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February 2017 -
Volume 15, Issue 2
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From the Editor

 
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Original Contribution / Clinical Investigation










<-- Saudi Arabia-->
Pattern of current tobacco use among the Saudi adult population: results of the national Survey of Risk Factors of Non-Communicable Diseases
[pdf version]
Abdelshakour M. Abdalla, Lamiaa Z. Abuzaid, Waleed S. Al-Hussain, Nasser A. Al-Hamdan, Abdalla A. Saeed, Ahmed A. Bahnassy

<-- Iraq -->
Concentrations of Azithromycin and Amoxicillin-Clavulanic acid in patients undergoing tonsillectomy
[pdf version]
Nidhal AK Mohammed Ali, Rasha G. Thanoon

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International Health Affairs


<-- Pakistan-->
Influence of Elderly parent on family dynamics: results of a survey from Karachi, Pakistan
[pdf version]
Waris Qidwai, Imdad Ali Khushk, Sabrina Allauddin, Kashmira Nanji

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Education and Training



<-- Saudi Arabia-->
Leadership in Postgraduate Family Medicine Training Programs: A “Steps-Model” Implementation in Eastern Province-MOH, Saudi Arabia
[pdf version]
Abdullah Dukhail AL-Khathami

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Case Study


<-- Lebanon -->
Evaluation of the Child with Short Stature
[pdf version]
Abdulrazak Abyad



Middle East Quality Improvement Program
(MEQUIP QI&CPD)

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

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Publisher -
Lesley Pocock
medi+WORLD International
11 Colston Avenue,
Sherbrooke 3789
AUSTRALIA
Phone: +61 (3) 9005 9847
Fax: +61 (3) 9012 5857
Email
: lesleypocock@mediworld.com.au
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Editorial Enquiries -
abyad@cyberia.net.lb
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February 2017 - Volume 15, Issue 2

From the Editor
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This issue is rich with many papers from the Region dealing with topics of interest to the field. A paper from Saudi Arabia looked at the Pattern of current tobacco use among the Saudi adult population: using results of the national Survey of Risk Factors of Non-Communicable Diseases . A total 4751 Saudi aged 15-64 years were analysed. Most of current tobacco users are tobacco smokers (92%). The overall prevalence of current tobacco smokers is 12.9% (611) of the total participants, with significantly higher proportion of males' smokers than females (24.7% of males and 1.4% of females). Univariate analysis shows that smoking prevalence was higher among males, age group 25-34, northern and eastern regions, educated people, and among those in certain occupations. Using logistic model, significant predictors for current smoking were: Male, younger adults, being in the eastern or northern regions, and being unemployed. The authors concluded that unlike adult females, tobacco smoking was prevalent among adult males in Kingdom of Saudi Arabia. Significant predictors for current smoking were: Male sex, younger adults, being in the eastern or northern regions, and being unemployed.

A second paper from Saudi Arabia looked at the Leadership in Family Medicine/ Primary Health Care. In Eastern province of Saudi Arabia, a step model leadership approach has been utilized to achieve targets set for training of postgraduates in Family Medicine training program-MOH. Step model leadership initiative is a transformational leadership that involves three steps. Step one essentially is based on a managerial role where tasks are assigned for the team and desired outcomes agreed at the start of the program. Step two is role model stage that ensures progression of the task. Step three is essentially an evaluator type of leadership role that tries to establish whether desired outcomes have been achieved or not. It utilizes advocacy as one of its main strategies.
It is important that one in a leadership position in this step model understands their role and contributes effectively in line with the expectations of the step model for leadership initiative. This Step Model for leadership has been successfully applied in the training of postgraduates in Family Medicine Program in Eastern province-MOH of Saudi Arabia. It is proposed that it should be applied throughout Saudi Arabia and in other countries of the region.

A cross-sectional study from Pakistan was carried out in a tertiary care hospital of Karachi, Pakistan through convenience sampling during August to October 2014. The aim of the study is to look at the Influence of Elderly parent on family dynamics: results of a survey from Karachi, Pakistan. The individuals who were > 35 years and had an elderly parent (> 65 years) were included. A pre-tested structured questionnaire was used for data collection. Analysis was done using SPSS 19.0. Logistic regression analysis was used to identify the reasons for appreciating elderly parent's influence in daily lives of study participants. A total of 200 study participants' information was included. About 35% of the participants were between 35 to 40 years of age and there was preponderance of females (68%) in the study. Majority (81%) of the participants responded that their parents have an influence on their family matters. Parents experience (OR: 2.5; 95% CI: 1.1-5.4), wisdom (OR: 2.1; 95% CI: 0.9-4.6) and respect (OR: 1.2; 95% CI: 0.6-2.5) are some of the factors because of which participant(s) get influenced by their elderly parents. The authors concluded that children respect their elders' decision(s) and appreciate their influence in family matters. The elders should let children take their own decisions and become autonomous. Children on the other hand should give respect to their elders and should involve them in family decisions.

A paper from Iraq attempts to assess the antibacterial activity of two antimicrobial agents indicated in the treatment of tonsillitis; azithromycin and amoxicillin-clavulanic acid. The authors followed a single blind comparative study was conducted on 43 patients with recurrent tonsillitis with mean age of 5.46±2.38 years who were scheduled for tonsillectomy in ENT department, Rizgary Hospital. The patients were allocated randomly into 2 groups. Group1 patients (n=20) were given azithromycin and group 2 patients (n=23) received amoxicillin-clavulanic acid at the recommended dose for each antibiotic. Bacterial isolation and identification were performed and minimum inhibitory concentrations (MIC) of isolated bacteria were determined. Blood and tonsillar tissue samples were taken from each patient before and 2 hours after drug administration. The plasma and tonsillar tissue concentration of each antibiotic were determined.

Staphylococcus aureus was the most predominant organism isolated from the patients. Azithromycin and amoxicillin-clavulanic acid attained mean plasma concentration of 0.27±0.04?g/ml and 5.49±0.33?g/ml respectively and the mean azithromycin concentration in tonsils tissues was 13.97± 2.75?g/g whereas no detectable concentrations of amoxicillin-clavulanic acid were determined in the tonsils tissue of the patients. The authors concluded that Azithromycin achieved higher tissue concentration than amoxicillin-clavulanic acid in tonsils tissues making this antibiotic a good choice for recurrent tonsillitis.

A paper from Lebanon reviews a case of short stature. Children with short stature are encountered often in family practice. By definition, one child in 33 has height measurements below the third percentile for age. While this is often defined as the lower limit of "normal," most of these children are, in fact, healthy and growing adequately. Many will attain normal stature as adults. The practitioner's task is to identify the few children who are short as a result of medical conditions that lead to failure of normal growth.

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

Ethics Editor and Publisher
Lesley Pocock
medi+WORLD InternationalAUSTRALIA
Email: lesleypocock@mediworld.com.au

Editorial enquiries:
aabyad@cyberia.net.lb

 




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