School Screening for Scoliosis among Male Adolescents in Abha City, Southwestern Saudi Arabia

Aim: To study the prevalence of scoliosis and its associated factors among male adolescents in Abha city intermediate and secondary schools, Aseer Region, Southwestern Saudi Arabia. Methods: Through a cross-sectional study, students were interviewed about personal and demographic data, method of back-bag carriage, and regular practice of any physical exercise. Body mass index (BMI) was measured and student’s bag weight/BMI ratio (%) was computed. Screening for scoliosis was performed using inspection of the vertebral column and Adam’s Forward Bending Test (FBT). Using scolimeter a reading equal or exceed 5 degrees was considered positive. Results: Out of 417 screened adolescents, 90 students were positive giving a prevalence rate of scoliosis of 19.1% (95% CI: 15.7- 23.0). Using multivariable logistic regression analysis, the probability of positive scoliosis was significantly higher in secondary school (aOR=2.304. 95% CI: 1.447-3.676) and obese and overweight (aOR=2.433. 95% CI: 1.565-3.787) adolescents. On the other hand, regular practicing of physical exercises was significantly negatively associated with scoliosis (aOR=0.469, 95% CI: -316-0.695). Conclusion: The present study identified scoliosis as a substantial problem among adolescents. School health authorities need to foster a screening program for scoliosis, particularly among secondary school adolescents. School health promotion programs should address overweight and promote physical exercise to deal with this problem.

Changes in hand hygiene compliance after a multimodal intervention among health-care workers from intensive care units in Southwestern Saudi Arabia

The aim of this study is to measure the degree of compliance with hand hygiene practices among health-care workers [HCWs] in intensive care facilities in Aseer Central Hospital, Abha, Saudi Arabia, before and after a multimodal intervention program based on WHO strategies. Data were collected by direct observation of HCWs while delivering routine care using standardized WHO method: "Five moments for hand hygiene approach". Observations were conducted before [February-April 2011] and after [February-April 2013] the intervention by well-trained, infection-control practitioners during their routine visits. The study included 1182 opportunities [observations] collected before and 2212 opportunities collected after the intervention. The overall, hand hygiene compliance increased significantly from 60.8% [95% CI: 57.9-63.6%] before the intervention to reach 86.4% [95% CI: 84.9-97.8%] post-intervention [P = 0.001]. The same trend was observed in different intensive care facilities. In logistic regression analyses, HCWs were significantly more compliant [aOR = 3.2, 95% CI: 2.6-3.8] after the intervention. Similarly, being a nurse and events after patient contact were significant determinants of compliance. It is important to provide sustained intensified training programs to help embed efficient and effective hand hygiene into all elements of care delivery. New approaches like accountability, motivation and sanctions are needed

Rift Valley fever among children and adolescents in Southwestern Saudi Arabia

Rift Valley fever [RVF] virus has expanded its geographical range, reaching Asia in 2000. This work investigated RVF seroprevalence among children born after the 2000-2001 outbreak in Saudi Arabia and compared it with the seroprevalence of adolescents born before the outbreak. In a seroepidemiological study in Southwestern Saudi Arabia [Jazan, Aseer, and Al-Qunfuda], a random sample of 389 children and adolescents was investigated. Data were collected regarding the subjects' sociodemographic status, housing conditions, and animal contact. Blood samples were collected and tested for RVF-specific IgG and IgM. None of the study samples were found to be seropositive for anti-RVF virus IgM. None of the study subjects aged 1-8 years [born after the outbreak] were positive for RVF-specific IgG. In contrast, 14 subjects [4.8%] aged 9-19 years [born before the outbreak] were positive for RVF-specific IgG. Among adolescents in our study, 4.9% were positive for anti-RVF IgG. This study showed that among adolescents, a history of contact with aborted animals [aOR = 13.361, 95% CI = 5.091-35.072] and transporting aborted animals [aOR = 18.861, 95% CI = 11.125-31.622] were significant risk factors. Despite the low virus activity recently reported among animals, neither clinically apparent RVF infections nor outbreaks among humans have been documented, indicating that the control measures taken by the Ministry of Agriculture and Ministry of Health are effective

Diagnostic importance of platelet parameters in patients with acute coronary syndrome admitted to a tertiary care hospital in southwest region, Saudi Arabia

