Physicians' knowledge, expectations, and practice regarding antibiotic use in primary health care.

OBJECTIVE: Physicians' knowledge of antibiotics, their attitudes, expectations, and practices regarding antibiotic prescription is fundamental for controlling the irrational antibiotic use. This study evaluates primary health care (PHC) physicians' knowledge, expectation, and practices regarding antibiotics use in upper respiratory tract infections. METHODS: A cross-sectional study conducted in the Qassim region where 32 PHC centers were selected randomly. A total of 294 PHC physicians were surveyed. A pre-tested questionnaire was used after an orientation of participating physicians. RESULTS: Response rate was 80.3%. There is a significant belief among participants that the use of antibiotics leads to relief of symptoms in the case of viral disease and that taking antibiotics without rational indication increases the side effects. Participants identified that inadequate prescription, use without prescription, and non-compliance of patients are the most important factors contributing to the development of bacterial resistance. Participants often blamed the pharmacist for contributing mostly to the development of the problem of antibiotic resistance. Most physicians identified that they feel under pressure if patients expect an antibiotic prescription. In the absence of laboratory confirmation, most physicians selected high fever as the symptom that makes them prescribe antibiotics. Although having practice guidelines, participants demonstrated that these guidelines do not consider individual variations of patients' need. They do not support a regulation to prohibit antibiotic prescription without laboratory confirmation. CONCLUSIONS: The distribution of PHC physicians' knowledge, attitudes, and practices did not significantly vary between urban and rural centers. Therefore, whichever measures will be taken to improve the antibiotics practices can be applied to any PHC setting.

Glycemic indices, glycemic load and glycemic response for seventeen varieties of dates grown in Saudi Arabia.

BACKGROUND: Dates are consumed worldwide, and are an important fruit for many individuals in Saudi Arabia. Currently, limited information is available on the glycemic indices of different date varieties. OBJECTIVES: To determine the glycemic index (GI), glycemic load (GL) and glycemic response for 17 common date varieties in Saudi Arabia. DESIGN: Prospective clinical trial on healthy subjects. SETTING: College of Medicine, Qassim University, Buraydah, Saudi Arabia. PATIENTS AND METHODS: The available carbohydrate content of Tamer stage dates was determined using standard laboratory methods. Healthy subjects (ten males and nine females) received 50 g of glucose (on three separate occasions) and 50 g equivalent of available carbohydrates from the seventeen varieties of date (each once). The GI and GL were then calculated. MAIN OUTCOME MEASURE(S): GI, GL, and glycemic response. RESULTS: The mean (SEM) GI of the date samples was 55.2 (7.7) (range, 42.8-74.6). Sellaj and Maktoomi exhibited the highest GI (74.6 [10.1] and 71.0 [11.1]), respectively, whereas Shaqra, Sukkary, and Sag'ai had the lowest GI (42.8 [5.5], 43.4 [4.7] and 44.6 [6]), respectively. The GL of the date samples ranged from 8.5 to 24. Sellaj had a high GL (24), whereas Ajwah and Shaqra had a low GL (8.5 and 9.2). The analyses suggested no significant difference in GI between the date varieties. However, the GL values differed significantly between the 17 date varieties (P < .001). CONCLUSION: The results provide reliable GI and GL values for 17 common date varieties in Saudi Arabia. The identification of date varieties with lower glycemic responses may help lower the GI of the diet of both healthy and diabetic Saudi individuals. LIMITATIONS: We used dates at the Tamer stage, which may not be translatable to all types of dates.

Disaster medicine education for medical students: Is it a real need?

