Knowledge, attitude and practice of patients with type 2 diabetes mellitus towards complementary and alternative medicine / 中西医结合学报

<p><b>OBJECTIVE</b>The use of complementary and alternative medicine (CAM) is relatively common among patients with type 2 diabetes mellitus (T2DM) around the world. Like many other countries, Saudi Arabia has a high incidence of T2DM, and incorporates the use of CAM in its treatment. This study explores the knowledge, attitude and practice (KAP) of CAM therapies among patients with T2DM and explores the relationships between sociodemographics and the KAP of CAM modalities.</p><p><b>METHODS</b>This is a hospital-based, observational, cross-sectional study that selected 302 outpatients with T2DM, from Diabetic Center of King Salman bin Abdul-Aziz Hospital, in Riyadh city, in May 2014. Patients were interviewed using a predesigned questionnaire.</p><p><b>RESULTS</b>The mean age of patients was (51.6 ± 10.6) years and 43.4% of them were males. The prevalence of CAM practices was 30.5%; 30.39% of them used herbs, 20.58% used wet cupping and 17.64% used nutritional supplements and other therapies. The factors found to predict the use of CAM therapies among patients with T2DM were: age above 51 years, unemployment and the participants± knowledge about the effectiveness of CAM products.</p><p><b>CONCLUSION</b>This preliminary study estimated the prevalence of CAM use, revealed positive attitude towards CAM and found three significant predictors of CAM use among patients with T2DM, which is consistent with regional data. A community-based research with a larger sample that targets T2DM population is needed in Saudi Arabia.</p>

Risk factors of congenital pediatric surgical birth defects: a case control study

Birth defect is a global health problem. Serious birth defects are life threatening or have the potential to result in disability. In Egypt the prevalence of birth defects is increasing, it reached 3.2% of all births [1998]. The present study was earned out to identify different potential risk factors for birth defects and estimate the magnitude of risk for each factor Identified. A case control study was carried out in the Pediatric Surgical Department of El Shatby University Hospital in Alexandria. A structured interview schedule was used to collect data. Gastrointestinal tract [GIT] is the most commonly encountered system for birth defect [53.0%]. Only 11.0% of cases were diagnosed during pregnancy. Boys were more encountered than girls. The final model of multiple logistic regression analysis revealed that high maternal education, unplanned pregnancy, medical problems prior to pregnancy and eating contaminated raw food were significant contributing factors that increased risk of birth defects. No significant associations were found between cases and controls as regards consanguinity parental age, housing and working conditions, family and reproductive history. A pre- pregnancy visit was recommended to identify risk factors and allow for appropriate testing and guide for better changes to improve chances of having a healthy baby

Predictors of clinical outcome among adolescents with first episode schizophrenia in Alexandria.

Evidence was emerging that the early phase following the onset of a first psychotic illness could be conceived of as a critical period, influencing the long-term course of the illness. Effective intervention at this stage might alter the subsequent course of the illness. Psychosis may be developed as the action of social or psychological stressors acting on the vulnerable individuals. The present study aimed at providing data about potential sociodemographic and family risk factors related to development of first episode schizophrenia [FES], identifying clinical profile of FES among adolescents, providing baseline assessment of patients with FES as well as changes in assessment domains during five months follow up period, and finally identifying significant contributing factors related to clinical outcome of FES among adolescents. A clinic-based case control study was carried out. Cases were recruited from Psychiatric Consultation Clinic for school children in Alexandria. The trained investigators themselves collected the data using precoded structured questionnaire. A structured clinical interview format was used for assessing five domains. The majority of cases [88.7%] claimed that illness was precipitated by stressful life events. Source of referral was the physician in 66.2% of instances. The most commonly cited reason for referral was aggression and violence [39.4%]. More than one-fifth of cases [21.1%] visited faith healer before referral and 19.7% did not seek any medical care. Just less than two-thirds of family members [60.6%] had negative attitude towards the illness. Nearly three-quarter of cases [73.2%] reported progressive course of illness. Significant risk factors for FES in logistic regression model were: positive family history of mental disorders [Adjusted OR=6.47, 95% Cl=1.29-9.61], unskilled fathers' occupation [Adjusted OR=1.34, 95% Cl=1.22-3.03], low mothers' educational level [Adjusted OR=4.92, 95% Cl=2.42-9.71], and negative parental rearing style [Adjusted OR=2.51, 95% Cl=1.67-4.471. The estimated remission rate following the follow up period was 86.3%. Positive symptoms improved in 87.3% of cases while negative symptoms improved in 83.1% of cases. Moreover, 73.2% of cases experienced improvement in psychopathological symptoms. Social functioning had improved in 76.1% of cases. Compliance to medication and family support were the only significant predictors for clinical improvement in patients with FES [Adjusted OR=3.15, 95% Cl=2.64-6.83, P<0.001, and 2.63, 95% Cl=1.89-5.72, P=0.0081. The present work concluded that the best strategy is to early diagnose and treat patients suffering from first episode psychosis. This includes appropriate medical diagnosis, neurocognitive and psychological assessment, and appropriate medication. The support and necessary education were needed for family members to be helpful