First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round.

The aim of this study was to analyse results of the pilot screening round for Al-Qassim Screening Mammography Programme and compare with international standards. Analysis was conducted in the central screening office in Prince Faisal Oncology Centre, which coordinates activities of various screening units. Data were collected during the period 1 January 2007 to 30 June 2008. Organizational and functional information was obtained from policy and procedure manuals of the programme. Out of 9812 eligible women, 1766 (18%) participated and data were available for 1628 (16.6%). The median age of participants was 47 (standard deviation 8.12) years. The low uptake rate (18%) and a high recall rate (31.6%) characterized the pilot screening round. Biopsy rate was 1.5% and cancer detection rate was 0.24%. Many performance indicators in this pilot screening round were not available. Many of the available indicators did not meet international standards.

First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round

The aim of this study was to analyse results of the pilot screening round for Al-Qassim Screening Mammography Programme and compare with international standards. Analysis was conducted in the central screening office in Prince Faisal Oncology Centre, which coordinates activities of various screening units. Data were collected during the period 1 January 2007 to 30 June 2008. Organizational and functional information was obtained from policy and procedure manuals of the programme. Out of 9812 eligible women, 1766 [18%] participated and data were available for 1628 [16.6%]. The median age of participants was 47 [standard deviation 8.12] years. The low uptake rate [18%] and a high recall rate [31.6%] characterized the pilot screening round. Biopsy rate was 1.5% and cancer detection rate was 0.24%. Many performance indicators in this pilot screening round were not available. Many of the available indicators did not meet international standards

Smoking patterns among primary health care attendees, Al-Qassim region, Saudi Arabia.

Prevalence, sociodemographic patterns and medical co-morbidity of smoking among a cross-section of primary health care (PHC) clients in Saudi Arabia were examined. We used a 44-item semistructured questionnaire to collect data from 1752 patients at 25 randomly selected PHC centres. Percentage of smoking was 52.3%. Although 85% were adult smokers, 8.6% began smoking before age 12. Smokers gave overlapping reasons to smoke including peer pressure; non-smokers gave religious and health logics against smoking. Of all smokers, 92.8% wanted to learn cessation strategies, 11.8% were ignorant of hazards and 32.4% reported manifestations of nicotine withdrawal. Besides alcohol use (13.4%), 81.8% had co-morbid physical disease.

Integration of mental health care into primary care. Preliminary observations of continuing implementation phase.

OBJECTIVE: The authors mainly focus on the initial observations of the implementation phase of a health project that aims to integrate mental health into primary care. METHODS: In the light of specific aims and objectives of both planning and curriculum development phases, 2- weeks of intensive psychiatric training consisting of basic theoretical and clinical concepts of psychiatry was imparted to a group of general practitioners and paramedical staff. In addition to assessing their pre-and post-training knowledge, attitude, and practice toward psychiatry, 2 internal Consultant Psychiatrists and participants evaluated the training course providing appropriate feedback to the organizers and trainers for modifying several adopted training methods, as well as a curriculum for subsequent courses. RESULTS: The 2-week psychiatric training of the medical personnel resulted in identifying several pros and cons of implementing this project at primary health care centers. Additionally, the immediate and the post-training evaluations of trainees by numerous methods were characterized by favourable changes in their attitude, knowledge and enhanced motivation to practice psychiatry at primary health care centers. CONCLUSION: The implementation of this project by training the first 3 groups of health personnel was successful, as evidenced both by the healthy encouraging comments of the evaluators and the post-training favourable positive responses of the trainees. The incorporation of mental health into primary care by offering condensed psychiatric courses to general practitioners should be the top training agenda as it is in line with the World Health Organization recommendations.

Integration of mental health care into primary care. Preliminary observations of continuing implementation phase.

OBJECTIVE: The authors mainly focus on the initial observations of the implementation phase of a health project that aims to integrate mental health into primary care. METHODS: In the light of specific aims and objectives of both planning and curriculum development phases, 2- weeks of intensive psychiatric training consisting of basic theoretical and clinical concepts of psychiatry was imparted to a group of general practitioners and paramedical staff. In addition to assessing their pre-and post-training knowledge, attitude, and practice toward psychiatry, 2 internal Consultant Psychiatrists and participants evaluated the training course providing appropriate feedback to the organizers and trainers for modifying several adopted training methods, as well as a curriculum for subsequent courses. RESULTS: The 2-week psychiatric training of the medical personnel resulted in identifying several pros and cons of implementing this project at primary health care centers. Additionally, the immediate and the post-training evaluations of trainees by numerous methods were characterized by favourable changes in their attitude, knowledge and enhanced motivation to practice psychiatry at primary health care centers. CONCLUSION: The implementation of this project by training the first 3 groups of health personnel was successful, as evidenced both by the healthy encouraging comments of the evaluators and the post-training favourable positive responses of the trainees. The incorporation of mental health into primary care by offering condensed psychiatric courses to general practitioners should be the top training agenda as it is in line with the World Health Organization recommendations.

Childhood enuresis. Epidemiology, pathophysiology and management.

The goal of this article is to review childhood enuresis, which is a common behavioral condition reported in millions of children worldwide. An online computer search was made, and the literature up to 1997 was screened in order to include relevant data for this review. The prevalence of childhood enuresis varies across reviewed studies. This was attributed to a variety of sociodemographic and cultural dynamics of societies. Similarly, the pathophysiology of this ubiquitous symptom is determined by multiple risk factors including biological, psychological, social, and cultural, but the developmental/maturational delay influenced by genetics remains the most plausible explanation. Although a variety of pharmacological and non-pharmacological treatment modalities are traced in the literature, there is yet no agreement on a single strategy. A general agreement about behavioral therapy as the first choice of treatment of this minor malady began to emerge. Additionally, tricyclic antidepressants are the most frequently prescribed drugs for the treatment of childhood enuresis. Enuresis is a pediatric public health problem and concerted efforts at all levels, ie, professional, promotional, educational and public should be made to address its multiple domains such as preventive, etiological and curative.

