Establishment of an Accelerated Doctor of Family Medicine Program at Unaizah College of Medicine, Qassim University, Kingdom of Saudi Arabia.

Primary health care is well known to be the cornerstone for the health of the society. Furthermore, efficient health care at the secondary and tertiary levels is entirely dependent on effective primary health care. The Kingdom of Saudi Arabia (KSA) is currently building up a rigorous primary health care system with a large number of well-equipped primary health care centers. However, there is an acute shortage of Saudi family physicians throughout the country; both in urban and rural areas. There is no evidence in the literature supporting the relatively long 7 years' traditional duration of medical programs in the KSA. Rather, several US and Canadian medical schools have established accelerated programs in Internal Medicine and Family Medicine with graduates comparable with those of the traditional curricula in terms of standardized tests, initial resident characteristics, and performance outcomes. In response to the challenges the KSA is facing in primary health care, Unaizah College of Medicine at Qassim University is proposing to establish an accelerated Doctor of Family Medicine Program that would run for total duration of 6 years. Herein, we describe a concise outline of this program.

Prevalence of mistreatment and justice of grading system in five health related faculties in Jordan University of Science and Technology.

BACKGROUND: Many Jordanian university students complain of the behavior of some teaching staff. Also, they complain of the grading systems in universities. AIM: This study concerns the occurrence of different forms of student mistreatment and student mistrust of the grading system in the Jordan University of Science and Technology (JUST) as an example of universities in Jordan. METHOD: A total of 500 students in five health related faculties in JUST responded to a questionnaire. RESULTS: Our results were as follow: (i) 61% of the students had experienced at least one form of mistreatment; (ii) perceived mistreatment most often (52%) had taken the form of psychological mistreatment (shouting and humiliation); (iii) other forms of mistreatment such as physical harm (32%), mistreatment related to religion (36%), mistreatment related to external appearance (35%), sexual harassment (33%) and mistreatment related to specialty (29%) were also common; (iv) with the exception of mistreatment related to specialty which was high among the nursing students, perceived mistreatment did not vary significantly between the different faculties; (v) the male students (66%) complain more than female students (56%); (vi) perceived mistreatment was exceptionally high among the Israeli Arabs, 83% compared to 59% for the Jordanians and 65% for other non-Jordanian Arabs; (vii) fellow students (44%), professors (37%) and laboratory technicians (19%) were cited as major sources of mistreatment. Many students (66%) believe that grading system in JUST is unfair. Ninety seven percent of the Israeli Arabs did not trust the grading system compared to 64% of the Jordanians and 66% of the non-Jordanian Arabs. CONCLUSIONS: This study suggests that, feelings of mistreatment among university students is strong while their trust of the university grading system is low. Perceived mistreatment and an unfair grading system may be a major source of stress among our students and may affect the process of teaching and learning in our country. This should alert the university administration to face these issues and try to solve them.

A comparative study of plasma renin activity, aldosterone and atrial natriuretic hormone between normotensive and hypertensive people living at below sea level altitude (Jordan Valley) and those residing at moderate altitude above.

A cross-sectional study was designed to investigate the association of the levels of plasma renin activity (PRA) and aldosterone (ALDO) and atrial natriuretic hormone (ANH) with the rates of hypertension prevalence in people living at 340 meters below sea level, the Jordan Valley (JV) and those residing at 620 meters above sea level, Irbid City. 1072 natives from the JV and 1402 natives from Irbid City were covered by a questionnaire to estimate hypertension prevalence in the JV and Irbid city (population age: 35-65 years). Male subjects were selected from the JV (24 hypertensives, 46+/-15 years old, and 93 normotensives, 33+/-13 years old) and from Irbid City (31 hypertensives, 47+/-12 years old, and 89 normotensives, 40+/-13 years old) to evaluate the levels of PRA, ALDO and ANH. Hypertension was less common in the JV than in Irbid City (9.9% vs. 13.6%). The levels of PRA in the hypertensive subjects compared to the normotensive subjects were lower in the JV (1.7+/-1.0 vs. 2.6+/-1.4 ng/ml/hr) but were similar in Irbid City (2.9+/-2.7 vs. 3.2+/-2.7). The levels of ALDO in the hypertensive subjects compared to the normotensive subjects were similar in the JV (119+/-58 vs. 139+/-66 pg/ml) but were higher in Irbid City (199+/-112 vs. 146+/-84). The levels of ANH in the hypertensive subjects compared to the normotensive subjects were lower in the JV (13.9+/-9.3 vs. 28.0+/-12.7 ng/ml) and were also lower in Irbid City (21.0+/-12.2 vs. 26.7+/-11.6).

