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From
the Editor
This issue has a variety of papers from Japan,
Saudi Arabia, Pakistan, Qatar, Kuwait, Turkey,
Iran, Australia and Lebanon.
Kelendar H et al., used a descriptive exploratory
approach in the modality of a case study through
semi-structured interviews with thirteen staff
involved in the care of PWT2D in four Kuwaiti
primary healthcare centres. The aim is to map
the flow of patients with type 2 diabetes (PWT2D)
without any complications in primary care, identify
potential waste and make recommendations for
improvement. Staff acknowledged waste as non-standardised
clinical practice, delays, waiting times and
unnecessary patient visits. Four potential improvements
were identified which could be consolidated
into a single visit: using point of care testing,
the posting of laboratory results to GP computer
systems, the introduction of guidelines that
standardise the practice for the patient's visit
and permitting the GP to prescribe four months
of medication. The authors concluded that the
process map of PWT2D has highlighted waste and
improvement suggestions that may reduce workload,
enhance patient satisfaction, avoid unnecessary
visits, enhance the timeliness of laboratory
testing, improve communication between and across
departments and minimise use of resources without
undermining the quality of care. These suggestions
need to be implemented and rigorously evaluated.
Miki, E et al., reported on the Effects of
Touch and Massage Care in Advanced Alzheimer
Patient. The patient was a woman in her late
80s with the most severe level of care need
and dementia due to AD. Once a month during
5 months, unscented jojoba oil was applied to
the patient's hands while she was seated on
a wheelchair with her hands on a table, and
she received 10 minutes of touch and massage
care on each hand, for a total of 20 minutes.
Salivary amylase activity was measured just
before and immediately after every intervention
session as a non-invasive indicator which reflects
psychological stress. The average salivary amylase
values before and after the 5 times that the
patient received the touch and massage care
were 185.6 KIU/L (SD = 44.5) and 112.8 KIU/L
(SD = 38.3), respectively. A significant decrease
was observed (P = 0.043). As for the patient's
appearance during the sessions, when she was
helped to move her arms onto the tabletop, her
arms and legs sometimes stiffened, and she flexed
them intermittently, however, the stiffening
diminished after the massage began. The authors
concluded that since this was a pilot case study
with a single patient, the results cannot be
generalized. However, the study showed that
touch and massage care could provide pleasant
stimulation for an advanced AD patient with
verbal communication difficulties and offered
the possibility of reducing physical and emotional
stress; therefore, it provides important clues
for the future occupational therapy intervention
and care of advanced AD patients.
Al Saudi H et al., surveyed primary care physicians
about their comprehension of HBA1C , and their
understanding of the common medical conditions
that can affect the accuracy of HBA1C. Although
the test is simple and straightforward, but
not, in reality health care professionals needs
to be very vigilant and critical when interpreting
values of HBA1C as HBA1C is affected by many
other medical conditions and medications, and
most of these medical conditions co -exits with
Diabetes melilites or develop as a result of
diabetes itself.
In this research we did a cross sectional study
among family physicians working in primary health
care corporation Doha, Qatar to see the awareness
and understanding of the different medical conditions
that can affect the accuracy of HBA1C levels
and to see if the physicians are aware of any
alternative bio marker other than HBA1C,that
is reliable in conditions in which HBA1C could
not be accurately used.
Hussain & Nizamani conducted a cross sectional
study, gathering total number of patients registered
with T2DM at AbuNakhla health center, Doha,
Qatar. The study aims at looking at the prevalence
of T2DM in a small rural population of AbuNakhla,
Doha, Qatar with age and gender distribution.
The results showed high disease burden in local
population of AbuNakhla. Around 51% patients
with T2DM are under the age of 50 years, out
of which 10% are under the age of 35 years.
Also, the number of females with T2DM is quite
high under the age of 35 years. Around 49% patients
are above the age of 50 years. The authors concluded
that there is a high diabetes prevalence in
AbunAkhla, Doha Qatar. Prevalence is higher
in younger age group i.e under 50 years with
a rapid rise in prevalence in age group 36 to
50 years for both males and females.
Dr AlKhaldi Y. M did a cross sectional study
to explore the prevalence of depression and
anxiety among tourists in Asser region, KSA.
The mean age of the participants was 31±12.5
years, women represented 56%, and 53% were married.
