Journal of Family and Community Medicine: A scientometric analysis 1994-2020.

The Journal of Family and Community Medicine (JFCM) is a peer-reviewed open access journal published by the Saudi Society of Family and Community Medicine. This review is aimed to analyze the scientometric attributes of manuscripts published over 27 years from 1994 to 2020 using scientometric technique. The bibliographic records of manuscripts published from 1994 to 2020 were retrieved from the Web of Science and Medline-PubMed databases. The data were analyzed by using VOSviewer, CiteSpace, and Biblioshiny software. A total of 648 manuscripts were included; these were written by 1442 authors, with an average of 2.22 authors per manuscript and 24 manuscripts per year. All manuscripts gained 2,693 citations with a mean ratio of 4.15 citations per manuscript. All the top-20 contributing authors belonged to Saudi Arabia, and 48% of the manuscripts were in the single-author pattern; the multiauthored manuscripts received a higher ratio of citations. The review highlighted the most contributing institutions and countries.Bibliographic coupling of countries, institutions, keywords co-occurrence, and co-citation of journals were also presented. The JFCM is an important journal of Saudi Arabia that has provided a platform to family medicine researchers to share their scholarly and scientific communication for the past 27 years. Over the years, the frequency and number of publications in the journal have improved. Although the journal has received manuscripts from all over the world, most contributions were from Saudi Arabia.

Introducing Family Medicine Clerkship to Medical Students' Curriculum at a Saudi Medical University: An Impact Study.

BACKGROUND: Family Medicine was introduced as a major undergraduate clinical rotation in 2016 after the medical college at Imam Abdulrahman Bin Faisal University revised its curriculum. OBJECTIVE: Assessing how students' medical knowledge has improved post Family Medicine introduction to the revised medical school curriculum. STUDY DESIGN: This was a cross-sectional epidemiological study among fifth year clinical medical students (n = 219). A pretest and post-test was distributed to all fifth year clinical medical students voluntarily during the period of October 2017 to May 2018. They were asked to rate the exam as well. RESULTS: The mean exam grades were 25.52 (SD = 4.44) and 34.16 (SD = 5.76) for pre-rotation and post-rotation, respectively. There was a statistically significant difference between post and pre rotation exam grade for the overall sample (t (218) = 23.73, P < .0001) indicating that students had a statistically significantly higher exam grades post-rotation (M = 34.16, SD = 5.76) than pre-rotation (M = 25.52, SD = 4.44). Females had a statistically significantly larger difference in post-rotation and pre-rotation exam grade than males indicating that they improved more in the post rotation exam. It was found that nearly 60% (59.36%) of subjects considered the exam difficult before the rotation; however, only around 40% (40.18%) considered the exam difficult after the rotation. CONCLUSION: Students benefited after taking the course of family medicine. This helps in advocating for both the importance of this specialty and for the university's decision in incorporating family medicine as a major clinical rotation for undergraduates.

Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

BACKGROUND: Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. OBJECTIVES: To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). DESIGN: Single-blind, nonrandomized. SETTING: Diabetes clinic of a university hospital in Saudi Arabia. PATIENTS AND METHODS: Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. MAIN OUTCOME MEASURE(S): Lipid and cardiovascular parameters, and BMI. RESULTS: Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. CONCLUSION: N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. LIMITATIONS: There were 9 subjects in each group lost to follow up; thus the sample size could not be maintained as per the sample size calculation. The study was nonrandomized and thus there was a possibility of allocation bias. (Clinical trial registration number: CTRI/2013/06/003781, Clinical Trial Registry of India).

Nigella sativa: A potential natural protective agent against cardiac dysfunction in patients with type 2 diabetes mellitus.

