Factors associated with fatigue in a family medicine clinic in the United Arab Emirates.

BACKGROUND: Fatigue is a common symptom in Family Medicine and it has many associated factors. The Arabian Gulf provides a unique setting for studying these factors, in particular the UAE where rapid development has been a prominent feature. OBJECTIVES: The aim of the study was to sample a group of GP attenders and examine the factors which were associated with fatigue in the UAE. METHODS: A fatigue scale, psychological questionnaire, detailed history, physical examination and laboratory testing were administered to a sample of attenders at a Family Medicine clinic. RESULTS: Fatigue was more prevalent than in western studies (males 34.0%, females 38. 2%). It was strongly associated with anxiety, especially in younger adults, and it has been recognized that rapid social change is felt most acutely in young adults and adolescents. Depression in females was also a factor. Lack of exercise, obesity and illiteracy played a minor role in the severity of fatigue. CONCLUSIONS: Fatigue appears to be a cultural 'idiom of distress', a way of expressing anxiety or depression in a rapidly changing society.

Immunisation coverage at a well-baby clinic in the United Arab Emirates.

The United Arab Emirates Survey of Immunisation Coverage by UNICEF in 1990 showed that the coverage for UAE infants up to one year of age was 60%. The objective of this study was to determine factors associated with attendance and immunisation uptake at a well-baby clinic. A birth cohort of 665 infants were selected and their records examined to determine the factors such as gender, distance of housing area from clinic and access to other primary health care facilities. Only 22% attended all the scheduled visits and 54.3% of the sample completed the immunisation program within the correct time. The distance the infant lived from the clinic was the only factor significantly affecting immunisation uptake. The identification and targeting of groups at high risk of delayed completion of the immunisation program is a necessary risk factor in improving future surveillance.

The translation into Arabic and revalidation of a fatigue questionnaire.

The aim of this study was to translate a fatigue questionnaire, which had been developed in England for use in epidemiological studies and in community settings, into Arabic. It was intended that the translated questionnaire could be used in any setting where Arabic is the first language of the patient. The process of translating the questionnaire and the revalidation method are described. The Arabic translation was shown to be both reliable and valid in the United Arab Emirates setting.

Paracetamol prescribing--an epidemic?

BACKGROUND: Although we are uncertain of its therapeutic mechanism, paracetamol is seen as a safe drug, especially for children. However, adult fatalities from overdose and its association with hepatotoxicity have cast doubt on its safety. OBJECTIVE: We aimed to establish the prescribing patterns of paracetamol in the United Arab Emirates (UAE). METHOD: The prescribing patterns in the UAE for paracetamol were studied by obtaining information on national utilization and recording in detail the pattern of prescribing in one primary health care centre. RESULTS: Paracetamol was included in 35.5% of all prescriptions from the study practice. Of these, 58.5% were for children under 12 years of age and overall 13.5% were for those infants under one year of age. CONCLUSIONS: National prescribing utilization is in keeping with the prescribing patterns of the index practice. Paracetamol prescribing is reaching epidemic proportions and the potential dangers of hepatotoxicity and the inhibition of the immune response in children are discussed.

An audit of general practitioner referrals for pelvic ultrasound.

Pelvic ultrasound is a widely used diagnostic tool and access to this investigation is not universally available to all general practitioners (GPs). The aim of this study was to assess if GPs working in the United Arab Emirates (UAE) were using pelvic ultrasound appropriately by determining the rates of diagnostic yield and referral after the investigation. It was then ascertained if these results were affected by the post-graduate training or gender of the doctor. The subjects were adult females who had had a pelvic ultrasound ordered by a GP over a 2-month period. A chart review determined the presenting complaint, the completeness of the request form, the result of the ultrasound and subsequent management of the patient. Diagnostic yields and referral rates were similar to those found in other studies and were unaffected by the post graduate training or gender of the doctor or the amount of information contained in the request form. This study supports the premise that GPs can use pelvic ultrasound appropriately and should be allowed free access to this investigation.