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April 2020 -
Volume 18, Issue 4

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From the Editor



Original Contribution

Knowledge and Prevalence of Energy Drinks Consumption among King Khalid University Female Students
Abrar Abdulaziz Sultan, Safar A. Al Saleem, Amani A.M. Osman, Ossama A. Mostafa
DOI: 10.5742MEWFM.2020.93793

The safest values of low density lipoproteins in the plasma
Mehmet Rami Helvaci, Abdulrazak Abyad, Lesley Pocock
DOI: 10.5742MEWFM.2020.93794

Prevalence of Symptoms and Risk of Sleep Apnea in the northern Population of Pakistan.
Faryal Subhani, Usman Ali, Rohan Advani, Muneeb Hussain, Waris Qidwai
DOI: 10.5742MEWFM.2020.93800

Assessment of Health-Related Knowledge and Practices among Patients with Peptic Ulcer
Mohammed Attieh Alzahrani, Khulood Alfageeh, Teaf Thabet, Nadia Ali, Njood Alnahdi, Malak Mohammed, Khalid Yousef Nabrawi, Awad Saeed Alsamghan
DOI: 10.5742MEWFM.2020.93802

Population and Community Studies

Prevalence of Fibromyalgia in Patients with Ankylosing Spondylitis
Abdlsatar J. Mathkhor, Abdulnaser H. Abdullah, Amer S. Khudhairy M
DOI: 10.5742MEWFM.2020.93795

Kidney stones in children aged less than 5 years in Aden, Yemen
Ali Ahmed Salem Hatroom
DOI: 10.5742MEWFM.2020.93796

The Importance of Screening - Screening Programs in Qatar
Hana Ansari Hayat
DOI: 10.5742MEWFM.2020.93799

Education and training

Emotional Intelligence of Family Medicine Residents in Qatar
Muna Taher, Mohamed Salem, Hisham El-Mahdi, Eman Fadhel, Teeba Salwan, Kahina Dameche, Ayat Alhakeem, Mansour El-Mahdi
DOI: 10.5742MEWFM.2020.93797

Personal Development Plan (PDP)
Shabana Shaheen, Muhammad Hameed
DOI: 10.5742MEWFM.2020.93801

Case Report

Unwitnessed Oesophageal Foreign Body Ingestion: A Case Report
Idris Akinwande, Saad Rehman
DOI: 10.5742MEWFM.2020.93798

Autoimmune Progesterone Dermatitis: A Case Report
Tahani Magliah, Salwa Bardisi
DOI: 10.5742MEWFM.2020.93803

Middle East Quality Improvement Program

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE


Publisher -
Lesley Pocock
medi+WORLD International

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April 2020 - Volume 18, Issue 4

From the Editor

Sultan, A.A., et al, assessed prevalence of energy drinks consumption and knowledge about its ingredient safety and side effects among female college students at King Khalid University (KKU). They followed a cross sectional study design. A self-administered questionnaire was constructed by the researchers and was validated and pretested. It consisted of socio-demographic characteristics, following unhealthy nutritional habits and knowledge about energy drinks, their effects and impact. A total of 300 female college students participated in this study. Their mean age was 20.9±1.6 years. Prevalence of energy drinks consumption was 31.3%. The commonest used one was Code Red (55.3%), Bison (40.4%), Red Bull (23.4%) and Power Horse (20.2%). The monthly intake of energy drinks ranged between 1 to 4 times among 61.7% of students. Overall, 64% of the students had poor knowledge about energy drinks, whereas only 0.7% had good knowledge. The authors concluded that energy drinks consumption is commonly practiced among female university students. It is frequently associated with fast food intake. Knowledge of female university students is generally poor to fair.

Alzahrani, M.A. et al , did a a deceptive cross sectional study to assess health-related knowledge and practices of patients with peptic ulcer at Abha, Saudi Arabia. A direct interview questionnaire constructed by researchers was used for data collection. A total155 patients were included with peptic ulcer aged from 20 to 60 years. Stomach pain was the most frequent symptom (88.4%) followed by hyperacidity (60.6%). Regarding the awareness of patients for their disease, 87.7% of them knew about symptoms of peptic ulcer followed with drugs and treatment methods (81.3%). In total 18.1% of the patients had good knowledge.

Patient's awareness level regarding their disease was poor especially the nature of the disease, risky population and its complications. As for health-related practice, the majority of patients had unhealthy behavior such as having drinks which may aggravate hyperacidity status. Also adherence for prescribed medication is not high and some have un-prescribed medications.

