Injection safety at primary health care level in south-western Saudi Arabia

In a study of injection safety in Abha health district, Saudi Arabia, data were collected from 47 physicians and 85 nurses at 24 primary health care centres, using an observation checklist and an interview questionnaire. All centres used individually packed disposable syringes and puncture-proof containers to collect used needles. Needlestick injury in the previous year was reported by 14.9% of physicians and 16.5% of nurses [0.21 and 0.38 injuries/person/year respectively]. Logistic regression analysis identified recapping the needle after use [physicians and nurses] and bending the needle before disposal [physicians] as significant risk factors for injury

Altitude and bronchial asthma in south-western Saudi Arabia

Through a house-to-house survey, 1325 people aged 11+ years registered at 2 primary health care centres [1 at high altitude and 1 at sea level] in Asir region, Saudi Arabia, were interviewed and examined for weight, height and peak expiratory flow rate. The prevalence of bronchial asthma at sea level [19.5%] was significantly higher than at high altitude [6.9%]. Illiteracy, low income, use of coal and wood for heating, having a mud or tent house, lack of electricity inside dwellings and presence of sheep were also significant risk factors for bronchial asthma. In multivariate logistic regression, only altitude was found to be significantly associated with bronchial asthma [adjusted odds ratio = 3.94]

Surgical interventions in multidrug-resistant tuberculosis: retrospective analysis of 27 patients treated at a tertiary level care center

To assess the results of surgery for Muttidrug- Resistant Tuberculosis [MDR-TB]. Retrospective analysis was done in 27 cases of multidrug- resistant tuberculosis in whom some surgical interventions were carried out at department of Thoracic surgery, Lady Reading Hospital Peshawar between the years 2002 to 2007. There were 18 male and 9 female patients in the age group of 14-54 years. All were sputum positive at the time of surgery. Majority of patients were treated with pulmonary resections [pneumonectomy [n=07], bitobectomy [n=08] and lobectomy [n=10]], while primary thoracoplasty with apicotysis was done in two patients. Post operatively 2[nd] line anti tubercular chemotherapy was prescribed for 24 months. There was one early and one Late death. Postoperative complications were seen in three cases. One patient developed bronchopleural fistula with empyema. At a mean follow-up of one year bacteriological cure was achieved in 24 patients. Judiciously performed adjuvant surgery can yield excellent long term bacteriological cure with acceptable mortality in multidrug- resistant tuberculosis. Morbidity and drug compliance remain as problem areas

Primary health care emergency services in Abha district of southwestern Saudi Arabia

To study emergency services delivery in all 30 primary health care centres in Abha district of Asir region, Saudi Arabia, data were collected about equipment and facilities, physicians' practices and attitudes, and patients' utilization of and satisfaction with emergency services. Two centres had no devoted place for emergency services. Lack of some essential equipment and drugs was evident. The greatest continuing medical education need for doctors was the management of cardiovascular emergencies [72.3%]. Many doctors [40.4%] did not consider the majority of cases as true emergencies. Many patients [43.7%] used the centres for emergency services, the most common being trauma, burns and orthopaedics [47.8%]. Most patients were satisfied overall with emergency services [82.2%]

Prevalence of low back pain in computer users

To study the prevalence of low back pain in computer users and how different age groups behave under prolong sitting posture on axial loading against time. A multicenter cross sectional study by initial screening questionnaire followed by further clinical examination and evaluation. Survey among students of computer institutes and the data from hospital base practice in the city of Karachi.Main out come measures: Variation in the pattern of low back pain in response to duration of work, age and gender against time was noted. Low back pain in computer users is more common in the younger age group [16-18 yrs] with a second surge [23-30 yrs] specially at the beginning of their carrier with a prevalence rate of 6.7%, mean age 30.29, std. deviation 12.744 and a frequency of male to female 223:95, novice to professional 182:136, single to married 192:127, about 44% of VDU users developed LBP in 4 hours and 35% in 3 hours about 50% of them found to have lax back muscles.Conclusion and Clinical Relevance: Low back pain is a common condition in computer users in all age groups. Working for long in faulty position; inappropriate ergonomics, old age and lack of physical exercises result in laxity of ligaments which are the main causes of back pain. Symptomatic conservative treatment with NSAIDS, muscle relaxant and regular back muscle exercises are extremely helpful