BACKGROUND: Disasters are serious public health problems that have increased over the last century. This study evaluated the familiarity and training needs of medical students regarding disaster medicine in Qassim University College of Medicine (QUCOM). METHODOLOGY: A mixed quantitative and qualitative study was conducted in which students in the clinical phase were asked to respond to a questionnaire. Clinical teachers of the college, emergency physicians and health administrators were interviewed for the qualitative part of the study. Data were analyzed using SPSS and relevant tool for the qualitative part. RESULTS: Two-hundred twenty-nine students (91.6%) responded. Familiarity of students with disaster medicine was low with a mean score of 1.65 out of five points. However, male students demonstrated significantly higher mean scores in certain themes of disaster medicine. Students endorsed the idea that a training course is needed with a mean score of 3.66/5 and supported the idea that disaster medicine training should be provided to the general public as well (mean 3.85/5). Qualitative data affirmed inclusion of relevant topics in the curriculum based on students' inputs and needs and as defined by the community. CONCLUSION: Disaster medicine education for medical students is recommended by students and experts, while the applicability and feasibility needs further exploration.

Students' perceptions about the family medicine course in Qassim, Saudi Arabia.

BACKGROUND: This study explores students' perceptions and attitudes regarding educational methodology, content and assessment methods in the Family Medicine (FM) Course at Qassim University College of Medicine (QUCOM) with a view to build innovations and improvements on its findings. RESEARCH DESIGN AND METHODS: Three batches of undergraduate medical students attending FM Course - 2011/12 participated in a cross-sectional questionnaire-based study. Data collected through anonymous self-administered questionnaires were analyzed using Statistical Package for the Social Sciences (SPSS). RESULTS: Participation rate was quite high; of the 79 students constituting the course cohort, 68 (86%) responded. Students' perceived problem-based learning (PBL) tutorials positively while both male and female students rated classroom lectures negatively. Primary health care training activities and evidence-based medicine received high positive scores. Male students assigned high positive scores to consultation skills and breaking bad news (BBN) modules, and to a lesser extent the medical audit module. By contrast, female students rated them negatively and gave significantly lower scores. These were the only areas indicating significant differences between opinions of male and female students. CONCLUSION: Although the degree of students' satisfaction with the different learning activities varied, students felt that having a variety of learning and teaching experiences was more appropriate.

Academic accreditation process: experience of a medical college in saudi arabia.

OBJECTIVE: This study aims to describe effects of the accreditation process of the National Commission for Academic Assessment and Accreditation (NCAAA) and its impact on the quality of medical education in one medical college in Saudi Arabia. METHODS: We conducted a mixed (qualitative-quantitative) study in Qassim University College of Medicine, where an accreditation exercise led by NCAAA was recently completed. Data pertaining to impact of the accreditation process were collected through self-administered questionnaires and focus-group discussion. Data were aggregated and analyzed and compared with the information from prior to accreditation, where available. RESULTS: The accreditation process lasted about two years, culminating in the preparation of a self-evaluation report and a visit of external reviewers. The process itself brought significant changes in the educational processes and administration and implementation of the curriculum. Our analysis also indicated significant improvements in the quality of medical education in the College. CONCLUSIONS: The accreditation process was successful in improving quality of medical education, without imposing radical changes in curriculum philosophy or orientation. Better monitoring of students learning outcomes and continuous quality improvement will improve the quality of medical education in the college.

Epidemiology of road traffic injuries in qassim region, saudi arabia: consistency of police and health data.

