Community-based screening for pre-hypertension among military active duty personnel.

OBJECTIVE: To determine the prevalence of both pre-hypertension and hypertension, and risk factors associated with the newly diagnosed Saudi military active duty personnel. METHODS: A community-based cross-sectional screening of 1238 Saudi military active duty service personnel was conducted during the period from September to December 2007 at the military units of Taif region, western Saudi Arabia. Screening tools included self-administrated questionnaire, general physical examination, anthropometric measurements, and assessment of blood pressure. RESULTS: All participants were Saudi males. Their age ranged from +/-7.02. By applying the Joint National Committee on prevention, detection, evaluation, and treatment of high hypertension criteria, 214 (17.3%) were considered pre-hypertensive. Multivariate logistic regression analysis showed that obesity as measured by body mass index [odds ratio (OR)=2.71, confidence interval (CI): 1.39-5.28], positive family history (OR=1.46, CI: 1.03-2.06), ever smoking (OR=1.45, CI: 1.05-2.02), and increased waist circumference (OR=1.04, CI: 1.02-1.06) were the significant predictors of hypertension among military active duty personnel. CONCLUSION: Pre-hypertension is a common hidden problem and it predicts the development of frank hypertension. Findings of the current study support the recommendation of lifestyle modification for pre-hypertension patients. However, further prospective studies are required to determine the role of pharmacotherapy in pre-hypertension.

Attitude, awareness and practice of evidence based medicine among consultant physicians in Western region of Saudi Arabia.

OBJECTIVE: To assess the awareness, attitude and practice of evidence base medicine (EBM) among Al-Taif Consultant Physicians and to define the perceived barriers for practicing EBM. METHODS: It is a cross-sectional study conducted during December, 2004, at all governmental hospitals in Western region of Saudi Arabia at Al-Taif Governorate. Two hundred and eight self administrated questionnaires had been distributed to all consultant physicians in different specialties who met the inclusions criteria for this study. RESULTS: The response rate was 85.5% of more than 16 different specialties involved in this study with different types of qualifications. The internal consistency reliability coefficient (Cronbach's alpha), that measures current attitude, was 0.76. The majority of respondents had a positive attitude toward EBM; 97% were welcoming EBM, 48% of participants reported regular use of EBM in their daily clinical practice, 42% sometimes and 9% never practice EBM. No distributed updated clinical letters, journals or guidelines was considered as the major barrier to practice EBM (60.3%), followed by no time available (31%) and then unavailability of internet access at locality (24%). Many of the respondents did not engage or receive formal training in the search strategy (59.3%), critical appraisal (54.8%) and (92%) would like to attend courses relevant in practicing EBM in the future (p<0.05). Participants reported a low level of awareness to extracting journals, review publication and databases related to EBM. CONCLUSION: Al-Taif Consultant Physicians appeared enthusiastic to utilize EBM in daily clinical practice with strong welcoming attitude to it; nevertheless, they need more knowledge and training on how to review publications, databases related to EBM and promote use of EBM in routine practice to be ensured that physicians have both the skills and knowledge to practice.

Epidemiologic study of nosocomial urinary tract infections in Saudi military hospitals.

A case-control study of patients with and without confirmed UTI was performed to identify risk factors for nosocomial UTI. Duration of hospitalization, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased risk of nosocomial UTIs.

Nosocomial urinary tract infection. Risk factors, rates and trends.

OBJECTIVE: This report aims at both estimation of the rates of overall nosocomial and urinary tract infection (UTI) and their linear trends as well as studying the potential risk factors of patients admitted to Al-Hada, Rehab and Prince Sultan military hospitals and developed nosocomial UTIs (NUTIs). METHODS: A case-control study on 206 discharged patients with confirmed UTI and 618 controls without UTI was carried out between August 2001 through to July 2003 to study risk factors for nosocomial UTI as well as hospital records during the period (1998-2002) were reviewed for calculation of the overall annual nosocomial infection and nosocomial UTI rates. RESULTS: Multiple logistic regression analysis showed that duration of hospital stay, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased risk of NUTIs. The mean incidence rate of overall nosocomial infection along the study period (1998-2002) was 2.82, while the mean incidence rate of UTI nosocomial infection was 0.85 per 100 discharged patients. Urinary tract infection represents approximately 31.7% of overall nosocomial infection throughout the study period. CONCLUSION: Urinary tract infections comprise approximately one third of nosocomial infections. The results, thus, indicated that to reduce the incidence of UTI nosocomial infection, it was important to take factors that can be managed into consideration. Therefore, the involved persons should pay more attention and set practical and effective guidelines for the hospital.