Knowledge and attitudes towards AIDS among Saudi and non-Saudi bus drivers

We explored the AIDS knowledge and attitudes of long-distance [non-Saudi] and in-city [Saudi] bus drivers in Saudi Arabia. The 69 non-Saudi drivers tended to score higher on knowledge than the 40 Saudi drivers although there were several gaps in their knowledge. As regards attitude, more Saudis knew that chastity could protect against AIDS and both groups tended to think that they were not the kind of people to get AIDS. Intensive health education and follow up is highly recommended for this sector of workers

Psychosocial assessment of geriatric subjects in Abha City, Saudi Arabia

Psychosocial assessment of geriatric subjects was carried out through a home-based survey of people aged 65 years and over [n = 810] in the catchment areas of 3 primary health care centres. All the participants had a structured interview and were given a short version of the geriatric depression scale. Depression was found in 17.5% of the subjects, more commonly in women [27.7% versus 12.7%]. The combined effect of impaired perceived health status [52.4%] and functional capacity [26.6%], loneliness [4.5%], single status [24.3%], and lack of education [80.5%] explained 23.7% of the variance in depression score by multiple regression analysis. Depression is a problem among the geriatric population in the region, especially women. Periodic home psychosocial screening of geriatrics is recommended

Central obesity in elderly individuals in south-western Saudi Arabia: prevalence and associated morbidity

Central obesity in all individuals aged 65 years and over [n = 810] in the catchment areas of three primary health care centres in Abha was determined from the waist circumference [WC] and waist-to-hip ratio [WHR]. The age-adjusted prevalence of central obesity was 32.4% and 43.5% based on the WC and WHR indicators respectively. WC was significantly associated with the risk of diabetes and hypertension, while WHR was significantly associated with the risk of diabetes only. These findings suggest that reducing the prevalence of central obesity in old age would decrease the risk of diabetes and hypertension. WC is a powerful independent predictor mainly of hypertension risk, while WHC is a good predictor of the risk of diabetes

need for traditional birth attendants [dayas] in Saudi Arabia

Preferences of women living in remote areas regarding delivery place and attendant were surveyed, opinions of primary health care [PHC] doctors about traditional birth attendants' [TBA] maternal care were assessed and training needs for TBAs were identified using questionnaires and a focus group discussion. Home deliveries and TBAs were preferred by approximately 24% and 38% of the women respectively. The fact that they were women and psychological comfort were the main reasons for preferring TBAs. TBAs disclosed many harmful practices. No PHC centre help was sought by 75% of TBAs. Lack of cooperation between PHC centres and TBAs was a concern of most of the doctors. Training and links to PHC services for TBAs are needed

Compliance and control of diabetes in a family practice setting, Saudi Arabia

This study aimed to identify some determinants of compliance with diet, anti-diabetic drugs and the appointment system amongst diabetic patients [n = 294] attending a family practice setting. The results showed that good compliance with diet was significantly higher among males [P = 0.01] and those with good diabetic control [P = 0.01], while good compliance with appointment systems was significantly associated with type II diabetes [P < 0.01] and good care [P < 0.01]. Compliance with drugs showed no significant association with any of the studied determinants [P > 0.05]. When multiple regression analysis was applied, the degree of control of diabetes, its duration and the total score of care were the only predictors of the three aspects of compliance [P < 0.05]

Effects on antithyroid agent [carbimazole] on thyroid glandul of Guinea pig with reference to hypertrophy of follicular cells

Effect of Carbimazole [antithyroid drug] on thyroid gland of guinea pig was noted Normal healthy male guinea pigs were divided into two groups, one group was given carbimazole treatment orally for 30 - days, the other group remained untreated and served as control. Histological observations showed enlargement [hypertrophy] of thyroid follicular cells with a significant decrease in the diameter of lumina of follicles amount of colloid and some increase in the diameter of follicles measured. An increase in connective tissue elements and vascularity was noted too. But all these changes were not very extensive because the duration of goitrogen [Carbimazole] treatment was too short [30 days] for such an animal [guinea pig] whose thyroid hormone metabolism is very slow with delayed TSH response to alter changes in histological picture of thyroid gland

