From the Editor
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Abdul Abyad, MD, MPH, MBA, AGSF, AFCHSE (Chief Editor)

Address correspondence to:
Abdul Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor)
Abyad Medical Center & Middle East Longevity Institute
Azmi Street, Abdo Center, 2nd Floor
PO BOX 618, Tripoli LEBANON
Tel & Fax: 961 6 443684/5/6
Email: aabyad@cyberia.net.lb
Web: www.amc-lb.com

In this the sixth issue this year we have a major paper on Global Competencies in Family Medicine, the result of an international IFPCRN collaboration. The Research and Author team was drawn from around 30 countries and 15 countries contributed national data. These countries however represented close to two thirds of our global population and included Low, Middle and High Income countries (based on World Bank PPP 2005).

Other papers this issue discuss hypertension, Qat chewing, self injection of kerosene, causes of blindness, use of atropine, rhinitis and pregnancy and irritable bowel syndrome.

A paper from King Saud Bin Abdul-Aziz University characterized adult patients with hypertension attending Armed Forces family medicine clinics in Tabuk, Saudi Arabia. Ten percent of all patients attending the Armed Forces family medicine clinics in 2003 were selected by stratified systematic random sampling. The prevalence of hypertension was 7.3%. The authors concluded that hypertension is common among patients attending family clinics in Tabuk; the prevalence increases with age. Patients with hypertension receive more health education and follow up than do patients without hypertension. Evaluating the content and outcomes of the education and follow-up visits could help to develop more effective interventions.

A case report from King Abdul Aziz University Hospital Jeddah looked at Qat Chewing and Autoimmune Hepatitis Association. The authors reported three male patients from Yemen with autoimmune hepatitis (AIH) associated with Qat chewing. Two of them had advanced cirrhosis at diagnosis and all of them had positive immune profile for type1 AIH. Treatment with Prednisolone and Azathioprine resulted in remission in the three patients. The authors stressed that Qat chewing may be a risk factor for AIH, that respond well to treatment. More data is needed for understanding this association.

A Case report from Jordan reported on Self- injection of kerosene, which is a rare occurrence. A 17 year old single female, was admitted through the emergency room (ER) following an argument with her family. The patient had injected an unknown amount of kerosene in both cubical fossae of upper limbs about five days prior to presentation in the ER.

A study was conducted at the major military hospital in north of Jordan (Prince Rashed Military Hospital) to determine the most common causes of blindness in north Jordan among patients attending ophthalmology clinics. This study showed that cataract, diabetic retinopathy and glaucoma were the main causes of blindness and loss of vision.

A prospective randomized study that was conducted at King Hussein Medical Center to evaluate the efficacy of atropine penalization in the treatment of amblyopia in comparison with conventional patching. The authors concluded that atropine penalization is as effective as patching in the treatment of anisometropic amblyopia, though the speed of recovery is slower.

A review paper from Pakistan on irritable bowel Syndrome (IBS) discussed the clinical approach in family Practice. The author stressed that IBS is a chronic, relapsing gastrointestinal problem, characterized by abdominal pain, bloating, and changes in bowel habit. The author said that a caring doctor-patient relationship is the first step in management. Other interventions may be helpful to various degrees.

A paper from Jordan looked at the risk factors of rhinitis during pregnancy. A total of two hundred and fifty primigravida aged 19-28 years (mean age 25) who were referred to otorhinolaryngology
clinic as part of antenatal care was studied. Rhinitis and nasal congestion frequently occur during pregnancy (30% ) and are related to hormonal changes . The authors concluded that smoking and allergy are the major risk factors for rhinitis in pregnancy , and the quality of pregnancy can be improved by modification of treatment strategies.