OBJECTIVES: To study the effect of Nigella sativa supplementation on cardiac functions in Type 2 diabetic patients treated with oral hypoglycemic agents. BACKGROUND: Diabetes mellitus is associated with a high risk of cardiovascular morbidity and mortality. A number of reported beneficial effects of N. sativa on cardiovascular function were the inspiration for this study. MATERIALS AND METHODS: Sixty patients with uncontrolled diabetes (hemoglobin A1c [HbA1c] >7%) and with no known cardiovascular complications were recruited from the outpatient diabetes clinic. They were assigned, by convenience, to two groups; the control group received activated charcoal as placebo while the test group received 2 g/day of powdered N. sativa for 1-year. All patients continued with their standard oral hypoglycemic agents. Echocardiography was used to evaluate the diastolic function, systolic function, and left ventricular mass (LVM) before the intervention and after 6 and 12 months of the treatment. RESULTS: HbA1c decreased significantly in the N. sativa group but did not change in the control group. Echocardiographic assessment in the control group showed impairment in diastolic function after 12 months, but there were no significant changes in fractional shortening (FS) or ejection fraction (EF). Furthermore, left ventricular (LV) dimensions at diastole and systole, LVM, and LVM index were significantly increased. In N. sativa group, no significant changes were found in diastolic function or LVM. LV dimension at systole was decreased while FS and EF were significantly increased after 6 and 12 months. CONCLUSION: N. sativa supplementation may protect the hearts of type 2 diabetic patients from diastolic dysfunction while improving LV systolic function.

Nigella sativa improves glycemic control and ameliorates oxidative stress in patients with type 2 diabetes mellitus: placebo controlled participant blinded clinical trial.

BACKGROUND AND OBJECTIVE: Oxidative stress plays an important role in pathogenesis of diabetes mellitus and its complications. Our previous study has shown glucose lowering effect produced by 3 months supplementation of Nigella sativa (NS) in combination with oral hypoglycemic drugs among type 2 diabetics. This study explored the long term glucose lowering effect (over one year) of NS in patients with type 2 diabetes mellitus on oral hypoglycemic drugs and to study its effect on redox status of such patients. METHODS: 114 type 2 diabetic patients on standard oral hypoglycemic drugs were assigned into 2 groups by convenience. The control group (n = 57) received activated charcoal as placebo and NS group (n = 57) received 2g NS, daily, for one year in addition to their standard medications. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), C- peptide, total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione and thiobarbituric acid reactive substances (TBARS) at the baseline, and every 3 months thereafter were determined. Insulin resistance and ß-cell activity were calculated using HOMA 2 calculator. RESULTS: Comparison between the two groups showed a significant drop in FBG (from 180 ± 5.75 to 180 ± 5.59 in control Vs from 195 ± 6.57 to 172 ± 5.83 in NS group), HbA1c (from 8.2 ± 0.12 to 8.5 ± 0.14 in control VS from 8.6 ± 0.13 to 8.2 ± 0.14 in NS group), and TBARS (from 48.3 ± 6.89 to 52.9 ± 5.82 in control VS from 54.1 ± 4.64 to 41.9 ± 3.16 in NS group), in addition to a significant elevation in TAC, SOD and glutathione in NS patients compared to controls. In NS group, insulin resistance was significantly lower, while ß-cell activity was significantly higher than the baseline values during the whole treatment period. CONCLUSION: Long term supplementation with Nigella sativa improves glucose homeostasis and enhances antioxidant defense system in type 2 diabetic patients treated with oral hypoglycemic drugs. TRIAL REGISTRATION: Clinical Trials Registry-India (CTRI) CTRI/2013/06/003781.

A new era for the Journal of Family and Community Medicine.

The Journal of Family and Community Medicine (JFCM) is the official scientific publication of the Saudi Society of Family and Community Medicine (SSFCM). The JFCM was first published in 1994 to meet "...a pressing need for a medical journal that would develop into a forum to address certain issues of family and community medicine."[1] Thanks to the efforts of the earlier editorial team, the journal continued to serve as a major source for research in the field of family and community medicine and helped many researchers to communicate their work with the scientific communities. These results were achieved in spite of many obstacles that faced the JFCM at its early years. Now, thanks to the efforts of the new editorial team and the continued support of the University of Dammam and the sponsors of the SSFCM, the JFCM is an international peer-reviewed journal. The journal is committed to relevance and excellence and has a clear vision "...of becoming a leader in medical journalism in the field of family and community medicine..."[2]

Knowledge of healthy diets among adolescents in eastern Saudi Arabia.