Identifying risk factors for acute coronary syndrome [ACS] is important for both diagnostic and prognostic purposes. Abnormal platelet parameters, mainly platelet count [PC], mean platelet volume [MPV] and platelet distribution width [PDW] are thought to be among these risk factors. In this study, the associations between PC, MPV and PDW and ACS were investigated in patients admitted to the tertiary care hospital in the south west region of Saudi Arabia. A retrospective cohort of 212 patients with the diagnosis of ACS admitted to Aseer Central Hospital during the period extending from February 1, 2008 to October 31, 2008 were included. The control group consisted of 49 matched subjects who were admitted for chest pain investigation and subsequently found to be non-cardiac chest pain after performing relevant investigations. Blood samples were taken at the time of admission for platelet parameters. Statistical analysis was made using SPSS software and P-values were considered significant if <0.05. A total of 212 patients with acute coronary syndrome [80 patients with MI and 132 patients with UA] and 49 matched controls were studied. The PC was not statistically different among the three groups [283.3 +/- 94.8 x 10[9] L[-1] for MI cases, 262 +/- 60.8 x 10[9] L[-1] for UA cases and 275.8 +/- 58.9 x 10[9] L[-1] for controls]. The MPV was significantly larger in MI cases compared to controls [8.99 +/- 1.5 fl vs. 8.38 +/- 0.51 fl, respectively, P < 0.009], similarly, the MPV was significantly larger in UA cases compared to controls [9.23 +/- 1.19 fl vs. 8.38 +/- 0.51 fl, respectively, P < 0.001]. The PDW was significantly higher in MI cases compared to controls [15.88 +/- 1.5 fl vs. 11.96 +/- 1.8 fl, respectively, P < 0.001], similarly, the PDW as also significantly larger in UA cases compared to controls [18.1 +/- 18 fl vs. 11.96 +/- 1.8 fl, respectively, P < 0.019]. Platelet parameters mainly MPV and PDW are readily available and relatively simple and inexpensive laboratory tests which we detected to be significantly raised in patients who have suffered an acute coronary syndrome compared with controls

Assessment of malignancy rate in thyroid nodules according to the Bethesda system of fine-needle aspiration. Report from a tertiary center in the Southwestern region of Saudi Arabia

To determine the rates of malignancy of thyroid nodules in each standard cytologic diagnostic category of the Bethesda system. In a retrospective cohort study from October 1998 to April 2007 at the Department of Pathology, Aseer Central Hospital, Southwestern region of Saudi Arabia, all cases of thyroid nodules that underwent preoperative cytologic examination by fine-needle aspiration [FNA] and concurrent postoperative histopathologic examination were included. All FNA diagnoses were reclassified using the thyroid FNA Bethesda reporting system, including non-diagnostic [insufficient], benign, atypical follicular lesion of undetermined significance [AFLUS], neoplasm, suspicious of malignancy, and malignant groups. The rate of malignancy based on final histopathologic evaluation was analyzed for each of these cytologic groups. A total of 323 thyroid fine needle aspiration cytology [FNAC] diagnoses were reclassified into non-diagnostic 6.2%, benign 57.3%, AFLUS 13.6%, follicular and Hurthle cell neoplasms 16.1%, suspicious of malignancy 1.5%, and malignant 5.3% groups. The corresponding rate of malignancy on histopathologic examination was as follows: 35% in the non-diagnostic group, 10.3% in the benign group, 15.9% in AFLUS group, 32.7% in follicular and Hurthle cell neoplasms, 60% in the suspicious of malignancy group, and 94% in the malignant group- Applying a standard terminology reporting system for thyroid FNA may enhance the communication between pathologists and clinicians, assists them to find out the rate of malignancy in each cytologic group, and facilitating a more consistent approach for patients' management

Patterns of thyroid cancer in southwestern Saudi Arabia

To examine the pattern of thyroid cancer, assess the magnitude of the problem, and evolve a management plan for such malignancies. This is a retrospective cohort study of all thyroid cases operated at Aseer Central Hospital, Abha, Kingdom of Saudi Arabia, between January 1998 and December 2007. Clinical presentations, management regimens, and recurrence were reviewed. Five hundred and sixteen patients were operated for different thyroid lesions. Ninety-two [17.8%] were malignant [20 males and 72 females]. Mean age for males was 41.35 +/- 15.52 years compared to 36.59 +/- 13.28 years for females. Papillary carcinoma constituted 50%, while follicular carcinoma formed only 4.3% of malignant cases. Lymphoma ranked third with only 1.1% of all malignant thyroid lesions. No cases of medullary carcinoma were found. Of 92 patients, 75 reported for follow-up. The recurrence rate for follow-up patients was 29 [31.5%]. High resolution neck ultrasonography and image-guided fine needle aspiration cytology should be considered as routine investigative tools in patients with suspicious thyroid swelling. Total thyroidectomy and removal of all lymph nodes in the central compartment of the neck seem to be the ideal management plan, until such trials emerge. Residual thyroid tissues, following surgery, should be ablated using radioiodine [I131] isotope

