Patients' attitudes and perceptions regarding research and their rights: a pilot survey study from the Middle East

Ethical and regulatory oversight of research may be suboptimal in low- and middle-income countries. To determine patients' attitudes and perceptions toward research participation and perceptions of their rights, we recruited 202 participants from hospitals in Egypt, Lebanon, Saudi Arabia and Sudan and asked them to complete a questionnaire assessing attitudes and perceptions. Around 20% believed that doctors sometimes perform research on patients without their knowledge and 35% believed that if participants withdrew from the research they would not receive good medical care. Over 85% believed that they should have rights regarding confidentiality of data, free medical care if injured during the research and asking questions. Almost half believed they have a right to withdraw without penalty and around 75% believed they could make complaints without fear of harm. Those who were illiterate or unemployed were less likely to appreciate their rights compared with their counterparts

Can the prevalence of dental caries be used as an indicator of the quality of dental services? a cross-sectional study among children in Almadinah Almunawwarah, KSA

Objectives: To report on the caries status and utilization of dental services of 6- and 12- year-old children

Methods: This cross-sectional analytical study was conducted in four primary schools during January through March 2013. Quantitative and qualitative data were collected by using an interview-based questionnaire and a clinical oral examination. Clinical oral examination recorded caries status using the decayed [D/d], missing [M/m] and filled [F/f] index; Decayed, Missing and Filled Index [DMFT]

Results: Of a total of 384 students, 330 responded [response rate of 86%]. Two thirds [65%] of participants were females and they had significantly more caries [p < 0.05] in both primary and permanent dentitions as compared to males. The mean DMFT for 6-year-old and 12-year-old children were 4.9 and 1.3, respectively. The prevalence of caries amongst 6-year-old children was reported to be 86% and that for 12-year-old was 68%. All respondents reported using a toothbrush and 20% claimed to visit a dentist regularly. Those who did not regularly visit a dentist had 78% prevalence of caries and they suggested "fear" [29%] and "no reason to visit a dentist" [20%] as reasons for not visiting a dentist. Of those who recently visited dentists, 69% were diagnosed with caries and the most common treatment modalities received were medication [50%] and oral hygiene instructions [19%]

Conclusion: The prevalence of dental caries in this cohort of children was similar to that of earlier studies done in the KSA. The utilization of dental services remained fairly low and those children who did attend dental clinics primarily received preventive services

Knowledge, attitudes and practice with regard to the articles of the framework convention on tobacco control among Egyptian adults

Egypt signed the Framework Convention on Tobacco Control [FCTC] in 2003, and it was ratified by the Egyptian Parliament in February 2005. Although most of the articles of the FCTC are reflected in Egyptian law and regulations, enforcement is rare for many reasons. The aim of the study was to evaluate knowledge, attitudes and practice toward the FCTC among Egyptian adults. Cross-sectional survey with an interview questionnaire about knowledge, attitudes and practice as regards the FCTC among 2941 people from them 1584 smokers [97% men, 3% women] in two governorates of Egypt. The prevalence of smoking varied, being higher among men [97%] than women [3%] and was higher among adults under the age of 55 years. Most smokers [74%] knew that smoking by children and adolescents was not allowed, and that tobacco contains tar and nicotine, which are hazardous to health. Half of the smokers were unaware of the presence of warning signs on boxes. Most smokers knew that advertising of cigarettes is not allowed [66.8%], the media do not advocate for smoking prevention [67.8%], not enough information is given about its hazards [64.3%], and there is no media campaign against smoking [83.9%].Most smokers [62.2%] considered that there is no active strategy against smoking, and 77.3% said that there was no Government policy against smoking. Half the smokers [50.4%] thought that people in the community were not interested in smoking prevention, and medical personnel should help; 70.7% concluded that little was being done to prevent smoking. The data from this study could be used as a baseline for future evaluations of tobacco control programmes implemented by the Ministry of Health of Egypt

Patient satisfaction from dental services provided by the college of dentistry, taibah university, Saudi Arabia

Quality is a major concern of health care agencies all over the world. Patients' satisfaction has been investigated in many colleges of dentistry in various countries. Dental complaints made by patients may cause a great deal of anxiety and stress among dental care providers. It is important for the profession to promote high standards of professional conduct among dentists. The aim of this study is to determine patients' satisfaction regarding the quality of dental care at dental clinics of the College of Dentistry at Taibah University. A cross sectional analytical observational study was conducted at the dental clinics of the College of Dentistry at Taibah University. A random sampling technique was employed over a threemonth period;March 1st-May 31st 2012. A self administered [Arabic/English] questionnaire was used. A total of 202 patients qualified for the study, but only 162 agreed to participate with a response rate of 80.19: [55.6%] were Saudi nationals and 44.4% were Non-Saudis. The overall ranking of factors related to satisfaction revealed a mean percentage of 79.5% agreement for the 4 disciplines of satisfaction denoting a high level of satisfaction. The association between respondents' nationality and the characteristics of the four disciplines of satisfaction revealed significant difference between Saudi and Non Saudis. The majority of patients were satisfied with the patient-dentist interaction, technical competency, administrative efficiency and clinic set up environment at the dental clinics of the College of Dentistry at Taibah University. Continuous evaluation of patient satisfaction is to be part and parcel of the oral health care delivery by the College of Dentistry at Taibah University to ensure patient satisfaction.