Childhood enuresis. Epidemiology, pathophysiology and management.

The goal of this article is to review childhood enuresis, which is a common behavioral condition reported in millions of children worldwide. An online computer search was made, and the literature up to 1997 was screened in order to include relevant data for this review. The prevalence of childhood enuresis varies across reviewed studies. This was attributed to a variety of sociodemographic and cultural dynamics of societies. Similarly, the pathophysiology of this ubiquitous symptom is determined by multiple risk factors including biological, psychological, social, and cultural, but the developmental/maturational delay influenced by genetics remains the most plausible explanation. Although a variety of pharmacological and non-pharmacological treatment modalities are traced in the literature, there is yet no agreement on a single strategy. A general agreement about behavioral therapy as the first choice of treatment of this minor malady began to emerge. Additionally, tricyclic antidepressants are the most frequently prescribed drugs for the treatment of childhood enuresis. Enuresis is a pediatric public health problem and concerted efforts at all levels, ie, professional, promotional, educational and public should be made to address its multiple domains such as preventive, etiological and curative.

Datura induced delirium: A report of two cases.

Full text is available as a scanned copy of the original print version.

Trihexyphenidyl (Artane) dependence: A controlled investigation between users and abusers.

This controlled study aims to identify the socioclinical factors predisposing psychiatric patients to abuse trihexyphenidyl (artane) and to document the extrapyramidal symptoms in artane abusers and users. Thirty patients (n=30), with mainly two major functional psychoses and who were abusing trihexyphenidyl, were compared with 90 artane user patients (n=90), who were matched for both the diagnosis and treatment. Besides a detailed clinical interview, each patient was assessed by using DSM-IIIR criteria, Brief Psychiatric Rating Scale, Simpson and Angus Scale, and Abnormal Involuntary Movement Scale. The analysis of data showed that, compared with users, trihexyphenidyl abusers were significantly characterized by being unmarried, unemployed, smokers and having past and concurrent history of multiple drug abuse, and genetic loading of mental disorders. Both groups of patients were prescribed antipsychotic drugs and trihexyphenidyl on a longer basis. Besides other socioclinical parameters, premorbid personalities, stressful life events and extrapyramidals, including tardive dyskinesias, we did not differentiate between the two groups. Artane abusers, when compared with users, were significantly characterized by less negative psychopathology. However, other psychopathological domains, in particular, the positive symptoms and depression, did not differentiate between abusers and users. In conclusion, patients having these socioclinical profiles tend to develop trihexyphenidyl abuse. The mental health professionals should not prescribe trihexyphenidyl indiscriminately or for a long time to such patients, who indeed require long-term antipsychotic maintenance medications.

Congenital malformations in primary health care in Al-Qassim region.

The objective of this predesigned research was to determine the prevalence, sociodemographic correlates, and pattern of congenital malformations (CMs) in a population less than 20 years of age. From January 1991 to December 1991, the extensive examination of family health files coupled with door-to-door survey identified 1736 patients with CMs. The results showed that the prevalence of CMs was 6.9/1000 population. The male to female ratio was 1.3:1. The patient's age, sibling order, co-morbid disorders of CMs, parental age, chronic maternal diseases, and the family history of CMs were significantly associated with groups of arbitrarily classified CMs. The most frequently encountered CMs were of central nervous system (39.2%) followed by cardiovascular (22.3%), alimentary (13.1%), musculoskeletal (6.85%), urogenital (6.16%), communicative and audiovisual (5.5%), and miscellaneous (6.9%). Further one-way ANOVA found significant differences among CM categories and age of patients and parents. Unlike Western trends, our study tentatively concludes that overall the inheritance rather than socioenvironmental factors contributes significantly in the etiology of different congenital malformations. We further suggest that the basic information of this research might be useful foundation data in future analytic studies on congenital malformations.

A seroepidemiological study of measles: Some practical implications for measles immunization program, Kingdom of Saudi Arabia.

It was hypothesized that the recent outbreaks of measles in a geographically defined area of Al-Qassim might reflect significant changes in the epidemiology of measles and cast doubt upon the real protective value of measles vaccines. Therefore, the two objectives of this research were to study some epidemiological parameters of cases of measles (n=993) and the current immunological status of immunized children (n=2810). The crossmatched data about measles patients were collected on an official proforma and 3 mL of blood were extracted from each child for determining the measles IgG and IgM antibodies. The results showed that female patients were significantly overrepresented (51.3%). The majority of patients encountered at primary health care centers (PHCCs) (81.3%) were more than five years of age (76.5%). Among nonvaccinated measles cases, 54.9% (n=402) were from rural/desert areas. The measles vaccine failure rate was 26.3%. The results of the surveyed children showed that 2% of them were not vaccinated. The measles IgM levels were detected significantly in recently vaccinated females (n=29/51, 56.9%). The measles IgG positivity unaffected by age, sex, and residence was found in 87.4% of children. A significant portion of children from rural/desert areas were not vaccinated (n=44/57, 77.2%). Though there were apparently high seroconversion rates in children under two years of age following Edmonston-Zagreb vaccine, overall it did not achieve any statistical significance when compared with seroconversion rates in all children following Schwartz vaccine. We conclude that besides at age six months, and MMR containing measles vaccine at 12 months, children at school entry (six years) should also be considered for measles vaccination.