histological study of human respiratory nasal mucosa: observations on glands

Mucosa of nasal septum, inferior turbinate and inferior meatus from eighteen autopsy cases of both sexes was studied. Observations showed that stroma was rich in connective tissue, blood vessels and glands. Collagen fibers were more than elastic fibers. Blood vessels were mostly subepithelial, and periglandular. Glands were of mixed type. The difference between serous and mucous cells of the septal, meatal and conchal regions of the same side was statistically significantant [p < 0.05]. In septal and inferior meatal region, the ratio of serious and mucous cells was approximately 2:1. In inferior conchal region their ratio was approximately 3:1

histological study of height of epithelium, distribution of Goblet cells and thickness of basement membrane in nasal cavity

A retrospective study of chromosomal changes in mentally retarded individuals was carried out at the Armed Forces Institute of Pathology, Rawalpindi from Jan 1988 to April 1993. Cases were referred mainly with the history of mental retardation and delayed milestones while some were referred with dysmorphic features. A total of 526 cases were studied. Ages of the patients ranged between 3 days to 25 years, with a male to female ratio of 2:1. Most of these patients [78%] were the product of consanguinous marriages. The technique of 72 hours lymphocyte culture with Giemsa banding was used for chromosomal studies. Out of the 526 cases, 144 [27.4%] showed chromosomal aberrations. Majority [128/144] of the cases were Down's syndrome, while 8 cases of Fragile X syndrome, 3 cases of trisomy 18, 2 cases of trisomy 13 and 3 cases were diagnosed as Prader- Willi syndrome [del 15q]. Out of 128 cases of Down's syndrome, 85 were the product of consanguineous marriages, parents of 33 cases being first cousins. The mean age of the mothers of Down's syndrome cases was 29.9 years. Number of mosaic Down's syndrome was significantly higher [27%] in our cases than reported in the Western studies. We compared the relationship of the type of Down's syndrome with consanguinity and found that the classical Down's syndrome with severe phenotype was significantly higher in the off springs of consanguineous marriages than unrelated marriages. Although the above data are institutional based, but these do highlight the fact that mental retardation due to chromosomal defects is not uncommon in our population and that the prenatal diagnosis could be a useful method in the control and prevention of such cases

Tetanus: a complication of parenteral drug abuse

A drug addict suffering from tetanus is described in order to alert physicians into recognizing this life-threatening complication of parenteral drug abuse. This young man had used all accessible veins and started injecting heroin subcutaneously. This resulted in numerous cutaneous ulcers and abscesses the probable site of Clostridium tetani infection. Prompt recognition and appropriate management resulted in complete recovery after a prolonged stay in the intensive care unit

Isospora belli diarrhoea as a presenting feature of AIDS

Isospora belli, an opportunistic coccidia, has recently been reported as a cause of severe diarrhea in AIDS patients. We report a 40-year-old female, who presented with prolonged watery diarrhea and weight loss. She had received blood transfusions in 1985 for a fractured femur. She was positive for human immunodeficiency virus antibodies. Her cd4 [helper] cells were markedly diminished. Isospora belli oocysts were repeatedly recovered from her stool specimens. She initially responded to trimethoprim-sulphamethoxazole therapy. However, eventually she expired. Patients with severe, chronic and intractible diarrhoea should be investigated for Isospora belli infection and underlying AIDS

Brucellosis: observations on 100 patients

This study is based on a retrospectively review of 100 patients with brucellosis observed over a two-year period ending May 1985. Fifty-eight percent were males, and the average age was 32 years. Fever and rheumatological findings dominated the clinical picture. Most commonly involved joints were hip, sacroiliac, knee and lumbar spine. Complications included ostemyelitis, 6%; orchitis, 6%; and neurological involvement, 5%. Bacteremia was noted in 33% of the patients. Initial serological titer was > 640 in 75% of the patients. There were no significant differences in the levels of titers between the bacteremic and nonbacteremic patients. Routine laboratory tests were not helpful in the diagnosis of brucellosis. Commonly used antimicrobial regimens consisted of streptomycin plus tetracycline or rifampin plus doxycycline. Both regimens appeared to be equally effective. Because of it nonspecific presentation, brucellosis can easily be overlooked. In suspected cases of brucellosis, serological tests appear to be most helpful in making an early diagnosis