Pattern of use and impact of patient sitters on the quality of healthcare in Saudi Arabia

To assess the pattern of use and impact of patient sitters on the quality of healthcare in Taif Armed Forces Hospital, Taif, Kingdom of Saudi Arabia [KSA]. A cross-sectional survey was conducted at the Armed Forces Hospital, Taif Region, KSA from 1st January to 30th March 2008. The study included 203 admitted patients, 125 patient sitters, and 213 physicians and nurses. Three different questionnaires were specifically designed for each group of participants including information on the pattern and duration of patient sitting, and potential benefits and harm among sitters. Approximately 58.4% of the participating sitters were women, 88% were Saudis, with age range from 17-60 years old, and mean [ +/- standard deviation] of 33.0 [ +/- 9.64] years. More than 73% of the sitters have regular jobs. Types of the room and patient's age were the significant predictors for the presence of sitters. Patient satisfaction was not significantly associated with the presence, or absence of patient sitters. Pattern and use of patient sitters in Saudi Arabia is unique where socio-cultural factors play the most important role. This study is another reminder to the healthcare system in KSA, as well as other Arab countries to develop policies that clearly specify patient criteria that support the decision of patient sitter use

Physical activity profile among patients attending family medicine clinics in western Saudi Arabia

To provide a current estimate of the prevalence and determining factors associated with physical activity among patients attending family medicine clinics in western Saudi Arabia. A cross-sectional study was conducted using an interview-administered questionnaire completed by 329 randomly selected adult Saudi male and female patients attending family medicine clinics at the Armed Forces Hospitals, Taif, Saudi Arabia. The study was conducted from December 2005 to January 2006. Approximately 54% of the participants were physically active, of whom 27.7% were practicing vigorous physical activities, and 72.3% were practicing moderate physical activities. Multivariate analysis showed that age, occupation, chronic health problems, and fear of criticism were significantly associated with practicing physical activity. Patients, as targets of health services need support and provision of facilities for appropriate understanding and practicing of physical activity. A national policy that encourages active living and discourages sedentary habits is also needed, and health care providers should pay an important role in this policy

Nucleic acid amplification technology for hepatitis B virus, and its role in blood donation screening in blood banks

To investigate the performance of hepatitis B virus polymerase chain reaction [HBV PCR] using one of the commercial methods used around the world to screen for HBV in some blood donors where other conventional serological assays have limitations to detect the virus. This study was designed to use Amplicor AmpliScreen for HBV testing to detect the presence of the HBV DNA in the specimens tested by COBAS AmpliPrep[TM] system using a modified manufacture protocol COBAS AmpliPrep of total nucleic acid isolation [TNAI] kit. All serological tests were carried out on the donors' samples to detect the hepatitis B surface antigen [HBsAg], Australian antibody anti-HBs [AUSAB] and hepatitis B core antigen [HBcAg] in the 2 periods of the study. The first period was started in February 2005 and the second period was started in April 2007. Both periods were continued for 2 months after beginning in the molecular pathology laboratory, Al-Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia. The 600 donors' data were then studied and analyzed. Five nucleic acid amplification test [NAT-HBV] positives were found out of 600. There were 3 positive for HBcAb and negative for HBsAg, 2 had reading with <100 mIU/mL anti-HBs [AUSAB], and one had >100 mIU/mL AUSAB readings. Our results show that there is a possibility to have "occult" HBV infection in some donors that cannot be detected by the HBsAg routine serological assays. Moreover, the study can be useful to formulate a new deferral policy based on the implementation of NAT-HBV for blood screening

Self-administration and reliability of computerized neurobehavioral tests among Egyptian pesticide workers

Behavioral Assessment and Research System [BARS] is a computer-based test system designed to assess neurobehavioral function and neurotixicity in humans. This system is available in 5 languages including Arabic. Tc assess the potential use of the Arabic version of computerized neurobehavioral system [BARS] and to compare performance of Egyptian pesticide workers to non-exposed populations using the same computerized battery. This study involved the administration of eight neurobehavioral tests from the Arabic computerized neurobehavioral test battery [BARS] to Egyptian workers occupationally exposed to pesticides [n= 25] as compared to non-exposed Egyptian workers [n= 25]. One-week test-retest reliability of the computerized battery was measured among non-exposed participants. Performance of pesticide non-exposed Egyptian workers did not show any significant differences between test and re-test [i.e., after one week]. Performance of pesticide exposed workers was significantly lower in most of the administered computerized tests as compared to non-exposed Egyptian and US populations. The current findings demonstrate the potential utility of the Arabic computerized BARS in occupational epidemiological research especially in the short-term intervals. Stability of the administered Arabic BARS tests over the short-term interval makes it broadly applicable in assessing exposures at different workplaces and with different cultural and educational levels

Quality improvement of diabetes care using flow sheets in family health practice

To show that the use of a flow sheet would improve performance of family physicians in diabetes care. This is a one-year intervention study conducted in 7 family practice clinics in Taif Armed Forces Hospitals, Taif, Saudi Arabia from March 2006 to June 2007. Diabetic flow sheet was developed based on the clinical practice guidelines of Canada for the management of type 2 diabetes. Patients' records were selected by systematic random sampling technique. Four hundred and fourteen medical records of patients with type 2 diabetes were included in the study. Compliance with the quality indicators was audited using 9 quality improvement indicators. Significant improvement was detected in the indicators of body mass index, glycosylated hemoglobin, microalbuminuria, lipid profile, retinoscopy, foot examination, and peripheral neuropathy examination. Flow sheet can be effective in improving quality of care not only for diabetes but also for other chronic conditions

Community-based screening for pre-hypertension among military active duty personnel

