Level of health awareness of Saudi patients on renal replacement therapy

To assess health awareness in patients on renal replacement therapy [RRT] in Saudi Arabia. This is a cross-sectional survey using a 22-item questionnaire in 143 randomly selected adult RRT patients [40 on hemodialysis [HD], 61 on peritoneal dialysis [PD] and 42 with renal transplant [TX]]. The study was carried out at King Abdul-Aziz Medical City, Riyadh in April 2006. The questionnaire was designed to evaluate patients' knowledge in 5 areas: 1. causes of renal failure, 2. biology of the kidneys, 3. symptoms of kidney disease, 4. therapeutic options available, 5. national kidney patients support facilities. The association between the level of awareness [the percentage of correct answers] to different demographic factors was assessed. Three fifths of the patients had less than secondary education. The average mark for correct responses of all patients was 45.9% with a highest [58%] for the category on biology of the kidney and lowest [36.8%] for national kidney patients support facilities. The PD group had the highest score [54.4%] followed by HD [44.3%] and finally TX [35.1%]. The level of our patients' health awareness is lower than satisfactory. Level of education seems to be a contributory factor

Proliferative glomerulonephritis and primary antiphospholipid syndrome

Little is known regarding the association of primary antiphospholipid syndrome APLS and proliferative glomerulonephritis GN. We describe a biopsy-documented case with primary APLS and proliferative GN with no evidence of thrombotic microangiopathy TMA, and in the absence of other manifestations of systemic lupus erythematosus SLE. She presented initially with left popliteal deep venous thrombosis and nephrotic syndrome. Her first pregnancy at the age of 26 years resulted in intra-uterine fetal death at term. Two subsequent pregnancies ended up with miscarriages at 3 and 4 months of gestation. Urinalysis revealed glomerular red blood cells of 1.0000.000/ml and granular cast; proteinuria of 13.4 grams/24 hours, which was non-selective; hemoglobin 12 gm/dl, normal white blood cell and platelets; serum albumin 2.6 gm/dl; anti-nuclear antibody ANA and anti DNA were negative and complement levels normal. Lupus anticoagulant was positive leading to a diagnosis of primary APLS. The biopsy findings were consistent with membranoproliferative GN. She continued to have steroid-resistant proteinuria, but stable renal function after a 12-year follow up period. She had 2 pregnancies during this period and was delivered at term using caesarian section. She received heparin during the pregnancies. Later she developed hypertension easily controlled by atenolol. This case provides evidence that primary APLS can be associated with proliferative GN due to immune deposits and not only TMA as previously reported, and in the complete absence of SLE. Performing more renal biopsies in this group of patients may disclose a greater prevalence of proliferative GN and may help in devising a rationale for treatment

Impact of nephrology publications from Saudi Arabia in the last decade

To study the present situation with regards to the research output in Nephrology from the Kingdom of Saudi Arabia [KSA] in terms of numbers, type, institution and fields covered. An extensive Medline search of Nephrologists working in KSA, as well research output from KSA was undertaken; in addition, all Nephrologists were contacted. All papers appearing in the Saudi Medical Journal, Annals of Saudi Medicine and The Saudi Journal for Kidney Diseases and Transplantation were screened for the years 1992-2001. An average of 45 papers per year appeared over the last 10 years with no major changes over the years. Half were in the indexed Journals. Whereas, 61% were original articles, the majority of the papers [78.2%] were retrospective in nature and 89.9% were clinical. The majority were concerned with transplantation [34.1%] and hemodialysis [24.4%]. It is of interest to note that KSA leads other Arab countries in the number of publications in Nephrology and it has a highest total percentage of medical publications compared to other Arab, and Asian countries as well as the United Kingdom, Canada and United States of America. Although KSA is leading the Arab countries in renal research, much improvement is still required especially in basic research

Relevance of some of the theories of Ibn Khaldoun in his Al Muqaddimah to contemporary medicine. A personal interpretation

The subjects in this paper include Ibn Khaldoun's thoughts on writing, and their implications on today's medical writing. This paper discusses why people write, plagiarism, "Original" and "Copied' writings and where history writing goes wrong and how this can be applied to Medical writing today. The paper also discusses the nature of Science and Knowledge as viewed by Ibn Khaldoun, the anatomy of intelligence, types of thought processes, and effects of environment and craftsmanship on intellect. Ibn Khaldoun's definition of the "Medical" profession and its social standing is discussed as well as his emphasis of the importance of exercise, diet and climate on healthy living. Ibn Khaldoun has clear and advanced concepts on education and methodology of education. He emphasizes 3 stages of coaching, and the importance of travel in consolidating and clarifying knowledge attainment. He abhors coercion as a method of educating the young. Developing the interest of the pupil in the art he is studying, is thought by Ibn Khaldoun to be the central theme of good education. Relevance of all this to contemporary medical education is discussed. Ibn Khaldoun has fascinating ahead-of-time views on the influence of peer pressure and what is now known as "Emotional Intelligence" and he rejects the idea that intelligence is ethnically determined. Instead, he emphasizes the environmental, social and craftsmanship influence on human behavior. He stresses that the method of education has alot to do with the "apparent" intelligence or "stupidity" of pupils