This is the first issue this year for the journal. The issue is rich with papers from the region including Turkey, Pakistan, Saudi Arabia, Sultanate of Oman, Qatar, and Yemen with a rich content. I would like to wish our authors, readers, editorial board and production staff headed by our publishing manager a happy start of the year.

Basheikh et al., did a cross-sectional study looking at the Perception of Saudi Older Adults about Themselves and their Health in Makkah Region. The study included 328 Saudi participants aged 60 years and above who lived in the Makkah region from July 2019 to June 2020. For data collection, we used the Canadian Study of Health and Aging questionnaire (CSHA). Most of our participants (82.01%) perceived their health as "very or pretty good," which was statistically significant with income (p = 0.01), age (p < 0.01), and marital status (p = 0.03). In addition, 60.37% were happy with their life; however, this perception only positively correlated with health (p < 0.001) and income (p = 0.001). The authors concluded that Overall, most Saudi older adults, regardless of age, gender, marital status, income, and multiple comorbidities, had a positive perception of life because of socioeconomic factors and an efficient healthcare system.

El-Gamal et al., conducted a cross-sectional survey using google forms sent to residents in Jeddah to explore the burden of stress, anxiety, and depression in adult population and to explore its associated socioeconomic, and clinical determinants. Depression (62.9%), Anxiety (62.6%) and Stress (47.7%) were common among the studied subjects. The authors concluded that Despite achievements in education, health care, and economic development of Saudi population over the past 3 decades, the trend of these disorders has alarmingly been increased. Considering the findings, it is necessary to develop appropriate community-based primary and secondary mental health prevention programs. More researches, about this issue, in different regions of the Kingdom need to be conducted.

Alqahtani, et al., investigated the perceptions of mentees' and mentors' concerning their experience. 67% of students (mentees) benefitted from mentoring. One to one mentoring was preferred by most students (82.5%). Only 68.6% of students had satisfactory contact with their tutors. The authors concluded that Attendance is essential for both the mentoring relationship and the amplification of the program. Mentors are motivated in curriculum development and teaching due to students' involvement in the activity; thus, a virtuous circle is created, leading to benefit the whole undergraduate medical education.

Bajaber et al., used a case control study to assess the association and factors affecting the presence of osteoporosis among postmenopausal Saudi women. Participants with at least one interpregnancy interval < one year had a significantly higher percentage of those belonging to cases. Cases had a significant higher mean number of inter-pregnancy interval less < one-year, lower T-score and lower Z- score compared to controls. The authors concluded that females in reproductive age should be educated about the importance of long IPI and the relation between short IPI on PMOP.

There are two papers on Covid 19., Jaffar et al., did a descriptive cross sectional study to determine the knowledge, practices, availability of personal protective equipment to health care providers and hindrance to delivering health care facilities during the COVID-19 pandemic. The authors concluded that the study recorded lack of knowledge about newly emerged COVID-19 pandemic among health care workers. Shortage of ventilators, testing kits and personal protective equipment was noted in many hospitals and departments. Lack of personal protective equipment and insufficient training in infection control management may act as barriers in delivering health care during COVID-19. TOKTAMI? et al., consider the question whether measles immunization lead to immunization for COVID-19? Cases diagnosed with COVID-19 through reverse transcriptase polymerase chain reaction (RT-PCR) at Ba?kent University Alanya Research and Training Center. The Rubeola IgG and IgM levels of the patients and the rubeola IgG levels of the health staff carried out for screening and who had been admitted to the immunization outpatient clinic in December 2019 as the control group were compared. The Rubeola IgG levels were found to be significantly higher in the COVID-19 group compared to the control group.

El-Gamal, et al., explored the impact of age on the clinical aspects and management of patients with rheumatoid arthritis, among adults, in Saudi Arabia. A cross-sectional survey was conducted, online, using Google form which was sent to patients with Rheumatoid arthritis, in Jeddah, Saudi Arabia. Rheumatoid Arthritis occurred in 41.8% of the patients before the age of 20 years, in 28.7% by the age of 20 to < 30 years, in 20.5% by the age of 30 to < 40 years, and in 9% by the age of 40 years and older. The authors conclude that rheumatoid arthritis, did not appear to be an old age disorder; it was common before the age of 20 years. Clinical picture and lines of management differed among different age groups. This evaluation raised questions for future studies and improved care for RA. Extrapolation of these differences, and also lack of access to care, may help health care providers to implement a promotional strategy to address this health care issue.

