Perceptions, attitudes, and practices towards research among resident physicians in training in Saudi Arabia.

Health research training forms an important part of medical education. This cross-sectional study examined the attitudes to research, perceived barriers to research and experience of participation in research projects among resident physicians in Saudi Arabia. A self-administered email questionnaire was completed by 191/207 residents working in different specialties and regions of Riyadh. A majority (97.9%) agreed that research is essential and improves health care and 86.9% that it helps in building a future academic career. Lack of research training (93.2%), lack of time (89.5%), work-related stress (83.2%) and lack of supervisors (73.3%) were perceived barriers to doing research. Only 58 (30.4%) had had any research involvement. Involvement in research was significantly more likely for residents at an advanced level of training than at earlier levels (OR 3.50, 95% CI: 1.1-11.1) and less likely for those who had 1 or 2 children during residency than those who had none (OR 0.29, 95% CI: 0.1-0.8).

Perceptions, attitudes, and practices towards research among resident physicians in training in Saudi Arabia

Health research training forms an important part of medical education.This cross-sectional study examined the attitudes to research, perceived barriers to research and experience of participation in research projects among resident physicians in Saudi Arabia.A self-administered email questionnaire was completed by 191/207 residents working in different specialties and regions of Riyadh.A majority [97.9%]agreed that research is essential and improves health care and 86.9% that it helps in building a future academic career.Lack of research training [93.2%], lack of time [89.5%], work-related stress [83.2%]and lack of supervisors [73.3%]were perceived barriers to doing research.Only 58 [30.4%]had had any research involvement.Involvement in research was significantly more likely for residents at an advanced level of training than at earlier levels [OR 3.50, 95% Cl:1.1-11.1]and less likely for those who had 1 or 2 children during residency than those who had none [OR 0.29, 95% Cl:0.1-0.8]

يعتبر التدريب على البحوث الصحية جزءا هاما من التعليم الطبي. وقد أجرى الباحثون هذه الدراسة للتعرف على مواقف الأطباء المتدربين تجاه البحوث، والتصورات حول العوائق أمامها، وخبرات المشاركين في مشاريع البحوث في المملكة العربية السعودية. وقد استكمل 191 من أصل 207 أطباء مقيمين يعملون في تخصصات مختلفة في بعض مناطق الرياض، وذلك عبر البريد الإلكتروني، استبيانات ذاتية الاستكمال، وتبين أن الغالبية العظمى منهم [97.9 %]يوافقون على أن البحوث ضرورية لتحسين الرعاية الصحية، كما وافق 86.9 % منهم على أن البحوث تساعد في بناء المستقبل المهني في العمل الأكاديمي، ورأى المشاركون في الدراسة أن العوائق أمام إجراء البحوث هي فقد التدريب عليها [93.2 %]، وضيق الوقت [89.5%]والكروب المرافقة للعمل [83.2 %]، وعدم توافر المشرفين [73.3 %]. ولم يكن لدى أكثر من 58 منهم [30.4 %]أي إسهام في البحوث.وقد كان الإسهام في البحوث أكثر احتمالا لدى الأطباء المقيمين في المستوى المتقدم من التدريب مما هو لدى المستويات المبكرة [نسبة الأرجحية 3.50 ، بفاصلة الثقة 95 %، إذ تتراوح النتائج بين 1.1 - 11.1]، وهي أقل احتمالا لدى من كان لديه طفلان أثناء فترة الإقامة ممن لم يكن لديه أطفال [نسبة الأرجحية 0.29 بفاصلة ثقة 95 %، وتتراوح النتائج بين 0.1 - 0.8]

La formation à la recherche en santé représente une partie importante des études de médecine.La présente étude transversale a étudié les attitudes de médecins internes en Arabie saoudite vis-à-vis de la recherche, des obstacles perçus et de leur expérience en matière de participation à des projets de recherche.Un autoquestionnaire envoyé par courrier électronique a été rempli par 191 médecins internes sur 207 travaillant dans différentes spécialités et régions de Riyad.La majorité [97, 9 %]convenait que la recherche était essentielle et améliorait les soins de santé et 86, 9 % des médecins étaient d'accord pour affirmer qu'elle contribuait à l'établissement d'une future carrière académique.L'absence de formation à la recherche [93, 2 %], le manque de temps [89, 5 %], le stress lie au travail [83, 2 %]et l'insuffisance de l'encadrement [73, 3 %]étaient les obstacles perçus à la pratique de la recherche.Seuls 58 internes [30, 4 %]avaient été impliqués dans des travaux de recherche.Une participation à des travaux de recherche était nettement plus probable chez les internes à un stade avancé de formation par rapport aux niveaux moins avancés [OR 3, 50; IC à 95 %:1, 1-11, 1]et moins probable chez ceux qui avaient eu un ou deux enfants pendant leur internat par rapport à ceux qui n'en avaient pas eu [OR 0, 29; IC à 95 %:0, 1-0, 8]

Migraine associated with road traffic accidents in United Arab Emirates.

