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From
the Editor
In this issue we have various papers from Australia,
Canada, Iraq, Jordan, Lebanon, Oman, Nepal,
Pakistan, Saudi Arabia, Turkey and the United
Kingdom on topics of interest to primary care.
Al-Kuwari et al., tried to assess the level
of health care providers' physical activity
Vital sing (PAVS) and physical activity knowledge
in relationships with health care providers'
physical activity interventions. The study recruited
102 health care professionals from different
specialties during the first Qatar physical
activity guideline awareness campaign. The authors
found that public health, physiotherapist, and
family physicians were more active than other
health care providers. The authors concluded
that the healthcare providers are influenced
by their physical activity vital sign (PAVS)
and physical activity knowledge.
Salem et al., did a Descriptive cross-sectional
study to assess patient satisfaction regard
continuity care clinics in west bay health center
, two hundred patients were asked to fill the
short form of patient satisfaction questionnaire
(PSQ 18).patients were satisfied in all domains
of patient satisfaction questionnaire however
the lowest scores in domains were for interpersonal
manner (3.54 ± 0.74) and time spent (3.80
± 0.78) . Females have significant score
(4.6 ±0.6) in general satisfaction domain
while chronic patients report borderline significant
score (4.1 ±0.5) in technical quality
domain. The authors concluded that patient satisfaction
scores were appropriate in all domains of care
in continuity care clinics but more attention
must be focused on training regard interpersonal
communication and quality projects to improve
time spent in health centers.
Al-Jadidi et al., attempted to determine the
frequency of post-stroke delirium by systematically
reviewing original research on this topic. They
did MEDLINE, EMBASE, PsychINFO and the Cochrane
Database of Systematic Reviews were searched
for potentially relevant articles published
from 1967 to March, 2014. The bibliographies
of relevant articles were searched for additional
references. Twelve studies met the inclusion
criteria. There was significant heterogeneity
in results of the studies of frequency of post-stroke
delirium. The proportions ranged from 10% to
48%. The summary proportion was 0.24 (95% CI
0.18, 0.32). The frequency of post-stroke delirium
may be related to medical co-morbidity or psycho-active
drug use. The authors concluded that Post-stroke
delirium may be frequent. Because of significant
heterogeneity in the results of studies of frequency,
the result of this review must be interpreted
cautiously.
Mohammed et al., did A cross-sectional study
involved 154 (88 males and 66 females) patients
with psoriasis, of them 42(23males and 19 females)
fulfilled the classification criteria of psoriatic
arthritis from Oct. 2018 -Jan.2020. The study
aimed to assess the occurrence of osteoporosis
in patients with psoriasis and psoriatic arthritis.
From the total sample, 154 patients, 112 patients
with psoriasis 65 (58.9%) were males and 47
(41.1%) were females, 42 patients with psoriatic
arthritis 23 (54.7%) were males and 19 (45.3%)
were females. The authors concluded that osteoporosis
frequently occurs in patients with psoriasis,
in particular male patients. It is less frequently
occurring in patients with psoriatic arthritis,
in particular those on anti TNF treatment.
Al-Jamea et al., did A Descriptive/Analytic
cross-sectional study was performed, survey
on a sample of 352 male and feminine students
at random elect from 2 health programs in Medical
schools in Jeddah city, Makkah region, Saudi
Arabia in a period of 1 year. The aim of this
study is to estimate the prevalence of self
medication practice of undergraduate medical
students listed at Medical schools. The current
study was administered among 352 Pharm. The
authors concluded that SM was quite common among
undergraduate medical students, is also thanks
to straightforward accessibility of medicines
and data from textbook. A number of the scholars
showed inadequate information and inappropriate
angle toward some points concerning self-medication.
Practice of SM is horrifying. Distribution of
medication should be coordinated by Saudi healthcare
professionals through rising precautionary and
interventional policies; so, correct use of
medicines is accomplished.
Alfayez et al., stressed that fundal placenta
with abnormal invasion is relatively rare .
Most of fundal placenta with abnormal invasion
is difficult to be diagnosed in antenatal period
,mostly diagnosed in postpartum period . Risk
of uterine rupture in fundal placenta with abnormal
invasion is one of the most dangerous complication
which can lead to haemoragic shock and leads
to death. They report a 32 years old woman presented
to our obstetric emergency room ,she is G2p1by
ceaserian section due to fetal disteress ,secondary
infertility 9 years ,spontaneous pregnancy ,complaining
of abdominal pain and history of vaginal spotting
at 34 weeks gestation. During ceserian section
haemperitoneum was noticed . After exploration
fundal placenta percreta with omental band adhesion
attached the placental site .
