Male Partners' Knowledge, Attitudes, and Perception of Women's Breast Cancer in Abha, Southwestern Saudi Arabia.

Background: Breast cancer (BC) is ranked as the most frequently diagnosed cancer site among women in Saudi Arabia. Several studies in Saudi Arabia have reported low awareness of BC and significant obstacles to early presentation among Saudi women. A key sociocultural obstacle against breast screening and early detection of BC in several conservative cultures is that men manage women's choices and activities. The aim of this research is to find out the key background knowledge, attitudes, and related practice among male partners in the city of Abha in relation to women's BC prevention and means for early detection. Methods: A cross-sectional study targeting husbands aged 20 years or older chosen from the outpatient clinics in the Urban Primary Health Care Centers in Abha City. Through questionnaires, interview data were collected regarding knowledge about BC and wife practices and attitudes towards BC. Results: The study included 832 husbands. The study showed that only 20.2% (95% confidence interval (CI): 19.9-24.1) of husbands had heard about mammography and only 22.1% had heard about breast self-examination among women as a screening test for BC. The most commonly mentioned variations that might occur in relation to BC were size changes (45.6%). The leading source of BC knowledge was from television (48.9%), and the least-mentioned source of information was healthcare workers (22.4%). Husbands mentioned that only 9.3% of wives had been examined before by mammography. In a multivariate logistic regression of male factors associated with wives' practices and attitudes towards BC, only good knowledge among husbands was a significant factor. Conclusions: The study documented the low level of BC knowledge among male partners. There is an urgent need to pay more consideration to disseminating awareness among men, as they are associates, and they must be armed with proper awareness. There is an urgent demand for establishing a national program and educational campaigns towards BC. Stressing the advantages and access to free mammography is necessary.

Knowledge and practices of primary health care physicians regarding updated guidelines of MERS-CoV infection in Abha city.

BACKGROUND: Human coronaviruses (hCoV) usually cause mild to moderate upper respiratory tract illnesses. The novel coronavirus (nCoV), or Middle East respiratory syndrome coronavirus (MERS-CoV), is a particular strain different from any other known hCoV with the possibility of human and also zoonotic transmissions. The aim of the study to assess primary health care (PHC) physicians' knowledge and adherence regarding Saudi Ministry of Health guidelines regarding MERS-CoV. MATERIALS AND METHODS: A cross-sectional study design was followed to include 85 PHC physicians in Abha city. An interview questionnaire has been designed by the researcher that was used to assess knowledge and practices of PHC physicians regarding diagnosis and management of MERS-CoV. It includes personal characteristics, the MERS-CoV knowledge assessment questionnaire, and practices related to adherence toward guidelines regarding MERS-CoV. RESULTS: PHC physicians' knowledge gaps regarding MERS-CoV included protected exposure (32.9%), highest seasonal incidence of MERS-CoV in Saudi Arabia (60%), relation between incidence of MERS-CoV and overcrowding (62.4%), case fatality of MERS-CoV cases (63.5%), and collecting specimens from MERS-CoV patients (64.7%). The knowledge of PHC physicians about MERS-CoV was poor among 5.9%, good among 63.5%, and excellent among 30.6%. Personal protective equipment to be used when seeing suspected cases of MERS-CoV infection were mainly the mask (94.1%), gloves (78.8%), the gown (60%), goggles (31.8%), and the cap (22.4%). All participants stated that the most important standard precaution that should be applied when seeing a case of MERS-CoV infection is hand washing, whereas 97.6% stated that the most important respiratory precaution to prevent transmission of respiratory infections in PHC setting when seeing a case of MERS-CoV infection is masking and separation of suspected MERS-CoV patients, and 81.2% stated that upon exit from the room of a MERS-CoV patient, the physician should remove and discard personal protective equipment. PHC physicians' knowledge about MERS-CoV differed significantly according to their nationality (P = 0.038), with non-Saudi physicians expressing higher percent of excellent knowledge than Saudi physicians (40% and 20%, respectively). Those who attended continuing medical education (CME) activities had significantly higher percent of excellent knowledge than those who did not attend a CME activity (55.6% and 23.9%, respectively, P = 0.011). PHC physicians' knowledge did not differ significantly according to their age, gender, qualification, experience in PHC, and practice-related adherence to guidelines. PHC physicians' practice-related adherence to guidelines about MERS-CoV differed significantly according to their position (P = 0.035), with specialists having the highest percent of excellent practice (13%). CONCLUSIONS: There are knowledge gaps among PHC physicians in Abha city, and their practice is suboptimal regarding MERS-CoV infection. Less than one-fourth of PHC physicians attend CME activities about MERS-CoV infection. However, significantly less practice-related adherence to guidelines are associated with Saudi PHC physicians, those who did not attend a related CME activity, and MBBS qualified physicians' general practitioners. To increase awareness, more CME activities related to MERS-CoV infection management needs to be organized.

Knowledge, attitude, and practice among Saudi primary health care attendees about family planning in Abha, Kingdom of Saudi Arabia.