Mathkhor, A.J., et al looked at prevalence of fibromyalgia in patients with ankylosing spondylitis. A total of 40 (30 male and 10 female) patients with AS, diagnosed according to the modified New York criteria, were studied. Two stage classification process was applied to determine the presence of FMS in AS patients: Stage 1: diffuse wide spread pain questionnaire to a sample of 40 (30 male and 10 female) patients with AS. Stage 2: all patients with wide spread pain were examined for 18 tender points. A sample of 40(30 male and 10 female) healthy individuals were examined as controls. There were 10 patients met the criteria of FMS, with a prevalence of 25.0% among patients with AS, of them 80.0% were women. The authors concluded that FMS is more prevalent in patients with AS than in the general population, and the prevalence is comparable with other musculoskeletal disorders. There is a trend for an increased frequency of FMS in females with AS. AS patients with FMS may benefit from psychological evaluation as a part of their treatment. Further study needed to correlate between FMS and AS disease activity of patients.

Taher, M., et al, attempted to measure the global Emotional Intelligence among the family medicine residents in Qatar and to describe the distribution of emotional intelligence parameters among the family medicine residents also to examine the relationship between emotional intelligence parameters' level and selected demographic variables. The study targeted residents of the family medicine training programs in Qatar. Final number of questionnaires analyzed: 46 (90.2%), The study has used self-administered questionnaire which is in Arabic Language. Generally, residents of family medicine program in Qatar are reporting average scores in the global EI and related factors and facets ,males showed statistically significant higher global EI, emotionality factors and its related facets (emotion expressions & relationship) ,the results showed that residents who were raised in small town/village had higher perceived global EI and well-being factor and its related facets (happiness, optimism and self-esteem ,there was statistically significant difference between batches with regard to scores in the emotionality factor and its facet (empathy) where senior residents showed high scores in both. The authors concluded that Family Medicine residents perceived lower E.I. scores , reversed gender relationship with E.I. scores. Academic performance and seniority showed significantly different EI scores

Hayat, H.A reviewed the Importance of Screening - Screening Programs in Qatar. The author stressed that by offering screening to a population, often based on demographic factors including age or gender, the aim is to reduce the incidence of serious health problems at a late or symptomatic stage of disease. It is well documented that the introduction of screening programs has improved national mortality rates, globally. This is demonstrated well by the introduction of breast screening in various parts of the world. More locally in the MENA region, it is well identified that 'mortality rates have declined…with late detection of the disease dropping from 64% in 2009 to 16% in 2013' . It goes on to champion screening services claiming 'As in other countries, one of the most effective ways of lowering mortality rates from cancer can be to engage the public in an education campaign around possible signs or symptoms. This also includes engaging public health bodies in organising campaigns and funding for mammograms…'

Subhani, F. et al tried to identify the prevalence and risk factors of sleep apnea in Chitral, Pakistan. A cross sectional study was conducted at the THQ hospital Booni, Chitral. The survey was conducted on individuals who had come to the hospital as attendants, patients or visitors of the admitted patients. We used the Berlin questionnaire to identify individuals at risk for OSA. 52 of total 408 were at high-risk for OSAS according to Berlin scale Questionnaire. Hence, the prevalence estimates of individuals at high-risk for OSAS was 12.75%. These participants were more likely to have conditions such as previous coronary artery disease, high cholesterol, and hypertension. The authors concluded that there is a high prevalence of OSA in Chitral and it is also associated with obesity, coronary diseases, smoking, and hypertension which is why it is important to have a proper evaluation and early screening for it. Given the high prevalence and association of OSA with many diseases, it is also important to increase awareness among physicians and the general population of rural areas, about the clinical presentations, risk factors and complications of OSAS.

Magliah, T & Bardisi, S presented a 29-year old female, who complained of a recurrent cyclical itchy skin rash over the dorsum of her hands for the last four years. She used to develop the rash during the initial weeks of each pregnancy, which then subsides spontaneously. The symptoms markedly decreased when she used contraceptive pills. On examination, there were multiple scaly erythematous plaques over the dorsum of the hands with signs of lichenification. Intradermal progesterone test showed an itchy erythematous papule over a wheal, at the site of injection, sized about one cm, which appeared after 48 hours. Therefore, she was diagnosed as a case of "autoimmune progesterone dermatitis". Daily oral contraceptive pills (levonorgestrel/ethinyl estradiol, 0.1 mg to 20 ?g) were prescribed. There was a marked reduction in the number of lesions during her next menstrual periods.

