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
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.
MD, MPH, AGSF, AFCHSE
Ethics Editor and Publisher