To determine the prevalence of both pre-hypertension and hypertension, and risk factors associated with the newly diagnosed Saudi military active duty personnel. A community-based cross-sectional screening of 1238 Saudi military active duty service personnel was conducted during the period from September to December 2007 at the military units of Taif region, western Saudi Arabia. Screening tools included self-administrated questionnaire, general physical examination, anthropometric measurements, and assessment of blood pressure. All participants were Saudi males. Their age ranged from +/- 7.02. By applying the Joint National Committee on prevention, detection, evaluation, and treatment of high hypertension criteria, 214 [17.3%] were considered pre-hypertensive. Multivariate logistic regression analysis showed that obesity as measured by body mass index [odds ratio [OR]=2.71, confidence interval [CI]: 1.39-5.28], positive family history [OR=1.46, CI: 1.03-2.06], ever smoking [OR=1.45, CI: 1.05-2.02], and increased waist circumference [OR=1.04, CI: 1.02-1.06] were the significant predictors of hypertension among military active duty personnel. Pre-hypertension is a common hidden problem and it predicts the development of frank hypertension. Findings of the current study support the recommendation of lifestyle modification for pre-hypertension patients. However, further prospective studies are required to determine the role of pharmacotherapy in pre-hypertension

Community-based screening for pre-hypertension among military active duty personnel

The majority of hypertension cases are asymptomatic and, therefore, goes unrecognized and untreated, leading to a high risk of coronary artery diseases, heart failure, renal failure, and cardiovascular diseases. The purpose of this study was to determine the prevalence of both pre-hypertension and hypertension and risk factors associated with newly diagnosed Saudi military active duty service personnel. Community-based screening of 1238 Saudi military active duty service personnel was conducted during the period September - December 2007 at six randomly selected out of a total of 15 military units of Taif region, Western of Saudi Arabia. Screening tools included self-administrated questionnaire, general physical examination, anthropometric measurements, and assessment of blood pressure. All participants were Saudi males. Their age ranged from 19-56 years old with mean +/- SD of 37.2 +/- 7.02. By applying the Joint National Committee on prevention, detection, evaluation, and treatment of high hypertension [JNC-7] criteria, 214 [17.3%] were considered pre-hypertensive. Multivariate logistic regression analysis showed that obesity as measured by body mass index [OR=2.71, Cl:1.39-5.28], positive family history [OR=1.46, Cl:1.03-2.06], ever smoking [OR=1.45, Cl:1.05-2.02], and increased waist circumference [OR=1.04, Cl:1.02-1.06] were the significant predictors of workplace newly diagnosed hypertension among military active duty personnel. Pre-hypertension is a common hidden problem and it predicts the development of frank hypertension. Findings of the current study support the recommendation of lifestyle modification for pre-hypertension patients. However, further prospective studied are required to determine the role of pharmacotherapy in pre-hypertension

Neurobehavioral performance among workers at water-based paints factory

Water-based paints have beneficial effects towards occupational and environmental health when compared to traditional paints that contain large amounts of organic solvents. Paint manufacturers have reduced the amount of volatile solvents by switching to water-based paints. However, most still contain a proportion of volatile solvents, thus retaining the potential to affect the central nervous system with special emphasis on the neurobehavioral performance of the exposed workers. To assess neurobehavioral performance among workers occupationally exposed to water-based paints. This study was conducted at small scale water-based paints factory in Egypt. Sixty-eight workers [mean duration of exposure was 6.5 years] were selected as an exposed group. Control group [n = 68] was recruited among workers' relatives who never worked with any type of paints. Neurobehavioral test battery was administered to all participants. The battery included tests of Similarities, Letter Cancellation, Trail-making part A and B, Digit Span, Symbol Digit and Spielberger's State-Trait Personality Inventory [STPI]. Ambient air samples were collected during regular working hours and analyzed for detection of toxic chemicals. After adjustment for potential confounders, exposed workers showed lower performance in all administered tests as compared to the control group. However, significant differences were found only in Symbol Digit, Trailmaking B and Spielberger's State-Trait Personality Inventory [STPI]. Ambient air monitoring showed presence of acrylates [1.8 mg/m[3]], formaldehyde [0.5 mg/m[3]] and ammonia [0.04 mg/m[3]]. Neurobehavioral assessment can be used as a valid, easily administered, non-expensive tool for early detection of neurotoxic effects of different exposures including water based paints. Health disorders in this industry can be reduced by replacing some toxic compounds with less toxic alternatives and by proper hygienic and ventilation measures

Slef-administration and reliability of computerized neurobehavioral tests among Egyptain pesticide workers

Behavioral Assessment and Research System [BARS] is a computer-based test system designed to assess neurobehavioral function and neurotixicity in humans. This system is available in 5 languages including Arabic. To assess the potential use of the Arabic version of computerized neurobehavioral system [BARS] and to compare performance of Egyptian pesticide workers to non-exposed populations using the same computerized battery. This study involved the administration of eight neurobehavioral tests from the Arabic computerized neurobehavioral test battery [BARS] to Egyptian workers occupationally exposed to pesticides [n= 25] as compared to non- exposed Egyptian workers [n= 25]. One-week test-retest reliability of the computerized battery was measured among non-exposed participants. Performance of pesticide non- exposed Egyptian workers did not show any significant differences between test and re-test [i.e., after one week]. Performance of pesticide exposed workers was significantly lower in most of the administered computerized tests as compared to non-exposed Egyptian and US populations. The current findings demonstrate the potential utility of the Arabic computerized BARS in occupational epidemiological research especially in the short-term intervals. Stability of the administered Arabic BARS tests over the short-term interval makes it broadly applicable in assessing exposures at different workplaces and with different cultural and educational levels