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From the
Editor
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Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
In this issue of the journal the third paper
on evidence based medicine is presented. The
paper is about Critical Reading of an Article
about Therapy. The main objective of this paper
is to understand the process of assessing the
quality of a therapy article and how to apply
its results to clinical practice. Specifically,
the learners are expected to be able to: Assess
the validity of a therapy paper; Determine the
importance of the results of a valid therapy
paper; and Determine how a valid and important
evidence from therapy paper be applied to patient
care.
A retrospective study was carried out at KFCH
over an 11-years period from 1994 to 2005. All
patients (3287), age of 12 years and above referred
for endoscopy unit were enrolled in this study.
The objectives of this study were to identify
the common indications and findings of upper
gastrointestinal (GI) endoscopy in patients
presenting to King Fahd Central Hospital (KFCH)
in Gizan town Southwest Saudi Arabia, and to
furthermore, determine the associations between
and the common endoscopic findings and some
selected clinical and demographic variables.
A total of 3287 patients were included in the
study with a mean age of 45.3 years (SD ±
18.4), Indications for upper GI endoscopy included
upper gastrointestinal (GI) bleeding (23.3%),
with a significant difference between males
and females (p-value = 0.000), Epigastric pain
(15.7%), Acid Peptic Disease (APD) (14.4%),
Dyspepsia (7.5%) and regular follow-up (6.5%).
The results of the study suggested that UGI
bleeding was the main indication for UGI E in
the vast majority of our patients. In addition
to that three common diseases; Oesophageal Varices,
Gastritis and Oesophagitis were the main findings
of the UGI E among study population. Preventive
measures should be adopted to cope with the
situation and to prevent complications of esophageal
and gastritis diseases among Gizan population.
A paper from Pakistan looked at the Strategies
for the Prevention of Hepatitis B, Hepatitis
C and Human Immunodeficiency Virus infection
in the Paediatric Population of Developing Countries.
After a brief background about the epidemiology
of Hepatitis B, C and HIV, strategies for their
prevention are discussed in the paediatric population
of developing countries. These strategies are
focused on mother to child transmission, misuse
of injections, use of infected needles, myths
and use of material infected with the hepatitis
positive patient such as a comb, tooth brush
etc. Malnutrition and its relationship with
Tuberculosis and HIV infection are discussed.
World Health Organization (WHO) guidelines on
the management of malnutrition, Tuberculosis
and HIV are discussed briefly. A real scenario
highlighting the existence of HBV, HCV and HIV
is described. Finally role of policy makers,
NGO, WHO and local governments in the prevention
of HBV, HCV and HIV in the paediatric population
is discussed.
A cross sectional descriptive study was conducted
in MOH hospitals and PHCC sectors and private
hospitals and dispensaries in Jeddah. Self administered
questionnaires were distributed to 210 general
managers and medical directors of MOH governmental
and private hospitals plus MOH PHCC supervisors
and only medical directors of private dispensaries.
Data were collected by 3 trained data collectors.
It was entered and analyzed using SPSS version
16. Ethical considerations were ensured. The
current study aim at identifying enabling factors
and determine barriers among health policy makers
toward utilization of national medical research'
recommendations in Jeddah city, Saudi Arabia,
2010.
There is concern for the international community
that research findings are not being utilized
in the implementation of research future wise.
19% of the respondents addressed that they received
recommendation from the previously conducted
research while only 12.4% indicated that there
was previous research conducted in their institution.
The authors concluded that among the interviewed
health policy-makers there was a gap between
the perceived importance of the research from
one side and its conduction and utilization
of its recommendations on the other side. The
reported barriers were mainly remediable as
being attributed chiefly to modifiable subjective
factors driven from the lack of knowledge and
experience about research methodology. In addition,
the insufficient time perceived as a barrier
reflects the vision of the studied institute
which were not focusing in part of it on conduction
of research and incorporating it in its plan
and regular routine work.
A paper from Turkey looked at Chronic obstructive
pulmonary disease as one of the terminal endpoints
of the sickle cell diseases. All patients with
the SCDs were taken into the study. The study
included 411 patients with the SCDs (199 females
and 212 males). There were 60 patients (14.5%)
with the COPD. Mean age of the patients was
significantly higher in the COPD group (33.0
versus 29.5 years, P=0.005). The male ratio
was significantly higher in the COPD group,
too (80.0% versus 46.7%, P<0.001). Smoking
was also higher in the COPD group, significantly
(36.6% versus 9.9%, P<0.001). Parallel to
the smoking, alcoholism was also higher among
the COPD cases, significantly (3.3% versus 0.8%,
P<0.05). The authors concluded that SCDs
are chronic catastrophic processes on vascular
endothelium particularly at the capillary level,
and terminate with accelerated atherosclerosis
induced end-organ failures in early years of
life. COPD may be one of the terminal endpoints
of the diseases.
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