Akinwande I., & Rehman, S., stressed that Children frequently ingest foreign bodies by accident. The diagnosis should be straightforward when the ingestion is witnessed and reported by the care giver or the child. Making a diagnosis however becomes challenging when the episode is not witnessed because many of the children are asymptomatic at presentation and when present, the symptoms can be subtle and non-specific. They reported a case where a father brought his three-year-old son into the clinic concerned that his son had lost his voice and had stopped talking 3-4 hours prior to presentation. The father also noted that he had started drooling saliva which was unusual for him. He had consumed milk without difficultly a few hours prior to presentation. On examination, the child was alert and responsive. He was subdued but still playing with his soft toys. His temperature and vital signs were within normal range. Examination of the mouth, chest and abdomen were all unremarkable.The family physician was unable to explain why he had stopped talking or drooling saliva but felt reassured that the child was not acutely unwell. He advised that he thought it was a viral illness and advised the child's father to manage him conservatively with analgesia if needed and to return if the symptoms did not improve in a few days, or earlier if he deteriorated. The drooling of saliva however continued at home and he became more tired, his parents contacted the ambulance service and he was taken to the emergency department of the local hospital. The clinicians at the emergency department suspected a swallowed foreign body, a metal detector confirmed the presence of a metallic foreign body. X-rays of the chest, neck and upper body revealed a radio opaque object in the oesophagus at the C5/C6 region and a two pence coin was removed by ears, nose and throat surgeons under general anaesthesia endoscopically.

Hameed, M., & Shaheen, S. presented a paper on personal development plan. They stressed Planning is the most important stage before an individual aim to do anything. Planning is required in every stage of an individual's life no matter how big or small the aim is. This makes the work to go better as the individual has an outline or a map in the mind as what he wants to achieve from this objective. Here we outline how to set PDP for a new GP who is training to become a trainer. Hence, PDP has taken a core place in all the medical portfolios of doctors in training as well as senior doctors in UK. The development of (Personal Development Plans) PDPs and the evidence of their completion has become an essential part of doctors' portfolios as directed by General Medical Council (2012). This is now an essential requirement for revalidation. ''Revalidation is a process, by which doctors demonstrate that they are up to date and fit to practice'' (RCGP). It has also been highlighted in good medical practice report by GMC that all doctors are legally responsible to keep their knowledge and skills up to date through CPD and PDPs (GMC CPD for all doctors 2012). So, PDP has become an integral part of RCGP Toolkit (Clarity).

Helvaci, M.R et al, tried to understand the safest values of low density lipoproteins (LDL) in the plasma. Patients with plasma LDL values lower than 80 mg/dL were collected into the first, lower than 100 mg/dL into the second, lower than 130 mg/dL into the third, lower than 150 mg/dL into the fourth, and 150 mg/dL and higher into the fifth groups. The study included 815 cases (477 females), totally. Parallel to the higher LDL values, the mean age, body mass index (BMI), fasting plasma glucose (FPG), triglycerides, high density lipoproteins (HDL), and white coat hypertension (WCH) were the highest in the fifth and smoking, hypertension (HT), and diabetes mellitus (DM) were the highest in the fourth groups. Whereas chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), and chronic renal disease (CRD) were the highest in the first group in contrast to the lowest LDL and HDL values. Interestingly, FPG, triglycerides, HT, DM, COPD, CHD, and CRD were the lowest in the second group, significantly, and there was no difference according to the mean age and smoking between the first and second groups, significantly. The authors concluded that the highest HT and DM parallel to the increased LDL and HDL and the highest COPD, CHD, and CRD in contrast to the lowest LDL and HDL values may show initially positive but eventually negative acute phase proteins functions of LDL and HDL in the metabolic syndrome. So the safest values of LDL were between 80 and 100 mg/dL in the plasma.

Hatroom, A.A.S followed a retrospective study of all children aged less than 5 years who suffer from kidney stone seen at urology center in Aden during period of 2 years. The total number of patients was 50. They were 29 (58%) males and 21 (42%) females. The male to female ratio was 1.4:1, and the mean age was 2.86 ± 1.4 years. The predominant age group involved was 1 - 3 years with 31 (62.0%), while the group 4 - <5 years was 19 (38.0%).

ESWL performed for 44(88.0%) cases and their stone sizes more than 20 mm and pyelolithotomy for patients who have stones sizes ? 20 mm, (p = 0.000). In ESWL, stone removed completely was in 39(78.0%). Six patients were treated by pyelolithotomy and stone removed completely was in 5(10%). Most of the patients were treated by ESWL and the stones removed completely in 78% of the cases.

Chief Editor:
A. Abyad