Practice in child restraint system use among attendees of Well-baby clinics in Jeddah, Saudi Arabia.

Background: The systematic use of child restraint system (CRS) while driving has been promoted by the WHO to improve road safety. Objectives: To assess the levels of practice in CRS use for children aged ≤5 years among mothers attending the Well-baby clinics and to explore the associated factors and attitudes. Methods and Material: A cross-sectional study was conducted among mothers visiting the Well-baby clinics at five primary health care centers in Jeddah, Saudi Arabia, using a multistage stratified-cluster sampling. Practice in CRS was assessed by interviewing the participants regarding the availability of a CRS in their car, usage frequency for a child <5 years, and alternative child-sitting methods. Sociodemographic data, further road safety parameters, and attitudes were analyzed as independent factors of adequate practice using multivariate logistic regression. Results: Of the 192 included mothers, eight (4.2%) had a history of accident while driving with a child. Majority of the participants (62.5%) declared not having their cars equipped with a CRS and used inappropriate car-sitting methods. Of the 37.5% who had CRS in their cars, 27.1% declared using it always or frequently. Adequate practice in CRS was independently associated with mother's age (OR = 0.91, P = 0.09), low (OR = 0.10, P = 0.001) and moderate family income (OR = 0.23, P = 0.012), and the belief that CRS is not essential while driving with children (0.32, P = 0.023). Conclusions: There is inadequate practice in child road safety among families attending the Well-baby clinics in Western Saudi Arabia, which is associated with several misconceptions and negative attitudes towards the utility of CRS.

Level of participation in public health volunteering and its determinants among ministry of health primary health care workers in Jeddah 2019.

CONTEXT: Volunteering is an important practice for health care systems globally and contributes to the development of health care services as well. AIMS: To estimate the level of participation in public health volunteering and its determinants among healthcare workers in ministry of health primary care sector, Jeddah. SETTINGS AND DESIGN: A randomized quantitative cross-sectional self-administered survey involving all primary healthcare workers in 15 centers. METHODS AND MATERIAL: The survey included socio-demographics and 33 determinants of volunteering (values, career development, enhancement, social, and protection) ranked by importance using a seven-point scale. The research committee of the joint program for family medicine in Jeddah validated the survey. Primarily we evaluated the level of participation in public health volunteering. Secondary endpoints were perception of the importance of volunteering determinants among participants, correlation between volunteering and independent socio-demographic variables, and any attribute of volunteering determinants. STATISTICAL ANALYSIS USED: Descriptive analyses using the Statistical Package for Social Sciences, version 24. RESULTS: 231 consenting participants filled the survey. Most of the participants were Saudi citizens, predominantly female, bachelor or higher degree holders, and married. Out of 227 respondents, 98 (43%) declared volunteering in the previous year. Only the age was positively correlated to volunteering significantly. Respondents significantly perceived the 33 attributes of the questionnaire as "extremely, very, or somewhat important." Determinants like values, enhancement, and social were significant predictors of volunteering but not career development or protection. CONCLUSIONS: Volunteering complements healthcare resources in coping with emergent situations like COVID-19 pandemic. More efforts are required to bring awareness toward volunteering opportunities in Saudi healthcare sector.

The Saudi clinical practice guideline for the management of overweight and obesity in adults.

OBJECTIVE: To assist healthcare providers in evidence-based clinical decision-making for the management of overweight and obese adults in Saudi Arabia. METHODS: The Ministry of Health, Riyadh, Kingdom of Saudi Arabia assembled an expert Saudi panel to produce this clinical practice guideline in 2015. In collaboration with the methodological working group from McMaster University, Hamilton, Canada, using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, which describes both the strength of recommendation and the quality of evidence  RESULTS: After identifying 11 questions, corresponding recommendations were agreed upon as guidance for the management of overweight and obese adults. These included strong recommendations in support of lifestyle interventions rather than usual care alone, individualized counseling interventions rather than generic educational pamphlets, physical activity rather than no physical activity, and physical activity in addition to diet rather than diet alone. Metformin and orlistat were suggested as conditional recommendations for the management of overweight and obesity in adults. Bariatric surgery was recommended, conditionally, for the management of obese adults (body mass index of ≥40 or ≥35 kg/m2 with comorbidities).  CONCLUSIONS: The current guideline includes recommendation for the non-pharmacological, pharmacological, and surgical management of overweight and obese adults. In addition, the panel recommends conducting research priorities regarding lifestyle interventions and economic analysis of drug therapy within the Saudi context, as well as long term benefits and harms of bariatric surgery.

Efficacy of insulin analogues in diabetic patients attending primary care centers.

OBJECTIVES: To measure the efficacy of new insulin analogues compared with the conventional types of insulin, and to compare their effects on patient satisfaction regarding their weight changes and the frequency of hypoglycemic episodes. METHODS: In this retrospective cohort observational study, data was collected from the medical records of 122 eligible diabetics on insulin therapy attending government primary care centers, in Jeddah, Kingdom of Saudi Arabia from June 2013 to July 2014. The data collected considered the efficacy, safety, and patient satisfaction of the types of insulin therapy used for their treatment. RESULTS: After 12 weeks, there was a reduction in mean glycosylated hemoglobin (HbA1c) of -0.88% for the analogue type versus -0.19% for the conventional type, and at 24 weeks, the mean drop in HbA1c was -2.02% for the analogue type versus -1.12% for the conventional type, but the differences were not statistically significant. More patients (87% versus 38%) on analogue compared with conventional insulin treatment were satisfied with therapy. CONCLUSION: In the primary health care setting, insulin analogues showed greater efficacy improvements than conventional insulin therapy within 6 months. However, conventional insulin therapy can still be used at primary care centers with limited resources, and when patients refuse to be converted.

Vision screening of preschool children in Jeddah, Saudi Arabia.

OBJECTIVE: To determine the prevalence of Amblyopia and other refractive errors and to identify the factors associated with these disorders. METHODS: The study was carried out in Jeddah, Kingdom of Saudi Arabia, in 1999, on children enrolled in governmental kindergartens during the academic year 1419-1420H. Children were screened for Amblyopia, any child who failed to pass the screening examination, was referred to the ophthalmologist for complete examination. A 95% confidence interval was used to describe the prevalence of eye disorders. RESULTS: The number of children referred to the ophthalmologists was 102. Out of this figure, 70% of children kept their appointment. Seventy-two children had decreased visual acuity of 20/30 or worse. The final diagnoses were as follows: Amblyopia in 8 cases, which, give a prevalence rate of 1.3% (95% confidence intervals: 0.4-2.3); refractive errors in 50 cases (69%); strabismus in 4 cases (6%), duane syndrome in 2 cases (3%); and 8 children (11%) were completely normal. The positive predictive value of visual screening examination was 89%. We found no significant correlation between Amblyopia and the risk factors mentioned in the literature. CONCLUSION: Vision screening is very important and recommended to be carried out as part of periodic health examination for pre school children. It is cost effective, highly sensitive, acceptable and easy to be administered.