From the Editor

This is the fourth issue this year and has various papers from the Region which includes collaborative work of some authors in Africa.

ALhasan M.Z et al investigated mass causality training by Jordanian level 3 hospital in Liberia. The authors stressed that mass casualties had associated with high risk of violence and injuries. They adapted guidelines from who’s community emergency preparedness : a manual for managers and policy makers(who 1999). They analyzed the situation through breaking the problem into its components to examine risks, their causes, possible preventive strategies, response and recovery strategies and trigger events for these strategies. They identified the required resources for response and recovery strategies , resources available ,discrepancy between requirement and availability, and responsibility roles and responsibilities designation: to individuals and organizations. The final written emergency plan will consist of outputs of each step of the process.

Alqahtani, S investigated the perception and parent’s Knowledge about High Body Temperatures in Children and Treatment Methods at Home. The objective of the study was to gauge the knowledge of parents about fever in their children and what treatment methods they do at home to treat it through a questionnaire. The study involved random selection of Saudi parents who have encountered having febrile children. A total of 353 parents completed the questionnaires. The study sample consisted mainly of mothers (62.3%). Fifty four percent of the parents are working (192) while the other forty five percent are not (161). A total of 38% of the parents believed that the best place to take the temperature of child is the ear (tympanic) followed by armpit (axilla) 37.1%. The rest of the parents took temperature orally (21%) and rectally (4%) respectively. In this study, about 43% believed that 37 degrees Celsius is the normal body temperature of a child followed by 36 degrees Celsius (20.4%). Approximately 30% of the parents considered a child with a temperature of 38-38.4 degrees Celsius as feverish followed by 38.5-39.90 degrees Celsius (26.3%).This study shows that parents should be more aware about high body temperatures and its consequences. There should be more health teaching among parents to correct the misconceptions they have about fever. Also, parents should be informed about different home treatments and its consequences. There is a need to develop programs that educate parents and provide them with information they need to better address the fever of their children.

Helvaci MR et al; tried to understand whether or not there are some relationships between rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) according to mean age of onset, frequency, and gender distribution in society. The study was performed in Medical Faculty of the Mustafa Kemal University between March 2007 and April 2016. All patients applying to the Internal Medicine Policlinic were included into the study. The study included 223 males and 210 females, totally. Mean ages of them were 30.4 versus 30.3 years, respectively (p>0.05). SLE was diagnosed in 6.0% of them (24 females and two males), and 92.3% of the SLE patients were female. Mean age of the SLE cases was 37.0 ± 13.6 (17-58) years. On the other hand, RA was diagnosed in 2.7% of them, so SLE was much more frequent in the society (p<0.001). Beside that 50.0% of the RA patients were female (six females and six males), so female predominance of the SLE was higher than RA (p<0.001). Mean age of the RA patients was 44.5 ± 7.6 (30-57) years, so RA patients were significantly elder than the SLE patients (p= 0.038). The authors concluded that because of the similar clinical presentation types, similar treatment agents, similar prognosis, and difficulties in differential diagnosis, RA may be one step further of the SLE due to its lower prevalence in the society (2.7% versus 6.0%, p<0.001), similar prevalences in both genders (50.0% versus 92.3% in females, p<0.001), and higher mean age of onset (44.5 versus 37.0 years, p= 0.038).

Helvaci MR et al; tried to understand effects of hydroxyurea on sexual performance in sickle cell diseases (SCDs). The study was performed between March 2007 and September 2013.The study included 337 patients (169 females). Mean number of painful crises per year was decreased with hydroxyurea (10.3 versus 1.7 crises per year, p<0.000). Mean severity of painful crises was decreased, too (7.8/10 versus 2.2/10, p<0.001). Although mean body weight, hematocrit (Hct) value, and mean corpuscular volume (MCV) increased, white blood cell (WBC) and platelet (PLT) counts and direct bilirubin, total bilirubin, and lactate dehydrogenase (LDH) values of serum decreased (p<0.000 for all). Parallel to these improvements, the mean number of sexual intercourse per month increased, significantly (2.0 versus 6.8, p<0.001). We detected hepatotoxicity in 13 acute painful crises among 1.211 episodes, totally (1.0%). All of them healed completely with withdrawal of all of the medications but not hydroxyurea alone. The solitary adverse effect of hydroxyurea was prominent anemia in higher dosages in 16 patients (4.7%), and they completely healed with transient withdrawal and decreased dosages thereafter. The authors concluded that Hydroxyurea decreases frequency and severity of painful crises, WBC and PLT counts, direct and total bilirubin, and LDH values of serum, whereas it increases mean body weight, Hct value, and MCV. Parallel to these physical and clinical improvements, mean number of sexual intercourse per month and chance of fertility increase in both genders in hydroxyurea users.

Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb

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