OBJECTIVE: To study migraine associated with road traffic accidents in the United Arab Emirates. METHODS: A cross-sectional hospital based study was conducted at Al-Ain Medical Health District, Al-Ain and Tawam Hospitals, United Arab Emirates. A total 1985 vehicle drivers aged 18 years and above were seen at Al-Ain and Tawam Hospitals for accidents and trauma for the period of 1994. During this period a total of 1715 vehicle drivers responded for the study. RESULTS: Of the 1715 vehicle drivers, 80 drivers had migraine condition in association with road traffic accidents. Migraine related vehicle accidents comprised about 4.7% of road traffic accidents; a higher proportion being relevant for motorways. The majority of victims (72.5%) were males and most (53.4%) were young and under the age of 35 years; 63% were married; 82.5 % had some formal education, 40% had a full license to drive a commercial taxi-cab; 63.7% had more than 2 years driving experience and 46.3% used safety seat belts occasionally. 61.3% admitted driving at excessive speeds; 35% smoke while driving; 33.8% use phones during driving and 38.8% drove with their child in the front seat. Overall, the prevalence rate of migraine at the present sample of adult drivers was 4.7% (80/1715). Of those studied 80 (4.7%) which were 72% migraine without aura and 28% migraine with aura, respectively. The comparison of licensed drivers with migraine and all other licensed drivers without migraine was made. Significantly higher risk was observed for careless driving [RR=1.54; 95% CI=1.21-1.94, p<0.002] and property damage [RR=1.88; 95% CI=1.02-3.44; p<0.05] among drivers having migraine. However, excessive speed violations, traffic violations, alcohol and drug use did not show significant association with RTA. Finally, there were very strong correlation between severity and frequency of migraine with the risk of careless driving (r=0.76, p<0.001) and property damage (r=0.61, p<0.001). CONCLUSION: More public awareness needs to be drawn to the dangers of driving while having difficulty with migraine conditions.

Pernicious anaemia and neurophysiological studies in Arabs.

While pernicious anaemia is a disease predominantly affecting people of north European descent, there is increasing awareness of its occurrence in other ethnic populations. We document herein details of six Arabs who had pernicious anaemia and significant neurophysiological abnormalities. All the patients made a complete haematological and symptomatic recovery following parenteral administration of hydroxycobalamin. The diagnosis of pernicious anaemia should be considered in Arab patients of all ages who have macrocytic anaemia, or symptoms of peripheral neuropathy. We caution against the empirical use of folic acid and vitamin B12 in the management of patients with chronic anaemia.

Acute hyponatremic encephalopathy after a cerebrovascular accident.

A 66-year-old hypertensive male with acute intracerebral hemorrhage developed acute hyponatremic coma 3 days after the addition of enalapril and a combination of amiloride and a thiazide diuretic to his hypotensive regimen. The patient recovered consciousness and serum sodium normalized 2 days after fluid restriction and withdrawal of both medications. Three weeks later, upon inadvertent reinstitution of enalapril and indapamide, severe hyponatremic encephalopathy promptly recurred; recovery was again rapid following fluid restriction and withdrawal of both medications. This temporal relationship establishes the thiazide diuretic or the angiotensin converting enzyme inhibitor or both as the cause of the profound symptomatic hyponatremia in this patient. Results of simultaneous serum and urine osmolality assays on several occasions were consistent with a decrease in free water clearance, a result of either increased antidiuretic hormone (ADH) secretion or potentiation of its peripheral action, and thiazide-induced natriuresis. The use of a thiazide diuretic in the presence of either of these aberrations of ADH homeostasis most likely explains the profound and rapid development of hyponatremia. Drug-induced disturbances in serum osmolality are a potentially reversible cause of deterioration of the mental state in a patient with an acute cerebrovascular accident.

Benign thoracic pain.

Seventy-three patients with mid-dorsal and/or unilateral chest pain seen consecutively in the rheumatology clinic by a single clinician over a three-year period were studied, after exclusion of visceral disease. The majority were young women. The pain was dull and continuous, was aggravated by coughing and sneezing and relieved by rest. There was frequently tenderness over the thoracic spine (T4-5) and an adjacent rib, and pain at extremes of thoracic spinal movement in one or two directions was invariable. Cutaneous hyperaesthesia in a radicular distribution was found in 16.4%, but there were no other neurological abnormalities. This clinical picture is probably the result of a thoracic disc prolapse, though confirmation by myelography was not thought to be ethically justified. The condition settled in most of the patients following manipulative treatment and advice on back care. No patient developed spinal cord compression. It is concluded that this is a common benign condition which deserves wider recognition.