Clinico-hormonal correlation of oligospermic patients in the below sea level environment (Jordan Valley).

A correlation between serum levels of luteinizing hormone (LH), total testosterone (T), free T and sex-hormone binding globulin (SHBG) in normospermic and in oligospermic male people was done. This study was designed to measure serum levels of these hormones and of SHBG in people living at different altitude environments relative to sea level: at 209-408 meters below (the Jordan Valley, JV) and at 620 meters above (Irbid city, IC). In addition, a clinical awareness study of oligospermia was done in the North of Jordan (IC). Seminal analysis in 287 male people (age range, 18 to 40 years old) during the period between 12/6/1999 and 12/2/2002 showed an oligospermia of 31.4%. Serum levels of LH, total T, free T and SHBG in normospermic subjects in IC were similar to those in normospermic of the JV (3.4 +/- 1.2 vs. 4.0 +/- 1.7 MIU/ml, 19.9 +/- 4.0 vs. 20.4 +/- 5.6 ng/ml, 53.9 +/- 15.6 vs. 47.9 +/- 10.7 pg/ml, 19.5 +/- 3.2 vs. 18.6 +/- 2.16 nmol/l, respectively). Oligospermia was associated with increase in total T at both IC (27.5 +/- 4.6 vs. 19.9 +/- 4.0 ng/ml) and the JV (30.7 +/- 3.4 vs. 20.5 +/- 5.6). The higher serum level of total T in oligospermic people in both IC and the JV was associated with higher levels of SHBG compared to those levels in normospermic subjects. On the other hand, oligospermic subjects have lower serum level of free T than in normospermic males (41.5 +/- 10.0 vs. 53.9 +/- 15.6) only in IC, while in the JV, serum free T level was similar (46.5 +/- 6.1 vs. 47.9 +/- 10.7). Taken together data for both locations, IC and the JV, suggest a clear correlation between total T and SHBG levels in both groups' normospermic and oligospermic subjects.

Effect of fasting during the month of Ramadan on serum levels of luteinizing hormone and testosterone in people living in the below sea level environment in the Jordan Valley.

OBJECTIVES: To study a possible effect of Ramadan fasting on luteinizing hormone and testosterone in people of the Jordan Valley. METHODS: A comparative study (n=40) of serum levels of luteinizing hormone (LH) and testosterone (T) between people living in the Jordan Valley (JV), n=20, 360 meters below sea level, and those living in Ramtha City (RC), n=20, 600 meters above sea level, was conducted in December, 1998. A similar study (n=40) was also done during January 1999 in fasting people during the month of Ramadan. RESULTS: Serum levels of LH in non-fasting people of the JV were statistically similar to those in people of RC. There was also no difference in serum levels of T between non-fasting people of the JV and those in RC. Serum levels of LH in fasting people of the JV were statistically indifferent from those fasting in RC. Serum T levels in fasting people of the JV, on the other hand, were higher than those in fasting people of RC (76+/-18.3 ng/ml compared to 62.7+/-24.2 ng/ml). CONCLUSIONS: It is probably the environmental factors such as the higher barometric pressure of the JV compared to that at above sea level that play a role in higher serum levels of T in people of the JV. Other factors, such as genetic background and/or the cultural and nutritional characteristics of the people of the JV, may also contribute to this difference in serum T levels.

Plasma levels of adrenocorticotropic hormone and cortisol in people living in an environment below sea level (Jordan Valley) during fasting in the month of Ramadan.

OBJECTIVES: To investigate the effects of Ramadan fasting on plasma levels of ACTH and cortisol in athletic students living in the Jordan Valley (JV) and compare them to those living at above sea level in Ramtha City (RC). METHODS: Sample collection and measurements were done in November 1998 from non-fasting and in December 1998 from fasting people. RESULTS: ACTH levels in non-fasting subjects in the JV were 36 +/- 4 IU/ml compared to 43 +/- 3 IU/ml for those in RC. Cortisol levels were 483 +/- 76 (JV) and 539 +/- 89 nmol/l (RC). Fasting led to an increase in ACTH (49 +/- 6 (JV) and 58 +/- 5 IU/ml (RC)) and cortisol levels (637 +/- 101 (JV) and 805 +/- 72 nmol/l (RC)). CONCLUSION: Fasting increases ACTH and cortisol levels in an altitude-independent fashion.