BACKGROUND: Bad dietary habits, such as eating high-fat/high-energy food, can contribute to obesity in adolescents, which tends to persist into adulthood. The objective of this study was to determine the level and sources of knowledge about foods and healthy diets among male and female adolescents. METHODS: This was a cross-sectional study of a sample of male (n=1240) and female (n=1331) adolescents from third grade, intermediate and all three grades of secondary school students in the Al-Khobar Area, eastern province of Saudi Arabia. A self-administered questionnaire was used to collect information. RESULTS: Approximately 51% of the male and 65% of the female students recognized unsaturated fats as healthy foods. However, 10% of the males and 8% of females reported saturated fats as healthy food items. About 49% of the males and 66% of the females correctly defined cholesterol. Dietary knowledge of both male and female students on the dangers of unhealthy foods and the benefits of fiber-rich diets was found to be unsatisfactory. The main sources of knowledge about health and disease reported by the male and female respondents were television (58% and 61%, respectively), magazines (31% and 39%) and daily newspaper (33% and 34%). Primary health care centers (PHCCs) staff were the least source of knowledge (17% and 16%). CONCLUSIONS: Knowledge of healthy diets among school students was inadequate. It is recommended that health education and information about healthy eating habits and lifestyle be included in school curricula.

Do children born before and after adequate birth intervals do better at school?

There are un-verified reports that adequate birth intervals are associated with better physical and mental development children in the school age. The objective of this study was to investigate the effect of preceding and succeeding birth intervals on the school performance of 9-10-year-old male Saudi children. This is a cross-sectional study of the performance of Saudi school children in relation to the length of the birth interval before and after the birth of the index child, conducted in Khobar, Eastern Saudi Arabia. A two-stage randomized sampling technique was adopted. Data were collected on scholastic achievements. Data was analyzed using SPSS software using chi-square, linear and logistic regression analysis. Children born after birth intervals longer than 31 months who scored grade A in the year of study, and the year before, were found to be significantly more than children born after intervals less than 17 months. There are more above-average students amongst those born after an interval of 31 months or more compared to those born after a shorter birth interval of 17 months or less according to teachers. Significantly more children born before birth interval longer than 35 months did better at school than children born before interval shorter intervals (less than 19 months). Logistic regression analysis showed that the possibility of classifying the index child as average or above in school performance increased as the succeeding birth interval increased. Results of the study verified previous findings that children born after adequate birth intervals do better at school. The study revealed that the succeeding birth interval in relation to school performance is more significant than the preceding birth interval. Apart from mother's education and breastfeeding, no other variables were found to be significantly related to the birth interval. These findings would enable us to advise couples that by observing a birth interval of around 3 years, their children are likely to do better at school.

The effects of birth interval on intellectual development of Saudi school children in Eastern Saudi Arabia.

OBJECTIVE: The primary aim of this study was to investigate the effect of birth intervals on some aspects of intellectual ability of Saudi primary school boys. METHODS: This is a cross-sectional study of Saudi school children comparing their intellectual ability (general intelligence) in relation to the length of the birth interval before and after the birth of the index child. The study area comprised 3 townships in the eastern province; Khobar, Thogba and Dhahran. The study was conducted in 2000/2001 and the study population comprised Saudi primary school boys aged 9-10 years from a middle class background. A 2 stage random sampling technique was adopted. Data were collected using student data sheet, a family questionnaire and the Standard Progressive Raven Matrices Test of intellectual ability, standardized for use in Saudi Arabia. Data were analyzed using SPSS software. RESULTS: More than 90% of children born after a birth interval greater than 35 months were classified as average and above according to the Raven Matrices Test, compared to 79% of children born after a birth interval of less than 19 months (p<0.03). Analysis of variance showed that test scores increased consistently as the succeeding birth interval increased. Multivariate analysis showed the most import predicting variables in the Raven Matrices Test to be family income and height. CONCLUSION: Longer birth intervals were shown to be associated with higher general intelligence levels in the 9-10 year olds. These results confirm those obtained in a previous study in Singapore conducted more than 2 decades ago. Our results have also shown that the succeeding birth interval is more significant than the preceding interval in relation to perceptive ability of children. The findings enable us to advise parents that by observing a birth interval between 2-3 years would make their children grow and do better at school.

Prevalence of obesity and overweight among Saudi adolescents in Eastern Saudi Arabia.