Hyperleptinemia and peripheral WBCs in nephropathy associated with type 2 diabetes

Peripheral white blood cell [WBC] count has been shown to be associated with insulin resistance, type 2 diabetes, coronary artery disease [CAD], stroke and diabetes micro-and macrovascular complication. Leptin's hematopoietic or proinflammatory role has been experimentally reported. We investigated whether serum leptin concentrations are associated with white blood cell [WBC] counts in diabetic nephropathy patients of type 2 diabetes mellitus. We studied three groups of patients according to albuminuria level: normal [18 patients], micrialbuminuria [17 patients] and third group with overt proteinuria [21 patients]. The total and differential leukocyte profiles of peripheral blood were measured and plasma leptin was examined by enzyme-linked immunosorbent assay. In our study, we showed a significant higher leptin level [p= 0.0 5] and neutrophilic counts [p= 0.017] in diabetic nephropathy patients but failed to show an association between leptin level and TLC or neutrophilia. Our study confirmed a significant hyperliptenemic state and higher neutrophilic counts in diabetic nephropathy patients of type 2 diabetes mellitus. These finding might be reinforcement of importance of inflammation in the pathogenesis of this microvascular complication of diabetes

Determinants of birth spacing among Saudi women

High fertility levels are of major concern to planners and policy makers in most countries in the developing world. In Saudi Arabia, the rale of population growth is the third highest of the countries of the Eastern Mediterranean Region. This study aimed at identifying determinants of birth spacing and attitudes toward family planning among Saudi women, A cross sectional survey of all women who lutve been married before, aged 15 -49 years attending A I Hada armed forces hospital [primary health care and antenatal care clinics], was conducted between 1[st] February 2005 and 31[st] January 2006. Data was collected on sociodemographic biological characteristics, beliefs, attitudes, and utilization of family planning services, pregnancy intervals and medical history. For the 786 women included in the study, the mean duration of interbirth interval was 2.38 +/- 1.24 years. The multivariate Cox regression revealed thai a woman's education, work status, husband's work status, a woman's history of chronic diseases, and husband's encouragement of inierbirth spacing were the only significant predictors of longer interbirth intervals. Shorter interbirth intervals were independently predicted by lower family income, and presence of female offspring only or equal number of male and female offspring as opposed to presence of more males. The great majority of participating women [98%] had a positive opinion of the effect of birth spacing on the family. This study showed that certain factors were significant predictors of interbirth spacing for the Saudi women. This should lead to the encouragement of longer intervals between births. However futher studies are needed to ascertain a cause-effect association

Depression and body image disturbances among females seeking treatment for obesity in Saudi Arabia

Obesity is an increasingly prevalent disease around the world and is becoming one of the main public health problems in developed countries. The relationship between obesity and psychological distress continued to be debated by researchers and clinicians alike. This study aimed at assessing depression and body image disturbances in obese patients seeking treatment for obesity. A case-control design was adopted in the study. A total of [236] obese women, selt-referred to a residential weight-loss facility for weight control, were invited to participate in this study. Obese women were compared with [296] of a control group [of the same age range, but with normal weight]. All participants completed the Beck Depression Inventory for depressive symptoms, Multidimensional Body-Self Relations Questionnaire for body-image satisfaction and The Body Image Avoidance Questionnaire. Results revealed that obesity was more common among older than younger females, among married than single females, and among those with lower level of education than those with higher level. Obese women as compared with non-obese reported significantly more symptoms of depression and signiticantly more negative body image

Conclusions: The present results indicate a high frequency of depressive symptoms, and concern with body image among obese patients. Therefore, obese women who seek treatment should be screened for depression and body image dissatisfaction

Proactive measures in family practice: the approach and limitations in a chronic disease model

Chronic diseases form an important health problem facing the health system in Egypt. The family health model provides an integral approach to health problems including chronic diseases to provide the basic services which include both health and population interventions. The aim of this work was to improve the health of the Egyptian population and to decrease the burden of chronic illness. Specific objectives were to assess the present and potential role of family practice in prevention and control of priority chronic diseases and to develop a prototype for family practice services dealing with these diseases. The study was conducted in one of family health units, Kafr Ayoub rural health unit Belbeis district, Sharkeya governorate. The methodology followed a Systems Analysis [SA] approach. In addition an exit interview questionnaire was done with clients for assessment of satisfaction and orientation about family practice. Hypertension was the selected model of chronic diseases in this study. Results of basic clinical examination done by the Ministry of Health and Population health team was compared to the results of clinical examination done by the research team to assess the quality of initial examination. Cases of Diabetes Mellitus were similar whereas diagnosed cases of hypertension showed variation. A protocol for diagnosis and follow up was suggested and implemented in this unit during the study period. Health education messages were prepared by the study team. Health care providers were trained to implement health education sessions for clients and hypertensive patient as a starting model for health education within the family practice program. The main recommendation is to increase awareness about family practice and the importance of the family physician in detecting and follow up of chronic disease being the first gait to the health system in the country. The importance of cooperation between MOHP and the university was emphasized