Canonical correlation analysis of the determinants of menopausal symptoms

To describe the intensity and determinants of symptoms commonly attributed to the menopause among a random sample of women aged 50 to 59 years, selected from the total population of a geographically defined area. Data were collected based on a cross-sectional design using structured questionnaire and face-to-face interview survey. Households. Four hundred and fifty women, aged 50 to 59 years, randomly selected from Alexandria residents by the method of cluster sampling. Self-reported symptoms, factor scores for menopausal symptoms extracted by factor analysis, and an index for the number of experienced symptoms.77.5% of currently married women and 800.3% of unmarried women reported moderate-to-severe symptoms with significant differences between the two groups in intensity of vasomotor [more intense among married], psychological, and miscellaneous [more intense among unmarried]. Canonical correlation revealed seven significant roots among married women explaining 82.2% of variance in menopausal symptoms and four among the unmarried explaining 57.5% of variance. Among married women, the prominent factors in relation to menopausal symptoms are duration of hormone use, obesity, knowledge and attitude concerning menopause, pattern of menopause, and physical activity. Among the unmarried, there were also correlations of menopausal symptoms with same factors in addition to work, education, and time since last menses. Though menopause is a natural biological process, it has been shaped by social, economic, medical, and reproductive factors. Putting these factors in mind of health care workers can help women to go through this passage of life with no or minimal discomfort

pharmacoepidemiological study of prescription pattern in outpatient clinics in Southwestern Saudi Arabia

A pharmacoepidemiological study of prescription pattern in outpatient clinics in Southwestern Saudi Arabia. A total of 3796 prescriptions from outpatient clinics of Aseer Central Hospital, Abha, Kingdom of Saudi Arabia were screened randomly and systemically over one-year period [April 2000 to April 2001]. The prescriptions were analyzed for the essential elements of the prescription order, and for the number and classes of drugs prescribed, source of prescription and appropriateness of prescription to the diagnosis. The source of prescriptions was not provided in 61.5% of prescriptions. The diagnosis was missing in 15.1% and not readable in 18.9% of prescriptions. Upper respiratory tract infection [URTI] was the most frequent diagnosis and was included in 21.6% of prescriptions. The average number of drugs per prescription was 2.1 +/- 1.05 [Mean +/- SD], with 90.8% of prescriptions containing 3 or fewer drugs. The most frequently prescribed drugs were nonsteroidal anti-inflammatory drugs [NSAIDs], including paracetamol which were included in 51.2% of prescriptions, followed by antibacterial agents [33.2%]. Only 46.4% of prescriptions were appropriate to the diagnosis, while 11.1% were partially appropriate and 5.3% were inappropriate. For the rest [37.2%], it was difficult to evaluate appropriateness due to deficient information. General practitioners and specialists were more likely to prescribe appropriately than emergency room physicians [64.6% and 60.4% versus 35.7%]. None of the prescriptions for antiplatelet and anticoagulant drugs and antihypertensive agents were inappropriate. These results emphasize the need for continuing medical education on rational prescribing, and for periodic monitoring of physicians habits on drug utilization

Health services delivery in Asir, Saudi Arabia: regional experience of integration

This paper presents the local experience of the General Directorate of Health Affairs in Asir, Saudi Arabia, regarding integration of health services. The geographical, sociodemographic and administrative situations of the region necessitate this approach. A historical background of the development of health services in the region in the recent past is presented. Restructuring of the health system, changes in management functions and advantages of integration of health services are discussed

Prevalence of hypertension in south-western Saudi Arabia

Prevalence of hypertension was surveyed in south-western Saudi Arabia. Hypertension was ascertained by measuring blood pressure under standard conditions and by interview for positive history. The overall prevalence was 11.1%, and the age-adjusted prevalence was 10.6% in men and 11.4% in women. Prevalence increased significantly by age. Among previously known cases, 76% were receiving treatment, but only 20% were found controlled. It is concluded that hypertension affects a sizeable proportion of Saudi communities. Further efforts are needed to improve control of the disease

Anaemia among elderly in Alexandria: an epidemiologic study

Anaemia among elderly in Alexandria was investigated using cluster probability sampling technique. The sample included 122 males and 219 females. The age ranged from 55 years to 91 years. More than half of the males [66.4%] and females [61.6%] were sufferring from anaemia. More than three quarters of elderly with anaemia among males [75.3%] and females [82.9%] were of the hypochromic type. No statistical significant difference was found between both sexes among different age groups concerning haemoglobin level, hematocrit, RBC's count, MCV, MCH and MCHC. Multiple and partial correlation analysis of haemoglobin with age, crowding index and income per capita showed no statistical significance. The study of sociodemographic variables [age, marital status, level of education, crowding index and income per capita] among elderly with different types of anaemia and those without anaemia showed no statistical significant difference