OBJECTIVE: To determine the prevalence of obesity and overweight among Saudi adolescents, using the 2 most widely used international references. METHODS: A cross-sectional study conducted towards the end of 2001 on a random sample of third grade intermediate and all 3 grades of secondary school Saudi students of both genders in Al-Khobar area, Eastern Saudi Arabia. The body mass index (BMI) was calculated. The American National Health and Nutrition Examination Survey (NHANES) growth charts, which have been adopted by the World Health Organization (WHO), were used. Student with a BMI of <85th and >95th percentile for age and genders, were defined as overweight and <95th percentile defined as obese. The International Obesity Taskforce (IOTF) age-sex-specific BMI cut-offs reference for defining overweight and obesity was used for comparison. RESULTS: The sample was 1766 students, comprising 675 males and 1091 females. The mean age was 16.4 +/- 1.7 years. The prevalence of obesity was higher in male than female students (19.3% versus 11.8%) while a higher proportion of female students than males were overweight (17.2% versus 10.2%). No significant difference was found between the 2 references used to determine the prevalence of obesity and overweight. CONCLUSION: The high prevalence of overweight and obesity recorded in this study call for prevention programs based on dietary and physical education in schools.

Barriers facing physicians practicing evidence-based medicine in Saudi Arabia.

INTRODUCTION: Tremendous advances in health care have been made through the development of evidence-based medicine (EBM). Studies show that physicians face barriers in practice, preventing the effective use of the best evidence available. Insight into these barriers should pave the way for an action plan to remove them. The aim of this study was to explore the major barriers to the practice of EBM by physicians in primary health care centers (PHCCs) and hospitals. METHOD: This cross-sectional study was conducted on physicians in PHCCs and Ministry of Health hospitals in the Dammam area (Dammam, Alkhobar, and Alqatief) of Saudi Arabia. A sample size of 409 physicians was chosen. Barriers to the practice of EBM and the reasons for not giving patients effective health care were investigated through questionnaires. RESULTS: The response rate was 66. 7%. The main barriers to practicing EBM stated by physicians were the lack of training in EBM (72.9%), facilities (34.4%), and time (29.2%). The least mentioned barriers were the lack of relevant evidence and the negative impact on medical skills (10.4% each). DISCUSSION: Rather than skepticism about the concept, the main barriers to the use of EBM by physicians appeared to be a lack of knowledge and basic skills. Therefore, targeted education in EBM and a system that quickly delivers high-quality evidence are needed. This includes the allocation of an adequate infrastructure and time and the availability of relevant evidence.

Physician attitudes towards evidence-based medicine in eastern Saudi Arabia.

BACKGROUND: Because of the growing awareness of the limitations of traditional information on clinical decisions, there is a shift in medical practice towards evidence-based medicine (EBM). METHODS: We assessed physician attitudes towards evidence-based medicine (EBM) in a cross-sectional study of a random sample of physicians in primary health care centers (PHCCs) and general hospitals in the Dammam area of eastern Saudi Arabia. A random sample of 409 physicians was drawn from the population of doctors. The tool of data collection was a self-administered questionnaire. Only physicians who said they had heard about EBM were included in the study. RESULTS: Only 108 (39.6%) physicians out of those who responded had heard about EBM. Of those, 71 (65.7%) were in favor of EBM and 89 (90.8%) had a positive attitude towards EBM, as they scored above the cut-off point in the questionnaire. Using multiple linear regression, it was found that critical appraisal knowledge and EBM knowledge scores were the only significant predictor variables of EBM attitude score. CONCLUSIONS AND RECOMMENDATIONS: There was an overall positive attitude among physicians towards EBM. There was a proportional relation between the knowledge of EBM and attitude towards it. Dissemination of the EBM concept and practice among physicians is highly recommended.

Evidence based medicine: an overview.

Evidence based medicine (EBM) considered one of the most important developments in the practice of medicine in recent years, has evolved as a tool for improving the quality of health care. Several studies have shown EBM to be safe and cost-effective. Physicians have welcomed EBM and shown a positive attitude toward it and have expressed desire to learn more about it. This is consistent in most studies done in different countries. However, some studies found considerable misunderstanding about terms and websites used in EBM. The major barriers to the practice of EBM perceived by physician in different studies include insufficient time and evidence, patients' preference and financial constraints. Training has been found to be conducive to the implementation and promotion of EBM. Some Arab countries are already implementing EBM and plan to include it in the undergraduate curriculum. In Saudi Arabia EBM was introduced in the late 90's and a National EBM Advisory Board was formed.