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EDITORIAL January 2024

This is first issue of the year that has a lot of interesting papers from the region. Dr Mohsin reviewed Lipid management guidelines. Comprehensive analysis was conducted on available guidelines to identify gaps in the available evidence for effective approaches to lipid management. The four guidelines included in the review are NICE, ESC, CCS and AHA/ACC/MS. Multiple databases were explored to locate relevant guidelines published within the past decade, until June 17, 2023. A qualitative comparison was made regarding recommendations on testing frequency, lipid-lowering therapies, and target cholesterol levels. All the guidelines unanimously advocated for statins as the primary therapy for reducing lipid levels. Noteworthy disparities were observed in the recommended cholesterol targets across the various guidelines. Each guideline provided specific target for the level of low-density lipoprotein cholesterol (LDL-C). For long-term patient monitoring, as many of the guidelines (n=2) recommended annual reviews, although some variations were noted, suggesting intervals ranging from 3 weeks to 12 months. All the guidelines have the same scope, despite few disparities, future research should focus on resolving these differences and on optimizing the preventive measures for lipid management.

Ali Fadlalla el al., looked at Health-Related Quality of Life (HRQoL) In Haemodialysis Patients In Khartoum, Sudan. Much research has been conducted in many countries on the Health-Related Quality of Life (HRQoL) of haemodialysis patients, but few have been conducted in Khartoum, Sudan. All studies have shown that patients' Quality of Life regarding the dimensions of physical, psychological, social, and environmental was affected by the disease. Previous research ignored the impact of religious beliefs on haemodialysis patients. We used the WHOQOL-BREF questionnaire (the English standard version) to collect data from 181 participating patients. Religious beliefs had a significant impact on the overall outcome of the study, strong social relationships among the Sudanese population (which distinguishes the Sudanese population from other nations) increased the patients' satisfaction rate with their social relationships. The lack of transport facilities from the patients' homes to the dialysis center (and vice versa) forced the patients to reduce the number of prescribed sessions.

Ali Alshehri 1, et al., did a descriptive cross-sectional questionnaire-based study was conducted among the population of Assir region in Saudi Arabia. The aim is to look at the Prevalence of Eustachian Tube Dysfunction and Its Associated Factors among the General Public in Assir Region, Saudi Arabia. Only 4% of participants had a history of Eustachian tube dysfunction. Hearing loss was reported by 27.3%, with 23.3% having a family history of it. Gender-wise, 31.86% of females and 17.71% of males had a history of hearing loss, the difference being statistically significant (p=0.007). Smoking exhibited a strong correlation, with 60.98% of smokers and 22.01% of non-smokers reporting hearing loss, the difference being highly significant (p=0.0001). Ear-related issues were prevalent, such as severe pain (41%), underwater sensation (36%), and cold-related problems (23%). Additionally, symptoms like cracking sounds (12%), ringing (16%), and muffled hearing (22%) were noted, sometimes affecting both ears (29%). The authors concluded that a significant association was found between smoking and hearing loss. Gender and smoking habits showed significant correlations with hearing loss, the low prevalence of ETD warrants further investigation. These findings contribute to the existing body of knowledge on auditory health and could inform targeted interventions for hearing-related issues in the region.

Abuageelah , et al., looked at the Knowledge, Attitudes, and Practices Toward Self-Medicating Eye Symptoms in Jazan Region. Self-medication with ophthalmic medications is a common practice; however, it raises concerns about the safety and appropriateness of treatment. Therefore, the current study aims to evaluate the knowledge, attitudes, and approaches toward self-medicating eye symptoms in the Jazan region. Methods: An observational cross-sectional study on the population comprises all individuals (aged 18 and up) who can read and write-those who were now taking or had previously used ophthalmic medicines. Following IRB approval, the questionnaire was distributed on social media to evaluate the aim of the study. Results: The majority of self-medicating ophthalmic medication users were male and aged between 18 and 29. 97.6% of self-medicators admitted to the practice; however, only 24.1% knew the specific type of medication they used. Lubricant eye drops were the most used medication. Eye dryness and redness were the most common symptoms leading to self-medication, with repeated symptoms and the perception of a simple condition being the most common reasons. Conclusion: Self-medication with ophthalmic medications is widespread in the studied population; nevertheless, there needs to be more knowledge about the specific medications used. Symptoms such as eye dryness and redness are common reasons for self-medication, driven by the perception of simplicity and repeated occurrence.

Dr Othman looked at the Level of Knowledge, Awareness, and Practice Regarding Osteoporosis Among Female Adults in Hail city, Saudi Arabia. According to The Textbook of Orthopedics - Fifth Edition defines Osteoporosis as "a general term referring to a state of decreased mass per unit volume of a normally mineralized bone due to loss of bone proteins. It's called a silent epidemic and usually remains undetected till the patient sustains a hip, rib or spine fracture" (Textbook of orthopedics, 2017). Osteoporosis is one of the most common orthopedic illnesses that affect postmenopausal women globally (Juliana M. Kling et al, 2014). Osteoporosis is more common in females than in males in the general population and it is estimated to affect 200 million women worldwide - approximately 10% of women aged 60, 20% of women aged 70, 40% of women aged 80 and 66% of women aged more than 90 (Kanis JA, University of Sheffield 2007). Two categories of osteoporosis have been recognized: primary and secondary. Primary osteoporosis is the most common form of the disease and includes postmenopausal osteoporosis (type I), and senile osteoporosis (type II) (Tümay Sözen et all, 2017). The core symptoms of osteoporosis impair bone integrity. In osteoporosis, there is a long latent period prior to clinical manifestations. Most prevalent complications are fractures of vertebral bodies, ribs, proximal femur, humerus, distal radius with minimal trauma (Textbook of Orthopedics ,2017). Many studies conducted worldwide and in Saudi Arabia regarding this topic, however the most recent studies in Saudi Arabia (National level, Riyadh and Jazan), have concluded that the level of knowledge regarding osteoporosis among women is sufficient. (Basim K AlHarthi, 2017; Darout IA, 2017; Alamri FA, 2015) However, none of these studies were conducted exclusively in Hail city, Saudi Arabia. The study aims to evaluate the adult female population level of knowledge, awareness and practice regarding osteoporosis in Hail city, Kingdom of Saudi Arabia.
Alshehri, et al., A descriptive cross-sectional survey based on an online structured questionnaire distributed over Saudi Arabia's different regions was conducted to assess knowledge, attitudes, and practices of self-ear cleaning among the general population in KSA. A total of 503 eligible participants completed the study questionnaire, 210 (41.7%) from the western region, 147 (29.2%) from the central region, 78 (15.5%) from the southern region, and others from other regions. Participants' ages ranged from 18 to about 60 years with a mean age of 27.5 ± 12.9 years old. A total of 304 (60.4%) participants were females. A total of 324 (64.4%) of the participants had an overall good knowledge and perception of self-ear cleaning. Exact of 420 (83.5%) practice self-ear cleaning, and most of them (95.5%) do it for both ears ear sticks were the most commonly used tools (61.9%) followed by tissues (28.8%). The study has shown that the public is highly aware of the risks, methods, and tools used in self-ear cleaning. More than three-quarters of people surveyed reported using ear sticks to clean their ears, and the majority of them experienced no negative symptoms or complications after cleaning.

Dr Abdulrazak Abyad
Chief Editor
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