Ibraheem et al., from Iraq had two papers on diabetes which is quite prevalent in the region. In the first paper they did a descriptive case control study to assess the effect of duration of type 2 diabetes mellitus on the serum electrolyte disturbances. HbA1c test and serum sodium were assessed in both diabetic patients and controls. Poor glycemic control was observed among 84% of diabetic patients with a highly significant difference in HbA1c level between diabetic patients and healthy controls (p<0.001). the authors concluded that hypernatraemia and hypocalcemia are frequent clinical entities of type2 diabetic patients. The second paper is a descriptive case control study aims at evaluation of the effect of body mass index (BMI) on serum electrolyte disturbances in diabetic patients. A convenient sample of 100 diabetic patient compared with 100 healthy controls. The authors concluded that hypocalcaemia is frequent clinical issue of type 2 DM patients. Serum calcium of type 2 DM patients is more likely to be inversely related with body mass index of the patients. No significant differences were observe between diabetic patients and healthy control regarding serum potassium level.

Saleh et al., attempt to determine the occurrence of Becker nevus among Yemeni patients and to define its clinical characteristics. During the study period, 84 patients were diagnosed with Becker nevus in our private clinic. The female to male ratio was 2:1 (F= 66.7% vs. M= 33.3%). The authors concluded that Becker nevus is a common condition among Yemeni patients in our series of 84 patients. Females were more commonly affected. The most common sites of involvement were the shoulders and chest. About a third of patients had associated hypertrichosis whereas breast hypoplasia was less frequent.

TOKTAMI? et al., did a systemic review to asses burnout among Turkish Physicians
Introduction and objectives: By evaluating systematically and collectively of studies examining burnout and accompanying factors of physicians in Turkey. The databases search resulted in finding of forty-nine articles that most of were regional and only seven representing the nationwide. A total of 12598 physicians were evaluated in the surveys. The authors concluded that there is a low level of EE, DP and a highly decrease in the sense of PA in physicians working in Turkey. The overall burnout impressed by those is not very high, but also is not very low. Female physicians appear to be at higher risk for EE sub-dimension and the risk of burnout is reduced with increasing age or experience.

Alnaemi, et al., did a systematic review synthesizes the differences in the EMG activation during different hip position in order to better understand the role of specific hip position in recruiting and activating hip muscle. The authors found that several previous conducted studies show the association between hip muscles activity and lower limbs pathology by evaluating the EMG. Current review aims to evaluate the differences in electromyographic activation with different hip position activities. Limited evidence by an absence of control, low sample size and heterogeneity in methodological design. Further research evaluating the value of different hip position and to rank the best hip position in activating and targeting hip musculature is needed.

Alenazy et al., did a cross sectional study looking at the Effect of obesity stigma on obese people, Saudi Arabia, 2020 . A pre-designed questionnaire was used to collect data about exposure to negative behavior by others because of obesity, ways and sources in which participants face discrimination and prejudice and were asked about their feelings and effect of obesity on their life and daily activities. in many times because of obesity 25.6% of the participants were exposed to negative behavior by others, 18.2% were exposed to bad comments from children, 25.2% were exposed to physical barriers and 25.4% exposed to bad comments from the family. The authors concluded that obese individuals should be health educated to accept themselves and in the national discourse on obesity, the weight stigma must be discussed.