More than one two-third (61%) complained of
physical symptoms, i.e. chronic headache (14%),
chronic joint pain (12%), IBS (10%), and chronic
back pain (9%). More than two-thirds had depression
(68.9%), ( 59.5%) have GAD, while both disorders
affect ( 28.4%). Mild depression affects(30.4%),
moderate depression (19.8%), while severe depression
reported among (18.7%). Moderate to severe anxiety
were more in women (30.3%) compared to men (20.9%)
with a significant difference (p-value = 0.018).
Dr. Jamal, et al, conducted a cross sectional
study, conducted among medical students, trainee
and resident doctors of Jinnah Sindh Medical
University and Jinnah Postgraduate Medical Centre
respectively from July 2019 to December 2019.
The aim was to assess the knowledge, attitude
and practices regarding stethoscope disinfection
among students, trainee and residents doctors
at Jinnah Postgraduate Medical Center. Their
study concluded that there is a lack of practice
by medical providers to disinfect their stethoscope
in spite of considering stethoscope as potential
vector for nosocomial infection. Therefore measures
should be taken to elevate practice of stethoscope
disinfection to reduce the nosocomial infection
effectively.
Alshahrani A.S, reported a rare presentation
of ATIL with hepatitis for a woman who has Crohn's
disease and was treated with infliximab for
9 months. She had clinical and biochemical improvement
after discontinuation of infliximab and starting
steroid therapy. The authors concluded that
treatment with Infliximab may cause a lupus-like
syndrome, which can be reversed upon its discontinuation.
Khan, H., et ., attempted to quantitatively
analyze the impact of type of contact and duration
of contact with infectivity of novel corona
virus. They analyzed 378 suspects/cases to prove
our null hypothesis. Relevant information's
were recorded on a predesigned proforma prepared
in accordance with the objective of the study
in SPSS. History of contact with positive COVID-19
patients was contributing in 35/41(85.36%) confirmed
cases. We observed that 25/41(60.97%) of the
positive cases had a contact history > 5
days. The authors concluded that it is the duration
of contact and not the type of contact that
has a statistically significant correlation
and a higher probability of exposure to COVID-19.
Wani, & Zaidi conducted a study in Jammu
And Kashmir examined the prevalence of posttraumatic
stress disorder (PTSD) symptoms, depression,
and coping mechanisms among the adult civilian
population in Indian Kashmir. The Everstine
Trauma Response Index-Adapted, the Beck Depression
Inventory, and the Coping Resources Inventory
were used to assess the three domains. Independent-sample
t tests were used between the directly and indirectly
traumatized groups to explore each of the five
hypotheses of this study. The results showed
significant differences for all of the hypotheses.
The implications of the study are discussed
and recommendations given to address the mental
health situation of the victims.
Helvaci et al., reports the most desired values
of high density lipoproteins in the metabolic
syndromee tried to understand the most desired
values of high density lipoproteins (HDL). Patients
with plasma HDL values lower than 40 mg/dL were
collected into the first, lower than 46 mg/dL
into the second, lower than 50 mg/dL into the
third, and 50 mg/dL and higher into the fourth
groups, respectively. The authors concluded
that the highest mean age, female ratio, BMI,
FPG, WCH, HT, and DM parallel to the highest
HDL and LDL, and the highest CHD in contrast
to the lowest HDL and LDL values may show initially
positive but eventually negative acute phase
proteins functions of HDL and LDL. Due to the
lowest mean age, female ratio, BMI, FPG, WCH,
DM, and CHD, the most desired values of HDL
may be between 40 and 46 mg/dL in the plasma.
Sheykhi, M.T., investigates the quality and
quantity of divorce event taking place all over
the world more than any time before. While divorce
is an stigma in one society, it is a regular
norm in the other. Divorce is being facilitated
all over the world due to modernization and
industrialization in process, and the outcome
of social change. Sociologists must be quite
vigilant to the phenomenon which is breaking
families and creating social problems of all
sorts. However, it is the sociology that can
judge and assess the demerits of divorce. Many
of the apparent social issues emerging such
as drug abuse, child labor, criminal behaviors
and many more, are somehow or the other associated
with divorce. Method of research used in the
present article is of qualitative type, and
the article eventually concludes that the outcome
of divorce is widely different in sociological
terms affecting both parties of parents as well
as children to a greater extent.
The second part of the review on Parkinson's
disease discussed the etiology and pathophysiology
of the disease. Parkinson's disease is a common
neurodegenerative disorder which involves the
loss of nigral dopaminergic neurons in particular.
The cause is uncertain but there is growing
evidence that this could be due to a combination
of ecological and hereditary factors.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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