Emotional and behavioral problems among male Saudi schoolchildren and adolescents.

OBJECTIVE: Determination of the prevalence rate of emotional or behavioral problems, or both, among male Saudi schoolchildren and identifying the possible risk factors behind these problems. METHODS: The study was conducted from March-May, 2003 and included all male schoolchildren of Al-Abnae schools specialized for the sons of the employees of the Saudi Ministry of Defense (military and civilians) in Taif Governorate, Kingdom of Saudi Arabia (total number 1416 students). It was conducted through 2 phases: A screening phase (using the Child Behavior Checklist "Parent`s form") for all schoolchildren and adolescents included in the study through a cross-sectional approach to assess their emotional and behavioral problems, and a case-control phase to study risk factors. RESULTS: Among the 1313 male schoolchildren that participated in the study, 109 (8.3%) were emotionally or behaviorally disturbed students. Among studied sociodemographic variables, only educational level (intermediate versus primary) and mother`s occupation (working versus non working) was associated with a higher risk of developing emotional or behavioral disturbance. Unwanted pregnancy (odds ratio [OR]=4.77, confidence interval [CI] 3.68-5.86), history of meningitis (OR=7.50, CI 5.12-9.88), history of accidents (OR=4.07, CI 2.87-5.26) and those with history of bronchial asthma (OR=2.96, CI 2.16-3.76) had an increased risk of emotional or behavioral disturbance. CONCLUSION: The prevalence rate of behavioral and emotional disturbance according to parent`s reports is lower than that reported in other countries. Several risk factors including child, familial, and environmental risk factors play an important role in the genesis of emotional and behavioral problems in schoolchildren. Mental health problems can be recognized and treated; caring families and communities working together can help.

A review of hepatoprotective plants used in saudi traditional medicine.

Liver disease is one of the major causes of morbidity and mortality across the world. According to WHO estimates, about 500 million people are living with chronic hepatitis infections resulting in the death of over one million people annually. Medicinal plants serve as a vital source of potentially useful new compounds for the development of effective therapy to combat liver problems. Moreover herbal products have the advantage of better affordability and acceptability, better compatibility with the human body, and minimal side effects and is easier to store. In this review attempt has been made to summarize the scientific data published on hepatoprotective plants used in Saudi Arabian traditional medicine. The information includes medicinal uses of the plants, distribution in Saudi Arabia, ethnopharmacological profile, possible mechanism of action, chemical constituents, and toxicity data. Comprehensive scientific studies on safety and efficacy of these plants can revitalise the treatment of liver diseases.

Pattern of use and impact of patient sitters on the quality of healthcare in Saudi Arabia.

OBJECTIVE: To assess the pattern of use and impact of patient sitters on the quality of healthcare in Taif Armed Forces Hospital, Taif, Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional survey was conducted at the Armed Forces Hospital, Taif Region, KSA from 1st January to 30th March 2008. The study included 203 admitted patients, 125 patient sitters, and 213 physicians and nurses. Three different questionnaires were specifically designed for each group of participants including information on the pattern and duration of patient sitting, and potential benefits and harm among sitters. RESULTS: Approximately 58.4% of the participating sitters were women, 88% were Saudis, with age range from 17-60 years old, and mean (+/-standard deviation) of 33.0 (+/-9.64) years. More than 73% of the sitters have regular jobs. Types of the room and patient's age were the significant predictors for the presence of sitters. Patient satisfaction was not significantly associated with the presence, or absence of patient sitters. CONCLUSION: Pattern and use of patient sitters in Saudi Arabia is unique where socio-cultural factors play the most important role. This study is another reminder to the healthcare system in KSA, as well as other Arab countries to develop policies that clearly specify patient criteria that support the decision of patient sitter use.