JOURNAL
Current Issue
Journal Archive
.............................................................
July 2019 -
Volume 17, Issue 7

View this issue in pdf format

........................................................
From the Editor

........................................................

 

Original Contribution

Clear corneal Phacoemulsification surgery under topical anesthesia and intracameral Lidocaine at the Royal Medical Services of Jordan
[pdf copy]
Rania Zaid Rawashdeh, Ibrahim Mohammad Kilany, Rania Abdelkader Alrawashdeh
DOI: 10.5742MEWFM.2019.93661

Knowledge, Attitudes, and Practice of Complementary and Alternative Medicine in the Abu Dhabi Region
[pdf copy]
Shaikhah Al Marshedi, Eiman Al Samahi , Maryam AL Mohammed, Ebithal Darwish, Maha Al Fahim
DOI: 10.5742MEWFM.2019.93663

A Novel Case Series of Munchausen Syndrome by Proxy Victim
[pdf copy]
Ashoor R. Sarhat, Zena N. Abdulrahman, Sarab K. Abedalrahman, Islam AR Zardawy
DOI: 10.5742MEWFM.2019.93664

The safest value of plasma triglycerides
[pdf copy]
Mehmet Rami Helvaci, Onder Tonyali, Abdulrazak Abyad, Lesley Pocock
DOI: 10.5742MEWFM.2019.93662

Communication Skills of Physicians during Consultation in Out-Patient Settings at a Tertiary Hospital in Nepal
[pdf copy]
Sudarshan Paudel, Krishna Bahadur G.C., Paban Kumar Sharma, Madhusudan Subedi, Sunil K Daha, Binita Lamichhane, Amit Arjyal
DOI: 10.5742MEWFM.2019.93660



Middle East Quality Improvement Program
(MEQUIP QI&CPD)

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

.........................................................

Publisher -
Lesley Pocock
medi+WORLD International
AUSTRALIA
Email
: lesleypocock@mediworld.com.au
.........................................................

Editorial Enquiries -
abyad@cyberia.net.lb
.........................................................

Advertising Enquiries -
lesleypocock@mediworld.com.au
.........................................................

While all efforts have been made to ensure the accuracy of the information in this journal, opinions expressed are those of the authors and do not necessarily reflect the views of The Publishers, Editor or the Editorial Board. The publishers, Editor and Editorial Board cannot be held responsible for errors or any consequences arising from the use of information contained in this journal; or the views and opinions expressed. Publication of any advertisements does not constitute any endorsement by the Publishers and Editors of the product advertised.

The contents of this journal are copyright. Apart from any fair dealing for purposes of private study, research, criticism or review, as permitted under the Australian Copyright Act, no part of this program may be reproduced without the permission of the publisher.

July 2019 - Volume 17, Issue 7

From the Editor

In this issue various papers from the Region and from Nepal discussed pertinent issues to primary health care. A retrospective, non-controlled, observational study was conducted in the Princess Haya Military Hospital, Royal Medical Services of Jordan between August 2018 and April 2019. The objective of the study was to assess the incidence of posterior capsule rupture, the visual outcome, and complications associated with clear corneal phacoemulsification surgery under topical anesthesia and intracameral lidocaine. Four hundreds files of patients who underwent clear corneal phacoemulsification surgery under topical anesthesia and intracameral lidocaine during the study period were considered for the research. 216 (54%) patients were males and 184 (46%) patients were females. Three eyes of three patients (0.75%) developed ruptured posterior capsule. The average unaided and best corrected visual acuity in decimal significantly improved (p < 0.01). Only Thirty-three (8.25%) patients developed minor complications. The authors concluded that Phacoemulsification surgery under topical anesthesia and intracameral lidocaine is a safe procedure and is not associated with sight-threatening complications, it does not increase the risk of posterior capsule rupture, and significantly improves the unaided and best corrected visual acuity.

