PubMed-listed papers published by the SAARC countries over the last 25 years axilla 141,783, which is 1.1% of the total papers indexed by PubMed in the same period. India alone produced 90.5% of total publications generated by SAARC countries. The average number of papers published per year from 1985 to 2009 was 5671 and number of publication increased approximately 242-fold. Normalizing by the population [per million] and GDP [per billion], India [133, 27.6%] and Nepal [323, 37.3%] had the highest publications respectively. There was a marked imbalance among the SAARC countries in terms of biomedical research and publication. Because of huge population and the high disease burden, biomedical research and publication output should receive special attention to formulate health policies, re-orient medical education curricula, and alleviate diseases and poverty

Effect of an intervention to improve the management of patients with diabetes in primary care practice

To assess the effect of an intervention targeted at primary care physicians [PCPs] in order to improve their management of diabetic patients. Diabetic patients seen by PCPs in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from January 2008 to July 2009 were included in this prospective cohort study. The PCPs were divided into intervention and control groups. The intervention group with the help of an assistant, utilized a customized designed computer program generating a checklist for the PCPs. The list included clinical and biochemical screening tests needed for the patient's current visit, according to evidence-based diabetes guidelines. For the control group, no assistant was used. At the end of one year, an independent reviewer evaluated the patients' files in both groups to assess the adherence to diabetes guidelines. We enrolled 162 patients in the control group and 517 patients in the intervention group. The intervention significantly improved the percentage of patients being screened for diabetic complications; retinopathy from 24.7-98.5%, neuropathy from 25.9-92%, and nephropathy from 37.8-73.7%. There was no improvement in glycemic control in both groups and glycosylated hemoglobin level [HbAlc] values were still above the 7% target. Management of diabetic patients in the primary care clinics is below standard. The intervention applied was effective in promoting better adherence to evidence-based diabetes guidelines

Students' views on student-teacher relationship: a questionnaire-based study

The aim of this study is to students' views on student-teacher relationship and its effect on academic grades. 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 fall 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%. 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 [X[2] =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 of controlling the class. Also [78.2%] students felt that the teachers treated them with respect, and their response were significantly associated with their grades [X[2]=11.8, p=0.003]. Eight-four percent of the students with higher and above overage grades strongly agreed that teacher's performance was affected by students' attendance or absence and the responses were significantly associated with their grades [X[2]=4.35, p=0.037]. The responses to most of the items by the students were independent of their grades. 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 1[st] year to 5th year undergraduate students is required to give a broader view of student-teacher relationship in a medical school

Family medicine residency program in Kingdom of Saudi Arabia: residents opinion

Medical Education continues to improve the outpatient settings; the future of both family physician and specialty of family practice will depend entirely on the quality of care which the patients receive. The initial stage of this process is its effective residency and periodical evaluation of the program. Therefore, this study attempts to explore the resident's views about their training experiences in family medicine clinical attachment and community medicine course. Questionnaire based study was conducted in family medicine training centers across the six cities representing all the regions of the Saudi Arabia. Questionnaire consists of family medicine clinical attachment and community medicine course, 139 trainees formed the sample size. About 85% of the residents believe that they should have a half day clinical attachment in family medicine training center every week throughout the whole program, 43% claimed that they do not have enough time for case discussion with their supervisor. Forty percent residents were not closely supervised by full time trainer; 60% believe that they were treated as service residents rather than trainees in family medicine. In addition, 64% stated that their training centers do not carry video camera facilities for training purposes and 74% believe that the community medicine course should be run by family medicine and community medicine trainers rather than community medicine alone. Furthermore, 50% prefer intergrated course rather than block system and 59% believe that the easily accessible facilities were available such as library, internet, audio-visual aids and 42% thought that their centers were not supported by enough numbers of full time trainers. The results of this study indicated that, it is the time to evaluate the curriculum of Saudi family medicine training program. Based on the resident's believes, immediate actions have to be taken to improve the clinical supervision, provide enough and qualified trainers for clinical teaching and evaluate the training centers and its ability to be optimal training centers rather than service centers

Assessment of care for type 2 diabetic patients at the primary care clinics of a referral hospital

There is rapid increase in the incidence of Diabetes Mellitus [DM] in the Kingdom of Saudi Arabia [KSA], as in other countries. An optimal care of diabetic patients depends on the health care providers as well as the type of health care setting. Due to the severity of chronic complications in Type 2 diabetic patients, it is essential to assess both the practices of the providers and the patient outcomes at any clinical setting. To assess the screening patterns7 of diabetes associated health care problems in primary care clinics of King Khalid University Hospital [KKUH] and while compare them to the current diabetes clinical practice recommendations of American Diabetes Association [ADA]. The retrospective review of charts of 103 eligible patients who attended the primary care clinics of KKUH over a 3 year-period [1/12001-31/12/2003] had provided 99 type 2 diabetic patients. The study variables included demographic data, complications, treatment, the provider screening practices [measurements of HbA1c, BP, Lipid profile, number of eye and foot examination]. From these data, the frequency of provider screening tests, normalized by patient-year could be compared with the ADA guidelines. The mean age of 99 type 2 diabetic patients was 57 years, with a mean BMI of 30.8 kg/m2 and with a mean duration of diabetes of 11.8 years. Many had comorbidites or complications: 25% had retinopathy, 17.2% had nephropathy, and 12.1% had neuropathy. The HbA1c level of /= 1 lipid profile, during their follow-up period. During 2[nd] and 3[rd] year follow up only 30% had >/= 1 HbA1c measurement and 26.5% [at 2[nd] year], 22% [at 3[rd] year] had >/= 1 foot examination. The proportion of patients, who had >/= 1 eye examination was also reduced during their follow up. The provider practice screening results per patient-year was well below the specified guidelines of ADA. Type 2 diabetic patients care at our primary care clinics did not adhere to the guidelines of ADA. The reasons for the deficiencies were not evident from this study. More detailed studies are needed to find out the relevant causes for the lack of adequate diabetic care at primary care clinics