Physical activity and major non-communicable diseases among physicians in Central Saudi Arabia.

OBJECTIVES: To evaluate levels of physical activity among physicians in Riyadh, Saudi Arabia and to study the possible factors affecting physical inactivity. In addition, the study aims to estimate the prevalence of major non-communicable diseases (NCDs) and a possible correlation between physical inactivity and major NCDs.  Method: A cross-sectional approach was used for this study conducted on 370 randomly-selected outpatient physicians of both genders working at 4 leading healthcare institutions in Riyadh, Kindom of Saudi Arabia between December 2013 and January 2014. Using a modified World Health Organization (WHO) STEPwise questionnaire. Data was analyzed using the Statistical Package for Social Sciences version 21. Results: The findings of the present study demonstrated a prevalence of physical activity among Riyadh physicians (63%), which is higher than the general population (32.4%). The main reason for not engaging in physical activity was lack of time (58.1%) followed by work duties (22.5%). The prevalence of the most frequently reported NCDs (cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers) was 21.9%. No significant association between physical inactivity and major NCDs among physicians in our sample was found.  Conclusion: The participating physicians are physically active and suffer from a small percentage of the most reported NCDs. The main factor associated with physical inactivity was lack of time. No association was detected between physical inactivity and major NCDs.

Epidemiology of pediatric hand fractures presenting to a university hospital in Central Saudi Arabia.

OBJECTIVES: To investigate the epidemiology of pediatric hand fractures and to provide recommendations regarding prevention. METHODS: Medical records and x-rays were retrospectively reviewed for age at the time of injury, gender, fracture pattern, place where the injury occurred, and mechanism of injury. The study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2005 and December 2011. RESULTS: Of 361 cases reviewed, there were 291 (80.6%) male and 70 (19.4%) female patients. Most (46.2%) were in the age group of 13-18 years. For age group 1-4 years, the  most common place of occurrence was at home (81.3%) and for the group 13-18 years, outdoors was the place of occurrence (64.7%). Females were mostly injured at home while males had similar distribution of indoor and outdoor injuries. The most common causes of fractures were: door slams in the 1-8 years age group; falls at home, in the 9-12 years age group; and both falls at home and sports in the oldest age group (13-18 years). The little finger ray are the most frequently injured part of the hand followed by the middle finger. CONCLUSION: Our series showed that most hand fractures in children occurred at home, which requires reevaluation of home settings. Implementation of safety measures during sports activities are relevant in the oldest age group.

Factors associated with public awareness of the Crown Health Program in the Al-Jouf Region.

OBJECTIVES: A community-based intervention, the Crown Health Project (CHP), was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. METHODS: A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics (e.g., age, gender, education, occupation, urban/rural residence) and CHP awareness (its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities). Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. RESULTS: Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5), "noncommunicable diseases" as the main diseases targeted (OR, 4.8; 95% CI, 3.6-6.4) and "attention to health" as the purpose (OR, 6.0; 95% CI, 4.0-8.9). CONCLUSION: The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf.

Awareness of an obstetric population about environmental tobacco smoking.

BACKGROUND AND OBJECTIVES: The reported rate of women's smoking is typically low. However, many pregnant women are exposed to environmental tobacco smoke (ETS), which could affect their own health and the health of their growing fetus. The aim of this study was to estimate the magnitude of the problem of exposure to ETS and assess the awareness of postpartum women to ETS and its possible effects. DESIGNS AND SETTINGS: This was a cross-sectional study conducted on 1182 postpartum women at a university hospital in Riyadh, Saudi Arabia, between 1(st) January and 30(th) June, 2012. MATERIALS AND METHODS: A structured questionnaire was used for data collection. Factors associated with the level of understanding of the possible effects of ETS exposure were analyzed. RESULTS: The majority of the participating women knew that exposure to ETS had adverse effects on maternal and fetal health (>80%), but their knowledge of the specific effects on fetal health was limited. The level of mothers' education was found to be associated with better knowledge of effects on mother and fetal health (P < 0.01). CONCLUSION: This study revealed that pregnant women in our sample had limited knowledge of the specific effects of ETS on fetal health. This shortcoming in knowledge needs to be addressed by improving health.

The role of rapid testing and clinical decision in the diagnosis of human influenza A H1N1 infection.