In Abu Dhabi a descriptive cross-sectional study was conducted during 2016-2017 using a self-administered questionnaire. The study targeted both UAE nationals and non-nationals attending seven clinics that are located in the Abu Dhabi region. The study aimed to assess the knowledge, attitudes, and practice of CAM among people living in the Abu Dhabi region. Most of the participants were UAE nationals (75%). Thirty-seven percent of the respondents reported that to have chronic disease. The proportions of respondents who had good, fair, and poor knowledge were 28.4%, 68.6%, and 3%, respectively. Higher education was associated with better knowledge (P = 0.044). The sources of CAM knowledge differed according to certain population characteristics. Educated people used the internet as a source of knowledge, whereas patients with chronic diseases obtained their knowledge primarily from health care providers (P = 0.02, 0.039, respectively). Ninety-five percent of the study group used CAM. The most common practices involved the use of herbs (53.6%), dietary supplements (44.7%), and honey products; the least common practices were chiropractice (9.9%) and cautery (8.6%). The authors concluded that the use of CAM is increasing in Abu Dhabi region. The results showed fair knowledge in most of the participants, and neutral attitudes toward CAM. Most of our respondents did not discuss CAM with their primary physicians; however, 80% preferred discussing it with their doctors. The most common practices were the use of herbs, dietary supplements, and honey products. Primary care physicians need to raise awareness about the benefits and risks of CAM use among the population, which can be achieved by patient education regarding evidence-based CAM practices.

A paper from Nepal assessed the communication practice of physicians when interacting with patients. A total of 169 interactions were observed. Mean total score of observed behavior of communication skill and practice ranged from poor to satisfactory across category and showed statistically significant variations. The ANOVA test between groups is strongly significant (p=0.000). More than three-forth (78.11%) have given insufficient time (less than 6 minutes) for consultation. Average interaction time was 5.26 (SD 2.31) minutes. The mean consultation time of Interns & Medical Officers is least (4.36; SD 1.79). Almost half seniors, one third juniors and 5.8% Interns & Medical Officers have given sufficient time for consultation. The study has revealed that history taking skill and practice is dearth mainly lower level physicians (medical officers/Interns and Junior faculties). The consultation time given by physicians was also insufficient. Thus, hospital authorities should give attention to improve communication skills of physicians.

A paper from Iraq look at a novel case series of Munchausen Syndrome by Proxy Victim. A 35 years old lady, a mother of two daughters (married 18 years old and 3 years old) and a son of (17) years. She was known to have social and marital problems and diagnosed as case of depression and on multiple antidepressants and attempted suicide for several times. She is using her 6-year-old daughter and her 3-year-grandson for visiting doctors 4-5 times a week. The reasons for doctor visiting are different like urinary tract infection, otitis media, gastroenteritis, respiratory infections, different kinds of traumas and etc. The authors concluded that Munchausen syndrome by proxy is a complex type of abuse, usually misdiagnosed and under-diagnosed, and its sequelae have a significant impact.

Helvaci MR et al tried to understand the safest value of plasma triglycerides according to the some components of the metabolic syndrome. They studied 457 cases (266 females and 191 males), totally. The mean ages of the groups, body mass index (BMI), and low density lipoproteins increased just up to the plasma triglycerides value of 200 mg/dL, significantly (p<0.05 for all). On the other hand, the mean fasting plasma glucose and prevalence of smoking, white coat hypertension, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease increased parallel to the plasma triglycerides values from the first towards the fourth groups, gradually. The authors concluded that plasma triglycerides may actually be some acute phase reactants indicating disseminated endothelial damage, inflammation, fibrosis, and accelerated atherosclerosis with eventual end-organ insufficiencies all over the body. There may be highly significant relationships between plasma triglycerides values and aging, BMI, and smoking. Interestingly, the greatest number of deteriorations of the components of the metabolic syndrome was observed just above the plasma triglycerides value of 100 mg/dL.

Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb

 




.........................................................................................................................

 

 

.................................................................................................................