BACKGROUND: Knowledge, attitude, and practice (KAP) of contraception are influenced by a host of interdependent demographic, cultural, economic, and social factors, therefore, KAP vary not only in different countries but also from region to region in a country. A cross-sectional study was carried out among Saudi primary health care attendees at Abha city, Saudi Arabia, with the aim to help in developing strategies that may enhance family planning in Abha. METHODS: A structured questionnaire was designed by the researcher to obtain the necessary information from all reproductive age group patients who attended primary health care centers in Abha for a period of 1 month (July to August 2017). Statistical analysis was done using two-tailed tests and alpha error of 0.05. P value less than or equal to 0.05 was considered to be significant. RESULTS: The study included 314 participants, with age ranging from 18 to 55 years. Among them, 70.4% were female, and 56.1% of the sample were university graduates. Approximately 80.6% of the participants knew about family planning, and 68.1% correctly defined family planning. Hormonal pills were recognized by 53.2% of the participants followed with intrauterine devices. Family members were the most common source of information (51.8%), followed by internet reading (37.5%) and healthcare workers (21.8%). The attitude of the studied group varied. Most of them only wanted to use family planning in agreement with their spouses, and 11.8% had negative attitude due to their fear of side-effects. Currently, 29.6% of the participants were using family planning methods whereas 53.5% had used contraception in the past. Oral contraception was the most commonly used method (49.5%), followed by surgical methods (30.1%) and natural methods (16.1%). CONCLUSIONS: The present study reveals that a significantly higher proportion of respondents know about contraception and more than half had good knowledge about contraception. However, the current practice of contraception methods is lower than many regions in the country. The selection of oral contraception as the method of choice is similar to other studies.

Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report.

OBJECTIVE: To report a Saudi young patient with early onset type 2 diabetes, who was misdiagnosed for 6 years as type 1 diabetic. CASE REPORT: A Saudi male aged 18-year old presented with uncontrolled diabetes. He was diagnosed 6 years earlier to have type 1 diabetes mellitus. He was kept insulin, but he was not compliant to treatment and his blood glucose kept on fluctuating and not controlled. He came to our diabetes center for management of his uncontrolled diabetes. There was no past history of hospitalization. His father was type 2 diabetic. His body mass index was 46.7 kg/m2. His glycosylated hemoglobin (HbA1c) level was 9.9%. Immune dysfunction was evaluated using serum antibody levels of glutamic acid decarboxylase, which proved to be negative (0.7 U/mL), while serum C-peptide level was not low (2.2 ng/mL). Therefore, the patient was diagnosed as early onset type 2 diabetic, not type 1 diabetic. The patient was advised to start physical exercise through daily walking for at least 1 h. The dietitian planned a strict diet plan for him to follow. Insulin injections and Metformin tablets were started. The patient received detailed health education on nature and management of his condition. After 4 months, his body mass index became 39.4 kg/m2 and his HbA1c became 6%. Insulin was stopped, and he was advised to continue on metformin, the diet, and daily walking. Two months later, his body mass index was 37.7 kg/m2 and his HbA1c became 5.41%. CONCLUSIONS: Early onset type 2 diabetes should be suspected among obese children with symptoms of diabetes. Proper health education and patient's compliance to medication, diet, and physical activity are essential for successful management of early onset type 2 diabetes. Moreover, primary care physicians need to be aware that type 2 diabetes is not necessarily adult-onset.

Impact of Obesity on Serum Levels of Thyroid Hormones among Euthyroid Saudi Adults.

AIM OF STUDY: To assess serum thyroid hormones levels among Saudi adults and to correlate participants' serum levels with their grades of body mass index (BMI). METHODOLOGY: A total of 278 adult subjects were recruited. Participants were categorized according to their BMI grades into normal weight (BMI < 25 kg/m2), overweight (BMI 25-29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). Serum thyroid hormones levels were assessed at the central laboratory of Aseer Central Hospital, Abha City, by chemiluminescence immunoassay. RESULTS: More than three-fourths of participants were either overweight (31.3%) or obese (44.6%). Mean TSH serum levels showed a significantly increasing trend with increasing BMI (p < 0.001). A negative trend was observed regarding participants' mean serum levels of fT4 with their BMI, but there were no significant differences in mean serum fT4 levels according to BMI. Moreover, no significant differences were observed in serum fT3 levels according to BMI. CONCLUSIONS: Mean TSH serum levels increase with BMI increase. Further largescale multicentric and longitudinal studies are necessary to prove the association between serum levels of thyroid hormones and BMI of euthyroid adults.

Knowledge, perceptions, attitude and educational needs of physicians to evidence based medicine in South-Western Saudi Arabia.

OBJECTIVE: To define the knowledge, perception, attitude, educational needs, and barriers in practicing Evidence Based Medicine (EBM) among physicians in Abha city, Kingdom of Saudi Arabia. METHODS: This is a cross-sectional study using a self-administered validated questionnaire distributed to 290 physicians between 1st July to 30th July 2008. This study took place in the Family and Community Medicine Department, King Khalid University, College of Medicine, Abha, Kingdom of Saudi Arabia. RESULTS: Completed questionnaires were received from 210 (72.4%) of 290 physicians. Most physicians had a positive attitude towards EBM (median score=8/10). Half of them support the shift from daily based practice to evidence based decision. They showed acceptable level of knowledge on the terminologies used in EBM and critical appraisal. The consultants and specialists had a better knowledge toward EBM compared with residents. The main barriers facing the respondents in practicing EBM as indicated by the physicians were lack of resources and time. CONCLUSION: The physicians showed acceptable level of knowledge on EBM. There was a gap between their knowledge and practice. This gap could be attributed to what was addressed by the physicians, namely, inadequacy of time and unavailability of access to internet in their working place. The better knowledge of the trained than the untrained physicians could draw the attention towards the importance of training courses relevant to EBM.