INTRODUCTION: In Saudi Arabia, road traffic accidents (RTA) are becoming a serious public health problem. Police reports are designed for legal purposes with very little information on the health consequences. Also, health system data include detailed health information, but not related or linked to the data obtained police reports. Examining the consistency of these sources is vital to build an accurate surveillance system that can track the risk factors and the health consequences, as well as establishing and evaluating prevention interventions. OBJECTIVES: This study is intended to: ▪ Examine the consistency of health -registration data with the data gathered by the traffic police department.▪ Elucidate the magnitude, risk factors and outcome of RTI in Qassim region of Saudi Arabia,▪ Compare the pattern of accidents in Qassim with those at different regions of the Kingdom. METHODOLOGY: Health care information was collected on visits of victims of road traffic accidents to emergency and outpatients' departments of the major hospitals in Qassim region during the year 2010. The information included the patients' demographics, and clinical characteristics. Traffic Police Department information was also collected on all accidents that occurred in the study region. A Questionnaire was also developed and pilot tested to collect data from a random sample of population attending hospital outpatient and Primary Health Care clinics. Data included previous involvement in road traffic accident, and information about any injury; fatality or disability due to these RTI. RESULTS: During the study period, road traffic death rate based on death registration data was almost twice as high as the rate reported by the police (P < 0.05). There was also a significant decline of 27% according to police-reported data during the study period, as opposed to a non-significant increase of 8% according to health registration data during the same period. Population Survey Information showed the overall age-sex-adjusted rate for non-fatal RTI was 20.7 (95% CI, 20.0 - 21.3)/100 persons/year. The rate for non-fatal RTI is higher in the 10-19 years age group (17.3%). Males had twice or more incidence rate for RTI requiring recovery period of ≤ 7 days as compared with females, however, RTI incidence for recovery period of >7 days is more than twice in females.. Also a total of 12 deaths due to RTI were reported in 5-49 years age group in the last 3 years, representing an estimated annual RTI mortality rate of 35.4/100,000 (95% CI 16.6 - 57.8). A total of 11 participants reported RTI related disability in the last 3 years representing an estimated annual RTI disability rate of 34.1/100,000 population (95% CI 11.4 - 55.7). Reports of the Traffic Police Department showed that 18623 accidents occurred throughout the year 2010. These accidents involved 23178 persons, and resulted in the injury of 2025 people and the deaths of 369. In contrast, the health system reports showed that 4232 people had been injured and 1054 had died. Comparison with local & Arab Rates showed that Qassim is among the highest 5 regions in the kingdom regarding the number of RTA Saudi Arabia is also having a very high level of road traffic accidents and fatalities compared to other Arab countries. CONCLUSION: RTI are responsible for significant loss of life, disability and injury in Qassim population and in Saudi Arabia. The inconsistency between police-reported data and health system data strongly suggests that active efforts to audit and monitor data quality are clearly necessary.

Genetic background of psoriasis.

Psoriasis is a chronic inflammatory dermatosis that contributes to approximately 1-5% of all skin disorders in Saudi Arabia. The genetic basis of psoriasis is supported by family based investigations; population based epidemiological studies, association studies with human leucocyte antigens (HLAs), genome-wide linkage scans, and candidate gene studies within and outside the major histocompatibility complex. Psoriasis represents a complex disease at the cellular, genomic and genetic levels, with infiltration of many types of leukocytes into the skin, altered growth and differentiation of skin-resident cells, and altered expression of more than 1,300 genes in psoriatic lesions. It is also apparent that there is considerable overlap between the molecular pathways that are involved in psoriasis and those that lead to other inflammatory or autoimmune diseases in humans. In this review article, we describe the immune-genetic basis of psoriasis, the molecular pathways of pathogenic inflammation and the potential role of the genes that confer increased susceptibility to psoriasis.

Prevalence of metabolic syndrome among qassim university personnel in saudi arabia.

OBJECTIVE: to estimate the prevalence of metabolic syndrome among Qassim university personnel in Saudi Arabia using the definition proposed by NCEP ATPIII. METHODS: a cross sectional study that included all male university staff of different ages and careers. 560 individuals participated in this study with a response rate of 85%. For all participants, the data collected were sociodemographic characteristics, past history or receiving medication for diabetes or hypertension, smoking habits, physical activity, and measurements necessary to identify metabolic syndrome. RESULTS: Prevalence of metabolic syndrome was 31.4%. The prevalence was found to show a steady increase with increasing age, BMI and serum cholesterol. General obesity measured by BMI was the most common component associated with the syndrome where 75% of participants suffered from overweight and obesity. Participants with high-density lipoprotein below protective level constituted 73.6%, while those with total cholesterol and triglyceride above clinically normal level constituted 60.0% & 46.4% respectively. Elevated fasting plasma glucose and hypertension were the least common. After adjustment, factors found to be associated with metabolic syndrome were being a Saudi national, smoking, not doing regular exercise, being obese having total serum cholesterol above 180 mg/dl, and age groups above 40 years. CONCLUSION: Almost a third of the university personnel have metabolic syndrome and therefore they are at higher risk for both cardiovascular diseases and diabetes mellitus. Similar studies are required among a wider range of subjects to assess the scope of the problem in Saudi Arabia.