Dr Razaq & Saqib reviewed diabetes management
in Ramadan. Fasting during Ramadan forms one
of the five pillars of Islam. The fast involves
abstinence from, food, drink, oral medications,
smoking and sexual activity from dawn to dusk.
It is obligatory for all healthy adults to fast.
However, fasting is not intended to create excessive
hardship and therefore exemptions exist. One
such group of individuals who are exempt include
those with chronic illnesses such as diabetes
for whom fasting may be detrimental to their
health. Despite this, many Muslims who could
seek exemption choose to fast for cultural,
social and religious reasons. The potential
risks for diabetic patients who choose to fast
in Ramadan include, hypoglycaemia, hyperglycaemia,
diabetic ketoacidosis, dehydration and thrombosis.
In addition to the risk of adverse events patients
can also make unsafe choices regarding their
diabetes management during this month. They
will often not consult with clinicians for advice
prior to fasting, arbitrarily change medication
doses, timings, frequency and or omit them altogether.
It is therefore important that healthcare professionals
are proactive in identifying and engaging with
diabetic patients who wish to fast during Ramadan
at an early stage. An individualized Ramadan
management plan should be discussed and agreed
upon, with the aim of providing the best possible
care and support to minimise the risk of any
complications.
Sushil et al., did a cross-sectional study
was conducted at Kathmandu Medical College,
Nepal from August 2019 to January 2020. After
obtaining an informed written consent, 81 breastfeeding
and 81 non-breastfeeding mothers between two
to four months postpartum were enrolled in the
study through random sampling. The aim of the
study is to evaluate o Postpartum Stress in
Breastfeeding and Non-breastfeeding Mothers
of Kathmandu, Nepal. A total of 162 mothers
(81 breastfeeding and 81non-breastfeeding) were
studied. The mean COHEN PSS score was 15.74(SD
2.36) for breastfeeding and 26.24(SD 3.78) for
non-breastfeeding mothers. The authors concluded
that the levels of perceived stress were high
in non-breastfeeding mothers as compared to
breastfeeding mothers.
Helvaci et al., tried to understand the most
desired values of high density lipoproteins
(HDL) in the metabolic syndrome. The study included
256 cases (153 females). Parallel to the highest
HDL values, mean age, female ratio, body mass
index (BMI), fasting plasma glucose (FPG), low
density lipoproteins (LDL), white coat hypertension
(WCH), hypertension (HT), and diabetes mellitus
(DM) were the highest in the fourth group. The
authors concluded that the highest mean age,
female ratio, BMI, FPG, WCH, HT, and DM parallel
to the highest HDL and LDL, and the highest
CHD in contrast to the lowest HDL and LDL values
may show initially positive but eventually negative
acute phase proteins features of HDL and LDL.
BMI, FPG, DM, and CHD were the lowest between
HDL values of 40 and 46 mg/dL, and DM was only
3.1% between these values against 22.2% of the
remaining.
The third part of Parkinson disease review
discussed the diagnosis , symptoms, and prognosis
of Parkinson's Disease. The author stressed
Parkinson disease is a clinical diagnosis. For
the condition, there are no laboratory biomarkers,
and findings on routine magnetic resonance imaging
and computed tomography scans are unremarkable.
Medical diagnosis involves 2 of 3 cardinal signs:
Resting tremor Bradykinesia and Rigidity. Parkinson's
disease often has a multitude of non-motor symptoms;
some may precede the diagnosis, while others
may occur early or late after the diagnosis
is made, depending on motor features. Careful
attention to the history is needed in patients
with Parkinsonism to exclude secondary causes
such as medication, toxins, or trauma.
Tariq et al., looked at the trajectory of Covid-19
in Pakistan. The Ministry of Health, Government
of Pakistan, reported its first two cases of
the COVID-19 from Karachi and the capital Islamabad,
on February 26th, 2020. Both had a history of
recent travel from Iran. All four provinces
and other territories compromising the state
of Pakistan had reported their first cases by
March 18th, 2020. The government of Pakistan
quickly sprang into action and took many beneficial
steps and implemented guidelines, which ensured
that Pakistan was coping well with the pandemic,
while its neighbors like Iran and China struggled
amidst a rapidly developing crisis. However,
effective policy making was in short supply
as a couple of months later, the country's situation
is quite dire, and deteriorating rapidly, due
to a lack of caution and indecision on many
crucial matters. In Pakistan, the total cases
reported so far have been 139,000, with 2632
deaths. In there article, the authors reviewed
measures implemented by the government, assess
the trajectory of the disease in the country,
while identifying some of the factors responsible
for a recent downward trend.
Chief Editor:
A. Abyad
MD, MPH, AGSF, AFCHSE
Email: aabyad@cyberia.net.lb
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