From
the Editor
In this issue various papers
from the region deal with important issues in
primary health care.
Qasim M, A et al ; explored barriers that PHC
physicians in the Eastern Province, KSA, face
in initiating insulin therapy for type 2 diabetes
mellitus. A self-administered questionnaire
was used among PHC physicians in the Eastern
Province (Dammam and Qatif) during January and
February 2014. A total of 194 primary care physicians
were surveyed, with an overall response rate
of 84%. Half of the physicians reported that
they have no experience with the initiation
of insulin. This study showed that PHC physicians
faced many problems in initiating insulin for
type 2 diabetic patients. Organizing focused
CPD sessions and implementing clear guidelines
supported with insulin initiating algorithm
will make insulin initiation easier. The PHC
system should provide supporting staff such
as chronic care nurses, dieticians, diabetic
educators and pharmacists to work in a collaborative
team with PHC physicians.
Helvaci, M,R et al; looked at some alarming
consequences of sickle cell diseases (SCDs).
The study included 434 patients (212 females)
with similar ages in males and females (30.8
versus 30.3 years, respectively, p>0.05).
Chronic obstructive pulmonary disease (25.2%
versus 7.0%, p<0.001), ileus (7.2% versus
1.4%, p<0.001), cirrhosis (8.1% versus 1.8%,
p<0.001), coronary heart disease (CHD) (18.0%
versus 13.2%, p<0.05), chronic renal disease
(CRD) (9.9% versus 6.1%, p<0.05), and stroke
(12.1% versus 7.5%, p<0.05) were also higher
in males. There were 31 mortality cases (17
males) with similar ages in males and females
(30.2 versus 33.3 years, respectively, p>0.05).
The authors concluded that SCDs are severe inflammatory
processes on vascular endothelium at the capillary
level, terminating with an accelerated atherosclerosis
induced end-organ failures and a shortened survival
in both genders. Leg ulcers, digital clubbing,
CHD, DVT and/or varices and/or telangiectasias,
cirrhosis, CRD, and BPH may be the alarming
consequences of SCDs indicating an advanced
disease.
Salem, M et al carried a Descriptive cross-sectional
study, this study was conducted at the Primary
Health Care Corporation (PHCC) in Qatar and
it included all physicians from seven health
centers affiliated to primary health care in
Qatar. The sample size was 144 physicians from
both genders male and female. With response
rate 90%. The prevalence of burnout in the study
sample reaches 16.08% among primary health care
physicians. No significan
Ledari, F,M et al; examined the relationship
between life skills with functional dysfunction
and sexual satisfaction in women referred to
health centers of Shahroud University of Medical
Sciences. The data collection tool was four
questionnaires of demographic, General Health
(GHQ-28), Life Skills and Sexual Function Index
(FSFI).Data were analyzed using SPSS. Mean score
of sexual function was 58.07 ± 10.63
and sexual satisfaction was 4.38 ± 0.99.
The average total score of life skills was 508.99±46.82,
which was ranged from lowest amount in the professional
skills as 10.42 ± 2.13 and the highest
amount in mental health as 81.93 ± 9.10.
There was a significant relationship between
life skills and sexual satisfaction and functional
dysfunction. (p0.05). The findings of the study
indicated a relationship between life skills
and sexual satisfaction and functional dysfunction,
so that an increased functional dysfunction
and sexual dissatisfaction was observed in people
with low life skills.
Ghaleghazi, D, M et al; Investigated the cytotoxic
effect of chamomile aqueous extract on 4T1 and
47D cells and level of caspase3 protein in breast
cancer cells T-47D. Breast cancer cells 4T1
and T-47D were treated by blue extract of Chamomile
with various concentrations for 24 hours and
then using MTT method, the rate of cytotoxic
effect of Chamomile was checked on abovementioned
cells. This study showed that Chamomile extract
significantly reduced breast cancer cells survival
concentration-dependent compared to control
group. Dependent on concentration and time,
the Chamomile extract also increased caspase3
protein, indicating induction of apoptosis in
mentioned cells. The authors concluded that
chamomile extract, dependent on concentration
and time, was able to remove breast cells that
can be arising from increasing the level of
caspase3 protein. These results can be used
in future studies on the anti-cancer effect
of Chamomile extract.
Negar Razeghi, N et al;compared the sexual
behavioral patterns and mental health in women
and men victims of identity in the family courts
of Tehran. In order to achieve this purpose,
100 cases of women and men (50 males and 50
females) were referred to courts and cluster
couples who were referred to the court or to
family counseling centers through ministry of
justice. Data of findings showed that the difference
between mean obsessive-compulsive disorder,
interpersonal sensitivity, depression, and anxiety
was significant in both male and female victims.
According to the mens mean in obsessive-compulsive
indices, anxiety was significantly higher than
women, and in depression, aggression and interpersonal
sensitivity in women is more than men, and also
the difference in mean sexual function in two
groups of women and men are not victims of betrayal.
Kerman, M, T et al; surveyed the effect of FIFA
11+ injury prevention program on on dynamic
balance and knee isometric strength of female
players in soccer super league.
Sample of study were included 30 subjects of
female players of Shahrdari Bam, super league
soccer team. 11+ injury prevention training
protocol should be completed within eight weeks,
at least two times a week and approximately
20-25 minutes. Research finding indicates that
11+ injury prevention training program led to
significant increase in flexion and extension
strength of knee joint and dynamic balance in
the posterior and poster-lateral directions
in experimental group (p>0/05). The
authors concluded that because 11+ injury prevention
program includes special soccer movements, plyometric,
strength and balance trainings, it has effect
on muscular strength and dynamic balance in
posterior and poster-lateral directions in professional
soccer players. It can also be preventive factor
in lower extremity injuries because of increasing
knee strength.
Dehkordi, P,K, H et al; looked at the role
of opium in the management of patients with
advanced COPD remains undefined. They studied
two groups of patients with COPD who were attending
the chest clinic of Labaffinejad hospital. Group
A- consists of COPD patients with history of
smoking alone and group B- patients who consume
opium in addition to cigarette smoking. Results
shows that there is significant difference (p
= 0) between two groups for FVC and FEVl. We
conclude that opium may have an beneficial effect
to improve Jung function in patients with sever
COPD.
Dehkordi, P,K,H et al; looked at the Diagnosis
of Pulmonary Tuberculosis by measurement of
ADA.CEA and PCR in Bronchoalveolar lavage. They
did a cross sectional study conducted in Shahrekord
Hajar hospital and then 100 patients enrolled
in our study (62 female,38male). These patients
admitted in hospital and we done bronchoscopy
with BAL and then fluid analysed for ADA,CEA
, PCR and sputum smear for TB .from 100 patient
that evaluated in this study 9 patient had TB
, 39 patient had pneumonia, 11 patient had primary
lung malignancy, 9 patient had metastases to
lung and 8 patient had bronchitis. In Patients
with TB the level of ADA were not significantly
elevated in BAL. ADA increased significantly
in patients with pneumonia (P: 0/95). In patients
with metastases to lung & primary lung cancer
&combination of both group compared to other
patient without malignancy there were not relationship
between CEA . PCR was positive in TB and other
patients, but significantly increased in TB.
(p=0/021). The authors concluded that although
thought that CEA may be elevated in BAL of patients
with malignancy and ADA in tuberculosis we did
not found correlation in these patients. this
study show that ADA and CEA levels in BAL fluid
do not help us in diagnosis of TB or cancer.
it may be has false positive in pneumonia ,COPD
,and other disease ,but PCR for TB may by help
us for TB diagnosis but not alone.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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