A. Abyad, MD, MPH, MBA, AGSF , AFCHSE Chief Editor

This is the fifth issue of the journal this year and we as of next issue , the MEJFM will provide a series of articles on the theme Focus on Quality Care. Each Focus will be written by experts in the field and will be published in one volume at the end of the series.

This issue is rich with a good number of research papers from the region. A study from Saudi Arabia investigate the use of antihypertensive medications in primary health Care. The aim of the authors were to find out the pattern of prescription of antihypertensive medications in Saudi primary health care, that will help in the identification of educational needs of practicing physicians. The study was a cross sectional study that included 13 primary health care centers. This study reveals evidence suggesting inadequate use of antihypertensive medications in PHC.

A study from King Hussein medical center looked at the lipid profile in diabetic patients. The aim of the study is to look at hypertriglyceridaemia, its age and sex distribution and prevalence in NIDDM and IDDM. One hundred and twenty patients of well established diabetes mellitus were included in the study. The authors concluded that Hypertiglyceridaemia is the most common lipid abnormality in diabetes mellitus, which is more common in NIDDM than IDDM.

In their first paper the Bangladesh Primary Care Research Network (BPCRN), reviewed the Past, Present and Future of Family Medicine in Bangladesh. The authors stressed that the aim of establishing a structures primary health care in Bangladesh with Family Medicine as an independent specialty can be achieved with priority government support and sincere cooperation from the medical fraternity. One of the aim of BPCRN is to contribute in achieving this goal.

Breast cancer detection and barrier to screening is discussed in two papers by Dr Al-Alaboud L & Kurashi NY. In the first study the authors studied The Barriers of Breast Cancer Screening Programs Among PHHC Female Physicians. This was achieved with a survey of 75 female PHC physicians in 43 Primary Health Centers regarding the barriers in implementing of breast cancer screening.

The main barrier of the BC screening program which may be instituted by PHCs female physicians was unavailability of a national screening program. Other barriers include time pressure, lack of training on the part of the physician, lack of good communication, there were not enough facilities in the PHHCs, lack of women cooperation and trust, walk-in clinic, and social and cultural reasons.

The authors recommended the development and institutionalization of breast cancer screening program, massive educational program on breast cancer. In the second paper the authors studied the effects of The Effects of Breast Cancer Early Detection Training Program on the Knowledge, Attitudes, and Practice of Female PHHC Physicians. A total of 45 PHCCs' female physicians participated in a workshop on knowledge of BC concepts and skills was developed and implemented on the participants. In this study before intervention was given, the physicians had good knowledge about breast cancer and early detection but scored low regarding practice of BC early detection and had negative attitude of it too, and after the educational program, there were significant positive changes in physicians KAP.

A paper from Iran discussed the development of a Community- based Care System Model for Senior Citizens in Tehran. In Iran a considerable percentage of old people " live " in the society who need to receive specialized health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as :existing resources and facilities; social and cultural issues and characteristics of each groups of elders seems to be necessary.

A study from Dubai reviewed the topic of Informatics in Clinical Practice The author stressed that though the implementation of a proper Electronic Medical Records system may be unaffordable for a small clinic most of the clinics use some form of computerized patient records. Detailed analysis of the data from these systems can provide information on key performance indices invaluable for strategic planning.

Dr Mutair et al, studied marine animal injuries to children in the South of Jordan. A total of 152 patients, who sustained different marine animal injuries in the Gulf of Aqaba were included in the study. SeaUrchin was the commonest cause of injuries while Stonefish was the cause of most serious injuries. A case report on the effect of vitamin B12 deficiency on infantile dyskinesia in an 11-months old female infant is presented.

At the end I would like to thanks all the contributors and looking forward for next issue in Nov.