Saleh et al. , did a descriptive cross-sectional study aimed to assess public awareness regarding antihistamines and its prescription in PHCCs in Abha City, Saudi Arabia. The study included 800 participants whose ages ranged from 18 to 55 years with mean age of 27.5 ± 10.9 years old. Majority of participants were females (73.5%; 588). As for known formulas of antihistamines, pills were the most reported formula (98.5%) followed by syrup (7.8%), nasal spray (3.8%), and eye drops (2.4%). Exact of 420 (52.5%) of the participants previously had antihistamines without prescription. The main cause of that was being available and easily achieved (82.6%). The authors concluded that public awareness regarding antihistamines was very poor especially concerning its types, and clinical effects. Also, unprescribed utilization of antihistamines was very high due to its availability and easily achieved

Alammar et al., used a cross sectional approach to assess social media utilization and its impact on mental health among medical college students in Abha city. The study included 311 students whose ages ranged from 17 to 29 years old with mean age of 22.8 ± 2.1 years. Female figured 64.6% of the participants and 90.7% of the students were not married. About 28.6% of the students were in the pre-clinical grades and 14.5% were interns. The study revealed that medical college students used social media platform intensively with reported high insomnia rate and poor mental health for half of them.

Alzeer et al., conducted a cross-sectional community-based study to evaluate awareness of the effects of combining smoking and oral contraceptives on cardiovascular health
among Saudi working women. The study population consisted of 301 women who responded and answered the questions, with an age range of 21-30 years. While 77 (25.6%) women were using OCs, only 13 (4.3%) were both smokers and users of OCs. Overall, 256 (85.0%) women believed that smoking increases CVH risk. The authors concluded that the majority of the respondents were not aware of the effects on CVH when combining smoking and the use of OCs. Public health awareness on this matter among Saudi women is therefore warranted.

Sumathipala S., reviewed the management of subclinical hypothyroidism in primary care. He stressed that subclinical hypothyroidism (SCH) is a relatively common condition, and it increases with age. A proportion of SCH patients will go on to develop overt hypothyroidism. Furthermore, there is concern that SCH increases the likelihood of extra thyroidal illness, such as cardiovascular disease. The diagnosis of SCH is a biochemical one, and given the frequent use of blood tests where thyroid function may be one component, the primary care clinician needs to understand what to do when a patient appears to have SCH. There are a variety of guidelines about the management of SCH for non-pregnant adults. The clinician needs to be aware that certain conditions can cause transient aberrations of thyroid blood test, and of those with persistent SCH, which patients might benefit from treatment and which ones would be better served with observation over time.

Al-Jadidi, S., reviewed Psychoanalysis from the Islamic religion point of view. Religion is an important constituent of a person's identity, whether it is an identity or an ethnicity. All religions share some common features that affect the analyst and the analysand's reactions (1). All major religions contain ideas about human motivation, interpersonal relations, and moral behavior that reflect a specific view of human nature (3). Many psychoanalysts have focused on religion's impact on therapy; both positive and negative. And some psychoanalysts and psychoanalytic thinkers have written more recently on Islam. In this review, we conduct an overview of the Islamic religion and psychoanalysis. We conclude that the outcome of the psychoanalysis of Muslim patients may go either very well or very poorly, and that Islam, per se, presents no major obstacle to psychoanalysis.

Ashfaq et al., conducted a cross sectional survey at family medicine clinics of Aga Khan University Hospital Karachi, Pakistan . The aim of this study is to assess the knowledge and practices of mothers regarding prevention of common accidents among preschool children in Karachi-Pakistan. Most of the mothers (79%) were between the ages of 31-40 years and were house wives. Children whose mothers were uneducated had a higher incidence of injuries. The most common types of accident among children were falls (88%) and approximately 90% of the mothers did not taught traffic rules to their children. The authors concluded that home-related injuries may lead to many health problem and their prediction and prevention are necessary to prevent from any major health hazards. This study concludes that majority of mothers have inadequate knowledge and improper practice on prevention of accidents among preschool children. There is a strong need to improve knowledge and awareness of mothers regarding hoem related injuries to prevent accidents in preschool children.

Issa et al., conduced a cross-sectional study on 150 medical interns using the WHO quality of life questionnaire. The aim is to assess the HQQOL of medicals interns in KSA and the relation between HRQOL and participants' characters. 39.3% and 24.7% of the participants were satisfied and very satisfied with their health respectively. Females had a significant higher score of Domain 1 (Physical health) compared to males, while married participants had a significant higher score of Domain 2 (Psychological health). The authors concluded that as the lowest scores in this study was for the Domain of social relationships and environmental health, there is a need to provide support of medical intern to cope with factors influencing their QOL through more assessment and training session done by specialists.

Abdulrazak Abyad
Chief Editor