Standards of growth and obesity for Saudi children (aged 3 -18 years) living at high altitudes.

AIM OF STUDY: To standardize the growth parameters for Saudi children aged 3-18 years living at high altitude and to investigate the appropriateness of using the National Center for Ilealth Statistics (NC(IIS) growth standards for the assessment of children's growth at this high attitude area. SUBJECTS AND METHODS: The present study follows a cross-sectional study design. A total of 13,580 native Saudi children (7,193 boys and 6,387 girls) aged 3-18 years living in Abha City (Elevation: 3,100 meters above sea level) constituted the study's sample. All chronically and acutely ill children were excluded. The data regarding the children were obtained from the well-baby clinics at primary health care centers and nurseries, as well as primary, intermediate and secondary schools. The percentiles for the weight and height and the body mass index (BMI) were calculated separately for the boys and the girls using one-year intervals. BMI values above the 95th and below the 5th percentiles were considered as diagnostic for obesity and underweight, respectively. RESULTS: Median values of weight and height for Saudi's children (both boys and girls) were lower than their corresponding values for children in the USA. Median values of the BMI for the Saudi's boys were almost identical to those of the USA's NCHS median values through all ages that were studied. On the other hand, the median values for the BMI were almost identical for the Saudi's and USA's girls aged 3-9 years. However, after the age of 9 years the differences in the median values for the BMI were increased progressively due to the higher values for the Saudi's girls. CONCLUSIONS: The use of the NCHS growth standards is not appropriate for the assessment of growth of children that live in the high altitude area of Abha and further studies are needed to determine the exact impact of high altitude on the growth patterns in children.

Appropriateness of requests for therapeutic drug monitoring of antiepileptic drugs: the experience in southwestern Saudi Arabia.

The purpose of this study was to evaluate request forms of therapeutic drug monitoring of antiepileptic drugs for appropriateness criteria according to published data. Request forms received by the laboratory were sampled as all requests in one day per week on an alternating basis. Drugs monitored were phenytoin (PHT), phenobarbital (PB), carbamazepine (CBZ) and valproic acid (VPA). A total of 420 request forms were collected. Age, gender and weight were provided in 95.5%, 97.1% and 56.9% of request forms, respectively. The diagnosis, seizure type and the indication for therapeutic drug monitoring were provided in 81.6%, 3.2% and 55.5%, respectively. Sampling times were provided in 45% and were considered appropriate in 25.2% of the request forms. The indications for therapeutic drug-monitoring were considered appropriate in 28.6% of the request forms, and only 19.2% of these were appropriately sampled. Only 37.9% of all samples were drawn at steady-state. Serum albumin and creatinine concentrations were lacking in 93.6% and 53.3% of requests, respectively. The potential for drug-drug interactions was detected in 28.6% of all requests. Thus, the information needed for the proper interpretation of therapeutic drug monitoring results and that was provided in the request forms was surprisingly scarce. Most of the appropriateness criteria for therapeutic drug monitoring were not met.

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

OBJECTIVE: To study the pattern of prescriptions in outpatient clinics in a teaching hospital in Southwestern Saudi Arabia. METHODS: 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. RESULTS: 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. CONCLUSION: These results emphasize the need for continuing medical education on rational prescribing, and for periodic monitoring of physicians habits on drug utilization.