This is the fourth issue this years with papers from the MENA region dealing with topics of importance for healthcare profession.

Alrashhedi et al., did a cross-section study looking at prevalence of Anxiety and Depression among postgraduate trainees in Qassim, Saudi Arabia. Depression Anxiety and Stress Scale (DASS-21) was used to measure the outcome variables. Logistic regression was used to assess the risk factors of depression, anxiety and stress. The prevalence of depression, anxiety and stress were 49.6%, 57% and 39.5% respectively. The authors concluded that a higher prevalence of mental disorders among postgraduate trainees in Qassim region of Saudi Arabia. This calls for implementing screening and support programs for trainees to improve their mental health and thus their learning and quality of care being provided by them.

Ali Holal, et al., did a descriptive questionnaire-based cross-sectional study of family physicians in Jazan to identify primary healthcare (PHC) physicians’ emergency management competence and the barriers they experience when dealing with emergency cases. The study included 450 PHC physicians, 342 (77.8%) were males, and 364 (82.7%) were Saudi. When compared to Arab Board of Family Medicine (ABFM) certification, physicians did better if they had Family Medicine (FM) Diploma (OR = 1.1486, p = 0.03704) or MBBS (OR = 1.1529, p = 0.00371). Compared to physicians who attended Basic Life Support (BLS) courses within the last 12 months, competence in clinical emergencies was far worse for those who did not do BLS (OR = 0.6710, p <0.001), or did it over two years ago (OR = 0.8796, p<0.001). The authors concluded that BLS and ATLS courses improve perceived competence among PHC physicians. There is a potential gap in defibrillation training among PHC-based family physicians in the southwestern area of Saudi Arabia. Therefore, BLS training should be an integral part of family physician core competence in handling emergency cases. More educational training should be devoted to defibrillation skills in clinical practice.

Timorkhan and Ibraheem reviewed studies focused on digital device usage, near work, and outdoor time in relation to myopia onset and progression in children during COVID-19 pandemic. And studies focused on the relation between screen time, asthenopia and dry eyes in children during COVID-19. Increased digital screen time, near work, and limited outdoor activities were found to be associated with the onset and progression of myopia during the COVID-19 pandemic period. Screen time was positively associated with asthenopia and dry eye in children during COVID-19. The authors concluded that the COVID-19 pandemic has led to dramatic changes in many aspects of daily life. Online learning has become the mainstream public learning mode during the pandemic. Several studies indicate accelerated myopic progression during the COVID-19 pandemic in children and the increase has been found to be related to excessive use of digital screen devices and the decrease of outdoor activities duration. Also prolonged screen time, and online-course time can significantly increase asthenopia and dry eye risk. Several studies recommended to decrease screen time and to increase outdoor activities.

Mathew et al., reported a case of multiple myeloma during the Covid 19 pandemic. They presented a 54-year-old gentleman whose initial presentation was a pathological rib fracture. However, a dig into his past medical history revealed gout (now asymptomatic) and abnormal laboratory findings that helped us to subsequently diagnose as Multiple Myeloma. The importance of simple investigations like ESR when managing patients with nonspecific symptoms in primary care, listening and looking for signals that suggest an alarming aetiology, following up of investigations and the continuity of care assured by the electronic medical record is highlighted by this case report.

Aldekhail et al., did a cross-sectional study enrolled 197 PHC physicians and residents from FMA Both Data were collected through an online questionnaire with variables on physicians’ knowledge about amblyopia based on the Canadian Pediatric Society Recommendations for Vision Screening at Infant and Well Child Visits. The data was analyzed using SPSS version 21. The majority were Saudi 120 (60.9%). Most of the 189 (96%) knew the definition of amblyopia. But the majority of 138 (70%) were not diagnosed with a case of amblyopia before. The authors stated that the study highlighted a good knowledge level regarding amblyopia among level primary health care physicians and family medicine residence residents. However, Strategies to improve vision screening are necessary. Early intervention is crucial to prevent treatable causes of vision loss in children.

Elnahas et al., did a descriptive cross-sectional study aimed to assess the knowledge and practice of food safety awareness among Egyptian healthy adults attending family medicine outpatient clinics, Cairo University, the study involved 305 participants, Food safety knowledge and practice were evaluated by Food Safety reliable, and valid questionnaire. Only (0.3%) of participants had sufficient knowledge and (19.3%) had sufficient practice, there was statistically significant difference between the studied participants regarding practice grade and education with (78%) of participants with sufficient practice was moderate or highly educated.

They concluded from this study that the general community has insufficient food safety knowledge and practices; as a result, it is required to hold training programs in the form of workshops or to incorporate courses in the ministry of health’s curriculum.