OBJECTIVE: To evaluate the role of the rapid influenza diagnostic test (RIDT) and clinical decision in the diagnosis of H1N1. METHODS: In November 2009, 290 suspected influenza patients were examined for H1N1 during an outbreak in Riyadh, Saudi Arabia. Nasopharyngeal swabs were analyzed using Directigen EZ Flu A+B kit. Monoclonal anti-human influenza A/B and reverse transcription- polymerase chain reaction (RT-PCR) were used. Positive and negative controls were used in each run of specimens. Validity indices were calculated for RIDT and clinical diagnostic criteria. RESULTS: The sensitivity and specificity of RIDT were 40.5% (95% confidence interval [CI]: 33.0-48.5), and 94.5% (95% CI: 88.6-97.6). The sensitivity of clinical decision was 66.3% (95% CI: 58.4-73.4), and the specificity was 65.4% (95% CI: 56.3-73.4). The sensitivity of clinical decision was higher in early presenters (79.2%; 95% CI: 57.3-92.1). The RIDT sensitivity was higher in younger patients (48.4%; 95% CI: 35.7-61.3). The positive predictive value (PPV) was 90.4% (95% CI: 80.7-95.7) for RIDT, and 71.1% (95% CI: 63.1-78.0) for clinical decision. The PPV for RIDT was greater for older (94.7%; 95% CI: 80.9-99.1) and late (90.7%; 95% CI: 76.9-97.0) presenters. The adjusted odds ratio for clinical decision was significant for cough, headache, and fatigue. CONCLUSION: The RIDT can be useful in epidemics and high prevalence areas, whereas clinical decision, and RT-PCR complement the diagnosis of H1N1 in any setting.

A validation study comparing the sensitivity and specificity of the new Dr. KSU H1N1 RT-PCR kit with real-time RT-PCR for diagnosing influenza A (H1N1).

BACKGROUND AND OBJECTIVES: A new test (Dr. KSU H1N1 RT-PCR kit) was recently developed to provide a less expensive alternative to real-time reverse transcriptase-polymerase chain reaction (RT-PCR). We report the findings of a validation study designed to assess the diagnostic accuracy, including sensitivity and specificity, of the new kit, as compared to real-time RT-PCR. DESIGN AND SETTING: Cross-sectional validation study conducted from 18-22 November 2009 at a primary care clinic for H1N1 at a tertiary care teaching hospital in Riyadh. PATIENTS AND METHODS: Nasopharyngeal swab samples and data on socio-demographic characteristics and symptoms were collected from 186 patients. Swab samples were sent to the laboratory for testing with both real-time RT-PCR and the new Dr. KSU H1N1 RT-PCR kit. We measured the sensitivity and specificity of the new test across the entire sample size and investigated how these values were affected by patient socio-demographic characteristics and symptoms. RESULTS: The outcomes of the two tests were highly correlated (kappa=0.85; P<.0001). The sensitivity and specificity of the new test were 99.11% and 83.78%, respectively. The sensitivity of the new test was affected only minimally (96%-100%) by patient characteristics and number of symptoms. On the other hand, the specificity of the new test varied depending on how soon patients were tested after onset of symptoms (100% specificity when swabs were taken on the first day of the symptoms, decreasing to 75% when swabs were taken on or after the third day). The specificity of the new test also increased with increasing body temperature. CONCLUSION: The new test seems to provide a cost-effective alternative to real-time RT-PCR for diagnosing H1N1 influenza. However, further testing may be needed to verify the efficacy of the test in different settings and communities.

Cost estimation and physicians' awareness concerning hypertension management: Experience from primary care centres.

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Epidemiological and sociocultural study of burn patients in Alexandria, Egypt

All burn cases admitted to the burns unit of Alexandria Main University Hospital over a period of one year were investigated. Burns were found to occur in younger age groups. There was an almost equal distribution of cases by sex, but when stratified by age, more females were found in most age groups. Most burns were domestic, with cooking being the most prevalent activity. Flame was the most common agent. Death occurred in about one-third of cases; when using logistic regression analysis, the outcome of the burn injury was significantly associated with age, sex, total surface area burnt and degree and depth of the burn

Compliance with antituberculosis drugs among tuberculosis patients in Alexandria, Egypt

Tuberculosis is an important reemerging disease with increasing global morbidity and mortality. Tuberculosis control is hindered by patient noncompliance with treatment regimens. To study compliance to antituberculosis drug regimens, 172 patients diagnosed with tuberculosis during the first three months of 1995 were investigated. The patients were interviewed at their homes during July and August 1995. More than one-third [34.9%] of the patients were not adhering to the antituberculosis drug regimen. Factors increasing drug compliance included: disease symptoms, knowledge about the disease, family history of tuberculosis and hospitalization. More information about the disease and the importance of compliance should be provided to tuberculosis patients at the time of diagnosis and initiation of therapy. Supervision of drug administration by health care personnel is stressed