From the Editor

We are starting the year 2004 with the third issue of the journal and we look forward to a successful year.  Due to the positive response of the readers and the large numbers of papers submitted to the journal , the frequency of the journal will be bimonthly. 

Medical care systems in most countries of the world have traditionally used generalist physicians as part of their health services delivery system. The Middle-East is following the same track, although there is lack in the number of training programs and the number of family physicians in the region.  We hope that through our journal that we will contribute toward raising the level of education of existing general practitioners in addition to stimulating further, the movement of family medicine in the area.  

This issue of the journal has a number of papers on prescribing and medication use. The study by  Dr AL Doghether and AL  Megbil studied the Determinants of prescribing for the elderly in primary health care.  The study showed 51% of patients are being followed up in the  primary care center, 56% of patients had two or more diseases, and 31% of patients are on three or more medications. 61% of patients get their medications from the primary care center and 95% of medications for the elderly may be available in the primary care center.  The authors concluded that most oelderly patients depend on the primary care center for their health care.

The paper by OZER C et al discussed the issue of overprescription of antibiotics for acute respiratory infections in children.  They stressed that this usually leads to increased antimicrobial resistance, and adds a significant cost to health care. The authors studied the effect of a semi-structured evaluation tool with one-on-one patient education in reducing patient expectations of antibiotics for the treatment of acute respiratory infections. The authors concluded that use of an evaluation tool combined with one-on-one patient education was found to be successful for changing antibiotic related behaviour and reducing antibiotic expectations of parents for acute respiratory infections.

In the accompanying review paper on prescribing: What’s all the fuss? the authors discussed the issue of prescribing and the fact that this skill is poorly taught at school. This was followed by discussion on the WHO guide for good prescribing    

A survey on parasitic infection in Kuwait was reported from primary care centers by Al Nakkas et al.  The objective of the survey was to determine the prevalence of different types of parasitic infections among patients attending primary health care centers.   A total of 912 participants in the study, comprised of 607 (66.6%) males  and 305 (33.4%) females. 354 (38.8%) were Kuwaitis. Based on stool examination, 255 (28%) subjects were found to be positive for different types of parasitic infections.  The study revealed that the parasitic infections were more prevalent among populations with  low socio-economic conditions. Hence, efforts are needed to increase prevention programmes and also to improve such conditions in the regions with high prevalence.

The paper by Dr Sarru discussed the effect of stress on physicians.  It stressed that the stress among physicians is a global problem.   The author stresses that several causes of physicians’ stress and frustration can be avoided by taking care of ourselves. He added that overstressed physicians “need to minimize efforts and avoid tasks that drain their energy, and invest in work that is more rewarding. They need to realize that they are vulnerable and might need help at times". Family physicians may be limited about what can be done about the health care environment, but they can change their attitude toward matters such as life and self.


A common problem that face all general practitioners is the management of hernia.  A nice review by Maurice Brygel discusses the use of mesh in hernia repair and the advantages of day surgery.  The author discusses the symptoms and management of hernia and the advantage of day surgery.  The author stressed the fact that the primary care physician is usually responsible for the initial assessment of the degree of urgency, referral for surgical assessment and the decision regarding where and by whom the surgery should be performed.  The authors discussed the different type of hernia and the possible management.

In addition this issue features a major interactive multimedia education section on Diabetes Type 2. You are invited to test yourself and enter the competition for an educational CD ROM on the topic.

The MEJFM is also delighted to welcome the new members of the editorial board. From Bahrain , Dr Faisal A. Latif Alnasir Associate Professor Department of Family and Community Medicine and Vice Dean, Student Affairs and Premedical Program College of Medicine and Medical Sciences  Arabian Gulf University.  From the Kingdom of Saudia Arabia,  Prof  Tariq Al-Habeeb,  who is Head, Division of Psychiatry, College of Medicine & King Khalid University Hospital King Saud University, and Professor Hassan Bella who is the Editor-in Chief , of the Journal of Family & Community Medicine, College of Medicine, King Faisal University, and Dr Mazen Saleh Ferwana, Consultant Family Medicine , Family Medicine Dep. King Fahad National Guard Hospital

In addition to Prof Changiz Geula, Associate Professor, Department of Medicine (Neuroscience);Division on Aging, Harvard Medical School, Boston, MA, United States and From Bangladesh Prof Kanu Bala , Professor & Medical Director Bangladesh Institute of Family Medicine & Research

We would like as well to announce the launching of the Middle-East Journal of Age and Ageing.  The Mission of the Journal is to promote geriatric medicine, gerontology and ageing related issues in the Middle-East .

The ME-JAA is a new peer-reviewed journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve in the Middle-East. The Journal will begin publication, online, in mid January 2004. The frequency will be initially once every six months for one year then once every four months followed by once every two months.  We will apply for medical index after the second issue.

The Journal will publish original clinical and educational research of interest to geriatricians, primary care physicians , practicing clinicians, residents, and others involved in, services for health related problems in older people. The Journal also publishes special articles and commentaries about the fundamental concepts of medical education, as well as book reviews and international reports.  It will fosters the basic and applied sciences of geriatric medicine, primary care for older people,  and gerontology care practice.

The web site of the ME-JAA will be

Finally on behalf of the editorial board and the production team I would like to wish all the general practitioners in the region a happy New Year and successful 2004. 

 Dr Abdulrazak Abyad
 Chief Editor