Khan, et al., did a costing study was conducted as part of randomized controlled trial on promoting safe birthing, among 60,000 pregnancies in Punjab. This costing study aimed to estimate the costs incurred by women for utilisation of skilled birth attendance. 640 women were recruited from six public health clusters in two districts of Pakistan.
Health services capital cost for enhancing utilization of skilled birth attendance was Rs: 801 (US$ 8) per LHW and the recurrent per pregnant woman was Rs. 4.8 (US$ 0.05). Client cost of skilled birth utilization for normal delivery ranged from 3564(US$ 35.64) at public facility vs 5276 (US$ 52.76) at private facility, while for caesarean delivery it ranged from 10383 (US$ 103.83) at public facility to 14339 (US$ 143.39) at private facility. Cost of normal delivery was found to be correlated with category of birth attendant. The authors concluded that the birth planning intervention was found to be cost-effective in enhancing skilled birth attendance rate as compared to the control arm.

El-Gamal et al., did a cross sectional study; a non-probability convenient sampling method was used to select 1073 subjects through online Google survey the aim to study magnitude of use, determinants and awareness of CAM therapy use among the population in Western region of Saudi Arabia. Almost half of the study population used CAM (51.6%), particularly those who live in the villages of Makkah city. The authors concluded that use of CAM is a common health practice among Saudi population. Majority of the participants had equivocal awareness about its effects. More health education programs by specialized health care authorities on the use and benefits of CAM are needed. Doctor-patient communication regarding CAM use is important. Increasing awareness of Saudi population about instructions and restrictions when using CAM is greatly needed.
Bakri, and El-Setouhy, did a cross-sectional questionnaire-based observational investigation using a simple random sampling scheme. The sampling frame was all PHC physicians practicing in Jazan Province. We used the Fear-of-COVID and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Poisson Regression modelling techniques were used to analyse the adjusted effect of sociodemographic factors on Fear-of-COVID and Pittsburgh Sleep Quality scores. Their study aimed to assess sleep disturbance and its association with coronaphobia among primary health care (PHC) physician in primary health care centers (PHCCs). A total of 385 physicians participated in the study. The authors concluded that Coronaphobia is common and has detrimental effect of sleep quality among PHC physicians. Coronaphobia has negative impact on sleep quality. Higher burden of depressive symptoms worsens physicians’ sleep quality. They recommended that support for PHC physicians’ psychological and physical well-being is paramount during the current COVID-19 crisis.

Almutairi, and Jahan, did a cross-sectional study including 288 physicians and nurses working at PHCCs in Buraidah city in Qassim region. A semi-structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence in addition to participants` demographic and occupational data. Among 288 study participants, 64.2 % were nurses and 63.7% were females. The reasons of violent event included misunderstanding, unmet service demand, overcrowding, and long waiting time. No action was taken as a reaction to violent event by 56.3% of the victims while reporting to supervisors was mentioned by 34.8% of the respondents. The authors concluded that a considerable proportion of physicians and nurses in PHCCs were exposed to violence at workplace; mainly verbal type. More than half of the violent incidents were not reported. Implementation of appointment system at PHC settings and increasing awareness of patients regarding their rights and responsibilities is recommended.

Khormi, et al., did a cross-sectional study to evaluate characteristics and factors associated with tobacco use among 409 undergraduate male students in Jazan University. A self-administrated questionnaire was used for data collection. It consists of 26 questions in 3 domains, covering demographic and socioeconomic characteristics of participants, tobacco use history, and factors associated with waterpipe use. A total of 409 university students took part in this study. About three-quarters of students (73.8%) reported having a friend who smokes waterpipe and 37.7% had a sibling who smokes waterpipe, while 15.2% and 2.4% of participants had fathers and mothers who smoke waterpipe, respectively. The authors concluded that the main factors associated with waterpipe smoking are age, monthly income, and having a father, siblings or friends who smoke waterpipe. Furthermore, students who smoke cigarettes or tobacco or have many friends who smoke waterpipe are significantly more likely to engage in waterpipe smoking.

Helvaci, et al., looked at acute chest syndrome and pulmonary hypertension in sickle cell diseases. All patients with the SCD were included. The study included 222 males and 212 females with similar mean ages (30.8 versus 30.3 years, p>0.05, respectively). Pulmonary hypertension (PHT) (12.6% versus 11.7), and deep venous thrombosis and/or varices and/or telangiectasias (9.0% versus 6.6%), significantly (p>0.05 for all). Mean ages of ACS and PHT were 30.3 and 34.0 years (p<0.05), respectively. The authors concluded that a lthough smoking, alcohol, disseminated teeth losses, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, COPD, and stroke-like atherosclerotic events were higher in males, and the male sex alone is a risk factor for atherosclerosis, ACS and PHT were similar in both genders, and mean age of PHT is much higher than ACS, significantly. In other words, PHT may have a hardened RBC-induced chronic, whereas ACS an acute thromboembolic backgrounds in the SCD.

 

 

Dr Abdulrazak Abyad
Chief Editor
Mobile: 961-3-201901